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Comment by whiddershins | Hacker News Reader

Psychedelics are not without risks, but the risks are for me a deal breaker when they are illegal.

There are too many ‘designer drugs’ out there with unknown properties that are sold by misrepresenting what they are.

LSD25, psilocybin, MDMA, DMT these are drugs with known risks and side effects, and there has been legitimate investigation into their benefits. It would be great if we could legally continue to gather data.

So far, it seems these substances are arguably much less dangerous than many illegal substances. I would be in favor of legalizing all of them.

Decriminalizing seems to be a necessary step in that direction, but it doesn’t allow for quality control. Legalization allows for real and enforceable disclosure about what I might be putting in my body.

I hope we get there someday.

Edit: and possibly less dangerous than some legal substances.

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People are getting hurt by the black market. We need to bring this into the light. I know someone who died from taking what he thought was LSD and was instead some kind of designer drug like 25I-NBOME.

N-Bombs are messed up, there is one variant that gives instant permanent parkinson's disease!

https://en.wikipedia.org/wiki/MPTP

There is so much to learn from these things, the cure for natural parkison's is probably within that drug, but we need the whole supply chain regulated and the ability to study these things in the light.

I absolutely hate the current status of the psychedelic community, full of anecdotes, invalidating victim's experiences, some straight up voodoo about how to "end trips early" with candy flipping. Dangerous. All because it relies on urban legends.

Pedantic quibble, MPTP is not an NBOMe: MPTP is opioid-adjacent. Though, your point stands: they are both certainly quite dangerous substances that are among the reasons that testing drugs is an important harm reduction measure.

> some straight up voodoo about how to "end trips early"

The proper way to do it is to use a drug that's a 5-HT2a antagonist with a stronger affinity to that receptor than the psychedelic. Trazodone or Seroquel are commonly prescribed ones that have a pretty low side effect profile and can be found at any pharmacy.

Always. Test. Your shit.

I wish there was more advocacy around this. DanceSafe [1] sells inexpensive kits that people can use to test against most of the bad stuff (like NBOMEs).

[1] https://dancesafe.org/

How often does someone get killed by an up-market dealer? I have no doubt that it happens but most of the deaths I read about look like street drugs or maybe somebody who scored in the bathroom at a bar or club.

Not totally sure what you mean by up market? Like not a sketchy street corner guy but someone that sells bulk?

https://www.justice.gov/usao-ut/pr/shamo-sentenced-life-pris...

That guy was selling fentanyl-laced oxy. I’m asking about something along the lines of the likelihood that one of my rich bro friends gets killed by his regular coke dealer.

Depends how desperate your bro's regular coke dealer or his dealer gets. I've heard first hand tales of dealers ending up with bricks of straight filler, like no coke, and passing it off to their customers, even high end ones, because if they didn't they'd be out a whole bunch of money.

Also another second hand anecdote, most coke you buy in America or Canada is probably not pure. Even when getting supposedly pure coke. I've heard what they have in south america and mexico in certain places is nothing like what they have up here.

No speediness, you can sleep, no cravings or come down.

I'm a big fan of what DanceSafe has been doing, although their reagent test kits are extremely expensive considering how cheap they are to manufacture. Their Marquis reagent costs $20 plus shipping and consists of 2 drops of formaldehyde in 3ml of sulfuric acid. Tremendous margins for a group that should want everyone and their grandma to have a testing kit.

Yep, it isn't cheap, but compared to the peace of mind of knowing you won't die from ingesting some crap, $20 sounds like a deal!

Kidding aside, I'm not sure what margins they are running on. I can't imagine they are selling enough kits that lowering the price wouldn't it make it impossible for them to exist.

> and there has been legitimate investigation into their benefits.

I'm pro-legalization and all for rigorous study of these compounds. That said, the recent headlines about psychedelic research have started to diverge from what the research actually says.

For example, recent headlines claimed that MDMA was shown to be beneficial for certain types of therapy. However, the actually study wasn't designed to show if MDMA was helpful, it was only designed as a proof of concept to show that it wasn't harmful. The study protocol involved something like 20 therapy sessions, only 2 of which involved MDMA. Most of the measured benefit happened before any patients took any MDMA at all, and the data didn't show any measured boost around the MDMA sessions. They also gave MDMA to every study participant instead of only half, meaning it was impossible to determine if the MDMA made a difference relative to non-MDMA controls.

The only thing they really measured was that MDMA didn't produce any immediately obvious problems, such as causing patients to withdraw from the program. Safety studies like this are an important first step, but they don't tell us if MDMA is actually helpful.

However, all of the headlines around the study proclaimed "MDMA shown to help treat PTSD". All of the internet comment sections were filled with people wondering if they should take MDMA to treat their PTSD. Really, the only thing the study showed was that traditional therapy produces measurable improvements in the condition, and that MDMA didn't interrupt those improvements.

