Last updated: November 2026
In the United States, you can legally get psychedelic therapy today in three main ways: ketamine-assisted therapy, clinical trials, and state-regulated psilocybin programs in Oregon and Colorado (with New Mexico's medical program about to open). You can also travel to medical programs abroad. MDMA and psilocybin are not yet FDA-approved, but both are under FDA review, so this picture may change in 2027.
I wrote this guide because "where can I get psychedelic therapy?" is one of the questions I hear most. Below I go through each option, what is and isn't legal, and why the support you get after a session matters as much as the session itself.
What is psychedelic-assisted therapy?
Psychedelic-assisted therapy combines a psychedelic substance, such as psilocybin, MDMA or ketamine, with psychotherapy before, during and after the session. The idea is that, in a carefully prepared setting, the substance can help people reach emotions or memories that are hard to work with in talk therapy alone.
The therapy around the session does much of the work: preparation beforehand, support during the experience, and integration afterwards. The field is still young. The research is promising, but legal access remains limited and depends heavily on where you live.
Is psychedelic therapy legal in the US?
Mostly not yet. Psilocybin and MDMA are still Schedule I drugs under federal law, so their legal use is limited to approved research and to state programs that operate under state law. Ketamine is the exception: it is FDA-approved as an anesthetic, and doctors can legally prescribe it off-label for depression and other conditions.
Decriminalization is not legal access
Some places have reduced penalties for personal use. Colorado's Proposition 122 (2022) decriminalized personal use of psilocybin and certain other natural medicines for adults 21 and older. Some cities, including Oakland and San Francisco, have made these substances a low enforcement priority. Oregon's Measure 110, which decriminalized drug possession, was largely reversed in 2024. In all of these places, decriminalization does not create a legal way to buy psilocybin or to receive supervised care.
State psilocybin programs: Oregon, Colorado and New Mexico
Three states have created regulated pathways to supervised psilocybin experiences and therapy:
Oregon was first. Under Measure 109 (2020), licensed service centers began serving clients in 2023. Clients must be 21 or older and do not need a prescription or referral. They must complete a preparation session with a licensed facilitator first.
Colorado licenses facilitators and healing centers under the Natural Medicine Health Act. The state issued its first healing center license in March 2025, and centers are now open in several parts of the state.
New Mexico passed the Medical Psilocybin Act (SB 219) in April 2025. It was the first state to do this through its legislature rather than a ballot measure. The program covers treatment-resistant major depression, PTSD, substance use disorders and end-of-life care. State officials have aimed to treat the first patients by the end of 2026, a year ahead of the law's deadline.
Therapy vs. facilitated experiences
In Oregon and Colorado, most sessions are facilitated experiences, not psychotherapy. A licensed facilitator supports you through preparation, the psilocybin session and integration, but facilitators do not need to be clinicians. The two states differ for licensed clinicians:
Colorado has a separate clinical facilitator license for psychologists, licensed clinical social workers, marriage and family therapists, professional counselors, addiction counselors, physicians, nurse practitioners and physician assistants. Clinical facilitators may use natural medicine to treat mental and physical health conditions within the scope of their own license, including psychotherapy, and must tell you in writing what that scope covers. A standard facilitator may not practice psychotherapy.
Oregon does not define psilocybin services as therapy. A facilitator who is also a licensed clinician may provide behavioral health care during preparation and integration sessions, if their license allows it and they tell you first. They may not practice under that other license during the psilocybin session itself.
If you want psilocybin within actual therapy, ask the provider directly whether they hold a clinical license and whether therapy is part of what they offer. New Mexico's program is medical: it is built around qualifying diagnoses and medical oversight.
Ketamine-assisted therapy: the most available option
Ketamine is the most widely available legal option in the US. Doctors prescribe it off-label for depression and other conditions. Esketamine (Spravato), a related nasal spray, has been FDA-approved for treatment-resistant depression since 2019. Ketamine is not a classic psychedelic. It is a dissociative anesthetic, but at lower doses it can change perception and sense of self, which is why it is often used alongside psychotherapy.
