Harm Reduction & Comfortable Trips

Psychedelic Praxis Guide to Harm Reduction & Comfortable Trips

The focus of this document is on the responsible and informed use of mind-altering substances. In this vein, we strongly advise that users use harm reduction measures and intentionally plan their set and setting in advance.

Thanks to /u/brainbanged for doing the bulk of the work formatting this document as plaintext, and for the Reddit community for making many contributions. These submissions come from the /r/PsychedelicPraxis community.

Set & Setting

If you are planning to use psychedelic drugs for the first time, we strongly advise that you do some general reading about how to prepare for a safe and productive trip.

Besides the actual chemical contents going into your body, the psychedelic is equally affected by one's surroundings and emotional experience. Set refers to personal preperation, including both one's personal history and their emotional state at the time of the trip. Setting refers to the physical surroundings: environments, sounds, other people, cultural icons, and anything else one perceives.

In order to prepare for a positive and productive trip, it is helpful to read about how people respond to different drugs under various circumstances, and try to intentionally construct a set and setting that feel comfortable and catered to you on the day of your trip. Here are some resources that provide helpful information on how to prepare yourself for a trip:

Trip Guides Online

For information on the individual substances you are consuming or may be considering consuming, be sure to also visit:

Harm Reduction

Some illustrated advice from Zendo Project on how to be a good tripsitter/how to be present during a trip, for those of you looking for a quick lesson.

Other information via Psychsitter and DanceSafe:

Medication and Drug Interactions

If you are on any medication taken regularly, especially if you are taking antidepressants or other psychiatric drugs including lithium or MAOIs, be sure to spend time researching and known interactions with any psychedelics or empathogens you plan on taking. Search forum posts and read what others have experienced under similar chemical combinations.

Be sure to check your Tripsit's drug interaction page, which contains the following chart of great utility, as well as futher information on interactions:

Related studies:

HPPD and PTSD

The intense mental effects of psychedelics can bring on a set of symptoms known as Hallucinogen Persisting Perceptual Disorder (HPPD), and overwhelming psychedelic experiences can also induce Post-Traumatic Stress Disorder (PTSD); it is not unusual for these conditions to occur in tandem.

HPPD can be recognized by persistent visual distortions while sober including visual static, increased tracers or afterimages, confusion over color perception or identification, bright or dark halos around objects of visual focus, size and perspective distortion, and many other features.

PTSD may emerge from traumatizing or unintegrated experiences had under the influence of psychedelics. These experiences may also be tied up in HPPD perceptions, which can make life very uncomfortable.

Most sufferrers of HPPD find it subsides within a few months of abstinence from psychedelics. For more information on managing these symptoms, refer to the following:

If you are overwhelmed by past psychedelic experience or suspect you may be developing symptoms of PTSD as a result of them, refer to MAPS's Integration List of therapists who practice psychedelic integration:

Informed Dosage

It always helps to know the dosage and effect of chemicals before you take them. Always ask your source if they know the dosage drugs you acquire, and if possible ask others who have already tripped on it what their impressions were.

If you are taking a substance for the first time, start by taking a low dose to test its effects on your psyche and physiology before delving more deeply. Suggested dosages are available on these websites:

Unfortunately, we often end up with drugs of unknown or degrated quality, and without an effective means of testing their effects before taking them. If you do not know the dosage of your drug (but are sure of what substance it contains), test it by taking a small quantity of what appears to be a single intended dose.

If you are taking chemicals that come as a powder or crystal, buy a milligram scale. Do not attempt to approximate milligram quantities by eyeballing them.

Bluelight Survey-Obtained Psychedelic Tolerance Curve

This plot was generated using anecdotal user reports via Bluelight. Source:  The Big & Dandy LSD & Shroom Tolerance FAQ and Discussion Thread

Here is a version of the curve based on a slightly more nuanced interpretation of the data, made by Mx. Rylee Fox:

Drug Testing

When ingesting mind-altering chemicals, it is critical to test their contents, especially if they were acquired from a new or unreliable source. This can be done simply using a reagent kit, available from the trusted below:

Below are some color identification charts for various reagent kits and chemicals of popular interest:

DanceSafe Fentanyl test strips

Obtaining Narcan

Narcan, a nasal spray which counteracts the effects of opioid overdose, is available without a prescription in most US states. Like an Epipen, carrying Narcan can help prepare you for the worst-case scenario. For a two-dose package, Narcan costs between $40-$150 depending on where it is available, and may be covered by insurance.

Reagent Reaction Videos

Bunk Police Android App contains HD reagent reaction videos for reference when testing substances:

MDMA Identification

Due to being one of the most adulterated drugs, the impurity of MDMA (also known as molly, mandy, and ecstacy) in different regions and at different times varies. According to data collected from a range of sources, anywhere between 30% and 60% of what is being sold as molly or ecstasy in the USA is not in fact MDMA. While MDMA purity is generally higher in Europe, adulterants do still appear. Substances such as synthetic cathinones (methylone, butylone, MDPV, ethylone, etc.), ketamine, amphetamine, methamphetamine, PMA or PMMA, alpha-Pyrrolidinovalerophenone (known as flakka), DXM, and even heroin or fentanyl have been found in supposed MDMA pills. There are also less controversial ingredients such as aspirin and caffeine, as well as inert binding agents.

In addition to proper reagent testing of pressed pills, please visit Ecstacy Data for lab tests and Pill Reports for subjective user reports.

MDMA Safety

While MDMA has therapeautic and recreational value, neurotoxicity has been shown in lab animals as a result of high and frequent dosing. There is no substitute for moderation. Doses should ideally be spaced 3 months apart, but at least 6 weeks as a general rule. Persistent use is linked to depression, suicidal ideation, sleep paralysis, and other side effects.

