Is the psychedelic therapy bubble about to burst?
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Depression is (imho) not to be healed with "here, swallow a pill", structural changes to one's life are necessary. Psychedelics can help to show the way, not to solve it.
But then you have a psychedelic experience, and for a brief moment, things are very much different. And if the experience is even slightly positive, it reminds you that it’s still possible to feel something good, and that glimmer of hope can chip away at your entrenched fatalism.
Of course, it's a nice to visit with molly every once in a while. But the real progress is in how I reframe life. Too bad that finding quality MDMA nowadays is so tough.
This is so interesting to read, because I had exactly the same experience - primarily with social anxiety.
I sat on a hill at a festival with a friend after taking MDMA for the first time and imagined just walking up to a food van and ordering food… and didn’t feel the automatic anxious reaction.
It showed me what was there, and what life could feel like without it. I found that it started a positive feedback loop afterwards, where I’d do something social and automatically steel myself against the incoming anxiety… only to feel none! It was absolutely beautiful.
So, which psychedelic matters a great deal.
I've never done psychedelics (at least not the kind that are experimentally used for mental health; I did Molly once but fuck that comedown), but I spent years depressed, anxious, guilty, etc. and then I started using weed. I went a little TOO hard for a while, because it was the first time in years I'd had my body and brain giving me primarily GOOD feelings.
Which led to me ending up in therapy and actually addressing my PTSD, because then I knew that feeling shitty wasn't just how I was programmed to be biologically because something was Wrong with me.
The 'too hard for a while' is probably why these things should be done under medical supervision. I basically spent 8 months blazed out of my mind.
[0] https://en.wikipedia.org/wiki/Eye_movement_desensitization_a...
(I'm a statistical oddity! YAY!)
That’s awesome you aren’t anymore!
And also: wait what? It’s possible to reverse blindness?? I’m totally ignorant on the subject but I’d b interested to know more if you care to elaborate.
I had really bad strabismus plus vision bad enough that it wasn't possible to correct my vision before I had surgery to fix my eye muscles. Since that didn't happen until I was 4, I spent my first 4 years with vision so bad my dominant eye is classified as 'can see movement' and my non-dominant eye is 'can see light'. Then I had surgery and they could correct my vision.
I'm not sure why it wasn't done earlier.
I have some visual issues related to this early period. I'm terrible with crowding [0], have no depth perception, have trouble with facial feature recognition (I recognize my loved ones based on their auditory cues), rely more on other senses than sight, etc.
My life can basically be broken down into periods based on what medical oddity I dealt with, looking back. Yikes.
Giving general anesthesia to babies/toddlers can be tricky, so that might be a key reason. Our two year old recently went under general anesthesia, and luckily things started going wrong early enough that they could abort and back out without doing any serious damage. Scary situation though.
I'm glad that your child was okay.
Then there is also this: Classical psychedelics are profoundly immunomodulating. All serotonin receptor 5-HT2A activators (agonists) reduce systemic inflammation. Generally in very beneficial ways.
Systemic inflammation and depression are intimately related.
(Of course, care should be taken not to suppress inflammation when it is needed. People probably ought not to take psychedelics when fighting off an infection.)
Source: https://www.frontiersin.org/articles/10.3389/fimmu.2015.0035...
(1) Where am I? / What the heck is going on?
(2) Where am I going to go next? / What am I going to do about it?
Sorry if this seems overly esoteric, but I really appreciate seeing applications of my thesis in the wild. Cheers
Please note that if you are depressed it is better to start with well researched medications like anti-depressants (whose working are still not fully understood) than psychedelics. To be safe, consider shock therapy or psychedelics only as a last resort, after you have exhausted both anti-depressants and Cognitive Therapy under a good therapist and are really desperate.
This is so real it hurts, I had two doctors diagnose me with severe anxiety without telling me — like they just put it in my chart thinking I already knew. And then one day I did one of those depression anxiety screens and failed so hard genuinely believing it was normal my doc, who I guess assumed it was managed, was like, “hey have you ever taken anything for mood.” And I was like “no, why would I do that?”
For literally the first time in my life I felt what “not anxious” feels like. I was in disbelief for months bracing myself for the pangs of anxiety I got in response to different triggers and… they just never came.
Meditation practice under a guide, can rewire your brain much like psychedelics.
Not to diss on psychedelics - but there is way too much hype about it being a miracle cure for all your psychological ailments.
Psychedelics are wonderful but dangerous and to be used under the right set and setting, a bad trip can induce psychosis and my fear is people with existing mental ailments will start popping psychedelics - not paying much attention and end up in a far worse place than they started.
Hopefully it is regulated.
I stopped taking them pretty quickly because I'm prone to addiction, but your experience mirrored mine completely.
Weed dependency is understated by many, but it typically takes longer to form a strong dependency, and the withdrawal symptoms are usually much milder than the other two.
So, I agree that your logic could apply in some cases… in the more typical case (like op’s) of someone stumbling into this experiential eye-opening organically, if it happens via coke/heroin it’ll probably be a much rougher road.
