A bad trip (also known as challenging experiences, acute intoxication from hallucinogens, psychedelic crisis, or emergence phenomenon) is an acute adverse psychological reaction to classic hallucinogens. With proper screening, preparation, and support in a regulated setting these are usually benign. A bad trip on psilocybin, for instance, often features intense anxiety, confusion, and agitation, or even psychotic episodes. As of 2011, exact data on the frequency of bad trips are not available. Bad trips can be exacerbated by the inexperience or irresponsibility of the user or the lack of proper preparation and environment for the trip, and are often reflective of unresolved psychological tensions triggered during the course of the experience.

Stanislav Grof Stanislav "Stan" Grof is a Czech-born psychiatrist who has been living in the United States since the 1960s. Grof is one of the principal developers of transpersonal psychology and research into the use of non-ordinary states of consciousness ...

, ''LSD Psychotherapy'' In clinical research settings, precautions including the screening and preparation of participants, the training of the session monitors who will be present during the experience, and the selection of appropriate physical setting can minimize the likelihood of psychological distress. Researchers have suggested that the presence of professional "

trip sitter A trip sitter—sometimes known as a sober sitter, spotter, or co-pilot—is a term used by recreational or spiritual drug users to describe a person who remains sober to ensure the safety of the drug user while they are under the influence of a ...

s" (i.e., session monitors) may significantly reduce the negative experiences associated with a bad trip. In most cases in which anxiety arises during a supervised psychedelic experience, reassurance from the session monitor is adequate to resolve it; however, if distress becomes intense it can be treated pharmacologically, for example with the

benzodiazepine Benzodiazepines (BZD, BDZ, BZs), sometimes called "benzos", are a class of depressant drugs whose core chemical structure is the fusion of a benzene ring and a diazepine ring. They are prescribed to treat conditions such as anxiety disorders, ...

diazepam. The psychiatrist

wrote that unpleasant psychedelic experiences are not necessarily unhealthy or undesirable, arguing that they may have the potential for psychological healing and lead to breakthrough and resolution of unresolved psychic issues. Drawing on narrative theory, the authors of a 2021 study of 50 users of psychedelics found that many described bad trips as having been sources of insight or even turning points in life.

Intervention

Medical treatment consists of supportive therapy and minimization of external stimuli. In some cases,

sedation Sedation is the reduction of irritability or agitation by administration of sedative drugs, generally to facilitate a medical procedure or diagnostic procedure. Examples of drugs which can be used for sedation include isoflurane, diethyl ether, ...

is used when necessary to control self-destructive behavior, or when hyperthermia occurs. Diazepam is the most frequently used sedative for such treatment, but other

benzodiazepines Benzodiazepines (BZD, BDZ, BZs), sometimes called "benzos", are a class of depressant drugs whose core chemical structure is the fusion of a benzene ring and a diazepine ring. They are prescribed to treat conditions such as anxiety disorders, i ...

such as lorazepam are also effective. Such sedatives will only decrease fear and anxiety, but will not subdue hallucinations. In severe cases, antipsychotics such as haloperidol can reduce or stop hallucinations. Haloperidol is effective against acute intoxication caused by LSD and other tryptamines,

amphetamine Amphetamine (contracted from alpha- methylphenethylamine) is a strong central nervous system (CNS) stimulant that is used in the treatment of attention deficit hyperactivity disorder (ADHD), narcolepsy, and obesity. It is also commonly used ...

s, ketamine, and phencyclidine.

Effects

Bad trips may cause hallucinogen persisting perception disorder (HPPD).

Perspectives

Stanislav Grof

Psychiatrist

once said in an interview: In a 1975 book, Grof suggested that painful and difficult experiences during a trip could be a result of the mind reliving experiences associated with birth, and that experiences of imprisonment, eschatological terror, or suffering far beyond anything imaginable in a normal state, if seen through to conclusion, often resolve into emotional, intellectual and spiritual breakthroughs. From this perspective, Grof suggests that interrupting a bad trip, while initially seen as beneficial, could potentially trap the tripper in unresolved psychological states. Grof also suggests that many cathartic experiences within psychedelic states, while not necessarily crises, may be the effects of consciousness entering a perinatal space.

Rick Strassman

Professor of psychiatry

Rick Strassman Rick Strassman is an American clinical associate professor of psychiatry at the University of New Mexico School of Medicine. He has held a fellowship in clinical psychopharmacology research at the University of California San Diego and was Profess ...

refers to bad trips as ''challenging experiences''.

References

External links

Crisis Intervention in Situations Related to Unsupervised Use of Psychedelics

Psychedelic Crisis FAQ: Helping someone through a bad trip, psychic crisis, or spiritual crisis

Psychedelic Harm Reduction

Psychedelic Harm Reduction and Policy
lecture in the Psychedelic Science in the 21st Century conference in 2010.
Psychedelics in the Psychiatric ER - Julie Holland, M.D.
lecture in the Psychedelic Science in the 21st Century conference in 2010.
The Psychedelic crisis (bad trip) entry at Drugs-Wiki
{{DEFAULTSORT:Bad Trip Drug culture Drug overdose Psychedelia Substance intoxication