Heaven and Hell-A Phenomenological Study of Recreational Use of 4-HO-MET in Sweden

Kjellgren and Soussan situate their study in the context of a growing market for so-called Internet drugs or research chemicals, many of which are synthetic tryptamines and phenethylamines sold legally online and little studied in humans. The authors note that 4-HO-MET (4-hydroxy-N-methyl-N-ethyltryptamine), a synthetic tryptamine first synthesised by Alexander Shulgin and sometimes called metocin, is chemically similar to psilocin and reported anecdotally to produce psychedelic effects. Published scientific information on 4-HO-MET was absent in major databases at the time of the authors' search, leaving a gap in knowledge about its subjective effects, risks and possible therapeutic relevance. This qualitative study therefore aimed to characterise the recreational experience of 4-HO-MET by analysing anonymous trip reports posted on public Internet forums. The investigators sought to describe the phenomenology of intoxication, identify common themes across reports and situate those findings relative to classical psychedelics such as psilocybin and LSD. The study is presented as exploratory and intended to indicate directions for future empirical and clinical research.

The researchers used the Empirical Phenomenological Psychological (EPP) method, an approach rooted in Husserlian phenomenology, to explore and describe subjective experiences without imposing preconceived categories. EPP is intended to make implicit experiential meanings explicit and to capture the structure of participants' lived experiences. Data were gathered from publicly available anonymous trip reports found via Internet searches. An initial Google search and manual searches of major discussion sites (for example Erowid, Bluelight and Flashback) yielded 173 hits for 4-HO-MET experience reports. After excluding reports that described polydrug use, duplicates and reports with incomplete or unreadable language, the final sample comprised 25 anonymous reports published on the Swedish forum www.flashback.org, totalling 82 pages of text. The reports typically included dose, age and sex information. Demographic and substance-use details extracted from the reports were: 25 authors (23 men, two women), ages 18–30 years (median 22), oral administration in 21 cases and nasal in three, with reported doses between 20 mg and 180 mg and modal reports around 25 mg; two reports lacked dose information. Analysis followed Karlsson's five-step EPP procedure. Step 1 involved repeated reading of the reports to gain an overall sense. Step 2 segmented the texts into 501 meaning units. Step 3 transformed those meaning units into researcher language using everyday terms. Step 4 grouped transformed units into 37 categories described by synopses. Step 5 raised abstraction to nine general themes. To assess reliability the Norlander Credibility Test (NCT) was applied: ten categories were randomly selected and five transformed meaning units per category were reassigned independently by two assessors, producing 96% agreement for each assessor. The authors report following EPP stages strictly to support validity.

The phenomenological analysis yielded 501 meaning units, organised into 37 categories and summarised under nine overarching themes: (1) motivation, preparation and expectation; (2) initial effects; (3) change of perception; (4) unfiltered awareness and intensified flow of information; (5) lateral cognition; (6) blurred boundary between subject and object; (7) heaven; (8) hell; and (9) subsiding effects. From these themes the investigators derived a temporal model called "The Process," describing a typical chronology of intoxication. Motivation, preparation and expectation: Report authors generally framed their use as recreational curiosity and a wish to explore non-ordinary states. Most participants sought information or discussed effects with peers beforehand, and many emphasised the importance of structure and a secure setting, although a few undertook ingestion without preparatory steps. Initial effects: Early somatic effects commonly reported were tingling, reduced motor coordination, chills, heat sensations, lassitude and increased heart rate, followed by vague feelings of difference, restlessness and heightened mental activation. Change of perception: Visual changes progressed from altered sharpness, contrast and colour to wave-like distortions, simple and later complex closed‑eye patterns, and finally vivid imagery with open eyes. Auditory changes included transient ringing and distortions, while gustatory experiences deepened and elicited novel associations. Synaesthesia was reported. Participants described impairments in ordinary perceptions of time, distance and depth. The authors emphasise that these perceptual phenomena closely resembled accounts of classic psychedelics such as psilocybin and LSD. Unfiltered awareness and intensified flow of information: Many reports described an overwhelming, uncontrollable influx of perceptions, thoughts and feelings leading to distractibility, concentration problems and memory lapses. Some participants also reported an intense here‑and‑now awareness that felt positive and mindful and could counterbalance difficult periods. Lateral cognition: Participants described shifts from linear, logical thinking toward creative, associative and non-linear thought processes, yielding new perspectives, insights about personal psychological patterns and pronounced philosophical or existential reflection. Blurred subject–object border: Accounts frequently reported dissolution of the usual boundary between inner experience and external reality. Music and social interactions had amplified effects, body image was altered (including out‑of‑body sensations), and some individuals experienced full identification with internal worlds or a sense of unity with everything. Heaven: Positive, harmonious states were common, including euphoria, elation, effortless pleasure, intense laughter, and feelings of universal love or deep affection. Hell: Discordant experiences involved anxiety, panic, loss of control, paranoia and intense somatic symptoms (heat, sweating, tachycardia). Attempts to resist the experience often worsened distress; effective coping strategies reported included acceptance, resting and seeking social support. The authors note that such acute distress raises practical safety concerns, especially for unprepared users. Subsiding effects: As effects faded participants described progressive restoration to ordinary states; many felt relief, while some reported post‑experience sadness, emptiness, headaches, fatigue and insomnia lasting up to three days. A process of retrospective integration was common and many participants expressed satisfaction and willingness to repeat the experience, regardless of having had both "heaven" and "hell" phases. The Process: Synthesising temporal aspects, the authors present a model beginning with curiosity and anticipation, through initial somatic changes, to fully developed psychedelic phenomena that can alternate between ecstatic and distressing states. The reports often lacked certainty about dose and purity, and many experiences occurred without supervision or harm‑reduction guidance. The authors also note an absence of documented injuries attributed to 4‑HO‑MET in their knowledge base but caution that risks of hazardous behaviour during intense intoxication remain.

Kjellgren and colleagues interpret the findings as indicating that 4‑HO‑MET produces subjective effects highly similar to classic psychedelics such as psilocin and psilocybin, encompassing profound perceptual alterations, shifts in cognition, experiences of unity, intense positive affect and periods of acute anxiety or terror. They emphasise that motivation for use in the sampled reports appeared mainly curiosity‑driven, with many users prepared to accept both positive and negative aspects of the experience. The authors position these results relative to earlier research on psychedelics, noting convergence with known phenomena such as reduced psychological defence, enhanced suggestibility, synaesthesia, and the potential for insight or therapeutic processes under controlled conditions. They highlight practical safety concerns: inexperienced or unprepared users face greater risk of hazardous behaviour during intense distress, and the Internet market makes these substances readily available without standardised dosing, purity information or harm‑reduction guidance. Key limitations acknowledged by the authors include the anonymity of reports, inability to verify that 4‑HO‑MET was actually ingested, lack of follow‑up, unclear generalisability and the impossibility of confirming the veracity of accounts. The study sample was restricted to publicly posted reports on a single Swedish forum and therefore cannot be taken as representative of broader populations. Implications and suggestions for further work stated by the authors include the need for international comparative prevalence studies, systematic toxicological and dependency research, documentation of acute injuries or accidents, and exploration of possible therapeutic potential given pharmacological similarity to substances that have shown clinical promise. The authors also reflect on sociocultural dynamics that might explain the apparent prominence of 4‑HO‑MET reports from Sweden, including restricted access to illegal psychedelics and cultural tendencies toward anonymous online discussion. Overall, they present this study as an initial phenomenological mapping intended to inform subsequent empirical and clinical investigations.