Edit: Probably why psychedelics work well… the experience is very different but has very weak habit-forming pull (it’s not easy to do casually because it’s an ordeal)
Cocaine doesn't really help because it just dramatically increases the intensity and energy of your current state, it doesn't really alter your thinking in a way that could introduce positive thoughts not already present.
If psychedelics had similarly severe downsides then they would likely not be effective at aiding depression in the long run, but fortunately it has relatively few issues with careful use.
The day we can discover what someone's exact neurotransmitter balance is, I think we'll learn a huge amount about how the brain works via that mechanism. I think if we ever reach that day, we'll also learn that there is no such thing as "neurotypical"
Well do some cocaine and you'd feel great for about an hour but nobody cured their depression that way.
But the experiences themselves don't change you. You still need to put in the work to make the changes. You can certainly do this without a guide. But if you take these drugs recreationally without such intentions and without putting in hard work pre- and post-session, nothing much is going to happen in the long term. A guide will help you to get the most out of the experience (while also helping with trip safety).
It's not about whether you use psychedlics or not, it's about how you take them.
"without putting in hard work pre- and post-session, nothing much is going to happen in the long term"
Sounds a lot like cognitive bias to me. It's ultimately a placebo if you still need to put the work in. Ergo, you could achieve the same results even without taking it. It's attributing personal growth to a drug rather than to your own willpower to do something.
If you take a doping pill to run faster, you still need to train and to expand heavy personal effort during the race. Is the doping pill "placebo"?
Heck, if you have leg surgery after an accident, depending on the type of surgery, you often need (and are advised by the doctor, and asked to take it up with physiotherapist and such) to put in personal work and exercize properly for months, to be able to walk and regain use of your leg again. Is the leg surgery placebo?
Or how about a debugger. It wont solve your problem automatically. You still need to write the program yourself, to look into different places, and to know how to find a bug etc. Is the debugger a placebo?
Needing to put personal work to get a result is not what's the distinction between a placebo and a drug.
A placebo is not that which is only effective when combined with additional personal effort (that can hold for any regular drug).
A placebo is a neutral drug that does nothing at all itself (it's just water, or some neutral powder or saline solution, etc) and it's effectiveness is all about the belief that it helps.
Besides, psychedelics (even assuming what they do have no bearing at all to getting better from depression, etc, an assumption with which research disagrees), have huge immediate effects on mental state when taken. So they're not neutral in the way a placebo is even on that account.
My original comment is my opinion. When there's further studies done rather than anecdotal rubbish pertaining to woowoo in the comments, then I'll reconsider my stance.
Analogies are unnecessary and distracting.
Not at all. "The sky is blue, therefore dogs are green" is not an opinion but a statement, factually incorrect, and annoyingly incomprehensible.
The idea that you presented, that if something doesn't solve everything then it is useless is just not true. Maybe you should keep this in mind.
The logic of the comment should hold for any analogous scenario.
You either have to argue why one or all of the above analogies doesn't hold (what element is crucially different, so that the same counter-argument can't apply to your psychedelics argument), or to argue that the points made for those other things are wrong.
Except if you believe that you've discovered some unique logic that only applies to a single specific case.
My opinion: people are likely commonly capable of working through things without the use of psychedelics, and we are crediting the substance and not the human being.
I'm not anti-drugs by any stretch, just feel like a lot more research needs to be done before we can start stating things like they're facts. Can you otherwise disprove that it wasn't placebo effect and the individual wouldn't have otherwise figured it out without a placebo or with a sugar pill he was told was a microdose of psychedelics that would unlock the secrets of the universe?
Not sure why you think studies aren't controlling for placebo? Although it's obviously notoriously hard with psychedelics.
Just to be clear: I agree that more studies are needed, just disagree with the rest of your statements.
So you openly admit that this is difficult to assess? That much we can agree on at least.
You can't control if exercising is placebo either, can you? But the consensus is that it's physically and mentally beneficial. I don't think controlling for placebo is of great use here although it obviously has to be taken into account.
Michael Pollan’s “How to change your mind” talks about psychedelic studies where the more effective, longer lasting changes are seen by the people who had more “mystic” experiences.
It’s not just about good intentions, or just taking psychedelics, but seemingly priming your mind to use the psychedelics to (temporarily) change fundamental thought patterns.
Say without drugs 20% of the depressed population gets better, and with drugs 80% of them. Why would you call this 'placebo' (which is an entirely different topic), and from this word deduce that it is bad? Nonsense.
If I tell someone that a tablet will make them able to do something and it's just a sugar pill, they'll likely be able to do it. The blocking factor is usually a confidence issue.
I dunno, if you regularly use lsd or mushrooms, you probably have had a “wow that was more than I wanted” experience, that means you had complete ego loss, had the veil of reality completely pulled back so you could “see” the arbitrariness of society and human interactions. Your embarrassing actions you have been deluding yourself about come crashing down around you. You sober up and you rationalize some of it away but there’s a big nagging thing in the back of your mind screaming “maybe you should stop doing ____”.
