Psychedelic use is on the rise. Recent data points to a substantial increase in both curiosity about and experience with substances that alter the mind and expand consciousness; reported usage of LSD within the last 12 months grew a whopping 54% between 2015 and 2018 alone. (1)
As we ride the psychedelic wave, it’s more crucial than ever to have a comprehensive understanding of psychedelic harm reduction and integration (PHRI)—what it is, its utility for both users and clinicians, and how best practices can help you have a safer, more holistic, and more rewarding experience.
Clinically speaking, PHRI is a patient-focused care model; a psychotherapeutic intervention system which includes various principles like: (2)
In plain English, PHRI is the framework used by professionals to ensure a patient has the tools they need to navigate their use of mind-altering drugs safely and effectively. One important caveat, though, PHRI does not typically involve the direct administration of psychedelics. It’s a system of best practices for what to do before, during, and after.
Psychedelic use has been under the scientific microscope for decades. As more research emerges, clinicians are catching up to what spiritual leaders and alternative medicine practitioners have known for generations—restriction and shaming do not deter people from wanting to use drugs, nor improve the experience. (3)
The principle of harm reduction is not exclusive to psychedelics, but it is particularly important as a guiding framework for psychedelic use. Why? Unlike many other drugs, the effects of psychedelics can last long after the physical sensations subside. PHRI mandates that users be given the tools they need to navigate the extended on- and off-ramps safely and effectively.
PHRI is all about how to take psychedelics safely. Most of the bases in terms of scientific research in this area have been covered, but it pays to take a closer look at some specific factors and how different parts of the world regard psychedelic use.
Set, setting, and support broadly describe the circumstances you create before embarking on a psychedelic journey. (4)(5) More specifically,
Research tells us that these factors vary depending on the type of psychedelic you’re taking and your purpose for doing so, but they’re consistently correlated with having a worthwhile experience. Neglecting them may dampen your outcome.
While PHRI is a powerful psychedelic safety guide, it’s not the only framework constructed around engagement with psychedelic substances.
Since things like mushrooms, LSD, or ketamine are still legally restricted in some form in most parts of the world, let’s take a quick look at some examples of what other regions are doing with these drugs:
On the policy front, psychedelic use expansion tends to come through platforms that emphasize religious expression and medical treatment. Unburdened leisure use is a tough nut to crack in many countries, but overall sentiment is slowly shifting in favor of psychedelic availability.
Before taking a common medication like a pain reliever, you read the label on the bottle. The same idea holds for psychedelics (even if they don’t come with a tidy list of advisories); under the guidance of a qualified facilitator, you need to prepare both your mind and body for the journey that lies ahead.
Luckily, contemporary research on psychedelic use can help us better understand what matters before we embark: (4)
It is absolutely essential to ensure, to the best of your ability, that any psychedelic substance you’re thinking of taking is both legitimate and dosed appropriately. To do so, you should take steps to learn where the drug is sourced from, and, particularly, vet the provider to the best of your ability.
Without proper precautionary measures like screening, you’re liable to experience more of the dangerous side effects of psychedelics, ranging from neurotoxicity to overdoses, which can require emergency medical treatment. (6)
Moreover, if you’re partaking in psychedelic use through a qualified provider like Beckley Retreats, you’ll undergo additional safety protocols—an evaluation of your medical history, medications you’ve taken or are taking, and more, to ensure nothing gets tangled, so to speak, during or after your journey.
Psychedelic trips distort your perception of reality. Whether that experience is more positive than negative (or the other way around) varies by a number of factors, including your physical environment and the people you surround yourself with.
“Set” refers to your mindset; the mental and emotional landscape you’ll traverse on your journey. Beckley Retreats facilitators help adjust your mindset prior to embarking through guided workshops and 1-on-1 coaching.
When it comes to setting, comfort is priority number one. Taking psychedelics in a familiar location like your home or at a guided retreat, with familiar people or qualified experts, can go a long way.
It’s also worth taking the time to address logistics. These can include arranging travel to and from the session if necessary, or, if you’re at home, ensuring you have food, water, and solitude readily available.
“Psychedelics” is an umbrella term for a variety of substances, each with their own unique chemical structure and effects. To get the most out of your experience, you need to have at least a cursory understanding of how psychedelic effects vary between drugs and by dosage.
If you’re new to using psychedelics, it’s in your best interest to begin your journey under the care and supervision of trusted professionals—whether that’s in a clinical or medical setting, or as part of a guided spiritual retreat.
In either case, you need to trust the environment you’re in and the people you’re with. To that end, you should:
With the groundwork laid and precautions taken, it’s time to begin your psychedelic journey. Once you’ve left the proverbial harbor, you need to know how to navigate unpredictability and stay on course.
