top of page

What exactly are psychedelics?

Hva er egentlig psykedelika som lsd eller magic mushrooms med psilocybin?

Briefly about psychedelics

  • Taking psychedelics is often referred to as "tripping". This is because being affected by these substances can be experienced as being on a near magical trip. The journey can take place in any domain: in the subconscious/your own psyche, in the universe, through known and unknown cultures, biological or material domains, through spirit worlds, or in the domain that lies behind everything what we think we know about reality

  • Unlike drugs such as alcohol, cocaine and amphetamines, you are neither dulled nor activated in the true sense: your observing self is still fully present, and can bring the insights back to this part of reality

  • The substances have somewhat erroneously been called hallucinogens, as the "travelerexperience phenomena that are usually assumed not to exist. Instead much indicates that these experiences are meaningful representations of real psychological, material or spiritual phenomena, domains, objects and states

  • Psychedelics provide increased communication between different areas of the brain – something that can lead to seeing things in a different way, or achieving a new and intuitive understanding of oneself, reality, symbolism, music or other phenomena

  • Psychedelics reduce activity in the so-called «default network» in the brain – the area responsible for maintaining all our ideas about the world, about ourselves and who we should be. This means that we may be able to free ourselves from ingrained and dysfunctional ideas and perspectives, and that creativity can increase radically

  • The most commonly used psychedelic substances are psilocybin, which is found in the mushroom Psilocybe Cubensis, as well as LSD (lysergic acid diethylamide), which is an artificially produced substance, but which can also be produced from lysergic acid from certain mushrooms

The question of whether psychedelics are dangerous or not makes no sense. Psychedelic substances are powerful tools that can be used constructively and destructively. You will get different opinions about whether a knife is dangerous from a surgeon who bases his assessment on use during operations and a police officer who investigates murder committed with a knife. Benefit or risk is not about characteristics of the knife per se

 

Humphrey Osmond

Mechanism of action

Psychedelics include a number of different substances that change the way we think and perceive reality. Both the effect and the duration vary, but common to all the so-called classic psychedelics, is that they activate the brains serotonin receptors, and inhibit the reuptake of serotonin in the synapses. It is still unclear exactly how the drugs lead to the subjective experiences one experiences, but as mentioned above, it is assumed that it is connected to the fact that the activity in the so-called default network in the brain is reduced, while at the same time there is increased activity in the nerve pathways that connect other parts of the brain together. Thus the traveler can see the world without the limiting filter we usually see it through. 
 

Where are psychedelics found?

Substances with psychedelic effects have been found in animals, plants and mushrooms across large parts of the world. Examples are the peyote cactus (contains mescaline), and the 5-MeO-DMT-producing Colorado toad in Mexico, the DMT-containing plant psychotria viridis in South America. We humans also produce small amounts of DMT in our bodies. 

In Europe, we find agaric mushrooms, which contain the psychedelic substance psilocybin. The most common thrip mushroom is nevertheless psilocybe cubensis. This comes in many sub-varieties with slightly different properties, and can also be grown indoors. In addition to all the naturally occurring psychedelic substances, there are a large number of synthesized psychedelic substances. 


Traditional use

Psychedelic plants and growths have been used, and are still used, by various indigenous groups in ceremonial and religious contexts. The psychedelic plant brew ayahuasca has been used by indigenous peoples in South America for hundreds of years, if not longer, while archeological finds from Texas suggest that peyote was used in this area as early as 3700 BC. Psilocybin was first identified in mushrooms used in religious contexts by the indigenous people of Mexico, and was brought to Europe by scientists Valentina Pavlovna Wasson and R. Gordon Wasson. ​There is also much evidence that such substances were in common ritualistic use in ancient Greece.

 

Modern Europe, on the other hand - or more correctly the so-called Western world - is one of the few cultures throughout human history that lacks a widely accepted way of using psychedelics. This must be assumed to be partly connected with the fact that what one experiences in these "trips" completely breaks with the ideas we like to stick to when it comes to what is true and real, and the very fabric of reality itself. Very few with some psychedelic experience remain very concerned with holding onto an exclusively material worldview. 

 

The various substances

LSD

One of the most famous psychedelic substances is LSD, which was synthesized by Albert Hofmann in 1938. The synthesis was based on alkaloids found in the rye mushroom ergot. LSD, also known as acid, has a very powerful effect that can last for ten to fourteen hours. The long effect makes you feel like you have taken part in an endless journey through time and space. For example, a single stroke of the piano string can feel like an eternity, telling stories that hardly can be expressed in words. LSD is not toxic to the body, and it is not possible to become addicted to the substance. Imitator substances exist, but are relatively rare. LSD can be easily tested with a kit. 

