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Psychedelics and mental illness

• h2odragon 5y ago
  I know a lot of cannabis fans (and count myself as one). Very, very few of them acknowledge that cannabis affects people inconsistently; one person's reaction to it can be very different than others. This is inconvenient for calling it a "medicine" so let's just ignore it. Psychedelics are even worse. The same dose of the same drug can produce wildly vary effects in the same person depending on factors we have trouble nailing down. "Set and setting" and the Erowid wisdom are all very well, but they are barely enough to describe the area and edges of the therapeutic window in a general way. Your trip, today, is still going to be an experiment.
  • vmoore 5y ago
    And we lack actual shamanic centers where we can do this stuff safely, where the dose is exact and you know what you're getting, and you can have guides to help you through the trip if things start feeling sketchy. And we could even have people on standby to administer anti-psychotic medicine in-case you have adverse reactions and need to calm down quickly before you do something stupid. The illegality of these substances is illegal in itself!
    • suction 5y ago
      I think the issue starts with the moniker "shamanic", which does not sound like a place many people would trust their health to.
      • hutzlibu 5y ago
        Well, I would rather say there are probably way too many people, who would totally trust such a place with their whole health, just because of the name and some other esoteric buzzwords like indigenous, ancient wisdom. I do have great respect for "real" shamans. But I met way too many fake ones, handing out horrible and dangerous advice, while glowing in their self declared illuminative state of higher consciousness.
        • aaaaaaaaata 5y ago
          Where'd you find these?
          • hutzlibu 5y ago
            All around the world. Most are quite harmless and you still can have interesting conversations with them. Some are more weird and even dangerous, like this individual, which I have not met personally, but people like him. https://en.m.wikipedia.org/wiki/Jake_Angeli https://en.m.wikipedia.org/wiki/Jake_Angeli
        • mountainriver 5y ago
          Yeah its interesting because I've had absolutely game changing experiences with real shamans, and then bad experiences with phony ones. If you find a good one, stick with them
    • npteljes 5y ago
      I agree. And I also think that for the same reasons, the psychiatry system, at least the parts that I was exposed to, is abysmal. They prescribe according to whatever scriptbook is en vogue at the jurisdiction and the substances themselves are very far from proven - and also the part where you're guided on the trip you're having can be almost completely missing. There's a huge room for improvement in this area.
    • darod 5y ago
      Check out the Cover Story podcast mentioned in the article. It's pretty eye opening. They mention a few centers that historically you can categorize as unsafe. The key would be to find professionals that have your best interests in mind but the podcast and this article reveal how surprisingly difficult that is.
  • bitxbitxbitcoin 5y ago
    As they say: everyone’s endocannabinoid system is different. They also say everyone’s brain is wired differently. Completely agree that every first use whether it is THC or psilocybin is at the end personal experimentation with non zero risk.
  • jamal-kumar 5y ago
    It's fun to send this "MAYBE YOU JUST HAVENT TRIED THE RIGHT STRAIN" [1] image to friends who don't like weed because it's a pretty hilarious embodiment of the downright anxiety the stuff engenders in a lot of people. I'm pretty sure it's like a genetic thing. I think I remember hearing something about the COMT gene being potentially affected if you smoke too much too early in life as a teenage stoner or whatever, and how this can lead to mental illness down the line... There's a lot we really don't understand yet fully about these things. [1] https://i.imgur.com/mJrlu1C.jpg https://i.imgur.com/mJrlu1C.jpg
    • endorphine 5y ago
      Cannabis triggered my first panic attack, which then triggered my depression for a few months. It wasn't the first time I was doing Cannabis, but I haven't done any more ever since then.
    • standardUser 5y ago
      I'm convinced that the "normal" way Americans consume weed is basically an overdose for most people. Heavy users drive the market and the 30% THC and higher strains are targeted at those high-spending, high-tolerance users. I started to enjoy weed again when recreational stores opened up and I could find 10-15% THC weed that gets me pleasantly high, not paranoid and incapacitated.
      • supertofu 5y ago
        I find that CBD-rich hemp still gets me "high", but the effect is extremely therapeutic. I hope low-THC cannabis is more widely studied. High-THC cannabis has a very negative effect on my mind, mood, and motivation. But CBD-rich strains with low THC are perfect for handling my anxiety and autoimmune symptoms.
        • aaaaaaaaata 5y ago
          That's moreso "stoned" than "high" — a calm, vs a stimulant sort of thing, with CBD vs THC.
  • PragmaticPulp 5y ago
    Psychedelic enthusiasts can be even worse in this regard. When someone does have a bad trip, they tend to reach for every possible excuse to avoid blaming the drug. This ranges from criticizing their "set and setting" to blaming "triggering an underlying mental health issue". The latter is particularly concerning in the context of treating mental health issues, because by definition everyone in that category has some level of underlying mental health issues. Research is particularly difficult in this area because the study volunteers are self-selecting for psychedelic research. Basically, anyone ending up in a psychedelic research study is doing so because they think psychedelics are promising for mental health and they want to try it out. This creates a huge risk of placebo effect when your patients are arriving with huge enthusiasm and preconceived notions of efficacy. Combine that with the weirdness of a psychedelic trip and it's a recipe for a sort of super-placebo. However, that's doubly interesting in that maybe the real reason psychedelics show efficacy in depression is that they are a sort of super-placebo. Put someone through a weird, confusing psychedelic experience and tell them that it their life will be radically different afterward and maybe they'll believe it so much that it becomes their new reality. Weirdly enough, we have the opposite problem with SSRIs right now because so many patients will start googling side effects and become convinced that they're not going to work before they even take the first dose. It's an interesting area of research, but I think right now there's too much crossover between the research and the pop-culture phenomenon of "psychedelics cure everything". It's also strange that so few people are questioning why all of the previous psychedelic users didn't notice that the drugs were treating depression. In fact, the common wisdom among psychedelic enthusiasts years ago was that psychedelics were to be avoided if someone was not in a good mental state, largely due to all of the negative reactions they noticed. It seems that telling someone "this will cure your depression" provides a different set and setting than just giving them the psychedelics without context.
