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☛ Official ☚ Psychedelic Safety: Guidance on difficult experiences & dangerous combinations

Xorkoth

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Working Through and Benefiting From Difficult Psychedelic Experiences

Humans have consumed psychedelics thousands of years in religious, recreational, medicinal, and psychotherapeutic capacities. These experiences often result in fluctuations in mood, auditory distortions, visual distortion, and synethesia. These effects could potentially create both positive enjoyable experiences and difficult experiences too.

Difficult psychedelic experiences have the potential of being, with proper care, some of the most beneficial. Here our goal is providing resources on working through and benefiting from difficult psychedelic experiences. Please give this a second look. Perhaps you'll encounter such experiences and having reviewed these resource could be useful in the long run.



Fest300 said:
In your festival adventures you may run across someone who is having a difficult psychedelic experience. It's important that we all take care of each other at festivals so don't abandon someone who may need your help. If that someone seems to be posing a danger to themselves or others, alert festival security immediately. Being a good samaritan shouldn't put you in physical danger.

However, if the person is lost and confused there are ways you can support him or her and keep them safe. Consider assisting them in getting to the medical tent. If you're concerned you may get in trouble check out this helpful response from our column Ask The Festival Lawyer. There are trained professionals who can help and will do so in a supportive, nonjudgemental manner. Some festivals have designated safe spaces for people in such a condition. The Zendo Project , a group based in Santa Cruz, California, provides such a space at festivals and has compiled Four Pillars of Psychedelic Support to utilize if no other help is available. The following description of Zendo's Four Pillars is an excerpt from my own experience working with the Zendo project in Costa Rica at Envision Festival.


1. Create a Safe Space


Photo by: The Zendo Project

Festival environments are designed to be highly stimulating: Bombastic sound systems, intense light shows and general cacophony create a surreal wonderland for adventure. But when things start to overwhelm, these dynamic effects can heighten anxiety. Zendo is designed to provide tranquility and comfort. In addition to feeling physically safe, the guest must feel emotionally safe, which involves volunteers exuding a non-judgmental, welcoming attitude.

The conditions for this safety system, according to Sara Gael, MA MAPS Harm Reduction Coordinator, holistic psychotherapist, and Zendo Envision lead, are known as “set” and “setting.”

“'Set' refers to an individual’s internal state and includes emotional state and mood, pre-existing mental conditions, stress, comfort, and developmental stage," she explains. "'Setting' refers to an individual’s external conditions including where the person is, whom they are with, dosage, and drug interactions."

Gael emphasizes that set and setting are not mutually exclusive, and affect and inform one another. When sitters pay attention to an individual's set and setting, a safety system, uniquely tailored to that individual, can be created, so that the individual can surrender to the experience, even if discomfort or fear arises.


2. Sitting, Not Guiding


Photo by: The Zendo Project

Rather than using direct intervention, the goal for the sitter is to allow healing to occur naturally. The tools we used were breathing, validating, mirroring and affirming. The importance of not intervening in a guest’s experience was emphasized over and over throughout the weekend.

From MAPS: How to Work With Difficult Psychedelic Experiences: “There is always the tendency to overpower the other with our knowledge, wisdom, and insight. So let go of all knowledge regarding the experiences that the person is having. Just be with, listen, and observe.”

Does that mean that the sitter must be rigid and avoid engaging with the guest at all?

“It can be useful to provide gentle reassurance or reframing of the experience," explains Chelsea Rose, Zendo's volunteer coordinator. "These methods of support reflect what is already happening for the individual, while also reassuring them that their experience is acceptable."


3. Talk Through, Not Down


Photo by: The Zendo Project

Sitters are taught to understand that there is a natural process going on in the mind of the affected guest. Thus there is no effort to end the psychedelic trip prematurely; sitters must simply let the guest experience it with as much safety and comfort as possible.

Linnae Ponté, Director of Harm Reduction at MAPS and Founder of the Zendo Project repeats the mantra of "Trust. Let go. Be open. Breathe. Surrender."

Ponté says that when re-experiencing emotions from a past trauma, (which sometimes happens with psychedelics) having the space to feel the extent of that pain and suffering can be a pivotal to the guest's healing opportunity. A sitter must acknowledge that any emotions that bubble to the surface during a psychedelic experience are often strongly charged and can bring guests to the threshold of his or her consciousness.

