1. Distinguish Medical, Religious, and Recreational Use
   • Determine if the psychedelic use is medically supervised, part of a protected spiritual practice, or recreational (e.g., ketamine-assisted psychotherapy; ceremonial psilocybin use in Indigenous communities or a church-based spiritual practice; self-directed ‘microdosing’ for mental health/spiritual purposes; episodic use at social gatherings). Legal and parenting implications can vary significantly across these contexts.
      
2. Focus on Functioning
   • The central question should always be: How does the parent's psychedelic use impact their ability to safely and consistently parent? Don’t assume impairment or harm based solely on substance label.
      
3. Use an Evidence-Based Lens, Not Stigma
   • Avoid outdated assumptions that equate psychedelic use with unfitness. Evaluate on current functioning, parental insight, and child safety, supported by contemporary scientific research. Consult recent peer-reviewed studies, licensed clinicians with expertise in psychedelics, and ethical practice guidelines.
      
4. Recognize Emerging Legality and Treatment Contexts
   • Be aware of changing legal landscapes and growing use of psychedelics in clinical settings (e.g., ketamine for depression, psilocybin for PTSD). Ask: Was the treatment prescribed by a licensed provider? Is the provider engaged in ongoing monitoring and follow-up care? Always request and review the treatment plan as part of the assessment process.
      
5. Evaluate Risk Through Specific Criteria
   • Assess for red flags – especially when the child is present or caregiving is impaired – including unsupervised psychedelic use in the presence of children, psychosis or disorganized behavior during parenting time, functional decline, or multiple unregulated international treatments without a treatment plan.
      
6. Incorporate Trauma-Informed and Culturally Competent Evaluation
   • Many psychedelic practices have Indigenous or religious roots. Evaluators should respect spiritual use of psychedelics and avoid cultural erasure or assumptions grounded in a colonial framework. When psychedelic use occurs in a cultural or religious context, assess whether it aligns with accepted practices and values within the individual’s specific cultural, spiritual, or religious community.
7. Develop a Return to Use (Relapse) or Recurrence Plan (If Applicable)
   • As with all substance-related concerns, create a clear plan for disclosure, treatment engagement, safety adjustments, and ongoing communication if concerns about misuse or instability arise, especially in cases where the individual is engaging in polysubstance use or use of multiple substances. The plan should include child contact provisions, a monitoring protocol, and a mechanism for reviewing the parenting plan based on safety and recovery indicators.
      
8. Avoid Overreliance on Drug Testing
   • Testing for many psychedelics (e.g., psilocybin, DMT, ketamine) is expensive and may not provide useful or timely information given the short detection windows in urinalysis. These substances are typically only present for a brief period, increasing the likelihood of false negatives. As a result, drug testing for most psychedelics is unreliable and should never be the sole basis for child custody decisions.
      
9. Ensure Individualized, Dynamic Parenting Plans
   • Use flexible, incremental parenting schedules based on demonstrated stability, and update frequently to reflect the parent’s functioning. Modifications to the parenting plan should generally not be based solely on diagnoses or discrete incidents.
      
10. Lead with Curiosity, Compassion, and Professional Humility
    • The field is evolving. Stay informed about scientific advances and avoid punishing parents for psychedelic use that is part of a reasonable, helpful, lawful clinical intervention or a practice protected under state or federal law. As with other mental health conditions, compassion, curiosity, and humility should guide case determinations.

Resources

Dupuis, D. (2021). Psychedelics as tools for belief transmission. Set, setting, suggestibility, and persuasion in the ritual use of hallucinogens. Frontiers in psychology, 12, 730031.

Jairaj, C., & Rucker, J. J. (2022). Postpartum depression: A role for psychedelics?. Journal of Psychopharmacology, 36(8), 920-931.

Karp Barnir, E., Rubinstein, Z., Abend, R., Lev-Ran, S., Naor, L., & Mikulincer, M. (2025). Peri-traumatic consumption of classic psychedelics is associated with lower anxiety and post-traumatic responses 3 weeks after exposure. Journal of Psychopharmacology, 02698811251334025.

Korkmaz, N. D., Cikrikcili, U., Akan, M., & Yucesan, E. (2024). Psychedelic therapy in depression and substance use disorders. European journal of neuroscience, 60(2), 4063-4077.

Marks, M. (2023). The varieties of psychedelic law. Neuropharmacology, 226, 109399. https://doi.org/10.1016/j.neuropharm.2022.109399

Marks, M., Brendel, R. W., Shachar, C., & Cohen, I. G. (2024). Essentials of informed consent to psychedelic medicine. JAMA psychiatry, 81(6), 611-617.

Mendes, F. R., dos Santos Costa, C., Wiltenburg, V. D., Morales-Lima, G., Fernandes, J. A. B., & Filev, R. (2022). Classic and non‐classic psychedelics for substance use disorder: A review of their historic, past and current research. Addiction Neuroscience, 3, 100025.

Mitchell, J. M. (2022). A Psychedelic for Trauma. Scientific American, 326, 56-61.

Simonsson, O., Mosing, M. A., Osika, W., Ullén, F., Larsson, H., Lu, Y., & Wesseldijk, L. W. (2024). Adolescent psychedelic use and psychotic or manic symptoms. JAMA psychiatry, 81(6), 579-585.

Richard, J., & Garcia-Romeu, A. (2025). Psychedelics in the Treatment of Substance Use Disorders and Addictive Behaviors: A Scoping Review. Current Addiction Reports, 12(1), 1-46.

Schimmers, N., Breeksema, J. J., Smith-Apeldoorn, S. Y., Veraart, J., van den Brink, W., & Schoevers, R. A. (2022). Psychedelics for the treatment of depression, anxiety, and existential distress in patients with a terminal illness: a systematic review. Psychopharmacology, 239(1), 15-33

Williams, M. T., Davis, A. K., Xin, Y., Sepeda, N. D., Grigas, P. C., Sinnott, S., & Haeny, A. M. (2021). People of color in North America report improvements in racial trauma and mental health symptoms following psychedelic experiences. Drugs: Education, Prevention and Policy, 28(3), 215-226.

Stephanie Tabashneck, PsyD, Esq., is a forensic psychologist and attorney in Boston. She is a Senior Fellow in Law and Applied Neuroscience, a collaboration between the Center for Law, Brain & Behavior at Massachusetts General Hospital and the Petrie-Flom Center. Her practice areas include substance use disorders, forensic psychological assessment, child custody, and criminal forensic evaluations. Stephanie presents regionally and nationally on psychology and law topics, including at events organized by the American Bar Association, the Federal Judicial Center, the American Psychiatric Association, the Association of Family and Conciliation Courts, the Massachusetts Trial Courts, and the New York Office of Attorneys for Children.