{"title":"Deepening Psychedelic Integration: Exploring Complex Settings, Understanding User's Struggles, and Implementing Safe Interventions.","authors":"Marc Aixalà","doi":"10.1007/7854_2024_532","DOIUrl":"10.1007/7854_2024_532","url":null,"abstract":"<p><p>This chapter adopts a transdisciplinary approach to explore the concept of psychedelic integration, considering its various contexts ranging from clinical trials to Neo-shamanic, traditional, and recreational settings. It aims to provide a comprehensive understanding and description of integration, distinguishing between the needs of maximising potential benefits and addressing adverse reactions. Psychedelic Integration is a widely used term that refers to a variety of practices commonly employed after psychedelic experiences to help ground the benefits or address the challenges that arise from them. Although the term is broadly accepted, it lacks a precise definition, and a wide range of practices and techniques, often quite different from one another, are included under this category. Drawing on the experiences at the ICEERS (International Center for Ethnobotanical Education Research and Services) Integration and Support Service since 2012, the chapter highlights the practical aspects of clinical intervention.The chapter delves into the profiles of individuals seeking integration support, focusing on the primary challenges they encounter. These profiles include lack of preparation, unresolved experiences, difficulties with facilitators, traumatic psychedelic episodes, the exacerbation of pre-existing mental disorders, the emergence of previously unknown traumatic events, repeated psychedelic use without proper integration, and perceptions of being attacked or possessed by entities.Moreover, an overview of a method of clinical intervention that underscores the fundamental values inherent in psychedelic work is presented. This approach aims to integrate these values into the intervention process, employing a brief and focused methodology. By tailoring the intervention to the individual's specific needs, this method facilitates effective integration and support.</p>","PeriodicalId":11257,"journal":{"name":"Current topics in behavioral neurosciences","volume":" ","pages":"375-395"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ontologically Challenging Psychedelic Experiences: Considerations for Managing Associated Distress.","authors":"Eirini K Argyri, Jules Evans","doi":"10.1007/7854_2025_609","DOIUrl":"10.1007/7854_2025_609","url":null,"abstract":"<p><p>Psychedelic substances have been increasingly recognised for their potential in treating various mental health conditions, yet they can also induce what we call ontologically challenging psychedelic experiences (OCPEs), a concept developed in our research to describe experiences that profoundly disrupt an individual's sense of self, reality, and existence. We present OCPEs not as a diagnostic category but as a phenomenological and harm reduction perspective on certain destabilising psychedelic experiences.While some individuals integrate OCPEs with ease, others struggle with ontological instability, existential distress, and impairments that persist long after acute effects. Importantly, ontological challenges are not always negative: for many, when they feel adequately resourced, they form part of the therapeutic mechanism and are a valued opportunity for personal development and growth. Drawing on our qualitative studies alongside other psychological research, we examine the phenomenology of OCPEs and their challenging aftermath, as well as strategies that may help facilitate recovery and integration. Grounding techniques, cognitive (re)framing, and supportive structures are discussed as potentially beneficial approaches and resources.Finally, we outline ethical and practical implications for clinical and harm reduction practice. We highlight the limits of informed consent in psychedelic therapy and argue for the value of preparation and post-experience support that is attuned to ontological disruptions. As empirical evidence remains limited, further research is needed to refine best practices. The development of an ethically responsible approach, informed by the phenomenology of OCPEs, can help maximise benefits of psychedelic substances while minimising long-term harm.</p>","PeriodicalId":11257,"journal":{"name":"Current topics in behavioral neurosciences","volume":" ","pages":"431-450"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145653393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Genetic Tools in Rodents to Study Cannabinoid Functions.","authors":"Krisztina Monory, Inigo Ruiz de Azua, Beat Lutz","doi":"10.1007/7854_2024_550","DOIUrl":"10.1007/7854_2024_550","url":null,"abstract":"<p><p>During the past 30 years, the endocannabinoid system (ECS) has emerged as a major signalling system in the mammalian brain regulating neurotransmission in numerous brain regions and in various cell populations. Endocannabinoids are able to regulate specific physiological functions and thus modify their behavioural manifestations and allostatic alterations of the ECS linked to different pathological conditions. As discussed in detail in other