Psychedelics

The term “psychedelics” serves as a gateway into a vast, intricate realm of psychoactive substances that have profound effects on human consciousness. In both historical and contemporary contexts, these substances have been both venerated and vilified, subject to rigorous scientific scrutiny and yet often relegated to the fringes of mainstream discourse. The multidisciplinary interest in psychedelics spans from their therapeutic potential to their ability to engender profound mystical experiences, making them unique among psychoactive substances.

Psychedelics have been used for millennia, dating back to indigenous societies that employed these substances primarily for spiritual and shamanic practises. Today, scientific and medical communities are increasingly recognising their potential for treating a wide array of psychological disorders, including depression, anxiety, and post-traumatic stress disorder (PTSD). Clinical trials and academic research are now laying down the empirical basis for what traditional practices have claimed for generations—that psychedelics can, under the right conditions, provide transformative experiences.

Noteworthy is the resurgence of what is termed as “psychedelic science,” a movement gaining traction in the 21st century, backed by an increasing body of reputable research. This resurgence follows a decades-long hiatus in academic investigation, largely due to societal stigmas and legal restrictions. Now, with more progressive attitudes toward drug policy, psychedelics are being revisited in a variety of research settings.

Furthermore, their status as cultural phenomena must be balanced. They have influenced art, music, philosophy, and even politics, with the 1960s countercultural movement as a prime example. However, it’s essential to note that this influence has not always been viewed positively, sometimes contributing to their controversial status.

Despite this rich tapestry of effects and applications, it is critical to approach psychedelics with a lens focused on safety, ethics, and education. Their capacity to radically alter one’s perception of reality also harbours the potential for misuse, thus necessitating robust harm reduction strategies. Therefore, this introduction aims to be an overview and a precursor to a balanced, nuanced understanding of psychedelics. With their potential benefits tantalisingly within grasp, a comprehensive examination of their characteristics, effects, and safety protocols is essential.

Definition and Classification

Psychedelics constitute a category of psychoactive substances that predominantly influence perception, cognition, and mood. These compounds interact chiefly with the serotonin receptors in the brain, resulting in altered states of consciousness characterised by enhanced sensory perception, emotional intensification, and, frequently, visionary experiences. Distinct from other classes of drugs like stimulants or depressants, psychedelics are known for their capacity to produce significant shifts in thought patterns, often leading to reflective or even spiritual experiences.

Some of the most well-known psychedelics include:

• LSD (Lysergic Acid Diethylamide): A synthetic compound first synthesised in 1938, LSD is renowned for its potent effects, which can include profound alterations in perception and cognition.
• Psilocybin: Found naturally in certain types of mushrooms, often called “magic mushrooms,” psilocybin is converted into psilocin in the body, which acts on serotonin receptors to produce its effects.
• DMT (Dimethyltryptamine): In certain plants and naturally within the human body, DMT is known for its intense, albeit brief, effects, often described as transporting the user to alternative dimensions or realities.
• Mescaline: Sourced from the peyote and San Pedro cacti, mescaline has a long history of traditional use in Native American spiritual practises and induces various effects, from vibrant visual hallucinations to deep emotional and philosophical introspection.
• Ayahuasca: A brew made from the Banisteriopsis caapi vine and the Psychotria viridis leaf, Ayahuasca is traditionally consumed in ceremonial contexts and is known for its powerful psychoactive effects, which can include visions, emotional revelations, and physical purging.

Physical Effects

Psychedelic substances interact with the central nervous system to produce various physical effects. These may include heightened sensory perception, dilation of pupils, increased heart rate, and elevated blood pressure. Some individuals may also experience nausea, especially when using plant-based psychedelics like Ayahuasca or peyote. More rarely, they may cause tremors, lack of coordination, and increased body temperature. In some instances, especially with misuse, there might be a risk of serotonin syndrome, a potentially life-threatening condition.

Psychological Effects

The psychological effects of psychedelics are often the most pronounced. Users may experience a profound alteration in perception, mood, and various cognitive processes. These effects can be highly variable, ranging from euphoria and a sense of interconnectedness with the surrounding environment to anxiety, paranoia, or even frightening hallucinations known as “bad trips.” It’s also possible for users to undergo ego dissolution, where the usual boundaries between the self and the environment become blurred. Additionally, psychedelics can induce states that users describe as spiritually meaningful, which sometimes leads to long-term changes in behaviour and attitudes.

