Psychedelic Therapy in California
Psychedelic-assisted care in California
California has not legalized psilocybin services statewide (SB 58 vetoed in 2023). Some cities—like Oakland and San Francisco—adopted lowest-enforcement-priority resolutions for certain entheogens. Ketamine and esketamine remain medical options. Governor’s veto · Oakland resolution · San Francisco resolution
How people access care
- Legal in California, ketamine in medical settings and esketamine in REMS-certified programs. Ketamine for mental health is off-label. SPRAVATO REMS
- Legal out of state, …licensed psilocybin services in Oregon (our Oregon guide) and regulated options in Colorado (our Colorado guide). Oregon OHA · Colorado DNM
- Underground or ceremonial options exist and carry legal risk. We do not broker illegal activity. Our concierge supports education, safety, and integration.
Not sure which path fits you?
Our concierge team helps you compare legal routes, understand rules in plain language, and choose a path that matches your needs, values, and safety profile.
Your access options
| Pathway | What it looks like | Key notes |
|---|---|---|
| Ketamine or Esketamine (in California) | Medical screening, monitored sessions, integration support recommended. | Esketamine is FDA-approved for TRD via REMS-certified sites. Most mental-health ketamine uses are off-label. Official REMS |
| Psilocybin services (Oregon) | Licensed service centers statewide, with preparation, administration, and integration. | How access works Our Oregon guide |
| Natural Medicine services (Colorado) | Licensed Healing Centers and facilitators under state rules. | Healing Centers · Licensing info Our Colorado guide |
| MDMA-assisted therapy | Not FDA-approved as of September 2025. Access primarily via clinical trials. | FDA CRL publicly released |
| Underground or ceremonial | Community or private settings. Laws and safety practices vary by location. | We do not broker or endorse illegal activity, and we do not instruct on obtaining substances. Our concierge provides education, vetting criteria, and integration support. |
The psychedelic landscape in California
California has a long history of innovation in mental health and integrative care. Several cities, including Oakland and San Francisco, adopted lowest-enforcement-priority resolutions for certain plant and fungal entheogens, while statewide legalization has not passed. Senate Bill 58 was vetoed in 2023. These actions are not licensed therapy or legal commercial sales.
While statewide frameworks evolve, people today most often access care through medical ketamine and esketamine programs, or by traveling to licensed psilocybin services in Oregon or regulated options in Colorado. Our concierge helps you compare routes, understand legal context, review safety, and plan preparation and integration so you are not doing this alone.
References: SB-58 veto · Oakland resolution · SF resolution · SPRAVATO REMS · Oregon psilocybin services · Colorado Healing Centers
Costs and logistics
Ketamine and esketamine, total cost depends on assessment, number of sessions, supervision, and integration. Esketamine occurs only in REMS-certified sites. Coverage varies by plan.
Psilocybin services in Oregon or Colorado, licensed centers set session pricing plus preparation and integration. Add travel and lodging. Verify licensing before you book.
Ask about HSA or FSA eligibility where applicable. Policies vary.
Considering underground or ceremonial settings
Underground and ceremonial options are part of today’s landscape. Laws vary by location, and safety practices differ widely. We do not broker, arrange, or endorse illegal activity. What we do provide is a clear and ethical path to decision making.
- Clarity, compare options side by side, including legal routes
- Safety, medication and history review to discuss with your clinician
- Vetting, facilitator criteria, ethics standards, scope of practice, and boundaries
- Preparation and integration, a plan so you are not doing this alone
Safety and screening
- Share all medications, especially SSRIs, 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
- If considering at-home or compounded ketamine, discuss supervision and current FDA alerts with your prescriber
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 (See our facilitator vetting checklist)
What we do not do
- Sell, supply, or store controlled substances
- Instruct on obtaining substances or connect to distributors
- Provide medical or legal advice
The Psychedelic Landscape in California (Cultural & Legal Overview)
Local momentum
California has been central to the modern psychedelic conversation. Cities like Oakland and San Francisco adopted lowest-enforcement-priority resolutions for certain plant and fungal entheogens. These measures acknowledge community interest and harm-reduction values, but they do not create licensed therapy programs or permit commercial sales.
Sources: Oakland resolution · San Francisco resolution
Statewide developments
At the state level, efforts have been iterative. Senate Bill 58 (2023) sought limited decriminalization but was vetoed, with calls for clearer therapeutic frameworks. As of September 2025, California has not legalized psilocybin services statewide.
Source: SB-58 veto
Care today: what people actually do
Right now, those seeking psychedelic-assisted care in California most often pursue one of three routes: 1) medical ketamine and esketamine programs with screening and monitoring, 2) licensed psilocybin services in Oregon or regulated options in Colorado, or 3) underground or ceremonial work, which carries legal risk and widely varying safety practices.
