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Comment by funnym0nk3y | Hacker News Reader

There is so much psychedelic research happening right now. But when will it reach patients outside of trials?

Beginning of my MD PhD program a guy who was big in that field and tried small scale trials gave a whole schpill about how big pharma was unfairly blocking this. Then I spent over an hour talking to him about it. This field has a huge challenge finding a consistent and reproducible outcome to aim for. When I pressed the guy he was pretty clear that there were participants in these studies that has pretty bad outcomes and would have been in bad shape if there wasnt a medical team on hand.

Im sure we will find a use for this someday but research has to do more than prove it is sometimes good for people. We need to know how to consistently identify those people who need it and the outcome desired.

> When I pressed the guy he was pretty clear that there were participants in these studies that has pretty bad outcomes and would have been in bad shape if there wasnt a medical team on hand

Are you aware of source-able examples of this?

I’ve been paying attention to the field for awhile, and I was under the impression that between pre-screening (people at risk for psychosis and a few other specific psychiatric issues should not participate), and proper set/setting, negative outcomes have been rare, and there is a high percentage of extremely positive outcomes.

TBH Id have to dig into my notes more than I care to now, but recall looking up his and his coauthors research at the time and the verbage was very similar to what you described. But that's kind of the point. Requiring a specific controlled setting with a medical team and someone to guide the individual through throughout the process is a lot of work to require for "good" outcomes.

The only time you can expect a drug will get approval without large reproduction of quantifiable outcomes is treating some aspect of a rare disease.

> Requiring a specific controlled setting with a medical team and someone to guide the individual through throughout the process is a lot of work to require for "good" outcomes.

Honestly this sounds like an incredibly small amount of work when considering the work involved in traditional therapy and/or psychiatric treatment, which plays out on a timescale of years if not an entire lifetime for some, and collectively requires a “medical team” numerous times.

And when the outcomes involve radical (lasting) improvement to everyday experience for individuals with treatment-resistant depression, I strongly question the urge to trivialize this with scare quotes about “good” experiences and their apparent cost.

> The only time you can expect a drug will get approval without large reproduction of quantifiable outcomes is treating some aspect of a rare disease

The good news is that there’s been quite a bit of progress, and growing interest in medical circles due to the positive outcomes. I’d strongly recommend looking at the latest studies/results; it sounds like you may be operating on some very dated information.

I apologize if what I shared sounded like a "scare quote". I was just responding to the question about whether this will be an available diagnosable drug anytime soon. It is really unlikely and there are some basic intuitive reasons why without going deep into any research.

Also, I didn't say I was unaware of anything in this field recently. I was replying to the specific individuals' research I mentioned earlier. I've seen plenty meta analyses and case studies but you need way more for this to be a viable medical prescription.

Finally, none of what I said is a statement on my opinion about whether this should be adopted or pursued more aggressively in medicine. You'd have a hard time finding anyone that wouldn't agree that prevention would be cheaper in the long run but that's not what you need to prove to a hospital system and the FDA. You need to have multiple phases of clinical trials and then convince a medical system that addition dedicated clinics are worth setting up for this.

I guess I just couldn't understand the position you were taking when framing this as a "lot of work". It sounded like you were dismissing it casually, and if that was a misread, I appreciate the clarification.

There's a certain common form of hostility that often emerges from some circles when this subject comes up, and I may have read into something that's not there.

Yes, this needs trials. Yes, that's what's in progress right now. And the results so far are worthy of attention.

Most of the psychedelic research I've seen boils down to "take psychedelics and do stuff to get a result, here's why you get the result". You can absolutely take psychedelics and do stuff yourself.

The American Medical Association says 'no no this is so unsafe, you need a Physician who completed US residency, doesnt matter if they are a lifelong expert in the craft from Europe, you pay our cartel or else. Ignore our blood letting, opioid, and ivermectin dark pasts.'

I dream of a science based medical system in the future.

The scientific models of the past were so dumb. Like the ancient Humoral Theory, which modeled health as `health = fn(blood, phlegm, yellow bile, blackBile)`. Or models like Ayurveda which is roughly `health = fn(Vata, Pitta, Kapha)`.

Modern science has put all those dumb ideas to rest!

Now we know that the true model is: `health = fn(bigPharmaMed1, bigPharmaMed2, bigPharmaMed3)`.

But what stuff to do?

I'd say just do them and come up with stuff to do. There are many of non-science forums on psychedelics, and you can quickly get the general idea how they can help you. But if you want to be sciency about it, read the aforementioned journals and do the "stuff" they describe yourself. Compared to experimental compounds, many are very easy (and often legal) to obtain. (but probably not legal to possess)

You can experience the world like a little child again. Except you have more knowledge and will probably understand the beauty of the universe in a more meaningful way.

At 21, I did a 6 month sabbatical from college just to experiment with psychedelics.

Here's a few things I did while tripping: - Took a hike - Danced in nature at the sunset - Listened to music (1st time listening Pink Floyd, the TDSOTM is a must!) - Took a swim in my hometown cold river - Experienced the "yin-yang" almost as an emotion-like feeling. Observing on top of my hometown mountains the greenery growing up on top of the charcoal again, after 2 years, when wildfires took 80% out. The moon and sun being present helped. - Walked around and explored a new city with music on (I was with friends, they were sober) - Painted and did drawings (I suck at it, it was incredible just seeing the ink flow out of the pen) - I meditated - I wrote about stuff - I explored the online content people make (r/LSD has a list of links + a lot of people on these communities provide a lot of interesting content) - felt like a Neanderthal eating a very juicy peach for the first time by doing exactly the same - masturbation (as demisexual, I wish I could had met someone who I could have sex with) - I played computer and felt like a god (usually I'm a noob, on that day I was truly overpowered) - I went to the beach - To the raves (I hated it!) - I observed animals - I climbed some trees - I spent time with friends

So... ye. You can literally do anything and you'll have a radically different experience from what you would normally feel. Just seek out information first how to do it carefully. I would also not advise leaving to far from home until you understand the dosages and the impact it has on you.

https://www.howtousepsychedelics.com/

Seems to be CBT therapy. I’m not sure if I would recommend DYI if only because it’s very hard to stick to a lesson (or any other) plan when you’re on shrooms. Just practically - it’s very hard to read for example

When they create a synthetic derivative that can be patented.

Exactly like happened with ketamine as esketamine.

I just acquire mushrooms on my own and discuss the trips with my psychiatrist. He’s always quite enthusiastic about it and I’ve found them to be very helpful.

Move to California. Order mushrooms from literally thousands of local websites and surprisingly reputable proprietors.

When it can be sufficiently monetized.

Move to Australia.

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