Harms After Psychedelic Use Can Persist for Years

Users tell of panic, depression, trauma, social disconnection, and feelings of unreality, even three years after their psychedelic experience.

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In a new study, researchers found that the difficulties caused by a “bad trip” can be long-term. Responses from 608 people who experienced adverse effects after psychedelic use demonstrated that even years later, the harms still linger.

Among the top difficulties experienced for years by the participants were panic, depression, trauma, social disconnection, and feelings of unreality.

A previous study found that 22.5% of those who take psychedelics experience adverse effects, but it has been unclear how many of those harms linger over the long term. The current study indicates that about a third (32.2%) of those who experience these difficulties will struggle with them for more than a year. About a sixth (17.1%) were still experiencing these harms more than three years later.

“In the wake of two decades of resurgent psychedelic research, and largely positive media coverage, many people may expect psychedelics to yield only benefits,” the researchers write.
“However,” they add, “our survey reveals that psychedelics’ effects can be a double-edged sword for some. These substances can foster greater social connection or, conversely, provoke intense social disconnection. They can alleviate anxiety or exacerbate it. They have the potential to heal post-traumatic stress disorder (PTSD) or induce it. They can boost an individual’s sense of meaning or plunge them into existential confusion. Importantly, these effects are not always transient.”

The study was led by Jules Evans at Queen Mary University, London, and Oliver C. Robinson at the University of Greenwich, London. It was published in PLoS ONE. The study was funded by Emergence Benefactors.

Psychedelic-assisted therapy is all the rage within psychiatric circles, being praised as a “miracle cure” for a variety of psychiatric diagnoses. Yet researchers have raised concerns about the use of these substances, including increased suicidal thoughts and abuse by therapists. This is all the more concerning given the lack of guidance or oversight for psychedelic-assisted therapy—and the fact that the therapy explicitly includes physical touch.

Most recently, the FDA advisory committee voted against approving MDMA-assisted therapy for PTSD. However, the FDA has overruled its advisors in the past when psychedelic drugs were concerned, such as its infamous approval of esketamine nasal spray despite the failure of the drug to beat placebo in five of its six efficacy trials. The FDA may well do the same when it comes time to rule on MDMA.

One issue with psychedelic-assisted therapy is the potential for “bad trips,” difficult psychedelic experiences that can have a lasting negative effect on a person’s relationship with themselves, others, and the world. The current study aimed to investigate this aspect of psychedelic use. The researchers wanted to see what types of bad experiences people have after psychedelics, how long they last, and if there are any factors that can predict these problems.

The study itself included 608 participants, recruited online, who answered questions about their psychedelic use. All participants had had negative psychedelic experiences since the goal was not to determine the prevalence of negative experiences among all psychedelic users but rather to examine in-depth the traits of those with these experiences.

The questionnaires the participants filled out included questions about specific aspects of the experience and an open-ended question where participants could describe their experience in their own words.

The most commonly used psychedelics were psilocybin (27%) and LSD (25%); over a dozen different drugs were cited in total. Thirty-five percent said they used the drug with friends; 18.9% said they took it on their own, and 12% said they were in a group ceremony. Others took the drugs at a rave, a party, or in a clinical trial, among other settings. A quarter of the participants (25.7%) said that no one present knew what dose they were taking.

The researchers suggested some possible difficulties, and many participants answered that they had experienced them:

  • Emotional struggles (76%)
  • Struggles with the way they perceived themselves (58%)
  • Cognitive difficulties (52%)
  • Struggles with social connection (52%)
  • Existential struggles (50%)
  • Spiritual struggles (34%)
  • Visual or auditory disturbances/hallucinations (26%)
  • Other (21%)

In the open-ended question, 67% of participants talked about emotional struggles such as anxiety, depression, paranoia, panic attacks, suicidality, and resurfaced trauma after their psychedelic experience. Twenty-seven percent talked about social struggles, such as feelings of disconnection from others or being hurt by others’ actions during the experience. Twenty-one percent had flashbacks or lingering hallucinations; 18% had difficulty thinking clearly or memory loss after the experience; and 47% struggled with feeling that the world was unreal, delusional beliefs, or a growing sense of nihilism.