At least this has happened to me on a couple of occasions and has led to me apologizing to people, changing my default behaviors, etc. I am not a super introspective person so the kick in the head that psychedelics occasionally provide has allowed for some personality changes that were necessary and good.
As an adult I now recognize that these experiences could be beneficial as therapy with the right person to guide you through it, that most people probably don’t get the full benefit these occasional experiences provide by themselves. I didn’t think this while young and just partying (though did have a bit of woo woo collective consciousness mind expansion mindset). Anything other than the recreation aspects of it were me trying to justify why it was ok, and getting high a lot is generally not ok. I actually sobered up for rest of my life after a strong mushroom trip left me thinking I was wasting my life and going down the wrong path.
In short, there’s meat here, but of course with all these things there will be people riding a fad and making a buck, but bad usually tags along with the good in some amount.
Those are also not mutually exclusive, to be clear. Come for the dance, stay for the self-insight.
My guess is that the intention that you set before “the trip”, really impacts the experience and hence the results. As well as having a professional guide/sitter that knows how to guide you and create a therapeutic setting.
I’ve been considering it myself, despite not being depressed or anxious, just to see what channels of growth it might open up.
That's what psychiatrists using psycho active drugs say: without proper stage setting and guidance, the experience can be terrifying and traumatic in itself. Remember, not everybody has good trips, especially not people dealing with depression and trauma.
Feels like those kind of therapies help make that happen. I know one person who was borderline suicidal and this kind of therapy helped her move life into a nice direction.
RCTs depend for validity absolutely upon precise, accurate diagnosis for validity. Bad diagnostics => meaningless results. RCTs are not magic. They can be as wrong as anything stupidly performed.
RCTs around depression are worse than most.
I'm puzzled how a small trial run can derail decades of larger-scale evidence?
I don't think the study is dispositive, but it's strong evidence, much stronger than a message board axiomatic derivation of why psilocybin should work.
Sometimes in poor cases it can sound like gym-bro science where I should totally pop a supplement because this guy had a good experience on it and trust me bro.
I would love to know more specifically about the subjective experience is like, so we can pick out pieces that have a greater meaning to collective understanding.
Depression is an umbrella term for one experience caused by many, many different problems. Some chronic medical situations are going to allow your body to be re-depressed after a positive drug experience, so being able to see subjective reports in detail can allow the public to decide if it's worth doing a psychedelic treatment.
Not to mention we should probably map this experience out to slowly cut down on the same speculative questions every time drugs come up; about the divine/psychological/medical nature of a drug trip.
I’ve taken LSD a few times. When people ask about it I like to say that the experience is exactly like how people describe it, but nothing like what I expected. Trying to “map it out” in complete detail would be like trying to map out sex. I’m not convinced I can fully explain my experience, and even if I did, I bet your experience would be different from mine.
Maybe the best description I can give is that your mind stops suppressing a lot of thoughts. When I hear music on LSD my brain turns the music into a whole planet that looks like that music sounds. When I look in the mirror I see myself as a fey creature full of animus and life. The things that my sober self stresses about seem ridiculous - like the fears of a 5 year old. And I still feel trapped by my fears at the same time.
It’s a very unique experience. As Sam Harris says, if you take enough LSD it’s impossible to be bored.
That's exactly right. I think of it like this: you've spent a lifetime building and entrenching filters around your perceptions and thought patterns to react to them. They persist because in evolutionary terms you being still alive means your behaviour is "adaptive" in a sense, irrespective of how you actually feel.
Psychedelics temporarily tear down most of those filters and disrupt those thought patterns, allowing you to perceive things in very novel ways and react to hem very differently.
Nobody's thought patterns or filters are going to be the same and so nobody's psychedelic experience will be the same even though many of them will have similarities (we are the same species in the same culture after all).
The 'otherworldly experiences' lsd are not outside the bounds of what we have seen before.
A fey creature full of animus and life, may be intense and full of subjective richness for you, we have seen this imagery before in pagan worship.
It's not so difficult to describe a travelogue of the experience. Aldous huxley wrote The Doors Of Perception.
Words are no substitute. The experience itself can't be expressed in language. Language can refer to it, but without a common reference point, language will always fall short.
> A fey creature full of animus and life, may be intense and full of subjective richness for you, we have seen this imagery before in pagan worship.
So? The imagery isn't the interesting part. The subjective richness is, and the imagery denuded of its subjective richness is just some boring pigments. I've seen that imagery before, but that didn't prepare me at all for my trip.
The imagery relates to the experience like a postcard relates to New York City.
If I had never felt pain before, do you think you could explain it to me? Do you think you could teach what the color blue looks like to someone who is colorblind? I don't think you can do it - but by all means, prove me wrong :)
Iron deficiency causes your leg to bounce.
CBT causes people to practice second order thinking.
Faith causes people to experience grace.
Your subjective experience has overlap with other phenomena, a description of the journey allows it to be mapped. People with medical grade depression can then decide if taking LSD is likely to resolve their problems.
