How Can We Apply Harm Reduction to HPPD?

By Ed Prideaux

In last week’s blog, Ed Prideaux told us everything we know (and don’t) about Hallucinogen Persisting Perception Disorder (HPPD), visual snow syndrome, and flashbacks. In part 2, he addresses ways to deal with the distress of having HPPD and ways to reduce the risk of developing it in the first place.

The real “problem” with HPPD is distress: anxiety, depression, isolation, panic, and the unhelpful coping mechanisms people can develop to overcome these (alcoholism and drug dependency are sadly common among HPPD patients). Remember, this distress is what technically defines HPPD.

Many people live with significant visual changes and do not find them distressing – rather, they may be sources of enjoyment, “free trips,” artistic inspiration, or purposefully leaned into as part of spiritual or occult practice. The world looking different doesn’t necessarily mean you have a problem. 

If you’re currently experiencing HPPD, though, overcoming the distress should probably be your first priority. Speaking crudely, once the distress is overcome, the visuals can more or less “take care of themselves.” With less distress, there is less fixation. With less fixation, there is less noticing. With less noticing, the visuals are less noticeable. They may rapidly normalize, filter in the background, and can disappear unexpectedly with time.

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How Can We Address This Distress – and Bring the Visuals Down?

Medication and clinical help:
Many in the HPPD community have found relief in the use (especially in the short-term) of medications including Lamotrigine and Klonopin. They can bring visuals and anxiety way down, though some report their symptoms getting worse. They can always bring side effects, too, so some caution is advised.

Do not be surprised, either, if clinicians have not heard of HPPD. It is little-known and poorly-understood. It may be useful to refer your clinician to the Information Guide included on the Perception Restoration Foundation’s website.

Healthy lifestyle changes:
Many HPPD patients report the decline and resolution of their symptoms – or otherwise acceptance and returning to “normal” life after avoiding further drug-taking, exercising regularly, cutting out processed foods, or trying specific elimination diets.

Noting Triggers: 
Pay attention to your triggers and act accordingly. Visuals and other HPPD symptoms can surface in response to:

  • Fatigue
  • Stimulation, including caffeine 
  • Anxiety and stress
  • The nature of the environment: visuals are more apparent in the dark, on blank surfaces, in enclosed rooms, and in environments where people had their original psychedelic experiences
  • Specific foods 
  • Fixation and attention, including staring at blank surfaces and an anxious tendency to look out for visuals 
  • Intoxication with other drugs, especially cannabis 

You should also pay special attention to how your condition manifests beyond visuals, in particular, if you are experiencing Depersonalization/Derealization Disorder. More than visuals, it’s often the case that people’s distress comes from DP/DR, and a rich body of literature and therapeutic approaches have been explored for this condition. 

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Community: You can seek community from others, such as groups on Facebook, or the forums at, r/HPPD, or r/visualsnow. However, tread cautiously around spending too much time on these forums. They can be extremely negative, and cause people to spiral and fixate on their perceptual changes.

Mindfulness meditation: The stress reduction and relaxation effects of meditation are well-established; many report breaking the cycle of visual fixation through learning to hone their attention.

Cognitive techniques: Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) may be useful for accepting and reframing perceptual changes. Challenging the internal beliefs triggered by HPPD could reduce both distress and the visuals – in particular, the beliefs that patients are “brain damaged,” “weird,” “isolated,” or a “casualty.”

Psychedelic integration: Introspection, journaling, and (if you can find and afford it) specialist, psychedelic-informed counseling can be helpful. In particular, you may benefit from exploring the particular details and events of what may have caused HPPD to originally materialize.

Somatic approaches: Certain somatic/bodily therapies have proven helpful for people with Visual Snow Syndrome. This includes the use of acupuncture, muscle relaxation techniques, neck massage, and specific dietary interventions.

Reframing: It may be helpful to learn that many people are not troubled by their perceptual changes. Again, they can be just a “thing” – how one sees now – that’s different, and not necessarily bad. Other people actively enjoy their perceptual changes or view them in a spiritual way, such as glimpsing auras, having broadened the possibility of the mind, or in seeing the intrinsic shakiness of ordinary experience.

