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Highlights

Psychedelic and dissociative drugs can temporarily alter a person's mood, thoughts, and perceptions. Among other health effects and safety concerns, people who use these substances report feeling strong emotions ranging from bliss to fear and experiencing vast changes in how they perceive reality.

In recent years, there has been growing research interest in the potential of psychedelic and dissociative drugs to treat medical conditions, including mental health disorders. An increasing number of people also report taking these drugs outside of medical settings for recreation, to improve well-being, or for spiritual or self-exploration.

NIDA supports and conducts research to better understand the health effects of psychedelic and dissociative drugs and to learn whether some of these drugs may help treat substance use disorders in medical settings.

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What are psychedelic and dissociative drugs?

Psychedelic and dissociative drugs can temporarily alter a person's mood, thoughts, and perceptions of reality.¹ Among other health effects and safety concerns, people who use psychedelic and dissociative drugs report feeling strong emotions, ranging from intense happiness and a feeling of connectedness to fear, anxiety, and confusion.2,3 People who use these drugs also report experiencing intense or distorted visions or sensations.¹

Many psychedelic drugs derive from plants and fungi, and some have been used for thousands of years in traditional or religious rituals. Some psychedelic and dissociative drugs are also synthetic (lab-made).² People report using psychedelic and dissociative drugs for a variety of reasons, including seeking new, fun, healing, or spiritual experiences.1,3

Psychedelic drugs

Dissociative drugs

Other

Drugs that primarily influence the way the brain processes the chemical serotonin. They can bring on vivid visions and affect a person's sense of self.²

Includes: psilocybin, LSD, DMT, mescaline, NBOMes

Drugs that primarily affect how the brain processes the chemical glutamate. These drugs can make people feel disconnected from their body and environment.⁶

Includes: ketamine, PCP

Drugs such as MDMA,⁷ ibogaine,⁸ and salvia⁹ affect a variety of brain functions to cause psychedelic and/or dissociative effects.

All of these substances have mind-altering properties with the potential to cause changes in thought processes, mood, and perception of reality.3,7,8,9

Psychedelic drugs (also called "classic psychedelics" or "psychedelics"), including psilocybin and LSD, mainly interact with specific receptors, which are molecular structures in the brain. Known as 5-hydroxy-tryptamine (5-HT) 2A receptors, these are targets for the neurotransmitter (chemical messenger) serotonin. At certain doses, psychedelics may bring on vivid visions or sensations, alter a person's sense of self, and promote feelings of insightfulness or connection.¹⁰

Dissociative drugs, including ketamine and PCP, block the action of N-methyl-D-aspartate (NMDA) receptors. These are part of the brain's system for transporting glutamate, another neurotransmitter. While dissociative drugs can alter perception, they also typically make people feel disconnected from their body and environment.⁶

Other drugs such as MDMA, ibogaine, and salvia work on a variety of brain functions to cause psychedelic or dissociative effects. For more information, see " How do psychedelic and dissociative drugs work in the brain? "

How do psychedelic and dissociative drugs affect the mind and body?

NIDA supports and conducts research on the short- and long-term health effects of psychedelic and dissociative drugs to better inform health decisions and policies related to their use. While research is ongoing, scientific studies have revealed important information about how these drugs work:

Psychedelic and dissociative drugs temporarily alter thought patterns, mood, and perceptions of reality. People who use these substances report feeling strong emotions, ranging from intense happiness and a feeling of connectedness to fear, anxiety, and confusion.1,3 Many people who use psychedelic drugs, such as psilocybin and LSD, report seeing vibrant shapes, colors, and scenes and reliving vivid memories.¹⁰ People who use dissociative drugs, such as ketamine and PCP, describe experiencing distorted vision and hearing.⁶

Dissociative drugs can make people feel "detached."Many people who use dissociative drugs report feeling as though they are floating or are disconnected from their body.¹³

People may experience adverse health effects. Physical side-effects of these substances, such as headache, nausea, or changes in heart rate, are generally not life-threatening.¹⁴ However, illicitly manufactured or processed drugs may be contaminated with colorless and odorless fentanyl or other dangerous substances that can cause serious adverse events, including overdose and death.¹⁵ Psychedelic or dissociative drugs may also produce adverse or debilitating psychological effects such as fear or anxiety.3,16 Research is ongoing to better understand short- and long-term health effects of psychedelic and dissociative drugs. For more information, see "Are psychedelic and dissociative drugs safe?"

Using psychedelic and dissociative drugs has been linked to dangerous behavior and injuries. People using these drugs may have impaired thought processes and perception that cause them to behave in unusual and sometimes dangerous ways. This may lead to injuries and other safety issues, particularly if there is not another individual present who can help prevent or respond to an emergency.¹⁴ For more information, see "Are psychedelic and dissociative drugs safe?"

How do psychedelic and dissociative drugs work in the brain?

More studies are needed to better understand how psychedelic and dissociative drugs work. While researchers debate how to describe these drugs and how specific drugs should be classified, they generally group them according to what is known about how they work in the brain. Better understanding these mechanisms is an active area of NIDA-funded research. This basic research plays an important role in identifying their health effects and potential therapeutic uses.

Top left: 2D chemical structure depiction of psilocybin Top right: 2D chemical structure depiction of LSD (lysergic acid diethylamide) Bottom: 2D chemical structure depiction of DMT (N,N-dimethyltryptamine)

Although research is ongoing, studies suggest psychedelic drugs-such as psilocybin, LSD, and DMT-primarily affect 5-HT 2A receptors in the brain, which ordinarily are activated by the neurotransmitter (chemical messenger) serotonin.¹⁰

Research suggests that the most prominent psychedelic effects stem from activity in the brain's prefrontal cortex, an area involved in mood, cognition, and perception.17,18 Psychedelic drugs also temporarily disrupt communication between different brain regions, including the regions collectively known as the default mode network (DMN). The DMN is most active during brain activity that's related to self-awareness-such as reflecting on past events or making plans.¹⁹ This may account for why psychedelic drugs can make a person's thoughts less self-centered and more expansive, promoting a sense of connectedness with others and the world.¹⁰

Left: 2D chemical structure depiction of ketamine Right: 2D chemical structure depiction of PCP (phencyclidine)

Dissociative drugs, such as ketamine and PCP, also affect the balance of certain chemicals in the brain.⁶ Some of these changes lead to altered perception, as well as feelings of being disconnected from the body or environment.²⁰ Ketamine and PCP disrupt the actions of the brain chemical glutamate at a type of receptor called the N-methyl-D-aspartate (NMDA) receptor.⁶ Glutamate plays a major role in learning and memory, emotion, and the perception of pain.⁷

2D chemical structure depiction of MDMA (3,4-methylenedioxymethamphetamine)

Researchers are also investigating other drugs sometimes classified as psychedelic and dissociative drugs, such as MDMA, and the way they work in the brain.

MDMA stimulates the brain to release serotonin and weakly activates serotonin receptors in the brain, producing some mind-altering effects associated with psychedelic drugs. MDMA also increases activity of other neurotransmitters, such as dopamine and norepinephrine, which are involved in mood and attention.⁷

Other drugs that produce effects associated with psychedelic and dissociative drugs work differently. For example, salvia activates kappa opioid receptors in the brain,²¹ while ibogaine affects a variety of brain receptors.⁸

How is NIDA advancing research on psychedelic and dissociative drugs?

NIDA conducts and supports research on psychedelic and dissociative drugs to help inform health decisions and policies related to their use. This research includes efforts to better understand the health effects of psychedelic and dissociative drugs, how chemicals in-or similar to-these drugs work in the brain, and whether they may be able to treat substance use disorders and other conditions. NIDA also funds research on how and why people use these substances.

In June 2022, NIDA's Office of Translational Initiatives and Program Innovations also announced a new program to support small businesses to develop psychedelic-based therapies for substance use disorders.

Along with other agencies, NIDA also supports major coordination efforts in this evolving field, such as the 2022 Psychedelics as Therapeutics workshop co-sponsored by the National Institute on Mental Health and the National Institute on Alcohol Abuse and Addiction.

See NIDA-funded projects related to psychedelic and dissociative drugs, and learn more about related clinical trials.

Why do people use psychedelic and dissociative drugs?

Some psychedelic drugs are derived from plants and fungi that have a long history of use in many different cultures around the world.²³ Aztec shamans used psilocybin in healing rituals, and some Native American tribes used peyote as long ago as 5,700 B.C. in religious ceremonies.²⁴ References to psychedelic drug use have been found in ancient texts from India and Greece.²

More recently, researchers are exploring the use of psychedelic and dissociative drugs in medical settings as treatments for substance use disorders and for other mental health disorders such as depression, anxiety, and post-traumatic stress disorder (PTSD).4,25

Are psychedelic and dissociative drugs safe?

While more research is needed, the reported incidence of serious adverse events from professionally supervised use of specific psychedelic and dissociative drugs, such as in clinical trials, is relatively low.2,10,11,26 However, many past clinical studies on these drugs have not adequately assessed or reported on adverse events.²⁷

Most people who report using psychedelic and dissociative drugs do so outside of medical or research settings.1,28 While further research is also needed to better understand the health and safety impacts of typical use of these drugs, some serious adverse effects and safety issues have been identified.14,27

Short-term physical side effects are typically mild or moderate but may require professional care. People who take psychedelic or dissociative drugs may experience short-term side effects such as a headache, abdominal pain, nausea or vomiting, high blood pressure, rapid heartbeat, trembling, and diarrhea.4,29 These are typically mild or moderate but may require medical care.³⁰ Importantly, reported cases of side-effects likely represent only a very small number of people who use psychedelic or dissociative drugs, and most people who use these drugs do not seek emergency services.

However, related data can provide insights on the side effects that may lead people to seek help. For example, according to U.S. poison control hotline data from 2000-2016, the most common negative short-term effects experienced by people who called in about using LSD and psilocybin were agitation, rapid heartbeat, pupil dilation, confusion, and vomiting. An analysis of these data found about 17% of these callers (600 people) who had used LSD and 6% of callers (363 people) who had used psilocybin mushrooms were admitted to critical care.³¹

Adverse reactions include fear and anxiety. People may also feel extreme emotions such as fear, confusion, or panic. These challenging experiences are also known as having a "bad trip."³² Research on the extent to which such experiences occur and their impact on health is limited, in part because definitions and reporting of these experiences vary.

Emerging evidence suggests certain psychedelic and dissociative drugs may contain dangerous adulterants. For more information, see "Can psychedelic and dissociative drugs be adulterated with fentanyl and other dangerous contaminants?"

Fatal overdoses and serious adverse effects are rarely associated with typical use of commonly used psychedelic and dissociative drugs. 14,34,35 A 2004 analysis of multiple studies estimated that psilocybin and LSD both have a safety ratio of 1000, meaning that the lethal dose of either drug is about 1000 times larger than a person would typically take for non-medical use.³⁶ However, some psychedelic and dissociative drugs-including NBOMes,37,38 ibogaine,³⁹ and PCP⁴⁰ -have been associated with a small number of reported deaths and serious adverse health effects. Though more research is needed, evidence to date shows that fatal overdoses involving these substances are typically associated with taking very high doses or using combinations of drugs, particularly combining these substances with alcohol, or being placed in excessive physical restraints while displaying unsafe behavior.¹⁶ More research is needed to understand to what extent certain psychedelic and dissociative drugs may be mixed with contaminants (such as fentanyl) that may cause an overdose. For more information, see "Can psychedelic and dissociative drugs be adulterated with fentanyl and other dangerous contaminants?"

Drug interactions may influence effects. Though more study in this area is needed and reported cases are exceedingly rare, some researchers suspect psychedelic drugs may interact with other drugs or medications a person has taken, including prescription medicines that also increase levels of the hormone serotonin in the brain. Too much serotonin in the brain is called serotonin toxicity or serotonin syndrome. Symptoms are typically mild but can be life-threatening in rare cases.41,42

Some psychedelic and dissociative drugs have been associated with specific long-term health problems. Research shows that long-term use of ketamine may cause ketamine-induced uropathy, a treatable but potentially serious condition that causes symptoms similar to those of a urinary tract infection.⁴⁶ Limited research also suggests using MDMA (considered by some to have psychedelic properties) may be associated with mild or moderate heart valve disease, in which one or more of the four valves controlling blood flow from the heart do not function normally.⁴⁷ In an analysis of studies conducted from 2015 through 2020, ibogaine use was associated with long QT syndrome, in which the electric impulses that control heartbeats function irregularly.⁴⁸

Research on long-term mental health effects of psychedelic and dissociative drugs is ongoing. More research is needed to better understand the long-term impacts of psychedelic and dissociative drugs on mental health. Mental health complications from psychedelic and dissociative drugs are currently extremely rare in clinical research settings, in part because these studies are highly controlled and participants are screened for existing mental illnesses.³² For more information, see "What is the relationship between psychedelic and dissociative drugs and mental illness?"

Can psychedelic and dissociative drugs be used as medicine?

The U.S. Food and Drug Administration (FDA) has approved the ketamine derivative esketamine (under the brand name Spravato ®) as a treatment for severe depression in patients who do not respond to other treatments.⁴⁹ The FDA has also granted Breakthrough Therapy designation for two formulations of psilocybin being studied as potential medical treatments for depression.

NIDA supports and conducts research to learn whether some of these drugs may help treat substance use disorders in medical settings.

What is the relationship between psychedelic and dissociative drugs and mental illness?

While scientists are still studying their effects, research suggests that some psychedelic and dissociative drugs may promote positive changes in thinking and mood.³ Researchers have suggested that these effects, including changes in brain functions that promote openness to new thoughts and experiences, may be valuable for supplementing mental health treatment.⁵⁰ The U.S. Food and Drug Administration (FDA) has approved the ketamine derivative esketamine (under the brand name Spravato®) as a treatment for severe depression in patients who do not respond to other treatments. The FDA has also granted Breakthrough Therapy designation for two formulations of psilocybin being studied as potential medical treatments for depression.

While short-term positive and negative mood changes are common with psychedelic and dissociative drugs, more research is needed to better understand the long-term effects these substances may have on mental health.

There is some evidence that psychedelic drugs might bring about or trigger schizophrenia-like illness in people with predisposing factors, but little evidence that they cause long-term psychiatric problems for most people. In a 1996 study where people with pre-existing psychoses were given LSD, three of 65 participants experienced persistent worsening of their psychiatric symptoms lasting 3-8 months.⁵¹

In modern psychedelic research, as a precaution, participants with previously diagnosed psychosis or bipolar disorder, and sometimes other mental illnesses, are excluded from participation. Under these conditions, the risk of psychosis or suicide among people who participate in research on psychedelic drugs, or who receive them as medication, is extremely low.⁵² An analysis of 34 clinical studies of LSD, psilocybin, or ayahuasca, published from 2006-2020 and involving 549 participants, found no evidence of longer-term adverse effects.²⁶ However, poor mental health outcomes may be more likely outside of clinical use.¹⁴

Research suggests, though, that the dissociative drugs PCP⁴¹ and ketamine⁵³ can make symptoms worse in people who have schizophrenia, and can cause short-term episodes of psychosis, in which a person experiences hallucinations and delusions, and has trouble experiencing what is real and what is not. PCP can also cause psychosis that persists for days to weeks.6,54 While it is not clear whether ketamine raises the risk of long-term psychosis, people who engage in regular recreational use of ketamine are more likely to experience delusions, even after weeks of abstinence.⁵⁵ Animal studies show that long-term use of PCP or ketamine can cause brain changes resembling those seen in people with schizophrenia.⁵⁶

One analysis found higher rates of suicidal ideation-thinking about, considering or planning suicide-but not attempted or completed suicide, in people who took esketamine, a ketamine derivative, compared to venlafaxine, an antidepressant medication.⁵⁷ In another analysis of 25 studies, medically unsupervised ketamine use was associated with related substance use disorder symptoms, memory loss, depression, and anxiety.⁵⁸

Can psychedelic and dissociative drugs be adulterated with fentanyl and other dangerous contaminants?

Many illicitly manufactured or processed drugs are increasingly found to contain contaminants that produce effects-including overdose and death-not associated with the substance or amount of substance a person intended to take.28,59 Adulteration of heroin, cocaine, and other drugs with highly potent fentanyl and related substances is a major contributor to rising drug overdose deaths.⁶⁰ Because fentanyl and related substances are colorless and odorless, they are difficult to detect without chemical testing. This means adulteration of psychedelic and dissociative drugs with fentanyl and similar compounds is possible, but more research is needed to understand to what extent this occurs. Some organizations are using harm reduction practices to help avoid drug overdose deaths related to possible adulteration of certain psychedelic and dissociative drugs, particularly those taken in pill, powder, or liquid form.¹⁵

How do psychedelic and dissociative drugs affect pregnancy?

The effects of psychedelic and dissociative drugs during pregnancy are not well understood, as data are limited. PCP use during pregnancy has been linked to a range of congenital abnormalities in an infant's heart, lung, urinary, cardiovascular, respiratory, urinary, and musculoskeletal systems.⁶¹ Some laboratory and epidemiological studies suggest MDMA (considered by some to have psychedelic properties) may cause motor delays and congenital abnormalities (particularly heart defects) in infants exposed to it during pregnancy.62,63

Are psychedelic and dissociative drugs addictive? Can people experience withdrawal?

To be diagnosed with a substance use disorder, a person must meet specific diagnostic criteria for continued substance use despite negative consequences. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)-a reference text professionals use to diagnose substance use disorders and other psychiatric disorders-includes diagnoses of phencyclidine (PCP) use disorder and "other hallucinogen use disorder"64,65 but does not include substance use disorder diagnoses related to other specific psychedelic and dissociative drugs.

Limited research suggests that use of psychedelic drugs, such as psilocybin and LSD, does not typically lead to addiction.1,35 Researchers think that one reason may be because people commonly experience unpleasant side effects when taking these substances, including headaches and nausea, which reduces their desire to take them again.⁶⁶

A small laboratory study published on psilocybin, DMT, and mescaline suggested that these psychedelic drugs are "weakly reinforcing," indicating their use is not likely to lead to a substance use disorder.⁶⁷ However, some evidence suggests people may quickly develop a tolerance to psychedelic drugs, meaning they must keep taking more of the drug to experience the same level of effects.²⁴

While more research is needed, laboratory research and a few human studies suggest that using the dissociative drug ketamine outside of a clinical setting can lead to cravings as well as symptoms of withdrawal.⁶⁸

NIDA conducts and supports research to better understand how often and to what extent people experience tolerance, withdrawal, and other substance use disorder symptoms related to the use of psychedelic and dissociative drugs.

What is the scope of psychedelic and dissociative drug use in the United States?

Information on the use of psychedelic and dissociative drugs is collected by several national surveys. These surveys use the terms "hallucinogen" and "hallucinogen use disorder" and data from those surveys are reported below.

How many people use hallucinogens*?

Among people aged 12 or older in 2021, 2.6% (or about 7.4 million people) reported using hallucinogens in the past 12 months.

Source: 2021 National Survey on Drug Use and Health

How many young students use hallucinogens**?

Among young people in 2022:

An estimated 1.2% of 8th graders, 2.1% of 10th graders, and 4.4% of 12th graders reported using any hallucinogen*in the past 12 months.

An estimated 0.6% of 8th graders, 1.3% of 10th graders, and 2.5% of 12th graders reported using LSD in the past 12 months.

An estimated 1% of 8th graders, 1.6% of 10th graders, and 3.4% of 12th graders reported using hallucinogens other than LSD in the past 12 months.

An estimated 0.6% of 8th graders, 0.7% of 10th graders, and 1.4% of 12th graders reported using MDMA.

An estimated 1.2% of 12th graders reported using ketamine in the past 12 months.

An estimated 0.8% of 8th graders, 0.8% of 10th graders, and 0.8% of 12th graders reported using salvia in the past 12 months.

Source: 2022 Monitoring the Future Survey

How many young adults use hallucinogens?

Among young adults aged 19 to 30 in 2021:

An estimated 8% reported using any hallucinogen*, representing an all-time high since the category was first surveyed in 1988.

Source: 2021 Monitoring the Future Panel Study Annual Report

How many people have a hallucinogen use disorder?

Among people aged 12 or older in 2020, 0.2% (or about 493,000 people) had a hallucinogen use disorder in the past 12 months.

Source: 2021 National Survey on Drug Use and Health

* Types of hallucinogens reported by participants in the National Survey on Drug Use and Health include DMT/AMT/Foxy, ketamine, LSD, MDMA, PCP, peyote/mescaline, psilocybin mushrooms, and Salvia divinorum.

**Types of hallucinogens reported by participants in the Monitoring the Future surveys included LSD, MDMA, mescaline, peyote, "shrooms" or psilocybin, and PCP.

What are examples of psychedelic and dissociative drugs?

While many emerging and established substances are classified as psychedelic and dissociative drugs, NIDA-supported research mainly focuses on the following substances, which are more commonly used and/or are being investigated as potential medical treatments. While some debate remains on how to describe these drugs and how specific drugs are classified, researchers generally classify them according to how they work in the brain.

Psychedelic Drugs

Psilocybin is a chemical compound in certain types of mushrooms, also called "shrooms" or "magic mushrooms."²³

LSD (lysergic acid diethylamide), or "acid," is a clear or white, odorless, lab-made (synthetic) substance derived from chemicals in fungi that grow on rye and other grains.⁶⁹

DMT (N,N-dimethyltryptamine) is a chemical compound found in plants native to the Amazon rainforest. These plants are sometimes used to make a tea called ayahuasca.⁷⁰ Lab-made (synthetic) DMT is a white crystalline powder that is usually smoked.⁷¹

Mescaline is a chemical compound found in peyote, a small cactus native to America's southwest and northern Mexico. Mescaline can also be lab-made (synthetic).⁷²

NBOMes (N-Benzylphenethylamines) are lab-made (synthetic) chemical compounds originally developed for use in brain research.⁷³ They are sometimes sold as LSD but are more potent with higher risk of adverse effects.

