Could LSD be the right prescription for the terminally ill? | Hacker News Reader

Could LSD be the right prescription for the terminally ill?

thedailybeast.com

64 pointsadam73 comments

I've been microdosing and taking full trips upwards of 300ug over the last year and turned my life around. I've been able to conquer my inner demons , learn to love development again and break ground on personal motivation and roadblocks and problem solving.

I was prescribed vyvanse and tried modafinil for a while and found they harmed more than helped in the long run , based all around getting me to enjoy mundane tasks rather than chase the excitement of challenges that acid gives me

> I was prescribed vyvanse and found they harmed more than helped in the long run

Care to elaborate? I was prescribed Ritalin and wondering about the long-term effects. Peter Breggin[0] who is a known critic of psychiatric meds quoted some research going as far to suggest them lowering IQ in long-term use.

[0] https://en.wikipedia.org/wiki/Peter_Breggin

Vyvanse, to put simply, causes your liver to synthesize dextroamohetamine (75% of adderalls active ingredients). Its effects on your body are similar to adderall. Levoamphetamine, 25% of adderalls active ingredients (what causes adderalls body high), supposedly has neurotoxic effects on the brain, lending some credence to that author's claim. Basically these amphetamines cause your brain to eject dopamine. This is contrasted with Ritalin/concerta/cocaine which act as dopamine reuptake inhibitors, preventing your brain from absorbing the dopamine thereby casing it to over produce in order compensate. Based on what I've read reuptake inhibitors aren't neurotoxic, and can actually guard against some of the neurotoxicity of adderall/levoamphetmine.

Just to clarify, you're saying that Vyvanse doesn't have the potentially neurotoxic effects that Adderall has? My doctor prescribed me Vyvanse and anecdotally it seems to be the preferred treatment for ADD these days.

How do you know that the acid is pure? How do mitigate the worry about impurities like the now rampant fentanyl introduced into other illicit drugs? Not saying that fentanyl is likely to be mixed with lsd just citing an example

TL;DR: Buy an Erlich Reagent test kit, they're $20 or so and could save your life. https://dancesafe.org/product/ehrlichs-reagent-testing-kit/

Long Version: So typically it's not really "mixing" or "cutting" with LSD. What is most common with LSD is laying 25I-NBOME on a sheet and selling it as LSD. The same is done with DOX and innumerable other research chemicals. These are both relatively untested research chemicals that produce similar effects but have more potential side effects. They use these because you can (kinda) trick someone into thinking they're taking LSD because it is a trippy experience and you're unlikely to think it was not LSD. The issue with these drugs is that they kill people so one ought test their "LSD".

LSD along with DMT and mushrooms is an indole alkaloid which means (roughly) they have a shape that can fit into a serotonin receptor nicely which is what gives you the effect of tripping. So, if we can test for them we can tell if it's really LSD or some shitty analog.

BUT HOW?

Thankfully there exists a test for just this. It's called an Ehrlich reagent test and you can buy one for about $15. https://dancesafe.org/product/ehrlichs-reagent-testing-kit/

To learn more go here: https://www.youtube.com/watch?v=1g0KThAbkjU

Edit: Additionally, buying online helps reduce your chances of getting some shitty research chemical because: 1. A vendor typically shoots for having repeat customers. 2. If you get LSD that is not LSD, you can leave a bad review saying so. But still get a test kit.

How does one go about finding a reputable (and legitimate) online seller?

pls respond. also interested.

So, this is only to explain how to do so in the safest way. This is not to encourage people to do drugs, buying drugs is illegal. First, find a market. There are many lists of markets with reviews. I think the news site deepdotweb (dot) com maintains a good list. Then find a quality vendor. Most markets will keep track of a vendors number of sales and their reviews. The reviews should be 95%+ positive and you should read the bad reviews. In the case of LSD I'd suggest finding a vendor that sells just LSD. These are typically people who are really into LSD not just drug dealers and your interactions with them will tend to be better because they're often (not always) ideologically motivated rather than financially motivated, as such they often have better prices and service. Your prices should fall between $2/tab and $4.5/tab depending on how much you buy.

