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Precautions and contraindications

Although both psilocybin and LSD are considered safe substances, there are both general cautions and particular reasons not to embark on a psychedelic journey.

Do not take psychedelics if you:

  • Have a very serious heart disease (great emotional stress can be dangerous)

  • Are pregnant (convulsions can harm the fetus/initiate premature labor)

  • Taking lithium for bipolar disorder (lithium can, together with e.g. psilocybin, cause dangerous convulsions)

  • Have a history of psychotic episodes in recent years

Be careful with taking psychedelics if you:

  • Have had psychotic episodes way back in time (15-20 years)

  • Are very young (under 25)

  • Have strong anxiety about the unknown and the unexplainable

General precautions:

  • Know why you're taking psychedelics, and don't take them on impulse

  • Be mentally prepared for what you may experience (set)

  • Make sure you are in a safe, secure environment (setting)

  • Start with a low dose

  • Never take psychedelics alone if you are not experienced. Make sure to have a person with your own experience present during the entire trip, and make arrangements to be able to talk about your experiences afterwards

  • Never accept a drug from someone you don't trust 100%

  • Know which drug you are taking and why you choose to take this particular drug

Håkon sits next to the bed where the customer lies. Sitting behind closed curtains in a hotel

Håkon and holding a stranger by the hand. The Tripsitters He gets paid to be there.

Håkon holds the customer's hand. Soon he will give the stranger an illegal pill. Håkon holds the customer's hand. Trip sitters TUVA SKEI TØNSET  Journalist ANDERS FEHN  Photographer PUBLISHED 21. NOV. AT 08:44 The man in bed swallows and waits. After a while he disappears into another world. For the next few hours, Håkon will be his only anchor to reality. Both take chances. Chances are, for similar reasons, they think it's worth taking. Håkon is in his late 30s. His name is not really that, but   will not be known again. He has a rather unusual full-time job. A job that requires him to be prepared for most things. Some customers scream at the top of their lungs. Others will roll around on the floor. Some lie motionless for several hours. Regardless of what they are experiencing, Håkon has to keep the mask on. He's a bit like a babysitter. Make sure everything goes well. The children, on the other hand, are replaced by adults. Adults who like to have their very first encounter with illegal drugs. This is how it is today too. The man in the bed has taken his life's first dose of MDMA. Now the customer's "trip" is in Håkon's hands. A misstep can have major consequences. Håkon walks outside in the rain with a yellow jacket on. Håkon has learned a lot of what he knows about trip sitting by reading up. The regular guy. A few hours earlier: Håkon arrives at a café in west Oslo. He is a typical   family man from Eastern Norway with a wife and children. But the job that provides money in the account is far from traditional. Without a background in healthcare, Håkon believes he can help people who struggle with mental disorders. He calls himself a "trip sitter" who performs psychedelic therapy with MDMA, LSD and wild mushrooms. The goal is to heal. The method he uses is illegal in Norway. Nevertheless, many claim that it works. Håkon is sitting in a cafe with the journalist. Håkon explored a lot himself with psychedelic substances before he became a tripsite. - Over 80 per cent of my clients state that they notice a good or very good improvement. There is no "hard science", but many people get good results, he claims. Since he started a year and a half ago, he has been a trip sitter for almost 90 people from all over the country. Everything from people in their 20s to their 70s. Rich senior managers, grandmothers, disabled people and former inmates. The variation is great. Yet they all have something in common. Håkon seen through the window of the cafe. In the beginning, Håkon only had sessions with friends and acquaintances. Then he started accepting strange customers. - Depression and anxiety very often recur. Many also have post-traumatic stress disorder (PTSD). Although Håkon's method is illegal, he is not nervous about the police getting involved. He does not think this is high on their priority list. And that they let people stay, as long as no one dies. Just a few blocks away from the cafe, today's customer is waiting for a hotel room. He himself has a user dose of MDMA with him. An illegal drug that often comes in tablet form or crystals. The substance increases the level of serotonin and oxytocin in the brain. Also called the happiness and love hormones. Each session lasts as long as a normal working day and costs NOK 8,000, says Håkon. He usually has two clients a week. Håkon is sitting in a cafe with a cup of coffee on the table. Håkon's friends and family know his profession. The growing interest in psychedelic drugs is traditionally associated with rave culture. Many people use these as party drugs. NRK has worked over several months to get inside environments that use the drugs for purposes other than partying and fun. Some do it because they struggle with mental disorders. Others do it with personal development or deeper insight as a purpose. We have come into contact with 12 people who are part of these environments in various ways. They say that in several places in the country large ceremonies and smaller sessions with psychedelic substances are arranged. Often with a tripsitter, shaman or facilitator present. Two MDMA tablets in purple and yellow. The picture illustrates what MDMA can look like. It often comes in tablet form, but also as crystals. PHOTO: REMI SAGEN / NRK. The substances that are mentioned most are MDMA, LSD, DMT and psilocybin from toadstools. All are illegal to both use and sell. Do you want to know more about these substances? If not, just read on