Ketamine-assisted psychotherapy combines prescribed ketamine with sessions with a licensed therapist. If you are considering it, ask whether the program includes preparation and integration, not just the dosing appointment.
Can I join a psychedelic clinical trial?
Yes, if you qualify. Universities and companies run trials of psilocybin, MDMA, LSD and other compounds, including in New York City. To find them, search ClinicalTrials.gov for your condition (for example "PTSD" or "treatment-resistant depression") plus the substance (for example "psilocybin" or "MDMA"). Listings show locations, eligibility criteria and contact details.
Trials have limits. Entry criteria are strict, many studies use a placebo or comparison group, and the study ends after a set period, often without long-term support.
Where the FDA reviews stand
MDMA for PTSD: the FDA declined to approve MDMA-assisted therapy in August 2024 and asked for an additional Phase 3 trial. In August 2026, Resilient Pharmaceuticals (formerly MAPS PBC and Lykos Therapeutics) resubmitted its application, and it is now back under FDA review.
Psilocybin for treatment-resistant depression: Compass Pathways is completing a rolling application for its psilocybin treatment (COMP360). It has a Commissioner's National Priority Voucher, which can shorten review. The company expects to launch in the first half of 2027 if the FDA approves it. That would make it the first FDA-approved classic psychedelic treatment in the US.
Neither treatment is approved yet. Until it is, the only legal way to receive either one in the US is through a clinical trial.
Can I get psychedelic therapy abroad?
Some countries now allow medical use. Since July 2023, authorized psychiatrists in Australia can prescribe MDMA for PTSD and psilocybin for treatment-resistant depression. Switzerland allows individually authorized physicians to treat specific patients, usually self-paid and with long waiting lists. Psilocybin truffle retreats in the Netherlands and Jamaica, and ayahuasca retreats in Peru, operate legally as wellness or ceremonial businesses. They are not medical treatment and are not regulated as healthcare.
The Czech Republic: a new option in Europe
As of January 1, 2026, the Czech Republic allows psilocybin for medical use, the first country in the European Union to do so. Under a government regulation issued in December 2025, only psychiatrists and specialists at facilities approved by the Ministry of Health can administer it. The main indications are serious depression, PTSD and existential distress. As of November 2026, no patients have been treated yet under the new law, because reimbursement and facility approvals are still being finalized. If you are considering it, check the current status with the National Institute of Mental Health (NUDZ) or with an approved clinic.
Prague is also home to Psyon, a clinic offering psychiatric and psychotherapeutic care with a focus on the clinical use of psychedelics, including ketamine-assisted therapy and psychedelic integration. I am closely connected to this work. I serve as Director of Clinical Implementation & Training at EPIC (the European Platform for Integration of MDMA in Mental Health Care), and I am on the board of Psyres, the Prague-based psychedelic research foundation, and I work closely with the team at Psyon. Having grown up between the US and the Czech Republic and speaking Czech, I'm well placed to help bridge these communities, and to support English- and Czech-speaking clients considering treatment in Prague.
Things to consider before you travel
Treatment abroad can be expensive, and it often comes with little follow-up once you are home. A powerful experience without ongoing support can be hard to make sense of. If you go abroad, plan your integration support at home before you leave, whether in person or by telehealth.
Why integration therapy matters wherever you go
Psychedelic integration therapy helps you make sense of a psychedelic experience and turn what you learned into lasting changes in your life. It does not involve taking psychedelics. It is psychotherapy for people who have already had an experience, or are preparing for one.
Integration is something you should consider. Clinical experience suggests that much of the lasting benefit depends on what happens afterwards: how insights are understood, how difficult emotions are processed, and how they are carried into thinking, behavior and relationships. A powerful experience without support often fades. A well-supported one can lead to lasting growth.
Integration is especially helpful after a challenging experience. Whether your experience happened in a legal program, a clinical trial, abroad or on your own, integration therapy can help you make it count. You can read more in What Psychedelic Integration Really Looks Like in Therapy and Psychedelic Integration Coach vs. Therapist.