Without a deep, embodied grounding for your reframing, though, it can be hazardous. Make sure the frame is not just “in your head,” but truly held across your entire mind and body in a felt way. Don’t gaslight yourself into enjoying your perceptual changes if they are actually disturbing you.

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How Can One Reduce the Risk of Developing HPPD When Taking Psychedelics?

There is reason to suspect that the immediate period after a trip – say, one-to-five days – is important. This is because the brain is still neuroplastic and affected by psychedelics for up to a week (or longer) after the trip. And HPPD may be understood as a problem of “resetting” one’s brain back into its ordinary perceptual categories after the shock of a psychedelic experience.

If you want to avoid HPPD, what matters is ensuring that your perception re-transitions to its prior sober state safely. In this one-to-five day period, it may be advised, then, to:

  1. Sleep well.
  2. Avoid cannabis and further drug-taking. Some people report that their HPPD was “kicked in” by a subsequent drug experience.
  3. Process the psychedelic experience through dedicated integration practices, such as journaling, contemplation, meditation, and inquiry. Speaking very crudely – and because HPPD may well be a “network disorder” involving cross-connected mixtures of perception, emotion and cognition – it may be that failing to integrate the experience may cause the energy to remain and be reactivated, including in cognition and possibly in perception (especially if the right triggers are also hit).
  4. Keep stress and anxiety to a minimum.
  5. Re-embodiment, or reconnecting to body sensations. Practices may be recommended, including through mindfulness meditation. This may help to reduce the risk of dissociative disorders like Depersonalization/Derealization as well.
  6. Reduce screen use. Focusing on screens may cause a disembodying effect, as well as holding back the psychological energies activated by the psychedelic experience.
  7. Avoid triggering environments, such as places that are enclosed or rich in blank surfaces, and try not to self-induce visuals through staring and fixation. If someone wants to be extra careful, they may wish to avoid the place where they had their psychedelic experience. “Training” the brain in hallucinatory ways of seeing while it’s neuroplastic may cause lingering changes once neuroplasticity is reduced and stable categories are reaffirmed.

Important Questions to Ask Before Having an Experience

Have you optimized your set and setting?
HPPD seems to be more likely after bad trips or challenging experiences – the likelihood of which strongly depends on how people organize their set and setting. In particular, stress and trauma going into a psychedelic experience may be a trigger for HPPD experiences, even at low dose (and microdose) levels.

Have you experienced some unusual visuals before?
HPPD patients may have had a higher-than-normal experience of certain visual oddities, which are rare parts of normal perception. In particular, phenomena like visual snow, halos, after-images, floaters, and colors in the dark may suggest an underlying tendency in perception that could be triggered by a psychedelic drug to be more intense.

Have you tested your drug? If so, what drug are you taking?
HPPD may be more likely with Novel Psychoactive Substances (NPSs) and Research Chemicals (RCs) with more unpredictable, less-researched, and possibly neurotoxic effects. Adulterants in street drugs may also have neurotoxic and other risky properties.

It seems that long-acting psychedelics like LSD are more likely to cause HPPD. While LSD may have certain advantages over other psychedelics subjective to each user, someone very conscious of developing HPPD (at least compared to other risks) may wish to avoid LSD in favor of a shorter-acting psychedelic.

How often are you tripping?
Taking lots of psychedelics frequently is likely to be correlated with a higher risk of developing HPPD. This can be explained in a number of ways:

  1. A higher likelihood of having a bad trip
  2. Activating a latent genetic susceptibility 
  3. More likely to over-excite relevant perceptual circuits
  4. More “re-training” of perception in hallucinatory ways of seeing
  5. Less time in which to integrate properly one’s experiences, and a possibility of a “cascade” of neuroplasticity from taking psychedelics while still in a neuroplastic state

    Do you have experience of Obsessive Compulsive Disorder (OCD), Autism Spectrum Disorder (ASD), Complex PTSD, Generalized Anxiety Disorder (GAD), or Attention Deficit (Hyperactivity) Disorder (ADD/ADHD)?
    While there has not been research on the relationship of HPPD to these conditions, reviews of online forums directly and indirectly suggest a relationship. People with Visual Snow Syndrome seem to experience these conditions more than average based on rough overviews, and people with these conditions may independently report certain visual changes similar to HPPD. If there is a relationship between HPPD and these conditions, the connection may occur through tendencies towards disembodiment, hypersensitivity, overstimulation, and dissociation, all of which may have visual components – and may be amplified by psychedelic experience.  

