Early psychedelic researchers in the 1950's and 60's found LSD helpful in the treatment of alcoholism, and Bill Wilson (founder of Alcoholics Anonymous) had his own experiences with psychedelics which led him to the opinion that they were helpful in treating addiction.

Many mental health professionals today view addiction through the lens of trauma, which often an underlying factor in substance use disorders, and using psychedelics in a therapeutic setting can help treat some of these underlying issues.

For treating opioid addiction specifically, a psychedelic called ibogaine has shown a lot of promise. We know a couple people who have maintained long-term recovery after ibogaine treatment. Ibogaine has to be taken under medical supervision and is thus not cheap, but it seems to be the "magic bullet" for some people.

The major issue here with this last method is that you still have to source your own psychedelics through unregulated underground markets, which can lead to all kinds of issues with adulteration and misrepresentation. This isn't really an issue for whole psilocybin-containing mushrooms, but when you get into the realm of pressed pills or bags of off-white powders, things get more risky.

To help people navigate underground markets as safely as possible, we made a resource called Dealing With Your Dealer which you can download for free.

We also recommend testing your drugs using chemical reagents and fentanyl strips.

These methods used together are fairly accessible for most people, but they can't catch all adulterants, so if you have $100-150 to spend in the name of safety, we also recommend using a laboratory service like DrugsData.org , energycontrol-international.org , or GetYourDrugsTested.com (depending on where you live). This is the only way to guarantee you know what you have and can make an informed choice about whether you want to take it.

If being our geeky selves can be of service to the community, bring it on.

Psychedelic-assisted psychotherapy is still illegal in the US, with the exception of ketamine therapy in some places.

Finding ketamine therapy in your area can be a simple as a Google search. Bigger cities are more likely to have ketamine clinics if they're legal in your state.

Until psychedelic-assisted therapy becomes legal, the next-best option which many people use is to use psychedelics on their own, and work with a psychedelic integration therapist to plan their journey beforehand and make sense of what came up during their journey afterwards. The Multidisciplinary Association of Psychedelic Studies has a list of integration therapists HERE.

Mental health professional who works with psychedelics will tell you that it's usually not what comes up during the session that leads to healing, but rather, what you do with it afterwards that has the lasting benefit, so this option is actually pretty good for a lot of people.

Happy to help! That's why we came back for another round - there are just so many questions, especially as psychedelics have been moving more into the mainstream.

Our masterclass is available on our website, which we update quarterly with new research and resources: https://www.psychedelicsafetyalliance.org/courses

We've also got an email list we regularly send out resources to: https://www.psychedelicsafetyalliance.org/f/psychedelic-safety-resources

Regarding legalization, it is our sincere hope that our country will continue to move in that direction. The recent announcement by the Biden administration formally announcing the failure of the policies around marijuana was an exciting step in the right direction: https://www.whitehouse.gov/briefing-room/statements-releases/2022/10/06/statement-from-president-biden-on-marijuana-reform/

The FDA's incremental progress in approving MDMA and psilocybin therapies has also taken some promising steps forward in recent months: https://theintercept.com/2022/07/26/mdma-psilocybin-fda-ptsd/

It's been the work of countless activists and researchers over decades, but I think, as a community, we're getting there!

Your instinct is right here in yes - it DOES depend on a whole array of different factors!

MDMA in particular has some unique properties that make it potentially harmful to take frequently, especially in higher doses. While there are some steps you can take to minimize the harm that MDMA has on your brainpan (we wrote up a guide on the science behind neuron-saving supplementation here: https://www.psychedelicsafetyalliance.org/f/mdma-harm-reduction) MDMA is not something that is appropriate to take more than once every few months, at least if you value your ability to consistently use your dopamine and serotonin receptors.

As a general rule of them with psychedelics, especially ones like LSD and psilocybin that don't build as much of a tolerance, we like to advise folks wait until they have fully integrated their last experience before moving on to the next one. Have you really absorbed whatever teachings your experience had to give? Has your body fully recovered and your mind returned to baseline? What benefit would you get out of doing it again that you can't achieve by doing something less risky? What's the minimum effective dose and frequency to get you what you want? Some people find that a regular microdose protocol gives them much of the benefits with less of the hassle of a regular macrodose, for example. Psychedelics are incredible tools, but you want to make sure you're applying them with intention and care.

