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Alone, at home, or remotely: what has been reported

The question here is whether being alone, at home or connected only by video changes what happens in a session, and what licensing rules say. This card sets out what surveys, a helpline log, a registry record and one state's rules report.

Published Information current to 7 November 2026Review due by 5 February 2027

Read this first. This page is education, not instructions to use. Metanoia does not supply any substance. In the United States, most of the substances discussed here are Schedule I under federal law (21 CFR 1308.11). State programs such as Oregon's and Colorado's operate under state law only, and federal law still applies. Legal status differs between countries, and none of this is legal advice. Nothing here is medical advice, and nothing here gives or recommends a dose. People who host, supply or take part in sessions involving controlled substances can face criminal liability under federal and state law. This page does not advise on that. "Healthy adults" means people with no diagnosed psychiatric or major medical condition, the population Metanoia studies. This page reports what published sources say about work done outside supervised programs, and it takes no position on the legality of any setting, practice or person.
Not an emergency resource. Metanoia is not an emergency service. In a medical or mental health emergency in the United States the number is 911, and the 988 Suicide and Crisis Lifeline is available by call or text. Elsewhere, local emergency numbers apply. Nothing on this card is a reason to delay or avoid care. This card describes what sources report. It is not a screening tool, it does not say who should take part in a session or in what setting, and it is not medical guidance.

The short answer

Does being alone, at home or connected only by video change what happens in a session, and what do licensing rules say?

As far as a documented search found, no controlled or prospective study compared outcomes of sessions taken alone with sessions taken with others, and none compared presence by video or phone with presence in the room. What exists is surveys of self-selected people, a helpline log, one registry record and two states' licensing rules. Oregon's licensed program requires a facilitator in the room and says video cannot meet that requirement. Colorado requires administration sessions to be in person and within Colorado. This card does not say what anyone should do.

What do studies report?

Reported findings, not recommendations. This marking applies to everything in this section. Each finding applies only to the group named, and an association is not a cause.

Surveys and a helpline log

  • Online survey of a hard experience, 2016. Of 1,993 adults recruited on drug-interest forums who described their worst difficult experience with psilocybin mushrooms, 25% were alone and 25% had a guide or sitter. A guide or sitter went with a shorter difficult stretch, not a less severe one. The sample was chosen for a hard experience, so it gives no rate of problems, and alone and accompanied were not compared directly. The authors write that the findings affirm concerns about uncontrolled environments. Source 1, level 1
  • Peer-support helpline log, 2023. Of 1,630 call records from people in the middle of an experience, 39.9% reported being alone, and 77.0% of those were at home. Callers chose to call, the authors are linked to the helpline, and the log does not tie being alone to any outcome. Source 2, level 1

Home and remote designs, and two states' rules

  • Registry record, laboratory study in healthy adults. A Johns Hopkins study of 17 healthy adults is registered as testing, in a laboratory, whether criteria for later home administration of psilocybin microdoses can be met. It is marked completed on 31 July 2026 with no results posted, and it describes no session at home. Source 3, level 1
  • Oregon's licensed program, rules in force. Sessions may take place only in a service center's designated area. A facilitator must be present and keep visual and audio contact with clients, apart from short restroom breaks, and video monitoring or other equipment may not be used to meet that requirement. A separate rule bars licensees from allowing a client to leave the premises with psilocybin products. These rules govern licensed programs only. The state says its 2026 rulemaking round will not produce final rules. Sources 4 and 5, level 1
  • Colorado's licensed program, rules in force. As of 8 November 2026, a facilitator must perform every administration session in person and within Colorado. Preparation and integration sessions may occur while the participant is in another state. Outside a healing center, sessions may be held only at the participant's private residence or at licensed health facilities, only for participants who receive or are eligible for palliative care, are in hospice, live with a disability or are homebound, and only with another facilitator present throughout or a video recording. Source 7, level 1

What is not known?