    • criticaltinker 5y ago
      Listen, your comments on all these threads make it clear you’re seriously pessimistic about psychedelic medicine, and that’s perfectly ok. What bothers me is the incessant pushing of this agenda: > anyone ending up in a psychedelic research study is doing so because they think psychedelics are promising for mental health and they want to try it out > maybe the real reason psychedelics show efficacy in depression is that they are a sort of super-placebo This amounts to uninformed armchair dismissal that is inconsistent with a growing body of scientific evidence, and easily refuted by a cursory survey of recent literature and clinical trial results. Surely you’re familiar with double blind randomized placebo controlled studies? I’ve linked you to recent ones in other comments. These methods aren’t perfect and your concerns certainly have merit in general - I just don’t understand why you continue to make these broad and suggestive claims without any supporting evidence.
  • newbamboo 5y ago
    Some psychedelics are more unpredictable than others, and incidentally these seem to be the ones that are hyped the most. LSD is much more predictable than mushrooms for instance, and is well researched partially because of that. The seems generally true for synthetic vs naturally occurring substances across the board, though there are plenty of horrible synthetic drugs like bath salts, synthetic weed. Advocates seem favor this as it allows them a no true Scotsman defense. “You didn’t get real ayauasca”, or with cannabis the hand wavey talk of the “entourage effect.” The biggest problem facing psychedelic research are the researchers involved. They have little credibility, almost like that’s their intention.
    • cmrdporcupine 5y ago
      I agree LSD may be more predictable than mushrooms, but it is also a crazy intense 12 hour voyage that leaves one with at least two days of recovery time after. Vs 4 hours for mushrooms. Both are extremely "set and setting" sensitive. Take either on a bad mood day with bad weather, a dirty house, and stuff on your mind... and you won't have a good time.
      • tsimionescu 5y ago
        > Take either on a bad mood day with bad weather, a dirty house, and stuff on your mind... and you won't have a good time. That doesnt sound like the start of an apparently very promising candidate for treating depression and PTSD. Just goes to show how different experiences are, I guess...
        • cmrdporcupine 5y ago
          Yeah, that's because it isn't (imho a promising candidate). It's an interesting experience, though.
          • tsimionescu 5y ago
            Sure, I imagined as much. My point was that your experience (and others like yours) seems to differ significantly from the experience of, for example, the people penning these studies. I personally have no experience with psychedelics (and no desire to get any), so I am just looking with a bit of wonder at the differences from the sidelines.
  • asdff 5y ago
    IMO the tolerance factor is huge with cannabis. Even for experienced daily smokers if you were to take a few days off, the effects are very noticeably more powerful. When you have zero tolerance, the drug feels like on another planet compared to something more familiar like alcohol. When you have a lot of tolerance, its a comfortable buzz you can be productive on, like a workingman's whisky drunk but without the slop.
    • supertofu 5y ago
      This is an anecdotal and slightly off topic response to your note on cannabis tolerance. I am a frequent cannabis user and have been for a long time. While I no longer use psychoactive cannabis regularly (not in a fully legal state anymore) but I do use CBD, which purports to be non-psychoactive and, by law, has THC delta-9 levels of below 0.3%. What I find fascinating is that CBD absolutely has a psychoactive effect on me. I suspect that this is because of my prolific use of typical cannabis. The components of CBD must tickle the same pathways that are so accustomed to psychoactive cannabis. The result is that I often get reasonably high from CBD hemp and CBD tinctures. A high tolerance for cannabis seems to create a stronger response to CBD, at least in my case!
      • colechristensen 5y ago
        I think the opposite is what is happening, the regulated CBD products aren't regulated in a way that keeps them free of psychoactive components and nobody noticed yet or aren't too excited to try to change it, legalization being on the menu all over the place.
        • aaaaaaaaata 5y ago
          CBN, CBG, and terpenes, are all responsible for medical and recreational things that regulators don't have a single clue on, and medical folks are only beginning to.
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  • netizen-936824 5y ago
    Medicines in general can effect people very differently based on their individual biochemistry/proteome
  • perardi 5y ago
    Yup, from experience, you can give the same dose from the same batch of a hallucinogenic drug to people who are broadly similar in terms of age and overall mental health, and you can get a real wild range of results. (Except maybe ketamine. Ketamine seems pretty consistent, in my anecdotal experience.)
  • jasonvorhe 5y ago
    All of medicine has a lot of possible side effects depending on the person taking them. Current anti depressants can have severe side effects, whether just until they're properly dosed or not. No one says we should start handing out shrooms to everyone over lunch. But either we allow illegal, unhealthy, corruption-causing criminal markets to flourish with a lot of negative effects on society or we legalize and control it.
  • operator-name 5y ago
    You may find this recently released video facinating as I did: https://youtu.be/2rUV4TAP46U https://youtu.be/2rUV4TAP46U The idea that cannabis would have inconsistent effects, or the effects of different strains was always a mystery to me until I watched it.
  • Fnoord 5y ago
    (Speaking a bit from experience given past drugs use.) Isn't the same true for stuff like SSRIs? We don't know if/how they are going to affect the patient.
    • h2odragon 5y ago
      Yes, but talking about that makes one a "science denier" etc. My wife has a good one: she burns opiates different, so they don't really benefit her. she just gets nausea from them. They've got her down as a "drug seeker" now cuz she refuses them.
      • Fnoord 5y ago
        The two times I got SSRIs prescribed both psychistrists underlined that fact. We are trying to find something which worked for me, and the first choice might not work out. For example, Fluoxetine (Prozac) got the adverse side effect that I got severe muscle fatigue. Basically, it makes me more sensitive to pain. But it also makes me less edgy. I find it counts for all drugs and even food (sugar makes thirsty, requires good dental hygiene; salt makes thirsty, pee less; yet we crave both in our food).
• Skilbucks 5y ago
  Do you think a disturbed work life balance could be a reason for mental illness as well?
  • kayodelycaon 5y ago
    Well… yes? Any stressor can be severe enough to cause problems in other areas of your life. It can also reveal undiagnosed mental illnesses. Not sure how this relates to the article.
    • outime 5y ago
      Not OP but if I read between lines it might mean that it is way cheaper to give people some soma than addressing the actual root problems certain societies have.
