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Comment by dawhizkid | Hacker News Reader

As soon as I can I will invest all my money in companies productizing therapeutic psychedelics...

It's sure to be a money loser compared to other addictive psychiatric drugs which are taken daily as a maintenance to the problem. Drugs like DMT should only be taken once in a blue moon, are not addictive, and are extremely cheap to produce.

The comment you replied to is basically advocating for the productization of therapy (using psychedics), not for the drugs.

You do make a great point though. Kind of like what a Goldman Sachs analyst recently said: "Is curing patients a sustainable business model?" Much better to keep them a little bit sick and dependent on your product.

Ideally competition would result in another player coming in and producing the cure. Since the non-cure treatment is already dominated by another player, you could make some money curing people versus no money trying to develop another non-cure to compete with an established player.

But in the real actual world that we all actually live in, such a company would quickly get snatched up and bought by the competitor before the general release of the drug or a captured government agency would get lobbied to put controls on who can produce and distribute the drug.

Monopolies don't sit idly by when disrupters come to town, they buy or kill them.

The competition model assumes business people act like victorians who play by the rules to be sporty. It almost never works like that. Dirty tricks and shenanigans are widely deployed.

What will be done about this situation?

It's easy to be cynical and think this (and not without some good reason) but we have a lot of examples of drugs that are absolute cures. Antibiotics come to mind, as well as vaccines (preemptive cure). I'm sure there are other examples.

Doctors for the most part actually do want to cure patients, not maintain them in sickness even if it would make them more money.

>Doctors for the most part actually do want to cure patients, not maintain them in sickness even if it would make them more money.

True, but corporate executives have the primary goal of making money for stockholders, and they often have far more leverage than lowly doctors because they determine who gets the money.

Which psychiatric drug is addictive ?

Xanax is one. Many anti depressants can have severe withdrawal effects as well, though I suppose that is more indicative of dependency rather than addiction.

Yes, but xanax is only used short term I think.

Withdrawal isn't the same as addicting, no ?

Wrong again, Xanax is prescribed for years at a time. Many people go decades taking a few mg of Xanax a day.

In the US.

In eg the UK it's somewhat difficult to get xanax, but similar meds should only be used short term.

https://bnf.nice.org.uk/drug/alprazolam.html

> Avoid prolonged use (and abrupt withdrawal thereafter); debilitated patients (reduce dose) (in adults); elderly (reduce dose) (in adults); history of alcohol dependence or abuse; history of drug dependence or abuse; myasthenia gravis; personality disorder (within the fearful group—dependent, avoidant, obsessive-compulsive) may increase risk of dependence; respiratory disease

https://www.nice.org.uk/guidance/qs53/chapter/Quality-statem...

> NICE guidance provides recommendations on pharmacological therapies for anxiety disorders. Benzodiazepines are associated with tolerance and dependence, and antipsychotics are associated with a number of adverse effects. Therefore they should not be used routinely to treat anxiety disorders.

> Healthcare professionals should be aware of circumstances in which benzodiazepines and antipsychotics may be appropriate, such as short-term care and anxiety disorder crises.

Here's a website showing that alprazolam is not prescribed in the community:

https://openprescribing.net/analyse/#org=CCG&numIds=0401020A...

I've been on Xaxax 9 years, without it, I would be dead. I only take it infrequently though (10-15 days a month ?) so I can't comment on everyday usage and increasing tolerance. It does bother me quite a bit that my doctor only lets me be a functional human being approximately half the month, but, I'll take what little solace I can get. On higher regular (everyday) dosages seizure and even possibly death is a real possibility if you go into withdrawal, so I suppose I see where people are coming from. It doesn't make me feel any better the rest of the month though....

I suppose that's why I am so interested in these one and done kind of drugs, who wants to take a pill every day just to feel normal ? Nobody. I think the new study of these psychedelics (mdma therapy, psilocybin (especially), ketamine, dmt and their derivatives) really needs to be looked into so people can break the chains of the other medication they are on and live full happy lives.

You can change doctor and represent your case for a better outcome. And then change it again.

Is it the "feeling" that you take pills ? Everyone wants to take-pill-get-fixed with no side-effects for every disease.

My guess is that they're referring to the part where you can't just stop taking them cold turkey without a spectrum of bad things happening to you. It's a slow slow taper process.

