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The Yale Manual for Psilocybin-Assisted Therapy of Depression

_virtu 6y ago
Does anyone have recommendations for being a subject these studies. I’ve been going through a really bad stint of anxiety and depression. I’m picking up CBT and am planning on counseling, but I have been seriously interested in trying this.
troydavis 6y ago
At least as written, the advice for problems during medication sessions is pretty simple (though note the presence of a physician "sitter" alongside the therapist): > Responding to intense, painful affect states > The therapists will gently encourage the subject to “lean in” or “go towards” intense or difficult affective states, rather than try to avoid or diminish them. > Responding to agitation or restlessness > The therapist will encourage breathing exercises and grounding techniques, as described above. If these are not helpful, the participant will be invited to sit up, take off the eyeshades and make visual contact with the therapists and the room. The therapists may offer reassurance that such states are to be expected and are likely to be short lived. > Responding to marked agitation > If the subject displays significant or marked agitation and previously mentioned interventions fail, the therapist will consult with the physician regarding the possible administration of benzodiazepine or antipsychotic medication. Medical intervention will be utilized only when agitation is persistent, and no other means to help relieve the agitation are effective.
- loceng 6y ago
  Based on just what you've copied here, Maps.org's manual for MDMA-assisted therapy seems more thorough and detailed. Arguably this is where mainstream medicine needs to catch up, and where a lack of multi-disciplinary approach still exists: Rick Doblin (the founder of Maps.org) has suggested that if someone has difficulty processing during an Ayahuasca ceremony (a potentially more intense, more potent version of Psilocybin session/ceremony) said to give a half-therapeutic dose of MDMA (100mg to 125mg is therapeutic dose; 180-200mg is generally what's used recreationally, usually not all at once) - and so I hope sooner than later this guide is updated to replace "possible administration of benzodiazepine or antipsychotic medication" with "possible administration of MDMA;" instead of numbing a person's nervous system/emotions with a benzodiazepine or changing how their brain is actually functioning, instead use MDMA to cause the brain to release more serotonin at once than it naturally can - allowing everything to feel and be easier to connect to and process; reducing the stress level enough where it's not acting as a blocking function, hence PTSD is from extremely stressful past experiences that are too overwhelming to process.
  - mpnagle 6y ago
    Because of the presence of MAOIs, mixing ayahuasca with other drugs that affect serotonin such as MDMA or anti-depressants such as selective serotonin reuptake inhibitors (SSRIs), may be particularly dangerous. via https://adf.org.au/drug-facts/ayahuasca/ https://adf.org.au/drug-facts/ayahuasca/ I imagine what Doblin meant is working with MDMA after an ayahuasca ceremony.
    - loceng 6y ago
      Good thought - but nope, and I've done it. The issue with SSRIs are them being reuptake inhibitors - they actually change how the brain functions vs. MDMA is simply causing serotonin to be released. I also happen to be taking a dopamine agonist to treat a benign brain tumour I have (prolactinoma) - first line of treatment is adding a dopamine agonist to the system, and not using an SSRI/SNRI/etc that changes the actual function was fine as well for ceremony; a caveat to research or understand/have caution with is that I had done 30+ Ayahuasca ceremonies prior to taking a dopamine agonist - and so my mind/brain was generally already "opened" how it will be. Care/caution may be necessary if a person has never "opened" up their mind/brain yet (after X ceremonies/experiences) and if they are taking dopamine for whatever reason, as maybe once the pathways that get opened from Ayahuasca et al then the impact of the dopamine would shift as well - perhaps then overcompensating for blocks that get cleared by the Aya etc - and the person may then experience undesired levels of effects from the dopamine. MDMA isn't directly changing the actual function, they're not causing inhibition; the action of how is important, the nuance is important to understand - though like from your comment - there isn't this general understanding that there is a difference, and I imagine most doctors/professionals will jump to the same conclusion without thinking about it - misattributing the different actions instead of critical thinking from foundational principles. It's not the neurotransmitter(s) that are a problem, at least not serotonin and dopamine, it's if the function change of how they're allowed to flow changes that's the problem. Interview/chat between Dr. K (Healthygamer_gg) and Rick Doblin - https://www.youtube.com/watch?v=1e2h-awLC-s https://www.youtube.com/watch?v=1e2h-awLC-s - where he mentions taking half-therapeutic dose; more of a casual conversation where you can also hear a bit of Rick's origin story. I did fairly deep research on this beforehand, looking into actual pharmacological aspect of interactions with things like dopamine, etc - a few people over the last 20 years have been keeping track of all related research. I don't have the link for the most succinct, detailed writeup I read handy.
- pmoriarty 6y ago
