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Organizations like MAPS (Rick Doblin) are pioneering the use of psychedelics and other drugs (mdma) to aid in psychotherapy for vets with PTSD, with some extremely impressive results.

Ibogaine is also a fascinating drug to look into. It’s frequently used as a treatment for heroin and other severe addictions. The trip is multiple hours long, and described as life-altering - many people describe vivid recollections of the worst moments of their lives, but stripped of the painful emotions associated with them. But the drug essentially interrupts the addiction cycle and requires those pathways inside your brain, with some pretty impressive rates of remission.

The idea of incarnation comes up a lot with these experiences from what I've read.

I had a similar experience with ketamine a month ago. At first I became detached from the situation I was in (severe accident) and was able to evaluate it analytically. Then I became even more detached (and I stopped getting meaningful signals from my senses) and I understood I was a being and my current self was one incarnation of that being. Then I saw all the choices I had made in my life and how they contributed to who this incarnation was and it gave me great insights and relief about my current life.

Sadly when I came to I lost a lot of the clarity. I think I'm still the same person I was mostly, the only striking difference is that I laugh a lot more and my laugh has changed. Also the idea of my own death has become comforting and soothing even though I don't really believe in reincarnation.

Congrats kid you went into a k-hole.

As mind blowing as you think that was, IMHO its nothing like the experience of candy-flipping...(MDMA+LSD)

Remember all things in moderation, I have lived to tell the tale, although I can't remember what tale I'm supposed to tell.

Man, drugs are fascinating, aren't they?

It feels like every time I tried a new drug, it helped me understand myself more. Don't understand me wrong, I don't take a lot of drugs. My experience is limited to one night on MDMA in Ibiza, one night on shrooms in Amsterdam and a whole lot of nights on weed.

I seem to suddenly understand everything about myself and the world when I smoke weed. It really puts me into the "Everything is connected and everything repeats itself"-mood, which I've heard from LSD trips. That all that's happening is supposed to happen, doesn't matter if it's objectively or subjectively bad or good right at that moment.

MDMA made me insanely happy about myself and my surroundings for an hour. It was like feeling pure joy and happiness for an hour straight. Although I took it in Ibiza, I spent the night listening to music on the couch in the AirBNB I had rented. I read that a lof of people feel depressive and blue for a couple of days after taking MDMA. For me, it was different - I felt content and insanely relaxed for a couple of days, but in a very good way. Still 100% in touch with the world, just happy. But that effect went away in an instant which I've really felt. Went from smiling and being happy back to normal. Not sad or depressed, just normal.

I have a huge admiration and respect for psychoactive drugs. I would never consider taking Heroin, Crystal Meth etc., but I would really like to try LSD and other substances. It also seems like THC helps me live with ADHD better than any official, legal pill.

All that being said, I don't really know how to handle drugs in the long run. I'm in my early twenties, so maybe it's normal to have a feeling of being lost and not knowing what I should really be doing with my life. I live in a nice apartment, earn good money, ride a beautiful motorbike and have a wonderful girlfriend. But except for my girlfriend, none of these things make me truly happy.

If I don't smoke weed for a long time, I seem to loose myself. But the same can be said for when I start smoking too much, too frequently. I don't even know what I'm trying to say, but reading your comment made me think about that topic :)

> As mind blowing as you think that was, IMHO its nothing like the experience of candy-flipping...(MDMA+LSD)

I disagree there. There isn't much that compares to a deep k-hole. Perhaps a DMT breakthrough experience. But LSD and MDMA doesn't compare*

* Assuming "normal" LSD dosage, if you are talking about eating a strip of tabs (1000ug) ok, then all bets are off, but at that level the MDMA isn't going to be able to do much

My friend was using that as a metaphor, not literally.

