If you are considering this for yourself
Work through the six questions above in order. They are sequenced so the ones that can rule you out come before the ones that cost you money.
Six questions, in the order that matters
Sequenced so the questions that can rule you out come before the ones that cost you money. Each has a short answer here and a longer one behind it.
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The short answer
Work through these in order: is it legal where you live, does the evidence support it for your condition, is it medically safe for you, could you join a trial, what would it cost otherwise, and what helps if the answer is no. Only 2 US states run a legal supervised-access program, so for most readers the honest route is a clinical trial — 133 are recruiting — or none of the above. This page exists because that last outcome is the common one and every other site in this category stops before it.
Is it legal where I live?
Almost certainly not, and this is the question that gates every other one.
Two states run supervised-access programs. Everywhere else in the United States, psilocybin is a controlled substance under state law and a Schedule I substance under federal law regardless of where you are. A city that has decriminalized it has not made it lawful. Start here because the answer changes what the rest of this site can offer you.
Does the evidence support it for what I have?
That depends enormously on the condition, and the honest answers range from strong to none.
Alcohol use disorder has the best-designed trial in the field. Depression has the largest evidence base and the most misreporting. PTSD has no published trial data for psilocybin at all. Dementia has two studies, neither testing psilocybin as a treatment. Read the one that applies to you rather than a general claim about psychedelics.
Is any of this safe for me specifically?
The risks are concentrated in identifiable groups, and you may be in one.
A personal or family history of psychosis or bipolar I is an exclusion in essentially every trial, for good reason. Lithium and MAOIs are the clearest drug interactions. Population-level safety data says nothing about any of that. This step comes before cost and before trials because it is the one that can rule you out on medical grounds no program will override.
Could I join a trial?
Possibly, and it is the only route that is free and available in most states.
Trial participation costs nothing and is often compensated. The catch that disqualifies most people is not obvious from the listings: roughly a third of open trials require you to come off psychiatric medication first. Every entry in our registry flags that, which is most of the reason the registry exists.
What would it cost if I paid for it?
Between $1,000 and $3,500 a session, entirely out of pocket.
No insurer covers psilocybin services anywhere in the United States. The price is labor rather than medicine — a trained facilitator present for six to eight hours, plus preparation and integration. Anyone offering the same thing much cheaper has removed the part that makes it safe.
What if the answer is no?
For most people reading this, it is — and that is where most sites stop.
Not legal where you live, not eligible for a trial, not able to spend three thousand dollars, or ruled out on medical grounds. That is the common case, not the edge case. There are things that help in the meantime and they are worth more than waiting, so this page exists rather than leaving you at a dead end.
Three ways in
Depending on why you are here
The same facts serve a patient and a policy analyst badly when they are written as one undifferentiated stack.
If you are a clinician
The evidence pages carry effect sizes with their confidence intervals and name the trials that missed their primary endpoints. The corrections ledger is the fastest way to see what your patients have been reading.
If you work in policy, insurance or research
Two maintained datasets — 51-jurisdiction legal status reviewed by hand, and the recruiting-trials registry pulled from ClinicalTrials.gov — both dated, both sourced, both licensable.
What makes this path different
Most sites in this field publish something that looks like this page and is built differently underneath. The usual sequence runs find medicine, prepare, microdose, choose a facilitator, integrate — and it has the answer written into it before you have asked anything. It assumes you are going to take psilocybin, and each step moves you closer to a booking.
This one is a decision path, and three of the six steps can send you somewhere other than a session — because your state sets the route, because your medical history settles it, or because the open trials call for a different profile than yours. Each of those is a real answer, arrived at early and cheaply. The sixth step is built for exactly those readers, since that is where most people land, and a path that can only go one way is a funnel wearing a map.
Common questions
Questions people ask first
Where should I start if I am new to this?
With whether it is lawful where you live, because that answer changes what everything else on this site can offer you. Two US states run supervised-access programs; everywhere else psilocybin remains a controlled substance under state law and a Schedule I substance federally. After that: what the evidence shows for your specific condition, whether it is medically safe for you, whether you could join a trial, what it would cost otherwise, and what helps if none of those work out.
What is the cheapest legal way to access psilocybin in the US?
A clinical trial. Participation costs nothing and is often compensated, and trials run in states with no legal program at all. The obstacle is eligibility rather than money: around a third of open trials require participants to stop psychiatric medication beforehand, and a personal or family history of psychosis or bipolar I disorder excludes you from essentially all of them.
How do I know if psilocybin is safe for me?
You do not, from a website, and that includes this one. What a page can tell you is which groups the trials excluded and why — psychosis or bipolar I in you or your family, lithium, MAOIs, uncontrolled cardiovascular disease. If any of those apply, the question is settled without needing a clinician. If none do, it is still a conversation with one.
What if psilocybin is not available to me?
That is the common outcome rather than the exception, and it is worth planning for rather than waiting through. Most people reading about this are in a state with no legal program, ineligible for the trials near them, or unable to spend several thousand dollars out of pocket. Our support page covers what has evidence behind it in the meantime.