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Note that this study is not a controlled trial. It is measuring 358 people who already were going to use psychedelics, before and after their use. What is seve

Note that this study is not a controlled trial. It is measuring 358 people who already were going to use psychedelics, before and after their use. What is severely missing is any report on incidence of adverse reactions, especially since they have two subsamples, one within traditional contexts and other completely self administered, which I would guess have different strategies on handling those. Anyone who experienced a bad trip can attest that set & setting matters a lot, and psychedelic experiences are far from guaranteed to be curative. For example for people high in neuroticism psychedelics can cause challenging experiences which can increase neuroticism even further. We don't know if those populations were screened out, implicitly or explicitly. [1] [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5540159/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5540159/

tempsy 6y ago
"bad trip" can mean a lot of things - there are cases when people really freak out but there's others where it's a difficult trip because psychedelics force you to let go and confront things that you've pushed away or avoided
PragmaticPulp 6y ago
Thanks for linking the actual study. The selection bias in studies like these is massive. Including only people who actively planned to use psychedelics is a guaranteed way to bias your results toward people who are already true believers. People who voluntarily chose to seek out psychedelics, despite high legal consequences for doing so, are likely already convinced that the psychedelics will "work" for whatever goal they're trying to achieve. Selecting these people over the internet will only further concentrate the group toward people who enjoy discussing and researching this topic online. In short, they optimized the test group for maximum placebo effect. It's fascinating to watch how internet comments will quickly tear apart any study of prescription medication that has obvious sampling bias, lacks control groups, and relies on self-reported information gathered from internet surveys except when the study tells people what they want to hear. I'm all for the resurgence of proper, controlled research into psychedelics for treating mental health issues in conjunction with therapy. Let's get to the bottom of this and draw some scientific conclusions on the matter. However, questionable studies like this do more harm than good for the body of research. It may feel good to see studies that claim positive results, but the more we build the body of research on top of obviously flawed studies like this, the harder it is for serious researchers and lawmakers to take it seriously.
- im3w1l 6y ago
  Even with all the caveats it's still interesting. It suggests that if someone is determined to use psychedelics to self-medicate their depression, you should not try to stop them. A priori you might think there is is a high likelihood that the drug use will just make everything worse.
  - astrophysician 6y ago
    I disagree -- "studies" like this give people the potentially misleading impression that psychedelics are helpful for depression and other mental health issues, so people who otherwise would have not used them may be more likely to, and we have no idea how this shakes out in an unbiased sample.
  - acituan 6y ago
    > It suggests that if someone is determined to use psychedelics to self-medicate their depression, you should not try to stop them. That is precisely the bias and weakness of this study. Self-medication is almost always a red flag; why not do it in a context of other people that know their stuff, be it tradition, institution (therapy) or even close friends that are mutually invested in each other's long term well-being? DIY approaches to self-transformation are fragile; no one to hold you out of potential pitfalls, to protect you from re-traumatization, to call you out on your self-deception. The title of the article that it "reduces depressive symptoms" is also telling of this bias. If symptom reduction was equivocal to enduring transformation, weed, cocaine and alcohol would have already healed the entire world. Without the study measuring if the subjects transformed their lives in a way that they were equally symptom free for the next 6 months, 1 year, 5 years, we can't conclude anything curative really took place. Don't get me wrong, they make a theoretical link to ACT in which experiencing of chronically difficult emotions are facilitated, which does offer potentially huge benefits, but just like we don't use studies on antidepressants that show symptom reduction to go shop bunch of prozac, we shouldn't readily assume we can use this one to facilitate our own healing in a DIY fashion either.
  - dongvsascript 6y ago
    and it does make it worse. "if someone is determined to use psychedelics to self-medicate their depression" they recognize they have a problem, are trying things to fix it, and hence have a higher chance of a control group that does nothing, or doesn't acknowledge how bad they feel, or have an urge to get better. you select a sample of people who want to get better, and are surprised they get better more frequently than a group including people who don't? where's the test on a person depressed and not actively trying to get better taking the same drug? i bet the negative side effects and the death of extra brain cells makes it worse. yes, if someone tries to use drugs to fix something, you absolutely should stop them. there's a reason you need a doctorate to prescribe those drugs. new test. my test. I'm going to prove wikipedia makes you a neurosurgeon. let's take 300 highschool seniors who read a wiki article on neurosurgery. let's take another 300 from a random sampling at the dmv. send them all to school for neurosurgery. wow. just wow. the 300 who read the article - a higher percentage of them succeeded in becoming a neurosurgeon. holy crap. wikipedia is amazing.
deleted 6y ago
[deleted]

tempsy 6y ago

"bad trip" can mean a lot of things - there are cases when people really freak out but there's others where it's a difficult trip because psychedelics force you to let go and confront things that you've pushed away or avoided

