What do you know, and/or what are your thoughts on the various folks that having success using psychedelics to treat cluster headaches and migraines?

Amazing work, I am very excited to learn more about your organization! Will you have a presence at Psychedelic Science 2023 in Denver?

Connecting with Decriminalize Nature to start an initiative to decriminalize plant-based psychedelics in your city or state is one option.

Supporting any such existing campaigns in your city or state is another.

If you're a college student, starting or joining a chapter of Students for Sensible Drug Policy is a good move.

You can also support the Drug Policy Alliance, which is the major national organization pushing for drug policy reform.

YES. If all the time and energy that has been spent battling often malicious regulatory environments had instead been spent on finessing clinically-sound treatment protocols using these compounds, we believe the world would be a much safer and happier place. But, here we are, and despite the War on Drugs, the scientific community is more vibrant than ever when it comes to exploring the therapeutic potential of these substances.

There are a couple.

A major one is the increasing prevalence of harmful adulterants like fentanyl in the underground drug supply. Though fentanyl specifically still doesn't show up in psychedelics sold in underground markets *that* often, there have been some reports of it showing up in ketamine, and given the way fentanyl has crept into many other drugs (heroin, methamphetamine, cocaine), we have concerns that this could continue further into the psychedelic market as well.

- Another issue is people not knowing how to dose themselves correctly, which is one of the things we cover exhaustively in our new masterclass. Being too high to drive or safely navigate public space carries a safety risk both to yourself and to others

- A very small but reliable percentage of people who take psychedelics will experience some kind of psychotic episode or become erratic, which can lead to unpredictable and risky behaviors that can affect their health and safety, as well as that of those around them. (As another example, one of us had a friend in college who was triggered into a major bipolar episode resulting from psychedelic use who impulsively decided to take a late-night bike ride to another state and was hit by a car.)

- There's also a possibility that more people experiencing psycho-emotional crises on psychedelics could check themselves into emergency rooms when they don't need medical attention, taking staff resources away from people in more urgent medical need.

How likely are these things? Hard to say. What we do know is that all of these things happen a little bit already and are statistically likely to happen to more people as more people start taking psychedelics without proper safety education.

It's a very long story indeed and far longer than a single comment could encompass! MAPS, and several other incredible organizations, have been working for decades to push psychedelic research through the steep financial and regulatory requirements involved in the onerous clinical research process. The primary compounds being studied are MDMA, LSD, psilocybin, and ketamine, for a wide variety of different clinical applications varying from treating PTSD to depression to OCD to end-of-life anxiety. We've been keen observers as this research has evolved and excited for the implications for so many that are suffering... but also have watched the enthusiasm for these treatments spill over into people trying out less-than-safe DIY applications in home and other unlicensed environments.

We're a big fan of Michael Pollan's book, "How To Change Your Mind", for a deep dive into the history of use of these compounds and how regulation and clinical research has evolved over the last century. From his website: https://michaelpollan.com/books/how-to-change-your-mind/ Amazon purchase link: https://amzn.to/3swCUEW

If you're not looking for a whole book, but would rather like to stay up to date on the clinical research as it emerges, Lucid News has as great weekly newsletter that sums up the headlines with the latest and greatest in clinical research developments: https://www.lucid.news/

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.

Aw man I read your comment and held my breath. I currently have some mushrooms ready to take in an attempt to treat my anhedonia and just can't seem to get in the mind set to take them. Part of me thinks if I take it and it doesn't work, I've lost my last hope.

I did read a study recently that claimed that microdosing is actually purely psychosomatic. In blind tests, the only significant result was that if you thought you had been given psilocybin, then you felt positive effects, regardless if you had actually been given any or not.

Have you tried full trips?

Firstly, we're sorry to hear that you're experiencing such long term negative effects - and unfortunately far from the first we've heard. HPPD is not well understood (especially when start of symptoms is when the brain is still developing as a young adult); consequently, the clinical treatment options are scarce and inadequately studied.

To start on simply keeping it from getting worse: you're definitely on the right track with ceasing use of hallucinogens. Anyone with lasting detrimental side effects from taking psychedelics should probably not take those psychedelics in the future. There is some anecdata indicating the other stimulants, such as common ones like caffeine and nicotine, may also exacerbate symptoms.

There are a few case studies out there in the clinical research indicating off label treatment using Lamotrigine has been successful. It might be worth seeking out a psychiatrist who has worked with HPPD specifically in the past to tailor a treatment protocol for you. Treatment of any co-occuring anxiety or other mental health issues has also been indicated to reduce severity of symptoms.