  I haven't seen any therapeutic guidelines recommending this, nor research supporting it, but anecdotally and from personal experience, doing something expressive with the body like dancing, chanting, singing, or playing an acoustic instrument during difficult experiences can help. This is, of course, something that's been done for millennia by traditional cultures in altered states of consciousness and during ritual, so there's plenty of precedent for it and it's far from a new idea. I hope some research is done on this sort of intervention, and expect the results will be positive.
  - danenania 6y ago
    Another tip, along the same lines as dancing, is to do some physical exercise. Excess physical energy and restlessness is a common side effect of psychedelics, and that can easily translate into mental anxiety. Expending some of that energy through jumping jacks, push ups, running, hiking or whatever can help calm the jitters and make it easier to relax into the experience. Just don't do anything that involves too much coordination or dealing with traffic :)
    - pmoriarty 6y ago
      A safety tip about that: Before taking whatever it is you're taking be sure to thoroughly investigate its physical effects and learn about the precautions you should be taking, and what to or not to do. For example, MDMA, which is sometimes sold on the street as Ecstacy or Molly (and sometimes other drugs are sold under those names, which is yet another danger) can interfere with the body's temperature regulation ability, so when you take it and start dancing and get hot you might not be able to cool off as effectively... which is one reason why people can die from it, especially if they're dancing a lot in already hot environments (like at an outdoor festival on a sunny day or in a hot club with poor ventilation), or when they don't drink enough water, or drink too much water.. any of these can kill you, and people have died from just this. DanceSafe's recommendations for MDMA are to drink one pint of water an hour. Below are some fantastic videos from Emanuel Sferios, the founder of DanceSafe, that he gave at UC Berkeley about MDMA (and general recreational drug) safety, which I highly recommend everyone watch. You could save your life or that of a friend by learning what's in these videos. So, everyone, please EDUCATE YOURSELF and stay safe! [1] - Part 1 - The History of MDMA https://www.youtube.com/watch?v=8ZY-ZFJnWbg https://www.youtube.com/watch?v=8ZY-ZFJnWbg [2] - Part 2 - Tips for Safer Use https://www.youtube.com/watch?v=HgUPKYrpBvY https://www.youtube.com/watch?v=HgUPKYrpBvY [3] - Part 3 - Pharmacology and Medical Use https://www.youtube.com/watch?v=UHduGGB5kJU https://www.youtube.com/watch?v=UHduGGB5kJU [4] - Part 4 - The Need for Drug Policy Reform https://www.youtube.com/watch?v=nTSiyQHm2s4 https://www.youtube.com/watch?v=nTSiyQHm2s4 [5] - Part 5 - Heather Brooks https://www.youtube.com/watch?v=O8s-nhlaACw https://www.youtube.com/watch?v=O8s-nhlaACw [6] - Part 6 - Joseph Pred https://www.youtube.com/watch?v=0wolzUE3lPk https://www.youtube.com/watch?v=0wolzUE3lPk [7] - Part 7 - Question & Answer https://www.youtube.com/watch?v=rovaoVjLnOk https://www.youtube.com/watch?v=rovaoVjLnOk [8] - Prohibition Fatalities and MDMA Complexities: Interview With Emanuel Sferios, the founder of DanceSafe https://www.youtube.com/watch?v=yHKYogJ8Yxs https://www.youtube.com/watch?v=yHKYogJ8Yxs
- ericmcer 6y ago
  Is it weird that I would want a therapist who had also taken psilocybin? Preferably many times. It feels like it would be demeaning to have someone who approached it in a clinical and proscribed manner.
  - chiefgeek 6y ago
    Not weird at all. I did a therapeutic mdma session with an incredibly well trained therapist who was also very experienced with medicine work. It’s the same for ayahuasca, which I also experienced. You wouldn’t want a shaman who hadn’t waked the walk.
  - pmoriarty 6y ago
    If I'm not mistaken, in order to get certified to do MDMA-assisted therapy in the US you have to have had the therapy yourself (and I'd be surprised if most therapists interested in doing this kind of therapy hadn't already had multiple psychedelic experiences before and during training). I'm not sure what the criteria for getting certified to do psilocybin-assisted therapy are or will be, but my guess is they'll probably be pretty similar. In general, at least for now, it's pretty safe to say that most therapists interested in doing psychedelic therapy are already interested in psychedelics and probably are already "experienced" or will be during training. For me, much more important than if they've had a psychedelic experience is if they're highly recommended by well-informed people who've gone through therapy with them and who I trust. If they green-light them, I'd feel much more secure.
    - thrav 6y ago
      That makes sense, as it’s true of many different varieties of therapy. During certification, the aspiring therapists are also required to undergo their own therapy.
- trianglem 6y ago
  Interesting the leaning into distressing states seems really scary if there is no way to correct the underlying problem. One of my disabled friends had a bad trip around the fact that he lost a leg and there was no way to correct that problem so he remained severely depressed for at least a year after the trip. He used to be a pretty bubbly guy before then.
  - dwaltrip 6y ago
    That sounds like a very difficult experience, I’m sorry for your friend. At risk of overstepping, I wonder if the underlying issue might be better viewed as needing to rectify and update previous ways of being, self-models, and goals with the new circumstances. As well as fully grieving this loss, coming to terms with how things are, and learning to imagine all of the new possibilities that can still be realized.
    - trianglem 6y ago
      I would argue that in very specific cases being in ignorance/denial is better than wholly accepting your circumstances.