> MDMA can be neurotoxic if taken repeatedly and heavily

I remember back in the days on a certain research chemicals subreddit where people were raving about the "borax combo" -- a mix of 4 or 5 substances that were indistinguishable from MDMA and had no crash like MDMA and the ingredients themselves were not known to be neurotoxic.

I think they just looked at the MDMA receptor affinity and just combined substances that would roughly match that receptor affinity.

Also as far as I know, MDMA is only neurotoxic because of it being processed by the liver and MDMA injected in pig or rat brain was not supposed to be neurotoxic.

AFAIK the mechanism is serotonin depletion. Spaced doses of a sane amount is not neurotoxic, but if you take too much or worse take it very frequently serotonin can be depleted and... I forget the chemical mechanism, but bad things happen. I'm sure it's not hard to find with a search.

The worst thing to do from what I've read is take more MDMA right after a dose wears off to try to prolong the high. That's where you get into neurotoxicity.

From what I understand, once serotonin is depleted enough in the synapse, the serotonin reuptake transporterss begin to bind to dopamine (instead of serotonin), and that by itself is toxic to that part of the neuron. To make matters worse, the neuron then converts the uptaken dopamine into hydrogen peroxide, which is VERY toxic to that part of the neuron (the axon terminal), which then causes it to fizzle away.

I recall a way around that (other than by just not taking MDMA at all, obviously) is to take an SSRI (like Prozac) at some point after rolling, which would bind to the reuptake transporters, preventing dopamine from doing so.

More sociable and outgoing people talk more with people.

Because of that, if halve the users become more outgoing and halve the users less so, for a net improvement of zero, what you’ll hear still can usually be in what they self-report as a good way.

As an extreme thought experiment, if 99% of users become depressed reclusive hermits directly after use and the others feel hugely improved, all self-reports you hear will be positive.

If MDMA would result in shut-ins then it wouldn't be such a big business, no?

(Though we have to control for how many new users entering the market, how many shut-ins it has already produced, etc. But looking at very rough data about MDMA use and depression prevalence per country, there's doesn't seem to be any correlation. For example Netherlands is at a constant 4% since 1990, but use went up from ~2.3% to 8.4% from 1997 to 2018. https://www.statista.com/statistics/632401/ecstasy-usage-in-... and https://ourworldindata.org/mental-health#depression )

This assumes that didn't know the person before they took it though. If you did then you'd likely hear their self-report even if they became a depressed recluse.

> because while I haven't closely known anyone with a horror story

I knew a girl whose story was fairly unpleasant. However, given her trip report (its multi-day length, with paranoia and hallucinations in particular) I believe that was not pure MDMA, it probably contained Bromo-DragonFly (one of the most dangerous and longest-acting psychedelics) or something like that.

That is definitely not MDMA. Max MDMA duration is 8-10 hours and that's on the high side. It does not typically cause paranoia or hallucinations.

Sounds like PCP plus meth, DOB plus meth, or some other nasty combo. Making cheap nasty "disco biscuits" out of meth plus random thing is apparently pretty common. The meth could account for some of the paranoia and strung out feelings.

Gotta love prohibition and how it encourages the production of "bath tub hooch."

Yeah that definitely sounds like something meth-based to me.

> MDMA can be a shockingly mind-altering drug for some people, and usually in what they self-report as a good way.

The problem is self-reporting as a good change means nothing here. What you really want to know is if the original person, knowing the full transformation, would prefer the outcome. You don't get that because the person making the self-report is the person that already underwent the change.

For example, if I had a pill that made you a serial killer, but nevertheless very good at it, enjoying it, and totally lacking empathy for your victims, you'd probably self-report as being happier too. But the you of today would be horrified.

If I held conservative Catholic views, that's probably what MDMA would seem like. I'd be happy with who I am with strong moral values, but there'd be this scary pill out there that could make me give all that up, destroying what meaning my life had previously. It's not much consolation that I'd later self-report it as a positive change.

Lobotomies used to be justified based on self-reported outcomes. Is there anything objectively different here?

