What Is a Bad Trip?
Psychedelic drugs can induce fear or distress
Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.
A trip is a period of intoxication from a hallucinogenic drug, such as lysergic acid (LSD) or magic mushrooms (psilocybin). It is called a “trip” because your perceptions of the world change so dramatically, it can feel as if you have taken a trip to a strange, new land.
You hope that it will be a pleasant experience, and it might be, but it can quickly turn unpleasant; sometimes, it is unpleasant from the beginning. This unpleasant experience of hallucinogen intoxication is known as a “bad trip.”
It is common for occasional unpleasant sensations, hallucinations, and thoughts to occur during a trip, and this does not necessarily mean you are having a bad trip. These experiences can sometimes seem interesting or funny, rather than upsetting or frightening, and they can pass quite quickly.
One of the earliest documented bad trips was reported by Albert Hofmann, the chemist who discovered LSD. He had started experiencing a bad trip, and in an attempt to soothe himself, requested some milk from his next-door neighbor, who appeared to have become “a malevolent, insidious witch.”
Are Certain People Exempt From Bad Trips?
When people first start experimenting with psychedelic drugs, they sometimes go through a “honeymoon period” causing them to believe all trips are good.
They might believe that they are “safe” from bad trips or that bad trips only happen to people with the wrong attitude. Some believe that bad trips are a myth dreamed up by the establishment to try and discourage people from becoming enlightened or having a good time. Others think that taking the drug with friends or a “guide” will prevent a bad trip.
None of these beliefs are correct—although sometimes they can provide a false sense of security and a carefree attitude that can help keep the mood positive. The more times you take psychedelic drugs, the more likely you are to eventually have a bad trip.
A bad trip can even cause you to think that the people you previously thought were “safe” can no longer be trusted. If this happens, it can be upsetting both for the person experiencing it, and for their companions, who can feel powerless to help.
Are Certain Drugs Exempt From Bad Trips?
Some psychedelic drug users believe that bad trips can only happen with a drug such as acid or PCP. They think that they can’t experience a bad trip from drugs they perceive as “safe” like ecstasy or magic mushrooms.
Sadly, many people don’t know what a bad trip is until they have one, so it is helpful to know ahead of time what you could experience, and what you should do if you have a bad trip or one of your friends does.
Unfortunately, there is no such thing as a “safe” drug. In fact, all psychedelic or hallucinogenic drugs can cause a bad trip, even ecstasy or magic mushrooms. Other drugs, such as weed (marijuana) and cocaine, can also produce intense, distressing effects, even in people who usually have a good time when intoxicated from these substances.
Signs and Symptoms
Bad trips symptoms vary a great deal and it’s impossible to predict how a hallucinogen will affect you. They can be mild or intense and can range from upsetting and overwhelming thoughts to frightening hallucinations and delusions that can lead to accidents.
Incidentally, many accidents that occur while under the influence of hallucinogens happen as the result of delusions that are not part of a bad trip. For example, someone might believe that they can fly or that they are indestructible. These kinds of delusions are unusual, but serious injuries and deaths have happened in these situations.
Though a highly individualized experience, there are some aspects that are often described by people who have had a bad trip.
This is the experience of time standing still. This can make it feel as if the other unpleasant aspects of the trip will never end.
Tip: If someone is having a bad trip, it can be reassuring to tell them it won’t go on forever, even if they feel as if it will.
Negative Reinterpretations and Paranoia
Previously positive or neutral interpretations of life or relationships can suddenly become negative. Someone having a bad trip might feel that their life is worthless, that they or someone else they normally feel fine about is bad or acting against them, or that the whole world is bad or corrupt.
These feelings can be all-consuming and can cause the person having a bad trip to panic and try and get away from the people around them.
Tip: Generally, it is unwise to allow someone who is having a bad trip to go off on their own, but be aware that acting confrontational or following them may increase their feelings of antagonism or paranoia. Try to have a trusted friend accompany them, saying they want to help them stay safe.
However, a stranger who comes across as caring, genuine, and calm may be more acceptable. Although involving police or medical personnel may be highly upsetting for someone having a bad trip, it is preferable to having them hurt themselves.
Most of the hallucinations that people have while tripping take the form of visual distortions—such as walls “breathing,” colored or geometric formations, or illusions.
