Bad Trips Research Articles

Inhaled Dimethyltryptamine (DMT): Use Patterns and Predictors of Consumption Frequency

ABSTRACT Despite increasing interest in psychedelics and their potential therapeutic effects, research on inhaled N,N-Dimethyltryptamine (DMT) remains limited. Inhaled DMT has a reputation for rapid, dramatic onset and a brief duration, but correlates of use frequency remain poorly understood. A sample recruited from relevant internet sites, including nearly 400 people who had inhaled DMT, reported substance use histories, motivations for use, DMT sources, risk perceptions, and other variables. Generally, participants reported initiation motivated by curiosity about DMT’s effects, interest in psychedelics more broadly, and potential spiritual benefits. Those who had used other psychoactive substances (especially ayahuasca) and who had extracted DMT themselves reported inhaled DMT more frequently. Most (>60%) reported obtaining DMT from a friend and claimed it was “slightly difficult” to procure. Participants most commonly inhaled DMT from a glass pipe, in private homes, frequently alone or in small groups. Salient positives associated with inhaling DMT included psychologically cleansing or cathartic experiences. Associated challenges concerned difficult integration, aversive experiences, or “bad trips.” Participants rated DMT as very or slightly safe. These data underscore the need for continued work on this topic to inform education and harm reduction efforts, particularly as the molecule’s reputation for ameliorative effects receives media coverage.

N-Ethylhexedrone: A very long and bad trip! A case series.

N-ethylhexedrone (NEH) is a new cathinone derivative with, currently, low toxicokinetic and toxicodynamic knowledge. We present three documented clinical cases of NEH intoxication with plasma and urine concentrations. A thorough search for metabolites was performed. The three patients were admitted to the emergency department, and two out of the three were hospitalized for an extended period. While recovering from the drug effects, 12-24 h after nasal intake of New Psychoactive Substance (NPS), the patients described the following disorders: anxiety, feelings of persecution, asthenia, anhedonia, abulia, psychomotor slowing and loss of consciousness. NEH was identified in all samples by liquid chromatography-high resolution mass spectrometry (LC-HRMS), and quantified by liquid chromatography coupled to tandem mass spectrometry (LC-MS-MS). Quantitative analysis showed decreasing concentrations over time: for Case 1, from 97.2 (Day 1, D1) to 0.7 (Day 7, D7) µg/L for plasma, and from 724 (D1) to 0.5 (D7) µg/L for urine. NEH concentration of 7.9 µg/L was found in the plasma collected at admission for Case 2. For Case 3, concentrations ranging from 49 (D1) to 1.8 (D7) µg/L in plasma, and from 327.3 (Day 6, D6) to 116.8 (D7) µg/L in urine were found. NEH was no longer detected in the urine sample at Day 10. Elimination half-life was estimated at 19, and 28 hours in Patients 1 and 3, respectively. Four metabolites were identified in blood and urine: reduced NEH, dealkyl-NEH, reduced dealkyl-NEH and hydroxy-NEH. The cases presented highlight the long detectable lifetime of NEH. Characterization of the metabolites will allow better identification of the consumption of this drug. Serious adverse events can be observed after NEH consumption, as two out of the three patients required intubation and ventilation. A syndrome of inappropriate antidiuretic hormone secretion (SIADH) was also diagnosed. Two out of the three cases are notable because of the number of samples collected and because NEH was the only drug of abuse detected.

ST-segment elevation acute myocardial infarction & stoned: a bad trip.

ST-segment elevation acute myocardial infarction & stoned: a bad trip.