“Not located” means that the searches Metanoia ran on 7 November 2026 did not return it. They covered PubMed, ClinicalTrials.gov and the Europe PMC preprint index (medRxiv, PsyArXiv, bioRxiv), where titles were scanned. Embase, PsycINFO, Web of Science and Google Scholar were not searched, and papers seen by title only were not read.

  • Whether being alone changes outcomes. No controlled or prospective comparison was located. A 2023 forum survey did compare people reporting “solo” use with group use, but it defines “solo” in more than one way and compares small groups, so this card gives no figure from it (source 6, level 1).
  • How a person present by video or phone compares with one in the room. No study was located.
  • How common solo use is. Every survey above drew a self-selected sample.
  • Traditional solitary practices. No source on this was read in full.

What this card does not say

  • It does not say whether anyone should be alone, at home or remote. It is not a standard of care. A figure from a studied group is not a statement about any person.
  • A friend, partner or therapist as a sitter is a separate entry, not yet written. See what a guide or sitter does and what helpers do when it gets hard.
  • This is not an emergency resource. In the United States, 911 and the 988 line are available.
  • It does not rate how risky, safe or worthwhile any setting is.

Send a correction

If this card reports something wrongly, tell us. Write to main@metanoia-ca.org and keep the card name in the subject line. Accounts of what happened in a session belong in the field reports channel, not in email. Please leave out names and anything that identifies a person or a place. We read every message.

Where does this come from?

Grade key: 1 = peer-reviewed publication or official document. A grade names the type of source, and the design and limits are given in the text. “Read in full” means Metanoia read every sentence on the date given, and any part not read is named.

Review due by 5 February 2027.

  1. Carbonaro TM, Bradstreet MP, Barrett FS, MacLean KA, Jesse R, Johnson MW, Griffiths RR. Survey study of challenging experiences after ingesting psilocybin mushrooms: acute and enduring positive and negative consequences. J Psychopharmacol 2016. DOI 10.1177/0269881116662634 PMID 27578767. Grade 1. Online retrospective survey, self-selected sample. Text and tables read in full 7 November 2026 (figures not read).
  2. Pleet MM, White J, Zamaria JA, Yehuda R. Reducing the harms of nonclinical psychedelics use through a peer-support telephone helpline. Psychedelic Med 2023. DOI 10.1089/psymed.2022.0017 PMID 37360327. Grade 1. Pilot analysis of helpline logs. Text read in full 7 November 2026 (figures not read). The abstract and the body give different caller counts, so this card uses neither.
  3. ClinicalTrials.gov, NCT06450210, Safety for Home Administration of Microdose Psilocybin Use, Johns Hopkins University. Grade 1. Registry record, last updated 13 August 2026. Read in full 7 November 2026, no results section.
  4. Oregon Administrative Rules 333-333-5200 (administration session requirements, version effective 1 January 2026) and 333-333-4500 (licensee prohibitions, version effective 1 January 2025), on the Oregon Secretary of State site, division 333. Grade 1. Official rule text. Both rules read in full 7 November 2026.
  5. Oregon Health Authority, Oregon Psilocybin Services, 2026 Rulemaking. Grade 1. Official page. Read in full 7 November 2026.
  6. Byrne KJ, Lindsay S, Baker N, Schmutz C, Lewis B. In naturalistic psychedelic use, group use is common and acceptable. J Psychedelic Stud 2023. DOI 10.1556/2054.2023.00261 Grade 1. Online survey, convenience sample, not indexed in PubMed. Text and tables read in full 7 November 2026 (figure not read). Cited only for how it defines “solo” and for the size of its groups. The abstract and the body report different odds ratios, so this card gives none.
  7. Colorado Code of Regulations, 4 CCR 755-1, Natural Medicine Licensure Rules, rules 6.14 and 6.18, official PDF of the version effective 5 December 2025. Grade 1. Official rule text. Section 6 read in full on 8 November 2026. Other sections were not used.