I have had the honor to be born and raised in Utah — no, not Mormon. I watched the cannabis boom happen overnight after moving to Colorado for my Master’s degree, and I am no stranger to Utah culture, the culture of drugs made legal, or the “optimization” mentality of our time.
When I moved back to Utah in 2016, I was part of one of the first ketamine clinics in the state. I have watched, been part of, promoted, and taught against the “psychedelic renaissance.” I completed an 18-month fellowship in ketamine assisted psychotherapy, psilocybin, and MDMA through IPI and MAPS — this was not basic training. I have also sat in space with psychedelics for over 10,000 hours and trained many therapists and medical providers in and out of Utah. I am highly trained and educated. But that does not change what I have witnessed — the beauty of medicine work, the struggles, and the harm, for myself and others.
Psychedelics — and when I say this, I am referring to “natural” medicine, not man-made — are and should be used by indigenous communities and cultures, and with individuals trained in this medicine. This is what can cause harm: medicine has become so mainstream that anyone and everyone is giving it to anyone and everyone. We call this “underground work,” which means it is illegal. I am aware of the religious organizations using medicine “legally,” and also the distinction between states that have legalized versus decriminalized — two very different things. Utah, for what it’s worth, has more ketamine clinics per capita than anywhere else in the country.
If we look at the origins of medicine, this work was done by shamans, in communities and villages, among people who knew one another — and that naturally created safety. These healers carry years of lineage in their bodies, a deep awareness of the medicine, and an honor of how, why, and how much should be used. When medicine went mainstream, we saw a surge of well-intentioned individuals giving medicine without proper training, without grounding in modern mental health or medical knowledge, and without the cultural context that makes it sacred. At the same time, more people seeking medicine are arriving with complex mental health needs, physical vulnerabilities, and the hope of finding a “cure” for their distress, grief, or suffering.
If any of this makes you uncomfortable or angry — that’s an invitation. Please seek more training. Ask yourself whether you are the right person to be holding this space, and what harm you may have caused or could cause without knowing better. When you know better, you should do better.
What Does Safety Actually Look Like?
The following is grounded in a harm reduction model and a guide I have used with my own clients. Safety in psychedelic work — whether you are giving or receiving — always comes down to one thing: knowledge.
If you are giving medicine:
1. Get more training.
2. Know which medicine you are using and why. Have a clear dosage protocol and safety measures in place.
3. Know what to do in a medical emergency — including whether you are prepared to call 911 and disclose what you’ve administered and how much.
4. Conduct a mental health background screening. Offer a preparation session. Know who supports your client after medicine. Provide integration.
If you are taking medicine:
1. Make sure your guide has legitimate training — indigenous or from a certified program.
2. Know which medicine is being used and why. Understand the dosage protocol and safety measures.
3. Know what happens in a medical emergency — does your guide have your emergency contact? Are you aware of the legal risks if you require hospitalization while using medicine illegally?
4. Understand adverse reactions to any psychotropic medications you take, and the possibility that trauma or unresolved material may surface. Have a therapist available for support before and after.
I am not for or against underground medicine. I am for harm reduction — the awareness that people will use medicine outside of legal frameworks, and the belief that we can create more safety, attunement, and accountability within that reality.
As a society, we are sad, overwhelmed, and carrying enormous amounts of grief and trauma. We all want to feel better. But in the process of trying to feel better, we should not be harmed. My hope is that we learn to heal in community — which, after all, is why medicine was first used.
