Eligibility Criteria

Under Colorado's Natural Medicine Health Act, all clients must meet these basic requirements:

• Age 21 or older

• Complete health screening - All clients undergo a comprehensive health assessment covering personal and family medical history, current medications, and factors that could affect your response to psilocybin.

• Safe transportation plan - You must have arrangements for safe transportation after your administration / journey session (driving yourself is not permitted).

• No diagnosis or prescription required - Unlike traditional medical treatments, you do not need a specific mental health diagnosis or doctor's prescription to access psilocybin therapy in Colorado.

Click this link to access Colorado State Department of Regulatory Agency’s Natural Medicine division.

Click this link to access Colorado State Department of Revenue’s Natural Medicine division.

Click this link to access the City of Boulder’s Natural Medicine department.

Initial Health Screening

Our comprehensive screening aims to address:

• General health history - Overall physical health status

• Mental health background - Personal and family psychiatric history

• Current medications - Including potential drug interactions

• Special needs assessment - Disability accommodations, service animals, spiritual considerations

• Goals and intentions - Your personal reasons for seeking psilocybin therapy

Consultation with a Licensed Facilitator

If you meet our basic eligibility criteria, you'll speak with a licensed facilitator who will:

• Review your unique situation in detail

• Answer questions about the process and what to expect

• Provide personalized recommendations based on your goals, budget, and timeline

• Discuss preparation and integration support

• Help determine the best treatment approach for your needs

Forms

As a newly regulated therapeutic service in Colorado, there is a high need for comprehensive support and consent prior to, during, and after psilocybin therapy. For a sneak peak at the forms each client will need to complete, please click this link.

If our health screening identifies potential risks, you may need to:

• Consult with a qualified medical or mental health provider before proceeding with treatment, AND/OR

• Consult with a qualified pharmacist who can provide comprehensive pharmacalogical assessment and advice services, AND/OR

• Work with one of our licensed clinical facilitators who can safely work within the scope of your specific risk factors

We will help you every step of the way.

Colorado's Natural Medicine Health Act of 2022 established a comprehensive framework that both decriminalized personal use of certain natural psychedelic substances for adults 21 and older and created a regulated system for psilocybin-assisted therapy through licensed healing centers. This groundbreaking legislation made Colorado the second state to legalize therapeutic psilocybin services while simultaneously removing criminal penalties for personal possession and use of specified natural medicines.

Personal Use Laws - A Synapsis

Colorado has decriminalized personal use and possession of certain natural psychedelic substances for adults 21 and older, but this is separate from the regulated therapy system. Here's what you need to know:

Decriminalized Substances (as of 2023):

• Psilocybin and psilocin (magic mushrooms)

• Dimethyltryptamine (DMT)

• Ibogaine

• Mescaline (excluding peyote, which remains protected for religious use)

What Decriminalization Means:

• Personal possession and use by adults 21+ is no longer a criminal offense

• You cannot be arrested or prosecuted for simple possession of these substances

• Sharing small amounts between adults 21+ without compensation is allowed

• Growing psilocybin mushrooms for personal use is permitted

What Remains Illegal:

• Sale or distribution for profit outside the regulated therapy system

• Public use - consumption must be on private property

• Possession by anyone under 21

• Driving under the influence of any psychedelic substance

• Use on federal property (remains federally illegal)

Important Distinctions:

• Decriminalization ≠ Full Legalization: While you won't face criminal penalties, these substances aren't regulated consumer products

• No Commercial Sales: You cannot buy psychedelics from shops or dispensaries for personal use

• Workplace Policies: Employers may still prohibit use and test for these substances, including the US Military

• Federal Jurisdiction: Federal law enforcement can still prosecute, yet it is not known how likely this is

Key Considerations:

• Personal use occurs without the safety protocols, medical screening, or professional guidance available in licensed healing centers

• There are no quality control or dosing standards for substances obtained outside the regulated system

• Legal protections are strongest within Colorado's therapeutic framework

While personal use is decriminalized, the regulated therapy system provides the safest, most legally protected pathway for psilocybin experiences with professional support and medical oversight.

