As access grows, we need better research and education on bad trips.
The term “psychedelic” was coined by psychiatrist Humphry Osmond: “To fathom Hell or go angelic / Just take a pinch of psychedelic.” But today’s public messaging around psychedelics has a dangerous tendency to gloss over the “fathoming hell” part, which has been euphemized into the language of a “bad” or “challenging” trip.
Challenging trips are generally ones that involve encounters with intense anxiety, unwelcome loss of control, surfaced trauma, or physical discomfort. They’re difficult experiences in the moment, but ultimately, once things settle down, they can be cast in a therapeutic light, and people look back on them as worthwhile.
Then there are just plain bad trips that do not resolve into a harmonious insight, no matter how much therapy, intention, and journaling you throw at them. “Choking, breathless, I was having a grief-tinged cosmic panic attack,” the Harvard theologian Rachael Petersen wrote of her experience in a psilocybin clinical trial. “A small kernel of doubt: a splinter wedged between me and the world … What if terror is just that — terrible, terrifying, absolute?”
The positive sides of psychedelics — therapeutic promise, spiritual renewal, and radical forms of creativity — attract more interest, and more funding, than research into what might go wrong for a minority of users. And to be clear, even outside of the well-controlled settings of clinical trials, the majority of psychedelic trips do seem to lean positive. One recent study that surveyed 613 lifetime psychedelic users drawn from a nationally representative sample found that 82.4 percent reported “never” or “rarely” experiencing bad trips. More than 90 percent reported either no subsequent impairment in their ability to function, or difficulties lasting no more than 24 hours.
But the attention capture of good trips has fed a poor understanding of the vast array of experiences that fall into the “bad trips” category, leaving those who suffer from them without much institutional support or information, even as states have begun providing regulated access to psychedelics and decriminalizing them for personal use.
“We need to learn more about the risks and harms of psychedelics … We’re still at the beginning of that process, in my view,” said Jules Evans, director of the Challenging Psychedelic Experiences Project. “It’s not just about researchers trying to be more rigorous in reporting adverse experiences in trials. It’s also about actively researching harms and how to treat them.”
In the late 1960s, poor public understanding of the actual risks of psychedelics allowed misinformation and sensationalized stories — of LSD users leaping from tall buildings to their death under the impression that they could fly, or irreparably damaged chromosomes — to spread, stoking a moral panic that led to the prohibition that is only just being relaxed, more than 50 years later.
This time around, we run a similar risk. Except now, many of those who are working to spread awareness of the potential harms don’t want another prohibition, and opposing one shouldn’t mean sweeping the risks under the rug so as to rush through legislation. Instead, an honest and transparent account of both the benefits and risks of psychedelics can help build a better, more resilient post-prohibition world.
If good trips can change long-term behaviors, so can bad ones
Last month, an off-duty pilot aboard a flight to San Francisco tried pulling the plane’s emergency shut-off handles because he thought he was in a dream and crashing would wake him up. He had struggled with depression for six years and also reported struggling with the recent death of a friend. Forty-eight hours before the flight, he tried psilocybin mushrooms for the first time, had a terrible experience, and hadn’t slept since.
In the subsequent media coverage, experts debated what role the drugs — whose subjective effects generally fade after six hours — might have played in the episode two days later. While it might seem strange that psychedelics could play a role in behavior changes that take place well after the molecules have left the body (psilocybin is generally metabolized within 24 hours), most of the hype around their therapeutic effects depends on it.
Current research on psilocybin suggests that a single dose, coupled with psychological support, can reduce symptoms of treatment-resistant depression for at least three weeks or help people quit smoking for good. If that’s the case, why wouldn’t it be possible to see negative effects persist along the same timelines? Why couldn’t the psilocybin have something to do with an episode occurring 48 hours later?
“There is hardly any empirical research on how best to treat extended difficulties. That’s one example of a massive research gap that still exists,” Evans said. At least until last month, when a new study he co-authored was published, surveying 608 psychedelic users who all reported extended difficulties lasting more than 24 hours after the trip itself subsided. Thirty-two percent reported difficulties persisting longer than a year.