For more, this article’s tips, advice, analysis (and more) is also featured in a more in-depth HPPD Information Guide, which can be freely downloaded from the Perception Restoration Foundation’s website, where a more direct guide for those struggling with HPPD is also hosted. Owing to the tentative nature of our HPPD knowledge base, the PRF invites any and all comments and criticisms for the Guide at, and any worthwhile amendments will be quickly published.

About the Author

Ed Prideaux is a UK-based writer and journalist who’s written about psychedelics for the BBC, VICEThe Independent, and Unherd, and other topics for The Guardian, The Financial Times, The Spectator, and The Quietus. Ed is working to advocate and raise awareness around Hallucinogen Persisting Perception Disorder (HPPD) in affiliation with the Perception Restoration Foundation, a new 501 (c) (3) nonprofit that has secured the launch of HPPD’s first breakout studies in decades.

More from Ed Prideaux:

HPPD and Flashbacks: Everything You Need To Know – And What We Don’t Know, Too

By Ed Prideaux

Hallucinogen Persisting Perception Disorder, or HPPD, is among the more mysterious, debilitating, and under-researched possibilities of psychedelic drug-taking. As enthusiasm around psychedelics and their possible benefits continues to grow, it’s imperative that researchers, user populations, and clinicians look closely at HPPD and other possible hazards.

HPPD is little-known among clinicians, and many reporting these experiences have trouble finding informed help. Treatments – pharmacological, psychotherapeutic, and somatic – are out there, and by reports, have proven useful for some, but no controlled trials have been performed to gauge their true effectiveness. 

In this article – intended as an exercise in harm reduction, raising awareness, and ensuring true informed consent before people ingest psychedelics – we’ll outline the current knowledge base around HPPD, including indications of the gaps and where future research may prove useful. This article’s tips, advice, and analysis (and more) is also featured in an in-depth HPPD Information Guide, which can be freely downloaded from the Perception Restoration Foundation’s website, where a more direct guide for those struggling with HPPD is also hosted.

The HPPD Basics: What is it?

Hallucinogen Persisting Perception Disorder is a DSM-5 listed condition in which people experience lasting, distressing changes to their perception after taking psychedelic drugs. There are two types: Type-1, in which people experience episodic (usually sudden) “flashbacks,” and Type-2 (the more commonly reported), in which people’s everyday perception is altered.

These perceptual changes may be married with shifts in cognition, mood, and somatic experience, and further research is required to understand how they relate. HPPD can last anywhere from weeks and months to several years – some people live with its perceptual changes for decades. In up to 50% of HPPD patients, the changes may spontaneously remit within five years.

The perceptual changes are wide-ranging, but most constellate around a stable set of experiences also reported in other conditions: Visual Snow Syndrome (VSS), migraine with aura, manic episodes, epilepsy, anxiety disorders, brain injuries, and also as experienceable features (under the right conditions) of normal, healthy perception.

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This implies that HPPD likely sits on a continuum with other disorders and ordinary perception. Further research is required to understand HPPD’s role in this continuum, the possibly unique contribution of psychedelics in affecting symptoms, and the kinds of treatments people with HPPD would benefit from versus other disorders. 

  • Visual snow: When the field of vision is coated with small, grainy dots like the static of a detuned TV
  • Haloes and starbusts: When objects have a bright “halo” or “aura” ring around them, or concentric colored rays around light sources
  • Trails: When an object moves, a trail of faint replicated images follows it
  • After-images: When the outline or silhouette of an object is seen on a surface after looking away
  • Enhanced hypnagogia, or the semi-visionary state experienced between waking and sleep
  • Intensified floaters: Most of us have seen “floaters,” which are the small squiggly lines and shapes that sometimes appear in our vision. With HPPD, these floaters can become more visible, disturbing, and irritating
  • Blue Field Entoptic Phenomenon: The appearance of tiny bright dots moving quickly along squiggly lines in the visual field, especially when looking into bright blue light such as the sky
  • Changes to size and depth perception: Things can seem smaller, at-a-distance, expanded, or possessing a two-dimensional quality
  • Assorted psychedelic-style effects: Fractal kaleidoscopic and geometric patterns, faces, “breathing” walls, moving, “wavy” or shaky text, flashing and strobing lights, closed-eye visuals, enhanced phosphenes
  • Complex pseudohallucinations 

