6.2 Bad trips

The experience of serious negative effects is often referred to as a ' bad trip' . No exact data are available about the prevalence of a ' bad trip' among regular users. The experience of a bad trip is probably the main reason of users of magic mushroom to visit emergency care facilities. In such cases, the intoxicated individuals are usually severely agitated, confused, extremely anxious, and disoriented with impaired concentration and judgment. Acute psychotic episodes may occur in serious cases, including bizarre and frightening images, severe paranoia and total loss of reality, which may lead to accidents, self-injury or suicide attempts. A bad trip is usually followed by faintness, sadness and depression and paranoid interpretations, which may persist for days, weeks or even months. Some of these symptoms are probably associated with the use of other controlled substances. Occasionally, intermittent and chronic psychotic states due to the use of magic mushrooms are observed. In some individuals, the use of magic mushrooms can exacerbate underlying personality disorders and psychosis-like states. A report on the internet from 2007 (Shroomery, 2007) refers to more severe acute effects by extracts of mushrooms being intravenously injected (Curry and Rose, 1985; Sivyer and Dorrington, 1984). Finally, it is speculated (Satora et al., 2005) that the combined use of magic mushrooms with other psychoactive drugs, including alcohol increases the risk for bad trips.

6.4 Acute physical adverse effects

In general, the physiological side effects are not significant and may include dizziness, nausea, weakness, muscle aching, shivering, abdominal pain and dilation of pupils (mydriasis). A UK clubbing magazine survey conducted in 2005 found that over 25 percent of those who had used magic mushrooms in the last year had experienced nausea or vomiting (Mixmag, 2005). Tachycardia is a common finding in patients intoxicated by Psilocybe mushrooms. Mild-to- moderate increase in breathing frequency, heart rate (tachycardia of 10 b.p.m.) and systolic and diastolic blood pressure increase (+25, and +10 mmHg, respectively) is observed at 0.2 mg/kg psilocybin p.o. (Gouzoulis-Mayfrank et al., 1999), confirming previous data of 8-12 mg/kg p.o. psilocybin (Quetin, 1960). Generally, body temperature remains normal, but pronounced physical symptoms such as severe stomach pain, persistent vomiting, diarrhea etc. have been recorded. The latter physical complaints are not induced by psylocibin itself, but are due to the consumption of mushrooms in general. The tendency for a temporarily increased blood pressure may also be a risk factor for users with cardiovascular conditions, especially untreated hypertension (Hasler et al., 2004).

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In 2005, the Amsterdam Municipal Health Service registered 2837 calls for ambulance service assistance related to recreational drug use (Buster and van Brussel, 2007). Alcohol intoxication was the most frequent reason of an emergency call (2056 times; 72.5%), whereas for magic mushroom use it was 70 times (2.5%). Most of the calls referred to ambulance services given to tourists: 92% of magic mushroom ‘victims’ were foreigners. In contrast to incidents related to cocaine, heroin and ecstasy, magic mushroom related incidents were relatively harmless: treatment in an intensive care unit was needed for 11-20% of the group who had used cocaine, heroin or ecstasy, and for 1.5% of those who had used magic mushrooms

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12. Conclusion

It is concluded, that the use of magic mushrooms rarely (if ever) leads to physical or psychological dependence, that acute and chronic adverse effects are relatively infrequent and generally mild, that public health and public order effects are very limited and that criminality related to the use, production and trafficking of magic mushrooms is almost non-existent. However, attention should be paid to the infrequent occurrence of flashbacks and accidents. More specifically, in the absence of proper surveillance of the user the panic attacks evoked by magic mushroom use may lead to severe and sometimes fatal accidents. 19 The list mentioned in section 6.5 is partly based on newspaper articles and will probably not be complete. On the other hand, fatal accidents were sometimes (e.g. case 8 to 11) attributed to the use of magic mushrooms although the evidence was not available (no autopsy or blood test report). Furthermore, the reported fatal accidents and suicides will not always appear as mushroom related deaths in the official statistics. Still, the infrequent but severe adverse effects are often associated with overdosing and the combined use with other drugs, including alcohol. When using magic mushrooms, many, if not all, accidents can be prevented by a supporting setting, such as surveillance by a ‘sober’ person. An attractive option is to make psilocybin available for use only on premises e.g. in specially designed environments for this purpose.

Källa: Harm potential of magic mushroom use: a review (van Amsterdam, 2011)

Antalet rapporterade dödliga och icke-dödliga akutfall på grund av hallucinogena svampar är mycket lågt. I allmänhet är de fysiologiska effekterna kortvariga och utan avgörande betydelse, och de kan omfatta yrsel, illamående, svaghet, muskelvärk, darrningar, magsmärtor, pupillutvidgning, svagt till måttligt ökad hjärtfrekvens och andningsfrekvens (takykardi, tachypne) samt förhöjt blodtryck. Det har emellertid också förekommit rapporter om uttalade fysiska symtom i form av svåra magsmärtor, ihållande kräkningar och diarréer. Den akuta toxiciteten i psilocybin anses vara låg och detta stöds av att det är sällsynt med rapporter om dödlig förgiftning av hallucinogena svampar. Förgiftningar kan ske vid konsumtion av svampar som plockats i det vilda, om giftiga arter förväxlas med hallucinogena svampar. Användningen av hallucinogena svampar kopplas mer allmänt till mentala hälsorisker. Även om andelen användare som upplever en snedtändning inte är känd är det sannolikt oftast dessa användare som tar kontakt med akutvården. I dessa fall är de påverkade personerna oftast ytterst oroliga, uppjagade, förvirrade och desorienterade, med försämrad koncentrationsförmåga och försämrat omdöme. I allvarliga fall kan det förekomma akuta psykotiska episoder, med bland annat bisarra och skrämmande föreställningar, svår paranoia och total förlust av verklighetsuppfattning, vilket kan leda till olyckshändelser, eller att personen försöker skada sig själv eller ta livet av sig. Även om många förebyggande program innehåller information om hallucinogena droger tillsammans med information om andra droger för att öka medvetenheten, verkar det råda brist på specifik information om hälsoriskerna i samband med bruk av hallucinogena svampar till dem som arbetar med ungdomar. Å andra sidan har användare och lobbygrupper skapat flera webbplatser med information om hallucinogena svampar.

