Therapeutic Psychedelics: Psychedelic Medicine in a Therapy Setting

There’s growing buzz around the use of psychedelics to treat health conditions like depression, anxiety, post-traumatic stress disorder (PTSD), and addiction.

Given the expanding catalog of psychedelic studies, the development of university-based research programs, governmental approval of a type of ketamine for depression, and an increase in the number of therapeutic centers around the country, you may be wondering if these drugs could support you, too.

While the emergence of psychedelic therapy may sound promising, it’s a complex arena with a controversial history, evolving legalities, and uncertain health applications. In short, the use of psychedelics for therapeutic purposes is still under scientific evaluation, and most hallucinogen use remains illegal at the U.S. federal and state levels.

Read on to learn more about what we know about psychedelics, including their potential health benefits, the risks they can pose, and more.

What Are Psychedelics?

Conventional medicine’s understanding of the term “psychedelics” continues to evolve. The National Institutes of Health (NIH) used the term “psychedelics” in “an umbrella fashion” to discuss the following substances:

Classic psychedelics (also called serotonergic agonists), such as psilocybin, DMT, and LSD
Dissociative anesthetics, such as ketamine
Empathogens or entactogens, such as MDMA

In general, these types of substances may have an effect on how the exterior world is perceived, and a person’s concept of their role within it. They also influence mood, stress management, memory, and social functioning.

Psychedelics are also referred to as hallucinogens, meaning they may cause hallucinations, distort perception, and lead to disorganized thoughts. People taking them may also experience euphoria, panic, paranoia, and anxiety.

They are also sometimes called serotonergic hallucinogens, because many psychedelics work by acting on serotonin 5-HT receptors in the brain. This is what can alter perception and mood.

According to the Psychedelic Medicine Association, these these substance, that come from plants, fungi, animals or are created in the laboratory, include for example, include:

DMT
5-MeO-DMT
Ayahuasca
Ibogaine
LSD
Mescaline
Psilocybin
Ketamine
MDMA

It’s worth noting that ketamine and MDMA (3,4-methylenedioxymethamphetamine, known as ecstasy) are not classic psychedelics because they have different mechanisms of action. They are considered “hallucinogenic agents” because they share some similar pathways in the brain.

History of Psychedelics

Psychedelics have been used for thousands of years. Ancient Greeks ingested a hallucinogenic drink during ceremonies, Aztecs consumed psilocybin-containing mushrooms in healing rituals, and Native North Americans took peyote (a cactus) during religious ceremonies.

These substances have been integral to spiritual and cultural traditions for many groups of people, and much of modern science’s psychedelic termed knowledge has been passed down by these Indigenous peoples.

In more recent history, artists have reportedly used psychedelic drugs as a way to expand their mind and enhance creativity. In the 1950s, scientists studied psychedelics as a means to potentially treat mental health and substance abuse disorders. But the Controlled Substance Act of 1970 categorized drugs like LSD, DMT, MDMA, and psilocybin as Schedule 1 drugs. This curtailed research in the United States.

Schedule 1 drugs are those that are declared as having no accepted medical use and a high potential for abuse, per the United States Drug Enforcement Administration (DEA).

?In the biomedical atmosphere of the 1970s, psychedelic drugs were “stigmatized” by some, which inhibited further exploration at the time, according to some scientific opinions.

Over the past few decades, psychedelic research has once again picked up. In 2000, Johns Hopkins University obtained regulatory approval in the United States to begin research, and over the years has discovered potentially favorable outcomes in psilocybin for smoking cessation and alcohol abuse, as well as major depression.

In 2006, under the Religious Freedom Act, the U.S. Supreme Court rendered a decision to allow the use of ayahuasca during religious ceremonies by members of two Brazilian churches with branches in the United States.

In 2019 and 2020, respectively, the Center for Psychedelic and Consciousness Research at Johns Hopkins Medicine and the U.C. Berkeley Center for the Science of Psychedelics opened. Around that time, the U.S. Food and Drug Administration (FDA) granted the “Breakthrough Therapy” designation to the nasal spray Spravato (esketamine, a form of ketamine) along with an oral antidepressant for treatment-resistant depression, ushering in a new era — and with it, a fever pitch of excitement for the potential of psychedelics in therapeutic settings.