Psilocybin

Psilocybin is found in a number of mushroom species, including Psilocybe Cubensis. The trip typically lasts for 4-6 hours and is very similar to LSD. Like LSD, psilocybin can provide a strong feeling of well-being, along with enhanced sensory impressions and synesthesia, i.e. mixing of senses. - For example, that you see colors and patterns when you listen to music. Psilocybin is also not poisonous, and it is not possible to become addicted to the substance. Unlike LSD, the substance is perceived by many to be more organic or "alive". For example, several people encounter the mushroom's spirit, either in the form of a voice, figure or the mushroom itself, as it appears on the forest floor. Many have very strong experiences of receiving advice or guidance from this spirit. It can also be experienced as showing us deep secrets both about ourselves and about the world as such. 

Eeffects overview

What different psychedelics have in common is that they change the way we experience reality. Colors can be enhanced and flow into each other, you can see patterns you don't normally perceive, and you can hear details in music that you wouldn't otherwise notice. With closed eyes, one can see complex geometric figures or vivid dream scenarios. 

The way you think also changes, and you may experience becoming more associative - or that you think more in symbols and images. Some may feel drawn towards philosophical and existential questions, or reflections on one's own place in life, as well as the relationship with other people and the outside world in general. At higher doses, one can also experience what is referred to in the literature as ego dissolution or ego death, where one loses the experience of being an individual self, and becomes one with the surroundings, the cosmos or  nothingness/eternity. This can be experienced as so great and mysterious that it forever changes the life of the person. 

Few clinical studies have been done to compare the subjective effects of different psychedelics, and the user literature sometimes gives varying descriptions of similarities and differences in the effect. 

What about MDMA and Ketamine?

When it comes to MDMA, this releases large amounts of serotonin, which is the substance that regulates sleep, mood, appetite and emotions. A lot of serotonin in the system can be experienced as something close to falling in love. MDMA is also probably the drug that is easiest to obtain. Nevertheless, there are several aspects of MDMA that make this not our preferred aid, neither as tripsiters nor for working with ourselves. 

Firstly, MDMA can lead to overheating of the body, and in the worst case organ failure, although this very rarely occurs, compared to how many doses are taken worldwide every single weekend. In controlled environments, the substance is considered safe. 

In addition, the fact that after a trip on MDMA, the brain and body are exhausted, and you can feel empty and depressed. Neither psilocybin nor LSD usually produce this effect - quite the opposite. After a psychedelic trip with one of these substances, you will be often feel better than ever for some time afterwards, although of course you may also be emotionally tired as a result of the material you have worked with. Another potential danger with MDMA is that there is a lot of fake MDMA in circulation. We can possibly help you test this with a test kit. 
 

Ketamine is a drug traditionally used for anesthesia and pain relief. In recent years, it has also become a treatment for depression, and the treatment shows promising results. At low doses, the effect can be similar to alcohol intoxication, while higher doses can induce hallucinogenic effects. This is what is used in the treatment of depression. We ourselves have no personal experience with the substance, nor do we have any opportunity to check whether the substance you may have is actually ketamine. We therefore do not offer assistance if you want to take this substance. 

Choice of substance

Our conclusion is that psilocybin from the mushroom Psilocybe Cubensis is the best substance for most people, both because it is physically safe, easy to dose and because the therapeutic and spiritual effects are very powerful. 

Both MDMA and ketamine show good effects in clinical studies, but our experience is that for most people the positive effects can be achieved just as well or better with psilocybin (or possibly LDS) - which is a 100% safe substance for the body. Admittedly, there are certain situations where MDMA or LSD would work better.

Nevertheless, it is our clear recommendation to start with psilocybin if you are going to carry out psychedelic development work outside the publicly recognized channels. Not of less importance is the very small chance of confusing psilocybin from mushrooms with another, dangerous substance. This is in no way meant to belittle the effects that can be achieved with other substances, including those that we have not gone into in detail here, such as e.g. DMT - either in pure form or as a component of Ayahuasca. 

Dosage of psilocybin

A typical therapeutic dose of psilocybin will amoun to approx. 1.6-5 grams of dried mushrooms. For work with PTSD or spiritual development work, even larger doses can be useful. For the vast majority of people, we think it is right to start on the cautious side when it comes to dosage, even if you should cross a certain threshold to indulge in the experience. As said set (your state of consciousness in the situation) and setting (surroundings such as colours, atmosphere in the room, music, the trip sitter's energy etc.) is almost as important as the dose itself. This part is therefore our job to take care of. 

