The Law Isn't Ready for Psychedelic Medicine | Hacker News Reader

The Law Isn't Ready for Psychedelic Medicine

blogs.scientificamerican.com

78 pointsElof90 comments

I frequent other message boards in which people share their stories about using drugs. One story I read a while ago was from a "newbie" (novice?) sharing his experience taking LSD. First he got some nice hallucinations but then he took a knife from his kitchen and started carving up his arm. Which, of course, meant he lost lots of blood and had to go to the hospital.

Anyways, the point, for me, wasn't the story itself but how the more experienced drug users reacted. They didn't write "You're lying! LSD is a mellow drug and won't cause you to harm yourself." Nope, nothing of the sort, instead their opinion was that the novice made a "classic rookie mistake" by leaving dangerous items around. One user wrote that before he tripped he always hid all dangerous items as a precaution. What I also read on that message board was that you shouldn't experiment with psychedelia unless you have a stable psyche.

Would a pill with the label "Not to be taken by people with an unstable psyche" or "Possible side effects: Knife carving of muscle tissue by user" pass any regulatory body? I think if such substance came from big pharma most people would be very skeptical.

If this did become used in a medical setting it would only be allowed to be prescribed by a small number of licensed physicians, and only in a specific type of healthcare session.

These types of risks are far less if you imagine taking them in a hospital room with a babysitter, similar to how ecstacy is currently prescribed.

People pull incredibly dumb stuff on alcohol all the time. No one cares, no warning labels "don't do alcohol when you're prone to being an aggressive douchebag" on alcohol, nothing.

Basic drug education in schools would prevent many of these issues. Stuff like "what are the effects/risks of various popular drugs", "always have someone sober as a tripsitter", "call an ambulance when someone overdoses, there are Good Samaritan laws"... but no, schools worldwide rather teach/preach abstinence and kids end up fucked, because from where should they know if their parents are not 60s hippie kids?

Seriously. This is the "anti-drug" argument I just don't get how people fall for. An acquaintance-of-a-friend dropped and then stabbed his roommate 57 times. Of course these stories can readily be found, but they just pale next to the shit drunk people do, and which we just dismiss.

Drunk people decide it's a good idea to get in their car, drive way over the speed limit and kill people all the fucking time and no one bats an eye. They happen simply so often that we have gone to view this as natural part of everyday life. A ten-liner in the local newspaper.

Murders like you described, however, are rare (and tend to be more brutal, which in today's outrage economy means more eyeballs and more ad revenue) so they're often on national or international news.

What's also a part of the difference in media attention: when I drive drunk, veer off course and run over someone, it can and will be excused as "driver lost control due to high speed and alcohol" (=frame-able as if it were an accident), but when I stab someone while high on meth, one cannot frame it as "accident". Stabbing someone is intentional, no matter if on drugs or not, and that makes for a massive difference in perception.

> Would a pill with the label "Not to be taken by people with an unstable psyche" or "Possible side effects: Knife carving of muscle tissue by user" pass any regulatory body?

And yet alcohol kills and maims millions per year. The tool is not dangerous, it is the person who (mis)uses it.

Millions? Citations needed. Assuming this is right in some sense, alcohol has been integrated into functioning civilizations for thousands of years and still causes this kind of damage, where insane garbage like LSD hasn't, and no civilization worth talking about has managed to integrate a psychedelic drug with it and maintain a high level of civilization. And yes, I've tried it, and I've seen what it does to people: nothing positive.

Sure makes people think they're clever though.

https://www.who.int/substance_abuse/publications/global_alco...

Page 14.

Great; some NGO, based on (citations needed) claims millions of premature deaths a year from alcohol, a substance which has been used by humans for at least 30,000 years. I look forward to their detailed report on what the projections are for widespread psychedelic use.

Of course there won't be any. Because psychedelic use is at least at present a useful form of social control. I know a few people who killed themselves drinking and driving, and have a cousin who drank themselves to death. I know dozens, perhaps hundreds of people who have destroyed themselves psychologically using psychedelics. Dead people are tragic. Zombies are worse.

