6 ms·

Your anecdata doesn’t match up with current ketamine research. The protocol for depression is really different than using it for a party drug. Same for mdma for

by kaikai 7y ago

Your anecdata doesn’t match up with current ketamine research. The protocol for depression is really different than using it for a party drug. Same for mdma for things like ptsd- it’s paired with therapy that helps you work through things. You’re right that just taking drugs isn’t enough, but please don’t discount medical treatment that changes the lives of many people.

empath75 7y ago
Rubbing ‘medical’ on something doesn’t magically change how it works. And it’s pretty much impossible to take mdma and not engage in talk therapy. I had conversations that went from favorite djs to the time they were raped in middle school with complete strangers. And then you go out and dance. I don’t think a hospital is going to improve the situation much. It’s just a loophole people have to go through to make it socially acceptable.
- trevordixon 7y ago
  Certain placebos only work when administered by a doctor in a clinic (heard it on some podcast once). Seems like ketamine could have different effects in different environments.
  - empath75 7y ago
    Ketamine is probably the one drug where the environment doesn’t make a lick of difference because once you drop into the hole, you are on another planet. The outside world may as well not exist.
    - kaikai 7y ago
      Only if you take very large doses. Maintenance doses for medical use are tiny; barely enough to feel any effect at all.
- kaikai 7y ago
  What? Talking about hard or traumatizing experiences is NOT the same as working through trauma with a trained therapist. It’s great, and it can be helpful, but just talking about something is the first step. Also, I don’t why y’all are acting like folks who use things like mdma and ketamine in a medical/therapeutic context haven’t also used them recreationally. It’s different, because the environment, intention, and often the dosage are all different. You taking drugs at a party is not the same, and using absolutist language to say otherwise when there’s actual medical research that contradicts you is an odd choice.
  - mistermann 7y ago
    > Also, I don’t why y’all are acting like folks who use things like mdma and ketamine in a medical/therapeutic context haven’t also used them recreationally. I think questions like this are underappreciated. I propose that the potential underlying mechanisms of why people behave the way they do are described here, at least in part: https://en.m.wikipedia.org/wiki/Heuristic https://en.m.wikipedia.org/wiki/Heuristic https://en.wikipedia.org/wiki/Thinking,_Fast_and_Slow https://en.wikipedia.org/wiki/Thinking,_Fast_and_Slow I think it's useful to observe how people, particularly intelligent people, interact with these ideas, and the inherent uncertainty involved. Are people curious about how nature plays out, or are they tied in some way to nature being a particular way? Are they willing to discuss these ideas, and defend their beliefs, or is there something subconsciously repulsive about certain beliefs that renders them unable to discuss it rationally, but instead forces them to revert to defensive techniques like appeal to authority or popular tribal axioms. Is uncertainty acceptable?
  - scarejunba 7y ago
    Do therapists actually contribute? I'm sceptical. For me, I got so much of the value from taking MDMA and just knowing my friends were around and actually loved me. Ended so much anxiety. Between Molly and Acid and these folks, I think I'm pretty much safe for the rest of my life.
- wtracy 7y ago
  My understanding is that the ketamine dosages used for treating depression are much, much lower than the dosages used recreationally. (I could be remembering wrong.) Otherwise, the big advantage of getting a nurse to do it is that they are in a position to treat you if one of the rare but potentially fatal side effects pops up.
missosoup 7y ago
It matches up with the experience of anyone who has ever taken these drugs. These drugs, taken with a good group of people, always lead to a therapy-like experience. And as GP comment said, they give you the ability to clearly identify what bothers you in life and what to do about it. The only difference between 'medical' sessions and 'recreational' ones is that you're talking to a therapist instead of friends. Having done both, friends are generally the better option. Actually acting on that information to improve your life is a completely different task, and without taking that step, these drugs do nothing for mental health long term. There is no difference between 'medicine' and 'drug' other than some regulatory body slapping a label on it. Especially the case with psychedelics where early pioneers performed and documented way more experimentation than FDA-approved research could ever hope to cover.
- golemiprague 7y ago
  MDMA and LSD gives you a bit of a different perspective, K not so much. Once it wears off you stay with your insights but it can't really help you act upon them. I probably took this stuff with a bit of a more fun kind of group so there was not much of "someone raped me when i was 9" type of talk. Just the understanding that the mind can work in a different way to the normal and that you can feel and behave in a different way is the main insight, but from there you still have to do the tedious work of actually implement the changes to your life.
- WalterSear 7y ago
  I've been taking intranasal racemic ketamine for a year. It's not a replacement for therapy - it's treatment for organic depression. As far as we can tell, the people like me who need ketamine don't have any effective alternatives, since their depression isn't simply exacerbated situational depression, but is driven by biologic processes, specifically involving inflammation. This isn't about drug induced insight - it's about brain chemistry. There is absolutely difference between medical and recreational ketamine use, since the actual chemistry is unrelated - the high of the ketamine is not related to it's beneficial effect. Moreover, my ketamine use and schedule wouldn't make sense recreationally. The dose is just enough to be debilitating - the equivalent of 1/4-1/2 a line. Ironically, due to the unfortunate nature of contemporary american society, regulatory capture has resulted in the FDA approved ketamine (s-ketamine aka esketamine) treatment being more inebriating and less effective antidepressant than recreationally consumed ketamine - which, being unpatentable is consequently unprofitable. A less inebriating, more effective antidepressant r-ketamine is 'in the wings', in order to let pharmaceutical companies milk as much money as they can from this otherwise cheap and effective drug. Hopefully psychiatrists will see through this, and start prescribing off-label ketamine once they have seen the effect that esketamine has on their treatment resistant patients.