Another 23% struggled with feeling disconnected from themselves, dissociated, or that they themselves weren’t real. Nineteen percent had “somatic” symptoms like sleep problems (including nightmares), nausea, and increased sensitivity to other drugs. Five percent thought they developed psychosis after the experience, and two percent said they now had problems with substance abuse.

Quotes from participants help illuminate the lingering effects of their psychedelic experiences:

  • “I became withdrawn, untrusting, disengaged from friends. I recall giving away my possessions. Though smart, I dropped out of high school.”
  • “It was absolutely traumatic. I have PTSD from it and experience flashbacks of the trip.”
  • “For about 18 months, I awoke with the sun every morning full of a feeling of absolute terror. . . Sometimes my anxiety would be so high in the morning that I would physically shake from the energy.”
  • “I collapsed into a severe, almost catatonic depression. I could not even tell my husband that I was having suicidal ideation. I reached out to my therapist for integration sessions once, and when he did not reply, I fell further into the abyss of hopelessness and despair. I went through the motions of existing, grateful that my busy schedule held me accountable for staying alive, but I did not see the point. This lasted over 2 months.”
  • “I felt like the person I was before had been entirely wiped from all sense memory and I felt completely dissociated from the body I was inhabiting. . .[I] essentially felt like I was completely disintegrating. My life has and never will be the same.”

Forty percent of the participants said that they thought past trauma might be responsible for the difficulties they experienced after taking psychedelics. About a quarter (28.5%) had a previous psychiatric diagnosis, and 45.9% of those said this might be responsible for the negative effects they experienced. However, there was no detail about what specific diagnoses people had received. Some people (18.8%) received a psychiatric diagnosis after the psychedelic experience, and over half of those (53.6%) blamed the psychedelics for leading to their mental health difficulties.

The researchers also investigated whether traits of the person or the psychedelic experience itself could predict adverse effects. They found that being unguided and having a challenging “trip” both predicted more difficulties. Ayahuasca, DMT, and LSD were linked to longer duration of problems than other drugs. However, having a prior psychiatric diagnosis was not predictive of lingering difficulties.

Despite these issues, 89.7% of the participants agreed with the statement, “I believe that the insights and healings gained from psychedelics, when taken in a supportive setting, are worth the risks involved.” However, when speaking specifically of their own experience (rather than a general statement), about half the participants had more qualms about it:

Fifty-five percent of the participants said they still take psychedelic drugs. However, the other 45% felt differently.

“Almost half no longer take psychedelic drugs, and in some instances, respondents reported feeling significantly harmed by their psychedelic experience and expressed regret over ever trying these substances,” the researchers write.

The researchers write that their ultimate goal is not to question the risks or benefits of psychedelics but to provide support for those who do experience long-term harm from psychedelic experiences.

“With millions of people turning to psychedelics to [sic] healing and personal growth, it is urgent to factor in support for individuals who encounter enduring difficulties,” they write.

 

 

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Evans, J., Robinson, O. C., Argyri, E. K., Suseelan, S., Murphy-Beiner, A., McAlpine, R., . . . & Prideaux, E. (2023). Extended difficulties following the use of psychedelic drugs: A mixed methods study. PLoS ONE, 18(10), e0293349. https://doi.org/10.1371/journal.pone.0293349  (Link)

 

