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This is fantastic! I am generally very pro-psychadelic - they seem like they can offer unique aid to people and they are not very prone to abuse. The only "dow

This is fantastic! I am generally very pro-psychadelic - they seem like they can offer unique aid to people and they are not very prone to abuse. The only "downside" is that, because outcomes vary widely (though are generally not negative, simply unhelpful), it's hard to call them "medicine" in the way that, say, asprin is medicine. However, with the proper understanding, I'm hopeful they can be a really helpful tool for some people.

petesergeant 4y ago
> because outcomes vary widely, it's hard to call them "medicine" Is that so different from any other psychiatric medicine?
- galangalalgol 4y ago
  No kidding! Might help, but won't cause harm, and you probably won't have to take it forever, matbe even just once? I know LSD has been attributed some harmful effects, does psilocybin have no chance of psychotic breaks or ???
  - tempsy 4y ago
    recreational doses are not necessarily therapeutic doses if you are taking a psychedelic as part of some therapy regime it is not a tripping balls level dose
    - Ingaz 4y ago
      It's actually could be other way. There is an anecdotic evidence that bad trips on first intake are more frequent with lower doses of psychedelics than higher. So it's very possible that those therapeutic sessions will be mind-shattering experiences and not like going to discotheque with friends.
    - TaylorAlexander 4y ago
      Everything I've learned about therapeutic psilocybin treatment is that the doses involved are actually quite a bit higher than I've ever done on a trip at home. For example for psychedelic therapy with psilocybin, you would see a therapist a few times with no psilocybin, then you would have a session where you take something like the equivalent of 1 gram of dried mushrooms, and go through that session with the therapist. Then come back 1-2 weeks later and take something like a "heroic" dose or about 5 grams dried mushroom equivalent and go through that session with the therapist. Then you come back again two weeks later and have a sober session again to talk about all of it. My understanding is that this is generally how the well respected research studies have gone. The most I have ever done myself is 2 grams dried mushroom equivalent, and I usually stay under 1.
      - sterlind 4y ago
        Jesus. five grams would scare me. does it just not work to use an eighth?
        TaylorAlexander 4y ago
        So in a clinical setting they actually give 20-30mg of psilocybin directly. This works out to approximately 3-5g of dried cubensis depending on their potency.
      - azinman2 4y ago
        I can’t imagine being completely detached from reality, and using that to work through really tough shit. Talk about a bad trip.
        geertj 4y ago
        From my limited understanding, when a trip is used in a therapy session, it allows a patient to observe past trauma from an (emotional) distance, allowing them to process it. I can see how that would work. If trauma is so severe that you can’t even think of it, you’d push it away to the back of your mind where it would fester.
      - 4y ago
    - naasking 4y ago
      A therapeutic MDMA dose is basically equivalent to a recreational dose from the literature I've read. Not sure about psilocybin. Ketamine dosage definitely leads to tripping balls.
      - Overtonwindow 4y ago
        Not at all actually. I underwent 11 weeks of ketamine therapy. No hallucinations whatsoever, and I checked with others because I thought I was missing out! I felt physically drunk, but mentally absolutely clear. You may be thinking of a higher dose taken recreationally.
        naasking 4y ago
        Or the reports I read were before they dialed in the dose.
  - Alex3917 4y ago
    > I know LSD has been attributed some harmful effects, does psilocybin have no chance of psychotic breaks or ??? Psilocybin has that risk, but it’s lower because the molecule binds to your receptors much less tightly.
- aeturnum 4y ago
  It's a fair question - but I would say yes? I know lots of people who have taken antidepressants and psychedelics and while both have been helpful the antidepressants have much more consistent effects (both person to person and dose to dose).
- tdehnel 4y ago
  This is rationalizing rhetoric. Full-on psychedelic drugs are very different from any other psychiatric medicine. Users should know this difference and be prepared to mitigate the risks. With psych drugs, the most common experience is that user takes them for a few weeks, and reports or doesn’t report some subtle change in their psyche. A bad experience is mostly limited to “didn’t work”. If the drug “doesn’t work” they stop using it and try something else. With psychedelic drugs, the effect is 100% going to be felt within less than an hour, the effect will be very strong and is guaranteed to be one of the most memorable experiences of the user’s life. A bad experience could easily consist of being rapidly confronted with some deep truths about the user’s self and ego. There is a reason psychedelics have been linked to schizophrenia: https://jamanetwork.com/journals/jamapsychiatry/article-abstract/493118 https://jamanetwork.com/journals/jamapsychiatry/article-abst...
