Harm reduction and integration for people choosing to use psychedelics is important for both safety and maximization of benefits. Simply put, psychedelic harm reduction is exactly what it sounds like— it is meant to help prevent harm to anyone using psychedelics. However, it is much more complicated in practice than in theory. 

Psychedelic harm reduction and integration is a core principle of the developing industry, but it encompasses many different ideas. Some methods are designed to help certified therapists address the rising interest in psychedelics, while others can be used by anyone to help prevent adverse experiences with psychedelics.

What is Psychedelic Harm Reduction?

According to a peer-reviewed paper put out by MAPS and Fluence in 2020, psychedelic harm reduction is a clinical model designed to help patients maximize the benefit of their psychedelic experiences. Per this theory, it does not include support during the psychedelic experience. 

Psychedelic Harm Reduction and Integration (PHRI) is a transdiagnostic and transtheoretical clinical model that incorporates principles of harm reduction psychotherapy, psychedelic-assisted therapy, mindfulness-based modalities, and psychodynamic therapy, and provides a framework for examining and working with psychedelic experiences in clinical care without providing the actual psychedelic experience as part of treatment.”

The paper focuses primarily on certified therapists who can utilize psychotherapy to help patients who have used psychedelics in a variety of contexts— including in a clinical setting, spiritual group, or by themselves. With the current rise in psychedelic use, it is important for mental health professionals to be prepared to help their patients who choose to partake.

A recent survey found that 80% of patients in Canada were not discussing their psychedelic use with their doctor. Health professionals have a big opportunity to help reduce the misuse of psychedelics through harm reduction and integration. However, many doctors may be concerned with the legal risks associated with discussing psychedelics with their patients.

The harm reduction and integration framework put out by MAPS and Fluence offers healthcare professionals tools to help their patients without actively becoming involved in the psychedelic experience. As a result, it keeps both the doctor and patients safe.

“PHRI is not a treatment modality or technique, but serves as a perspective which therapists of all training backgrounds can incorporate into their practice.”

This use of the term, however, is only one side of harm reduction and integration. Some tools allow anyone— certified healthcare professional or not— to help ensure safety and improve outcomes of psychedelic use. 

The idea of harm reduction and integration is meant to help provide people with information so that they can mitigate any potential risk. 

Harm reduction is not a concept exclusive to psychedelics. It has been used in the greater drug and addiction space and is based on the principle of helping people who choose to use mind-altering substances make informed decisions.

When it comes to psychedelics, harm reduction is a bit different than if a therapist was working with someone who was taking drugs such as cocaine or heroin. Since psychedelics have fewer physical risks and therapeutic benefits, harm reduction could help improve the outcomes of a person’s trip. 

Psychedelics are not particularly dangerous, though they can be in some situations. Someone struggling with serious mental health issues may need to weigh the risks with potential benefits.

For healthy users, harm reduction and integration can be a way to improve the outcomes of a trip. It is well acknowledged within the psychedelic space that being intentional with the set and setting can have a big impact on a psychedelic trip. However, someone who is not familiar with psychedelics may not know this. 

A therapist or guide trained in psychedelic harm reduction and integration can help improve outcomes by informing novel users of set and setting, and other tools. They can also help people make sense of their experience. This is especially important for people who have unsettling trips and may not know how to integrate it. 

This more general definition of harm reduction opens up the practice to anyone who wants to assist people with their psychedelic journey.

One new psychedelic harm-reduction and integration tool is the Fireside Project. This hotline offers support before, during, and after a psychedelic experience. It is staffed with volunteers who are trained to help people throughout their psychedelic journey, especially those who are having a difficult time. 

There is also a growing number of psychedelic coaches that offer assistance with psychedelic experiences. Dr. Cheryl Tien, from San Francisco, offers preparation and integration services to her patients going through ketamine treatment. While she has professional mental health training, other coaches often gain their training through psychedelic-specific courses.

Psychedelic Harm Reduction & Education

As more educational resources become available in the psychedelic space, harm reduction is a main principle of what guides are learning.

There is currently a growing number of people searching for assistance with their psychedelic experiences. Educational courses are growing to meet that demand. The Neuly psychedelic course directory has over 400 psychedelic courses listed, compared to under 100 just a couple of years ago.

Some courses offer harm reduction and integration techniques directly to those consuming psychedelics. Double Blind Mag offers a “How to Use Psychedelics” course to provide information on how to prepare, dose, and integrate a psychedelic experience. 

Resources like these are great for some people. However, others do not feel comfortable consuming such strong mind-altering substances without active support from someone who is qualified to help ensure a safe trip. Trained guides can help meet this demand.

Fluence, a psychedelic education company, includes a harm reduction and integration certificate in many of its courses. It is a key pillar of the modern approach to psychedelic treatment which aims to reduce risk and improve outcomes.

In the past few years, there has been an influx of new ideas and tools to help people stay safe and make sense of their psychedelic experiences. There is something for everyone, but finding the right resources can be difficult. 

Directories, such as Neuly, can help people interested in supporting the psychedelic experiences of others gain the skills that they need to do that successfully. Unfortunately, there is no perfect formula for this.

Even with the most qualified practitioners on hand, some people are going to have challenging experiences that may be difficult to reconcile with. That is where integration comes in. Having the tools to help these individuals to the best of a person’s ability is what becoming educated on harm reduction and integration practices is about.

Psychedelic harm reduction and integration tools are evolving rapidly. This reflects the growing interest in the therapeutic potential of psychedelics. This concept reaches far beyond the clinical model, encompassing a wide range of strategies and approaches.

Though psychedelic harm reduction and integrations can, and should, be used as a tool for therapists to help their patients, there are other ways to integrate harm reduction into the psychedelic space. It extends to anyone interested in improving the safety and outcomes of psychedelic journeys.

The broader definition of harm reduction highlights the importance of providing individuals with the knowledge and resources to mitigate risks associated with psychedelic use. While these substances may not be dangerous for most users, set and setting play an important role in shaping the experience. Educating people about these factors, and helping them integrate their experiences can make a crucial difference in the ultimate outcome of a psychedelic experience.

Innovative approaches, such as the Fireside Project and the emergence of psychedelic coaches, are making harm reduction and integration more accessible and personalized. These resources offer support before, during, and after psychedelic experiences, ensuring that people have guidance when they need it most.