Bad trip

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A bad trip (also known as challenging experiences, acute intoxication from hallucinogens, psychedelic crisis, or emergence phenomenon) is a term describing an acute adverse psychological reaction to effects produced under the influence of psychoactive substances, namely psychedelics. To date, there is no clear definition of what constitutes a bad trip. Additionally, knowledge on the cause of bad trips and who may be vulnerable to such experiences are limited. Existing studies report that possible adverse reactions include, anxiety, panic, depersonalization, ego dissolution, paranoia, as well as physiological symptoms such as dizziness and heart palpitations. However, most studies indicate that the set and setting of substance use influence how people respond. [1]

Contents

With proper screening, preparation, and support in a regulated setting these are usually benign. [2] A bad trip on psilocybin, for instance, often features intense anxiety, confusion, agitation, and psychosis. [3] They manifest as a range of feelings, such as anxiety, paranoia, the unshakeable sense of one's inevitable and imminent personal demise or states of unrelieved terror that they believe will persist after the substance's effects have worn off. As of 2011, exact data on the frequency of bad trips are not available. [3]

Bad trips can be exacerbated by the inexperience or irresponsibility of the user or the lack of proper preparation and environment for the trip, and are often reflective of unresolved psychological tensions triggered during the course of the experience. [4] [ page needed ] In clinical research settings, precautions including the screening and preparation of participants, the training of the session monitors who will be present during the experience, and the selection of appropriate physical setting can minimize the likelihood of psychological distress. [5] Researchers have suggested that the presence of professional "trip sitters" (i.e., session monitors) may significantly reduce the negative experiences associated with a bad trip. [6] In most cases in which anxiety arises during a supervised psychedelic experience, reassurance from the session monitor is adequate to resolve it; however, if distress becomes intense it can be treated pharmacologically, for example with the benzodiazepine diazepam. [5]

The psychiatrist Stanislav Grof wrote that unpleasant psychedelic experiences are not necessarily unhealthy or undesirable, arguing that they may have the potential for psychological healing and lead to breakthrough and resolution of unresolved psychic issues. [4] [ page needed ] Drawing on narrative theory, the authors of a 2021 study of 50 users of psychedelics found that many described bad trips as having been sources of insight or even turning points in life. [6]

Intervention

Medical treatment consists of supportive therapy and minimization of external stimuli. In some cases, sedation is used when necessary to control self-destructive behavior, or when hyperthermia occurs. Diazepam is the most frequently used sedative for such treatment, but other benzodiazepines such as lorazepam are also effective.[ citation needed ] Such sedatives will only decrease fear and anxiety, but will not subdue hallucinations. In severe cases, antipsychotics such as haloperidol can reduce or stop hallucinations. Haloperidol is effective against acute intoxication caused by LSD and other tryptamines, amphetamines, ketamine, and phencyclidine. [7] [8]

Effects

Bad trips may cause hallucinogen persisting perception disorder (HPPD). [9]

Perspectives

Stanislav Grof

Psychiatrist Stanislav Grof once said in an interview:

There is a tremendous danger of confusing the inner world with the outer world, so you'll be dealing with your inner realities but at the same time you are not even aware of what's happening, You perceive a sort of distortion of the world out there. So you can end up in a situation where you're weakening the resistances, your conscious is becoming more aware, but you're not really in touch with it properly, you're not really fully experiencing what's there, not seeing it for what it is. You get kind of deluded and caught into this. [10]

In a 1975 book, Grof suggested that painful and difficult experiences during a trip could be a result of the mind reliving experiences associated with birth, and that experiences of imprisonment, eschatological terror, or suffering far beyond anything imaginable in a normal state, if seen through to conclusion, often resolve into emotional, intellectual and spiritual breakthroughs. From this perspective, Grof suggests that interrupting a bad trip, while initially seen as beneficial, could potentially trap the tripper in unresolved psychological states. Grof also suggests that many cathartic experiences within psychedelic states, while not necessarily crises, may be the effects of consciousness entering a perinatal space. [11]

Rick Strassman

Professor of psychiatry Rick Strassman is critical of reframing the experience of bad trips as one of "challenging experiences". [12]

See also

Related Research Articles

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Lysergic acid diethylamide, commonly known as LSD, and known colloquially as acid or lucy, is a potent psychedelic drug. Effects typically include intensified thoughts, emotions, and sensory perception. At sufficiently high dosages LSD manifests primarily mental, visual, and auditory hallucinations. Dilated pupils, increased blood pressure, and increased body temperature are typical.

<span class="mw-page-title-main">Psilocybin</span> Chemical compound found in some species of mushrooms

Psilocybin is a naturally occurring psychedelic prodrug compound produced by more than 200 species of fungi. The most potent are members of genus Psilocybe, such as P. azurescens, P. semilanceata, and P. cyanescens, but psilocybin has also been isolated from about a dozen other genera. Psilocybin is itself biologically inactive but is quickly converted by the body to psilocin, which has mind-altering effects similar, in some aspects, to those of lysergic acid diethylamide (LSD), mescaline, and dimethyltryptamine (DMT). In general, the effects include euphoria, visual and mental hallucinations, changes in perception, distorted sense of time, and perceived spiritual experiences. It can also cause adverse reactions such as nausea and panic attacks.

<span class="mw-page-title-main">Psychedelic drug</span> Hallucinogenic class of psychoactive drug

Psychedelics are a subclass of hallucinogenic drugs whose primary effect is to trigger non-ordinary mental states and an apparent expansion of consciousness. Also referred to as classic hallucinogens or serotonergic hallucinogens, the term psychedelic is sometimes used more broadly to include various types of hallucinogens, such as those which are atypical or adjacent to psychedelia like salvia and MDMA, respectively.