"Our job isn’t to intervene, but to trust whatever is happening for them, and whatever it brings up in us, and to know it’s all temporary," Ponté continues. "We live in a world where emotional discomfort is suppressed with all kinds of drugs and behaviors, and we give guests the opportunity to instead go into the discomfort, and find out what’s underneath it."


4. Difficult is Not the Same as Bad


Photo by: The Zendo Project


The assumption that a difficult experience is “bad” can in fact contribute to the anxiety and general discomfort of the journey. “The mindset evident in the term 'bad trip' helps shed light on the outdated and often harmful methods by which these experiences are often addressed, including hospitalization and the involvement of law enforcement," explains Sara Gael. This approach to handling someone having a difficult psychedelic experience is common at events and often worsens or escalates a situation. They are methods that attempt to end or interrupt the individual’s experience and can send a message to the individual that something is wrong with them or that they are not safe."

Clearly, that is not the ideal approach for someone who is already feeling overwhelmed or frightened.



Photo by: The Zendo Project

For a more complete explanation of how to support individuals who are experiencing an intense psychedelic experience, including important ethical concerns, check out the newly compiled Manual of Psychedelic Support. This incredible resource was the result of a collaboration between researchers, artists, psychiatrists, therapists, psychonauts, and festival producers and is freely available under a Creative Commons license.

https://www.fest300.com/magazine/how-to-help-someone-who-s-tripping-out-at-a-festival



Zendo Project Psychedelic Harm Reduction - Training

[video=youtube_share;CphDzpr8wL8]http://youtu.be/CphDzpr8wL8[/video]



Other resources are available here.
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List of Dangerous & Potentially Unsafe Combinations

Here we'll try to keep a list of combinations of drugs that aren't safe to take in combination. This will be a work in progress & this list will not be exhaustive, so please still research things thoroughly before you ingest them!

Thanks to SurvivedAbortion for getting the ball rolling on this thread!

If your combination is not in the list, or you would like to ask about a specific combination or discuss potentially dangerous/risky combinations, or even make suggestions for this thread, please visit the Dangerous Combination Discussion Thread.

It would also be wise to check out the Medication & Supplement Interaction Thread for further information on medication reactions beyond simply stating whether a combination is dangerous or not.


If you see anything wrong in this list or something that needs to be added, please either post in the above thread, or PM one of the PD moderators and we'll get right on it.

Table of Contents

You can use the find/search function (Ctrl + F) to search for any of the sections mentioned in the contents and quickly find dangerous combinations for these drugs.

Known Dangerous Combinations

  • lMAOIs
  • SSRI/SNRI antidepressants
  • Anticonvulsants
  • Beta-blockers
  • Triptans
  • 5-HTP
  • Alcohol
  • Ibogaine
  • Serotonin releasers
  • Stimulants


Potentially/Likely Dangerous Combinations

  • Serotonin releasers
  • Stimulants




Known Dangerous Combinations



MAOIs (e.g. Phenelzine, Tranylcypramine, Selegiline):

X All phenthylamine psychedelics (e.g. DOx, 2C-x, 3C-x, TMA-x, 25x-NBOMe)
X aMT (alpha-Methyltryptamine)
X MDxx (e.g. MDMA, MDA, MDEA)
X Other serotonin releasers (e.g. 6-APB, 5-APB, 5-API, 5-IAI, MDAI)
X All cathinones
X DXM (Dextromethorphan)
X Ibogaine
X SSRI/SNRI antidepressants (e.g. Sertraline, Seroxat)
X Methoxetamine
X Tramadol
X 5-HTP

SSRI/SNRI antidepressants (e.g. Sertraline, Seroxat):

X aMT (alpha-Methyltryptamine)
X 2C-T-7
X Ayahuasca/Pharmahuasca
X Other MAOIs (e.g. Phenelzine, Selegiline)
X DXM (Dextromethorphan)
X Ibogaine
X Tramadol
X 5-HTP

Anticonvulsants (e.g. Lithium, Valproate):

X All classical psychedelics (5HT-2a agonists like LSD, mushrooms, 2C-B)
X All phenethylamines
X Ibogaine

Beta-blockers (e.g. Propranolol, Atenolol):

X All stimulants and empathogens (e.g. Amphetamine, Cocaine, MDMA, Mephedrone)
X aMT (alpha-Methyltryptamine)
X LSD/LSA
X Datura/Belladonna/Brugmansia

Triptans (e.g. Sumatriptan, Rizatriptan, Zolmitriptan):

X aMT
X 2C-T-7
X Ayahuasca/Pharmahuasca
X Other MAOIs (e.g. Phenelzine, Selegiline)
X LSD/LSA

