Understanding Risk

As more people get interested in the potential benefits of psychedelics, many are asking questions about how to minimize risks while using these substances. Most well-known psychedelics, save for ketamine, remain illegal in the United States. (Ketamine is a Schedule III drug, meaning that it is legal when prescribed for medical use as an anesthetic.) Unless that changes, BCSP cannot and will not offer referrals or instructions for how to use them. That said, as part of a commitment to risk reduction, the Center has assembled a group of experts to answer frequently asked questions about psychedelics, including the potential risks involved in their use.

The BCSP does not recommend or encourage use of psychedelics, or offer instructions in the use of psychedelics. As part of a commitment to risk reduction, BCSP has assembled a group of experts to answer frequently asked questions about psychedelics, including physical and psychological safety considerations. However, these answers are being provided for informational purposes only.

Read BCSP’s full disclaimer on our Mission & Vision page.

Risk Reduction 101

The effects of a psychedelic substance can vary considerably depending on a number of factors, including the user’s expectations, the amount taken, possible impurities, and the setting in which it’s taken. While fatally overdosing on a pure psychedelic is extremely rare, some substances may be adulterated. Someone taking an adulterated substance faces an increased risk of having a stronger and/or a different experience than they intended, and there are even reports of deaths attributed to adulterated psychedelics. Taking a very high dose of a psychedelic, no matter how pure, is associated with a higher likelihood that the experience will be upsetting, jarring, or traumatic. 

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.

Here are the top 5 risk reduction tips from the experts:

  1. Be intentional. Identify what you want from the experience and evaluate your physical and psychological risk factors. Clinicians caution that some people should not take psychedelics, including those on certain medications or with a personal or family history of schizophrenia or bipolar disorder.
  2. Check your drugs. Know what and how much you’re taking. Unless you have expert guidance, it’s best to start with small amounts, using more only after you become familiar with the substance.
  3. Make sure you’re in an environment that feels safe.
  4. Don’t go solo with nontrivial doses. Have a sober sitter with you. Before your experience, discuss what kinds of physical contact (if any) would be comfortable for you, and commit in advance to listen to them if they warn you not to do something that could endanger you. Psychedelics can amplify human emotions, from affection to anxiety, and having a sitter and clear boundaries can help keep the experience safe.
  5. Have a plan for how you’re going to process and integrate your experience afterwards. Those with serious conditions, including major depression and PTSD, should seek out professional help when considering taking a psychedelic.

Questions for David E. Nichols

Understanding the Substance

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Questions for Sylver Quevedo

Understanding Your Risk Factors

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Questions for Rajan Grewal

Setting Up and Managing Expectations

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Questions for Hanifa Nayo Washington

The Role of Place and Mindset

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Questions for Pilar Hernandez-Wolfe

The Importance of Culturally Attuned Care

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Questions for Vilmarie Narloch

Resources for Sitters

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Questions for Brian Anderson

Long-Term Physical Effects

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Questions for Mary Cosimano

Long-Term Psychological Effects

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Harm Reduction Resources

The harm reduction movement acknowledges that despite the risks, many people will still choose to use both legal and illegal drugs. By connecting users with resources, harm reduction groups hope to equip drug users with information to minimize these dangers and make their experiences as safe as possible.

To learn more, visit the National Harm Reduction Coalition and DanceSafe.

Organizations that specialize in harm reduction resources for psychedelics:

The Zendo Project provides psychedelic harm reduction support and education. Their website provides a comprehensive set of resources including training manuals and crisis hotlines.

The Fireside Project offers free peer support by phone and text message to people in the midst of psychedelic experiences, people holding space for others who are in the midst of psychedelic experiences, and people integrating past psychedelic experiences.