Participants reported using a number of drugs — mostly LSD and psilocybin — in a broad range of settings, including solo trips, underground ceremonies, clinical trials, therapy sessions, and raves. The most common type of difficulty reported was emotional, including things like anxiety, depression, paranoia, and low mood. Another 42 percent reported “existential difficulties,” consisting of subtypes like “existential struggle,” derealization (when the world comes to feel “less real,” or as if it’s a dream, akin to what the pilot reported), and difficulties integrating experiences into everyday life. In total, the report divided the blunt category of “extended bad trips” into nine themes and 62 subthemes, creating a more granular account of what exactly people experience.
Despite the entire sample reporting extended difficulties, about 90 percent agreed that “the insights and healings gained from psychedelics” are worth the risks, “when taken in a supportive setting,” which is left open to interpretation.
What should bad trips mean for regulation and access?
“None of us want to see psychedelics become less accessible,” Erica Siegal, a social worker who supports victims of sexual assault who were harmed while on psychedelics, told the Berkeley Center for the Science of Psychedelics’ newsletter, the Microdose.
That’s a big shift from the late 1960s, when stories of distressed airline pilots or psychedelic sexual abuse might have fed directly into prohibition efforts. But if heavy restrictions are not what’s wanted, then what to do?
According to Katrina Michelle, the former director of harm reduction for the Multidisciplinary Association for Psychedelic Studies (MAPS), “The power lies in educating people and empowering them with information to make intelligent choices.” She explains that public access to information about risk management can help mold the public’s idea of what responsible use looks like. Society uses a similar approach to cars and alcohol, where after meeting basic accessibility criteria or obtaining a license, we rely on a mix of public education and individual responsibility.
Evans offers another metaphor, likening psychedelics to “dangerous sports, like diving or mountain climbing. It took humans decades to develop safety protocols for these sports, and even now there are accidents.”
He outlines four pillars for improving psychedelic safety: researching harms, communicating them, supporting those who experience them, and regulating the emerging psychedelic markets to minimize those harms.
That last point will be thorny, especially since we don’t know what types of markets will be legalized (state-level reforms have focused on decriminalization, research, and restricted access rather than full commercialization). Transform, a UK-based drug policy foundation, will publish a report next week that provides guidance on four different approaches: decriminalized private use and non-commercial sharing, nonprofit membership associations (a model pioneered by cannabis social clubs in Spain), licensed production and retail, and commercial guided experiences.
“Despite there being plentiful, eloquent critiques of the failure of prohibition, these have not necessarily produced credible visions for an alternative approach which public, professional and policy-maker audiences can buy into,” the report states.
As these regulatory visions take shape, addressing the imbalance in research on benefits and risks could be an important part of building good institutions for the next era of legal psychedelic use. It won’t be easy, but Evans sees a few hopeful signs. “Thankfully, I see some of the big psychedelic philanthropists now looking to fund more research in this area,” he said. “I also see younger psychedelic researchers keen to learn more to make the field safer.”
Republicans have lots of good pickup opportunities. Democrats, not so much.
Sen. Joe Manchin (D-WV) will not run for reelection — a decision that likely means Democrats will lose a Senate seat in the narrowly divided chamber in 2024.
The stubborn centrist represented one of the most Republican states in the country — one that Trump won by nearly a 39 percentage point margin in 2020. Yet Manchin was able to defy West Virginia’s partisan leanings via his long history in state politics, including as a former governor, dating back to the years when Democrats won the state regularly.
Since then, the West Virginia Democratic Party has been decimated, as the state’s voters have increasingly voted with their national partisan loyalties. It is hard to believe any other potential Democratic nominee would be able to match Manchin’s political strength there.
Democrats currently have a 51-49 majority in the Senate, so losing Manchin’s seat would put them back to 50-50 — still enough for control if President Joe Biden and Vice President Kamala Harris win reelection.
The problem is that Democrats’ 2024 Senate challenges go far beyond West Virginia. They face such a starkly unfavorable map that, if things even go somewhat poorly for the party, they could fall into a deep Senate hole for years to come.