We should also add here that there are two kinds of crises one can experience while on psychedelics: Medical Crisis and Psycho-Emotional Crisis.

People experiencing an acute medical crisis sometimes need hospitalization, as a medical crisis can be fatal in some instances. Getting people in this camp medical attention can often keep them alive or prevent things from getting worse.

People experiencing a psycho-emotional crisis can often present as being in bad shape and really scared, possibility to a legitimately traumatic level, even to the the point where they think they're dying, but actually are not dying. Getting people in this camp to a hospital can often subject them to environments and situations which can make things more scary or traumatic.

To help some festival first responders in our network determine the difference between the two types of psychedelic crises, we made this nifty Crisis Laminate, which you can download for free, print out, and take with you when you're out in the world.

Legality varies greatly by jurisdiction and individual psychedelic compound in question, so we're hesitant to provide sourcing information in a public forum. We'd recommend checking the legal status of the compounds that you are interested in in your given city/province. For example, many jurisdictions have licensed ketamine-assisted psychotherapy clinics, so you can have a safe, supervised experience if you are seeking psychedelics for purposes of clinical treatment.

For most folks, however, psychedelic access is largely restricted to either growing/making your own (complex and again, legally fraught) or accessing black/gray market sources. We created a brief harm reduction guide for Dealing With Your Dealer to minimize the likelihood of getting something other than what you were looking for (and maybe causing harm to yourself or community members as a result): https://www.psychedelicsafetyalliance.org/f/dealingwithyourdealer

Thanks! Doing our best.

Erowid kicks ass.

To be clear, we're not conducting our own academic research, but we do study and aggregate a bunch of academic research for a lay audience. Many of the researchers we've spoken with have told us that science has an information dissemination problem, so we view part of our role as filling that gap.

It's also worth noting that many emergency medical professionals like Erowid, as they don't receive much education about psychedelics during their training and can be asked to care for patients experiencing some kind of medical issue that could be due to a substance that they've never heard of before.

Though Erowid doesn't always have information on *every* drug out there (especially very new ones), it's the most encyclopedic database we know of, has been around the longest, and was a major starting point for both of us in our journeys to understand WTF was up with drugs generally, psychedelics specifically, and how to keep people safe.

There are tons of groups that are lobbying for drug policy reform in the United States; expanding clinical research and treatment options is just one of many. Many of the nonprofits and businesses that have been funding clinical research are also very involved in pushing for regulatory reform, most notably in the US MAPS. There are plenty of groups with a more international scope, such as Beckley Foundation.

There's excellent sociological science that's been produced that has examined the negative impact of the War on Drugs on marginalized populations that has in turn led to social justice-oriented reform initiatives by the ACLU, Drug Policy Alliance, and others. While the focus of organization efforts varies by local chapter, SSDP also does excellent work on the activism front as well.

Due to the freeze on psychedelic research that hit in the late 60's, there's still a ton of research to be done on various psychedelics, especially more esoteric ones like DMT. So if you're looking for peer-reviewed research on medical benefits, in many instances, you just have to wait until the research has been funded and conducted in the first place.

That said, if you want to see what does exist in the medical literature, PubMed or Google Scholar are our go-to databases for published research findings. Many of the studies you'll find in there are pretty jargon-heavy and not meant for the general public, but you can easily go in there and do a keyword search for the compound you're curious about and you'll get a list of things folks have published. Some studies have methodological issues that only research geeks can pick apart and it's still not always possible to say definitively that the findings of a single study are conclusive, but it's a start.

A better option for laypeople can be databases like Erowid or PsychonautWiki, which, though they don't list much in the way of medical research findings, can give you a more accessible glance at the experiences other people have had on a wide variety of psychedelics through the Experience Reports they collect. You can also occasionally find research cited on Wikipedia, though you'll want to follow up with those to make sure they're legit.

There are two major categories of deaths associated with psychedelics....

