by NuminusFeb 17, 2023
It’s common for people to have questions about the safety of psychedelic drugs and whether there are risks associated with them. Fortunately, classic psychedelics have little to no abuse potential. In fact, studies suggest they might even be anti-addictive. Even in vulnerable populations, it’s rare for complications like psychosis to arise from the use of psychedelics.
That being said, psychedelics may not be for everyone—which is why we take such great precaution before proceeding down the psychedelic path at our clinics.
What screening is done before deciding on psychedelics?
We only use psychedelics when there is a mental health-related diagnosis on record. We also complete thorough medical and psychiatric screening including reviewing pertinent factors such as personal or family history of psychosis and any history of substance abuse. Only after these precautions are in place do we consider psychedelic-assisted therapy.
Are these drugs safe?
According to many studies, the short answer is YES. Psychedelics have significantly lower risks than alcohol, cannabis, tobacco, and other drugs. Data from a study of psilocybin found that cases of mental health complications following a psychedelic are rare (<.1%), even in vulnerable populations (<.2%), and rarer still with proper screening. Another notable study, examining the classical (serotonergic, or 5-HT2A receptor agonists) psychedelics, LSD, psilocybin, & mescaline, found that no evidence of increased rates of mental health problems, and psychedelic use has been associated with reduced psychological distress and suicidality. Additionally, studies examining use patterns in humans & self-administration in animals suggest that classic psychedelics possess little or no abuse liability and may even be anti-addictive. These conclusions come from a comprehensive review of several kinds of psychedelic compounds, including classical psychedelics (psilocybin, LSD, & mescaline), indirect 5-HT agonists, (e.g., MDMA), NMDA antagonists, and κ-opioid receptor agonists (KOAs).
Why do some people experience brief psychotic episodes even days after use?
There are several factors that can play into this. As a general guideline, people with cognitive & emotional conditions associated with disorganized or diminished ego strength are not good candidates for psychedelics. Regardless, however, the short-term psychological effects that accompany psychedelic use are profound. Sympathetic nervous system arousal may occur both because of fear, and from direct effects of the drugs–particularly during the initial phase of sessions when barriers between physical senses dissolve; touches, smells, and tastes can take on sounds, shapes and colors. Proper supervision is also important. These drugs’ effects are sufficient to require that professionals skilled in managing adverse effects are present, for safety & to guide patients through their experiences. Additionally, when taken without adequate preparation and when surroundings are anxiety-provoking—either physically uncomfortable or emotionally intimidating—the psychedelic experience predictably results in fear, a prolonged sense of dread, or full panic. Conversely, in controlled settings with elements of soft light, art, and appropriate music, or nature, and gentle, compassionate people, such adverse reactions are rare.
What conditions can Ketamine-Assisted Therapy (KAT) treat?
- Depressive disorders
- Post-traumatic stress disorder, post-traumatic stress and anxiety
- Addictive disorders, including substance use and behavioural
What conditions are not suited Ketamine-Assisted Therapy at Numinus?
Absolute Contraindications – KAT is not a fit for those with the following conditions:
- Allergic reaction to ketamine
- History of ketamine abuse
- History of stroke or brain aneurysm
- Uncontrolled high blood pressure
- Acute Angle Glaucoma
- Uncontrolled thyroid disorder
- History of mania/bipolar 1
- Age 14 and under
- Current diagnosis of schizophrenia, schizoaffective disorder, major depressive disorder with psychotic features, psychotic disorder
- Pregnancy (individuals who can become pregnant must use contraception if sexually active)
Relative Contraindications – We can some times treat those with the following conditions, on a case-by-case basis, with additional medical support:
- Active or unstable substance use disorder that is not an indication for treatment will be evaluated on a case by case basis by the screening physician
- History of heart disease
- Dissociative identity disorder
- History of psychosis
Heal, David J et al. “Evaluating the abuse potential of psychedelic drugs as part of the safety pharmacology assessment for medical use in humans.” Neuropharmacology vol. 142 (2018): 89-115. doi:10.1016/j.neuropharm.2018.01.049
Studerus, Erich et al. “Acute, subacute and long-term subjective effects of psilocybin in healthy humans: a pooled analysis of experimental studies.” Journal of psychopharmacology (Oxford, England) vol. 25,11 (2011): 1434-52. doi:10.1177/0269881110382466