Warning: Do lookup how illegal possessing LSD is in your area. Often times the laws are somewhat insane (25 years for 1 gram of material including the weight of the tab). While it is very unlikely that anything would happen to you while buying online (it's kinda hard for the post office to detect 100 micrograms embedded in a piece of paper in a paper envelope) and LSD is perhaps one of the safest drugs to buy online. Make yourself aware of the associated risks before doing anything.

You'll have to do a lot of independent research but a good place to start unraveling the thread is the darknet markets subreddit.

The idea that drugs and drug experiences are so bad that they should be denied to all, and even the dieing should only be bludgeoned out of their pain with opiates, is one I find fairly disgusting.

There is a cornucopia of mental states to be experienced. If LSD and/or psilocybin offer lasting relief from the terror and darkness of imminent death, they should be embraced openly. As should any and all other drugs that may ease someone's passing.

I think using hallucinogens and other drugs is absolutely what we should be giving to those who are terminally ill. Doping them all up so they just sit around drooling is inhumane. This may sound way out of the bounds of normalcy, but I think cannabis should be provided to everyone in a nursing home. Dying, and waiting to die, for all things considered, seem like a very painful, depressing, stressful process. Anything that can be done to let terminally ill patients float off into the afterlife in peace and without pain is a good thing, and anything we can do to improve end of life care we should consider.

But doping them up might be the only answer to the pain. LSD is not a day to day drug than can help with pain or feeling ill from chemo.

Having watched somebody die miserably over weeks in a hospital hooked up to machines and being treated like an object I think being drugged up is vastly preferable. There was almost no warmth or comfort in the process.

I remember watching a Canadian movie about a father dieing from cancer and the children buying him heroine. In the end they all got together and he overdosed and died in peace. Seems like a good way to go out out.

Obviously I don't know how I would really respond in that situation.

That's basically what hospice care is. Give patients opiates until their heart stops.

It's worth noting that there is a risk here. LSD can put you in a mental state prime for significant changes to your psyche - in either direction. It's vitally important that the right scenario be crafted or the trip could spiral into a tramautic experience, especially if they have a terminal illness to dwell on during the trip. LSD is an amazing drug with potential to help people, but let's not forget that it can be dangerous and administer it carefully.

> let's not forget that it can be dangerous

I don't agree that it's that dangerous for the average person to take, but I agree that, for someone who is already dealing with a very stressful scenario (like a terminal patient), lots of caution is warranted.

I think it also depends on the dose. I've heard microdosing is very different.

Microdosing is just under the threshold so my guess is that it actually does not have any effect at all and instead just a powerful placebo feeling.

That or that people are not microdosing at all so they are getting enough to start tripping lightly, experiencing some energy and euphoria.

Effects before they are epi-apparent. I think the effects are definitely measurable on a neurotransmitter level, but not so much on a sensory level.

There are doses between microdose and tripping balls. The patients can begin at a small dosage, and slowly ramp up as they become more familiar with the drug.

I'm not sure starting small is a good idea for beginners, nor how researchers and therapists approach this. More often than not, small doses tend to create anxiety without any real breakthrough in experience.

I think it's person-to-person. More research would be nice (!!!)

Interesting, this idea seems antithetical to my personal experiences (not that that has any impact on objective truth). I also find this odd given that when LSD was legal and used in conjunction with talk therapy (to arguably great effect) patients were given doses of about 25 ug (1/4th of an average lowish dose).

I mean if you're already planning on giving a terminally ill person LSD, why not slip them some MDMA, benzodiazepines, and opiates, too?

You're getting downvoted but when I do psychedelics I take a small dose of opiates to ensure it doesn't spiral into fear and paranoia. If the goal of theraputic use of psychedelics is to create a deeply seated positive experience, I don't see why mixing a little bit of warm fuzzies into it would be determental.

Opiates are highly addictive. Want a warm fuzzy experience? Mesc. Want a theraputic experience? Mdma. Opiates are playing with fire though.

I'm only using opiates as an example. In my experience no psychoactive drug has the exact same effect on different people.