MDMA affects the neurotransmitters in your brain. It releases lots of serotonin, which is the substance that regulates sleep, mood, appetite and emotions. With a lot of serotonin inside, it can be experienced as the feeling of falling in love. MDMA is an intense drug that can lead to overheating. If you become boiling hot, in the worst case it can lead to organ failure and death. After the so-called ups and downs, comes the downs. Then the brain and body are exhausted, and you can feel empty and depressed.

Another danger is that there is a lot of fake MDMA in circulation. LSD, also known as acid, is an intoxicant with a powerful effect, which can last as long as six to twelve hours. It affects how you perceive your surroundings - a so-called change in your state of consciousness and sensory perception. Possible side effects are feelings of fear, panic, anxiety, disorientation and confusion. Some end up with permanent visual hallucinations or visual disturbances. Fleinsopp (psilocybin) The intoxication typically lasts for 4-6 hours and has similarities to LSD and DMT. Fleinsopp can give a feeling of well-being, enhanced sensory impressions, visual illusions and synesthesia, but also temporary anxiety or confusion. Fleinsopp can make the user confused or scared and increase the risk of accidents in situations where irrational behavior can be dangerous. DMT is a short-acting classic psychedelic substance that is found naturally in the human body and in many plants. It can produce extremely intense intoxication experiences. At high doses, it is not unusual to experience that one travels out of the body, ends up in another universe or encounters alien beings under the influence. It should therefore only be used in safe and quiet surroundings, preferably sitting or lying down and preferably with eyes closed. Source: What do the different drugs actually do? and the Drug Enforcement Administration. Nevertheless, these environments are not something Kripos spends a lot of time on, they say. They focus more on international criminal networks. Network that transports large quantities of drugs to Norway. Several of the 12 we spoke to believe that psychedelic therapy has become more widespread in recent years. But it is difficult to quantify this. What we do know is that there was a record high number of seizures of LSD and MDMA in Norway last year. This is shown by figures from Kripos' drug and doping statistics. The good results In Østfold there is a man who is allowed to prescribe MDMA. His name is Tor-Morten Kvam and he is a psychiatrist and senior physician at the Østfold DPS. You could say that Kvam is a kind of trip sitter. In a legal research project, mind you. He is a therapist in a rather unique study. It sees MDMA as medicine for post-traumatic stress disorder. In combination with talk therapy. Kvam sits in a chair by a bed. In it lies the journalist. The picture illustrates what a treatment at Østfold Hospital looks like. Here with the journalist. PHOTO: ANDERS FEHN / NRK. Kvam says that psychedelic drugs lower the psychological defences. It can lead to you having to face your problems and challenges. And thus process the hurt. - Volunteers have undergone a careful screening in order to participate in our study, says Kvam. It is the first in Europe and is carried out at Sykehuset Østfold. Preliminary studies on the same from other places in the world show good results. So good, in fact, that MDMA is likely to be approved as a medicine for PTSD. For that to happen, several studies must conclude with the same good results. - In Norway, an approval can happen in 2024 or 2025 at the earliest, says Kvam. Tor-Morten Kvam is inside the treatment room. Kvam believes there is a big difference between taking MDMA in a therapeutic context and in a party context. PHOTO: ANDERS FEHN / NRK. The hopeful meeting There are several similarities between Kvam and Håkon's method. Nevertheless, they are each other's extremes. Håkon practices outside the legal framework. Because he is today's office at a hotel in Oslo. The barely 20 square meters is his therapy room. Håkon does not want NRK to enter the room during the session. He believes it can disrupt and affect the customer's trip. We ask if Håkon can send us pictures and sound recordings after the session is over. So that we can better understand