References – Altered States

Science evolves faster than culture, and the lessons that harm reduction communities use today did not come from guesswork. It is grounded in biochemistry, clinical research, and years of field-tested experience. This section brings those sources together so you can explore the science for yourself. Each link and citation connects to the studies and data that inform the science behind the book, offering transparency and context for anyone who wants to understand why these choices matter.

Chapter 1: Who Are You?

Carhart-Harris, R. L., & Friston, K. J. (2019). REBUS and the Anarchic Brain: Toward a Unified Model of the Brain Action of Psychedelics. Pharmacological Reviews, 71(3), 316–344. https://doi.org/10.1124/pr.118.017160
→ Describes how psychedelics disrupt the DMN and hierarchical brain processes, producing ego dissolution and altered identity.

Northoff, G., & Bermpohl, F. (2004). Cortical midline structures and the self. Trends in Cognitive Sciences, 8(3), 102–107. https://doi.org/10.1016/j.tics.2004.01.004
→ Supports the notion that “selfhood” is neuroanatomically distributed, especially across midline structures of the brain.

Vollenweider, F. X., & Kometer, M. (2010). The neurobiology of psychedelic drugs: implications for the treatment of mood disorders. Nature Reviews Neuroscience, 11, 642–651. https://doi.org/10.1038/nrn2884
→ Highlights how serotonin (5-HT2A) receptor activation alters thalamocortical information filtering
Mashour, G. A. (2005). Consciousness unbound: toward a paradigm of general anesthesia. Anesthesiology, 102(6), 1101–1110. https://doi.org/10.1097/00000542-200506000-00012
→ Shows how modulating brain connectivity and neurotransmitter balance shifts states of consciousness.

Preller, K. H., & Vollenweider, F. X. (2016). Phenomenology, structure, and dynamic of psychedelic states. Current Topics in Behavioral Neurosciences, 36, 221–256. https://doi.org/10.1007/7854_2016_459
→ Supports how psychedelics modify perception, identity, and memory by disrupting normal integration pathways.

Doss, M. K., Považan, M., Rosenberg, M. D., et al. (2022). Psychedelics flatten the brain’s energy landscape: evidence from receptor-informed network control theory. Nature Communications, 13(1), 7614. https://doi.org/10.1038/s41467-022-35240-5
→ Provides evidence that psychedelics reduce the brain’s energy barriers, allowing greater flexibility in mental states.

Nichols, D. E. (2016). Psychedelics. Pharmacological Reviews, 68(2), 264–355. https://doi.org/10.1124/pr.115.011478
→ A definitive overview of how different psychedelic drugs act on neurotransmitter systems, particularly 5-HT2A and dopamine receptors.
Yaden, D. B., et al. (2021). Psychedelics and consciousness: Distinctions, challenges, and implications. Neuroscience of Consciousness, 2021(1), niab009. https://doi.org/10.1093/nc/niab009
→ Discusses the neurochemical and philosophical aspects of how psychedelics affect consciousness.

Ly, C., et al. (2018). Psychedelics Promote Structural and Functional Neural Plasticity. Cell Reports, 23(11), 3170–3182. https://doi.org/10.1016/j.celrep.2018.05.022
→ Demonstrates how psychedelics promote dendritic growth and synaptic strength

de Vos, C. M. H., et al. (2021). Effect of psychedelic drugs on personality structure and related variables: A systematic review. Neuroscience & Biobehavioral Reviews, 123, 204–228. https://doi.org/10.1016/j.neubiorev.2021.01.048
→ Examines how psychedelic-induced neuroplasticity correlates with changes in personality and identity.

Mishra, B., Khan, F. D., & Tiwari, A. (2025). Computational Attitudes in Counselling Psychology. In Clinical Aspects of Neuropharmacology (Wiley Online Library). Link
→ Supports computational models of neurotransmitter dynamics and their influence on mood and consciousness

Le, P. H., Upshaw, W. C., et al. (2025). Drug-associated delirium: basic pharmacologic principles and clinical considerations. Advances in Health Research. PDF
→ Offers insight into how drugs disrupt consciousness and self-awareness via neurotransmitter interference.

Chapter 2: Set & Setting

Haijen, E. C. H. M., et al. (2018). Predicting responses to psychedelics: a prospective study. Frontiers in Pharmacology, 9, 897. https://doi.org/10.3389/fphar.2018.00897
→ Demonstrates how openness, absorption, and emotional state predict the intensity and positivity of psychedelic experiences.
Studerus, E., Gamma, A., & Vollenweider, F. X. (2012). Prediction of psilocybin response in healthy volunteers. PLoS ONE, 7(2), e30800. https://doi.org/10.1371/journal.pone.0030800
→ Found that baseline personality traits (e.g., openness) and expectations significantly impact the subjective effects of psilocybin.

Hartogsohn, I. (2016). Set and setting, psychedelics and the placebo response: An extrapharmacological perspective on psychopharmacology. Journal of Psychopharmacology, 30(12), 1259–1267. https://doi.org/10.1177/0269881116677852
→ Argues that the psychedelic experience is co-produced by cultural, social, and environmental cues
Kettner, H., Rosas, F. E., Timmermann, C., et al. (2021). Psychedelic communitas: Intersubjective experience during psychedelic group sessions predicts enduring changes in psychological wellbeing and social connectedness. Frontiers in Pharmacology, 12, 623985. https://doi.org/10.3389/fphar.2021.623985
→ Suggests that supportive group settings enhance psychedelic outcomes and long-term mental health.

