3 ms·

I think the article stated that 8% of the respondents who said they had a “bad trip” had their trip in a clinical trial. Not that 8% of clinical trials resulted

I think the article stated that 8% of the respondents who said they had a “bad trip” had their trip in a clinical trial. Not that 8% of clinical trials resulted in a bad trip.

reaperman 2y ago
That is what the article said, thank you for clarifying. This comment led me to read the article and try to find the data behind the study. Mainly I looked for this because the article doesn't say how this 8% compares on a normalized basis to other settings, but does make the claim that it provides evidence/proof that > This [8%] finding challenges the “set and setting” hypothesis of psychedelics. Edit 3: This claim was made by the article on nautil.us but was not made by the study, and indeed the Discussion in the study seems to be axiomatically accepting of the "set and setting hypothesis", and indeed the authors actually pull out quite a few statistics from previous studies which can only be viewed as supporting the "set and setting hypothesis". Some of those cited studies, such as Simonsson [1] would likely also be worth reviewing for anyone who finds interest in this one. I provided a link to Simonsson as it seems most directly relevant at first glance and I don't have time right now to review the other studies quoted, but the other studies cited shouldn't be overlooked by curious minds - they all seem quite relevant in their own way. I've been unable to find a resource with more numbers, or ideally the underlying dataset itself to analyze on my own. If you or anyone else know where I can find more numbers from the n=(about 608) survey, I'd greatly appreciate a pointer to it. Edit: Found the study[0] Edit 2: The study does not have enough granular data for me to perform my own quantitative analysis. Of note though, 5.3% of participants took it in a clinical setting, but 8% of the people who "suffered afterward" had taken it in a clinical setting. This is elevated compared to what it would be with a uniform distribution but the study itself also says: > "Experiencing a greater range of difficulties was predicted by being in an unguided setting at the time of the trip and having a more challenging trip. Duration of difficulties was predicted by the challengingness of the trip but no other factors emerged as significant. " Taking this at face value, it would seem that an unguided setting is more strongly correlated to a "challenging trip" than a therapeutic setting. And "challenging trip" was shown to be the greatest, and one of the only, predictors of post-trip difficulties: > To test this, linear regression analyses were conducted, firstly with range of difficulties as the DV and secondly with duration of difficulties as the DV. The overall regression model for the prediction of range of duration was significant (R2 = .04, F(4,519) = 4.97, p < .001). In terms of individual predictors, two emerged as significant; the challengingness of the trip (β = .17, p<0.001) and being in an unguided setting (β = .11, p = 0.008). 0: Study from the posted article: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0293349 https://journals.plos.org/plosone/article?id=10.1371/journal... 1: Simonsson study: https://www.sciencedirect.com/science/article/pii/S0165032723000915?via%3Dihub https://www.sciencedirect.com/science/article/pii/S016503272...
- mtalantikite 2y ago
  Thanks for digging these out. It definitely would be interesting to look at this dataset, because there are some parts of the study I wasn't expecting. For instance, the participants could report more than one substance during their experience -- I had assumed single drug use for the session -- where 10% indicated cannabis use. The only times I've seen people on psychedelics go from "everything is great" to "wow wtf is going on" has been after they smoked weed while a couple hours into an LSD trip. They also didn't seem to have an option for alcohol use, which seems like an important factor if we're collecting data on mixed drug use. I'd even be interested in tobacco use, it's certainly a powerful drug and would likely be involved in most ayahuasca ceremonies. Also was surprised that 26% of people had no idea what their dosage was. That seems really irresponsible. Anyways, thanks again, interesting data and would love to be able to look at it more!
  - reaperman 2y ago
    > Also was surprised that 26% of people had no idea what their dosage was. That seems really irresponsible. I agree that it's irresponsible, but personally I was surprised it wasn't way higher. I have a 0.1mg resolution analytical balance and for my psychonaut acquaintances/friends I'm almost always the very first person to introduce them to consistently weighing their doses to help start building a sense of what's appropriate for them. Even for people who've been using them regularly for >10 years. And no one I know has ever quantitatively tested the purity+dose of their drugs either, which is relatively "easy" through http://energycontrol-international.org http://energycontrol-international.org (a few do reagent testing to test for contaminants but it doesn't tell you much about % purity or dose) Note also that with mushrooms, weighing the fresh or dried mushrooms gives you very little information on your psilocybin/psilocin dose, different strains can vary by two orders of magnitude and even within the same strain you might find the strongest sample has 5x the concentration of the weakest sample. https://www.copsychedeliccup.com/2023-psychedelic-cup-data https://www.copsychedeliccup.com/2023-psychedelic-cup-data
    - denton-scratch 2y ago
      A 0.1mg-resolution balance would let you measure your dose to the nearest 100 microgrammes. That gives you just 3 gradations between no dose at all, and a fairly "standard" 300 mikes.
mtalantikite 2y ago
Yeah you're right, my slight bias against the clinicalization of psychedelics probably slipped through there! Thanks.
- reaperman 2y ago
  I share your bias, although until we find a better way to pair therapists and patients in other settings, I am accepting of the clinical setting. I have always been pro-legalization and I personally enjoy mushrooms, MDMA, and weaker psychoactive compounds -- but I've always had a rational skepticism of overpowered medical claims, especially when it comes to popular, politicized topics like medical applications of recreational drugs. The data and results for MDMA-assisted clinical therapy have blown me away. For example, a 2020 study[0] measured outcomes 12 months after the final MDMA-assisted therapy session and nearly half the participants ceased lifelong suicidal ideation for the full year following treatment. I was willing to easily believe that MDMA-assisted clinical therapy reduced symptoms of PTSD but I was worried that the benefits would wear off quickly; it wasn't until just the past few years we started measuring outcomes >3 months past the completion of MDMA interventions. Seeing these strong long-term effects in has really made me a believer that there's value in the clinicalization of psychedelics, even if other guided settings might have even stronger results. Moving over to pure conjecture, I also believe that the submission of MDMA for FDA approval (which, if granted, will force the DEA to reschedule MDMA), has been used as a lever to pressure the DEA to move on rescheduling THC/marijuana -- I believe the timing is mainly because it would be embarrassing if MDMA were moved off Schedule I before marijuana was. Obviously the broad public support for rescheduling of marijuana is a necessary prerequisite, but I don't believe it's the trigger for the specific timing. I also believe part of the timing is to generate positive press close to a presidential election. But I would be very happy to see these both rescheduled, regardless of the reasons. I also desperately want better access for Americans to get their drugs tested, so that we can more easily shift cultural norms towards getting in the habit of knowing their dose, purity, and contaminants before taking recreational, psychedelic, or pharmaceutical drugs. 0: https://link.springer.com/article/10.1007/s00213-020-05548-2 https://link.springer.com/article/10.1007/s00213-020-05548-2
  - 2y ago