Research into psychedelics remains a challenge. More recently in 2024, the FDA rejected the the application for the use of MDMA-assisted psychotherapy for PTSD, which had previously shown promise. That said, further studies will continue, and advocates hope that with better research, approval may one day be granted.

What Is Psychedelic Therapy?

Psychedelic therapy (also called psychedelic-assisted therapy, or PAT) refers to the treatment of mental disorders with psychedelic substances. More specifically, it’s where a patient takes one or a few moderate to high doses of a classic serotonergic psychedelic (such as psilocybin, LSD, or ayahuasca). This should occur under carefully controlled conditions in a professional clinical setting.

That said, nonclassic psychedelics, like ketamine or MDMA, are also used in therapeutic ways following the same protocols as psychedelic therapy. These substances may be an alternative to those who are unwilling [or legally unable] to try classic psychedelics.

How Does Psychedelic Therapy Work?

Researchers believe that psychedelics work in two ways. Firstly, by changing both your brain, and then by altering your perspective, says Matthew Johnson, PhD, the Susan Hill Ward professor in psychedelics and consciousness and a professor of psychiatry and behavioral sciences at Johns Hopkins Medicine in Baltimore.

Neuroplasticity, which refers to brain changes, happens when a person is exposed to hallucinogens (or similar drugs, like ketamine and MDMA). Some hallucinogens, like LSD and psilocybin, hit a serotonin receptor called 5-HT2a in the brain. This affects how the brain communicates with itself during what’s colloquially known as a trip.

“It seems that there are radically different ways in which the brain operates and organizes,” says Dr. Johnson. “Areas of the brain that normally don’t sync with each other now communicate more, and areas that normally talk to each other do not,” he explains. This may create an environment where new neural connections form new ways of thinking.

Then there’s the experience of the hallucinogenic trip itself, including the setting and characteristics of the practitioner.

“Studies suggest that there’s something about the experience itself,” says Johnson. “The vast majority of people will say that they went through something. They saw themselves in a different perspective or had insights and reestablished a new normal.” These revelations are perhaps similar to a conventional-psychotherapy breakthrough, when you learn something about yourself or develop coping skills, altering how you view yourself within the world.

The integration component is also key for successful treatment, notes Johnson. Through the integration phase, your therapist may help you process what you experienced in a healthy way. This can reinforce what you learned and assist you in readjusting to life after your treatment.

Who Performs Psychedelic Therapy?

In the United States, psychedelic therapy is not federally standardized. You may find it performed in a multitude of settings, both legally (in a licensed clinic, the parameters of which vary by state and city, or in a medical trial) and illegally (any non-FDA-approved hallucinogen administered outside a legal environment).

Everyday Health is not in any way condoning the illegal use of psychedelic drugs for therapeutic or recreational purposes.

For psychedelic therapy, it’s best practice to work with a licensed mental health therapist who has knowledge of these substances, and who will remain with you and guide you along the journey — from prep, to substance administration, to integration after treatment. Psychedelic therapy should be administered by a medical professional in a clinic or location designed for supervised administration of these substances.

You’ll have to do some research on your own, since there are currently no formal U.S. state or federal regulations on how psychedelic therapy is practiced. You should start by looking at the legalities in your state. Don’t seek out any psychedelic-assisted therapy from someone who is offering therapy using an illegal substance, even if they have proper mental health credentials.

Types of Psychedelic Therapy Approaches

The exact protocol of your session will depend on the psychedelic drug and your healthcare goals. There are several basic approaches to psychedelic therapy. Here are some of them.

Psychedelic-Assisted Therapy

This is where a qualified therapist guides you through the psychedelic experience. Right now, ketamine assisted therapy is the only psychedelic-like legal substance assisted therapy available nationally to the public. That said, you can find research centers that are conducting controlled trials in psychedelic-assisted therapy with a variety of psychedelics for specific conditions.

