Psychedelics can treat depression. They can treat anxiety, they can help you quit smoking, they can help recovering alcoholics and they can treat cluster headaches.

But these classic psychedelics, LSD and psilocybin, can also have a nasty bite. ‘Bad trips’ have been publicised since the psychedelic culture of the 60s, including (often fabricated) tales of people jumping off buildings or staring at the sun until blind. But it’s a reality that powerful psychedelic drugs can cause traumatic experiences if not used correctly.

In the most recent edition of the Journal of Psychopharmacology, Professor David Nutt introduces two new studies that add to the growing body of evidence suggesting that psilocybin can be used to help people with anxiety or depression related to terminal illness. It’s all exciting stuff, is already being covered by major news outlets, and will no doubt help to further the cause of the psychedelic reform movement.

Included in the issue is a paper about ‘challenging experiences’ people encounter when using psilocybin outside of a clinical setting. It’s an interesting contrast to the unrestrained positive message we’ve been hearing about psilocybin in recent studies. Here, the authors point out that of nearly 2000 recorded ‘bad trips’, around 50 resulted in physical violence or hospitalisation. 152 of those surveyed felt they needed treatment for the long-term psychological effects of the experience, and three people attempted suicide.

It’s a sobering study, and it reminds us of the power of psychedelic substances when used in large doses or in uncontrolled settings. But instead of feeling that this will harm the psychedelic movement, and instead of just ignoring results like these, we need to embrace this study as showing us the realities of psychedelic use. Psychedelics can be dangerous! But their therapeutic and spiritual potential can easily outweigh the dangers.

It takes studies like this to show us the importance of set and setting, and of planning psychedelic experiences with respect and mindfulness. As the authors of this paper state, when classic psychedelics are administered in a controlled laboratory setting, the risks of negative long-term effects are very low.

Despite 39% of the bad trips in this study being reported as “among the top five most challenging experiences of [my] lifetime”, over 80% of the nearly 2000 respondents said that the experience had benefitted them. This speaks to the healing power of psychedelics; even when used improperly, they can have a positive impact on our lives. Let’s maximise that impact by learning how to use them wisely, responsibly, and with care.