 Thanks to everyone for attending this conference, and thanks for the organizers to invite me. And thanks, Tarik, for this excellent presentation on NPS, which is my other field of expertise besides psychedelics. First, I have to show you this disclosure that I was only sponsored by my mom. And next, I would like to make an advertisement of this upcoming new Journal of Psychedelic Studies, which is based in Hungary. It's a collaboration between three universities and the Hungarian Academy of Science. So this will be a new psychedelics-dedicated journal coming up this autumn. And we will invite some speakers from here to publish in the first issue of this. Yeah, so my name is Levent Amoro, and I'm doing my PhD at the Center of Cognitive Neuroscience in Finland. But I'm based in Hungary, in Budapest, and I'm the current president of the Hungarian Maps Association. And the reason I'm here, it's more like the time, also, the manager of the dot.hu. It's the Hungarian Psychedelic Communities website. And related to this website and the community, we are doing also a psychedelic harm reduction. And so the topic is the crisis intervention at psychedelic festivals. You can see the psychedelic festival, how it looks like here. Probably many of you have attended these types of events. And it is based in the contemporary psychedelic subculture, like electronic dance music events. And it's like go-up, citrons, chill-out types of music styles. There's a manifold higher prevalence of hallucinogenic drug use among the visitors of these events. It has been statistics by studies and research. Hallucinogens, I mean, it's like LSD, DMT, psilocybin, mescaline, these are quite present at these events. And the set and setting is actually ideal for drug use. You have lots of days, lots of supportive friends. So actually these life-enriching experiences can be very nice in a supportive environment. But there are substantial risks associated with the ingestion of psychoactives. That's a fact. So what is harm reduction at parties and festivals? There's an increased safety risks because of the isolated location of the festival. It's usually in the middle of nowhere. There are harsh environmental conditions. It could be raining or very hot. There's outdoor phenomena, such as creeping little insects and other funny things. And of course, the psychoactive substance use, which is prevalent. So we need definitely harm reduction in interventions. And those health services may include the distributing of drinking water, which is very essential. Like water works magically in any kind of an altered state situation. It just boots up people very nicely. We handle out substance information, which is very important at the festivals. Also about the substances that are present at the festival. There's a first aid, usually provided by professional ambulance crews or emergency crews. But there's a need also for psychological help, just to talk with people who have some difficult experiences. And there is some services which analyze drugs. And in response to this question, some of these crews are using the thin layer chromatography technique, which means that you can separate the substances first before of these colorimetric tests. So that is how it works with combinations. Yes. And so this is our micro's party harm reduction equipment. You can see what services we provide. So first of all, the drinking water with plastic cups. We provide magnesium and some glucose. Just to, it's good for the muscles and also for the brain. And the salt is next, just to eat something up. Earplugs, condoms, sniffing tubes. So these are the basic harm reduction things. Some first aid kit and drug information leaflets and so on. The risk of psychopathy drugs are manifold. You can see some small advertisements at a certain festival in Hungary a few years back. You can actually see those new psychoactive substances appearing at the psychedelic festival as well. So you can see MDPV over there and AMT over there. They were in the previous presentation as well, novel psychoactives, just in the mixture with algae and good hash and other stuff. So there are impurities and dosing errors, misidentification of a white powder, which can be another white powder, interactions between drugs, drugs and alcohol, drugs and the medicals. And the people might not be fully healthy. So they might have pre-existing medical conditions, which they might know or might not know about. And there's usually a reckless attitude towards substance use makes all of it worse. So they may cause physical and or mental discomfort. So we definitely need some help because there might be very serious health consequences or accidents. So psychedelic support services. This is a microdiscount to PsyHELP team. These services are called the PsyHELP support, or PsyCare, or PsyHELP emergency services. These are the generic names. So it's a specialized type of harm reduction for handling psychedelics related emergencies and the spiritual crisis, which is a subtype I will talk about briefly. My crew has been working since June 2013. And currently, we have about 47 volunteers. Two coordinators, I'm one of them. And in the three years, we had been attending 86 parties and festivals. So it's a very active crew. These are mostly in Hungary and in Budapest, mostly, and then on the countryside. But we had been invited to international festivals as well lately. There's an international collaboration. Many of these things, we adapted from the Boom Cosmic Air team, which is a marvelous team. If you ever go to the Boom Festival, then you are welcome to visit it, not as a client who is carried in. But you can just drop by and see how it works also this year. And so the types of emergencies that we have, we categorize to five different types. There are medical emergencies. These are like a threat to the biological body. We have psychological difficulties. These are more like difficult processing of emotional data. And it might resolve with just some discussion with the helper. And there are psychiatric cases. These are mostly people with preexisting psychiatric disorders who just attend the festival. For some reason, psychiatric people just love the festivals. And they might get, either they don't take their regular medication in the festival environment, or they just might get like a drug-triggered acute psychosis because they just try to experiment with