what happens behind closed doors. With the customer's approval, he answers yes to that. For reasons of anonymity, events are only described in text form. Håkon holds the customer's hand. Håkon's job is to be a support player during the customer's trip. Håkon usually meets his clients in hotel rooms or at their homes. The majority of those who seek him out struggle with anxiety and depression. The idea is that a single dose of MDMA should make them better equipped to process. The customers buy the fabric themselves, but it is Håkon's responsibility to check that it is clean. That it is not mixed with anything else. And that customers get the right amount. He does this based on experience. Ahead of today's meeting, Håkon and the man in the bed have had two telephone conversations. With the aim of gaining insight into what the customer is struggling with. Before, Håkon was more insecure when dealing with customers. The responsibility could make him nervous. - People have such extremely different reactions. I had some scary experiences in the beginning. Håkon has, among other things, experienced that customers think they are having a heart attack. The fear has also triggered real chest pains. In today's therapy room, Håkon spends the first half hour talking to the client about the weather. It should calm the mood. Soon the man will swallow MDMA. Then there is no turning back. Håkon sits next to the bed where the customer lies. Håkon sits with the customers as long as a normal working day. The opposite method. The method both Håkon and the researchers use is quite specific. The person is lying in a bed. Eye mask in front of the eyes. Headphones with instrumental music on the ears. In sheltered surroundings without distractions. Heidi prefers to take in her surroundings. She is a trip sitter for friends and friends of friends. Heidi is in her early 30s and lives in Oslo. Nor does she want to come forward with her own name because the practice is illegal. Heidi in profile in the backlight out in the park. Heidi herself has explored a lot with psychedelic substances. LSD is one of the things she uses the most. PHOTO: ANDERS FEHN / NRK. The fascination with psychedelic substances arose when she herself was deeply depressed a few years ago. At one point, she was so indifferent to living that she experimented with large doses of LSD and mushrooms all by herself. Multiplied by what are normal user doses.  In the midst of her misery, she began to notice a change. It was as if the drugs forced her to take action. And she did. - Psychedelic drugs are a kind of shortcut. They make it easier to go deeper into myself and explore what is painful and difficult. I think it would take more of me to achieve the same without the drugs. Now it happens that Heidi helps others to use illegal drugs. She does not charge for the trip sitting. Only for the psychedelic drugs that she procures and doses herself. Sometimes the session takes place at home in the living room of Heidi and her roommate. But other times they take the trip outdoors. Preferably in parks, the forest, the city or in the mountains. She describes the feeling of being at one with nature as they move from place to place. The trip sitters. Outdoors, Heidi becomes one with her surroundings. The trip sitters. Her challenges are reflected in the intoxication like reflections in water. Heidi likes to take others out into nature if she is a trip sitter. PHOTO: ANDERS FEHN / NRK. Heidi nevertheless believes that there is always a certain risk present. Both for themselves and others.- I understand that consuming psychedelic substances is by no means risk-free. It is often both challenging and painful, but if you are well prepared and take it in the right setting, it does not have to be negative. She has no desire to stop taking psychedelic drugs and trip-sitting. In Heidi's eyes, the upside is greater than the risk. Heidi is sitting on the ground in a park. Heidi also likes to sense her surroundings by touching what is around her during a trip. PHOTO: ANDERS FEHN / NRK. The unusual relationship of trust In the hotel room in west Oslo, conversations about weather and wind are history. Both Håkon and the customer know what they are really there for. Although they were strangers to each other until today, trust is the very foundation of everything that will happen. The customer must trust that the tripsitter knows what he is doing. And that he is not left in a helpless situation. Håkon must have confidence that the customer does not withhold information about his own health. That he does not have an underlying heart defect. And that he has not had psychotic experiences. - Helping others feels meaningful. There are people who are having a hard time and don't know what to do. They feel they get help from this. It changes lives and it feels good.  – Some will think that this is exploitation of vulnerable people for profit. What do you think? - I think it is the same as a psychologist who charges twice as much as I charge for an hour. I tell my clients that I will be happy if they don't come back to me again. When he works full-time, Håkon has two customers a week. According to him, it will be NOK 16,000. He has established his own sole proprietorship which, on paper, deals with psychotherapy. Håkon nevertheless claims that money is not the motivation. According to himself, he earned more in his previous job. The one that was legal. - That's perfectly fine. I'd rather earn a little less and do something I think is fantastic fun. Although Håkon describes the job as fun, it is also serious. Today is no exception. The man in the bed takes part of the dose of MDMA. A while later, Håkon gives him the rest. Then the customer begins to breathe deeply. Håkon holds the customer's hand. Strangers or not, Håkon lends the customer a hand along the way. The negative consequences. Preliminary studies do not suggest that MDMA-assisted psychotherapy has serious side effects. On the other hand, little is known about what happens outside research, according to Tor-Morten Kvam. He will not recommend the use of MDMA as medicine until it is possibly approved. Or to buy drugs on the illegal market. - Nevertheless, it must be recognized that underground therapists may help some people. At the same time, Kvam believes that there is a risk in using these. Close-up of Tor-Morten Kvam. Tor-Morten Kvam believes there is a big difference between taking MDMA in a medical context and in a party context. PHOTO: ANDERS FEHN / NRK. The trip sitter's expertise can vary, and it is not a given that they have enough knowledge, Kvam issues. Neither to carry out a necessary screening, nor to know what to screen away. Researchers screen out people with cardiovascular diseases and serious mental disorders, among other things. In addition, they will not treat very vulnerable people, with, for example, an acute risk of suicide or a personality disorder. Tor-Morten Kvam sits in his office. Kvam believes it is risky to use underground therapists. PHOTO: ANDERS FEHN / NRK. The unpredictable effect. The trip to the man in bed lasts several hours. Along the way, Håkon holds his hand. It is mostly the customer who speaks. Håkon observes and offers supportive words when necessary. Towards the end, the effect wears off, and the man in the bed comes more to himself. At this point in the trip, they start to talk a little about the experience, says Håkon. - When the customer feels safe and has landed again, I say thank you. Håkon leaves the hotel room after spending the day there. Nothing has tipped him off the stick. The session took place without any major surprises. Nevertheless, Håkon thinks it is important to follow up with customers a few weeks later. Hear what they think. If they have noticed any difference. And whether they have processed all impressions. The hope is that they will not need a new meeting and a new session. This is how it often goes. But not always. dare. 21 Oct., 14:08 "Håkon": Hello, Tuva. The client has undergone one round of MDMA and will have another in a month's time. "Håkon": He has started to notice more positive changes, but he is still a long way from being "diagnosed". So the sunshine story is not quite finished yet. Dear reader! Did this case make you stop and think about something, or do you recognize the theme? Feel free to write to me if you have anything to say, or if you have tips for other related matters I should look into. Here are some of the cases I have worked on in the past: On the inside of the party for 18-year-olds, Mobile dating's dark background and Nav spent 19 years on work clearance.

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