I think the article stated that 8% of the respondents who said they had a “bad trip” had their trip in a clinical trial. Not that 8% of clinical trials resulted in a bad trip.

reaperman 2y ago

That is what the article said, thank you for clarifying. This comment led me to read the article and try to find the data behind the study. Mainly I looked for this because the article doesn't say how this 8% compares on a normalized basis to other settings, but does make the claim that it provides evidence/proof that > This [8%] finding challenges the “set and setting” hypothesis of psychedelics. Edit 3: This claim was made by the article on nautil.us but was not made by the study, and indeed the Discussion in the study seems to be axiomatically accepting of the "set and setting hypothesis", and indeed the authors actually pull out quite a few statistics from previous studies which can only be viewed as supporting the "set and setting hypothesis". Some of those cited studies, such as Simonsson [1] would likely also be worth reviewing for anyone who finds interest in this one. I provided a link to Simonsson as it seems most directly relevant at first glance and I don't have time right now to review the other studies quoted, but the other studies cited shouldn't be overlooked by curious minds - they all seem quite relevant in their own way. I've been unable to find a resource with more numbers, or ideally the underlying dataset itself to analyze on my own. If you or anyone else know where I can find more numbers from the n=(about 608) survey, I'd greatly appreciate a pointer to it. Edit: Found the study[0] Edit 2: The study does not have enough granular data for me to perform my own quantitative analysis. Of note though, 5.3% of participants took it in a clinical setting, but 8% of the people who "suffered afterward" had taken it in a clinical setting. This is elevated compared to what it would be with a uniform distribution but the study itself also says: > "Experiencing a greater range of difficulties was predicted by being in an unguided setting at the time of the trip and having a more challenging trip. Duration of difficulties was predicted by the challengingness of the trip but no other factors emerged as significant. " Taking this at face value, it would seem that an unguided setting is more strongly correlated to a "challenging trip" than a therapeutic setting. And "challenging trip" was shown to be the greatest, and one of the only, predictors of post-trip difficulties: > To test this, linear regression analyses were conducted, firstly with range of difficulties as the DV and secondly with duration of difficulties as the DV. The overall regression model for the prediction of range of duration was significant (R2 = .04, F(4,519) = 4.97, p < .001). In terms of individual predictors, two emerged as significant; the challengingness of the trip (β = .17, p<0.001) and being in an unguided setting (β = .11, p = 0.008). 0: Study from the posted article: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0293349 https://journals.plos.org/plosone/article?id=10.1371/journal... 1: Simonsson study: https://www.sciencedirect.com/science/article/pii/S0165032723000915?via%3Dihub https://www.sciencedirect.com/science/article/pii/S016503272...