Dissociative Drugs

Ketamine is a chemical compound used in prescription medications for anesthesia in humans and animals. It is also illegally manufactured as a liquid or off-white powder.²⁸ A derivative called esketamine is FDA-approved for treatment-resistant depression.

PCP (phencyclidine) is a synthetic chemical compound mostly commonly used as a liquid or white crystal powder.⁴⁰

Other

Researchers are also interested in the psychedelic and dissociative properties of other drugs. These include:

MDMA (3,4-methylenedioxy-methamphetamine), also called "Molly" or "Ecstasy," is a lab-made (synthetic) drug that has effects similar to stimulants like methamphetamine. Some researchers and organizations consider MDMA to be a psychedelic drug because it can also mildly alter visual and time perception.⁷

Ibogaine is a chemical compound that comes from the bark of certain plants. These include the iboga shrub, which is used in religious rites in Western Africa. While ibogaine does have psychedelic properties, it affects a different spectrum of brain activity than psychedelic or dissociative drugs.⁸

Salvia (salvia divinorum) is a plant common to southern Mexico and Central and South America. Salvia leaves are typically chewed, extracted as juices, smoked, or vaporized. Unlike psychedelic or dissociative drugs, it primarily activates kappa opioid receptors in the brain.²¹

What is microdosing?

Some people report "microdosing" psychedelic drugs, typically LSD or psilocybin. Microdosing refers to regularly taking these drugs in very small amounts, typically one tenth to one twentieth of a typical non-clinical dose. People report that they microdose to lessen mental health symptoms such as depression and stress, improve productivity, and ease pain. However, research to date has not established that microdosing is safe or effective.²²,74

Are psychedelic and dissociative drugs legal?

Find More Resources on Psychedelic and Dissociative Drugs

References

1. Nichols DE. Psychedelics. Pharmacol Rev 2016;68:264-355.doi:10.1124/pr.115.011478

2. Johnson MW, Hendricks PS, Barrett FS, Griffiths RR. Classic psychedelics: An integrative review of epidemiology, therapeutics, mystical experience, and brain network function. Pharmacol Ther. 2019;197:83-102. doi:10.1016/j.pharmthera.2018.11.010

3. Garcia-Romeu A, Kersgaard B, Addy PH. Clinical applications of hallucinogens: A review. Exp Clin Psychopharmacol. 2016;24 (4):229-268. doi:10.1037/pha0000084

4. Bender D, Hellerstein DJ. Assessing the risk-benefit profile of classical psychedelics: a clinical review of second-wave psychedelic research. Psychopharmacology (Berl). 2022;239(6):1907-1932. doi:10.1007/s00213-021-06049-6

5. Ivan Ezquerra-Romano I, Lawn W, Krupitsky E, Morgan CJA. Ketamine for the treatment of addiction: Evidence and potential mechanisms. Neuropharmacology. 2018;142:72-82. doi:10.1016/j.neuropharm.2018.01.017

6. Lodge D, Mercier MS. Ketamine and phencyclidine: the good, the bad and the unexpected. Br J Pharmacol. 2015;172(17):4254-4276. doi:10.1111/bph.13222

7. Dunlap LE, Andrews AM, Olson DE. Dark Classics in Chemical Neuroscience: 3,4-Methylenedioxymethamphetamine. ACS Chem Neurosci. 2018;9(10):2408-2427. doi:10.1021/acschemneuro.8b00155

8. Wasko MJ, Witt-Enderby PA, Surratt CK. DARK Classics in Chemical Neuroscience: Ibogaine. ACS Chem Neurosci. 2018;9(10):2475-2483. doi:10.1021/acschemneuro.8b00294

9. Johnson MW, MacLean KA, Reissig CJ, Prisinzano TE, Griffiths RR. Human psychopharmacology and dose-effects of salvinorin A, a kappa opioid agonist hallucinogen present in the plant Salvia divinorum. Drug Alcohol Depend. 2011;115(1-2):150-155. doi:10.1016/j.drugalcdep.2010.11.005

10. Vollenweider FX, Smallridge JW. Classic Psychedelic Drugs: Update on Biological Mechanisms. Pharmacopsychiatry. 2022;55(3):121-138. doi:10.1055/a-1721-2914

11. Studerus E, Gamma A, Kometer M, Vollenweider FX. Prediction of psilocybin response in healthy volunteers. PLoS One. 2012;7(2):e30800. doi:10.1371/journal.pone.0030800

12. Oliver CF, Palamar JJ, Salomone A, et al. Synthetic cathinone adulteration of illegal drugs. Psychopharmacology (Berl). 2019;236(3):869-879. doi:10.1007/s00213-018-5066-6

13. Jansen KL. A review of the nonmedical use of ketamine: use, users and consequences. J Psychoactive Drugs. 2000;32(4):419-433. doi:10.1080/02791072.2000.10400244

14. Breeksema JJ, Kuin BW, Kamphuis J, van den Brink W, Vermetten E, Schoevers RA. Adverse events in clinical treatments with serotonergic psychedelics and MDMA: A mixed-methods systematic review. J Psychopharmacol. 2022;36(10):1100-1117. doi:10.1177/02698811221116926

15. Palamar JJ, Salomone A, Barratt MJ. Drug checking to detect fentanyl and new psychoactive substances. Curr Opin Psychiatry. 2020;33(4):301-305. doi:10.1097/YCO.0000000000000607

16. Schlag AK, Aday J, Salam I, Neill JC, Nutt DJ. Adverse effects of psychedelics: From anecdotes and misinformation to systematic science [published online ahead of print, 2022 Feb 2]. J Psychopharmacol. 2022;2698811211069100. doi:10.1177/02698811211069100

17. Calvey T, Howells FM. An introduction to psychedelic neuroscience. Prog Brain Res. 2018;242:1-23. doi:10.1016/bs.pbr.2018.09.013

18. Lee HM, Roth BL. Hallucinogen actions on human brain revealed. Proc Natl Acad Sci U S A. 2012;109(6):1820-1821. doi:10.1073/pnas.1121358109

19. Zhang R, Volkow ND. Brain default-mode network dysfunction in addiction. Neuroimage. 2019;200:313-331. doi:10.1016/j.neuroimage.2019.06.036

20. Jansen KL. A review of the nonmedical use of ketamine: use, users and consequences. J Psychoactive Drugs. 2000;32(4):419-433. doi:10.1080/02791072.2000.10400244

21. Hernández-Alvarado RB, Madariaga-Mazón A, Ortega A, Martinez-Mayorga K. DARK Classics in Chemical Neuroscience: Salvinorin A [published online ahead of print, 2020 Nov 9]. ACS Chem Neurosci. 2020;10.1021/acschemneuro.0c00608. doi:10.1021/acschemneuro.0c00608

22. Kuypers KP, Ng L, Erritzoe D, et al. Microdosing psychedelics: More questions than answers? An overview and suggestions for future research. J Psychopharmacol. 2019;33(9):1039-1057. doi:10.1177/0269881119857204

23. Van Court RC, Wiseman MS, Meyer KW, et al. Diversity, biology, and history of psilocybin-containing fungi: Suggestions for research and technological development. Fungal Biol. 2022;126(4):308-319. doi:10.1016/j.funbio.2022.01.003

24. Nichols DE. Hallucinogens. Pharmacol Ther. 2004;101(2):131-181. doi:10.1016/j.pharmthera.2003.11.002

25. Castro Santos H, Gama Marques J. What is the clinical evidence on psilocybin for the treatment of psychiatric disorders? A systematic review. Porto Biomed J. 2021;6(1):e128. Published 2021 Feb 11. doi:10.1097/j.pbj.0000000000000128

26. Goldberg SB, Shechet B, Nicholas CR, et al. Post-acute psychological effects of classical serotonergic psychedelics: a systematic review and meta-analysis. Psychol Med. 2020;50(16):2655-2666. doi:10.1017/S003329172000389X

27. Breeksema JJ, Kuin BW, Kamphuis J, van den Brink W, Vermetten E, Schoevers RA. Adverse events in clinical treatments with serotonergic psychedelics and MDMA: A mixed-methods systematic review. J Psychopharmacol. 2022;36(10):1100-1117. doi:10.1177/02698811221116926

28. Morgan CJ, Curran HV; Independent Scientific Committee on Drugs. Ketamine use: a review. Addiction. 2012;107(1):27-38. doi:10.1111/j.1360-0443.2011.03576.x

29. van Amsterdam J, Opperhuizen A, van den Brink W. Harm potential of magic mushroom use: a review. Regul Toxicol Pharmacol. 2011;59(3):423-429. doi:10.1016/j.yrtph.2011.01.006

30. van Amsterdam J, Van Den Brink W. Harm related to recreational ketamine use and its relevance for the clinical use of ketamine. A systematic review and comparison study. Expert Opin Drug Saf. 2022;21(1):83-94. doi:10.1080/14740338.2021.1949454

31. Leonard JB, Anderson B, Klein-Schwartz W. Does getting high hurt? Characterization of cases of LSD and psilocybin-containing mushroom exposures to national poison centers between 2000 and 2016. J Psychopharmacol. 2018;32(12):1286-1294. doi:10.1177/0269881118793086

32. Johnson M, Richards W, Griffiths R. Human hallucinogen research: guidelines for safety. J Psychopharmacol. 2008;22(6):603-620. doi:10.1177/0269881108093587

33. Carbonaro TM, Bradstreet MP, Barrett FS, et al. Survey study of challenging experiences after ingesting psilocybin mushrooms: Acute and enduring positive and negative consequences. J Psychopharmacol. 2016;30(12):1268-1278. doi:10.1177/0269881116662634

34. Johnson MW, Griffiths RR, Hendricks PS, Henningfield JE. The abuse potential of medical psilocybin according to the 8 factors of the Controlled Substances Act. Neuropharmacology. 2018;142:143-166. doi:10.1016/j.neuropharm.2018.05.012

35. Nichols DE, Grob CS. Is LSD toxic?. Forensic Sci Int. 2018;284:141-145. doi:10.1016/j.forsciint.2018.01.006

36. Gable RS. Comparison of acute lethal toxicity of commonly abused psychoactive substances. Addiction. 2004;99(6):686-696. doi:10.1111/j.1360-0443.2004.00744.x

37. Gee P, Schep LJ, Jensen BP, Moore G, Barrington S. Case series: toxicity from 25B-NBOMe--a cluster of N-bomb cases - PubMed (nih.gov). Clin Toxicol (Phila). 2016;54(2):141-146. doi:10.3109/15563650.2015.1115056

38. Wood DM, Sedefov R, Cunningham A, Dargan PI. Prevalence of use and acute toxicity associated with the use of NBOMe drugs. Clin Toxicol (Phila). 2015;53(2):85-92. doi:10.3109/15563650.2015.1004179

39. Köck P, Froelich K, Walter M, Lang U, Dürsteler KM. A systematic literature review of clinical trials and therapeutic applications of ibogaine. J Subst Abuse Treat. 2022;138:108717. doi:10.1016/j.jsat.2021.108717

40. Bertron JL, Seto M, Lindsley CW. DARK Classics in Chemical Neuroscience: Phencyclidine (PCP). ACS Chem Neurosci. 2018;9(10):2459-2474. doi:10.1021/acschemneuro.8b0026

41. Malcolm B, Thomas K. Serotonin toxicity of serotonergic psychedelics [published online ahead of print, 2021 Jul 12]. Psychopharmacology (Berl). 2021;10.1007/s00213-021-05876-x. doi:10.1007/s00213-021-05876-x

42. Volpi-Abadie J, Kaye AM, Kaye AD. Serotonin syndrome. Ochsner J. 2013;13(4):533-540.

43. Müller F, Kraus E, Holze F, et al. Flashback phenomena after administration of LSD and psilocybin in controlled studies with healthy participants [published online ahead of print, 2022 Jan 25]. Psychopharmacology (Berl). 2022;10.1007/s00213-022-06066-z. doi:10.1007/s00213-022-06066-z

44. Halpern JH, Lerner AG, Passie T. A Review of Hallucinogen Persisting Perception Disorder (HPPD) and an Exploratory Study of Subjects Claiming Symptoms of HPPD. Curr Top Behav Neurosci. 2018;36:333-360. doi:10.1007/7854_2016_457

45. Martinotti G, Santacroce R, Pettorruso M, et al. Hallucinogen Persisting Perception Disorder: Etiology, Clinical Features, and Therapeutic Perspectives. Brain Sci. 2018;8(3):47. Published 2018 Mar 16. doi:10.3390/brainsci8030047

46. Castellani D, Pirola GM, Gubbiotti M, et al. What urologists need to know about ketamine-induced uropathy: A systematic review. Neurourol Urodyn. 2020;39(4):1049-1062. doi:10.1002/nau.24341

47. Fonseca DA, Ribeiro DM, Tapadas M, Cotrim MD. Ecstasy (3,4-methylenedioxymethamphetamine): Cardiovascular effects and mechanisms. Eur J Pharmacol. 2021;903:174156. doi:10.1016/j.ejphar.2021.174156

48. Ona G, Rocha JM, Bouso JC, Hallak JEC, Borràs T, Colomina MT, Dos Santos RG. The adverse events of ibogaine in humans: an updated systematic review of the literature (2015-2020). Psychopharmacology (Berl). 2021 Aug 18. doi: 10.1007/s00213-021-05964-y. Epub ahead of print. PMID: 34406452.

49. Hashimoto K. Rapid-acting antidepressant ketamine, its metabolites and other candidates: A historical overview and future perspective. Psychiatry Clin Neurosci. 2019;73(10):613-627. doi:10.1111/pcn.12902

50. Reiff CM, Richman EE, Nemeroff CB, et al. Psychedelics and Psychedelic-Assisted Psychotherapy. Focus (Am Psychiatr Publ). 2021;19(1):95-115. doi:10.1176/appi.focus.19104

51. Fink M, Simeon J, Haque W, Itil T. Prolonged adverse reactions to LSD in psychotic subjects. Arch Gen Psychiatry-. 1966;15(5):450-454. doi:10.1001/archpsyc.1966.01730170002002

52. Zeifman RJ, Singhal N, Breslow L, Weissman CR. On the Relationship between Classic Psychedelics and Suicidality: A Systematic Review [published correction appears in ACS Pharmacol Transl Sci. 2022 Feb 22;5(3):176]. ACS Pharmacol Transl Sci. 2021;4(2):436-451. Published 2021 Mar 11. doi:10.1021/acsptsci.1c00024

53. Tyler MW, Yourish HB, Ionescu DF, Haggarty SJ. Classics in Chemical Neuroscience: Ketamine. ACS Chem Neurosci. 2017;8(6):1122-1134. doi:10.1021/acschemneuro.7b00074

54. Javitt DC, Zukin SR. Recent advances in the phencyclidine model of schizophrenia. Am J Psychiatry. 1991;148(10):1301-1308. doi:10.1176/ajp.148.10.1301

55. Morgan CJ, Muetzelfeldt L, Curran HV. Consequences of chronic ketamine self-administration upon neurocognitive function and psychological wellbeing: a 1-year longitudinal study [published correction appears in Addiction. 2010 Apr;105(4):766]. Addiction. 2010;105(1):121-133. doi:10.1111/j.1360-0443.2009.02761.x

56. Kristiansen LV, Huerta I, Beneyto M, Meador-Woodruff JH. NMDA receptors and schizophrenia. Curr Opin Pharmacol. 2007 Feb;7(1):48-55. doi: 10.1016/j.coph.2006.08.013. Epub 2006 Nov 9. PMID: 17097347.

57. Gastaldon C, Raschi E, Kane JM, Barbui C, Schoretsanitis G. Post-Marketing Safety Concerns with Esketamine: A Disproportionality Analysis of Spontaneous Reports Submitted to the FDA Adverse Event Reporting System. Psychother Psychosom. 2021;90(1):41-48. doi:10.1159/000510703

58. van Amsterdam J, Van Den Brink W. Harm related to recreational ketamine use and its relevance for the clinical use of ketamine. A systematic review and comparison study. Expert Opin Drug Saf. 2022;21(1):83-94. doi:10.1080/14740338.2021.1949454

59. Ivory ST, Rotella JA, Schumann J, Greene SL. A cluster of 25B-NBOH poisonings following exposure to powder sold as lysergic acid diethylamide (LSD). Clin Toxicol (Phila). 2022;60(8):966-969. doi:10.1080/15563650.2022.2053150

60. D'Errico S. Commentary. Fentanyl-related death and the underreporting risk. J Forensic Leg Med. 2018;60:35-37. doi:10.1016/j.jflm.2018.09.007

61. Holbrook BD, Rayburn WF. Teratogenic risks from exposure to illicit drugs. Obstet Gynecol Clin North Am. 2014;41(2):229-239. doi:10.1016/j.ogc.2014.02.008

62. McElhatton PR, Bateman DN, Evans C, Pughe KR, Thomas SH. Congenital anomalies after prenatal ecstasy exposure. Lancet. 1999;354(9188):1441-1442. doi:10.1016/s0140-6736(99)02423-x

63. Singer LT, Moore DG, Min MO, et al. Motor delays in MDMA (ecstasy) exposed infants persist to 2 years. Neurotoxicol Teratol. 2016;54:22-28. doi:10.1016/j.ntt.2016.01.003

64. Ryu IS, Kim OH, Lee YE, Kim JS, Li ZH, Kim TW, Lim RN, Lee YJ, Cheong JH, Kim HJ, Lee YS, Steffensen SC, Lee BH, Seo JW, Jang EY. The Abuse Potential of Novel Synthetic Phencyclidine Derivative 1-(1-(4-Fluorophenyl)Cyclohexyl) Piperidine (4'-F-PCP) in Rodents. Int J Mol Sci. 2020 Jun 29;21(13):4631. doi: 10.3390/ijms21134631

65. American Psychiatric Association, Substance-Related and Addictive Disorders, Diagnostic and Statistical Manual of Mental Disorders, 10.1176/appi.books.9780890425787, (2022)

66. Johnson MW, Sewell RA, Griffiths RR. Psilocybin dose-dependently causes delayed, transient headaches in healthy volunteers. Drug Alcohol Depend. 2012;123(1-3):132-140. doi:10.1016/j.drugalcdep.2011.10.029

67. Fantegrossi WE, Woods JH, Winger G. Transient reinforcing effects of phenylisopropylamine and indolealkylamine hallucinogens in rhesus monkeys . Behav Pharmacol. 2004;15(2):149-157. doi:10.1097/00008877-200403000-00007

68. Kokane SS, Armant RJ, Bolaños-Guzmán CA, Perrotti LI. Overlap in the neural circuitry and molecular mechanisms underlying ketamine abuse and its use as an antidepressant. Behav Brain Res. 2020;384:112548. doi:10.1016/j.bbr.2020.112548

69. Passie T, Halpern JH, Stichtenoth DO, Emrich HM, Hintzen A. The pharmacology of lysergic acid diethylamide: a review. CNS Neurosci Ther. 2008;14(4):295-314. doi:10.1111/j.1755-5949.2008.00059.x

70. Domínguez-Clavé E, Soler J, Elices M, et al. Ayahuasca: Pharmacology, neuroscience and therapeutic potential. Brain Res Bull. 2016;126(Pt 1):89-101. doi:10.1016/j.brainresbull.2016.03.002

71. Carbonaro TM, Gatch MB. Neuropharmacology of N,N-dimethyltryptamine. Brain Res Bull. 2016;126(Pt 1):74-88. doi:10.1016/j.brainresbull.2016.04.016

72. Dinis-Oliveira RJ, Pereira CL, da Silva DD. Pharmacokinetic and pharmacodynamic aspects of peyote and mescaline: clinical and forensic repercussions. Curr Mol Pharmacol. 2019;12(3):184-194. doi:10.2174/1874467211666181010154139

73. Poulie CBM, Jensen AA, Halberstadt AL, Kristensen JL. DARK Classics in Chemical Neuroscience: NBOMes [published online ahead of print, 2019 Nov 12]. ACS Chem Neurosci. 2019;10.1021/acschemneuro.9b00528. doi:10.1021/acschemneuro.9b00528

74. de Wit H, Molla HM, Bershad A, Bremmer M, Lee R. Repeated low doses of LSD in healthy adults: A placebo-controlled, dose-response study [published online ahead of print, 2022 Feb 1]. Addict Biol. 2022;e13143. doi:10.1111/adb.13143

75. Siegel JS, Daily JE, Perry DA, Nicol GE. Psychedelic Drug Legislative Reform and Legalization in the US. JAMA Psychiatry. Published online December 07, 2022. doi:10.1001/jamapsychiatry.2022.4101

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NIDA. 2023, April 14. Psychedelic and Dissociative Drugs. Retrieved from https://nida.nih.gov/research-topics/psychedelic-dissociative-drugs

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What are psychedelic and dissociative drugs?

Psychedelic and dissociative drugs can temporarily alter a person's mood, thoughts, and perceptions of reality.¹ Among other health effects and safety concerns, people who use psychedelic and dissociative drugs report feeling strong emotions, ranging from intense happiness and a feeling of connectedness to fear, anxiety, and confusion.2,3 People who use these drugs also report experiencing intense or distorted visions or sensations.¹

Many psychedelic drugs derive from plants and fungi, and some have been used for thousands of years in traditional or religious rituals. Some psychedelic and dissociative drugs are also synthetic (lab-made).² People report using psychedelic and dissociative drugs for a variety of reasons, including seeking new, fun, healing, or spiritual experiences.1,3

Psychedelic drugs

Dissociative drugs

Other

Drugs that primarily influence the way the brain processes the chemical serotonin. They can bring on vivid visions and affect a person's sense of self.²

Includes: psilocybin, LSD, DMT, mescaline, NBOMes

Drugs that primarily affect how the brain processes the chemical glutamate. These drugs can make people feel disconnected from their body and environment.⁶

Includes: ketamine, PCP

Drugs such as MDMA,⁷ ibogaine,⁸ and salvia⁹ affect a variety of brain functions to cause psychedelic and/or dissociative effects.