> "Because psychedelic is at least at present a useful form of social control"

Why significantly more so than alcohol?

Different tools have differences though. And some tools harm people more easily than others, independently of the person who uses them.

I don't understand why alcohol has such an important place in some cultures and I find disturbing the degree to which it is associated with social activity. However, I still consider LSD to be a more dangerous drug.

Prohibition is at least part of the problem. Since LSD isn't something anyone with a prescription can wander down to CVS/Walgreens and pick up a known quantity, how much LSD is in a given dose is a mystery until after empirical testing. Imagine if a can of alcohol had an unknown effect until an hour or two after drinking it, with effects ranging from a mild buzz, to being black-out drunk, to alcohol poisoning resulting in hospitalization or death. Every regulatory body would be similarly hesitant to allow it as the situation mentioned here.

And not just that; street LSD is also not unusually mixed with various other compounds

I agree that prohibition does cause a lot of issues.

This makes even less sense since one difference is that there is no equivalent to "alcohol poisoning" with LSD. A dose at which LSD is physically toxic is so high (200 times a recreational dose) that it's incredibly unlikely to take by accident. As far as I know, there are no known overdose deaths due to LSD.

(However, there are analogues to LSD that are toxic: 25I-NBOMe and 25C-NBOMe).

The 25x-NBOMe class of chemicals are not analogues of LSD.

I guess I shouldn't use terms that could also have a precise chemical meaning. My understanding is that they cause similar effects to LSD, but analogue is probably not the right word for it.

All sorts of medical drugs have contraindications- that’s why we have doctors prescribe them in the first place. E.g., you have severe sleep apnea, you shouldn’t use benzodiazepines; if you have bad anxiety you shouldn’t take address; etc etc. LSD will take a bit more diligence (it’s powerful!) but is not qualitatively different in that respect.

I would imagine the hypothetical clinical dose would be lower than the common recreational dose.

I don't think that I have a stable psyche, and I have experimented with psychedelics a lot of times in my life, but I can't imagine doing something like that on LSD or shrooms.

What have most likely had happened is that he was sold some other psychedelic, like NBOMe, or 2CB (which are often more easily available than LSD-25).

So therefore we should imprison everyone that happens to have it on them, use that to bar them from employment for the rest of their lives, remove several of their constitutional rights including voting and discredit everything they say

Okay, chief

I would prefer responsible use, predictable ingredients, supply chain transparency

The US government did spend millions of dollars in psychedelic research before the 70s, I would hope they’ve developed protocols for safe usage at some point. Research from that time certainly could serve as groundwork for valid health treatments if done in an ethical and transparent manner.

The anecdote you describe happened under the illegal black market, where production is unconfirmed and harm reduction is not available as easy.

With decriminalization or even a legal market, that person maybe wouldn't have done it like that. With the black market, and criminality as it is, they probably didn't get the safety information they needed for harm reduction.

One thing is for sure, prohibition creates dangerous production pipelines and enriches cartels/mafias the level of nation states and that makes danger for everyone around.

The warnings on alcohol would be similar to other illegal drugs, alcohol is more toxic and dangerous than most of them. Cannabis, LSD and psilocybin (mushrooms) have the lowest toxicity of any drugs including aspirin, caffeine, nicotine and more. The information about safety and harm reduction would be clearer with a decriminalized or legal market and production would be much better with the latter, ultimately safer.

> With decriminalization or even a legal market, that person maybe wouldn't have done it like that. With the black market, and criminality as it is, they probably didn't get the safety information they needed for harm reduction.

How do you figure that? The mind-altering effects of psychedelia aren't affected by the legality of the substances.

> The warnings on alcohol would be similar to other illegal drugs, alcohol is more toxic and dangerous than most of them.

That may be true but it is also irrelevant in a discussion on how dangerous psychedelia is (it's a form of what-about-ism). Plus, the analogue would be leaving kitchen knives around when drinking alcohol. I have truly never heard anyone call that a "rookie mistake".