Short-term and Long-term Effects

• Short-term: Immediate effects can include visual and auditory hallucinations, alterations in the perception of time, and emotional shifts, which can range from extreme euphoria to acute anxiety. Depending on the substance and dosage, these effects can last from a few hours to more than a day. Physical sensations, such as tactile sensitivity, might also be heightened, and synaesthesia, where one sensory experience triggers another, may occur.
• Long-term: Psychedelics are generally considered to have a low potential for addiction. However, frequent use, known as tolerance, can decrease the effects experienced during use. Although research is still in its nascent stages, some studies suggest potential therapeutic benefits, including lasting improvements in mental health conditions like depression and PTSD. However, long-term misuse may contribute to persistent psychological issues, including the risk of triggering latent mental health conditions.

Treatment of Mental Health Disorders

Psychedelics have shown promise in the treatment of various mental health conditions such as depression, anxiety, and PTSD. They are thought to help reset neural pathways, enabling healthier patterns of thought and behaviour.

Treatment of Substance Abuse

Some psychedelics, like ibogaine and psilocybin, are being explored for their potential to treat addiction to substances like alcohol, nicotine, and opioids.

End-of-life Care

Patients facing terminal illnesses have reported reduced anxiety and improved quality of life after psychedelic-assisted therapy.

Research and Experimental Use

Psychedelics are the focus of increasing scientific research for a range of neurological and psychological conditions.

Natural Psychedelics

Include substances like psilocybin mushrooms (“magic mushrooms”), mescaline from the peyote cactus, and DMT from various plant sources.

Synthetic Psychedelics

Common examples include LSD, MDMA, and synthetic cannabinoids.

Lysergic Acid Diethylamide (LSD)

• Street Names: Acid, Blotter, Lucy, Tabs, Doses
• Methods of Use: Ingested through blotter paper, gelatine, or liquid forms.
• Short-term Effects: Visual and auditory hallucinations, altered perception of time, heightened sensory experiences, euphoria.
• Long-term Effects: Flashbacks and potential worsening of existing mental health conditions, though physical addiction is uncommon.

Psilocybin (Magic Mushrooms)

• Street Names: Shrooms, Boomers, Caps, Fungus
• Methods of Use: Consumed orally, brewed into tea, or dried and smoked.
• Short-term Effects: Altered perceptions, hallucinations, emotional sensitivity, and spiritual experiences.
• Long-term Effects: Emotional instability with chronic use, but generally low risk of addiction.

Mescaline (Peyote)

• Street Names: Buttons, Cactus, Hikuli
• Methods of Use: Consumed orally from cactus buttons or synthesised into powder or capsule.
• Short-term Effects: Vivid visual hallucinations, emotional swings, altered perception of self.
• Long-term Effects: Unclear due to limited research, but there is potential for psychological dependency.

N, N-Dimethyltryptamine (DMT)

• Street Names: Dmitri, Spirit Molecule, Businessman’s Trip
• Methods of Use: Smoked, vapourised, or used in Ayahuasca brews.
• Short-term Effects: Intense visual and auditory hallucinations, sense of connection with a higher power or the universe.
• Long-term Effects: Largely unknown, though excessive use may exacerbate existing mental health issues.

Ketamine

• Street Names: Special K, K, Kit Kat, Cat Valium
• Methods of Use: Snorted, injected, or consumed orally.
• Short-term Effects: Dissociation, altered perception, numbness, hallucinations.
• Long-term Effects: Cognitive deficits, bladder problems, risk of dependency.

This offers a detailed panorama of various types of psychedelic substances, shedding light on their recreational terminology, modes of administration, and immediate and protracted physiological and psychological repercussions.

Prescription Psychedelics

Psilocybin

• Types of Psilocybin: Synthetic psilocybin, extracted psilocybin.
• Brand Names: COMPASS Pathways is developing a synthetic version.
• Street Names: Not applicable for prescription form; street forms include Shrooms Magic Mushrooms.
• Methods of Use: Oral ingestion in capsule form during supervised sessions.
• Short-term Effects: Altered consciousness, emotional release, and enhanced introspection.
• Long-term Effects: Potential for lasting changes in mindset, generally non-addictive.

MDMA-Assisted Psychotherapy

• Types of MDMA: Pure MDMA hydrochloride.
• Brand Names: Under development by MAPS (Multidisciplinary Association for Psychedelic Studies).
• Street Names: Not applicable for prescription form; street forms include Ecstasy Molly.
• Methods of Use: Oral ingestion in tablet form during psychotherapy sessions.
• Short-term Effects: Euphoria, emotional openness, reduction in symptoms of PTSD.
• Long-term Effects: Improved mental health outcomes, potential risk of serotonin syndrome with misuse.

