Hacker News Reader

Comment by EmilyHughes | Hacker News Reader

going by that logic cocaine and heroin should also treat depression in the same way, but they clearly don't.

Coke and heroin form a stronger dependency faster, and then you’ve created a new & very distracting problem.

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)

Well, if the reason Heroin doesn't help depression is because the body quickly adjusts to it and then you end up needing to use it just to maintain your previous baseline. If it didn't cause chemical dependence and retained its initial efficacy long term it would probably be extremely valuable.

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.

Various stimulants can also have a different effect, depending on one's neurotransmitter balance. For example, Adderall is generally speed to someone without a dopamine deficiency. I would imagine even crystal meth would be far less harmful with a dopamine deficiency than without (although there are still the issues with purity and dose size that would make it inadvisable to experiment).

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"

Having done none of these, perhaps it's something about the quality of the experience? E.g. perhaps when you do cocaine/heroin, the quality of the high is so clearly unusual and extreme that you could never mistake it for being an accurate representation of "how things could actually be" without depression/anxiety? And maybe shrooms etc aren't nearly as extreme?

Are there any examples? These drugs are very dangerous and addictive but that doesn’t mean nobody anywhere has ever had a positive long term outcome from trying them. It just means that statistically a negative outcome is a lot more likely. There are always a few outliers.

There's that Dr. Carl Hart story https://reason.com/video/2022/04/12/carl-hart-on-life-libert... that has popped up twice or more on HN https://news.ycombinator.com/item?id=31145393

Those are completely different drugs, so no, that doesn’t follow from that logic.

That's my point. OP reduced the effectivenes of psychedelics down to just being able to feel good for a short while.

Well do some cocaine and you'd feel great for about an hour but nobody cured their depression that way.

I take your point, but I think the distinction is that some drugs can make you feel euphoric, but psychedelics affect you on a deeper, psychological level. You're not just feeling an absence of pain or a rush of pleasure (though that can happen, too), you're also thinking in a different mindset.

On high dose psychedelic, “you” are not thinking in a different mindset. The current “you” is completely obliterated. This is the difference between psychedelics and other drugs.

Reply on news.ycombinator.com