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Fairly interesting post, especially for those who weren't aware that hallucinogens sometimes cause minor hallucinations indefinitely, but arguments like the con

Fairly interesting post, especially for those who weren't aware that hallucinogens sometimes cause minor hallucinations indefinitely, but arguments like the conclusions section are why we need to, as a society, beat "the plural of anecdote is not data" into every single person's head. Some people have a negative reaction to LSD. Some people don't. Some people have a positive reaction to LSD. Some don't. What's missing, crucially, is the only useful information- how many of each there are. There is nothing else that is relevant! If "some guy had a bad time" was a robust argument for "never ever do this thing", it would be a bad idea to do anything ever. > Reading reddit anecdata about how LSD has changed people’s lives for the better - and the army of comments that dogpile on, agreeing - makes me upset at their naiveity and harmful promotion It is indeed naive to think that some random guy on the internet talking about their experience is useful. Now how did we decide it was "harmful promotion" again?

medler 3y ago
The tail risk is real though. I do hope someday we’ll have accurate estimates of those risks. In the meantime it seems pretty clear to me that the expected value of these drugs is negative. I think it was Charlie Munger who said “in the best case scenario you feel good for a few minutes. In the worst case scenario it ruins your life.”
- ravi-delia 3y ago
  I mean maybe? Depends on how willing you are to trade small risks for small benefit. But we have no real bounds on upsides or downsides, and no real probability of any of it. I don't know about you, but my prior in situations such as these is that if a strong effect in either direction were likely, we'd have better data.
- lagadu 3y ago
  This is true for anything though. For example: I dance (professionally), surf and snowboard. All three of them have caused me injuries, though only one of them left me with something permanent (very minor, more of an annoyance thankfully) and people have gotten extremely serious injuries and even death from all of them. Should we stop doing them recreationally because of possible risks?
  - medler 3y ago
    No, because they all have significant upsides that far outweigh the tail risks
    - deleted 3y ago
      [deleted]
  - MagicMoonlight 3y ago
    If the dance involved slamming your head off the pavement repeatedly until you start smelling colour then yes we would stop that form of dancing. That's why we have things like alcohol and don't have things like heroin. It's all about risk vs reward. Heroin makes you feel much nicer than alcohol but it's almost certain to fuck your life up so we don't do it. The head slam may be cooler than interpretive dance, but we don't do it because it gives you brain damage.
    - lagadu 3y ago
      > The head slam may be cooler than interpretive dance, but we don't do it because it gives you brain damage. Counterpoint: there's a whole sport based on that and it does cause brain damage: American Football[0]. [0] https://med.nyu.edu/departments-institutes/population-health/divisions-sections-centers/medical-ethics/education/high-school-bioethics-project/learning-scenarios/the-nfl-brain-injury https://med.nyu.edu/departments-institutes/population-health...
    - cosmojg 3y ago
      > That's why we have things like alcohol and don't have things like heroin. No, by your logic, alcohol would have been banned long before any other mind-altering substance. A multitude of longterm studies[1] have borne out the fact that most illegal drugs are safer than alcohol on multiple metrics[2]. Contemporary drug policy is based on culture and superstition, not science and medicine. [1] https://www.bbc.com/news/uk-11660210 https://www.bbc.com/news/uk-11660210 [2] https://doi.org/10.1016/S0140-6736(10)61462-6 https://doi.org/10.1016/S0140-6736(10)61462-6
- Khelavaster 3y ago
  Munger should be realistic. In the best case scenario, the drugs trigger metabolic changes that let your body deal with incipient cancer or some other significant disease.
jtbayly 3y ago
I grew up being warned that “it only takes one time” and you can fry your brain. Then I read on HN that was BS. Flashbacks don’t happen, trips can be made safe, etc. I’m actually glad to finally see this LSD etc promotion challenged. Seems like what I heard growing up was more true than what I’ve read on HN up until today.
- ravi-delia 3y ago
  But that's exactly what I'm talking about! In no sense does this article "challenge" random people on HN, because there's nothing to challenge at all. Some people did say they liked LSD, which is as true as it ever was, and other people say they don't like LSD, which is also true. Anyone going from "well I heard it's ok" => "flashbacks don't happen" was wrong before this story was ever published, because the plural of anecdote is not data.
- SideburnsOfDoom 3y ago
