Psychedelics Are Not for Everybody
Research suggests that while psychedelics may have benefits, they could also exacerbate existing mental health problems as well as have medical contraindications.
Contraindications can include pregnancy, seizure disorder, heart conditions, taking anti-depressants, family history of psychosis or bi-polar disorder and previous adverse event from psychedelics.
People with contraindications are at higher risk of serious, adverse reactions.
Psychedelics can be dangerous for people who have a personal or family history of primary psychotic or affective disorders like Schizophrenia, Schizoaffective disorder, or Bipolar 1 disorder. It can also be dangerous for people who experience psychotic symptoms in the setting of depression.
UCSF. Medical contraindications to 'classic' psychedelic use. Published March 22, 2022.
There is still much we don’t know, so outcomes can be unpredictable. Little research has been done on the use of psychedelics for spiritual, self-medicating or recreational purposes.
Adverse Reactions
Psychedelics can induce profound changes in perception, mood and cognition, which may lead to psychological distress in some users.
Emotional responses can range from euphoria to paranoia, terror and fight-or-flight panic, which can result in suicidal ideation and suicide, psychological trauma, erratic behavior, accidental injuries, even violence or death.
Evans J. (2023), Psychedelic Experiences Project.
Psychedelic experiences can have short- and long-term adverse consequences. Short-term risks include the destabilizing effects that psychedelics can have through the experiences they can trigger, which can be difficult to handle both for the person and their therapist – experiences that can result to everything from increased acute agitation to prolonged emotional dysregulation.
Van Elk M et al. (2023). Ther Adv Psychopharmacol.
In a Johns Hopkins survey of people who had a challenging experience with psilocybin mushrooms, roughly 11% of participants put themselves or others at risk of physical harm and 2.6% of participants behaved in a physically aggressive or violent manner.
Theresa M. Carbonaro et al. (2016), Journal of Psychopharmacology.
Dangerous clinical effects attributed to ibogaine that have been reported include fatal arrhythmias, seizures, and sudden death from unexplained causes.
Jessica A. Meisner et al. (2016), Ther Adv Psychopharmacol.
As a class, the classic psychedelics are regarded as having very low toxicity to the body’s organs. However, when under the influence of any psychedelic, there is a risk of behaving in ways that could harm oneself or others.
Long Term Effects
Long-term psychological effects are a concern, particularly in vulnerable individuals or those with pre-existing mental health conditions
Two new studies reported functional impairment or persistent adverse reactions in up to 9% of psychedelic experiences.
Jules Evans et al. (2023), PLOS ONE.
Hallucinogen-associated hospital visits in California have increased more than 50% in recent years.
Nicolas Garel et al. (2024), Addiction.
In the days and weeks following use of a psychedelic substance, a person can have a prolonged adverse reaction and harm oneself or others. One study found that 8.9% of people reported functional impairment lasting longer than a day after a difficult trip, and 6.7% who reported challenging psychedelic experiences considered harming themselves or others.
Otto Simonsson et al. (2023), Journal of Affective Disorders.
Long-term psychological effects are a concern, particularly in vulnerable individuals or those with pre-existing mental health conditions. About 9% of people who take psychedelics in naturalistic settings report functional impairment lasting longer than a day. One third said their difficulties lasted longer than a year, and one sixth said their difficulties lasted longer than three years.