Sometimes these distortions are extremely vivid, such as a familiar person’s face morphing into that of a demon. Occasionally, hallucinations take the form of seeing beings or objects that don’t even exist.
Tip: Usually, people who are tripping are aware that these hallucinations are the effects of a drug, and can be reassured that what they are seeing is part of the trip.
Your mood can change dramatically when you are tripping, and feelings of sadness and despair can reach new depths, while anxiety can quickly develop into panic.
Tip: Although acts of violence or self-harm are unusual while tripping, tell someone as soon as possible if you are having any thoughts about harming yourself or someone else—you are not thinking clearly and indulging in these thoughts may have regrettable consequences.
How to Stop a Bad Trip
Although it is not possible to “switch off” the effects of hallucinogenic drugs, a bad trip can be transformed into a more positive experience if the person having the trip is open to being supported or comforted. Often, lying down and listening to soothing music in the presence of a calm support person can help.
The most intense period of the trip typically occurs from one to three hours after the drug is consumed, so time will usually ease the most intense aspects of the trip, but the effects will often continue for an additional six to twelve hours after that, during which time the person will not be able to sleep.
Having a bad trip can possibly be averted by the presence of a good friend, and by avoiding people or places that you usually find upsetting. But again, there is no guarantee that this will keep a trip good.
One of the characteristics of hallucinogenic drugs is that they can cause you to see and think about the world in a very different way from how you usually do, so the previously trusted friend can quickly change and appear to be deceitful, mean-spirited, even evil.
If the person is open to receiving medical help, which they may be if they think the intensely unpleasant aspects of the trip could be alleviated, you could accompany them to a walk-in clinic or the emergency room. There may be medical interventions that could help.
Never attempt to self-medicate by taking other drugs—this is risky and could worsen the effects of the trip or cause drug interactions. It can also lead to developing problems with other drugs taken in an attempt to calm down, such as heroin.
A Word From Verywell
The only way to avoid a bad trip is to avoid hallucinogenic drugs. While you may be intrigued by the idea of tripping, there is a reason that people don’t usually take them for long—sooner or later, they have a bad trip, and never want to repeat the experience.
A bad trip is an unpleasant experience that can happen after taking psychedelic drugs such as lysergic acid (LSD) or magic mushrooms.
Bad trip from smoking pot? It could be a sign of mental illness
VANCOUVER—It took years for doctors to figure out why she was hearing voices in her head. It started innocently at first. The voices were distant. Sometimes they came from her television. In this alternate reality, she was the belle of Hollywood’s A-list, sought after by the directors and actors of Beverly Hills.
Before age 25, Anita Smith had never touched marijuana. She had an otherwise unremarkable, sheltered upbringing with no family history of mental illnesses. Following high school, she spent three years in the Canadian Forces before deciding to enrol in film school. Her group of friends in college introduced her to pot.
That was back in the mid ’90s, when the psychoactive component in cannabis, THC, was mild compared to today’s standards. For more than two years, Smith was a daily user. So was everyone else in her peer group. But only she heard the voices.
As Canada is poised to legalize recreational marijuana in October this year, with federal legislation making the drug legal to possess in limited amounts for anyone 12 or older, experts are attempting to figure out how best to educate Canadians on the mental health risks for using the drug.
In particular, research in Denmark has discovered heavy cannabis users are substantially associated with the development of schizophrenia and bipolarism. In fact, of those who were hospitalized with a pot-related mental condition, almost 50 per cent were diagnosed with schizophrenia or bipolarism later on in life. The risks increase the younger a person starts using. Experts have not yet determined whether cannabis causes schizophrenia or bi-polar disorder, or whether it simply triggers a first psychotic episode.
“I had my own world inside my head and it was a great world at first . Conan O’Brien wanted to marry me, this rock star thought I was the greatest thing. It fed my ego so much,” Smith said.
But then she started believing what her mind was telling her. She was going to live in a van, move to the U.S., meet the lover of her dreams. The first time she went to hospital, she called 911 on herself.