Källa: EMCDDA: Hallucinogena svampar: Hur ska vi hantera problemet med naturligt förekommande substanser i ett informationssamhälle? (EMCDDA, 2007)

It is near impossible to take a dose of psilocybin mushrooms that is physically toxic to your body or brain. Psilocybin does strongly affect judgement and coordination however, so doing something like driving whilst under the influence of psilocybin would be very dangerous and illegal. Whilst there are many urban myths about bizarre deaths on hallucinogenic drugs, people do very occasionally get injured or killed because of the effects of the drug on their behaviour. Someone taking psilocybin mushrooms should plan ahead to make it impossible that they might end up around roads, cliffs or anywhere where they could have a serious accident. Psilocybin can induce states of confusion, misery, agitation and fear. Negative experiences induced by hallucinogenic drugs are often referred to as ‘bad trips’. A point here is that assuming that a trip as a whole is going ‘bad’ at the first sign of an unpleasant effect could be a self-fulfilling prophesy. Bad or at least overly intense, difficult moments during strong trips are quite common but usually pass or can be overcome. Having said that, there is a risk that high doses of magic mushrooms can cause disastrous, prolonged and traumatic effects called a ‘psychedelic crisis’, though this is not common. The risk of someone suffering unpleasant effects is increased if the drug is taken without preparation or if it is taken in a less-than-ideal setting, like a busy, loud party full of strangers. There is also a risk of making mental illness worse or even triggering it if the person taking the drug has a pre-existing vulnerability to this. However, the risk of long-term psychological disturbance is low.

Are there health conditions that make psilocybin mushrooms (magic mushrooms) more dangerous?

Any history of mental health problems could increase the chance that the trip is unpleasant or traumatic, and the more serious risk that there are lasting harms (see also the information provided in the LSD entry). If you have or have ever had schizophrenia or a psychotic episode, tripping could trigger a relapse or worsening of the condition. As mentioned before, external conditions (the 'setting', see below) can also have a tremendous impact on the nature of the psychedelic experience which means that an obnoxious environment (e.g. people or location) can increase the risk of inducing unpleasant or horrible trips.

How addictive are psilocybin mushrooms (magic mushrooms)?

People do not seem to become addicted to psilocybin mushrooms. Although some people take them quite regularly, they are unlikely to struggle with stopping taking them if they feel that the drug is causing them problems. Temporary tolerance discourages people from taking mushrooms repeatedly over a short period, as a dose that on one day produced strong effects may have no effects if repeated the next day. Harms such as HPPD seem more likely in people who use drugs regularly and heavily.

Källa: ISCD - Independent Scientific Committee on Drugs: Psilocybin mushrooms / 'Magic mushrooms'

A. The re-experiencing, following cessation of use of a hallucinogen, of one or more of the perceptual symptoms that were experienced while intoxicated with the hallucinogen (e.g., geometric hallucinations, false perceptions of movement in the peripheral visual fields, flashes of colors, intensified colors, trails of images of moving objects, positive afterimages, halos around objects, macropsia, and micropsia.

B. The symptoms in Criterion A cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

C. The symptoms are not due to a general medical condition (e.g., anatomical lesions and infections of the brain, visual epilepsies) and are not better accounted for another mental disorder (e.g., delirium, dementia, Schizophrenia) or hypnopompic hallucinations.

21,967 respondents (13.4% weighted) reported lifetime psychedelic use. There were no significant associations between lifetime use of any psychedelics, lifetime use of specific psychedelics (LSD, psilocybin, mescaline, peyote), or past year use of LSD and increased rate of any of the mental health outcomes. Rather, in several cases psychedelic use was associated with lower rate of mental health problems.

Conclusion

We did not find use of psychedelics to be an independent risk factor for mental health problems.

A majority of the participants — 62 percent — said their bad trip was among the top 10 most psychologically difficult situations of their lives. Eleven percent said it was their number one most difficult experience.

But 34 percent of participants said the bad trip was among the top five most personally meaningful experiences of their life and 31 percent said it was the among the top five most spiritually significant. And 76 percent said the bad trip had resulted in an improved sense of personal well-being or life satisfaction. Forty-six percent said they would be willing to experience the bad trip all over again.

Interestingly, the degree of psychological difficulty was statistically associated with beneficial outcomes. More difficult or challenging experiences tended to be viewed as more beneficial or meaningful. However, longer bad trips were associated with less beneficial outcomes.

Källa: Psypost 2016-08-30: Study: ‘Bad trips’ from magic mushrooms often result in an improved sense of personal well-being