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Screening before a session: what programs ask and why

People ask what programs want to know about a person's health before a session, and whether asking changes what happens. This card sets out what guidelines, studies and state rules 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 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 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 screening tool and it does not say who should take part in a session.
For people using without a guide. This card shows what programs ask about health before a session. Research guidelines, retreat organizations, practitioners and two US state programs describe a health intake before a session, and what they ask overlaps on mental-health history, some physical conditions, medicines and pregnancy. Oregon's rules require a client information form and Colorado's rules a written screening tool, and each applies to its own program only. As far as a documented search found, no study has compared outcomes with and without screening. This card is not a screening tool, and nothing here concerns starting, continuing or stopping any medicine.

The short answer

What do programs ask about a person's health before a session, and does asking change what happens?

Research guidelines, retreat organizations, practitioners and two US state programs describe a health intake before a session. What they ask overlaps: mental-health history, some physical conditions, medicines and pregnancy. The questions, and what an answer leads to, differ. As far as a documented search found, no study has compared outcomes with and without screening. This card is not a screening tool.

What do programs and sources report?

Reported practice, not a recommendation. This marking applies to everything in this section.

  • A 2008 paper from one US research group. It describes selecting healthy volunteers for high-dose studies by medical history, examination, tests and a psychiatric interview. It reports excluding personal history of psychotic disorders or bipolar disorder, a first or second degree relative with either, medicines thought to alter the effects, pregnancy, and resting blood pressure exceeding 140 systolic and 90 diastolic mm Hg, averaged across four assessments on at least two separate days. These are expert guidelines, not a measured result. Source 1, level 1
  • A 2021 systematic review. The review of 14 studies reports little consensus on predicting an individual's reaction. Source 2, level 1
  • Retreat organizations. In interviews with 49 publicly advertised retreat organizations (2023, convenience sample), all collected medical histories and 36 excluded people with certain conditions, most often psychosis or schizophrenia (24), cardiovascular conditions (17) and bipolar disorder (16). All relied on self-report. The study did not test whether any practice changed adverse outcomes. Source 3, level 1
  • People who provide support for naturalistic use. In a 2023 anonymous convenience survey, 103 of 107 people who said they provide support for naturalistic psychedelic use reported screening potential clients at least sometimes, and 93 said always. Most said they screen for compatibility with the practitioner (92), psychiatric conditions (90) and physical conditions (77). Answers were not verified. Source 4, level 1
  • Two state programs. Oregon's rules require a client information form with 14 yes or no questions. A yes to lithium in the last 30 days, to current thoughts of harming self or others, or to a diagnosis or treatment for active psychosis means the client may not take part. Colorado's rules require a written screening tool to be given to every prospective participant, and a safety assessment using a tool that reflects “generally accepted standards of practice”. Where screening identifies risk factors suggesting the need for a medical or behavioral health provider, services may go ahead only with a direct referral, a clearance, or a consultation and risk review (rules 6.15 and 6.16). A facilitator license also does not cover participants taking lithium or antipsychotic medicines unless one of the same three conditions is met, and a facilitator must tell prospective participants in writing that anyone taking a psychotropic medicine flagged on the screen must meet one of them (rule 2.2 A.6, A.7 and A.9). Each applies to its own program only. Sources 5 and 6, level 1
  • Rules under review. On 28 August 2026 Oregon's health authority proposed to amend the client information form rule (wording on where the form is published) as one of 54 rules. It then stated it would not file final rules from that process and would begin a new one with a planned effective date of 15 January 2027. On 17 September 2026 Colorado held a stakeholder meeting on possible changes to several rules, including 6.15, on subjects other than the screening tool, and said no decisions would be made there. Sources 5 and 6, 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, Europe PMC including preprints and ClinicalTrials.gov. Embase, PsycINFO and Google Scholar were not searched, and one 2026 paper on medical exclusion criteria in trials was seen in abstract only and could not be opened. More searching could change the picture.

  • Whether screening changes outcomes. Not located.
  • How well self-reported intake identifies what it asks about. The retreat study's authors say it may be inaccurate.
  • Whether trial-based lists apply to other people. Several sources describe research volunteers or diagnosed groups. A 2024 review reports that family-history exclusion criteria varied between trials, and that the trials which did not exclude such people did not report how many participants had that history (source 7).
  • Screening in traditional settings. No source read describes it.

What this card does not say

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. Johnson M, Richards W, Griffiths R. Human hallucinogen research: guidelines for safety. J Psychopharmacol 2008. DOI 10.1177/0269881108093587 PMID 18593734. Grade 1. Expert guidelines, peer reviewed. Read in full, every section, on 7 November 2026 (author manuscript). The blood pressure criterion was re-checked in the manuscript on 8 November 2026.
  2. Aday JS, Davis AK, Mitzkovitz CM, Bloesch EK, Davoli CC. Predicting reactions to psychedelic drugs: a systematic review of states and traits related to acute drug effects. ACS Pharmacol Transl Sci 2021. DOI 10.1021/acsptsci.1c00014 PMID 33860172. Grade 1. Systematic review. Read in full on 7 November 2026, including tables (the supplementary spreadsheet was not opened).
  3. McGuire AL, Neitzke-Spruill L, Robinson JO, Beit CS, Singh N, Mathai DS. Reported safety practices of publicly advertised psychedelic retreats. JAMA Netw Open 2026. DOI 10.1001/jamanetworkopen.2025.52505 PMID 41499117. Grade 1. Qualitative interview study of organizations. Main text and tables read in full 7 November 2026 (supplement not read).
  4. Glynos NG, Baker A, Aday JS, Pouyan N, Barron J, Herberholz M, et al. Going underground: demographics, services, and best practices endorsed by practitioners providing support for naturalistic psychedelic use. J Psychoactive Drugs 2025. DOI 10.1080/02791072.2024.2405685 PMID 39297183. Grade 1. Anonymous online survey, convenience sample. Read in full on 7 November 2026.
  5. Oregon Administrative Rules 333-333-5050, Client Information Form, on the Oregon Secretary of State site, division 333, read in full 7 November 2026 (version history ends with an amendment effective 1 January 2025). Also read: the notice of proposed rulemaking filed 28 August 2026 (the list of 54 rules and the pages on rule 5050, in full) and the OHA 2026 rulemaking page (read in full). Grade 1. Official documents.
  6. Colorado Code of Regulations, 4 CCR 755-1, Natural Medicine Licensure Rules and Regulations, section 6 (Standards of Practice) and the editor's notes, as posted by the state as “Rules Currently in Effect” on the Division of Professions and Occupations Natural Medicine page, read in full on 7 November 2026. Grade 1. Official rule text. The editor's notes list an emergency rule effective 5 December 2025, which concerns rule 5.4 (continuing education) only. 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. On 8 November 2026 sections 2.1 to 2.8 of the Secretary of State's PDF, which include rule 2.2, were also read in full. Sections other than 2 and 6 were not used. Also read in full: the state's notice of the 17 September 2026 stakeholder meeting.
  7. Downey AE, Bradley ER, Lerche AS, O'Donovan A, Krystal AD, Woolley J. A plea for nuance: should people with a family history of bipolar disorder be excluded from clinical trials of psilocybin therapy? Psychedelic Med 2024. DOI 10.1089/psymed.2023.0051 PMID 40051581. Grade 1. Review and proposal. Read in full on 7 November 2026 (the risk tool figure is an image and was not read).