  • ActorNightly 5y ago
    From knowing a whole bunch of people with ranges of issues, my personal opinion is that it seems that certain people are just simply not "tuned" to their lifestyle/environment, and the mental health issues stem from a certain part of that psyche not wanting to change their environment. Not that this would get past any ethics board, but it would be an interesting experiment if you took someone suffering from severe depression, fed them 10 grams of shrooms to reset their brain, and then put them in a remote village in South America with no phone or internet where basically their entire day has PURPOSE - i.e wake up, do work with fishing/farming/hunting construction, socialize in the evening, all as a group activity.
    • chiggsy 5y ago
      People with severe depression probably have things they don't get around to here. No phone or internet means no family or friends, but I guess if you are planning to feed them 10g of shrooms and dump them back into a hunter gatherer lifestyle in South America you won't want them contacting anybody. I personally would very much like to use my phone after somebody fed me TEN GRAMS of shrooms. I strongly feel that I would want to do them on the plane, and not in a remote village where I don't even speak the language, and I've got to occupy myself in the darkness with strangers who are going to make me stagger into the jungle and fish, or farm, or hunt. Something I was not severely depressed about would be my very low parasite load, or the lack of arthropods in close proximity. In fact, there are virtually none here. Somewhere in South America there are very large spiders. We don't have them here. I would certainly not be depressed about this. In fact, I am jubilant and appreciative of my good fortune. In fact, were I to have this condition, it would stem from an imbalance in my head. Because of it I would become depressed. This would be different than me not being "tuned" to my lifestyle, it's not clinical depression if I just need to paint my walls orange or just stop being such a mopey downer, it's a real drag, pitter patter, let's get at er! WEW! PROBLEM SOLVED! It's like going bald, or having asthma, or being washed away by a tsunami while you are on a date. Sometimes things happen, which are not ideal and also not because of any defect or sin on your part. Sometimes things just happen, sometimes they happen to you. For example, the poor person who's mind you reset with TEN GRAMS of shrooms and fired off thousands of miles from home and back in time thousands of years to do backbreaking manual labor among strangers. Seems unusually coercive, no? Punitive. Would you do that to your dog? A dog? For being sad too long? Depressed is not stupid, after the monumental shroom trip, you'd have to force them to stay there, surely? This is probably the part where the ethics board might ask more questions, I reckon. We agree on that at least. Anyway, what if they in fact are not shamming and succumb to despair? Or simply tip the canoe or whatever over learning how to fish? TEN DAMN GRAMS of shrooms is going to make skills acquisition difficult, for quite some time after they eat them. Socialization might be a lot to ask, do we share a language? What's the purpose of this anyway? Shouldn't this PURPOSE be something defined by me? Lack of agency was not a problem I had before, why is it part of your experiment? I mean, you don't even give me a choice, can't I volunteer or something? My friends probably are not sick, can I socialize with them? Instead of the strangers? In the village? How about you send me to work in Milan? Ok, Wales? Scotland? Missis... hmm. Scotland? I mean really, you think phone and internet need to go, but instead want to force group interactions with strangers instead? By the way, about your "personal opinion." If you know a whole bunch of people with ranges of issues, how did you achieve the deep insight into las depresionistas? Or are you saying that slacking is the root cause of mental illness? Force them into paleolithic lifestyle and they'll snap out of it? Would you say you've read 10 books on the subject? How many more than 10? Lots? I'm just trying to properly value your opinion here. How's your results? Finally, I have to say that your experiment kind of seems similar to pray away the gay camp or whatever name was used for it. Isolation, coercion, duress and reconditioning. Plus TEN GRAMS OF SHROOMS. Whole thing seems a bit sus, frankly.
• sn00tz00t 5y ago
  https://erowid.org/experiences/subs/exp_Mushrooms.shtml https://erowid.org/experiences/subs/exp_Mushrooms.shtml Neat list of mushroom trip experiences. Ranging from schizophrenic horror unimagined to unenglishable religious experiences. I've had both experiences in the same trip. I'd hate to be on my deathbed and have a bad trip tho.
  • lioeters 5y ago
    > deathbed and have a bad trip Reminds me of a recent report that human sacrifice victims in the Inca empire were given ayahuasca and coca: Ritual drug use during Inca human sacrifices on Ampato mountain (Peru): Results of a toxicological analysis https://www.sciencedirect.com/science/article/abs/pii/S2352409X22000785 https://www.sciencedirect.com/science/article/abs/pii/S23524...
    • mountainriver 5y ago
      Yeah I visited some of their sacrificial sites out there, weird vibe. They believed the person being sacrificed would be reborn as royalty basically. Parents viewed it as a great honor to have a child sacrificed
• lighttower 5y ago
  The author says > Quite a few psychedelic drugs are naturally-occurring, and have been used for hundreds of years (this doesn’t include synthetic ones like LSD, obviously). LSD occurs naturally in the Ergot mushroom: > The ergot fungus contains a number of highly poisonous and psychoactive alkaloids, including lysergic acid (LSD), which was synthesized from the ergot fungus in 1938 by chemist, Albert Hoffmann [1] What the author means is that it's synthetically made these days. Psilocybin can also be synthetically made these days. psychedelics are the best hope humanity treating refractory mental illness. I know at least 5 people personally that have embarked on psychedelic voyages to treat their demons. Some of them are renowned psychiatrists. [1] https://www.fs.fed.us/wildflowers/ethnobotany/Mind_and_Spirit/ergot.shtml#:~:text=The%20ergot%20fungus%20contains%20a,a%20proposed%20explanation%20of%20bewitchment https://www.fs.fed.us/wildflowers/ethnobotany/Mind_and_Spiri....
  • after_care 5y ago
    The US Forest Service is just wrong on this. Ergot does not contain LSD, although it contains very similar psychoactive alkaloids. Ergot cannot be called a mushroom, it is a fungus that grows on wheat, rye or other grains/grasses.
    • ada1981 5y ago
      I think the confusion here is that LSD was initially synthesized from ergot fungus. Ergot is not a mushroom and it does not contain LSD. But LSD is derived from the ergot alkaloids.
