The recent survey of difficult recreational psilocybin experiences by Heffter Board member and researcher Roland Griffiths, Ph.D. and his team at Johns Hopkins University draws two main conclusions that at first may seem contradictory. On one hand, psilocybin use outside the medical setting occasionally involves traumatic and potentially harmful experiences, as well as occasionally dangerous behaviors. On the other hand, most people report improvements in their quality of life after these difficult experiences.

The medical research setting provides crucial protections from harm that the recreational setting does not: a psychiatric evaluation to exclude subjects with a history of a serious mental disorder that could recur with psilocybin. Another key protection is the presence of specially trained psychotherapists with experience administering psilocybin to support subjects through distressing and confusing experiences, which can happen to anyone in any setting. Finally, the medical research setting provides hours of both pre-session preparation and post-session integration psychotherapy sessions to help the subject maximize the benefit from the session and ensure the positive impacts are enduring.

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The relative lack of protections afforded by the recreational setting is apparent in the data. The survey of recreational users found that 24% reported psychological symptoms after their difficult experience, some of which included risky or violent behavior, the need for medical help, and suicide attempts. By comparison, less than 1% of Hopkins medical research subjects experienced enduring psychological symptoms, and no medical research subjects participated in dangerous behavior.

The association of difficult life experiences resulting in personal benefit is well-known and almost goes without saying. Hard work, athletic training, and education are often difficult and yet are widely understood to be effective in helping people improve their lives. But because difficult psilocybin experiences are a rare and different kind of phenomenon in our culture, we don’t associate them with the “no pain, no gain” concept that we are used to hearing about more common life struggles. These survey data appear to confirm that learning from difficulty applies to intense inner experience as well as to the more common difficulties in everyday life.

The findings from this Heffter-funded study also confirm the need to place safety first. Psilocybin is a powerful medicine and it is Heffter’s position that the positive effects found in research to date are most reliably achieved when psilocybin is administered by a doctor with special training and used in a therapeutic setting. Safety has not been demonstrated for psilocybin when used outside of a clinical or laboratory setting, and we caution against recreational use of psilocybin because of potential adverse psychological reactions.

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