Other, non-perceptual symptoms are reported, too:

  • Physical effects, such as head pressure, acute neck pain, unequal pupil sizes, muscle twitches
  • Tinnitus and ringing of the ears
  • More intense dreams
  • Auditory changes
  • Confused and unclear thoughts, including brain fog, trouble processing information, memory loss, dyslexia, and the onset of stammering
  • Depersonalization/Derealization Disorder (DP/DR), in which people feel detached from their bodies and the world stops feeling real
  • Psychosis
  • Anxiety, depression and panic 

Note, to be diagnosed with HPPD, these changes must prompt distress – which they do, in many cases. They can disrupt people’s everyday function – relationships, work, operating heavy equipment, driving, navigating the day-to-day, and beyond – and cause anxiety, panic attacks, depression, and suicidal thoughts in high numbers of clinical patients. Many report a strong degree of isolation and loneliness, and the disorder is also strongly-correlated with dissociative experiences like Depersonalization/Derealization Disorder (DP/DR). 

How Common is HPPD?

We don’t know. It seems that developing perceptual changes after taking psychedelics is not necessarily that uncommon; the distressing, intrusive kind that manifests in HPPD is likely a real but minority experience. 

A 2011 survey of 2,455 users of psychedelics (via Erowid) found that up to three-fifths of psychedelic users reported lingering changes, 25% in ways that were seemingly permanent, and 4.2% in ways so distressing that they could prompt seeking clinical help. The latter is suggestive of diagnostic HPPD. 

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What Kinds of Psychedelics Are Implicated?

Practically every psychedelic, but some more than others: LSD, psilocybin, ayahuasca, 2-CB, ibogaine, etc., but also related (but not classically psychedelic) drugs like MDMA, cannabis, dextromethorphan (DXM), datura, ketamine, salvia, and diphenhydramine (DPH) have been implicated. 

In anecdotal reports and the existing literature, it seems that LSD is the leading cause of perceptual changes compared to other kinds of drugs. Whether this is because LSD has been historically the most commonly-used psychedelic or there is something special to the LSD experience or its effect on neurophysiology is unclear. Short-acting psychedelics like DMT seem to be less implicated. 

Some report that, after heavy use of classic psychedelics, their HPPD developed suddenly after the use of research chemicals like 25-i-nBOME, which is often mis-sold as LSD; HPPD is also reported in particular among users of synthetic cannabinoids. Cutting agents in street MDMA, including synthetic cathinones (“bath salts”), may make HPPD more likely.

Can Non-Psychedelic Drugs Create These Perceptual Changes?

Yes. SSRI antidepressants, antibiotics, antipsychotics, and nootropics have been described in self-reports as triggering very similar visual changes. There is also considerable overlap between HPPD/post-psychedelic perceptual changes and another drug-free condition known as Visual Snow Syndrome (VSS). 

At the same time, compared to other drug classes, it seems that psychedelics (in particular, LSD) provide a higher risk factor for developing these perceptual changes. It may also be that HPPD patients report different kinds of visuals (perhaps more psychedelic ones), or more cognitive and emotional changes (as with psychedelics’ powerful psychoactive effects), compared to non-psychedelic groups.  

Is HPPD the Same Thing as Flashbacks? Aren’t Flashbacks a Myth?

It’s complicated. The “flashback” describes a particular kind of experience in which people feel they truly re-live a prior psychedelic state: something that is real and can happen, and is what people may experience in Type-1 HPPD. Most cases of Type-2 HPPD, though, will likely not be true examples of flashbacks in this way.

To give a brief overview, the idea that psychedelic drugs could cause lasting changes in perception was noted from as early as 1954 – 15 years before the notion of the “flashback” was ever coined. A number of authors in the first wave of psychedelic research from the 1950s to the early 1960s reported patients experiencing a wide range of complications after their drug experiences – including what sounds like standard HPPD – but also states that blur more into psychosis and the experience of complex pseudohallucinations. They noted that some patients were acutely re-living their trips.

