10 ms·

The weak science behind psychedelics

96 points by Hooke 2y ago

neonate 2y ago
https://archive.ph/ptIQy https://archive.ph/ptIQy
Gooblebrai 2y ago
I agree with the sentiment of the article. We need better science in general. It came to my mind if we have equally solid research for the effectivity of drugs like antidepressants. They have fame of sometimes working and sometimes don't depending on the patient, and I guess the same could be said of many psychedelics.
- mb7733 2y ago
  > They have fame of sometimes working and sometimes don't depending on the patient, and I guess the same could be said of many psychedelics. The same could be said for almost any drug or intervention.
- esperent 2y ago
  Antidepressants also have the fame of having a ton of side effects, whether they work or not. Reduced libido, sexual dysfunction, weight gain, brain zaps are the most common. Not to mention that they take weeks or months to both start and stop. I'm not at all against antidepressants, and I know several people who have been helped a lot by them. But if there are potential alternatives like ketamine and psychedelics that have lower risk of side effects (ketamine in particular is extremely safe taken in a therapeutic setting) and only need to be taken once to potentially see an immediate effect, even if the science is weak, shouldn't these at least be available for adults to try before putting them on antidepressants?
  - Gooblebrai 2y ago
    What about the addiction potential of ketamine?
    - swores 2y ago
      Therapeutic use for treating depression is one dose every several weeks, so there's no chance of addiction forming unless the patient decides to start using it recreationally - and even then, although some people do get mentally addicted to ketamine, it's fairly rare even among frequent users. And my memory of reading up on this is that the current understanding of how ketamine works for treating depression is that it's something about the way the body processes & gets rid of the ketamine, it's not from the effects that the person taking it feels (unlike with psychedelics where it's the effects themselves that open up new neural pathways in the brain allowing therapy to potentially be more effective). And taking ketamine daily won't be more effective for treating depression. So I wouldn't expect many patients to go from the medical treatment to thinking "I want to start using this recreationally" (though if enough people get treated with it, of course a few people are bound to go down that path - but plenty of people already go down the path of choosing to use it for fun).
- codr7 2y ago
  We have way less experience with antidepressants though. And none of the psychedelics I'm familiar with has anywhere near the same amount/degree of unwanted side effects. Empirical research is also research. That said, I agree. We need more research, which would have happened a long time ago if it wasn't for criminalization.
doctorpangloss 2y ago
I don't know. It's good that we have know conclusive non-effectiveness, right? Is Olga Khazan volunteering $150m to run the first two phases of a drug trial? Should that money be spent on worse bets? Does she have an opinion on which bets were better (no)? IMO, better to live in a world where drug development happens due to good storytelling and we get an answer, good or bad, regardless of macro, rather than drug development only occurring during ZIRP.
z3ncyberpunk 2y ago
[flagged]
- dang 2y ago
  https://hn.algolia.com/?dateRange=all&page=0&prefix=false&sort=byDate&type=comment&query=%22article%20quality%22%20%22site%20quality%22%20by:dang https://hn.algolia.com/?dateRange=all&page=0&prefix=false&so...
  - z3ncyberpunk 2y ago
    Okay, have you not seen the quality of their articles?
    - dang 2y ago
      Like other publications in their category, they occasionally produce a good one that makes for a decent HN submission. Looking at https://hn.algolia.com/?dateRange=all&page=0&prefix=true&query=comments%3E30%20theatlantic.com&sort=byDate&type=story https://hn.algolia.com/?dateRange=all&page=0&prefix=true&que..., it's clear that a bunch of those were too sensational for good HN threads, but there are definitely some worthy threads in there. The recent one on Google Books, for example: https://news.ycombinator.com/item?id=41917016 https://news.ycombinator.com/item?id=41917016.
- nabla9 2y ago
  Internet rule 23 When one disses the site, the one must mention better site.
- deleted 2y ago
  [deleted]
- perching_aix 2y ago
  "credibility of opinions" is wild
  - codr7 2y ago
paulpauper 2y ago
I was wrong. sorry about this comment which I am unable to remove
- codr7 2y ago
  In other words, you've never tried a serious dose of acid or shrooms (not to mention dmt) and now you look like a fool to anyone who has. Most people certainly aren't capable of having the same kind of experience without the substance, goes for all of the ones I mentioned and more. And while we haven't been able to do the amount of science one could wish for, because of criminalization; there's plenty of experience out there and enough science to understand how the drugs deliver their effect.