  I would encourage most people to learn to drive a motor car, and get a driver's licence. I wouldn't tell them that it's perfectly safe, because well, it isn't. It can be made _safer_ but won't be risk-free. Nevertheless, "don't try it" is not a good conclusion to draw from the existence of that risk. Similarly, the thinking that LSD or other recreational pharmaceutical must be either entirely bad or entirely safe, the "bad outcome does not actually happen" or "it only takes one time" is binary, black or white, absolutist thinking. The truth is somewhere in the middle. And I think that most participants know that it's an "extreme sport" a "daredevil thrill" like skydiving or a roller-coaster. A roller-coaster that never gains velocity or height would be pointless and boring.
  - jtbayly 3y ago
    Doing LSD is closer to texting and driving than it is to driving.
greenpeas 3y ago
> hallucinogens sometimes cause minor hallucinations indefinitely The author definitely did not think those were minor side-effects. > What's missing, crucially, is the only useful information- how many of each there are. There is nothing else that is relevant! the evidence that a bad trip can potentially cause permanent damage is useful and relevant. > If "some guy had a bad time" was a robust argument for "never ever do this thing", it would be a bad idea to do anything ever. "some guy got permanently fucked up doing something" is a strong argument for me to very carefully consider the potential benefits of "doing something" and whether they are worth it; in the case of LSD, for me personally, the benefits don't outweigh the potential downsides, and anecdata is more than enough for me to make this decision.
- ravi-delia 3y ago
  > the evidence that a bad trip can potentially cause permanent damage is useful and relevant. I would argue that this is not true in isolation! I guess it's not technically wrong, in that a new article is not 0 information, but without an attached probability there isn't much to learn. Frankly, some of the symptoms the author experienced are typical of HPPD, and some are not. Correlation isn't causation, and one datapoint absolutely does not show so much as correlation. You almost certainly partake in activities with a chance to go far more wrong every day! In fact, if the mere possibility of something going wrong is enough to dissuade you, then you shouldn't have needed the article in the first place- there's always a chance things could go horribly wrong! To be clear, I'm not saying LSD has no risks. The author got very unlucky, but not as unlucky as others who have been documented in the literature. My pitch is not even that those risks are mostly worth it- for many they probably aren't. What I'm saying is that the author's experience is every bit as useless as the people who constantly hype LSD up. The conclusion is "Fuck you, Jobs"- can you say with a straight face that the author wouldn't have concluded the same way even if no one else in the world had ever had a bad experience on LSD?
  - greenpeas 3y ago
    > but without an attached probability there isn't much to learn. But there is an attached probability implicitly. I can make some common sense assumptions about the number of people that have ever done LSD and get a lower bound on the risk (with a huge confidence interval, but still). Of course a chance of say 1 in ten millions is really small, but if the perceived benefits of doing LSD are also small, then that might be enough for me to make up my mind. > Frankly, some of the symptoms the author experienced are typical of HPPD, and some are not. Correlation isn't causation, and one datapoint absolutely does not show so much as correlation. This is a good point, I have to decide for myself whether that person is trustworthy or not, and whether their experience is relevant to my case. But if I decide that I can trust their evidence, then I'm going to factor it into my decision, even if it's only one datapoint. If in the future a controlled study on the risks of doing LSD gets published, I can reevaluate my position then. > You almost certainly partake in activities with a chance to go far more wrong every day! In fact, if the mere possibility of something going wrong is enough to dissuade you, then you shouldn't have needed the article in the first place- there's always a chance things could go horribly wrong! Yes, I partake in many activities that have a nonzero chance of harming me temporarily or permanently. But with each of those activities, I've decided that the potential benefits outweigh the risks. And mind you, I did not need to read extensive studies with attached probabilities do decide that crossing the road or swimming in the sea is worth the risks. This touches on another disagreement I have with your original response. We don't live our lives constantly evaluating the risks based on peer reviewed studies with attached probabilities. We rely on common sense and our lived experiences as well as other people's experience that we learn about. The plural of anecdote is not data, but together with a healthy dose of common sense, it can provide acceptable heuristics for evaluating risks and making decisions.