Playing the subjective-definition game is entry level stuff. There is real suffering that could be allieviated here with a little more insight and mapping.
i have read a single take can increase neuronal connectivity by 10% in rodents, which is not surprising after that experience.
still feeling great more than a year after.
meanwhile my mom gas been on AD for 40 years.
implementing those changes over time is the key
What does "proper set & setting & guide" mean? Clinical? Or friend/shaman type thing?
but yea I'm not "down with the scene", I don't "know people" and have been on anti-depressants for over a decade off and on with little break-through.
I've suspected that psychedelics or things like MDMA could help, but I don't know where to turn to for that.
The best way I had it described to me is:
Psychedelics are microscopes, not panaceas. A trained psychiatrist is the panacea.
Clinical depression rarely has anything to do with what you've done or events in the outside world.
Psychiatry has settled on treating depression with two strokes, a cocktail which is a chemical antidepressent, and a chemical stabilizer, and they expect you to take these daily and stay on it for the rest of your life. I have no evidence for it, but I assume this is some pharmaceutical company's agenda, to keep you a customer for the rest of your life. While it works, chemicals always have side-effects, and with so much exposure, daily, they are bound to compound, making it more difficult to consume.
Therapy alone can cure depression, it just takes a lot of time and effort. I don't think it is possible talk therapy could ever make things worse, but it just doesn't work fast enough. Still, recommended.
But I have discovered a way to cure depression relatively quickly in two ways.
First, chemically, but without a life sentence. I have discovered a substance that will cure depression overnight, not unlike an aspirin cures a headache. You get headaches, too? How would you feel about being told you need to take a daily medication for the rest of your life to cure it? No, one dose will do. The drug is unregulated, and is available OTC in cough gels. You won't find this in any PDR, but depending on the patient's weight, say for a 160lb. man, 900mg of dextromethorphan will cure depression overnight, and it has been for some time in many clinical studies exploring its potential as a fast acting treatment for treatment-resistant depression. You take the large dose with a pepsid, and go to bed, wake the next day depression free, and its depression-killing effects can last up to a year. It is an old and safe drug, and the lethal overdose is estimated, because it is unknown. Though it is an OTC remedy for cough, dextromethorphan has already been approved for treatment of emotional incontinence, which could be seen as sort of a cousin of depression.
The other cure, chemical free, is sunlight. Light in the eyes regulates mood. Not enough light will eventually cause depression. Too much light will cause mania (as we should have suspected from the exploits of Florida Man). Put enough sunlight in your eyes, it will cure your clinical depression. If daylight is not enough, get an artificial light that is an accurate simulator of natural sunlight, which is probably not LED, due to too much blue light, which also damages the eye and slowly blinds you, but you can't go wrong with halogen. Point it at your eyes. You can even close your eyes, light goes right through the eye lids and is still effective at fighting depression.
Do you have any evidence for this? This contradicts some studies I've seen on the matter, for example, one where 75% of chronically depressed patients reported clinically significant histories of childhood trauma.[1]
Not to mention that your second cure, sunlight, is literally an example of things we've done or events in the outside world (i.e. time spent outside).
https://www.verywellmind.com/the-chemistry-of-depression-106...
> This contradicts some studies I've seen on the matter, for example, one where 75% of chronically depressed patients reported clinically significant histories of childhood trauma
There is no contradiction here; the correlation you think you see is not causation. Generally, if there is an external trigger for depression, it is more immediate than having an abusive childhood decades ago, such as recently losing a loved one, or recently getting fired, or recently being physically abused. But in essence, our bodies make us feel the way we do, and more specifically, the brain and its electrical and chemical processes, no matter what external trigger we may want to point to for a cause, the reaction is fundamentally an internal process.
> Not to mention that your second cure, sunlight, is literally an example of things we've done or events in the outside world (i.e. time spent outside).
We evolved on a rotating planet. Daylight regulates mood as it does circadian rhythms. Sunlight will cure depression; it does not cause depression.
> There is no contradiction here; the correlation you think you see is not causation.
You're doing literally the exact same thing. You're pointing to chemical differences in people with depression and saying "there, that's causation! it has nothing to do with lifestyle or life events!". Consider that the chemical differences that result in depression could be caused by lifestyle factors and life events (and it's undisputed that these things cause chemical differences).
> You misunderstood. Daylight regulates mood. Sunlight can cure depression; it does not cause depression.
No, it's you who misunderstood me. If sunlight cures depression, then our basic actions in life are the issue, i.e. our lifestyle is a low-sunlight lifestyle (something very much in conflict with the environment our brains evolved in).
You simply haven't given enough evidence to back up your confidence on the idea that depression isn't caused by our actions in life, or life events. Yes, brain chemistry is involved, we know that. But our actions and experiences affect our brain chemistry. So you're going to have to work a lot harder than you have to rule it out.
The most I can see you saying is that the start of the causal chain (life events) doesn't matter because you only care about the end of the causal chain (brain chemistry). But this is a wildly different statement to saying that actions or life events aren't part of the causal chain, which you appear to be asserting.