 Ketamine

• Types of Ketamine: Esketamine, racemic ketamine.
• Brand Names: Spravato for esketamine; generic formulations for racemic ketamine.
• Street Names: Not applicable for prescription forms; street forms include Special K, K, and Kit Kat.
• Methods of Use: Intranasal spray, intravenous injection, under medical supervision.
• Short-term Effects: Rapid anti-depressive effects altered the state of consciousness.
• Long-term Effects: Potential for habituation, bladder issues, cognitive impairment with misuse.

Understanding the methods through which psychedelics can be administered is paramount for both clinicians and users, given that each method has distinct physiological and psychological impacts.

Oral Consumption

Oral ingestion remains a conventional method of administration for many psychedelics. Drugs like LSD, psilocybin, and MDMA are frequently available in pill, tablet, or capsule form. Upon consumption, these substances pass through the digestive system and are absorbed into the bloodstream. The liver plays a critical role in metabolising these drugs, which can influence the drug’s effectiveness and the duration of its effects. Orally ingesting psychedelics often results in a slower onset, but longer-lasting effects compared to other methods. This method is considered relatively safer but may result in gastrointestinal discomfort in some individuals.

Intranasal Administration

Intranasal administration involves snorting powdered forms of certain psychedelics. This allows for faster absorption through the mucous membranes in the nasal passages. Drugs like ketamine are often administered this way. Although this method offers a quicker onset of effects, it can cause significant damage to the nasal passages and upper respiratory tract over time. Moreover, the intensity of the effects can be harder to predict, making this a riskier method of administration.

Smoking or Vaporising

Some psychedelics, such as DMT, can be smoked or vapourised. By inhaling the drug, it is rapidly absorbed into the bloodstream through the lungs, leading to an almost immediate onset of effects. The potency of the effects can be incredibly intense but typically short-lived. However, smoking or vaporising can have adverse impacts on the respiratory system and may expose the user to additional risks related to the combustion of materials.

Injection

Injecting psychedelics like ketamine or psilocybin is less common but possible. This method involves intramuscular or intravenous injection, leading to immediate and intense effects. Due to the rapid onset, the margin for error in dosing is slim, thereby increasing the risk of overdose. Additionally, injecting drugs raises concerns about cleanliness, sterility, and the possibility of transmitting infectious diseases, particularly if needles are shared.

Other Methods

Other less common methods include rectal administration, where a solution of the psychedelic is introduced into the rectum, and sublingual administration, where a drug is placed under the tongue for absorption. Topical applications, usually through patches or creams, are also being researched. Each of these methods carries its own unique set of risks and benefits, and their appropriateness depends on the specific drug, the clinical setting, and the desired therapeutic effects.

In summary, these methods of administration present a range of options for the intake of psychedelic substances, each with specific considerations regarding the speed of onset, intensity, and associated health risks. Such understanding is vital for both healthcare providers and users to ensure the responsible and effective use of these substances.

The abuse of psychedelic substances poses a host of health risks, both mental and physical. Psychedelics, while sometimes used for therapeutic or spiritual purposes, can lead to negative consequences when misused. An accurate understanding of the signs, symptoms, and repercussions is essential for early intervention and effective treatment.

Signs of Abuse

• Initial Attraction: Psychedelics often lure users with promises of heightened sensory perception, emotional release, and introspective insights.
• Psychological Symptoms: Over time, abuse can lead to mental health challenges such as depersonalisation, dissociation, and even psychosis.
• Physical Signs: Tolerance to substances, uncontrolled usage, and going to great lengths to acquire more are key indicators of abuse.

Consequences of Chronic Use

• Psychological Hazards: Long-term abuse of psychedelics can cause persistent psychological issues, including anxiety disorders and derealisation.
• Neurological Consequences: Abuse has been linked to deficits in cognitive functions such as memory and attention.
• Social and Economic Impact: Chronic use can lead to social isolation, job loss, and breakdown of familial relationships, causing a ripple effect that extends beyond the individual.

Overdose Symptoms and Management

• Physiological Symptoms: Overdosing on psychedelics can lead to a range of severe physical outcomes, such as hyperthermia, seizures, and respiratory distress.
• Preventive Measures: Recognising early signs of abuse, as well as understanding how to manage potential overdoses, can be life-saving. Safe environments and immediate medical attention are critical.