>I mean if you're already planning on giving a terminally ill person LSD, why not slip them some MDMA, benzodiazepines, and opiates, too?

we do give many terminally ill people opiates, a lot and of very strong opiates. What do you think fentanyl is? An illegal drug to cut heroine? No. It is a very powerful medical drug prescribed to cancer patients in particular (especially toward the end when less powerful opiates start to be not enough - IANAD, just common knowledge)

When I was a teenager my friends and I took LSD one night and one of the group took twice as much as everyone else and had a full blown psychotic episode, running around the house breaking things and screaming that he was going to kill me. He got off easy; he didn't remember any of it. The rest of us had serious PTSD. For two years after that every time I heard someone yell my pulse would accelerate and my palms would sweat. I don't bring this up to say that LSD is inherently dangerous, just that it peels back all of the defensive layers of abstraction that you live in day to day, so anything that happens to you in that state can have serious and long lasting consequences (good and bad).

I've touched on it on HN before but I also had a very, very bad trip once. It wasn't the first bad trip but it was the worst and one of the worst I've heard from people who I've shared the experience with. Out of the dozens or more positive experiences I had, it was enough to turn me off of psychedelics and drugs in general for, so far, the rest of my life.

I won't get in to the details, but like yourself, it mostly came down to the folks who I was with (who I trusted absolutely prior to this experience). I also had a lot of the blame, because I simply took too much that night. It took me years to fully recover my personality. To me, it is very dangerous, indeed, to suggest that nothing bad can come from psychedelic experimentation.

> I also had a lot of the blame, because I simply took too much that night

How much did you take?

Over an eighth, less than a quarter, and it had been months since my previous mushroom (or acid, for that matter) trip.

There is existing clinical evidence that Psilocybin is helpful for treating anxiety and depression in cancer patients.

https://www.theatlantic.com/health/archive/2016/12/the-life-...

and according to the government who keeps it on the Schedule I, there is basically nothing bad about Psilocybin :

https://www.justice.gov/archive/ndic/pubs6/6038/#risks

Compare the "risks" listed there with side effects of a typical OTC medicine, not even mentioning any serious medical drug. One can only wonder why it is on the Schedule I. Is there something bad about Psilocybin what government hides from us? :)

The annual Global Drug Survey has repeatedly found mushrooms containing Psilocybin to be much, much safer than alcohol.

https://www.theguardian.com/society/2017/may/23/study-halluc...

Maybe rather than prescribing xor proscribing, the answer is to simply stop stymieing individuals from figuring out what works for themselves.

I don't get why he compares opiates and LSD as LSD would not replace the opiates here at all.

Not to forget the wonderful contributions to the field by Joan Halifax and Stanislav Grof!

Stanislav Grof, really? The crank psychoanalyst whose therapeutic ideas are based on summoning and coming to terms with false memories of birth and whatnot?

Imagine a world where a terminally ill patient has a dedicated medical practitioner. Now imagine that practitioner is also a psychedelic shaman who guides a patient through twelve hours of intense LSD-induced hallucinations.

Now imagine that you are the owner of this bridge I am selling, for a very reasonable price.

The key is this: Substances such as LSD, psilocybin or DMT can put the brain into a special mode of functioning which can in turn enable capacities which can be described as "psychic" in certain circumstances (this is also linked to the "mystical experience" which is often mentioned by users). These experiences make people aware of the fact that there is a whole invisible world (or spiritual dimension) which has nothing to do with our material experience. This understanding leads to a much higher degree of freedom for the person experiencing all of this. For obvious reasons, such a person can be much less manipulated by negative emotions such as greed, hatred and fear. It leads to less war and less consumerism. But both of these components make up big parts of the US economy, which represents a small percentage of very wealthy people who are afraid of losing their dominance. This is probably the most important reason why these substances which have so much potential have been suppressed for so long, without real and valid justification.

It also makes you prone to believe in absurd conspiracies, it appears.

I mean I don't buy into the whole other mystical world spiritual plane nonsense myself, but can you think of a more compelling explanation for why psychedelic drugs are illegal?

Because they impair your ability to function and can lead to long term psychological problems?

To play devil's advocate, they clearly have potential for therapeutic use in a medical setting. It's a shame there are so many hurdles in the way.

