Safe Psychedelics Use: Harm Reduction Best Practices

Being aware of potential drug-related harm and knowing how to stay safe while using psychedelics can help reduce risks and help to ensure positive experiences. Harm reduction involves education about the safe use, testing, and effects of psychedelics. There is also an emphasis on the importance of a supportive community and a comfortable and secure environment.

Using practical strategies and methods to promote safety and reduce negative experiences can help ensure a more constructive and beneficial journey. Aspects of safety and harm reduction for psychedelic use include, but are not limited to: ^(1)(2)(3)(4)

Organizations like the National Harm Reduction Coalition, the Fireside Project, and the Zendo Project are committed to providing educational resources and helping to implement these strategies. Along with their education and support around drug safety and harm reduction, they also highlight the importance of recognizing and respecting the rights of individuals who use psychedelics. ⁽¹⁾⁽²⁾

Family History and Contraindications 

While psychedelics may potentially improve some physical and mental health conditions, it is important to be aware that they can also cause an increased risk of harm in those with certain conditions or using specific medications. ⁽⁴⁾

Individuals with a personal or family history of certain mental or physical health conditions, or those taking prescribed medications, should consult with a medical professional before taking psychedelics.

Physical health

As some psychedelic substances tend to increase heart rate and blood pressure, individuals with certain physical health conditions are at an increased risk of harm. These can include: ⁽⁵⁾⁽⁶⁾

Mental health

In some cases, psychedelics can exacerbate symptoms of preexisting mental health conditions. As such, they may not be safe for individuals with conditions or symptoms such as: ^(4)(5)(7)

Medications

Many psychedelic substances, such as LSD, ayahuasca, and psilocybin impact levels of the neurotransmitter serotonin. Taking psychedelics may not be suitable for individuals who are prescribed serotonergic medications, including: ⁽⁴⁾⁽⁸⁾

Combining these medications with psychedelics can increase the risk of serotonin syndrome, a potentially severe condition caused by dangerously high levels of serotonin. ⁽⁸⁾

Serotonin syndrome caused by psychedelics is rare, but it is advisable to speak to a healthcare provider if on antidepressants before taking psychedelics. ⁽⁶⁾

Get more information with Psychedelic Safety: Crisis and Support Resources for Harm Reduction

Preparation and Harm Reduction Education

Education and preparation are important aspects of harm reduction and can significantly contribute to beneficial psychedelic experiences. Understanding and preparing for substance use can reduce potential risks to physical and psychological well-being, including: ⁽¹⁾⁽²⁾

Many organizations are available to attend parties, events, and festivals, where they can provide education and information on these subjects. 

For example, Zendo Project and Dance Safe are organizations that attend festivals and events to discuss harm reduction techniques with attendees before use. They also provide information and resources relating to safe drug use, drug testing, health, and sexual safety. ⁽²⁾⁽³⁾

These organizations also provide workshops and education sessions online and in person, the purpose of which is to teach individuals about safe psychedelic practices, provide information on how to help friends struggling with bad experiences, and answer questions about psychedelic use. ⁽¹⁾⁽⁹⁾

Know the Psychedelic Substance

A crucial part of preparing for psychedelic use is education about the substance. This includes understanding how it will affect mood, perception, or physical sensations. Having an idea of the effects that are likely to occur can help prevent surprising or unexpected experiences that could cause distress. ^(10)(11)

Reading guides or listening to trusted podcasts about psychedelic use can help develop a better understanding of specific drug experiences. ^(12)(13)

The Importance of Safe Psychedelic Dosing

It is crucial to be informed about appropriate dosing. The effects of a substance will often differ from person to person, particularly individuals who are new to the drug compared to those who have experience with it. ⁽¹⁰⁾

It is usually a good idea when taking a substance for the first time to take a very small dose initially. This can allow the effects of the drug to be experienced at a milder level. After the first dose, individuals may gradually increase their doses in a safe and supportive environment. Taking a large dose before understanding the effects could contribute to an unpleasant experience. ⁽¹³⁾

Moderating dosage may support a more positive experience while reducing the risk of harmful consequences.

Administration

Education about substance use also includes information about safe administration. Psychedelics are typically ingested, inhaled nasally, smoked, vaped, or administered intravenously. The method of administration can impact the effect and safety of the substance. ⁽¹⁴⁾

Examples of administration methods include:

Other factors to take into consideration:

Awareness and understanding of this information can be key to a safe and enjoyable experience. ⁽¹⁵⁾

Managing a Bad Psychedelic Experience

Sometimes people can have a negative or challenging experience when taking psychedelics, which is often referred to as a bad trip. This could include: feeling afraid or anxious, experiencing distressing perceptions, and/or uncomfortable sensations. These experiences have the potential to have a lasting effect on an individual, especially if they bring up harmful emotions or memories. In some cases, a bad trip may require additional support such as counseling to process fully. However, they may also have the potential to provide an opportunity for growth and learning. ⁽¹⁶⁾

