FREQUENTLY ASKED QUESTIONS
SAFETY
During a psilocybin session, people may experience a wide range of physical, emotional, and psychological effects. These experiences are often temporary and usually resolve as the effects of the psilocybin wear off. Many people report: Changes in visual perception, changes in the perception of time and space, increased emotional awareness or personal meaning and enhanced reflection on thoughts and life experiences. Many participants also report positive emotional experiences, such as increased self-understanding, greater emotional openness, and feelings of connection. However, experiences vary from person to person, and positive outcomes cannot be guaranteed.
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Some common physical side effects can involve nausea or stomach discomfort, dizziness, headache, locomotor impairment. Psilocybin can sometimes also bring up strong emotions, memories, or challenging thoughts. During the experience, some people may feel anxiety, confusion, fear or emotional discomfort.
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Although these experiences can feel challenging, these effects are generally temporary, and trained therapists can provide support throughout the session.
It is natural to have questions about privacy in a group setting, particularly during the dosing session when you might experience an altered state of consciousness. Protecting your privacy is a priority for the research team.
Group sessions are conducted in small groups, typically with three to four participants. All group members are identified by their first name only. Before the program begins, to foster a space of connecting, trust, and healing, we ash that all participants are required to sign a confidentiality agreement, committing to keep any personal information shared during the program private.
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Group sessions are facilitated by licensed clinicians with expertise in leading clinical groups. At the start of the program, group leaders establish clear guidelines regarding confidentiality, respect, and psychological safety.
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Group facilitators are committed to protecting your privacy and cannot share information discussed during the group outside the therapeutic setting without your consent. However, there are some situations where they are legally or professionally required to act. These may include:
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A participant is at serious risk of harming themselves or someone else.
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A participant discloses the abuse or neglect of a child or vulnerable person.
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A regulated healthcare professional is reported to have engaged in sexual abuse or sexual misconduct.
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A medical record is requested through a lawful court order, subpoena, or other legal process.
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While every effort is made to protect your privacy, group sessions involve sharing experiences with others. Participants are expected to respect each other's confidentiality, but it is not possible to guarantee that information shared within the group will remain confidential.
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The group format is designed to foster connection, support, and shared learning, you remain in control of what you choose to share at all times. Our experienced team of facilitators is there with you each step of the way to ensure safety and support throughout the journey and thereafter.
PSYCHEDELICS
The term psychedelics broadly refers to psychoactive substances whose effects are “mind revealing” or consciousness expanding. These groups of substances that can temporarily change the way a person experiences thoughts, emotions, senses, and their sense of self. People may notice changes in perception, mood or how they relate to themselves and the world around them. Many psychedelic substances have been used for centuries in traditional and ceremonial practices.
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Pharmacologically, psychedelics can be divided into four classes: (1) classic psychedelics, 5HT2A receptors agonists, such as LSD, DPT, and N,N-Dimethyltryptamine (DMT); (2) empathogens, serotonin and dopamine reuptake inhibitors, such as 3,4-methylenedioxyphenethylamine (MDMA); (3) dissociative anesthetic agents, N-methyl-D-aspartate (NMDA) receptors antagonists, as ketamine; and (4) atypical psychedelics, such as tetrahydrocannabinol, salvinorin A, and ibogaine.
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Researchers are currently investigating whether psychedelic-assisted therapies may help people experiencing conditions such as depression, anxiety, post-traumatic stress disorder (PTSD), substance use disorders, and psychological distress related to serious illnesses such as cancer. It is important to note that psychedelic experiences can vary greatly from person to person. Factors such as mindset, physical health, environment, and professional support can influence the experience.
Psilocybin is a naturally occurring psychedelic compound found in certain species of mushrooms, popularly referred to as "psychedelics mushrooms".
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When psilocybin is consumed, the body converts it into a substance called psilocin, which interacts mainly with serotonin receptors in the brain. The effects of psilocybin usually begin within 20 to 60 minutes after administration and may last approximately 4 to 8 hours, although this can vary between individuals.
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In research settings, researchers are exploring whether psilocybin may help improve psychological well-being and reduce symptoms associated with depression, anxiety, and emotional distress.
THE CLINICAL TRIAL
The emotional and psychological effects of psilocybin may continue to be processed after the session has ended. Researchers often refer to this period as integration, a time when individuals reflect on their experience and begin to make sense of any insights, emotions, or perspectives that emerged during the session.
