Harm Reduction Journal
April 11, 2021
Brian Pilecki, Jason B. Luoma, Geoff J. Bathje et al.
135 citations
As clinical trials show strong evidence for psychedelic-assisted therapy's benefits, many people are using psychedelics on their own rather than waiting for legal medical access. Therapists have an ethical duty to support these clients, but incorporating psychedelics into traditional psychotherapy poses risks given their prohibited status. This paper explicates these risks and describes ways therapists can mitigate them while practicing within legal and ethical boundaries. A harm reduction approach is emphasized as a useful framework for conducting therapy around clients' psychedelic use. Therapists can meet with clients before and after personal psychedelic experiences to help minimize risk and maximize benefit. Common clinical scenarios in this growing area are discussed.
Harm Reduction Journal
July 9, 2019
Thomas Anderson, Rotem Petranker, Adam Christopher et al.
130 citations
A mixed-methods study of an active microdosing community categorizes the experiences participants report, identifying high-potential avenues for future scientific research. The resulting taxonomy distills intervention targets from participant reports to help allocate research funding efficiently. Microdosing research complements full-dose psychedelic studies as clinical treatments and neuropharmacological mechanisms are developed. The framework aims to guide researchers and clinicians as experimental microdosing research begins in earnest.
Harm Reduction Journal
September 4, 2017
Martin Andersson, Mari Persson, Anette Kjellgren
93 citations
People with treatment-resistant cluster headache and migraine often turn to online forums to discuss alternative pharmacological treatments, including illicit psychoactive substances. A qualitative thematic analysis of discussions on three forums found that patients are in a desperate and vulnerable situation, viewing such substances as a last resort. Psilocybin, lysergic acid diethylamide, and related psychedelic tryptamines were reportedly effective for both preventing and treating attacks, while cannabis results were more unpredictable. Users showed little interest in psychoactive effects, often using sub-psychoactive doses to avoid them. No severe adverse events were reported, but desperation sometimes led to risky behavior in obtaining and testing treatments.
Harm Reduction Journal
January 1, 2013
Levente Móró, József Rácz
82 citations
A Hungarian online community called Daath, run by the 'Hungarian Psychedelic Community' since 2001, provides peer-led harm reduction services for users of hallucinogenic and related substances. The website serves about 1200 visitors daily and has over 8000 registered members. Daath offers online services such as a discussion board and an Ecstasy pill database, along with offline activities like field testing of Ecstasy pills and a documentary film about psychedelics. The community operates with a strong commitment to harm reduction without promoting drug use. The review outlines Daath's history, growth, guidelines, and activities over the past decade, and discusses future challenges and trends in harm reduction.
Harm Reduction Journal
January 1, 2007
Rachael Butler, Janie Sheridan
78 citations
Young New Zealanders aged 17–23 who used BZP-party pills in the previous year did so mainly during weekend social occasions and dance parties, seeking stimulant effects and enhanced socialisation. They often combined the pills with other legal and illicit drugs, especially alcohol. Many experienced physical and emotional negative effects, none life-threatening or long-term, and some reduced their use because of adverse effects. Risky behaviours included taking large doses, mixing substances, and driving while under the influence. The findings suggest that although users were not suffering excessive or dangerous harm, the potentially risky patterns of use indicate a need for harm reduction interventions.
Harm Reduction Journal
November 28, 2019
Martin Andersson, Anette Kjellgren
35 citations
Psychedelic microdosing—taking tiny, repeated doses of substances like LSD or psilocybin—is used for therapeutic and enhancement purposes, with predominantly beneficial effects reported, especially for depression. Intentions for use influence outcomes. Social interactions on YouTube focus on discussing views, strategies for optimal results, minimizing risks, and sharing emotional support. Microdosing may offer some benefits of full-dose interventions with fewer adverse reactions, but repeated exposure over extended periods could introduce additional risks.
Harm Reduction Journal
July 24, 2022
Madelene Palmer, Olivia Maynard
29 citations
People who use psychedelics recreationally adopt more harm reduction practices with experience, and those practices are linked to more emotional breakthroughs and fewer challenging experiences. In a mixed-methods online survey of 163 participants, greater use of harm reduction strategies in the most recent trip compared to the first trip was associated with higher scores on the Emotional Breakthrough Inventory and lower scores on the Challenging Experience Questionnaire, especially for the first experience. Participants emphasized the importance of 'set and setting' over specific drug details for enhancing positive effects. The findings inform the development of harm reduction advice for recreational psychedelic use.
Harm Reduction Journal
December 10, 2023
Silvia L. Cruz, Miguel Bencomo-Cruz, María E. Medina-Mora et al.
10 citations
At an outdoor electronic music festival near Mexico City, 40 young adults (mostly single men aged 22–48) provided 51 drug samples for voluntary, confidential testing. Most samples contained the expected drug plus adulterants such as methylene-dioxy-ethyl-amphetamine, methylene-dioxy-propyl-amphetamine, hydroxyamphetamine, and the antidepressant venlafaxine. Fentanyl was detected in 2 of 4 cocaine samples and in 14 of 22 MDMA samples. These adulterants, especially fentanyl and amphetamine-like substances, pose serious health risks. The authors urge monitoring of adulterants at festivals and call for prevention, treatment, and harm reduction policies in Mexico, including naloxone distribution and drug-assisted therapies.
Harm Reduction Journal
March 29, 2026
Piotr Siuda, Paweł Matuszewski
An analysis of the largest Polish drug forum, Hyperreal, found that health-related posts about psychoactive substances had moderate quality. Topic modeling of 159,145 posts revealed associations between specific drugs and health topics—such as ketamine with depression, marijuana with symptom relief, amphetamines with cardiovascular issues, and fentanyl with palliative care—that mirrored medical literature, indicating knowledge grounded in evidence rather than anecdote. However, expert evaluation using a custom questionnaire showed significant informational gaps. The mean quality score was 35.67 out of a possible range, with factual accuracy rated moderate and safety aspects—especially dosage guidance and encouragement to consult specialists—scoring lowest. The findings highlight the need to improve content quality on drug forums for harm reduction.