All of these substances have mind-altering properties with the potential to cause changes in thought processes, mood, and perception of reality.3,7,8,9

Psychedelic drugs (also called "classic psychedelics" or "psychedelics"), including psilocybin and LSD, mainly interact with specific receptors, which are molecular structures in the brain. Known as 5-hydroxy-tryptamine (5-HT) 2A receptors, these are targets for the neurotransmitter (chemical messenger) serotonin. At certain doses, psychedelics may bring on vivid visions or sensations, alter a person's sense of self, and promote feelings of insightfulness or connection.¹⁰

Dissociative drugs, including ketamine and PCP, block the action of N-methyl-D-aspartate (NMDA) receptors. These are part of the brain's system for transporting glutamate, another neurotransmitter. While dissociative drugs can alter perception, they also typically make people feel disconnected from their body and environment.⁶

Other drugs such as MDMA, ibogaine, and salvia work on a variety of brain functions to cause psychedelic or dissociative effects. For more information, see " How do psychedelic and dissociative drugs work in the brain? "

How do psychedelic and dissociative drugs affect the mind and body?

NIDA supports and conducts research on the short- and long-term health effects of psychedelic and dissociative drugs to better inform health decisions and policies related to their use. While research is ongoing, scientific studies have revealed important information about how these drugs work:

Psychedelic and dissociative drugs temporarily alter thought patterns, mood, and perceptions of reality. People who use these substances report feeling strong emotions, ranging from intense happiness and a feeling of connectedness to fear, anxiety, and confusion.1,3 Many people who use psychedelic drugs, such as psilocybin and LSD, report seeing vibrant shapes, colors, and scenes and reliving vivid memories.¹⁰ People who use dissociative drugs, such as ketamine and PCP, describe experiencing distorted vision and hearing.⁶

Dissociative drugs can make people feel "detached."Many people who use dissociative drugs report feeling as though they are floating or are disconnected from their body.¹³

People may experience adverse health effects. Physical side-effects of these substances, such as headache, nausea, or changes in heart rate, are generally not life-threatening.¹⁴ However, illicitly manufactured or processed drugs may be contaminated with colorless and odorless fentanyl or other dangerous substances that can cause serious adverse events, including overdose and death.¹⁵ Psychedelic or dissociative drugs may also produce adverse or debilitating psychological effects such as fear or anxiety.3,16 Research is ongoing to better understand short- and long-term health effects of psychedelic and dissociative drugs. For more information, see "Are psychedelic and dissociative drugs safe?"

Using psychedelic and dissociative drugs has been linked to dangerous behavior and injuries. People using these drugs may have impaired thought processes and perception that cause them to behave in unusual and sometimes dangerous ways. This may lead to injuries and other safety issues, particularly if there is not another individual present who can help prevent or respond to an emergency.¹⁴ For more information, see "Are psychedelic and dissociative drugs safe?"

How do psychedelic and dissociative drugs work in the brain?

More studies are needed to better understand how psychedelic and dissociative drugs work. While researchers debate how to describe these drugs and how specific drugs should be classified, they generally group them according to what is known about how they work in the brain. Better understanding these mechanisms is an active area of NIDA-funded research. This basic research plays an important role in identifying their health effects and potential therapeutic uses.

Top left: 2D chemical structure depiction of psilocybin Top right: 2D chemical structure depiction of LSD (lysergic acid diethylamide) Bottom: 2D chemical structure depiction of DMT (N,N-dimethyltryptamine)

Although research is ongoing, studies suggest psychedelic drugs-such as psilocybin, LSD, and DMT-primarily affect 5-HT 2A receptors in the brain, which ordinarily are activated by the neurotransmitter (chemical messenger) serotonin.¹⁰

Research suggests that the most prominent psychedelic effects stem from activity in the brain's prefrontal cortex, an area involved in mood, cognition, and perception.17,18 Psychedelic drugs also temporarily disrupt communication between different brain regions, including the regions collectively known as the default mode network (DMN). The DMN is most active during brain activity that's related to self-awareness-such as reflecting on past events or making plans.¹⁹ This may account for why psychedelic drugs can make a person's thoughts less self-centered and more expansive, promoting a sense of connectedness with others and the world.¹⁰

Left: 2D chemical structure depiction of ketamine Right: 2D chemical structure depiction of PCP (phencyclidine)

Dissociative drugs, such as ketamine and PCP, also affect the balance of certain chemicals in the brain.⁶ Some of these changes lead to altered perception, as well as feelings of being disconnected from the body or environment.²⁰ Ketamine and PCP disrupt the actions of the brain chemical glutamate at a type of receptor called the N-methyl-D-aspartate (NMDA) receptor.⁶ Glutamate plays a major role in learning and memory, emotion, and the perception of pain.⁷

2D chemical structure depiction of MDMA (3,4-methylenedioxymethamphetamine)

Researchers are also investigating other drugs sometimes classified as psychedelic and dissociative drugs, such as MDMA, and the way they work in the brain.

MDMA stimulates the brain to release serotonin and weakly activates serotonin receptors in the brain, producing some mind-altering effects associated with psychedelic drugs. MDMA also increases activity of other neurotransmitters, such as dopamine and norepinephrine, which are involved in mood and attention.⁷

Other drugs that produce effects associated with psychedelic and dissociative drugs work differently. For example, salvia activates kappa opioid receptors in the brain,²¹ while ibogaine affects a variety of brain receptors.⁸

How is NIDA advancing research on psychedelic and dissociative drugs?

NIDA conducts and supports research on psychedelic and dissociative drugs to help inform health decisions and policies related to their use. This research includes efforts to better understand the health effects of psychedelic and dissociative drugs, how chemicals in-or similar to-these drugs work in the brain, and whether they may be able to treat substance use disorders and other conditions. NIDA also funds research on how and why people use these substances.

In June 2022, NIDA's Office of Translational Initiatives and Program Innovations also announced a new program to support small businesses to develop psychedelic-based therapies for substance use disorders.

Along with other agencies, NIDA also supports major coordination efforts in this evolving field, such as the 2022 Psychedelics as Therapeutics workshop co-sponsored by the National Institute on Mental Health and the National Institute on Alcohol Abuse and Addiction.

See NIDA-funded projects related to psychedelic and dissociative drugs, and learn more about related clinical trials.

Why do people use psychedelic and dissociative drugs?

Some psychedelic drugs are derived from plants and fungi that have a long history of use in many different cultures around the world.²³ Aztec shamans used psilocybin in healing rituals, and some Native American tribes used peyote as long ago as 5,700 B.C. in religious ceremonies.²⁴ References to psychedelic drug use have been found in ancient texts from India and Greece.²

More recently, researchers are exploring the use of psychedelic and dissociative drugs in medical settings as treatments for substance use disorders and for other mental health disorders such as depression, anxiety, and post-traumatic stress disorder (PTSD).4,25

Are psychedelic and dissociative drugs safe?

While more research is needed, the reported incidence of serious adverse events from professionally supervised use of specific psychedelic and dissociative drugs, such as in clinical trials, is relatively low.2,10,11,26 However, many past clinical studies on these drugs have not adequately assessed or reported on adverse events.²⁷

Most people who report using psychedelic and dissociative drugs do so outside of medical or research settings.1,28 While further research is also needed to better understand the health and safety impacts of typical use of these drugs, some serious adverse effects and safety issues have been identified.14,27

Short-term physical side effects are typically mild or moderate but may require professional care. People who take psychedelic or dissociative drugs may experience short-term side effects such as a headache, abdominal pain, nausea or vomiting, high blood pressure, rapid heartbeat, trembling, and diarrhea.4,29 These are typically mild or moderate but may require medical care.³⁰ Importantly, reported cases of side-effects likely represent only a very small number of people who use psychedelic or dissociative drugs, and most people who use these drugs do not seek emergency services.

However, related data can provide insights on the side effects that may lead people to seek help. For example, according to U.S. poison control hotline data from 2000-2016, the most common negative short-term effects experienced by people who called in about using LSD and psilocybin were agitation, rapid heartbeat, pupil dilation, confusion, and vomiting. An analysis of these data found about 17% of these callers (600 people) who had used LSD and 6% of callers (363 people) who had used psilocybin mushrooms were admitted to critical care.³¹

Adverse reactions include fear and anxiety. People may also feel extreme emotions such as fear, confusion, or panic. These challenging experiences are also known as having a "bad trip."³² Research on the extent to which such experiences occur and their impact on health is limited, in part because definitions and reporting of these experiences vary.

Emerging evidence suggests certain psychedelic and dissociative drugs may contain dangerous adulterants. For more information, see "Can psychedelic and dissociative drugs be adulterated with fentanyl and other dangerous contaminants?"

Fatal overdoses and serious adverse effects are rarely associated with typical use of commonly used psychedelic and dissociative drugs. 14,34,35 A 2004 analysis of multiple studies estimated that psilocybin and LSD both have a safety ratio of 1000, meaning that the lethal dose of either drug is about 1000 times larger than a person would typically take for non-medical use.³⁶ However, some psychedelic and dissociative drugs-including NBOMes,37,38 ibogaine,³⁹ and PCP⁴⁰ -have been associated with a small number of reported deaths and serious adverse health effects. Though more research is needed, evidence to date shows that fatal overdoses involving these substances are typically associated with taking very high doses or using combinations of drugs, particularly combining these substances with alcohol, or being placed in excessive physical restraints while displaying unsafe behavior.¹⁶ More research is needed to understand to what extent certain psychedelic and dissociative drugs may be mixed with contaminants (such as fentanyl) that may cause an overdose. For more information, see "Can psychedelic and dissociative drugs be adulterated with fentanyl and other dangerous contaminants?"

Drug interactions may influence effects. Though more study in this area is needed and reported cases are exceedingly rare, some researchers suspect psychedelic drugs may interact with other drugs or medications a person has taken, including prescription medicines that also increase levels of the hormone serotonin in the brain. Too much serotonin in the brain is called serotonin toxicity or serotonin syndrome. Symptoms are typically mild but can be life-threatening in rare cases.41,42

Some psychedelic and dissociative drugs have been associated with specific long-term health problems. Research shows that long-term use of ketamine may cause ketamine-induced uropathy, a treatable but potentially serious condition that causes symptoms similar to those of a urinary tract infection.⁴⁶ Limited research also suggests using MDMA (considered by some to have psychedelic properties) may be associated with mild or moderate heart valve disease, in which one or more of the four valves controlling blood flow from the heart do not function normally.⁴⁷ In an analysis of studies conducted from 2015 through 2020, ibogaine use was associated with long QT syndrome, in which the electric impulses that control heartbeats function irregularly.⁴⁸

Research on long-term mental health effects of psychedelic and dissociative drugs is ongoing. More research is needed to better understand the long-term impacts of psychedelic and dissociative drugs on mental health. Mental health complications from psychedelic and dissociative drugs are currently extremely rare in clinical research settings, in part because these studies are highly controlled and participants are screened for existing mental illnesses.³² For more information, see "What is the relationship between psychedelic and dissociative drugs and mental illness?"

Can psychedelic and dissociative drugs be used as medicine?

The U.S. Food and Drug Administration (FDA) has approved the ketamine derivative esketamine (under the brand name Spravato ®) as a treatment for severe depression in patients who do not respond to other treatments.⁴⁹ The FDA has also granted Breakthrough Therapy designation for two formulations of psilocybin being studied as potential medical treatments for depression.

NIDA supports and conducts research to learn whether some of these drugs may help treat substance use disorders in medical settings.

What is the relationship between psychedelic and dissociative drugs and mental illness?

While scientists are still studying their effects, research suggests that some psychedelic and dissociative drugs may promote positive changes in thinking and mood.³ Researchers have suggested that these effects, including changes in brain functions that promote openness to new thoughts and experiences, may be valuable for supplementing mental health treatment.⁵⁰ The U.S. Food and Drug Administration (FDA) has approved the ketamine derivative esketamine (under the brand name Spravato®) as a treatment for severe depression in patients who do not respond to other treatments. The FDA has also granted Breakthrough Therapy designation for two formulations of psilocybin being studied as potential medical treatments for depression.

While short-term positive and negative mood changes are common with psychedelic and dissociative drugs, more research is needed to better understand the long-term effects these substances may have on mental health.

There is some evidence that psychedelic drugs might bring about or trigger schizophrenia-like illness in people with predisposing factors, but little evidence that they cause long-term psychiatric problems for most people. In a 1996 study where people with pre-existing psychoses were given LSD, three of 65 participants experienced persistent worsening of their psychiatric symptoms lasting 3-8 months.⁵¹

In modern psychedelic research, as a precaution, participants with previously diagnosed psychosis or bipolar disorder, and sometimes other mental illnesses, are excluded from participation. Under these conditions, the risk of psychosis or suicide among people who participate in research on psychedelic drugs, or who receive them as medication, is extremely low.⁵² An analysis of 34 clinical studies of LSD, psilocybin, or ayahuasca, published from 2006-2020 and involving 549 participants, found no evidence of longer-term adverse effects.²⁶ However, poor mental health outcomes may be more likely outside of clinical use.¹⁴

Research suggests, though, that the dissociative drugs PCP⁴¹ and ketamine⁵³ can make symptoms worse in people who have schizophrenia, and can cause short-term episodes of psychosis, in which a person experiences hallucinations and delusions, and has trouble experiencing what is real and what is not. PCP can also cause psychosis that persists for days to weeks.6,54 While it is not clear whether ketamine raises the risk of long-term psychosis, people who engage in regular recreational use of ketamine are more likely to experience delusions, even after weeks of abstinence.⁵⁵ Animal studies show that long-term use of PCP or ketamine can cause brain changes resembling those seen in people with schizophrenia.⁵⁶

One analysis found higher rates of suicidal ideation-thinking about, considering or planning suicide-but not attempted or completed suicide, in people who took esketamine, a ketamine derivative, compared to venlafaxine, an antidepressant medication.⁵⁷ In another analysis of 25 studies, medically unsupervised ketamine use was associated with related substance use disorder symptoms, memory loss, depression, and anxiety.⁵⁸

Can psychedelic and dissociative drugs be adulterated with fentanyl and other dangerous contaminants?

Many illicitly manufactured or processed drugs are increasingly found to contain contaminants that produce effects-including overdose and death-not associated with the substance or amount of substance a person intended to take.28,59 Adulteration of heroin, cocaine, and other drugs with highly potent fentanyl and related substances is a major contributor to rising drug overdose deaths.⁶⁰ Because fentanyl and related substances are colorless and odorless, they are difficult to detect without chemical testing. This means adulteration of psychedelic and dissociative drugs with fentanyl and similar compounds is possible, but more research is needed to understand to what extent this occurs. Some organizations are using harm reduction practices to help avoid drug overdose deaths related to possible adulteration of certain psychedelic and dissociative drugs, particularly those taken in pill, powder, or liquid form.¹⁵

How do psychedelic and dissociative drugs affect pregnancy?

The effects of psychedelic and dissociative drugs during pregnancy are not well understood, as data are limited. PCP use during pregnancy has been linked to a range of congenital abnormalities in an infant's heart, lung, urinary, cardiovascular, respiratory, urinary, and musculoskeletal systems.⁶¹ Some laboratory and epidemiological studies suggest MDMA (considered by some to have psychedelic properties) may cause motor delays and congenital abnormalities (particularly heart defects) in infants exposed to it during pregnancy.62,63

Are psychedelic and dissociative drugs addictive? Can people experience withdrawal?

To be diagnosed with a substance use disorder, a person must meet specific diagnostic criteria for continued substance use despite negative consequences. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)-a reference text professionals use to diagnose substance use disorders and other psychiatric disorders-includes diagnoses of phencyclidine (PCP) use disorder and "other hallucinogen use disorder"64,65 but does not include substance use disorder diagnoses related to other specific psychedelic and dissociative drugs.

Limited research suggests that use of psychedelic drugs, such as psilocybin and LSD, does not typically lead to addiction.1,35 Researchers think that one reason may be because people commonly experience unpleasant side effects when taking these substances, including headaches and nausea, which reduces their desire to take them again.⁶⁶

A small laboratory study published on psilocybin, DMT, and mescaline suggested that these psychedelic drugs are "weakly reinforcing," indicating their use is not likely to lead to a substance use disorder.⁶⁷ However, some evidence suggests people may quickly develop a tolerance to psychedelic drugs, meaning they must keep taking more of the drug to experience the same level of effects.²⁴

While more research is needed, laboratory research and a few human studies suggest that using the dissociative drug ketamine outside of a clinical setting can lead to cravings as well as symptoms of withdrawal.⁶⁸

NIDA conducts and supports research to better understand how often and to what extent people experience tolerance, withdrawal, and other substance use disorder symptoms related to the use of psychedelic and dissociative drugs.

What is the scope of psychedelic and dissociative drug use in the United States?

Information on the use of psychedelic and dissociative drugs is collected by several national surveys. These surveys use the terms "hallucinogen" and "hallucinogen use disorder" and data from those surveys are reported below.

How many people use hallucinogens*?

Among people aged 12 or older in 2021, 2.6% (or about 7.4 million people) reported using hallucinogens in the past 12 months.

Source: 2021 National Survey on Drug Use and Health

How many young students use hallucinogens**?

Among young people in 2022:

An estimated 1.2% of 8th graders, 2.1% of 10th graders, and 4.4% of 12th graders reported using any hallucinogen*in the past 12 months.

An estimated 0.6% of 8th graders, 1.3% of 10th graders, and 2.5% of 12th graders reported using LSD in the past 12 months.

An estimated 1% of 8th graders, 1.6% of 10th graders, and 3.4% of 12th graders reported using hallucinogens other than LSD in the past 12 months.

An estimated 0.6% of 8th graders, 0.7% of 10th graders, and 1.4% of 12th graders reported using MDMA.

An estimated 1.2% of 12th graders reported using ketamine in the past 12 months.

An estimated 0.8% of 8th graders, 0.8% of 10th graders, and 0.8% of 12th graders reported using salvia in the past 12 months.

Source: 2022 Monitoring the Future Survey

How many young adults use hallucinogens?

Among young adults aged 19 to 30 in 2021:

An estimated 8% reported using any hallucinogen*, representing an all-time high since the category was first surveyed in 1988.

Source: 2021 Monitoring the Future Panel Study Annual Report

How many people have a hallucinogen use disorder?

Among people aged 12 or older in 2020, 0.2% (or about 493,000 people) had a hallucinogen use disorder in the past 12 months.

Source: 2021 National Survey on Drug Use and Health

* Types of hallucinogens reported by participants in the National Survey on Drug Use and Health include DMT/AMT/Foxy, ketamine, LSD, MDMA, PCP, peyote/mescaline, psilocybin mushrooms, and Salvia divinorum.

**Types of hallucinogens reported by participants in the Monitoring the Future surveys included LSD, MDMA, mescaline, peyote, "shrooms" or psilocybin, and PCP.

What are examples of psychedelic and dissociative drugs?

While many emerging and established substances are classified as psychedelic and dissociative drugs, NIDA-supported research mainly focuses on the following substances, which are more commonly used and/or are being investigated as potential medical treatments. While some debate remains on how to describe these drugs and how specific drugs are classified, researchers generally classify them according to how they work in the brain.

Psychedelic Drugs

Psilocybin is a chemical compound in certain types of mushrooms, also called "shrooms" or "magic mushrooms."²³

LSD (lysergic acid diethylamide), or "acid," is a clear or white, odorless, lab-made (synthetic) substance derived from chemicals in fungi that grow on rye and other grains.⁶⁹

DMT (N,N-dimethyltryptamine) is a chemical compound found in plants native to the Amazon rainforest. These plants are sometimes used to make a tea called ayahuasca.⁷⁰ Lab-made (synthetic) DMT is a white crystalline powder that is usually smoked.⁷¹

Mescaline is a chemical compound found in peyote, a small cactus native to America's southwest and northern Mexico. Mescaline can also be lab-made (synthetic).⁷²

NBOMes (N-Benzylphenethylamines) are lab-made (synthetic) chemical compounds originally developed for use in brain research.⁷³ They are sometimes sold as LSD but are more potent with higher risk of adverse effects.

Dissociative Drugs

Ketamine is a chemical compound used in prescription medications for anesthesia in humans and animals. It is also illegally manufactured as a liquid or off-white powder.²⁸ A derivative called esketamine is FDA-approved for treatment-resistant depression.

PCP (phencyclidine) is a synthetic chemical compound mostly commonly used as a liquid or white crystal powder.⁴⁰

Other

Researchers are also interested in the psychedelic and dissociative properties of other drugs. These include:

MDMA (3,4-methylenedioxy-methamphetamine), also called "Molly" or "Ecstasy," is a lab-made (synthetic) drug that has effects similar to stimulants like methamphetamine. Some researchers and organizations consider MDMA to be a psychedelic drug because it can also mildly alter visual and time perception.⁷

Ibogaine is a chemical compound that comes from the bark of certain plants. These include the iboga shrub, which is used in religious rites in Western Africa. While ibogaine does have psychedelic properties, it affects a different spectrum of brain activity than psychedelic or dissociative drugs.⁸

Salvia (salvia divinorum) is a plant common to southern Mexico and Central and South America. Salvia leaves are typically chewed, extracted as juices, smoked, or vaporized. Unlike psychedelic or dissociative drugs, it primarily activates kappa opioid receptors in the brain.²¹

What is microdosing?

Some people report "microdosing" psychedelic drugs, typically LSD or psilocybin. Microdosing refers to regularly taking these drugs in very small amounts, typically one tenth to one twentieth of a typical non-clinical dose. People report that they microdose to lessen mental health symptoms such as depression and stress, improve productivity, and ease pain. However, research to date has not established that microdosing is safe or effective.²²,74

Are psychedelic and dissociative drugs legal?