Besides Manchin, two other Democratic senators represent states Donald Trump won in 2020, and they’re also up for reelection in 2024. Sens. Jon Tester (D-MT) and Sherrod Brown (D-OH) are both running again, but these are all very red states, and winning them in a presidential year will be quite difficult for Democrats.
But the vulnerabilities go deeper. The only remotely close states (per presidential results) where Republicans are defending seats are Florida and Texas — two states where Democrats have had few victories in recent years. Meanwhile, Democrats are also defending seats in five states Joe Biden very narrowly won in 2020. These seats are currently held by Kyrsten Sinema (I-AZ), Tammy Baldwin (D-WI), Bob Casey Jr. (D-PA), Jacky Rosen (D-NV), and Debbie Stabenow (D-MI).
Democrats might think they have nothing to worry about regarding this group of seats, because, look, the party defied the naysayers in the tough year of 2022, winning at least one statewide contest in all these states — so clearly these states lean in their favor.
But it’s always a mistake to overread the results of the last election, and to underestimate how much things could change before the next one. Particularly if Trump is not the nominee again, the party coalitions could be scrambled in unpredictable ways. And even Trump came quite close to winning these states in 2020.
The Class of 2024
Senators serve six-year terms, so only one-third of the body is up for election each cycle. And the particular grouping of Senate seats (referred to as a “class”) up for election in 2024 has enjoyed a particularly charmed run for Democrats. You have to go all the way back to the 1994 GOP wave for a strong Republican performance. Since then, they’ve been on the ballot in the following years:
- 2000: A closely fought presidential year in which Al Gore won the popular vote but George W. Bush won the Electoral College, and Democrats picked up four Senate seats on net
- 2006: A Democratic wave year, in which the party retook both the House and the Senate, picking up six seats in the latter chamber
- 2012: A strong Democratic year for Barack Obama’s reelection, in which the party unexpectedly expanded its Senate majority by two seats
- 2018: Another Democratic wave year — but the party had won so many seats in deep red states in previous cycles that they had several incumbents in strongly Republican territory, so they ended up with a net loss of two seats
So this Senate class is risky for Democrats in part because they’ve had such good luck with it in the past. Nearly half of Democrats’ Senate majority — 23 sitting senators — come from this grouping of seats, so they’ll all be on the ballot in 2024. Meanwhile, only 10 Republicans will be up, though special elections could increase this number. That’s already a numerical disadvantage. But the disadvantage extends to which specific seats are up.
Which specific seats are up
To understand the extent of the Democrats’ challenge, it’s important to realize that the Senate has changed. In the past, it was common for a state’s voters to back Senate and presidential candidates from different parties. For instance, after the bitterly fought 2000 election, 30 of 100 sitting senators represented states that their party’s presidential nominee did not win in the most recent election. That’s a lot of ticket-splitting.
Since then, that number has gradually dwindled, as red-state Democrats and blue-state Republicans have retired or gone down to defeat. When Trump took office, there were 14 such senators remaining. Now, there are just six. The Senate has sorted by partisanship.
Of course, states that have a roughly equal partisan balance can still go either way. But it’s gotten much tougher to defy partisan gravity in deeply Republican or Democratic states — especially in a presidential year. In 2016, zero states elected presidential and Senate candidates from different parties. In 2020, just one state did, as Republican Sen. Susan Collins won in Maine, a Biden state.
Now, in 2024, the seats of all three Democratic senators representing states Trump won in 2020 — Manchin in West Virginia, Tester in Montana, and Brown in Ohio — are up.
/cdn.vox-cdn.com/uploads/chorus_asset/file/24220842/Screen_Shot_2022_11_22_at_4.04.02_PM.png)
Andrew Prokop/Vox
Manchin’s seat is likely lost due to his retirement. But the best hope for Tester and Brown is for Republicans to have a messy and divisive primary, after which a controversial nominee emerges. Even then, though, it would be tough to defy the presidential lean of their states, which have both backed Trump pretty solidly in the past two cycles.
So that’s three seats where, per underlying partisanship alone, Democrats will have a hard go of it.
Then there are five swing states which, if recent history is any guide, are likely to have closely matched Senate and presidential outcomes.