To me it seems that users are well aware of the risks involved and when they discuss among themselves they are open about it. But when they are on message boards with "opponents" (like on HN), the tone of the discussion completely changes and risks are being downplayed.

Would a machine that would sometimes (in its infancy) kill you simply by itself be legal? Apparently cars got legal. Why not psychedelics?

Because you're in control of a car as the driver; I'm not sure why you (and others) are drawing out analogies like this. Whataboutism.

Back then cars used to explode uncontrollably.

Even though I don't think the car analogy is a good one, I understand that just the fact that something can harm you doesn't make it inherently bad or unethical to use.

You have enough control of your car to not kill yourself (or anybody else) as long as you drive responsibly, and take precautions. And the vast majority of people need to be teached not just about the technical aspects of driving but also about more common sense issues like why they should use their seatbelt or avoid driving under the effects of drugs, fatigue, etc.

Some people (I guess I include myself here) think that LSD and other drugs can be used responsibly, too. Even though they don't have the obvious practical benefits of a car, the dangers related to their use can be significantly reduced if you take precautions and have an educated perspective. And just as with the car thing, nobody is born knowing how to safely use LSD. You need information, but that information is not readily available to most people at the moment. The internet or anectodical data are not good sources of information for this.

So I guess that it may be a poor analogy, but the idea is that you can reduce the risk of using LSD to acceptable levels just as you can with a car.

Drugs have different effects on different people. This is why mental health is important. We all need to take it seriously rather than entertaining the idea as we have in recent years as something secondary to physical health. A record of mental health for each individual will allow doctors to make informed decisions when prescribing a drug or not.

That's why psychedelics must be regulated and the dosage controlled to observe the effects on the individual. Anecdotes of illegal use/misuse are not useful in determining the common effects of said drug and the general benefits/side-effects.

I'd say a better precaution is to always trip with a trip-sitter - someone sober who can help and guide you if things start to get a bit dark/scary.

I think you've highlighted the one of the primary reasons that prohibition is harmful. If these substances were treated like medicine, studied, and understood then we would all be much safer. Perhaps there is an actual scientific means of determining if someone has an "unstable psyche" before prescribing them the psychedelic (currently hard to discern because of restrictions on research of controlled substances). I'd imagine that if your doctor was thinking about this as a potential treatment for you then they'd want you to experience it there at the office, in the care of trained professionals, to gauge your reaction before sending you off into the unknown.

Also, there are people who would die if they ate a PB&J. The difference is that, with regard to peanut allergies, we have data on how to test patients and how to protect them from exposure. With psychedelics it's either D.A.R.E or some guy on the internet - and the information provided by those sources is so contradictory that you're left rolling the dice.

I'd predict that psychedelics are very safe for almost everyone without a severe pre-existing mental condition (this is my experience as a guy on the internet).

Really?

Psychotic reactions aren't uncommon.

Not to mention insanely complex, unpleasant side effects.

Many anti depressants have a suicide idealization side effect. Ambien has people sleep driving/walking (very dangerous). And alcohol... do we really need to give any explanation there?

It isn't a matter of intensity of issue (given that suicide is generally worse than cutting), and it isn't frequency (since we have many more side effects from legal drugs).

The issue is the media, and the way your mind selects news stories to create the reality you perceive.

Looking at stats and numbers is a great way to overcome this bias.

If psychedelic use becomes more widespread it could lead to a radical change in society the like of which we haven't seen since the 1960's. This is the one slight sliver of hope I'm holding out for the future.

IME and opinion, their potential to elicit empathy and mental growth is overrated, and not imediately related to their antidepressant and trauma integrative effects.

Their effects are largely a result of what you're trying to get out of them, and how earnestly you pursue those ends. People who want those things, and mean it, tend more often to find them, in my own experience.

That hasn't been my experience - either my directly, or in regards to what I've seen in others.

I don't think dueling anecdotes are very useful without some context management. I won't ask after the particulars of your background with this stuff, because that might be asking you to admit to a crime. Please consider reading my reply to a sibling comment of yours for some context on where I'm coming from, if you'd like.

