How Safe Are Psychedelics? What Are The Risks?

We’ve heard of the 60s psychedelic ‘craze’, cut to an abrupt end by legislation deeming them a “danger” to society, with bold, unfounded claims that psychedelics “melt our brain” and public ad campaigns like the infamous “This Is Your Brain on Drugs” video. Of course, today we know this couldn’t be further from the truth. 

Science has proven that psychedelics work wonders for promoting neural connectivity, even extending the size and quantity of those signaling pathways by over 10% compared to baseline functions. Today, we see our western world coming to amends with the same psychedelic medicines that were slandered not long ago, but the beautiful product of this mishappening is that protocols for safety management and harm prevention could not be more air tight. 

Though, as is with anything else, too much of something can never be a good thing. That’s why today we’ll be discussing all of the potential risks that may come with psychedelic substance use, along with criteria that should be met and considered before embarking on these journeys.

Preparation is Key to Mitigating Risk

We won’t go too deeply into preparation procedures since we’ve already written an entire article on safe trip practices. The best measures to ensure safety during a psychedelic trip are most often taken during the preparation and planning stages of your journey. If you’re partaking in a psychedelic-assisted therapy session, preparation methods are usually covered at length by your facilitator. In any case, there’s certain factors that should be considered before you even begin planning your experience.

Potential Risk Factors

Cardiovascular Conditions and Respiratory Illnesses

Most pressingly, if you have a cardiovascular condition that could pose a threat to your life, engaging in a psychedelic journey is not recommended, as psychedelics can propound hypertension and tachycardia. During the peak of a trip, many experience over stimulating sensations that increase heart and respiration rate and could further affect a pre-existing condition, so it’s heavily advised that those with a heart condition or a respiratory illness, consult their doctor with any concerns of the sort, and to stay on the safe end, abstain from any psychedelic use.

Schizophrenia

You should also evaluate medical family history, including your own. If you’re predisposed to any mental illnesses whose onset could be triggered by a potent inner-environmental change, like schizophrenia, you should refrain from taking any hallucinogenic substances. Psychedelics can blur the line between our day-to-day reality and these altered states of mind, so treading delicately and cautiously should always be of priority.

Bipolar Disorder

Though our research on psychedelics in conjunction with bipolar disorder are limited, it’s suggested that you speak to your psychiatrist before making a decision. There’s a chance that exposure to a psychedelic experience could trigger an unwarranted manic episode or cause a worsening of symptoms, but in some cases, this could be potentially avoided by an adjustment of dosing size.

Suicidal Ideation

If you’re experiencing suicidal ideations, it’s of high importance that you try your best to partake in the experience at a time when your mental state isn’t so fragile. Some clinical trials are already working on examining the efficacy of psychedelic medicines on people with suicidal ideations, so if you’re still adamant about taking a ride in on the ‘magic’ mushroom train, you need to consult an experienced psychedelic facilitator that could guide you in the right direction. Someone with suicidal ideations should never partake in a psychedelic experience alone, as the potential for overstimulation could drive unhealthy, impulsive choices. 

A quick note: Mescaline is also known to induce flashbacks, so if you have a history of PTSD, you might want to consider choosing another psychedelic drug.

Antidepressants and Other Pharmaceutical Medications

The last concern that may arise is in mixing antidepressants with psychedelics. SSRIs, SNRIs, MAOIs, and some other prescription medications like Trazadone, are known to blunt the effects of tryptamines like LSD and psilocybin mushrooms. 

Conversely, tricyclic medications like Elavil and Norpramin, are known to induce more potent psychedelic hallucinations, so it’s suggested that antidepressants be tapered off prior to psychedelic consumption—always under the strict supervision and guidance of your psychiatrist. 

Mixing MAOIs with psychedelics could potentially cause serotonin syndrome—a physiological reaction to an overabundance of serotonin in your system, though research into this matter is severely lacking. Also, the use of MDMA/ecstasy and Ayahuasca during use of antidepressants can very quickly cause serotonin syndrome. Ayahuasca and really, any other psychedelic drug, should never be combined with MDMA, amphetamines, or cocaine as it could cause dangerous rapid hypotension. 

In any case, tapering off of these medications should resolve and prevent any negative drug interactions. We’ve actually written an entire guide on how antidepressants should be handled when you’re thinking of embarking on a psychedelic experience, so definitely check that out if you’re interested in learning more about pharmaceutical interactions with psychedelic medicines.

