6 ms·

I don't want people self-medicating with psilocybin, just like I don't want people self-medicating with SSRIs. Which is more dangerous?

by HKH2 2y ago

phoronixrly 2y ago
The best thing to do is to consult with a physician on matters related to your health.
- Wytwwww 2y ago
  Why? I mean it certainly depends but as far non severe mental health issues go physicians are just going to checklists since there is hardly anything else they can do (besides long-term therapy).
- maeil 2y ago
  That's not clear cut. There clearly exist plenty of combinations of "situation + physician" where this is not the best thing to do. To claim otherwise may as well be religious dogma.
  - phoronixrly 2y ago
    I'm sorry, but how is trusting a person who dedicated 10+ years of their life studying/practicing this, and relying on rigorous safety and effectiveness research of drugs religious dogma? Are you sure you know what religion is? Are you sure you know what science is? Are you just trolling?
    - beagle3 2y ago
      If you actually read the effectiveness and safety research with a critical eye, you would realize “rigorous” is often the wrong adjective, whereas “cherry picked” to the point of “fraudulent” is often more in line with reality. Case in point: 50,000 people died, with about 5 times as many suffering life-changing serious adverse events, from “rigorous research” on the safety of Vioxx. Yes, it has since been pulled from the market, which FDA apologists often construe as “system working as designed”. No, it isn’t, even in the least, when you go into the details. Also: Purdue and OxyContin. Regulatory capture of the FDA is decades old at this point. Ignoring that is not a rational or healthy position.
    - farts_mckensy 2y ago
      I don't know, why don't we ask my colon? Oh, wait, we can't. I was prescribed accutane, subsequently got ulcerative colitis so bad that they had to remove the organ entirely. The surgeon said my colon was literally falling apart in his hands as he took it out. Blind deference to authority of doctors lead to this situation. They do not always make great decisions, especially if there is a financial incentive for them to do otherwise.
    - maeil 2y ago
      I'm not trolling, see my reply elsewhere. Do you not know anyone who has spent many years of their life doing something and are still rather poor at it? You probably do. You may even have such a skill yourself - I certainly do!
  - bobthepanda 2y ago
    At the very least, consulting with one or more physicians gives more data points than you would otherwise have. If your goal is to know more, having other opinions is pretty fundamental.
    - maeil 2y ago
      Doing a rain dance and concluding that it doesn't help also gives you another data point. Praying as prescribed in 50 different religions a whole lot more data points. And so on. I'm not a nut screaming "It's all a scam, don't participate in modern healthcare!". Just noting that it's complicated, and the idea that going to a physician is always the best option should receive more scrutiny, because it's not black and white.
- dingnuts 2y ago
  that's easy to say when you forget about the state of healthcare.. everywhere, actually. I was going to say the US but in other countries it's not like you can just pop in for a chat about taking shroomies, either. I'm not sure having a ten minute meeting with a stranger who has a PhD in internal medicine is going to yield useful strategies for curing the existential dread underpinning your depression whether you're there to discuss getting zonked on LSD or something more "traditional" like Xanax
  - phoronixrly 2y ago
    > it's not like you can just pop in for a chat about taking shroomies You sure can just pop in to discuss options for your crippling depression though? And sorry, I do indeed live in a country with a functioning healthcare system, not the US.
    - dingnuts 2y ago
      In the US normally you talk to a therapist (not a doctor) or psychologist (not a medical doctor) about your depression at length, and then if you're deemed sufficiently depressed you get a short consult with a psychiatrist (finally a doctor) to prescribe medication. This is when you would theoretically finally be able to bring up shrooms, and your psychiatrist will laugh at you, write an Rx for an SSRI, and you'll see him next year when the Rx expires I'm not sure how it is in most countries but I'd expect the biggest difference is that it will cost you money in the US, but I've read many many horror stories about people waiting many months to have only a short chat with a physician from other countries. The lack of time available to spend taking to physicians seems to be a problem in other places too my point is that consulting a doctor with random questions isn't a simple, casual thing people can easily do in most places. in most places you have to plan ahead and either wait a long time for an appointment, and/or there is a cost barrier. if you have examples of countries where people are able to get to know their doctors on a personal level and can afford in time and money to talk to their physicians for more than a few minutes per year, please link them below
    - Wytwwww 2y ago
      > You sure can just pop in to discuss options for your crippling depression though To get a prescription for one of the the handful of drugs are are available and are considered to be effective. What else can you learn by just "popping in"? > with a functioning healthcare system, not the US. What do you even mean by that?
- standardUser 2y ago
  The US government severely restricts research on Schedule 1 drugs like psilocybin. Physicians don't have the data they need to inform patients.
- Der_Einzige 2y ago
