Do people who experienced long-term difficulties after tripping still think psychedelics are worth the risks?

Jules Evans
14 min readJul 26, 2023

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Photo by Jennifer Coffin-Grey on Unsplash

Earlier this year, the Challenging Psychedelic Experiences Project conducted the first study of extended difficulties after psychedelic experiences, what they’re like, how long they last, and what people say helped them deal with the difficulties. We received 608 responses and let me just say a huge thank you to everyone who took the time and emotional effort to share their experiences. It was a truly fascinating and moving read, and we shared some of the data and quotes in our first study, out now in pre-print. We have another study on the way on what helped people, and many of our respondents will be contacted for follow-on interviews so we can learn more.

The final question in the survey was this: ‘Please indicate your agreement with the below statement: I believe that the insights and healings gained from psychedelics, when taken in a supportive setting, are worth the risks’ .’ These were the results — a resounding ‘agree’:

Does this mean that all our respondents ultimately saw their own difficulties as healing and positive? Not exactly. After the final question, we added a box where people were asked if there was anything else they’d like to add before the end of the survey. Many people commented on the last question, and while some gave resounding endorsements of their faith in psychedelics, others expressed the ambivalence they feel both about their own difficulties and psychedelics in general. We didn’t ask people ‘do you wish you hadn’t ever taken psychedelics?’ (partly because I felt that was asking people ‘do you regret the direction your life took?’) but some responses touch on this — and it’s hard to answer with a simple yes or no. If a challenging experience like an illness or car crash has profoundly shaped your life trajectory, it’s made you who you are, for better or worse. One of the respondents, for example, developed psychosis after a trip, and told us: ‘The delusions of grandeur and voice hearing it triggered have definitely been a hindrance in my personal development but also crazily a boon because I am very sensitive now to others pain and potential mental anguish’. So even people who develop psychosis learn to adapt to and accept their situation, and even to appreciate it. Does this mean psychedelics were ‘worth’ all the anguish? Hard to say. You can get a sense of this ambivalence in some of the responses below, which I selected from the hundreds of responses to this question that we received. I also, as a humanities scholar, love the quiddity of the responses — I feel for the person who took a high dose of LSD and then locked themselves out of their house during the 1987 UK storm! Thank you again to our respondents for sharing their lives with us.

‘The topic of whether we should use psychedelics to help people is a very slippery. It’s hard to say either way whether one’s life is actually better off doing them vs avoiding them, and erring on the side of caution I would tell people to skip them. But that being said they did appear to help me come out of my shell and relieve certain cognitive problems, but again it’s really hard to say if the costs are worth it.’

‘I’ve had beautiful experiences too, but the hellish ones are what have left a lasting impact on my mental and physical health’

‘Psychedelics seemingly lately have been banded about with a level of proposed safety that including myself has made many people believe they are safe and can really help improve their mental wellbeing when for many they are simply dangerous and quite frankly in my opinion they are outright dangerous regardless of the individual. There are many a chart that can be found very quickly online stating how for instance shrooms are safer than even alcohol, which is interesting as many people who suffer serious life long lasting effects from alcohol consumption are usually because they are chronic alcoholics who drink copios amount daily, whereas I have read many a post of a psychadellic user (with some like myself 1g use and a microdose) who after a miniscule amount have now debilitating mental health illnesses that results in much anguish and unfortunately in many cases suicide, much has to be said about the organisations who are in part responsible for banding about such information in such a dangerous manner given there are many desperate and nieve people in the world hoping to help thier mental health.’

‘However dark, scary, difficult… my journeys have been, I have always trusted that it’s all part of the healing. And so far, my trust has been rewarded, which leads me to continue trusting, even as my psychedelic experiences become more and more challenging each time.’

‘Psychedelics are a tool. Although they can have huge benefits, it is very important to know that they can be harmful if you are not prepared (enough). Compare it with driving a car. It brings you freedom, but you can do a lot of damage when causing an accident.’