    • ki85squared 5y ago
      Parent used the term mushroom, but the article does not. It's correct that the fungus does not contain LSD the chemical, but it does contain lysergic acid which is colloquially LSD the drug. For a short, layman-targeted article I'm inclined to give the US Forest Service a pass on this one.
      • LordDragonfang 5y ago
        >but it does contain lysergic acid which is colloquially LSD the drug The chemical differences between "lysergic acid" and LSD areas significant as the differences between morphine and heroin, if not more so. Pure lysergic acid is closer to LSA, which is still categorically not the same thing as LSD - to the point that many people will refuse to take the former when a test kit reveals they got that as opposed to the latter. They are not colloquially equivalent.
• after_care 5y ago
  I concur with the core message -- that the current research on psychedelics is not strong. Some of the problem is that the research itself was not designed with an eye on earning FDA approval. This was hard to do because we'll never have a true double-blind psychedelic trial for psychedelics like we can have for SSRIs. Spravato recently showed a path for FDA approval, because ketamine treatment for depression closely mirrors protocols for psychedelics.
• cmehdy 5y ago
  The article makes a lot of good points. I'm a lover of psychedelics, I've apparently managed to be wired in a way that has made every single experience one that I don't regret (whether joyous, superficial, or intricate, unexpected), but I would never make the mistake of assuming my experience directly translates to other people's. Hype, cultists and people thinking in absolute only do a disservice to what we could extract from those experiences. Serious research with people who are detached from the drugs is something we should all want, especially because we've only had a short time for detailed records of psychedelics experiences to exist at all and most experiences to this day aren't really observed scientifically at all. I believe that science is the best thing we've got to approach the unknown, psychedelics aren't a "godly exception". I also remain aware that science doesn't always offer answers right away and we just keep on going anyway. It's been true for most technologies, for a lot of what goes in our food every day, for how we've structured society, etc. We accept that there's unknown risks, we try to mitigate what comes our way and prepare for what we can estimate, and we learn to live through what we didn't see. But we still eat the food, use the technologies, try social systems, and so on. I think that attitude is also one to have with psychedelic experiences. That happens through testing what you have, guided experiences if and when there's a need or uncertainty, "set & setting" and discussing them beforehand, being gentle with dosage, making a sincere attempt at an inventory of the self before deciding on taking the psychs, and so on and so forth. And some people try some of it, some people don't, and that's OK as long as everyone strives to have an experience they can handle with what they know. Just like with everything else.
  • wackget 5y ago
    Is it true what they say about psychedelics helping people to come to terms with their own mortality and death? Occasionally I'll get crippling anxiety when I think about how one day I'm going to stop existing and there's absolutely nothing I can do to stop that. I've heard people say that [some drug] has shown them how to no longer fear death and always wondered about that.
    • cmehdy 5y ago
      I don't think it's possible to make a broad statement like that about psychedelics. You'll always just hear one take from a person with their experience and the experience of the people they might have tried it with or even guided, but the spectrum of experiences is too vast to qualify and quantify it without the actual research. My personal standpoint is fairly different from yours because my anxiety is permanent and a measure of the "agitation" of my existence, to which death is almost a relief really. From that standpoint I've never quite had to confront much of anything about mortality or death. In fact I've almost always felt more alive during trips, at peace with whatever flowing model of the self and existence experienced in the moment. Psychedelic effects can make our senses feel more 'salient' too (for me musical experiences can be very profound), which I've used to contemplate extremes (like noise-cancellation silence after a roaring musical piece). The main regularly noticeable thing I experience after just about every trip (of various kinds of psychedelics) is severe depression being alleviated for anywhere between a couple days to a few weeks. Ultimately though, most of what I would say is just likely to be whatever personal theory I've built up this unique stream of experiences. That's why we really need people to get in there and do the difficult work. edit: also the "some drug" in question is most likely DMT, and I've had extensive experiences with it (on its own or not) and absolutely appreciate that others would have religious experiences, near-death experiences, etc.. but I don't think anybody with any experience of DMT that goes beyond a one-shot would testify to the reliability of trips of such nature. It can be a very volatile experience, as well as being much less predictable from person to person than the more mild stuff like low doses of mushrooms etc. Again, science might eventually come to the rescue :)
• scrollbar 5y ago
  The article mentions Cover Story: Power Trip podcast which I finished last night and enjoyed so much. It’s by New York Magazine and the folks at Psymposia. Highly recommend as a balancing counterpoint to all the positive hype about psychedelics. For the record, I have been both helped and harmed by psychedelics and in net believe their return is positive. I’ve seen enough oddities in the Bay Area psychedelics and mental health scenes to warrant some serious caution about the current path we’re taking.
• jamal-kumar 5y ago
  "This is just an anecdotal account, but there’s an interview with the psychedelics researcher Manoj Doss, who says that he “only know[s] one psychedelic researcher who’s never done psychedelics”, and notes (in an encouragingly self-critical way) that this is a conflict of interest." - Yeah that's a good point to be honest I think that some of the most interesting applications for psychedelics as medicine target treatments that aren't strictly mental health related. Ketamine is already approved for ischemic brain damage or stroke, like you better hope that's the first thing you get in the ambulance to prevent glutamate excitotoxicity from getting really nasty if you fall of a motorcycle or whatever - But DMT actually shows a lot of promise for recovery too, and I'm actually getting involved in a project tangent to that research right now. We're talking sub-psychedelic micordoses to build people's neurons back from brain damage, one of those things in modern medicine we're still generally hopeless about. Pretty interesting stuff! [1] [1] https://www.technologynetworks.com/neuroscience/blog/could-the-spirit-molecule-dmt-assist-in-stroke-recovery-346249 https://www.technologynetworks.com/neuroscience/blog/could-t...
• slibhb 5y ago
  I like the article. With psychedelics, it's clear that much of the excitement comes from people (including scientists) who have used them and found their experiences helpful. That's not science but that doesn't mean it's wrong. Not everything is amenable to clinical study and this doesn't mean we should disregard it. And the issue isn't just psychedelics being hard to study. Mental health is hard to study. An overweight man with no friends who plays computer games all day is not depressed unless he feels bad about it. Mental health depends on subjective feelings. Hard to study that! My view is that we should continue to think about psychedelics from a religious or spiritual perspective. Even if that's literally incorrect, it's the correct metaphor. I'm also very skeptical of people who think widespread use of psychedelics can make society better. Lots of people used LSD in the 60s and 70s and as far as I can tell they didn't usher in a new age of love, peace, and tolerance.
