Dear Trip Guide,

I’ve been doing some research on guided trips and the potential benefits of intentional psychedelic use followed by supported integration. I came across an external page linked on your website that mentions that ‘a person may also experience seizures from taking the drug, and they have a higher chance of heart attack.’ As much as I feel a guided trip could be right for me, I’m worried about having a heart attack during a session. Have you got any psychedelic safety know-how to put my mind at ease?

Sincerely,

Heartthrob in Houston

Dear Heartthrob,

Thanks for writing, and for raising this super important issue relating to psychedelic safety in general, and heart health more specifically. Your concern is totally valid, and one I have often shared! I too worry about my heart due to a family history of heart disease and heart attacks, as well as my own health issues. Information is power, and I wouldn’t want to naively engage in something with a particular danger to my heart.

I was actually confused by the claim on the website you linked, so I set out last night to do my due diligence on the subject. Here’s what I found:

1. First things first: let’s look at the source. That website cites the Center for Substance Abuse Research, but I noticed the link they included is dead. I poked around on the CSAR website, but was unable to find this same claim anywhere. I called the number listed on the hallucinogens.com site, but was put through to a substance abuse hotline unaffiliated with the site. I filled out a contact form provided with my question, but have had no response yet. If I ever do hear back, you’ll be the first to know. But for now, the validity of their claim seems… dubious.

Full disclosure: I’m a research nerd. And if they have research backing their claim, I want to read it, and I want all of us at Guided Tripping to stay up-to-date on the science of psychedelic safety. Staying informed and keeping people safe is one of my callings and I take it very seriously. But until peer-reviewed research proves otherwise, I am unfamiliar with heart attacks being a risk associated with the consumption of psilocybin.

“I am unfamiliar with heart attacks being a risk associated with the consumption of psilocybin.”

2. But who am I, you ask? Certainly not a medical professional! …I reply. Great point. This is why we undertake a health screening with all our potential clients, to guarantee psychedelic safety and take necessary precautions to make sure no one will be embarking on a journey they’re not equipped to take. Guided Tripping also has a medical doctor, Ajit, who consults when working with patients who have specific needs and health-related concerns.

I spoke with Ajit last night and he was also confused by the website’s broadly-worded claim. I have personally worked with multiple clients who had a medical history of seizures, as well as with clients with heart concerns.

All of these clients consulted with our own doctor, and together with their own GPs we were able to create a plan as a team that worked for our clients.

I should say, there have also been cases where we felt we could not confidently provide the care necessary for certain prospective clients. We’re not afraid to say no! Which isn’t personal… at the end of the day, psychedelic safety and proper precautions are a top priority of ours at Guided Tripping. We want what’s safest for every individual.

3. Based on my experience, here’s where I think the website you mentioned went wrong: because psilocybin mushrooms are still criminalised in many countries, the legal risk of taking mushrooms is conflated with the risk of taking the wrong mushrooms, making people unjustly wary of even the most fastidious fungal consumption.

There are definitely major health risks when you go foraging for mushrooms and can’t be 100% sure that the mushroom you’re about to consume is the mushroom you think it is. There have been some studies looking at mushroom poisoning and its effects on the heart. There are also accounts of people mistakenly ingesting poisonous mushrooms and having seizures. Many dangerous mushrooms cause seizures, and here’s a study to back up that claim.

The mushroom in that study is called Amanita phalloides, and—in line with our rigorous psychedelic safety measures—it’s a mushroom we would never in a million, billion years, ever advise patients to consume!

We recommend that our trippers use Psilocybe atlantis truffles, available for purchase at smart shops here in the Netherlands, where their sale is legal and regulated. That way you know that what you’re buying is a species that’s safe for consumption.

The closest Ajit and I could come to identifying the link between the website’s claim and the scientific literature is the known relationship between psychedelics and 5-HT2B receptors in the heart. Studies have been conducted that look at MDMA (an entheogen that is similar in some ways to psilocybin, but in many ways in a class all its own) and heart defects or heart disease such as valvular heart disease. For example, check out this study and this study.

But in all our experience guiding and following psychedelic science, we’ve come across zero evidence, studies, or research connecting psilocybin and heart attacks in healthy hearts (meaning hearts not diagnosed with defects or disease). There is also one obscure study that investigates mushrooms in a heart transplant donor, but it’s not of much relevance here.

Thanks very much for bringing this to our attention! The more I’ve read on hallucinogens.com the more unsupported claims, serious gaps in research, and moralising language I’ve encountered. I’ve therefore recommended that we remove it from our website and replace it with a source that’s more scientifically rigorous.

My (not so) inner nerd was very happy for the chance to roll up her sleeves and dive into the data-mining, collaboration, and research trenches once again. All in the name of psychedelic safety. So many thanks!

I hope this quells any concerns you may still have. No matter what, if you decide to move forward with an intake, your health and safety are our top priority, as is the integration of all that there is to be learned during a safe psychedelic trip.

All the best,

Your Trusty Trip Guide April