chapters of this book, endocannabinoids are involved in learning and memory, stress, and anxiety, feeding, energy balance, development, and ageing. Likewise, many CNS disorders (e.g. schizophrenia, epilepsy, substance use disorders, and multiple sclerosis) are associated with dysregulation of the ECS. Discerning the physiological functions of the synthetic and degrading enzymes of endocannabinoids and their receptors is a challenging task because of their distinct and complex expression patterns. Techniques of genetic engineering have been able to shed light on a number of complex ECS-related tasks during the past years. In this chapter, first, we take a critical look at the toolbox available to researchers who would like to investigate cannabinoid effects using genetic engineering techniques, then we comprehensively discuss genetically modified rodent models in various neuronal and non-neuronal cell populations, both within and outside the nervous system.</p>","PeriodicalId":11257,"journal":{"name":"Current topics in behavioral neurosciences","volume":" ","pages":"145-207"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H M Harris, C F Moore, B W Jenkins, M F Bedillion, E M Weerts, C A Arout
{"title":"Delta-9-tetrahydrocannabinol and Cannabidiol for Pain: Preclinical and Clinical Models.","authors":"H M Harris, C F Moore, B W Jenkins, M F Bedillion, E M Weerts, C A Arout","doi":"10.1007/7854_2025_604","DOIUrl":"10.1007/7854_2025_604","url":null,"abstract":"<p><p>Cannabinoids are increasingly being used to manage pain resulting from a variety of conditions. Both preclinical animal models and human studies have played a crucial role in advancing our knowledge of cannabinoids, their involvement in pain mechanisms, and their potential utility as novel analgesics. This chapter first reviews basic pain neurobiology and the most common experimental pain paradigms, which provide a basis for our discussion of preclinical, human laboratory, and clinical research characterizing the effectiveness of cannabinoids for managing pain. While a substantial body of literature exists describing these effects, findings are complex and largely mixed, dependent on the cannabinoid administered, route of administration, and pain modality/syndrome tested. Herein, we highlight the need for more rigorous, placebo-controlled research defining the therapeutic efficacy of cannabinoids. The chapter concludes by emphasizing the need for further investigation of other cannabis constituents (e.g., minor cannabinoids and terpenes), potential interactions between cannabinoids and other analgesic medications, as well as other emerging issues in the intersection between cannabinoids and pain management.</p>","PeriodicalId":11257,"journal":{"name":"Current topics in behavioral neurosciences","volume":" ","pages":"389-431"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12832180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ethical Aspects of Psychedelic-Assisted Treatments: An Overview.","authors":"Christopher Poppe, Dimitris Repantis","doi":"10.1007/7854_2024_533","DOIUrl":"10.1007/7854_2024_533","url":null,"abstract":"<p><p>In this chapter, we provide an overview of ethical aspects of psychedelic-assisted treatments in the areas of clinical ethics, research ethics, and at the intersection of psychedelic medicine and society. In contrast to earlier psychedelic research, nowadays medical ethics have been firmly established as a discipline regulating patient-physician relationships which highlight the importance of autonomy, shared decision-making and informed consent in clinical ethics. During and after altered states of consciousness, autonomy is particularly important as participants are in a vulnerable state. In this vulnerable state, both touch and suggestibility are central ethical concerns. In turn, the debate surrounding hallucinogenic and nonhallucinogenic psychedelic substances discusses the importance of altered states of consciousness in general. Of further concern are exceptional training requirements and competencies of psychedelic therapists, as well as the particular context of end-of-life care. Lastly, this section discusses how ethical integrity in clinical treatments can be supported through institutions. In research ethics, inclusivity, research equipoise, and expectation management are key issues in the participation and trials, while open question for the posttrial access to care after psychedelic trials remain. Finally, the chapter addresses the question of equitable access to psychedelic medicine. Furthermore, justice for indigenous communities using psychedelics and the impact of legalization and medicalization of psychedelic substances are pressing ethical concerns amidst the \"psychedelic renaissance.