  - pas 4y ago
    recreational dose is easily 10-20x more than therapeutic dose for most drugs. comparison has to take this into account, so they are not different, the dose is the real difference.
ActorNightly 4y ago
There is already a proper understanding of them - they are pharmacologicaly super safe. Beyond that, they should be available for anyone to try, whether you "need" them or not, in non hero dose amounts, in therapy settings.
- aeturnum 4y ago
  Yes that is what I am saying.
cleanchit 4y ago
Can you drive on psilocybin?
- gchokov 4y ago
  You can’t, just like with A LOT of other medicines.
- di456 4y ago
  All the way to the stars and back
- louhike 4y ago
  That would be a pretty bad idea. You could have visual hallucinations, be pretty slow and not thinking normally.
- mathgladiator 4y ago
  Nope, absolutely not... The world is not exactly straight, and things can get a bit melty.
- BossingAround 4y ago
  It's a good question, but no, you cannot. On LSD, even walking gets difficult.
LoganDark 4y ago
We hope to be able to try it some day, since we have DID and heard that psychedelics can actually help a lot. It's a shame that we'll probably have to wait years, though... -Emily
- windowshopping 4y ago
  Why you sign your comments? Just genuinely curious.
  - rjbwork 4y ago
    Because they claim to have DID, and thus are saying that at that particular time, they are "fronting" with a persona they call Emily. FWIW, a large amount of the psychiatric establishment believes DID to not be real, per se. Instead they think it can be caused by an especially suggestible patient responding to a therapist or other psychiatric professional's coaching. Essentially playing a role in the therapy (for genuine underlying problems!) that they believe they are expected to play.
    - windowshopping 4y ago
      Oh the answer to my question was already there and I read over it without realizing it. Thanks!
    - zealtrace 4y ago
      A number of studies indicate the prevalence of DID to be about 1% in the general population. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6296396/#!po=1.21951 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6296396/#!po=1....
      - hhjinks 4y ago
        Dissociative disorders in general, not DID in particular.
        4y ago
sirsinsalot 4y ago
It being MDMA and psilocybin is a bit odd. MDMA is very prone to abuse. Not saying it doesn't have therapeutic uses, but it is certainly a drug that needs huge respect and caution.
- MrScruff 4y ago
  Not arguing that caution shouldn’t be applied but I think it’s a bit more subtle than that. MDMA is prone to abuse in the recreational use sense, but it’s not really habit forming in the same way other drugs are. Sure, you can always find edge cases but compared to many other drugs (including alcohol) you’re unlikely to meet many daily users.
  - sirsinsalot 4y ago
    I somewhat agree. Daily use doesn't produce the high being sought, but it is very habit forming. I know from personal experience and that of many people around me that doing molly every weekend quickly becomes a dependency and will mess you up very quickly. In a therapy setting I'm sure risks are low, but I wouldn't make such black and white comparisons against alcohol or say, cocaine. The reality of addiction is more than a function of frequency or tolerance and often comparing drugs directly is misleading.
    - MrScruff 4y ago
      I’d refer you to the extensive research on the topic by David Nutt, Professor of Pharmacology at Imperial College and former government drugs adviser. It’s possible to compare the ‘relative harm’ of substances, and they will, partly by the nature of the different ways they interact with our reward systems have different risk profiles. Again, not dismissing the risk, but sane drugs policy does require an evidence based assessment of how each substance impacts society and individuals.
      - nmca 4y ago
        I'm broadly pro harm reduction & happy about psych legalisarion, but the details of the Nutt studies are, aha, pretty Nutty. The most cited one just involved taking some doctors and asking them to yolo out some qualitative harm estimates. Not ideal evidence-based medicine. (I would provide a close cite but I only recall from his book "drugs without the hot air" & am on mobile)
onlypositive 4y ago
It's not that fantastic. Australia has draconian driving laws. Any drugs found in your system is a fine and 3 month licensed suspension. Permanent loss on secondary offense. So while we are getting medical access to psychedelics we can't actually use them if we also need to drive a car.
more_corn 4y ago
Um. No. Outcomes don’t “vary widely” Studies of Psilocybin treatments for depression show remarkable success rates. In some cases a single dose paired with one session of talk therapy provides relief for 3 months. Compared to the next most viable treatment SSRIs that take 3 weeks to start working and come with danger of opposite effects if the treatment is stopped. Studies using MDMA to treat PTSD work surprisingly well. The few studies done on using those two drugs in psychiatric settings show phenomenally positive results. I don’t know where you’re getting your information from but it’s not by reading the scientific studies.

