As far as the risks, I have a friend who's been "microdosing" acid and shrooms for a while, and recently had a legitimate psychotic break, thinking all of her life-long friends were in some kind of Truman Show-esque grand conspiracy against her. She ditched town and cut us all off for over a month.

I can't say the drug use caused it, but I and the rest of her friends are of the opinion that it contributed (we all have experience with psychedelics, mostly in our younger days). We know that the microdosing also turned into macrodosing on a lot of occasions. She's in a group of friends who follow Phish around, and it's basically part of their identity.

She's doing better now, but still thinks she's in some kind of a stimulation, and has described feeling like she's on a never-ending acid trip. She's always been one of my most solid friends, and this came completely out of left field.

We can't get her to see any psychiatrists who would want to put her on anti-psychotics (which is basically all of them). So we just tell her we love her, and try to convince her that if this is all a big simulation, we're not in on it either.