If Your Psychedelic Experience Isn’t Going According to Plan, Call a Psychedelic Helpline

The psychedelics industry has catapulted in the last five years – there’s no denying that. While people worldwide were struggling to deal with the mental health repercussions brought about by lockdowns and job loss, public psychedelic companies like Compass Pathways and MindMed were some of the first industry players who shocked the world by renewing interest towards psychedelics as potential tools for treating affective disorders. Three years later, that number has catapulted to over 50 psychedelic public companies using LSD, MDMA and magic mushrooms to treat a variety of mental health diseases; some of which have already reached Phase 3 clinical trials, the final step needed for a drug to reach FDA approval. But publicly traded companies aren’t the only companies whose press releases have inundated online media. The Multidisciplinary Association of Psychedelic Studies (MAPS) who is expected to announce positive results from its second Phase 3 MDMA for PTSD clinical trial this year could very well lead to the FDA approval of MDMA-assisted therapy by the end of 2023.

Of course, the resurgence of public interest in these substances and the positive coverage of psychedelic research by the media has contributed to the destigmatization of natural and synthetic drugs. As psychedelic research continues to ramp up, so does psychedelic use among adults in the United States. According to a 2022 NIH-funded survey, the use of psychedelics is at a historical high.

Although the use of psychedelics had lingered around the same numbers in recent decades, hallucinogen use increased in 2021 when 8.1% of  U.S. adults aged 19 to 30 years reported past-year psychedelics use compared to 5.1% in 2019 and 3.4% in 2011. Adults between the age of 35 and 50 were also not left behind, reporting a 2.5% increase in psychedelic use in 2021.

It is to be expected that nonclinical psychedelic use is increasing. Although there are over 116 psychedelic clinical trials in 2023, not all applicants – and there is a plethora of them – fit the criteria, leaving those struggling with debilitating illnesses no choice but to self-medicate. Of course, some of the psychedelic users are experienced psychonauts who are well educated and simply want to use these drugs for spiritual purposes. However, there is a large proportion of desperate and inexperienced folk who will not necessarily face risks associated with toxicity or overdose of the substance but rather face adverse effects like panic attacks, emotional distress, and inability to control the effects of the psychedelic journey. In other words, unprepared psychedelic users who may want to try these substances alone, without support or outside of a clinical setting may feel unsettled by the feelings of ego death and vulnerability that often accompany altered states of consciousness caused by psychedelics. Without proper support, preparation, and setting, one can easily experience some psychologically perturbing secondary effects.

To address the question of how to reduce the risks for those who may experience challenges during and after a psychedelic trip, a team of researchers conducted a pilot study using data collected through the Fireside Project psychedelic helpline, a peer-support helpline staffed by rigorously trained volunteers providing emotional support during and post-trip.

According to the study findings which were published in the National Library of Medicine, of the callers who sought psychedelic support:

• 65.9% reported that the psychedelic helpline aided them in de-escalating psychological distress.
•  29.3% indicated they may have been harmed if they hadn’t spoken to a person from the helpline.
• 12.5% reported  that they may have dialed 911.
• 10.8% said they may have visited the emergency room.

Study Methods

The researchers used data collected between April 2021 and September 2022 from anonymous post-call surveys texted to callers a day after their communication with a Fireside volunteer. Data was also collected from 4047 call logs filled out by the peer-support specialists post-conversation. The log calls display the questions and answer choices. Not all questions have responses as the peer-support crew was tasked to ask questions that pertain to the callers’ needs only as well as to build rapport. From the 4047 call logs, 848 (20.9%) responses were received.

Psychedelic Helpline Survey Results

Out of the 848 respondents, 12.5% of callers reported that they may have dialed 9-1-1 if they hadn’t communicated with a peer-support specialist, approximately 11% said that they may have sought emergency help, and 29.3% believed that they “may have been physically or emotionally harmed.” 

According to the data collected, the conversations with a peer-support specialist had a notable impact on the callers with 65.9% of the individuals indicating that the call de-escalated their emotional, mental, or physical distress.

Reducing risks during psychedelic integration

Of the 259 survey respondents who spoke to a Fireside volunteer to talk through past psychedelic experiences, 66.4% reported that their conversation de-escalated them from psychological distress. Moreover, 23.2% indicated that they may have been “physically or emotionally harmed” if they hadn’t spoken to a peer-support specialist, 6.1% said they may have dialed 9-1-1, and 14 callers 5.4% reported that they would have sought emergency help. This data indicates that psychedelic integration support may in fact be essential to prevent potential harm. 

Emotional content of callers’ psychedelic experiences 

The 3386 callers who contacted the psychedelic helpline reported a range of difficult emotions. Out of the sample, 33.7% indicated feeling anxiety, 24.8% reported that they were feeling overwhelmed, 22% felt fear and 13.8% reported feeling confused during their current or past psychedelic experience. 

Social Context of the psychedelic experience

The researchers also looked into 1,630 call logs that provided information about the social context in which the callers had taken psychedelics. According to the caller responses, 39.9% indicated that they had taken the substance alone. Of those who had done so, 77% were at home and only 4.3% had a psychedelic experience in nature.

Consuming psychedelics to self-medicate

According to the collected responses, it appears that a proportion of nonclinical psychedelic users consume these substances to treat certain psychiatric disorders. Of the 3386 Fireside callers who discussed their current or previous psychedelic experiences, 27.4% reported having an underlying psychiatric condition, including post-traumatic stress disorder (PTSD), major depressive disorder, generalized anxiety, substance use disorder, ADHD/ADD, and more.

Study Limitations

The study did however have some limitations that we must consider for future research. First, the callers were individuals who self-selected as people who need psychedelic support, which means that we cannot generalize the results to the rest of the psychedelic users who take psychedelics in a non clinical setting. Moreover, only 20.9% of callers responded to the survey – we cannot project the results onto the rest of the individuals who called the helpline. Furthermore, the logs regarding a psychiatric condition were completed by Fireside specialists and not by clinicians. This limits the reliability of the question related to mental health conditions. Moreover, since the Fireside volunteers were instructed to build rapport with the users and address their needs, the information collected should not be generalized to other callers or to psychedelic users who have taken a psychedelic outside a clinical setting.  Finally, since the psychedelic helpline’s call log and survey systems run on different software platforms, the researchers could not connect survey responses to the call logs, which prevents from fully understanding the experiences that the callers’ were going through.

Final Thoughts

Some people who take psychedelics in nonclinical settings may not consider the need to take safety precautions prior their journey. One cannot assume that everyone will take the time to research all possible events that could occur during a psychedelic experience, how to prevent a “bad trip”, how to navigate the experience, or how to prepare for a psychedelic journey. A psychedelic helpline may be a useful tool in reduce harm and risks associated with psychedelic use outside a clinical setting. For those unable to navigate the altered states of consciousness and the emotions that psychedelics can bring to the surface, the peer-support specialists of the Fireside Project can be a valuable asset.