  The idea that doctors aren't constantly "off base" and must be deferred to uncritically is pretty terrible. For example, it took literally two decades after it became well known that peptic ulcers were mostly caused by bacteria for the medical community to embrace giving anti-biotics for GI pain. To this day, there are still many American doctors who don't actually know about the Nobel Prize given in 2000 for this discovery, and claim it's "stress" and tell you to go home. Some claim they "know" but than try to "change your gut PH" and still refuse to give antibiotics due to "superbug" risk. This is a "small" thing (GI pain is not small to those who have it) - but if the doctors are screwing up such a small thing institutionally, what else do they mess up on? One is travelers sickness. Doctors in the USA do not want to perscribe front line antibiotics for it because of fear of superbugs - but they'll uncritically go eat their lunch at a McDonalds that same day, where they consume meat bathed in antibiotic slop which is more likely to contribute to superbugs then the amoxicillin that they didn't give you would have. Or what about right now, when it's become clear that Ozempic is literally a super-drug. Every doctor on earth should be trying to give that stuff to literally anyone. I can go to "third world countries" with deregulated health systems and get infinitely better care that I have real control over for on the orders of 1 USD (that's how much it cost for me in Thailand to get front line antibiotics for travelers sickness INCLUDING THE DOCTORS VISIT!) Why do we still sell Neosporin despite doctors wanting it off the market (also for risk of superbugs)? Why do few people in America use Providone-iodine for wound treatment despite it being by far the best solution scientifically for it (and it stains yellow)? Maybe it's because we're stupid. There really aren't better explanations. What about Circumcision? I'd straight up put doctors who do it in jail and many European nations would do the same. American doctors think circumcision is just fine, and long, deeply bitter swaths of medical ethics journals are dedicated to fighting over this again and again. Or what about the widespread disagreement over even basic stuff like digital rectal exams? There's no agreement on if they are worth it because often sticking one's hand up the butt of an old man does more damage to them than finding out that they (like everyone else at old age) have benign prostate cancer? Doctors in America have not earned their position of deference. The scientifically minded on HN who do their own research can and often do know how to treat certain conditions better than white-coats.
- m_fayer 2y ago
  I really wish we would retire this chestnut already. As if there’s a reasonable grownup option here and everything else is playing with matches. No it’s not the best thing to do to brave huge waiting lists, call a hundred providers none of whom are taking new patients, pay a fortune out of pocket, and/or be faced with a distracted impatient person stuck to their screen who has 10 minutes for you. And I live in Germany, not the US.
striking 2y ago
Psylocybin? Easily? You have to put effort into making an experience with psylocybin meaningful and helpful. It could go wrong very easily, especially for those who are in a difficult situation or headspace. (Speaking from experience.) As for SSRIs? Safe, effective, with a handful of annoying side effects. Straightforward to use, low potential for misuse, requires sustained use for any intended effects. A doctor who already has familiarity with a patient's mild or moderate symptoms of anxiety or depression may very well just prescribe one if asked and if not contraindicated. Not that you should randomly start popping Prozac, but it's unlikely to hurt you if you did. Ask your doctor, try the things that doctors currently believe are most likely to work first. If for whatever reason you choose to go beyond the current medical consensus, please stay safe and keep your doctor up to date.
- HKH2 2y ago
  So are you okay with people choosing their own dose of SSRIs?
  - standardUser 2y ago
    A prescribing doctor will not magically know the precise amount of an SSRI a patient should be taking, or which one to take. For most patients, finding the right drug and dosage is a process. And just like with psilocybin, no one would want to take a random amount. Like with any drug, a person would want to be informed and have proper guidelines about dosage from the start.
- jorvi 2y ago
  > Psylocybin? Easily? Err.. no? This is from the Dutch National Institute for Public Health and the Environment: https://www.rivm.nl/bibliotheek/rapporten/340001001.pdf https://www.rivm.nl/bibliotheek/rapporten/340001001.pdf Page 19 onward has the charts. What do do we find at the very low end in terms of chronic and acute toxicity? Shrooms (“paddos”) and LSD. It always blows my mind how anti-drug people will do a handwavey gesture to the authority of institutes like the FDA, but never actually check up on what actual research says. > As for SSRIs? Safe, effective, with a handful of annoying side effects. Except the multitude of ways you can put yourself into a serotonin coma. I agree with your assessment that (first) use of psychedelics should be under proper guidance. But what you refer to, “going bad”, can sometimes be a traumatic past experience that people have stuffed away and by surfacing and processing it they can move past it. It’s not always meant to be kumbaya and flowers. Educate yourself, then talk.
dyauspitr 2y ago
Definitely psilocybin. For instance, if you take psilocybin and then spend some time in a cow slaughterhouse house, you might go crazy. The same wouldn’t be true of SSRIs.
- HKH2 2y ago
  With SSRIs, the dangers are long-term.