9 COMMENTS

  1. I am all for free speech, and so altough I do not want articles like this banned, I am VERY angry about this article!!! It goes against my very life story which I will explain a bit now: I was turned onto LSD when I was 15. My dream was to become a dancer, and things fell into place and I got the opportunity to go and live in London, and take lessons at Covent Garden Dance Studios. I was having to get jobs though to support myself, and THE fateful one was riight in the heart of Piccadilly Circus. And it was here one day when I was leaning over the road railings on a break breathing in the car fumes that I felt a tap on my shoulder, and one of the people who were working on a clothing stall near me invited me to a party and I accepted.
    On the way I was offered a tiny tiny blue pill, and being rather naive I assumed it was ‘speed’ because an amphetamive known as ‘bluies’ was talked about in the news. So I took it, and then found myself say on a couch observiing people at the party who were mostly stoned on cannabis. The trip began when the door to my left seemed to blow into the room like a psychedelic balloon. I then began to see people’s body language, and how it conflicted with the social personas they were hiding behind. I found this SO hysterially funny I thought I would die laughing. Towards the end thre was an element of ‘bad trip’ because people started looking green and I freaked out a bit.
    However in the year I was in London I went onto have a series of powerful trips. I was utterly amazed how solid matter, walls etc NOW seems to breath and ripple and wave, and how everything seemed so connected with my consciousness. I saw ‘notes’ fly off played guitar strings like multi-coloured sparks. Seeing music……………. But the most tranformative parts of the trips for me was on their ‘come down’ when we would leave the place we had taken the acid, and then at dawn went walkabout, past gardens (this was in Spring and Summer) and into parks, and this is where I saw nature as UTTERLY magical, alive, intelligent, creative, and I felt DEEPLY connected with it…….Now this was a profound thing, because from being about 8/9 I had become totally dulled to nature. I lived near a lovely park, and could have walked through it to and from school but always chose the main road. I would throw litter in parks and countryside.
    My main obsession was with big cities, and the promises of future technology. I was also getting a sadistic streak. The experience which encapsulated this amazing change for me was my memeory of coming down when reclining by a lake in Hyde park called The Serpentine.
    I was watching the rising sun’s reflections on the rippling water, and it was like a zillion golden stars, and I knew that it was ALL connected, and I could see how I would have usually observed it–eg., the-light-is-reflecting-off-the-water. You know in a mechanical linear way we are all drilled in schools . Because we ARE indoctrinated via a mechansitic philosophy which totally disenchants nature and our being. Nature is made out to be mechansitic and insentient, be also animals and humans are said to be machines. But here in front of/part of this lake I experiencing the deeply magical experience of it all.
    There is also something significantly synchronistic this happened in front of the lake called the SERPENTINE. Mythically so, because these experiences encouraged a lifelong interest in looking into mythology, and the one that really resonates with me is Goddess mythos in which serpents and serpentine energy is VERY sacred; however I found that ALL patriarchal myths are anti nature, and so we see how the West’s most important ‘creation myth’ in the Bible totally trres to defame and demonize the Serpent.

    I see THE main problem of humankind is losing access to the human right to experience ecstasy incpired with psychedelics, and how this rightful freedom can dissolve the chasm between them and nature and this is why I am very angry with this fear-mongering article which adds to all the propaganda against psychedelics going way back. This fear-mongering didn’t just begin in the 1960s but is right at beginning of the rise of the patriarchy.

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    • I would really like to go deeper into the mythical aspects and how they connect with psychedelics. I was inspired to do all this because of my early psychedelic experiences, and ongoing experiences.
      It is a case of seeing connections, patterns. Our ‘education’ system does not really encourage this, and rather enforces ‘left brain’ thinking on generations of children so as to ‘fit’ them into a mechanstic culture with established roles, and the most pernicious social-controlling myth being the mental illness myth. A myth which claims we are machines, and if we ‘go wrong’ which can simply mean feeling sad, it means we are ‘chemically imbalanced’ and need their drugs. As people here should know there is no actual medical science supporting this at all.

      As I said in my previous post, my LSD experience was profound in how it helped me reconnect with nature whereas before I had become dulled to it, it bored me and I was obsessed with big cities. In years ongoing I am seeing what I was becoming all around me. And a big reason I have found for this deadness is that the stories people have been told from ancient to now , the myths, have been anti nature. I can give examples:

      We could begin with the ancient mystery school of Orphism in Greece (the first mystical school which wrote down its dogma). The myth was that the body had been created from ashes of the ‘evil Titans’ the chief of the gods Zeus had destroyed them because they attacked and eat his only son, Dionysos. Hence, so the story went, although the body was evil, inside was a divine spark of Dionysos and the goal was to become pure and eventually escape nature.
      In Eastern philosophy was the idea nature and the body were illusionary, ‘Maya’, and again the goal was to escape nature and achieve ‘Oneness’.

