MAPS Bulletin 2021: Vol. 31, No. 2
MAPS has been providing psychedelic harm reduction and peer support services at festivals and events since the early 2000s. For over 20 years, MAPS staff and volunteers have engaged in peer support provision at numerous events where psychedelic use was being explored in the setting of what is today known as transformational festivals and events. Over the years, MAPS approach to psychedelic support has been informed through collaboration with other groups and organizations within the fields of psychedelic research and therapy and built upon the knowledge and principles of early psychedelic care pioneers. The Zendo Project, the flagship program of the MAPS harm reduction department was officially launched in 2012 at the Burning Man event. Over the past 9 years, the Zendo Project has provided psychedelic peer support services at dozens of events around the world and assisted over 6,000 individuals experiencing difficult emotional experiences, psychedelic or otherwise.
Education Rooted in Experience
From its inception, public education has been a primary focus of the harm reduction department. The Zendo Project has provided peer support training to over 5,000 individuals. We have facilitated over 40 training workshops to volunteers and the public. Zendo Project staff have given presentations at over two dozen conferences worldwide and have been invited to speak on numerous podcasts, webinars, and online panels.
In collaboration with the MAPS Communications and Events department, the Zendo Project curated two annual webinars and an annual lecture series featuring leading pioneers and experts in the fields of psychedelic harm reduction, research, and therapy. The public education and outreach of the departments has inspired and and seeded the psychedelic field for other organizations and individuals to psychedelic harm reduction and peer support.
The Zendo Project was born out of the festival and events industry. However, the experiences, learning, and the expertise forged in providing psychedelic crisis care was never meant to stay solely within the context of mass gatherings. Music and arts festivals and events can be seen as a type of microcosm. What we learn in these settings is directly transferable to the larger society. As is the case in society, at mass gatherings multiple health and safety departments work together to help ensure the health and safety of the public. At events we have attended, we have worked in close collaboration with other health and safety providers including paramedics, security, law enforcement, and mental health crisis intervention teams.
Uniquely positioned as a leader in the psychedelic field, the MAPS Harm Reduction Department now plans to take what has been learned at events and festivals out into the public sector, integrating psychedelic harm reduction into existing health and safety infrastructure and informing policies and protocols related to psychedelic use.
Decriminalization and Harm Reduction
In May of 2019, the City and County of Denver passed Ordinance 301, becoming the first U.S. city to effectively decriminalize the personal use and possession of psilocybin mushrooms and making personal psilocybin use the lowest law enforcement priority. Mandated by the passage of Ordinance 301, the Denver Psilocybin Mushroom Policy Review Panel (DPMPRP) was formed, a first-of-its-kind panel whose primary purpose is to collect data and advise policymakers on the effects decriminalization may have on the community, including but not limited to health, safety, and fiscal impacts.
In February 2020, MAPS Harm Reduction Officer and former MAPS Director of Harm Reduction Sara Gael was appointed as the harm reduction advocate for this effort. The panel is comprised of two members of city council, two proponents of Ordinance 301, one certified addictions counselor, one harm reduction advocate, one representative from the Denver Police Department, one representative of the Denver Sheriff Department, one criminal defense attorney, one representative from the Denver District Attorney’s Office and one representative from the Denver City Attorney’s Office.
The panel implemented a harm reduction training working group to discuss the possibility of integrating psychedelic harm reduction training into City and County of Denver Health and Safety Departments including the Denver Police and Sheriff Departments, mental health co-responder units, Denver Paramedics, and the Denver Fire Department. On September 11, 2020, the panel voted to involve the Multidisciplinary Association for Psychedelic Studies (MAPS) in their harm reduction training initiative.
Goals of the Multi-Responder Training Initiative
At MAPS, a team of over 20 professionals has been engaged to undertake the curriculum and training development effort. The team has backgrounds in risk management, law, medicine, psychiatry, mental health, neuropsychopharmacology, law enforcement, crisis response, quality improvement, insurance, education, certification, human resources, and information technology.
The curriculum is undergoing development according to the gold standard medical education model used for instructing physicians at academic medical centers.
The overarching goal of this training initiative is for first responders to enhance their knowledge, attitudes, and skills required to quickly recognize and effectively respond to emotional and behavioral crisis incidents involving psilocybin and other psychedelics. Paramount to the success of this program is enhancing responder safety and reducing risk and liability in situations where individuals are experiencing a psychedelic-induced crisis.
This initiative expects to deliver a comprehensive public safety and risk reduction curriculum developed to support the following goals:
- Provide education to create understanding of psilocybin usage, psychological and physiological response, and potential adverse effects of psilocybin ingestion
- Demonstrate the need—and legal considerations—for proper education of first responders
- Create standards and protocols for effective psilocybin-related crisis response planning, training, and deployment
- Increase the knowledge, capabilities, and preparedness of city first responders to effectively respond to psilocybin-related crises.