I'm worried that the exuberance to paint psychedelic drugs as miracle cures is going to backfire in a few years if the eventual study data doesn't live up to the hype.

There have been a -lot- [0] of MDMA studies at this point, for PTSD and other issues. In particular a common finding is that the efficacy of MDMA+Therapy 1 year post-treatment is far higher than therapy alone (significant reduction in relapse of symptoms as well as severity of symptoms). I encourage you to look at the variety of studies conducted and their different designs and controls and not base your judgement on a single study (this is good advice for any medical research, not only MDMA, as well).

[0] https://maps.org/research/mdma

Yes, and I read them all as they come out, including the MAPS studies. My point still stands: The studies, to date, appear to be structured in ways that primarily explore the potential downsides rather than exploring relative efficacy. Not all of them, of course, but it is a common theme.

I'm confused... Are you saying the ongoing MAPS FDA Phase 3 trials [0] are more about safety than efficacy? The whole point of Phase 3 trials is to prove efficacy.

Additionally, earlier studies [1] measured the participant's CAPS (Clinician Administered PTSD Scale) pre and post treatment which showed pretty significant results.

[0] https://maps.org/research/mdma/ptsd/phase3/timeline [1] https://maps.org/news/media/7538-reason-ptsd-study-finds-dra...

I did my fair share of psychedelics a few years ago. The community is very diverse and spans a lot of different backgrounds.

One thing I repeatedly saw was those with weaker minds getting sucked into the "oneness spirituality psychic-plane we-are-just-vibrations" bullshit. I watched a smart young lady drop out of university to become a psychic. I watched an acquaintance get divorced because she realized she had sacred powers, saying "my husband drains my energy and he's why could never levitate". I'm struggling to pull my partner out of this hole after she has spent close to $10,000 on building a "vibration healing" business.

I've done just as many drugs as these people, yet I never fell to these delusions. Sure, there are people who get sucked in to this stuff without the drugs, but I can't help but notice the correlation.

My biggest concern with legalizing LSD and psilocybin is that we don't have a good way to combat these delusions when people take them on.

Yep. I never took psychedelics, but I spent a decent amount of my time in meditation.

I think these drugs can be very beneficial if you use them to "expand your mind". But the cases you mention above are almost the opposite. Instead of an expanded, non-attached viewpoint these people formed new and even stronger attachments.

In the end it's more than just legalization. Regulation and quality control are key factors as well. You easily kill yourself with alcohol, but due to regulation, quality control (and experience in society) we can manage the risks vs the rewards.

> My biggest concern with legalizing LSD and psilocybin is that we don't have a good way to combat these delusions when people take them on.

You are falling for the classic delusion that drug prohibition prevents drug use; even after illustrating multiple times how false that assertion is.

I'm not advocating for prohibition, just asking "what are we going to do with the next problem that comes after legalization?"

We need a social context for how and when to take them (beyond "let's partee!"). If you look at cultures with a long history of psychedelic practice, the use tends to be very ritualized, with a lot of specific context as to when they are taken, how often, and for what purposes. There is also substantial effort taken to integrate the experiences.

If you just take a bunch of stuff at a party and believe everything you experience is literally true, sure you are in a risky position. We need to push people towards communally-meaningful experiences with integration afterwards, and away from just blasting their minds into space willy-nilly.

We can't do this while they are illegal though. Keeping them illegal encourages the worst kinds of uses, with no oversight or integration or cultural meaning.

The cultures with a long history of psychedelic practice are just as bad for spiritualist bullshit as this new age culture. Actually, most of the bullshit these New Spiritualists spout is taken directly from these cultures; chakras, spirits, "bad energy", shamanism, etc. all comes from those cultures.

there are some people but from my experience not many people abuse psychedelics compared to other drugs

Be careful with correlation and causation here. A lot of the people I knew in the psychedelic trance scene were already heavily into various forms of spirituality before they started using drugs.

Or was predisposed for mental illness.

That may be true, but it doesn't lessen the risks. People who are predisposed to mental illness don't necessarily know that they're predisposed to mental illness.

If we're going to have honest discussions about the risks, it's important that we avoid blaming the victims by post-facto assuming that people harmed by a drug somehow had it coming due to an invisible predisposition. It doesn't change the math at all.

If after taking psychedelics safely and guided by a community that does them responsibly they discover that they are predisposed to mental illness earlier than just waiting and getting symptoms because their brains deteriorate with age, then that's a good and not a bad thing.

How is it good?

They can start therapy or get psychiatric help sooner, or make lifestyle changes sooner that will result in them living a fuller life of being present for more of it.