5-HTP:

X aMT (alpha-Methyltryptamine)
X 2C-T-7
X Ayahuasca/Pharmahuasca
X Other MAOIs (e.g. Phenelzine, Selegiline)
X All SSRIs/SNRIs (e.g. Sertraline, Seroxat)
X MDxx (e.g. MDMA, MDA, MDEA)
X Other serotonin releasers (e.g. 6-APB, 5-APB, 5-API, 5-IAI, MDAI)

Alcohol (e.g. Beer, Wine, Vodka):

X Ibogaine
Additionally, tyramine-containing alcoholic beverages such as draught beer and wine should not be combined with any of the following:
X aMT
X Ayahuasca/Pharmahuasca
X 2C-T-7
X Other MAOIs (e.g. Phenelzine, Selegiline)​

Ibogaine:

X Alcohol
X DXM
X All SSRIs/SNRIs (e.g. Sertraline, Seroxat)
X MDxx (e.g. MDMA, MDA, MDEA)
X Other serotonin releasers (e.g. 6-APB, 5-APB, 5-API, 5-IAI, MDAI)
X All other stimulants (e.g. Amphetamine, Cocaine, MDPV)
X All anticonvulsants (e.g. Lithium, Valproate)
X Antibiotics
X Grapefruit Juice
X Quinine (Tonic water)

Serotonin releasers (e.g. MDMA, MDA, MDEA, 6-APB, 5-APB, MDAI, Mephedrone, Methylone):

X aMT (alpha-Methyltryptamine)
X 2C-T-7
X Ayahuasca/Pharmahuasca
X Other MAOIs (e.g. Phenelzine, Selegiline)
X DXM (Dextromethorphan)
X Ibogaine
X 5-HTP

Stimulants (e.g. Amphetamine, Cocaine, MDPV, Methcathinone):

X Beta-blockers
X Ibogaine


Potentially/Likely Dangerous Combinations


Adrenergic autoreceptor antagonist antidepressants (mirtazapine, yohimbine)

X Dissociatives (DXM, ketamine)
X Ibogaine

Serotonin releasers (e.g. MDMA, MDA, MDEA, 6-APB, 5-APB, MDAI, Mephedrone, Methylone):

X 5-MeO-MiPT and 5-MeO-DiPT
X Methoxetamine

Stimulants (e.g. Amphetamine, Cocaine, MDPV, Methcathinone):

X All of the NBOMe series (e.g. 25C-NBOMe, 25I-NBOMe)
X 5-MeO-MiPT and 5-MeO-DiPT
X Bromo-DragonFLY
X aMT (alpha-Methyltryptamine)
X 2C-T-7
X Ayahuasca/Pharmahuasca
X Other MAOIs (e.g. Phenelzine, Selegiline)

Alcohol (e.g. Beer, Wine, Vodka):

X Dissociatives (e.g. Ketamine, DXM, PCP, Methoxetamine)
X 5-HTP



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Xorkoth

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We've just created this new thread in the hopes of having a place people can easily find and come to to get a general understanding on how to use psychedelics safely, and how to safely navigate the psychedelic experience. Thanks to TheBlackPirate for initiating this idea and producing the content above. I intend for this to be a community project, so if you have any ideas on how to convey that message and make this better, or any other feedback, please don't hesitate to share. :)

By the way, what sparked this idea is the sheer number of threads we always get from people who are having traumatic trips with lasting negative consequences. I believe that, except in the case of underlying mental illness, these traumatic experiences could have been framed as difficult but still rewarding experiences, if only there was more of an awareness of how to work through difficult experiences. So we want to try to do whatever we can to help people be prepared to undertake such a journey, in hopes they'll be able to face a difficult experience in a healthy way.

For starters, my first idea is that it would be a good idea to have a section with a checklist of the factors to consider when choosing to trip, and common reasons NOT to trip that keep coming up (ie, should I trip with my parents home? - No)

What do you guys think?
 
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Cream Gravy?

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^I dig your idea. Most every time I see someone spiral into a bad loop, it's because they have homework due later, or their parents are coming to see them soon, or they're girlfriend doesn't want them tripping, etc. If these factors were mitigated, I'm sure those people would be able to have a more positive experience.
 

TheBlackPirate

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Thanks Xorkoth, I feel really confident about the wonderful direction this is going. Our future has plenty of positive potential. I am glad this happened. This is wonderful progress.

Good vibes!
 

