One night in 2019, while strangers vomited around her, Lynn Cohen had a vision.
After being tipped off by a friend, Ms. Cohen, 62, traveled from her home in Milwaukee to Chicago to drink ayahuasca — a sludgy, psychoactive brew from the Amazon that ignites hallucinations while also inducing nausea. She arrived, carrying her own pillow and blanket, at a private house, where she was greeted by a shaman. In the living room, she curled up on a sleeping mat, and over the course of that one very intense night, went on a journey that mostly involved lying still.
“I was shown why I’m not happy, and it became clear I was carrying around the pain of my ancestors,” said Ms. Cohen, a deep-tissue manual therapist who has struggled with depression for 20 years. After that night, she said she found clarity, and has since sought out two other psychedelic retreats, traveling to Costa Rica and California for guided, extended experiences with hallucinogens.
Psychedelic retreats — in countries like Costa Rica and Jamaica, where many psychedelic substances are allowed, as well as among a shadow network of shamans in the United States who share drugs and details over social networks — are experiencing widespread growth. Their rise overlaps with an increasing popularity of cannabis tourism during the pandemic.
Psychedelic drugs are quietly gaining steam, thanks to growing interest among some mental health professionals who see them as a novel therapeutic for depression and post-traumatic stress disorder. That interest is now being wrapped into the global wellness industry, which — spurred by the coronavirus pandemic and the increased mental fragility that has come with it — is set to reach $1.2 trillion by 2027, according to a report by Global Industry Analysts.
There is extraordinary cause for caution: Psychedelics can cause psychosis or long-term mental health issues, particularly in patients with a predisposition to mental illness. This can create a tricky scenario for health care providers to navigate because many people turn to psychedelics after struggling with at least some form of depression or anxiety. And in retreat centers, when guests are not properly monitored, the potential for long-term transformation could have deadly consequences.
“There’s a paradigm shift with psychedelics, which makes them exciting. But we need to go slowly,” said Dr. Collin Reiff, an assistant professor of psychiatry at New York University who has co-authored numerous publications on psychedelic compounds. “The danger is becoming a true believer, and not being mindful of the dangers with them.”
Last year, a 29-year-old British woman went to Peru for an ayahuasca retreat and developed mental health issues upon returning home. She died by suicide shortly after. In 2015, a Canadian tourist said he stabbed to death a fellow practitioner at a psychedelic retreat in the Amazon who had attacked him under the influence of ayahuasca. Three years later, a shaman and another tourist were killed in a double murder at a different retreat nearby. Robberies have also been reported in psychedelic retreat settings, as have sexual assaults. Psychedelic experiences produce immense physical and emotional vulnerability, and some women have said they were molested by shamans while under the influence.
Even with such cause for concern, retreats have been popping up for more than a decade. Today they exist along palm-tree-fringed beaches in Jamaica, where psilocybin mushrooms are openly sold, as well as in the Netherlands, where psychedelic mushrooms are illegal but a legal loophole has kept psychedelic truffles above board. In Mexico, where exceptions are made for sacramental use of psychedelics, travelers can find retreats offering psilocybin as well as ibogaine, a powerful psychoactive that may help combat drug addiction; and in U.S. cities including Santa Cruz, Calif., and Denver, where psilocybin has been decriminalized, plant-medicine ceremonies are regular fixtures. Prices vary, but most run between $5,000 and $10,000 for seven days.
“The entire cultural conversation around psychedelics has changed,” said Ronald Griffiths, a professor at the Johns Hopkins University School of Medicine and founding director of the Johns Hopkins Center for Psychedelic and Consciousness Research. “And that’s a concern to me, because I think we’re underestimating the risks involved,” he said. “The retreat center question is, buyer beware.”
Proponents of psychedelic retreats describe them as places of life-changing transformations, where the drugs are incorporated into day- or weeklong programs that involve preparation, the psychedelic experience itself, and then an integration process that can be applied for weeks and months after. Some retreat attendees recall moments of terror, pain and searing clarity. But for many, there is a common refrain: the drugs, for whatever reason, can kick-start real change in behavior or mental outlook after months or years of stagnation.
Channa Bromley, a relationship expert from Nova Scotia, traveled to OM Jungle Medicine in Costa Rica to participate in an ayahuasca ceremony in December 2020 in hopes of reconciling childhood traumas. At first, she was underwhelmed.
“I didn’t experience much. But what I did get out of it was a feeling of community. I’d always felt like a black sheep in Canada. It’s not a normal conversation to want to explore the depth of your consciousness,” she said.
