How to Prepare for a Psychedelic Experience

What this guide covers

This guide is about the practical work before a session in a setting where it is lawful or openly tolerated: a licensed psilocybin service centre in Oregon or Colorado, a retreat abroad, a clinical trial, or ketamine treatment at a clinic. It does not give doses or advice for illegal use.

Two other articles cover the psychology of the day itself. Set and setting explains why mindset and surroundings matter, and challenging experiences covers what to do when a session turns difficult. This page is the checklist that comes before both.

Formal programmes treat preparation as part of the treatment, not an extra. In Oregon a client must attend a preparation session with a licensed facilitator before any administration session. (Oregon State Legislature, current edition) In the phase 3 MDMA trial for severe PTSD, each participant had three preparatory therapy sessions before the first medicine session. (Nature Medicine, 2021)

Choose where, starting with the law

The legal footing differs more than most marketing suggests, so start there. The is it legal tool and the legal overview set out the position place by place with sources.

• Oregon and Colorado. Oregon licenses psilocybin service centres for adults 21 and over, and the psilocybin may only be taken at a licensed centre under a facilitator, with no take-home. (Oregon State Legislature, current edition; Oregon Health Authority / Oregon Secretary of State, 2025) Colorado began licensing in late 2024 and issued its first healing centre licence on 31 March 2025. (Colorado General Assembly, 23 May 2023; Colorado Department of Revenue, Natural Medicine Division, 2 Apr 2025) Psilocybin remains Schedule I under federal law in both states. (Legal Information Institute (Cornell) reproducing the U.S. Code, current text) The legal psilocybin guide lists the licensed centres.
• Retreats abroad. Peru declared the traditional Amazonian use of ayahuasca part of its national cultural heritage in 2008. (Agencia Peruana de Noticias Andina (state news agency), 12 Jul 2008; Ministerio de Cultura del Peru, Centro de Recursos (hosted academic article), 2012) Costa Rica's health ministry warned in January 2025 that ayahuasca and ibogaine products are not authorised for therapeutic use. (Ministerio de Salud de Costa Rica, 27 Jan 2025) The listed Costa Rica ayahuasca centres are compared side by side on price per night, ceremonies, group size and screening. In the Netherlands fresh truffles may be sold but dried truffles are treated as prohibited. (Jellinek, current page) Jamaica never listed psilocybin as a dangerous drug, although its health ministry has not approved mushroom products. (University of Miami Inter-American Law Review, 2025; Jamaica Gleaner, 24 Aug 2024) The retreat countries comparison sets these side by side with published prices and how many centres describe screening.
• Clinical trials. Trials screen heavily: the 2023 JAMA psilocybin trial for depression, for example, excluded people with a history of psychosis or mania and required participants to taper off psychiatric medication first. (JAMA, 2023) A listing on ClinicalTrials.gov does not mean the federal government has evaluated the study. (U.S. National Library of Medicine (NIH), Oct 2023) The clinical trials page lists studies that are recruiting.
• Ketamine. Esketamine (Spravato) is approved for depression and given only in certified healthcare settings. (eCFR (Office of the Federal Register), current; U.S. National Library of Medicine, DailyMed (Janssen label), 24 Sep 2026) Ketamine clinics using other forms are prescribing off-label. (U.S. Food and Drug Administration, 10 Oct 2023) The ketamine therapy guide covers the routes in detail.

For a broad view of what centres charge, the Q4 2026 report gives published prices per night by country.

Medical screening before you book

Screening belongs before you pay a deposit, not on arrival. Rather than repeat it here, work through the screening checklist and check every medicine and supplement you take in the interaction checker.

A few points decide many cases. Oregon's required client form rules out anyone who has taken lithium in the last 30 days, who has ever had active psychosis, or who currently has thoughts of harming themselves or others. (Oregon Health Authority, Public Health Division, 2026) In an online survey of 541 people with bipolar disorder who had used psilocybin, 32.2% described new or worse symptoms afterwards. (Journal of Psychopharmacology, 2023) Ayahuasca's MAO-inhibiting alkaloids combined with SSRI antidepressants may cause serotonin syndrome. (Journal of Psychoactive Drugs, 1998; ICEERS, 2026) Ibogaine carries a cardiac risk that calls for an ECG and blood tests first; the ibogaine clinic safety guide explains why. (Global Ibogaine Therapy Alliance (Internet Archive copy), 2016)

If a medicine is a problem, the answer is a conversation with the doctor who prescribed it. ICEERS says some antidepressants may need to be stopped at least two weeks before ayahuasca, but only under strict medical supervision, because stopping psychiatric medication abruptly can be dangerous. (ICEERS, 2018) Never change a dose on your own to make yourself eligible.