PotatoMan

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i'd like to know a little more about the ketamine and alcohol combo. i've found the mix to be quite unpleasant that promotes forced breathing, hard breathing and obvious nausea.

it's really shitty but i've found sipping on one beer and one hour spaced bumps to be semi enjoyable w 0 bad side effects.

i'm wondering about the effect it'll have on the respiratory system..
 

sxh

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Do you guys think that If smoked heroin one day before an ayahusca ceremony I'll have an hypertensive crisis?

 

Xorkoth

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No, but you need to make sure the heroin is totally clear from your system, if you're still even a little high from it, you should wait. If it's not too late, it would be much better though if you didn't smoke heroin the day before.
 

sxh

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No, but you need to make sure the heroin is totally clear from your system, if you're still even a little high from it, you should wait. If it's not too late, it would be much better though if you didn't smoke heroin the day before.
I'll have to do an heroic effort to not doing it >_<
¿do you know a fast way to clear my system from the heroin?
 

Xorkoth

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Ah that's the million dollar question isn't it? No, only time will do that. It helps to exercise, it helps a lot, though it's hard to make yourself do.

How long does it take you to go into withdrawal? You won't want to be in withdrawal when you take the ayahuasca. Worst case scenario, do the aya when you're not high anymore, but before you go into withdrawal. Best case scenario, get off heroin and past withdrawal and then do aya.
 

_sand_<3

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Not sure if i got this right.
So LSD + MDMA not a good combo? i was lucky than.
and ive been taking 5htp...whats the safest time till LSD?
was planning to trip soon.
Thank you




*everything is the same, everything different...but the same.
 

LowneWolf

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apparently I was born a ramblin man

I was wanting to try DMT and came upon this post
"-Horrible-devastating-DMT-trip"

and this sticky while doing research on how to best prepare (finding you can't totally prepare though). IMO the op of that post didn't have what I thought a bad trip would be...I have other thoughts on their issue but that's for another post and I have to admit I'm a little hesitant to really state my opinion since I haven't actually used dmt myself so my "opinion" is really a little ignorant.

I've od'd on jwh18 and had intense hallucinations , had great cannabis hits, lost my mind while using am-2201 (as well as nearly dying from short term kidney failure using it, all healed now), but the experiences and theories happened upon listed in that "devastating" post I already came upon myself through just talking to myself and pondering existence while totally sober in a mindset unlike daily living that was brought about by deep, intense, and honestly, very disturbing introspection.

I've also been able to somewhat induce an almost hallucination state similar to what the deadly am2201 would sometimes induce by watching a very specific type of fractal "visualization" on winamp...a sort of moving in while shapes move out yet the entire things makes a greater picture but this greater picture is also ever changing...it seemed to relate to an understanding of the universe, then existence, then reality....and as if you would begin to see this and understand this by grasping the big picture but just when you were about to it was already flowing into another form...so I never grasped a single form but saw patterns in the greater forms formed by the smaller forms formed by the flowing in and out of lesser forms...but this allowed me to begin to understand the nature of the various forms...like hearing a foreign language and beginning to understand some of the emotions speakers express by beginning to understand a few phrases...I couldn't totally gasp it all but could "see where it was going". A very strange and enjoyable experience...and I'm rambling.

The theory presented in that first post linked; that I am all that exists (but can't control the environment), that we are god living every life in existence, that we are young gods living in such a way to mature, etc, etc. While i don't honestly believe these I do find them curious mind games, but again I happened upon these all and others through my intense out loud conversations with myself...they say you aren't crazy if you talk to yourself only if you answer...well that seals the deal, I get into full blown arguments with myself working out things from every single counter argument I can imagine might exist all to seek my own personal truth that I can "back up". In reality I believe we are animals that are too intelligent for our own good...we live, we die, then there is nothing. Of course the concept of nonexistence is so foreign we cannot accept it, and it does scare me...but I try not to allow that fear to overtake me.

I say all this not to encourage discussion but to give insight into my mindset, which as I understand it, is part of set and setting which occurs not just externally but internally as well.

