Are there risks in psychedelic experiences? Myths and facts in psychedelic medicine.

Psychedelics may bring relief to the mental health of millions of people. But are there risks in psychedelic experiences? Let's look at the myths and facts in psychedelic medicine.

Many of our earliest ideas about psychedelic risks come from measures of criminalization. Sensationalist media stories from the mid-1900s painted a frightening picture of psychedelics and the people who used them. However, when we analyze psychedelic risk from an evidence-based perspective, these reports don't hold up. The reality is more nuanced. Here's the evidence-based scoop.

Do psychedelics cause schizophrenia and psychosis?

For some time now, we've had this cultural idea that psychedelics cause psychosis. In studies conducted during the 1960s, patients sometimes presented with psychotic symptoms lasting up to 48 hours. This was a major fear to address when the DEA banned psychedelics in 1970.

These early studies often did not meet the standards we require today. For example, initial studies may [1]:

• Neglected to control the environment where patients took psychedelics.
• Failure to exclude patients at risk of psychosis.
• It did not maintain a control group.

As we now know, all these factors make the results of these studies difficult to analyze at best, and irrelevant at worst.

With what we know now, it is clear that these Adverse outcomes for patients often result from unethical science. Patients often received high doses of LSD without preparation and were even restrained during their experiences. Given this context, it appears that the psychotic episodes were caused not by LSD, but by abusive research methods. 

However, there are rare cases in which psychedelics have caused overwhelming hallucinations. People with a history of psychotic disorders may be at greater risk for these negative outcomes. Modern clinical trials have yet to examine the psychosis resulting from psychedelic medicine. But it remains a concern for many people.

Do psychedelics cause addiction?

In the 1960s, the media coined the term “use of period between artistic types”[1]. The basic idea was that hallucinogens caused a specific type of substance dependence. Many believed that, because people used them frequently, they must have a high potential for abuse.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-V) recognizes hallucinogen use disorder (HUD). The manual lists three categories of HUD: hallucinogen dependence, hallucinogen abuse, and other HUDs.

However, psychedelics do not fit the profile of other substances that cause addiction. Few people find it difficult to reduce their use of psychedelics – a hallmark of pathological addiction. The conclusion is that the HUD is unusual and There is a low risk of people developing dependence after trying psychedelics [2] . Most people who use psychedelics are not dependent on them.

In fact, when compared to other substances, psychedelics have a very low potential for abuse and dependence. In 2017, the Substance Abuse and Mental Health Services Administration ranked psychedelics at the bottom of its addiction risk list [3].

Psychedelic therapists still need to educate themselves about abuse and how to avoid it in the rare cases where it may occur.

Can psychedelics cause flashbacks?

You may have heard in high school that LSD flashbacks can happen years after a psychedelic experience. This popular legend still persists and has been documented by some users. But these post-experience hallucinations are not specific to psychedelics. They can also occur with other psychoactive substances, such as alcohol and benzodiazepines [1].

If these hallucinations persist, they are called Hallucinogen Persistent Perception Disorder (HPPD). We're still not sure how common this syndrome is. The DSM-V reports a prevalence rate of 4.2% in people who use hallucinogens [4]. However, this is even rarer in the clinical context, and we believe this is due to patient screening and preparation [1].

A small study seemed to show that people who experienced anxiety and panic during their psychedelic experiences were more likely to experience HPPD afterward. Because of this, flashback symptoms may be more like a response to trauma than to residual effects of psychedelics [5].

What if patients experience a "bad trip" during therapy?

Your patients may be concerned about having challenging experiences, or "bad trips" while taking psychedelics. This can happen, although it is rarer in the context of therapy. There is no exact definition of this experience. People generally describe feelings of fear, anxiety, dysphoria and paranoia that do not last beyond the acute hallucinogenic period [1].

However, even these "bad trips" may not be all bad. A 2016 study measured the outcomes for people who reported challenging experiences with psychedelics. 84% of this group said that they still benefit from their experiences in the long term, despite these “bad trips” [6]. Research suggests that these unpleasant experiences are transient and do not detract from the therapeutic benefits of psychedelics [7].

We still don't know why some people have negative experiences and others don't. Some research suggests that people with high levels of openness, acceptance, and absorption may be more likely to have positive experiences. People who are more apprehensive or worried may be more prone to “bad trips” [8] .

To mitigate this risk, Psychedelic experiences should be combined with therapy sessions and close supervision. The settings and dosage must also be carefully controlled to reduce the likelihood of negative experiences. Over time, we will learn more about how to prevent or interpret challenging experiences in patients.

Can people get hurt while taking psychedelics?

It's no secret that psychedelic experiences can be emotionally charged for people. Psychedelics can bring to the surface past traumas and make people see the world in a different way. Sometimes, people become overwhelmed by the experience. If they are not prepared or in the wrong environment, the effects of psychedelics can cause people to act in dangerous ways [9].

In rare cases, people on psychedelics have jumped from buildings and not survived [10]. This is a serious risk for people who undergo psychedelic experiences without supervision.

Other substances, such as alcohol and opiates, cause thousands of deaths each year. Compared with other substances, the risk of physical harm is relatively rare [11].

Within psychedelic medicine, physical harm is mitigated by using safe standards of care for all patients. Establishing rapport and trust with patients before their experiences helps them feel safe. The controlled setting of supervised therapy ensures that patients cannot harm themselves or others. That is why proper education is vital for the success and safety of patients.

Can you overdose on psychedelics?

In normal doses, psychedelics are physiologically safe. Overdoses have occurred at very high doses, for example, more than 550 times the recommended dose of LSD [1, 12]. Even with those high doses, they made a full recovery. Mixing psychedelics with other substances like alcohol can also increase the chances of toxicity [13].

However, In a clinical setting, dosage is defined and controlled. Doctors closely monitor patients for abnormal physiological symptoms or symptoms of overdose. Due to the rigorous standards of psychedelic medicine, toxicity and overdose have not occurred in the clinical setting.

Are psychedelics neurotoxic?

Early research and setbacks in psychedelic medicine fostered the idea that psychedelics were toxic to the brain and could even damage chromosomes. These initial findings were widely publicized. Unfortunately, by the time these ideas were refuted or retracted, the damage to public perception had already been done [1].

Most researchers believe that psychedelics are not toxic. They do not damage mammalian organs and are generally physiologically safe [14]. We cannot see any neurocognitive problems from contemporary research [15]. In fact, Some research even suggests that psychedelics promote neuroplasticity and neurogenesis. – which means they can actually help us build more connections and new neurons [16].

Key findings regarding the risks of psychedelic medicine.

In medicine, we often look for "right" and "wrong" answers. We want to give patients clear answers that won't confuse them.

But psychedelic medicine, like all medicine, is more complicated than that. Just as with prescribing any other medication, psychedelic doctors must understand that one therapy will not be useful for all patients. Every medical intervention has its risks and benefits. By dismantling old misconceptions, we hope to create a better understanding within this growing field.

Psychedelic medicine has the potential to change countless lives. With the right education, high standards, safety precautions, and further research – we can mitigate the risks of psychedelic therapy to unlock its healing potential.

References:

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