Strictly anecdotal obviously, but having spent a majority of my 20s in and about the Ayahuasca "peace and love let's dance with flowers in our hair" crowd, I can tell you that a lot of the empathy and mental growth is very superficial. At least seemed that way to me.

I've been working with ayahuasca for about a decade now, off and on, myself, have done a number of dietas, and been the guy blowing smoke on people who are falling apart in ceremony or helping them to and from the bathroom or whatever. While there is absolutely a lot of what you describe and worse (like blatant predation) in that world, there's also just a lot of superficiality everywhere. Some people just won't see through their own bullshit well enough to offer anything but superficial, and that's probably going to come across particularly sharply once you can see it.

My own experience, since we're swapping anecdotes and beyond confirming that stuff exists, is that the people I've kept in touch with from that world aren't like that, whether they went to Peru once, or a dozen times, or never. They have reliably grown in ways they can't imagine themselves having done, without their work with the medicine. Since you can't A/B test someone's life, you can never say, but having seen however much of these people's lives, they all seem better off, in so many ways.

But selection bias is a thing, obviously. And dueling anecdata is interesting. Just probably not very useful.

EDIT: Phrasing

You sure it's not just being around young people. The prefrontal cortex doesn't mature until late 20s, so people are more impulsive and selfish.

The 30+ crowd in Ayahuasca/Psychedelics have been some of the kindest, most giving people I have ever met in my life.

MDMA boosts empathy: https://bigthink.com/surprising-science/mdma http://theconversation.com/ecstasy-users-are-more-empathetic...

LSD on Empathy (Increasing altruism): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5813062/

LSD enhances emotional empathy: https://www.nature.com/articles/npp201682

Lifetime usage of psychedelics correlates to increase in nature relatedness: https://www.ncbi.nlm.nih.gov/pubmed/28631526

Anecdotally, 3 of my friends and myself (sample=4) all have self-reported significant improvements in empathy, as well as verified confirmation by our romantic partners. This has also led to objective changes such as volunteering, random acts of kindness, increased gratitude and altruism, and more.

There are also studies on terminally ill showing dramatic decreases in anxiety and depression: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367557/

I don't know if you've ever suffered from either of these, but I can assure you, severely depressed or anxious people are not overly empathetic as they are ruminating and caught in their own minds more than being interested in others (overactive default mode network).

In short... there are numerous scientific studies confirming the benefits of these drugs. I fail to see any "overrated" potential after studying these molecules myself for years for experientially and academically.

What does psychedelic use have to do with a change in society? I lived in Seattle during the time marijuana was legalized, and did not see anything of the sort.

Cannabis is not psychedelic, at least to the same degree that classical psychedelics are (Psilocybin, Mescaline, DMT).

You're right. Although someone like Terrence McKennna would categorize cannabis as psychoactive. Very heavy doses have that almost borderline trippy visuals effect once in a while, in my personal experience.

Psychoactive is a blanket term that applies to all substances that affect the brain. It primarily consists of sedatives, stimulants, and hallucinogens.

That does not explain why any effect is expected.

Did the rate of marijuana use meaningfully change, though? It's been abundantly available on the west coast for decades. The only thing that changed is who you buy it from, and to a certain degree who you have to hide it from.

Pot is very very different from lsd. And also I doubt legalization had a meaningful impact in usage rates.

For that matter, I suspect even if lsd were legal, I don’t think a lot of people would do it.

Back in the 90s when lsd was super cheap and everywhere on the east coast, most people didn’t do it. Even when I was going to raves a lot and hanging around with people who did a lot of drugs and sold drugs, most people did not do lsd very often. It’s an intense experience and a lot of people don’t find the idea appealing and don’t enjoy it when they try it.

This time we have the Internet.

We should eliminate a majority of law. Too much law is like an over engineered program with edge cases for everything that prevents anything from changing in the future. Law cements stagnancy in our society. And at the worst, it creates moats for the powers that can use law to protect their interests over others.