You're basically saying "getting shot doesn't kill you, bleeding to death does!"
Then you employ the tu quoque fallacy, which I am not inclined to entertain. You elegantly complete your rant with straw man and ad hominem fallacies.
I tell ya what... how about you believe whatever the hell you want and leave me out of it? Appreciated, friend.
«Is the psychedelic therapy spark about to fizzle out?» might have been a more apt analogy.
(I have no reason to opine either way regarding the answer)
One day I got to work and noticed that for the first time in a while, I was feeling really happy. In a way where I realized that other times I thought I was happy, I was really just not-too-sad. This was what actual happiness felt like. I was kind of surprised, but thought “wow, I guess the meditation and exercise are finally paying off? It must be that… nothing else has been different recently…”
And then I remembered that I’d tried shrooms for the first time the day before.
So far, trips seem to pretty reliably have this effect for maybe 1-2 weeks. I suspect I’m also seeing some more durable benefits beyond that, but a little harder to be sure.
Meditation trains the mind to learn to see when it is falling into maladaptive grooves. It doesn’t prevent it, just a raises awareness. Exercise for me seems to shift the baseline mood forward a bit. Kind of feels like my hormones are in the right place after 25 years.
Psychedelics are very different from the other two tho, just like exercise is very different from meditation.
They are all very worthwhile and can help you grow.
Meditation and exercise are best practiced regularly. Psychedelics are best used for singular cathartic events, saved for special occasions.
Psychedelics can change your outlook overnight, while meditation is a more gradual process. Excercise won't really change your outlook palpably, it will just keep you in a better head and body space.
They all can be difficult and rewarding. Its possible to harm yourself with any of them, but generally you come out well ahead if you do them responsibly. They can all make you a better person.
I do think meditation rewires your brain in a way that’s similar to psychedelics (there’s common themes you experience with both, like ego death), but I think it just takes much longer to achieve similar effects. I’d meditated daily for close to a year straight, and while it helped, I didn’t feel like I got anywhere close to how I felt either during tripping (kinda obviously maybe) or after tripping.
That said, while so far psychedelics seem safe, they’re at the very least more logistically “disruptive” than meditation, not to mention social stigmas, difficulty getting them, etc. Meditation does seem like a more sustainable long-term practice.
Some of the above is why I’ve become interested in trying ketamine therapy instead.
I tried to stick to it but I find it kinda hard to.
Exercise never yielded the benefits I sometimes saw in studies for me but every time I manage to motivate myself to do the healthy/sane/right thing against inner resistance, it leads to a small boost in self-respect that accumulates over time.
I didn’t experience any psychedelic effects, but my mood was significantly improved during the weeks after. Anxiety greatly diminished, confidence greatly increased and I for the first time in a few years, I feel like I have a path to conquering my impostor syndrome.
I’m not yet totally comfortable telling my social circle that I’ve been prescribed horse tranquilizers, but I’ve been an immediate convert to the possibilities of these courses of treatment. I can’t say it isn’t psychosomatic or the placebo effect at work, but I’ve been frankly shocked at how quickly it worked for me and how well it has seemed to work.
Good point.
I wonder what kind of interesting experiments could be designed around psychedelics, skilled counsellors & mediators, and people who've ended up with various "extreme" beliefs, political or otherwise.
Fits the theory that this is a paid hit piece, obviously without evidential support. Remind me, could there be an industry financially interested to get psychedelics back into the box?
https://www.madinamerica.com/2021/09/ending-silence-psychede...
If you know other sources on your comment, I would love to check them out as well!
It's not a good look to rationalise away all bad news as "paid hit piece".
There was another HN front page article today about how legalization caused a measurable decline in the stock prices of the big pharma companies. There's a long track record of cannabis replacing opioids for pain management. MDMA, psilocybin and ketamine are not patentable, and if they can displace regular, lifelong use of antidepressants with a small number of treatments, that sounds like serious threat to their bottom line. Seems pretty plausible to me.
Psychedelics _can_ permanently fix problems - anxiety, alcoholism, depression - that otherwise would make pharma companies huge amounts of money.
LSD is incredibly cheap to manufacture. There's no patent on it. Same with mushrooms and many others.
Now look at how much money those pharma companies made with Lexapro, with Prozac, with Risperdal. Even when they were caught marketing those drugs for unapproved uses, to children; and caught buying academics opinions, they made billions off the stuff.
Compare the list of side effects on their drugs to mushrooms or LSD. Compare the effectiveness. These companies aren't maintaining huge divisions of PR goons for the fun of it; they absolutely are out there on the internet, lobbying, and on traditional media, convincing people to form opinions like yours.
See Juul, attacked by both the smoking industry and anti-smoking lobby. Ecigs don’t have brand loyalty like “Marlboro”—and cigarettes cost only 6 cents a pack to manufacture. So, buy Juul, kill it, preserve the massive profit flow.
