Just how safe is it to take psychedelic drugs during therapy like Prince Harry?
Never before, or since, have I been so petrified. Pure evil was stalking me across our living room. I backed away rapidly, but became trapped against a sofa by the sinister force.
Racked with terror, I screamed so hard that my ribs broke. Chunks of bone began to tumble from my mouth.
As a young philosophy student in the early 1980s, I had already taken the psychedelic drug LSD several times. Dabbling with hallucinogens seemed a normal part of university life.
My LSD experiences had ranged from deeply reflective to hilariously exhilarating.
But the abruptly traumatic acid trip I endured that night rattled me to my mental foundations. At the time, I quelled my terror by sitting for hours in the dark in front of a comforting gas fire. But for the following three months, I felt profoundly disturbed.
Now Prince Harry has admitted using psychedelics — magic mushrooms, psilocybin (the active component of magic mushrooms) and ayahuasca, a plant-based psychedelic from the leaves of a shrub — in an attempt to help him heal the ‘grief’ and ‘trauma’ he felt after the death of his mother
Somehow I’d acquired a subliminal notion that the malevolent power had inhabited me. Rationally, I knew this to be nonsense. Nonetheless, the idea haunted me that summer.
Mercifully, my strange psychological symptoms faded within a few months until they were almost forgotten. But not so completely forgotten that I ever took LSD again.
How things have changed. Psychedelic drugs such as LSD, magic mushrooms, ketamine and ecstasy (or MDMA) are now being touted by some British psychiatrists as a respectable new therapeutic answer for mental illnesses such as depression, post-traumatic stress disorder (PTSD) and substance abuse or addiction.
And now Prince Harry has admitted using psychedelics — magic mushrooms, psilocybin (the active component of magic mushrooms) and ayahuasca, a plant-based psychedelic from the leaves of a shrub — in an attempt to help him heal the ‘grief’ and ‘trauma’ he felt after the death of his mother.
‘I would never recommend people to do this recreationally,’ he said during an interview on U.S. TV on Sunday night. ‘But doing it with the right people if you are suffering from a huge amount of loss, grief or trauma, then these things have a way of working as a medicine.
‘For me, they cleared the windscreen . . . the misery of loss. They cleared away this idea that I had in my head that . . . I needed to cry to prove to my mother that I missed her. When, in fact, all she wanted was for me to be happy.’
British therapists are investigating the use of hallucinogenic drugs to treat mental illnesses.
For example, psychiatrists at the Maudsley Hospital in London are conducting a National Institute for Health Research (NIHR)-funded trial into the use of magic mushrooms for treatment-resistant depression.
And psychiatrists at King’s College London are carrying out trials of MDMA on former servicemen suffering with PTSD to see if it will alleviate their symptoms. Meanwhile, private company Awakn Life Sciences, which has clinics in Bristol and London, is developing therapies using ketamine to treat addictions and eating and anxiety disorders.
Ketamine is used clinically as an anaesthetic, sedative and painkiller. It is also taken as an illegal psychedelic drug (according to a press report, when he was 17 Harry admitted he’d tried this drug).
In all these studies, the drugs are used alongside psychotherapy. Scientists claim hallucinatory experiences induced by the drugs can alter people’s habitual thinking patterns, serving as a catalyst for making psychotherapy work.
Rick Doblin, founder of California-based Multidisciplinary Association for Psychedelic Studies, previously told Good Health: ‘It’s not the drug doing the therapeutic work, it’s the psychotherapy. The drug makes therapy more effective, reducing patients’ fear-based responses to traumatic memories. It gives them a ense of safety.’
Enthusiasts also claim that brain scans demonstrate that people undergoing psychedelic-assisted psychotherapy show less activity afterwards in areas of their brains associated with depression.
There are, however, concerns that the brain scans used for these studies — functional MRI — produce unreliable results.
British therapists are investigating the use of hallucinogenic drugs to treat mental illnesses. For example, psychiatrists at the Maudsley Hospital in London are conducting a National Institute for Health Research (NIHR)-funded trial into the use of magic mushrooms for treatment-resistant depression [File photo]
And the bigger question is whether psychologically vulnerable people should be exposed to the risk of psychotic hallucinations so profoundly terrifying that they render them even more traumatised than before — and possibly leave them permanently harmed?