‘I guess one thing I wonder about, is that for me this “negative” experience came very suddenly. It starting very light and fun and within one second felt like my world was upside down with me stuck in the middle. I think, that was also the part that made it scary; as now I worry how quickly things can change without a warning so to say. I think it took about a year that I can finally say, I can also see the good and strength that comes out of this experience. Going back, I wish I would have been brave enough to just ask someone professional for support.’

‘I did not intend to take a heroic dose of liquid LSD. I thought I was merely trying a micro dose that might assist my creativity with some songs I was working on, but for reasons that still are not clear, the dose turned out to be upwards of 800 micrograms, as I’m told by a knowledgable friend who assayed the remaining contents of the eye-dropper bottle I used. Needless to say the “set” (of set & setting) was not ideal.’

‘The challenging experience ended up being incredibly healing for me, but it took a long time. Had this trip happened in a more supportive environment I am pretty sure it wouldn’t have been so challenging, although I am not sure I would have had the same effect as this felt like the bandaid was ripped off and I was forced to face some demons.’

‘I believe that the growth that happened during and after the difficult experience was enormous and looking back it helped me to live a better life’

‘I want to emphasize the correlation between my trip and the onset of panic disorder. I hope at some point my experience can be helpful to others. I hope to be able to have more psychedelic experiences in the future. I want to try MDMA again, very badly, but in a clinical setting. I definitely have a fear of drugs following this trip that wasn’t present before and continues to impact my life. I hope to overcome this at some point as I believe drugs and psychedelics are worth pursuing as tools in my recovery.’

‘Psychedelics are powerful tools, so it is not surprising that an adolescent mixing substances at 4 in the morning received some backlash! I work in mental health and still think that my experience with psychedelics have informed my understanding of human nature better than any degree or post grad studies.’

‘I would like to state that even through this incredibly hard experience (this is the hardest thing I have done in my life), I know it is all happening for good. Alongside it I have been going through deep spiritual awakenings and have continued journeying with high doses. Going deeper and deeper. The experiences get harder and harder but each one brings healing and growth.’

‘If it were up to me I would add some question to this survey (probably too late now though) that asked something like: “Despite the negative/traumatic experience, I STILL would do it all over again” — strongly disagree, disagree, agree, etc. If you had asked this question, and had added a “HELL YEAH!” option, I would have ticked this box! I have had several “bad trips” and friggin love them too because of how much I learn from them!’

‘I’d like to add that, although the PTSD around that trip faded after 8 years, I think it’s still in my mind in an attenuated form because I can get a faint hint of it if I dwell on how it felt — I can almost recall the “flavour” of it. The trip was back in 1975. I hope you can help people with this as it can be so massively distressing.’

‘I was diagnosed with c-ptsd and had then total of 5 years therapy, off all meds and working full time. I considered (and my psychologist agreed) that I was recovered. Did my very first psilocybin retreat and had a complete mythical experience which was 100pct positive and gave me so much insight and self love. 6 months later I did it again but with a very poor outcome that totally reversed the effects from the first one.’

‘Instead of researching psychedelic therapy, research HPPD and treatment for that before giving patients psychedelics and making something worse and not knowing how to fix them. People are suffering and the more that this is known the better’

‘I was clinically depressed before using psychedelics. Now I feel joy in life and taking psylocybin is the best thing I have ever done.’

‘Thank you for this research, I wish there had been more support/ understanding of what I experienced when it happened and I hope this research will help those who have/ will experience challenges with psychedelics.’

‘In the fervor to bring about legalized Psychedelic Assisted Psychotherapy work, it is being overlooked or minimized that sometimes the psychedelics don’t work, or they can give a bad trip. I foresee a lot of troubles.’