Regulated Model for Psilocybin-Assisted Therapy in Colorado - A synapsis

Colorado's Natural Medicine Health Act prioritizes ethical and safe use through comprehensive regulatory requirements and a harm reduction approach. Here's how safety is built into the system:

Facilitator Training & Certification:

• Licensed facilitators must complete extensive training programs

• Ongoing education requirements ensure current best practices

• Emphasis on harm reduction principles in all therapeutic approaches

Regulated Environment:

• All sessions must occur in licensed, inspected healing centers

• Strict protocols for dosing, preparation, and integration support

• Medical screening and contraindication assessments are required

Harm Reduction Focus:

• Facilitators are trained to minimize risks and maximize therapeutic benefits

• Emphasis on set, setting, proper preparation and integration, and high quality products

• Integration support to help process experiences safely

• Clear protocols for managing challenging experiences

Oversight and Accountability:

• Regular inspections of healing centers

• Reporting requirements for adverse events

• Ongoing monitoring of facilitator practices

• Quality control standards for psilocybin products

Client Safety Protocols:

• Thorough intake processes and health screenings

• Contraindication assessments (mental health, medications, medical conditions) - see below

• Preparation sessions to ensure readiness

• Integration support following sessions

This comprehensive framework ensures that psilocybin therapy in Colorado maintains the highest standards for safety, ethics, and therapeutic effectiveness while prioritizing participant wellbeing through evidence-based harm reduction practices.

A contraindication is an evidence-based reason why a particular treatment or medication should not be used because it could be harmful or dangerous for that specific person. Furthermore, there are different levels of contraindications for psilocybin therapy, as there are different degrees of risk based on those variables.

Absolute Contraindications are situations where a treatment should never be used under any circumstances because the severe and potentially life-threatening risks involved make the intervention unacceptable. Absolute contraindications are contraindications for which there are no reasonable circumstances for undertaking a course of action.

Relative Contraindications are situations where a particular treatment or procedure should be used with caution. The risk of using the treatment or procedure is acceptable because the benefits likely outweigh the risks. These conditions require careful evaluation and enhanced monitoring but don't automatically exclude treatment.

For your education (not providing medical advice), the following exclusion criteria listed here further break down “absolute” and “relative” contraindications based on psychological conditions, medical conditions, and medication-based (drug to drug interactions) conditions for psilocybin therapy.

Your safety is our top priority. While psilocybin is considered safe for most people, we cannot provide services under any of the following conditions based on Colorado law:

• Under 21 years of age

• Currently pregnant or breastfeeding

• Allergic reaction to mushrooms or other fungi in the past

• Recent lithium use - Any form of lithium within the past 14 days

Not sure about how your current medications may impact your psilocybin journey? We recommend consulting with Kristin Speer, PharmD (she/her) and her Interaction Checker (linked here).

The determination of safety ultimately depends on comprehensive clinical assessment by qualified healthcare providers who can evaluate individual risk factors, family history specifics, and other relevant medical and psychological factors. Each case requires individualized professional medical evaluation rather than blanket exclusions based solely on family history. If you have family history of these psychological conditions, it is best to consult with a qualified medical professional prior to pursuing psilocybin therapy.

Absolute Contraindications:

• Personal or first-degree family history of Schizophrenia

• Personal or first-degree family history of psychotic disorder (i.e., schizotypal personality disorder, delusional disorder, brief psychotic disorder, schizophreniform disorder, schizoaffective disorder, substance/ medication induced psychotic disorder, catatonia, and any psychotic disorder due to another medical condition)

• Current or recent thoughts of self-harm or harming others

• Personal or first-degree family history of bipolar disorder and/or mania episodes (recognized or suspected)

• Personal or first-degree family history of major depressive disorder with psychotic features

• Psychiatric condition judged to be incompatible with establishment of rapport with therapy team and/or safe exposure to psilocybin, e.g. borderline personality disorder

Relative Contraindications:

• Current or previous experience with Hallucinogen Persisting Perception Disorder (HPPD)

• Previous Adverse Events Related to Prior Psychedelic Use

In many psychedelic research protocols:

• First-degree relatives mean biological parents, siblings, children with schizophrenia, bipolar disorder, or psychotic disorders, and typically constitute exclusion criteria

• Second-degree relatives mean biological grandparents, aunts, uncles, half-siblings are generally not considered grounds for automatic exclusion, though this may vary by protocol and study