petesergeant 4y ago

> because outcomes vary widely, it's hard to call them "medicine" Is that so different from any other psychiatric medicine?

galangalalgol 4y ago
No kidding! Might help, but won't cause harm, and you probably won't have to take it forever, matbe even just once? I know LSD has been attributed some harmful effects, does psilocybin have no chance of psychotic breaks or ???
- tempsy 4y ago
  recreational doses are not necessarily therapeutic doses if you are taking a psychedelic as part of some therapy regime it is not a tripping balls level dose
  - Ingaz 4y ago
    It's actually could be other way. There is an anecdotic evidence that bad trips on first intake are more frequent with lower doses of psychedelics than higher. So it's very possible that those therapeutic sessions will be mind-shattering experiences and not like going to discotheque with friends.
  - TaylorAlexander 4y ago
    Everything I've learned about therapeutic psilocybin treatment is that the doses involved are actually quite a bit higher than I've ever done on a trip at home. For example for psychedelic therapy with psilocybin, you would see a therapist a few times with no psilocybin, then you would have a session where you take something like the equivalent of 1 gram of dried mushrooms, and go through that session with the therapist. Then come back 1-2 weeks later and take something like a "heroic" dose or about 5 grams dried mushroom equivalent and go through that session with the therapist. Then you come back again two weeks later and have a sober session again to talk about all of it. My understanding is that this is generally how the well respected research studies have gone. The most I have ever done myself is 2 grams dried mushroom equivalent, and I usually stay under 1.
    - sterlind 4y ago
      Jesus. five grams would scare me. does it just not work to use an eighth?
      - TaylorAlexander 4y ago
        So in a clinical setting they actually give 20-30mg of psilocybin directly. This works out to approximately 3-5g of dried cubensis depending on their potency.
    - azinman2 4y ago
      I can’t imagine being completely detached from reality, and using that to work through really tough shit. Talk about a bad trip.
      - geertj 4y ago
        From my limited understanding, when a trip is used in a therapy session, it allows a patient to observe past trauma from an (emotional) distance, allowing them to process it. I can see how that would work. If trauma is so severe that you can’t even think of it, you’d push it away to the back of your mind where it would fester.
    - 4y ago
  - naasking 4y ago
    A therapeutic MDMA dose is basically equivalent to a recreational dose from the literature I've read. Not sure about psilocybin. Ketamine dosage definitely leads to tripping balls.
    - Overtonwindow 4y ago
      Not at all actually. I underwent 11 weeks of ketamine therapy. No hallucinations whatsoever, and I checked with others because I thought I was missing out! I felt physically drunk, but mentally absolutely clear. You may be thinking of a higher dose taken recreationally.
      - naasking 4y ago
        Or the reports I read were before they dialed in the dose.
- Alex3917 4y ago
  > I know LSD has been attributed some harmful effects, does psilocybin have no chance of psychotic breaks or ??? Psilocybin has that risk, but it’s lower because the molecule binds to your receptors much less tightly.
aeturnum 4y ago
It's a fair question - but I would say yes? I know lots of people who have taken antidepressants and psychedelics and while both have been helpful the antidepressants have much more consistent effects (both person to person and dose to dose).
tdehnel 4y ago
This is rationalizing rhetoric. Full-on psychedelic drugs are very different from any other psychiatric medicine. Users should know this difference and be prepared to mitigate the risks. With psych drugs, the most common experience is that user takes them for a few weeks, and reports or doesn’t report some subtle change in their psyche. A bad experience is mostly limited to “didn’t work”. If the drug “doesn’t work” they stop using it and try something else. With psychedelic drugs, the effect is 100% going to be felt within less than an hour, the effect will be very strong and is guaranteed to be one of the most memorable experiences of the user’s life. A bad experience could easily consist of being rapidly confronted with some deep truths about the user’s self and ego. There is a reason psychedelics have been linked to schizophrenia: https://jamanetwork.com/journals/jamapsychiatry/article-abstract/493118 https://jamanetwork.com/journals/jamapsychiatry/article-abst...
- pas 4y ago
  recreational dose is easily 10-20x more than therapeutic dose for most drugs. comparison has to take this into account, so they are not different, the dose is the real difference.

