There are a couple.

A major one is the increasing prevalence of harmful adulterants like fentanyl in the underground drug supply. Though fentanyl specifically still doesn't show up in psychedelics sold in underground markets *that* often, there have been some reports of it showing up in ketamine, and given the way fentanyl has crept into many other drugs (heroin, methamphetamine, cocaine), we have concerns that this could continue further into the psychedelic market as well.

- Another issue is people not knowing how to dose themselves correctly, which is one of the things we cover exhaustively in our new masterclass. Being too high to drive or safely navigate public space carries a safety risk both to yourself and to others

- A very small but reliable percentage of people who take psychedelics will experience some kind of psychotic episode or become erratic, which can lead to unpredictable and risky behaviors that can affect their health and safety, as well as that of those around them. (As another example, one of us had a friend in college who was triggered into a major bipolar episode resulting from psychedelic use who impulsively decided to take a late-night bike ride to another state and was hit by a car.)

- There's also a possibility that more people experiencing psycho-emotional crises on psychedelics could check themselves into emergency rooms when they don't need medical attention, taking staff resources away from people in more urgent medical need.

How likely are these things? Hard to say. What we do know is that all of these things happen a little bit already and are statistically likely to happen to more people as more people start taking psychedelics without proper safety education.