An issue with MDMA is its ability to raise body tempurature. It is important to take frequent breaks from physical activity to cool off while under the influence.

Another issue is water retention and the associated decreased salinity of the blood. During the roll, you may notice that you have difficulty peeing or experience cranial pressure. You may feel very thirsty and dry-mouthed, and it is important to stay hydrated, but drink no more than 1-2 glasses of water per hour. Drinking beverages with electrolytes or isotonic (salty) fluids will reduce the risk of hyponatremia, especially in women. Drinking alcohol is not recommended as it dehydrates you, depletes electrolytes, dulls the stimulating effects of the MDMA, and can increase the risk of blackouts & hangovers.

Magnesium is often taken to reduce jaw clenching/"gurning" and reduce nausea. There are a variety of types of magnesium with different degrees of bioavailability, with glycinate/chelate as the most recommended. Antacids and natural remedies such as ginger may also be taken to reduce nausea.

Many users suggest pre-loading and post-loading with neuroprotective antioxidant supplements such as Alpha Lipoic Acid (ALA), Acetyl-L-carnitine (ALCAR), Ascorbate (Vitamin C), Vitamin E, Nicotinamide, Ubiquinone (Co-Q10), grape seed extract, and green tea extract (EGCG). It is also recommended to take 5-HTP (with vitamin B6) to help promote the replacement of endogenous serotonin after a roll. More information can be found at:

As seen in the tripsit.me drug combinations chart, cannabis has a low risk and high synergy with MDMA, but anecdotal reports suggest increased headspace at higher doses, and caution should be used considering the tendency of other substances to be sold as MDMA. MAOIs should not be taken with MDMA, due to the increased risk of the potentially fatal serotonin syndrome. SSRIs will typically reduce the effects of MDMA, SNRIs may change effects, and TCAs will generally increase the effects at unknown levels. Some users report utilizing SSRIs after a roll to stop the flood of serotonin and reduce neurotoxicity.

MDMA also lowers the seizure threshold so proceed with extreme caution if you have a history of seizures. Studies have shown that MDMA interferes with one's ability to discern negative emotion from facial expression. While fear reduction is great for therapy and having a good time, take care in unfamiliar places and with strangers. You don't want to be taken advantage of!

Psilocybin Mushroom Species Potency Guide

Different mushroom species can vary in potency. Even among the same species, actual psilocybin content may vary. For more information visit:

Smoked Cannabis vs Edibles

"The base pharma- cokinetic equivalency ratio is 1 to 5.71. This means that one milligram of THC in edible form, is equivalent to 5.71 milligrams of THC in smokable form." (https://www.colorado.gov/pacific/sites/default/files/MED%20Equivalency_Final%2008102015.pdf)

Leafly Cannabis Strain Explorer

Leafly's index has information on many strains of cannabis, and includes subjective effects for each entry as well as a cannabinoid profile.

Cannabinoid Profiles

Information regarding various parts of the cannabis plant continues to grow. As you may be aware, CBD has little to no psychoactive component and can be used to treat pain and anxiety. Other calming cannabinoids are CBN and CBG. THCV is energetic and shows promise as an appetite suppressant. Below are a variety of uses of different cannabinoids, which unfortunately remain unevaluated by drug regulating agencies due to a prohibition on research.

Cannabinoid Vaporization Temperatures

Here are the boiling points of several compounds found in cannabis.

Preliminary Analysis of FDA’s 36 Kratom-related Deaths

This is a breakdown of the causes of the kratom deaths that the FDA has used to justify its stance to heavily regulate the drug. There appears to be a number of novel drugs combinations implicated in these deaths, and it is recommend reading for anyone who wishes to understand the problem further.

Additional documents linked from the analysis:

DXM Dosage Calculator

These web tools that takes your weight and spits out appropriate dosages for the different "plateaus" of DXM.

Benzodiazepine Converter

This is a simple calculator made to help you figure out how much a given benzodiazepine converts to another benzodiazepine dosage.

Dissociative Anesthetics

There have been recent reports of O-PCE being sold as DCK, with 2 samples confirmed in lab last month (https://twitter.com/hamiltonmorris/status/951524523966451713?s=21). There are now reports of potentially lethal PCC appearing in large quantities in batches of 3-MeO-PCP (https://www.reddit.com/r/RCSources/comments/81e0l7/warning_potential_lethal_batch_of_3meopcp_going/). This is not a new phenomenon given that PCC is a precursor (https://erowid.org/archive/rhodium/chemistry/pcp.pcc.analysis.html) but it is something to look out for. One suggestion is to test with steel wool and hydrochloric acid and look for a dark blue reaction (http://bluelight.org/vb/threads/649827-PCP-to-PCC).

The Secret-Alchemist Club Anti-Nausea Shot

An anti-nausea solution which was highly recommended by a community member.

=========== Microdosing

A variety of resources on microdosing LSD and mushrooms, including a paid course and access to a private community, are available at the third wave.

Participants in the Fadiman/Korb microdosing study (https://sites.google.com/view/microdosingpsychedelics/home), using LSD, 1p-LSD, or mushrooms, have reported using certain medications and supplements with no adverse response. If you are looking for a medication or supplement of interest, we recommend using CTRL+F to find it. https://sites.google.com/view/microdosingpsychedelics/drugs-and-supplements

Dr. Dave Nichols talks about the potential downsides of microdosing, including cardiac valvulopathy, on this Psychedelic Salon podcast: https://psychedelicsalon.com/salon2-034-psychedelic-chemistry/. Concern arises from activity with the 5HT-2B receptor as indicated in the research paper "Serotonin Receptors and Heart Valve Disease – it was meant 2B" (2011):

 

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