Find More Resources on Psychedelic and Dissociative Drugs

References

1. Nichols DE. Psychedelics. Pharmacol Rev 2016;68:264-355.doi:10.1124/pr.115.011478

2. Johnson MW, Hendricks PS, Barrett FS, Griffiths RR. Classic psychedelics: An integrative review of epidemiology, therapeutics, mystical experience, and brain network function. Pharmacol Ther. 2019;197:83-102. doi:10.1016/j.pharmthera.2018.11.010

3. Garcia-Romeu A, Kersgaard B, Addy PH. Clinical applications of hallucinogens: A review. Exp Clin Psychopharmacol. 2016;24 (4):229-268. doi:10.1037/pha0000084

4. Bender D, Hellerstein DJ. Assessing the risk-benefit profile of classical psychedelics: a clinical review of second-wave psychedelic research. Psychopharmacology (Berl). 2022;239(6):1907-1932. doi:10.1007/s00213-021-06049-6

5. Ivan Ezquerra-Romano I, Lawn W, Krupitsky E, Morgan CJA. Ketamine for the treatment of addiction: Evidence and potential mechanisms. Neuropharmacology. 2018;142:72-82. doi:10.1016/j.neuropharm.2018.01.017

6. Lodge D, Mercier MS. Ketamine and phencyclidine: the good, the bad and the unexpected. Br J Pharmacol. 2015;172(17):4254-4276. doi:10.1111/bph.13222

7. Dunlap LE, Andrews AM, Olson DE. Dark Classics in Chemical Neuroscience: 3,4-Methylenedioxymethamphetamine. ACS Chem Neurosci. 2018;9(10):2408-2427. doi:10.1021/acschemneuro.8b00155

8. Wasko MJ, Witt-Enderby PA, Surratt CK. DARK Classics in Chemical Neuroscience: Ibogaine. ACS Chem Neurosci. 2018;9(10):2475-2483. doi:10.1021/acschemneuro.8b00294

9. Johnson MW, MacLean KA, Reissig CJ, Prisinzano TE, Griffiths RR. Human psychopharmacology and dose-effects of salvinorin A, a kappa opioid agonist hallucinogen present in the plant Salvia divinorum. Drug Alcohol Depend. 2011;115(1-2):150-155. doi:10.1016/j.drugalcdep.2010.11.005

10. Vollenweider FX, Smallridge JW. Classic Psychedelic Drugs: Update on Biological Mechanisms. Pharmacopsychiatry. 2022;55(3):121-138. doi:10.1055/a-1721-2914

11. Studerus E, Gamma A, Kometer M, Vollenweider FX. Prediction of psilocybin response in healthy volunteers. PLoS One. 2012;7(2):e30800. doi:10.1371/journal.pone.0030800

12. Oliver CF, Palamar JJ, Salomone A, et al. Synthetic cathinone adulteration of illegal drugs. Psychopharmacology (Berl). 2019;236(3):869-879. doi:10.1007/s00213-018-5066-6

13. Jansen KL. A review of the nonmedical use of ketamine: use, users and consequences. J Psychoactive Drugs. 2000;32(4):419-433. doi:10.1080/02791072.2000.10400244

14. Breeksema JJ, Kuin BW, Kamphuis J, van den Brink W, Vermetten E, Schoevers RA. Adverse events in clinical treatments with serotonergic psychedelics and MDMA: A mixed-methods systematic review. J Psychopharmacol. 2022;36(10):1100-1117. doi:10.1177/02698811221116926

15. Palamar JJ, Salomone A, Barratt MJ. Drug checking to detect fentanyl and new psychoactive substances. Curr Opin Psychiatry. 2020;33(4):301-305. doi:10.1097/YCO.0000000000000607

16. Schlag AK, Aday J, Salam I, Neill JC, Nutt DJ. Adverse effects of psychedelics: From anecdotes and misinformation to systematic science [published online ahead of print, 2022 Feb 2]. J Psychopharmacol. 2022;2698811211069100. doi:10.1177/02698811211069100

17. Calvey T, Howells FM. An introduction to psychedelic neuroscience. Prog Brain Res. 2018;242:1-23. doi:10.1016/bs.pbr.2018.09.013

18. Lee HM, Roth BL. Hallucinogen actions on human brain revealed. Proc Natl Acad Sci U S A. 2012;109(6):1820-1821. doi:10.1073/pnas.1121358109

19. Zhang R, Volkow ND. Brain default-mode network dysfunction in addiction. Neuroimage. 2019;200:313-331. doi:10.1016/j.neuroimage.2019.06.036

20. Jansen KL. A review of the nonmedical use of ketamine: use, users and consequences. J Psychoactive Drugs. 2000;32(4):419-433. doi:10.1080/02791072.2000.10400244

21. Hernández-Alvarado RB, Madariaga-Mazón A, Ortega A, Martinez-Mayorga K. DARK Classics in Chemical Neuroscience: Salvinorin A [published online ahead of print, 2020 Nov 9]. ACS Chem Neurosci. 2020;10.1021/acschemneuro.0c00608. doi:10.1021/acschemneuro.0c00608

22. Kuypers KP, Ng L, Erritzoe D, et al. Microdosing psychedelics: More questions than answers? An overview and suggestions for future research. J Psychopharmacol. 2019;33(9):1039-1057. doi:10.1177/0269881119857204

23. Van Court RC, Wiseman MS, Meyer KW, et al. Diversity, biology, and history of psilocybin-containing fungi: Suggestions for research and technological development. Fungal Biol. 2022;126(4):308-319. doi:10.1016/j.funbio.2022.01.003

24. Nichols DE. Hallucinogens. Pharmacol Ther. 2004;101(2):131-181. doi:10.1016/j.pharmthera.2003.11.002

25. Castro Santos H, Gama Marques J. What is the clinical evidence on psilocybin for the treatment of psychiatric disorders? A systematic review. Porto Biomed J. 2021;6(1):e128. Published 2021 Feb 11. doi:10.1097/j.pbj.0000000000000128

26. Goldberg SB, Shechet B, Nicholas CR, et al. Post-acute psychological effects of classical serotonergic psychedelics: a systematic review and meta-analysis. Psychol Med. 2020;50(16):2655-2666. doi:10.1017/S003329172000389X

27. Breeksema JJ, Kuin BW, Kamphuis J, van den Brink W, Vermetten E, Schoevers RA. Adverse events in clinical treatments with serotonergic psychedelics and MDMA: A mixed-methods systematic review. J Psychopharmacol. 2022;36(10):1100-1117. doi:10.1177/02698811221116926

28. Morgan CJ, Curran HV; Independent Scientific Committee on Drugs. Ketamine use: a review. Addiction. 2012;107(1):27-38. doi:10.1111/j.1360-0443.2011.03576.x

29. van Amsterdam J, Opperhuizen A, van den Brink W. Harm potential of magic mushroom use: a review. Regul Toxicol Pharmacol. 2011;59(3):423-429. doi:10.1016/j.yrtph.2011.01.006

30. van Amsterdam J, Van Den Brink W. Harm related to recreational ketamine use and its relevance for the clinical use of ketamine. A systematic review and comparison study. Expert Opin Drug Saf. 2022;21(1):83-94. doi:10.1080/14740338.2021.1949454

31. Leonard JB, Anderson B, Klein-Schwartz W. Does getting high hurt? Characterization of cases of LSD and psilocybin-containing mushroom exposures to national poison centers between 2000 and 2016. J Psychopharmacol. 2018;32(12):1286-1294. doi:10.1177/0269881118793086

32. Johnson M, Richards W, Griffiths R. Human hallucinogen research: guidelines for safety. J Psychopharmacol. 2008;22(6):603-620. doi:10.1177/0269881108093587

33. Carbonaro TM, Bradstreet MP, Barrett FS, et al. Survey study of challenging experiences after ingesting psilocybin mushrooms: Acute and enduring positive and negative consequences. J Psychopharmacol. 2016;30(12):1268-1278. doi:10.1177/0269881116662634

34. Johnson MW, Griffiths RR, Hendricks PS, Henningfield JE. The abuse potential of medical psilocybin according to the 8 factors of the Controlled Substances Act. Neuropharmacology. 2018;142:143-166. doi:10.1016/j.neuropharm.2018.05.012

35. Nichols DE, Grob CS. Is LSD toxic?. Forensic Sci Int. 2018;284:141-145. doi:10.1016/j.forsciint.2018.01.006

36. Gable RS. Comparison of acute lethal toxicity of commonly abused psychoactive substances. Addiction. 2004;99(6):686-696. doi:10.1111/j.1360-0443.2004.00744.x

37. Gee P, Schep LJ, Jensen BP, Moore G, Barrington S. Case series: toxicity from 25B-NBOMe--a cluster of N-bomb cases - PubMed (nih.gov). Clin Toxicol (Phila). 2016;54(2):141-146. doi:10.3109/15563650.2015.1115056

38. Wood DM, Sedefov R, Cunningham A, Dargan PI. Prevalence of use and acute toxicity associated with the use of NBOMe drugs. Clin Toxicol (Phila). 2015;53(2):85-92. doi:10.3109/15563650.2015.1004179

39. Köck P, Froelich K, Walter M, Lang U, Dürsteler KM. A systematic literature review of clinical trials and therapeutic applications of ibogaine. J Subst Abuse Treat. 2022;138:108717. doi:10.1016/j.jsat.2021.108717

40. Bertron JL, Seto M, Lindsley CW. DARK Classics in Chemical Neuroscience: Phencyclidine (PCP). ACS Chem Neurosci. 2018;9(10):2459-2474. doi:10.1021/acschemneuro.8b0026

41. Malcolm B, Thomas K. Serotonin toxicity of serotonergic psychedelics [published online ahead of print, 2021 Jul 12]. Psychopharmacology (Berl). 2021;10.1007/s00213-021-05876-x. doi:10.1007/s00213-021-05876-x

42. Volpi-Abadie J, Kaye AM, Kaye AD. Serotonin syndrome. Ochsner J. 2013;13(4):533-540.

43. Müller F, Kraus E, Holze F, et al. Flashback phenomena after administration of LSD and psilocybin in controlled studies with healthy participants [published online ahead of print, 2022 Jan 25]. Psychopharmacology (Berl). 2022;10.1007/s00213-022-06066-z. doi:10.1007/s00213-022-06066-z

44. Halpern JH, Lerner AG, Passie T. A Review of Hallucinogen Persisting Perception Disorder (HPPD) and an Exploratory Study of Subjects Claiming Symptoms of HPPD. Curr Top Behav Neurosci. 2018;36:333-360. doi:10.1007/7854_2016_457

45. Martinotti G, Santacroce R, Pettorruso M, et al. Hallucinogen Persisting Perception Disorder: Etiology, Clinical Features, and Therapeutic Perspectives. Brain Sci. 2018;8(3):47. Published 2018 Mar 16. doi:10.3390/brainsci8030047

46. Castellani D, Pirola GM, Gubbiotti M, et al. What urologists need to know about ketamine-induced uropathy: A systematic review. Neurourol Urodyn. 2020;39(4):1049-1062. doi:10.1002/nau.24341

47. Fonseca DA, Ribeiro DM, Tapadas M, Cotrim MD. Ecstasy (3,4-methylenedioxymethamphetamine): Cardiovascular effects and mechanisms. Eur J Pharmacol. 2021;903:174156. doi:10.1016/j.ejphar.2021.174156

48. Ona G, Rocha JM, Bouso JC, Hallak JEC, Borràs T, Colomina MT, Dos Santos RG. The adverse events of ibogaine in humans: an updated systematic review of the literature (2015-2020). Psychopharmacology (Berl). 2021 Aug 18. doi: 10.1007/s00213-021-05964-y. Epub ahead of print. PMID: 34406452.

49. Hashimoto K. Rapid-acting antidepressant ketamine, its metabolites and other candidates: A historical overview and future perspective. Psychiatry Clin Neurosci. 2019;73(10):613-627. doi:10.1111/pcn.12902

50. Reiff CM, Richman EE, Nemeroff CB, et al. Psychedelics and Psychedelic-Assisted Psychotherapy. Focus (Am Psychiatr Publ). 2021;19(1):95-115. doi:10.1176/appi.focus.19104

51. Fink M, Simeon J, Haque W, Itil T. Prolonged adverse reactions to LSD in psychotic subjects. Arch Gen Psychiatry-. 1966;15(5):450-454. doi:10.1001/archpsyc.1966.01730170002002

52. Zeifman RJ, Singhal N, Breslow L, Weissman CR. On the Relationship between Classic Psychedelics and Suicidality: A Systematic Review [published correction appears in ACS Pharmacol Transl Sci. 2022 Feb 22;5(3):176]. ACS Pharmacol Transl Sci. 2021;4(2):436-451. Published 2021 Mar 11. doi:10.1021/acsptsci.1c00024

53. Tyler MW, Yourish HB, Ionescu DF, Haggarty SJ. Classics in Chemical Neuroscience: Ketamine. ACS Chem Neurosci. 2017;8(6):1122-1134. doi:10.1021/acschemneuro.7b00074

54. Javitt DC, Zukin SR. Recent advances in the phencyclidine model of schizophrenia. Am J Psychiatry. 1991;148(10):1301-1308. doi:10.1176/ajp.148.10.1301

55. Morgan CJ, Muetzelfeldt L, Curran HV. Consequences of chronic ketamine self-administration upon neurocognitive function and psychological wellbeing: a 1-year longitudinal study [published correction appears in Addiction. 2010 Apr;105(4):766]. Addiction. 2010;105(1):121-133. doi:10.1111/j.1360-0443.2009.02761.x

56. Kristiansen LV, Huerta I, Beneyto M, Meador-Woodruff JH. NMDA receptors and schizophrenia. Curr Opin Pharmacol. 2007 Feb;7(1):48-55. doi: 10.1016/j.coph.2006.08.013. Epub 2006 Nov 9. PMID: 17097347.

57. Gastaldon C, Raschi E, Kane JM, Barbui C, Schoretsanitis G. Post-Marketing Safety Concerns with Esketamine: A Disproportionality Analysis of Spontaneous Reports Submitted to the FDA Adverse Event Reporting System. Psychother Psychosom. 2021;90(1):41-48. doi:10.1159/000510703

58. van Amsterdam J, Van Den Brink W. Harm related to recreational ketamine use and its relevance for the clinical use of ketamine. A systematic review and comparison study. Expert Opin Drug Saf. 2022;21(1):83-94. doi:10.1080/14740338.2021.1949454

59. Ivory ST, Rotella JA, Schumann J, Greene SL. A cluster of 25B-NBOH poisonings following exposure to powder sold as lysergic acid diethylamide (LSD). Clin Toxicol (Phila). 2022;60(8):966-969. doi:10.1080/15563650.2022.2053150

60. D'Errico S. Commentary. Fentanyl-related death and the underreporting risk. J Forensic Leg Med. 2018;60:35-37. doi:10.1016/j.jflm.2018.09.007

61. Holbrook BD, Rayburn WF. Teratogenic risks from exposure to illicit drugs. Obstet Gynecol Clin North Am. 2014;41(2):229-239. doi:10.1016/j.ogc.2014.02.008

62. McElhatton PR, Bateman DN, Evans C, Pughe KR, Thomas SH. Congenital anomalies after prenatal ecstasy exposure. Lancet. 1999;354(9188):1441-1442. doi:10.1016/s0140-6736(99)02423-x

63. Singer LT, Moore DG, Min MO, et al. Motor delays in MDMA (ecstasy) exposed infants persist to 2 years. Neurotoxicol Teratol. 2016;54:22-28. doi:10.1016/j.ntt.2016.01.003

64. Ryu IS, Kim OH, Lee YE, Kim JS, Li ZH, Kim TW, Lim RN, Lee YJ, Cheong JH, Kim HJ, Lee YS, Steffensen SC, Lee BH, Seo JW, Jang EY. The Abuse Potential of Novel Synthetic Phencyclidine Derivative 1-(1-(4-Fluorophenyl)Cyclohexyl) Piperidine (4'-F-PCP) in Rodents. Int J Mol Sci. 2020 Jun 29;21(13):4631. doi: 10.3390/ijms21134631

65. American Psychiatric Association, Substance-Related and Addictive Disorders, Diagnostic and Statistical Manual of Mental Disorders, 10.1176/appi.books.9780890425787, (2022)

66. Johnson MW, Sewell RA, Griffiths RR. Psilocybin dose-dependently causes delayed, transient headaches in healthy volunteers. Drug Alcohol Depend. 2012;123(1-3):132-140. doi:10.1016/j.drugalcdep.2011.10.029

67. Fantegrossi WE, Woods JH, Winger G. Transient reinforcing effects of phenylisopropylamine and indolealkylamine hallucinogens in rhesus monkeys . Behav Pharmacol. 2004;15(2):149-157. doi:10.1097/00008877-200403000-00007

68. Kokane SS, Armant RJ, Bolaños-Guzmán CA, Perrotti LI. Overlap in the neural circuitry and molecular mechanisms underlying ketamine abuse and its use as an antidepressant. Behav Brain Res. 2020;384:112548. doi:10.1016/j.bbr.2020.112548

69. Passie T, Halpern JH, Stichtenoth DO, Emrich HM, Hintzen A. The pharmacology of lysergic acid diethylamide: a review. CNS Neurosci Ther. 2008;14(4):295-314. doi:10.1111/j.1755-5949.2008.00059.x

70. Domínguez-Clavé E, Soler J, Elices M, et al. Ayahuasca: Pharmacology, neuroscience and therapeutic potential. Brain Res Bull. 2016;126(Pt 1):89-101. doi:10.1016/j.brainresbull.2016.03.002

71. Carbonaro TM, Gatch MB. Neuropharmacology of N,N-dimethyltryptamine. Brain Res Bull. 2016;126(Pt 1):74-88. doi:10.1016/j.brainresbull.2016.04.016

72. Dinis-Oliveira RJ, Pereira CL, da Silva DD. Pharmacokinetic and pharmacodynamic aspects of peyote and mescaline: clinical and forensic repercussions. Curr Mol Pharmacol. 2019;12(3):184-194. doi:10.2174/1874467211666181010154139

73. Poulie CBM, Jensen AA, Halberstadt AL, Kristensen JL. DARK Classics in Chemical Neuroscience: NBOMes [published online ahead of print, 2019 Nov 12]. ACS Chem Neurosci. 2019;10.1021/acschemneuro.9b00528. doi:10.1021/acschemneuro.9b00528

74. de Wit H, Molla HM, Bershad A, Bremmer M, Lee R. Repeated low doses of LSD in healthy adults: A placebo-controlled, dose-response study [published online ahead of print, 2022 Feb 1]. Addict Biol. 2022;e13143. doi:10.1111/adb.13143

75. Siegel JS, Daily JE, Perry DA, Nicol GE. Psychedelic Drug Legislative Reform and Legalization in the US. JAMA Psychiatry. Published online December 07, 2022. doi:10.1001/jamapsychiatry.2022.4101

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Psychedelic and Dissociative Drugs | National Institute on Drug Abuse

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Psychedelic and dissociative drugs can temporarily alter a person's mood, thoughts, and perceptions. Among other health effects and safety concerns, people who use these substances report feeling strong emotions ranging from bliss to fear and experiencing vast changes in how they perceive reality.

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I've been a medical cannabis patient for somewhere between three and five years now. In those years, I've only met two kinds of people:

1. People who don't really know anything about cannabis, other than that it's a drug (scary!)

2. People who don't really know anything about cannabis, other than that they love smoking it ("Pass the joint, will you?"). These folks might know the difference between an indica and a sativa, but their knowledge ends there.

Whether you are new to medical cannabis and are considering getting a card to treat a medical condition or you're a regular stoner who just doesn't know much about cannabis or the industry that produces it, this is the guide for you.

"Marijuana" is not one monolithic product. There are all different kinds of marijuana plants, different preparations of marijuana, and different ways of ingesting it. It's a little like alcohol - you can buy beer, wine, vodka, tequila, or liquor-infused candies.

The big difference, though, is that there's a lot more variety with cannabis.

Any alcoholic product has one active ingredient: Ethanol alcohol. You can dress it up with different flavors, additives, and ferment it from different products, but ethanol alcohol is ethanol alcohol.

Cannabis, on the other hand, has many active ingredients. There's THC, of course, the active ingredient everyone associates with "getting high," but there's also CBD, a compound that is associated with a smooth, relaxed feeling that, surprise surprise, can also get some people high. These are only two of 144 cannabinoids found in the cannabis plant.

Plenty of people buy products that have only THC or only CBD, but it's best not to think of cannabinoids in isolation. Much like vitamins in your body interact to keep you healthy, the different cannabinoids available in the cannabis plant interact to produce all kinds of healthful medical and psychotropic effects. People often buy THC-only products to get high, but these THC-only products are not going to produce nearly as many anti-inflammatory or other healthful effects.¹

Cannabis variety is why some people will report that "cannabis cured their anxiety" and other people will report that cannabis causes anxiety attacks. That's why some epileptics find cannabis cures their seizures while people with inflammatory bowel disease find cannabis restores their gut health for the first time in decades. It's not that cannabis is a wonder-drug that does it all; it's that these people are consuming different chemicals.

Black-market cannabis tends to be cannabis bred to be heavy on the THC and light on all the other cannabinoids. People who buy marijuana from a dealer buy because they want to "have a good time," and the marijuana dealers sell reflects that.

Buying from a dealer is not like buying from a store. You don't get to pick the strain you want or ask about various qualities. The dealer often has one type of marijuana available (the THC-heavy veriety) and you can either buy that or go home.

