Risks

The ever-present, however negligible risks of psychedelics

It can be argued that the greatest misconceptions about psychedelics emanate from discussions surrounding the risks associated with their consumption. 

That being so, there are legitimate risks that should be considered amongst all users, from novice to expert, across the entire spectrum of hallucinogens. 

As with the positive experiences offered by any given psychedelic, adverse effects come in many forms and layers — not always as apparent or obvious, and not always as avoidable or innocuous as one may think.

But first, perhaps, it’s necessary to touch on the context of why we are where we are when it comes to our historically turbulent relationship with psychedelics. 

From Satanic Panics to Pharmacodynamics

Much of what has shaped public perception regarding psychedelics has unfortunately come on the back of cultural apprehension spurred on by political or religious authority over the last century, if not longer.

From the way by which religious officials condemned Peyote (mescaline) on the heels of European settlement in the late 19th Century to the momentous fears of everything from devil worship to cult ideologies a hundred years later, psychedelics have always been grouped in with delinquent behaviour that often could not be disentangled from certain perceived ideations — addictions, crime, violence. 

Accordingly, various unfounded risks became associated with the consumption of hallucinogens, instigating a growth of misconceptions surrounding their use and effects. 

Though, despite the innumerable socio-economic and political motivations that sought to suppress psychedelics, interest remained steadfast in the face of unreasonable suppression up until today, as psychedelics now seem to be enjoying something of a renaissance amidst their increasing acceptance into the public stream. 

At the time of this writing, bills are currently circulating the legislatures of large states like California to comprehensively legalize and/or decriminalize many (if not most) psychedelic substances. Some countries, like Brazil and the Netherlands, have historically taken a rather lenient approach to hallucinogens and have only positive research to show for it. 

The reason for this newfangled acceptance is largely due to the gains we’ve made in the field of pharmacodynamics — the study of physiological effects of drugs, which looks specifically at drug-receptor interactions and the chemical signaling between cells in the brain. 

A lot has come to light which not only dispelled the myths of yesterday (that, for instance, hallucinogens cause holes in the brain) but also enlightened our horizons towards tomorrow (that such substances can be a powerful catalyst for habit reformation).

The Not So Real Risks

Numerous myths remain tied to the use of various psychedelics, many of which have piggy-backed atop other substances (say, opiates) or are simply misunderstood as a whole from many anti-drug campaigns of our less educated past. 

i. Psychedelics are addictive

One of the most-often referred to risks relating to psychedelics is that they’re addictive; that one may become dependent on the ‘high’ that is generated. 

Of importance is the need to discern what addiction really means — whether we’re referring to the kind of physiological addictions that can develop with, say, opiates or amphetamines, or whether we’re referring to the idea of a psychological addiction that is akin to, say, gambling or videogames. 

Psychedelics have formally fallen into the latter category, as they do not consecrate a physical dependency. Though, as will be discussed in the next section, this does not mean they aren’t exactly immune from abuse by consumers with addictive personalities.

ii. Psychedelics are mainly used for recreational purposes or used exclusively as a ‘party drug’

While this label will likely always be unavoidable, and while it’s true that psychedelics are often used recreationally, the utility of any particular hallucinogenic is often disregarded.

From therapeutic to spiritual to self-developmental, psychedelics offer a tremendously effective avenue to alter consciousness for productive ends as opposed to just serving recreational habits. 

Critics will often view psychedelics through the context of its use by more adolescent portions of the population, who would naturally supplement any conscious-altering substance with recreational purposes. Unfortunately, this undermines the tremendously productive qualities that many hallucinogens offer.

iii. Psychedelics cause brain damage

Many anti-drug campaigns of the 80s and 90s went so far as to claim that psychedelics like LSD destroyed parts of the brain, causing anything from physical holes in brain matter to permanent psychological defects. 

Research has not shown that psychedelics either hinder or bolster the physical structures of brain matter and there’s nothing to indicate that brain damage is a consequence of consuming hallucinogens. 

Much more has been understood in terms of the psychological effects (as opposed to the physiological) — in reforming thinking patterns or altering sensory experience, for instance, and much more continues to be uncovered in terms of our conscious experience under the influence of any particular hallucinogen. 

The Real Risks

i. Psychedelics may cause a bad trip 

‘Bad trips’ are perhaps the most-often touted risk associated with the consumption of psychedelics, and for good reason.

The chemical process associated with the consumption of most psychedelics effectuates real changes to our emotional states and sensory experiences, and a lot will hinge upon our perspectives while experiencing the effects of a particular hallucinogen. While the good changes are often praised (relaxation, euphoria, synesthesia), there is of course the possibility to experience negative effects, especially when they can easily compound into one another. 