other hallucinogens, which might be quite close structurally to their own medication. So they might end up in the worst condition that they came in. And there are the classical psychedelic bad trips. This we have the most. We actually shouldn't call them bad trips. We usually call them difficult experiences because they might be like a roller coaster from more difficult to less difficult. So it's not bad in that sense that there's lots of space to make something good out of it when processing properly. So these are hallucinatory and delusional perceptions of the world, of the person's own body and his or her mind. And we have the spiritual crisis situations, or spiritual emergencies, which by content they are more like religious or mystical. The person is pondering about the life and universe and everything. And this is quite rare, but we still have to be prepared for it at psychedelic festivals. So what is the psychedelic consciousness alteration as a process? It happens mainly from serotonergic hallucinogens like LSD psilocybin. It's only a temporary alteration. So there's a destabilization of the baseline everyday consciousness state and then re-patterning temporarily to a metastable state of consciousness, which then later again destabilizes and the basic baseline state of consciousness gets back. So there might be some looping or incoherent thought process is present. And there's an impairment of short-term and long-term memory, although long-term memory can be the opposite. So some old memories can surface, which might not be that nice for the person. There are hallucinations and delusions and they may appear as real for the person. So in their subjective reality, they are really like existing things. So it's quite hard to convince someone that he's only hallucinating or he has only delusions. It's quite the opposite that he or she experiences. And attention may turn inwards or towards unreal things. That can happen also. And there are repressed emotions or traumatic memories that may surface under these altered states. And then it needs some processing. And we should be prepared for very diminished rational and verbal levels of interaction. So it's not always possible even to talk with the client. It could be in a condition that there is no access verbally. It's only like just a very frightened state or something. So when you can talk with the client, then it's kind of like a progress already. So what the client could be like? There's anxiety or fear present. As I said, it might be difficult to access verbally. You can't even figure out that what language the client speaks in the beginning when it's just looking like that. So they may not tolerate proximity. So it's not the first thing that you just hug them because they might just run away or just kill you at place. That didn't happen, actually, ever. But you have to be very careful that how much bodily contact you can take with the client. There is unpredictable behavior. So you can never be sure that someone is all right because it might change from some environmental stimulus, can trigger something, and then they just run away or something. So it's very unpredictable. There are no ethical norms and social rules. So you should be prepared that they might kick you or spit you or try to urinate on you. So everything is possible. There is a paranoia, catatonia, and stupor, and all other states, or just this orientation. So they might not even tell you what they took and in what amount. So a client case examples. There are naked people sitting, walking, running, and so on at every festival. Of course, it's like the warm summer festivals and the hippie attitude that you want to show your body parts. But this is actually not a big problem. It indicates, although that maybe the person is not fully aware that in what condition he or she is. And the other thing is that if there are police presented festivals, then they might not appreciate this that much. And there are timeless long trips when there's a trip which could be very good. But after like eight or 10 or 12 hours, it might be a bit annoying. And the people feel this timelessness on hallucinogens. So they think that it will never end. Five minutes. OK. So there might be a crashing after a long usage of stimulants mainly. So after a few days not sleeping and taking stimulants, it can be very hard on the body. So they might just crash and just sleep for a day. It's a common situation when friends are lost at the festival and people get frightened under the influence of something. There might be epileptic seizures. It's very rare. But stroboscopic lights might induce epileptic seizures. Red-less dosage. It's when someone is pouring LSD on your hand. And then, oh, it was a little bit more. But I still lick it. I don't know how many doses that can happen on the dance floor. There are psychiatric patients, as I said. They are very hard cases because you have to know if they are psychiatric patients. And then you might have to be able to provide medication during the festival. And then you might even have to evacuate them properly after the festival because they're not even able to get their stuff together and they don't know where to go. So these are problematic. There are some people who are just energetic. But the security can't tell the difference between aggressive and energetic. So we need to make a diagnosis and say that, OK, he's OK. He's just like climbing on the decorations or something like that. And it's not any kind of aggression. There are spiritual crises, as I said. It happens rarely. But some people might have this kind of transpersonal or transcendent processing. And then it's hard to tell apart from psychiatric cases or psychosis. So this needs a very specialized diagnosis on site. There are these designer hallucinogens, which might be on the blotter instead of LSD. Enblem is given more body load. But the DO substance is the psychedelic amphetamines. They might cause very long trips, like 16 to 24 hours. And it might be frightening for the clients that, OK, what happens? So I usually come down from LSD after like 8, 10 hours. And this had been going on for a day or so. So this is a situation which had happened at many festivals. And there are free loaders who actually not real clients, but as they see a nice tent with nice people around, then they are under some influence. But if we ask them that, OK, are you in some