Cannabis / hemp would be another. Alcohol giants, cotton, painkillers, and many more have a lot to lose to an alternative that's superior in many ways.
Fossil fuel companies spend huge amounts putting doubt into people's mind about nuclear and renewables, lobbying for themselves, systematically buying academics and news stories.
With the above examples, there are people dying thanks to the PR FUD.
Microsoft did similar stuff, buying and squashing competitors by any means necessary. Even the DoJ had to step in when they tried to own the internet. Some people think MS Office is still around because it's better than the competitors, lol.
Banks lobby to make business as awkward as possible for credit unions.
Bitcoin maxis smear superior tech with the most laughable arguments.
Etc.
Juul started with all kinds of flavors, but then they were banned and only tobacco extract flavors were allowed.
Those extracts are more than flavor. They contain the same psychoactives which make tobacco smoking so addictive compared to vaping freebase nicotine — which Juul is not because it is an extract of tobacco nicotine salts to begin with.
I use a Juul most of the time to vape. To keep myself in cartridges, I do have to buy the Juul ones, so I get a cart full of the magic Juul juice to keep me company.
Then I refill it a bunch of times with third-party nicotine salts which taste better. It's the same thing basically.
Juul popularized using salts at high concentration with less vapor. That's about it. The rest is good product design and a fad.
There are also legitimate concerns about biases in the evidence base for claims about the efficacy of psychedelics: https://stuartritchie.substack.com/p/psychedelics
And yes, psychedelics have side effects: https://en.wikipedia.org/wiki/Hallucinogen_persisting_percep...
The originator pharma companies pay generic mfgs to not manufacture the drugs, ultimately the arrangement is such that both parties profit while maintaining the status quo allowing single-entity control of a given substance - in the US at least, which is the only place any of this matters. Not that that's the case with the previously mentioned medications.
Ritchie on his vast tower of scientific conceit totally fails to acknowledge the human element in all of this. These drugs are interesting because of their mechanism, but that mechanism isn't necessarily complimented well by the "therapeutic" setting; the drug in and of itself isn't necessarily the catalytic element, but rather the experience - itself derived from the set and setting:
In normal (particularly traditional use) practice it is unheard of to take a bunch of these drugs and hang out in a lab with a bunch of strangers. Anthropology shows us these drugs are uniformally used in group practices with familiars.
And this is something noted in the textbooks, you can have internal and external validity - and "internally" yes, it may not look great but that's kinda predictable because it's going to get railroaded into the narrow confines allowed by statistics and ethics. You can on the other hand hop on Erowid and read countless case studies from various perspectives to get a holistic view, but that's not "science" because it has nigh-zero internal validity. But to me that reads as a semantic difference and we could debate it all day - what I think really matters in this case is that in the wild, in real practice, it's efficacious.
Bro. They have new drugs that are a molecule different which they sell instead. And your scorn notwithstanding, they do have entire division of goons, whose explicit purpose is to alter opinion online, in academia, in politics, etc.
> There are also legitimate concerns about biases in the evidence base for claims about the efficacy of psychedelics
Pfft. Same goes for pharma drugs.
> And yes, psychedelics have side effects:
I didn't say they don't. The side effects are on a different level though.
We're talking about companies that knowingly sold AIDS infected products, among other atrocities. You'd wanna be a little less naive.
There is a lot of problems with "big pharma" but being against cheap and effective permanent solutions is not one of them, otherwise they wouldn't sell vaccines: many vaccines are cheap, one time use, effective and prevent profitable (?) diseases.
The pharmaceutical industry has ways of making money of cheap and out of patent drugs. For example, by patenting a 0.1% more effective derivative and selling it, or by simply jacking up the price when you are the only one making it (see the Epipen scandal). This, by the way is the problem with the pharmaceutical industry, they spend way too much effort making money with old medicine and finding patentable derivatives than researching new ones. If LSD turned out safe and effective by regulatory agency standards, they will definitely sell it, or maybe some slightly tweaked and patented variant of it.
https://www.wired.com/story/race-to-engineer-new-psychedelic...
What is wrong with insinuating an "industry conspiracy"? Industries are found guilty by judges and juries in massive lawsuits all the time.
> Guess who would ultimately own the labs, run the clinical trials
Big Pharma doesn't run most of its lab experiments. They use contracted research companies to do that. In the past this was done to evade responsibility and it doesn't seem to have changed. See the Pfizer Covid vaccine whistle blower article as an example of that: https://www.bmj.com/content/375/bmj.n2635
> and be first to market with a safe and precise FDA approved antidepressant based on a psychedelic active ingredient
They can't patent molecules found in nature or synthetic molecules they didn't create.
> Let's not forget LSD started as a research chemical in a drug r&d lab in Switzerland.
How is one lab in Switzerland representative of al all the other pharmaceutical companies?
> Industry never wanted it criminalized.
How do you know that?
> It's not a good look to rationalise away all bad news as "paid hit piece".
The health industry is a major source of revenue of all major US news publications.
Not a peep about the side-effects of "traditional treatments", which presumably include the designer drugs.