ActorNightly 4y ago

There is already a proper understanding of them - they are pharmacologicaly super safe. Beyond that, they should be available for anyone to try, whether you "need" them or not, in non hero dose amounts, in therapy settings.

aeturnum 4y ago
Yes that is what I am saying.

cleanchit 4y ago

Can you drive on psilocybin?

gchokov 4y ago
You can’t, just like with A LOT of other medicines.
di456 4y ago
All the way to the stars and back
louhike 4y ago
That would be a pretty bad idea. You could have visual hallucinations, be pretty slow and not thinking normally.
mathgladiator 4y ago
Nope, absolutely not... The world is not exactly straight, and things can get a bit melty.
BossingAround 4y ago
It's a good question, but no, you cannot. On LSD, even walking gets difficult.

LoganDark 4y ago

We hope to be able to try it some day, since we have DID and heard that psychedelics can actually help a lot. It's a shame that we'll probably have to wait years, though... -Emily

windowshopping 4y ago
Why you sign your comments? Just genuinely curious.
- rjbwork 4y ago
  Because they claim to have DID, and thus are saying that at that particular time, they are "fronting" with a persona they call Emily. FWIW, a large amount of the psychiatric establishment believes DID to not be real, per se. Instead they think it can be caused by an especially suggestible patient responding to a therapist or other psychiatric professional's coaching. Essentially playing a role in the therapy (for genuine underlying problems!) that they believe they are expected to play.
  - windowshopping 4y ago
    Oh the answer to my question was already there and I read over it without realizing it. Thanks!
  - zealtrace 4y ago
    A number of studies indicate the prevalence of DID to be about 1% in the general population. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6296396/#!po=1.21951 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6296396/#!po=1....
    - hhjinks 4y ago
      Dissociative disorders in general, not DID in particular.
      - 4y ago

sirsinsalot 4y ago

It being MDMA and psilocybin is a bit odd. MDMA is very prone to abuse. Not saying it doesn't have therapeutic uses, but it is certainly a drug that needs huge respect and caution.

MrScruff 4y ago
Not arguing that caution shouldn’t be applied but I think it’s a bit more subtle than that. MDMA is prone to abuse in the recreational use sense, but it’s not really habit forming in the same way other drugs are. Sure, you can always find edge cases but compared to many other drugs (including alcohol) you’re unlikely to meet many daily users.
- sirsinsalot 4y ago
  I somewhat agree. Daily use doesn't produce the high being sought, but it is very habit forming. I know from personal experience and that of many people around me that doing molly every weekend quickly becomes a dependency and will mess you up very quickly. In a therapy setting I'm sure risks are low, but I wouldn't make such black and white comparisons against alcohol or say, cocaine. The reality of addiction is more than a function of frequency or tolerance and often comparing drugs directly is misleading.
  - MrScruff 4y ago
    I’d refer you to the extensive research on the topic by David Nutt, Professor of Pharmacology at Imperial College and former government drugs adviser. It’s possible to compare the ‘relative harm’ of substances, and they will, partly by the nature of the different ways they interact with our reward systems have different risk profiles. Again, not dismissing the risk, but sane drugs policy does require an evidence based assessment of how each substance impacts society and individuals.
    - nmca 4y ago
      I'm broadly pro harm reduction & happy about psych legalisarion, but the details of the Nutt studies are, aha, pretty Nutty. The most cited one just involved taking some doctors and asking them to yolo out some qualitative harm estimates. Not ideal evidence-based medicine. (I would provide a close cite but I only recall from his book "drugs without the hot air" & am on mobile)

onlypositive 4y ago

It's not that fantastic. Australia has draconian driving laws. Any drugs found in your system is a fine and 3 month licensed suspension. Permanent loss on secondary offense. So while we are getting medical access to psychedelics we can't actually use them if we also need to drive a car.

more_corn 4y ago

Um. No. Outcomes don’t “vary widely” Studies of Psilocybin treatments for depression show remarkable success rates. In some cases a single dose paired with one session of talk therapy provides relief for 3 months. Compared to the next most viable treatment SSRIs that take 3 weeks to start working and come with danger of opposite effects if the treatment is stopped. Studies using MDMA to treat PTSD work surprisingly well. The few studies done on using those two drugs in psychiatric settings show phenomenally positive results. I don’t know where you’re getting your information from but it’s not by reading the scientific studies.