The first category has to do with the physiological impact that the psychedelic has on the body - in short, an overdose. These are extremely rare for most psychedelics, given that they have such a high LD50 (the "lethal dose" amount of a material which causes the death of 50% of subjects) compared to other psychoactive compounds such as alcohol. A famous example is the legendarily high dose of LSD that had to be given to an elephant to result in its death: https://www.illinoisscience.org/2016/06/lsd-and-the-elephant/

But other compounds may cause death through other physiological mechanisms - especially psychedelics with a strong impact on cardiac systems, such as ibogaine or MDMA. Each compound presents its own unique challenges, and should be researched carefully with respect to contraindications with other drugs - another potential source of fatal effects - and underlying conditions that may not place nice with your psychedelics.

The biggest risk we see is how psychedelics change behavior, and in particular awareness of the environment. People on psychedelics much more in danger from the world around them - from perhaps not checking both ways before crossing the street while on bicycle day ride, from accidentally drowning in a DIY float tanks in their home bathtubs while K-holed, from losing their balance and falling while giddily climbing tall structures at festivals - all situations ourselves and/or our first responder community members have had to deal with. Ketamine seems to be a particularly common factor in deaths of this nature.

This is why we strongly recommend folks not only take preventative steps to make sure they are taking the appropriate substance in an appropriate dose for their individual biology, but also use substances in community so that they have people that can help them not accidentally harm themselves while on their cosmic voyage. We've got a safe(r) psychonaut dosing protocol we put together for community here to minimize risk: https://www.psychedelicsafetyalliance.org/f/safer-psychonaut-dosing-protocol

Connecting with Decriminalize Nature to start an initiative to decriminalize plant-based psychedelics in your city or state is one option.

Supporting any such existing campaigns in your city or state is another.

If you're a college student, starting or joining a chapter of Students for Sensible Drug Policy is a good move.

You can also support the Drug Policy Alliance, which is the major national organization pushing for drug policy reform.

An example: there was a notable headline-generating incident recently in which an individual who had taken psilocybin-containing mushrooms assaulted several individuals on a plane. While rare, taking high doses of psychedelics in the wrong set and setting can be immensely disruptive and sometimes dangerous for those around you. While certainly not the majority of use cases, when situations like these end up in the headlines, it certainly makes it harder for activists to make the case for decriminalization or legalization on the basis of there being little public safety risk. https://www.washingtonpost.com/travel/2022/10/10/psychedelic-mushrooms-united-flight/

There are a couple.

A major one is the increasing prevalence of harmful adulterants like fentanyl in the underground drug supply. Though fentanyl specifically still doesn't show up in psychedelics sold in underground markets *that* often, there have been some reports of it showing up in ketamine, and given the way fentanyl has crept into many other drugs (heroin, methamphetamine, cocaine), we have concerns that this could continue further into the psychedelic market as well.

- Another issue is people not knowing how to dose themselves correctly, which is one of the things we cover exhaustively in our new masterclass. Being too high to drive or safely navigate public space carries a safety risk both to yourself and to others

- A very small but reliable percentage of people who take psychedelics will experience some kind of psychotic episode or become erratic, which can lead to unpredictable and risky behaviors that can affect their health and safety, as well as that of those around them. (As another example, one of us had a friend in college who was triggered into a major bipolar episode resulting from psychedelic use who impulsively decided to take a late-night bike ride to another state and was hit by a car.)

- There's also a possibility that more people experiencing psycho-emotional crises on psychedelics could check themselves into emergency rooms when they don't need medical attention, taking staff resources away from people in more urgent medical need.

How likely are these things? Hard to say. What we do know is that all of these things happen a little bit already and are statistically likely to happen to more people as more people start taking psychedelics without proper safety education.

You're welcome!

YES. If all the time and energy that has been spent battling often malicious regulatory environments had instead been spent on finessing clinically-sound treatment protocols using these compounds, we believe the world would be a much safer and happier place. But, here we are, and despite the War on Drugs, the scientific community is more vibrant than ever when it comes to exploring the therapeutic potential of these substances.

It's a very long story indeed and far longer than a single comment could encompass! MAPS, and several other incredible organizations, have been working for decades to push psychedelic research through the steep financial and regulatory requirements involved in the onerous clinical research process. The primary compounds being studied are MDMA, LSD, psilocybin, and ketamine, for a wide variety of different clinical applications varying from treating PTSD to depression to OCD to end-of-life anxiety. We've been keen observers as this research has evolved and excited for the implications for so many that are suffering... but also have watched the enthusiasm for these treatments spill over into people trying out less-than-safe DIY applications in home and other unlicensed environments.