NIDA on dramatic increase of mushroom seizures

From 2017 – 2022, law enforcement seizures across the United States of mushrooms containing psilocybin increased dramatically, according to a new study funded by the National Institute on Drug Abuse (NIDA). The number of law enforcement seizures increased from 402 seizures in 2017 to 1,396 in 2022. In addition, the total weight of psilocybin mushrooms seized by law enforcement increased from 226 kg (498 lbs.) seized in 2017 compared with 844 kg (1,861 lbs.) in 2022. This analysis, published in Drug and Alcohol Dependence, was led by researchers at New York University (NYU) Langone Health in New York City, and the University of Florida, Gainesville. The data used for the analysis were collected through the High Intensity Drug Trafficking Areas (HIDTA) program, a grant program aimed at reducing drug trafficking and misuse administered by the Office of National Drug Control Policy. Though law enforcement seizures do not necessarily reflect prevalence of use, they represent an indicator of the availability of illicit drugs. “We are in the middle of a rapidly evolving cultural, media, and legal landscape when it comes to psychedelics, and we need data to help shape informed and appropriate public health strategies,” said NIDA Director Nora D. Volkow, M.D., in announcing the research publication last week. “Moving forward, we must continue to track data on the availability of psychedelics, patterns in use, and associated health effects to guide efforts in promoting accurate education and reducing potential harms among people who do plan to use psychedelic drugs.” Adverse effects of psilocybin mushrooms, such as “bad trips,” are marked by “distorted thinking, perceptual changes, putting oneself in physical danger, and intense feelings of fear, anxiety, and confusion,” according to NIDA. “People who take psychedelic drugs like psilocybin may also experience short‐term side effects such as raised blood pressure and heart rate, agitation, confusion, vomiting, or nausea, which may be severe and require medical attention.” Joseph J. Palamar, Ph.D., M.P.H., associate professor at the NYU Grossman School of Medicine, co‐investigator on the NIDA‐funded National Drug Early Warning System (NDEWS), and lead author on the paper, said “Research studies suggesting its effectiveness in treating mental health issues and extensive positive media coverage may lead some people to seek ‘shrooms’ outside of medical contexts. People who use psilocybin outside of medical supervision need to be educated about risks associated with use.”

Guiding Through Challenging Psychedelic Experiences and "Bad Trips".

Psychedelic substances have gained recognition for their therapeutic potential, but they also present challenges, with individuals occasionally experiencing distressing episodes referred to as challenging experiences or, in the recreational setting, "bad trips". Trial therapists and physicians, but also healthcare professionals in emergency rooms, need a comprehensive strategy to effectively manage these cases. Three case reports are presented to underline the problem and propose strategies for handling these situations. Finally, this article outlines a stepwise approach, encompassing helpful interventions, supportive care, and rescue medication, to ensure the well-being of individuals undergoing challenging psychedelic experiences and prevent further complications and long-term harm.

The Music of Fausto Romitelli: Concerning the Question of “Musical Material”

The end of the 20th century demonstrates an expansion of horizons of the comprehension of musical sonorities, the conception of their transformation from music into “sound,” which radically changes the perception of timbre: this element becomes transformed from a peripheral component of sound to the primary element, thereby changing entirely the entire conception of musical material. Thus, the theory of music material developed by outstanding German philosopher Theodor Adorno in the middle of the 20th century has found its confirmation. The latter’s concept of the historicity of music material was upheld and further developed by Italian composer Luigi Nono, who fundamentally changed the sphere of perception of this phenomenon, which subsequently was testified by his German student Helmut Lachenmann. This required not only new combinations of sound, but a reevaluation of the attitude of working with them. Fausto Romitelli (1963–2004) pertains to the generation of composers that discovered new paths for work with sound. In his musical output sound becomes a complex multicomponent phenomenon presuming an interaction between acoustic instruments, electronic sounds and reverberation — the sound “aura” and the sound “halo,” both of which are also composed consciously (presenting “composed resonance”). Romitelli’s individuality demonstrates itself in the fact that he builds this component of his musical material, basing himself on sonar discoveries in the sphere of rock music, in particular, the Pink Floyd ensemble, which finds reflection in such of his works as EnTrance, Professor Bad Trip, etc. Romitelli characterized the “aura” of his sound as “dirty,” comprehending this as a specific resonance of the sound of the electric guitar in rock music. Romitelli’s “composed resonance” is not characteristic solely of him; “composed resonance” as an element of musical material may be discerned in the works of other composers, in particular, Kaija Saariaho in her Amers for solo cello and ensemble.

