On Minimizing Risk and Harm in the Use of Psychedelic

Introduction

Psychedelic drugs, defined here as classic serotonergic compounds such as psilocybin, LSD, mescaline and DMT, are presented as having therapeutic potential but also carrying distinct risks. The authors note that a minority of non-clinical users—about 9%—report functional difficulties lasting longer than a day after acute effects, and that some post-psychedelic problems can persist for weeks, months or years. Risks appear lower in clinical trials, likely because of screening and controlled conditions, yet serious adverse events (AEs) still occur and some AEs may be under-reported. The paper places these concerns in the broader context that all effective psychotropic treatments have AE profiles and that psychotherapeutic components can themselves produce adverse responses; combined drug-plus-psychotherapy approaches therefore require monitoring of both pharmacological and interpersonal harms. This article responds to gaps in knowledge about the types, predictors and treatments of psychedelic harms and about how best to support people who experience post-psychedelic difficulties. It aims to synthesise the perspectives of 30 psychedelic researchers to identify critical research priorities and practical steps for creating a more robust ‘psychedelic safety net’, including improved surveillance, better support services, clearer public communication, and targeted funding mechanisms to reduce risk during wider implementation and scale-up.