This chapter explores the risks of guruism and cultic social dynamics in organisations that work with psychedelic drugs, which include therapist offices, clinics, research departments, retreat centres, training programmes, NGOs, underground ceremonies and new religious movements. It has been hypothesised, and argued by experienced practitioners, that psychedelics can increase suggestibility, amplify transference and facilitate an intense form of projective mechanisms in the recipients. They may thereby lead to ego-inflation and feelings of grandiosity and omnipotence in those giving the drugs and intensify cultic social dynamics in psychedelic communities – all of which can create conditions that make cases of harm and misconduct more likely to occur and go unreported. This chapter briefly introduces the terms ‘guruism’ and ‘cultic social dynamics’ and how these dynamics can lead to harm and abuse and then discusses how psychedelic drugs might amplify these processes, before outlining possible safeguards.