Researchers have amassed a trove of more than 25,000 calls to a support hotline for people during and after psychedelic trips, making it “the largest dataset of psychedelic support interactions ever assembled—exceeding the combined sample sizes of all published psychedelic clinical trials by an order of magnitude,” according to a study published on Friday in Science Advances.
Despite the popularity of psychedelics as recreational drugs, and increasing interest in them as medically-prescribed therapeutic treatments, there is very little research about the effects of these substances outside of clinical settings with carefully-selected patients. That, scientists say, is limiting what we can learn about the effects of these drugs, because the vast majority of psychedelics are consumed by all kinds of people in homes, festivals, ceremonial gatherings, or other uncontrolled environments.
The Fireside Project, a nonprofit founded in 2020, has filled this knowledge gap with its Psychedelic Support Line, which connects callers who are on bad trips, or who are seeking more information about psychedelics, with trained volunteers who offer confidential peer support.
The team has now published a compendium of 25,419 anonymized interactions with 220 hotline volunteers that took place between April 2021 and February 2026. The database opens an unprecedented window into the experiences of people on psilocybin, ketamine, MDMA, LSD, ayahuasca, and even cannabis, which is not generally considered a psychedelic but can trigger similar effects, such as mild hallucinations.
It’s a “treasure trove,” said Félix Schoeller, a senior research scientist at the Institute for Advanced Consciousness Studies, a California-based nonprofit, who led the study, in a call with 404 Media. “In general, we’re really lacking any evidence and data beyond what exists in the underground world, if you will, for psychedelic therapy.”
“There’s different types of knowledge,” continued Schoeller, who is CEO of ReWire Neurotechnologies, a startup focused on novel experiential treatments for depression. “Some cultures and communities have been doing that for thousands of years. But there’s a question about how to do this in a way that follows the principles of biomedical science.”
The interactions included phone calls and text exchanges with hotline volunteers who provided support by talking through the experience or connecting callers with emergency services in the most urgent cases. About 40.2 percent of callers (10,208 interactions) were actively tripping, while 32.1 percent of callers reached out after they had tripped, a period known as “integration.”
The rest of the calls fell into smaller categories, such as informational inquiries about certain substances, requests to prepare or buy drugs, or calls from “trip-sitters” assisting a person on psychedelics.
Psilocybin was the most commonly reported substance (9,348 callers), followed by LSD (2,247callers), cannabis (2,004 callers), and ketamine (1,194 callers), and MDMA (682 callers), with ayahuasca and other drugs logging much smaller numbers.
Surprisingly, callers who had used cannabis reported the highest distress rate—47.2 percent had bad experiences with the drug. Though cannabis has a reputation as a low-stakes substance, the study confirms that it can induce real distress in some cases that warrant consideration for harm reduction. The distress rates for the rest of the commonly used psychedelics were only slightly lower than cannabis, ranging between 40 to 42 percent.
The study also revealed 43 rare but disturbing instances of “facilitator abuse,” including at remote retreats or ceremonial gatherings involving ayahuasca. In these cases, callers reported abuse from the people providing psychedelics, such as reports they had deliberately been given extra doses without consent.
Those reports “provide the first quantitative documentation of this phenomenon in a community help-seeking sample,” according to the study. “The pattern of these reports—clustering in ceremonial settings involving plant medicines, presenting primarily as trauma-processing calls, and involving callers with elevated rates of prior PTSD diagnoses—suggests that even modest surveillance through existing peer support infrastructure can detect harm occurring in unregulated psychedelic settings.”
Some calls also came from people who said they suffered from schizophrenia, or had taken multiple psychedelics, offering a rare glimpse of situations that could not be observed in clinical settings.
“This kind of data can inform us on these topics in the context of legalizing these drugs and making them accessible,” said Schoeller. “I’m glad that there’s this data that exists that people can look into to support or contradict the claims that they make as to how these things should be done.”
The study also outlines several limitations, including its sample bias of people who are inclined to call a hotline in the first place—which is not representative of psychedelic consumers at large—as well as self-reported accounts of doses, among other factors that are impossible to verify.
Despite the noisiness of the data, however, it contains helpful clues about avenues for future research. In Schoeller’s view, one of the most important revelations was that the success of a call was strongly linked to the perception that the hotline volunteer showed genuine care and empathy toward the caller. Using 2,777 postinteraction satisfaction surveys, the team found that the few negative experiences with the hotline tended to stem from feelings that the volunteer was dismissive, or didn’t seem to care about the caller.
“My takeaway is that the number one thing that predicts whether a support call will not work” is “the volunteer being perceived as genuine,” Schoeller said. “That’s something that, in many ways, poses a problem to the biomedical system of centralized hospitals. I’m not trying to be ideological in any way, but when you create a centralized institution where you throw everybody to a single place to get care” then “clinicians become burned out.”
For this reason, Schoeller and his colleagues plan to follow up on the role of perceived care and empathy in treatment, and to emphasize this factor in guidance for community-based peer support for people in crisis due to psychedelics. It also reinforces the value of the Fireside Project’s hotline, which provides a safe and confidential service for people who might be reluctant to contact emergency services because of the criminalization of these substances or fear of incurring medical debt.
“For many people, they have experiences with psychedelics, and they may not be required to go to the ER, but they still need someone to help them navigate the difficult experience,” Schoeller concluded. “The hotline can truly be a lifeline for them.”