  • kayodelycaon 5y ago
    > Mental health depends on subjective feelings. This isn’t correct in a lot of places. There is a number of diagnostic criteria. The most important being how much it affects your quality of life. This can be directly measured by looking at how the individual functions day to day. An example is “Was the person able to shower regularly?” (This assumes the person wishes to shower if they have the ability and opportunity.) It’s pretty easy to record the number of panic attacks or how often the person has suicidal ideation. ADHD can be measured by asking the individual to preform tests under specific conditions. Significant changes in psychosis and paranoia can readily be determined with structured interviews. The problem is most of these things are not easily and correctly measured by a questionnaire. You need more expertise to get this information out of a patient.
    • slibhb 5y ago
      It's worth it to study these things from a behavoral or functional perspective but that is also very hard. If only because, ultimately, people seek treatment or don't based on subjective feelings. I think there's unavoidably an element of subjectivity here. You can attempt to minimize it but it's always there.
• ada1981 5y ago
  I liked the article and tend to agree there is a lot of pressure to rush psychedleics to the mainstream. This is from a person who used MDMA to heal bipolar / schizophrenia in an underground setting; ran an underground clinic for 3 years; took funding from Dr. Bronner to found a non-profit to decriminalize plant medicine; and was featured in a PBS documentary administering MDMA in an underground setting. Also, the author obviously hasn't done psychedelics ;) and he states as such. "I’d think about taking them if I had a relevant condition and the evidence they worked was convincing." You could argue that the relevant condition is that you are a living human, and we've evolved to be in relationship to altered states of consciousness.
  • mountainriver 5y ago
    Yeah I have the same impression. The author wouldn't have even written the article if he had tried psychedelics, which are often reported as the most significant experience in peoples lives. This is just reductionist thinking, which can be good to temper things and reduce harm, but the authors bias is pretty readable
    • nonbirithm 5y ago
      I have to wonder how many of our strongly held beliefs can be rendered irrelevant to our own minds by something as mundane as a few micrograms of a chemical. I also have to wonder how many of those beliefs can only be corrected by something as drastic as a foreign substance acting on it against our will. In some other universe, the world might become a very different place if the people in power chose to take LSD with an open mind. If so, there would be no "meaning" we could attribute to that radical change except that it was the result of a chemical formula. It feels like there is something profound about that related to the meaningfulness of all things, but since I haven't taken psychedelics, I guess I am still blind to what it is.
      • int_19h 5y ago
        It does stimulate empathy among other things, which is something that's very lacking in politics (meaning genuine empathy, not the virtue signalling performance variety).
• monktastic1 5y ago
  This argument seems disingenuous: > Just as you’d feel extra-sceptical if all the research showing that pork is unhealthy was written by Muslims who’d already decided for religious reasons not to eat pork, you should be worried about the sheer number of studies by psychedelic researchers who are themselves aficionados of the drugs. Perhaps a better analogy would be: just as you'd feel extra-skeptical if all the research showing that exercise is beneficial was written by exercisers who'd already decided for experiential reasons to exercise, ... It's not like people are born into the religion of psychedelia and have strong cultural reasons to conform. If something truly is good, of course the people researching it are going to be "aficionados" of it. And this doesn't save it: > (You might wonder if they’re into psychedelics precisely because the research shows such impressive benefits, switching around cause and effect. But as we’ll see below, that evidence doesn’t exist yet. That particular horse is coming way after the cart). Why can't they be into it simply because it worked for them? There's nothing about the fact that psychedelic researchers are excited about psychedelics that by itself is suspicious, as we are strongly being led to believe.
  • kmod 5y ago
    Personally I think it's valid to consider selection-bias effects in authorship -- in general, things are written by the people who are the most excited about the topic, which leads to there being a bias towards excitement. I don't think it invalidates the research but it feels like a valid point. I think an interesting observation is that this anti-psychedelics post is written by someone who doesn't even want to try them, so this argument of his also says to treat this blog post with skepticism.
    • monktastic1 5y ago
      My qualm isn't about whether it introduces bias, but why it does. The example he gave implies that the only possible reason is a _religious_ one, and that's not fair.
  • chiggsy 5y ago
    >There's nothing about the fact that psychedelic researchers are excited about psychedelics that by itself is suspicious, as we are strongly being led to believe. It's also quite possible that they are excited about the potential to try a different method of reducing the suffering of patients with mental illness with more efficacy, or fewer side effects, or some other positive change. Anybody can be excited about something while doing another thing. Presumably at least some of these people wish to provide aid, um, when they are not reeling from acid, and grooving on E's, or apparently, assaulting patients, based on the article. By the way, how does he know they use the drugs? He said some guy said he knew a lot of people who did. A valid concern with mental health is the difficulty of evaluating statements people make about their, or other peoples internal states, and for what reason they make such statements. Basically he's saying, "They're addicts! Some dude told me!" That's literally hearsay, although this is not a court environment, I suppose. Still, I, for one, would prefer a bit more rigorous statement about this endemic drug use among researchers. As for his example, lots of people don't eat pork, for a variety of reasons. If someone follows their procedure and replicates their results, then does it matter if they were Muslims? Skeptical? Have some bacon and do the experiment, see if you get what they got. Of course you wouldn't just take it on faith, my goodness! Not all, certainly, but some people don't allow their desires to supersede their professionalism. I don't know, are Muslims even that invested in not eating pork as to fake a bunch of studies to fool the masses into not eating back bacon? Actually, given what we know about the replication crisis.. hmm. But surely people who take psychedelics have their own subculture, right? Dr. Alice and Dr. Bob might spend long weekends listening to Cream and obviously Black Sabbath, and definitely some jazz, staggering high because they are trying acid to wean them off of the Oxy's they were into 3 years ago, or the boozing they did under quarantine ... but what if they got results that are worth looking into? Anybody who's known someone using psychoactive drugs surely... well the drugs available now sure seem sub-optimal. ( What about their kids? They're trippin with the kids? Really? REALLY? ) You know, I'm quite unsure about this assumption that the researchers need to spread their drug of choice to people claiming ( skepticism about the afflicted seems to be a theme in the comments? I guess they should just snap out of it? ) mental defect to a third party, which is a life changing decision. I'm not saying that these things are impossible, or inconceivable. Unfortunately. I question the number of people who act like this, while maintaining well enough to author research papers and do Guardian interviews, vs the number of people who are enthusiastic about reducing suffering and are pursuing a surprising and somewhat promising avenue to do so. They would be in a great position if this work led to a better way of treating mental illness. Seems exciting.