Bad Trips: Spiritual Agonies and Ecstasies in the Films of Gaspar Noé

Bad Trips: Spiritual Agonies and Ecstasies in the Films of Gaspar Noé

Psilocybin as an antidepressant strategy - a review of safety aspects

IntroductionPsilocybin is considered a classical psychedelic and is increasingly attracting scientific and media attention as an alternative approach to the treatment of various mental disorders.Apart from its efficacy, an important question is the tolerability and safety of psilocybin in general and in a controlled environment. Accurate knowledge of drug safety aspects might be essential for applicability in clinical practice and for drug adherence.ObjectivesThis paper aims to provide an overview of drug safety aspects of psilocybin.MethodsA narrative review was conducted. The literature search was conducted using the bibliographic database MEDLINE.ResultsThe literature search of papers published in recent years showed no serious side effects under psilocybin in controlled study conditions. Common reported ADRs were headache, gastrointestinal complaints such as nausea, diarrhoea and vomiting, tachycardia and arterial hypertension. The lethal dose of psilocybin is many times higher than the therapeutic dose and overdose deaths have not been identified.An often mentioned problem is the occurrence of hallucinogenic persisting perception disorder (HPPD) which, however, did not occur in the studies examined and is most likely to be a problem in the context of recreational use. The results on the safety of psilocybin must be regarded as preliminary; in the studies conducted, risk populations were predominantly excluded, which is, however, relevant for everyday clinical practice. The risk of delusional experiences and so-called “bad trips” is also a relevant safety risk, as it can be associated with risky behaviours. However, these would also be observed more in the area of recreational use.ConclusionsThe use of psilocybin in rigorously controlled study designs appears to be predominantly safe and without serious side effects. At the same time, it should be noted that the results must be considered preliminary and many questions remain open. Many of the risks are more likely to occur in uncontrolled recreational use of psilocybin. At the same time, we see a certain risk in the use of a substance associated with high expectations and a certain “fame” that, without appropriate regulations, the boundaries between sensible therapeutic use and abusive use could become blurred and permeable.Disclosure of InterestNone Declared

Is psilocybin an effective antidepressant and what is its Mechanism of action?

Goodwin etal.1 report a single 25mg dose of psilocybin has an antidepressant effect short-term in medication-resistant depression. Unanswered questions include drug blood level as a guide to dose, psychedelic effects relationship to antidepressant benefit, and potential suicide risk of psilocybin.

Una cita con la lady by Mateo García Elizondo

Reviewed by: Una cita con la lady by Mateo García Elizondo Haley Osborn García Elizondo, Mateo. Una cita con la lady. Vintage Español, 2020. Pp. 197. ISBN 978-0-593-08284-3. Told from the point of view of a burned-out, bottomed-out junkie, Una cita con la lady is a psychedelic journey of both good and mostly bad trips. The protagonist is on his way to the last stop on the line of local civilization, the sleepy town of El Zapotal, Mexico, in pursuit of death. Not only has his indomitable addiction to lady (the slang terminology for heroin) sabotaged his own life, it has also impinged on the lives of those who loved him most, driving him to chase the final fix in a place so remote that no one will be there to revive him with naloxone as they had done countless times before. Replete with gothic imagery, hauntings, out of body experiences, and encounters with surreal people and places, the protagonist’s journey is far from normal; it is paranormal, but not a typical ghost story. Divided into brief chapters, Elizondo’s use of first-person narration places the reader in the cadaverous skin of the wandering user. The tone is a drugged-out stream of conscious that traps us in the protagonist’s inferno of obsession and delirium, forcing us to understand his desperate attempts at achieving a high to feel something other than withdrawal, such as when he stabs his veins with the tails of live scorpions to absorb the intoxicating venom. Even this cannot satiate his need. Through his testimony and interactions with some peculiar characters, the reader gains access to his fragmented memories, visions, reflections on life, and existential musings about the afterlife and is thereby tasked with having to decipher between the blur of his time at the pension, opium dreams, nightmares, withdrawals, and even life and death itself. The result of this structure is an empathetic one that familiarizes and humanizes the undertakings of the drug addict living in the margins, a member of society whose illness is frequently diagnosed by many as merely a consequence of multiple bad choices. Some of those for the protagonist include allowing his inherited family home to become a traphouse, getting his own girlfriend hooked on heroin, and neglecting his dog, who waits countless hours during the protagonist’s self-inflicted stupors to be fed and let out. The long-term effects of this behavior are devastating, indeed. During a high at a friend’s house, another user staying at his family home leaves the door open and, in search of his beloved master, the dog escapes and is subsequently hit by a car. The protagonist’s girlfriend, likewise, is killed by an overdose of his own seductive temptress, lady (the drug). More than a postmodern drug culture novel worthy of psychoanalysis and interesting to Latin American generalists, upon closer scrutiny, this fiction has much to offer Mexicanists specializing in indigenous studies. To be sure, it would be difficult to ignore the many ways in which [End Page 327] elements from the plot parallel characteristics from pre-Columbian Mesoamerican mythology. By way of example, although never mentioned in the novel, El Zapotal in Veracruz, México where the story takes place was home to the Totonac and Aztec people for hundreds of years until succumbing to the installation of the Spanish colonial encomienda system. The protagonist’s mission, furthermore, is to commit suicide by overdose there. It is no coincidence, then, that El Zapotal houses the ruins of the shrine of Mictlantecuhtli, the lord of death in Aztec belief often portrayed as a walking corpse. Complementing this imagery, the protagonist frequently mentions his own now emaciated, living-dead appearance from drug abuse. No longer able to stomach most food he ingests or exert himself physically, his own human body seems to be ousting his soul from it, as if he already has one foot in Mictlantecuhtli’s kingdom of the underworld. The living inhabitants of El Zapotal treat the protagonist like he is invisible or an unwelcome spirit; they ignore and avoid him when he approaches them for guidance in...

