Like any medication, both FDA-approved or not, psychedelics can have side effects that may not be suitable for everyone. Look at what’s possible.

Psychedelics, over the past several years, have received positive examples of acceptance as medicine in mental health in a number of states, as well as in Canada. As with everything, we need to look at all aspects of these substances regarding their utility as well as any problems that may have been noted or indicated by persons using them.

Because this area is expanding at a quick pace and there are many diverse substances, uses, settings, and demographics involved, it is difficult to assess the hazards of psychedelic usage.

On an individual basis, Canada’s Minister of Health has approved the use of psilocybin to alleviate the pain and suffering of a number of terminally sick individuals. In December 2020, Health Canada announced their plan to expand the Special Access Programme (SAP). According to successful preliminary results, this would allow practitioners to request access to prohibited pharmaceuticals on behalf of patients with critical or life-threatening diseases.

A study with cancer patients also had promising results for psilocybin. In one study, participants with terminal cancer were given a high dose of psilocybin in a supportive environment, and it was found to alleviate anxiety and depression symptoms while improving quality of life.

To prove that the high dosage of psilocybin was effective, eleven out of seventeen therapeutically relevant measures met conservative criteria. Results demonstrate that psilocybin significantly reduced clinical and self-reported depression, anxiety, and mood disturbance while increasing optimism, life purpose, quality of life, and acceptance of mortality. No adverse events were noted in this study, and researchers were optimistic about its future use.

Clinical trials examining psilocybin-assisted psychotherapy as a possible treatment option for alcohol use disorder, treatment-resistant depression, and end-of-life psychological distress in advanced-stage cancer patients will be supported by a research investment of nearly $3 million in Canada in 2023 through the Canadian Institutes of Health Research.

For patients in Europe who have not responded to existing therapies for mental health issues, such as serious depression or post-traumatic stress disorder (PTSD), Switzerland has set up a special use program for d-lysergic acid diethylamide (LSD) and psilocybin.

Since the initial wave of research and experimentation with psychedelics, much has changed. Still, little is known about the physiological, psychological, and mental hazards they may pose. A rundown of some of the most important possible negative side effects of psychedelics, with an emphasis on the ones that people still worry about, include the following: harm to self or others, neurotoxicity, hallucinogen–induced disorders, hallucinogen persistence perception disorder, hypertension, cardiovascular disease, hallucinogen disorder, emergency medical treatment, and other unforeseen challenging experiences. One disorder that has not been noted and that is not considered a risk is hallucinogenic use disorder (HUD) since researchers have not noted that those who use psychedelics become dependent on them.

One specific group that is increasing in the number of individuals and that may require therapeutics for the treatment of terminal diseases, such as cancer, is older adults worldwide. The results of psychedelic clinical trials may not apply to this population that geropsychiatrists primarily treat due to the small number of older individuals and those with multiple health issues included in the studies. Future clinical applications of knowledge gained from studying the neurophysiologic and molecular effects of psychedelics in older people are required. Most studies on these substances have been with healthy volunteers or specific clinical populations under 65.

While many people may be seeking the downside or negative effects of psychedelics, not everyone sees their use this way. Using psilocybin in controlled interventions may increase the length of leucocyte telomeres. Telomeres are a powerful predictor of death and diseases linked to getting older, but we need more evidence to support this hypothesis regarding telomere length, longevity, and psychedelic use.