Medical Screening for Women in Psychedelic Retreats: The Path to Safe, Supportive Journeys
Grace Blest-Hopley and Victoria Murra, 2024
Exploring psychedelics in retreat settings has grown in popularity, especially among women seeking holistic wellness and self-discovery. However, entering such a deeply transformative experience requires careful preparation to ensure safety and support, both medically and psychologically. As the final part of our blog series focusing on psychedelic retreats and their safety for women, Hystelica spoke with Samantha Alvarez, a nurse practitioner for 15 years and founder of Safe Plant Journey, about the nuances of medical screening for retreats and creating safe spaces for women in the psychedelic landscape.
The discussion gave insights on the unique challenges and considerations women should be aware of before embarking on a psychedelic retreat. Our conversation also highlighted the importance of medical screening not just for safety, but also a key step in the preparation process. Samatha also shares her 12 key elements for Psychedelic and Plant Medicine safety.
Rethinking Medical Screening for Psychedelic Retreats
We know that medical screening is vital for retreat safety—not just for the individual, but for all participants. While basic contraindications like psychosis, cardiovascular disorders, or epilepsy are often discussed, Samantha raises the question: should we think about medical screening differently?
The answer is yes. Screening can go far beyond ticking boxes. It’s not just about “meeting the checklist,” but about assessing whether the individual is prepared, both physically and mentally, to navigate the unique challenges of a psychedelic retreat.
Understanding the Nurse Practitioner Role: Treating the Person, Not Just the Disease
First, it is important to understand: what is a nurse practitioner, and how do they differ from doctors? A nurse practitioner is a nurse first, then studies the nursing perspective on medicine for two to three years. Unlike doctors, whose primary focus is on diagnosing and treating diseases, nurse practitioners prioritize the holistic experience of the individual and the human experience of illness.
Samantha explains that nurse practitioners take a "whole-person" approach, focusing on the human experience of illness and wellness. For those preparing for a psychedelic retreat, this perspective is invaluable, as it emphasizes care by a professional trained with the highest clinical understanding while further recognizing that each person’s needs and experiences are different and should be individually assessed and discussed.
The Expanded Role of Medical Screening in Psychedelics
Medical screening for psychedelics can often be overlooked in their importance, particularly if the intended participant is in generally good health. However, medical screening goes well beyond standard questions like “What medications are you taking?” Samantha explains: “When I do my screenings, I'll spend about half the time on physical aspects and about half the time on mental aspects.”
For women, it involves considering further elements such as mental health history, trauma, hormonal cycles, and potential drug interactions. Samantha points out that psychedelics can affect and be affected by medications and supplements, often through metabolism interactions that can be impacted in unpredictable ways. For example, hormonal contraceptives may be less effective, and HRT can be difficult to discontinue even temporarily. Samantha emphasizes that for many women who are on HRT, it is extremely discomforting and uncomfortable to come off of it, so discussions often center on weighing risks and benefits. Another example includes common supplements like ashwagandha, which has monoamine oxidase inhibitor (MAOI) properties that can interact with ayahuasca, potentially increasing safety risks.
The Role of Cycles and Hormonal Health
Women’s hormonal cycles can profoundly impact their experience with psychedelics, as they can significantly affect mindset. As Samantha describes, for those who are menstruating, awareness of where you are in your cycle before a retreat can help set expectations and prepare for unique challenges. For example, certain times in the cycle may bring heightened emotional sensitivity, negative rumination, or physical discomfort.
While we may not always have the option to choose exactly the timing of a retreat, awareness of how your hormones could affect your experience is crucial. Being aware of where you are in your menstrual cycle and discussing the normal range of effects it has (both mental and physical) can help in the decision-making process of whether using psychedelics at a set time in the month presents any particular risk or offers invaluable insight into how your experience may be impacted.
On a practical and safety level, understanding if you are likely to be near or on your bleed during a retreat is important to ensure that staff members at the retreat are aware. This is particularly relevant for any required fasting periods, which can be especially tough during the late luteal phase or during menstruation, often leading to lightheadedness. Additionally, having this awareness can help in planning for bathroom breaks that may be required during ceremonies.
Beyond Physical Health: Mental Preparation and Screening for Vulnerability
Psychological readiness is as crucial as physical health. Psychedelics can open up buried emotions and unprocessed traumas, making mental preparation essential. A “checkup from the neck up,” as Samantha describes it, helps ensure that retreat participants are prepared for what might surface. Samantha emphasizes that women should feel empowered to advocate for themselves and establish their needs with facilitators to build a solid foundation of safety.
Gendered Differences in Trauma and Safety
Women's experiences with trauma often differ from men's, both in content and triggers, and this affects safety and safety planning. Women are more likely to have trauma related to relationships or sexual abuse; furthermore, women are twice as likely to develop PTSD. For women, trauma triggers can be subtle and internal, often surfacing from what could be seen as benign actions from others.
