Psilocybin Harm Reduction Checklist: Everything Before Your Session
This checklist covers what to verify, prepare, and arrange before a psilocybin session. It is organized by the timeframe in which each item should be addressed.
2+ Weeks Before: Health and Safety Screen
Medical contraindications — verify you do not have:
- [ ] Personal history of psychosis, schizophrenia, or bipolar I disorder
- [ ] First-degree family history of schizophrenia (a risk factor requiring evaluation)
- [ ] Current lithium use (serious interaction risk — serotonin syndrome/seizure)
- [ ] Severe cardiovascular disease or uncontrolled hypertension
- [ ] Current antipsychotic medications
Medication review:
- [ ] If on SSRIs or SNRIs: psilocybin may be blunted; discuss timing with prescribing physician if relevant. Do not stop SSRIs without medical guidance.
- [ ] If on MAOIs: do not combine with psilocybin without expert guidance — serious interaction
- [ ] Other medications: consult the drug interaction checker on this site or a pharmacist
If you have any of the above: consult a physician or psychiatrist before proceeding. This is not bureaucratic caution — these are evidence-based risk factors.
1 Week Before: Preparation
Source verification:
- [ ] Know where your psilocybin came from; ideally from a known grower or tested source
- [ ] If using wild mushrooms: spore print confirmed dark purple-brown, bluing confirmed, matched against physical field guide
Intention setting:
- [ ] Written intentions (2–3 sentences) for what you want to explore or work on
- [ ] Intentions are specific, not vague ("explore my relationship with my anger" vs. "heal everything")
Practical preparation:
- [ ] A full day is clear — no obligations for 8 hours after ingestion
- [ ] A trusted sober sitter is arranged if appropriate (recommended for first experiences or doses above 2g)
- [ ] The sitter knows: dose you're taking, your location, expected duration, when to check in, when to call emergency services
Mental preparation:
- [ ] Reduce stressful activities and media consumption this week
- [ ] Time in nature, meditation, or contemplative practice
- [ ] Resolve any immediate personal conflicts if possible
1–2 Days Before
Physical preparation:
- [ ] Rest well
- [ ] Light exercise (beneficial for mood and body preparation)
- [ ] No alcohol for 24 hours
- [ ] Consider reducing cannabis if regular use (may interact)
- [ ] Plan to fast 4–6 hours before the session
Environment preparation:
- [ ] Clean and prepare the session space
- [ ] Comfortable surface to lie on (couch, bed, yoga mat)
- [ ] Blanket and layers available
- [ ] Eye mask available
- [ ] Water and light snacks (for after the session) accessible
- [ ] Playlist curated and queued (4–6 hours minimum)
- [ ] Phone will be silenced or off during the session
Day Of: Final Checks
- [ ] Feeling physically healthy (not ill, hungover, or exhausted)
- [ ] Feeling relatively settled emotionally (acute crisis or severe agitation is a reason to postpone)
- [ ] Sitter is confirmed and in place
- [ ] Environment is prepared
- [ ] Dose is confirmed and set out
Trusted contact protocol (if solo or with a peer sitter, not a professional):
- [ ] One trusted person knows you're doing this session, your location, and has a check-in time
- [ ] That person has instructions on when to call emergency services if check-in is missed
Emergency Reference
If in crisis during or after the session:
- Fireside Project: 62-FIRESIDE (62-347-3733) — free peer support, daily 3pm–3am Pacific
- Crisis Text Line: Text HOME to 741741
- Emergency services: 911 (US) — if there is an immediate safety concern
If you consumed unknown mushrooms and suspect Galerina poisoning (delayed onset, not an ordinary bad trip):
- Poison Control: 1-800-222-1222 — call immediately, don't wait for symptoms
Post-Session: Integration Planning
Schedule these before your session day:
- [ ] 1 integration therapy session within 7 days of session
- [ ] Journal materials available for day-after reflection
- [ ] Day after session: light schedule, time outdoors if possible