The Psychedelic Handbook

The Psychedelic Handbook: A Practical Guide to Psilocybin, LSD, Ketamine, MDMA, and DMT/Ayahuasca by Rick Strassman is a thoroughly-researched reference book and manual detailing the science and history of psychedelics; the benefits of the drugs (including their potential to treat depression, PTSD, substance abuse, and other disorders, as well as to increase wellness, creativity, and meditation); practical guidelines on how to trip safely and what you should know about microdosing; and recognizing and caring for negative reactions to psychedelics.

Clinical research psychiatrist, founding figure of the American psychedelic research renaissance, and best-selling author of DMT: The Spirit Molecule [2001], Dr. Rick Strassman shares his experience and perspectives as neither advocate nor foe of psychedelics to help readers understand the effects of these incredible drugs.

“Psychedelic drugs are remarkable mind-altering substances, arguably the most interesting drugs in all of medicine. They reliably produce a unique state of mind in which you see visions and hear voices. You may lose awareness of your body while your consciousness travels through deep outer—or inner—space. You may feel almost unbearable ecstasy, terror, or both—or nothing at all,” Dr. Strassman says. “No matter what their specific effects might be, the hallmark of any full psychedelic experience is the sense that it is ‘more real than real.’ Effects of some psychedelics begin seconds after smoking or injecting them, and some last up to eighteen hours after consuming them orally.”

Summary Review of The Psychedelic Handbook

Rick Strassman has been around in the psychedelic world since before the turn of the century. His research on DMT, which he covers in DMT: The Spirit Molecule, marks the beginning of the psychedelic renaissance. The research conducted in the 1990s marks the first-in-human studies in the US after the Controlled Substances Act came into effect. Now, Strassman brings together a lifetime of experience in possibly the best introductory book to psychedelics.

The book is divided into four parts, 1) what are psychedelic drugs? 2) how do they work? 3) profiles of psychedelics, and 4) practical guidelines. As an introductory book, each section touches the surface of what we know. But, this doesn’t take away that each part (e.g. a profile on MDMA) is done with great care and expert knowledge. Strassman doesn’t fall into the mistake of being a cheerleader without reserve. He also details the risks associated with psychedelic use. Though the book covers a lot, it doesn’t come off as missing organisation and might very well be one book you can send psychedelic naive friends who want to get to know the landscape.

Strassman aims to create an “accessible, thorough, neutral, expert introduction to these compounds.” He does this with a background trained in Freudian psychotherapy, someone with deep Buddhist experiences and Jewish roots. After his seminal DMT research, Strassman has worked with over 1000 patients as a psychotherapist. If there is ever a person with a well-rounded profile to write this book, it is Strassman.

Part 1 – What are Psychedelic Drugs?

Chapter 1 – What are Psychedelics?

Psychedelics are mind-altering substances that lead one to see the world from another perspective, one that is often described as “more real than real.” This is their (academic) history.

Though they have been around for millennia, drug research with psychedelics began with the isolation of mescaline (from the peyote cactus) by Arthur Heffter in the 1890s. The second significant moment is the synthesis of LSD by Albert Hofmann (late 1930s and self-experiments in 1943 – see LSD: My Problem Child).

Events then turned for the worse, with researchers, intelligence agencies, and the general public using psychedelics, not for research but more nefarious purposes. In the middle of the 1960s, “it was getting difficult to tell the difference between psychiatric research and the development of a religious cult.”

And so, in 1970, the Controlled Substances Act effectively put an end to in-human psychedelic research. Still, animal research around that time proved useful in discovering the neurotransmitter serotonin.

From the early psychedelic research, we can learn that set and setting are vital when using psychedelics. “Set refers to the state of the person who takes the psychedelic. This includes their physical and mental health… Set also includes expectations and intention… Setting refers to the environment in which one takes the psychedelic. Indoors or outdoors. With friends or alone. In a research or party environment.”

Strassman will cover most of the well-known psychedelics in this book. The “classical” psychedelics are usually divided into 1) tryptamines (e.g. LSD, DMT, psilocybin) and 2) phenethylamines (e.g. mescaline). Three outliers covered in the book are 1) MDMA (a phenethylamine but not “classical” psychedelic), 2) ketamine (arylcyclohexylamine), and 3) salvinorin A (terpene).