• Third-degree relatives mean biological cousins, great-grandparents and beyond are typically not considered relevant for screening purposes

The scientific rationale for these exclusion criteria is largely based on genetic risk factors. At baseline, having a first-degree relative with a psychotic disorder increases an individual's risk for developing psychosis to 10% compared to 1% in the general population (see Santestaban-Echarri et al., 2022). Leading safety guidelines on clinical trials involving psychedelics recommend that individuals with a personal or family history of psychotic or bipolar disorders be excluded due to concerns that psychedelics such as psilocybin and LSD can evoke a lasting psychotic reaction, more often in people with a family history of psychosis (see Honk et al., 2024; and, Tullis, 2021).

Regarding HPPD, if you have a previous history of HPPD, this could represent a significant “relative contraindication” as psilocybin could potentially trigger or worsen persistent perceptual disturbances. Careful risk-benefit analysis and extensive patient counseling about the possibility of symptom recurrence or exacerbation would be essential before considering treatment.

Additionally, history of severe psychological distress, prolonged anxiety, or other negative reactions to psychedelics indicates increased risk for similar responses. However, these experiences don't automatically exclude someone from therapy if they occurred in uncontrolled settings, as the structured, supervised environment of legal psilocybin therapy may significantly reduce these risks.

Medically based exclusion criteria from many studies investigating psilocybin assisted therapy include the following:

Absolute Contraindications

Cardiovascular Conditions

Psilocybin can cause temporary increases in blood pressure and heart rate, making certain cardiovascular conditions exclusionary in clinical trials. Psilocybin appears to be relatively safe for the heart when used at typical therapy doses (around 25 mg), with the most common effects being temporary increases in heart rate and blood pressure that usually don't require medical treatment.

While rare, serious heart complications like heart attacks or heart failure have been reported, mainly when people took very high doses or had existing medical conditions. Research shows there's a good safety buffer at normal therapy doses - you'd need to take 500 times more psilocybin to cause serious heart problems in most people. Since the risks to your heart increase with higher doses, it's important that licensed facilities monitor your heart activity during sessions to ensure your safety throughout the treatment.

This is why proper medical screening and heart monitoring are essential parts of safe psilocybin therapy - to make sure you're a good candidate and to keep you safe during your session. Here are a couple of peer-reviewed papers for you and your medical provider to read in your consideration of this therapy:

• See Wsół (2023): Cardiovascular safety of psychedelic medicine: current status and future directions (click on link)

• See Nahlawi et al. (2025): Cardiovascular effects and safety of classic psychedelics (click on link)

Seizure Disorders

The combination of lithium and psilocybin can cause seizures, especially in people who are prone to seizures. This indicates that individuals with existing seizure disorders or those taking seizure-lowering medications may face exclusion or require special medical consideration.

• See Nayak et al. (2024): Classic Psychedelic Coadministration with Lithium, but Not Lamotrigine, is Associated with Seizures: An Analysis of Online Psychedelic Experience Reports

• See Simonsson et al. (2022): Prevalence and associations of classic psychedelic-related seizures in a population-based sample

Allergy to Fungi

While rare, individuals with documented allergies to mushrooms or other fungi may have allergic reactions to psilocybin-containing mushroom preparations. Synthetic psilocybin may be preferred in these cases, but the supportive research for synthetic forms of psilocybin are still being researched for their effectiveness and efficacy, and they are not yet available in the Colorado framework. Comprehensive allergy testing may be needed to determine if the reaction was to psilocybin itself or other mushroom compounds.

General Medical Exclusions

Clinical trials tend to have a comprehensive list of criteria that excludes patients from participating in studies or trials investigating the therapeutic potential of psilocybin. Of particular concern are lithium use in the past 30-60 days, uncontrolled hypertension, severe heart failure or heart disease, recent myocardial infarction or stroke (within the past 6 months), and active seizure disorders. Given these are considered “absolute” contraindications, it will be a requirement to have a comprehensive medical evaluation completed by your medical provider prior to engaging with any therapies related to psychedelics.