Our goal is for your psychedelic journey to be 100% safe, and for you to come out of it as a wiser and more harmonious version of yourself.

there is an increased interest in psychedelic substances for use in the treatment of mental disorders. The substances are considered safe when given within a clinical setting. Older studies from before 1970 have methodological weaknesses, but in recent years there have been promising results from use in unipolar depression, depression in life-threatening illness, anxiety and addiction. The purpose of this literature review is to provide an overview of recent results and the limitations of these studies. KNOWLEDGE BASE We searched the database PubMed for clinical studies from the period 1990–2017 with the keywords anxiety, depression, addiction and psychedelic substances. The quality of the studies was then assessed based on method and strength calculation. RESULTS The search yielded 424 articles, of which nine were included (four on anxiety and depression in life-threatening illness, two on depression, two on addiction disorder and one on obsessive-compulsive disorder). Two double-blind, randomized, controlled phase II studies with a moderate number of patients found an immediate, marked and sustained effect of a single dose of psilocybin against anxiety and depression in life-threatening illness. The other studies had more uncertain results. There were no serious side effects or reports of addiction. INTERPRETATION Psychedelic substances in the treatment of several mental disorders have shown promising results, but the studies are small and have methodological challenges. There is a need for systematic clinical studies to obtain solid documentation for efficacy and to establish routines for monitoring possible side effects.  In the 1950s and 60s, the classic psychedelic drugs lysergic acid diethylamide (LSD) and psilocybin were investigated in many clinical studies. These suggested an effect on anxiety and depression in life-threatening illness, unipolar depression and addiction (1–3). In an open study of LSD in cancer patients, improvement in various symptoms such as pain, anxiety and depression and increased acceptance of death was found in approximately 70% (1). A review of psychedelic substances' effect on unipolar depression in open studies showed around 80% improvement (2). A meta-analysis of randomized studies of LSD in alcohol abuse showed a significant effect of LSD compared to the control group, with an odds ratio of 1.96 (3). Treatment and research on psychedelic substances ended around 1970 as a result of international legislation (4). Psychedelic substances are classified by the UN among substances with abuse potential and serious health-damaging effects and without therapeutic potential, but this classification has been criticized (5). Classic psychedelic substances are synthetic (such as LSD) or naturally occurring, such as psilocybin from the mushroom, N,N-dimethyltryptamine (DMT) from the herbal drink ayahuasca, and mescaline from the peyote cactus. They are all serotonin receptor agonists and mainly stimulate the 5-hydroxytryptamine (HT)2A receptor (4, 6). Classic psychedelic drugs cause altered perception, especially visual, affective changes in both the direction of ecstasy and anxiety, altered perception of time, audiovisual synaesthesia, derealization and depersonalization, as well as pseudo-hallucinations (i.e. hallucinations where the perception of reality is preserved) (7). The effects of the most researched psychedelic drugs, psilocybin and LSD, last for approx. 6 and 12 hours (4). Repeated use leads to tolerance due to 5-HT2A receptor downregulation (4). It has been claimed that classic psychedelic substances can produce dangerous side effects, but this stems from studies with uncertain methodology (4). Systematic studies to date show that they have low toxicity and a high therapeutic index (4). Classic psychedelic substances pose a minimal risk of addiction (4). In a ranking of 20 legal and illegal substances based on their harmful effects on the individual user and society, alcohol was the worst, while psilocybin and LSD were among the least harmful (5). Little influence is seen on dopaminergic systems, which may explain the low risk of developing addiction (4). At the same time, there are case reports of serious but rare and mainly transient side effects, such as rhabdomyolysis, ischemia in the lower extremities and cortical blindness after recreational use (4). Use of psychedelic substances with uncontrolled strength and degree of purity and often simultaneous use of several psychoactive substances complicates the interpretation of such case reports (4). Furthermore, the risk of these complications seems low in a controlled clinical situation. In modern clinical studies of classic psychedelic substances on selected patient groups, these side effects have not been seen (8–16).

