Bad trip

A multitude of reactions can occur during a psychedelic crisis. Some users may experience a general sense of fear, panic, or anxiety.[2] A user may be overwhelmed with the disconnection many psychedelics cause, and fear that they are going insane or will never return to reality. The fear that is felt during a bad trip has a psychotic character, coming as it does from within the mind of the tripper and not from the external environment. For example, during Albert Hoffman's first acid trip, he hallucinated that his neighbour had turned into a malignant demon, when in fact she was only a friendly woman trying to help him.

A person having a bad trip might try to harm themselves or others around them.[3] They may experience suicidal ideation, or make full-blown suicide attempts. Because of the magnification of emotions they induce, many psychedelics could possibly cause thoughts of death and intensely adverse reactions in some users. Users can believe that their death is imminent or that the very universe itself is collapsing.[3] Rapid "aging" of other people may be observed by the user, perpetuating the aforementioned fears to an even greater degree.

Some users may experience disorientation. The normal views of time, space, and person can be substantially altered, causing fear. Some can worsen their condition by trying to fight the psychedelic experience after embarkment. There can be illusions of insects crawling over or into one's self, or of being in dirty places such as sewers. Some users may experience a feeling of losing control of their minds due to persistent racing thoughts.

In rare cases an apparent complete loss of control can be observed, with an individual's behavior tending to exhibit a temporary loss of normal understanding of navigation of one's physical environment. An individual in such a state can cause accidental harm to themselves and to others, and can include behavior such as flailing about or even running into traffic, or, as such a state may not necessarily involve physical movement, may involve induction of a catatonic state or the expression of seemingly random vocalizations i.e. not limited to true speech. This may be caused by a failure to recognize external stimuli for what it is. Stanislav Grof explains this feature:

There is a tremendous danger of confusing the inner world with the outer world, so you'll be dealing with your inner realities but at the same time you are not even aware of what's happening, You perceive a sort of distortion of the world out there. So you can end up in a situation where you're weakening the resistances, your conscious is becoming more aware, but you're not really in touch with it properly, you're not really fully experiencing what's there, not seeing it for what it is. You get kind of deluded and caught into this.[4]

Generally, a person experiencing a psychedelic crisis can be helped either to resolve the impasse, to bypass it, or, failing that, to terminate the experience. A person's thoughts before taking or while under the influence of the psychedelic, often greatly influence the trip.

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. Diazepam is the most frequently used sedative for such treatment, but other benzodiazepines such as lorazepam are also effective. 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. Haloperidol is effective against acute intoxication caused by LSD and other tryptamines, amphetamines, ketamine, and phencyclidine.[5][6]

According to Timothy Leary, a crisis can be a result of wrong set and setting. Leary 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.

Alternatively, psychiatrist 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 could be a 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, Grof suggests that interrupting a bad trip, while initially seen as beneficial, could potentially trap the tripper in unresolved psychological states. Grof also suggests that many cathartic experiences within psychedelic states, while not necessarily crises, may be the effects of consciousness entering a perinatal space.[7]

• Psychedelic experience
• Existential crisis
• Psychedelic therapy
• Psychonautics
• Psychosis
• Recreational drug use
• Psychedelics, dissociatives and deliriants
• Responsible drug use
• Hard and soft drugs
• Altered state of consciousness
• Lucid dreaming
• Sensory deprivation
• Spiritual crisis
• Out-of-body experience
• Overdose
• Ego death
• Posttraumatic stress disorder
• Posttraumatic growth

• Psychedelic Crisis FAQ: Helping someone through a bad trip, psychic crisis, or spiritual crisis
• Crisis Intervention in Situations Related to Unsupervised Use of Psychedelics
• The Psychedelic crisis (bad trip) entry at Drugs-Wiki
• Psychedelic Harm Reduction
• Psychedelic Harm Reduction and Policy lecture in the Psychedelic Science in the 21st Century conference in 2010.
• Psychedelics in the Psychiatric ER - Julie Holland, M.D. lecture in the Psychedelic Science in the 21st Century conference in 2010.