These observations continued once psychedelics became popular drugs of adult use in the mid-to-late 1960s. This was reported in popular media from, at latest, 1966. 

The “flashback” label was coined by author Mardi J. Horowitz in 1969, and used for many years afterwards, including by Dr. Henry Abraham, who first developed the psychiatric diagnosis of HPPD. Perhaps contrary to what we’d expect, authors in the “flashback” literature were at pains to emphasize the complexity, variation, and need for further research in explaining the phenomenon, as well as noting that many (some surveys suggested the majority) did not find their experiences distressing.

The Flashback Problem

Unfortunately, the idea of the flashback was later sensationalized by journalists and prohibition activists, who tied the idea to certain marked untruths: that the drug can be “stored” in the spine or fat cells, make people legally insane, or otherwise cause major brain damage.

The flashback idea also had some conceptual problems, which is perhaps to be expected from the first attempts at describing a new phenomenon. With some critical exceptions, authors were bound by a consensus that post-psychedelic visuals and flashbacks were re-experiences of the visuals glimpsed in the psychedelic state – as if the drug had not properly worn off, perhaps as a matter of lasting changes to neurological function. The notion that HPPD is a “re-experiencing” has also become one of the core criteria of the current DSM-5 diagnosis.

As noted earlier, though, identical perceptual phenomena can be experienced both through non-psychedelic drug classes, and as part of experiences in which drugs played no necessary role: other kinds of neuropsychological conditions, or otherwise as a feature of normal perception. 

In contemporary literature, some authors have noted that many patients experience visual effects that never manifested in their trips – though this isn’t the case for everyone. Those who are “reliving” their trips may be described plausibly as experiencing flashbacks.

The idea of the flashback is also not unique to psychedelics – in particular, it’s used as a descriptor for experiences of post-traumatic stress disorder (PTSD), in which people can feel “flung back” to the original trauma in quasi-visionary states. This implies that the psychedelic “flashback” may not be a distinct phenomenon for some (or most) cases: rather, that it’s an example of a psychedelic drug-induced traumatic flashback, where the real issue is trauma (not drugs per se).

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How Do We Explain What’s Going On?

Since authors first noticed that psychedelics can cause lingering changes in perception, a variety of different hypotheses have been pursued to explain what’s going on. The HPPD experience will likely involve a complex, multi-factor origin that varies from patient to patient.  

Could psychedelic experiences alter neurophysiological function?

HPPD’s leading neurophysiological hypothesis, introduced by Dr. Henry Abraham, relates the condition to a “disinhibition” of the visual cortex. Drugs like LSD decrease, or “disinhibit” the filters of the brain’s visual cortex, so visual noise that would otherwise be filtered out may remain in the field of vision. HPPD occurs when these filters do not return to their pre-drug state. This may make HPPD akin to a form of “visual tinnitus” (and tinnitus is also experienced as a symptom).

This disinhibition is linked to reductions in alpha waves in the brain. A neuroimaging study by Abraham (2001) suggested that alpha wave frequency increases with HPPD patients versus controls. The role of an objective alteration to visual perception was lent support by 1982 and 1988 studies executed by Abraham, in which he found both non-HPPD LSD users and HPPD patients had decreased ability to discriminate color differences and light sensitivity during dark adaptation, with HPPD patients reporting further decreased ability.

There could be a role for neuroplasticity, or neurons’ ability to change and reform in response to experience. This may be explained in the context of a “Bayesian Brain” model, similar to the REBUS and entropic brain hypotheses introduced by UCSF’s Robin Carhart-Harris: by shaking the “snowglobe” of our nervous system’s categories of perception through a psychedelic experience (or psychoactive changes altogether), it could be that those categories do not settle as before. A neuroplasticity model may explain why, in some cases, further psychedelic experimentation can reduce or eliminate HPPD presentation. It may underlie also why teenagers are especially vulnerable, as they have more plastic, developing brains.  

LSD’s long duration may explain why the drug is so associated with HPPD – that is, with more hours of seeing abnormal visual changes, the brain is more likely to reprogram itself than with shorter-acting drugs. Smokeable DMT, for instance, isn’t particularly-associated with perceptual changes, while longer-acting ayahuasca is.