    - curryst 6y ago
      Sure, but isn't that exactly what we would be trying to treat? I would like to believe in hallucinogenic therapy, but if it can cause an underlying problem to expand to the point where it causes a negative change in behavior, that's not good. It would certainly depend on the risk, but having a risk of triggering a mental illness the person was previously coping with is not a good thing. Finding a way to deal with your problems is the best solution. In lieu of that, I would argue coping with them without handling them is the second best, with neither handling them not coping them being a distant last place.
- deleted 6y ago
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- wavefunction 6y ago
  You could just give them a hydrocodone or other opioid to kill the trip in about 10 to 15 minutes.
  - mushlove 6y ago
    ~5mg of Trazadone works as well. Applies to LSD and other psyches
dukeofdoom 6y ago
yes, but did he see interdimensional elves?
loceng 6y ago
Here's MAPS.org's 69 page manual (PDF; 2015) for MDMA-assisted therapy for PTSD (and other): https://maps.org/research-archive/mdma/MDMA-Assisted-Psychotherapy-Treatment-Manual-Version7-19Aug15-FINAL.pdf https://maps.org/research-archive/mdma/MDMA-Assisted-Psychot...
- c-c-c-c-c 6y ago
  Maps could learn a thing or two from the typesetting of the Yale manual.
- nosmokewhereiam 6y ago
  Thanks! Found page 59 interesting as well and looks great for learning more: 10.0 Appendix B: Suggested Reading List
Felony_Fred 6y ago
Cutting edge -> Matthew Johnson: Psychedelics | Lex Fridman Podcast #145 https://www.youtube.com/watch?v=ICj8p5jPd3Y https://www.youtube.com/watch?v=ICj8p5jPd3Y Matthew W. Johnson is a professor and psychedelics researcher at Johns Hopkins.
canada_dry 6y ago
> "placibo sessions" are noted in a couple parts of the paper. I can't imagine any participant not realizing they've been subject to a placibo after no more than an hour into the session (unless they have no idea it is a psilocybin study).
- Alex3917 6y ago
  Scientists usually use active placebos for psilocybin therapy, so the difference isn't necessarily going to be obvious.
  - budoso 6y ago
    Huh, didn't know that active placebos existed. (I'm not in the medical field) Would you go more in depth on this? What would they use as a placebo, if not psilocybin? Couldn't an active placebo affect the patients and skew the results/measured effectiveness of the main drug being studied?
    - cuspycode 6y ago
      I'm not in the medical field either, but I remember they used niacin (a form of vitamin B₃) as an active placebo in the Good Friday Experiment[0] in 1962. The niacin doses produced some noticeable physiological effects, but it didn't take long before it became abundantly clear for everyone present who had gotten the psilocybin and who had gotten the niacin. [0]. https://en.wikipedia.org/wiki/Marsh_Chapel_Experiment https://en.wikipedia.org/wiki/Marsh_Chapel_Experiment
- JacobSuperslav 6y ago
  niacin as the other person said, but also: in my experience a placebo can be just as strong as a low dose acid trip.
ada1981 6y ago
The idea of letting go and surrendering into an experience is useful for all types of psychedelics. We use this approach as well with http://TryWithin.com http://TryWithin.com (in home psychedelic assisted therapy)
- krmmalik 6y ago
  This is super interesting. What geography do you operate in? Could you assist someone in the UK for example? (My concern is the legality of it all rather than the practical aspects)
  - ada1981 6y ago
    Right now we have been focused in the US. We’d be open to find an MD in the UK who could prescribe however if you are interested.
- krmmalik 6y ago
  Also. Why is your service not more well known? I've been researching this area quite a while. This is ground breaking stuff with the potential to seriously change lives. I'm surprised your company isn't plastered everywhere? If I can be of any help, do let me know? I'm a business strategist.
  - ada1981 6y ago
    We were in a private beta test, and have just started to try and reach more clients. We’d love help! We do think we can help more people and that we haven’t solved the best way to reach them.
    - krmmalik 6y ago
      I'd love to chat. What's the best way to reach you?
      - ada1981 6y ago
twirlock 6y ago
I should be allowed to take mushrooms. Telling me that someone needs a credential to give me mushrooms is a violation of separation of church and state. It shouldn't be that legislators and law enforcement can only learn obvious things from dickheads in labcoats or in the media.
deleted 6y ago
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f430 6y ago
One of the craziest thing about Psilocybin mushroom is that it is quite possibly one of the most bizarre things on earth literally. Here's what TM had to say about it's chemical structure: “I’ve mentioned that psilocin, which is what psilocybin quickly becomes as it enters your metabolism, is 4 hydroxy dimethyltryptamine. It is the only 4-substituted indole in all of organic nature. Let this rattle around in your mind for a moment. It is the only 4-substituted indole known to exist on earth. It happens to be this psychedelic substance that occurs in about eighty species of fungi, most of which are native to the New World. Psilocybin has a unique chemical signature that says, “I am artificial; I come from outside.” However, this isn't the most bizarre thing, the crazy feature of psilocybe is that you can have communications with it, you can tell it to be MDMA or any drug and it will produce effects very similar. I've definitely tested out the latter statement as first discussed by TM and its a technique that I find has by far the most anti-depressant effect that still