I don't want people self-medicating with psilocybin, just like I don't want people self-medicating with SSRIs. Which is more dangerous?

by HKH2 2y ago

I don't want people self-medicating with psilocybin, just like I don't want people self-medicating with SSRIs. Which is more dangerous?

phoronixrly 2y ago

The best thing to do is to consult with a physician on matters related to your health.

Wytwwww 2y ago
Why? I mean it certainly depends but as far non severe mental health issues go physicians are just going to checklists since there is hardly anything else they can do (besides long-term therapy).
maeil 2y ago
That's not clear cut. There clearly exist plenty of combinations of "situation + physician" where this is not the best thing to do. To claim otherwise may as well be religious dogma.
- phoronixrly 2y ago
  I'm sorry, but how is trusting a person who dedicated 10+ years of their life studying/practicing this, and relying on rigorous safety and effectiveness research of drugs religious dogma? Are you sure you know what religion is? Are you sure you know what science is? Are you just trolling?
  - beagle3 2y ago
    If you actually read the effectiveness and safety research with a critical eye, you would realize “rigorous” is often the wrong adjective, whereas “cherry picked” to the point of “fraudulent” is often more in line with reality. Case in point: 50,000 people died, with about 5 times as many suffering life-changing serious adverse events, from “rigorous research” on the safety of Vioxx. Yes, it has since been pulled from the market, which FDA apologists often construe as “system working as designed”. No, it isn’t, even in the least, when you go into the details. Also: Purdue and OxyContin. Regulatory capture of the FDA is decades old at this point. Ignoring that is not a rational or healthy position.
  - farts_mckensy 2y ago
    I don't know, why don't we ask my colon? Oh, wait, we can't. I was prescribed accutane, subsequently got ulcerative colitis so bad that they had to remove the organ entirely. The surgeon said my colon was literally falling apart in his hands as he took it out. Blind deference to authority of doctors lead to this situation. They do not always make great decisions, especially if there is a financial incentive for them to do otherwise.
  - maeil 2y ago
    I'm not trolling, see my reply elsewhere. Do you not know anyone who has spent many years of their life doing something and are still rather poor at it? You probably do. You may even have such a skill yourself - I certainly do!
- bobthepanda 2y ago
  At the very least, consulting with one or more physicians gives more data points than you would otherwise have. If your goal is to know more, having other opinions is pretty fundamental.
  - maeil 2y ago
    Doing a rain dance and concluding that it doesn't help also gives you another data point. Praying as prescribed in 50 different religions a whole lot more data points. And so on. I'm not a nut screaming "It's all a scam, don't participate in modern healthcare!". Just noting that it's complicated, and the idea that going to a physician is always the best option should receive more scrutiny, because it's not black and white.
dingnuts 2y ago
that's easy to say when you forget about the state of healthcare.. everywhere, actually. I was going to say the US but in other countries it's not like you can just pop in for a chat about taking shroomies, either. I'm not sure having a ten minute meeting with a stranger who has a PhD in internal medicine is going to yield useful strategies for curing the existential dread underpinning your depression whether you're there to discuss getting zonked on LSD or something more "traditional" like Xanax
- phoronixrly 2y ago
  > it's not like you can just pop in for a chat about taking shroomies You sure can just pop in to discuss options for your crippling depression though? And sorry, I do indeed live in a country with a functioning healthcare system, not the US.
  - dingnuts 2y ago
    In the US normally you talk to a therapist (not a doctor) or psychologist (not a medical doctor) about your depression at length, and then if you're deemed sufficiently depressed you get a short consult with a psychiatrist (finally a doctor) to prescribe medication. This is when you would theoretically finally be able to bring up shrooms, and your psychiatrist will laugh at you, write an Rx for an SSRI, and you'll see him next year when the Rx expires I'm not sure how it is in most countries but I'd expect the biggest difference is that it will cost you money in the US, but I've read many many horror stories about people waiting many months to have only a short chat with a physician from other countries. The lack of time available to spend taking to physicians seems to be a problem in other places too my point is that consulting a doctor with random questions isn't a simple, casual thing people can easily do in most places. in most places you have to plan ahead and either wait a long time for an appointment, and/or there is a cost barrier. if you have examples of countries where people are able to get to know their doctors on a personal level and can afford in time and money to talk to their physicians for more than a few minutes per year, please link them below
  - Wytwwww 2y ago
    > You sure can just pop in to discuss options for your crippling depression though To get a prescription for one of the the handful of drugs are are available and are considered to be effective. What else can you learn by just "popping in"? > with a functioning healthcare system, not the US. What do you even mean by that?
standardUser 2y ago
The US government severely restricts research on Schedule 1 drugs like psilocybin. Physicians don't have the data they need to inform patients.
Der_Einzige 2y ago
The idea that doctors aren't constantly "off base" and must be deferred to uncritically is pretty terrible. For example, it took literally two decades after it became well known that peptic ulcers were mostly caused by bacteria for the medical community to embrace giving anti-biotics for GI pain. To this day, there are still many American doctors who don't actually know about the Nobel Prize given in 2000 for this discovery, and claim it's "stress" and tell you to go home. Some claim they "know" but than try to "change your gut PH" and still refuse to give antibiotics due to "superbug" risk. This is a "small" thing (GI pain is not small to those who have it) - but if the doctors are screwing up such a small thing institutionally, what else do they mess up on? One is travelers sickness. Doctors in the USA do not want to perscribe front line antibiotics for it because of fear of superbugs - but they'll uncritically go eat their lunch at a McDonalds that same day, where they consume meat bathed in antibiotic slop which is more likely to contribute to superbugs then the amoxicillin that they didn't give you would have. Or what about right now, when it's become clear that Ozempic is literally a super-drug. Every doctor on earth should be trying to give that stuff to literally anyone. I can go to "third world countries" with deregulated health systems and get infinitely better care that I have real control over for on the orders of 1 USD (that's how much it cost for me in Thailand to get front line antibiotics for travelers sickness INCLUDING THE DOCTORS VISIT!) Why do we still sell Neosporin despite doctors wanting it off the market (also for risk of superbugs)? Why do few people in America use Providone-iodine for wound treatment despite it being by far the best solution scientifically for it (and it stains yellow)? Maybe it's because we're stupid. There really aren't better explanations. What about Circumcision? I'd straight up put doctors who do it in jail and many European nations would do the same. American doctors think circumcision is just fine, and long, deeply bitter swaths of medical ethics journals are dedicated to fighting over this again and again. Or what about the widespread disagreement over even basic stuff like digital rectal exams? There's no agreement on if they are worth it because often sticking one's hand up the butt of an old man does more damage to them than finding out that they (like everyone else at old age) have benign prostate cancer? Doctors in America have not earned their position of deference. The scientifically minded on HN who do their own research can and often do know how to treat certain conditions better than white-coats.
m_fayer 2y ago
I really wish we would retire this chestnut already. As if there’s a reasonable grownup option here and everything else is playing with matches. No it’s not the best thing to do to brave huge waiting lists, call a hundred providers none of whom are taking new patients, pay a fortune out of pocket, and/or be faced with a distracted impatient person stuck to their screen who has 10 minutes for you. And I live in Germany, not the US.

