Legal Psilocybin Retreats Offer New Path for Mental Health Treatment as FDA Approval Nears

Martha Stem spent decades packing traumatic experiences into what she calls her "trauma box"—two sexual assaults in college, a suicide attempt, two divorces, and years of anger and depression managed through compartmentalization and antidepressants. Then Hurricane Helene hit in September 2024, and she discovered her ex-husband Jimmy dead from a self-inflicted gunshot wound after his eight-year battle with cancer. The box burst open.

By Palm Sunday 2025, the 70-year-old retired appellate paralegal and grandmother found herself kneeling in a Tampa church pew after communion, tears streaming down her face. She had tried traditional psychotherapy and two decades of medication. "But it's not helping, and you need to find another way," she told herself.

That alternative path led Stem to a five-day psilocybin retreat in Ashland, Oregon—one of a growing number of legal, regulated psychedelic therapy programs emerging across the United States as research accelerates and attitudes shift around substances long banned under federal law.

From Counterculture to Clinical Care

Psilocybin, the psychedelic compound in "magic mushrooms," has been used for thousands of years by Indigenous Mesoamerican communities. Modern therapeutic research began in the 1950s but was derailed by political and cultural pushback in the 1960s, leading to criminalization and decades of research stagnation.

The landscape has changed dramatically in the last twenty years. A growing focus on mental health treatment and more open attitudes toward therapeutic uses of drugs like marijuana created space for psilocybin research to resume.

Johns Hopkins University pioneered the modern-day study of psychedelics in 2000 when the late Dr. Roland Griffiths, a psychiatry and neuroscience professor, launched the first FDA-approved study of psilocybin since the drug was banned. The Johns Hopkins Center for Psychedelic and Consciousness Research has since produced a substantial body of evidence showing high doses of psilocybin can be effective in treating depression, with promise for conditions including PTSD and addiction.

"Potentially, by regrowing these connections in the brain, or creating this new neuroplasticity, it's possible that it helps people to get out of some of their negative behavioral and emotional patterns," said Dr. Albert Garcia-Romeu, associate director of the Johns Hopkins center, describing one of several proposed mechanisms for psilocybin's therapeutic effects. Other theories include disrupting entrenched neural traffic patterns and anti-inflammatory effects.

Research suggests the benefits of just a couple of doses can last up to six months, with some people reporting relief from symptoms for more than a year.

In 2018, the U.S. Food and Drug Administration granted psilocybin "breakthrough therapy" designation for treatment-resistant depression, acknowledging the drug's potential and expediting the research and review process. Psilocybin drug products are now on track to be submitted to the FDA for possible approval in the not-too-distant future, according to recent announcements from pharmaceutical companies conducting clinical trials.

State Regulatory Frameworks Create Access

While psilocybin remains illegal under federal law, states have begun carving out legal pathways under their own regulatory frameworks.

Oregon became the first state to legalize psilocybin mushrooms in 2020 through a ballot measure, then rolled out regulated psilocybin services in 2023. The Oregon Health Authority licenses and regulates the manufacturing, transportation, delivery, sale, and purchase of psilocybin products and the provision of psilocybin services. Nearly two dozen licensed service centers now operate across the state.

Colorado followed in 2023 with legislation establishing its own framework, issuing its first "healing center" licenses in 2025. New Mexico adopted legislation in 2025 establishing a Medical Psilocybin Program, currently in development.

The state regulatory models differ from what FDA approval would create. State programs in Oregon and Colorado allow broader access—people without formal medical diagnoses can participate in psilocybin experiences for personal growth, spiritual development, or existential exploration, not just treatment of specific conditions.

"While there may be some overlap, in practice, different people with different levels of needs can benefit from different environments," said Ismail Ali, co-executive director of the Multidisciplinary Association for Psychedelic Studies (MAPS), outlining how FDA-approved psilocybin drugs might coexist with state regulatory models serving different populations.

A February 2026 study published in medRxiv examined mental health outcomes among participants in Oregon's state-regulated psilocybin services, providing early real-world evidence of the program's effects outside controlled clinical trial settings.

The Retreat Experience

Stem's research led her to Confluence Retreats, a program housed in cabins on 115 acres of forested land near Ashland, Oregon. The five-day group experience included extensive preparation before participants received psilocybin, then integration work afterward to help process the experience and apply insights to daily life.

Before leaving Florida, Stem participated in individual and group video calls with facilitators about what brought her to the retreat and what to expect. She completed assigned reading on childhood trauma. In consultation with Confluence facilitators and her doctor (who Stem said was skeptical), she tapered off her antidepressant medication—a common step because research suggests certain antidepressants could blunt psilocybin's effects.

At the retreat, days were filled with meditation, sessions with facilitators, journaling, and walks in the forest. Nutritious meals were served family-style or in individual cabins. Between the structure and the setting, Stem said it felt calm and peaceful.

Oregon law requires licensed facilitators to administer psilocybin at licensed service centers. Confluence participants received the drug at Omnia Group Ashland, one of the state's licensed facilities. The service center provided a quiet room with individual floor beds, each with weighted blankets, eye shades, and headphones playing music curated for psychedelic experiences.

Participants started with a lower dose on the first journey—15 milligrams of gray powder mixed into hot water and served like tea with optional lemon and honey. Doses could increase up to 34 milligrams on a second journey two days later.

Facilitators encouraged participants to set intentions beforehand. Stem's first intention was clear: "to open up the trauma box and deal with everything that was in there—just to be done with it."