      In the Christian myth the so-called Original Sin was eating the ‘FORBIDDEN FRUIT’ and thus disobeying the ‘God’. In my research I have found that this fruit was covertly referring to psychedelic fruit. So according to this myth disobeying ‘God’ caused the ‘Fall’ of nature. So again we can see how believers in this story are being distanced from nature and also having to feel guilt and shame for being the cause of it. This is the first myth ever to blame humans for causing death!

      Then we come into the age of ‘Reason and Science’ and now nature is supposed to be mechanical and insentient, and animals and humans are machines. So my point is that I see a pattern whereby in the history of the patriarchy there have come lineage of stories whose intent has been to divide generations of people from a spiritual connection with nature, and to make sure of this comes the forbidding of psychedelic inspiration which can GREATLY undermine such deep propaganda

      So then what about the so-called ‘psychedelic resurgence’ of our more recent times? I have thought a lot about this, and first important thing to know is that much of the lingo the therapists use is still upholding the mental illness myth and hence will come promises that eg psilocybin therapy can ‘heal treatment-reistant depression’ etc . And the rituals are again cutting the individual off from not only nature, but the external, by blindfolding them and putting earphones on. No doubt this way can have healing potential, but I am still seeing this ongoing pattern of distancing people from nature and interaction, and the general opinion of therapists is that ‘recreational tripping’ is inferior to this method.

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  2. A bad trip causing psychological harm? How does this harm compare to the conditioning of the brain and the life activity by a social process that captured us in infancy and is destroying the Earth through us and all our children’s futures and there is nothing any of us can do? There is an ENORMOUS opportunity cost to NOT taking psychadelics, and that is to wriggle free from your socially conditioned factory consciousness that destroys the integrity and clarity of perception and conditions that perception with distorting and perverting judgements, and all judgements are social judgements. We learn the form ‘judgement’ from the social miiue but no judgement is a fact – it is a social invention, a tool of social violence, the way individuals regulate each other through judgement and negation. Psychadelics dissolve the default mode network in the brain, dissolve the factory consciousness, leaving this consciousness to creatively try and heal itself. Without this healing, your brain is as good as chopped liver, and it’s been chopped by society, and not even an anarchist in this state can claim to have even the remotest degree of freedom from society. To call yourself an anarchist is total social unfreedom because it is merely an intellectual statement, drawn from the social milliue, and we are defining ourself according to this piece of social conditioning, and our description of anarchism would be wholly socially conditioned.

    All thought and identity is socially conditioned. By what power did total human beings, did the complex phenomena of a human mind and heart and body, come to believe it WAS it’s skin colour or it’s sexual behaviour? By the power of our social conditioning which is normative and based on deviance from the white heterosexual man, who was once a human being, as were all people, until one group called another man ‘a black man’ and in doing so became a ‘white man’, therefore no longer human beings, therefore no longer brothers, but divided, different ‘kinds’ of people. But it is only a concept and a superficial detail. Hair colour doesn’t divide – why should skin colour? And why am I who I want to have sex with? Who decided that? Our conditioning. See how it perverts everything we are and interfears and destroys all clarity, sanity and understanding. Perception is immune to all these problems but thought is nothing but these problems, this idiocy, this disease of the hearts and minds of each one of us.

    What is it that is not socially conditioned? A life that is not controlled by thought, and a mind that does not try to find its identity in thought, for example calling themselves gay, black, an anarchist or a feminist, because these are, unarguably and manifestly, intellectual statements that we mistake for BEING WHO WE ARE, thus who we think we are is mere socially conditioned thought. We are not socially conditioned words, statements, are we, because that is 100% social in origin and content. So what are you actually? You are not even the body – that is an idea or a pattern of sensation. You are CONSCIOUSNESS, which is to say, awareness and the various happenings in awareness. That is the only fact that is. We call the various happenings in awareness sensation, emotion, thought, imagination, feeling, and non-ordinary psychological experiences. The sensation is then conceptualized by thought as the outside world, me, my body, my feelings, car, train, river etc, but this labelling process is the social historical process conditioning the brain and through that conditioning of the brain, conditioning and prejudicing what you see. This is the social process conditioning your brain and all your thinking and life activity, and you think finding an identity within that conditioning called ‘anarchist’ is somehow related to real, actual freedom. Mother Nature is already instinctive freedom. We are Mother Nature burdened with thought and other social structures. We need to free her from those structures, and free ourselves from them, because we are Mother Nature enslaved by thought and society. Anarchist and feminism and all other isms and identities are mere thought. Be free consciousness and liberate the nature that you are and that is, all around you. Destroy the system that’s destroyed the Earth and all our children’s futures, and which destroys and conditions you day in, day out, until you reach the grave. If you die an anarchist or feminist then it has won.