• ComradePhil 5y ago
  The reality is that people are open to anything that promises alleviation of suffering from what os diagnosed as "mental illness" because the mental health industry has proven to be a complete scam designed to keep people sick and provide them lifelong "treatments" that don't work.
• orangepurple 5y ago
  Not mentioned anywhere, but probably the strongest effect of psychedelics, is that LSD absolutely kills the desire to drink alcohol for months.
  • zafka 5y ago
    As someone who quit drinking alcohol quite a long time ago ( which I am quite sure is why I am alive today) I agree that one of the "side affects" of LSD is that it helps one to come to the realization that they are killing themselves from a bad habit. I cannot say that it killed my desire to drink, and I did drink for a while after an experience with what might have been LSD. An interesting historic tidbit is that the founder of Alcoholics Anonymous was introduced to LSD and thought it was a tremendous tool to fight Alcoholism. By that time a foundation had sprung up around AA, and the board members urged Bill Wilson not to proselytize on the subject less it incur bad publicity for the organization( one of their traditions is to avoid controversy on outside subjects) Since the name of Bill Wilson was synonymous with AA he agreed to quit talking on the subject.
    • orangepurple 5y ago
      Months after dosing with LSD drinking alcohol has the appeal of drinking department store paint thinner. It works. It's sad that people are scared to associate with it due to its demonization.
  • tacocataco 5y ago
    I like to drink like a fish after a long trip. Helps take the edge off and get my body to relax after hours of laughing tears of joy. Drugs are tools. Know yourself, know what you're taking, and plan accordingly. ce
• seanwilson 5y ago
  > A few years ago, John Ioannidis (RIP) published an article on conflicts of interest in nutrition research. The conflicts you get in this field, he said, are different from those in, say, Big Pharma-funded trials of new drugs. Not only are there those usual kinds of financial conflicts—some research is paid for by the food industry; nutrition scientists have diet books to sell—but there are “nonfinancial” conflicts, too. If you’re a strong adherent to the particular kind of diet you’re researching (vegan, Atkins, gluten-free, etc.), Ioannidis argued, you should disclose this at the end of the paper, so readers can be fully informed about how the research was produced. I find it's common to see forum comments like "we know this researcher is a big advocate of X so this study is bias". I find this critique is usually very shallow and sets an impossible standard. Where are you you going to find researchers pouring years of their life into researching a subject they have no interest in or opinions of? If you were studying vegan or Atkins diets for example, it's an ongoing personal choice in your day-to-day life if you're going to switch to/from that diet or not, where either choice could be used to imply bias in your future studies. And after a few years of research, how could the evidence you collect not impact your personal choice? And if it doesn't, what would that say about your belief in your own research? Researchers are trained to be aware of their biases, to devise experiments that reduce these biases, and peer review helps identify problems here also. Another part of peer review where the media jumps the gun is that other researchers should be able to replicate the studies themselves to check the results - if you become known for producing highly biased research that can't be replicated this is surely going to impact your career (e.g. less citations, less funding, distrust from peers) so there's a very strong incentive to keep this in check? I think in general, the real problem here is the dysfunctional click-bait approach the media has with scientific reporting (exaggerated, sensationalist, premature, lacking any nuance/caveats/details) and the public's understanding of the scientific method is very broken e.g. the notion that scientists are always changing their minds, little understanding of how to evaluate how strong evidence is before accepting it as true, which includes dismissing everything about a study because they can create a story about one researcher being bias.
  • kayodelycaon 5y ago
    > If you become known for producing highly biased research that can't be replicated this is surely going to impact your career so there's a strong incentive to keep this in check? I would strongly say no. If the vast majority of studies in the “soft” sciences are already not reproducible, the risk to a person’s career is minimal. This is before accounting for the pattern of prioritizing short term gains over mitigating long-term risk, especially if that risk is considered to be low.
• zafka 5y ago
  I would be very interested to know where Stuart Ritchie's funding is coming from these days also. I am rather surprised that he did not list all his sources of income in a show of transparency.
• newbamboo 5y ago
  It’s easier to market “psychedelics” than meditation, prayer or something like DBT. We should learn from that and try to make more things as popular as psychedelics. “Put this little square of paper on your tongue” is much less of an ask than “sit in chair for 30 minutes everyday and be mindful of your breathing.” It’s like the McDonald’s approach to mental health, and who doesn’t love McDonald’s! Over a billion served. Psychedelics scale similarly.
  • ActorNightly 5y ago
    Psychs are absolutely not comparable to "sober" activities. While things like meditation have benefits, you are still largely operating in the same regimes within the neural network in the brain. The main idea behind psychs is that they allow you to operate in a vastly different regimes. And, unlike McDonalds, and compared to other drugs, they are INCREDIBLY safe. It should be a no brainer for anyone needing them to use them.
  • chiggsy 5y ago
    If it works, and that's all it takes, that's fantastic! But you have an incredible solution too it seems? “sit in chair for 30 minutes everyday and be mindful of your breathing.” Now this is great advice for everybody. Unless during these quiet times the weight of the world lays upon you, or your grasp over your inhibitory system is not sufficient to find stillness, never mind finding discipline of the breath. What about the people who's affliction is not due to some implied lack of industry or effort? What if the problem is not ... sloth?* ... but actually a flaw in the brain, or imbalance? I guarantee you that there are not a billion people who are gagging for psychedelics as a solution to their mental problems. The question is: Are they in fact a solution? Prayer: Unless you are praying to some entity who publishes regularly, I feel this avenue has been tried and found to be lacking. [*] I do not endorse this concept. I don't think you can just "apply yourself" and heal your mind, any more than you can do could with your lung cancer. Sure it helps, but we'd like to minimize the suffering, not endure as much as possible.