That sense of community was so stirring that Ms. Bromley is now living in Costa Rica as a digital nomad and attending multiple psychedelic ceremonies a month, where she takes a variety of substances, including psilocybin and kambo, a toxin secreted by tropical frogs.
“There is a lot of blurriness right now between the recreational party scene and the ceremonial plant-medicine scene,” she said. “The mind-set has to be about going into it for healing.”
In the United States, retreat organizers connect with participants via Signal, Telegram and WhatsApp, said Craig Gross, an entrepreneur and former Christian evangelist who has run a number of psychedelic retreats in Northern California. Organizers then rent an Airbnb in a city where drug use is decriminalized. “Someone tells a friend and someone else brings their loved one, and it’s a domino effect,” he said. “You don’t need to advertise.”
Throughout the worst months of the pandemic, Mr. Gross and his family lived at Rainbow Ridge, a psychedelic retreat center near Santa Cruz, offering 30 psilocybin retreats for a handful of people at time. He never charged participants. He has since sold his home, worth $1.3 million, and cashed out his retirement fund.
“The money will come back in different ways,” Mr. Gross said. “We gave this away to over 300 people and the life change that came out of it, it was an evangelistic thing that didn’t need a church or a Bible or a religion.”
“All this stuff that was underground is starting to become above ground,” Mr. Gross said.
Many attendees of psychedelic retreats say that reading Michael Pollan’s 2018 book, “How to Change Your Mind,” which explores the science of psychedelics in treating mental illness, was a turning point. Scott Ropp, 49, a health care executive, is one of them. He attended a psychedelic retreat with his wife, Lena, after reading that book, an event the couple say changed their life, so much so they are now building a resort in Costa Rica.
They hope to open their sustainable rainforest resort, Wilder, in 2023, on the Pacific Coast. Ms. Ropp, a raw foods chef, will run courses on plant-based eating; the retreat will also include a permaculture farm, surfing, mindfulness training and shaman-led psychedelic experiences.
“It’s not just providing fun experiences for people, it’s providing healing experiences,” Ms. Ropp said. “It’s very hard to help your head with just fresh-squeezed juice.”
During the pandemic, some retreat owners said the demand for their services was so high that they continued to offer programs because they felt the benefit outweighed the risk.
Amanda Schendel, 39, opened The Buena Vida Psilocybin Retreats, a collective of roving five- and seven-day psychedelic retreats run from within luxury resorts in Mexico, in January 2019. The retreats include breath work, hypnosis and gourmet food; attendees are screened for cardiovascular and mental health fitness before attending. They shut down in March 2020, but by June were back up.
“The amount of lives that I feel this has saved, and changed in a drastic, meaningful way, made me feel able to take that risk,” Ms. Schendel said. “The people who came in 2020 all felt like, ‘Yes, I know there’s a pandemic and I’m risking my life, but what I have been suffering from is so severe that I’m willing to take that chance.’”
Ms. Schendel works with local tribal medicine healers, who help source the psychedelics as well as dose them for her participants. She requires participants to fill out a medical intake form that screens for mental and physical fitness, then flags any applications that might present a risk and passes them to an on-staff medical doctor. About 10 percent of applicants for her retreats are ultimately not admitted. The entire psychedelics industry needs to be vigilant, she said.
There haven’t been any health emergencies or psychological crises at her resort, she said. “The minute one thing goes wrong or a mistake is made, it could crumble the whole house of cards a lot of us have spent many years building,” she said.
At OM Jungle Medicine in Costa Rica, the managing partner Angel Twedt — a former nurse who believes psychedelics cured her multiple sclerosis — handles logistics and runs the physical space. For dosing the psychedelics at her resort, she, too relies on local shamans, and says she trusts their tribal knowledge.
“There’s something very special about sitting with the tribe that has done this work for many generations,” she said. “Their knowledge comes from a place that is magical, pure and authentic. It makes you feel really safe.”
Dr. Griffiths, of Johns Hopkins, said that while he welcomes the erasure of decades-old stigma around psychedelics, he also urges travelers to ensure that any psychedelic experience is done under the care of a vetted medical team, with proper screening and oversight.
The American Psychiatric Association, said Dr. Reiff, is at work on a policy statement that notes the research on psychedelics is promising but does not yet recommend anyone take them outside of a clinical trial. “By all means, I support psychedelics,” he said. “I think they’re fascinating. But these are medicines, not recreational drugs.”
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