Hallucinogen Persistent Perception Disorder (HPPD) is a condition that has been mainly associated with recreational use of LSD (17). The condition is characterized by acute perceptions being relived long after acute exposure to the substance. The condition has an unknown distribution, but it is considered rare. Studies of the condition have methodological weaknesses and are largely based on case reports (17), and it has not been seen in the modern studies in the field (8–16). An American study with 130,000 participants, where 13.4% reported current and/or previous use of psychedelics (LSD, psilocybin or mescaline), showed no connection between use and psychological difficulties (18). A more recent and larger population study found that the risk of psychological problems including suicidal thoughts was reduced among users of classic psychedelic substances, while it was increased among users of other illegal substances (19). Method We carried out a literature review of the treatment of mental disorders with classic psychedelic substances. PubMed was used to identify relevant articles. The search was limited to the period 1.1.1990–31.12.2017 to ensure a focus on modern studies that use methods that are in accordance with current standards for evidence-based medicine. We used the keywords "anxiety" OR "depression" OR "addiction", in combination with "psilocybin" OR "LSD" OR "DMT" OR "mescaline". The search procedure is shown in Figure 1. The identified articles were reviewed manually in the following way: Inclusion criteria were English-language original articles where clinical studies had been conducted on patients. Exclusion criteria were population studies, review articles and studies on healthy volunteers. Other substances with psychedelic properties, such as e.g. ketamine and MDMA (3,4-methylenedioxymethamphetamine) are not included. All the studies reviewed in the results section were identified through the above-mentioned searches. FIGURE 1 The flowchart shows the knowledge base in this overview article, which is based on nine articles. The search was made in PubMed for the period 1.1.1990–31.12.2017.

Results Of a total of 424 articles, nine met the inclusion criteria (8–16). These were divided into the four main categories of anxiety and depression in life-threatening illness (4 studies), depression (2 studies), addiction (2 studies) and obsessive-compulsive disorder (1 study). In all the studies, psychedelic substances were administered integrated with psychological treatment. The studies are summarized in table 1. TABLE 1 Overview and comparison of the nine studies that were identified through the literature search. HAM-A: Hamilton Anxiety Rating Scale; HAMD: Hamilton Rating Scale For Depression; HADS: Hospital Anxiety and Depression Scale; STAI: State-Trait Anxiety Inventory; BDI: Beck's Depression Inventory; QIDS: Quick Inventory of Depressive Symptoms; YBOCS: Yale-Brown Obsessive Compulsive Scale. ANXIETY AND DEPRESSION IN LIFE THREATENING ILLNESS  Anxiety and depression increase morbidity and accelerate death in cancer patients. Available treatment options are often ineffective (10). In a double-blind controlled crossover pilot study with 12 patients with anxiety and advanced cancer (11), patients received either a moderate dose of psilocybin (0.2 mg/kg) or niacin, which produces a mild physiological response without psychological impact, before crossover. Depression measured with the Beck Depression Inventory (BDI) improved after psilocybin treatment and became significant after six months. Anxiety measured with the State Trait Anxiety Inventory (STAI) was also reduced, reaching significance one and three months after treatment. In a double-blind randomized controlled pilot study with 12 patients with anxiety and life-threatening illness, most of whom (72.7%) had cancer, the effect of 200 μg or 20 μg of LSD was studied. A positive tendency towards reduction of anxiety was demonstrated, both state anxiety/situational anxiety and trait anxiety/trait anxiety measured with the STAI scale. The reduction in anxiety persisted at follow-up after 12 months (16). In a double-blind randomized controlled crossover study, 51 cancer patients with life-threatening disease and anxiety and/or depression received either high-dose or low-dose psilocybin before crossover (10). All patients met the criteria for a mental disorder according to the Diagnostic and Statistical Manual of mental disorders IV (DSM-IV), including adjustment disorder, generalized anxiety disorder, dysthymia and depressive episode. All patients received both low- and high-dose psilocybin with approx. five weeks apart. There were significant differences between the groups: both reduction of depression and anxiety and increased quality of life and acceptance of death. The differences were confirmed both by clinicians, the patients themselves and relatives. The primary endpoints of the Hamilton Anxiety Rating Scale (HAM-A) and the Hamilton Rating Scale For Depression (HAMD) were assessed by clinicians. The results persisted at follow-up six months after treatment: 77–83% of patients responded and 59–71% were in remission. Blinding measures provided some protection against expectation effects. In a double-blind randomized controlled crossover study, 29 patients with cancer-related anxiety and depression received either psilocybin or niacin before crossover (14). All patients met criteria for a mental disorder according to the DSM-IV system: 90% had adjustment disorder and 10% had generalized anxiety disorder. Significant differences were found between the groups before crossover, both for anxiety and depression. Six months after treatment, 60–80% of the patients had still responded to psilocybin based on Beck's depression scale and the Hospital Anxiety and Depression Scale (HADS).DEPRESSION A large proportion (20–30%) of patients with unipolar depression are treatment resistant (2). In an open-label study of 12 patients with treatment-resistant depression, defined as no improvement after at least six weeks of treatment with at least two types of antidepressants, psilocybin (9) caused eight of 12 patients to achieve remission as measured by the Quick Inventory of Depressive Symptoms (QIDS) at one week after the treatment. At the last check-up after three months, 5 out of 12 patients were still in remission, and 7 out of 12 still showed a response (9). An open-label study of ayahuasca with six patients with recurrent depression demonstrated an immediate antidepressant effect that was statistically significant and persisted at follow-up one and three weeks (15) after treatment. Two weeks after treatment, a non-significant increase in symptoms was seen. Since ayahuasca consists of both the psychedelic substance N,N-dimethyltryptamine and a monoamine oxidase inhibitor, and the latter is an established group of antidepressants, it is challenging to study the potential antidepressant effect of ayahuasca. It is difficult to envisage extensive use of ayahuasca in clinical studies before a standardized preparation of the active substances is established (4). ADDICTION