by kaikai 7y ago

empath75 7y ago

Rubbing ‘medical’ on something doesn’t magically change how it works. And it’s pretty much impossible to take mdma and not engage in talk therapy. I had conversations that went from favorite djs to the time they were raped in middle school with complete strangers. And then you go out and dance. I don’t think a hospital is going to improve the situation much. It’s just a loophole people have to go through to make it socially acceptable.

trevordixon 7y ago
Certain placebos only work when administered by a doctor in a clinic (heard it on some podcast once). Seems like ketamine could have different effects in different environments.
- empath75 7y ago
  Ketamine is probably the one drug where the environment doesn’t make a lick of difference because once you drop into the hole, you are on another planet. The outside world may as well not exist.
  - kaikai 7y ago
    Only if you take very large doses. Maintenance doses for medical use are tiny; barely enough to feel any effect at all.
kaikai 7y ago
What? Talking about hard or traumatizing experiences is NOT the same as working through trauma with a trained therapist. It’s great, and it can be helpful, but just talking about something is the first step. Also, I don’t why y’all are acting like folks who use things like mdma and ketamine in a medical/therapeutic context haven’t also used them recreationally. It’s different, because the environment, intention, and often the dosage are all different. You taking drugs at a party is not the same, and using absolutist language to say otherwise when there’s actual medical research that contradicts you is an odd choice.
- mistermann 7y ago
  > Also, I don’t why y’all are acting like folks who use things like mdma and ketamine in a medical/therapeutic context haven’t also used them recreationally. I think questions like this are underappreciated. I propose that the potential underlying mechanisms of why people behave the way they do are described here, at least in part: https://en.m.wikipedia.org/wiki/Heuristic https://en.m.wikipedia.org/wiki/Heuristic https://en.wikipedia.org/wiki/Thinking,_Fast_and_Slow https://en.wikipedia.org/wiki/Thinking,_Fast_and_Slow I think it's useful to observe how people, particularly intelligent people, interact with these ideas, and the inherent uncertainty involved. Are people curious about how nature plays out, or are they tied in some way to nature being a particular way? Are they willing to discuss these ideas, and defend their beliefs, or is there something subconsciously repulsive about certain beliefs that renders them unable to discuss it rationally, but instead forces them to revert to defensive techniques like appeal to authority or popular tribal axioms. Is uncertainty acceptable?
- scarejunba 7y ago
  Do therapists actually contribute? I'm sceptical. For me, I got so much of the value from taking MDMA and just knowing my friends were around and actually loved me. Ended so much anxiety. Between Molly and Acid and these folks, I think I'm pretty much safe for the rest of my life.
wtracy 7y ago
My understanding is that the ketamine dosages used for treating depression are much, much lower than the dosages used recreationally. (I could be remembering wrong.) Otherwise, the big advantage of getting a nurse to do it is that they are in a position to treat you if one of the rare but potentially fatal side effects pops up.

missosoup 7y ago

It matches up with the experience of anyone who has ever taken these drugs. These drugs, taken with a good group of people, always lead to a therapy-like experience. And as GP comment said, they give you the ability to clearly identify what bothers you in life and what to do about it. The only difference between 'medical' sessions and 'recreational' ones is that you're talking to a therapist instead of friends. Having done both, friends are generally the better option. Actually acting on that information to improve your life is a completely different task, and without taking that step, these drugs do nothing for mental health long term. There is no difference between 'medicine' and 'drug' other than some regulatory body slapping a label on it. Especially the case with psychedelics where early pioneers performed and documented way more experimentation than FDA-approved research could ever hope to cover.

golemiprague 7y ago
MDMA and LSD gives you a bit of a different perspective, K not so much. Once it wears off you stay with your insights but it can't really help you act upon them. I probably took this stuff with a bit of a more fun kind of group so there was not much of "someone raped me when i was 9" type of talk. Just the understanding that the mind can work in a different way to the normal and that you can feel and behave in a different way is the main insight, but from there you still have to do the tedious work of actually implement the changes to your life.
WalterSear 7y ago
I've been taking intranasal racemic ketamine for a year. It's not a replacement for therapy - it's treatment for organic depression. As far as we can tell, the people like me who need ketamine don't have any effective alternatives, since their depression isn't simply exacerbated situational depression, but is driven by biologic processes, specifically involving inflammation. This isn't about drug induced insight - it's about brain chemistry. There is absolutely difference between medical and recreational ketamine use, since the actual chemistry is unrelated - the high of the ketamine is not related to it's beneficial effect. Moreover, my ketamine use and schedule wouldn't make sense recreationally. The dose is just enough to be debilitating - the equivalent of 1/4-1/2 a line. Ironically, due to the unfortunate nature of contemporary american society, regulatory capture has resulted in the FDA approved ketamine (s-ketamine aka esketamine) treatment being more inebriating and less effective antidepressant than recreationally consumed ketamine - which, being unpatentable is consequently unprofitable. A less inebriating, more effective antidepressant r-ketamine is 'in the wings', in order to let pharmaceutical companies milk as much money as they can from this otherwise cheap and effective drug. Hopefully psychiatrists will see through this, and start prescribing off-label ketamine once they have seen the effect that esketamine has on their treatment resistant patients.