The weeks before

Intentions. Most programmes ask you to think about why you are going. Write down what you hope for and what you are afraid of, in plain words, and bring it to the preparation session. An honest answer to "why now?" is more useful than a polished one.

Diet and abstinence. Some ayahuasca centres publish a diet to follow for days or weeks beforehand. The reason usually given is tyramine, found in foods such as aged cheese, soy sauce and some meats. ICEERS says large amounts of tyramine with ayahuasca can, in rare cases, cause a dangerous rise in blood pressure, but that the MAO inhibitors in the brew clear relatively quickly, so poisoning from food eaten before or after a session is unlikely. (ICEERS, 2018; Journal of Ethnopharmacology, 1999) Strict diets rest more on tradition and caution than on measured risk. Preparing for Rythmia sets one centre's diet next to what the pharmacology says. ICEERS also advises avoiding alcohol, stimulants, opioids and other drugs in the days or weeks before an ayahuasca session, and that advice has a firmer basis. (ICEERS, 2018)

For ketamine the instructions are clinical. The Spravato label tells patients to avoid food for at least 2 hours and drinks for at least 30 minutes before a dose, because of nausea. (U.S. National Library of Medicine, DailyMed (Janssen label), 24 Sep 2026)

Your own life. If you are in an acute crisis, ask the provider whether waiting would be wiser. Tell one person at home where you will be and how to reach the centre.

Money, deposits and travel

Read the booking terms before you pay. Points to settle in writing:

• Deposit and refund. How much is due now, and what you get back if you withdraw or if their screening turns you down after you have paid. A centre that screens properly will sometimes say no, and the refund terms should allow for that.
• What the price covers. Accommodation, transfers, food, integration calls, and any extra ceremonies or medicines.
• Travel insurance. Read the exclusions, ask the insurer directly whether a retreat or treatment abroad is covered, and keep the answer in writing.
• Getting home. Do not book a flight for the morning after the last session. With Spravato, the label says not to drive until the next day after a restful sleep, and the same caution is sensible after any session. (U.S. National Library of Medicine, DailyMed (Janssen label), 24 Sep 2026)

In Oregon, centres do not have to report what sessions cost, so ask for the full price in writing. (Oregon Health Authority, 2026) Clinical trials vary as well: the National Institute on Aging suggests asking whether taking part costs anything and whether travel, lodging and meals are reimbursed. (National Institute on Aging (NIH), current page)

What to bring

• A written list of every medicine, supplement and dose, and your prescriber's contact details.
• Any medical letters or test results the provider asked for.
• Comfortable, loose clothes and warm layers.
• An eye mask, a notebook and a pen.
• Enough of your regular medicines for the whole stay, in original packaging.
• The address and phone number of the nearest hospital, and an emergency contact the staff can call.

Leave anything that would make you anxious to lose, and check whether the centre allows phones in the ceremony space.

Questions to ask the provider

No outside body checks the quality of most retreat ceremonies, including intake, aftercare and the number of sober staff present. (DRUGSinfo (Drugs Infolijn), Trimbos-instituut) Your questions are the check. Ask:

1. Who screens me, what are their qualifications, and what makes you turn someone away?
2. How many staff stay sober during a session, and how many guests are there?
3. Who has medical training on site, and how far is the nearest hospital?
4. What is your written plan for a medical emergency, and when did you last use it?
5. What is your policy on touch? Chacruna's community guide warns that sessions alone with a healer have been a common setting for sexual abuse, and that sexual contact during or after a ceremony is not acceptable in ayahuasca traditions. (Chacruna Institute for Psychedelic Plant Medicines, 2018)
6. What happens after I leave: is there follow-up, and with whom?
7. Do you add other substances, such as tobacco purges, kambo or 5-MeO-DMT? Each carries its own risks, and a published autopsy case attributed a death to 5-MeO-DMT taken with the harmala alkaloids found in ayahuasca. (Journal of Analytical Toxicology, 2005; ICEERS, 2023)

Vague answers, pressure to book quickly or advice to stop a medicine without your doctor are reasons to look elsewhere.

The day before and the days after

Sleep, eat as instructed and arrive early enough to settle in. Unsupervised use carries more risk: in the Global Ayahuasca Survey, taking ayahuasca without supervision was linked to more physical adverse effects. (PLOS Global Public Health, 2022) If you are supporting someone else, the trip sitter's guide covers that role.

Clear at least two days afterwards with no work or travel. Oregon facilitators must offer an integration session after the administration session, although taking it up is optional. (Oregon State Legislature, current edition) What helps in the weeks after is covered in integration practices.