Are Psychedelics Right for You? What You Need to Know

You can’t miss it. If you use social media, Netflix, television, or listen to podcasts, you have likely noticed increased attention on the therapeutic use of psychedelics. Maybe you’ve read Michael Pollan’s book How to Change your Mind or watched a documentary on microdosing in Silicon Valley. However, this topic is not actually a new topic of research. Psychedelics were extensively studied by scientists in the 1940s through the 1960s until research was essentially stopped in the early 1970s when they were made illegal in most countries.  In fact, psychedelics have been used by cultures for thousands of years, perhaps more often than not, as tools for healing and growth. Recently, a wave of research has confirmed that if safely administered in a clinical setting, psychedelics can provide mental health benefits and help with conditions such as PTSD and depression. You may be wondering how psychedelic therapy works. You might even be curious about trying it out for yourself one day.   Here are some factors to consider.

Psychedelics Are Still Illegal 

For the most part, psychedelics remain illegal in the US. Some are willing to accept the risks (legal and otherwise) and use psychedelics for therapeutic purposes in the “underground.” In addition, in some cities, such as such as Denver, Colorado or Oakland, California, psilocybin mushrooms have been essentially decriminalized.  In these cities, they are considered a low priority for local law enforcement. In addition, members of Native American and other churches can also legally consume some psychedelic substances, like ayahuasca or peyote. Clinical trials of psychedelics provide another legal alternative, but they are very difficult to get into even if you meet all of their specific criteria.  If you have the resources to travel to countries where psychedelics are legal, such as the Netherlands, Jamaica, or parts of South America, there still are risks given that the quality of psychedelic tourism can vary and is not often regulated. Traveling to other countries also raises ethical qualms around psychedelic tourism continuing a history of colonialism and cultural exploitation. Proponents of psychedelics are hopeful that psychedelic-assisted psychotherapy will be available in the US within 2-3 years, though it is possible that unforeseen problems may delay this.  One legal alternative, ketamine, is currently available as a treatment for depression.  However, ketamine is somewhat controversial in its classification as a psychedelic and is often prescribed in doses that don’t result in psychedelic effects.

The Pros and Cons of Psychedelic Use

When used with proper guidance and in appropriate settings, psychedelics can be extremely beneficial. It is common for people to see themselves and their lives in a new way, leading to insights about future changes.  Many who are depressed or anxious can experience a profound sense of safety or joy that reminds them that it is indeed possible for them to break free from their stuck places.  It is possible to experience increased connection with others, nature, one’s own body, or a sense of spirituality that was previously not present.  Some let go of old pain that they have been holding on to and feel whole and complete for the first time.  Sounds great, right?

While these remain possibilities, they don’t happen for everyone.  Some individuals have a mild or neutral experience, leaving them feeling disappointed and wondering why psychedelics didn’t work for them.  In addition, some people can have an overwhelming or terrifying experience, especially when used without adequate preparation or in uncontrolled settings, Due to their illegality, it may be difficult to access support to process what happened.  In addition, buying drugs off the street carries some risk as they may be impure and contain dangerous substances.  Finally, pre-existing medical conditions such as psychosis, bipolar disorder, or heart conditions may interact with psychedelic use in problematic ways. 

Are Psychedelics Right for You? 

Psychedelics are probably not right for everyone.  If you are thinking about trying psychedelics, there are a few things you should do.

  • Get Educated. There is much stigma, misinformation, exaggerated benefits, and exaggerated risks out there.  Therefore, you should familiarize yourself with the actual risks and benefits.  This will help you make a more well-informed decision given your own situation.

  • Obtain Realistic Expectations. It is easy to think that all you have to do is eat some dried fungi, sit, and wait for enlightenment to occur.  It is important to understand what the psychedelic experience is. For example, even when the outcome is beneficial, it may involve facing some inner demons or bad feelings that you’ve been burying your whole life. If you are not anticipating this possibility or do not have adequate support, you are more likely to get overwhelmed.  In traditional cultural use of psychedelics, they are approached with great respect and humility that includes long-term preparation.

  • Clarify Your Intentions. What are you looking for from psychedelics?  If you can’t answer this question right away, take some time to reflect.  Are there other ways to get what are looking for that you haven’t tried yet?  Going into a psychedelic experience with a clear sense of intention and purpose is helpful and increases the chances for therapeutic benefit. 

  • Develop a Safety Plan. If you do choose to use psychedelics, make sure to think through all of the possible issues that could occur.  For example, have someone sober and experienced with psychedelics with you.  Know appropriate dosages and test the pureness of your substances with available drug testing kits.  Have a backup plan in case of an unexpected circumstance, such as if the babysitter calls.  Make sure you find a setting that you feel safe and comfortable in.

  • Plan for What Happens Next. The days and weeks after a psychedelic experience can be a pivotal period. Make sure you have adequate time to process what happens before jumping back into your life.  Have a plan for social support. The days after a psychedelic experience are usually not the time to make drastic life changes. Like any memory that fades with time, make the most of insights or wisdom gained by devoting adequate space and energy to making it a part of your everyday life.

Following these guidelines can help mitigate the risks involved with psychedelics and maximize the chances of a beneficial outcome. Additionally, a qualified therapist who understands harm reduction approaches can help you get the information you need to make informed decisions, set expectations, develop an intention, and integrate insight.  

If you live in Portland, Oregon and need help thinking through whether psychedelics are something you want to use, or if you would like help in making use of positive psychedelic experiences or dealing with difficult ones, I offer these kinds of services. Please note that I do not help anyone to find or obtain illegal substances.

Brian Pilecki, Ph.D.

Author: Brian Pilecki, Ph.D.

Dr. Brian Pilecki is a licensed clinical psychologist who earned his Ph.D. from Fordham University and completed his postdoctoral training at the Warren Alpert Medical School of Brown University. He specializes in the treatment of anxiety disorders, trauma and PTSD, and matters related to the use of psychedelics. Additionally, Dr. Pilecki has experience in mindfulness and meditation and practices primarily from an orientation based on Acceptance and Commitment Therapy (ACT). He is also engaged in scientific research on psychedelics.
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