Training development encompasses substantial research into the problems, current approaches, and ideal responses, so that gaps are identified and filled by the curriculum. Multiple pilot programs will be conducted and feedback assessed and incorporated into the training design.
The Denver Harm Reduction training initiative has been enthusiastically received by City of Denver leadership. We are looking forward to offering training based on this program to other municipalities and states where psychedelic reform has passed leaders understand that psychedelic harm reduction improves public health and safety.
In Spring of 2021, the Denver Psilocybin Mushroom Policy Review Panel is delivering a Comprehensive Report to the city, which will include the findings and learnings of the panel and recommendations to inform public policy decisions. In addition to continuing to advance the training initiative, the panel is advocating for increased public education and awareness around psilocybin mushrooms, including possible benefits, and exploring the potential for psilocybin therapy and research in the city and county of Denver.
Creating a Model for a Post-Prohibition World
Recent surveys indicate that individuals are using psychedelics now more than ever, and this use spans all age groups. This increase is accompanied by a lack of widespread public informational campaigns highlighting potential risks of adverse experiences. The absence of such information, combined with a growing number of first-time users, would predictably increase the incidence of psilocybin-induced crises which would in turn warrant deployment of first responders. Most educational substance use programs focus on opioids and methamphetamines and do not address the differing effects and impacts of psychedelic substances. As such, specialized training focusing on effective approaches for first responders to psilocybin-induced crises stands to increase public safety and responder safety while minimizing risk of first responder liability.
It will forever be important to provide psychedelic harm reduction services at events and gatherings where psychedelic use may be more concentrated. However, as psychedelics become more integrated into our society and people choose to take psychedelics in other settings—at home and in nature, and in community—it is important that society’s first responders are equipped with knowledge and education about psychedelics to help them adequately respond to potential adverse effects.
The majority of individuals who choose to take psychedelics do so outside of clinical or ceremonial settings. As we explore the vast potential benefits of psychedelics as a society, it is also our responsibility to help people adequately understand and mitigate risk. The vast majority of psychedelic experiences have little to no severe physical or psychological adverse effects or impact, but emotionally or psychologically challenging or uncomfortable psychedelic experiences are not uncommon. The very nature of the psychedelic state, with its varied sensations, expressions, and dynamics, can be disorienting, confusing, and at times frightening.
A small percentage of people may respond particularly adversely to psychedelics. Some experiencing psychedelic-induced altered states can become unstable and erratic, which in turn can lead to harmful behaviors. People experiencing psychedelic crises who are subject to inappropriate first response have been shown to experience severe adverse outcomes including trauma.
Honest and informed education is necessary for both individuals who choose to use psychedelics as well as the psychedelic movement itself. Psychedelic research and the exploration of its therapeutic potential during the mid-20th century was disrupted and impacted in no small way by the inability of the psychedelic movement to effectively address and navigate adverse psychedelic experiences. We must do better this time around by providing adequate education, information, and tools to help our society deal with the complex psychological and emotional territory of the psychedelic experience.
Many adverse incidents and crises related to psychedelics can be prevented and avoided by increasing public education and awareness around the importance of set and setting, preparation and integration, and providing tools and knowledge that increase the likelihood of mindful and responsible use. The prohibitionist “just say no” approach to drug education made access to this type of education very challenging. In Denver and in other cities and states where psychedelics are being decriminalized, we have an opportunity for policies and protocols to be shaped by science, research and harm reduction philosophies and practices rather than fear, stigma, and misinformation.
Bryan H. Lang is CEO of Trans World Health Services, Inc., an international healthcare consultancy and IT firm. His has served over 400 commercial, government, military, and not-for-profit organizations on five continents in medical performance improvement, risk management, artificial intelligence, aviation, and neuropsychopharmacology. His first organization became the first publicly-listed population health management company. Processes and systems on which he led development supported care for 93 million Americans as well as all hospitals in NHS England. His interests in PTSD and chronic conditions led to publications on psychotropic crisis care as well as design and development of artificial intelligence-based care management systems.
Sara Gael received her master’s degree in Transpersonal Counseling Psychology at Naropa University. She began working with MAPS in 2012, coordinating psychedelic harm reduction services at festivals and events worldwide with the Zendo Project. She served as the Director of Harm Reduction at MAPS from 2017-2020. Sara continues to train individuals and organizations in principles of psychedelic peer support. She is a therapist for the MAPS clinical trials of MDMA-assisted psychotherapy for PTSD in Boulder. She maintains a private practice as a psychotherapist specializing in trauma and psychedelic integration. She has presented at conferences, universities, and events around the world. She serves on the board of directors at DanceSafe and as the harm reduction advocate on the city of Denver psilocybin policy review panel. Sara believes that developing a comprehensive understanding of psychedelic medicines through research and education is essential for the health and well-being of individuals, communities, and the planet.