<span class="mw-page-title-main">Stanislav Grof</span> American psychiatrist

Stanislav "Stan" Grof is an American psychiatrist. Grof is one of the principal developers of transpersonal psychology and research into the use of non-ordinary states of consciousness for purposes of psychological healing, deep self-exploration, and obtaining growth and insights into the human psyche. In 1993, Grof received an Honorary Award from the Association for Transpersonal Psychology (ATP) for major contributions to and development of the field of transpersonal psychology, given at the occasion of the 25th Anniversary Convocation held in Asilomar, California. He also received the VISION 97 award granted by the Foundation of Dagmar and Václav Havel in Prague on October 5, 2007. In 2010, he received the Thomas R. Verny Award from the Association for Pre- and Perinatal Psychology and Health (APPPAH).

A trip sitter—sometimes known as a sober sitter, spotter, or co-pilot—is a term used by recreational or spiritual drug users to describe a person who remains sober to ensure the safety of the drug user while they are under the influence of a drug; they are especially common with first-time experiences or when using psychedelics, dissociatives and deliriants. This practice can be seen as a means of harm reduction.

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<span class="mw-page-title-main">Set and setting</span> Mindset and location of a drug experience

Set and setting, when referring to a psychedelic drug experience or the use of other psychoactive substances, means one's mindset and the physical and social environment in which the user has the experience. Set and setting are factors that can condition the effects of psychoactive substances: "Set" refers to the mental state a person brings to the experience, like thoughts, mood and expectations; "setting" to the physical and social environment. This is especially relevant for psychedelic experiences in either a therapeutic or recreational context.

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<span class="mw-page-title-main">Rick Strassman</span> American drug researcher

Rick Strassman is an American clinical associate professor of psychiatry at the University of New Mexico School of Medicine. He has held a fellowship in clinical psychopharmacology research at the University of California San Diego and was Professor of Psychiatry for eleven years at the University of New Mexico. After 20 years of intermission, Strassman was the first person in the United States to undertake human research with psychedelic, hallucinogenic, or entheogenic substances with his research on N,N-dimethyltryptamine, also known as DMT. He is also the author of DMT: The Spirit Molecule, which summarizes his academic research into DMT and other experimental studies of it, and includes his own reflections and conclusions based on this research.

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References

  1. ↑ Gashi, Liridona; Sandberg, Sveinung; Pedersen, Willy (2021). "Making "bad trips" good: How users of psychedelics narratively transform challenging trips into valuable experiences". International Journal of Drug Policy. 87: 102997. doi:10.1016/j.drugpo.2020.102997. hdl: 10852/81144 . ISSN   0955-3959. PMID   33080454.
  2. ↑ Barrett, FS; Bradstreet, MP; Leoutsakos, JS; Johnson, MW; Griffiths, RR (December 2016). "The Challenging Experience Questionnaire: Characterization of challenging experiences with psilocybin mushrooms". Journal of Psychopharmacology. 30 (12): 1279–1295. doi:10.1177/0269881116678781. PMC   5549781 . PMID   27856683.
  3. 1 2 van Amsterdam, Jan; Opperhuizen, Antoon; van den Brink, Wim (2011). "Harm potential of magic mushroom use: A review". Regulatory Toxicology and Pharmacology. 59 (3): 423–429. doi:10.1016/j.yrtph.2011.01.006. PMID   21256914.
  4. 1 2 Grof, Stanislav (2008). LSD Psychotherapy. Multidisciplinary Association for Psychedelic Studies. ISBN   978-0-9798622-0-5.
  5. 1 2 Johnson, Matthew W.; Richards, William A.; Griffiths, Roland R. (2008). "Human Hallucinogen Research: Guidelines for Safety". Journal of Psychopharmacology. 22 (6): 603–620. doi:10.1177/0269881108093587. PMC   3056407 . PMID   18593734.
  6. 1 2 Gashi, Liridona; Sandberg, Sveinung; Pederson, Willy (2021). "Making "bad trips" good: How users of psychedelics narratively transform challenging trips into valuable experiences". International Journal of Drug Policy. 87: 102997. doi:10.1016/j.drugpo.2020.102997. hdl: 10852/81144 . PMID   33080454. S2CID   224821288.
  7. ↑ Giannini, A. James; Underwood, Ned A.; Condon, Maggie (2000). "Acute Ketamine Intoxication Treated by Haloperidol". American Journal of Therapeutics . 7 (6): 389–91. doi:10.1097/00045391-200007060-00008. PMID   11304647.
  8. ↑ "Sage Journals". Archived from the original on 2014-08-24. Retrieved 2018-03-27.[ dead link ]
  9. ↑ Bracco, Jessica (May 2019). "The United States Print Media and its War on Psychedelic Research in the 1960s". The Exposition. 5 (1): 9–10.
  10. ↑ "Beyond Psychotic Experience - Stan Grof interviewed by Jon Atkinson". Archived from the original on 2011-09-27. Retrieved 2011-04-12.
  11. ↑ Grof, Stanislav (1975). realms of the human unconscious - Observations from LSD research. souvenir press. pp. 95–153. ISBN   0-285-64882-9.
  12. ↑ "Misguided Mainstreaming of Psychedelic Drugs: Challenging Experiences". Rick Strassman MD. 25 October 2017.
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