Relative Contraindications

Controlled Hypertension

Patients with well-managed hypertension may be candidates for psilocybin therapy with enhanced cardiovascular monitoring, as the transient increases in blood pressure that psilocybin creates are typically manageable in stable patients. The temporary nature of psilocybin's cardiovascular effects makes controlled hypertension a relative rather than absolute contraindication, requiring careful pre-screening and continuous monitoring during sessions.

Recent Cancer Diagnosis

Psilocybin was granted Breakthrough Therapy status by the FDA for treatment of major depressive disorder (Heal et al., 2024) in 2019, and is currently being researched similarly for the treatment of anxiety and depression associated with cancer diagnoses. However, recent diagnosis of cancer may require careful coordination with oncology care teams to ensure treatment timing doesn't interfere with cancer therapies and that the patient's overall health status can tolerate the physiological stress of a psychedelic experience.

Liver and Kidney Diseases

Since psilocybin is metabolized in the liver to its active form psilocin and eliminated through renal pathways, impaired liver or kidney function could affect drug clearance and increase risk of prolonged or intensified effects. Patients with mild to moderate hepatic or renal impairment may still be candidates with dose adjustments and extended monitoring, while severe dysfunction would likely constitute an absolute contraindication.

Medication-based exclusion criteria from studies investigating psilocybin assisted therapy and clinical best practices include the following:

Absolute Contraindications

Lithium

All formulations of lithium carbonate and lithium citrate represent absolute contraindications due to severe seizure risk and life-threatening serotonin syndrome. The combination of lithium and psilocybin can cause seizures, especially in people who are prone to seizures and when taken with psilocybin, lithium can cause a dangerous increase in serotonin levels, leading to serotonin syndrome. Complete discontinuation tends to be required along with close medical supervision, and lithium's long half-life necessitates an extended washout period. No safe concurrent use has been established, making this a true absolute contraindication regardless of dosage or timing.

• See Nayak et al. (2024): Classic Psychedelic Coadministration with Lithium, but Not Lamotrigine, is Associated with Seizures: An Analysis of Online Psychedelic Experience Reports

Atypical Antipsychotics

Risperidone, olanzapine, quetiapine, and aripiprazole may significantly block or diminish psilocybin's therapeutic effects through serotonin receptor antagonism, though they don't seem to create direct safety risks. Washout timing varies considerably by medication half-life - quetiapine (shorter-acting) versus olanzapine (longer-acting) - but discontinuation must always be medically supervised due to withdrawal risks and potential psychiatric relapse. The primary concern is therapeutic efficacy rather than safety.

• See Downey et al. (2024) A Plea for Nuance: Should People with a Family History of Bipolar Disorder Be Excluded from Clinical Trials of Psilocybin Therapy?

• See Kim et al. (2025) The many faces of psilocybin-related psychosis: A case series

Relative Contraindications

SSRI / SNRI Antidepressants

Sertraline, fluoxetine, paroxetine, citalopram, escitalopram, venlafaxine, and duloxetine significantly reduce psilocybin's therapeutic effectiveness while creating mild serotonin syndrome risk. SSRI / SNRIs appear to weaken psilocybin drug effects relative to a non-serotonergic antidepressant, and the combination of psilocybin with SSRIs or SNRIs may increase the risk of serotonin syndrome. The current consensus suggests a period of 4-6 weeks following the tapering off of SSRIs to ensure optimal results, though SSRIs typically require tapering off over a timeframe this is specific to your needs. The dampening effect on psilocybin may persist for up to 3 months following discontinuation, requiring careful timing considerations.

• See Goodwin et al. (2023) Psilocybin for treatment resistant depression in patients taking a concomitant SSRI medication

• See Gukasyan et al. (2023) Attenuation of psilocybin mushroom effects during and after SSRI/SNRI antidepressant use

• See Erritzoe et al. (2024) Effects of discontinuation of serotonergic antidepressants prior to psilocybin therapy versus escitalopram for major depression

MAOIs (Monoamine Oxidase Inhibitors)

Phenelzine, tranylcypromine, isocarboxazid, and selegiline can create life-threatening risk for serotonin syndrome when combined with psilocybin. There is the small possibility of serotonin syndrome if MAOIs are combined with psilocybin, and caution is advised, especially when combining psilocybin with MAOIs, due to the increased risk of serotonin syndrome. A minimum 2-week washout period tends to be required by medical providers due to irreversible enzyme inhibition, as the risk persists until new MAO enzymes are synthesized. The potentially fatal nature of serotonin syndrome with this combination makes MAOIs an absolute contraindication.

