In August 2008, the Journal of Psychopharmacology published "Human Hallucinogen Research: Guidelines for Safety", proposing recommendations for the safe administration of classic psychedelics and the minimization of potential adverse reactions within a research context.1 Written by three researchers from the landmark Johns Hopkins psilocybin and mysticism study, the paper provides a detailed history of human research with psychedelics and an assessment of the risks involved. It was published coincident with the release of the 14-month follow-up to their mysticism study,2 and it describes protocols developed for that research.

While physiological safety considerations pertaining to psychedelics research have received attention in recent years,3 Johnson et al. do an admirable job of examining the unique psychological and contextual factors ("set and setting") inherent with their use. The importance of volunteer selection and preparation, interactions between the volunteer and study personnel, and the careful creation of the study site are all discussed. Creating a context of safety, trust, and rapport between the researchers and subjects is emphasized as a strategy for preventing and counteracting adverse reactions. Reviewing previous research giving psychedelics to human subjects, the authors found that extensive preparation and interpersonal support led to "fewer adverse psychological reactions, such as panic reactions and paranoid episodes, and increased reports of positively valued experiences".1

Despite being very rare, bad trips leading to dangerous behavior and the even less likely possibility of prolonged psychosis or hallucinogen persisting perceptual disorder (HPPD) are identified as the most concerning risks that a researcher must prepare for. A milder but more common risk is that of the subject leaving the study site during the session.

Written in a clear prose that should be accessible to most Erowid members, this article is the most up-to-date peer-reviewed overview of the physical and mental risks associated with psychedelics. Well worth reading for anyone interested in this field of research, it includes practical information about preparing for and conducting sessions that are also applicable for the deliberate use of psychedelics outside of a research setting.