Synaptogenesis may also be involved. As described by Samuel Štancl, “Psychedelics induce strong synaptogenesis, or the creation of new synapses, resulting in high synaptic density. EEG scans show less inhibitory activity in the visual cortex both in people on psychedelics and in people with HPPD.” This means that electrical currents are being enhanced in the visual cortex by increased synaptic connection. This also underwrites why pruning excessive synapses through pharmacological treatments like lithium – or even exercise – may be useful.

What about psychological factors?

A 2018 paper by Halpern and Passie suggested that challenging drug experiences, including intense reactions of panic, dysphoria, anxiety and trauma, may be associated with a higher likelihood of developing HPPD. This is more likely for psychedelic use in uncontrolled settings. 

Recall, HPPD often co-arises with Depersonalization/Derealization, a dissociative reaction in which people feel disconnected from their bodies and immediate environments. This is suggestive of anxiety and trauma. Drug-free anxiety and depersonalization are independently-associated with similar, if not identical, perceptual changes. Somatic cognitive changes, including head pressure and brain fog, are also associated with anxiety. Challenging and traumatic drug experiences may therefore induce elevations of anxiety, which has its own uncharted pathway towards many changes, including perception.

In the historical flashback literature, there was tentative evidence that visual phenomena could be experienced as matters of attention, hypnotization, and placebo suggestion. The role of trait absorption – or a person’s tendency to become occupied by mental imagery and internal experience, including daydreaming, fantasy and hypnagogia – has also been discussed by authors as a possible personality determinant of HPPD likelihood.

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What’s more, there are case reports of people altogether resolving their distress and visuals through targeted psychotherapies without pharmaceuticals: in particular, Cognitive Behavioral Therapy (CBT) to target the destructive internal beliefs people formed around their condition (“I am brain damaged,” “I’m a weirdo,” “I’m a freak,” etc.), including in combination with relaxation techniques. The sense of isolation may also be addressed through the therapist leaning into their own capacity for abnormal visual phenomena, and experiencing them with the patient – something that resolved one person’s HPPD.

Psychedelic researcher Stanislav Grof explained and resolved his patients’ cases of HPPD through psychodynamic therapies. He interpreted HPPD as a problem of the psychedelic surfacing unconscious material that needed to be re-integrated through additional encounter experiences, including with psychedelics and breathwork.

Could HPPD patients simply be noticing more stuff that previously filtered into the background?

Yes, at least for some patients. Phenomena like visual snow, after-images, tinnitus, and floaters are not necessarily uncommon, even among “normal” people. As a possibly overlapping mechanism with anxiety and fixation, it may be that some people with HPPD are noticing perceptual features that had previously been filtered into the ignorable background of their experience. Halpern and Passie found that HPPD patients were possibly more likely to have experienced visual oddities before they took drugs.

This led Krebs and Johansen to recommend re-attributing some HPPD experiences to Somatic Symptom Disorder, whereby people fixate and ruminate on normal somatic experiences and perceptions.

This is unlikely to be exhaustive, because many HPPD patients report florid and extreme visual changes that plausibly could not have been ignored before; it will also have limited applicability to those whose visuals are distinctly psychedelic and are experiencing Type-1 HPPD. It’s possible, too, that histories of such visual experiences imply a vulnerability that has been activated or catalyzed by drug experiences. 

Part 2 of this article, focusing on harm reduction, will be posted shortly!

This article’s tips, advice, analysis (and more) is also featured in a more in-depth HPPD Information Guide, which can be freely downloaded from the Perception Restoration Foundation’s website, where a more direct guide for those struggling with HPPD is also hosted. Owing to the tentative nature of our HPPD knowledge base, the PRF invites any and all comments and criticisms for the Guide at, and any worthwhile amendments will be quickly published.

About the Author

Ed Prideaux is a UK-based writer and journalist who’s written about psychedelics for the BBC, VICEThe Independent, and Unherd, and other topics for The Guardian, The Financial Times, The Spectator, and The Quietus. Ed is working to advocate and raise awareness around Hallucinogen Persisting Perception Disorder (HPPD) in affiliation with the Perception Restoration Foundation, a new 501 (c) (3) nonprofit that has secured the launch of HPPD’s first breakout studies in decades.

The Need for an International Psychedelic Religious Survey

By Gary Michael Smith, Esq.