- yarg 2y ago
  > The science behind this stuff has always been weak and subjective or due to placebo effects. Give someone a sugar pill and tell them it's psychedelic , and some may actually feel something. (Replying to the comment that you made before completely rewriting it.) You're completely wrong about the sugar pill (or at least whether or not it matters) - it's one of the issues with psychedelic medicines: there's no viable placebo at higher doses, and it's the higher doses that seem to have the deepest and longest lasting impact on depression.
advael 2y ago
Better evidence is always good, but we much more drastically need better policy. Psychadelics' potential benefits are still being explored, but their risks are pretty well-documented and quite minimal compared to a broad swath of substances legal for adults to acquire. There is no reason consenting adults should be criminalized for seeking them out
- Spivak 2y ago
  Yep, we even have a name for substances that are generally recognized as safe, are consumed regularly by lots of people, and live a de facto decriminalized state— party drugs. We're doing people a disservice by not providing them in an above-board pure form, and bucketing them in with "not-even-once" drugs. How we didn't see that normalizing business dealings with criminal enterprise and then selling diy testing kits at the pharmacy wasn't a good way to handle this is beyond me. We could have taken the hint that once they're legalized in 1-2 states the safety and quality across the US jumps for some unknown reason.
  - kelnos 2y ago
    Drug policy is often more about finding excuses to punish certain types or groups of people the state doesn't like, than it is about safety and health.
- SpicyLemonZest 2y ago
  The risks of extended-release oxycodone were well-documented and minimal too - but it turns out that causing a widespread addiction crisis isn't a side effect that shows up in clinical studies. Unsupervised courses of addictive drugs are inherently dangerous.
  - dunefox 2y ago
    Good thing psychedelics aren't addictive.
    - eth0up 2y ago
crtified 2y ago
The articles point that fanaticism and 'belief' are no standalone basis for medical attention is entirely fair. However, the article also contains many opinion statements by the journalist, some of which are written for effect. For example, it opens by claiming No psychiatric treatment has attracted quite as much cash and hype as psychedelics have in the past decade - really?? Nobody would seriously believe that, of the entire pharmaceutical world, the largest $ slice goes to psychedelic research. Not even close. Or, Suggesting that people should get off proven medications in order to try MDMA or psilocybin is dangerous unless those drugs are backed by airtight evidence - this is an arguable claim, in the wording semantics, because it implies that it's standard for regulated medications to be risk-free, "airtight" idealisms with only good possible outcomes, when the reality is quite far from that! - a % of SSRI patients routinely experience seriously unpleasant or debilitating side effects and withdrawal ordeals. To exclude effective treatments by way of special, higher ethical barriers to entry is not necessarily scientifically sound practice.
- epcoa 2y ago
  > Nobody would seriously believe that, of the entire pharmaceutical world, the largest $ slice goes to psychedelic research That’s not what it said though. It said “no psychiatric treatment”. I’m a little behind on the antipsychotic pipeline but I’m not sure the statement as written - past decade, psychiatric - is too far off the mark.
  - kelnos 2y ago
    I think that statement in the article is still unlikely to be true even if we restrict ourselves to the psychiatric sphere.
- shadowmanifold 2y ago
  It is a ridiculous article but did you really expect more? Journalism is really a type of opinion piece, social lubricant in 2024. The purpose is so you and I have something to talk about and connect when we would not have other wise. Did either of us learn anything? Of course not but only an idiot would expect to learn anything based on the title. If I want to learn something I will just browse arXiv myself.
slibhb 2y ago
Psychedelics boost your mood in the days, weeks, and even months after taking them. Source: I've used them. It's really dramatic. However, eating a piece of chocolate also makes you feel good. Doesn't mean chocolate is an effective treatment for depression. Whether psychedelics are effective treatments for various psychological conditions, I don't know. Whether the risks outweigh the benefits, I don't know. I've grown more conservative about drug use over the past few years. I hope we keep up the research but it is very clear that -- as the article argues -- these drugs have been overhyped.
- readthenotes1 2y ago
  I have a friend who refuses to find the counsel of a licensed therapist because hens so proud of the insights received while tripping. Sadly, hen and hens family desperately need help.
  - codr7 2y ago
    So, you think you know better how your friend should live his/her life? How would you feel if the tables were reversed and you were being pushed into tripping instead of therapy? These are the kinds of choices that we have to learn to respect, for all of us, which means less judging. There may be other ways to help if that's really what you want to do.
    - slibhb 2y ago
      This idea that we have to respect other people's decisions is so stupid. There is nothing in the world wrong with believing that someone else is making a mistake. We have brains so we can make these sorts of judgements.