kind of a crisis, then they will get into a crisis and then they can stay in the tent for a long time. So this also happens. We have to make a difference. So how to help in psychedelic emergencies? Cases can be managed with somewhat similar methods. The metabolic activity works for us. So it decreases the drug levels and gradually by time. So people will return to the baseline basically. So the helping process requires active participation only for a few hours practically. And first we have to convince the people to stay at the helping premises. And then we should prevent accidental injuries. And we should advise them from taking more drugs. That's also important because more variables. It's a less predictable outcome. So we need to provide a calming presence and occasional communications. Not too much actually is better. You shouldn't talk about abstract things with the clients, not too many questions, and no negative associations that you could have died or something like that. And the simple verbal instructions are the best with these people. And the repeated reassurance that the trip will surely end and you will get back to the baseline. You might have to tell it like in every minute for like an hour, but this works as well. What are the special requirements for helpers in these situations? The knowledge of first aid, handling emergency situations. I count it two, but anyway. Knowledge of psychoactive substances. Knowledge of altered mental states. And the psychological suitability, teamwork suitability, and client work suitability. And there's a list of psychological suitability for the helpers, which I will just list like openness, mental fitness, unselfishness, humility, self-control, tolerance, altruism, attachment, detachment from the client, discretion, co-equality, pressure handling, and patience. And in half minute, I will tell about the PsyCare team at the PsyFi Festival here in the Netherlands. It was last summer, and it will be also this summer. And it has 15,000 visitors. It was an international collaboration between a German, Dutch, and Hungarian teams and some other helpers. We had this not so lovely military tent outside near a lake, which means in Holland it's a swamp area. But in the inside, it was really nice. So this was the cozy place with the heaters and blankets and sofas. So basically, we filled out some documentation forms about our clients. We got 83 cases documented and put it into an Excel table. And the statistics show these substances that we had to take care of for people under the influence of these. LSD, MDMA, predominantly, and some others also including some MPS. And from the cases, I just briefly mentioned yelling and running naked at night, walking naked until mom came with a car and fetched. Then some people were kicked out from magic truffle ceremonies because they were bad energies. So they ended up at our tent. And there was some amphetamine binge after a few days that the person couldn't stop his muscles. He had to be hospitalized just to be sure. Their relationship breakups at the festival is very typical. So it might have some problems. And there is the Saturday tripping and Monday hallucinogen relate to persistent perception disorder. So still some after effects after using hallucinogen and some contagious bad trip when someone sees a bad trip and then he gets a bad trip from that. Like it's a trauma from seeing other people in bad condition. So all these things are collected in our PsyHEP manual, which you can download in English, Hungarian, and Finnish. From this website, you just Google PsyHEP manual. And thank you for your attention. We are monitoring the dance floor with my lovely girlfriend. And thanks for your attention. On the festivals themselves, it's already very reassuring thought, so it's also very preventive in a very preventive way without doing actually take care of set and setting. Then the question, how do you experience the balance or the amount of first time or novel users and experienced users that come to the PsyHEP? There are, of course, first time trippers. It's more like depending on their friends and the group of people who are initiating this person into this psychedelic culture. So if anyone is surrounded by friends, then it's a very strong factor that it might be a good experience. And even for first timers. So it's not about being experienced. It's more like having a strong support. There is no special bias towards first time users? Not especially. First timers are, if they are initiated by friends, then it shouldn't be a special problem because the friends know the dosage. I had a little question on the help kit. The magnesium, why is that inside? Magnesium helps with the muscles. So people usually dance a lot. And the magnesium is helping with the muscles. And it has some placebo effect as well. So people think, oh, I'm taking care of myself by taking magnesium, so I must be fine. So it's like self-dissolving tablets into the water. Hello. Okay, thanks. That was amazing. Could you say a little bit about the particular methods you use for timeless long trips and spiritual crises? Not related directly. The timeless long trips are really like when there's an unknown hallucinogen, which is not like the LSD duration of time. The spiritual crisis is not typically related to the longness or the length of the... No, I just mean, what would you actually do to help somebody in that situation? Like somebody feels like, oh, this is never going to stop. Yeah, the spiritual crisis situation is that you ask, that actually we have to rely on the person that it's his or her processing. So we don't want to interfere with any kind of our thoughts that no, no, you're wrong or something like that. So it's more like supportive, and he or she will figure out for herself or himself. So it needs just like ears, we give some ears. And to get rid of the timelessness feeling? Yeah, the timelessness feeling, it's just what I mentioned also that it's the continuous reassurance that yes, I know this feeling, it's because you don't feel your body needs, like you don't have to eat, drink, or pee, pee, so you feel like time is not progressing forward. But after some time, your biological robot will also send some signals, and from that you will feel that, okay, there is time because there are processes going on, and that the kind of naturally resolves the situation. Thank you. Thank you.