With the emergence of more and more psychedelic religions, many people are finding themselves in a situation where proving that their religion is sincere is the difference between being able to practice their religion legally or not. Could an International Psychedelic Religious Survey be the answer?

My lord, I suspect an incredible secret has been kept on this planet: that the Fremen exist in vast numbers – vast. And it is they who control Arrakis.

-Duncan Idaho, David Lynch’s “Dune” (1984)

To expand and clarify religious freedom and liberty in the United States and abroad, it is sometimes necessary to seek court rulings. One of the missing pieces of evidence that would prove helpful in most psychedelic religion cases is a reliable data set evidencing the demographics and statistics behind the world’s psychedelic religions. How many religious groups exist? How many members are there? What type of sacraments do they use? How to quantify communities that may not have stable membership? And more? I have gone looking for a reliable resource but have not found one yet. Indeed, I have spoken with some of the lead legal practitioners in this area, and they also lament the absence of this data. And the concern is not limited to lawyers. My friend, Brad Stoddard, Ph.D., a professor of religious studies, points out additional challenges in defining and applying metrics, including:

1. Some people will identify as spiritual but not religious. 

2. Some people are likely to identify as neither religious nor spiritual but will still engage in practices many would consider religious or spiritual (the so-called “nones”). 

3. Many Native Americans reject the category of religion as something that misrepresents their traditions. They also reject the categories of entheogens and psychedelics as they relate to sacraments like peyote and San Pedro. The politics of labeling these groups “religious” is tricky. 

4. Beyond the U.S., even today, wide groups of people don’t have a category in their native language that corresponds to Western definitions of religion or spirituality, so assessing psychedelic religion in, say, rural India, would be almost impossible without extensive ethnographic surveys.

So, this gave me an idea. I would like to propose that some ambitious Ph.D.-types consider undertaking (as a Ph.D. thesis?) an international survey. For purposes of this article, I call it the International Psychedelic Religious Survey, but it could have a variety of different names. What is important is that the survey be conducted under scientific principles that could withstand court scrutiny, and that the data it procures answers the right sorts of questions. 

Our new 12-month certificate program, Vital, begins April 19th. Registration is closed, but sign up for the waitlist for next year’s edition now at!

Why are Psychedelic Religions Secret?

Psychedelic religions are not mainstream, and they are dogged by the omnipresent threat of allegation of criminality. It is therefore natural that psychedelic religious groups and their adherents stay mostly out of public scrutiny. There is justifiable fear of social stigma and risks to liberty, amongst myriad downstream repercussions. But these same forces that keep the psychedelically-inclined underground also serve as a shackle for things to remain so. The existence, nature, and populations participating in the world’s psychedelic religions is not well-documented. Some are out in the open, but most are not.  

Why a Survey?

The importance of having numbers and an understanding of the types and varieties of psychedelic religions is helpful in court cases. This sort of data could be especially important in aiding the defense of persons criminally charged for their participation in psychedelic religious practice. Such data could also inform legislatures and other policy makers, increasing their awareness of (and possibly, sensitivity to) psychedelic religions. Indeed, the information could be useful to the United Nations, and could help the UN Office on Drugs and Crime with policy reform.

Similar to how a census counts a population and derives statistics, psychedelic religions might benefit from being counted. My suspicion is that revelation of the true demographics of psychedelic religions is apt to be a lot like Frank Herbert’s Dune – like the Fremen, the numbers of people who participate in psychedelic religions is secret and vast. When it comes to psychedelic religion, there persists popular ignorance and misunderstanding that have dampening effects on how these minority psychedelic religions are treated. Having data, even if it be anonymous, reflecting that these minority religions are not nearly as small as they appear helps to give these religions presence. From presence can flow understanding.   

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Consider that most psychedelic religions do not behave like more broadly accepted mainstream religious organizations. Out of fear, most psychedelic religions do not have billboards, do not evangelize, do not have television or radio ads, do not seek public donations, etc., and for similar reason, most do not fight court fights. Litigation is often prohibitively expensive, and minority religious groups trying to fly under the radar tend not to have financial means. A survey could provide synergy by which these minority religious groups could gain collective leverage. A survey could change the conversation about psychedelic religions with backed statistics and data. A survey might even move public policy focus away from chemical structures (the metric law enforcement uses) toward purpose and effect (the metric psychedelic religions use). Courts are not presently accustomed to the argument of “it is not how you get there that matters, it is that you get there,” but a reliable data set could further the point.   