      - codr7 2y ago
        You are certainly entitled to an opinion. But it would be wiser to base it on empathy and understanding than ego.
yarg 2y ago
Bullshit. The reason that psychedelics are under-researched is that the corrupt medico-governmental chimera has a vested interest in blocking the substances and preventing the research that should have taken place decades ago. I know, from repeated personal experience, that psychedelics (or mushrooms at least) can be highly effective against even severe depression. They have been the single most effective anti-depressant that I have ever taken. Now, I haven't had the depression curing wonder of an experience that some people claim; It never pulled me out right out of it - but it pulled me back from suicide (on multiple occasions) and a single (rather large) dose is effective for 3 or 4 months before I find myself spiraling back down. And if we're gonna have a conversation about anti-depressants that are being used despite scant evidence in their favour, perhaps we should start with SSRIs - which not only made my depression worse, but also left me almost asexual for ~20 years.
- hn_throwaway_99 2y ago
  Yeah, it's one thing to say "the evidence for psychedelics is weak", but if you look at the data for, say, SSRIs, the effect size is generally extremely modest, yet those are multi-billion dollar blockbuster drugs.
crmd 2y ago
>as evangelists whose enthusiasm for the drugs compromised the integrity of their findings. The integrity of most drug research is compromised by commercial incentive. Molecules like psilocybin, MDMA, and DMT can’t be patented. I am more skeptical of commercial evangelism than whatever is currently going on with psychedelic research.
- yosame 2y ago
  They absolutely can be patented, look at what happened with esketamine. If these molecules work, pharma will just change them slightly (or reformulate) and sell them at a premium.
  - pantalaimon 2y ago
    The funny thing is that this is already happening with LSD to create a legal version (1P-LSD, 1cP-LSD, 1V-LSD, 1D-LSD, 1S-LSD) until that gets banned again and a new prodrug has to be created
23B1 2y ago
You can stop reading at "Psychedelics are by nature challenging to research because most of them are illegal" because... no duh. True for any 'new' thing be it drugs, LLMs, or kids and devices. The Atlantic is clickbait for the professional-managerial class.
deleted 2y ago
[deleted]
willtemperley 2y ago
I'm a bit upset by this article. What exactly does Matthew Perry's sad and untimely death have to do with psychedelic research? I seriously doubt there are any researchers that believe injecting someone with ketamine 27 times in a week is a good idea. The reality is people were profiteering from a vulnerable person, using fraudulent prescriptions [1]. I agree the science is weak, but it is promising [2]. Let's be more specific and avoid emotional language like in this article. [1] https://edition.cnn.com/2024/08/20/us/matthew-perry-death-5-charged/index.html https://edition.cnn.com/2024/08/20/us/matthew-perry-death-5-... [2] https://pubmed.ncbi.nlm.nih.gov/39106989/ https://pubmed.ncbi.nlm.nih.gov/39106989/
- codebolt 2y ago
  Was the ketamine not prescribed to him? That makes it an example of the kinds of abuse/misuse we could expect more of if these things become more widespread, if nothing else.
  - kelnos 2y ago
    > Was the ketamine not prescribed to him? Yes and no. He was being dosed under the supervision of a doctor, but he acquired the "extras" from some other people who saw him as an easy, vulnerable mark who would pay them a lot for it. > That makes it an example of the kinds of abuse/misuse we could expect more of if these things become more widespread, if nothing else. Sure, and that's something to consider, but I don't think we should stop testing things that could be lifesavers for some people because they can be misused. If that's how we're going to do it, we need to go back to prohibition and just ban everything, including alcohol and tobacco. That certainly worked out well the last time we tried it... Perry also didn't die of an overdose in the "traditional" sense: the large amount of ketamine in his system acted as a sedative and he drowned. If he hadn't gone in the water, he probably would not have died that day.
- Joel_Mckay 2y ago
  In general, getting high is a maladaptive coping strategy chosen by some people, and technically it is against the Hippocratic Oath to assist giving them a chemical lobotomy. The opioid epidemic helped erode away ethics in medicine, as many physicians partnered with drug-dealers/Sackler-family to exploit users knowing full well the "medication" had serious side-effects. As I watch the squirrels getting high on the poisonous mushrooms, and howling at a passersby in the yard this time of year... it reminds one that the methodology of self-harm is an irrelevant detail. Drug addicts have an endless supply of excuses why they think their behavior is justified. Indeed, there are an ecosystem of unethical people willing to help them along the wrong path. I don't think people should go to jail for seeking an artificial cathartic experience, but rather be forced to join the Native shamans in a 2 week Datura fueled experience. However, facing insanity while hallucinating and rolling in your own excrement naked for 2 weeks is not popular for some reason... =3
yowayb 2y ago
Around the beginning of the micro-dosing trend, I went to Colorado for a String Cheese Incident concert, and met a group of people that follow the band on your and attend multiple shows. Some of these people had been frying acid for 4 days in a row, and doing nothing of consequence. Using psychedelics to improve anything (except maybe some forms of art) seems to me like when writers would drink to help them write. There's never going to be any rigorous evidence for any benefit.