Don't know why you are being down-voted. You make interesting philosophical points.

If something change your values in a way that the old you would not accept, are you still you?

Maybe it’s not “something changes your values” but you learn to view them from a different perspective.

But is it not your values your perspective about the world?

I'd say one must be very mindful of the complex (and not well understood at all) implementation of such things with respect to the conscious vs subconscious mind.

I think they can probably evaluate that. The general pattern is a loosening of rigid characteristics driven by belief. What that means is depends on what you believed. If you mostly just believed the world is a terrible place, that's quite a relief. Subjectively, we know that it often feels better, perhaps the way no longer straining or exerting a muscle does...I think it lifts compulsions made of psychological knots rather than from physical causes, but it doesn't distinguish between a compulsion that drove you to physical fitness or alcoholism. So if they find the probable external changes to get that better inner state abhorrent enough, then they should avoid that drug.

This works for the lobotomy example as well, if they have their memories in tact from before. You can assume there's a decent chance you'd feel better if others with similar problems felt better, and you have to weigh that against fairly objective external changes which you might find abhorrent, fairly obvious in the case of a lobotomy.

Perhaps medical ethics should make a point that the type of changes you could experience should be outlined, but there's a general pattern that I think can be defined and understood enough for informed consent to be given or withheld. Like most medical treatments, it would get defined in terms of risks and probabilities rather than certainties. You risk coming out with weakened religious beliefs, etc.

There are much more fundamental issues with doing any research on drugs like this.

First there's a huge selection issue, many won't ever want to take it.

Since the drug has a strong effect you cannot easily design a placebo study - people would still know if they got a sugar pill or the real deal [0].

Anything that's a highly unusual experience is likely to be rated as significant.

Very hard to design a good study.

I believe the reported efficacy would greatly go down with increased availability. If alcohol was a mostly illegal schedule 1 drug in most of the world I could see similar narratives forming around it.

[0] btw I think that's a very underappreciated factor across all kinds of research. Even with regular medical drugs. Don't see it brought up too much.

99% People dont change THAT much with mdma. You should try.

Thank you for this comment! I suspect most people would do far worse than you in the mental exercise of explaining views they don't actually hold. As a conservative,

"This scary pill out there that could make me give [strong values that I'm happy with] up, destroying what meaning my life had previously. It's not much consolation that I'd later self-report it as a positive change."

summarizes my thoughts about MDMA perfectly.

I think the scariest thing about MDMA is that it's not really the pill that can do that, the pill is just a shortcut to the type of high-intensity scenario in your brain which can lead to that sort of change. There are plenty of both good and bad other scenarios that could lead to a similar result. Falling in love, meditation, near-death experiences. Where does your brain go when you take the bumpers off?

I think the biggest problem with how many people see MDMA and psychedelics is uncritically accepting the first things that come to mind after taking them, that feel oh-so-true, or that they "give" you insight. It's still you, you're not God, you just have a whole lot more feelings for a bit. (But, depending on what walls you have up intellectually or emotionally, having those feelings take them down for a bit can be very productive.)

If you generalise this, it sums up the difference between the mindsets perfectly.

Conservatives aren't scared of change, they're scared that they themselves, and others around them, would come to fully accept it. The fear is that this completely invalidates their current worldview rendering existence meaningless. It's the fear of being wrong about life on an emotional level.

So a non-conservative, not having these fears, would willingly take the serial killer pill discussed above.

No, they won't too but for different reasons (instead of the fear of being wrong).

If your mental model of conservatives says that they would not take the serial killer pill because they fear being wrong about serial killers, then I don't think it's a particularly good model.

Hence the reason why that's not a contentious topic in politics.

It's only applying to current political charged issues.

Not MDMA, but MDA. I had a magical time, but felt depressed for about 3 months after.

Canada's military industrial complex can cause these adverse reactions.

https://mdacorporation.com/corporate/