{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:05:15Z","timestamp":1790661915614,"version":"4.1.0"},"reference-count":96,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p>Psychedelic and other psychoactive substance use is increasing in non-clinical environments, including music festivals, concerts, and other large-scale gatherings. As psychedelic use expands beyond clinical settings, policymakers, healthcare systems, event operators, and researchers require evidence-informed frameworks for understanding and responding to psychoactive-related distress in naturalistic environments. Despite the growing presence of psychedelic harm reduction services, few studies have established reproducible methods for documenting their operation, coordination with event-health services, or role within triage and escalation pathways in naturalistic settings. This methodological paper proposes an evaluation framework for psychedelic harm reduction services and reports a formative mixed-methods field application involving the Zendo Project at two large-scale events. Nineteen pre-event surveys, five retained post-event surveys, and two matched pre\/post records were obtained from medical personnel. Quantitative responses were summarized descriptively, while open-ended responses were used formatively to contextualize and refine the proposed measurement domains. The framework positions psychedelic peer support as a complementary intermediate pathway for medically stable but psychologically distressed individuals, operating alongside rather than in place of medical and public-safety services. The field application identified interpretable measurement domains concerning psychological-distress burden, preparedness, workload, safety, interprofessional coordination, escalation, and attendee disposition. Four respondents completed several principal post-event items and reported favorable perceptions of Zendo's operational role. These responses represent staff perceptions and counterfactual estimates rather than independently verified effects. Beyond evaluating a single intervention, this study offers an initial framework for measuring and comparing non-clinical psychedelic support models and for informing future research, policy development, and event-health infrastructure as psychedelic use continues to expand beyond clinical settings. Additionally, by translating field-based psychedelic support into measurable operational, public health, and economic outcomes, the proposed methodology offers a foundation for the future evaluation, comparison, and development of products, services, and care infrastructures designed to support altered-state experiences in non-clinical environments.<\/jats:p>","DOI":"10.3389\/fpubh.2026.1927839","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:46:48Z","timestamp":1790660808000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Designing evaluation infrastructure for psychedelic harm reduction at events: a methodological framework with formative mixed-methods field application"],"prefix":"10.3389","volume":"14","author":[{"given":"Nima","family":"Veiseh","sequence":"first","affiliation":[{"name":"Zendo Project","place":["Grass Valley, CA, United States"]},{"name":"Walden 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