If one is to consume psychedelics in, say, an uncomfortable setting or in an unstable frame of mind, a psychedelic experience can very quickly turn into a daunting circumstance, especially if certain physiological changes are also being effectuated (i.e. rapid heartbeat or nausea). These effects can all interrelate one another to exponentiate a poor experience or a bad trip. 

Fortunately, much can be done to mitigate the likelihood of such an experience, as will be discussed later in more detail. 

ii. Psychedelics can be psychologically addictive 

Most hallucinogens act as serotonin receptor agonists, which means that they stimulate the production of serotonin, boosting positive moods and relaxation. The same process occurs when we engage in most pleasurable activities — eating certain foods or watching something stimulating, for example.  

Accordingly, we may become addicted to psychedelics in the same way we can become habitually addicted to certain activities (i.e. shopping) or risky habits (i.e. gambling). 

Mixed with the fact that tolerance with hallucinogens develops rather quickly (over the course of days), users who take these compounds for reasons relating to achieving a level of physical pleasure will often be chasing the original sensations with diminishing returns after each use. 

In consequence, dependency can develop in the form of a psychological need to experience the dissociative effects of a particular psychedelic, or perhaps to cope with reality in a certain way. 

That being said, there are no physiological withdrawal risks to hallucinogens; the body does not go into a relative state of shock if prolonged use is discontinued (as it does with, say, alcohol), though a consumer may experience various psychological effects, such as mood fluctuations or mental fatigue. 

iii. Psychedelics can effectuate real neurological and physical responses

Consuming psychedelics does impart real neurological and physiological effects on both mind and body, some more pronounced than others: increased heart rate, excessive sweating, tremors, nausea, seizures, amnesia, flashbacks, panic.

 

These effects will vary dramatically from user to user, as many will never have experienced any such side-effects whilst others may have experienced all of the above. Some may spin into an immediate panic attack whilst others may find that it only helps them think clearer. 

Accordingly, the subjectivity of a psychedelic trip cannot be overstated. 

And it’s for this reason that a safe approach is paramount, and that psychedelics be treated with a relative sense of responsible consumption on a case-by-case basis. 

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Mitigation

Lastly, in consideration of all risks and myths associated with psychedelics, it’s critical to note that we’re able to, as we’ve always been able to, mitigate matters for the better. 

Whether we’re talking about a collective mitigation of our apprehension surrounding hallucinogens by way of our continued ventures into pharmacodynamics or we’re referring to an individual level of mitigation by encouraging a first-time consumer into ensuring that they choose a comfortable space to experiment with a particular psychedelic, much can be done across the entire spectrum of our ongoing and evolving relationship with psychedelics to reduce friction where possible. 

A bad trip can be mitigated by ensuring that someone with ample experience is supervising a novice consumer; it’s also critical to ensure that any experience is confined to a safe or pleasurable setting with nothing that can trigger anxiety (i.e. the presence of authorities or an overly busy atmosphere). Some may consider taking smaller steps before big leaps (microdosing before macrodosing) to become familiar with the onset of effects and comfortable with the altered states of consciousness. Ensuring that supplies are obtained from trusted sources is also vital, as is a stable frame of mind with a health purpose of experimenting with a new psychedelic.

And some ways by which we can mitigate the effects of harmful perspectives, as a collective, is to ensure that we’re not blindly following along to myths and believing unfounded pseudo-facts about psychedelics. The louder a conviction is against psychedelics, the more likely it is that it stems from a source that has something to gain from their continued condemnation and suppression. It’s important for us all to remain committed to the continuous expansion of our knowledge relating to these enigmatic substances and to understand that they offer something tremendous to us through the expansion of our consciousness, even if it seems to remain just out of reach of our modern understanding. 

Maybe it’s supposed to. 

Notable Studies

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The exploding interest in psychedelics has not only created a strong demand for further information, but it has also carved out an area of intense academic interest, as students are finding themselves at the frontier of a revived area of science that had, until now, been ostracized.

This public and commercial interest, compounded with an reinvigorated (and nurtured) academic curiosity, has created a highly favorable atmosphere for the proliferation of psychoactive research initiatives. 

 

Countless studies are being spearheaded, many of which have been published only in the last few years, and this trend is only exponentiating by the semester.

 

Below are a few pivotal studies that serve to provide detailed commentary on the risk/benefit analysis of DMT, psilocybin, mescaline and LSD.  

"Risk assessment of ritual use of oral dimethyltryptamine (DMT) and harmala alkaloids"

 

Published January 2007 by Robert S. Gable

About: The aim of this study consisted of assessing the acute sysetmic toxicity and psychological hazards of a DMT/ayahuasca brew, as used in religious ceremonies for thousands of years. The author sought to review literature and interview participants as a method of risk-assessment, applying a systemic evaluation to determine the level of risk associated with physiological or psychological disturbance, ultimately concluding that the level of risk associated with dependence potential (of oral DMT) and psychological harm is 'minimal'. 