- block_dagger 2y ago
  My personal experience with LSD as a youth was positive, therapeutic, mind opening. However, I saw others abuse it or react negatively, including a close acquaintance jumping out of a moving car while tripping, resulting in his death. Your mileage will vary greatly.
hn_throwaway_99 2y ago
While I agree with parts of the sentiment of the article, and that better science is needed, I think the headline is almost clickbait in that it attempts to dismiss something that clearly has been life changing for a lot of people. I am someone who has suffered bouts of depression, sometimes severe with consistent thoughts of suicide, since I was a child. I had been in therapy for over a decade (which was immensely helpful for me), and I had tried a couple different antidepressants. This spring, partially due to some particularly bad sleep issues, I had an unusually bad bout of depression where I was borderline non-functional. As a "last ditch" effort I went in for ketamine infusion therapy at a clinic. Before the therapy they have you take a "depression assessment" questionnaire, the PHQ-9. The scores range from 0 to 27, and I went in as a 25 (basically, ready to jump off a bridge). Without exaggeration, my initial ketamine session, which lasted about 2 hours, was the most profound experience of my life, and I firmly believe it saved my life. Not only that, it completely changed my understanding of my mental illness. Mental illness is hard to separate from your vision of "you", because if you, say, break your arm, nobody considers you a different person, but your mind is really what people most consider to be "you" - when it's broken, it's hard to not feel like you are broken. With my depression, the best way I could explain it is not just that things that used to make me happy no longer did, not even that I could no longer feel joy, but that I couldn't remember what joy itself actually felt like. When you can't even remember what the emotion of happiness feels like, existence feels pretty bleak. What ketamine did for me is essentially "broke the damn", and I felt an enormous rush of actually being able to feel emotions again. The analogy I like to use is that my depression was like "brain atherosclerosis", i.e. my emotional channels were "clogged", and the ketamine therapy was like "brain angioplasty" - it felt like it broke up all the "clot" in my brain so that my neurons could talk to each other again and I could feel. It was the first time I actually understood my mental illness as a physical disease. At the end of my session I was literally balling for like 30 mins just because the flood of emotions felt so intense. The next morning I was singing in the shower, and a couple days later when I retook the PHQ-9 I was a 3. It's been about 9 months since my first session, and while I don't always feel as awesome as I did right after it, I do feel like my completely changed view of my depression has made me much more resilient, and also much more willing to ask for help. In my initial series I had 4 sessions spaced over about 3 weeks (the recommendation for an initial series is 6, but for me after the 4th one I was like "no, I'm totally good" - I didn't want to "get used to" the ketamine trip because it was such a powerful experience for me). I had one "booster" session of ketamine about 3 months ago when I was feeling not great, and it was very helpful. Now, I know that I was extremely lucky - my shrink calls me a "ketamine responder". The problem with depression is that it's not a disease, it's a symptom, and since doctors don't often know the underlying cause, a lot of the treatment is just "throw things at it and see what works". I have a friend that got very little depression release from ketamine, but TMS (transcranial magnetic stimulation) was what was helpful for him. So I'm very, very wary of ketamine getting oversold as a "wonder cure" - it may work for some people, but not others, and I've already seen how CBD and marijuana shops have popped up all over basically planning to cure every symptom under the sun since marijuana was legalized. At the same time, I'm also wary of psychedelics being dismissed in a similar way to how they were dismissed and demonized about 50-60 years ago. I fully understand that the plural of anecdotes is not data, but I'm also not trying to find the statistically significant treatment for your average person - I'm just trying to not die. For me, I have all the evidence I need, and I feel it would be a tragedy to take away that option for other people before we know more.