I have read from scientific professionals that CBD is an antipsychotic, maybe you could try some therapy with that.

Due to the freeze on psychedelic research that hit in the late 60's, there's still a ton of research to be done on various psychedelics, especially more esoteric ones like DMT. So if you're looking for peer-reviewed research on medical benefits, in many instances, you just have to wait until the research has been funded and conducted in the first place.

That said, if you want to see what does exist in the medical literature, PubMed or Google Scholar are our go-to databases for published research findings. Many of the studies you'll find in there are pretty jargon-heavy and not meant for the general public, but you can easily go in there and do a keyword search for the compound you're curious about and you'll get a list of things folks have published. Some studies have methodological issues that only research geeks can pick apart and it's still not always possible to say definitively that the findings of a single study are conclusive, but it's a start.

A better option for laypeople can be databases like Erowid or PsychonautWiki, which, though they don't list much in the way of medical research findings, can give you a more accessible glance at the experiences other people have had on a wide variety of psychedelics through the Experience Reports they collect. You can also occasionally find research cited on Wikipedia, though you'll want to follow up with those to make sure they're legit.

There are two major categories of deaths associated with psychedelics....

The first category has to do with the physiological impact that the psychedelic has on the body - in short, an overdose. These are extremely rare for most psychedelics, given that they have such a high LD50 (the "lethal dose" amount of a material which causes the death of 50% of subjects) compared to other psychoactive compounds such as alcohol. A famous example is the legendarily high dose of LSD that had to be given to an elephant to result in its death: https://www.illinoisscience.org/2016/06/lsd-and-the-elephant/

But other compounds may cause death through other physiological mechanisms - especially psychedelics with a strong impact on cardiac systems, such as ibogaine or MDMA. Each compound presents its own unique challenges, and should be researched carefully with respect to contraindications with other drugs - another potential source of fatal effects - and underlying conditions that may not place nice with your psychedelics.

The biggest risk we see is how psychedelics change behavior, and in particular awareness of the environment. People on psychedelics much more in danger from the world around them - from perhaps not checking both ways before crossing the street while on bicycle day ride, from accidentally drowning in a DIY float tanks in their home bathtubs while K-holed, from losing their balance and falling while giddily climbing tall structures at festivals - all situations ourselves and/or our first responder community members have had to deal with. Ketamine seems to be a particularly common factor in deaths of this nature.

This is why we strongly recommend folks not only take preventative steps to make sure they are taking the appropriate substance in an appropriate dose for their individual biology, but also use substances in community so that they have people that can help them not accidentally harm themselves while on their cosmic voyage. We've got a safe(r) psychonaut dosing protocol we put together for community here to minimize risk: https://www.psychedelicsafetyalliance.org/f/safer-psychonaut-dosing-protocol

Firstly: we're glad to hear you're reaching out after such a series of difficult experiences, and that you've given yourself a pause on further recreational substance usage while you work through this.

What you're describing is rare, but not unheard of, and something one of us (Ally, writing) has seen in clinical settings with some frequency. People sometimes have such a traumatic time on psychedelics - either due to something that happened during the psychedelic experience itself, or a traumatic experience that it unearthed from their memory - that they develop demonstrate symptoms of PTSD. This includes sometimes a reliving of the trauma in flashback episodes. For other individuals, repeated psychotic episodes after a difficult psychedelic experience may be in part influenced by a genetic predisposition to schizophrenia or other related disorders; it could be that family history is a factor here.

Whatever the cause - and again, it could be a few things - there are folks out there who can help you unpack that in a compassionate, nonjudgmental way, who are also quite skeptical of mainstream behavioral healthcare. (That's why so many of us have shifted our focus into psychedelic-assisted psychotherapy, as we are acutely aware of how poorly the establishment has treated so many with mainstream psychiatry.) As difficult as it may be, a good first step would be seeking the right professional assistance on this to tease out a pattern behind the psychotic episodes. Working with someone with a clinical eye to establish what's triggering them - which is sometimes subtle and quite surprising! - can help understand their root cause, and help identify more customized strategies for how you minimize their intensity and reduce their frequency in the long term. If you're not quite up to finding someone to partner with on this, we'd advise starting a journaling practice to try to gather this information for yourself to see if you can pick apart a pattern, and if one of your friends has interest in supporting you in using a co-counseling or similar model.