Labate, B. C., & Cavnar, C. (Eds.). (2014). The Therapeutic Use of Ayahuasca. Springer. https://doi.org/10.1007/978-3-319-03260-2
→ Explores ritual contexts in indigenous and Western settings, confirming that structured ceremonial environments enhance healing.
Dupuis, D. (2022). Psychedelics as tools for belief transmission. Set, setting, and suggestion in the ritual use of hallucinogens. Transcultural Psychiatry, 59(3), 340–357. https://doi.org/10.1177/13634615211036312
→ Shows how set and setting in ritual contexts facilitate the transmission of culturally relevant beliefs during psychedelic experiences.

Kaelen, M., et al. (2018). The hidden therapist: Evidence for a central role of music in psychedelic therapy. Psychopharmacology, 235(2), 505–519. https://doi.org/10.1007/s00213-017-4820-5
→ Music functions as a “nonverbal guide” and modulates emotional trajectory in psychedelic sessions.
Bonny, H. L., & Pahnke, W. N. (1972). The use of music in psychedelic (LSD) psychotherapy. Journal of Music Therapy, 9(2), 64–87. https://doi.org/10.1093/jmt/9.2.64
→ One of the earliest clinical reports on music’s role in therapeutic LSD sessions.

Olson, J. A., Suissa-Rocheleau, L., Lifshitz, M., et al. (2020). Tripping on nothing: Placebo psychedelics and contextual factors. Psychological Consciousness, 7(1), 1–20. https://doi.org/10.1037/cns0000208
→ Demonstrates that placebo psychedelics can induce altered states when set and setting are manipulated.
Van Elk, M., & Yaden, D. B. (2022). Pharmacological and extra-pharmacological factors in psychedelic experiences: A retrospective survey. Frontiers in Psychology, 13, 865960. https://doi.org/10.3389/fpsyg.2022.865960
→ Finds that non-drug factors like intention and atmosphere explain as much variance in outcomes as dose or compound.

Chapter 3: MDMA

Liechti, M. E. (2017).
Modern clinical research on MDMA (Ecstasy).
Pharmacology & Therapeutics, 177, 83–190.
https://doi.org/10.1016/j.pharmthera.2017.03.005
→ Confirms MDMA’s action on serotonin, dopamine, oxytocin, and potential in treating PTSD and anxiety disorders.
Mithoefer, M. C., et al. (2011).
The safety and efficacy of ±3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant PTSD.
Journal of Psychopharmacology, 25(4), 439–452.
https://doi.org/10.1177/0269881110378371
→ Landmark MAPS-sponsored study showing significant symptom reduction.
Doblin, R. (2002).
A Clinical Plan for MDMA (Ecstasy) in the Treatment of Post-Traumatic Stress Disorder (PTSD): Partnering with the FDA.
Journal of Psychoactive Drugs, 34(2), 185–194.
https://doi.org/10.1080/02791072.2002.10399958
→ Foundational MAPS document outlining the clinical roadmap.
Parrott, A. C. (2013).
Human psychobiology of MDMA or ‘Ecstasy’: An overview of 25 years of empirical research.
Human Psychopharmacology: Clinical and Experimental, 28(4), 289–307.
https://doi.org/10.1002/hup.2318
→ Extensive review of neurotoxicity, long-term effects, and serotonin system changes.
Hysek, C. M., et al. (2012).
MDMA enhances emotional empathy and prosocial behavior.
Social Cognitive and Affective Neuroscience, 9(11), 1645–1652.
https://doi.org/10.1093/scan/nst161
→ Validates the “empathogen” classification with behavioral neuroscience data.
Danforth, A. L., et al. (2016).
Reduction in social anxiety after MDMA-assisted psychotherapy with autistic adults: a randomized, double-blind, placebo-controlled pilot study.
Journal of Psychopharmacology, 30(6), 556–570.
https://doi.org/10.1177/0269881116642532
→ Expands MDMA’s potential beyond PTSD to social anxiety in autism spectrum.
Sessa, B. (2017).
Why MDMA therapy for alcohol use disorder?
Neuropharmacology, 142, 83–88.
https://doi.org/10.1016/j.neuropharm.2017.03.011
→ Suggests MDMA-assisted therapy as a disruptor for addiction treatment models.
Grob, C. S., et al. (1996).
Psychobiologic effects of 3,4-methylenedioxymethamphetamine in humans: Methodological considerations and preliminary observations.
Behavioral and Brain Sciences, 20(4), 597–607.
https://doi.org/10.1017/S0140525X00037842
→ Early, careful human studies supporting methodological rigor in MDMA trials.
Karageorgiou, J., & Milani, R. (2021).
MDMA-assisted psychotherapy: A systematic review of neurobiological mechanisms and therapeutic effects.
Frontiers in Psychiatry, 12, 710273.
https://doi.org/10.3389/fpsyt.2021.710273
→ Neuroimaging and mechanistic evidence supporting therapeutic use.
Nichols, D. E. (1986).
Differences between the mechanisms of action of MDMA, MDA, and related substances.
Pharmacology Biochemistry and Behavior, 24(3), 389–399.
https://doi.org/10.1016/0091-3057(86)90550-9
→ Biochemical basis for empathogenic and stimulant properties.

More coming soon!