People who use psychedelics prefer trip sitters—caregivers who monitor them during a session—to have personal experience with psychedelics or other non-ordinary states of consciousness, knowledge of health and medical fields, and familiarity with psychedelic literature. Forum discussions on The Shroomery and DMT Nexus also reveal a demand for remote trip sitting, where consumers communicate plans online to a sitter who is not physically present, balancing privacy with care. These preferences likely stem from stigma and the value of empathy; trip sitters with lived experience can relate to the effects and help consumers avoid judgment. The findings suggest that harm reduction services should be delivered by peers and should explore remote care options.
A renaissance in psychedelic drug research is underway in North America and Europe, overturning a 30-year political embargo. Randomized controlled trials using active placebos have shown that psilocybin can occasion spiritual experiences leading to long-term positive personality changes. Multiple trials indicate that one or two doses of psychedelic medicines like psilocybin or LSD, within a psychotherapeutic program, reduce anxiety and depressive symptoms in advanced-stage cancer patients, sustained for 6 months. Psychedelics also show promise as adjuncts for substance use disorders; an open-label trial of psilocybin-assisted psychotherapy for tobacco addiction found much higher abstinence rates at 6-month follow-up.
Psychedelic consumers prefer interpersonal interactions during their experiences that are nonintrusive, involve boundary setting, offer help, and include a sober sitter or coconsumer. These preferences align with clinical guidelines for psychedelic-assisted psychotherapy in areas such as carer acceptance, minimal involvement, nondirection, hazard management, and emotional stability. However, consumers also desire agency, the option to consume psychedelics alongside other consumers, and carers who have personal experience with psychedelics—preferences that diverge from existing guidelines. The findings suggest clinical implications for developing future therapeutic frameworks.