Things are changing, and the past is returning. What am I talking about? Well, a cultural and pharmaceutical change is coming to a community near you.
Psychedelics are on the forefront of research—and recreation. That, in turn, will hit our clientele in higher volumes sooner rather than later. Many of us have responded to the result of the occasional backstreet dealings of LSD (acid), psilocybin (magic mushrooms), MDMA (ecstasy), mescaline and Ayahuasca, but such products are going to become a little more accessible.
Pluses and minuses
In the 1950s and 60s, psychedelics were studied heavily for behavioral disorders, such as anxiety, depression and post-traumatic stress disorder. Throughout these studies, substantial evidence indicated that psychedelics have extraordinarily positive effects on these conditions. However, psychedelics received a bad rap during the Vietnam War, when draft age Americans stood up to “the man,” the man being the U.S. government. In 1968, a prohibition was placed on psychedelic compounds. Two years later, they were labeled as a Schedule 1 controlled substance—meaning that they have no medical use in the eyes of the Federal Drug Administration.
Fast forward to not that long ago: Psychedelics again are in the limelight, with the expectation of becoming legal in many communities. Oregon already legalized the use of psychedelics, and other states and hundreds of communities decriminalized possession of psychedelics.
The positive side of all of this: a potential fantastic step for our country’s mental health status in the form of utilizing psychedelics for therapeutic treatments in a controlled setting. The negative side: We will experience an influx of inappropriate ingestion of these substances in an uncontrolled environment, which can lead to some bad trips and, even worse, full-blown psychosis.
What do psychedelics do?
Psychedelics primarily alter perception. They assist people to “see” their consciousness from a few steps back and to digest what they are experiencing. Now, not all of these substances act the same way. For example, LSD and mushrooms can add visual effects and even cause terrible thoughts for the individual who ingests them (this is why a controlled environment is necessary).
In any case, as a provider, you must go into a situation with an open mind. You must understand that you very well might not know specifically what the person is experiencing because of the individual’s change in perception. Psychedelics have the capability to open closed doors in someone’s psyche; sometimes, they are very, very bad doors that let out terrible memories. People who consumed a psychedelic could be living their worst hell—and you are about to intervene. So, tread lightly and speak very easy with your patients to assist with trust, because it will be very difficult for these people to trust a stranger at that point in time.
A good way to think about speaking with these patients: Go in with understanding to thoughts and feelings. Avoid agreeing or disagreeing, because this can lead you into a social connective trap. Just listen, acknowledge and validate what they are experiencing.
In extreme cases of the ingestion of a psychedelic, a form of psychosis is developed and lingers with the patient for hours—or months or years in some cases.
You must treat it all as though this is a fragile person and respect wishes to the best of your ability.
Be mindful
There are other signs and symptoms that you must look out for and manage as you would with supportive care: nausea, vomiting, tachycardia, abdominal pain, hyperthermia, weakness, dry mouth, dilated pupils, diaphoresis, distorted sense of time, mixed senses (being able to see sounds) and the sense of a mystical experience. At times, some people might have the worst trip of their life and be in a full psychosis state. We graciously can bestow benzodiazepines upon these individuals, to calm them down and assist with making them relaxed.
Each time that you encounter someone on “a journey,” remember, you very well could hold a very important place in that individual’s life at that very moment. Treat that moment as though you know that it makes a difference for the patient and be open minded to the person’s perception. These mind-altering plants and substances are here to stay. Expect to see them more and more.
Brandon Heggie
Brandon Heggie is a lieutenant firefighter/paramedic who has worked in fire and EMS for more than a decade. He served as a tactical medic on a SWAT team and is involved in high-angle rope rescue. Heggie provides in-depth knowledge in aggressive, simplistic medical assessment and care. He obtained an associate degree in emergency medicine and health services. As an instructor, Heggie provides a high-energy educational approach to maximize the learning experience and taught at Firehouse World and Firehouse Expo.
