Building Safer Psychedelic Services: What Experts Say About Setting Standards of Care
As interest in psychedelic-assisted therapy continues to grow, a new study sheds light on the crucial question: how do we ensure that psychedelic care is not only effective, but also ethical, inclusive, and safe?
A recent qualitative study published in the International Journal of Drug Policy brings together expert perspectives to help answer this question. The paper explores the current gaps in care standards for psychedelic therapy and highlights what needs to change to make this treatment safer and more accessible across diverse communities. A team of researchers including Jason B. Luoma, PhD and Christina Chwyl, PhD from the Portland Institute for Psychedelic Science (PIPS), helped conduct this research.
Why Standards Matter in Psychedelic Care
Despite the rapid expansion of psychedelic research and practice in the U.S., clear professional standards for psychedelic care remain underdeveloped. This is concerning given the unique psychological and relational vulnerabilities that arise during psychedelic states — including increased suggestibility and emotional openness — which can create significant risks if not handled responsibly.
The study involved focus groups with 38 experienced providers and harm reduction experts from across the U.S., representing clinical, community, ceremonial, and underground psychedelic settings. Participants shared their experiences and insights on what’s working, what’s not, and what’s needed to improve the safety and inclusivity of psychedelic services.
Five Key Themes Emerged:
Strengthening Safety Through Accountability
Participants emphasized the urgent need for greater oversight in psychedelic care — especially in unregulated settings. Many shared concerns about unethical practices, including boundary violations and lack of trauma-informed training among facilitators. Some suggested the creation of community-based restorative justice models and better public education to empower people to recognize and report unsafe behaviors.
Advancing Inclusive and Culturally Responsive Care
The study highlights how current psychedelic frameworks often fail to account for the unique needs of marginalized groups, including BIPOC, LGBTQIA+ individuals, and veterans. Participants stressed the importance of person-centered care that honors clients’ cultural and spiritual backgrounds. Some even noted that overly standardized care models can unintentionally alienate people by not considering systemic oppression or intergenerational trauma.
Healing in Community
Rather than isolating psychedelic therapy within medical offices, many participants advocated for integrating these experiences into community-based systems. They emphasized the importance of follow-up and integration support, especially peer-led groups and culturally aligned spaces that can provide ongoing care and reduce the risk of adverse outcomes.
Ensuring Safe Use: Preparation, Screening, and Medication Considerations
The need for robust screening and preparation processes was another key theme. Experts pointed out that simple checklists are often inadequate to assess someone’s readiness for psychedelic experiences — especially for people with severe mental health histories or medication use. The risks of unsupervised tapering from psychiatric medications and lack of access to knowledgeable consultation were noted as significant safety concerns.
Navigating Legal and Informational Gray Areas
Legal ambiguity remains a major barrier for many providers. In states like Oregon, where psilocybin services are now legal, professionals are often uncertain about how much guidance they can legally offer. Many rely on informal networks for consultation due to a lack of clear, accessible, and evidence-based materials. Some participants expressed fear of legal repercussions simply for referring clients to licensed centers.
Why This Matters Now
The study’s findings come at a pivotal moment. With Oregon’s psilocybin services program now active, and other states exploring similar frameworks, there is an urgent need to develop clear, ethically grounded, and culturally inclusive standards of care.
The researchers argue that psychedelic services — whether in medical or community settings — must go beyond harm reduction. They must also address systemic inequities, provide trauma-informed support, and create spaces where all people can feel safe, respected, and understood.
Moving Forward
This study underscores that building safer psychedelic care is not just about minimizing risk — it’s about creating care systems that are equitable, accountable, and genuinely supportive. For psychedelic therapy to fulfill its promise, providers, policymakers, and researchers must work together to ensure that the structure of care matches the transformative potential of these substances.