5 ms·

I was a participant (ie, research subject) in one of the previous rounds of studying psilocybin for smoking cessation at Johns Hopkins. I was randomly assigned

I was a participant (ie, research subject) in one of the previous rounds of studying psilocybin for smoking cessation at Johns Hopkins. I was randomly assigned to the non-psilocybin "control" group. I still successfully quit smoking -- the "cognitive behavioral therapy" and just general support was great. The researchers showed genuine care, it wasn't like being a lab rat. Because the study was designed with a "crossover" component, I still got the option, which I took, to return 6 months later for a psilocybin session. The session was interesting, but I wouldn't say life-changing. Probably. I am still a non-smoker, over 2 years after quit date, did the 6-months-post-quit session help? Maybe? Ask me anything! Although I'm not sure what else there is to say!

loceng 5y ago
So what I'm curious about then is the practices/experiences the researchers/staff involved used/had in order to provide you with the space that you found supportive enough to help you quit smoking. What was the dosing for the session with psilocybin? Did they tell you the strain/weight?
- throwaway990909 5y ago
  They told me the weight, but I forget. It was a large "heroic" dose. The research protocol is perhaps already available somewhere (published paper, pre-print, registered study, not sure) which would have the dose. They used manufactured/sythesized psilocybin compound in a capsule, not mushrooms or extracted from mushrooms. I think they tried to take all the 'best practices' for quitting smoking and gave it to all participants, same experience up until quit day. On quit day, "control" group got a prescription for nicotine patch; "psilocybin group" got a session (and no patch!) -- the psilocybin group in this particular study was just one "heroic" dose session on smoking quit day, that's it. Some of the supportive practices or suggestions included: * just regular sessions, that were in some ways more or less like a "therapy" session focused on looking at smoking in your life. (whatever that means to you, it really was also just a good therapy session!) * set your quit day near the beginning, several months before the quit day. Build up to it. * at one period, every time you want to smoke, note what you feel like and what is precipating it, make a note of it. Develop a sense of what things make you want to smoke and why, and what role is has in your life. * A "practice quit" day a month or two (I forget) before actual quit day -- just try not to smoke for 24 hours, see what it's like, knowing you can smoke again after that. Now you know what it's like, and that you got through the worst day, and what parts are going to be hardest and can develop more strategies for them. * Get a clear list of the reasons you want to quit. Think about em. Write it down, to refer to it when it gets hard. * Make a list of things you can do instead of smoking, after you quit. It doesn't matter if they are unhealthy (junk food or whatever), they're still healthier than smoking. * after quit day, phone number of a therapist you've been working with, invitation to call or text if you feel tempted and need support and to talk through it. Therapist texted me daily checking in, seeing how it's going. (seriously, why DON'T we use techniques we associate with alcohol and other drug addiction treatment on cigarettes, you know? they are crazy addictive!) There were other things too, additional like little cognitive-behavioral (I guess?) games/techniques. I don't even remember them all. I should have taken more notes on all of it! Just having people there rooting for you and to whom you feel kind of accountable to is big. If their study really does show significantly more success in psylocybin group than control group, I find it meaningful that even the control group got really good support from good counselors. (And I still wouldn't say it was easy to quit!)
  - gjs278 5y ago
    how the hell do you have a control group for this? it’s obvious if you didn’t have the drug
  - loceng 5y ago
    Awesome, thanks for the lengthy reply. Heroic is usually considered at least 5g - there's a saying you can meet God at 5g; so it was probably an equivalent dose to that in synthetic form. I am curious myself if there are other diagnostics, health metrics that are easily/non-invasively measured to help determine or predict what experience a person will have for their first experience or to give an idea of how many sessions may be necessary for what level of "breakthrough." Sounds like a good practical list of things to do - to develop multiple angles of "attack" to build more weight towards the goal, to reference for yourself as support to counter the strength/weight of urges. In part reminds me of "psychological flexibility" practices - to help