• eric4smith 5y ago
  I’ve always wondered… Do psychedelics cause mental illness or treat mental illness? Our minds are so weird that I have a simple theory that we are all slightly insane in at least some small way. But from what I have observed from friends who take them - they cause them to cope with troubles that are normally difficult to deal with. I guess I’m not brave enough to try them to deal with my own troubles myself right now.
  • the_only_law 5y ago
    I don’t think the brain or the drugs themselves are are simple enough to be reduced to one or the other.
  • zwkrt 5y ago
    My strong-man description of your (I think correct!) feeling is that we all have a very specific lens through with we look at the world. Because all of us have very very limited lenses, but the world is actually quite large and complicated, we each end up with our own neurotic worries that are in a way over-blown when compared with the chaotic complexity of actual reality. Just think of that friend you have that always brings up the cost of something, or that person in your life who seems to always bring the conversation to how their political viewpoint would alleviate the problem, or the person who seems to always have a new and exciting reason to not have a kid yet. Psychedelics just allow us to step out of our rigid framework for a few hours. For people with flexible/creative minds it might not be such a big deal as they are used to looking at reality and asking "but what if it were this way...", but lots of us have rather rigid conceptions of reality. Taking mushrooms and realizing that most of our worries are 'made up' in the sense that they don't relate to our basic needs can be eye opening.
    • mountainriver 5y ago
      Yeah this seems intuitively correct. Psychedelics are largely playing with your beliefs of the world, which is why it can go a lot of ways and is hard to study. In a good setting with good guides it can be wildly transformative in a positive direction.
  • 5y ago
• btilly 5y ago
  I agree with the basic point of the article entirely. However he shows the same kind of bias that he is speaking out again by not discussing the best known branch of such research. And that is MDMA for PTSD. It is best known simply because it is, in fact, demonstrating that it works. The FDA has been repeatedly calling it a "breakthrough therapy" since 2017. It is in multiple phase 3 trials around the world that are going well, and full approval is expected this year. Research papers on it, like https://www.nature.com/articles/s41591-021-01336-3 https://www.nature.com/articles/s41591-021-01336-3, are appearing in the top science journal in the world and are no less enthusiastic than a press release. Let me quote, "These data indicate that, compared with manualized therapy with inactive placebo, MDMA-assisted therapy is highly efficacious in individuals with severe PTSD, and treatment is safe and well-tolerated, even in those with comorbidities. We conclude that MDMA-assisted therapy represents a potential breakthrough treatment that merits expedited clinical evaluation." So no matter how much questionable research there may be - and I'm sure it is a lot - let's not throw out the baby with the bathwater. There is also good research, and these drugs have the potential to make a huge difference.
  • aw1621107 5y ago
    > Research papers on it, like https://www.nature.com/articles/s41591-021-01336-3 https://www.nature.com/articles/s41591-021-01336-3, are appearing in the top science journal in the world and are no less enthusiastic than a press release. The article actually discusses that very paper: > While we’re here, it’s worth talking about the MAPS MDMA-therapy trial itself. In May 2021, to much media fanfare, they published their Phase III clinical trial in Nature Medicine. The trial reported enormous, nearly unbelievable effect sizes: 0.91 of a standard deviation difference in score on a PTSD questionnaire between an MDMA and a placebo group (both groups got therapy). That’s the kind of effect medical researchers fantasise about. > Are these effect sizes plausible? Nature Medicine also published two critical commentaries on the paper. The first one points out the issue we discussed above: that the blinding was almost certainly compromised in the study, since the control group got a completely inert placebo and the treatment group surely could tell whether they’d been given ecstasy. Expectations could have played a major role, and might explain at least some of the huge difference between groups (the commentary also makes the interesting point that researchers used to be required to collect data on which condition patients thought they were in, but since 2010 this is no longer the case. It might be time to bring back this rule). The second commentary asked for studies with more relevant control groups and longer follow-up periods to check the safety of the treatment. The MAPS researchers also responded, somewhat limply. > The journal also published an entirely uncritical commentary co-authored by Imperial College London’s David Nutt. Remember him? He was Fired4Truth as a drugs adviser by the UK Labour government in 2009 for criticising government policy on drug classification; he’s now a major psychedelics researcher who co-authored the psilocybin trial we encountered above. The commentary calls MDMA “remarkable” three separate times in about 1,000 words (it’s true the effect sizes in the study are remarkable, but what if they’re due to expectancy bias?). It also says it’s likely that MDMA “will be an approved medication within a few years”. > So there’s a final potential harm that stems from the breathless hyping and cheerleading of psychedelic treatments way beyond the evidence: it could mean that therapies—which come with their own rare but real dangers—are approved and rolled out to large numbers of patients when we need a lot more evidence that they really are beneficial in the long term.
• VictorPath 5y ago
  >> Overall, it is difficult to see how prohibition of psychedelics can be justified as a public health measure” > This is activism, not science. As I said above, I actually support drug legalisation – but it’s far from appropriate to include this kind of thing so prominently in what’s supposed to be a neutral, factual scientific analysis. Scientific studies that ingesting chemicals like THC are one of the reasons we have things like the Rockefeller drug laws. Activism from some in the scientific community is one reason people are rotting in jail for selling marijuana (while tobacco companies donate to politicians and in return get trade deals where it is illegal to have a law requiring warnings on cigarette packs. People can be arrested for ingesting mescaline from peyote plants like Native Americans used to, scientific studies and activism is one reason for this, but scientists asking for people not to be imprisoned for getting mescaline from a cactus is not "appropriate". (I have never tried mescaline but don't want to be imprisoned if I ever do)
• drooby 5y ago
  I don’t fully understand the issue with blinding. How is it different than trying to double blind talk therapy. Obviously someone knows that they are getting talk therapy, likewise, people obviously know they are getting psychedelics. Yet we are still able to get experimental results supporting talk therapy and no one complains, right?