Samatha elaborated, "when I think about psychedelics and plant medicines, it’s deeply connected to your internal sense of safety. Women may inherently feel less safe in their environment. When we take psychedelics, we open ourselves up, creating a bigger sandbox—‘our world’—to explore. If, as women, we have a lower sense of social safety due to how we navigate society, opening up to this vulnerable space for experiences of oneness, mysticism, and connection with ourselves, the past, and the future requires a stronger safety net to hold us during these transformative moments."
Discussing past trauma can help identify what you want in terms of contact and touch from others while at the retreat—especially during ceremonies, where you may not be able to advocate for yourself. Doing this with a trained and informed individual, like Samantha, allows for exploration of what boundaries you want to set for yourself. Setting boundaries beforehand, similar to practices in BDSM or other consent-focused communities, is crucial in the psychedelic space.
Other Special Considerations for Women
Health issues specific to women—such as pregnancy, postpartum recovery, or menopause—present unique considerations when attending a retreat. For example, postpartum women might face challenges in reconnecting with their sense of self, which can amplify during psychedelic journeys. Menopausal women may experience unpredictable emotional or physical shifts that alter how psychedelics interact with their body. Additionally, women who experience heightened anxiety, mood disorders, or sleep issues in relation to hormonal changes may need extra preparation to ensure safety. These nuances underline the need for detailed and personalized medical screening.
Creating Safe Containers in Psychedelic Spaces
Creating a safe environment in psychedelic retreats goes beyond traditional medical and psychological screening. Samantha shares that having a thorough medical screen with a nurse practitioner or doctor who understands psychedelics helps participants enter the experience feeling secure and supported. This screening can make the journey itself more impactful, allowing participants to explore deeper levels of healing and insight without the fear of unaddressed medical issues.
Furthermore, you should be looking for retreat spaces where you know everyone has been screened and is as safe as they can be. Samantha explains, “If you’ve got six or eight people in a ceremonial setting and somebody’s having a really hard time, but everybody’s been medically screened and everybody knows that everybody’s been medically screened, it creates this overall sense of greater safety and a stronger bubble of trust.”
Takeaways: Preparing for a Meaningful, Safe Psychedelic Journey
Entering a psychedelic retreat involves far more than just showing up. For women especially, the preparation stage can make a world of difference in creating a positive, healing experience. By engaging with thorough and thoughtful medical screening, we can best prepare ourselves for psychedelic experiences, alleviating anxieties and concerns about health and well-being as we go into the process. This makes medical screening a sensible and proactive gift to give oneself when preparing for a retreat.
Samantha’s 12 Key Safety Elements for Psychedelics and Plant Medicine:
These elements provide a framework for self-advocacy and preparation for psychedelic experiences, particularly for women, addressing safety and well-being.
Psychedelic/Plant Medicine
Different substances (e.g., Bufo, psilocybin, ayahuasca) vary in duration, intensity, and safety considerations. Understand the specific medicine and its unique demands, such as preparation, effects, and recovery time.Location
The setting is crucial. Whether it’s a retreat, a ceremony, or another environment, research the location and facilitators to ensure it's a safe and supportive space where you feel comfortable and secure.Time for Preparation
Allow time to mentally and emotionally prepare before the experience. This "pre-integration" phase helps you process intentions and align your mindset, improving your ability to engage with the journey.Time for Integration
Post-experience, take time to integrate insights into your daily life. This "external integration" ensures that the lessons and transformations from the experience are processed meaningfully and sustainably.Overall Physical and Mental Health
Assess your current health. Are you feeling strong, healthy, or frail? This includes mental health, as those coming to psychedelics often do so as a last resort after trying other treatments.Cycle Health/Insightfulness
For women, understanding your menstrual cycle and how it aligns with the experience can impact how you respond. Certain phases may amplify or suppress aspects of the journey, so awareness can lead to a more grounded experience.Specific Physical/Mental Health Conditions
Chronic conditions or past illnesses (e.g., cardiovascular issues, mental health disorders) may influence your safety during the experience. Consult professionals when necessary to ensure compatibility with the medicine.Medications and/or Supplements
Some medications (e.g., antidepressants, cholesterol medication) may interact negatively with psychedelics. Research potential interactions and, if needed, consult a healthcare provider about tapering off or pausing medications.Habits
Assess your lifestyle habits, such as diet, substance use, sleep, or exercise. Certain habits may need adjustment before a psychedelic experience to enhance safety and receptivity.Trauma
Psychedelics can bring suppressed trauma to the surface. Be mindful of unresolved trauma and ensure you have proper emotional support before, during, and after the journey to process these experiences safely.Past Medical and Family History
Family history of conditions such as psychosis, addiction, or cardiovascular issues can influence your suitability for certain psychedelics. Knowing this history helps in risk assessment.Limitations
Be honest about your boundaries—physical, emotional, or social. Understanding and respecting your limitations can help create a safer container for the experience, allowing for deeper engagement.
Samantha is a nurse practitioner and the founder of Safe Plant Journey, which offers medical screenings for plant medicine experiences. If you are planning a psychedelic journey and want to speak with a Board-Certified Healthcare Provider about safety, contact Safe Plant Journey at: support@safeplantjourney.com.
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