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Keeping track: outcomes, follow-up and records

People ask whether anyone follows up after a session, how effects are recorded, and whether anyone can tell afterwards what happened. This card sets out what rules and studies report, and what was not located.

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 recommends a dose. Where an amount appears, it is the amount a study reports, not a suggestion. 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 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 medical care. This card describes what sources report. It is not a protocol and it does not say what to do before, during or after a session.

The short answer

Does anyone follow up after a session, how are effects recorded, and can anyone tell afterwards what happened?

Some programs and studies follow up, and what they keep and for how long differs. Oregon and Colorado require licensed facilitators to keep session records and to report adverse events to the state, in different ways. One Oregon research cohort followed 346 clients and has reported three months.

What do official rules report?

Reported practice, not a recommendation. These are the texts of two states' rules as read on 7 November 2026. Each applies only in that state's licensed program.

  • Oregon. Facilitators record for every client the forms, the date and times of each session, the products consumed with amount and whether in one dose or several, and any adverse or post-session reactions. Records are kept five years unless a rule says otherwise. Centers send the state quarterly counts, not individual records: clients, sessions, average dose in milligrams of psilocybin analyte, and adverse and post-session reactions. Clients may ask that their demographic and reason-for-visit data be left out. A post-session reaction is one within 72 hours of release, likely related to the product, that led to emergency contact or medical care. Sources 1, 2, 3, 4 and 5, level 1
  • Oregon, a proposal. A proposal filed on 28 August 2026 would have changed how average dose is reported. The state has since said it will not file final rules from it, and a new process has a planned effective date of 15 January 2027. Source 11, level 1
  • Colorado. Facilitators keep records for each participant, including the product amount and whether in one dose or several, any adverse reactions that needed medical attention or emergency services, and “outcome information, to the extent provided by the participant,” for at least three years. They collect and provide to the state, on request, de-identified data for each participant and each administration, including any reported benefit and any adverse health event. A life-threatening or serious adverse health event is reported to the state within 24 hours. On 17 September 2026 the state held a stakeholder meeting on possible changes to the data collection and adverse event reporting rules, and said no decisions would be made there. Healing centers licensed by the Department of Revenue must report any participant reaction needing medical attention and any incident needing emergency response within two business days, and must submit administration session data at least quarterly, absent a collection mechanism set up by the state health department (rules 3015 and 8035). Sources 6 and 12, level 1

What do studies report?
  • An Oregon cohort, OPEN. The authors write that state mandates for collecting safety events cover only the first three days after services and underestimate actual safety events over time. The cohort enrolled 346 adults, and the paper reports three months, with 90.2% responding. Four serious behavioral adverse reactions (1.2%) were recorded, all in people with no earlier psychedelic use, and facilitator and participant reports often differed. Among those who answered (322 at one week, 312 at three months), self-reported persistent worsening depression attributed to the session was 3.0% and then 4.5%, and persistent worsening anxiety 3.6% and then 2.3%. The authors say the cohort is about 5% of people receiving services in Oregon in that period, and it had no comparison group. Source 7, level 1
  • An online survey outside research. In an anonymous survey of adults planning to take psilocybin outside research, 2,833 completed the baseline and 657 the last survey, 2 to 3 months afterward. Among those who answered, 11% at 2 to 4 weeks and 7% at 2 to 3 months reported persisting negative effects, most often mood fluctuations, and 26% and 50% had taken a further dose. The sample was self-selected and answers could not be verified. Source 8, level 1
  • Which scales are used. A systematic review of 93 clinical-setting trials, with searches to May 2023, found 17 different rating scales for the acute experience, and its authors advised developing a core outcome set. Source 9, 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 and ClinicalTrials.gov. More searching could change the picture.

  • Cohort results beyond three months. Not located.
  • Other states' reporting rules. Not read.
  • Whether follow-up changes anything. Not known.

What this card does not say

  • It does not say anyone should keep records, follow up or report.
  • It is not a standard of care or legal advice.
  • Metanoia holds no one's records.
  • It does not rate how risky, safe or worthwhile any practice is.