There was a time when dealers would sell plants they bred themselves or that others bred, but these days, most dealers sell product they bought from a weed-legal state and illegally moved across state borders. That makes it a lot safer than black-market marijuana of the past, but it has next to no medical value - and, of course, it's still illegal. ²

Recreational cannabis is a lot like buying cannabis in a liquor store. Liquor stores often have cops protecting the premises, and you have to present a card or other proof of legitimacy when you walk into the store. Once you're in the store, you can shop around, look at product, and take something you like home with you.

Recreational cannabis stores are, unsurprisingly, usually heavy on THC products as well. There will be a lot of concentrates (juice for vapes), edibles, and flower (that's the green cannabis plant itself, dried and ready to smoke) that are all either bred for THC or chemically manufactured to contain only THC.

But because they're stores, they often have some variety.

They may have edibles and concentrate that is "full-spectrum," mentioned earlier, which is a type of product where the edible or concentrate retains the hundreds of cannabinoids that were available in the plant it came from, not just THC or CBD. They are called full-spectrum because they contain the full spectrum of cannabinoids from the original plant. (If you haven't guessed by now, I always buy full-spectrum products).

They may have what are called "1:1" products, referring to flower, edibles, or concentrate where the proportion of THC is equal to the proportion of CBD. Science has indicated that there are some healthful properties of cannabis consumption that only occur when THC and CBD are present together to interact and become more than the sum of their parts. (I always buy 1:1 products when possible).

Medical cannabis is basically just recreational cannabis with a state-issued card. To get a medical marijuana card in my state, I need to show proof of my medical condition (a stack of medical records) to a certified marijuana doctor, who writes me for a card.

Honestly, this whole process seems totally illegitimate to me. The "certified marijuana doctor" is not my doctor. They're just a random doctor assigned to me by the marijuana certification agency, and it's different every year. Getting a medical card is much more a matter of preparing a convincing bureaucratic case than it is having a legitimate and pressing medical condition.

And, of course, once you have the card, your "treatment" is basically up to you. As a "patient," I decide what kind of cannabis I buy, when, and how much. The people who work at the dispensaries are not medical professionals, either; they're just regular enthusiasts like me.

I don't think this is unsafe. Cannabis is a very safe product, especially when packaged and sold in a legal market. It does annoy me, however, that conservative states will spend years getting their knickers in a twist about "drug addicts" and "what will it do to the children", only to design a system with nearly no medical oversight that is also an expensive bureaucratic nightmare.

Oh, did I forget to mention that? Getting your medical card in more conservative states is expensive. Every year when I recertify my medical card, I have to pay both the state and the agency certifying me hundreds of dollars. Cannabis in more conservative states tends to be more expensive, too.

I'm clearly not paying the state for attentive medical care, so what exactly am I paying them for?

Cannabis absolutely has healthful medicinal properties. For years, I've regularly smoked or consumed cannabis edibles to manage pretty crippling irritable bowel syndrome. Cannabis consumption has stabilized my gut health enough for me to travel, buy new foods, and live a much better life.

But that's not because medical science uncovered something special about cannabis. It's not because some state agencies certified me specially for use of this "very dangerous" chemical. The cannabis I'm smoking is not much different from the cannabis that's been bred for thousands of years.³

As far as I can tell, there are two reasons my state allows medical cannabis but not recreational cannabis:

1. A bunch of - forgive me - panty-waisted baby boomers are terrified the devil's lettuce will corrupt their children or some such nonsense.

2. What's regulated can be taxed, and the more heavily regulated it is, the more heavily taxed it can be. My state is known for promoting cannabis legislation which is very heavily regulated and taxed.

If you are desperately looking for relief from a medical condition but are leery of "doing drugs," you needn't be. When you purchase the right product, cannabis is a very mild and healthful product that can really improve your functioning from a variety of different health conditions.

But, you should know that there's nothing special about medical vs. recreational cannabis. The same cannabis is for sale at recreational and medical dispensaries all over the country. The only reason "medical marijuana" legislation exists is because it makes legislators comfortable, not because it makes you any safer.

When I first became interested in marijuana, I myself was leery. I was a straight-edge college student raised by straight-edge parents. My parents had never smoked weed, and I had never even seen weed. And like a good straight-edge kid, I believed that partaking of the devil's lettuce was a one-way ticket to mediocrity.

But my stomach started hurting. More and more and more. I cut out gluten, and then high fructose corn syrup, then synthetic dyes, then fatty food, until I was subsisting on nothing except a few favorite foods. I couldn't go out to eat with friends and I couldn't travel. I couldn't even leave the house for more than six hours because I didn't know where I'd be able to find food I could eat. And after years of this, I was willing to risk the devil's lettuce to find some relief.

Well, the joke was on me. The devil's lettuce is basically not a threat, and all it did to me was settle my stomach enough for me to start eating real food again. Thank god for marijuana.

If you want to read more thought-provoking articles like this one, my weekly digest is just the thing for you.

Click to join my Weekly Digest today!

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Everything You Need to Know About Medical Marijuana

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I've been a medical cannabis patient for somewhere between three and five years now. In those years, I've only met two kinds of people: People who don't really know anything about cannabis, other than that it's a drug (scary!) People who don't really know anything about cannabis, other than that they love smoking it ("Pass the joint, will you?").

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A Netflix documentary I would recommend

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Klicke hier, wenn du nach einigen Sekunden nicht automatisch weitergeleitet wirst.

Psychedelische Abenteuer: Have a good trip!

2020 ‧ Dokumentarfilm ‧ 1 h 25 min

Psychedelische Abenteuer: Have a good trip! ist eine Dokumentation von Netflix aus dem Jahr 2020 mit Film- und Fernsehdarstellern, die über ihre Erfahrungen auf und mit LSD und anderen Halluzinogenen auf witzige Art und Weise berichten. Wikipedia

Erscheinungsdatum : 11. Mai 2020 (Ersterscheinung)

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Psychedelische Abenteuer: Have a good trip! - Google Suche

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Klicke hier, wenn du nach einigen Sekunden nicht automatisch weitergeleitet wirst. Psychedelische Abenteuer: Have a good trip! 2020 ‧ Dokumentarfilm ‧ 1 h 25 min Psychedelische Abenteuer: Have a good trip! ist eine Dokumentation von Netflix aus dem Jahr 2020 mit Film- und Fernsehdarstellern, die über ihre Erfahrungen auf und mit LSD und anderen Halluzinogenen auf witzige Art und Weise berichten.

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The Psychedelic Experience - Mind Field S2 (Ep 2)

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. -By Xavier Francuski November 5, 2018

Such an experience can be terrifying, liberating, exhilarating, and full of absolute awe.

Certain substances, such as DMT, psilocybin, ayahuasca, peyote, LSD and Ketamine, taken in different quantities, have a strong reputation of being able to push the mind or soul over the edge, allowing it to seemingly detach from its bodily counterpart. Often hard to put into words, this can create a state that some have called ego dissolution, ego loss, or even ego death.

According to new scientific research, these experiences can have a powerful and positive effect on mental health. In a recent study on ego dissolution, researchers at Maastricht University examined people before and after drinking ayahuasca in a ceremonial setting. The researchers discovered that positive emotion, satisfaction with life, and mindfulness abilities were "significantly related to the level of ego dissolution experienced during the ayahuasca ceremony". In other words, people who scored higher on ego dissolution tended to be more positive and have a better outlook on their life after the experience. But why exactly is the encounter with the infinite possibly therapeutic and so intense? Well, to understand this, first we need to consider the architecture of our finite existence.

The Building Blocks of the Ego

What if all the ideas and opinions you've been carefully honing about yourself throughout your life weren't actually solid and maybe even weren't really yours? And, taking this a step further, what if even your most basic thoughts and feelings, the things that define you as a person, were never your own to begin with?

Try to consider everything you have ever been told and shown about the world, about who you are, how things work, and what actions and reactions are adequate. Throughout your development, all of these external voices eventually came together, creating a complex personality with ideas, desires, ambitions, fears, attitude patterns, beliefs about the world, levels of education, aptitudes, and so on.

Starting from your family environment, through your teachers and friends at school and university, all the music idols whose lyrics you knew by heart, all the way to the social circles you move in as an adult, the brands and marketing you're exposed to, the politics you identify with, the economy and law you abide by, the history and philosophy that make up your awareness, you have been a receiver of information and experiences your whole life. And all this input has become such a present part of you that it's entirely impossible to imagine yourself as anything but it.

This data also gets stored somewhere. Even if you can't pull it out of your memory on command, it stays in your subconscious mind and shapes the way you think and feel. To make matters even more complicated, most of our memories are not actually the original informationbut a version altered by the context you remembered them in, with gaps filled in with best subconscious guesses. This version also morphs depending on what else you have associated with it and degrades with time with blanks filled in based on your desires and fears. We are loaded with falsified memories that help determine everything we do, and they are what we identify with as our selves.

Our ego is what we know and who we believe ourselves to be.

This is what we, synonymously, refer to as the ego. Our ego is what we know and who we believe ourselves to be. It's a result of the influence of all the external contexts we have in our experience, not actually us (there is even a complex neuroscientific model that argues for this). So, who, or what, then, are we really?

This is quite a question, and the answer escapes verbal explanation and rational understanding. Beneath all the layers of personality, there appears to be some existence. It is beyond definition, because it has no defining features. It's the mystical concept referred to as the soul. It's the source of life, fueling our existence from within our bodies, but, at the same time, it may not be fully dependent on this frail husk.

Melting into the Cosmos

Try to imagine forgetting everything: your name, the people you know, the facts you've learned, the skills you've mastered, the places you've been to, all loves, all fears, all desires, all needs, money, language. What is left? A free, floating entity, eternal, self-sustainable and bound by nothing-pure, intelligent light that's aware of, and connected to, all existence. The soul is life itself; it's pristine energy, part of the infinite and finite at the same time.

Reaching full egolessness is, of course, quite an ambitious goal. The closest concept we can compare it to might be nirvana, as described in Hinduism and Buddhism, although even enlightenment in this way is still somehow tethered to the realm of humans. Attaining nirvana entails freeing the soul from desire and the causes of suffering, achieving omniscience, and living in accordance with the basic truths of existence. It is this point of reaching this mystical state that most likely offers an experience of ego death and a chance to feel, if only for a brief (but seemingly infinite) moment, what it is to only be.

Meditation and other mindfulness techniques seem to be a valid path to shedding layers of the ego and, perhaps, with utmost dedication, to completely dissolving it. Another way, which is greatly supported by practicing mindfulness or some other spiritual path, is through the use of psychedelics.

When we take a high dose of ayahuasca, psilocybin, LSD, Ketamine, etc., we can go through numerous experiences that might make us question the fabric of reality. At the beginning of the trip, sensory changes are abundant: the field of view expands, sensitivity to light and color increases, sounds and music are felt with the body and seen as twirling colorful lights and shapes when we close our eyes, smells are more intense and deep, things we touch can cause tingling sensations, while our whole body can feel like it's melting into the ground we're sitting or lying on. It's almost as if the physical aspect of our existence were opening up to receive more information.

Similar processes happen on the inside, too. Research has shown that novel neural connections are formed under the effects of LSD between regions of the brain that normally don't communicate with one another. These connections have been shown to persist over time and are reinforced by repeated psychedelic experiences.

Sensory enhancements can be both an enjoyable and meaningful aspect of taking psychedelics. However, if anything, they attach us more to the body and its experiential qualities. True ego death lies well beyond this realm.

Many diverse psychological and spiritual pursuits are to be found between these two states. Endless opportunities arise to reevaluate our lives and assume new perspectives in dealing with our hardships. There are the dark paths, which hold the seeds of growth in the center of the suffering; and there are light ones, which can flood us with abundant self-forgiveness and support, showing us that acting out of love is the best we can do, and that this best is good enough. There are feelings we've never truly felt, even though we had heard words that point to them, such as awe, humility, transcendence, infinity, freedom, sacredness, and stillness. And then there are the feelings that words don't even exist for.

At the end of the line though, there is the sensation of death. Or what feels like the closest to death we can lucidly approach and still return to tell the story. The term "ego dissolution" is often used synonymously with "ego death" or "ego loss", and for a good reason: this process can actually feel as if we are physically dying. This is understandable; when all we know about ourselves disappears, we are truly left believing that who we are no longer exists.

This is where the awesome power of ego death manifests itself. By reaching this state, where we have no choice but to let go of all that we are and to make peace with the infinite offers unparalleled potential to positively redefine how we live when we come back. Facing our mortality inevitably makes us more human and allows us to let go of negative attachments, which some spiritual traditions say are the root cause of all suffering. The experience makes us more present and more connected to our primordial nature and to everything that exists. As Stanislav Grof, one of the pioneers of research on altered states of consciousness described it.

Ego dissolution is an ecstatic state, characterized by the loss of boundaries between the subject and the objective world, with ensuing feelings of unity with other people, nature, the entire Universe, and God.

Psychedelic Ego Death and Therapy

It is highly plausible that the effect of ego death can account, at least in part, for the therapeutic potential of psychedelics. There is now ample evidence suggesting that substances like psilocybin have long-lasting beneficial effects on subjective well-being and can reduce and depression long term, even from a single dose. LSD's potential to treat anxiety disorders and ayahuasca's power in fighting depression are becoming recognized as well, as this kind of research is just starting to unfold. An interesting recent article suggests ego dissolution and unitive experience are central mechanisms at play in psychedelic-assisted psychotherapy and possibly the future of treating mental illnesses. The author argues that the emotion of awe, caused by mystical experiences, promotes the activity of the "small self", which he claims is the apparent key to understanding the effects of these experiences in a therapeutic context.

Ego death appears to be potentially very beneficial to healing with psychedelic therapy. As daunting as it may appear, the ability to temporarily experience the loss of the ego and become everything seems to hold a great secret, a key for unlocking new visions of the self and for remembering what feels like a pure state of well-being. But like all psychedelic therapy work, it's up to the individual to take this insight and new perspective and actively integrate it into his or her life. Ego death is just the beginning; the rebirth is the real journey.

original article:
https://kahpi.net/ego-death-psychedelics-ayahuasca/

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Why We Strive for Ego Death With Psychedelics

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By Xavier Francuski November 5, 2018 Such an experience can be terrifying, liberating, exhilarating, and full of absolute awe. Certain substances, such as DMT, psilocybin, ayahuasca, peyote, LSD and Ketamine, taken in different quantities, have a strong reputation of being able to push the mind or soul over the edge,

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Live LSD Simulation: “An Interactive Trip” (EDUCATIONAL CONTENT)

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When psychedelic drugs finally become legal in the United States and elsewhere around the world, the lion's share of the credit will go to Rick Doblin. Since founding the Multidisciplinary Association for Psychedelic Studies (MAPS) in 1986, Doblin has argued forcefully for the benefits of frequently demonized substances such as MDMA, LSD, psilocybin, and ibogaine in helping people cope with posttraumatic stress disorder (PTSD), depression, anxiety, and other debilitating problems. For decades, Doblin and MAPS have been pushing not just for social and cultural acceptance but also for legal and medical legitimacy.

MAPS is currently sponsoring Phase 3 clinical trials of MDMA-assisted psychotherapy as a treatment for PTSD. Within the next few years, if all goes well, the Food and Drug Administration (FDA) is expected to approve MDMA-a.k.a. Ecstasy, which the federal government banned in 1985 as a dangerous party drug-for use by prescription as a psychotherapeutic catalyst. Further down the line, psychedelic drugs such as LSD and psilocybin, which the FDA has recognized as a "breakthrough therapy" for depression, could undergo a similar legal transformation.

The rehabilitation of these once-vilified substances is a remarkable development that signals growing recognition of their life-enhancing uses and perhaps growing tolerance of people who choose to explore that potential. During a late-February ride from Manhattan to the John F. Kennedy International Airport, Reason Editor at Large Nick Gillespie talked with Doblin about his role in this psychedelic renaissance and the experiences that drew him to the movement.

"I'm very much a child of the Cold War," Doblin says, recalling how he was taught to "duck and cover" at school during the Cuban missile crisis. His fear of nuclear Armageddon, ecological catastrophe, and genocide was the initial impetus for his vision of "mass mental health" facilitated by psychedelics, which he believes can have a unifying effect when used properly.

Although MAPS is doing everything by the book in seeking approval of MDMA as a prescription drug, Doblin's vision goes beyond such doctor-approved uses. He aspires to a world in which people can use psychedelics responsibly without permission from physicians or priests. "Psychedelics are tools," Doblin says. "They're not good or bad in and of themselves. It's how they are used. It's the relationship you have with them."
Reason: Many people are attracted to psychedelics because they're fun. The approach that MAPS has taken, by contrast, suggests that psychedelics should not be taken lightly. Talk about the contrast between using psychedelics recreationally and using them by prescription as an FDA-approved medicine.
Doblin: I think that people should have the fundamental human right to change their consciousness. When we talk about the Bill of Rights, freedom of speech, freedom of assembly, and freedom of religion, underlying all of that is freedom of thought. Psychedelics are a good example of the freedom of thought that we should have.

At the same time, when people take these things for recreational purposes and they're only looking for positive experiences, that can be dangerous if difficult material comes up. If you suppress it, you could end up worse off.

So there's an aspect of it that's work. One of our big statements is that difficult is not the same as bad. A lot of times, when people approach this as a recreational experience and stuff that's difficult comes up, they think, "Oh, it's a bad trip." But it is also an opportunity. So medicalization is a strategy for achieving broader access and mass mental health.
When you talk about medicalization, are you saying we need to maintain the current power structure, dominated by big pharmaceutical companies and doctors who serve as the high priests, telling us what to do and how to think? Or do you have in mind a broader concept of mental health or well-being?
Our core approach is that we are not the guides. We don't know where people need to go. People are their own guides. One of the concerns I have about traditional medicine, psychiatry, and psychotherapy, is that even in certain shamanistic settings, the healers are the ones who do it to the person. The power is in their hands. They're like surgeons; you don't do your own surgery. But when we're talking about mental surgery, we're trying to empower people to heal themselves.

To give you a sense of how much progress we're making, one of our donors, Bo Shao of the Evolve Foundation, said that when we had the psychedelic revolution in America, his parents in China were suffering under the Cultural Revolution. His parents' whole generation is traumatized still from that. So he's helping us bring [MDMA-assisted] therapy to China. We've already brought Chinese psychiatrists and psychotherapists to the United States for training, and I've been to China.

We're trying to universalize it in that way. But unlike most pharmaceutical companies, since we're doing it in a nonprofit context, we're trying to help people learn how to heal themselves without having to come to doctors and therapists.
Give me an update about what's going on with FDA approval of MDMA-assisted psychotherapy for PTSD.
On November 29, 2016-30 years after I started MAPS-we had what's called an end-of-Phase-2 meeting. That's where we discussed the data we had gathered during Phase 2 of clinical trials and whether the FDA would permit us to go to Phase 3 [the final step before approval of a prescription drug]. The FDA said yes. Then we negotiated for eight months every aspect of the Phase 3 research protocol, the statistical analysis plan, all the other supplemental material that's required when you move into Phase 3.

Phase 1 usually involves healthy volunteers, and you're just trying to understand what the drug does. In Phase 2, you do pilot studies, exploring who is your patient population, what are your doses, what is your treatment, who do you exclude and include. Phase 2 enables you to figure out how to design Phase 3, where you do the large-scale, randomized, placebo-controlled studies that are required to prove safety and efficacy. Those are the pivotal studies that you need to get approval for marketing.

There are also Phase 4 studies, which the FDA can require after you've gotten permission to market the drug when there's additional information that the FDA wants. We've already negotiated some of the Phase 4 studies. If we succeed in Phase 3, the FDA wants more information about how we can tell ahead of time who will respond well to the treatment and what we can say about relapse rates. How long do the benefits last?

Another aspect of it is that many drugs are tested in adults, and then they're prescribed to adolescents or children. If we succeed in adults, which means 18 or over for PTSD, then we have to do studies in 12- to 17-year-olds. If that works, then we have to study 7- to 11-year-olds who are traumatized.
When do you expect the Phase 3 trials to be completed?
The FDA can come back and say, "You did everything right [and] it looks good, but we're going to screw you over and stretch it out a little bit." We don't expect that the FDA will screw us over, because, once we got permission for Phase 3, we entered into this eight-month process where we negotiated everything. That's called the special protocol assessment process. If you end up agreeing, you get what's called an agreement letter, and the FDA is legally bound to approve the drug, assuming you get statistically significant evidence of efficacy and no new safety problems arise. And since MDMA has been around for 40, 50 years, tens of millions of people have taken it. We have a very good idea of the safety profile.

The other thing the FDA did, after we got this agreement letter, was declare MDMA a breakthrough therapy [a designation that is supposed to facilitate approval of promising drugs for hard-to-treat conditions]. So I don't think that they want to screw us over in any way.

In Phase 3, we have to do a minimum of two studies, each with 100 people, and then we do what's called an interim analysis for each study. We have enrolled almost 100 people in the first of the Phase 3 studies, and the interim analysis will be sometime in late March or early April this year. Then we'll know whether we need to add anybody for statistical significance. We expect to start the second Phase 3 study in the summer of 2021, so we should have all the data from the studies near the end of 2021.

Then we submit that to the FDA, and sometime in 2022, depending on how long the review process is, we anticipate approval. We're also negotiating with the European Medicines Agency, and that process is a year or two behind the FDA process.

We will need to raise around $30 million to finish Phase 3 in Europe and a similar amount to finish Phase 3 in the United States. But in the history of MAPS, we've received donations of about $80 million, and we're trying to do this all through donations. We don't want investors. I'm sympathetic with for-profit people getting involved. The scale of the problem is so big. We need all sorts of people, sponsors, resources. But I think the profit motive has warped American health care.
You've created a public benefit corporation to market MDMA. How will that work?
For the first 25 years of MAPS, I just assumed that once MDMA became a medicine, it would be a generic medicine, and it would be sold for very little money. MDMA was invented by Merck in 1912, so the patents have expired.