• See Santestaban-Echarri et al. (2022) Family history of psychosis in youth at clinical high risk: A replication study

• See Barnett et al. (2025) Hypertensive Emergency Secondary to Combining Psilocybin Mushrooms, Extended Release Dextroamphetamine-Amphetamine, and Tranylcypromine

• See Sarparast et al. (2022). Drug-drug interactions between psychiatric medications and MDMA or psilocybin: a systematic review

Tricyclic Antidepressants

Amitriptyline, nortriptyline, and imipramine create moderate risk for serotonin syndrome and additive cardiac effects. These medications typically require a 1-2 week washout period for safe psilocybin administration, though enhanced cardiac monitoring may be necessary given the potential for additive cardiovascular effects. The relatively shorter half-lives of most tricyclics make them more manageable relative contraindications compared to SSRIs.

• See Sarparast et al. (2022). Drug-drug interactions between psychiatric medications and MDMA or psilocybin: a systematic review

Benzodiazepines

Lorazepam, alprazolam, clonazepam, and diazepam can significantly blunt or completely abort the psychedelic experience, as they're commonly used as "trip killers" in emergency situations. Washout timing depends on half-life: short-acting benzodiazepines (24-48 hours) versus long-acting formulations (1-2 weeks for complete clearance). Their presence may render psilocybin therapy ineffective, making timing coordination essential for therapeutic success.

• See Nicholas et al. (2024) Co-administration of midazolam and psilocybin: differential effects on subjective quality versus memory of the psychedelic experience

• See Hibicke et al. (2024) Preadministration of Lorazepam Reduces Efficacy and Longevity of Antidepressant-Like Effect from a Psychedelic

Timing-Specific Considerations

Post-Anesthesia Recovery

Recent general anesthesia (within 24-48 hours) represents a timing-specific relative contraindication due to residual anesthetic effects and compromised cognitive baseline. Complete recovery from anesthetic agents should be ensured before psilocybin administration to avoid unpredictable interactions and ensure accurate assessment of psilocybin's effects versus residual anesthetic influence.

• See Emerick et al. (2024) Perioperative Considerations for Patients Exposed to Hallucinogens

GLP-1 Receptor Agonists

Semaglutide (Ozempic, Wegovy), liraglutide, and tirzepatide create unique challenges due to delayed gastric emptying leading to unpredictable psilocybin absorption and significantly delayed onset. People on ozempic and other weight loss drugs don't absorb magic mushrooms effectively, and "Ozempic stomach paralysis" means delayed gastric emptying or gastroparesis, in which the stomach takes too long to empty. CLP-1 medications may require alternative administration routes, extended observation periods, or modified dosing protocols, as standard timing expectations for onset and peak effects may be significantly altered.

• See Sarparast et al. (2022). Drug-drug interactions between psychiatric medications and MDMA or psilocybin: a systematic review

Polypharmacy

Concurrent use of 5 or more medications increases the likelihood of unknown drug interactions, compromises hepatic metabolism, enhances risk of adverse events, and creates difficulty isolating causation of side effects. Comprehensive medication review with clinical pharmacist consultation is recommended for all polypharmacy cases to identify potential interactions and develop appropriate monitoring protocols.

Not sure about how your current medications may impact your psilocybin journey? We recommend consulting with Kristin Speer, PharmD (she/her) and her Interaction Checker (linked here).

Our facilitators may be able to provide enhanced services for clients who are:

• In hospice or receiving palliative care

• Homebound due to medical conditions

• Living with disabilities that require special accommodations

These clients may be eligible for in-home or healthcare facility sessions with additional safety protocols. Contact us directly to inquire more.

If none of the exclusion conditions above apply to you, you're likely a good candidate for our services!

The next step is to contact us using the form below to schedule a consultation with one of our facilitators. This confidential conversation will help us understand your unique needs and determine the best path forward for your healing journey.

All health information is kept strictly confidential and is used solely to ensure your safety and optimize your therapeutic experience. The Clearing is licensed under Colorado's Natural Medicine Health Act and operates in full compliance with state regulations.