Smith, who was diagnosed with schizophrenia, is hardly the only example in British Columbia. For the past seven years, emergency departments in the province have been tracking hospital admissions of those who were diagnosed with mental or behavioural issues to due cannabis consumption, and overdoses related to the drug. Each year, the numbers of people so mentally ill from marijuana that they had to go to the emergency room has increased consistently.
Data obtained from St. Paul’s Hospital, Vancouver General Hospital, Surrey Memorial Hospital and Kelowna General Hospital show 567 people in total in these categories were admitted to these emergency departments last year. In 2012, that figure was 168.
The difference in the number of admissions for mental health issues due to marijuana at the four hospitals reveal an approximately 30 per cent average year-over-year increase in these types of hospital visits.
In Denmark, the records examined by researchers displayed remarkably similar circumstances as the count from B.C. Each of the 1,492 people examined in the country had been admitted to hospital for cannabis-related psychosis, defined under the same International Classification of Diseases metric as the figures presented by B.C. hospitals.
Just under half were diagnosed with schizophrenia or bipolarism later on in life, often within the next two to three years after their first hospital visit.
“It was very surprising,” said Dr. Marie Starzer, lead author of the Danish study, in an interview. “(These) were cases so severe you would need hospitalization or at least a visit to the psychiatric emergency room . there’s probably a lot more cases of people who get some sort of psychotic symptoms when they smoke cannabis but they pass after a couple of hours.”
Cannabis being associated with schizophrenia is not a new theory. Just over the past year, Health Canada provided $83,000 to the Schizophrenia Society of Canada to develop its health-messaging website, cannabisandpsychosis.ca.
Dr. Phil Tibbo, chair of the Schizophrenia Society of Canada Foundation, said there’s a misconception among the public that because marijuana is “natural,” that it’s completely safe for consumption.
“When you talk to youth, that’s what they hear. ‘There’s no issue. It’s harmless. It’s a natural product. How can it do me any harm?’ That’s the perception of cannabis,” Tibbo said.
Particularly, the concern for youth is how cannabis consumption disrupts the endocannabinoid system responsible for passing information in the brain during adolescent brain development, Tibbo said. It’s the disruption of that system that could result in psychosis. Or put another way, adolescent cannabis usage could potentially undermine the ability of the brain to properly pass along information.
“Some might call it a ‘bad trip’ . which is really not what you’re supposed to expect if cannabis is a pleasurable experience,” Tibbo said. “What I’ll say to a patient in front of me is that, ‘Yes. Your friends may be smoking a lot but they’re not here. You’re here in front of me. It’s something about your brain.’”
To date, much of the prevailing theory is that marijuana doesn’t cause mental illness so much as act as a “trigger” for those already at risk, said Dr. Tim Stockwell, director of the Canadian Institute for Substance Use Research in B.C.
“That’s the summary of the established position. Personally, I think it may be a little more of a problem than that,” Stockwell said. “I’ve encountered people who it appears from family reports had no other symptoms until they got heavily into using cannabis.
“It’s controversial and people argue fiercely on both sides.”
In a statement, B.C.’s Ministry of Health said it started encouraging hospitals to collect data in 2011 to contribute information to a national database on why people attend emergency rooms, and the cannabis data was captured as part of a wider range of information.
Dr. Bonnie Henry, B.C. provincial health officer, said the increase in numbers may be due to how doctors are becoming ever more aware of marijuana-related symptoms, in addition to the presence of more users overall, thanks to the proliferation of recreational marijuana in recent years.
But Henry said the issue is how THC levels are not currently measured, and the provincial government is looking to Ottawa to enforce labelling requirements on the quantity THC within recreational cannabis products. Henry said one option B.C. has at its disposal would be to set pricing based on the quantity of THC in each product.
“We know products that contain really high THC levels are ones more likely to trigger psychosis or other ill health effects,” Henry said in an interview. “If you’re somebody who has a family history of mental health issues of psychosis or anxiety, then you’re somebody who should not be using cannabis.”
Health officials also don’t know how much THC would be considered high enough to exacerbate risks due to lack of knowledge. In lieu of recommended daily dosage guidelines, the message of currently endorsed guidelines to prevent mental illness risk is simply: use less, use lower levels of THC or abstain.
None of the B.C. hospitals provided a subject matter expert, or anyone from their emergency departments, for an interview. Interior Health, which saw 81 cases at its Kelowna General Hospital in 2017, provided a statement from Andrew Hughes, the hospital’s health service administrator.
