Psychedelic crisis
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A psychedelic crisis, colloquially known as a bad trip, is a disturbing or frightening experience associated with use of a hallucinogenic drug such as LSD, mescaline, DXM, or psilocybin. Such effects are not seen as threatening or negative in the therapeutic community, and have the potential to be highly beneficial to the user when properly resolved. They have been attributed to the inexperience or irresponsibility of the user, lack of proper preparation and environment for the trip, or unresolved psychological tensions triggered during the course of the experience.<ref>Stanislav Grof, LSD Psychotherapy; passim</ref>
It is suggested that, at a minimum, such crises be managed by preventing the individual from harming oneself or others by whatever means necessary up to and including physical restraint, providing him or her with a safe and comfortable space, and supervising him or her until all effects of the drug have completely worn off.
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[edit] Aspects
Some of the experiences that may occur during a crisis are:
- Fear
- Harmful behavior
- Aggression against self or others
- Suicidal ideation or attempts
- Entrapment
- Fighting the inability to return to normal
- Disorientation
- Confrontation with death
- Sensation of one's imminent death or the death of the universe
- Perception of rapid aging of self or others
- Unpleasant sensations
- Profound depression
- Illusion of insects crawling over or into one's body
- Illusion of being in dirty places such as sewers
[edit] Unpredictability of the experience
The effects of psychedelic drugs vary widely from one individual to the next, and from one experience to the next. Sometimes individuals under the influence of such drugs forget that they have taken them, and believe that the wildly distorted world they perceive is real and will be with them indefinitely. In cases where the individual cannot be kept safe, hospitalization may be useful, though the value of this practice for individuals not mentally ill is disputed by proponents of investigative or recreational use of psychoactive compounds. Psychosis is exacerbated in individuals already suffering from this condition.
[edit] Intervention
Generally, a person experiencing a psychedelic crisis can be helped to either resolve the impasse, bypass it, or, failing that, to terminate the experience.
[edit] Psychologically
Experienced individuals functioning as trip "sitters" can assist a tripper trapped in an excruciating mental state break out of that condition. Less experienced sitters, if they have the tripper's trust, can attempt to "talk down" an individual having a difficult trip. One must get a feel for how distorted or disconnected the individual is, and then attempt to remind the individual that they took a drug and that the feelings they are experiencing are a result of the drug, and that these will eventually pass. It is also very important to talk calmly to the individual and not become agitated by their behavior, as this will only amplify the most negative aspects of whatever their mind is processing during the bad trip.
[edit] Medically
Medical treatment consists of supportive therapy and minimization of external stimuli. In some cases, sedation is used when necessary to control self-destructive behavior, or when hyperthermia occurs. Valium is the most frequently used sedative for such treatment, but other benzodiazepines such as Ativan are also effective. It should be noted that such sedatives will only decrease fear and anxiety, but will not subdue hallucinations. In severe cases, antipsychotics such as haloperidol can reduce or stop hallucinations, but this treatment is only effective against the so-called "classical" hallucinogens (LSD, psilocybin and mescaline, among others). Antipsychotics are not effective against dissociatives such as PCP and ketamine, and should not be used if these drugs are involved. According to Timothy Leary, a simple temporary fix to a bad trip is sugar (in the form of candy, oranges, etc.), since crises may often be the result of people forgetting to eat and experiencing hyperawareness of low blood sugar.
[edit] Potential Causes
According to Timothy Leary, a crisis can be a result of wrong set and setting, and advised that users of psychedelics be sure that they are comfortable before taking the drugs. Leary claimed that the frequency of difficult trips was highly exaggerated by anecdotes and fabrications in the popular press, and was actually about 1 in 1000.
Alternatively, psychologist R. D. Laing held that psychedelic crises and other such extreme experiences, drug-induced or not, were not necessarily artificial terrors to be suppressed but rather signs of internal conflict and opportunities for self-healing. The greater the pain and pathos of an experience, the greater the urgency to explore and resolve it, rather than attempt to cover it up or dismiss it.
Likewise, Stanislav Grof suggested that painful and difficult experiences during a trip were the result of the mind reliving experiences associated with birth, and that experiences of imprisonment, eschatological terror, or suffering far beyond anything imaginable in a normal state, if seen through to conclusion, often resolve into emotional, intellectual and spiritual breakthroughs. From this perspective, interrupting a bad trip, while initially seen as beneficial, can trap the tripper in unresolved psychological states.
[edit] Effects of cannabis
Though cannabis can lead to panic states in some cases, it does not cause "bad trips" when used by itself. These are merely anxiety attacks which lead the unexperienced user to a confused state. Simply talking them down and possibly having them eat will suffice for these anxiety attacks. However, because it can induce anxiety attacks that could trigger an actual crisis, marijuana should not be used while under the influence of a hallucinogen especially at difficult moments, since instead of calming, it is likely to exacerbate confusion, panic and paranoia. Prior mental illness can be a catalyst for a bad trip on marijuana.
The species of marijuana known to cause to high anxiety and panic attacks is Cannabis Sativa, which provides an uplifting, energetic high. Cannabis Indica is known for reducing anxiety and inducing calm, "down" highs.
[edit] See also
- Psychedelic psychotherapy
- Psychonaut
- Recreational drug use
- Psychedelics, dissociatives and deliriants
- Responsible drug use
- Hard and soft drugs
- Altered state of consciousness
- Lucid dreaming
- Sensory deprivation
- Out of body experience
- Overdose
[edit] Notes
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