The dark side of the psychedelic renaissance

Psychedelics, right now, seem to be immune to criticism. And in some ways I can understand why.

Advocates of their healing-slash-therapeutic properties are keen to dismantle half a century of war on drugs hysteria, which hampered research into this broad class of drugs. It has become clear that psilocybin, LSD, DMT and ayahuasca – especially when taken in a supportive setting coupled with talking therapy – have very real potential as tools to help treat some mental disorders. Psilocybin, the active ingredient in magic mushrooms, for instance, has been proven, when administered in a clinical setting with supportive psychotherapy, to relieve major depressive disorder symptoms for some people.

Having said that: nobody talks about the dark underbelly of the psychedelic renaissance, the paradigm shift that’s taken place over the past two decades – from ​“evil-hippy-drugs” to ​“these-drugs-could-fix-our-broken-minds-and-broken-society”. If you have a mental disorder like depression, you might have seen the studies, articles and podcasts telling you that psychedelics could help. But they don’t tell you that psychedelics might actually make your problem worse.

The truth is that psychedelics are notoriously unpredictable. Yes, in the right setting, with the right guidance and support, psychedelics could help you with a mental disorder. They do tremendous things for some people, who often then understandably extol the virtues of psychedelics at every opportunity. For an often unacknowledged minority of users, however, taking these substances can result in long-lasting adverse effects.

I asked Jules Evans, a researcher and Director of the Challenging Psychedelic Experiences Project, why we don’t hear a lot about the minority of people who have long-lasting psychological distress after taking psychedelics.

“Most research on psychedelics that has happened in the last 20 years, during the psychedelic renaissance, has been funded by a handful of philanthropists,” he says, referring to financiers like Christian Angermayer – the leading investor of COMPASS Pathways, a London-based mental health care company researching psilocybin therapy. He claims his activities are motivated by a desire to help people suffering from mental health issues. As Evans puts it: “[They] tend to be extremely… evangelical about the therapeutic and spiritual potential of psychedelics.” Opposing views, therefore, tend to be obscured by the mushroom cloud of positivity.

Evans recently co-authored a study, Extended difficulties following the use of psychedelic drugs, which drew on a sample of 608 people who had reported long-lasting negative effects after taking psychedelics. The researchers followed up with questions about the experience: drug, dosage, setting, how challenging the trip was, and so on.

The context in which the project participants took psychedelics was detailed in this study: 2.8 per cent said it was ​“at a clinic or medical trial”, 5.3 per cent said they’d taken them ​“at a psychedelic therapy session” and 6.4 percent ​“on a psychedelic retreat”. Another 9.4 per cent took the dose ​“at a rave, nightclub or festival” and 3.0 per cent at a party.

The most commonly reported category was ​“emotional difficulties”, with 26 per cent of responses reporting long-lasting ​“anxiety and/​or fear” after using psychedelics. ​“I felt completely destroyed and terrified for weeks after [the trip],” one respondent recalls. The next most common category was ​“existential struggle” which was reported by 17 per cent of participants. ​“I cannot avoid starting to think about the meaning of life and death,” another respondent explained. ​“And I experience an overwhelming feeling of confusion and fear (almost panic) about the reason for the universe’s existence.”

Pretty heavy, right?

“Depersonalisation” (in 16 per cent of responses) and ​“derealisation” (in 15 per cent of responses) were also reported. What do those existential-level crises mean? The former: when someone feels like they are outside of their body looking in. The latter: when someone feels detached from their surroundings.

“Almost exactly two months after the trip, something happened,” another respondent recalled. ​“I was in a restaurant and all of a sudden I began to feel like something was wrong. I went to the bathroom. All of a sudden, the bathroom was not real.” They continued: ​“It just looked wrong. I had to get out of there. But when I left the restaurant, the street outside was not real either. The whole world was simply not real.”

It’s unclear if this quote was from one of the participants who took psychedelics at a medical trial, during a psychedelic therapy session or at a rave. But whichever it was: an unreal world is no one’s idea of a good mental-health outcome.

Another common theme was ​“visual distortions and hallucinations” occurring well after the trip had ended (12 per cent of participants reported this).

“Multiple times throughout the day, if I focus on something, my vision looks like it’s stretching and moving around,” one person explained. This could be described as a symptom of Hallucination Persistent Perception Disorder (HPPD), an offshoot of which is sometimes referred to as Alice in Wonderland Syndrome.

For around one-third of the participants, these problems persisted for over a year. For around a sixth of them, they continued for over three years. People who had taken ayahuasca, DMT and LSD were more likely to have a longer duration of difficulties compared to those who took MDMA and psilocybin (magic mushrooms).

The people who shared their experiences had taken psychedelics in a variety of contexts – on their own (note: perhaps not the best idea), at a psychedelic therapy session, with friends, on a psychedelic retreat, at a festival, at a clinic or medical trial, at a house party, etc. – and the researchers are not claiming that their findings can be generalised across society. But, with relatively little research into the long-term effects of bad or challenging trips, the study does add valuable insight in this area.

“If the psychedelic industry and psychedelic researchers and promoters only talk about the miraculous benefits of psychedelics and don’t mention the possible harms and risks, then what happens is millions of people will take psychedelics hoping for therapeutic relief or spiritual enlightenment,” Evans says. ​“And when a minority of them have difficult experiences, possibly experiencing harms lasting weeks, months or years, they’re going to be completely shocked and angry.”

All that said: with the rise in psychedelic research over the past two decades has come an increased knowledge, awareness and appreciation of the therapeutic benefits of these drugs. Books, podcasts and Netflix shows flooded in. It got to the point that the most popular podcast host in the world (sadly, this is Joe Rogan) revealed a full-sleeve tattoo dedicated to a DMT trip.

In came psychedelic tourism, and the opportunists and charlatans arrived, supercharged by the advent of a social media-driven content economy, and they were ready to cash in.

I know someone who was charged hundreds of pounds, by an Englishman from Newcastle who self-identified as ​“a shaman”, to sit on a yoga mat in a church hall and take huge doses of ayahuasca. No aftercare, no screening for a family history of psychosis (something that Evans tells me is a risk factor associated with a potential negative reaction).

On top of cultural appropriation issues here we have opportunism and taking advantage of vulnerable people, not to mention just acting like a dickhead. Leave the therapy to the therapists. And leave the shamanism to the specialists native to the Amazon rainforest.

“You do get that tacky appropriation of completely different cultures,” Evans says. ​“Plant shamanism is fascinating, but you couldn’t get a more different culture to 21^st century Britain.” He adds: ​“You get the full range of operators. From people really doing their best to provide a good and safe experience, to people who think they’re illuminated after one trip and they’re a shaman and therefore the universe wants them to now offer retreats, to people just after a fast buck to people who are driven by the desire for power over other people.”

Certainly, we can’t dismiss out of hand the reported benefits of psychedelics. It’s a field of medicine that could well go on to revolutionise the way we deal with mental disorders, improving society immeasurably as it does so. But for this to happen, we also need to talk about the potential disadvantages of this medicine.

“Psychedelics have had incredibly positive press for the last decade or so because scientists showing amazing benefits has been the new story,” Jules Evans concludes. ​“But now there needs to be a more balanced conversation.”

Are you struggling with issues relating to psychedelics? Click here for help.