“The number of patients admitted with cannabis use disorders or overdoses has remained very small over the last eight years when taken in the context of the overall patients we see at Kelowna General Hospital,” Hughes said.
Fraser Health’s Surrey Memorial Hospital saw the largest proportion of cases, with 270 cases last year. Spokesperson Jacqueline Blackwell said the treatment for the typical patient with a cannabis-related emergency would involve determining whether there is an ongoing mental health or substance use concern.
“The addictions medical consultation team will collaboratively develop a treatment plan to support them while they are in hospital and following discharge,” Blackwell said in a statement.
Janice Jacinto started using marijuana when she was 13. As a survivor of childhood trauma, she had always understood the anguish of mental pain. She dabbled with drugs, not just marijuana, simply due to the people she would hang out with at the time.
Jacinto’s problem is that when she uses marijuana, dark memories of years past come flooding back with the intensity of a current event taking place.
“It’s not always the memory. It’s a sensation in the body that remembers the stress. I was remembering things in from sixth grade I don’t normally think about . when you’re moving in that sped up kind of dial, the noise gets louder,” the 33-year-old said.
Her first true manic episode was in 2007. Since then, Jacinto’s been in and out of hospital for psychiatric treatment more than a dozen times, almost always due to psychosis following marijuana consumption.
For years, she was on and off anti-psychotic medications that often leave her without energy or creativity. But despite her continuing occasional consumption of marijuana, in part to offset the effects of anti-psychotic medications, she’s been able to gain a measure of control. The last time she was hospitalized was around 2014.
“I’ve always had a trace of bipolar since I was little but it only got amplified when I started using every day,” Jacinto said. “I’m not saying weed is bad. For some people it isn’t.”
The Vancouver Police Department, meanwhile, attributed the emergency room cases to an increase in mental-illness-related violence in the city. In its 2016 mental health strategy, the department described how its officers struggle to be the front-line of a mental health crisis in the city, with the number of contacts between police and the mentally ill increasing every year.
“It is only a small subset of this population who demonstrate a propensity toward violent behaviour, generally those with psychosis, often caused by schizophrenia or a related illness,” reads the mental health strategy. “The drivers of this increase include . a 300% increase in marijuana-induced psychosis over the last five years.” The police attributed this increase to “an increase in the toxicity of marijuana in recent years.”
The data-set used by the Vancouver police is identical to the one obtained by StarMetro. Vancouver police did not provide an interview to clarify its interpretation of the information.
Henry, the provincial health officer, said she believes the incidents referred to by Vancouver police are associated with “manufactured highly concentrated THC products like shatter,” which she believes should be illegal.
“While I agree with their stats and concerns, 300 per cent increase is still quite small in the actual numbers,” Henry said. “These are dramatic but not common events.”
As one positive sign, Henry referred to 2013 figures collected from 30,000 B.C. youths from Grades 7 to 12 that showed only about one-in-four teens had used marijuana in their lifetimes, down about 5 per cent from the previous survey done in 2008. Younger users under the age of 25 have an increased risk in developing mental illness due to marijuana use, she said.
“That age group from 19 to 25 is actually the highest using age group right now of cannabis, and prohibiting it in that group is not going to help,” Henry said.
“Now is our opportunity to put out the information and to make sure people know, what are the challenges, who are the groups that are in particular at high risk of psychosis or issues with mental health problems.”
Meanwhile, Smith, the patient diagnosed with schizophrenia, said she still uses marijuana on a daily basis, but controls the amount she consumes. For her, it’s about balancing her mental wellness without crossing that invisible line between reality and insanity.
“My doctor would always tell me we give you anti-psychotics to bring the psychosis down. You smoke to bring the psychosis up because you’re addicted to the mania,” Smith, 47, said. “Sometimes marijuana gets the motor in motion, it just helps a bit . You have to be honest. Is this actually helping or hurting?”
Correction — July 21, 2018: This story was updated from a previously edited version that errenously stated the legal age for possession of recreational marijuana as 21.
At four hospital emergency departments in B.C., 567 people were admitted due to mental and behavioural disorders or overdoses from cannabis in a singl…