Deciding on the frequency and dosage depends entirely on you and your own unique biology and intentions - we can't really advise a one-size-fits-all approach. I'd suggest starting with establishing what you are hoping to get out of your experience. Depending on the intention, a micro or a macro dose may be more effective; and, if it's something that intersects with trauma or other mental health challenges, creating a treatment structure with the assistance of a professional, licensed psychedelic therapist may be the safest way to go.

We made this Safer Psychonaut Dosing Protocol a while ago to help people think through these issues methodically with respect to any one experience. Minimally, we recommend taking it slowly and cautiously in increasing dosage and frequency, and ensuring that the prior experience has been fully integrated before proceeding to the next one. Take your time - and lots of notes to reflect on each experience afterwards!

This crisis laminate thing was made as a shorthand addendum to a longer training offered to festival first responders. formatted to fit into little laminates you can wear around your neck and is meant to jog someone's memory in a crisis without missing critical indicators of safety or being so dense as to be illegible at night.

We've mentioned it here because it's the best free thing we have right now for crisis response, but it's certainly imperfect for anyone who hasn't taken that training. When we're able to get around to making one in long form that's better suited for folks without first responder training, your feedback will be super helpful, so thanks for that.

Right now the only place we offer comprehensive crisis response triage and training to people who aren't first responders is our psychedelic safety masterclass.

You're welcome! Well wishes for you on your journey.

As far as information about "tapering on" specifically, we're not aware of much in the way of dedicated research or anecdotal data on how to do it. One strategy informed by Alexander Shulgin's approach could be to raise your dose at small, consistent increments (indexed to the dosage range of the particular substance in question) over successive sessions.

For instance, many drug databases like Erowid or PsychonautWiki list a range of dosages from "threshold" to "heavy." You could start at the low end of a "threshold" dose, then do something on the higher end of a threshold dose. Then something on the low end of a "light" dose, then something on the high end of a light dose, and so on.

This is a good example of bad science followed by bad science journalism creating a speculative nonissue out of nowhere. While it hasn't been demonstrably proven that microdosing doesn't cause cardiac issues, the original article with that assertion also doesn't do a great job of proving that it does. Here's a great write up of some of the methodological issues with the original article from Third Wave. To summarize: Dr Ketan has no real-world data to back up his theory; they rely on an assumption of frequency of microdosing that does not match the most commonly used protocols; and finally, he actually extrapolates his hypothesis using some data from MDMA, which has a completely different structure and dosing protocol. That's not to say that there aren't issues and we can definitely say that this is absolutely safe, since the research out there is scant and there is tons we don't know... but this particular assertion is a theoretical stretch and needs some data before it can be given serious attention.

tl;dr, reading beyond the headline and into the methodological details of what smart-sounding people are saying is important.

Word. We're familiar with McKenna and don't think it was meant to be macho in a traditional sense either, which is why it's a bummer that it's sometimes taken that way out of context.

Totally. We've also heard the term "risk reduction" or "risk management" used, which are probably a little better and would likely still be tolerated by major social media platforms. This has given us some good stuff to think on in regards to how we present what we do online, so thanks for jogging our brains on this.

So, the legal framework in Oregon for psilocybin-assisted psychotherapy is actually still in development (and is experiencing some significant issues) - unfortunately, you can't count on having safe, legal access to professional resources there quite yet. Ketamine clinics have been cropping up in Oregon, however, which may be a useful treatment to consider in discussion with your mental health providers - many folks have found some relief from the symptoms of trauma, freeing up the capacity to work on the underlying issues in the long term.
We're very sorry to hear that you've been labeled as "drug seeking" by folks you've worked with in the past. That type of stigmatizing treatment by mental health professionals gives the rest of us a bad name, and we know you are not the only one who has not sought out treatment because of fear of the people who are supposed to be there to help them. Plenty of psychiatrists and others working in the behavioral healthcare field have not been exposed to all the excellent research that has been happening in this field in recent years, let alone received training that would enable them to have an even-handed, nonjudgmental conversation about their use. We would advise coming in prepared with your research before speaking with your doctor. If they are not prepared to treat your interest in exploring these other treatment modalities in a nonjudgmental, professional manner, that may mean identifying someone who has received more education and training on these subjects in your area.

If we're gonna get technical (and we will, we're nerds), the term "tolerance" refers to your body's lowered response to a drug after taking it, so we're going to address what it seems you're getting at here, which is building a base of experience in working up to higher doses.