I'm more curious now as to what dmt will show me having reached these theories on my own while sober but I'd be lying if I said I wasn't a little more concerned as well...especially since I will have to resort to using this alone...which deals with the external setting. No time soon, mind you, and I'm trying to prepare myself as best I can, but from what I've read thus far there no way to. I considered using psilocybin in increasing doses to prepare myself but I'm finding that won't actually help. I've never had more than a few induced hallucinations so I was thinking using mushrooms would help me in the same way working out ones legs could help one understand how to work out their arms...not the same motions or exercises but the concept of "losing reality" might be less drastic if i'm somewhat familiar with one form of it? When I do try it I will undoubtedly be alone for two reasons. 1. I literally have no one in my social network that would approve of this. Secondly, I always have been alone, even despite my best efforts not to be. I suppose I find I am at peace alone and that I am depressed when I am around others or in society. Of course I'm not totally alone, got my two dogs that I enjoy being around :)

Again, insights into my mindset.

For the past decade I've been on a journey of deep introspection and attempts at understanding existence, my first experience was a total annihilation of everything I once believed and was utterly destroyed, I'm only just now really "recovered" from that. Over the past year I've evolved this into simply learning to accept and find joy in what is my reality...usually that was with "highs" but they haven't been available in over a year for a variety of reasons so it's turned from getting a buzz to being at peace with existence. I'm still a ways off from actually trying dmt or shrooms, I have more research to do first. I've read about set and setting but I don't really see how I could ever possible prepare both aside from having my house clean and tidy and having relaxing lighting. I found that even calming music can turn on me so might not go with it at first...I had some pretty intense episodes with "synthetics". So I worry that I could never really fully prepare s/s. While I wouldn't neglect it I wonder if aside from having the environment as calm as possible there is anything more I can do, and as this profound investigation of self and reality is constantly on my mind I'm not sure how to prepare the setting of my mind or if I can :\
 
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Xorkoth

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I was wanting to try DMT and came upon this post
"-Horrible-devastating-DMT-trip"

and this sticky while doing research on how to best prepare (finding you can't totally prepare though). IMO the op of that post didn't have what I thought a bad trip would be...I have other thoughts on their issue but that's for another post and I have to admit I'm a little hesitant to really state my opinion since I haven't actually used dmt myself so my "opinion" is really a little ignorant.

I fully agree, I had that sort of breakthrough experience and although it was frightening at first, it left me filled with joy and understanding. I think the biggest thing to take from that thread is that how you will be affected by an experience (of any kind, not just a psychedelic experience) is largely dependent on how you decide to frame the experience. Some people have real difficulty losing control, and if you're one of those people, psychedelics are going to be very challenging, because you WILL lose control. Some people experience terror on psychedelics (I certainly have for periods of time), and then allow themselves to get all traumatized by that, rather than letting it happen and pass through you, and then move on. It's very useful to always remember that it is a drug, it will pass... many psychedelic experiences, especially when you haven't had much experience, will likely contain periods of difficulty, but if you can keep your composure and remain as objective as possible, they will pass. Changing your scenery can help a lot, as can music. Scenery change isn't much good for something so fast and powerful like DMT, but music on for it can be great.
 

Joedoesthablow

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Hi I'm new to blue light I take acid a lot but I'm trying shrooms this weekend and I took 400mug of acid two days ago would the acid effect or make my trip bad?
 

Xorkoth

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You shouldn't take mushrooms until you've waited at least a week, or ideally at least 2 weeks, since the last psychedelic you took. It won't make the trip bad, it will just make it a lot weaker, you won't be able to get as full of a trip because of tolerance (all psychedelics are cross-tolerant). Also doing this too often will cause you to lose the magic.

But no, there are no negative interactions. My recommendation is to not take psychedelics too often. Take it from someone who used to take psychedelics 3-5 times a week at my heaviest period of use. Eventually I lost the ability to trip, and it took 3 years before I could start to trip again (of no psychedelics at all), and then 3 or so more years of using them around twice a month to finally feel like I could fully trip again like I used to.
 

Shamandrums

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Awesome thread, muchas gracias!....Zendo's resources are excellent online & a beautiful concept. PS17 they produced a great workshop... My 2nd acid trip, I'd an experienced sitter, by chance & when I started to melt into the floor, his ability to use simple words & vibes to change my focus, made it one of the most valuable experiences.

Surrender & respect towards the psychedelic experience makes a huge difference, along with the 2-3-or 4 S's.
 

Shamandrums

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I'll have to do an heroic effort to not doing it >_<
¿do you know a fast way to clear my system from the heroin?

Gabor Mate', uses Iboga & or Ibogaine to clear addiction, as it has a buffer affect that lasts days to weeks even months, then he uses Ayahuasca as a 2nd round of healing. Iboga is quite an experience & takes a couple days at least, to complete. This was dicussed at Psychedelic Science 17. Go to the MAPS site for more info, bro.
 
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