allow thoughts to be less rigid, to offer more fluidity to thought - perhaps you already had that open-fluid mind and so you simply needed the practice/guidance for the practice to then benefit from that value; an example is perhaps you normally would tell yourself "I feel happy" but then that might trigger a stress or feeling of cognitive dissonance, and so instead you'd train yourself to acknowledge all aspects of you in that moment and instead say "I feel happy AND sad;" perhaps not the best example or explaining of similarity. I wonder if the researchers first created a survey to determine the level of this kind of psychological flexibility a person has, and then see how those different groups perform in the psilocybin research - if and how the outcome of different groups differ; could perhaps divide it up even further by providing psychological flexibility training to part of the different groups - and see how all the numbers conclude. Fun fact: the co-founder of Alcoholics Anonymous actually wanted the first step to be everyone do LSD/acid.
    - throwaway990909 5y ago
      > Heroic is usually considered at least 5g 5g of actual mushroom fungus bodies? Yeah, this was just chemical psilocybin on it's own nothing else, and if I remember right the dose was consequently measured I think in mg rather than g, but they did use the phrase "sometimes called 'heroic'" when I asked about the dose, so, yeah, something like that. (They were clear that it was going to be a very large dose -- informed consent!) > So instead you'd train yourself to acknowledge all aspects of you in that moment and instead The counselors/guides involved definitely had a sort of Buddhist philosophy, with regard to quitting smoking as well as the psilocybin session. I find Americanized (not to be pejorative, just we're always in our culture) Buddhist philosophical approaches to be increasingly popular among therapist and mental health experts generally. But they definitely were here. I have an interest in them myself. I do not actually think I have a particularly "open-fluid" mind, compared to others, but I guess I'm trying (-without-trying). :) > I wonder if the researchers first created a survey to determine the level of this kind of psychological flexibility a person has, and then see how those different groups perform in the psilocybin research They definitely gave me all sorts of survey instruments, at various points in the study. Most of them multiple times, at various points before and after the session. It sometimes seemed obvious what they were "for" from the questions, other times mysterious. My sense is that while some of it may be, like you say, to see what kinds of people might have different outcomes -- more than this, I think a lot of it was to see if the psylocybin session changed people in what ways. I don't think it actually changed me in a way that would show up on the survey instruments (I was kind of hoping it would!), but I haven't seen the analysis of my survey instruments, and I didn't keep copies of my answers!
sammalloy 5y ago
Just wanted to pipe in here: I quit smoking tobacco in 1995 due to the influence of psilocybin. We knew back then it worked. I think you need a lot more than just psychedelics to quit smoking, however. The first week was easy. The next 11 months were hard. After a year, I never wanted a cigarette ever again.
- throwaway990909 5y ago
  Me, the first week was pretty hard, the next 6 months were still hard, the next year was a lot easier -- but I still want a cigarette with some frequency! It's just a "want" I can, now, after two years, fairly easily choose not to fulfill. But when I see other people smoking in a context I remember being enjoyable, OR when I am especially stressed or depressed -- I definitely still want a cigarette. I don't especially think I'll ever never want a cigarette again. They are so addictive!
  - sammalloy 5y ago
    I’m curious, have you ever used psychedelics in a therapeutic context? Such as, I’m going to take x dosage of y drug to work on myself? Psychedelics tend to break the addiction chain of thought and habit, and as long as you do the work over time, the feeling and emotional content of addiction basically disappears. I don’t want a cigarette because it no longer has any hold over me. Psychedelics helped me get to that point. You basically retrain your brain intentionally, by working through bad habits and emotional attachments. When you get to the bottom of those, you realize that the tobacco addiction itself is just a placeholder masking other issues altogether. That’s just the first step. The second step is to overcome the psychological addiction, and that takes time. But there is a light at the end of the tunnel. And when you get there, you make a choice to keep moving on into the light or to go back to the darkness. Psychedelics helps you make the right choice and to stay on the path.

