Doctors Warn About Emergence of ‘Trip-Killers’

A study points out that psychonauts online are turning to benzodiazepines and other potentially dangerous drugs to end a psychedelic trip.
Trip-Killers
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In the event of a bad psychedelic trip, you may be better off riding it through than taking additional drugs to extinguish the trip—which can actually be more dangerous.

In a new study, doctors are warning about so-called “trip-killers,” or drugs used to counteract the effects of a psychedelic trip. What they found is that over half of anecdotal recommendations online call for benzodiazepines, antipsychotics, alcohol, and other remedies, but found that trip-killers are often more dangerous than the psychedelics themselves. This LSD Reddit thread, for instance, has trip-killer recommendations. Less than 2% of recommendations they found were for CBD or cannabis to lessen a trip. 

The study, “Trip-killers: a concerning practice associated with psychedelic drug use,” was published in Emergency Medicine Journal on Dec. 19. It was announced in a news release the same day.

There’s no Narcan to end a psychedelic trip, but people have tried various drugs to do just that. Researchers found that drugs such as benzodiazepines and antipsychotics are the options most frequently recommended, but warnings about their potential side effects are rarely included, they noticed. 

Benzodiazepines or benzos, are central nervous system (CNS) depressants primarily used to treat anxiety. Benzos are dangerous in numerous ways—notably there’s a risk of overdose, and also a risk of powerful dependence that can lead to dementia. Like fentanyl, benzodiazepines can stop breathing, and there are few ways to reverse a benzo overdose.

The intensity of a psychedelic trip can lead to distress, agitation, and  psychosis, and researchers cited recent data indicating that more than 8% of drug-related trips to emergency rooms in Europe involve psychedelic drugs.

The study was led by Manchester-based Dr. Gregory Yates, in the U.K., who thinks there is a huge lack of peer-reviewed research showing how these drugs are being used and the risks involved.

Instead of going to a doctor, which is pretty much impossible to do during a trip, psychonauts are turning to Reddit.

“There are multiple ways to control a ‘bad trip’ and avoid hospitalization. One is to take psychedelics under the supervision of a ‘trip-sitter’—a non-intoxicated friend who can provide psychological support. Another is to use additional psychoactive drugs—‘trip-killers’—to attenuate or prematurely end the psychedelic experience. Trip-killers are not new, but have received increased attention on social media in recent years.”

“Information on trip-killers is not available through drug advice services, despite the probable risks they pose,” researchers wrote. “To our knowledge, no relevant papers have been published in the medical literature. It was the aim of our study to gather descriptive data on the use of psychedelic trip killers by analysing posts made on Reddit, a publicly accessible, anonymous social media website.”

Researchers analyzed posts on social media platforms like Reddit, and found 128 threads created between 2015 and 2023, with a total of 709 posts.

“The most recommended trip-killer, with 440 recommendations, comprising nearly half (46%) of all the trip-killers mentioned in posts, were benzodiazepines, known for their sedative effects and physical dependence. Benzos were followed by several different antipsychotics (171;18%).

One in 10 recommendations were for antidepressants, while 1 in 20 were for alcohol. Opioids, antihistamines, herbal remedies, such as camomile and valerian, and prescribed sleeping pills, attracted 3% each. Cannabis and cannabidiol each took 2% of the vote share.”

Trip-killers were mostly discussed in reference to countering the effects of LSD (235 recommendations), magic mushrooms (143), and MDMA, popularly known as ecstasy (21).

Trip Sitters in Europe

Set and setting are so important when it involves psychedelics and hallucinogens. Not observing set and setting, or disregarding the profound nature of psychedelics can lead to bad trips, which can be terrifying.

Much like the United States, leaders in Europe are currently figuring out how to incorporate psychedelic therapy into its healthcare landscape most effectively.

A European lobby group representing developers and professionals within the industry advocates for including seasoned practitioners as integral members of a multidisciplinary advisory body. 

Seasoned practitioners—i.e. trip sitters—would serve as a guiding authority, offering essential insights to regulators and healthcare practitioners regarding optimal practices as the field expands and changes. This effort comes from the European Psychedelic Access Research and European Alliance (PAREA), as reported by Politico, as per a briefing document slated for submission to the European Medicines Agency (EMA).

The document reads that people with actual experience with psychedelics should have say-so over the dos and don’ts of psychedelic trips. This aligns with the idea that those with an actual relationship with the substance, rather than simply a desire to profit from it, makes for better business, as seen in the cannabis industry as well. 

If psychedelics are taken with better care, often with a trip-sitter involved, bad trips would be less common and people would be less reliant on so-called trip-killers.

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  1. In fact there are numerous “…Narcan(s) to end a psychedelic trip…” (5HT2A antagonists) which are undergoing research and a brand new human LSD study on exactly this topic has literally just been published:

    International Journal of Neuropsychopharmacology, 2023, 26, 97–106
    Ketanserin Reverses the Acute Response to LSD in a Randomized, Double-Blind, Placebo-Controlled, Crossover Study in Healthy Participants
    “…24 healthy participants who underwent two 14-hour sessions and received ketanserin (40 mg) or placebo 1 hour after LSD (100 μg) …Ketanserin reversed the acute response to LSD, thereby significantly reducing the duration of subjective effects from 8.5 hours with placebo to 3.5 hours. Ketanserin also reversed LSD-induced alterations of mind, including visual and acoustic alterations and ego dissolution…Ketanserin can effectively be used as a planned or rescue option to shorten and attenuate the LSD experience in humans in research and LSD-assisted therapy.”

    Lastly it’s worth noting that Benzodiazepines are routinely administered to people who are having a bad psychedelic (5HT2A) trip and present to E.R. at hospitals. They can both dramatically calm people (tranquillise them) and even seem to reduce hallucinations. Benzodiazepines have in truth little risk of overdose, with most ‘overdose’ deaths on them involving combining them with another CNS depressant e.g. alcohol (correctly termed a poly-drug related death and not an overdose). The very reason Benzo’s largely replaced numerous other classes of CNS depressants in medical use, e.g. Methaqualone and Barbiturates, is because of their high level of safety when used by themselves – swallowing a whole packet of Valium or Xanax on its own rarely kills, but rather puts tyhe person into a temporary comatose state.

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