Glowing Experience or Bad Trip? A Quantitative Analysis of User Reported Drug Experiences on Erowid.org

Erowid.org is a website dedicated to documenting information about psychoactive substances, with over 36,000 user-submitted drug Experience Reports. We study the potential of these reports to provide information about characteristic experiences with drugs. First, we assess different kinds of drug experiences, such as 'addiction' or 'bad trips'. We quantitatively analyze how such experiences are related to substances and user variables. Furthermore, we classify positive and negative experiences as well as reported addiction using information about the consumer, substance, context and location of the drug experience. While variables based only on objective characteristics yield poor predictive performance for subjective experiences, we find subjective user reports can help to identify new patterns and impact factors on drug experiences. In particular, we found a positive association between addiction experiences and dextromethorphan, a substance with largely unknown withdrawal effects. Our research can help to gain a deeper sociological understanding of drug consumption and to identify relationships which may have clinical relevance. Moreover, it can show how non-mainstream social media platforms can be utilized to study characteristics of human behavior and how this can be done in an ethical way in collaboration with the platform providers.

Subjektívne vnímané riziká užívania psychedelík

Introduction. With growing interest in hallucinogens, majority of psychedelic research focus mostly on the therapeutic potential and benefits. The objective of this paper is to explore how users of psychedelics verbalize their experience and perceived risks of using such substances. Methods. The authors used a questionnaire with open-ended and multiple-choice items. The sample included persons with at least one phenomenological experience with psychedelics (N = 422, age M=27.78; SD=7.84; SE=0.38; 35.1% women). Qualitative data were analyzed using concepts of The Grounded Theory using the Atlas.ti suite. Results. The target group uses terms taken from the English language (“bad trip”, “set and setting”, “sitter”, or the grammatically localized version of the word „psychedelic“), with shared and well-understood semantic meaning within the community. The central domain “inappropriate set and setting” and its inadequate preparation is linked to the negative experience of “bad trip” which can lead to difficult “integration of experience” or even “psychotic disorders”. Users of psychedelics report various harm reduction strategies which are consistent with relevant literature. Conclusion. This study illustrates that Slovak users of psychedelics seem to understand and use the established terminology of international discourse related to these substances. At the same time, the authors suggest that users seem to use various relevant strategies to lower risks associated with the use of psychedelics.

Psychedelic Experiences During the Early COVID-19 Pandemic: Findings From an International Online Survey.