‘After the expirience it seemed bad and hard. I did not understand it, it was challenging to deal with it. Now after 5 years i can rate this expirience as a start of my spiritual death and reborn. It was necesary for me, the way i do things. And after i reexpirienced it 2–3 times more but i was able to understand why. Without a doubt i needed this expirience to make me who i am today’

‘The psilocybin I took no doubt stopped me from dying from addiction…but the dose and lack of ongoing support has contributed to me having to deal with some issues that i feel afraid to disclose to anyone or that might not even seem to rise to the level that doctors and others would care. I often feel alone and I also feel like this types of disclosures are more common than talked about bc people need help so desperately they want to be good patients and/or want the work to succeed.’

‘I definitely think the LSD and cannabis combination led to my innate psychosis being triggered and magnified. Madness runs in my family but the drugs took it and played with it. I know now its not real and just a trick of the mind that can be very enjoyable but the delusions of grandeur and voice hearing it triggered have definitely been a hindrance in my personal development but also crazily a boon because I am very sensitive now to others pain and potential mental anguish and feel I have definitely been taught a valuable lesson by life that is humbling and freeing ultimately’

‘I got just as much insight from my challenging trip as from my non-challenging ones.’

‘My diagnosis was PTSD, and the stressful event was the Ayahuasca ceremony that I participated in for spiritual reasons. The shaman was extremely well trained within a south American lineage and was also a trained psychotherapist. Another person in the ceremony also had longlasting negative effects and also had to take a year off school. There were really no identifiable red flags in either “set” or “setting”. Sometimes the drug is just not a good match for a person, and there’’s very little you can do to prevent that.’

‘I don’t get much opportunity to do psychedelics these days, but I believe them to have been incredibly beneficial at helping my to address early life traumas and process traumas as they occured as an adult. The perspective they give you on your own issues is invaluable. Psychedelic therapy should be available on the NHS.’

‘I guess I think that what I’m experiencing is not exactly a bad thing. I mean… It is: and it’s scary and I feel lonely and confused and lost. But maybe this is what I needed to shake my soul enough to start questioning my atheism, and start a spiritual path. I’m on this journey, now, since a year. I left almost everything I had. But I feel like I need a guide. I’m currently in south America, close to the Amazonian forest, trying to find it. And avoiding scams.’

‘I’m not opposed to psychedelics now but I am acutely aware of the severity of the negative side effects that rarely get talked about. And I am a mental health professional, so I “should know” what to do! But I could not save myself. I could barely function. I could not even tell my best friend who went to the experience with me. She had no clue about what I was going through. I felt mute, both physically and emotionally: a) I don’t feel like talking about this b) why bother because nothing will make it go away c) this is what you get for messing around with drugs d) this is the price you pay for being stupid. I felt so ashamed of myself.’

‘I was gaslit by many people (including the trip facilitators and integration circle), who told me “there’s no such thing as a bad trip,” and judged me for being upset about it. It was awful.’

‘I do feel that the importance of having a healthcare team involved could help mitigate some of the risks, regulating the underground psychedelic movement could help prevent very terrible experiences — after speaking with many others, there is a lot of shame and fear to reach out for help after partaking in an underground experience’

‘I would still do it in a supportive setting with a therapist. But since what I went through was so extremely difficult, I cannot say that I am sure that it would be worth it for me or for most people because I would not want anyones life “destroyed” for years like that. Not sure what could make that worth it.’

‘what happened to me was a huge wake up call. I felt incredibly suicidal when how I was feeling was at its worst. I am lucky enough to be surrounded by a very supportive and loving community of people so I know where to go for help and I got that help, but it made me wonder what would happen for the people who don’t have that support and help at their fingertips. Had my situation been different, perhaps I would have acted on those suicidal thoughts because what I was experiencing was so intense and unbearable.’

‘Post manic episode, I now have insomnia, trouble with my working and short-term memory, and tinnitus. Due predominantly to the manic episode, my husband divorced me and I lost my job. Were the insights and healings worth it? I do not know.’