Also adding: as someone who has operated in clinical environments for much of my career, it's often frustrating that we are pressured by regulatory to create a diagnosis to put on paper to justify insurance billing purposes, or for ease of communication with other providers in such a fast paced environment, when the nuances of an individual case really defy whatever is in the latest already-outdated DSM and can feel dehumanizing. In my experience, a lot of the therapists that specifically work with psychedelics are also skeptical of mainstream diagnostic labeling and mainstream psychiatry for some of the same reasons you are, so you might be best of seeking someone off the MAPS psychedelic integration list. There's some specific nuance to the experience of trauma while on psychedelics that a mainstream behavioral specialist who doesn't have that specialized education just won't get. It's such a uniquely hellacious experience, and I wouldn't wish it on anyone.

Thanks for posting. What dose and how frequently were you tripping, may I ask?

"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.

What dose did you take, may I ask?

Do you mind if I ask how it ruined your life?

Happy to help! That's why we came back for another round - there are just so many questions, especially as psychedelics have been moving more into the mainstream.

Our masterclass is available on our website, which we update quarterly with new research and resources: https://www.psychedelicsafetyalliance.org/courses

We've also got an email list we regularly send out resources to: https://www.psychedelicsafetyalliance.org/f/psychedelic-safety-resources

Regarding legalization, it is our sincere hope that our country will continue to move in that direction. The recent announcement by the Biden administration formally announcing the failure of the policies around marijuana was an exciting step in the right direction: https://www.whitehouse.gov/briefing-room/statements-releases/2022/10/06/statement-from-president-biden-on-marijuana-reform/

The FDA's incremental progress in approving MDMA and psilocybin therapies has also taken some promising steps forward in recent months: https://theintercept.com/2022/07/26/mdma-psilocybin-fda-ptsd/

It's been the work of countless activists and researchers over decades, but I think, as a community, we're getting there!

Early psychedelic researchers in the 1950's and 60's found LSD helpful in the treatment of alcoholism, and Bill Wilson (founder of Alcoholics Anonymous) had his own experiences with psychedelics which led him to the opinion that they were helpful in treating addiction.

Many mental health professionals today view addiction through the lens of trauma, which often an underlying factor in substance use disorders, and using psychedelics in a therapeutic setting can help treat some of these underlying issues.

For treating opioid addiction specifically, a psychedelic called ibogaine has shown a lot of promise. We know a couple people who have maintained long-term recovery after ibogaine treatment. Ibogaine has to be taken under medical supervision and is thus not cheap, but it seems to be the "magic bullet" for some people.

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.

Psychedelic-assisted psychotherapy is still illegal in the US, with the exception of ketamine therapy in some places.

Finding ketamine therapy in your area can be a simple as a Google search. Bigger cities are more likely to have ketamine clinics if they're legal in your state.

Until psychedelic-assisted therapy becomes legal, the next-best option which many people use is to use psychedelics on their own, and work with a psychedelic integration therapist to plan their journey beforehand and make sense of what came up during their journey afterwards. The Multidisciplinary Association of Psychedelic Studies has a list of integration therapists HERE.

Mental health professional who works with psychedelics will tell you that it's usually not what comes up during the session that leads to healing, but rather, what you do with it afterwards that has the lasting benefit, so this option is actually pretty good for a lot of people.

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.

Lithium is highly likely to cause seizures and bad trips. If you haven't already, I'd definitely stop taking any psychedelics with it.

Microdosing. Safest, easiest way to take mushrooms.

Your instinct is right here in yes - it DOES depend on a whole array of different factors!

MDMA in particular has some unique properties that make it potentially harmful to take frequently, especially in higher doses. While there are some steps you can take to minimize the harm that MDMA has on your brainpan (we wrote up a guide on the science behind neuron-saving supplementation here: https://www.psychedelicsafetyalliance.org/f/mdma-harm-reduction) MDMA is not something that is appropriate to take more than once every few months, at least if you value your ability to consistently use your dopamine and serotonin receptors.

As a general rule of them with psychedelics, especially ones like LSD and psilocybin that don't build as much of a tolerance, we like to advise folks wait until they have fully integrated their last experience before moving on to the next one. Have you really absorbed whatever teachings your experience had to give? Has your body fully recovered and your mind returned to baseline? What benefit would you get out of doing it again that you can't achieve by doing something less risky? What's the minimum effective dose and frequency to get you what you want? Some people find that a regular microdose protocol gives them much of the benefits with less of the hassle of a regular macrodose, for example. Psychedelics are incredible tools, but you want to make sure you're applying them with intention and care.

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.

There's not enough research on this and not enough of it is centralized, which sucks given that this is a common question.

It's a really complicated thing to try and study given how many psychedelics and psychiatric medications there are.

Here's a table we found about combinations between various psychedelics and antidepressants.