  • lukasb 5y ago
    Yeah I don't really get this either. The author suggests asking a lot of detailed questions about which arm participants thought they were in. What happens if participants (as you would expect) make very accurate guesses?
  • mountainriver 5y ago
    Also don't get this, how would you ever possibly isolate that? Give them a drug which kinda feels like MDMA? But what about the individualized effects of that drug? It feels more like they are just looking for a critique. All in all it looks eons better than most SSRIs we prescribe willy nilly every day.
    • tasty_freeze 5y ago
      Give non-alcoholic beer to 100 people who don't drink beer. I don't know the number, but I would be surprised if there weren't at least 10% who reported feeling tipsy and acting in stereotypically drunk ways. I know that some psychedelic researchers use a suitable dose of niacin as the control arm. The person will experience some flushing and a faster heart rate. If they are new to psychedelics, they don't what psychedelics are supposed to feel like, and so they assume it is the real thing.
  • hannob 5y ago
    > Yet we are still able to get experimental results supporting talk therapy and no one complains, right? Wrong. https://blogs.bmj.com/bmjebmspotlight/2020/10/07/seeing-is-believing-the-problem-of-blinding-in-psychological-research/ https://blogs.bmj.com/bmjebmspotlight/2020/10/07/seeing-is-b... I think this is a problem that is generally recognized. Also the science on psychological interventions is generally quite messy.
• eurasiantiger 5y ago
  The argument ”all but one psychedelics researchers have taken psychedelics” is not particularly convincing; many other researchers have taken psychedelics, too. Certainly one wouldn’t expect e.g. liberal arts, sociology or organic chem majors and their cohorts to be completely naive to them.
• deleted 5y ago
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• TedShiller 5y ago
  • mountainriver 5y ago
    Maybe for you, really depends on the person, the illness, the drug, and the setting
• umvi 5y ago
  Why are these articles so popular with HN? Any article about treating mental illnesses (including depression) with LSD/shrooms/cannabis/[drug] immediately shoots to the top, and I see articles like this every other day at the top of HN. Is it just people wishing for a silver bullet that will cure their mental problems? At any rate, the number of mentally ill people on the internet must be much larger than I am estimating.
  • IgorPartola 5y ago
    To your first point, I suspect that hacking your own brain and pituitary gland fits with the ethos of hacker culture. What’s cooler than going to the doctor and getting the same SSRIs as every other chump when you can hack together your own medication? In reality this is why we need serious research into these drugs. I am sure there are therapeutic benefits and also yet unknown risks. Would be nice to study them formally. To your second point: I know very few people without mental illness. GAD and generalized depression account for a large part of it, but so do neurodivergenicies like autism. Chances are much higher than you think that you yourself have one or more condition like this. That’s not to say I wish for you to have one, just that statistically speaking lots of people have them, so much so that the current advice is to establish mental healthcare same as you do with a primary care physician and have at least yearly checkups.
  • drooby 5y ago
    Did... you read the article? It's highly critical of the hype around psychedelic research and how we have been interpreting it. Anyways. In general, HN is a community that is highly focused on emerging technologies, and undervalued, overlooked or novel solutions. Psychedelics, in my opinion is fertile ground for discovery and just super interesting, so it gets my upvote.
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  • tsol 5y ago
    Psychedelics are just in with this crowd IMO. Microdosing was a big thing in silicon valley for a while
• leemoore 5y ago
  One challenge around studying these drugs is efficacy is often linked to expectation. Some speculate 1 key mechanism at work is an amplification of the placebo effect. If this is the case then clearly testing of these drugs using traditional techniques to eliminate the placebo effect will be problematic
• stakkur 5y ago
  As a counterpoint, I'd read Michael Pollan. Also, a fundamental problem with this article is the lumping of 'psychedelics' into a neat category so it can be critiqued. In the real world, the story of what's happening is diverse. TL;DR: This is a dangerously biased dismissal of actual science and historical progress in understanding of various 'psychedelics', and it's exactly the kind of cherry-picking dismissal that's been fought against for decades.
• NoImmatureAdHom 5y ago
  The author points out a bunch of problems that are present in basically all research involving human behavior. He implies that it is particular to research involving psychedelics (except for I think a single example involving diet), and that is false. He should take a look at the dumpster fire that is Social Psychology...
• anomosmarxist 5y ago
• listless 5y ago
  Anecdotal but I did LSD when I was 19 and have been a been a huge consumer of mental health services, antidepressants and anxiety meds ever since. Prior to that horrific incident, I had no issues to speak of. So we can't say that they can cure it, but they most certainly can cause it. Perhaps the sword needs to cut both ways to be effective?
• robbiep 5y ago
  That’s really interesting. I’m reminded of something the PhD Pharmacologist Psychiatrist told us during med school - effect size of new depression meds decreases over time (probably because you have an early positive result and then it’s pushed in and then later better quality studies show smaller difference) so the joke is ‘every time a new depression medication comes out there’s a race to use it before it stops working!’
• nomendos 5y ago
  This article goes onto being biased on unproven allegation of bias, not exploring other possibilities
• mnkv 5y ago
  This article is interesting but a major issue is that the vast majority of the points (and the linked articles!) are not about psychedelics. They are about pharmacology, psychology, statistical significance, and science in general. The majority of the author's critiques can and are applied to a lot of other fields (he even takes a meta-review critical of nutrition and applies the logic to psychedelics). His main three themes (author bias, statistical significance, double-blinding/scientific rigour/confounding) are not at all unique to research with psychedelics. If the author's point is that we should take all studies with a grain of salt then why focus on psychedelics? If psychedelics is really such a problem field then I would expect more evidence than a couple bad actors (the MAPS stuff sounds terrible!) and light issues in a few studies that were brought up in reviews before publication. It seems the main point isn't research as much as the public's perception and hype (partially fueled by researchers to be fair). That's a good point and I'm totally against the psychedelics version of "weed cures cancer" bros. But, as the author points out, this isn't unique to psychedelics either! Ironically, I found the intro and most of the article to sound much more critical of the research than the conclusion really is.