We don't like the term "heroic" for high doses because that term has some Epic Badass Connotations to it, which we feel is misplaced given that higher doses are more likely to lead to difficult trips, not being able to navigate you environment safely, unearthing major trauma you weren't prepared to deal with, and seems to anecdotally increase the risk of lingering negative consequences like psychotic episodes and HPPD.

That said, working your way up to higher doses over many sessions can give you a better idea as to what's par for the course and what's not. This can help you determine what kind of help/support you need in a given moment (a trusted friend on the phone vs. a hospital, for instance). Also, if you happen to be one of those rare people who reacts poorly to a given drug due to some genetic factor, health condition, or mental health condition, it's often less bad to learn that at a lower dose.

It's always better to be cautious than totally fucked.

"Harm reduction" is a good term if you're trying to get often-fickle public funding to help people who suffer from acute, negative impacts from taking drugs. People who suffer from overdose due to adulterated drugs or disease spread by dirty needles are definitely experiencing harm and need those harms to be reduced.

But Dr. Hart is right: drug use is a lot more complex than just harm reduction. One of the things that the professional drug people in our network sometimes talk about is the the positive counterpart to many "harm reduction" practices is that they maximize the benefits people get from using drugs.

A lot of social media platforms will kick you off if you say anything about benefit optimization being the result of many of the things we study and teach (a Facebook Ads expert recommended we use the word Safety in the name of our org for this reason), so in the name of not getting our accounts deleted, we've opted to be verrrrry careful about the language we use and made peace with this sub-optimal compromise.

We'd strongly advise anyone seeking a deliberate, significant change in their cognitive function to seek out a licensed professional therapist to develop a targeted treatment selecting the appropriate modalit(ies) that will address the underlying issue (which is rarely as "simple" as it may appear): there is no "one size fits all" approach. Everyone's brain chemistry is unique, and therefore presents unique challenges: and creating a customized treatment plan with the help of a professional is essential. For one person, perhaps a therapist with somatic training is appropriate; for another, perhaps family systems therapist; for another, maybe it's just combining classic CBT with the psychedelic experience.

However, as far as we know, taking SSRIs with psilocybin does not cause serotonin syndrome. Taking way too much MDMA does, as can taking the supplement 5-HTP while on MDMA.

If you're on an SSRI and you don't respond to mushrooms on them, we're not aware of anything you can take to change that, short of doing a controlled taper off your SSRIS and being off them for a little while (which, to be clear, we are not recommending and should be done under the supervision of a medical professional).

SSSRIs are the main pharmacological agent we're aware of that will inhibit your response to psilocybin, but that doesn't mean they're not out there.

As far as boosting the effects of psilocybin, the one thing we know of is thelemon tek method, which you can also do a quick, jankey version of by just throwing some lemon into your mushoom tea.

And while there does seem to be some variation in effects between different mushroom strains, we've not seen anything indicating the difference is so major that it's going to make your microdoses markedly differently.

Absolutely. While it absolutely makes sense that the clinical trials are proceeding cautiously, with very strict parameters on who they treat and how they treat them and only changing a few variables at a time, there is a lot of eagerness by the innumerable folks who have not found relief through traditional psychiatry to DIY these protocols now. It's hard not to want to jump in when you've been experiencing so much unrelieved suffering, and you're seeing all these exciting headlines in mainstream news outlets.

For the interactions with SSRIs, there's this handy chart that summarizes some of the (known) issues, along with relevant citations. If you are able to identify a psychedelic-friendly psychiatrist in your area, it's worth it to talk through contraindications and any proposed change or taper to your medications with them. It could prevent further exacerbation of whatever mental health challenges you may have, such as triggering (potentially fatal) Serotonin Storm Syndrome.

As a general rule of thumb, we encourage anyone who is seeking treatment to seek as much professional assistance as they can find while on this path. It's a bit of a wild west out there right now in terms of identifying competent integration specialists who can truly help you on your path - not all of them are adhering to safe sourcing or testing strategies (here's a recent horror story about someone being given meth instead of MDMA for their underground therapy session). Having a professional, licensed person to guide you on your path in preparing and integrating the experience can help you identify any potential issues that may be difficult to identify without that outside set of eyes. We always advise, regardless of known underlying mental health conditions, to start with a low dose, and go slow, with any doses, and slowly titrate up to the desired dose to match your intention over the course of many sessions. This takes time, but will help you carefully evaluate your body's response and find a dose that minimizes negative effects while maximizing benefits. We've got our Safer Psychonaut Dosing Protocol here to minimize risk, and a set & setting checklist to help people create as safe a container as they can for their experience.