That's not addicting. And kinda makes sense to tapper off (with many types of drugs).

No, I agree. I think "physical dependence" would be a much better word. People don't keep taking Zoloft because they want the next hit.

Funny you say this, because I moved, I've been out of my SNRI, and only took two in the last seven days. Last night I felt like a drug addict, I need to take it or I'll have withdrawals.

The sucky part is the withdrawals won't go away for several days at least....

If it's an instant-release, you can lower the dose little by little.

I mean more so that now that I'm back on my medicine, it's going to be a bit before I'm back at it's full effect.

Pretty much every SSRI (the most commonly used class of psychiatric drug? Not completely sure) has really nasty withdrawal after only a few weeks

But not addicting, your body/mind doesn't thirst for it.

That is false. Xanax withdrawal is extremely dangerous and suddenly stopping can cause death.

Please google Xanax addiction before posting more nonsense.

Addiction and dependency are two different things.

Addiction is the "thirst", the cravings for a drug/behavior. Addiction can be a form of psychosis. Addiction by itself never kills anyone but drives people to behaviors that can be fatal, such as ignoring the dangers of acquiring the drug.

Dependency is the adjustment of the patient's body to the drug, requiring both higher doses to attain the same result and a maladjusted state when the drug is not taken. Withdrawal is what happens when a person that is dependent on a drug does not get their drug, and in the case of Xanax, could be fatal.

Addiction can cause dependency, and dependency can cause addiction, but they are not the same.

Imo it is just semantics. I, personally, prefer to just separate those as "physical addiction/dependency" vs "psychological addiction/dependency". For example, xanax would qualify as physical, while cannabis as psychological.

P.S. Not trying to say that one can't use cannabis without being addicted, it is absolutely possible. But psychological dependence potential is there. Realistically, almost anything can be psychologically addicting imo

Xanax is not an SSRI but a benzodiazepine.

These are completly different drug classes.

Xanax isn't an SSRI.

Amphetamines (used to treat ADHD and narcolepsy) and Benzodiazepines (used to treat anxiety disorders) are both well-known to be addictive. Benzodiazepines in particular can have fatal withdrawal symptoms if a patient quits them cold turkey.

SSRIs and SNRIs both have horrible withdrawal symptoms and can take months for patients to taper off if they decide to quit or change their meds.

SSRIs and SNRIs do not really meet the threshold for being considered addictive, however, since they do not induce any kind of euorphia, intoxication or immediate relief of depressive/anxious feelings.

Amphetamines and Benzodiazepines have a much higher potential for abuse, which is why prescriptions for them are carefully monitored by drug enforcement agencies.

Most notably you can't patent them

Not sure there's much money to be made there, as many of the psychedelic compounds are both cheap to produce and unpatented.

Look at Ketamine...just make some trivial change with no impact to the active part of the chemical and you can patent it.

Why on earth would someone use an expensive, patent-encumbered drug when there's regular Ketamine that can do the same thing?

It's the racket of big pharma. Ketamine isn't approved for the treatment of depression but Johnson & Johnson's patented Esketamine is. If you want to go the legal route that is your only option.

Depending on how much your insurance plan covers you, as a patient, might only pay a fixed copay with your insurance covering the rest, so you might not actually "feel" the $7k price tag at all.

The real scam that has played out over the last few decades though is that as employer insurance costs rise wage growth has slowed. We've all been paying for rising insurance costs even if we don't necessarily feel it.

It's really a form of regulatory capture and goes way beyond drugs into medical devices, IT systems, etc. The "approved" thing is often a more expensive, less complete/reliable/modern version of something people who aren't subject to regulation can get off the shelf. You can think of it sort of like if car dealerships managed to get a law passed that said you can only service your car at the dealership, and then 10x'd their prices.

Because the penalties for unauthorized possession in the US range from (up to) 6 months to 8 years with fines up to $25,000 varying by state and the only way to acquire it in an authorized manor restricts it's prescribed usage to a narrow scope of conditions, the treatment of depression not included.

Only to promptly lose it when it's blanket-banned because a 15 year old got his hands on some, and then committed suicide in the midst of a paranoid hallucination.

(fwiw I think it should be legal too)

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