Bad trip

Bad trip is a slang term for a psychedelic crisis, a disturbing experience sometimes associated with use of a psychedelic drug such as LSD, salvinorin A, mescaline, or psilocybin.

The manifestations can range from feelings of vague anxiety and alienation to profoundly disturbing states of unrelieved terror, ultimate entrapment, or cosmic annihilation. Psychedelic specialists in the therapeutic community do not necessarily consider unpleasant experiences as threatening or negative, focusing instead on their potential to be highly beneficial to the user when properly resolved. They can be exacerbated by the inexperience or irresponsibility of the user or the lack of proper preparation and environment for the trip, and are reflective of unresolved psychological tensions triggered during the course of the experience.

It is suggested that, at a minimum, such crises be managed by preventing the individual from harming oneself or others by whatever means necessary up to and including physical restraint, providing him or her with a safe and comfortable space, and supervising him or her until all effects of the drug have completely worn off.

Aspects

A multitude of reactions can occur during a psychedelic crisis. Some users can experience many general senses of fear. Some users may be catapulted into an anxiety attack, a disabling reaction in which one is overcome with extreme fright. A user may be overwhelmed with the disconnection many psychedelics cause, and fear that they are going insane or will never return to reality. This can cause the user to fall into a profound depression. Other reactions include an amplification of nameless fears; that is, fears that are unfounded and are usually not encountered in normality.

Users may exhibit actions suggesting harm to themselves or others around them. This harm could take the form of suicidal ideation, or full blown suicide attempts. Because of the magnification of emotions many psychedelics cause, death or thoughts of death can cause intensely adverse reactions in some users. Users can believe that their death is imminent or that the very universe itself is collapsing. Rapidly accelerated aging of other people may be experienced, irritating the aforementioned fears even more.

Some users may experience disorientation. The normal views of time, space, and person can be substantially altered, causing fear. Some can worsen their condition by trying to fight the psychedelic experience after embarkment. There can be illusions of insects crawling over or into one's self, or of being in dirty places such as sewers.

Unpredictability of the experience

The effects of psychedelic drugs vary widely from one individual to the next, and from one experience to the next. Sometimes individuals under the influence of such drugs forget that they have taken them, and believe that the wildly distorted world they perceive is real and will be with them indefinitely. In cases where the individual cannot be kept safe, hospitalization may be useful, though the value of this practice for individuals not mentally ill is disputed by proponents of investigative or recreational use of psychoactive compounds. Psychosis is exacerbated in individuals already suffering from this condition.

Intervention

Generally, a person experiencing a psychedelic crisis can be helped to either resolve the impasse, bypass it, or, failing that, to terminate the experience.

Medically

Medical treatment consists of supportive therapy and minimization of external stimuli. In some cases, sedation is used when necessary to control self-destructive behavior, or when hyperthermia occurs. Diazepam is the most frequently used sedative for such treatment, but other benzodiazepines such as lorazepam are also effective. Such sedatives will only decrease fear and anxiety, but will not subdue hallucinations. In severe cases, antipsychotics such as haloperidol can reduce or stop hallucinations, but this treatment is only effective against the so-called "classical" hallucinogens (LSD, psilocybin and mescaline, among others). Antipsychotics are not effective against dissociatives such as PCP and ketamine, and should not be used if these drugs are involved.

Potential causes

According to Timothy Leary, a crisis can be a result of wrong set and setting. Leary advised that users of psychedelics be sure that they are comfortable before taking the drugs. Leary claimed that the frequency of difficult trips was highly exaggerated by anecdotes and fabrications in the popular press, and was actually about 1 in 1000.

Alternatively, psychologist R. D. Laing held that psychedelic crises and other such extreme experiences, drug-induced or not, were not necessarily artificial terrors to be suppressed but rather signs of internal conflict and opportunities for self-healing. The greater the pain and pathos of an experience, the greater the urgency to explore and resolve it, rather than attempt to cover it up or dismiss it.

Likewise, Stanislav Grof suggested that painful and difficult experiences during a trip could be a result of the mind reliving experiences associated with birth, and that experiences of imprisonment, eschatological terror, or suffering far beyond anything imaginable in a normal state, if seen through to conclusion, often resolve into emotional, intellectual and spiritual breakthroughs. From this perspective, interrupting a bad trip, while initially seen as beneficial, can trap the tripper in unresolved psychological states. Grof also suggests that many cathartic experiences within psychedelic states, while not necessarily crises, may be the effects of consciousness entering a perinatal space.