In Arizona, Kyrsten Sinema quit the Democratic Party, and it’s currently unclear whether she’ll run for reelection; if she does, a three-way race would ensue. In Nevada, Jacky Rosen just saw her colleague Catherine Cortez Masto narrowly survive a very close contest in 2022. Then there are the three seats in the Rust Belt swing states — those held by Tammy Baldwin (D-WI) and Bob Casey Jr. (D-PA), who are running again, and Debbie Stabenow (D-MI), who is retiring.
Democrats don’t start off as underdogs in any of these states, and they could well win them all. But again, much will likely depend on the presidential contest. If that contest trends toward the GOP, several of these Senate seats could follow.
Moving on to the GOP-held seats up for election — barring some sort of GOP candidate catastrophe in a deep red state, Democrats have only two plausible targets: Florida and Texas.
/cdn.vox-cdn.com/uploads/chorus_asset/file/24220565/Screen_Shot_2022_11_22_at_2.37.28_PM.png)
Andrew Prokop/Vox
In Florida, Sen. Rick Scott (R) is running for a second term. Back in 2018, Scott only won by an incredibly narrow 0.12 percent margin. But the Sunshine State has been trending away from Democrats since then, as seen in Gov. Ron DeSantis and Sen. Marco Rubio’s landslide reelection victories last year.
Texas, where Sen. Ted Cruz (R) is up, has been moving the other way demographically —Trump only won it by 5.6 percentage points in 2020, and Cruz won reelection by 2.6 percentage points in 2018). Still, Democrats haven’t won a statewide race there since 1994. Rep. Colin Allred, the frontrunner for the Democratic nomination to face Cruz, hopes to change that.
The takeaway
Democrats are fortunate that they picked up a Senate seat in the 2022 cycle, expanding their majority to 51-49 rather than 50-50. That gives them a cushion to survive the likely loss of Manchin’s seat. But they have no other room for error.
The problem is that even if Democrats have a great year nationally in 2024, the underlying partisanship of the map means they’d likely lose three seats. The 2022 Senate map was, as I wrote during that cycle, “relatively balanced,” but the 2024 map just isn’t. (And again, that’s mainly because Democrats have been so successful in these races previously, so they simply have more to lose.)
And if 2024 is not a good year for Democrats nationally? Well, then they could lose some or all of those five swing state seats, putting them at a serious deficit in the Senate that it could take many years to climb out of.
Update, November 9, 2023, 4:00 pm ET: This article was originally published in November 2022. It has been updated to include developments in Senate races since then.
The latest from the MCU teases a comic book superhero team.
This post includes spoilers for The Marvels.
The Marvels had everything: the return of Captain Marvel a.k.a. Carol Danvers (Brie Larson), the big-screen debut of Ms. Marvel a.k.a. Kamala Khan (Iman Vellani), and the ascension of Monica Rambeau (Teyonah Parris) to full-fledged superhero. It had that illustrious trio teaming up, becoming The Marvels, and saving the day from Dar-Benn (Zawe Ashton), a beautiful Kree alien with a giant hammer and a maniacal thirst to drain worlds of their natural resources. It had a bunch of aliens that look like cats, with a song from Andrew Lloyd Webber’s feline musical to boot.
Given all that, you’d think that Marvel might hold off on introducing more stuff. But this is Marvel, a studio that can’t help but attach a teaser or some kind of Easter egg to its films. And for longtime superhero fans, this movie has a huge one.
/cdn.vox-cdn.com/uploads/chorus_asset/file/8565937/spoilers_below.png)
The Marvels credits scene teases the introduction of the X-Men, again
In the movie’s finale, Captain Marvel, Ms. Marvel, and Monica Rambeau have to fix Dar-Benn’s mess.
Before perishing, Dar-Benn uses a massive amount of power to tear through space and time, creating, as Monica describes, a wormhole into another universe. Yes, it’s back to the multiverse for the MCU, but thankfully it’s very simple here: No one needs to know Kang or quantum realms or any of the complicated stuff found in this year’s Quantumania. Monica has to use her light powers to patch up the hole so that each universe remains intact.
Monica is able to seal them shut, but in doing so, she crosses over to the parallel universe. Captain Marvel tries to save her, but she’s too late. The movie ends with Monica separated from Carol and Kamala.