The Importance of Court Admissibility

If you are sitting in a criminal defense chair, charged for psychedelics but claiming religious exemption, the burden is on you to educate the judge and jury on the nature, basis, and supposed validity of your defense. The probability that the judge and jury are going to be well-educated about psychedelic religion is low. Your burden to come forward with credible, persuasive, court-admissible evidence supporting your psychedelic religion defense is made that much more difficult and necessary.   

The key is court admissibility. To have a jury or a judge consider data, it needs to be admissible. It also needs to be relevant and authenticated. The most compelling and relevant evidence is meaningless if a court will not admit it. Hence, the need for a scientifically-run survey that considers all the details: who will gather the data, how that data will be gathered, what form of survey will be used, what questions would be posed in the survey, the types of answers permitted, etc. The survey will also need to be verifiable and be able to demonstrate things like chain of custody, all encapsulated in a report that can be admitted within a hearsay exception or over a hearsay objection.

Why International?

Religion is not national. Indeed, the First Amendment to the United States Constitution would find the notion of national religion abhorrent, and no court in the United States could rule a religion “un-American.” Rather, at most, a court could rule an organization altogether not a religion, or a person’s observation thereof insincere, but a court could not weigh the merits or values of a religious group. Rather, under Constitutional principles, court inquiry is limited to examination for the trappings of things commonly associated with religion – concepts like contemplation of the imponderables of existence itself, contemplation of the source of all things, the nature of spirit, etc. Neither nationality nor nation of origin are relevant points of inquiry.

Pragmatically, it is a lot harder to claim religious exemption when the court knows nothing about, has had no life experience with, and is questioning the validity of your religion or the sincerity of your practice. The benefit of having a court-admissible survey demonstrating that you are far from alone, but are acting in conformity with possibly millions just like you, is manifest. Likewise, one of the greatest challenges that many of us entheogen lawyers are hoping to crack is the multi-sacramental conundrum, or the wholesale legal transcendence of relevance of sacrament. Along with the many holes in appellate precedent, there is no high-level appellate decision that has affirmed multiple psychedelic sacraments as acceptable religious practice. But that case can be made, and it can be made better with better evidence.

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Although the United States Constitution contemplates a variety of religious expression, it would still be dangerous in court to ignore that Abrahamic lineage dominates in the United States. Statistically, it is more probable that the judge and jury in any psychedelic religion case will be most familiar with concepts of a revelatory religion that is manifested in scriptural texts, and whose members meet in some form of congregation and group worship, employing scripted prayers and relying upon faith. Many psychedelic religions look like this. Many do not. And getting that point across in a meaningful fashion to a court can make the difference between winning or losing a psychedelic religion case. An International Psychedelic Religious Survey can help demonstrate that minority adherents in one country may not be as minority as they seem, when taken in a global context, and could likewise reveal trends in the spread of psychedelic religions around the world.

Content and Manner of the Survey

The precise execution of the survey is admittedly at the edges of most lawyer’s skill sets. I imagine this project calls for a Ph.D. or aspiring Ph.D. theology student, or a professor excited to take on one of the most significant projects of their career (not to mention perhaps a couple qualified statisticians). I also offer that while we won’t do the survey ourselves (again, not our skill set), I and fellow entheogen attorneys, Greg Lake, Ian Benouis, and Dan Peterson are happy to contribute, particularly regarding framing survey questions that would be helpful for court admissibility. Brad Stoddard, Ph.D., Associate Professor of Religious Studies at McDaniel College, is also available to assist and welcomes contact. Anyone interested in picking up the mantle and running with it is invited to reach out to any of us. My friends and I hope this article inspires one or more of you to take on this very important task.

About the Author

Gary Michael Smith is an attorney, arbitrator, and founding member of the Phoenix Arizona-based Guidant Law Firm. He is also a founding director and current president of the Arizona Cannabis Bar Association, board member of the Arizona Cannabis Chamber of Commerce, and is general counsel to the nation’s oldest multi-racial peyote church. He also authored Psychedelica Lex: The Law of Psychedelics and hosts a Youtube video podcast of the same name.