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 Safety and Proper use of Plant Medicines

Medical Safety Standards

A. Cardiovascular Assessment

Providers must screen all participants for:

  • Uncontrolled or poorly controlled hypertension

  • History of heart disease, arrhythmias, palpitations, or stroke

  • Structural heart disease or implanted cardiac devices

  • Significant kidney or liver disease

  • Uncontrolled diabetes with autonomic involvement

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Required Actions:

  • Ask for recent vitals if available (BP, HR).

  • Refer participants with complex cardiac history to a licensed physician for clearance before acceptance.

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Medication Review

Providers must obtain a full list of all medications and supplements, with special attention to:

  • Antidepressants: SSRIs, SNRIs, tricyclics

  • MAOIs: Strong contraindication

  • Antipsychotics

  • Benzodiazepines

  • Stimulants

  • Blood pressure medications

  • Psychoactive supplements (e.g., Syrian rue, microdosing regimens)

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Required Actions:

  • Collaborate with a medical professional when medication interactions are unclear.

  • Do not allow participation if medication risks cannot be safely mitigated.

 

C. Substance Use Assessment

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Providers must:

  • Screen for recent or heavy use of alcohol, cocaine, methamphetamine, opioids, benzos, or ketamine.

  • Evaluate for current withdrawal risk.

  • Require abstinence for a defined period before ceremony (minimum 48–72 hours; longer when appropriate).

Psychological Safety Standards

A. Exclusionary Conditions

San Pedro / Huachuma is contraindicated for individuals with:

  • Current or past psychotic disorders

  • Bipolar I disorder with manic episodes

  • Active psychosis or severe dissociation

  • Recent or severe suicidal ideation/attempt

  • Borderline or antisocial traits when containment is limited

 

B. Trauma & Veteran Considerations

Providers must:

  • Screen for PTSD severity, triggers, dissociative tendencies, and TBI.

  • Ensure veterans receive trauma-informed preparation.

  • Have grounding strategies ready for combat-related responses.

 

C. Stability & Support

Providers must confirm:

  • Participant has at least one supportive relationship (friend, partner, therapist).

  • Participant is not in an acute crisis or unstable living situation.

  • Participant has capacity to tolerate emotional intensity without aggression or self-harm.

Preparation Standards

A. Informed Consent

Providers must give clear, written explanations of:

  • What San Pedro / Huachuma is

  • Expected duration (8–12+ hours)

  • Physical and psychological effects

  • All risks and contraindications

  • The role of integration

Participants must sign informed consent before acceptance.

 

B. Intentions & Expectations

Providers must:

  • Help participants clarify intentions.

  • Address unrealistic expectations (“one ceremony will fix everything”).

  • Explain the importance of mindset and environment.

Ceremony Safety Standards

A. Facilitator Qualifications

Providers must ensure:

  • Primary facilitator has extensive San Pedro experience.

  • Assistants are trained in trauma-informed support.

  • Ratio is appropriate (recommended 1:4–1:6 maximum).

  • Someone with first aid / CPR is always present.

  • A physician or medical professional is on call.

 

Environment Standards

The space must be:

  • Safe, clean, comfortable, private

  • Equipped with blankets, mats, bathrooms, hydration

  • Free of hazards, clutter, or unsafe terrain

  • Clearly boundaried regarding physical contact and privacy

 

Dosing & Monitoring

Providers must:

  • Use conservative doses for first-time participants

  • Adapt dosage to body weight, age, medical complexity, and sensitivity

  • Monitor signs of distress, panic, disorientation, hypertension

  • Have grounding techniques ready (breath, gentle verbal support, relocation to quiet area)

Post-Ceremony Safety Standards

A. Immediate Aftercare

Participants must:

  • Remain on-site until fully oriented

  • Receive hydration and light food

  • Be monitored for emotional or physical concerns

  • Not drive or use vehicles for the rest of the day/night

 

B. Integration Requirements

Providers must:

  • Offer at least one integration session within 48–72 hours

  • Encourage ongoing support (therapy, groups, journaling, meditation)

  • Provide written integration resources

  • Document adverse reactions and adjust protocols accordingly

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