Psychedelic drugs are increasingly visible, from ketamine at dance parties to LSD experiments in research centres. Dr Rick Strassman, in The Psychedelic Handbook, offers insights into substances such as LSD, psilocybin, ayahuasca, DMT, MDMA and ketamine, while providing guidance on how to prepare for safe and meaningful experiences.
Published in 2022 by Strassman, whose 1990s DMT trials broke new ground, the handbook provides practical and science-based information without promoting or discouraging use. It explores the neurobiology and cultural history of psychedelics, explaining how they foster mystical states by altering brain connectivity and self-awareness.
A research revival
In the 1950s and 1960s, psychedelics were widely studied, with more than 1,000 papers on LSD alone. But the US Controlled Substances Act of 1970 restricted research for decades. Interest revived in the late 2000s, and today clinical trials are advancing worldwide.
At Johns Hopkins, psilocybin therapy has provided lasting relief for up to two-thirds of depression and anxiety patients five years after treatment. Yale researchers are studying its potential for PTSD and addiction. MDMA-assisted therapy for post-traumatic stress disorder, granted breakthrough status in 2017, is approaching approval. Ketamine is increasingly used for treatment-resistant depression, while Imperial College London leads UK research on psilocybin for end-of-life anxiety.
The principles of preparation
Strassman stresses the importance of “set, setting, and dose” in reducing risks.
- Set refers to the user’s mental, physical, social and spiritual state, including intentions such as relaxation, problem-solving or meditation. Those with conditions like schizophrenia or bipolar disorder should seek professional advice.
- Setting involves the environment. Calm, familiar surroundings with trusted companions reduce anxiety, unlike chaotic scenes that can increase dangers.
- Dose dictates intensity. Beginners are advised to start small, for example 1–2 grams of dried psilocybin mushrooms for mild effects. LSD microdoses of 10–20 micrograms can support creativity, while full trips of 100–200 micrograms require more preparation.
Benefits and risks
Psilocybin has shown lasting improvements in mood with low toxicity. Ayahuasca retreats maintain traditional roles in spiritual growth. DMT produces short but powerful visionary experiences, MDMA enhances empathy useful in therapy, and ketamine can relieve suicidal thoughts quickly.
Risks remain, including “bad trips” with paranoia or panic, flashbacks known as hallucinogen persisting perception disorder, and cardiovascular strain in vulnerable people. Legal restrictions also persist, though some regions such as Oregon and Colorado are easing laws on psilocybin.
The role of integration
Strassman highlights integration as essential. Journaling or working with integration coaches can help translate psychedelic experiences into daily life. For those who struggle after use, support from trusted friends, counsellors or therapists may be necessary.
As psychedelic research continues to expand, The Psychedelic Handbook provides a timely resource for safe and informed use, emphasising preparation, care and responsible choices.