Introduction: The current corona virus disease (COVID-19) pandemic has caused a serious global health crisis that has affected large parts of the public and private life worldwide, including the use of psychoactive substances. In this study, we investigated the effect of the COVID-19 pandemic on the use of serotonergic psychedelics, i.e., the settings in which people use psychedelics, the motives of usage, and the subjective quality of psychedelic experiences.Methods: The study was part of an international, cross-sectional, internet-based survey (N = 5,049) available in five languages (English, German, Spanish, Italian, and Korean) carried out during the early phase of the pandemic from April to August 2020. Participants were asked to retrospectively rate settings and motives of psychedelic substance use before the pandemic and in the last 4 weeks during the pandemic, as well as changes in psychedelic experiences.Results: Of n = 1,375 participants that reported the use psychedelics in 2019 or 2020, n = 642 (46.6%) also took psychedelics during the pandemic. During the pandemic, participants used psychedelics significantly less often in settings that were outside their home. Top motives to use psychedelics were comparable before and during the pandemic, but participants consumed less out of curiosity, to celebrate, or because friends took it, and more out of boredom. An increase in positively connoted, often pro-social experiences was observed. Two thirds of participants who used psychedelics during the pandemic claimed that psychedelics had helped them to deal better with the corona pandemic at least slightly.Discussion: Changes in setting and motives were mostly in line with restrictions caused by control measures to contain the spread of the virus. The unexpected increase in positively connoted experiences possibly reflects a favorable interaction of environmental macro- and individual micro-contexts during the pandemic (e.g., by reducing the use in more uncontrolled recreational settings or by encouraging a strong self-selection of substance users due to the expectation of “bad trips”). Increased pro-social feelings under psychedelics might reflect a desire for social interactions in times of social distancing and pandemic-related stress and anxiety.

Day trip to hell: A mixed methods study of challenging psychedelic experiences

Abstract Background and aims This article presents a mixed methods study of challenging psychedelic experiences or “bad trips”, with the aim of exploring the nature and characteristics of such experiences. While challenging psychedelic experiences have been studied in previous research, the article posits that the focus of this research has been overly narrow in terms of the characteristics and etiology of these experiences, and that it would be helpful to broaden our understanding of what a challenging psychedelic trip might be and how it affects users. Methods In the first study, respondents (N = 38) were recruited at various online fora for individual anonymous interviews via private messaging. The Cannabis and Psychedelics User Survey used for the second study was constructed on the basis of the knowledge obtained from interviews, and recruited 319 participants (median age 33; 81% male) from seven different online communities. Respondents were asked to characterize both a typical and their worst psychedelic experience, allowing for comparisons between the two and for regression analyses of associations between challenging experiences and other factors. Results Both in interviews and in the survey, respondents reported a broader range of characteristics for challenging psychedelic experiences than what has previously been recognized in the research literature. Despite the often dramatic narratives, they were convinced that the experience had positive long-term consequences. Conclusions The two studies found that challenging psychedelic experiences have a greater thematic range than what has previously been identified. Besides the near ubiquity of fear in these experiences, confusion was also identified as an important aspect. Meditation practice had paradoxical effects on challenging psychedelic experiences, appearing as a fruitful area for further research.

Classic Psychedelic Coadministration with Lithium, but Not Lamotrigine, is Associated with Seizures: An Analysis of Online Psychedelic Experience Reports.

Psychedelics show promise in treating unipolar depression, though patients with bipolar disorder have been excluded from recent psychedelic trials. There is limited information on the use of classic psychedelics (e. g., LSD or psilocybin) in individuals using mood stabilizers to treat bipolar disorder. This is important to know, as individuals with bipolar depression may attempt to treat themselves with psychedelics while on a mood stabilizer, particularly given enthusiastic media reports of the efficacy of psilocybin for depression. This study analyzed reports of classic psychedelics administered with mood stabilizers from 3 websites (Erowid.org, Shroomery.org, and Reddit.com). Strikingly, 47% of 62 lithium plus psychedelic reports involved seizures, and an additional 18% resulted in bad trips while none of 34 lamotrigine reports did. Further, 39% of lithium reports involved medical attention. Most of the lamotrigine reports (65%) but few (8%) of the lithium reports were judged to not affect the psychedelic experience. Although further research is needed, we provisionally conclude that psychedelic use may pose a significant seizure risk for patients on lithium.

The need for publicly funded research on therapeutic use of psychedelic drugs.

The need for publicly funded research on therapeutic use of psychedelic drugs.

