Protective Behavioral Strategies for Psychedelic Use: A Mini Review of the Evidence.

A review of protective behavioral strategies (PBS) for psychedelic use outside clinical settings found that a culture of harm reduction exists within psychedelic communities. Identified strategies include careful drug acquisition, dosing, managing set and setting, bodily nourishment, planning for challenging experiences, and post-use integration. Although research is limited, emerging evidence suggests that using these strategies may reduce negative consequences. The review calls for better measurement tools and more studies to understand how PBS can support the growing number of people—8.5 million Americans over 12 reported past-year use in 2022—who use psychedelics nonclinically.

Study at a glance

Abstract

Approximately 8.5 million Americans over the age of 12 endorsed past year psychedelic use in 2022, with 1.4 million individuals initiating use during this time. Although emerging evidence indicates there may be beneficial aspects of psychedelic use, there is a need to understand how individuals might mitigate potential risks within nonclinical contexts, such as through the use of protective behavioral strategies (PBS). PubMed and Google Scholar databases were searched to identify articles reporting on PBS (i.e., harm reduction strategies implemented at the individual level) for psychedelic use within nonclinical contexts. We include articles pertaining to both classical serotonergic psychedelics (e.g., lysergic acid diethylamide [LSD], psilocybin) and nonclassical psychedelics (e.g., 3,4-methylenedioxymethamphetamine [MDMA], ketamine). Although research on psychedelic PBS use is limited, evidence suggests a culture of harm reduction present within psychedelic communities. Psychedelic PBS identified in the literature include strategies related to drug acquisition, dosing, set and setting, bodily nourishment, planning for and working through challenging experiences, and integration of psychedelic experiences. Few studies have examined the relationship between psychedelic PBS use and outcomes, but emerging evidence suggests that psychedelic PBS use may be associated with decreased consequences. There is a need to continue developing and validating measures of psychedelic PBS and outcomes for use within research and intervention settings. Additional research examining associations between psychedelic PBS use and outcomes is also critical to best serving the needs of individuals who use psychedelics within nonclinical contexts.