lingers. Many people freak out because they try to figure out what Psilocybin mushroom is and then all sorts of craziness is shown to you that can produce panic in beginners. Some people try it once, get freaked out by its deep introspective qualities that addresses the holes in our spirits. In fact one of the scariest experience was the second time I tried it where I experienced ego death for the first time. It literally feels like you are dying but funny enough it is because our body-mind complex is so fixated and attached to our ego, a mere illusion that is created by this...reality. Perhaps the most fundamental change in value systems that occurs during psilocybin creating a feeling of oneness and zen like state that reveals love is the only truth, everything else is falsehood and deception. It's no wonder that it poses a threat to hierarchial, dominant culture of centralized power by a small group. Psilocybe is not only the red pill that wakes you from the hypnosis of our modern reality shaped by the petrodollar economy that is destroying the planet, and as such, it is deemed illegal, taboo. One of the most frightening realization was that not the experiences that come out of consuming the psilocybin mushroom but the very reality that we live in and choose to ignore while focusing on only what we want to see because its too painful to admit what has happened in our modern world-an all out war against everything human: our bodies, our thoughts, our expressions. If we are to change this planet and our course of direction we must continue in our discovery of the past because it holds the key to our salvation. If only 1% of the population can cause a shift in consciousness it will have butterfly impact on the rest. We simply do not judge or hold contempt for the close minded, instead continue educating, continue the discussion, so that we can wake from the slumber, our constant desire for novelty and meaningless consumption. Psilocybin works because it is a device which causes truths to emerge from the swamps of lies and deceptions pulled over our heads. Barring sensory deprived meditation states like the Yogis of tibet that naturally produces DMT, the descendants of the Stoned Apes are once again rediscovering the very thing that has led to their dominance on this planet. Perhaps this is what TM was talking about the great "transcendental attractor object", we are perhaps on the edge of massive transformation of not only the human psyche through spiritualism but physicists will reveal part of the nature of the universe that will add more and more backing towards this "New Age" era.
andred14 6y ago
How about we get to the root of the problem ie. unlawful lockdowns and "safety measures" that are proven to not work and are not needed? "In the present study, virus culture was carried out on samples from asymptomatic positive cases, and found no viable SARS-CoV-2 virus. All close contacts of the asymptomatic positive cases tested negative, indicating that the asymptomatic positive cases detected in this study were unlikely to be infectious" https://www.nature.com/articles/s41467-020-19802-w https://www.nature.com/articles/s41467-020-19802-w https://rationalground.com/mask-charts/ https://rationalground.com/mask-charts/
imperio59 6y ago
Right. You're depressed, so the best solution must obviously be to consume drugs and take a trip that could potentially render you psychotic for life. This is not medecine. It is no better than the voodoo doctors of old who made you take the "funny herbs" to cure your "demons". This is garbage and not science.
- lifty 6y ago
  I’m sorry, but you are clueless.
- colonwqbang 6y ago
  It's all drugs in psychiatry, the good ones and the bad ones. We don't know which are the good ones unless we conduct proper research.
- thrwn_frthr_awy 6y ago
  Ketamine treatment was the only thing the helped my severe depression. Without it It was like a flip was switched. Your dismissiveness if really inconsiderate to people that have been living through chronic depression for years.
  - nefitty 6y ago
    Hi, I’m curious about your experience. I hear the ketamine therapy experience frequently described as “a switch flip”. What do you find is different from one state to the other? I began hearing of an interesting idea that depression can be treated with CBT because that therapy teaches the patient not how to ruminate less, but instead, how to ruminate more efficiently. Presumably, more efficient rumination on problems leads more quickly to acceptable solutions, ideas, etc, which can then be integrated by the person.
- LocalH 6y ago
  It's a much better solution than SSRIs, the research is starting to show. I presume you also oppose the research into cannabinoids?
hn_asker 6y ago
I find that it is important to have these during a psychadelic experience: 1. Medical supervision - the security makes it easier for one to let go. 2. Professionalism - be led by someone who has guided others and who the person trusts. 3. Integration - reflect on the experience to learn from it.
kvee 6y ago
We built https://tripinstructions.com https://tripinstructions.com as a little hackathon project earlier this year Considering building it out a bit more Would love any feedback or suggestions anyone might have
intricatedetail 6y ago
All those people who prevented research and helped throw innocent and suffering people to jail or worse should be in jail themselves. It is scary how many people believe in drug prohibition scam.
Projectiboga 6y ago
Niacin is the best kill switch for adverse psychedelic responses or just to finish session promptly. This was used decades ago by the group that provided first aid at psychedelic sessions in San Francisco way back when. I don't recall the name for that help group.