Why is tech infested with know-it-all libertarians? Honestly, do you think we'd all be better off in a lawless anarchy?

Same reason "Let's just throw it away and rewrite it the right way this time!" is such a common failure mode of engineering projects.

While it nearly assures the death of the project, it's so enticing due to its simplicity.

The point isn’t to throw it away - law has meaning. It has less meaning when it defines everything.

I can't speak for the rest of "tech", but this know-it-all libertarian prefers lawful anarchy to the lawless variety. :-)

(Not sure I'm really a libertarian either, but almost certainly a know-it-all)

yes.

Cognitive artifacts exacerbate the fundamental attribution error in proportion to their social effect.

I think the parent meant less laws, not lawless. Anarchy? No.

Correct. Typical knee-jerk reaction of our zeitgeist.

Sad, downvoted? Ok - what a way to inspire conversation. Thanks HN. Stay bright.

Strange, I thought it's infested with know-it-all socialists.

https://en.wikipedia.org/wiki/Wikipedia:Chesterton%27s_fence

A lot of laws were written before the internet and don't really apply now that culture has changed so much. And the rest are so vague that even lawyers argue over what they mean. Newer laws are written by corporate lawyers and passed by corrupt politicians to further protect their monopolies, with no regard as to their long-term effects.

Trump has a 5:1 ratio on regulations cut vs passed: https://cei.org/blog/trump-maintains-one-five-out-pace-rules...

tl;dr no point in paying attention to existing laws.

I'm more a fan of the inverse: anything that could be reformed in the future should not be proposed without an accompanying explanation of the full context of the decision to enact the policy.

If you believe reforms should not be made, publish those arguments to the best of your abilities.

Never assume that your reasoning will be obvious to even the next person in your position, let alone the next generation.

One of my favorite policy proposals I've ever seen is Andrew Yang's proposal to sunset old laws, and put expiration dates on legislature. Laws should have to continuously defend their existence.

Particularly in regards to laws that provide benefits to a group of people, it's basically political suicide for somebody to run on the platform of removing that benefit.

My girlfriend used to work in affordable housing, and she would tell me about how the reference book of codes and laws they had to keep in line with had increased by orders of magnitude in size as compared to those from a few decades prior. A politician adds access to affordable housing for those making less than 45k, except for those who were part of the 1985 initiative benefiting LGBTQ out of state college graduates, in which case their children can continue to benefit from access to the affordable housing for 7 years after the death of their parents at a more forgiving 75k minimum salary, after which a 15 year period lowers it to 60k, given that they continue to work within 50 miles of the initial residence of their parent beneficiaries. I'm obviously making this specific example up, but it's not too far off from reality.

This would just result in industries, sharks and scam artists waiting until laws expired and quietly doing the thing the law was designed to prevent like crazy until it was noticed and legislative machinery could slowly get around to closing the loophole again.

Legislation and regulation are horribly slow to get passed anyway, a rule like that would add an order of magnitude more overhead. Now the question wouldn't be "how may laws apply to the thing I want to do" but "how many laws will pop out of existence over the duration of the thing I want to do, which ones benefit me and which hurt me, how much will I have to spend on lawyers and lobbyists to maintain a vaguely stable environment, and who will be spending to oppose this?"

That, or representatives tacking on pork barrel spending to legislation renewal when their vote is needed to pass it.

"Oh, you want to renew the "Don't put lead in milk" law? Yeah, you're gonna have to set aside $50m for this project I think is super important.."

My personal twist on this one is to make showing a habitual failure to enforce a law be an affirmative defense for all crimes. That way, the law is by definition what is enforced, and singling someone out for infractions that are generally overlooked becomes a much more risky tool for the police to use.

> My personal twist on this one is to make showing a habitual failure to enforce a law be an affirmative defense for all crimes

Murder would be legal in Detroit, or at least, it would have been for more than one year.

It doesn't seem reasonable to me to evaluate if a law is necessary by checking how enforceable it is. Even if a crime is hard to fight, I think that's a problem but not an excuse.