Potential For Addiction?

The big question ringing around the therapeutic use of psychedelics is on their potential for addiction, and understandably so. Everyday, we’re surrounded by news articles of yet another alcohol-induced car crash or overdose hospitalization, but what about psychedelic drugs? Well friends, this is where it really gets exciting. 

Psychedelic drugs like psilocybin mushrooms and LSD are not inherently addictive. Much like cannabis, a habit can be formed around use, but their potential for addiction could never be on the same scale as ‘hard’ drugs like heroin, prescription painkillers, and even alcohol. 

The nature of a psychedelic journey itself, warrants far too deep of an experience for people to consider everyday psychedelic use (aside from microdosing). Psychedelics alter our states of consciousness in such a perceptually engrossing way, that entering these realms routinely, can be downright unappealing to most people. 

In fact, psychedelic trips, though sometimes euphoric, don’t always bring with it a ‘feel-good’ experience. Imagine doing 10 years worth of therapy in one sitting. Most, if not all of us, do not have the emotional capacity to bear this immense weight monthly, let alone, weekly or daily. 

The height of tolerance formed by these substances also make it nearly impossible to feel the same effects consecutively, therefore these substances could rarely even allow the time or space for our brains to grow ‘addicted’ to their effects. Someone would  have to take three times their previous dose to feel consistent effects if they’re even considering taking these substances on a routine basis, which is highly unfeasible considering the sheer amount of psilocybin mushrooms you’d have to consume.

Of course, there’s several outside factors that could promote habit-formation surrounding psychedelics. If you’re someone who’s had a history of substance use disorder, it’s highly recommended that you embark on this journey with a knowledgeable psychedelic guide. Predispositions to any habit-related issue could encourage misuse of psychedelic medicines, which could counter the positive benefits of these practices. 

Depending on your circumstances, it’s likely that you’d benefit more from the stability of a microdosing regimen. Micro dosing can be controlled much more meticulously than large-dose trips, since no hallucinogenic effects are felt from their experience.

The Magic of Set & Setting

The concept of a therapeutic psychedelic experience stiffly aligns with your intentions for the journey. Recreational use of psychedelics differs from therapeutic use because it lacks any conscious objective for healing and personal development. Therefore it’s vital that you consider two crucial elements of the trip to ensure the safest, most effective results: set and setting.

Set refers to the state of mind you’re entering the experience with. The choice to refrain from psychedelic use doesn’t always have to come from the presence of a concrete diagnosis. It’s widely accepted that psychedelics should not be used at any time when our mental states are in a fragile place—like immediately after the loss of a loved one, after an emotionally damaging breakup, and really, at any point when outside circumstances are already heavily affecting your psyche. 

Taking psychedelics in the presence of a burdened mind is likely to exacerbate the psychological effects of the situation, almost ensuring the emergence of a ‘bad trip’. However, if we enter the experience with a clear mind, an open heart, and a productive intention, psychedelics can offer a world of healing, sometimes in just one sitting.

Setting is a little bit different, it encompasses the environment you’re in and the people you’re with. Psychedelics should never be taken in a crowded setting, near any potentially dangerous environments, and you should always have a trip sitter whose focus is solely on ensuring your utmost comfort and physical safety. 

As with any other substance, driving, operating heavy machinery, or exposing oneself to physically-threatening, unstable environments, should never be considered. Generally, taking psychedelics in your own home is the safest and most comfortable approach. 

A safe in-home psychedelic experience should allow for spacious movement like rolling around on a cushioned surface or dancing about in absence of any sharp or heavy objects. If psychedelics are taken in the wrong setting, you may not get the therapeutic benefits you were hoping for, and most importantly, hazardous environments could warrant dangerously unfortunate accidents that should be easily avoided with proper planning and supervision.

The people you’re with could also have an immense impact on the trajectory of your trip. A psychedelic experience is intangibly vulnerable, so it’s important that the people you’re with are also willing to express their discomforts, pleasures, and general thoughts, without any apprehension. 

These experiences make us extremely aware of the subtle behavioral cues being expelled by other people and increased suggestibility in these states could create an anxious space where the group is unconsciously mirroring the anxiety of others around them. Hence, the general principle is that you should only share a psychedelic experience with someone you’re already very comfortable with. 