Does anyone have recommendations for being a subject these studies. I’ve been going through a really bad stint of anxiety and depression. I’m picking up CBT and am planning on counseling, but I have been seriously interested in trying this.

troydavis 6y ago

At least as written, the advice for problems during medication sessions is pretty simple (though note the presence of a physician "sitter" alongside the therapist): > Responding to intense, painful affect states > The therapists will gently encourage the subject to “lean in” or “go towards” intense or difficult affective states, rather than try to avoid or diminish them. > Responding to agitation or restlessness > The therapist will encourage breathing exercises and grounding techniques, as described above. If these are not helpful, the participant will be invited to sit up, take off the eyeshades and make visual contact with the therapists and the room. The therapists may offer reassurance that such states are to be expected and are likely to be short lived. > Responding to marked agitation > If the subject displays significant or marked agitation and previously mentioned interventions fail, the therapist will consult with the physician regarding the possible administration of benzodiazepine or antipsychotic medication. Medical intervention will be utilized only when agitation is persistent, and no other means to help relieve the agitation are effective.

loceng 6y ago
Based on just what you've copied here, Maps.org's manual for MDMA-assisted therapy seems more thorough and detailed. Arguably this is where mainstream medicine needs to catch up, and where a lack of multi-disciplinary approach still exists: Rick Doblin (the founder of Maps.org) has suggested that if someone has difficulty processing during an Ayahuasca ceremony (a potentially more intense, more potent version of Psilocybin session/ceremony) said to give a half-therapeutic dose of MDMA (100mg to 125mg is therapeutic dose; 180-200mg is generally what's used recreationally, usually not all at once) - and so I hope sooner than later this guide is updated to replace "possible administration of benzodiazepine or antipsychotic medication" with "possible administration of MDMA;" instead of numbing a person's nervous system/emotions with a benzodiazepine or changing how their brain is actually functioning, instead use MDMA to cause the brain to release more serotonin at once than it naturally can - allowing everything to feel and be easier to connect to and process; reducing the stress level enough where it's not acting as a blocking function, hence PTSD is from extremely stressful past experiences that are too overwhelming to process.
- mpnagle 6y ago
  Because of the presence of MAOIs, mixing ayahuasca with other drugs that affect serotonin such as MDMA or anti-depressants such as selective serotonin reuptake inhibitors (SSRIs), may be particularly dangerous. via https://adf.org.au/drug-facts/ayahuasca/ https://adf.org.au/drug-facts/ayahuasca/ I imagine what Doblin meant is working with MDMA after an ayahuasca ceremony.
  - loceng 6y ago
    Good thought - but nope, and I've done it. The issue with SSRIs are them being reuptake inhibitors - they actually change how the brain functions vs. MDMA is simply causing serotonin to be released. I also happen to be taking a dopamine agonist to treat a benign brain tumour I have (prolactinoma) - first line of treatment is adding a dopamine agonist to the system, and not using an SSRI/SNRI/etc that changes the actual function was fine as well for ceremony; a caveat to research or understand/have caution with is that I had done 30+ Ayahuasca ceremonies prior to taking a dopamine agonist - and so my mind/brain was generally already "opened" how it will be. Care/caution may be necessary if a person has never "opened" up their mind/brain yet (after X ceremonies/experiences) and if they are taking dopamine for whatever reason, as maybe once the pathways that get opened from Ayahuasca et al then the impact of the dopamine would shift as well - perhaps then overcompensating for blocks that get cleared by the Aya etc - and the person may then experience undesired levels of effects from the dopamine. MDMA isn't directly changing the actual function, they're not causing inhibition; the action of how is important, the nuance is important to understand - though like from your comment - there isn't this general understanding that there is a difference, and I imagine most doctors/professionals will jump to the same conclusion without thinking about it - misattributing the different actions instead of critical thinking from foundational principles. It's not the neurotransmitter(s) that are a problem, at least not serotonin and dopamine, it's if the function change of how they're allowed to flow changes that's the problem. Interview/chat between Dr. K (Healthygamer_gg) and Rick Doblin - https://www.youtube.com/watch?v=1e2h-awLC-s https://www.youtube.com/watch?v=1e2h-awLC-s - where he mentions taking half-therapeutic dose; more of a casual conversation where you can also hear a bit of Rick's origin story. I did fairly deep research on this beforehand, looking into actual pharmacological aspect of interactions with things like dopamine, etc - a few people over the last 20 years have been keeping track of all related research. I don't have the link for the most succinct, detailed writeup I read handy.
pmoriarty 6y ago
I haven't seen any therapeutic guidelines recommending this, nor research supporting it, but anecdotally and from personal experience, doing something expressive with the body like dancing, chanting, singing, or playing an acoustic instrument during difficult experiences can help. This is, of course, something that's been done for millennia by traditional cultures in altered states of consciousness and during ritual, so there's plenty of precedent for it and it's far from a new idea. I hope some research is done on this sort of intervention, and expect the results will be positive.
- danenania 6y ago
