Title & Introduction

  • Paper Title: On Minimizing Risk and Harm in the Use of Psychedelics
  • Published In: Psychiatric Research and Clinical Practice
  • Publish date: February 11, 2025
  • Authors: Jules Evans, Marc Aixalà, Brian T. Anderson, William Brennan, Rebecka Bremler, Joost J. Breeksema, Lisa Burback, Abigail E. Calder, Robin L. Carhart-Harris, and others
  • Objective: To identify key risks associated with psychedelic use and propose strategies for harm reduction, improved safety measures, and better post-use support.
  • Importance: As the use of psychedelics increases for both therapeutic and recreational purposes, ensuring safety and minimizing harm are critical. This study highlights research gaps, proposes safety measures, and calls for increased funding to create a robust psychedelic safety net.

Summary & Takeaways

Key Takeaway: Psychedelic use can lead to both short-term and long-term risks, including emotional distress, psychotic episodes, and existential confusion. The authors recommend enhanced research, improved harm reduction strategies, and increased funding for safety measures.

Practical Application: This study provides guidelines for psychedelic researchers, therapists, and policymakers to enhance safety, minimize adverse effects, and ensure informed use of psychedelics.

Key Background Information

  • Context: Psychedelics, including psilocybin, LSD, mescaline, and DMT, are gaining popularity for therapeutic and recreational use. However, some users experience persistent negative effects, highlighting the need for better harm reduction strategies.
  • Hypothesis: A more structured safety framework, including better support systems and funding for research, can reduce the risks associated with psychedelic use.

Methodology

  • Study Design: Expert consensus paper based on a survey of 30 psychedelic researchers
  • Participants: Psychedelic researchers and clinicians
  • Intervention/Exposure: Analysis of psychedelic-related risks and harm reduction strategies
  • Controls: Review of previous clinical and naturalistic studies on psychedelic use
  • Duration: Review of existing literature and expert recommendations

Key Findings

Primary Outcomes:

  • Psychedelic-related harms include anxiety, depression, psychotic episodes, social disconnection, derealization, and Hallucinogen Persisting Perception Disorder (HPPD).
  • Post-psychedelic difficulties can persist for days, weeks, or even years in some individuals.
  • Risks are lower in controlled clinical settings but can still occur, especially with inadequate screening and preparation.
  • Current safety measures are insufficient, with gaps in research, harm reduction, and post-use support.

Secondary Outcomes:

  • Predictors of adverse outcomes include mental health history, set and setting, and substance dosage.
  • Psychedelic integration therapy lacks standardized, evidence-based approaches.
  • Harm reduction strategies should focus on public education, peer support groups, and affordable therapy.
  • The authors propose that psychedelic companies and philanthropists commit 1% of their investments to safety research and support services.

Interpretation & Implications

  • Conclusion: Psychedelic use presents both benefits and risks. While clinical research supports their therapeutic potential, there is an urgent need to address safety concerns through research, education, and improved support systems.
  • Implications: Implementing harm reduction strategies, funding safety initiatives, and improving public education can make psychedelic use safer. Clinicians should emphasize thorough screening, informed consent, and post-use support.
  • Limitations: The study is based on expert consensus rather than empirical data, and more long-term studies are needed to assess psychedelic-related risks fully.

Researchers & Publication

  • Researchers: Jules Evans, Marc Aixalà, Brian T. Anderson, William Brennan, Rebecka Bremler, Joost J. Breeksema, Lisa Burback, Abigail E. Calder, Robin L. Carhart-Harris, and others
  • Publication Name: Psychiatric Research and Clinical Practice
  • Study URL: https://doi.org/10.1176/appi.prcp.20240128
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