Leading the Change: Transforming Psychedelic Healthcare Through Harm Reduction Practices
The future of psychiatric treatment includes psychedelic healthcare. As the negative stigma around psychedelics and cannabis continues to shift, other stigmatized mind-altering medicines have emerged into mainstream culture and healthcare, offering options for addressing difficult mental health concerns, such as depression, anxiety, addiction, post-traumatic stress disorder, obsessive-compulsive disorder, eating disorders such as anorexia nervosa and bulimia, and bipolar disorder.
Innovative and pioneering healthcare leaders have an opportunity to transform the current course of conventional mental health treatment by redefining therapeutic landscapes and offering psychedelic approaches. Psychedelics have re-emerged after several decades, and the last generation that had previous access to any type of psychedelic treatment that was available to the public were the baby boomers.
Psychedelic medicines such as Ketamine, MDMA, LSD, Psilocybin (magic mushrooms), Ayuasca and Ibogaine have gained the interest of many professional healers, as well as many mental health sufferers, due to their profound ability to shift perspectives and improve difficult symptoms related to various mental health conditions. However, similar to psychotropic medicines, psychedelic medicines have strong effects. Some effects of psychedelics include disassociation, altered perception, hallucinations, euphoria, distorted sense of time, heightened emotions, spiritual experiences, and increased introspection.
Any professional seeking to work with psychedelics should understand the subjective effects of the medicine that they are working with. They should take precautionary measures to manage, reduce and mitigate any adverse side effects that can take away from the profound mystical experiences that it provides; that invoke transformation, shifts in identity, greater access to unconscious feelings, a healthy regression back to earlier states of well-being, relaxes ego defenses and boundaries, recovers childhood memories, and facilitates effective release. What other medicines in this world could do this? As the benefits of the psychedelic experience attract many individuals who have had difficulty improving their psychological conditions with conventional mental health treatments, the need for safety and harm reduction practices to provide and facilitate these medicines is of the most importance.
During my tenure as the Executive Clinical Director at The Psychedelic Treatment Program at The Happy Clinic at the Center of Inner Transformations, I have been leading initiatives in harm reduction to ensure the safety of my clients and promote their treatment goals. In 2017, I developed a harm reduction program for my unique medical cannabis health program in metropolitan New Jersey and New York City. As other psychedelics have shown promising effects on providing more revolutionary experiences, I shifted my focus to include Ketamine options at my clinic, and legal international psilocybin psychedelic retreats. As recent studies and legislation suggest, MDMA and LSD have a decent probability of being available for psychiatric treatment in the future, so my clinic is prepared to address this need with measures that can ensure optimal safety for patients who choose higher healing.
This article explores the basics of how adopting harm reduction strategies with therapeutic contexts can look. It is based on what I have adopted within my clinic as I seek to set new standards of excellence and ethical practice.
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Understanding Harm Reduction
Harm reduction is a pragmatic and compassionate approach that seeks to minimize the negative consequences associated with risky behaviors. Rather than stigmatizing or criminalizing substance use, harm reduction acknowledges the reality of human behavior and aims to meet individuals where they are, offering support and resources to mitigate potential harm.
Applying Harm Reduction to Psychedelic or Psycholotic Treatment
1. Comprehensive Screening and Preparation: A comprehensive screening process allows providers to identify individuals who may be at higher risk for adverse reactions. At my clinic, this includes psychological testing and measuring, assessing mental and medical history, mental health status and treatment history, current medications, as well as a comprehensive bio-psycho-social assessment. Additionally, we offer comprehensive preparation sessions, often referred to as “pre-flight” sessions, to educate participants about the potential risks and benefits of psychedelic experiences, as well as to establish a safe and supportive therapeutic container.
2. Safety Protocols and Monitoring: Ensuring physical safety during psychedelic sessions is crucial for treatment efficacy. This includes providing a comfortable and secure environment, as well as implementing protocols for managing medical emergencies should they arise. During this process at my clinic, we assist our clients by creating the “set and setting” of their psychedelic experience. Additionally, we provide clear guidelines for dosing and administration that help minimize the risk of accidental overdose or adverse reactions. During the active treatment session, we provide continuous monitoring of participants throughout the session by trained therapists or facilitators. Clients are never alone during the treatment, which is essential for identifying and addressing any emerging concerns promptly.
3. Integration and Support Services: The psychedelic experience does not end when the session concludes; rather, it is an ongoing process of integration and reflection. Consider post-session support services, whether they be individual therapy sessions, group integration circles, or educational workshops. We seek to provide these services to help individuals process their experiences healthily and constructively. We offer integration support that is tailored to the unique needs and experiences of each participant, providing them the tools and resources they need to integrate insights gained from the psychedelic experience into their daily lives.
4. Community Engagement and Education: Building a supportive community around psychedelic therapy can provide individuals with a sense of belonging and connection, reducing feelings of isolation and alienation. Consider ways to help build a supportive community through a peer support network, harm reduction education campaigns, or advocacy efforts. These can empower individuals to make informed choices about their psychedelic use and seek help when needed.
As we continue to explore the potential of psychedelic medicines in the treatment of mental health disorders, leaders in the field should prioritize harm reduction and safety. By integrating comprehensive harm reduction practices into psychedelic treatements as I did with The Psychedelic Treatment Program at COIT, we can maximize the therapeutic benefits of these substances while minimizing potential risks. Together, let us lead the change towards a more compassionate and responsible approach to psychedelic healthcare, The Happy Way.