Contrary to what you read or hear around some places, we don't know if psychedelics "accelerate" the onset of symptoms of degenerative mental conditions. For example you may experience schizophrenia-like symptoms under the influence of LSD and while that may be a warning that you need to see if you will actually develop "natural" schizophrenia, maybe you will never do. But maybe you will! and you would have never known without that "bad trip". It's true that there's a lot of anecdotal evidence of subjects that don't "come back" after a psychedelic induced breakdown, particularly when they are in the bipolar spectrum. But most people, even the ones that actually have mental conditions, do come back and a lot of them report it helps with symptoms or commodities: most notable depression or social anxiety but sometimes also paranoia, suicidal idealization or intent to harm others.

If you are interested in the connection between psychedelic use and mental illness you should look into the work of researchers that adhere to the psychotomimetic theory of the drug/brain interaction. A good recent place to start is this compilation: https://www.sciencedirect.com/book/9780128047910/the-complex...

While it's on cannabis use, for which we have way more evidence of it causing early onset of degenerative mental conditions than psychedelics (even LSD), it does reference a lot of studies about the effects of psychedelic experiences in individuals prone to neurodivergency.

> we don't know if psychedelics "accelerate" the onset of symptoms of degenerative mental conditions. For example you may experience schizophrenia-like symptoms under the influence of LSD and while that may be a warning that you need to see if you will actually develop "natural" schizophrenia, maybe you will never do. But maybe you will!

This sounds like there is only downside risk.

Schizophrenia can be hard to treat. Bringing it on ‘early’ seems like just losing good years, even more so if there is a chance it would never have developed at all.

Schizophrenia is impossible to treat. You deal with the symptoms with drugs or a support group.

As I said there's no solid evidence that psychedelics bring anything early or make you develop something that you wouldn't have. It could be argued that they make it easy to manifest a tendency to go into certain mental states that a "typical" person would not go into, but it would be hard to find a case of someone that went schizo on psychedelics by only a few uses and really didn't come back.

Of course if you develop an addiction, or abuse them and repeatedly mix and binge them with other drugs in crazy intense environments after those first experiences, they are going to break you. But that downside risk is not exclusive for psychedelic drugs and does not warrant spending inordinate amounts of resources and wasted opportunities by keeping them totally illegal or tightly controlled.

In any case, the reason to make some of this drugs illegal is that they allegedly pose no medicinal use at all and that recreational use is terribly dangerous for society. The first one is totally false, there's even ongoing promising medical research with psychedelics even though they are illegal! The second one is close to what you are arguing about, and honestly the reasons why this may pose a danger to society is more because society sucks and not because the drugs suck. What we should make illegal is abandoning people because they have a mental disease, not drugs.

I don’t know why you are talking about whether drugs should be illegal or not - that seems like a different issue.

If you are seriously claiming that there is no risk to someone who is predisposed to schizophrenia taking LSD, I think you are spreading dangerous bullshit.

Certainly all of MAPS clinical studies screen such people out of LSD trials, because there is a risk.

Triggering a psychotic episode in a schizophrenic person is about the worst thing you can do for them.

> If you are seriously claiming that there is no risk to someone who is predisposed to schizophrenia taking LSD, I think you are spreading dangerous bullshit.

I'm saying we don't know, so yeah there's a risk but there's also a risk they are beneficial and we will never know.

> Certainly all of MAPS clinical studies screen such people out of LSD trials, because there is a risk.

It's not only because there is a risk, as I said there's only anecdotal evidence for that. I think the main reason MAPS clinical studies screen people with schizo tendencies and also bipolar is because those studies are to deal with certain PTSD and ASD symptoms and test subjects with "comorbidities" would ruin their experiments because of how low n is.

A predisposition doesn't mean someone is destined to become ill, and it also doesn't dictate the severity of the illness should one arise.

The problem is that psychedelics can induce mental illness in those who might have never become ill, and psychedelics can induce severe psychotic disorders in people who would have otherwise lived normal lives.

These kind of delusions seem to be ego-syntonic, so discovering them about yourself won't lead you to get them treated. You have to force it on people if it shows up.

> One thing I repeatedly saw was those with weaker minds getting sucked into the "oneness spirituality psychic-plane we-are-just-vibrations" bullshit.

One of the biggest challenges with online drug discourse is that discussing negative side effects is not welcomed. The discussion is too entangled with legalization, leading to a lot of defensive responses trying to dismiss or downplay risks.

Discussions of legalization aside, I agree that psychedelics aren't as as harmless as internet discourse suggests. There is a massive difference between someone being given psychedelics in the presence of a trained therapist once or twice in their life and someone taking LSD hundreds of times alone in a recreational manner. We have to be honest that excessive psychedelic use comes with significant risks that aren't always apparent to the users.

