There Are Now Clinics for People Harmed by Psychedelics. Here Is Where They Are
Most writing about psychedelics, including much of ours, describes what happens when things go well. This is about the other outcome. A small number of people finish a psychedelic experience and do not fully return from it, and until recently there was almost nowhere to send them. That has started to change.
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| Key Takeaway | Detail |
|---|---|
| What is new | Johns Hopkins opened a clinic in Baltimore in 2025 dedicated to lasting psychedelic side effects |
| Who it treats | Roughly half its patients have HPPD. The rest present with manic or psychotic episodes after use |
| How common | A 2024 meta analysis found about 4 percent of users had serious problems, mostly people with preexisting conditions |
| The treatment | Antidepressants and antiseizure medications drawn from case studies. Close to a third recover fully within a year |
| The access problem | The Baltimore clinic saw 10 patients in its first year and is limited to in person or in state telehealth |
| Also available | A Berlin clinic has run since 2017 and offers international telehealth. Emory expects to open in Atlanta in 2026 |
What These Clinics Actually Treat
The Clinic for Post-Psychedelic Difficulties opened at Johns Hopkins in Baltimore last year. Psychiatrist Azin Bekhrad directs it. It is the first US clinic dedicated to studying and treating lasting psychedelic side effects.
Patients arrive with two broad presentations. Some have had a manic or psychotic episode following psychedelic use, sometimes involving other drugs or alcohol.
About half have hallucinogen persisting perception disorder. HPPD produces visual disturbances that do not stop when the experience does. Patients describe visual snow, halos and geometric patterns that persist for months or years. We explain the condition itself in our guide to HPPD and its symptoms.
How Common Is This
Honest numbers matter here, in both directions.
A 2024 meta analysis in JAMA Psychiatry found that about 4 percent of psychedelic users experienced serious problems. The qualifier is the important part. Those problems occurred primarily among people with preexisting neuropsychiatric conditions.
One web based survey put HPPD prevalence near 4.2 percent. Treat that figure cautiously, because web surveys draw people motivated to respond.
Researchers also believe these numbers undercount. Stigma keeps people from reporting, and a person having visual symptoms after an illegal drug experience has obvious reasons to stay quiet. Related work has linked flashback experiences to higher rates of anxiety and somatic conditions.
Where the Clinics Are
Three places currently exist, and their capacity is limited.
Johns Hopkins in Baltimore takes in person visits and telehealth within Maryland. It saw 10 patients in its first year. That is a real constraint, not a formality.
Berlin has run a clinic since 2017 under psychiatrist Tomislav Majić. It sees 150 to 200 patients annually and offers international telehealth consultations, which makes it the most accessible option for many people.
Emory University expects to open a clinic in Atlanta during 2026.
What Treatment Looks Like
Expectations should be set carefully. The regimens in use come from case studies published in the late 1990s. They involve antidepressants and antiseizure medications.
Close to a third of patients achieve full recovery within a year. That is meaningful, and it also means most do not, at least not within that window.
This is an early field practicing on thin evidence. It is still considerably better than the alternative, which for decades was nothing.
Why This Took So Long
Majić has offered a candid explanation for the gap, and it is about scientists rather than patients.
Psychedelic research was shut down once before. Researchers who lived through that history worry that documenting harms could hand ammunition to prohibition and close the door again. The result has been a field slow to publish its own adverse events.
He describes patients who suffered for 20 years or more without treatment, unaware that help existed anywhere. His summary of the drugs is worth repeating. They are not toxic and they are not addictive. They are also not without risks.
The Counterargument
Not everyone frames the risk the same way. Michael Silver, a neuroscientist at UC Berkeley, emphasizes that these compounds produce powerfully positive experiences for many people.
In his reading, the primary risks are psychological rather than neurological, and they often trace back to inadequate preparation or a poor environment. That points at set and setting rather than at the molecules.
Both views can hold. A risk that is largely psychological and preventable is still a risk that needs a clinic when prevention fails.
If You Cannot Reach One of These Clinics
Most people reading this will not live near Baltimore or Atlanta, and Berlin is a long way to go.
Start with your existing physician or psychiatrist and be specific. Describe the symptoms and their duration rather than leading with the substance. HPPD is a recognized diagnosis, and a clinician who knows the term can act on it.
Ask about a telehealth consultation with the Berlin clinic if symptoms are persistent and nobody local is familiar with the condition.
Bring documentation. Note when symptoms began, what they look like, whether they fluctuate, and what makes them worse. That record shortens the road to a diagnosis considerably.
Know that many cases improve. A third of treated patients recover fully within a year, and time helps a portion of the rest.
What This Means for Providers
Clinics delivering ketamine or supervised psychedelic care should know these referral options exist. A patient may call months after an experience elsewhere, and having somewhere to send them is part of responsible practice. Screening for preexisting neuropsychiatric conditions matters for the same reason, since that is where the serious problems concentrate.
Broader side effect context sits in our overview of common psychedelic side effects.