medler 3y ago

The tail risk is real though. I do hope someday we’ll have accurate estimates of those risks. In the meantime it seems pretty clear to me that the expected value of these drugs is negative. I think it was Charlie Munger who said “in the best case scenario you feel good for a few minutes. In the worst case scenario it ruins your life.”

ravi-delia 3y ago
I mean maybe? Depends on how willing you are to trade small risks for small benefit. But we have no real bounds on upsides or downsides, and no real probability of any of it. I don't know about you, but my prior in situations such as these is that if a strong effect in either direction were likely, we'd have better data.
lagadu 3y ago
This is true for anything though. For example: I dance (professionally), surf and snowboard. All three of them have caused me injuries, though only one of them left me with something permanent (very minor, more of an annoyance thankfully) and people have gotten extremely serious injuries and even death from all of them. Should we stop doing them recreationally because of possible risks?
- medler 3y ago
  No, because they all have significant upsides that far outweigh the tail risks
  - deleted 3y ago
    [deleted]
- MagicMoonlight 3y ago
  If the dance involved slamming your head off the pavement repeatedly until you start smelling colour then yes we would stop that form of dancing. That's why we have things like alcohol and don't have things like heroin. It's all about risk vs reward. Heroin makes you feel much nicer than alcohol but it's almost certain to fuck your life up so we don't do it. The head slam may be cooler than interpretive dance, but we don't do it because it gives you brain damage.
  - lagadu 3y ago
    > The head slam may be cooler than interpretive dance, but we don't do it because it gives you brain damage. Counterpoint: there's a whole sport based on that and it does cause brain damage: American Football[0]. [0] https://med.nyu.edu/departments-institutes/population-health/divisions-sections-centers/medical-ethics/education/high-school-bioethics-project/learning-scenarios/the-nfl-brain-injury https://med.nyu.edu/departments-institutes/population-health...
  - cosmojg 3y ago
    > That's why we have things like alcohol and don't have things like heroin. No, by your logic, alcohol would have been banned long before any other mind-altering substance. A multitude of longterm studies[1] have borne out the fact that most illegal drugs are safer than alcohol on multiple metrics[2]. Contemporary drug policy is based on culture and superstition, not science and medicine. [1] https://www.bbc.com/news/uk-11660210 https://www.bbc.com/news/uk-11660210 [2] https://doi.org/10.1016/S0140-6736(10)61462-6 https://doi.org/10.1016/S0140-6736(10)61462-6
Khelavaster 3y ago
Munger should be realistic. In the best case scenario, the drugs trigger metabolic changes that let your body deal with incipient cancer or some other significant disease.

jtbayly 3y ago

I grew up being warned that “it only takes one time” and you can fry your brain. Then I read on HN that was BS. Flashbacks don’t happen, trips can be made safe, etc. I’m actually glad to finally see this LSD etc promotion challenged. Seems like what I heard growing up was more true than what I’ve read on HN up until today.

