Survey study of challenging experiences after ingesting psilocybin mushrooms: Acute and enduring positive and negative consequences

Abstract

Acute and enduring adverse effects of psilocybin have been reported anecdotally, but have not been well characterized. For this study, 1993 individuals (mean age 30 yrs; 78% male) completed an online survey about their single most psychologically difficult or challenging experience (worst “bad trip”) after consuming psilocybin mushrooms. Thirty-nine percent rated it among the top five most challenging experiences of his/her lifetime. Eleven percent put self or others at risk of physical harm; factors increasing the likelihood of risk included estimated dose, duration and difficulty of the experience, and absence of physical comfort and social support. Of the respondents, 2.6% behaved in a physically aggressive or violent manner and 2.7% received medical help. Of those whose experience occurred >1 year before, 7.6% sought treatment for enduring psychological symptoms. Three cases appeared associated with onset of enduring psychotic symptoms and three cases with attempted suicide. Multiple regression analysis showed degree of difficulty was positively associated, and duration was negatively associated, with enduring increases in well-being. Difficulty of experience was positively associated with dose. Despite difficulties, 84% endorsed benefiting from the experience. The incidence of risky behavior or enduring psychological distress is extremely low when psilocybin is given in laboratory studies to screened, prepared, and supported participants.

Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial

“…Difficult experiences are not necessarily pathological and can be understood as part of the therapeutic process (e.g. working through cancer-related psychological or existential distress through challenging encounters or emotionally charged confrontations with cancer-related fearful imagery or symbolism) (Carbonaro et al, 2016). …”

Neuroticism is associated with challenging experiences with psilocybin mushrooms

“…Within empirical studies, individuals who are high in neuroticism may be either explicitly (as in Studerus et al, 2012) or implicitly screened out of the study. Also, aspects of the environment such as interpersonal support that may mitigate challenging experiences are present by design in experimental laboratory settings (as in Griffiths, Richards, McCann, & Jesse, 2006; Johnson, Richards, & Griffiths, 2008; Studerus et al, 2012), but are variable and in many cases absent during experiences analyzed in the current report (Carbonaro et al, 2016). …”

“…Responses from a total of 1993 participants who provided useable data for an online survey of challenging experiences with psilocybin (Barrett et al, 2016; Carbonaro et al, 2016) were included in the current analyses. Analysis of Study 1 data constitutes a secondary analysis of previously reported data (Barrett et al, 2016; Carbonaro et al, 2016).…”

“…Analysis of Study 1 data constitutes a secondary analysis of previously reported data (Barrett et al, 2016; Carbonaro et al, 2016). Participants were recruited to report on their single most psychologically difficult or challenging session or experience (worst “bad trip”) via internet advertisements (70.4% of respondents indicated that they became aware of the study through websites that are frequented by individuals interested in psychedelics such as Erowid, an online information library on psychoactive substances, www.erowid.com), email invitation via emails that were sent by study staff to email distribution lists related to websites and groups that are frequented by individuals interested in psychedelics (6.6% of respondents indicated that they received an email for the survey as a member of a large email distribution list, and 5.0% of respondents indicated that they received a personal email regarding the survey from a friend), and word of mouth (6.7% of respondents indicated that they became aware of the survey via personal communication other than email, and 0.9% of respondents indicated that they heard about the survey at a conference or public presentation).…”

DMT Models the Near-Death Experience

“…For example, controlled research has found that certain personality traits, e.g., ‘absorption’ and ‘neuroticism’ can predict the intensity and quality of a psychedelic experience (Studerus et al, 2012; Carhart-Harris et al, 2015, 2018; Carbonaro et al, 2016; Barrett et al, 2017) while readiness to ‘let go’ and quality of the environment also seems to be predictive of response (Carhart-Harris et al, 2018). In a similar fashion, the prevalence and nature of NDEs appear to be sensitive to environmental, demographic and personality variables, such as etiology and prognosis of the NDE, age, absorption and a propensity to report paranormal experiences (Kohr, 1983; Greyson, 2003).…”