Inside bad trips : Exploring extra-pharmacological factors
Journal of Psychedelic Studies, 2018, 2, (1), pp. 53–60
Objective : This study aimed to clarify the influence of extra-pharmacological factors in the etiology of bad trips, a common adverse reaction related to the consumption of psychedelic drugs.
Methods : A descriptive approach was adopted. The information was collected using a web-based survey. The survey respondents volunteered to participate based on the condition that they had suffered a bad trip in the past.
Results : This report reveals some variables that are commonly related to this adverse reaction (i.e., the recreational consumption of drugs, the consumption of drugs in large, open outdoor spaces, or being inexperienced with the drug). In addition, we note that some problems, which may be related to bad trips (i.e., mixing drugs, ignorance about the purity, or the dosage), can be solved through harm reduction strategies.
Conclusions : We found certain aspects that could be related to the appearance of a bad trip, but it is not possible to establish a causal connection. We recommend conducting prospective studies with larger samples to collect more information about the role of extra-pharmacological factors.
Keywords : psychedelic, bad trip, drug adverse reaction
Psychedelic drugs like lysergic acid diethylamide (LSD-25), 3,4-methylenedioxymethamphetamine (MDMA), and psilocybin are being investigated again, showing therapeutic potential for certain psychological disorders, such as post-traumatic stress disorder (Amoroso & Workman, 2016; Mithoefer et al., 2013; Oehen, Traver, Widmer, & Schnyder, 2013) and depression and anxiety associated with life-threatening illnesses (Grob et al., 2011; McCorvy, Olsen, & Roth, 2016). There are dozens of references on this issue, so we suggest reading the following recent reviews: Garcia-Romeu, Kersgaard, and Addy (2016) and Nichols, Johnson, and Nichols (2017). Alongside this therapeutic trend, recent studies have
begun to challenge the notion that the psychedelics are harmful to mental health (Krebs & Johansen, 2013). On the contrary, we may consider the possibility that the consumption of these drugs by healthy people in naturalistic contexts could have benefits to mental health (Johansen & Krebs, 2015; Ona & Spuch, 2017). We note that all drug users are exposed to some adverse reactions (Grof, 2005; Strassman, 1984). These substances can exacerbate the psychopathological traits that could cause persisting
adverse reactions (Cohen, 1960; Johnson, Richards, & Griffiths, 2008; Strassman, 1984). When drug users do not have previous psychopathological traits, they may experience acute adverse reactions like fear, panic, overwhelming anxiety, or confusion, which together constitutes what is commonly known as a bad trip. This phenomenon has not been studied in depth. While there are important number of studies, which address the adverse reactions related to the consumption of psychedelics (Abraham & Aldridge, 1993; Bewley, 1967; Carbonaro et al., 2016; Cohen & Ditman, 1963; Fink, Simeon, Haque & Itil, 1966; Frosch, Robbins &Stern, 1965; Glickman & Blumenfield, 1967; Heaton, 1975; Kleber, 1967; Malleson, 1971; Smart & Bateman, 1967; Strassman, 1984), few studies specifically focus on bad trips (Barrett, Bradstreet, Leoutsakos, Johnson, & Griffiths, 2016; Carbonaro et al., 2016; Cohen, 1960; Ungerleider, Fisher, Fuller, & Caldwell, 1968). Literature on psychedelic-induced states of consciousness suggests that the extra-pharmacological factors are determinant (Grof, 2005; Masters & Houston, 1974; Prepeliczay, 2002; Sumnall, Cole, & Jerome, 2006), because states of consciousness induced by psychedelics potentiate perception and experience of external stimuli (Grof, 2005). The delineation of these extra-pharmacological factors is conceptualized in the notion of “set and setting,” that is to say,
the way the experience is influenced by the individual’s mindset (set) as well as the surroundings and atmosphere (setting). In this study, the relationship between bad trips and a delimited list of extra-pharmacological factors will be explored.