How I work with this
I'm Ingmar Gorman, PhD, a clinical psychologist licensed in New York. I offer telehealth psychotherapy and psychedelic integration therapy to clients residing in New York State and clients living outside the USA, in English or Czech. I have served as a clinical trial investigator in psychedelic treatment research, including trials of MDMA-assisted therapy for PTSD. I co-founded Fluence, where I led psychedelic therapist training from 2019 to 2025. I don't provide psychedelics. I help people prepare, make sense of what they experienced, and decide on safer next steps.
Frequently asked questions
Is there a legal way to access psychedelic therapy for PTSD?
MDMA-assisted therapy for PTSD is not FDA-approved. The application was resubmitted in August 2026 and is under review, so for now the legal US routes are clinical trials, ketamine-assisted therapy prescribed off-label, and New Mexico's medical psilocybin program, which includes PTSD, once it opens. Evidence-based trauma therapy is available now; see my trauma therapy page.
Is there a legal psychedelic therapy option for depression right now?
Yes. Esketamine (Spravato) is FDA-approved for treatment-resistant depression, and ketamine is widely prescribed off-label. Psilocybin is available through Oregon's and Colorado's programs and clinical trials, and Compass Pathways expects a 2027 launch if the FDA approves its treatment.
Is there a legal psychedelic therapy option for anxiety right now?
No psychedelic is FDA-approved for anxiety. Adults 21 and older can use Oregon's or Colorado's regulated psilocybin programs without a diagnosis, and clinical trials for anxiety disorders are listed on ClinicalTrials.gov.
Is there a legal psychedelic therapy option for grief right now?
No psychedelic treatment is approved for grief. Oregon's and Colorado's programs do not require a diagnosis, so adults 21 and older can take part, but most sessions are facilitated rather than therapy, and grief therapy can be valuable alongside them.
Is there a legal psychedelic therapy option for burnout right now?
Burnout is not a medical diagnosis, so no medical psychedelic program treats it directly. Adults 21 and older can use Oregon's or Colorado's facilitated psilocybin programs, and psychotherapy can address burnout directly.
Do I have to go to Oregon or Colorado for psychedelic therapy?
Not necessarily. Ketamine-assisted therapy and clinical trials are available in many states, including New York, and integration therapy by telehealth can support you wherever your experience took place.
Talk to me about your options
If you're weighing psychedelic therapy, preparing for an experience, or making sense of one, I offer a free 30-minute consultation. Contact me here to book a time.
References
National Institute of Mental Health, Czech Republic (NUDZ). (2026, March 23). Official statement on the availability of psilocybin treatment.
Mind Medicine Law. (2026). Czech Republic psilocybin law: first in the EU.
NSW Health. Psilocybine and MDMA (prescribing by authorised psychiatrists from 1 July 2023).
Oregon Health Authority. (2023). Psilocybin 101: What to know about Oregon's psilocybin services.
KGW. (2024). Kotek signs bill overhauling Measure 110, recriminalizing drug possession.
Colorado Department of Revenue, Natural Medicine Division. (2025, April 2). The DOR's Natural Medicine Division issues Colorado's first healing center license.
Psychedelic State(s) of America. (2025, December 9). New Mexico to accelerate its launch of therapeutic psilocybin access.
Psychedelic Alpha. (2026, August 12). Two years after rejection, Resilient quietly refiles MDMA for PTSD application.
Compass Pathways. (2026, November 3). Compass Pathways announces third quarter 2026 financial results and business highlights.
NPR / MPR News. (2019, March 5). FDA approves esketamine nasal spray for hard-to-treat depression.
PsyAccess. (2026, September 4). Which European countries allow psychedelic therapy? (Switzerland, Netherlands).
U.S. National Library of Medicine. ClinicalTrials.gov.
Colorado Code of Regulations, 4 CCR 755-1, Rule 2 (Licensure) and Rule 6 (Standards of practice).
Oregon Health Authority. (2026, October 30). Oregon Psilocybin Services: Guidance on administrative rules.
If your question is about psychedelics and pregnancy or breastfeeding specifically, see Mushrooms While Pregnant: What the Research Actually Shows, a summary of the 2026 peer-reviewed evidence.
This article is for educational purposes only. It is not medical or legal advice and is not a substitute for individual care.