Psychedelic Therapy in San Francisco
San Francisco decriminalized natural psychedelics in 2022, making enforcement of personal use a low local priority. That is deprioritization, not legalization: psilocybin remains illegal under California law, with no legal sales or regulated program. Ketamine and esketamine are widely available, and seekers travel to Oregon or Colorado for licensed psilocybin services.
Your paths to care in San Francisco.
Medical ketamine and esketamine (Spravato) in clinical settings. Psilocybin remains illegal under California law.
The Board of Supervisors made entheogen enforcement a low local priority. This is not legalization, and it offers no protection from state or federal law.
Licensed psilocybin services in Oregon and regulated natural medicine in Colorado.
Compare the routes, side by side.
We help you choose clear-eyed.
Our concierge compares legal routes, explains the rules in plain language, and helps you choose a path that matches your needs, values, and safety profile.
Psychedelic care in San Francisco.
San Francisco's Board of Supervisors passed a resolution in 2022 supporting the decriminalization of plant-based psychedelics and making enforcement a low local priority. It reflects the Bay Area's long leadership on psychedelic reform. It is not legalization: psilocybin remains a Schedule I substance under California law, there are no legal sales, and there is no regulated program.
San Francisco has a deep clinical and research ecosystem, including a strong ketamine and esketamine market and major psychedelic research at UCSF. Deprioritization does not protect against state or federal enforcement, and quality varies across providers. For legal psilocybin services, the route runs through Oregon or Colorado, both short trips away.
Our concierge helps you compare these routes, understand the legal picture, review medical and psychological safety, and plan preparation and integration so you are not navigating it alone.
What to budget for.
In San Francisco, IV ketamine commonly runs several hundred dollars per session, with a starting course of multiple sessions, and is usually off-label and out of pocket. Esketamine (Spravato) is often insurance-covered for treatment-resistant depression because it is FDA-approved.
If you travel for licensed psilocybin services, Oregon and Colorado centers set their own session pricing, commonly well over a thousand dollars and sometimes several thousand, usually including preparation and integration. Add travel and lodging.
Ask about HSA or FSA eligibility where applicable. Our concierge fees are separate from any provider's charges; see our pricing page.
Before any session, cover this.
- Share all medications, especially SSRIs and SNRIs, MAOIs, stimulants, and blood-pressure drugs.
- Review cardiac history, seizure risk, bipolar spectrum, psychosis risk, pregnancy, and sleep apnea.
- Confirm monitoring, chaperone policies, and emergency planning with any provider.
- If considering at-home or compounded ketamine, discuss supervision and current FDA alerts with your prescriber.
Learn more about our Safety and Harm Reduction principles.
What we do, and what we don’t.
What we do
- Education, safety screening guidance, and integration support
- Compare legal options and verify licensed programs
- Share the vetting questions we ask any facilitator
What we do not do
- Sell, supply, or store controlled substances
- Instruct on obtaining substances or connect to distributors
- Provide medical or legal advice
A closer look at San Francisco.
A 2022 resolution
San Francisco's Board of Supervisors voted to make entheogen enforcement a low local priority and to urge broader state reform, continuing the Bay Area's leadership on the issue.
Deprioritization is not protection
The resolution does not legalize psilocybin or stop state or federal enforcement. Possession and sale remain illegal under California law.
A research capital
San Francisco anchors major psychedelic research at UCSF and has one of the deepest ketamine and esketamine markets in the country. Quality still varies, which is where vetting matters.
Care today: what people actually do
Most seekers here pursue medical ketamine or esketamine with screening and monitoring, or travel to licensed psilocybin services in Oregon or Colorado. Underground and ceremonial work also exists and carries legal and safety risk. We do not broker illegal activity. We help you compare options and plan safely.
Why this matters
A permissive local stance can blur the legal reality. Our concierge helps you understand what deprioritization does and does not mean, and choose a route that fits your goals and risk profile.
Questions, answered plainly.
Is psilocybin therapy legal in San Francisco?+
No. San Francisco deprioritized enforcement in 2022, but psilocybin remains a Schedule I substance under California law. Deprioritization is not legalization.
What did San Francisco actually do?+
The Board of Supervisors passed a resolution making entheogen enforcement a low local priority and urging state reform. It does not permit sales or create a program.
What legal options are in San Francisco today?+
Medical ketamine (IV or IM, off-label) and esketamine (Spravato) at REMS-certified clinics are legal and available. For psilocybin, the legal route is to travel to licensed services in Oregon or Colorado.
Does the resolution protect me legally?+
No. It affects only local enforcement priorities. State and federal prosecutors are not bound by it, and possession and sale remain illegal.
Can I travel for legal psilocybin services?+
Many people from San Francisco travel to Oregon or Colorado, where supervised psilocybin or natural medicine services are licensed and regulated. Our concierge can help you understand how access works and plan preparation and integration.
How much does ketamine therapy cost in San Francisco?+
IV ketamine commonly runs several hundred dollars per session, with a starting course of multiple sessions. Esketamine (Spravato) is often insurance-covered for treatment-resistant depression because it is FDA-approved. See our pricing page for our concierge fees, which are separate from any provider's charges.
What should I ask a clinic or facilitator before booking?+
Ask about medical and psychological screening, who monitors you during sessions, emergency planning, and what preparation and integration are included. These are the questions we ask any provider before we match you.
Are there medical or medication contraindications?+
Share all medications, especially SSRIs and SNRIs, MAOIs, stimulants, and blood-pressure drugs, and review cardiac history, seizure risk, bipolar spectrum, psychosis risk, pregnancy, and sleep apnea with a qualified provider. This is general information, not medical advice.
Need help choosing? Let’s talk.
Our concierge can walk you through the legal options in your area, with no pressure and no sales pitch.