The effects of (classical) psychedelics can be divided into 1) physical and 2) psychological effects. The physical effects include the (relatively minor) raising of blood pressure and heart rate, increased body temperature (most problematic with MDMA), and pupil dilation. Vomiting is only common with ayahuasca and peyote, though nausea is not uncommon. The psychological effects can encompass just about any aspect of human consciousness: “perception, body awareness, emotions, thinking, and sense of self.” In his famous lecturers (see The Nature of Drugs), Sasha Shulgin described psychedelics as ‘stars’, contrasting them with other psychoactive substances, which are ‘uppers’ (e.g. caffeine) and ‘downers’ (e.g. alcohol).

There are a variety of psychological effects, including the merging of senses (e.g. seeing sounds), but perhaps most striking is the “meaning-enhancing” effects that reliably occur at high doses. Coined by Ido Hartogsohn, this refers to “an all-consuming, overarching conviction that what one is experiencing is “more real than real.” This does not mean that the visions and the voices take on a greater reality than things we see and hear in normal everyday consciousness. Rather, the meaning of the experience, its significance, intensity, personal relevance, and truth value are greater than anything we have normally felt or believed.”

Chapter 2 – The Many Names for Psychedelics: Why They Matter

Strassman noticed similarities between the descriptions of psychedelics and his personal meditation experiences. This got him initially interested in the field. Others got there by seeing psychedelics as substances that produce hallucinations (hallucinogen) or as simulating a psychosis (psychotomimetic). Nowadays, both terms are rarely used; Strassman prefers psychedelics (mind-manifesting).

Another term (even your reviewer was unfamiliar with) is ‘oneirogen,’ which stands for dream-creation. The term is mostly used concerning ibogaine, though it could also apply to other psychedelics.

MDMA is often referred to as an ‘entactogen’ (within-touch) or ’empathogen’ (empathy-generation).

A more recent and popular addition is ‘entheogen’ (“generate God from within”). The religious or spiritual meaning ascribed to psychedelics often reflects the experience, but this doesn’t always have to be so. This is why Strassman prefers psychedelic: “The drugs themselves don’t “produce” psychosis any more than they “produce” spiritual experience. Rather, they simply interact with the mind of the person taking them.”

What one chooses to name psychedelics/entactogens/etc. is part of the (mind)set and how the setting is prepared. If one is prepared to model psychosis, a white room and questions about negative aspects will dominate the set & setting. But if one expects an overwhelming spiritual experience – and none follows – participants may be disappointed too.

Chapter 3 – What are Psychedelics Good for? What are their Risks?

Psychedelics have been successfully demonstrated to help with various mental health and pain disorders. Though studies are still in early phases, meaning that only a small group of patients have been studied in the lab, it seems that psychedelics will become part of the medical toolkit. Compared to two of the currently most widely used tools, psychotherapy (talk therapy) and antidepressants (e.g. SSRIs), psychedelics work much quicker (often relieving symptoms within hours).

For much more on psychedelics for many problems, see our free reports.

In clinical/medical use, psychedelics are often combined with therapy. One model where multiple relatively low doses were given repeatedly is called the psycholitic approach. Another more commonly used model is the psychedelic approach, where one or two (very) high doses are given. Nowadays, this is put within a larger container of multiple non-drug therapy sessions.

Outside trials, psychedelic users usually score better on health and behaviour surveys. For instance, they are shown to have a greater appreciation of nature.

For all the survey studies, see the papers that are surveys.

But, psychedelics don’t come without risks. Physically, classical psychedelics are nontoxic, and “there is no convincing evidence that classical psychedelics produce brain damage, reduce IQ, or cause other neurological adverse events.” Addiction is possible, but there are no known physiological mechanisms (which, for instance, nicotine does have) known. Still, someone might become psychologically dependent on it. So then, what are the risks?

The psychological risks of psychedelics shouldn’t be overlooked. Within research settings, the risk is extremely low. “The rate of psychosis lasting more than [24] hours was approximately 0.1 percent, and suicide attempts 0.1 percent or less.” Outside of that, people taking unknown quantities of psychedelics on multiple occasions have triggered mental illnesses. This can lead to a total loss of connection to how most of normally experience reality (in a very small number of cases).

For a larger number of people, the effects of psychedelics may resurface days and months after the acute experience. These ‘flashbacks’, experienced by 77% on one survey, are usually mild and experienced very negatively. For some, diagnosed with Hallucinogen-Persisting Perception Disorder (HPPD), it has long-term negative outcomes.

The setting can also have negative effects. Strassman divides them into 1) unscrupulous practitioners (sexual, physical, emotional, spiritual, or financial abuse) and 2) negative model effects (expecting certain outcomes because of the model the therapist/healer/etc. uses).

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