Psychedelic Travel

Certain U.S. states are on their way to legalizing these substances. For instance, Oregon was the first state to legalize the use of psilocybin for anyone over the age of 21.

Colorado has passed similar laws since.

California is also looking to follow in these footsteps.

You may travel to one of these states to receive treatment in the future, though this is not approved federally.

Psychedelic Tourism and Retreats

Some people travel to other countries to have a psychedelic experience with substances such as with ayahuasca. There are still legal and safety risks involved, since you may not have access to a medical professional who can help you manage adverse reactions. Experts don’t generally recommend these experiences.

On Your Own

Experts don’t recommend trying psychedelics on your own either. You can suffer side effects, such as heart problems in susceptible individuals, as well as distressing hallucinations, confusion, fear, anxiety, and paranoia, and you may not be able to obtain help during these experiences. Additionally, people who use these drugs may have impaired thought processes and perceptions. This could cause them to behave in unusual or dangerous ways, potentially leading to injuries and other safety issues, particularly if there is no one else present who can prevent or respond to an emergency.

“There are credible cases of people using [psychedelics] by themselves, but it’s not the safest way to approach it, and the likelihood of the treatment being effective is not nearly as high,” says Johnson.

Microdosing

This approach involves taking much lower than normal doses of a drug, which doesn’t cause a hallucinogenic response. The drug is typically taken intermittently with various days on and off.

At present there isn’t one recognized definition of microdosing for any psychedelic drug.

That said, some research suggests dosages may be approximately one-fifth to one-twentieth of a typical recreational dose of psychedelics.

Some people have praised microdosing for reducing anxiety, and improving focus, mood, and creativity, among other benefits. While there have been some positive anecdotal accounts, recent studies have not found a difference between microdosing and placebo, says Charles Grob, MD, an investigator at the Lundquist Institute and a professor of psychiatry and biobehavioral sciences and pediatrics at the David Geffen School of Medicine at UCLA in Los Angeles. “In spite of the enthusiasm for microdosing, there’s a lack of definitive proof that it’s effective,” he says.

Possible Benefits of Psychedelic Therapy

First of all, it's important to understand the limitations of psychedelic therapy. Much more research needs to be done, says Grob. “Until very recently, it was unacceptable to even consider psychedelics as having treatment potential. There is still a lot to learn and a lot of work to do,” he says.

With that in mind, here are some potential health benefits.

May Alleviate Depression

Ketamine is usually used as an anesthetic, but research indicates that when administered at lower levels, it can help treat depression. One meta-analysis and review of 28 studies found that a single ketamine infusion decreased depressive symptoms within hours, though the effects of the dose tended to peter out within seven days. Current practice is for people to be given a short course of several treatments, followed by maintenance treatments, which may help prevent a depression relapse. Authors of the study highlight the need for more long-term research.

Ketamine is indicated for treatment-resistant depression, or someone who has “failed” conventional treatments, like SSRI medication, says Mailae Halstead, a therapist with Behavioral Wellness Clinic in Tolland, Connecticut, who specializes in ketamine-assisted therapy and psychedelic integration. “Ketamine [may] alleviate depressive symptoms so that patients might be able to do the things they need to do to keep depression at bay, such as a regular movement practice or cognitively reframe negative biases and self-talk,” she explains.

Ketamine also appears to be effective as a treatment method for people with a high risk of suicide, which often correlates with depression.

May Ease Trauma Responses in Those With PTSD

A phase 3 randomized controlled clinical trial of 91 participants published in May 2021 in Nature Medicine examined the effect of MDMA therapy on those who had severe PTSD.

?Participants were first given a form of psychotherapy that followed guidelines from the Multidisciplinary Association of Psychedelic Studies (MAPS).

?They then received treatment with either MDMA or a placebo. After treatment, the MDMA group experienced a nearly twofold reduction in their score on a scale measuring PTSD symptoms.