Even though I wrote my Ph.D. thesis at the Kennedy School of Government on the regulation of Schedule I drugs-psychedelics and marijuana-I missed something. I learned only in 2013 or so that President Reagan had signed a bill to provide incentives for developing drugs that are off patent. Since they couldn't give patents, they offered what was called data exclusivity, which means you're the only one who has the right to use your data in the U.S. for five years. If you do pediatric studies, you get an additional six months of data exclusivity, which blocks generic manufacturers from even applying, and it takes the FDA at least six months to review those applications.

So we'll have about six years of data exclusivity. Once I realized that we might actually be able to sell MDMA for more than cost as a medicine, I realized that we had a different story to tell our donors: We're not going to be perpetually asking you for money, and we might even be able to make money from the sale of MDMA and use that for more research.

Doing that is a taxable situation, and you can't stay inside the nonprofit. A public benefit corporation is a kind of corporation that explicitly seeks to maximize benefits for the public rather than the return to shareholders. So that's the approach we're taking.
This is kind of like a legal version of the Brotherhood of Eternal Love, which sold LSD for practically nothing in the '60s and '70s.
They are a big part of the story of psychedelics that not that many people know about. They really had a mission beyond making money, and the mission was consciousness change. That is our mission.

All of our research staff and all of the research money has been transferred to the public benefit corporation. We are taking not just a new approach to mental health, which is psychedelic-assisted psychotherapy, but a new approach to marketing medical treatments and drugs. We will charge somewhat more than the MDMA costs us, but we're not going to charge the maximum of what the market will bear, because that means that you have fewer people paying more for treatments. And our goal is mass mental health.
Where is the biggest pushback against what you're doing coming from these days?
So far we haven't had a whole lot of pushback. Veterans [with PTSD] have such support, particularly among Republicans-there's a libertarian strand of the Republican Party that has been a strong ally in looking at the benefits of illegal drugs. There's pushback from drug warriors who think that we need to demonize these drugs to justify the drug war. That's why there's been suppression of research into cannabis.

The pushback that I've received has not been from regulatory agencies. The FDA is aware that there are enormous numbers of people with mental conditions that are not adequately helped by the currently available medicines. That's why MDMA was declared a breakthrough therapy. Psilocybin has been declared a breakthrough therapy for treatment-resistant depression. The most important new development in mental health treatment over the last 20 or 30 years has been ketamine for the treatment of depression.

Traditional psychiatry is coming around. Yesterday, the American Journal of Psychiatry published an article about psychedelic psychotherapy and how it was promising.

I've received pushback from some of our donors who ask, "Why did you accept money from [Republican] Rebecca Mercer, [libertarian Charles] Koch, or others? Just stick to medicine." Right now some of our big donors are telling me that I should shut up about drug policy reform and the fundamental human rights issue, that we want people to have access to these drugs with proper education and harm reduction, but outside of medicine and religion.

There is potential for pushback from fundamentalist Christians, although it doesn't seem to have happened yet. Classic psychedelics like psilocybin have been used for thousands of years for religious and medical purposes. Through ego dissolution, people have mystical experiences, which suggests there may be a common mystical core in all the world religions. There are fundamentalists in each religion who say, "My religion is the only true one. Everybody else is an infidel." The psychedelic mystical experience is a challenge to that. But I think the fundamentalists could benefit from a deeper appreciation of their own spirituality.

The other possible area of pushback is parents worrying about their kids. If you make this into a medicine, they might think, kids will get the message that it's a good thing.

What we've been doing in that regard is going to festivals around the world where young people are using these psychedelics. A lot of them are using them unwisely and irresponsibly and just trying to have a good time. Difficult material comes up, and they then try to suppress it or push it down. We've started what we call the Zendo Project, which does psychedelic harm reduction at Burning Man, the Boom Festival in Portugal, all over the world. The aim is to help people who have difficult trips work through them and process the material, so that they don't get tranquilized, don't go to the hospital, and don't have long-term mental disruptions because of it.
You once told a reporter, "We're not the counterculture; we are the culture." And I think there's some real truth to that. But you're also a parent. How old are your kids, and have you tripped with them?
My kids are 25, 23, and 21. We've wanted to take [psychedelics] together as a family.
That sounds both wonderful and kind of terrifying.
When I had my bar mitzvah at 13, that really opened the door to psychedelics for me. Because my bar mitzvah did nothing. I mean, it was a nice party. I was the oldest of four kids. I really did expect that there would be some kind of spiritual experience. And the next morning, I'm lying in bed, and God did not come. Nothing happened, but I was ready for it. I felt really bad, and I felt that traditional rituals didn't really work.

When our children turned 13, my wife and I spoke to them and said, "If you want to try marijuana or MDMA, come to us and, and we'll give it to you." It was the best anti-drug strategy that we could have had, this idea of doing drugs with your parent. They all said, "We're not ready yet."

This is a hot-button issue. But if you look at the traditional cultures that have successfully integrated psychedelics in America, we have half a million members of the Native American Church who use peyote. We have many people who are using ayahuasca in ritual settings, and they've successfully integrated ayahuasca. They believe that children who are interested in ceremonies with their families can try small amounts of these drugs, and they don't have age limits. I went to a Native American Church ceremony with my wife. It was to celebrate the wedding of a friend of ours. A Navajo man brought his 9-year-old son, who took peyote and stayed up the whole night. Now, the 9-year-old didn't take the full dose.

I am pro-family values. When it comes to the education of children, we should leave that to the families, not to the government. In 23 states, the laws prohibiting the use of alcohol by young people have a parental override that allows parents to give alcohol to their children, even at restaurants, as long as there is parental supervision. So this idea is not foreign to America. I think that's the way it should be with other drugs as well.

One of the worst parts of the drug war is that parents are scared to be honest with their own children. To have the intrusion of the government in the most intimate situations, where you are trying to educate your children, is terrible. I know people who still hide the fact that they smoke marijuana from their children, even in legalization states like Massachusetts, where I live.
Do you worry about a backlash? In the 1960s, there was Diane Linkletter's suicide, which her father, the writer Art Linkletter, blamed on LSD. In the 1980s, there was the cocaine-related death of Len Bias, who had just been drafted by the Boston Celtics. His death helped inspire draconian anti-drug legislation. Do you worry about that sort of thing?
I very much worry about backlash. That's why we've reached out to the police, to try to educate them. That's why we are actively reaching out to bipartisan groups and why we have bipartisan financial support.

In the '80s and '90s, when the rave milieu was just starting, people were taking MDMA and overheating sometimes and dying from hyperthermia. Those stories were used to block the research, and then drug warriors could say there's no evidence of benefit. But now, because we have strong evidence of benefits, the situation is different.

Now we're able to say that in a medicalized context, we're getting more benefits than risks. When people take drugs in nonmedical settings and have tragic outcomes, I don't think that's going to boomerang back on the research. We have veterans who have attempted suicide multiple times but are now PTSD-free after MDMA-assisted therapy. I felt that it was necessary for us to work with the hardest cases and to show that there can be value for people who have unsuccessfully tried other treatments.

So we accept people [into our trials] who have attempted suicide in the past. We just have to create a very strong support system for people throughout the entire process of therapy. And so far there's only been one person who has attempted suicide-unsuccessfully-during our trials. The therapist thinks that was a person who was in the placebo group and was so disappointed she wasn't randomized to the MDMA group that she lost hope.

We have to be very careful not to exaggerate the benefits or minimize the risks. I think what happened with Timothy Leary and others in the '60s is that the government was exaggerating the risks and denying the benefits. And Tim and others, I think, did the opposite: exaggerated the benefits and minimized the risks.

We try to be clear that this doesn't work for everybody. This is not a panacea. It's not a one-dose miracle cure. What we're really doing is psychotherapy. It's not that you just take this pill and something changes for the better. That provides a level of comfort, when people understand that it's done in a therapeutic context.

The best way to think about drugs is that they're tools. Psychedelics are tools. They're not good or bad in and of themselves. It's how they are used. It's the relationship you have with them.
The government's survey data indicate that nearly half of Americans 12 or older have tried marijuana at least once, while about 10 percent have used it in the last month. With hallucinogens, which includes LSD, psilocybin, and mescaline, about 16 percent of Americans say they have tried them, and less than 1 percent report using them in the last month. Assuming everything is medicalized or legalized in the way you want, do you think psychedelics will ever be a mass phenomenon?
No. I think it will be something that more people will want to use, because it helps you with core aspects of being human: What's the meaning of my life? What do I think about death? Why do I have social anxiety? How do I deal with trauma? I think larger numbers of people will use psychedelics, but it's not going to be like weed. Psychedelics are used intermittently, and the emphasis is on what you bring back from the experience. There won't be a lot of frequent users, but there will be more occasional users.
Are you optimistic about the future? Not just for psychedelics, but for a broader vision of self-guided mental health?
I'm very optimistic. This idea of unification, of a common mystical core, of shared humanity and global spirituality-it also permits greater individuality. Sometimes people think that when you talk about global spirituality or shared mystical experiences, all the differences are washed out. I think it works both ways. The more we can understand our commonality, the more we will appreciate our differences and our uniqueness.

This interview has been condensed and edited for style and clarity. For an audio version, subscribe to The Reason Interview With Nick Gillespie.

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'People Should Have the Fundamental Right To Change Their Consciousness'

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When psychedelic drugs finally become legal in the United States and elsewhere around the world, the lion's share of the credit will go to Rick Doblin.

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A Complete Introduction to Psychedelics ~ Science, Origins, and Ayahuasca

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Michael Pollan | Michael Pollan writes about the places where nature and culture intersect: on our plates, in our farms and gardens, and in the built environment.

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By Bridget Huber

For starters, assessing risk is tricky. A lot of what both scientists and the general public think they know about the potential risks of psychedelic use comes from the first wave of research and experimentation in the 1950s, 60s and 70s. But this body of knowledge includes studies that wouldn't meet today's scientific standards; urban legends; and sensational, unsubstantiated news stories.

Also, reporting and describing adverse events is often subjective to some extent, psychiatrist Rick Strassman noted in a 1984 paper. Some people consider the drug-induced state itself pathological, he wrote, while others believe even the worst reactions are part of "throwing off 'straight' society's 'shackles' and in reaching a 'higher' level of consciousness." And many of the more recent studies on the potential harms of LSD and other hallucinogens draw on data from the 1950s and 60s. Those studies had a lot of methodological problems; many lack baseline data about their subjects, didn't use placebos and/or failed to specify the source of the drug or the setting in which it was given. ¹

Also, though it's tempting to generalize from case reports or news stories, Krebs and Johansen argue it's important to take a "statistical perspective to risk" and they point out that nothing we do is without risk. ² Here are some of the specific reasons why they say case reports (and news reports, I'd argue) of mental distress/problems arising from psychedelic use should be taken with a major grain of salt.

Several issues are important to keep in mind when considering case reports. 1) Adverse effects of psychedelics are usually short-lived; serious psychiatric symptoms following psychedelic are typically resolved within 24 hours or at least within a few days. 2) Both mental illness and psychedelic use are prevalent in the population, likely leading to many chance associations; for instance, about 3% of the general public will have a psychotic disorder sometime in their lives. 3) The typical onset period of both mental illness and psychedelic use occurs in late adolescence and early adulthood, again possibly leading to mistaken causal inferences. 4) Most case reports do not rule-out preexisting psychiatric difficulties, life stresses, or use of other drugs. Many psychiatric disorders are believed to be heavily influenced by genetics and earlier experiences, even if symptoms are often first triggered by a stressful event. Note, however, that people with first-episode psychosis often have no apparent family or personal history of mental illness, whether or not if they have previously used psychedelics. 5) Because of the striking subjective effects of psychedelics, some people attribute psychiatric symptoms to the use of psychedelics even if the symptoms started months or years later. 6) Some health professionals may have a biased view since they meet people with mental health problems and have little or no contact with the majority of psychedelic users. 7) Caution should be used when generalizing from LSD to other psychedelics because of emerging evidence of unique effects of LSD. 8) Case reports of mental health problems following psychedelics are often comparable to case reports of mental health problems linked to intensive meditation, visiting holy sites or viewing beautiful artwork and sublime natural scenes." ³

To complicate things further: People may think they've taken LSD when they've really taken something else. For example, a West Virginia man was charged with murdering his wife in 2013. He and his wife took what they thought was LSD and the wife started having convulsions and died. There were a number of media reports blaming her death on LSD, but it later came out that the couple had unwittingly taken a synthetic hallucinogen 25b-NBOMe, which isn't illegal in West Virginia. The husband then pled guilty to a lesser charge: involuntary manslaughter. ⁴ I also found a case report about an 18-year-old man who called 911 saying he'd tried to kill himself after taking two hits of acid. He'd actually taken NBOMe, as well, which seems to be more dangerous and potent than LSD. ⁵
General safety information
In Drugs - Without the Hot Air, David Nutt calls psychedelics "among the safest drugs we know of". ⁶ He and a team of experts in addiction, drug policy, psychology and other fields ranked 20 drugs on their harmfulness, using criteria ranging from drug-related mortality (death by overdose) to environmental damage. Overall, psilocybin mushrooms were ranked as the least harmful drug, followed by LSD and the addiction drug buprenorphine, which had the same score. Alcohol was ranked most harmful (more then ten times as harmful as mushrooms or LSD), followed by heroin, then crack. Referring to mushrooms and LSD, Nutt writes:

"It's virtually impossible to die from an overdose of them; they cause no physical harm; and if anything they are anti-addictive, as they cause a sudden tolerance which means that if you immediately take another dose it will probably have very little effect." ⁷

Matthias Liechti recently published a paper in Nature that reviews all of the clinical research on LSD that's been done in the past 25 years. In these controlled settings, subjects' experience of LSD was "predominately positive", he writes, and no severe adverse reactions to LSD were reported. ⁸

Emergency Room visits
LSD and psilocybin accounted for just 0.005% of US emergency room visits, according to federal statistics published in 2013. ⁹ There were an estimated 4,819 emergency department visits related to LSD use in 2011, according to the most recent federal data available. Another 8,043 ER visits that year were attributed to "miscellaneous hallucinogens". Note that the substance use in both cases was self-reported, not toxicologically confirmed. ¹⁰

For comparison:
Toxicity and Overdose
In their 2008 guidelines for the safe administration of high doses of LSD and psilocybin in a clinical settings, Matthew Johnson, Bill Richards and Roland Griffiths write that hallucinogens aren't considered addictive and they don't appear to cause organ damage or neurotoxicity. They can cause side effects like dizziness, blurred vision, weakness and tremors, while they are active. The authors also note that hallucinogens can raise the pulse and blood pressure, but they say none of their patients ever experienced a medically-dangerous spike in blood pressure or had to take blood pressure drugs. ¹¹ I did find a report published this year of a 34-year-old man with an undiagnosed heart condition who went into cardiac arrest after taking LSD recreationally and died. ¹²

Many of the papers I read said there haven't been any documented deaths from LSD overdose. I did find one case report from 1985 of a 25-year-old man whose death was attributed to LSD overdose based on toxicological examinations. The paper's authors described it as "the first reported fatal case of LSD poisoning". ¹³

Another case of a non-fatal but serious LSD overdose is cited in a couple of papers. In 1972, after a dinner party in San Francisco, eight people snorted a very high dose of LSD, after mistaking it for cocaine. They got really sick: five went into comas, three had to be intubated, four experienced mild generalized bleeding. But within 12 hours they were back to normal. Doctors followed five of the patients for a year and said they showed no apparent psychological or physical ills. ¹⁴

By one estimate, the fatal dose of LSD is 1000 times larger than the dose that causes an effect. So, it would be much harder to accidentally overdose on LSD than most other drugs - the fatal dose of intravenous heroin, for example, is just 5 times larger than the effective dose. ¹⁵
Physical harms caused by changes in perception/judgment
Even if psychedelics aren't toxic, per se, there are a lot of pop-culture accounts of people getting hurt, dying or hurting others while on the drug - probably the most common stories are those of people think they can fly and fall to their deaths. But Johansen and Krebs write that these sorts of situations are very rare:

"Both the European Monitoring Center for Drugs and Drug Addiction (EMCDDA) and the health authorities in the Netherlands, where hundreds of thousands of servings of psilocybin mushrooms are legally sold in shops each year, report that serious injuries related to psychedelics are extremely rare (EMCDDA, 2011; CAM, 2007). Furthermore, Dutch police report that legal sale of psilocybin mushrooms has not led to public order problems (Van Amsterdam et al., 2011)." ¹⁶

Still, I did find a bunch of relatively recent news reports of people who either hurt themselves or other people, apparently while on LSD, though it was unclear in a lot of these stories whether that was toxicologically confirmed. (James Fadiman told one reporter that he's investigated some stories of people apparently going crazy after taking LSD and found that they've actually taken another drug.) ¹⁷

-In 2011, a 22-year-old died after jumping out of a vehicle after taking LSD: http://www.ocregister.com/2011/09/20/bad-lsd-trip-turns-into-deadly-nightmare/
-In 2016, a 20-year-old man on LSD caused a three-car crash that killed a man: https://www.abqjournal.com/901960/police-man-high-on-lsd-caused-fatal-crash-2.html
-In 2017, a 15-year-old boy fell or jumped off a balcony after taking LSD and died: http://www.latimes.com/local/lanow/la-me-ln-student-dies-20170320-story.html

-In 2016 a man attacked his girlfriend, tried to cut off his penis and jumped out a window after taking LSD:
http://metro.co.uk/2016/04/20/man-high-on-lsd-attacked-girlfriend-and-tried-to-hack-off-his-penis-before-throwing-himself-out-window-5829027/
-In 2016, a college student murdered his girlfriend after taking LSD: http://www.tri-cityherald.com/news/local/crime/article67693647.html
Serious mental health issues
Despite horror stories about people having psychotic breaks or other mental health problems after taking psychedelics, two recent large-scale studies (which examine a similar set of US data) suggest people who have used psychedelics may be less likely to have serious mental health problems or be suicidal than those who have not.

One paper, published in 2015 by a team of researchers from Johns Hopkins and the University of Alabama, analyzed data collected from more than 191,382 people between 2008 and 2012 during the annual National Survey on Drug Use and Health. More than 13 percent of those surveyed (27,235 people) had used "classic psychedelics" (which the researchers defined as DMT, ayahuasca, LSD, mescaline, peyote or psilocybin) at some point in their life. The respondents who had used a classical psychedelic were 19 percent less likely to have been in psychological distress during the previous month, 14 percent less likely to have had suicidal thoughts over the last year, 29 percent less likely to have made plans for suicide and 36 percent less likely to have attempted suicide in the past year than the survey respondents who had never used psychedelics. Interestingly, the use of other, non-psychedelic drugs was associated with more psychological distress and suicidality in this group. Of course, the study had limitations - for one, people self-reported both drug use and psychological distress. Also, these sort of studies can only demonstrate association, not causation. ¹⁸

The same year, Johansen and Krebs published a paper that looked at responses to the same survey from a slightly different time period. Of 135,000 US adults surveyed, 19,299 had used LSD, psilocybin, mescaline or peyote. The respondents who had used psychedelics were no more likely to have experienced serious psychological distress, suicidal thoughts or behavior, anxiety, depression or to have needed or received mental health treatment in the past year than those who had not. In fact, people who had used psychedelics were less likely to have undergone inpatient psychiatric treatment than never-users. Johansen and Krebs concluded: "There is little evidence linking psychedelic use to lasting mental health problems. In general, use of psychedelics does not appear to be particularly dangerous when compared to other activities considered to have acceptable safety." ¹⁹
Data from the first wave of psychedelic research seems to support this idea. About 10,000 patients are thought to have participated in LSD research in the 1950s and 60s and the rate of psychotic reactions, suicide attempts and suicides during treatment "appears comparable to the rate of complications during conventional psychotherapy" according to an analysis of data from this era done in 2008 by Torsten Passie. ²⁰
More recently, a 2011 paper by Erich Studerus, Franz Vollenweider and colleagues analyzed data from eight double-blind, placebo-controlled psilocybin studies conducted in their laboratory over the past decades. They looked at 110 subjects who'd undergone a total of 227 psilocybin sessions. None of the subjects had prolonged psychotic reactions to the psilocybin sessions and schizophrenia-spectrum disorders were not precipitated in any of the subjects. One subject did seek treatment for symptoms of anxiety, emotional disability and depression. ²¹
In their safety guidelines for hallucinogen research, Johnson and co-authors note that psychedelics could possibly provoke the onset of prolonged psychosis, but they say the chances are low. In their clinical research, they exclude people who meet the criteria for a diagnosis of schizophrenia, bipolar I or II or other psychotic disorders. They also exclude people with a first or second degree relative with those disorders.
Here they describe some of the earlier evidence of psychotic breaks related to psychedelics given in a therapeutic setting:

In a survey of investigators who had administered LSD or mescaline, Sidney Cohen (1960) reported that only a single case of a psychotic reaction lasting more than 48 hours occurred in 1200 experimental (non-patient) research participants (a rate of 0.8 per 1000). Notably, the individual was an identical twin of a schizophrenic patient and thus would have been excluded under the proposed guidelines. Prolonged reactions over 48 hours were slightly more frequent in patients undergoing psychotherapy than in experimental non-patient participants, but still relatively rare, occurring at a rate of 1.8 prolonged reactions per 1000 patients. Cohen (1960) also reported that suicide attempts and completed suicides occurred at a rate of 1.2 and 0.4, respectively, per 1000 patients. The causal link between hallucinogen exposure and suicide or suicide attempt was only clear for a portion of these cases in patients, and no suicides or suicide attempts were noted for the 1200 non-patient, experimental participants. However, it is important when evaluating these data to consider that only 44 of the 62 researchers queried by Cohen returned survey results (Cohen, 1960; Novak, 1997). Although Cohen and Ditman (1962) subsequently expressed misgivings over the increased incidence of adverse effects due to the increasing recreational use of LSD and some questionable clinical practices, they maintained that when used under the proper guidelines, LSD was an important tool for use in human research (cf., Novak, 1997). McGlothin and Arnold (1971) reported 1 case out of 247 individuals who received LSD in either experimental or psychotherapeutic studies in which an LSD-related psychotic reaction lasting more than 48 hours occurred. That single case was a patient who received repeated LSD administrations in a psychotherapeutic context. Although very rare, care must be taken to minimize the risks of such an episode.
Bad trips & other short term ill-effects
The most common adverse reaction to psychedelics is the bad trip, which can involve feelings of fear, anxiety, dysphoria and/or paranoia. Johnson et al write: "Distressing effects may be experienced in a variety of modalities: sensory (e.g., frightening illusions), somatic (e.g., disturbing hyperawareness of physiological processes), personal psychological (e.g., troubling thoughts or feelings concerning one's life) and metaphysical (e.g., troubling thoughts or feelings about ultimate evil forces." Hallucinogens often intensify people's emotional experiences, they write, which could lead to erratic and potentially dangerous behavior if people aren't properly prepared and supervised. ²² Other short-lived but negative effects can include: "temporary paranoid ideation and, as after-effects in the days following a LSD experience, temporary depressive mood swings and/or increase of psychic instability." ²³
I didn't find much information about how common bad trips are - one 2010 analysis of psilocybin studies done between 1999 and 2008 looked at the experiences of 110 patients. Negative experiences weren't common and seemed to be dose-dependent - higher doses of psilocybin were associated with higher rates of adverse reactions. All of the short-term adverse reactions were "successfully managed through interpersonal support" and didn't require taking any drugs and seemed to have no lasting effects, based on follow-up interviews. ²⁴
A group of Johns Hopkins researchers conducted an online survey of 1993 people who had had a difficult or challenging experience with psilocybin mushrooms. Only 2.1 percent of the respondents took psilocybin in a setting that resembled a controlled clinical environment. For 39 percent of the respondents, the bad trip ranked among the top five most challenging experiences of their lifetime. More specifically:

"11% reported putting themselves or others at risk of physical harm, 2.6% reported behaving in a physically aggressive or violent manner, and 2.7% reported getting medical help during the occasion. Of those whose session occurred at least 1 year earlier, 7.6% reported that they sought treatment for one or more psychological symptom they attributed to the challenging psilocybin experience. Three cases appeared associated with onset of enduring and impairing psychotic symptoms and three cases with attempted suicide." ²⁵

But, interestingly enough, despite these negative experiences, many of the survey respondents still found even these bad trips to be meaningful and spiritually important. For 34 percent of participants, their most challenging trip on psilocybin was ranked among the top five most meaningful experiences of their life. And 31 percent said it was among the top five most spiritually significant experiences of their life. Eighty-four percent of the respondents said they had benefitted from the challenging parts of their trip and 46 percent said they would repeat that session if they could, despite the challenges. ²⁶
Flashbacks
There's not a lot of conclusive information about how common and/or debilitating flashbacks are. Reports of flashbacks have been around for a very long time - in 1898 Havelock Ellis described a heightened sensitivity to ''the more delicate phenomena of light and shade and color' since he'd taken mescaline. ²⁷ In 1986, hallucinogen flashbacks were first described in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) and then revised in the DSM-IV under the diagnosis Hallucinogen Persisting Perception Disorder with the following diagnostic criteria:

A) The reexperiencing, following cessation of use of a hallucinogen, of one or more of the perceptual symptoms that were experienced while intoxicated with the hallucinogen (e.g., geometric hallucinations, false perceptions of movement in the peripheral visual fields, flashes of color, intensified colors, trails of images of moving objects, positive after- images, halos around objects, macropsia and micropsia).

B) The symptoms in Criterion A cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

C) The symptoms are not due to a general medical condition (e.g., anatomical lesions and infections of the brain, visual epilepsies) and are not better accounted for by another mental disorder (e.g., delirium, dementia, Schizophrenia) or hypnopompic hallucinations.

Using this criteria, Halpern and Pope analyzed 20 studies of people who'd experienced flashbacks that were conducted between 1955 and 2000. In general, they found that the term "flashback" had been used in so many different ways that it was "virtually useless". They also found that the studies reported wildly different rates of flashbacks - some researchers saw hardly any, but others said more than 33 percent and 77 percent of participants who had taken LSD had flashbacks. They also noted that people who'd taken LSD in therapeutic or research settings seemed to have far lower rates of flashbacks. The studies' designs also made it hard to rule out confounders like underlying medical conditions and the use of other drugs. Still, the authors did conclude that: "Despite all of these reservations, it seems inescapable that at least some individuals who have used LSD, in particular, experience persistent perceptual abnormalities reminiscent of acute intoxication, not better attributable to another medical or psychiatric condition, and persisting for weeks or months after last hallucinogen exposure." ²⁸

More recently, Halpern and other researchers have distinguished between two types of flashbacks. The first type are "brief re-experiences of alterations in perception, mood, and/or consciousness, as previously experienced during a hallucinogenic intoxication." The person experiencing these typically realizes they are having a flashback and the frequency of the experiences, which can be pleasurable, often diminishes over time. ²⁹

Halpern describes the second, more severe sort like this:

Type 2 HPPD (consistent with Abraham (1983) and part of the definition in the DSM-V) entails constant or near-constant visual effects. These can include the following:

A. Palinopsia: the persistent perception of an object removed from view;

B. halos: a brightening glow or colored shining/shimmering surrounding objects;

C. trails or akinetopsia: a series of discrete positive afterimages following in the wake of moving objects; and

D. visual snow: a TV static-like graininess superimposed upon the visual field.

Symptoms may occur alone or in combination. Sound and other perceptions are unaffected. In most cases, visual phenomena are reported to be uncontrollable and disturbing, though some individuals regard them as enriching (Baggott et al. 2011). Claimed constant visual phenomena are often accompanied by mild-to-moderate depersonalization, derealization, anxiety, or depression (Holland and Passie 2011). These psychopathological states are claimed to trigger the occurrence and intensity of visual phenomena (Abraham 1982, 1983; Abraham and Duffy 1996, 2001) depending on the waxing and waning nature of current affect. ³⁰

But Halpern notes that this second type of flashback wasn't clearly reported in the 1960s nor was it described in the studies of the 10,000 or so people who took psychedelics in the 1950s and 60s in research settings.

In terms of how common psychedelic-induced flashbacks or HPPD may be, Halpern basically said we don't know:

Data do not permit us to estimate, even crudely, HPPD's prevalence according to DSM-V or ICD-10 criteria. Although millions of doses of hallucinogens were consumed by millions of individuals since the 1960s (SAMHSA 2011), few large HPPD case series were reported. Horowitz (1969), Cohen (1960, 1977) estimate the incidence of Type 1 HPPD in a population of regular hallucinogen users in the 1960-1970s as 1:20. Type 2 HPPD, if it exists as a reliable and distinct entity, appears to be very rare (Hermle et al. 2008, 2015; Holland and Passie 2011). Grinspoon and Bakalar (1997) estimate that Type 2 HPPD occurs in 1 of 50,000 hallucinogen users. Baggott et al. (2011) collected data online in a Web-based questionnaire from 2455 individuals reporting visual experiences while drug-free that resembled a past hallucinogen intoxication. Most of these experiences were simple, non-disturbing "flashbacks," while 4.2 % found these visual phenomena significant enough to at least contemplate seeking treatment. ³¹

Krebs and Johansen, meanwhile, expressed strong skepticism about the idea of HPPD in a 2013 paper that analyzed responses to the National Survey on Drug Use and Health from 2001 and 2004, and concluded, overall, that psychedelic use was not an independent risk factor for mental health problems. Here's what they say about flashbacks:

In this study, lifetime use of psychedelics and past year use of LSD was not associated with past year symptoms of visual phenomena (''seeing something others could not''), panic attacks, psychosis, or overall serious psychological distress. Thus, our findings does not support either the idea of ''flashbacks'' described in extreme cases as recurrent psychotic episodes, hallucinations, or panic attacks, or the more recent ''hallucinogen persisting perceptual disorder'' (HPPD) described as persistent visual phenomena with accompanying anxiety and distress. All of the purported symptoms of HPPD are also present in people who have never used psychedelics. Occasional visual phenomena are common in the general population, especially among people with anxiety disorders. Recent randomized controlled trials with psilocybin do not report any cases of ''flashbacks'' or persistent visual phenomena. Interviews with over 500 regular participants in Native American peyote ceremonies did not identify anyone with ''flashbacks'' or persistent visual symptoms. Interviews with 120 adults in the US complaining of persistent visual symptoms found that only 5% had ever used LSD (in comparison, over 10% of the general US adult population has used LSD) and there did not seem to be any relationship between drug use and visual symptoms. Only two small studies have reported higher rates of visual symptoms in LSD users compared to non-users. Both studies had serious methodological problems: participants in both studies were psychiatric inpatients who knew that the purpose of the studies was to document harms from LSD; the LSD group and the control groups were not matched on other drug use or psychiatric diagnosis; and in the first study several of the people included in the LSD group were later found to have epilepsy, panic, anxiety, affective disorder, or temporoparietal abnormalities that may be related to visual symptoms. In case reports of ''flashbacks'' or HPPD, symptom onset is often weeks, even years, after last psychedelic use, and a causal relationship between persistent perceptual symptoms and use of psychedelics remains unproven. Overall, the validity of the HPPD diagnosis remains scant. HPPD appears to fit within the somatic symptom disorders. In an llustrative case example, a young man was diagnosed with HPPD by the originator of the diagnosis; symptoms began in conjunction with major life changes and several weeks after taking LSD; on initial consultation with physicians, he was told that his vision was fine and somatization disorder was implied; he improved after psychotherapy for his depression and worries, and reassurance that his visual experiences were ordinary perceptual phenomena that most people ignore. ³²
Bridget Huber is Michael's research assistant.
1 Strassman 1984
2 Johansen and Krebs, 2015
3 Krebs and Johansen 2013
4 See http://www.wvgazettemail.com/News/201312170156 AND http://www.wsaz.com/home/headlines/New-Drug-Blamed-for-Overdose-Death-194512531.html
5 Suzuki 2014
6 Nutt 2012, pg. 254
7 Nutt 2012 pg. 254
8 Liechti 2017
9 Johansen et al 2015
10 Drug Abuse Warning Network - National Estimates of Drug-related Emergency Department Visits, 2004 - 2011
11 Johnson 2008
12 The poster abstract is only available online: http://www.atsjournals.org/doi/pdf/10.1164/ajrccm-conference.2017.195.1_MeetingAbstracts.A3773
13 Fysh et al, 1985
14 Klock 1973
15 Gable 2004 and 2006
16 Johansen and Krebs 2015
17 http://www.thestranger.com/features/2017/03/08/25008382/adventures-in-microdosing
18 Hendricks et al, 2015
19 Johansen and Krebs, 2015
20 Passie 2008
21 Studerus et al 2011
22 Johnson 2008
23 Passie 2008
24 Nichols 2016
25 Carbonaro 2016
26 Carbonaro 2016
27 Halpern and Pope 2002 (quoting from Havelock's "Mescal: A new artificial paradise", published in The Contemporary Review in 1898)
28 Halpern and Pope 2003
29 Halpern et al 2016
30 Halpern 2016
31 Halpern 2016
32 Krebs and Johansen 2013

Carbonaro, Theresa M., et al. "Survey study of challenging experiences after ingesting psilocybin mushrooms: Acute and enduring positive and negative consequences." Journal of Psychopharmacology (2016): 0269881116662634.

Drug Abuse Warning Network, 2011: Selected Tables of National Estimates of Drug-Related Emergency Department Visits. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, 2013.

Fysh, R. R., et al. "A fatal poisoning with LSD." Forensic Science International 28.2 (1985): 109-113.

Gable, Robert S. "Comparison of acute lethal toxicity of commonly abused psychoactive substances." Addiction 99.6 (2004): 686-696.

Gable, Robert S. "The toxicity of recreational drugs." American scientist 94.3 (2006): 206.

Halpern, John H., and Harrison G. Pope. "Hallucinogen persisting perception disorder: what do we know after 50 years?." Drug and alcohol dependence 69.2 (2003): 109-119.

Halpern, John H., Arturo G. Lerner, and Torsten Passie. "A Review of Hallucinogen Persisting Perception Disorder (HPPD) and an Exploratory Study of Subjects Claiming Symptoms of HPPD." (2016): 1-28.

Johansen, Pål-Ørjan, and Teri Suzanne Krebs. "Psychedelics not linked to mental health problems or suicidal behavior: A population study." Journal of Psychopharmacology 29.3 (2015): 270-279.

Johnson, Matthew W., William A. Richards, and Roland R. Griffiths. "Human hallucinogen research: guidelines for safety." Journal of Psychopharmacology 22.6 (2008): 603-620.

Klock, John C., Udo Boerner, and Charles E. Becker. "Coma, hyperthermia and bleeding associated with massive LSD overdose: a report of eight cases." Western Journal of Medicine 120.3 (1974): 183.

Krebs, Teri S., and Pål-Ørjan Johansen. "Psychedelics and mental health: a population study." PloS one 8.8 (2013): e63972.

Liechti, Matthias E. "Modern Clinical Research on LSD." Neuropsychopharmacology: official publication of the American College of Neuropsychopharmacology (2017).

Nutt, David J. Drugs -Without the hot air: minimising the harms of legal and illegal drugs . Cambridge: UIT, 2012.

Passie, Torsten, et al. "The pharmacology of lysergic acid diethylamide: a review." CNS Neuroscience & Therapeutics 14.4 (2008): 295-314.

Strassman, Rick J. "Adverse reactions to psychedelic drugs. A review of the literature." The Journal of nervous and mental disease 172.10 (1984): 577-595.

Suzuki, Joji, Justin L. Poklis, and Alphonse Poklis. ""My friend said it was good LSD": a suicide attempt following analytically confirmed 25I-NBOMe ingestion." Journal of psychoactive drugs 46.5 (2014): 379-382.

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What do we know about the risks of psychedelics? | Michael Pollan

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By Bridget Huber For starters, assessing risk is tricky. A lot of what both scientists and the general public think they know about the potential risks of psychedelic use comes from the first wave of research and experimentation in the 1950s, 60s and 70s.

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Revealing the Mind: The Promise of Psychedelics

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Structures of serotonin, LSD, psilocybin, and mescaline.

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In March, the U.S. Food and Drug Administration approved esketamine, a drug that produces psychedelic effects, to treat depression-the first psychedelic ever to clear that bar. Meanwhile the FDA has granted "breakthrough therapy" status-a designation that enables fast-tracked research-to study MDMA (also called "ecstasy") as a treatment for post-traumatic stress disorder and psilocybin as a treatment for major depression.

While these and other psychedelic drugs show promise as treatments for specific illnesses, FDA approval means doctors could also prescribe them for other, "off-label" purposes-including enhancing the quality of life of people who do not suffer from any disorder. Hence if MDMA gains approval as a treatment for PTSD, psychiatrists could prescribe the drug for very different purposes. Indeed, before the federal government banned MDMA, therapists reported striking success in using MDMA to improve the quality of intimate relationships. Recent research bolsters these claims, finding that the drug enhances emotional empathy, increases feelings of closeness, and promotes thoughtfulness and contemplativeness.‌

Similarly, while psilocybin has shown potential as a treatment for depression and anxiety, physicians could also prescribe the drug to promote the well-being of healthy individuals. When researchers at Johns Hopkins gave psilocybin to healthy participants with no history of hallucinogen use, nearly eighty percent reported that their experiences "increased their current sense of personal well-being or life satisfaction 'moderately' or 'very much'"-effects that persisted for more than a year.‌

Yet while the FDA generally does not regulate physicians' prescribing practices, a federal law called the Controlled Substances Act bars them from writing prescriptions without a "legitimate medical purpose." Although this prohibition aims to prevent doctors from acting as drug traffickers, the law does not explain which purposes qualify as "legitimate," nor how to distinguish valid prescriptions from those that merely enable patients' illicit drug abuse.‌

Would prescribing a psychedelic drug simply to promote empathy or increase "life satisfaction" fall within the scope of legitimate medicine-or would these practices render the physician a drug dealer?

To many the answer may seem obvious: to qualify as a "medical" use, a drug must be prescribed to treat an illness. But in fact, medical practice has always included interventions aimed at promoting the well-being of healthy individuals. Doctors provide contraceptives and induce abortions regardless of whether their patients' health is threatened by pregnancy. Plastic surgeons first honed their skills treating the traumas of the First World War, but quickly found themselves reshaping normal bodies and faces simply to enhance appearance.

Today physicians may prescribe stimulants to improve performance at school or minor tranquilizers to help cope with the ordinary stresses of modern life, regardless of whether patients meet the diagnostic criteria of a specific disorder. Indeed, some diagnoses themselves seem little more than thinly-veiled excuses to prescribe drugs simply to enhance quality of life-as when the FDA approved flibanserin to treat a condition called " hypoactive sexual desire disorder," which consists of not desiring sex as much as one would prefer.

At a time when "lifestyle drugs" are marketed as consumer products, it is increasingly difficult to draw a bright line that distinguishes legitimate medical practices from their illicit cousins. If prescribing mind-altering drugs to help healthy people achieve desirable mental states falls within the bounds of legitimate medicine, what is left of the concept of recreational use?

These line-drawing challenges argue for moving away from the drug war's simplistic, punitive approach in favor of more sophisticated strategies for minimizing the risks of psychotropic drugs. For example, when the FDA determines that a drug poses special risks, the agency can require Risk Evaluation and Mitigation Strategies, or "REMS," to promote the safe use of the drug.‌

Rather than focusing on whether a drug is prescribed for a "legitimate medical purpose," REMS can require physicians to register with the FDA and receive special training in order to prescribe the drug. Risk management plans can also stipulate that physicians may only dispense the drug in specific healthcare settings and that a healthcare professional must monitor each patient using the drug.

Similar strategies could be used to mitigate any unique risks posed by psychedelics, without limiting their use to patients suffering from particular disorders. One can imagine a system in which psychedelic drugs could be lawfully prescribed to a healthy individual, but only as part of a guided therapy session led by a specially trained physician. Multiple studies have found that both MDMA and psilocybin can be safely administered in well-supervised clinical settings like these, without harming patients or promoting drug dependence.

The prospect of psychedelic drugs gaining approval as treatments will force a reckoning for our existing system of drug control. While current policies characterize any use of these substances as illicit abuse, acknowledging that these drugs may offer meaningful benefits will require more flexible approaches. Psychedelic medicine may prove to be the thin end of a wedge that moves drug policy away from the elusive goal of eradication in favor of more nuanced strategies that harness the benefits of psychotropic drugs while minimizing their risks.

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Psychedelic Medicine Is Coming. The Law Isn’t Ready

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In March, the U.S. Food and Drug Administration approved esketamine, a drug that produces psychedelic effects, to treat depression-the first psychedelic ever to clear that bar. Meanwhile the FDA has granted "breakthrough therapy" status-a designation that enables fast-tracked research-to study MDMA (also called "ecstasy") as a treatment for post-traumatic stress disorder and psilocybin as a treatment for major depression.

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About 20 per cent of Australians struggle with a mental illness every year, ranging from depression and anxiety to substance or alcohol abuse.

The potential hardship and isolation posed by COVID-19 risks leaving more people vulnerable.

While we are fortunate to have a range of pharmaceutical and psychological treatments for mental illness, these may not be effective in some people, or at least they may still leave people with residual symptoms. Additionally, there are usually some side effects which commonly occur from drug therapies.

Current treatments for mental illness aren't always effective in some people. Picture: Getty Images

Given the scale of mental illness in society, innovative new treatment approaches are urgently needed.

One of these new approaches is the medicinal use of previously prohibited psychotropic plant-based medicines such as cannabis, or psychedelic compounds such as 'magic mushrooms'.

For example, there has been a resurgence of research interest in cannabis that by the end of 2020 around 80,000 Australian approvals will have been granted to prescribe medicinal cannabis since November 2016.

The science of supporting others

The next evolutionary step is for additional psychoactive compounds to be rigorously assessed in safe clinical and scientific models.

To this end, there have been a rising number of studies on a range of other plant-derived and related psychotropic compounds for psychiatric disorders.

Examples include psilocybin (the compound found in magic mushrooms), ayahuasca (a two-plant combination originating in the Amazonian basin, which has been used in shamanic applications for centuries), the North, Central and South American peyote and the San Pedro cacti which both contain the psychoactive compound mescaline, and even LSD (lysergic acid diethylamide), the well-known synthetic hallucinogen popularised in the 1960s.

These psychedelics work, in part, in a similar way to traditional antidepressants - they affect the chemical pathways in the brain involving serotonin (the hormone that influences mood and can make us feel good).

However, they also have a range of other beneficial biological activities, like anti-inflammatory effects.

Ayachuascua (pictured being prepared), is a promising target for research. Picture: Awkipuma/Wikipedia

Potential areas of therapeutic application of psychedelics include treating depression, substance or alcohol addiction, healing trauma and assisting in addressing end-of-life anxiety.

These mental health conditions often co-occur, which increases the clinical complexity and can worsen the overall prognosis.

So, what's the current evidence for the effectiveness of these medicinal psychedelics for mental health disorders?

The legacy of maltreatment on the brain

We recently conducted, at Western Sydney University's NICM Health Research Institute, the first 'meta-analysis' (pooling data from clinical trials for analysis) involving both healthy adults and those with clinical mood disorders to evaluate the clinical effects of psychedelic agents versus placebo on mood state and symptoms of depression.

Our literature research found 12 eligible studies undertaken over the last decade involving 257 participants (124 healthy participants, and 133 patients with mood disorders).

The data was from randomised controlled trials involving psilocybin (eight trials), LSD (three trials), and Ayahuasca (one trial).

