Who Shouldn't Take Psychedelics

Cropped shot of an unrecognizable teenage girl drinking medication

Tassii / Getty Images

At this point, most of us have heard of psychedelics. From counter-culture scenes that glorified the use of psychedelics for artistic expression to the current rise of psychedelic-assisted therapy, this class of drugs is gaining steam.

There is increasing evidence that using psychedelics can benefit one’s overall mental health, which is beginning to destigmatize the use of these substances. Despite these advances, psychedelics are not a fit for everyone.

First, if you’re considering using psychedelics therapeutically, please seek out the support of a professional. All of the studies that celebrate the therapeutic effects of psychedelics only refer to treatment that is guided and monitored by a trained mental health professional.

There is always the risk of a bad reaction to psychedelics and rare but possible harm, but this risk is very low in the context of psychedelic-assisted therapy clinical trials due to the controlled nature of the trials. Several states have now legalized the use of psychedelics in therapeutic settings, so it is possible to receive this type of care, but people with certain mental health conditions might be more at risk for adverse reactions.

Who Is At Risk?

There are some circumstances where it is ill-advised to take psychedelics. Personal autonomy when making a decision regarding taking psychedelics is important. Knowing when it could be harmful to take psychedelics can support you in making an informed decision.

Regular Users

Those who use hallucinogens recreationally regularly are at an increased risk of long-term hallucinogen-persisting perception disorder (HPPD). This disorder can lead to individuals continually experiencing the effects of the hallucinogen over a long period of time. Potentially permanent, HPPD can lead to vision and perception issues that can significantly alter one’s life.


The use of psychedelic drugs can lead to nausea and vomiting plus a spike in one's blood pressure, making them especially problematic for those who are immunocompromised or are living with pre-existing conditions. 

Pregnant People

There is minimal research on the effects of psychedelics on pregnant people. Since there is already a 3 to 5% chance of birth defects in every pregnancy, taking substances that have not been explicitly cleared for pregnant people is risky. That being said, there is developing research indicating psilocybin could be beneficial for postpartum depression. Despite this advance, it is critical to remember that all risks have not been fully studied yet.

Individuals With Pre-Existing Mental Health Conditions

Psychedelics can have profound therapeutic impacts on mental health conditions when taken under the close supervision of a trained professional. While it is rare, it is possible for those ingesting psychedelics to experience psychosis as a result. For those who have a history of psychosis in their family, have experienced it before, or have a diagnosis that involves psychosis (like schizophrenia or bipolar I), psychedelic use is cautioned.

System-Impacted Individuals

Most psychedelics are criminalized, and utilizing them can lead to prosecution. For those who are system-impacted and have already experienced run-ins with the criminal justice system, being caught buying or utilizing psychedelics could only lead to further issues. If you do have prior convictions and are interested in exploring psychedelics, be aware of the laws and limitations in your jurisdiction. Some states have begun to decriminalize the use of psychedelics, which can make usage much safer.

Folks Struggling With Substance Use

Those struggling with substance use may want to take extra care when considering the use of psychedelics. Some psychedelics are used therapeutically for addiction, but that requires strict protocol under professional supervision. Some psychedelics have a higher risk for misuse—for example, MDMA is derived from amphetamine, making it a riskier choice for those navigating addiction.

Why Do People Take Psychedelics?

There are different reasons why people choose to take psychedelics. To begin, those who choose to use these drugs recreationally may be particularly drawn to the general impact of these substances, which is to have an altered sense of reality.

This desire can be motivated by a hope of escaping pain in their day-to-day life, or it could be due to curiosity. Some may be drawn to psychedelics to create art, a theme that has been long-documented through “psychedelic art." Others may have a treatment-resistant mental health condition and find psychedelic-assisted psychotherapy a worthy venture. 

How Are Psychedelics Used Therapeutically?

Psychedelics are now being used as part of therapeutic programs for those experiencing issues finding an effective treatment. Typically, a clinician will provide the client with the substance in the session. Then, the client is invited to relax while listening to soothing music, noticing any thoughts and sensations that arise. The therapist is present the entire time, and the client is welcome to begin freely speaking and engaging in psychotherapy whenever they’d like.

Evidence has shown that MDMA is successful in treating PTSD. Psilocybin is promising in treating cancer-related anxiety and depression. Evidence for the therapeutic use of LSD for treatment-resistant conditions is still growing but has been promising thus far. Just one ibogaine treatment has been clinically proven to decrease or end opioid use. In the case of ibogaine treatment, supervision is provided after the session for a few days to monitor food intake, exercise, and sleep. 

A Word From Verywell

There can be many reasons for wanting to take psychedelics, from wanting to heal to desiring to boost one’s creativity. However, it is important to weigh the risks of taking these drugs.

For those taking them recreationally, there are significant health concerns due to the lack of control and oversight in taking them. Additionally, they are still criminalized and can lead to legal issues. As for those who wish to participate in a clinical trial, it is critical to examine your motivations for doing so. Additionally, being extremely honest with the professionals running the clinical trial is equally important.

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

9 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Husain MI, Umer M, Mulsant BH. Can the revival of serotonergic psychedelic drugs as treatments for mental disorders help to characterize their risks and benefits? Expert Opin. Drug Saf. 2022;21(6):721-724. doi:10.1080/14740338.2022.2063274

  2. Orsolini L, Papanti GD, De Berardis D, Guirguis A, Corkery JM, Schifano F. The “endless trip” among the nps users: psychopathology and psychopharmacology in the hallucinogen-persisting perception disorder. A systematic review. Front Psychiatry. 2017;0. doi:10.3389/fpsyt.2017.00240

  3. National Institute of Health. Psilocybin mushrooms ("Magic Mushrooms").

  4. Jairaj C, Rucker JJ. Postpartum depression: A role for psychedelics? J Psychopharmacol. 2022;36(8):920-931. doi: 10.1177/02698811221093

  5. Nature. How ecstasy and psilocybin are shaking up psychiatry.

  6. Marks M. The varieties of psychedelic law. Neuropharmacology. 2023;226:109399. doi:10.1016/j.neuropharm.2022.109399

  7. Krippner S. Ecstatic landscapes: the manifestation of psychedelic art. JHP. 2017;57(4):415-435. doi:10.1177/0022167816671579

  8. Schenberg EE. Psychedelic-assisted psychotherapy: a paradigm shift in psychiatric research and development. Front Pharmacol. 2018;9:733. doi:10.3389/fphar.2018.00733

  9. Noller GE, Frampton CM, Yazar-Klosinski B. Ibogaine treatment outcomes for opioid dependence from a twelve-month follow-up observational study. Am J Drug Alcohol Abuse. 2018;44(1):37-46. doi:10.1080/00952990.2017.1310218

By Julia Childs Heyl
Julia Childs Heyl, MSW, is a clinical social worker and writer. As a writer, she focuses on mental health disparities and uses critical race theory as her preferred theoretical framework. In her clinical work, she specializes in treating people of color experiencing anxiety, depression, and trauma through depth therapy and EMDR (eye movement desensitization and reprocessing) trauma therapy.