Who Sets the Ethical Standards for Psychedelics Now?

In the rapidly shifting landscape of drug policy reform, the boundary between legal facilitation, clinical research, and clandestine practice is becoming increasingly blurred. As access to psychedelics for medical, spiritual, and recreational use continues to expand, the conversation surrounding ethics across every level of the psychedelic ecosystem has moved from a peripheral issue to one of the most urgent in the movement. 

At this point, we’ve all heard the cautionary tales of unethical use and administration, which is almost always compounded by an absence of meaningful oversight. Instances of abuse (whether that be physical, spiritual, or financial) and a lack of accountability in both clinical and underground settings have served as a sobering reminder of the power dynamics inherent in the facilitation of psychedelics.

However, a new paradigm is beginning to emerge. An increasing number of psychedelic community leaders and grassroots organizations are refusing to wait for federal legalization to implement safeguards. Instead, they are proactively integrating diverse ethical frameworks into the foundation of the psychedelic “semi-underground," which comprises both legal avenues for psychedelic care and those that fall outside the bounds of established law.

Ethical care and conduct in psychedelic contexts doesn’t just refer to the dynamic between facilitator and client. It also extends to including marginalized voices — such as Indigenous communities and identity-informed care practitioners —  in shaping the future of psychedelic medicine, policy, religion, and more. As the public’s appetite for these big, transformative experiences grows, the success of ethical initiatives may ultimately determine whether the underground can transform into a sustainable, respected pillar of the broader psychedelic movement.

One of the clearest stress tests for these ethical commitments is now playing out within the sphere of organized religion. Many emerging New Age and non-denominational religious institutions now claim certain psychedelic plants, fungi, and compounds as religious sacraments. While some psychedelic churches operate openly through brick-and-mortar locations and formal membership structures, others have evolved from earlier models that relied on what critics describe as a “donation loophole,” shifting instead toward programs centered on spiritual preparation and integration. Although most U.S. psychedelic churches currently operate outside federal law due to facilitating Schedule I substances, a small number have received religious exemption from the Drug Enforcement Administration’s (DEA) Controlled Substances Act to administer compounds like ayahuasca and peyote specifically to their congregants.

The Congregation for Sacred Practices (CSP), a Washington, D.C.-based psychedelic church, made waves last year by becoming the world’s first accredited psychedelic seminary. This designation makes the church a higher education institution that can formally ordain psychedelic ministers. Beyond enforcing a robust code of conduct for its ministers and members, CSP is recognized as a higher education institution by the Global Accreditation Council  (GAC), an international accrediting body in the Netherlands dedicated to transformational learning and to advancing new standards for higher education. Through its seminary, CSP offers a four-year, experiential minister training program, with optional graduate degrees including a Master of Arts or a doctorate in divinity or entheogenic studies.

As part of their broader academic offerings, CSP has created a new Ethics Certificate program for the general public. The first cohort begins in July 2026 and will feature in-person meetings, online sessions, and community engagement. “[The program] answers a psychedelic hunger for honorable practitioners in a field too often marked by boundary violations, spiritual manipulation, and quiet forms of abuse,” said CSP Founder Paul Ryder. “[It] calls entheogenic ministers and practitioners to build their own ethical compass and enter into the right relation – with power, with consent, with the psyche, and with the sacred – because sacraments demand integrity and community cannot flourish without trust." 

Meanwhile, in the clinical world of legal psychedelic care, ketamine-assisted therapy practitioners across the United States are seeking to incorporate the traditions of their underground predecessors into modern clinical care. Earlier this month, Beyond Consulting and Dr. Stephanie Karzon-Abrams launched Galilea, a multidisciplinary protocol designed to integrate hormonal and menstrual cycle-informed care into already existing psychedelic-assisted healthcare systems. By utilizing biological and hormonal data, the method creates personalized treatment plans that may include ketamine and psilocybin-assisted therapies tailored to a patient’s specific life stage and nervous system.