Her first journey began with tingling in her fingertips and toes, then visualizations of colors and shapes. She had a long conversation with Jimmy.

"Guilt was one of the biggest obstacles I had to overcome," Stem said. "When someone you love dies, it's like, 'Why was I mean that time, and why did I say that?'" In her psilocybin experience, they talked together. She apologized for things she'd been carrying. He forgave her.

"I cried for probably five and a half hours," Stem said. "It was hard. It was very hard. I was exhausted by the end of the day."

Two days later, Stem approached her second journey with a different intention: "to be at peace, to be happy, to be calm, to just find joy in life again, rather than be angry and crying all the time."

She wanted to feel like she did as a little girl, carefree and playing on the beach. This time, the medicine took her back to sleeping on her grandparents' screened-in porch after a day in the sand. She asked for her guardian angels to visit.

The two journeys were "a yin and yang," she said—the first heavy and difficult, followed by a lighter and freer experience.

Safety Screening and Professional Oversight

As psilocybin retreats proliferate in Oregon, Colorado, and internationally (Jamaica, Mexico, and Costa Rica have become popular destinations), safety and quality control remain critical concerns.

"Patients considering psilocybin should seek out a qualified practitioner for safety planning, particularly those on prescription medications," said Dr. Lynn Marie Morski, president of the Psychedelic Medicine Association, which educates healthcare providers on the therapeutic use of psychedelics through the lenses of clinical evidence and harm reduction.

Safety planning is especially important "for those with a personal or family history of bipolar disorder, psychotic disorder, or schizophrenia spectrum disorder, or who have active substance use disorder, suicidal ideation, or convulsive disorders," Morski said.

She cautioned that using psychedelics in unsafe contexts—alone at home or under the guidance of untrained or nefarious facilitators—"may not deliver the intended benefits and can pose serious risks of physical harm, psychological distress, or both."

Reputable retreat operators require prospective participants to provide medical and psychiatric histories to screen for conditions, circumstances, and medications that could present safety issues. Some cases are referred to physicians for medical or psychiatric review when additional evaluation is needed.

Morski advises people exploring retreats to ask whether facilitators have training beyond basic psilocybin facilitator certification. Are there licensed therapists, counselors, or social workers on staff? Do they work with a physician who conducts full medical clearance?

At Confluence, three facilitators licensed through the Oregon Health Authority's Psilocybin Services division are present during retreats for eight-person groups, according to founder Myles Katz, who is a licensed facilitator. At least one facilitator is a licensed mental health practitioner.

Much of psilocybin's benefit comes when paired with talk therapy, Garcia-Romeu emphasized. He recommends enrolling in clinical trials for "a safe, medically monitored setting" because some retreat operators may not thoroughly screen for dangerous conditions or medication interactions and may not provide sufficient mental health resources to make the experience positive and effective.

Diverse Motivations, Varied Outcomes

Dozens of people who participated in psilocybin retreats in the US and abroad shared their experiences with CNN. Depression, PTSD, other mental health struggles, grief, and trauma were motivating factors for many. But some were primarily curious or sought "spiritual adventure."

Experiences ranged from profound and life-changing to scary and disappointing. The same substance in different contexts, with different preparation and support, and in different individuals can produce vastly different outcomes.

Most psilocybin administered in Oregon is actually through individual sessions rather than group retreats, according to Oregon Health Authority figures. The model includes preparation beforehand and "integration" afterward—sessions with facilitators to help participants process the experience and apply insights to daily life.

For someone like Stem, traveling from Florida, the multiday group retreat format offered the opportunity for two profound journeys in a peaceful, well-supported environment along with community among fellow participants navigating similar struggles.

Stem emphasized she's not discounting traditional psychotherapy and medication, which helped her for years. "But then it got to the point that talking about it wasn't helping anymore," she said. "I need to change the way I think about things."

Months after her Oregon retreat, Stem reports feeling fundamentally different. The anger and depression that shadowed her for decades have lifted. She's off antidepressants and continues the mindfulness and integration practices she learned.

The Path Forward

Psilocybin appears to be "knocking on the door of FDA approval," Morski said, which would create another pathway to access alongside state regulatory programs.

FDA approval would require psilocybin drugs to be prescribed for specific diagnosed conditions and administered in clinical settings meeting federal standards. State programs like Oregon's and Colorado's allow broader access without requiring formal diagnoses, creating space for personal growth work that doesn't fit neatly into medical categories.

The two systems could coexist, serving different populations with different needs, Ali suggested.

Questions remain about cost and access. Psilocybin retreats are expensive—often thousands of dollars for multiday programs. Insurance coverage is limited, particularly for state-regulated services not treating diagnosed medical conditions. Even after FDA approval, insurance reimbursement policies will shape who can actually access these treatments.

International retreats in countries where psilocybin exists in legal gray areas or is explicitly legal remain popular but carry additional risks around quality control, safety protocols, and legal protections.

For people like Stem who have exhausted traditional treatments and continue suffering, the risks of trying something new feel acceptable compared to the cost of remaining in crisis. The expanding research base and emerging regulatory frameworks suggest psilocybin therapy is transitioning from fringe alternative to legitimate treatment option—though questions about optimal protocols, safety guardrails, equitable access, and long-term outcomes will take years to answer.

In the meantime, thousands of people are making the journey to Oregon, Colorado, and international destinations, seeking relief from conditions that have resisted conventional treatment. Some, like Stem, return transformed. Others find temporary relief or disappointment. All are participating in a massive real-world experiment as psychedelic medicine moves from the margins toward the mainstream.