striking 2y ago

Psylocybin? Easily? You have to put effort into making an experience with psylocybin meaningful and helpful. It could go wrong very easily, especially for those who are in a difficult situation or headspace. (Speaking from experience.) As for SSRIs? Safe, effective, with a handful of annoying side effects. Straightforward to use, low potential for misuse, requires sustained use for any intended effects. A doctor who already has familiarity with a patient's mild or moderate symptoms of anxiety or depression may very well just prescribe one if asked and if not contraindicated. Not that you should randomly start popping Prozac, but it's unlikely to hurt you if you did. Ask your doctor, try the things that doctors currently believe are most likely to work first. If for whatever reason you choose to go beyond the current medical consensus, please stay safe and keep your doctor up to date.

HKH2 2y ago
So are you okay with people choosing their own dose of SSRIs?
- standardUser 2y ago
  A prescribing doctor will not magically know the precise amount of an SSRI a patient should be taking, or which one to take. For most patients, finding the right drug and dosage is a process. And just like with psilocybin, no one would want to take a random amount. Like with any drug, a person would want to be informed and have proper guidelines about dosage from the start.
jorvi 2y ago
> Psylocybin? Easily? Err.. no? This is from the Dutch National Institute for Public Health and the Environment: https://www.rivm.nl/bibliotheek/rapporten/340001001.pdf https://www.rivm.nl/bibliotheek/rapporten/340001001.pdf Page 19 onward has the charts. What do do we find at the very low end in terms of chronic and acute toxicity? Shrooms (“paddos”) and LSD. It always blows my mind how anti-drug people will do a handwavey gesture to the authority of institutes like the FDA, but never actually check up on what actual research says. > As for SSRIs? Safe, effective, with a handful of annoying side effects. Except the multitude of ways you can put yourself into a serotonin coma. I agree with your assessment that (first) use of psychedelics should be under proper guidance. But what you refer to, “going bad”, can sometimes be a traumatic past experience that people have stuffed away and by surfacing and processing it they can move past it. It’s not always meant to be kumbaya and flowers. Educate yourself, then talk.

dyauspitr 2y ago

Definitely psilocybin. For instance, if you take psilocybin and then spend some time in a cow slaughterhouse house, you might go crazy. The same wouldn’t be true of SSRIs.

HKH2 2y ago
With SSRIs, the dangers are long-term.