And finally: for folks with a genetic predisposition to schizophrenia-type disorders, there is a small but nonzero risk of triggering psychotic episodes, especially at higher doses. We encourage folks with this predisposition to have especial caution when thinking about LSD, psilocybin, and their analogues.

Though honestly, if you're at the 200mg level, variations in potency are unlikely to make a microdose *too strong*, so if you get a bunch of one batch at one time, grind them all up in a coffee grinder to minimize any variability in potency between stems and caps, and store the powder in a sealed mason jar in the fridge, you should be able to get consistent potency for awhile.

These are all real issues. Damn you, prohibition! You make sensible science so difficult sometimes!

At a physiological baseline, it takes half a week for your tolerance to LSD and mushrooms to fully reset after a single dose, so that's another factor to consider.

Hey, if it works for you, suppose that's better than nothing. While we cannot speak to your individual biology, your anhedonia might respond better to different microdosing protocols, which are easy to find online

We know one or two who have also used Hawaiian baby woodrose seeds to get high on LSA, but we don't know anything about the preparation thereof.

How stupid were you? Certainly enough to make yourselves sick off some seeds from the internet.

There hasn't been anywhere near as much as research into this as there should be. This is a bummer, as many people are interested in taking psychedelics to alleviate mental health issues which they currently take psychiatric medications for.

The task of studying contraindications between psychedelics and mental health conditions is mind-bogglingly complex given the number of combinations possible, and we've yet to find a truly definitive guide to what we know thus far.

Here's one table we've found about combining antidepressants with psychedelics, though it doesn't include lithium specifically.

As to what's happening to your brain on lithium and psychedelics, it comes down to the specific psychedelic and your specific brain, which even a trained expert would not be able to fully determine or predict.

That said, if you have had negative experiences taking psychedelics on lithium, it's probably a good idea to avoid doing so in the future: your brain could be trying to send you a message, and it's a good idea to listen when that happens.

Ibogaine is unfortunately classified as a schedule 1 substance in the US, despite its promising clinical applications. Wikipedia has a great chart showing its status by country: https://en.wikipedia.org/wiki/Legal_status_of_ibogaine_by_country

Two cautionary notes when seeking ibogaine: it is one of the riskier psychedelics to take, especially if there are underlying cardiac conditions - though the clinical research is not as robust yet as with some other compounds. We recommend that it is only done with careful consultation with your physician and a clear-eyed view of the personal health risks.

We would also recommend confirming that the sourcing of the iboga is done in an environmentally sustainable way, as increasing mainstream demand for ibogaine has resulted in unfettered deforestation that threatens the long term viability of ibogaine as a treatment option. More on conservation efforts here: https://chacruna.net/iboga_conservation/

We've seen some of the reports you mention, and to our understanding, the research is still too new and ongoing to be conclusive.

Microdosing exploded in popularity during COVID lockdown and there are more people doing it than ever before, so we're very curious to see if this could ultimately lead to larger sample sizes for microdosing research and/or more people who'd be willing to take place in microdosing studies, should the funding and interest become available to do more investigation.

It should also be noted that some licensed mental health providers are offering psychedelic-assisted psychotherapy under the table, which is not great given that many of them have no training in this whatsoever. Even those who have received training in underground psychedelic therapy programs often have no idea how to source safely, as this horror story can attest.

It's mixed. We feel many ways about this.

On the one hand, everyone and their mom wants psychedelic therapy right now, but capacity in clinical trials is low, which means many people who could benefit from psychedelic-assisted treatment or the therapeutic support of a clinical trial can't get it. In this situation, taking psychedelics on your own and working with an integration coach could be the best option that's available for people who are going to do it no matter what, and can theoretically be beneficial. That said, we've also heard stories of this route going poorly for people, so it's not the best option by far and really comes down to the individual providing the service.

On the other hand, a lack of regulation isn't great when we're talking about the hearts and minds of people who are suffering. If you're gonna look for someone to do psychedelic integration work with, we'd recommend going through a licensed therapist who at least has *some* training and experience working with clients, whether or not that training covered psychedelics.