You are right that it's easier to note a correlation. But you are kinda standing on one side of the line regarding prohibition and that's the side of "regulated medical use", which is almost the same thing.

I could argue that they don't have weaker minds, they have neurodivergent personality types that predispose them to isolationist behaviors either like hermit-type or narcissistic delusions. You don't know what would have happened if they didn't do that, sometimes a religious experience just makes you pull the trigger on a change you subconsciously want, faster.

You don't know if your friend was going to do well in University, or become a rogue professional that wants to follow her instinct because of how smart she is and ends up building a career on bullshitting everyone. You don't know if your acquaintance was going to cheat on her husband and commit suicide. It could have happened, it didn't, something else happened because they decided to live their life differently after they took an entheogen, you don't know if it was better or worse and it was their probably conscious choice.

I have very close friends that left "normal life" after drug induced religious experience, like very close, from childhood, friends. I know how fucked up their lives were because we've been like brothers since we were kids or because we became super close as teens, they were fucked up. They were in school like you say or they were having what seems like a normal life with their girlfriends, but the scars of abuse on their minds were not closed. Yeah one is a shaman now and the other one is a monk and the other one is a mathematician, they are all completely isolated from reality and it's really hard to have a normal conversation with them. But they are happy and they feel well, which is what for me matters.

Similarly, there is way too much emphasis on taking heroic doses, or achieving "ego death." When someone gives a trip report after some reasonable dose, say 150ug of LSD, almost always someone will egg them on that they really should be doing much more than that if they really want to experience what it has to offer.

Chainsaws are really great tools and I'm glad I have one, but every time I use it I treat it with respect and view it with a healthy amount of fear of what can go wrong.

I don't think that's a problem with psychedelic drugs so much as people fitting their experiences into pre-existing molds that only prospered because of their illegality (so the experiential dialogue around the drugs is biased towards the small set that take them, which generationally reify the lore).

I think it's especially worse with psychedelics because the experiences tend to be hard to articulate into language so people take those experiences and relate them to their ideas of God or extra-dimensional beings or the hippie culture we're often taught prospered in the 60s.

i am concern is we will make more people anti war and the military industrial complex won't enough people to send to countless wars. This is what happened in the 70's.

What your are saying 100% didn't happen because of the drugs, these people where already like that, they just used the experience to validate their nonsense

> One thing I repeatedly saw was those with weaker minds getting sucked into the "oneness spirituality psychic-plane we-are-just-vibrations" bullshit.

I'm going to be bold here and posit that the 'trip' allowed them to ideate on a specific type of dissociated state of mind that they first experienced through some past trauma.

The first time I had a flashback to a real life near death experience was scary. I can't imagine how weird it would be to relieve repressed psychological abuse and how hard your instictive defense mechanisms would fight it.

That being said that's not the only path to getting sucked into bullshit by a trip. You can create a narrative were some enhanced perception effects, like being more sensitive to gestures or actual real visual resolution enhancement, are some kind of superpower you have and others don't. That will sometimes lead you on a "fake path to enlightenment" in like pseudo buddhist terms. You can get sucked into some kind of narcissistic delusional state, no trauma required, and it can cause you great harm.

Not saying anything you've said is wrong, or even that what I'm saying is true in all cases...

I feel like many of the people who get sucked in are the ones who were drawn to using the drugs as a way to find something to believe in, or because they felt they had nothing to believe in. They found a community that accepted them and the drugs made them feel good. To an extent, people in religions, political parties, etc can fall into a similar (usually less severe) beliefs and practices.

I dunno, we currently have plenty of people falling down the QAnon hole, and that doesn’t seem to be related to drugs at all as far as I can see.

Harm reduction is the name of the game.

We already allow many many many things that are more harmful. Most of the people on the planet even consider those things part of their identity.

I'm not claiming that because we allow more harmful things we should allow LSD too, nor I'm certain that trying to stop LSD usage is more harmful than allowing it, but it'd be great to get these things figured out and then do the "right thing" (ie. pick the less harmful one) instead of guessing and hypothesizing.

And on top of this, restricting freedoms should not be the default, and even then people should be free to create responsible ways to enjoy things. (There's both a speed and drinking limit on the road, but we have racetracks and we have clubs/concerts/festivals, and we usually don't mix them. Similarly, living on a ranch and singing kumbayaa or building a total anarchist/communist community is a-okay, but not allowing people to leave is not - cough Scientology et al.)

I generally agree with you, but I think decriminalizing is not only good first step, but does itself allow for a small amount of quality control. For instance if MDMA is decriminalized, but PMA (something you very much would prefer not to ingest but is nevertheless sometimes sold as MDMA) is not, then people holding PMA would still be at legal risk. Over time this should tilt the scales in favor of the decriminalized substances over counterfeits.

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