ravi-delia 3y ago
But that's exactly what I'm talking about! In no sense does this article "challenge" random people on HN, because there's nothing to challenge at all. Some people did say they liked LSD, which is as true as it ever was, and other people say they don't like LSD, which is also true. Anyone going from "well I heard it's ok" => "flashbacks don't happen" was wrong before this story was ever published, because the plural of anecdote is not data.
SideburnsOfDoom 3y ago
I would encourage most people to learn to drive a motor car, and get a driver's licence. I wouldn't tell them that it's perfectly safe, because well, it isn't. It can be made _safer_ but won't be risk-free. Nevertheless, "don't try it" is not a good conclusion to draw from the existence of that risk. Similarly, the thinking that LSD or other recreational pharmaceutical must be either entirely bad or entirely safe, the "bad outcome does not actually happen" or "it only takes one time" is binary, black or white, absolutist thinking. The truth is somewhere in the middle. And I think that most participants know that it's an "extreme sport" a "daredevil thrill" like skydiving or a roller-coaster. A roller-coaster that never gains velocity or height would be pointless and boring.
- jtbayly 3y ago
  Doing LSD is closer to texting and driving than it is to driving.

greenpeas 3y ago

> hallucinogens sometimes cause minor hallucinations indefinitely The author definitely did not think those were minor side-effects. > What's missing, crucially, is the only useful information- how many of each there are. There is nothing else that is relevant! the evidence that a bad trip can potentially cause permanent damage is useful and relevant. > If "some guy had a bad time" was a robust argument for "never ever do this thing", it would be a bad idea to do anything ever. "some guy got permanently fucked up doing something" is a strong argument for me to very carefully consider the potential benefits of "doing something" and whether they are worth it; in the case of LSD, for me personally, the benefits don't outweigh the potential downsides, and anecdata is more than enough for me to make this decision.

ravi-delia 3y ago
> the evidence that a bad trip can potentially cause permanent damage is useful and relevant. I would argue that this is not true in isolation! I guess it's not technically wrong, in that a new article is not 0 information, but without an attached probability there isn't much to learn. Frankly, some of the symptoms the author experienced are typical of HPPD, and some are not. Correlation isn't causation, and one datapoint absolutely does not show so much as correlation. You almost certainly partake in activities with a chance to go far more wrong every day! In fact, if the mere possibility of something going wrong is enough to dissuade you, then you shouldn't have needed the article in the first place- there's always a chance things could go horribly wrong! To be clear, I'm not saying LSD has no risks. The author got very unlucky, but not as unlucky as others who have been documented in the literature. My pitch is not even that those risks are mostly worth it- for many they probably aren't. What I'm saying is that the author's experience is every bit as useless as the people who constantly hype LSD up. The conclusion is "Fuck you, Jobs"- can you say with a straight face that the author wouldn't have concluded the same way even if no one else in the world had ever had a bad experience on LSD?
- greenpeas 3y ago
  > but without an attached probability there isn't much to learn. But there is an attached probability implicitly. I can make some common sense assumptions about the number of people that have ever done LSD and get a lower bound on the risk (with a huge confidence interval, but still). Of course a chance of say 1 in ten millions is really small, but if the perceived benefits of doing LSD are also small, then that might be enough for me to make up my mind. > Frankly, some of the symptoms the author experienced are typical of HPPD, and some are not. Correlation isn't causation, and one datapoint absolutely does not show so much as correlation. This is a good point, I have to decide for myself whether that person is trustworthy or not, and whether their experience is relevant to my case. But if I decide that I can trust their evidence, then I'm going to factor it into my decision, even if it's only one datapoint. If in the future a controlled study on the risks of doing LSD gets published, I can reevaluate my position then. > You almost certainly partake in activities with a chance to go far more wrong every day! In fact, if the mere possibility of something going wrong is enough to dissuade you, then you shouldn't have needed the article in the first place- there's always a chance things could go horribly wrong! Yes, I partake in many activities that have a nonzero chance of harming me temporarily or permanently. But with each of those activities, I've decided that the potential benefits outweigh the risks. And mind you, I did not need to read extensive studies with attached probabilities do decide that crossing the road or swimming in the sea is worth the risks. This touches on another disagreement I have with your original response. We don't live our lives constantly evaluating the risks based on peer reviewed studies with attached probabilities. We rely on common sense and our lived experiences as well as other people's experience that we learn about. The plural of anecdote is not data, but together with a healthy dose of common sense, it can provide acceptable heuristics for evaluating risks and making decisions.