Researchers found that MDMA potentially enhanced the beneficial effects of this specific form of therapy more than the placebo-therapy group, but the placebo group showed benefits too, meaning results are not conclusive. The FDA ultimately rejected the use of MDMA as a treatment for PTSD following these trials, due to safety concerns, and the notion that it was hard to tell if participants benefited more from the MDMA itself, or the accopanying psychotherapy.

May Be Effective in Treating Alcohol Use Disorder

Some research indicates that psilocybin (magic mushrooms) may be beneficial in the treatment of alcohol use disorder. A study featuring of 93 people found that when taken in combination with talk therapy, psilocybin may significantly decrease the percentage of heavy drinking days in the eight months after treatment.

May Assist in Eating Disorder Recovery

Research into the use of psychedelics as treatment for eating disorder treatment is at its very early stages. Brain imaging studies show that the same pathways activated by psilocybin are the very same as those affected in anorexia nervosa. Research suggests psilocybin may be able to spark changes in the connections in these brain networks to induce healing.

?This authors point out the critical nature of these findings, as up to half of people with anorexia never recover, and the illness greatly increases their risk of dying early.

In 2022, Xpira Pharmaceuticals announced that they were granted approval from the FDA for an “investigational new drug” designation for psilocybin in anorexia therapy, and they will begin a phase 2a clinical trial. This trial is specifically designed to assess how much psilocybin should be given.

?Until more is known, this remains an emerging treatment.

A more recent 2023 study also showed positive results, with authors stating that weight concerns and body shape concerns of participants decreased significantly overall. But they also note that the effects of the treatment varied greatly between participants.

May Play a Role in End-of-Life Care

The experience of death, or the idea of it, can be uncomfortable and distressing for some, and psychedelics may help soothe a patient’s end-of-life journey by alleviating anxiety and existential dread. According to a review published in 2021, some research shows that among people with potentially fatal illnesses, those who received high doses of LSD under supervision had less anxiety than those given an active placebo.

Research also shows that patients given a life-threatening cancer diagnosis and administered a high dose of LSD reported higher levels of well-being and less anxiety and depression than those who took a low dose.?

Finally, there is also some preliminary research suggesting psilocybin could be supportive for patients with life-threatening or life-limiting illnesses distress.

May Improve General Well-Being

While some controlled trials evaluate psychedelics for specific healthcare uses, psychedelics may also promote general well-being, according to some research. In an online survey of 2,500 adults who have used psychedelics (legally or illegally) at some point in their lives, these drugs were associated with improved symptoms of depression and anxiety, and better emotional well-being.

Ayahuasca was specifically linked to enhanced emotional well-being compared with other hallucinogens, even among those who had used it just once. Participants claimed that psychedelics led to transformative experiences and insights that shifted their mindsets and attitudes, as well as leading to enhanced selflessness and a drive to help others. The authors point out that these substances appear to be most effective in infrequent doses to initiate change within one’s self, rather than taking them long term to level out one’s mood. Of course, not all outcomes seemed positive. One in eight people reported experiencing harm from psychedelics, and it’s important to note this is survey data based on self-reporting, rather than an actual experimental or clinical trial.

It is also worth noting that the American Psychiatric Association (APA) ethical recommendation is for psychedelic prescriptions (as they become approved by the FDA and DEA) to be limited to clear clinical and diagnosable conditions for which the psychedelic was studied in clinical trials, and not for general well-being or self-enhancement.

Risks and Side Effects of Psychedelic Therapy

More research is needed to better understand all the risks of psychedelic therapy. There is much to learn and study relating to how psychedelics may interact with medications, including mental health medications, as well as other drugs, so be sure to tell your treatment provider all the medications and drugs you take.

Here are some of the main risks of psychedelic therapy although this can vary by substance, personal risk factors and dose:

Anxiety
Paranoia
Increase in heart rate (especially for those with heart conditions)
Increase in blood pressure changes
Potential for substance abuse

In addition, there are risks, both legal and health and safety, no matter how or why you use psychedelics. Some people may choose to do this in an underground setting, when an illegal psychedelic is given in a therapeutic or nontherapeutic setting which further increases the potential risks.