For example, a study using quantitative interviews of 50 Norwegian psychedelic users looked at the power of storytelling when dealing with a bad trip. It found that participants were often able to process a bad trip through narrative sense-making (storytelling) and that sharing their experiences could help integrate them into their life stories. ⁽¹⁷⁾

It can be beneficial for individuals to know how to help themselves through a bad experience, though help and guidance from an expert is recommended. Some tips that may help with this include: ^(2)(9)(16)

Safer Psychedelic Substance Use and Drug Testing

Potency and Purity

The purity and potency of a drug can greatly affect both the user’s journey and the chances of a negative or even harmful experience. Often, it is difficult to know exactly how pure or potent a substance is before taking it. Being unaware of the purity and potency of a psychedelic substance can contribute to unnecessary risks, harmful effects, or unpleasant experiences.

It’s not always possible to test the purity and potency of psychedelics, many tests can detect the presence of other substances. This allows for informed decision-making around psychedelic use and dosage. ⁽³⁾

Fentanyl

Fentanyl is a synthetic opioid prescribed by medical professionals. It is also produced and used illicitly. It is roughly 100 times stronger than morphine and 50 times stronger than heroin. Because it is inexpensive to produce, fentanyl is often mixed with other drugs, such as cocaine, heroin, and methamphetamines. There have also been reports of fentanyl being mixed with psychedelic substances such as MDMA.^(18)(19)

Because of its extreme potency, a small dose of fentanyl can cause severe and even life-threatening effects, particularly if individuals are unaware that they are taking it. Although fentanyl is not typically mixed with classic psychedelics such as psilocybin or LSD, it has been found in MDMA. In 2022, three school girls were hospitalized after consuming ecstasy pills laced with fentanyl, as just one example. MDMA samples have also been found to be contaminated with other substances such as amphetamines (including meth), dextromethorphan (DXM), and ketamine.^{(18)(19)(20)(21)}

Fentanyl test strips can check for the presence of fentanyl in a substance, helping to reduce potential harm and overdose.⁽²²⁾

Drug Testing

Several organizations, including Dance Safe, Test Your Poison, and Test Kit Plus offer drug testing services including at-home test kits and lab testing. Substance testing can take place in a variety of settings, including: ^(3)(22)

Being aware of the contents of a substance can help reduce harm, allow individuals to make informed decisions, and promote safe and moderated substance use.

Learn more from our list of Psychedelic Integration & Practical Guidance Books

Designating a Tripsitter, Guide, or Therapist

Having a sober person to act as a tripsitter, guide, or therapist, is often vital to individuals wishing to get the most out of psychedelics and non-ordinary states of consciousness in a safe and controlled way. ^(10)(22)(23)

How They Can Help Your Psychedelic Experience

A tripsitter, guide, or therapist will be a sober person accompanying and supporting the individual before, during, and immediately after their non-ordinary state of consciousness. This may help ensure physical comfort, prevent or manage any unpleasant or distressing emotions, provide reassurance, and maintain safety. ^(23)(24)

Utilizing a guide can help individuals feel at ease with their psychedelic experience, particularly those who are experiencing one for the first time. They can also help create a more positive or enlightening experience and contribute to the healing process. ⁽¹⁰⁾

Vetting

It is important that individuals feel comfortable with the person who will act as their guide or therapist, as this can significantly impact the quality and outcome of the experience. If the person who will be performing this role is unknown to the individual, it may be a good idea to meet with them and understand their plan for the experience.

Questions that might be useful to ask beforehand include: ⁽²⁷⁾

The Importance of Set and Setting

Set and setting describes the internal and external environment in which substance use takes place. Simply put:

A psychedelic experience can be significantly influenced by the set and setting. Negative emotions or an anxiety-provoking environment can lead to distress and increased risks, while a calm, supportive, and pleasant environment may heighten positive effects. ^(10)(14)

Taking time to prepare the set and setting may increase the benefits, safety, and comfort of a psychedelic experience. This includes: ^(2)(10)(11)

Psychedelic Peer Support and Integration

Peer support and integration can be significant factors in the quality of an individual’s psychedelic journey. Being part of a community that promotes empathy, compassion, and support can contribute to a positive and healing experience, helping individuals feel safe and reassured throughout the experience. ^(1)(10)

Psychedelic integration is a process in which a person revisits and actively engages in making sense of, working through, translating, and processing the content of their psychedelic experience. Through intentional effort and supportive practices, this process allows one to gradually capture and incorporate the lessons and insights into their lives, thus moving toward greater balance and wholeness, both internally (mind, body, and spirit) and externally (lifestyle, social relations, and the natural world). ^(24)(26)

Integration can include: ^(4)(10)(26)

Integration can be a long process that requires contemplation, discussion, support, and practice, with the idea of making positive changes. It can take place within group settings, such as integration circles and workshops, as a solitary reflection, or in a one-on-one setting, such as with a therapist. Each can be beneficial to the exploration, sharing, and integration of new experiences and ideas. ^(11)(26)

Some practices that may help with the integration process include:

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