Harm Reduction, Part Eight: Psychedelics and Harm Reduction

​Welcome back! The next two installments in my harm reduction series concern strategies and techniques best used with psychedelics (such as LSD and mushrooms) and empathogens (such as MDMA).
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The mainstream media (such as this illuminating New Yorker article by Michael Pollan) has recently given much attention to the resurgence of research on psychedelic- and empathogen-assisted psychotherapy, and the promising results being obtained in treating PTSD, depression, end-of-life anxiety, substance misuse, and other forms of distress. Additionally, a new generation of enthusiasts are buzzing about the magic of microdosing.
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​Many of us in the field are eagerly awaiting our renewed ability (following decades of restrictions) to make use of these powerful change agents, and in the meantime, are attending international conferences and certificate training programs in anticipation of a post-prohibition world.

In the meantime, it's critically important that we recognize that the overwhelming majority of use happens outside formal therapeutic or research settings--at festivals, parties, and clubs--and the outcomes of such use have immense impact on public perception of these medicines. Though negative incidents are relatively rare, they tend to attract a great deal of media attention.

Photo credit: John Curley

HARM REDUCTION

In response to the needs of our community, organizations such as the Zendo Project aim to create safe, calm environments with trained volunteers to support psychedelic users having difficult experiences, preventing the automatic intervention of law enforcement or medical services.

The Zendo Project has successfully staffed numerous festivals--such as Burning Man and Lightning in a Bottle--since 2012.  I've been inspired by their work, and would like to share some of the most important points here.

If you happen to encounter someone who is having a difficult trip and are able to assist them, begin by asking about any physical complaints which might necessitate medical attention. You may then find out what they've taken, how much, when they took it, and if they are on any other medications or substances (including alcohol) that might interact.

You might then support them using these four principles:

1) Safe Space: These substances often enhance perception, making us extraordinarily sensitive to our environment, and we can easily become overwhelmed by sensory and interpersonal input. If someone is having a challenging experience, you may attempt to move them to a setting that is quiet and comfortable, with enough space for them to feel at ease. Adjust temperatures if they are too hot or cold, and offer water. Soft music and dim lights are helpful.

2) Sitting, Not Guiding: Provide a calm, reassuring, non-directive presence, without feeling the need to "fix" anything. Respond when needed, but don't take over; allow their unfolding experience to guide. Just be with, listen, and observe. Encourage any expression that needs to happen (via conversation, art, dance, movement, sound, etc).

3) Talk Through, Not Down: Help them connect with their feelings, and invite them to gently explore, rather than resist; most difficult experiences are a result of fighting what's happening during the trip. If it is helpful, you may remind them, when needed, that (a) they have taken a drug, and its effects will pass before too long and (b) they are safe where they are, and any medical needs will be attended to.

4) Difficult Is Not the Same As Bad: Where appropriate, you may remind them that many other people have had similar trips, and that challenging experiences often lead to learning and growth. Encourage them to face their experience with curiosity about why these feelings are arising now.

(Do you want to see a role-play video of these techniques? Sure, why not?)

The intervention of medical or security staff still remains an option in extreme cases, but many are able to resolve their difficult experiences fairly organically and positively when given this type of support.


These principles can help someone who is in the middle of a challenging trip, and you might recall them for yourself as needed. (Full credit and gratitude to the Multidisciplinary Association for Psychedelic Studies and to Zendo, a MAPS project, for this important information!)

However, perhaps you want both tools to troubleshoot problems, and tips on how to have the most positive experience possible. Benefit maximization is just as important as harm reduction, and I'll cover that in my next post. Go here for the next bite-sized bit on this topic!