  Another tip, along the same lines as dancing, is to do some physical exercise. Excess physical energy and restlessness is a common side effect of psychedelics, and that can easily translate into mental anxiety. Expending some of that energy through jumping jacks, push ups, running, hiking or whatever can help calm the jitters and make it easier to relax into the experience. Just don't do anything that involves too much coordination or dealing with traffic :)
  - pmoriarty 6y ago
    A safety tip about that: Before taking whatever it is you're taking be sure to thoroughly investigate its physical effects and learn about the precautions you should be taking, and what to or not to do. For example, MDMA, which is sometimes sold on the street as Ecstacy or Molly (and sometimes other drugs are sold under those names, which is yet another danger) can interfere with the body's temperature regulation ability, so when you take it and start dancing and get hot you might not be able to cool off as effectively... which is one reason why people can die from it, especially if they're dancing a lot in already hot environments (like at an outdoor festival on a sunny day or in a hot club with poor ventilation), or when they don't drink enough water, or drink too much water.. any of these can kill you, and people have died from just this. DanceSafe's recommendations for MDMA are to drink one pint of water an hour. Below are some fantastic videos from Emanuel Sferios, the founder of DanceSafe, that he gave at UC Berkeley about MDMA (and general recreational drug) safety, which I highly recommend everyone watch. You could save your life or that of a friend by learning what's in these videos. So, everyone, please EDUCATE YOURSELF and stay safe! [1] - Part 1 - The History of MDMA https://www.youtube.com/watch?v=8ZY-ZFJnWbg https://www.youtube.com/watch?v=8ZY-ZFJnWbg [2] - Part 2 - Tips for Safer Use https://www.youtube.com/watch?v=HgUPKYrpBvY https://www.youtube.com/watch?v=HgUPKYrpBvY [3] - Part 3 - Pharmacology and Medical Use https://www.youtube.com/watch?v=UHduGGB5kJU https://www.youtube.com/watch?v=UHduGGB5kJU [4] - Part 4 - The Need for Drug Policy Reform https://www.youtube.com/watch?v=nTSiyQHm2s4 https://www.youtube.com/watch?v=nTSiyQHm2s4 [5] - Part 5 - Heather Brooks https://www.youtube.com/watch?v=O8s-nhlaACw https://www.youtube.com/watch?v=O8s-nhlaACw [6] - Part 6 - Joseph Pred https://www.youtube.com/watch?v=0wolzUE3lPk https://www.youtube.com/watch?v=0wolzUE3lPk [7] - Part 7 - Question & Answer https://www.youtube.com/watch?v=rovaoVjLnOk https://www.youtube.com/watch?v=rovaoVjLnOk [8] - Prohibition Fatalities and MDMA Complexities: Interview With Emanuel Sferios, the founder of DanceSafe https://www.youtube.com/watch?v=yHKYogJ8Yxs https://www.youtube.com/watch?v=yHKYogJ8Yxs
ericmcer 6y ago
Is it weird that I would want a therapist who had also taken psilocybin? Preferably many times. It feels like it would be demeaning to have someone who approached it in a clinical and proscribed manner.
- chiefgeek 6y ago
  Not weird at all. I did a therapeutic mdma session with an incredibly well trained therapist who was also very experienced with medicine work. It’s the same for ayahuasca, which I also experienced. You wouldn’t want a shaman who hadn’t waked the walk.
- pmoriarty 6y ago
  If I'm not mistaken, in order to get certified to do MDMA-assisted therapy in the US you have to have had the therapy yourself (and I'd be surprised if most therapists interested in doing this kind of therapy hadn't already had multiple psychedelic experiences before and during training). I'm not sure what the criteria for getting certified to do psilocybin-assisted therapy are or will be, but my guess is they'll probably be pretty similar. In general, at least for now, it's pretty safe to say that most therapists interested in doing psychedelic therapy are already interested in psychedelics and probably are already "experienced" or will be during training. For me, much more important than if they've had a psychedelic experience is if they're highly recommended by well-informed people who've gone through therapy with them and who I trust. If they green-light them, I'd feel much more secure.
  - thrav 6y ago
    That makes sense, as it’s true of many different varieties of therapy. During certification, the aspiring therapists are also required to undergo their own therapy.
trianglem 6y ago
Interesting the leaning into distressing states seems really scary if there is no way to correct the underlying problem. One of my disabled friends had a bad trip around the fact that he lost a leg and there was no way to correct that problem so he remained severely depressed for at least a year after the trip. He used to be a pretty bubbly guy before then.
- dwaltrip 6y ago
  That sounds like a very difficult experience, I’m sorry for your friend. At risk of overstepping, I wonder if the underlying issue might be better viewed as needing to rectify and update previous ways of being, self-models, and goals with the new circumstances. As well as fully grieving this loss, coming to terms with how things are, and learning to imagine all of the new possibilities that can still be realized.
  - trianglem 6y ago
    I would argue that in very specific cases being in ignorance/denial is better than wholly accepting your circumstances.
  - curryst 6y ago
    Sure, but isn't that exactly what we would be trying to treat? I would like to believe in hallucinogenic therapy, but if it can cause an underlying problem to expand to the point where it causes a negative change in behavior, that's not good. It would certainly depend on the risk, but having a risk of triggering a mental illness the person was previously coping with is not a good thing. Finding a way to deal with your problems is the best solution. In lieu of that, I would argue coping with them without handling them is the second best, with neither handling them not coping them being a distant last place.
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wavefunction 6y ago
You could just give them a hydrocodone or other opioid to kill the trip in about 10 to 15 minutes.
- mushlove 6y ago
  ~5mg of Trazadone works as well. Applies to LSD and other psyches