And if the problem is the police singling out some people like you said, then in my opinion there are other, more straight forward ways to tackle it. There are too many cases where a crime should be prosecuted even if it's difficult to do so.

(As an example, I consider rape a difficult crime to deal with, but I wouldn't understand not prosecuting it because of that)

This. We should be constantly striving for the minimal set of laws which produce the desired effects. After all, the more lines you write the more space there is to play in between them.

Honestly, what IS the law ready for?

Lawyers making money? Check. Benefiting the public at large? Big Nope.

Yeah, for millions of years, we always waited for the law to be ready, before we made some breakthrough.

Many states (Oregon and Colorado) are starting to decriminalize psilocybin. The interesting thing is always how the federal government views this and what actions it takes. I'm optimistic.

Just happed in June in the Bay Area, CA. Alameda County, which includes Berkeley and Oakland. The law is for naturally derived psychedelics so it includes things like DMT and Ibogaine as well

It's a cultural crime that psychedelics have been criminalized for half a century or so.

The expansion of certain mental faculties (3-D Visualization, free thought association, meta-thought) could have been harvested for societal benefit...

Oh well, wishes to the dust and all that.

It's the start of a journey. There are huge benefits to psychedelics that are still undiscovered. It will take at least 50 more years but we will eventually get there

1970-2030+ or so will be seen as a drug dark age. A time where criminalization made everything more dangerous, and harm reduction worse. Part of a 60+ year gap in innovation using all substances for many health related cures and issues as well as recreational fun and exploration.

We learned nothing from alcohol (a drug) prohibition.

All prohibition and criminalization does is make everything more harmful, from use, to production, to creating cartels/mafias that become as powerful as nation states.

>creating cartels/mafias that become as powerful as nation states.

The state is balls deep in those cartels. Go read about Freeway Rick Ross and Afghanistan poppy fields for prime examples. It's all part of the military industrial complex, Peter Dale Scott has great books on the matter.

The books of the mentioned author on that topic:

https://rowman.com/isbn/9780742525221/drugs-oil-and-war-the-...

https://rowman.com/isbn/9780742555952/american-war-machine-d...

Author's page:

https://www.peterdalescott.net/q/

Drugs have been largely a tool by the government to justify aggressive searches of poor people. I don't think the justice system we have can work only with only the search justifications of terrorism, child pornography, and intellectual property theft. Maybe I'll be surprised, though.

Maybe hate speech/bullying will be the new frontier. We have to know what everybody is reading and writing to make sure they aren't hating: "my dog alerted to the smell of a flash drive."

Why do you think there is an expansion of any sort? For any effect a simple explanation is that some function gets reduced, and result simply looks wild.

> some function gets reduced

What does this mean?

Like your driving skills and logic obviously dwindle.

If you try to imagine an orange on the table, you normally won't see that orange as if it really was on the table in front of you. It's a lower fidelity imagination.

There are of course good reasons for this, you wouldn't survive long in the wild if things you thought about suddenly seemed to appear in front of you.

On psychedelics, this doesn't necessarily happen either, but you can learn to visualize things in 3D as if they were real objects in front of you. Using this for anything useful takes some skill and practice, but it can be done. Some people can do this without psychedelics, but they tend to have mental health issues.

Is there any kind of research? How can I know a person under psychedelics actually sees a 3D object correctly in detail, not just thinks she does?

The implication that this has anything to do with the law is amusing.

Psychedelics are legal if you're wealthy.

There are plenty that are cheap to obtain or grow.

But the cops only care about them if you're poor.

The cops are only involved if you are purchasing the expensive ones from dealers.

Essentially nobody is being arrested for purchasing spore syringes, cactus seeds or salvia divinorum. The police aren't interested.

If you are growing shrooms then you'll likely being charged with possessing them with intent to distribute, which is 5 years in prison.

Sure, but about anything is legal if you're wealthy. (sometimes a travel to a poorer country might be needed). Or more precisely: the law bothers you only if you're poor or piss off someone richer than you.

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