If you have any doubts about going into the experience with someone, you should assume that those uncertainties will arise during the trip with a much more corpulent tone of unease. Though, doubt shouldn’t be confused for nervousness. It’s perfectly normal to feel anxious about a trip as it nears closer, but making these set and setting choices are the best way to avoid an uncomfortable situation. 

Always clear a time, preferably multiple, to plan your experience with this person or people. Speak about what you’ll do if an uncomfortable thought or sensation arises, discuss alternating around different rooms and vocalizing the need for space throughout the trip.

Can You Overdose On Psychedelics?

To date, there are no cases of fatality directly linked to biological over-absorption of psychedelics that we know of. Can psychedelics pose a physical risk when taken in the wrong setting? Yes, but this is completely due to exposing oneself to dangerous situations while on the drug, not because of the drug itself. 

It’s also important to differentiate a ‘bad trip’ from an overdose. A bad trip is described as an overwhelming feeling of sensory overload, with incessant loops of negative or frightening thoughts/visual disturbances that may provoke or even be provoked by physical symptoms of nausea, increased heart rate, dry mouth, and distortions of time. These experiences are typically caused by higher doses of psychedelics, which is why we advise starting small in terms of dosage, then increasing your dose as you become more familiar and comfortable in altered states of consciousness.

How much would you need to consume to overdose on a psychedelic? Well, this one is tricky. Due to the rarity of overdosing on psychedelics, it’s difficult to even assign attributes to this occurrence. At the moment, there exists no straightforward response to this question, but research suggests that an LSD dose between 50 and 200 micrograms is medically safe for consumption, posing no risk of toxicity when taken in a safe, therapeutic setting. 

Of the most drastic cases reported on psychedelic overconsumption, the case of an accidental ingestion by a 15-year-old, seems of relevance. The teenager consumed about 1,200 micrograms of LSD at a high school party and had to be hospitalized overnight, but a 26-year-old woman also attending the event, consumed about 500 micrograms and did not necessitate any medical attention. 

Some research suggests that a potentially lethal dose of LSD would range at and upward of 14,000 micrograms, that’s about 70 times the largest-recommended dose and since a tab of acid typically contains 100-200 micrograms, a lethal dose would be considered 70-140 tabs of acid consumed all at once. Where 30 standard alcoholic drinks—and in some cases, much less—can be lethal to human beings, these observations help us deduce that psychedelics are amongst some of the safest drugs when taken responsibly.

Is Psilocybin-Assisted Therapy Safe?

The short answer—yes. The long answer—considering the high level of safety protocols put in place to protect both the journeyer and the facilitator, psychedelic-assisted therapy is likely the safest way to embark on a psychedelic journey. 

A therapeutic psychedelic experience is always tailored to your specific needs, automatically ensuring proper dosing and a healthy setting. Having an experienced facilitator assist you throughout your journey means that you don’t have to worry about discerning criteria application, all on your own. 

In preparation for the journey, facilitators will carefully screen your family history and personal medical history, as well as  current emotional circumstances to assess the safest route for your journey. Arguably, one of the biggest upsides of this approach is the assistance you’ll receive in integrating your findings after the conclusion of a trip. Guides can help us hold ourselves accountable for putting in the therapeutic work that’s necessary to ensure a safe and productive transition between these very drastic perceptual changes.

If you need some help discerning the most important qualities to be looking for in a psychedelic facilitator, we encourage you to give this article a quick read. Though we must admit, this is kind of what we do here at Psychedelic Passage…well, it’s pretty much all we do here. 

We have an entire team of psychedelic facilitators that are eager to help you embark on your healing journey, from all 50 states, across the entire nation, and we’d be honored to facilitate this mind-altering and possibly life-changing experience for you. Whether that’s with us or with another facility we believe the most important factor is finding the right fit for your particular needs. 

We give you our word, safety is our primary concern. No experience can be comforting and encouraging without ensuring safety first. You can book a consultation with us here to learn more! 

We hope this information brought some value to your libraries of intellect, as well as some peace of mind. Psychedelics can be some of the safest drugs in the world, but only if they’re used under the right circumstances, with the right intentions, and surrounded by a loving environment of people and places.

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nick and jimmy headshot, psychedelic passage co-founders

About Us

We (Nick & Jimmy) are spiritually oriented psychedelic guides who facilitate in-person ceremonial psychedelic experiences with an emphasis on harm reduction all across the U.S. We foster transformational journeys through the exploration of consciousness, which we believe to be a fundamental human right.

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