In an open study of psilocybin with ten patients with alcohol dependence, alcohol consumption was significantly reduced from baseline to follow-up after 36 weeks (8). In an open study of psilocybin with 15 patients with treatment-resistant tobacco/nicotine addiction (12), 80% of the participants were abstinent after six months. This was confirmed with objective measures of smoking cessation. COMPULSIVE DISORDERIn an open-label study of psilocybin with nine patients with obsessive-compulsive disorder, most of the patients experienced a reduction in their core symptoms. However, the lack of connection between dose and response, and also the effect on the very low minimum dose, means that expected effects are likely (13).SIDE EFFECTS The review showed that no serious side effects have been reported in any of the nine studies. A summary of eight double-blind randomized controlled trials with a total of 110 healthy volunteers showed that psilocybin appears to be well tolerated: 7% of participants in the high-dose group experienced acute side effects, but these could be managed with the help of supportive healthcare personnel and without the use of emergency medication. There were no long-term side effects (7). Persistent psychotic symptoms are very rare. In a single case among 1,200 healthy volunteers, there was a psychotic reaction beyond 48 hours, and this person had an identical twin with schizophrenia (20). Psychosis in the participant and a first- or second-degree relative are exclusion criteria for modern studies (21). Persistent psychotic symptoms have not been observed in the modern studies in the field (8–16). Discussion The main findings from the studies in this literature review support that one or a few doses of a classic psychedelic substance, most often psilocybin, have an immediate and persistent effect in several mental disorders. No serious side effects were reported in any of the nine studies. The two largest randomized controlled studies (10, 14) came independently to the same conclusion, namely a significant and persistent (six-month) effect of psilocybin against cancer-related anxiety and depression. Overall, the studies show that psilocybin and LSD have an effect against anxiety and depression in life-threatening illness (10, 11, 14, 16). All the studies mentioned have methodological limitations, either related to design, blinding, unclearly defined endpoints, selection of patients and/or sample size. It is not possible to confirm hypotheses about the effect of psychedelic substances in open studies without a control group or in open phases of randomized controlled studies. It is also difficult to separate drug effects from psychological treatment given in combination without a control arm. Furthermore, the review shows that it is difficult to use the results from current studies as a basis for changing clinical practice. The results indicate that psychedelic substances have a potential clinical effect with few side effects in a controlled clinical setting, and there is a basis for conducting systematic studies of solid quality. It will then be important to distinguish psychological from pharmacological effect

  • carry out a protocol without selection bias in personnel or participants

  • deal with problems related to blinding and expectation effects, for example when using a low dose rather than an ordinary placebo

  • check for somatic and psychological side effects acutely and as a long-term effect (6)

Psychedelic substances must be examined in more and larger studies to be able to determine clinical effect in the treatment of mental disorders. It will be important to limit psychological treatment to a minimum in order to distinguish it from drug effects without compromising the patient's need for adequate security and support.

If the existing results can be confirmed in future studies, the immediate and sustained effect of a single dose will introduce a new principle in psychiatric treatment. This corresponds to what has been observed in trials of ketamine in depression, although the effect there persisted for a few weeks (22). There are many indications that it may be wise to start studies of psychedelic substances precisely in severe depressions, such as treatment-resistant depression. This is a major clinical problem with few or no effective treatment options (6). Today's antidepressants only work after a few weeks and must be taken daily. It would be an advantage to have a faster onset effect. Sustained effect of a single dose will provide advantages compared to daily administered drugs with associated side effects. Furthermore, psychedelic substances have a different mechanism of action than currently available antidepressants, namely 5-HT2A agonism rather than mainly monoamine reuptake inhibition (4). There are now several phase II studies of psychedelic drugs being planned or conducted according to the ClinicalTrials.gov database. Psilocybin should be investigated for depression, obsessive-compulsive disorder and nicotine, alcohol and cocaine addiction. LSD must be examined for anxiety with and without life-threatening illness (23). This is an exciting development. We need new evidence-based treatment options for mental disorders.

bottom of page