Psychedelic trips can both nourish and challenge your mind. If you find yourself veering into an unpleasant emotional experience, grounding techniques—methods designed to help you maintain your perspective and remain calm—are invaluable in helping you manage your emotions. Some common ones include:
Psychedelics can be a calming emotional breeze or a howling tornado. Staying in the driver’s seat emotionally is crucial to ensure you get the most out of your journey from start to finish.
Supervision during psychedelic use is paramount, especially if you’re a beginner. Think of sitters or facilitators as shepherds. A sitter observes your trip and helps you avoid physical danger or panicking, while a facilitator takes a more active role in guiding your spiritual journey.
No matter how well you prepare or how ready you feel going in, psychedelic experiences carry a risk. That said, there’s a difference between veering into unpleasant emotions worth unpacking, and going through a true crisis.
It’s important to recognize the latter—as early as possible. Physical symptoms can manifest as excessive sweating, jitters, or restlessness. Mentally, you might feel trapped, in immediate danger, or like you have no control over the direction or intensity of your thoughts.
Psychedelic trips aren’t discrete experiences. Integration refers to merging your revelations and the meaning you gleaned from them into your daily life. Get it right, and you’ll have a fuller, more balanced, and more holistic perspective.
After you come down and return home to yourself, you need time to reflect on your journey. If you’re not in a supervised setting, peace and solitude are key to helping you parse through what you’ve learned. This is the time to talk to yourself, silently or aloud even, about what you learned and how it makes you feel.
Leaving these stones unturned can rob you of some of the richness provided by a psychedelic experience. It’s not homework—it’s cashing the emotional check you’ve earned.
To that end, guided therapy and a peer group can go a long way. Psychedelic stewards have personal experience with trips and the appropriate professional background to ensure you cross the finish line safely.
Beckley Retreats’ integration program focuses on just that. After your trip, our providers help you tie all your loose threads together via guided practices, group reflection, and a daily toolkit you can access right on your phone through our app.
This is also an area where mental health providers shine. A good psychotherapist can enhance integration by asking the right questions, helping you arrive at the conclusions that matter.
Afterward, you’ll need to do a bit of emotional (and in some cases, physical) cleanup. Depending on the psychedelic you used, you may need to feed or hydrate yourself after an hours-long journey. Emotionally, soothing assurances that you’ve arrived home, from a familiar or trusted sitter, can go a long way.
We’ve got a handle on what to do before, during, and after a psychedelic experience to maximize harm reduction. Let’s dive specifically into risk management.
Psychedelics are not meant to be mixed. These substances are, on their own, powerful cognitive catalysts. Although certain psychedelics act in similar ways—psilocybin and DMT both affect serotonin receptors—they are not necessarily synergistic.
For example, data from 2022 on serotonergic psychedelics concluded “some combinations may present a significant risk for serotonin toxicity, while others are likely benign.” (7)
You don’t need to double down, and doing so absolutely does not mean you’ll have twice as much fun or double the realizations. Take one substance at a time, and wait several weeks before indulging in something different.
Some studies have argued that the majority of people experience bad trips, no matter their psychedelic of choice. (8) Here’s the good news: There are ways to transmute a negative journey into something valuable.
Specifically, reframing the narrative of your trip can be a powerful tool. After all, you have the power to determine the emotional context of your experience; a so-called “bad trip” can be framed as a learning experience, or a lesson in touching parts of your emotional spectrum you want awareness of, but not necessarily interaction with.
Psychedelic retreats can elevate the meaning of the experience and the worth it provides to you. By turning yourself over to the guidance of spiritual experts, you can access deeper parts of your consciousness and come out the other side with more valuable insights.
That said, consider these factors when assessing a potential psychedelic retreat:
Psychedelic harm reduction (and integration, sometimes) describes a set of practices for managing potential negative effects associated with consuming psychedelic substances like psilocybin or MDMA.
How can I prepare for a psychedelic experience safely?In short, preparing for safe psychedelic use starts weeks prior to the actual trip. Abstaining from stimulants (like caffeine) and alcohol, getting adequate rest, preparing a low-stress environment, and recruiting a qualified supervisor or sitter are all smart steps to take.
What should I do if I’m having a difficult trip?You can rely on several grounding techniques if you’re experiencing a difficult psychedelic trip. Sensory familiarity goes a long way, as can deep breathing exercises, sipping small amounts of water, or practicing mindfulness and affirmation.
Is it safe to mix psychedelics with alcohol or antidepressants?No. Alcohol and antidepressants should not be mixed with psychedelics, as they are also mind-altering substances. Ingesting them alongside psychedelics may dampen the effects or, worse, amplify them unpleasantly.
How can I integrate a psychedelic experience in a healthy way?Integration after psychedelic use is all about translating the abstract emotional experiences you had during your trip into actionable, long-term change. Strategies like talk therapy, deep introspection, meditation, or journaling go a long way.