The detrimental impacts of psychedelic abuse extend far beyond the individual user. They have broader societal implications, affecting communities and healthcare systems alike. As such, it’s crucial to foster awareness, education, and accessible treatment options to address the complex issue of psychedelic abuse.

The United Kingdom has established a multifaceted legal framework to regulate the use, possession, sale, and production of psychedelic substances. This framework aims to weigh the potential therapeutic benefits of psychedelics against the risks of misuse and adverse health consequences.

Regulation of Prescription Psychedelics

• Controlled Substances: Prescription psychedelics fall under regulatory purview via the Misuse of Drugs Act (1971), Medicines Act (1968), and the Psychoactive Substances Act (2016).
• Scheduling System: These acts place psychedelics in one of three classes (A, B, and C) based on their abuse potential and medical efficacy. Class A includes substances considered most harmful and carries the most stringent penalties.
• Prescription Regulations: Medical practitioners are bound by detailed guidelines when prescribing these drugs, ensuring they are dispensed cautiously and responsibly.

Illicit Psychedelic Laws and Penalties

• Prohibition and Criminalisation: Illicit use of psychedelics, such as LSD or magic mushrooms, is also governed by the Misuse of Drugs Act (1971). These substances are typically classified as Class A drugs, denoting high abuse potential and severe legal repercussions.
• Penalties: Legal penalties for illicit use can be severe and encompass financial fines and imprisonment. The severity of these penalties varies depending on the drug’s classification and the nature of the offence committed.

The UK’s legal environment surrounding psychedelic drugs is intricate, constituted by an array of statutes and regulations. Adequate understanding of this framework is crucial for healthcare providers, individuals, and the larger community to ensure that these substances are used within the parameters of the law.

Navigating the intricate realm of psychedelic substances requires a multi-faceted approach that incorporates both harm reduction and safe use guidelines. The surge of interest in medical and recreational domains has rendered this topic highly pertinent. A nuanced understanding of these guidelines can serve as a roadmap for new and experienced users. Such an understanding not only mitigates risks but also optimises the potential benefits of psychedelics, be it for spiritual exploration or therapeutic applications. Adherence to these guidelines is not just a personal safety net but also a public health priority. Thus, these guidelines serve as a cornerstone for a responsible and educated approach to psychedelic usage.

Dosage and Frequency Guidelines

• Medical Use: In a medical setting, the administration of psychedelics is closely supervised by healthcare professionals. Following prescribed dosages and frequency is essential to ensure the therapeutic outcomes are as expected. Deviation from this can lead to unanticipated psychological or physiological effects, potentially harming the individual. Accurate dosing is crucial not only for patient safety but also for the integrity of ongoing research into the medicinal benefits of psychedelics.
• Recreational Use: For individuals who engage in recreational use of psychedelics, the absence of a medical framework makes self-responsibility imperative. Users must be diligent in understanding the potency and duration of effects of their chosen psychedelic. This precautionary step helps avoid negative experiences like “bad trips” or health risks that might arise from overdose.

Safe Use Practises

• Set and Setting: The context in which psychedelics are consumed—the physical environment and the user’s psychological state—can profoundly impact the experience. Therefore, choosing a safe, comfortable, and familiar environment is recommended.
• Substance Testing: Utilising reagent tests to determine the substance’s identity is a rudimentary yet essential safety practise. Verification aids in ruling out the presence of adulterants or different substances altogether, thereby reducing risks.
• Sitter Presence: Having a trained or experienced individual, often termed a “sitter,” is advised to help manage any challenging or disorienting situations that may arise during the experience.
• Sanitary Administration: Using clean and sterilised equipment for any form of administration reduces the risk of infection and other complications. Whether it’s the use of sterilised needles for intravenous administration or ensuring orally ingested substances are clean, this practise is paramount for safety.

Resources for Help and Support

• Medical Support: Various specialised healthcare providers offer support and interventions for psychedelic-related complications. These include psychiatric units and specialised detox centres equipped to handle such unique cases.
• Community Support: Offline and online community support groups provide a safe space for sharing experiences, advice, and emotional support.
• Online Forums: Digital platforms provide anonymity and a broad spectrum of insights, from first-hand experiences to scientific studies, allowing individuals to make informed decisions.