Excerpt: "DMT is capable of inducing aversive psychological reactions or transient psychotic episodes that resolve spontaneously in a few hours. There was no evidence that ayahuasca has substantial or persistent abuse potential. Long-term psychological benefits have been documented when ayahuasca is used in a well-established social context.

Link: https://pubmed.ncbi.nlm.nih.gov/17207120/

"Self-reported negative outcomes of psilocybin users: A quantitative textual analysis"

 

Published February 2021 by Bheatrix Bienemann et. al.

About: Assuming a context that the presence of negative outcomes linked to psilocybin use remains unclear, the authors of this study sought to invesitgate the self-reported negative effects of psilocybin consumption, according to the users' own perceptions presented through a myriad of online platforms. Utilizing textual analysis software, 346 reports had been analyzed, catalogued and contextualized. Among other conclusions, it had been found that 'bad trips' were more frequent in female users, being associated with thinking distortions, and that the combination of psilocybin with other substances was linked to the occurrence of negative outcomes. 

Excerpt: "Findings reinforce the need to manage anxiety during psilocybin administration, indicating that distortions at the level of thought were the main cause for bad trips... Longer-term health problems were associated with multiple doses and concurrent use with other substances, in agreement with existing literature. These findings clarify individual and contextual elements that may precipitate negative outcomes linked to psilocybin use"

Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7034876/

"Psychedelics"

 

Published April 2016 by David E. Nichols. 

About: In a stunningly comprehensive analysis of psychedelics, from a standpoint of safety and risk, Nichols examines the potential that psychedelics hold for therapeutic uses and psychiatric ambitions. He assesses the physiological safety of numerous compounds and provides detailed commentary on notions of dependency, addiction and misuse. More importantly, Nichols traverses the pharmacological landscape of the hallucinogenic effects on the brain, offering an exceptionally detailed glimpse into the neurochemical context of it all. 

Excerpt: "if the positive therapeutic effects of psychedelics continue to be validated by additional well designed clinical studies, it opens up a whole new dimension of medical research. If psilocybin or LSD can acutely abolish depression or anxiety after one or only a few treatments, the question must be asked, “How does that occur?” There are many who believe that such improvement must be related to neurochemical effects, or neuroadaptation, and refuse to believe that the mystical experience may be relevant. Yet both modern and older studies consistently find that those who experience the most profound mystical experiences invariably receive the greatest symptom improvement."

Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4813425/

"Twenty percent better with 20 micrograms? A qualitative study of psychedelic microdosing self-rapports and discussions on YouTube"

Published November 28th, 2019 by Martin Andersson and Anette Kjellgren

 

About: Building atop the trending practice of microdosing LSD, the authors of this study sought to qualitatively analyze social media accounts, cultivating data and assessing it through a method that the authors refer to as 'inductive thematic analysis'. They conclude that microdosing can provide similar benefits to full-dose therapeutic interventions with less risk of adverse reactions that are related to experiences with higher doses. 

 

Excerpt: "Social media and internet discussion forums have played a substantial role in the growing visibility of the microdosing phenomenon...  In recent years, the microdosing forum of Reddit.com has annually doubled the number of subscribers... Self-reporting and sharing of drug experiences in online text-based drug forums have proved to be an expedient source of qualitative data for research... A process of augmented self-reflection was often seen as central to the microdosing practice. The microdosers gave extensive descriptions of thoughtful insights and psycho-spiritual changes, reportedly enabling improvements in personal orientation, priorities, and habits."

 

Link: https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-019-0333-3

"Lysergic acid diethylamide (LSD) promotes social behavior through mTORC1 in the excitatory neurotransmission"

 

Published February 2nd, 2021 by Roland Danila De Gregoria et. al. 

 

About: This study sought to examine whether microdoses of LSD could offer the potential to promote various levels of social behaviour. Administering low doses of LSD to mice, the authors detailed the prosocial effects of LSD as it influences various receptors relating to social behaviour. Specifically, repeated doses of LSD served to excite AMPA and 5-HT2A receptors by increasing the phosphorylation of a protein (mTORC1) that modulates social behaviour. 

 

Excerpt: "It is noteworthy that the behavioral outcomes documented in our study were obtained with a relatively low dose of LSD, compared to previous studies in animals (100 to 200 µg/kg) and humans... our study unveils a mechanism contributing to the prosocial effects of LSD, through the stimulation of 5-HT2A and AMPA receptors and the activation of the mTORC1 pathway in excitatory neurons."

 

Link: https://www.pnas.org/content/118/5/e2020705118