\"</p>","PeriodicalId":11257,"journal":{"name":"Current topics in behavioral neurosciences","volume":" ","pages":"453-468"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Completing the Circle: A History of Psychedelics and Harm Reduction.","authors":"Erika Dyck, James Dixon","doi":"10.1007/7854_2024_511","DOIUrl":"10.1007/7854_2024_511","url":null,"abstract":"<p><p>Harm reduction officially entered the public health lexicon in the 1980s as a response to the HIV/AIDS crisis and its spread amongst intravenous drug users, but risk prevention has been an important part of psychedelic consumption in ways that predate this formal conceptualization.We look at psychedelic drug trials in the 1950s and 1960s to consider how people-first perspectives informed those early clinical studies, and how pioneering psychedelic researchers themselves approached risk management at a time that predates the formal recognition of harm reduction. Next, we follow psychedelic drugs out of the clinic and into music scenes and festivals that proliferated during the war on the drugs, where community-based organizations stepped up to support music fans who chose to combine psychoactive substances with dancing and drugs at all-day festivals. Finally, we reflect on the longer history and traditions of the Native American Church as one specific example of how Indigenous ceremonies involving psychedelic substances combined spirituality and healing in a community setting curated to promote wellness. Ultimately, we argue that psychedelic risk management has deep historical roots in psychedelic communities representing biomedical, cultural, and Indigenous perspectives - we might heed these historical lessons as we consider how to promote sustainable risk management strategies with psychedelics going forward.</p>","PeriodicalId":11257,"journal":{"name":"Current topics in behavioral neurosciences","volume":" ","pages":"3-23"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Guiding Through Challenging Psychedelic Experiences and \"Bad Trips\".","authors":"Michael Koslowski, Peter Gasser","doi":"10.1007/7854_2024_515","DOIUrl":"10.1007/7854_2024_515","url":null,"abstract":"<p><p>Psychedelic substances have gained recognition for their therapeutic potential, but they also present challenges, with individuals occasionally experiencing distressing episodes referred to as challenging experiences or, in the recreational setting, \"bad trips\". Trial therapists and physicians, but also healthcare professionals in emergency rooms, need a comprehensive strategy to effectively manage these cases. Three case reports are presented to underline the problem and propose strategies for handling these situations. Finally, this article outlines a stepwise approach, encompassing helpful interventions, supportive care, and rescue medication, to ensure the well-being of individuals undergoing challenging psychedelic experiences and prevent further complications and long-term harm.</p>","PeriodicalId":11257,"journal":{"name":"Current topics in behavioral neurosciences","volume":" ","pages":"337-354"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142072330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tim Hirschfeld, Felix Blei, Lavinia Stegemann, Daan van der Gouwe, Laura Smit-Rigter
{"title":"Psychedelic Drug Checking: Analytical and Strategic Challenges in Harm Reduction for Classic Psychedelics.","authors":"Tim Hirschfeld, Felix Blei, Lavinia Stegemann, Daan van der Gouwe, Laura Smit-Rigter","doi":"10.1007/7854_2025_606","DOIUrl":"10.1007/7854_2025_606","url":null,"abstract":"<p><p>Classic psychedelics such as LSD, psilocybin, and DMT from unregulated markets pose considerable risks through unknown adulterants and potencies. In this chapter, we explore the importance of drug checking in minimizing harm among users of classic psychedelics and examine the opportunities and challenges associated with intervention settings, analytical techniques, and risk communication strategies. Gas chromatography (GC) and liquid chromatography (LC) coupled with mass spectrometry (MS) provide the most reliable and comprehensive analysis results for classic psychedelics. However, they are relatively costly, stationary, and require legal permission to obtain reference standards. Combined presumptive tests, such as thin-layer chromatography (TLC) and reagent testing, offer a time-efficient and cost-effective approach to initial substance screening. For certain compounds, Fourier-transform infrared spectroscopy (FTIR) serves as a valuable complementary technique, although potent psychedelics, such as LSD and NBOMe on blotter paper or in diluted solution, and complex botanical matrices challenge its detection limit, requiring the use of multiple analytical methods to confirm results. Such combination can effectively prevent acute risks, while confirmatory instrumental analysis remains essential for ongoing monitoring and public health efforts. Alongside robust testing procedures, drug checking's consultative component is crucial for clarifying analytical constraints, promoting safer use practices, and offering referrals to health services. By identifying mislabeled samples and ensuring tailored risk communication, drug checking not only protects individual users but also informs the public and health professionals regarding dangerous or novel substances. This chapter situates drug checking as a key public health measure that reduces acute harm from misrepresented psychedelic substances while supporting monitoring efforts.</p>","PeriodicalId":11257,"journal":{"name":"Current topics in behavioral neurosciences","volume":" ","pages":"313-335"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maha N Mian, Allison R Coker, Grace Kretzer, Clancy Cavnar, Jennifer M Mitchell, Brian T Anderson