“People want help and are willing to try things out of desperation, but they can end up at the mercy of unethical [practitioners]. I encourage everyone to be careful, whether in the U.S. or abroad,” says Joe Tafur, MD, an integrative family physician working in collaboration with Daytryp Health and the Ocotillo Center for Integrative Medicine in Phoenix.

Should someone experience a medical event mid-session, you want to be confident that the person administering the drug will call for help without fear of legal repercussions, adds Johnson.

Similarly, outside of a clinical setting, products sold as pure MDMA, psilocybin, or LSD may be altered with other unidentified substances, which can increase the toxicity. In other words, people might not have a way of knowing what else is in the drug they are obtaining, and this can be dangerous.

Risks of Psychedelic Tourism

Psychedelic tourism has risks of its own. There have been reports of sexual assaults and abuse, per the BBC,

and robberies and deaths, per the New York Times.

In addition, psychedelic tourism retreats that are not subject to healthcare regulations may not have adequate procedures for screening and preparing participants, and therefore may be risky for individuals not stable enough for psychedelic experiences.

“If you go out of the United States, you want to be very careful. It’s a very vulnerable position to put yourself in, being in another country where you might not know the language or the culture,” says Dr. Tafur, who is also the author of The Fellowship of the River, which explores the role of spiritual healing in modern healthcare.

This is why the movement to create legal pathways for these substances, whether through therapeutic or spiritual pathways, is so important, says Tafur. “We want to find ways to bring this aboveboard so we can make sure we have ways for people to explore this safely,” he says.

If you’re interested in pursuing psychedelic therapy of any kind, talk to your doctor first. In addition, know the dose and purity of the substance you will be taking in a clinical setting, ensure you work with a licensed therapist before, during, and after treatment, and identify where the closest hospital is in case you need medical intervention.

Who Should Avoid Psychedelic Therapy

Not everyone is a candidate for psychedelic therapy. Your therapist should go over your medical history with you in depth before you embark on a treatment regimen.

If you are traveling to another state for treatment, get clearance from your doctor before doing so. “There are medical conditions to take into account before you have an experience like this,” says Grob. A psychedelic-assisted journey can be stressful and taxing for your heart, and psychedelics tend to increase your heart rate and blood pressure. For these reasons, if you have unstable hypertension, you will be ruled out as a candidate. An arrhythmia (irregular heartbeat) is also a concern: “[In this case,] your cardiac function needs to be monitored carefully [during therapy],” he says.

In addition to being pregnant, a prior history of bipolar manic episodes or schizophrenia and psychotic episodes, paranoid traits, or a family history of schizophrenia, may disqualify you for treatment, as the hallucinogenic component may be destabilizing, according to Tafur and the Translational Psychedelic Research Program at the University of California in San Francisco.

Tips for Talking to Your Doctor About Psychedelic Therapy

It may feel intimidating to approach your doctor about psychedelic therapy, but it’s vital you consult your healthcare provider to find out if you, medically, are a candidate before pursuing treatment.

“Any experience will be safer if you go to the doctor and make sure your heart health is good, and they’re confident you don’t have a predisposition to schizophrenia. Those are the two most important things to screen out,” says Johnson.

Initially, you could approach your primary doctor, specialist, or psychiatrist with a phrase like: “I have some questions about psychedelics, are you open to discuss this with me?” Further questions about the potential role of psychedelic therapy could include the following:

Is psychedelic-assisted therapy right for me?
What are my options for treatment?
Medically, am I a candidate for psychedelic therapy?
Do I have any health risks that would need to be closely monitored?

In addition, ask yourself if you have the right support in place to go through psychedelic therapy, says Tafur. Ideally, you would speak with your current conventional therapist, as well as the therapist who will be guiding you through psychedelic therapy.

“You might have a very transformative experience, but without adequate support, either personally in your community or professionally through a therapist, it can be tough to go through something like that alone,” he says. For one thing, the treatment might be less effective and could be psychologically stressful, Tafur explains.