PragmaticPulp 6y ago

Thanks for linking the actual study. The selection bias in studies like these is massive. Including only people who actively planned to use psychedelics is a guaranteed way to bias your results toward people who are already true believers. People who voluntarily chose to seek out psychedelics, despite high legal consequences for doing so, are likely already convinced that the psychedelics will "work" for whatever goal they're trying to achieve. Selecting these people over the internet will only further concentrate the group toward people who enjoy discussing and researching this topic online. In short, they optimized the test group for maximum placebo effect. It's fascinating to watch how internet comments will quickly tear apart any study of prescription medication that has obvious sampling bias, lacks control groups, and relies on self-reported information gathered from internet surveys except when the study tells people what they want to hear. I'm all for the resurgence of proper, controlled research into psychedelics for treating mental health issues in conjunction with therapy. Let's get to the bottom of this and draw some scientific conclusions on the matter. However, questionable studies like this do more harm than good for the body of research. It may feel good to see studies that claim positive results, but the more we build the body of research on top of obviously flawed studies like this, the harder it is for serious researchers and lawmakers to take it seriously.

im3w1l 6y ago
Even with all the caveats it's still interesting. It suggests that if someone is determined to use psychedelics to self-medicate their depression, you should not try to stop them. A priori you might think there is is a high likelihood that the drug use will just make everything worse.
- astrophysician 6y ago
  I disagree -- "studies" like this give people the potentially misleading impression that psychedelics are helpful for depression and other mental health issues, so people who otherwise would have not used them may be more likely to, and we have no idea how this shakes out in an unbiased sample.
- acituan 6y ago
  > It suggests that if someone is determined to use psychedelics to self-medicate their depression, you should not try to stop them. That is precisely the bias and weakness of this study. Self-medication is almost always a red flag; why not do it in a context of other people that know their stuff, be it tradition, institution (therapy) or even close friends that are mutually invested in each other's long term well-being? DIY approaches to self-transformation are fragile; no one to hold you out of potential pitfalls, to protect you from re-traumatization, to call you out on your self-deception. The title of the article that it "reduces depressive symptoms" is also telling of this bias. If symptom reduction was equivocal to enduring transformation, weed, cocaine and alcohol would have already healed the entire world. Without the study measuring if the subjects transformed their lives in a way that they were equally symptom free for the next 6 months, 1 year, 5 years, we can't conclude anything curative really took place. Don't get me wrong, they make a theoretical link to ACT in which experiencing of chronically difficult emotions are facilitated, which does offer potentially huge benefits, but just like we don't use studies on antidepressants that show symptom reduction to go shop bunch of prozac, we shouldn't readily assume we can use this one to facilitate our own healing in a DIY fashion either.
- dongvsascript 6y ago
  and it does make it worse. "if someone is determined to use psychedelics to self-medicate their depression" they recognize they have a problem, are trying things to fix it, and hence have a higher chance of a control group that does nothing, or doesn't acknowledge how bad they feel, or have an urge to get better. you select a sample of people who want to get better, and are surprised they get better more frequently than a group including people who don't? where's the test on a person depressed and not actively trying to get better taking the same drug? i bet the negative side effects and the death of extra brain cells makes it worse. yes, if someone tries to use drugs to fix something, you absolutely should stop them. there's a reason you need a doctorate to prescribe those drugs. new test. my test. I'm going to prove wikipedia makes you a neurosurgeon. let's take 300 highschool seniors who read a wiki article on neurosurgery. let's take another 300 from a random sampling at the dmv. send them all to school for neurosurgery. wow. just wow. the 300 who read the article - a higher percentage of them succeeded in becoming a neurosurgeon. holy crap. wikipedia is amazing.

deleted 6y ago

[deleted]