AbstractThis commentary addresses the potential for a nocebo effect arising from the public discourse on psychedelics, especially considering the increasing interest and engagement with these substances. The resurgence of psychedelics in the public and scientific arenas has led to a proliferation of discussions, both positive and cautionary, about their use. However, an imbalance in this discourse, particularly a focus on potential harms without adequate contextualisation, might inadvertently create a nocebo effect. This effect could manifest in naturalistic settings, influencing individuals' experiences with psychedelics, possibly leading to adverse outcomes. The paper discusses the importance of a balanced narrative that equally acknowledges the benefits and risks associated with psychedelic use. It advocates for comprehensive and transparent information dissemination to enable informed decision-making by users.

AbstractBackground and aimsScientific interest in the therapeutic potential of psychedelics has been experiencing significant growth. Understanding the perceptions of psychedelic assisted psychotherapy (PAP) among health professional, patients, and the public is essential to guide future research objectives, trial protocols, and identify any barriers to future implementation.MethodsA comprehensive search of the databases (Medline, EMBASE, PSYCHinfo, SCOPUS, and Web of Science) was conducted on the 29th of November, 2022. This review included cross-sectional, longitudinal, and quasi-experimental studies published in peer-reviewed journals exploring perceptions of PAP among the three stakeholder groups. Studies were limited to English-language and the years 2012–2022. The protocol and review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines.ResultsThe sample consisted of 29 studies, including n = 17 health professional, n = 6 patients, and n = 6 public. Broadly, knowledge of PAP was low among all three stakeholder groups. There was mixed to positive belief in the therapeutic potential of psychedelics, with male gender, younger age, and personal psychedelic experience/knowledge being key predictors of more favourable views. The majority of findings reported strong endorsement of further research. Consistent themes were identified surrounding concerns about legal status, funding, access, side-effects, and implementation.ConclusionThe evaluated research indicates a need for further research that will provide clarity about safety and elucidate how PAP may be implemented in public health settings. Further education of health professionals and the public should be a priority.

AbstractThe present research study investigated the phenomenon of recreational use of psychedelics at music festivals, analysing whether the resulting experiences could possibly be recognized as valuable in terms of preventive mental health strategies. Quantitative (online survey) and qualitative (interviews) research methods have been combined to illuminate 3 main topics: motivation for the setting choice; the nature of the resulting experiences & their influence on people's lives; learnings from psychedelic experiences at music festivals (PEMF).Among other findings, motivation evolved around fun, enhancing the sensory exploration of the world, and deepening the connection to its diverse parts through engagement with art, nature and other beings. Factors, distinguishing music festivals from other settings, were significant for the setting choice (non-controllability of the environment, community & connection aspect, diversity & richness of the surroundings, pharmacological specifics). Remarkably, the non-controllability of the environment, otherwise avoided in the psychedelic research, contributed to the life-changing effects of PEMF. Exploration of their nature showed that, mostly rooted in poly-drug use, the enjoyable were clearly dominating over the challenging ones. The mystical PEMF appeared to be surprisingly common. Participants shared the related life-changing effects, centred around changed perception (increased empathy, awareness, acceptance; new perspectives, etc.) and changed behaviours (increased mindfulness in all life areas; making different life choices; changed approach to relationships, etc.). Except for post MDMA recovery, a positive impact of PEMF on mental health and the emotional state of the participants was reported, referring to increased levels of happiness, compassion, awe, trust and to emotional balance. This study showed the potential value of PEMF in terms of preventive mental health strategies in various forms. Acknowledging these findings as well as the existence of potential risks for triggering psychiatric conditions, de-stigmatization of recreational use could help introduce meaningful changes, including substance testing availability, prioritization of education as well as mandatory welfare and harm reduction services on-site.

AbstractIn 2021, the final series of phase 3 clinical trials looking at MDMA-AT for treatment-resistant post-traumatic stress disorder (PTSD) found that 71.2% of 3,4-methylenedioxymethamphetamine (MDMA) full-dose participants no longer met criteria for PTSD. MDMA-assisted therapy is not US Food and Drug Administration (FDA) approved in treating borderline personality disorder (BPD), and while PTSD is quite different from BPD, it is possible that some of the beneficial effects of MDMA-assisted therapy may be applicable in treating BPD. Interviewing two clinicians utilizing dialectical behavioral therapy treatment and two MDMA-assisted therapy clinicians was one way to examine the phenomenology of MDMA-assisted therapy with BPD individuals in a thoughtful manner. An exploratory, qualitative, interview-based study assessed clinicians' perspectives of MDMA-assisted therapy and BPD and increased our understanding of underlying therapeutic mechanisms and processes and the role of pharmacological factors in these treatment modalities, optimizing treatment context, and leading to improved clinical responses and patient recovery. The codes generated unique perspectives of the participants revealing a chronological narrative which included three phases of treatment.

AbstractBackground and aimsEmerging research indicates that psychedelics may have therapeutic potential by fostering meaningful experiences that act as “inflection points” in people's narratives of personal development. However, psychedelic research has largely failed to address pertinent developmental considerations. We investigated whether attachment-related variables were associated with psychedelic experiences and whether psychedelic experiences moderated expected links between perceived attachment history and current adult attachment orientations.MethodsWe administered an online survey to an international Jewish sample (N = 185) with psychedelic experience. The survey included measures about recollection of attachment interactions with parents (perceived attachment history), adult attachment orientations (anxiety, avoidance), and psychedelic phenomenology (mystical experiences, challenging experiences, emotional breakthrough, ego dissolution, sensed presence) associated with respondents' most memorable psychedelic experiences.ResultsPerceptions of an insecure attachment history were positively linked to all measures of psychedelic phenomenology (r's = 0.19–32, p's mostly < 0.01). In contrast, adult attachment orientations were unrelated to psychedelic phenomenology. Also, psychedelic phenomenology mostly did not moderate the links observed between perceptions of an insecure attachment history and adult attachment orientations.ConclusionsOur findings suggest that perceptions of early attachment experiences may be relevant to psychedelic phenomenology. However, subjective experiences associated with naturalistic psychedelic use do not typically attenuate links between a perceived insecure attachment history and attachment insecurity at present.