mtalantikite 2y ago
Thanks for digging these out. It definitely would be interesting to look at this dataset, because there are some parts of the study I wasn't expecting. For instance, the participants could report more than one substance during their experience -- I had assumed single drug use for the session -- where 10% indicated cannabis use. The only times I've seen people on psychedelics go from "everything is great" to "wow wtf is going on" has been after they smoked weed while a couple hours into an LSD trip. They also didn't seem to have an option for alcohol use, which seems like an important factor if we're collecting data on mixed drug use. I'd even be interested in tobacco use, it's certainly a powerful drug and would likely be involved in most ayahuasca ceremonies. Also was surprised that 26% of people had no idea what their dosage was. That seems really irresponsible. Anyways, thanks again, interesting data and would love to be able to look at it more!
- reaperman 2y ago
  > Also was surprised that 26% of people had no idea what their dosage was. That seems really irresponsible. I agree that it's irresponsible, but personally I was surprised it wasn't way higher. I have a 0.1mg resolution analytical balance and for my psychonaut acquaintances/friends I'm almost always the very first person to introduce them to consistently weighing their doses to help start building a sense of what's appropriate for them. Even for people who've been using them regularly for >10 years. And no one I know has ever quantitatively tested the purity+dose of their drugs either, which is relatively "easy" through http://energycontrol-international.org http://energycontrol-international.org (a few do reagent testing to test for contaminants but it doesn't tell you much about % purity or dose) Note also that with mushrooms, weighing the fresh or dried mushrooms gives you very little information on your psilocybin/psilocin dose, different strains can vary by two orders of magnitude and even within the same strain you might find the strongest sample has 5x the concentration of the weakest sample. https://www.copsychedeliccup.com/2023-psychedelic-cup-data https://www.copsychedeliccup.com/2023-psychedelic-cup-data
  - denton-scratch 2y ago
    A 0.1mg-resolution balance would let you measure your dose to the nearest 100 microgrammes. That gives you just 3 gradations between no dose at all, and a fairly "standard" 300 mikes.

mtalantikite 2y ago

Yeah you're right, my slight bias against the clinicalization of psychedelics probably slipped through there! Thanks.

reaperman 2y ago
I share your bias, although until we find a better way to pair therapists and patients in other settings, I am accepting of the clinical setting. I have always been pro-legalization and I personally enjoy mushrooms, MDMA, and weaker psychoactive compounds -- but I've always had a rational skepticism of overpowered medical claims, especially when it comes to popular, politicized topics like medical applications of recreational drugs. The data and results for MDMA-assisted clinical therapy have blown me away. For example, a 2020 study[0] measured outcomes 12 months after the final MDMA-assisted therapy session and nearly half the participants ceased lifelong suicidal ideation for the full year following treatment. I was willing to easily believe that MDMA-assisted clinical therapy reduced symptoms of PTSD but I was worried that the benefits would wear off quickly; it wasn't until just the past few years we started measuring outcomes >3 months past the completion of MDMA interventions. Seeing these strong long-term effects in has really made me a believer that there's value in the clinicalization of psychedelics, even if other guided settings might have even stronger results. Moving over to pure conjecture, I also believe that the submission of MDMA for FDA approval (which, if granted, will force the DEA to reschedule MDMA), has been used as a lever to pressure the DEA to move on rescheduling THC/marijuana -- I believe the timing is mainly because it would be embarrassing if MDMA were moved off Schedule I before marijuana was. Obviously the broad public support for rescheduling of marijuana is a necessary prerequisite, but I don't believe it's the trigger for the specific timing. I also believe part of the timing is to generate positive press close to a presidential election. But I would be very happy to see these both rescheduled, regardless of the reasons. I also desperately want better access for Americans to get their drugs tested, so that we can more easily shift cultural norms towards getting in the habit of knowing their dose, purity, and contaminants before taking recreational, psychedelic, or pharmaceutical drugs. 0: https://link.springer.com/article/10.1007/s00213-020-05548-2 https://link.springer.com/article/10.1007/s00213-020-05548-2
- 2y ago