Related elements in the Metanoia Exposure Record

These elements of the draft data element set (version 1.1, open for comment until 2 December 2026) ask about the same area. This list makes no claim about what the set covers or leaves out. The exposure record form, completion guide and data dictionary are published with the set. Read the data element set.

Related cards: When a session gets hard, Integration after a session and What a guide or sitter does.

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, official document or primary record. 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. Oregon Administrative Rules, OAR 333-333-5100, Facilitator Record Keeping and Confidentiality. Official rules site. Grade 1. Official rule. Full text, as shown on the Oregon Secretary of State site on 7 November 2026.
  2. OAR 333-333-4820, Record Retention. Grade 1. Official rule. Full text read 7 November 2026 (history: PH 21-2025, effective 1 January 2026). Same page as source 1.
  3. OAR 333-333-4910, Required Reporting of Data. Grade 1. Official rule. Full text (history: PH 21-2025, effective 1 January 2026). Same page as source 1.
  4. OAR 333-333-4900, Collection and Maintenance of 303 Client Data. Grade 1. Official rule. Full text. Same page as source 1.
  5. OAR 333-333-1010 (Definitions, including post-session reaction) and OAR 333-333-5250 (Duration of Administration Session, including the 72-hour contact). Grade 1. Official rules. Both read in full on 7 November 2026. Same page as source 1.
  6. Colorado Office of Natural Medicine Licensure. Natural Medicine Licensure Rules and Regulations, 4 CCR 755-1, section 6 (Standards of Practice) with the editor's notes, as posted by the state as “Rules Currently in Effect” on the Division of Professions and Occupations Natural Medicine page. Grade 1. Official rule text, read in full on 7 November 2026. The editor's notes list an emergency rule effective 5 December 2025 that concerns rule 5.4 only. Other sections were not used. On 8 November 2026 the Secretary of State's official PDF of the same rule was also read, and its current version lists the same emergency rule of 5 December 2025. The two texts were not compared line by line. Also read in full: the state's notice of the 17 September 2026 stakeholder meeting.
  7. Korthuis PT et al. Safety and Mental Health Outcomes of Oregon State-Regulated Psilocybin Services. JAMA Netw Open 2026. DOI 10.1001/jamanetworkopen.2026.30608 PMID 42616497. Grade 1. Prospective single-arm cohort, 346 adults, 3-month results. Full text read 7 November 2026 (appendices not read). The journal posted corrections on 8 September and 16 October 2026. Authors note an uncontrolled design, about 5% of recipients, and Oregon only.
  8. Nayak SM et al. Naturalistic psilocybin use is associated with persisting improvements in mental health and wellbeing: results from a prospective, longitudinal survey. Front Psychiatry 2023. DOI 10.3389/fpsyt.2023.1199642 PMID 37795509. Grade 1. Online survey, self-selected sample, large attrition. Full text read in full on 7 November 2026 (figures not read).
  9. Hovmand OR, Poulsen ED, Arnfred S. Assessment of the acute subjective psychedelic experience: a review of patient-reported outcome measures in clinical research on classical psychedelics. J Psychopharmacol 2024 (online 2023). DOI 10.1177/02698811231200019 PMID 37969069. Grade 1. Systematic review of trials in clinical settings, searches to May 2023. Full text read in full on 7 November 2026 (supplements not read).
  10. Metanoia. Minimum Common Data Element Set for Non-Clinical Psychedelic Exposure Records, version 1.1, draft for public comment, 25 September 2026. Metanoia's own document, not independent. Linked for the reader. No statement in the card text rests on it.
  11. Oregon Health Authority. 2026 Annual Rulemaking, Part One (page read in full), and the Notice of Proposed Rulemaking filed 28 August 2026 (the list of 54 proposed rules and the summary for OAR 333-333-4910 read). Grade 1. Official page and notice, read 7 November 2026.
  12. Colorado Department of Revenue Natural Medicine Division. Colorado Regulated Natural Medicine Rules, 1 CCR 213-1, official PDF of the version effective 12 August 2026 (emergency rule 2026-00359). Grade 1. Official rule text. Rules 3015 and 8035 and all of Part 8 were read in full on 8 November 2026. The other parts were not used. A final rulemaking hearing was listed for 4 November 2026, and its result was not located.