We're a big fan of Michael Pollan's book, "How To Change Your Mind", for a deep dive into the history of use of these compounds and how regulation and clinical research has evolved over the last century. From his website: https://michaelpollan.com/books/how-to-change-your-mind/ Amazon purchase link: https://amzn.to/3swCUEW

If you're not looking for a whole book, but would rather like to stay up to date on the clinical research as it emerges, Lucid News has as great weekly newsletter that sums up the headlines with the latest and greatest in clinical research developments: https://www.lucid.news/

The Not-So TL;DR:

Our first responder and psychedelic harm reduction friends have reported a recent, noticeable uptick in calls involving people who read a glowing article or watched How To Change Your Mind, took psychedelics with no idea what they were doing, and ended up in an unexpectedly difficult, traumatic, or dangerous situation.

We’re here to help you avoid being that person.

For context, the psychedelic research studies you've heard about are conducted on extensively screened subjects. Pharmaceutically pure compounds made in licensed labs are used. The sessions themselves are conducted by trained professionals in tightly controlled environments with lots of preparation and aftercare for the subjects. Medical professionals are standing by in the next room the whole time in case they're needed.

This is in many ways the exact opposite of how people take psychedelics in the real world.

When you’re taking psychedelics in an unsupervised, uncontrolled environment like a festival, party, or event at home, the number of risk vectors you have to anticipate, track, and manage on your own goes way up.

We learned about the importance of psychedelic safety while coming of age working as staff, performers, and first responders at festivals, which are arguably one of the most (if not THE most) complex, uncontrolled environments where people regularly take psychedelics.

Over the years, we have seen a small but painfully consistent percentage of people overdose, have terrifying experiences, injure themselves, experience psychotic episodes, and rarely (but heartbreakingly) even die in situations involving psychedelics. Many of these incidents involved friends and people we cared about, so we got real nerdy with an interdisciplinary team of psychedelic safety experts to figure out how to take care of our communities.

We’ve now been working together for seven years to create a comprehensive video masterclass for people who use psychedelics outside of supervised medical, therapeutic, and ritual contexts. Having recently completed and launched the masterclass, we’re now able to help answer a wide range of psychedelic safety questions, including:

- Avoiding dangerous drug combinations

- Safer dosing practices

- Determining whether your mindset and environment (“set and setting”), and the people you're with are conducive for a safe, beneficial experience

- How to test your drugs for purity and screen for harmful adulterants like fentanyl- Medical and mental health conditions which are contraindicated with various psychedelics

- Where to find quality, no-BS information about drugs on the internet

- How to triage and respond in a crisis if something goes sideways and you need to get help

- Strategies for supporting someone having a difficult trip

- Consent around psychedelics

- How to make sense of psychedelic experiences and integrate them into your life

A COUPLE NOTES:

- This AMA is intended for informational and harm reduction purposes and should not be taken as medical advice. We’re not doctors and we don’t play them on the internet, but we also know that most medical professionals don’t receive comprehensive training about psychedelics. Thus, we encourage you to do your own research and will be happy to direct you to legit sources of online drug information.

- The word “psychedelics” is an umbrella term which refers to a wide array of compounds from many different classes of drugs. Drugs from different classes have different effects, work differently in your body, and have different safety profiles, which makes general questions about “psychedelics” hard to answer. Asking us questions about specific drugs will get you better answers.

- We don’t know everything about psychedelic safety and won’t pretend to. There’s just too much to know. We teamed up because our complimentary knowledge bases allow us to cover a lot more ground than most people in this space, but new research is coming out all the time, there are hundreds of new drugs being created every year, and there are always edge cases. If we don’t know the answer to a legit question, we’ll tell you so and will try to direct you somewhere or to someone who might.

- There is no such thing as taking psychedelics risk-free. If you take enough drugs at high enough doses over a long enough period of time, something will inevitably go sideways. Part of the point of all this safety stuff is to minimize the impact when it does. That said, there are also always going to be a small percentage of people who react poorly to psychedelics due to genetic factors or predispositions which could not have been known or anticipated in advance.

Okay, that’s all the additional stuff.

Now, should you feel so inclined…Ask Us Anything!