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During this period, some people may experience increased emotional sensitivity, as well as heightened sensitivity to visual or auditory stimuli. It is also common to spend time reflecting on the experience and considering how its meaning or lessons may relate to everyday life. For some individuals, this process can feel inspiring and meaningful, while for others it may feel challenging or emotionally intense at times.
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For these reasons, participants are generally encouraged to keep the remainder of the session day and the following day as calm and restful as possible. Allowing time for rest, reflection, and self-care can support the integration process. Participants are also advised to avoid using alcohol or other substances during this period.
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Any significant physical discomfort, emotional distress, or concerns about possible side effects should be communicated promptly to the research team.
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Follow-up support is an important part of psychedelic-assisted therapy and research. Depending on the study protocol, participants may receive support from facilitators and members of the research team in the days and weeks following their session.
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In this study, participants will receive follow-up support from the study team, including a check-in on the day after the session. This provides an opportunity to discuss how they are feeling, ask questions, and address any concerns that may arise.
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Ongoing monitoring helps support participant safety and well-being while providing guidance throughout the integration process.
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Family members, caregivers, and other supportive individuals can also play an important role during this period. When appropriate, involving a participant's support network may help create a safe and understanding environment that promotes healthy integration and positive outcomes.
It can be challenging to explain psychedelic assisted therapy to friends and family, especially if they are unfamiliar or have strong preconceptions. You do not need to share more than you feel comfortable with, and you are not responsible for persuading others.
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At the same time, we know that supportive relationships can play an important role in integration after dosing sessions. Previous research has shown that having a support system in place may help participants with processing their experiences and integrate insights into daily life.
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Importantly, support does not depend on loved ones fully understanding the study, it can also come from emotional presence, openness, and respect for your experience.
Once your final follow up is complete, your participation in the study will come to an end. At that point, you will no longer take part in any study related assessments or sessions.
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Many individuals who have participated in psychedelic assisted therapy find that experiences from the study continue to unfold over time. It can be helpful to think of this period as a continuation of integration, where insights, emotions, or shifts in perspective may continue to emerge a long time after your dosing day.
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If you feel you need support after the study has ended, you are encouraged to reach out to your existing care providers or community supports. The study team can also provide information about relevant resources if needed.
CULTURAL PERSPECTIVES
How are equity, diversity, inclusion, and accessibility being discussed or addressed in PAT research?
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The past decade saw an emergent interest in PAT for a variety of medical conditions and serious illnesses, including advanced cancer. The field of PAT research and clinical care has been growing rapidly as the scientific community seeks to understand how PAT works, its effectiveness, who it works for and under which conditions it should be implemented into current care. Although there is enthusiasm, clinical research on psychedelics remains in its early phases, and further studies and regulatory developments are necessary before they can potentially be used widely in clinical settings.
EDIA - Equity, Diversity, Inclusion, & Accessibility
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Ultimately, researchers and clinicians want to ensure that PAT is safe, effective, accessible and responsive to individuals from diverse communities. This involves understanding how individuals from different racial, cultural, spiritual, gender, and socioeconomic backgrounds experience PAT, as well as the barriers and facilitators to participation in research and care. Currently, researchers and individuals in diverse communities are discussing the need for improvements in several PAT research domains to ensure equitable access, honest recognition of PAT origins, Indigenous rights, and the inclusion and involvement of diverse communities in understanding culturally informed and responsive care. Below is a summary of the EDIA areas being discussed and researched by the scholarly community.
Not always. There are ongoing concerns that PAT research trials are overrepresented by White participants and populations with higher education levels and underrepresented by racialized and ethnic communities such as Black, Indigenous, Asian and Hispanic/Latin participants. Concerns also exist about inconsistent or incomplete reporting in PAT trials, which rarely include data on sexual orientation, immigrant status, or gender identities. While the issue of representation is not unique to PAT trials, it remains an important concern for PAT research and clinical practice. Racial categories are social constructs without a biological basis; however, variations in drug or treatment responses may reflect genetic factors that are more prevalent in certain ancestral groups and can be associated with self-identified race. Additionally, self-identified race/ethnicity may be associated with lived experiences that result in biological manifestations that aren’t genetically determined (e.g., experiencing structural or interpersonal racism and associated elevations in blood pressure and cardiovascular risk). For example, it has been suggested that system-wide barriers may result in certain groups obtaining diminished benefits (reduced psychedelic effects in minority populations); however, this has only been examined in the context of psychedelic use outside of a therapeutic context, rather than within structured psychedelic-assisted therapy (PAT), necessitating further research.