I am bipolar but was diagnosed incorrectly with depression and OCD, taking an SSRI. I was a regular marijuana smoker and took DMT which resulted in acute psychosis that lasted months. I'd had what I now recognized as hypomanic episodes before, but nothing this bad.
I will not get into details for privacy reasons but had to take months off of work or school. I alternately thought I was famous, being followed, could control cameras that were following me at all times - the works. I had visual and auditory hallucinations days after the DMT experience, auditory weeks to months later. I told friends strange things about my mental health history that were misperceived. It is a bit of a blur.
About a week after taking DMT, I was involuntarily hospitalized and only sent home with family supervision. They put me on strong antipsychotics with nasty side effects. They didn't help at all. I only got better months later, after I got off of all psychiatric drugs, and realized when talking with a friend that I was not famous. I then entered into a nearly year long depression and perceived that I had lost almost all my friends, although I now think that was not the case.
Now, I've been stable for almost 10 years, and am married with a great career. We have a dog, a house, and are looking to have kids soon. I'm incredibly happy and only recovered with the support of family, friends, and great doctors. I've been taking lamotrigine daily for bipolar. For me, it is a wonder drug. Bipolar is incredibly hard for psychiatrists to diagnose. It took them years to identify it.
Another friend of mine had acute psychosis due to another psychedelic drug and had a similar experience to mine with a hospitalization.
If you have any family history of schizophrenia or bipolar or are on psychiatric drugs, please really carefully consider the possible consequences of using psychedelics.
But I have seen good results (treatment-seeking, successful) in borderline schizophrenics after exposure to MDMA.
just adding my comment so people see that getting help is perfectly fine (if you get the right treatment/diagnosis, it's a life changer for the best!) - mental health is still a bit taboo in some circles and I remember reading about the good experiences of people online made me finally jump into treatment :)
I feel like we’re at the beginning of the opioid wave again, and the obvious and foreseeable negative consequences are just being shunted aside. We never learn anything.
The way I've always seen it is this - Learning your lesson with these things is kind of like learning your lesson because you just got your ass handed to you in a fist fight, except with psychedelics it's like getting cosmically beaten into a pulp by having your consciousness put into a cannon and fired across the universe and back. Some people are really attuned to this kind of thing and can just shake it off while laughing the entire time. Others, who have no idea what they're getting into, with stuff like pre-existing anxiety conditions? If anyone really thinks them going solo on these kind of journeys is going to make them better then they might as well send them down some rapids with no boating or swimming experience for a 'therapeutic' prank show.
The key thing this article and the researchers touch on is that it's the integration part of the therapy that works, the drug is something like a catalyst, and any hype around treatments which work without that component is likely to turn out to be a dangerous disappointment. I don't disagree with this at all.
The more likely outcome is that the industry will create a synthetic analogue of psilocybin, conduct the trials needed to get it FDA-approved as a depression treatment, and then market it widely, making it more readily available and widely known than psilocybin itself.
This isn't necessarily a bad thing: such an analogue might (say) have fewer side effects or work more reliably. But it will result in the pharmaceutical industry getting the bulk of the profits.
But this narrative is getting old now, and the promising results in question are actually quite slim, in a field which is historically riddled with treatments that have a low effectiveness (when they work at all)
I want to see the science continue to study these drugs and psychedelic therapy, but for me there’s no doubt in my mind this has been significantly more beneficial in the short term than any other medication I’ve ever taken (i.e., been prescribed). If the science shows it isn’t right for everyone or most people - so be it. But it has been a game-changer for me.
Promising results that occur outside of formal scientific settings still occur, although consciousness (possibly amplified by various pre-existing beliefs) can make it appear as if they do not. As luck would have it, psychedelics can be very helpful in sorting out one's thinking on such things.
2) There's a distortion at work here. Many people, including myself, thing that natural growing mushrooms or other plants containing hallucinogens should not be illegal. The problem is that it appears the only way to legalize at the current time is to force them into a doctor/patient therapeutic relationship. This is causing people to twist themselves into a knots trying to explain why this small step towards legalization should be allowed. Many exaggerations and false claims are being made. And who wants to always have to do their trip with a doctor sitting by their side?
My hometown of Santa Cruz California is on the right track. Decriminalize for personal use and move on to more important issues.
Santa Cruz decriminalizes magic mushrooms and other natural psychedelics, making it the third US city to take such a step
https://www.cnn.com/2020/01/30/us/santa-cruz-mushrooms-psych...
One thing stands out: Oregon decriminalized all drugs in 2020 - it feels like a not well-known fact.
Another side-note: because mushroom spores do not contain the psychoactive ingredient, they are not illegal to ship across state lines, so it's entirely legal to purchase spores on the internet ("for microscopy use only"), and then use "Uncle Ben Tek" to grow your own mushrooms (this part is illegal).