Boy, I sure am glad alcohol is illegal.

The rejoinder to that argument is "two wrongs don't make a right" or generally that you can't justify allowing some bad thing because some other similar bad thing is allowed. It's a form of whataboutism.

Sure, it may make no sense that alcohol and tobacco are legal but weed and mushrooms aren't. They're all natural substances, they are all mood altering, they are all capable of being enjoyed in moderation and also can cause harm if used in excess.

But though alcohol and tobacco are legal, for whatever good or not good reasons, that isn't a logical argument for making more intoxicants legal.

> that isn't a logical argument for making more intoxicants legal.

"Alcohol is legal, therefore anything less harmful than that should also be legal" isn't a logical argument?

Not if you believe that alcohol being legal is already wrong but are pragmatic about its pre-existing hold on society making it impossible to change.

To be clear I don’t buy this argument since I disagree with the premise, but if you agree with the premise then it does make sense.

Pre-existing hold plus the ingredients required to create ethanol (sugar, water, airborne or fruit or baking yeast, warmth) are legal and ubiquitous.

There isn't really a clear line that goes "you need to be less than THIS risky to be legal". We're comparing things with each other and kind of classifying them based on that. Alcohol and guns being legal definitely should move that line down, because it shows that, as a society, we're okay with some more risky things because <reasons>.

It ignores the historical context behind controlled substance regulation, and also substitutes first-principles message board reasoning for empiricism. So, that's not quite the rhetorical kill-shot you're hoping for.

I wasn't hoping for a kill shot, but that's beside the point. How would you argue for or against the legalization of something without comparing it to other things?

A case for prohibition of both alcohol and hallucinogens can be rational, but for the popularity of alcohol making it untenable to enforce that prohibition. In that set of circumstances, a prohibition targeting hallucinogens alone can still be rational even if the harm from alcohol is comparable.

The point, of course, is that comparable harm from alcohol is not dispositive in the discussion of a ban on hallucinogens.

Obviously, the notion that LSD is no more harmful than whiskey is also not broadly accepted in our public policy, or really the public policy of most western countries. So there's (at least) two hurdles for your argument to clear. But I'm stipulating the latter argument, because it's the logic you're employing that bugs me, not the equivalence you're trying to draw.

These are positive arguments, not normative ones.

What if alcohol is legal at the moment, but society is making it less and less legal, possibly outlawing it in far future?

You have it backwards - there needs to be a coherent argument to keep them illegal in a free society.

When you are saying you will take someone's freedom, their employment prospects, their whole life away because of possession of a substance, you need to be able to justify what you're doing, and to show how the action you are taking to suppress the substance is not causing much more harm.

Look at the war on drugs - that argument has been resoundingly lost. States and countries are starting to realise it.

I enjoy wine, cocktails, and beer occasionally, but alcohol has completely destroyed the lives of several people close to me. I would give up my right to it if that reduced the number of people in the future who would otherwise suffer a similar fate.

I wonder why drugs like this aren't more popular: http://content.time.com/time/health/article/0,8599,1913016,0...

It's been grandfathered. If alcohol was discovered today it would be illegal.

That is not a unique attribute however.

I buy into the spiritual plane stuff easier than the “kept illegal by people who profit from war and consumerism” stuff. If it were the magic the OP implied, those folks would profit off of it too, were they so ingenious. But they aren’t. It’s illegal because it has been illegal and because it’s reasonable to discourage embracing hallucination in civil society.

> there is a whole invisible world (or spiritual dimension) which has nothing to do with our material experience

More likely most of us don't understand the connection between the material world and these dimensions, and whether they truly are separate or not.

Right off the bat, I don't mean to be overly critical but greed is an attitude not an emotion.

Also there's no such thing as a negative emotion. Everything we feel is a necessary (or at least programmed) reaction to our experience.

Also emotions aren't things with sentience that can manipulate you. Either you are at peace with them and rational in how you live them out, or you are not.

I hope I don't come accross as pedantic or condescending, I truly do think we dramatize certain aspects of our psyches that would otherwise be healthier.

(I don't know anything about LSD but I still feel that you're romanticizing it a bit.)