Safer Consumption Tips

• Start Small: Especially if encountering a new substance or a different batch, it’s prudent to begin with a modest dose to assess bodily and psychological responses. Over time, one can adjust the dose as necessary.
• Hydration and Nutrition: Just as you wouldn’t run a marathon without adequate preparation, taking psychedelics also demands physiological readiness. Ensuring you are well-hydrated and nourished can significantly reduce the risk of physical discomfort or complications during the experience.
• Rest and Recovery: The effects of psychedelics can be taxing on both mind and body. Allowing time for rest and mental recuperation between uses is essential to prevent negative after-effects like exhaustion or emotional drain.

By adhering strictly to these guidelines, individuals can significantly reduce the risks and potential harm associated with psychedelic use. Furthermore, the propagation of these guidelines can contribute to fostering a community that is not only safer but also more responsibly informed about psychedelics.

In the ever-evolving discourse on psychedelics, it becomes incumbent upon us to adopt a nuanced, data-driven perspective that fosters both public safety and scientific curiosity. The intriguing history of psychedelics, which spans ancient ritualistic uses to modern clinical studies, sets the stage for a complex narrative that resists facile judgements. Indeed, one can neither dismiss these substances as purely recreational nor canonise them as unproblematic panaceas. Their position, rather ambiguous in the gamut of human pharmacology, calls for a concerted effort to chart the responsible course ahead.

Contrary to widespread misconceptions, the risk profile of psychedelics is substantially milder compared to more conventional narcotics or even some prescription medications. However, the absence of extreme physical harm should not be interpreted as a carte blanche for uninformed experimentation. The concept of “set and setting,” often glossed over in mainstream dialogues, is paramount here. Recognising that the internal emotional state and the external environment can significantly modulate the impact of psychedelics offers a more dynamic, contextual approach to their use.

The potential of psychedelics to serve as therapeutic agents represents a burgeoning area of research—early findings, although nascent, are tantalising in their promise. A range of psychiatric disorders, from depression to post-traumatic stress disorder, may find relief through carefully administered psychedelic therapy. Yet, a prudent approach must prevail. Moving hastily from promising research to general clinical application could precipitate unintended adverse outcomes. Therefore, while we continue to probe the depths of psychedelic efficacy in clinical settings, these substances should remain within the purview of controlled scientific enquiry until unequivocal evidence supports broader therapeutic usage.

Lastly, focusing on harm reduction transcends the dichotomous debates of legality or therapeutic efficacy. Whatever one’s stance on the psychedelic issue may be, the immediate goal must be to minimise harm. This requires disseminating accurate information, endorsing safe usage guidelines, and facilitating access to medical and psychological support. As a society, we must move from polarised viewpoints toward a more integrated model that places human welfare at its core. Whether you view psychedelics as sacraments, medicines, or simply compounds of scientific interest, the road ahead calls for a multi-disciplinary collaboration that fuses caution with curiosity, ethics with empiricism, and safety with serendipity.

Medical News Today Article on Psychedelics: https://www.medicalnewstoday.com/articles/psychedelics

Britannica’s Scientific Overview of Psychedelic Drugs: https://www.britannica.com/science/psychedelic-drug

National Institute on Drug Abuse Research Topics on Psychedelic and Dissociative Drugs: https://nida.nih.gov/research-topics/psychedelic-dissociative-drugs

NCBI Article on Psychedelics: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4813425/

American Addiction Centres Information on Psychedelics: https://americanaddictioncenters.org/psychedelics

New York Times Article on Oregon’s Legalisation of Psychedelic Mushrooms: https://www.nytimes.com/2023/10/23/us/oregon-psychedelic-mushrooms.html

Johns Hopkins Medicine Research on Psychedelics: https://www.hopkinsmedicine.org/psychiatry/research/psychedelics-research

ScienceDirect Article on Psychedelics: https://www.sciencedirect.com/science/article/pii/S0960982221016857

New Scientist’s Definition of Psychedelic: https://www.newscientist.com/definition/psychedelic/

NPR Health Shots on Psychedelic Drugs and Psychiatric Disorders: https://www.npr.org/sections/health-shots/2022/12/27/1145306096/psychedelic-drugs-psychiatric-disorders-brain-research

Greater Good Berkeley Article on How Psychedelics Work in the Brain: https://greatergood.berkeley.edu/article/item/how_do_psychedelics_work_in_the_brain

BBC News Article on Psychedelics in Australia: https://www.bbc.com/news/world-australia-66072427

National Institute on Drug Abuse Research Topics on Psychedelic and Dissociative Drugs (Repeated): https://nida.nih.gov/research-topics/psychedelic-dissociative-drugs