- To reassure the legal authorities that the use of them is properly supervised and safe
- To bring them to a wider audience, such as a depressed grandma who needs to accept her approaching death but would never take them on her own
- For their own status, power and money needs. It worries me that once they achieve this, they will fight legalization for recreational use
That's all fine, but don't tell me I can't take them for my own pleasure and purpose when I want, such as at a music festival, on a hike in the woods, or just because. I really don't need a therapist to guide my trip, thank you very much.
Edit: Another thing, I've raised the issue on Twitter that doctors and therapists who used them in therapy settings should have some experience with hallucinogens. They shut me down really quick. It's the elephant in the room apparently. How are you going to guide someone when you have no experience with them?
[1] For me, for example, I didn't have any major traumas before I tried MDMA (so therapy would have been pointless), but I were really shy. MDMA at a party setting helped me realize deeply that there's no reason for being scared of talking and connecting with people.
Err, what? What could possibly be lackluster about that? A one time (or few times) treatment does marginally better than a daily pill? Even if taken at face value, that's a spectacular result.
> In this trial the primary outcome did not differ significantly between the trial groups.
> Secondary outcomes generally favored psilocybin over escitalopram; however, the confidence intervals for the between-group differences were not adjusted for multiple comparisons, and no conclusions can be drawn from these data.
There's a lot stopping people from producing patented drug concoctions.
Sometimes I wonder if SSRIs are one of those things that the industry overinvested in and now that there's plenty of momentum (and budget) to support the narrative that they are the cure it's hard to suggest that there may be simpler alternatives
SSRIs are that. Opiates are almost that (for long term pain management.) Statins are suspicious (and also held up as miracles by paid experts suggesting that we might add both them and lithium to the water supply like fluoride.)
I see a future of bare clinic rooms filled with beds, and on each bed someone who is being intravenously fed psychedelics (that are still illegal to grow, or take without a doctor's signoff and a nurse's supervision.) Each of them paying a $10 copay, while the facility bills the government and insurance $500/hr.
It'll be like the methadone clinic model, where we decided that to get people off heroin, we would addict them to a drug far harder to quit than heroin.
edit: I wish we would simply decriminalize psychedelics, and not do this thing again where something gets captured by a couple of oligarchs and sends their worth into the stratosphere, while every media outlet is fanning the flames. Really fucking dreading seeing the psychedelic (completely industry-funded) patients' rights organizations representatives getting interviewed while crying on tv about how party/politician X doesn't take depression seriously and is trying to genocide them by not letting five year olds trip.
Integration is definitely the key step. Without integration, the trip is no different than recreational use for fun. Integration requires sustained effort and guidance. If you don't have professional help, then meditation is the best DIY method. It usually leads to Spirituality. Pyschedlics tend to go very well with Buddhist and Vedantic spiritual practices. I think it best complements with Neo-Advaita. If Advaita is the theory, then psychedelics are the practicals.
Begging the question:
The important thing is to have something you can cultivate because otherwise what might happen is that you accidentally heighten your existing feedback loops, which are likely negative, leading to a bad trip and in the worst case possibly psychosis.
Having strong foundational positive feedback loops that you can use as a anchor or bedrock are useful not only during chemically altered brain states, but in general life as well in protecting your mind (a Patronus for your “defense against the dark arts” you might say).
I can't believe someone who wants to help someone else (and, by the way, try to demonstrate the power of psychedelics that they no-doubt believe in) would jeopardize the whole enterprise that way.
Why has nobody in this thread commented on that?
Surely you wouldn't suggest that research into the efficacy of automobile safety technology should continue unchanged were it determined that humans were being irreversibly harmed by said research.
To those of us "of a certain age," this sounds ... familiar.
The studies which show inspiring results on hard problems like PTSD and depression involve high dose, singular experiences, and because of the nature of that high dose, a lot of preparation takes place, weeks or months sometimes and a lot of care planned out via therapist.
I believe it was a Roland Griffiths study that showed that if the subjective and measured (brain scan) experience was not consistent with a deeply spiritual experience, the positive long term effects did not come.
There is so much potential in this and so much catching up to do. Many who are familiar with the relevant substances know this.
Our various corrupt systems (political, financial, "health" care, media, etc.) have deliberately prevented this type of therapy from exploding for a very, very long time. It will massively reduce the pharma industry's revenues, among other things.
Whatever bizarre conspiracy theory that would convince you of the opposite is evidence that there's already lots of money being spent.
And a whole lot of new risks to go with the potential. As the saying goes: it's important to keep an open mind, but not so much that your brains fall out.
As long as alcohol is legal and easily available we shouldn't worry about psychedelics. I know plenty of people who have taken all kinds of psychedelics and seem OK. Psychedelics just don't seem very addictive for most people. I also know quite a few people who have been hurt by alcohol. They either hurt themselves or they hurt others while drunk.
Unfortunately, Bettridge's Law applies here.
This is said early on. But then the article continues and the gist is that it's still early days for psychedelics. That is, they compared well tested therapies with a new one (i.e., it's possible the dosage isn't optimized yet).
Given that psychedelics have been around much longer, then it's actually the newer (propriety Big Pharma) therapies that are coming up short.