loceng 5y ago

So what I'm curious about then is the practices/experiences the researchers/staff involved used/had in order to provide you with the space that you found supportive enough to help you quit smoking. What was the dosing for the session with psilocybin? Did they tell you the strain/weight?

throwaway990909 5y ago
They told me the weight, but I forget. It was a large "heroic" dose. The research protocol is perhaps already available somewhere (published paper, pre-print, registered study, not sure) which would have the dose. They used manufactured/sythesized psilocybin compound in a capsule, not mushrooms or extracted from mushrooms. I think they tried to take all the 'best practices' for quitting smoking and gave it to all participants, same experience up until quit day. On quit day, "control" group got a prescription for nicotine patch; "psilocybin group" got a session (and no patch!) -- the psilocybin group in this particular study was just one "heroic" dose session on smoking quit day, that's it. Some of the supportive practices or suggestions included: * just regular sessions, that were in some ways more or less like a "therapy" session focused on looking at smoking in your life. (whatever that means to you, it really was also just a good therapy session!) * set your quit day near the beginning, several months before the quit day. Build up to it. * at one period, every time you want to smoke, note what you feel like and what is precipating it, make a note of it. Develop a sense of what things make you want to smoke and why, and what role is has in your life. * A "practice quit" day a month or two (I forget) before actual quit day -- just try not to smoke for 24 hours, see what it's like, knowing you can smoke again after that. Now you know what it's like, and that you got through the worst day, and what parts are going to be hardest and can develop more strategies for them. * Get a clear list of the reasons you want to quit. Think about em. Write it down, to refer to it when it gets hard. * Make a list of things you can do instead of smoking, after you quit. It doesn't matter if they are unhealthy (junk food or whatever), they're still healthier than smoking. * after quit day, phone number of a therapist you've been working with, invitation to call or text if you feel tempted and need support and to talk through it. Therapist texted me daily checking in, seeing how it's going. (seriously, why DON'T we use techniques we associate with alcohol and other drug addiction treatment on cigarettes, you know? they are crazy addictive!) There were other things too, additional like little cognitive-behavioral (I guess?) games/techniques. I don't even remember them all. I should have taken more notes on all of it! Just having people there rooting for you and to whom you feel kind of accountable to is big. If their study really does show significantly more success in psylocybin group than control group, I find it meaningful that even the control group got really good support from good counselors. (And I still wouldn't say it was easy to quit!)
- gjs278 5y ago
  how the hell do you have a control group for this? it’s obvious if you didn’t have the drug
- loceng 5y ago
  Awesome, thanks for the lengthy reply. Heroic is usually considered at least 5g - there's a saying you can meet God at 5g; so it was probably an equivalent dose to that in synthetic form. I am curious myself if there are other diagnostics, health metrics that are easily/non-invasively measured to help determine or predict what experience a person will have for their first experience or to give an idea of how many sessions may be necessary for what level of "breakthrough." Sounds like a good practical list of things to do - to develop multiple angles of "attack" to build more weight towards the goal, to reference for yourself as support to counter the strength/weight of urges. In part reminds me of "psychological flexibility" practices - to help allow thoughts to be less rigid, to offer more fluidity to thought - perhaps you already had that open-fluid mind and so you simply needed the practice/guidance for the practice to then benefit from that value; an example is perhaps you normally would tell yourself "I feel happy" but then that might trigger a stress or feeling of cognitive dissonance, and so instead you'd train yourself to acknowledge all aspects of you in that moment and instead say "I feel happy AND sad;" perhaps not the best example or explaining of similarity. I wonder if the researchers first created a survey to determine the level of this kind of psychological flexibility a person has, and then see how those different groups perform in the psilocybin research - if and how the outcome of different groups differ; could perhaps divide it up even further by providing psychological flexibility training to part of the different groups - and see how all the numbers conclude. Fun fact: the co-founder of Alcoholics Anonymous actually wanted the first step to be everyone do LSD/acid.
  - throwaway990909 5y ago
    > Heroic is usually considered at least 5g 5g of actual mushroom fungus bodies? Yeah, this was just chemical psilocybin on it's own nothing else, and if I remember right the dose was consequently measured I think in mg rather than g, but they did use the phrase "sometimes called 'heroic'" when I asked about the dose, so, yeah, something like that. (They were clear that it was going to be a very large dose -- informed consent!) > So instead you'd train yourself to acknowledge all aspects of you in that moment and instead The counselors/guides involved definitely had a sort of Buddhist philosophy, with regard to quitting smoking as well as the psilocybin session. I find Americanized (not to be pejorative, just we're always in our culture) Buddhist philosophical approaches to be increasingly popular among therapist and mental health experts generally. But they definitely were here. I have an interest in them myself. I do not actually think I have a particularly "open-fluid" mind, compared to others, but I guess I'm trying (-without-trying). :) > I wonder if the researchers first created a survey to determine the level of this kind of psychological flexibility a person has, and then see how those different groups perform in the psilocybin research They definitely gave me all sorts of survey instruments, at various points in the study. Most of them multiple times, at various points before and after the session. It sometimes seemed obvious what they were "for" from the questions, other times mysterious. My sense is that while some of it may be, like you say, to see what kinds of people might have different outcomes -- more than this, I think a lot of it was to see if the psylocybin session changed people in what ways. I don't think it actually changed me in a way that would show up on the survey instruments (I was kind of hoping it would!), but I haven't seen the analysis of my survey instruments, and I didn't keep copies of my answers!

sammalloy 5y ago

Just wanted to pipe in here: I quit smoking tobacco in 1995 due to the influence of psilocybin. We knew back then it worked. I think you need a lot more than just psychedelics to quit smoking, however. The first week was easy. The next 11 months were hard. After a year, I never wanted a cigarette ever again.

throwaway990909 5y ago
Me, the first week was pretty hard, the next 6 months were still hard, the next year was a lot easier -- but I still want a cigarette with some frequency! It's just a "want" I can, now, after two years, fairly easily choose not to fulfill. But when I see other people smoking in a context I remember being enjoyable, OR when I am especially stressed or depressed -- I definitely still want a cigarette. I don't especially think I'll ever never want a cigarette again. They are so addictive!
- sammalloy 5y ago
  I’m curious, have you ever used psychedelics in a therapeutic context? Such as, I’m going to take x dosage of y drug to work on myself? Psychedelics tend to break the addiction chain of thought and habit, and as long as you do the work over time, the feeling and emotional content of addiction basically disappears. I don’t want a cigarette because it no longer has any hold over me. Psychedelics helped me get to that point. You basically retrain your brain intentionally, by working through bad habits and emotional attachments. When you get to the bottom of those, you realize that the tobacco addiction itself is just a placeholder masking other issues altogether. That’s just the first step. The second step is to overcome the psychological addiction, and that takes time. But there is a light at the end of the tunnel. And when you get there, you make a choice to keep moving on into the light or to go back to the darkness. Psychedelics helps you make the right choice and to stay on the path.