Making “bad trips” good: How users of psychedelics narratively transform challenging trips into valuable experiences

BackgroundWe study the significance of stories about bad trips among users of psychedelics. Drawing on narrative theory, we describe the characteristics of such stories and explore the work they do. MethodsIn-depth qualitative interviews with 50 Norwegian users of psychedelics. ResultsAlmost all participants had frightening experiences when using psychedelics and many described these as bad trips. The key feature of a bad trip was a feeling of losing oneself or going crazy, or ego dissolution. Most users said that these experiences could be avoided by following certain rules, based on tacit knowledge in the subcultures of users. Possessing such knowledge was part of symbolic boundary work that distinguished between drug culture insiders and outsiders. Some also rejected the validity of the term bad trip altogether, arguing that such experiences reflected the lack of such competence. Finally, and most importantly, most participants argued that unpleasant experiences during bad trips had been beneficial and had sometimes given them deep existential and life-altering insights. ConclusionBad trip experiences are common among users of psychedelics. Such experiences are often transformed into valuable experiences through storytelling. Bad trip narratives may be a potent coping mechanism for users of psychedelics in non-controlled environments, enabling them to make sense of frightening experiences and integrate these into their life stories. Such narrative sense-making, or narrative work, facilitates the continued use of psychedelics, even after unpleasant experiences with the drugs.

Reframing Bummer Trips: Scientific and Cultural Explanations to Adverse Reactions to Psychedelic Drug Use

AbstractThe concept of a bad or bummer trip has been used to capture the imagination of public health advisors and drug regulators, especially for producing warnings against taking drugs that cause...

Self-reported negative outcomes of psilocybin users: A quantitative textual analysis

Psilocybin, a substance mainly found in mushrooms of the genus psilocybe, has been historically used for ritualistic, recreational and, more recently, medicinal purposes. The scientific literature suggests low toxicity, low risk of addiction, overdose, or other causes of injury commonly caused by substances of abuse, with growing interest in the use of this substance for conditions such as treatment-resistant depression. However, the presence of negative outcomes linked to psilocybin use is not clear yet. The objective of this study is to investigate the negative effects of psilocybin consumption, according to the users' own perception through self-reports extracted from an online platform. 346 reports were analyzed with the assistance of the IRAMUTEQ textual analysis software, adopting the procedures of Descending Hierarchical Classification, Correspondence Factor Analysis and Specificities Analysis. The text segments were grouped in 4 main clusters, describing thinking distortions, emergencies, perceptual alterations and the administration of the substance. Bad trips were more frequent in female users, being associated with thinking distortions. The use of multiple doses of psilocybin in the same session or its combination with other substances was linked to the occurrence of long-term negative outcomes, while the use of mushrooms in single high doses was linked to medical emergencies. These results can be useful for a better understanding of the effects of psilocybin use, guiding harm-reduction initiatives.

How can primary care practitioners address substance use by adolescents? A position paper of the EUROPEAN academy of PAEDIATRICS

The objective of this article is to review how primary care providers - paediatricians, family practitioners, nurse practitioners - could address the use of substances by adolescents and respond to problematic behaviours and situations. Given the highly addictive properties of nicotine, adolescents should be supported in avoiding any consumption of tobacco or quitting if they already do so. Screening and investigation of substance use is usually not difficult, provided that it is processed in a neutral and empathetic atmosphere and securing confidentiality if the adolescent asks for it. Any type of substance use is potentially linked with adverse events such as injuries, violence, unplanned and unsafe sexual experience, alcoholic coma, 'bad trips' or unpleasant psychological experiences. As such, substance use should be identified and openly discussed with the adolescent. Moderate intermittent recreational use of legal and illegal substances (mainly alcohol and cannabis) should be carefully monitored over time, as it can lead to problematic use. Problematic use and substance use disorder require various interventions, including motivational interviewing, family counselling and psychotherapy, especially when substance use is linked with mental health disorders. Despite the importance of confidential care, parents or caregivers should be involved in problematic situations as much as possible. What is known: • While problematic use of substances is transient amongst many adolescents, it may be a threat to health and school/professional functioning • Primary care providers (PCPs) can address queries or offer preventive interventions to adolescents who use substances What is new: • Some interview tools can assist PCPs efficiently to identify problematic users of substances • There are effective approaches that PCPs can use to address problematic use by adolescent patients.