Finding a Psychedelic Therapy Practitioner

It’s important that you find a practitioner who has taken continuing education in psychedelic therapy. They’ll be able to assist you in determining if this is right for you. Some therapists are also certified psychedelic-assisted psychotherapists (PAPT), which means they underwent a yearlong training program offered through the Integrative Psychiatry Institute (IPI). IPI also offers ketamine medical provider online training for healthcare providers. The program is run with the American Society of Ketamine Physicians, Psychotherapists & Practitioners, a nonprofit. In addition, the IPI has a directory of providers who have their PAPT. This is a place to start, but you should still talk to a particular provider about their experience, how they offer the therapy, and other medical providers they work with to administer the treatment.

Anxiety and paranoia are common side effects of psychedelics, and an established rapport between the therapist and patient may help the patient feel safe throughout the experience, says Johnson. “Therapy really needs a monitored session, otherwise you could take something that could be a therapeutic experience and turn it into something hellish, where no learning occurs,” he adds.

The New York City clinical psychologist Lisa Morse, PhD, found that continuing education in psychedelics was relevant for her practice after she had a handful of patients ask her opinion on them.

“I realized I had a responsibility to understand more. Without this education, we’re really not in a position to help patients on this issue,” she says. So, she took a course in psychedelic therapy, which included information on specific drugs, harm reduction, and more. Morse now feels she’s somewhat more equipped to provide guidance, as patients “consider and evaluate their options, in a nonjudgmental way, that’s never advocating they break the law,” she says.

For providers who are interested in learning more on psychedelics, Morse recommends Fluence, a continuing-education platform in psychedelic-assisted therapy and integration.

If your provider is still unsure of what to say or you don’t feel heard, you may consider a second opinion to get medical advice and clearance to move forward in a safe, informed manner. For example, you might seek out an integrative doctor or integrative psychiatrist who may be more experienced with discussing psychedelic therapy or could refer you to a doctor who is.

What to Expect Before, During, and After Psychedelic Therapy

Psychedelic therapy has the potential to be of great value [to some patients], says Grob. “However, it’s imperative that we go about understanding these compounds in the right way, which means under controlled conditions with the right personnel,” he says.

That means seeking out an experienced facilitator (a licensed therapist or doctor who can administer psychedelics legally) who will screen you ahead of time to make sure that you’re an appropriate candidate for treatment, says Grob.

Stages of Psychedelic-Assisted Therapy

Right now, outside of clinical trials, ketamine therapy is the only psychedelic-like treatment available legally on a federal level in the United States. If you move forward with psychedelic-assisted therapy, there are three main stages you’ll go through with a trained professional.

Preparation and Exploration

After receiving an evaluation and clearance for psychedelic-assisted therapy, you will start preparation. In a series of sessions, the therapist will go over what you need to know, including how long treatment will take, what you might feel, potential side effects, and what you might feel coming off, and after the drug. In the preparation stage, it’s also important to discuss what you hope to get out of the experience. That can set the stage for what happens during the medication portion: “We find that the ‘substance’ of the intention often manifests during the course of the treatment session,” says Grob.

Medication

This is when you will receive the psychedelic, which may be done intravenously, intranasally, intramuscularly, or orally, and varies by drug. The length each session lasts also differs by drug and therapist protocol. You’ll also need to plan time before and after treatment for prep and observation, which varies by patient. “The facilitator needs to be present the entire time,” says Grob. The therapist should gently guide you along your journey and make it feel like a safe space.

Integration

These are nondrug sessions with your therapist to talk about and interpret your experiences, gauge your progress and functionality, as well as discuss any adverse effects from the medication, says Grob. Integration is a key component of care, but some ketamine centers are medical only, and only offer the medication or infusion. In that case, you should seek out a qualified therapist as an adjunct to help you transition after treatment.

Integration sessions look just like a typical psychotherapy session, adds Halstead. You’ll focus on meaning-making, as well as setting up practices that will improve your mental well-being. During these integration sessions, you can also capitalize on the increased neuroplasticity from treatment, which can reinforce your learning. Overall these integration sessions can increase the efficacy of treatment.