‘till this day, despite the very challenging psychedelic experiences I have had so far (2 with psilocybin and 1 with MDMA), there are no other options/solutions left for me to explore. So I keep hoping that at one point psychedelics will work for me.’

‘I am so regretful taking ayauascha. I had 4 prior experiences with no effect but the fith destroyed my life’

‘Despite not having an official diagnosis, I have now been told by a therapist and suspected myself that I have PTSD from this experience. I believe I can’t be the only person to have this reaction but it’s incredibly difficult to find anything online because of the extensive research into treating PTSD with psychedelics, the key words get muddled and search results only ever indicate that PTSD can be treated with psychedelics and not caused by them. I don’t think this is useful for harm reduction.’

‘The experience and resulting changes in my life weren’t entirely negative. Negatives were, increase in anxiety about what I am, my place in the universe, death / non-existence. Positives were, less caught up over trivial things, much more connected to all-living creatures. Considering eating less meat, restarting donations towards charitable causes, donating to animal charities for the first time ever.’

‘Although I can see how psychedelics can be healing, I cannot say they are worth the risk. I had a very narcissistic, controlling mother who gaslit me constantly. I was also raped in my 20s. Both led to anxiety and some PTSD from the rape, but I was managing quite well before the bad trip. The bad trip I had re-traumatized me and made my PTSD 100 times worse.’

‘The dosage involved was excessive, and I had become too blasé about the experience to handle it. Circumstances also contributed — there was a major storm after I dosed (the great storm of 1987 — it has a wiki page), and in an attempt to change setting I went outside and locked myself out in it!’

‘Whilst I feel that the negative aspects of my experience have effected me for nearly thirty years, the positive aspects of psychedelic experiences have ultimately outweighed this. After a break of about twenty years, I now use mushrooms regularly and find them hugely beneficial.’

‘The mental illnesses that I had previous diagnoses of before the event were complex PTSD, depression, and anxiety. Most of my psychedelic experiences have reduced symptoms of all three of those diagnosis. The negative experience i have described in this survey seriously increased the symptoms of PTSD, both by surfacing old traumas and by adding a new trauma, but it still somehow decreased symptoms of depression and anxiety (other than anxiety directly related to the bad experience). In the end, as with most “bad trips”, it ended up teaching me a lot and leading to really valuable growth and learning.’

‘Taking psychedelics opened up something which took years to integrate. But I was very young and there wasn’t as much information around then and the internet did not exist.’

‘Whilst it’s great that these may help it concerns me that there is NO mention of any risks in any detail & as someone who suffered a “drug induced psychotic event”, I find it massively irresponsible. In my own journey to try & understand what has happened to me, I’ve researched as much as I could, emailed many organisations & various professionals and there’s nothing on the dangers, but also I realise that these psychedelics could be “the thing” that sorts me out. I definitely want more research because I so desperately want to heal. As time goes by, that glimmer of hope recedes more & more.’

‘I also think that it’s worth explaining how bad the experience actually was. It is so hard to put into words how terrifying and horrific it was. I am positive about psychedelic therapy being beneficial. But sometimes I think, is it worth it, when an experience like this is a potential consequence. The ayahuasca ceremony is supposed to heal trauma, but for me, it gave me trauma.’

‘Truly Worth It.’

‘I need help. My life has been destroyed’

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Support for post-trip difficulties can be found at:

  • ICEERS free online support service
  • Fireside Project free phone support service
  • A list of US-based therapists who offer post-psychedelic therapeutic support
  • And a list of UK-based therapists who offer post-psychedelic therapeutic support
  • Finally, some books that people say they found helpful in post-trip difficulties include Stan Grof’s books such as The Stormy Search for the Self; Tara Brach’s book Radical Acceptance, and my own and Tim Read’s book Breaking Open: Finding a Way Through Spiritual Emergency
  • The Challenging Psychedelic Experiences Project is seeking funding for our second year of research — please get in touch if you’re interested in supporting our work.

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