We don't know of anything relevant to contraindications with anti-anxiety meds and many psychedelics, but because ketamine is a legal medicine, you can at least find contraindications between ketamine and various psych meds using the Drugs.com Interaction Checker.

There's some research you can do on Google by typing "__name of psychedelic___" and "__name of psychiatric medication__", then adding the words "interaction," "combination" and "contraindications" to that in three successive searches. Much of what you'll find through this method is not medical research and thus should be treated as for informational purposes only.

There's a whole field of psychedelic harm reduction dedicated to just this thing, and they have hella best practices to share.

During a challenging psychedelic experience, one of the easiest things you can do is call the free hotline offered by the Fireside Project, where someone trained to hold space for your difficult time can monitor you and help you through it over the phone.

For general theory on what to do, the Manual of Psychedelic Support is one of the texts a lot of people point to.

Legality varies greatly by jurisdiction and individual psychedelic compound in question, so we're hesitant to provide sourcing information in a public forum. We'd recommend checking the legal status of the compounds that you are interested in in your given city/province. For example, many jurisdictions have licensed ketamine-assisted psychotherapy clinics, so you can have a safe, supervised experience if you are seeking psychedelics for purposes of clinical treatment.

For most folks, however, psychedelic access is largely restricted to either growing/making your own (complex and again, legally fraught) or accessing black/gray market sources. We created a brief harm reduction guide for Dealing With Your Dealer to minimize the likelihood of getting something other than what you were looking for (and maybe causing harm to yourself or community members as a result): https://www.psychedelicsafetyalliance.org/f/dealingwithyourdealer

Start asking. Be aware that it's not a buyers market, and that testing your substances is as simple as ordering a kit from Amazon

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.

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.

You already said it. Harming and criminalizing indigenous communities sucks, as does endangering any plant or animal species. There are plenty of other ways to get the benefits of psychedelics.

Chacruna is a psychedelic justice organization that does work around this for anyone who wants to know more.

Tim Ferriss also put out a piece about this not too long ago.

Fuck yeah. Erowid rocks. They're a huge influence for us and our fledgling website doesn't hold a candle to the groundbreaking thing they made.

That said, we've found there's much information on Erowid that it can be overwhelming if you don't know how to synthesize all the info and plug it into a clear, repeatable safety protocol.

So we made one. Here! Have it for free!

We're safety people, so the main questions we think about with solo journeys are:

"What are the things that could go sideways during a solo trip?"

"How many of those things can I prevent in advance with good technique, preparation and awareness?"

"What are the risks I can't fully prevent, and how do I need to set myself up to access whatever help I might need to address those things in the absence of another person?"

Dax here! No, I'm far more handsome than he is.

Ally here: can confirm, much more handsome.

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.

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.

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.

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!

Easy: Buy some sketchy black market drugs from an untrained person you don't know, don't test them, take a large, unmeasured dose in a chaotic environment with people you feel unsafe with, throw a bunch of other drugs in the mix without checking for potential interactions, and see what happens!

Just kidding. We've seen people do all those things and it rarely goes well.

We made a masterclass to answer this question. It covers all the skills and awareness you need to have if you plan to take psychedelics outside of a supervised medical, therapeutic, or ritual environment and want be as safe as possible.

We still don't recommend that anyone take psychedelics without professional supervision, but if you're gonna do it anyways, you might as well know all the ways people accidentally fuck themselves up so you can avoid same.

To start with the initial question: Drug-induced psychosis (DIP) refers to a clinical diagnosis. DIP may encompass a few different symptoms that demonstrate a lack of connection to reality, such as hallucinations and feelings of paranoia, and is, by definition, always triggered by use of a drug of some kind. Ego death is a single symptom that some folks may experience, which is not necessarily attached to a psychotic episode (let alone specifically one that is drug-induced.)

To your broader experience: that's unfortunately more common than we'd like to see, and is often preventable with some care taken on the preventative side. We really advise folks take their time to prepare for an experience and really think through all the individual factors that could lead to a difficult time - when you minimize risks, it usually also maximizes potential benefits. We made a checklist of our dosing protocol here, and a more specific one about evaluating set & setting here. Creating a safe container for you to voyage in is absolutely critical, and if you don't have that safe container you're a lot more likely to have a difficult time like what you've experienced.

We don't do much on ayahuasca. Neither of us has taken it, neither of us has been trained on it, and our focus is specifically on providing education to people who take psychedelics outside of a supervised context, which is usually how ayahuasca is used.

Here's a table that covers answers to your question in regards to the most common psychedelics.

What shroom species did you eat and your friend same or different?