What is underrepresentation and why does it matter?
Underrepresentation means that specific demographics may participate in or are studied at rates lower than their actual proportion in the general population. If research excludes or doesn’t include specific populations, it can be difficult to know whether findings apply or generalize to everyone. Scholars have highlighted several reasons why underrepresentation is a problem, including but not limited to 1) it compromises the generalizability of research findings, 2) it may represent greater costs when healthcare interventions don’t meet the needs of the population, 3) it can hinder fully understanding processes or varied treatment effects, 4) it can cause trials to fail if there’s low participation; 5) it may lead to accessibility issues to effective medical interventions, 6) it undermines trust in diverse communities, and 7) it can compound existing health disparities. The lack of representation may partly result from insufficient community-engaged research, in which research is conducted without community members actively participating in co-designing questions or being involved in the research process. Without diverse representation in clinical trials, treatments can’t account for variability in effects or potential adverse outcomes across populations, which may have further repercussions for existing care down the line. Without community involvement, researchers may overlook community- or patient-important questions, jump to extract knowledge without collaboration, or overlook important cultural or sociodemographic factors that influence intervention outcomes. Therefore, when interventions are built with and for diverse populations in mind, researchers can ensure they incorporate diverse perspectives and account for variability in delivery and outcomes.
A recurring documented problem in PAT research and clinical practice has been the failure to acknowledge its Indigenous roots and the communities who have used psychedelic plant medicines for time immemorial for traditional healing ceremonies and other purposes. As such, it may lead many to wonder if ancestral plant medicines are being respected or exploited. Some literature attributes the ‘discovery’ of psychedelics to the 1940s and 1950s; however, it’s widely documented that psychedelic plant medicines were used for centuries prior to uptake in scientific circles. The ongoing exclusion of Indigenous healers and peoples raises concerns about dismissing traditional knowledge and misappropriating spiritual or healing practices. Various communities worldwide, including Indigenous communities in Mesoamerica, North America, Africa, and South America, have historically used different psychedelic medicines, each with its own knowledge systems and ceremonies. Although there are clear differences, much of the literature tends to present these practices in a broad, Pan-Indigenous way, emphasizing themes such as relationality, plant sentience, and reverence, though often depicting them as static and historical, thereby overlooking their ongoing evolution. Therefore, research and clinical practice can benefit from respectful collaborations with Indigenous communities, respect different ways of knowing by giving equal importance to Indigenous knowledge, and secure Indigenous-led involvement in shaping psychedelic science and practices. Researchers and clinicians thus must face the challenge of addressing the complex legacies of colonialism and finding ways to respectfully partner biomedical knowledge with Indigenous traditional knowledge. Currently, Canada has launched several Indigenous-partnered and Indigenous-led programs and research initiatives, including the Roots To Thrive centre partnership with the Snuneymuxw First Nation, the Naut Sa Mawt Centre for Psychedelic Research, and the CIHR network LIVE-PATH (Lifting Indigenous Voices and Experiences in Psychedelic-Assisted Therapy and Healing). More broadly, the Chacruna Institute & Indigeneity Reciprocity Initiative examines partnerships between North and South countries that engage respectfully with plant medicines. At this critical juncture, scholars highlight the importance of reflecting on the shortcomings of current models, the colonialist origins of psychedelic science, and the revisions needed to place Indigenous worldviews and knowledge on an equal plane with Western biomedical models, allowing multiple perspectives to coexist and contribute equally.