Our analysis shows that medicinal psychedelics have a statistically significantly superior effect to placebo on improving negative mood outcomes and symptoms of depression over the short-term (three hours to one day after treatment) and longer-term (16 to 60 days after treatments) for patients with a mood disorder.

Meta analysis of previous trials suggests medicinal psychedelics may help depression. Picture: Getty Images

The best results for depressive symptoms were achieved within two-to-seven days. Additionally, short-term mood enhancement was also observed for people who were mentally healthy and didn't have depression.

Importantly, the data suggests that medicinal psychedelics have a good safety profile, though they are strongly not recommended for people with a personal or family history of psychosis - schizophrenia, for example.

Transient reactions may also occur in some people, like anxiety or panic, or a mild increase in cardiovascular function. It's therefore vitally important to have medical support at hand if required.

Borderline Personality disorder: It's time to change the narrative

We also have compelling data showing that the psychedelic formulation Ayahuasca may also be of benefit in treating depression as well as substance/alcohol addiction and abuse.

The Global Ayahuasca Project (GAP) is a University of Melbourne-led observational survey undertaken across 2017-2020 involving 10,838 people who reported use of Ayahuasca.

The results (which have been submitted and are under review at two academic journals) revealed that consumption of the plant brew was associated with reduced alcohol and drug use, as well as enhanced psychological wellbeing and better mental health.

Around 65 per cent of all respondents reported drinking alcohol less frequently since first consuming ayahuasca. Among the 708 individuals identifying as having an alcohol problem at the time of drinking ayahuasca, 89 per cent reported their condition 'much improved' or 'completely resolved' as a result of their ayahuasca consumption.

Similarly, of 1571 participants who identified as having depression at the time of ayahuasca consumption, 78 per cent reported that their depression was now either 'very much' improved or 'completely resolved'.

Medicinal psychedelics may have potential as treatments for drug and alcohol abuse. Picture: Getty Images

It's important to note that it is vital the study and potential use of psychedelics is carried out within a psychotherapy-supported and medically-supervised framework.

The psychological treatment model for the medical use of serotonin-inducing psychedelics is a critical aspect which substantially differentiates it from other drug therapies. This focus is known as 'set and setting'.

The optimisation of these factors through appropriate preparation with a trained clinician, along with support before, during and after an acute experience, can facilitate emotional and trauma processing.

What actually works for anxiety and depression?

This is important if the patient is to take on the new perspectives, sense of meaning and enhanced self-understanding that are also important for the clinical change needed in mental health disorders and addiction.

The strength of the acute clinical effect, fast onset, and enduring therapeutic effects of these psychotherapeutic agents should encourage further larger clinical trials to assess them across a range of mental health applications.

We know that more research is already being conducted around the globe on a range of agents for several psychiatric conditions.

If their safety and efficacy can be proven by further robust research, there is real potential for medicinal psychedelics to be used as a new therapeutic option within dedicated medically-supervised facilities in Australia, involving trained clinical psychologists.

This would provide a game-changing option, especially for currently intractable mental health disorders.
If you have any mental health concerns, please contact your GP, or if you or anyone you know is experiencing a mental health crisis, please contact Lifeline on 13 11 14.
Banner: Santo Daime (Ayahuasca)/Getty Images

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Professor Jerome SarrisHonorary Principal Research Fellow, Department of Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne; Professor of Integrative Mental Health; NICM Health Research Institute, Western Sydney University

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Professor Nicole Leite Galvão-CoelhoNICM Health Research Institute, Western Sydney University; National Institute of Science and Technology in Translational Medicine, Brazil

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Dr Daniel PerkinsHonorary Research Fellow, School of Social and Political Science, Faculty of Arts, University of Melbourne; Director of the Office of Medicinal Cannabis in the Victorian Department of Health and Human Services

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Psychedelic medicine: A mental health game changer?

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About 20 per cent of Australians struggle with a mental illness every year, ranging from depression and anxiety to substance or alcohol abuse. The potential hardship and isolation posed by COVID-19 risks leaving more people vulnerable.

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Also called empathogens, entheogens, and hallucinogens, psychedelics are intoxicating substances. They can produce changes in a person's conscious experience, including alterations in feelings, emotion, cognition, and perception. The best-known psychedelics include:

Lysergic acid diethylamide (LSD)

N, N-dimethyltryptamine (DMT)

Mescaline

Psilocybin

However, psychedelics are illegal in many countries around the world. Yet this is only a relatively recent event. In this article, we answer the question: "Why are psychedelics illegal?"

Why Are Psychedelics Illegal in the U.S.?

In Peru, the psychedelic, ayahuasca, is legal to use and possess. In the Netherlands, adults can buy and use psilocybin in the form of magic truffles. However, it is illegal to consume the drug in the form of mushrooms. Overall, there are a handful of countries that permit the usage of certain psychedelics.

This isn't the case in the U.S., barring a small number of exceptions. One of the most noteworthy involves Members of the Native American Church. These individuals are legally permitted to consume peyote anywhere on the reservation. However, states such as Colorado, Nevada, and New Mexico don't recognize this law.

So, why are psychedelic drugs illegal in the United States? It is ostensibly due to the perception that these substances cause harm.

These drugs work by acting on neural circuits in the brain that use the neurotransmitter, serotonin. Some of their most noticeable effects take place in the brain's prefrontal cortex. This is the part of the brain involved in perception, cognition, and mood.

The duration of the effects varies according to the drug used. For example, DMT's effects tend to last between 20 and 45 minutes. Drinking ayahuasca could lead to effects that last up to four hours. Psilocybin's effects could last for up to 12 hours.

What Are the Reported Side Effects?

The effects vary depending on the psychedelic. However, they may include short-term issues such as:

Profound sweating (peyote)

Panic, paranoia, or nervousness (psilocybin)

Sleeplessness and dizziness (LSD)

Increased heart rate (DMT)

Two of the more disturbing long-term effects often associated with hallucinogens are:

Persistent Psychosis: This is a series of ongoing mental issues. It can include symptoms such as mood changes, paranoia, and visual disturbances.

Hallucinogen Persisting Perception Disorder (HPPD): This can result in flashbacks where the user has recurrences of specific drug experiences. These episodes happen without warning. They can begin within days of using the drug, or up to a year afterward. Occasionally, HPPD is mistaken for disorders such as a brain tumor or stroke.

The Trouble with Analyzing the Risks of Psychedelics

Relatively little was known about psychedelics until the early 1900s in the West. The suggestion is that humans have used these drugs in Africa and Asia for thousands of years. It was a botanist called Mr. W, who was the first person in the West to document the use of psilocybin. He did so after ingesting a mushroom containing the drug in 1914[1].

LSD didn't exist until it was synthesized in a lab in 1938. Even then, researchers weren't aware of its psychedelic effects for another five years.

The first wave of experimentation and research didn't begin until the 1950s. A proportion of today's studies draw on data from this era.

However, the old studies had a variety of issues with their methodology. Some lacked baseline data about subjects, while others failed to use placebos.

A study published in PLoS One in 2013 analyzed the potential link between psychedelics and mental health. It used data drawn from the National Survey on Drug Use between 2001 and 2004. Over 130,000 people responded to these surveys. The researchers found that almost 22,000 respondents (13.4%) reported lifetime psychedelic use.

The study outlined no significant associations between lifetime usage of any psychedelic and increased rate of mental health problems. In some instances, the use of a psychedelic was linked with a lower rate.

Johns Hopkins Researchers Call for a Change in Schedule for Psychedelics

Research at John Hopkins University, published in Neuropharmacology in 2018, weighed heavily in favor of psychedelic use. It was part of a review that assessed medically administered psilocybin. The study concluded that psilocybin could "provide therapeutic benefits that may support the development of an approvable New Drug Application (NDA)."

According to the researchers:

Humankind has used psilocybin mushrooms for millennia.

Human and animal studies show evidence of no physical dependence potential and low abuse.

Extensive national surveys show low levels of abuse, harm, and treatment-seeking among those using psilocybin.

Overall, the team suggested that psilocybin warrants Schedule IV status. This is a classification similar to many prescription drugs.

The Real Reason Why Psychedelics Are Illegal

The weight of evidence is beginning to show certain drugs in a better light in recent times. Therefore, why are psychedelics illegal? A study published in the CBHSQ Report in 2013 looked at the highlights of the 2011 Drug Abuse Warning Network findings on drug-related ER visits.

It highlighted the meager number of hospital visits linked to psychedelics compared to other drugs. In 2011, LSD and psilocybin accounted for just 0.005% of emergency room visits in the United States.

With such data to hand, one must question the notion that psychedelics are banned for public health reasons. After all, the opioid epidemic is claiming tens of thousands of lives annually. However, these drugs remain widely available with a doctor's prescription.

There are a few potential reasons why governments are against the use of psychedelics. Please note that the following are theories and should not be taken as fact.

Money

Marijuana is becoming legal in certain American states because it is possible to tax it. California became the first state to legalize MMJ in 1996. The Golden State now permits the use of recreational marijuana. California hopes to earn over $1 billion per annum in tax revenue within the next few years.

Yes, it is possible to tax LSD, for example. However, cynics point out that it is impossible to tax something found in a field, such as psilocybin mushrooms. Therefore, one possible reason why psychedelics are illegal is due to a lack of taxation.

One way around this is for pharmaceutical companies to create a synthetic version of psilocybin. The research by Johns Hopkins already leaves the door open for this to happen sooner rather than later.

Free Thinking

It is said that a government's ideal populous is one that readily absorbs everything spoon-fed to it. The suggestion is that critical thinking is not permitted. Many advocates of psychedelic drugs said they inhibit hippocampal censorship mechanisms. As a result, users of these drugs see things the way they really are.

Richard Nixon

There is perhaps merit to this particular suggestion. Though psilocybin received its ban during the tenure of Lyndon B. Johnson, Nixon began a war on drugs in the early 1970s. The Vietnam War had become extremely unpopular in the United States by this period. The number of open protests escalated dramatically.

Those involved in the most frequent and noticeable protests were individuals who were part of the hippy movement.

They regularly used psychedelics and marijuana. Nixon decided to demonize their lifestyle and began calling them enemies of the state. Soon enough, law enforcement started cracking down and arresting them.

Meanwhile, there were rumors of the military conducting studies on the effects of potent psychedelics. According to the story, they dosed soldiers with LSD secretly. However, the military found that LSD made the soldiers pacifists. This theory is another version of the 'curtailment of free-thinking' notion.

Ultimately, these theories and many others are based on perhaps some facts, but also a lot of supposition.

When Were Psychedelics Made Illegal?

In 1960, Timothy Leary was involved in the infamous Psilocybin Project at Harvard. With the help of Dr. Richard Alpert, he studied various applications of so-called magic mushrooms. One experiment found that psilocybin reduced recidivism rates amongst prisoners.

However, other faculty members took exception to the research, and Harvard stopped it in 1963. A slew of academics openly criticized Leary and Alpert, saying the studies were dangerous. The government noted this disapproval, and officially banned psilocybin in the United States in 1968.

During the presidency of Nixon, the government introduced the Controlled Substances Act in 1970. It was a policy that made psychedelics illegal. Mescaline, LSD, psilocybin, and marijuana became Schedule I drugs, the strictest classification. By 1977, all research into psilocybin on humans had ended in America[2].

Are All Psychedelic Drugs Illegal?

The answer is 'no,' but it depends on the jurisdiction. The United Nations adopted the Convention of Psychotropic Substances in 1971. It made the sale, possession, use, and distribution of many drugs, including psychedelics, illegal worldwide. The only exception involved scientific research into the drugs.

A few countries have softened their stance on psychedelics. However, it is still challenging to find psychedelic mushrooms that are not illegal. The possession and sale of psilocybin mushrooms are legal in:

Interestingly, psilocybin mushrooms have never been illegal in Jamaica. Several South American countries also allow the use of ayahuasca. In Portugal, LSD is widely available since the nation decriminalized possession of small amounts of most drugs in 2001.

As for the United States, ketamine-assisted psychedelic psychotherapy is available under certain circumstances. Possession of psilocybin-containing mushrooms remains illegal. However, the spores don't contain intoxicating chemicals. As a result, it isn't against the law to sell spores in many states. Nonetheless, the sale of spores to produce hallucinogenic mushrooms is illegal.

Final Thoughts on the Legality of Psychedelics

In general, the sale and possession of psychedelics such as LSD and psilocybin are illegal in the United States. These drugs are also prohibited in a significant majority of countries. Up until recently, anti-psychedelics laws passed due to a reliance on old data. It is only recently where researchers have used modern techniques to perform detailed studies.

They are starting to discover that old information on psychedelics is outdated. Nonetheless, it seems likely that the U.S. Government will approve synthetic versions of psychedelics, rather than allowing people to consume them as nature intended.

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Why Are Psychedelics Really Illegal? [Fully Explained]

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Also called empathogens, entheogens, and hallucinogens, psychedelics are intoxicating substances. They can produce changes in a person's conscious experience, including alterations in feelings, emotion, cognition, and perception. The best-known psychedelics include: Lysergic acid diethylamide (LSD) N, N-dimethyltryptamine (DMT) Mescaline Psilocybin However, psychedelics are illegal in many countries around the world.

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Psilocybin mushrooms, sometimes known as magic mushrooms or shrooms, are among the most popular psychedelic substances worldwide. In this in-depth guide, we'll explain everything you need to know, including how to identify and use mushrooms, what to expect, and more.

What Are Magic Mushrooms?

The term 'magic mushrooms' applies to any species of fungus that contains the active ingredient psilocybin or its derivative psilocin. These compounds bind with serotonin receptors in the brain to induce a psychedelic experience, commonly known as a 'trip.'

There are numerous types of magic mushrooms - over 180 species have been identified to date.

However, their effects are all somewhat similar. Depending on the dosage, they can induce anything from feelings of mild euphoria to powerful hallucinations and spiritual experiences.

For this reason, humankind has used them for millennia as an important element of religious ceremonies and rituals. More recently, they have become popular as a recreational substance, and scientists are exploring their therapeutic potential.

Magic Mushrooms Effects and Dosage

The effects of magic mushrooms can vary depending on the individual taking them, the setting, and the dosage.

People who use them commonly describe a heightened emotional state and an increased sense of introspection. Some users also experience time distortion and synesthesia, a phenomenon that involves the blending of the senses, for example, tasting colors.

Psilocybin can also cause visual effects. Shifting shapes and colors, halos or rainbows around objects, or geometric patterns when closing the eyes are common examples. There may be a sense that the world is pulsing or breathing, along with feelings of inner-peace, contentment, or connection.

Taking an appropriate dose of magic mushrooms is one of the keys to ensuring a positive experience. While the effects of a particular dose often vary from person to person, many recommend first-time users to start out with a microdose. More experienced mushroom users will often consume up to 5 grams or more at once, but this large of a dose will typically produce intense psychoactive and hallucinogenic effects, and may lead to paranoia for inexperienced users.

It is also critical to take mushrooms in a comfortable and safe setting, while in a positive frame of mind. Having a close friend or professional act as a 'trip sitter' can further enhance the event. They should preferably have experience with psychedelics and remain sober so they can act as a guide, alleviating any concerns that arise.

What is the Best Kind of Psychedelic Mushroom?

There are many different kinds of magic mushrooms, and all contain the same active compound: psilocybin. Therefore, it is difficult to say one is better than the others. However, one of the most potent varieties is Psilocybe cyanescens, also known as wavy caps. Another species with a generous amount of psilocybin is Psilocybe azurescens.

Some other common types of magic mushrooms include:

What Kind of Mushrooms Get You High?

Aside from psilocybin mushrooms, another common fungus with psychoactive effects is Amanita muscaria, also known as fly agaric.

However, this type of mushroom does not work in the same way as the species we have listed above. Its intoxicating chemicals are ibotenic acid and muscimol rather than psilocybin.

Rather than producing classic psychedelic effects, the fly agaric high is similar to being intoxicated on alcohol, causing euphoria and impaired coordination. In the latter stages, this mushroom induces sleepiness, and some users report having lucid dreams.

Fresh fly agaric is toxic, and it is necessary to prepare it in a specific way to avoid extreme sickness.

What Do Magic Mushrooms Look Like?

Since there are so many varieties of magic mushrooms, it is unsurprising that they can vary significantly in appearance. Therefore, when considering how to identify psilocybin mushrooms, it is best to familiarize oneself with the varieties growing locally.

Psilocybe semilanceata grows in many different regions, including North and South America, Europe, Asia, Australia, and New Zealand. They are small mushrooms with a bell-shaped cap, hence their nickname: Liberty Caps. They have thin, wavy stems that may bruise blue when handled.

Psilocybe cubensis is among the most common varieties found in tropical regions around the world. They are parasol-shaped mushrooms with stubby stems and light to golden-brown caps. The caps are bulbous when young and flatten out as the mushrooms mature.

Although these species are the most widespread, there are many other types of magic mushrooms, all with unique features.

How to Find Magic Mushrooms

The best growing environments for all kinds of fungi are those with rich nutrient sources and plenty of moisture. Therefore, magic mushrooms love to grow in forests where they can feed on the nutrients that dead trees provide. They are most likely to appear close to large bodies of water.

Some species, such as Psilocybe semilanceata, will also grow in open grassland. However, it is essential to avoid foraging for mushrooms on farmland that may harbor chemical pesticides. It is also critical to only harvest when extremely confident about how to identify magic mushrooms.

Picking the wrong species could cause sickness and death, luckily the latter is rare.

Magic Mushrooms Side Effects

According to scientific literature, psilocybin has a low risk of toxicity, addiction, or overdose. However, it can cause some adverse reactions.

The most common side effects of mushrooms include the following:

Changes in heart rate and blood pressure

Nausea

Sweating

Tremors

Increased tendon reflexes

Dilated pupils

Some other, more unusual side effects of taking mushrooms include anxiety, panic attacks, paranoia, and mood swings. One can minimize the likelihood of these negative effects occurring by preparing correctly and fostering a positive mindset before tripping.

Although it is rare, some people experience a condition called hallucinogen persisting perception disorder (HPPD). This can cause altered perception for several weeks or months after using a psychedelic.

Finally, magic mushrooms can interact with several medications, especially those with psychoactive properties. It is unwise to take psychedelics alongside medications such as Adderall, Xanax, or SSRI antidepressants. Drinking alcohol and taking mushrooms at the same time can also produce adverse effects.

How to Use Magic Mushrooms

Most people take magic mushrooms by eating them, although their taste and texture are rather unpleasant. To make them more palatable, people often brew them as a tea, mix them with peanut butter or Nutella, or blend them into smoothies.

It is also possible to grind dry mushrooms into a powder and make them into capsules. This method may be especially appropriate for those wishing to microdose mushrooms for medicinal use.

Magic Mushrooms Medical Use

In recent years, studies have started emerging regarding magic mushrooms' medical use. Some of the conditions that scientists are investigating include:

Unfortunately, the Controlled Substance Act still classifies magic mushrooms as a Schedule 1 Substance. Therefore, anyone wishing to try psilocybin for medical use may have difficulty accessing it. Individuals' best course of action may be to investigate whether any clinical trials are ongoing in their area, or they can travel to retreat centers in places in the world where they are legal.

Are Magic Mushrooms Addictive?

To the best of our knowledge, there are no reports of magic mushroom addiction. In fact, there is some evidence that magic mushrooms could benefit people with other addictions, such as alcoholism.

Final Thoughts on Magic Mushrooms

Magic mushrooms are a popular form of psychedelic that humans have used for thousands of years. As well as being integral to many spiritual and religious ceremonies, they also have a loyal following of recreational users. Furthermore, a growing number of people are using magic mushrooms medicinally.

Although their legal status has hindered research in the last century, scientists are now beginning to recognize psilocybin's therapeutic potential.

Magic mushrooms show promise for various conditions, and we expect to see more evidence emerging soon. Until then, remember that magic mushrooms are still illegal in the majority of places. Therefore, those opting to use them do so at their own discretion.

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Magic Mushrooms: Everything You Need to Know About Them

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Psilocybin mushrooms, sometimes known as magic mushrooms or shrooms, are among the most popular psychedelic substances worldwide. In this in-depth guide, we'll explain everything you need to know, including how to identify and use mushrooms, what to expect, and more. The term 'magic mushrooms' applies to any species of fungus that contains the active ingredient psilocybin or its derivative psilocin.

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An interview with the Co-Founder of Novamind

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Yaron Conforti

Episode Summary

In this episode, Psychedelic Spotlights, Director of Content, Jill Ettinger sits down with Chief Executive Officer, Director, and Co-Founder of Novamind, Yaron Conforti. Novamind is a Canadian-based company developing the infrastructure required for the regulated psychedelic industry.

Episode Notes

To learn more about Novamind and the work they're doing be sure to visit their website, Novamind.ca. Investors can find them on the Canadian Securities Exchange under the symbol NM.

Get the latest industry news around all things psychedelics by visiting our website, PsychedelicSpotlight.com, and be sure to subscribe to our newsletter to never miss a thing.

This interview was recorded on January 12, 2021.

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In this episode, Psychedelic Spotlights, Director of Content, Jill Ettinger sits down with Chief Executive Officer, Director, and Co-Founder of Novamind, Yaron Conforti. Novamind is a Canadian-based company developing the infrastructure required for the regulated psychedelic industry.

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What we now about psychedelics (medical use) so far

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The Netherlands is Europe's Most Psychedelic-Friendly Country - PsyTech

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The Netherlands is one of the most psychedelic friendly environments in Europe. Obtaining mushrooms, salvia, peyote, and other similar psychedelics from coffee shops is a common occurrence throughout the country. Studies have shown that psychedelics contain many health effects that may help overcome various mental and psychological conditions.

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Deckard Technologies - Analytics and Tourism Reporting

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STR data that equips municipalities and tourism boards with the precise, actionable insights.

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Quote - Steve Jobs