Access to Psychedelic Therapy: How Much Does It Cost?

Costs for psychedelic therapy vary depending on the clinic. We will focus on the cost of ketamine therapy, since it’s the current option that’s federally legal in the United States.

While Spravato is a prescription medicine that may be covered, in part, by insurance, the company also has savings programs available to defray the cost.

Ketamine centers, or ketamine given in a therapist’s office, may also be partly covered by insurance. Costs to you depend on your copay or deductible, according to your benefits. Aside from insurance, costs vary depending on several factors, Halstead points out, which can include:

Number of prep, medication, and integration sessions needed
Maintenance program or duration of “booster” treatments
Experience or level of the therapist you’re working with
How involved the therapist is during your journey (for example, constant surveillance)
Area of the country

Typically, if insurance does provide coverage, they will only do the preparation and integration sessions. They will not pay for the medicine itself, says Halstead. Again, check your benefits and have a conversation with the center about the cost for each stage of therapy. This can add up to thousands of dollars, she says.

A Google search of ketamine infusion centers shows that a one-hour ketamine infusion (of which you may need several) varies depending on provider, location, and services offered. For example (note, these are for illustrative purposes and not an endorsement):

Sage Integrative Health charges $400–$600 for the psychiatric intake, $1,000–$1,120 for the ketamine session, and $250–$280 for prep or integration sessions.
NY Ketamine Infusions costs $525 for each infusion, and six infusions are recommended in a 12-day period.
Mindbloom, which offers at-home virtual ketamine care, is far less expensive, charging an initial fee of $99 for new clients, and a fee of $359 per month for three months of treatment (6 sessions).

No matter where you go, inquire about your financial options, as sliding scales, payment plans, and other available programs that may help reduce costs. If you are part of a psychedelic clinical trial, then you would not need to pay. Ideally, as research evidence mounts, psychedelic therapy will include more substances and be better covered by insurance.

The Takeaway

Psychedelic therapy is continuously evolving. It holds great potential for psychological therapy in using psychedelic substances to to help treat mental health conditions such as, PTSD, eating disorders, substance abuse disorders, and end-of-life challenges, among others. Substances used in psychedelic therapy include psilocybin (“magic” mushrooms), or psychedelic-like drugs, such as ketamine and MDMA, in the treatment of mental health conditions. These include depression, PTSD, alcohol use disorder, and end-of-life distress.

Although there is increasing interest internationally, research on the potential benefits and risks of these therapies is ongoing and much is in the initial stages.

Currently, most psychedelic drugs are federally illegal. Exception of ketamine, psilocybin (in Oregon and Colorado), and a couple of religious exemptions for ayahuasca. If you’re interested in psychedelic-assisted therapy, talk to your doctor about if you’re medically and psychologically a candidate for treatment.

Common Questions & Answers

What is psychedelic therapy?

Psychedelic therapy involves the controlled use of hallucinogenic drugs, such as psilocybin, LSD, ayahuasca, and the psychedelic-like drugs MDMA and ketamine as part of a treatment plan for mental health conditions such as depression or PTSD, in trials and clinical settings.

Is it legal to use psychedelics for therapy?

Apart from certain religious exceptions, most psychedelic drugs are considered Schedule 1 drugs and are illegal in the United States. Ketamine treatment, though it's not a classic psychedelic medicine, is legal. Certain states, such as Oregon, have also legalized, decriminalized, or deprioritized psilocybin, known as “magic” mushrooms.

How does psychedelic therapy work?

Psychedelic drugs may initiate changes in the brain that create neural connections and alter thoughts, potentially setting the stage for healing. Hallucinogens also cause a “trip” (a nonmedical term for the experience itself), and for some, that experience can be enlightening. Together, these characteristics may make psychedelic drugs helpful for treating mental health disorders.

What are psychedelics used to treat?

Research is still emerging, but psychedelics may be effective for depression (particularly treatment-resistant depression), PTSD, anxiety that happens at end of life or as a result of a terminal cancer diagnosis, and alcohol use disorder.

