Safe Travels provides information about the safe use of psychedelics so that you can make informed decisions based on the latest science and harm reduction practices.
Aside from the legal risks associated with the use of psilocybin and LSD, the short-term risks of microdosing are relatively low. A primary challenge is accurately measuring dose size. If a dose is larger than anticipated, it could result in anxiety or mild psychedelic effects. Other unwanted effects reported by microdosers include physiological discomfort (disrupted senses, temperature dysregulation, headache), increased anxiety, impaired energy and impaired mood1.
The long term risks of microdosing are not well understood. Occasional use of psychedelics at higher doses is generally safe for most people. However, ingestion of low doses of psychedelics over months and years could present unique safety concerns. In addition to primary psychedelic effects caused by activating the serotonin receptor known as 5HT-2A, psychedelics such psilocybin and LSD also activate a different serotonin receptor called 5-HT2B2. This receptor is not only found in the brain but also in the heart. It is known that long term use of other drugs which bind to this receptor can cause serious cardiac issues including valvular heart disease3. There is not yet enough research to understand whether long term microdosing can have similarly negative effects on the heart. However, these risks should be taken seriously until more research becomes available.
1. Psychedelic microdosing benefits and challenges: an empirical codebook
2. The risk of chronic psychedelic and MDMA microdosing for valvular heart disease
While ketamine therapy has been shown to be helpful for many people, the high costs of treatment make it inaccessible for many. Ketamine therapy may require three to eight sessions spread over a few weeks with each session typically costing between $300-$800.
The main reason why ketamine therapy is so expensive is that it is often not covered by health insurance plans. While ketamine has been FDA approved since the 1970s as an anesthetic, it has only recently shown to be effective in the treatment of certain mental health conditions such as depression and is therefore prescribed "off-label" in the context of mental health treatment. Typically health insurance providers are reluctant to cover off-label prescriptions, often leaving the full cost of treatment up to the patient. Additionally, ketamine therapy sessions are typically longer than traditional medical approintments or therapy sessions. Therefore, a clinician's time is also accounted for in the high cost of treatment.
Before starting ketamine therapy it is worth checking with your health insurance provider to determine if ketamine therapy might still be covered under your plan. It is also possible that you may be able to receive out-of-network reimbursement for ketamine therapy.
Another option is to ask your doctor about Spravato, which is a form of ketamine (eskatamine) that has been FDA approved for treatment resistant depression. Due to the fact that Spravato has been FDA approved for certain types of depression, health insurance companies are more likely to cover its costs.
While psilocybin mushrooms are not considered to be toxic to ingest, they can sometimes cause significant psychological distress. Furthermore, certain individuals are at higher risk for adverse events associated with psychedelics:
Individuals with schizophrenia and bipolar disorder are at an elevated risk for psychotic or manic episodes.
Individuals with family members who have schizophrenia and bipolar disorder. Having an immediate family member with either of these psychiatric conditions increases your risk of having a psychotic or manic episode as a result of psychedelic use including psilocybin.
Individuals with cardiovascular issues: Psychedelics including psilocybin can increase heart rate and blood pressure, which could be harmful to individuals with heart conditions.
Individuals currently taking certain medications: Psilocybin acts directly on serotonin receptors, therefore combining it with other serotonergic drugs should be done with caution. For example, MAOI medications (Marplan, Nardil etc..) may increase duration or intensity of psychedelic effects and could possibly result in serotonin toxicity1. Other serotonergic drugs like SSRIs (Prozac, Lexapro, Zoloft etc..)and SNRIs (Effexor, Cymbalta etc..) may decrease psychedelic intensity2.
For the most updated evidence on interaction risk levels with your specific medications and health conditions, check out psychedelicinteraction.com which features hundreds of drug search options and considers both micro- and macro-doses in the interaction.
www.psychedelicinteraction.com
Therapeutic use of psilocybin: Practical considerations for dosing and administration
Drug-drug interactions between psychiatric medications and MDMA or psilocybin: a systematic review
If possible, yes. One risk associated with using MDMA or any illict drug is the uncertainty about what the substance actually contains. It is not uncommon for substances sold as MDMA to contain other drugs or adulterants, some of which may be harmful or deadly.
Testing kits such as those provided by DanceSafe are available to check for the presence of MDMA and some common adulterants. These tests can potentially identify dangerous substances, however, they cannot guarantee the safety of the substance. No test can accurately determine the dosage or purity of the substance, nor can they identify every possible adulterant.
So, if you are considering using MDMA, testing it with a kit can provide some information about its content, but it does not eliminate the risks associated with its use. Regardless, testing is always a good idea.
DanceSafe provides test kits for a variety of drugs including MDMA, amphetamine, cocaine, ketamine and LSD as well as fentanyl test strips.