In the credits scene, Monica wakes up in what appears to be some kind of medical unit. She looks over and sees a woman who appears to be her dead mom, Maria Rambeau (Lashana Lynch). The woman doesn’t recognize Monica and pulls away. Monica slowly starts to put together that even though this woman looks like her mom (after all, it’s the same actress), she isn’t the Maria that Monica knows. She might not even be Maria at all.
/cdn.vox-cdn.com/uploads/chorus_asset/file/25068868/SSW1180_comp_trx_v0016.1105.jpg)
Courtesy of Marvel Studios
While both women are trying to piece together what’s happening, someone unseen enters the room and starts briefing them. The male voice explains that Monica was found floating in space by someone called Binary, and Binary took Monica in for medical care. Monica, the voice says, seems to be from a different universe. The camera pans up and reveals that the person speaking is Beast a.k.a. Hank McCoy a.k.a one of the X-Men. Kelsey Grammer, who played Beast in Fox’s X-Men movies, reprises his role.
Beast tells Monica that Charles (as in Charles Xavier, head of the X-Men) wants to speak to all of them and that the woman she thinks is her mom is Binary, the hero who saved her. The scene cuts as Monica puts it all together that she’s trapped in a parallel timeline and has to figure out how to get back home — probably with the help of Beast, Binary, Charles, and possibly the X-Men. The X2 theme from the 2003 movie plays as the scene ends.
What The Marvels’ post-credits scene means
The scene is significant for a number of reasons, but the biggest one is that it teases the possibility of the X-Men finding their way into the MCU sooner than later. Since Marvel re-acquired the film rights to X-Men (as part of the Fox acquisition), fans have been waiting to see when and how the company would bring mutants into the MCU. Before Marvel turned the Avengers into a multibillion-dollar movie franchise, the X-Men, along with Spider-Man, were the company’s most recognizable and profitable heroes.
If the X-Men exist in a parallel universe and Monica Rambeau is there too, it stands to reason that there could be a storyline in which one or two of our merry mutants tag along with her when she gets back to the main timeline.
But that’s not all.
/cdn.vox-cdn.com/uploads/chorus_asset/file/25068870/ALF1100_comp_WTA_v0061.1040_R.jpg)
Courtesy of Marvel Studios
This is now the second time an X-Man has appeared in an MCU movie. In 2022’s Doctor Strange in the Multiverse of Madness, Charles Xavier a.k.a. Professor X (Patrick Stewart), appears in, yes, a parallel universe. But Wanda Maximoff (Elizabeth Olsen) kills him in a fit of rage. Professor X’s death in that previously seen universe would indicate that Monica is actually in a different world from the one we saw in Multiverse of Madness. That means there are at least two parallel universes in the MCU in which X-Men exist and have interacted with the main MCU timeline. And if there are X-Men in these alternate realities, it could suggest there might be some variation of the X-Men and mutants already present in the main MCU timeline.
The other shocking thing that happens in the credits scene is the reference to Binary. In the comics, Binary is Captain Marvel/Carol Danvers’s most powerful form. Carol becomes a cosmic entity and this allows her to travel at the speed of light and command the power of the stars. While this comic book incarnation possesses Carol’s human consciousness, their Binary is referred to as a higher or more powerful autonomous being. She’s an ally to the X-Men (mainly because the X-Men are in space a lot and because the X-Men are friends with Carol) but prefers to travel and adventure solo in the cosmos, zooming from galaxy to galaxy. The X-Men usually stick close to Earth.
Given that Binary is associated with Carol Danvers, it could be that the woman Monica thinks is her mom (and again, played by the same actress) is actually that universe’s variant of Carol. Or, perhaps in that universe, Maria Rambeau becomes Binary herself, which would explain why she doesn’t know Monica.
What’s clear is that the introduction of Binary and twisty reprisals of all these X-Men characters are going to spur fan theories and speculation — and that’s something Marvel needs given the lackluster state of the MCU. It’s an exciting crossover with a lot of potential. The rub is that we’ll only find out exactly how the X-Men will factor into the MCU when Monica and the trio reunite — whenever that may be.