LSD has been notoriously blamed for the tragic psychosis that dogged Syd Barrett, the founding genius behind the British rock group Pink Floyd.
He split from his bandmates in 1968 after experiencing a psychedelically induced psychotic breakdown. Afterwards, he lived as a mentally frail recluse until his death 38 years later, aged 60.
According to the UK drug information charity Frank: ‘LSD may have serious, longer-term implications for someone who has a history of mental health problems. It may also be responsible for setting off a mental health problem that had previously gone unnoticed.’
Supporters of psychedelic therapy, however, argue that bad trips are rare, and even when they do occur they often provide challenging personal insights that fuel healthy psychological growth.
David Nutt, a professor of neuropsychopharmacology at Imperial College London, is a leading exponent of psychedelic therapies. He told Good Health: ‘Our research studies covering several hundred people who took hallucinogens have not resulted in any bad trips, except for a patient on LSD who had one when they were inside an MRI machine having their brain monitored.’
Proponents also point to the presence of a therapist in the trials, during the entire time the patient is under the influence of hallucinatory drugs.
In February 2022, Professor Nutt co-authored a review of research, in the Journal of Psychopharmacology, which said that bad trips (or ‘challenging experiences’, as he refers to them) are ‘often positive . . . and the risks of psychotic episodes or overdose are rare’.
The research paper claimed that psychedelic drugs have an unwarrantedly bad reputation and argued ‘many — albeit not all — of the persistent negative perceptions of psychological risks are unsupported by the currently available scientific evidence’.
Professor Nutt has a controversial history regarding psychedelics, stemming from when he was the Government’s top drugs adviser. He was sacked as chair of the Advisory Council on the Misuse of Drugs in October 2009 after saying that ecstasy and LSD are less dangerous than alcohol.
Now he is commercially involved in developing psychedelic drugs as psychiatric therapies.
Last year, he was appointed chief research officer of Awakn Life Sciences, to lead the company’s neuroscience research into developing psychedelic compounds to treat people with serious addictions to alcohol and other drugs.
Other investigators, however, fear that psychiatrists are rushing to adopt psychedelics without properly exploring the extent and danger of bad trips.
Jules Evans, an honorary research fellow at Queen Mary University of London, told Good Health: ‘We are not paying attention to the risks of psychedelics. Some people’s bad experiences can worsen their mental health, lasting for weeks, months or years.’
Medicine is not even yet sure how to treat sufferers of bad trips, he says.
‘Despite the first scientific paper on psychedelics being published back in the 1880s, and despite £3 billion in investment in psychedelic companies, there is still no research on what helps people who have difficult experiences. We just don’t know,’ he adds.
To fill this gap, Jules Evans has launched a research project with the University of Greenwich, Imperial College London and University College London, to understand the difficulties people have encountered when they have taken psychedelic drugs. He was inspired by his own experience of taking LSD at the age of 18, in the mid-1990s.
‘It took me a few years to recover,’ he says. ‘I took the drug at a rave. I felt badly paranoid and did not have anyone who could reassure or support me.
‘It was a very scary experience, even though nothing scary was happening in reality.’
As a consequence, Jules Evans, now in his mid-40s, began to suffer from panic attacks, nightmares and dissociation.
‘It’s frightening when you still don’t feel well weeks after,’ he says. ‘You seriously question whether you will ever return to normal.’
Jules Evans attempted to cope in what he calls ‘a very English fashion’ — he didn’t discuss his problem with anyone and instead tried to bury the experience. ‘It was the wrong thing to do,’ he says. ‘Slowly, through my university years, I developed PTSD and social anxiety, but was not diagnosed for that until after I had graduated.’
In his early 20s, he finally discussed the problems with his parents, who recommended that he see psychiatrists.
‘Psychiatrists had little knowledge and no practical help,’ he says.
Eventually, what worked was finding a support group for people with social anxiety that used cognitive behavioural therapy (CBT) as a coping aid.
‘I was the only one there with post-psychedelic problems,’ he says. ‘Since then, I’ve found other people who have found the CBT approach useful after bad trips.’
But this is only anecdotal evidence and the common lack of awareness about bad trips still persists among psychedelic experimenters and mental-health professionals, says Jules Evans.