Another issue already present in mental health care is limited access to culturally attuned treatment. What is cultural attunement? Ching (2024) defined it as the embodiment of cultural sensitivity, competence, informed, responsive, and humble care, which together constitute the active process of knowledge, awareness, recognition of, attention to, collaboration with, and empowerment of diverse individuals as cultural beings with unique intersectional identities. Unlike other interventions, PAT may carry higher stakes because outcomes are discussed to be shaped by psychological, contextual, or cultural factors (also known as set and setting). One potential benefit of having adequate representation in PAT research is not only understanding health and safety but also how to best deliver PAT to meet the needs of diverse groups, ensuring the intervention is culturally attuned. PAT has tremendous potential to provide culturally attuned care by considering systemic barriers that affect individuals, as well as cultural healing practices, languages, spiritual integration and music, among other cultural factors that may affect the delivery, acceptability, or outcomes of PAT. Additionally, while problems may not be linked to one’s identity, it’s important that support is available if such topics arise during preparatory, dosing, or integration sessions. Researchers are still seeking to understand how the physical environment (e.g., access to nature, ambiance), music, narrative framing, and psychological safety, among other aspects, shape the PAT experience, prompting a consensus expert group to encourage reporting of these aspects. Researchers still don’t know how best to include cultural elements, though it’s known that historically PAT elements (e.g., dosing, preparation, integration) emerged from practices already used by communities (e.g., use of singing, drumming, chanting, incense/herbs and approach to sacred plant medicines with relationality and reverence present in Indigenous ceremonies). Thus, cultural attunement depends heavily on the representation and engagement of diverse communities in the research process, ensuring that PAT considers cultural needs and preferences. Numerous questions persist, which are currently under discussion, such as how best to deliver culturally and spiritually sensitive care, whether non-Western frameworks will be incorporated into PAT, whether relational bonds with medicinal plants or collective healing will be incorporated, and how to respect, credit, and integrate cultural and spiritual practices or approach them with cultural humility.
Ching TH. A Primer for Culturally Attuned Psychedelic Research: National Institute of Mental Health; 2024.
Yes. Historical harm is part of psychedelic sciences’ past, intertwined with past issues in medical and structural systems, including psychological and practical barriers such as stigma, medical mistrust, psychedelic-assisted conversion therapy and past CIA-funded research abuses and unethical experiments with Black incarcerated individuals. These historical harms have caused stigma and sustained systemic racism, which may lead some individuals to wonder whether participating in PAT could result in differential treatment concerning legal status, employment, or immigration, or cause additional harm or trauma stemming from participation in healthcare and research systems. Systemic biases and inequities also emerge from the omission of Indigenous and non-Euro-Western contributions and perspectives. Compounding these issues is also documentation of cases where there’s been exploitation of individuals in heightened induced states of suggestibility and vulnerability in underground and past clinical settings. Remaining cognizant that these issues, such as stigma, medical mistrust and epistemological injustice, are not only historical but still present, some researchers have posited that there may be greater hesitancy to explore psychedelic-related therapeutics or medicinal plants; however, some state that reluctance may not be the problem but rather access and structural exclusion. Given the harms and abuses inflicted against Indigenous and racialized communities in early Western psychedelic research, the field needs to work to acknowledge the harms of the past, rectify injustices and inequities, centre the voices of those marginalized and excluded, and work to build trust to move forward in ensuring equitable and culturally safe treatment. Furthermore, as PAT transitions from research to clinical practice, several questions arise related to regulatory processes and context. These include concerns about the intervention's accessibility given its resource-intensive nature (e.g., 8-hour dosing sessions, extensive preparation and integration), potential costs, the availability of the necessary time and resources (e.g., childcare, transportation) for participation, and whether cognitive or physical barriers might be contraindications. These issues are actively under discussion.
The above sections are not a comprehensive list of the considerations currently under review and discussion within the scientific community, but they reflect how much work remains to be done in areas of equity, diversity, inclusion, and accessibility. PAT research and clinical developments must grapple with recognizing inequalities, dismantling barriers that disproportionately harm or exclude different communities, ensuring the representation of diverse communities in the research process, involving historically excluded and marginalized communities as equal partners, and understanding accessibility issues as PAT moves from research to clinical care. Part of building and testing a healthcare intervention involves bringing together the various people affected by or involved in its implementation. This can include patients who have lived experience of cancer, communities previously excluded (e.g., Indigenous, racialized, gender-diverse individuals), researchers, clinicians and policy makers. Co-designing interventions ensures participation from diverse members. CAN-PACT’s mission is to co-design and engage the community in research so that PAT for cancer care (known as PACT) can be built with those involved in various aspects of implementation. Although it may seem like there are more questions than answers, the discussions currently held ensure that the field holds space for the complexities and nuances that arise with using psychedelic plant medicines in clinical and therapeutic settings and ensure that ethical, safe, effective, culturally responsive care and epistemologically just practices are at the forefront of PAT research and clinical care.