dukeofdoom 6y ago

yes, but did he see interdimensional elves?

loceng 6y ago

Here's MAPS.org's 69 page manual (PDF; 2015) for MDMA-assisted therapy for PTSD (and other): https://maps.org/research-archive/mdma/MDMA-Assisted-Psychotherapy-Treatment-Manual-Version7-19Aug15-FINAL.pdf https://maps.org/research-archive/mdma/MDMA-Assisted-Psychot...

c-c-c-c-c 6y ago
Maps could learn a thing or two from the typesetting of the Yale manual.
nosmokewhereiam 6y ago
Thanks! Found page 59 interesting as well and looks great for learning more: 10.0 Appendix B: Suggested Reading List

Felony_Fred 6y ago

Cutting edge -> Matthew Johnson: Psychedelics | Lex Fridman Podcast #145 https://www.youtube.com/watch?v=ICj8p5jPd3Y https://www.youtube.com/watch?v=ICj8p5jPd3Y Matthew W. Johnson is a professor and psychedelics researcher at Johns Hopkins.

canada_dry 6y ago

> "placibo sessions" are noted in a couple parts of the paper. I can't imagine any participant not realizing they've been subject to a placibo after no more than an hour into the session (unless they have no idea it is a psilocybin study).

Alex3917 6y ago
Scientists usually use active placebos for psilocybin therapy, so the difference isn't necessarily going to be obvious.
- budoso 6y ago
  Huh, didn't know that active placebos existed. (I'm not in the medical field) Would you go more in depth on this? What would they use as a placebo, if not psilocybin? Couldn't an active placebo affect the patients and skew the results/measured effectiveness of the main drug being studied?
  - cuspycode 6y ago
    I'm not in the medical field either, but I remember they used niacin (a form of vitamin B₃) as an active placebo in the Good Friday Experiment[0] in 1962. The niacin doses produced some noticeable physiological effects, but it didn't take long before it became abundantly clear for everyone present who had gotten the psilocybin and who had gotten the niacin. [0]. https://en.wikipedia.org/wiki/Marsh_Chapel_Experiment https://en.wikipedia.org/wiki/Marsh_Chapel_Experiment
JacobSuperslav 6y ago
niacin as the other person said, but also: in my experience a placebo can be just as strong as a low dose acid trip.

ada1981 6y ago

The idea of letting go and surrendering into an experience is useful for all types of psychedelics. We use this approach as well with http://TryWithin.com http://TryWithin.com (in home psychedelic assisted therapy)

krmmalik 6y ago
This is super interesting. What geography do you operate in? Could you assist someone in the UK for example? (My concern is the legality of it all rather than the practical aspects)
- ada1981 6y ago
  Right now we have been focused in the US. We’d be open to find an MD in the UK who could prescribe however if you are interested.
krmmalik 6y ago
Also. Why is your service not more well known? I've been researching this area quite a while. This is ground breaking stuff with the potential to seriously change lives. I'm surprised your company isn't plastered everywhere? If I can be of any help, do let me know? I'm a business strategist.
- ada1981 6y ago
  We were in a private beta test, and have just started to try and reach more clients. We’d love help! We do think we can help more people and that we haven’t solved the best way to reach them.
  - krmmalik 6y ago
    I'd love to chat. What's the best way to reach you?
    - ada1981 6y ago

twirlock 6y ago

I should be allowed to take mushrooms. Telling me that someone needs a credential to give me mushrooms is a violation of separation of church and state. It shouldn't be that legislators and law enforcement can only learn obvious things from dickheads in labcoats or in the media.

