Psychedelics and the essential importance of context.
Robin Carhart-Harris, Leor Roseman, Eline Haijen, David Erritzøe, Rosalind Watts, Igor Branchi, Mendel Kaelen
J Psychopharmacol February 15, 2018 DOI: 10.1177/0269881118754710 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Opinion piece Peer reviewed |
|---|---|
| Keywords | Psychedelics Hallucinogens Entheogens Psychedelic compounds Mind-altering substances Therapeutic potential Beneficial outcomes Positive results Healing potential Medical applications Treatment potential Therapeutic benefits Beneficial results Set and setting Environment Preparation Context Surroundings Mindset Supportive setting Structured setting Administration care Thoughtful care Crucial insight Essential factors |
| Citations | 646 |
| Key points | Argues that classic psychedelics' effects are exceptionally sensitive to context due to their pharmacological mechanism, and that contextual determinants of the acute experience predict long-term mental health outcomes. |
Abstract
Psychedelic drugs are making waves as modern trials support their therapeutic potential and various media continue to pique public interest. In this opinion piece, we draw attention to a long-recognised component of the psychedelic treatment model, namely ‘set’ and ‘setting’ – subsumed here under the umbrella term ‘context’. We highlight: (a) the pharmacological mechanisms of classic psychedelics (5-HT2A receptor agonism and associated plasticity) that we believe render their effects exceptionally sensitive to context, (b) a study design for testing assumptions regarding positive interactions between psychedelics and context, and (c) new findings from our group regarding contextual determinants of the quality of a psychedelic experience and how acute experience predicts subsequent long-term mental health outcomes. We hope that this article can: (a) inform on good practice in psychedelic research, (b) provide a roadmap for optimising treatment models, and (c) help tackle unhelpful stigma still surrounding these compounds, while developing an evidence base for long-held assumptions about the critical importance of context in relation to psychedelic use that can help minimise harms and maximise potential benefits.