Karzon-Abrams’ work as a neuropharmacologist, clinical researcher, and ethicist gives her a unique perspective on the importance of weaving ethical and representation-aligned practices into next-gen mental healthcare organizations. She told Doubleblind that her work as a practitioner is inspired by a personal respect for the ancient wisdom of plant medicine stewards and the glaring disparities in access to gender-informed mental health treatment options in the United States.

“There is so much care, reverence, and harm reduction already existing outside [of these] institutions,” she added. “Clinical settings should aim for cultural fluency and specialization, ensuring that safety, informed consent, and long-term integration are as central as the molecule itself…Paradoxically, ethical practice demands both personalization and structure. Context is key in medicine, and ethics live in how we hold people, not just how we dose them."

But questions of ethics do not stop at the clinic. As Indigenous traditions are rapidly integrated into Western spiritual and clinical frameworks, concerns regarding the exclusion of Indigenous voices persist. Recently, Indigenous leaders in Colorado alleged the state’s Natural Medicine Health Act was developed without their meaningful participation, leading to policies they say prioritize commercialization over the protection of sacred traditions. While critics argue the exploitation of Indigenous voices is common in modern reform, some organizations are actively seeking to combat appropriation by investing directly in these communities.

The Center for Shamanic Education and Exchange (CSEE), an Austin-based nonprofit, is among those organizations. It has operated for nearly 20 years to support Indigenous-led projects that fortify spiritual foundations. Through art exhibitions and public events, CSEE Founder Mary Olivar told DoubleBlind that the organization helps illuminate how Indigenous practitioners have used psychedelic plants for millennia with ethical clarity and cultural accountability. "Benefit sharing is not a concept but a practice – funds raised are returned directly to Indigenous communities stewarding living traditions," said Olivar, the founder of CSEE. Olivar, who also serves as executive director of the ACT Conference, noted that these lineages “offer essential guidance for contemporary practitioners operating beyond Western medical frameworks.”

Beyond Colorado’s borders, Indigenous reciprocity within legal, state-regulated psychedelic care programs is being addressed in real time in New Mexico. In 2025, the state Legislature passed the nation’s first regulated psilocybin-assisted therapy program, marking a departure from the ballot-initiative process used in other states. During the New Mexico Psilocybin Advisory Board’s inaugural meeting on December 5, 2025, State Sen. Jeff Steinborn – a co-sponsor of the New Mexico Medical Psilocybin Act – urged board members and the public to view the regulatory process as an opportunity to innovate. Steinborn said the state should strive "to make things better than maybe they've been in other states," noting that some jurisdictions may have "gone down a road that hasn't been as fruitful that we need to deviate from."

Indigenous leaders in New Mexico have responded to that call by advocating for the integration of traditional practices into the program’s foundation. Marlena Robbins, director of the Indigenous Research Fellowship Program at the UC Berkeley Center for the Science of Psychedelics, is working with several tribal groups to determine how to best incorporate longstanding Indigenous protocols into the state’s regulated access model.

"For countless generations, Indigenous peoples have maintained North–South trade routes and systems of shared knowledge long before political borders existed,” said Robbins in a statement provided to DoubleBlind. ”New Mexico now has a unique opportunity to reconnect with Indigenous relatives to the south, whose ceremonial relationships with mushroom medicines remain intact.” This, in turn, will help establish ethical, Indigenous-led standards for psychedelic education and care.

This emerging thread of ethical experimentation and organizational restructuring suggests that the future of the psychedelic movement may hinge not only on federal policy, but also on the ability of the semi-underground to establish clear, shared, and enforceable standards of ethical conduct. Ultimately, the long-term success of the psychedelic movement will be measured by its ability to ensure safety, integrity, respect, and diverse care.

So how do we develop and maintain this delicate order? Karzon-Abrams says it’s to recognize and adapt to the complexities facing the evolving psychedelic zeitgeist.

“There is no such thing as a neutral container. Every space carries meaning, and every person arrives with a different history, nervous system, and need, which is why one-size-fits-all facilitation won't lead to lasting change.”

Note: This article was produced in partnership with Psychedelic State(s) of America - a nonprofit-sponsored news organization dedicated to rigorous independent psychedelic journalism. Learn more about PSA’s Media Partnerships Program and the PSA Media Fund here.

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