We do not broker or endorse illegal activity. Our role is to help you compare options, understand legal considerations, review medical and psychological safety factors, and plan robust preparation and integration.
References: SPRAVATO REMS · Oregon psilocybin services · Colorado Healing Centers
Why this matters
California combines research, clinical practice, and community-based healing. As policy evolves, the focus remains on safety, informed consent, equity, and integration. If you are exploring this path, our concierge can help you choose a route that fits your goals, values, and risk profile.
California Psychedelic Therapy FAQs
Frequently Asked Questions
Is psilocybin therapy legal in California?
Short answer: No, California has not legalized psilocybin services statewide.
Senate Bill 58 was vetoed in 2023, so there is no licensed psilocybin therapy program in California today. Some cities, including Oakland and San Francisco, adopted lowest-enforcement-priority resolutions for certain plant and fungal entheogens. That is not the same as legalization or licensed clinics. If you want licensed psilocybin services, people typically travel to Oregon or regulated options in Colorado and verify providers on state pages before booking. See the Governor’s veto and local resolutions for the current picture. Veto letter · SF resolution
What legal options are in California today?
Short answer: Medical ketamine statewide and esketamine in REMS-certified programs.
Clinicians in California can prescribe ketamine, an FDA-approved anesthetic used off-label for mental-health conditions. Esketamine (Spravato) is FDA-approved for treatment-resistant depression and must be administered in REMS-certified sites with monitoring. Expect a medical intake, screening for medications and conditions, supervised dosing, and integration support. Coverage for esketamine depends on your plan, while off-label ketamine is often self-pay. If psilocybin is your goal, most people compare ketamine locally with traveling to Oregon/Colorado for licensed services. SPRAVATO REMS
Can I travel for legal psilocybin services?
Short answer: Yes—Oregon has licensed centers, and Colorado is regulating Natural Medicine services.
In Oregon, sessions occur at licensed service centers with trained facilitators and a required process of preparation, administration, and integration. Colorado is licensing Healing Centers and facilitators; always verify status on state sites. Plan for travel, lodging, and the number of visits recommended by the center. Many clients book preparation and post-session integration with us so their care feels continuous. Start here: Oregon access · CO Healing Centers
Is MDMA-assisted therapy available?
Short answer: Not FDA-approved as of September 2025; access is mainly through clinical trials.
The FDA declined approval in 2024 and publicly released the Complete Response Letter in 2025, so MDMA-assisted therapy is not an approved treatment at this time. If you are exploring this route, most people look for actively recruiting studies and review eligibility, time commitment, and risks in plain language before applying. We can help you understand what participation typically entails and how to plan integration around study requirements. Overview: FDA CRL made public
How much does psychedelic-assisted care cost in California?
Short answer: It varies by pathway, number of sessions, and clinical support.
Costs depend on intake and screening, session length and frequency, route of administration, medical monitoring, therapy time, and integration visits. Off-label ketamine is often self-pay; esketamine is billed through REMS-certified sites and may be covered depending on your plan. Licensed psilocybin services in Oregon/Colorado are paid to the center and include preparation and integration; travel and lodging are additional. We help you compare total program costs and consider HSA/FSA eligibility where applicable. Our Pricing page includes more information about pricing.
Can your concierge help if I am considering a ceremony?
Short answer: Yes—education, safety, and integration support; we do not broker illegal activity.
Underground and ceremonial settings exist, but laws and safety practices vary. We do not sell or supply substances, we do not instruct on obtaining them, and we do not connect clients to distributors. What we do provide is objective education about legal context, rigorous safety screening guidance you can discuss with your clinician, a vetted question set for evaluating facilitators, and a preparation and integration plan tailored to your needs.
What should I ask a facilitator or clinic before booking?
Short answer: Training, screening, supervision, ethics, and integration.
Ask about credentials and scope of practice; medical and psychological screening; supervision during sessions; boundaries, consent, and chaperone policies; emergency plans; and integration support. Clarify the number of sessions, total cost, cancellation policies, and what is included. In licensed settings, verify the center or facilitator on state sites; in community settings, request references and discuss consent and safety in detail. We can share our full vetting checklist during a concierge call. You can download a guide of questions to ask your facilitator prior to your experience Download the facilitator questions checklist.
Are there medical or medication contraindications?
Short answer: Yes—this depends on your history and medicines; always review with a clinician.
Common flags include certain heart conditions, seizure risk, uncontrolled hypertension, bipolar spectrum or psychosis risk, pregnancy, and untreated sleep apnea. Medications such as MAOIs, some SSRIs/SNRIs, stimulants, and blood-pressure drugs may require adjustments or may not be compatible with specific modalities. Licensed programs and ethical facilitators should screen carefully, coordinate with your prescriber, and build a monitoring plan. Our team helps you prepare the right questions for your medical providers.
Next steps
Need help choosing? Our concierge can walk you through legal options in your area.