He fears this means the drugs will be prescribed without any real understanding of what the safety nets might be.
This comes as emerging evidence shows that significant numbers of people can suffer lasting mental disturbance from psychedelics.
A study of international research published last November in the journal PLoS Global Public Health, led by Dr Daniel Perkins, co-founder of the Medicinal Psychedelics Research Network at the University of Melbourne, reported that survey data from more than 10,800 people who’d tried the South American herbal psychedelic, ayahuasca — one of the ones Harry took — shows that more than 6 per cent later needed professional mental-health support to cope with traumatic bad trips.
Despite such disturbingly high numbers, a Canadian psychedelic drug firm, Filament Health, announced the same month that it has created a pill form of the powerful hallucinogen, which is traditionally consumed as a tea.
Ben Lightburn, the company’s CEO, says he hopes the pill will be approved in the U.S. for medical use, if drug trials scheduled for next year on patients with PTSD or depression prove successful.
Other worrying evidence about the consequences of bad trips was reported in 2016 in the Journal of Psychopharmacology by investigators at Johns Hopkins University, Baltimore, who surveyed more than 1,900 people who had suffered bad trips after taking hallucinogenic psilocybin, which Prince Harry has also taken.
Researchers found that among those who had suffered bad trips more than a year previously, some 8 per cent had needed treatment for enduring symptoms, such as persistent psychosis or suicidal thoughts.
Such levels of trauma are potentially an underestimate, says Jules Evans.
‘It seems from all the early evidence that up to 15 per cent of people who take psychedelic drugs may have difficult experiences that might require self-care, peer support or professional support,’ he warns. ‘But there is little research on longer-term issues.’
Instead, people suffering psychological effects of bad trips are often left consulting inadequate or even damaging therapists, he claims.
‘You can go to a psychiatrist who may not understand the issues and label your symptoms as the onset of schizophrenic psychosis — I was told it was “just adolescence”.
‘Or you may enter the wacky world of spiritual healing and get shamans telling you there’s a demon inside you, or it’s about your wrongdoing in a past life.’
Jules Evans stresses he’s not against the idea of using psychedelics as therapy, if the approach is proven to be safe and effective.
‘We do need to explore new psychiatric treatments,’ he says. ‘But the field is surrounded by naïve and reckless enthusiasm.
‘We need to keep this field honest and report difficult experiences, and keep it within properly regulated and safe clinical trials.
‘I wouldn’t want to take a medicine where there’s, say, a one-in-ten risk of problems, and where you don’t know the nature of the risk or how to deal with it,’ he adds.
Professor Nutt, meanwhile, maintains that the risks of psychotic episodes from taking psychedelics ‘are rare and only reported in individual cases’.
Nevertheless he agrees that therapists must exercise caution first and foremost.
‘The risks need to be minimised by careful patient selection and preparation,’ he says.
Jules Evans is currently trying to gather a properly comprehensive survey of people’s problems with bad trips, as well what remedies have then helped them, whether those be therapy, medication or self-care.
He’s running an online survey (go to challengingpsychedelic experiences.com) and is about to conduct hour-long interviews with around 50 of the people who have already filled in the survey, with the aim of publishing the findings later this year.
Although Jules Evans says that psychedelic bad trips can trigger persistent mental illness in some people (which may perhaps have emerged regardless), he adds that, ‘thankfully it seems from our evidence that in most cases the after-effects wear off over time’.
But Dr Max Pemberton, an NHS psychiatrist and Daily Mail columnist, warns that: ‘While the psychological ill-effects of bad trips are usually self-limiting, they can cause life-long problems in people who are susceptible to psychosis, and can lead to long-term psychiatric illnesses such as schizophrenia.’
He adds: ‘I’ve seen patients in their 60s and 70s with schizophrenia who dabbled in hallucinogens in their 20s and believe that they caused their lasting psychiatric problems.
‘Patients in the current research trials are very carefully screened and monitored, and I haven’t heard of any bad-trip problems arising from them,’ he adds.
‘My fear, however, is that news of clinical trials may encourage other people to try these drugs informally, illegally and perilously.
‘Prince Harry’s blundering into this area may only increase the danger further.’