    Demons and idiocies march out of the mouths of all our politicians. They are unconscious vampires, and along with the business and cultural and spiritual vampires like Eckhart Tolle who has over $80 million in the bank from desperate people like you, they are the living dead we warned ourselves about through culture. What isn’t the living dead? The baby, the animal, the free human being. Which of these can you be now?

    Let’s be raindrops shattering into the ground. Beautiful why they last but part of the eternal water cycle. Cuz that’s what we are, a falling bit of sea. Eclipse!

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  3. Harms persist for years, yet “Despite these issues, 89.7% of the participants [who had suffered significant, protracted and often very severe side effects] agreed with the statement, “I believe that the insights and healings gained from psychedelics, when taken in a supportive setting, are worth the risks involved.””

    I wonder how that would compare to other psychoactive substances, such as commonly prescribed psych meds. I doubt that many harmed psych-drug takers would have anywhere close to as positive view of risk vs benefits for antidepressants, antipsychotics, benzodiazepines, or other common meds.

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  4. Many people’s psychedelic experiences are wonderful for them. How many have ‘bad trips,’ and what causes those to happen, merits further inquiry.
    For some, a psychedelic adventure that goes awry can put them in psychiatric treatment for the rest of their lives. I have seen one person to whom this happened. I liked the person very much, and was quite sad, because, being stuck in the mental health system is not always fun.

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    • It is just not true! Look, I was turned onto LSD when 15. A young lad, and had FREE recreational powerful psychedelic trips, and these experiences brought me back to nature, because the REAL ‘bad trip’ for many psychedelic users is the ‘come down’ when after the most ecstatic fun there comes the gradual return to this soul-dead mechanistic reality we are all oppressed with!! Get me? The myths we are under are anti nature, and soul/spirit crushing. THAT is the REAL ‘bad trip’.

      So the whole looking into psychedelics and experience entails going VERY deep and looking into mythology. This is because we are all being controlled by stories, and the psychiatric scam is a story whichj claims we are merely electro-chemical machines. So because of psychedelics this not only brought me to nature, but gave me the encouragement and inspiration to devote life-time study to looking into why the world is insane. All there ever seems to be is war wars war, and all kinds of exploitation, and now recently they attacked the world with a scamdemic with the intention of injectiing everyone with an evil serum which is now harming and killing people worldwide, and there is utter denial from the establishment this is going on! As well as that there is their continuing climate change hoax, and they are coming after our natural food, and their end game is to merge their technology with our very bodies for ultimate control. Psychedelics are really for waking us up to their evil spells so we can all urgently stop the nightmate the powers that be want to control the world and us with. Meanwhile psychiatry and psychology’s role is to call people ex-posing what is going on ‘mentally ill’!

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  5. This study sought negative experiences from psychedelic trips across 49 countries. The researchers found just this number of such subjects.

    It pays to include how many continued to experience negative effects in the longer rather the shorter term. It also pays to mention those who were abused during the negative trip.

    There is at least one ultra-slow release of such a product chasing patent right now. What luck to have such research on the side of those intending to make $$$millions – researchers are so concerned to remove the trip from their products because they care soooo much about possible negative trip effects. No mention of the optimal set and setting effects to mitigate bad trips.

    Another interesting question is the number of ordinary medical treatments that lead to damaging results. Who wants to continue to be unable to walk because potential surgery can always carry the risk of worse outcomes including death – and that’s all surgery.

    People would like to have their lives back *from* the hell of PTSD.

    There is much else to say.

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