What is integration therapy?

Integration therapy is an important component of psychedelic-assisted therapy. After psychedelic treatment, patients meet with a licensed mental health therapist who aims to help them process and learn from the experience of taking the drug.

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Justin Laube, MD

Medical Reviewer

Justin Laube, MD, is a board-certified integrative and internal medicine physician, a teacher, and a consultant with extensive expertise in integrative health, medical education, and trauma healing.

He graduated with a bachelor's in biology from the University of Wisconsin and a medical degree from the University of Minnesota Medical School. During medical school, he completed a graduate certificate in integrative therapies and healing practices through the Earl E. Bakken Center for Spirituality & Healing. He completed his three-year residency training in internal medicine at the University of California in Los Angeles on the primary care track and a two-year fellowship in integrative East-West primary care at the UCLA Health Center for East-West Medicine.

He is currently taking a multiyear personal and professional sabbatical to explore the relationship between childhood trauma, disease, and the processes of healing. He is developing a clinical practice for patients with complex trauma, as well as for others going through significant life transitions. He is working on a book distilling the insights from his sabbatical, teaching, and leading retreats on trauma, integrative health, mindfulness, and well-being for health professionals, students, and the community.

Previously, Dr. Laube was an assistant clinical professor at the UCLA Health Center for East-West Medicine and the David Geffen School of Medicine at UCLA, where he provided primary care and integrative East-West medical consultations. As part of the faculty, he completed a medical education fellowship and received a certificate in innovation in curriculum design and evaluation. He was the fellowship director at the Center for East-West Medicine and led courses for physician fellows, residents, and medical students.

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Heidi Green, MD

Medical Reviewer

Heidi Green, MD, is board certified in psychiatry, addiction medicine, and lifestyle medicine. She currently divides her time between maintaining a small private practice and working at specialized opioid treatment programs in North Carolina.

In her private practice, Dr. Green provides psychiatric consultative services and offers an office-based buprenorphine maintenance program to support recovery from opioid addictions. She enjoys offering lifestyle medicine consultation to those interested in maximizing their emotional and physical health by replacing unhealthy behaviors with positive ones, such as eating healthfully, being physically active, managing stress, avoiding risky substance use, improving sleep, and improving the quality of their relationships.

At the opioid treatment programs, Green serves as medical director, working with a team of counselors, nurses, and other medical providers. The programs provide evidence-based treatment (including buprenorphine, methadone, and naltrexone) for persons suffering from opioid use disorders (such as addictions to heroin, fentanyl, or prescription pain medications).

Previously, Green has worked in community health and mental health settings where she provided consultation to behavioral health teams, integrated care teams, substance abuse intensive outpatient programs, and a women’s perinatal residential program. She also enjoyed supervising residents in her prior role as assistant consulting professor to the department of psychiatry at Duke University School of Medicine. During her training at the UNC department of psychiatry, she was honored to serve as chief resident, clinical instructor of psychiatry, and psychotherapy supervisor.

Green is passionate about the years we can add to our life and the life we can add to our years through lifestyle medicine! She focuses on maintaining her own healthy lifestyle through work-life balance, contemplative practices, and eating a plant-based diet. She finds joy through a continual growth mindset, shared quality time with her partner, and time spent outdoors backpacking and mountain biking.

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Jessica Migala

Author

Jessica Migala is a freelance writer with over 15 years of experience, specializing in health, nutrition, fitness, and beauty. She has written extensively about vision care, diabetes, dermatology, gastrointestinal health, cardiovascular health, cancer, pregnancy, and gynecology. She was previously an assistant editor at Prevention where she wrote monthly science-based beauty news items and feature stories.

She has contributed to more than 40 print and digital publications, including Cosmopolitan, O:The Oprah Magazine, Real Simple, Woman’s Day, Women’s Health, Fitness, Family Circle, Health, Prevention, Self, VICE, and more. Migala lives in the Chicago suburbs with her husband, two young boys, rescue beagle, and 15 fish. When not reporting, she likes running, bike rides, and a glass of wine (in moderation, of course).

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