{"title":"Investigating Safety Concerns and Harm Reduction in Entheogenic Churches: The Case for Community-Based Participatory Research.","authors":"Maha N Mian, Allison R Coker, Grace Kretzer, Clancy Cavnar, Jennifer M Mitchell, Brian T Anderson","doi":"10.1007/7854_2025_607","DOIUrl":"10.1007/7854_2025_607","url":null,"abstract":"<p><p>Alongside the important contributions of the harm reduction movement to improving public health in secular settings, communities that use psychedelics as religious sacraments (i.e., entheogens) have developed their own frameworks for supporting safety within their spiritual practices and hold their own conceptualizations of risk and harm. In order to understand better the lived realities of substance use, safety practices, and potential harms among entheogenic communities, researchers can collaborate closely with these communities in the formulation and conduct of their studies in this shared pursuit. The integration of community-based participatory research (CBPR) practices can not only help center these communities in the co-creation of research but also improve engagement, generate trust, and illuminate local priorities for knowledge production. The current work presents preliminary findings from a CBPR study with entheogenic communities. We share \"lessons learned\" from forming the study's community advisory board (CAB) and initial pilot data gathering in order to encourage biomedical investigators to consider CBPR approaches for their own research with psychedelic communities. Lessons include consultation with community engagement experts; considerations for compensation and confidentiality; utilizing multimodal strategies for recruiting study participants and CAB members; and the importance of considering the unique historical context of these communities. These lessons support the development of best practices for current and future psychedelic research as well as subsequent policies and public education efforts focused on psychedelic harm reduction and the community-based uses of psychedelics more broadly.</p>","PeriodicalId":11257,"journal":{"name":"Current topics in behavioral neurosciences","volume":" ","pages":"513-529"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145573290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Psychedelic-Related Psychosis: From Model Psychosis to Psychotherapy.","authors":"Anna-Lena Bröcker, Tomislav Majić, Christiane Montag","doi":"10.1007/7854_2026_613","DOIUrl":"10.1007/7854_2026_613","url":null,"abstract":"<p><p>Psychotic symptoms are uncommon and non-specific adverse effects of classic (serotonergic) psychedelics such as lysergic acid diethylamide (LSD), psilocybin, and mescaline. They can emerge during the acute phase of psychedelic drug effects, persist into the subacute (\"afterglow\") period, or, in rare cases, develop into long-term psychotic illness. Across all three scenarios, the symptoms can be deeply distressing due to their rapid changes, unpredictability, and significant adverse behavioral consequences.Psychedelics have a long history of use as research models for schizophrenia because of the phenomenological overlaps between their acute effects and the core symptoms of psychosis. This \"model psychosis\" paradigm, however, has been widely criticized: although certain acute symptoms may appear similar, the etiology and psychodynamic background of primary psychosis only partially apply to psychedelic-related psychosis. Moreover, it remains unclear whether psychotic symptoms following the use of classic psychedelics differ meaningfully from those associated with other substances, such as dopaminergic stimulants or cannabis.A transient porosity of ego boundaries is a core feature of acute psychedelic states, ranging from heightened feelings of connectedness with oneself and others to complete ego dissolution. These experiences are often perceived as positive and may be followed by a subacute phase characterized by sustained increases in openness to new experiences. In some cases, however, ego dissolution may become fear-inducing and progress from challenging but manageable experiences to paranoid psychotic reactions that require therapeutic guidance and intervention.In this chapter, we examine phenomenological similarities and differences between psychedelic-induced psychosis and primary psychosis. Consistent with current international diagnostic classification systems, we conclude that, with increasing temporal distance from the initial psychedelic \"index\" experience that predated the symptoms, persisting psychedelic-induced psychotic symptoms become indistinguishable from primary psychosis. Finally, we present a psychodynamic therapeutic approach for schizophrenia-spectrum psychosis that may, to some extent, be adapted to psychotic symptoms observed across all three phases of psychedelic drug effects.</p>","PeriodicalId":11257,"journal":{"name":"Current topics in behavioral neurosciences","volume":" ","pages":"153-181"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147303511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}