This looks like a band-aid solution on problems we created ourselves. I was reading quite a bit on this subject and it looks like humans were much more at peace with death a century or two ago. Without using LSDs or whatever.

We as a society have changed so much since then. We either need to undo some changes or work out new ways to get along with death. On the other hand, band-aids may be good as temporary solution. But it's definitely not "the right prescription"...

I should do more research on the subject of social attitudes toward death throughout History. I think you may be right that it helps explain a lot of our less healthy (or more controversial*) habits. It's possible though that life itself feels much more oppressive; though it most likely isn't, our subjective experiences are often extremely alienating and their purpose very abstract (compared to say, plowing fields).

The major change is your average citizen no longer sees death. Not so long ago, death was everyday occurrence. Elders or sick ones dying at home. Some of siblings dying at young age. Wars sweeping by and leaving a trail of corpses. Now people not only die less frequently, but they usually die away in hospitals.

The other change expectations of continuity. All religions have some sort of explanation for death. Whatever the explanation was, one of the reasons was to comfort people. Meanwhile today's popular explanation is void.

Of course people are scared of unknown emptiness. Both the process and what comes after that are totally unknown today, while they were rather clear not so long ago.

>Also there's no such thing as a negative emotion. Everything we feel is a necessary (or at least programmed) reaction to our experience.

Have you ever met someone with emotional issues, i.e. anger management issues? There are indeed many people with habitual "programmed" emotional responses which are detrimental to their well being and are extremely difficult to manage.

You might like to read the works of the evolutionary pyschologist and athropologist Dr. Paul Eckman. He posits that emotions are valuable life saving forces that help us act quickly in critical situations without having to think. However, our emotional habits have also evolved over many thousands of years, and so many of the emotional responses which may have saved our life as a paleolithic hunter gatherers may no longer be relevant and can have the opposite effect in a civilized society.

Nowadays I'm back in university, studying psychology (I just started).

As far as I know, the problem with anger management is not the anger itself, it's how you deal with it so it doesn't overwhelm you, and so you can have less of it. What I mean is that it's a symptom, not the issue itself. It's normal to be angry when someone is a jerk to you, it's healthy even, and so it's not* inherently "bad" (as we so often portray anger and sadness). The problem is when you let it get away from you.

I hope I understand correctly that your last paragraph is agreeing with my comment. If not, then I should have extended the notion of "necessary" to "useful", in the sense that you are describing. However the problem with evo psych is that it's largely non-falsifiable. The part you are describing is somewhat an obligatory aspect of evolution, but evo psychologists and anthropologists tend to draw conclusions that aren't rigorous (in my opinion). This is coming from someone who has 30 credits in Anthropology from a few years back :)

Generally there is no harm in theorizing, but I consider psychology and psychotherapy to be too important to allow ourselves to consider untested information. I do agree that other people may find Dr Eckman interesting... I don't but others might ;)

>Generally there is no harm in theorizing, but I consider psychology and psychotherapy to be too important to allow ourselves to consider untested information.

Psychology and psychotherapy are almost wholly theoretical, subjective, soft sciences, rather than objectively testable hard sciences like physics and biology.

>psychiatric diagnosis still relies exclusively on fallible subjective judgments rather than objective biological tests".[1][2]

-Allen Frances

https://en.m.wikipedia.org/wiki/Allen_Frances

*Psychology and psychiatry I meant to say

What do you think schizophrenia is?

How will the world change when everyone takes acid?

I've been trying to get a straight answer to this for years.

Now don't get me wrong, I'm very pro legalisation of the less harmful drugs, and decriminalisation and management of the addictive nasties. And I'm not short on psychedelic experience either. But I don't get it. Personal growth I can see, short and long term changes in ones relationship with oneself, absolutely but... what does society look like?

It's not like we don't already know the people in charge are crooks and bullies, how does LSD, DMT or psilocybin change this? I know a lot of folks who have indulged at points in their lives and all are fairly successful capitalists these days.

(Oh and the whole "spiritual dimension" must have passed me by. I'm pretty sure that these substances can induce a sense of the profound, but I'm a lot less sure there's anything beyond that sense)

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