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f430 6y ago

One of the craziest thing about Psilocybin mushroom is that it is quite possibly one of the most bizarre things on earth literally. Here's what TM had to say about it's chemical structure: “I’ve mentioned that psilocin, which is what psilocybin quickly becomes as it enters your metabolism, is 4 hydroxy dimethyltryptamine. It is the only 4-substituted indole in all of organic nature. Let this rattle around in your mind for a moment. It is the only 4-substituted indole known to exist on earth. It happens to be this psychedelic substance that occurs in about eighty species of fungi, most of which are native to the New World. Psilocybin has a unique chemical signature that says, “I am artificial; I come from outside.” However, this isn't the most bizarre thing, the crazy feature of psilocybe is that you can have communications with it, you can tell it to be MDMA or any drug and it will produce effects very similar. I've definitely tested out the latter statement as first discussed by TM and its a technique that I find has by far the most anti-depressant effect that still lingers. Many people freak out because they try to figure out what Psilocybin mushroom is and then all sorts of craziness is shown to you that can produce panic in beginners. Some people try it once, get freaked out by its deep introspective qualities that addresses the holes in our spirits. In fact one of the scariest experience was the second time I tried it where I experienced ego death for the first time. It literally feels like you are dying but funny enough it is because our body-mind complex is so fixated and attached to our ego, a mere illusion that is created by this...reality. Perhaps the most fundamental change in value systems that occurs during psilocybin creating a feeling of oneness and zen like state that reveals love is the only truth, everything else is falsehood and deception. It's no wonder that it poses a threat to hierarchial, dominant culture of centralized power by a small group. Psilocybe is not only the red pill that wakes you from the hypnosis of our modern reality shaped by the petrodollar economy that is destroying the planet, and as such, it is deemed illegal, taboo. One of the most frightening realization was that not the experiences that come out of consuming the psilocybin mushroom but the very reality that we live in and choose to ignore while focusing on only what we want to see because its too painful to admit what has happened in our modern world-an all out war against everything human: our bodies, our thoughts, our expressions. If we are to change this planet and our course of direction we must continue in our discovery of the past because it holds the key to our salvation. If only 1% of the population can cause a shift in consciousness it will have butterfly impact on the rest. We simply do not judge or hold contempt for the close minded, instead continue educating, continue the discussion, so that we can wake from the slumber, our constant desire for novelty and meaningless consumption. Psilocybin works because it is a device which causes truths to emerge from the swamps of lies and deceptions pulled over our heads. Barring sensory deprived meditation states like the Yogis of tibet that naturally produces DMT, the descendants of the Stoned Apes are once again rediscovering the very thing that has led to their dominance on this planet. Perhaps this is what TM was talking about the great "transcendental attractor object", we are perhaps on the edge of massive transformation of not only the human psyche through spiritualism but physicists will reveal part of the nature of the universe that will add more and more backing towards this "New Age" era.

andred14 6y ago

How about we get to the root of the problem ie. unlawful lockdowns and "safety measures" that are proven to not work and are not needed? "In the present study, virus culture was carried out on samples from asymptomatic positive cases, and found no viable SARS-CoV-2 virus. All close contacts of the asymptomatic positive cases tested negative, indicating that the asymptomatic positive cases detected in this study were unlikely to be infectious" https://www.nature.com/articles/s41467-020-19802-w https://www.nature.com/articles/s41467-020-19802-w https://rationalground.com/mask-charts/ https://rationalground.com/mask-charts/

imperio59 6y ago

Right. You're depressed, so the best solution must obviously be to consume drugs and take a trip that could potentially render you psychotic for life. This is not medecine. It is no better than the voodoo doctors of old who made you take the "funny herbs" to cure your "demons". This is garbage and not science.

lifty 6y ago
I’m sorry, but you are clueless.
colonwqbang 6y ago
It's all drugs in psychiatry, the good ones and the bad ones. We don't know which are the good ones unless we conduct proper research.
thrwn_frthr_awy 6y ago
Ketamine treatment was the only thing the helped my severe depression. Without it It was like a flip was switched. Your dismissiveness if really inconsiderate to people that have been living through chronic depression for years.
- nefitty 6y ago
  Hi, I’m curious about your experience. I hear the ketamine therapy experience frequently described as “a switch flip”. What do you find is different from one state to the other? I began hearing of an interesting idea that depression can be treated with CBT because that therapy teaches the patient not how to ruminate less, but instead, how to ruminate more efficiently. Presumably, more efficient rumination on problems leads more quickly to acceptable solutions, ideas, etc, which can then be integrated by the person.
LocalH 6y ago
It's a much better solution than SSRIs, the research is starting to show. I presume you also oppose the research into cannabinoids?

hn_asker 6y ago

I find that it is important to have these during a psychadelic experience: 1. Medical supervision - the security makes it easier for one to let go. 2. Professionalism - be led by someone who has guided others and who the person trusts. 3. Integration - reflect on the experience to learn from it.

kvee 6y ago

We built https://tripinstructions.com https://tripinstructions.com as a little hackathon project earlier this year Considering building it out a bit more Would love any feedback or suggestions anyone might have

intricatedetail 6y ago

All those people who prevented research and helped throw innocent and suffering people to jail or worse should be in jail themselves. It is scary how many people believe in drug prohibition scam.

Projectiboga 6y ago

Niacin is the best kill switch for adverse psychedelic responses or just to finish session promptly. This was used decades ago by the group that provided first aid at psychedelic sessions in San Francisco way back when. I don't recall the name for that help group.