photochemsyn 2y ago
All the psychedelic substances which produce their activity through interactions with the serotonin 5-HT2A - mescaline, LSD, psilocybin, and DMT in particular - are largely banned by governments and their production, distribution and use all have varying criminal charges associated in most countries and regions. These drugs are generally much less addictive than alcohol, nicotine, opiates, and amphentamines, drugs which are considered to have medical uses of some sort and are not criminalized as energetically as the psychedelics, which is a bit odd. I suppose if you want an orderly obedient population not given to asking difficult questions of the established authoritarians (such as 'why are we paying you taxes that you use to live in a big mansion with lots of servants'), then you might be concerned about psychedelic use for reasons having nothing to do with medicine. You might be afraid of losing control, of random ideas popping up and spreading through the population, a questioning of long-established social norms, etc. I really wonder if that's where the control freak hysteria on this topic comes from.
exodust 2y ago
> "weak science" The irony is when you're under the influence of psychedelics, "weak science" is the least likeliest thought you'll have. We know psychedelics change perception and mood significantly. That should be the starting point. I'm surprised anyone bothers with placebos. Lab coats and data analysis only gets you so far. Leary was right, set and setting is crucial. We come from a 'billion years of evolution', and the idea is to reflect on your own humanity and consciousness. If you attempt that within a 4 walled room, you're asking for trouble. Temporary loss of ego is a whole topic that needs to be part of the learning. Big doses push perception outside yourself. That effect alone is beneficial, if unsettling. If in doubt, avoid. Climbing a mountain or going on epic multi-day adventure in nature is healthier anyway if you have the opportunity.
hn-throwaway998 2y ago
Confession: have not read the article. I write in only to say that I’ve taken MDMA under the guidance of a specialist, who had MAPS training and a lot of experience. MDMA is typically not considered to be a psychedelic, but it’s in-family with psychedelic therapy. Two sessions, separated by about 6 months, helped me to see many relationships in my life in a new way. There was intention setting beforehand, and notes taken during session, and integration afterwards. All that seemed very important to the process. Interested people could check out Julie Holland’s book on Ecstacy, or Rachel Nuwer’s book I feel love, or of course Michael Pollan’s wonderful book How to change your mind.
louison11 2y ago
The thing is you also can’t reduce psychedelics to science because they open an innately subjective (often called “mystical”) experience. What is reproached to some of the parties here is to have a spiritual ideology, but that’s precisely what working with these medicines opens up. The healing that takes place is not so much physical, as it is psycho-spiritual, it’s the change in perception of the world - often in the direction of spiritual beliefs, that contributes to the betterment of the person’s mental health condition. So you can’t isolate the two easily. It’s just tricky, and still this article raises important points.
- swores 2y ago
  For some people, psychedelic use leads to mystical/spiritual/religious thinking. But that's not the main way in which they are able to treat mental health problems, specifically not in the majority (I suspect all) actual scientific research on this subject, but also just for people using them outside medical trials. The key thing, it seems, is that psychedelics temporarily (while you're under the influence) increase the connectivity between different neurons in the brain, and between different areas of the brain. That can help in two ways, the first of which is that some new connections can become not temporary, and keep existing for the foreseeable future. The other is that, while under the influence, those additional neuron connections allow the person to think in different ways than they normally do, to see ideas or problems from a different angle/perspective. And this difference is what allows the therapy administered at the same time as the psychedelic drug (or the self-therapy version of using a drug and then thinking about the subjects that are causing you distress in life) to potentially have a better chance of making a stronger change to how the person thinks about certain things than if the same therapy were provided without psychedelics enabling greater levels of rewiring of the brain.
  - pantalaimon 2y ago
    > The key thing, it seems, is that psychedelics temporarily (while you're under the influence) increase the connectivity between different neurons in the brain, and between different areas of the brain. Couldn’t it be that this is what’s being experienced as mystical?
sheerun 2y ago
I wish I had a choice
bob_theslob646 2y ago
>Psychedelics were made out to be a safe solution for society’s most challenging mental-health problems. By whom?
more_corn 2y ago
They should certainly be reclassified since they appear to have medical use and low risk of abuse (being non-addictive), but are still classified as schedule 1.

96 points by Hooke 2y ago

https://archive.ph/ptIQy https://archive.ph/ptIQy

I agree with the sentiment of the article. We need better science in general. It came to my mind if we have equally solid research for the effectivity of drugs like antidepressants. They have fame of sometimes working and sometimes don't depending on the patient, and I guess the same could be said of many psychedelics.

mb7733 2y ago
> They have fame of sometimes working and sometimes don't depending on the patient, and I guess the same could be said of many psychedelics. The same could be said for almost any drug or intervention.
esperent 2y ago
Antidepressants also have the fame of having a ton of side effects, whether they work or not. Reduced libido, sexual dysfunction, weight gain, brain zaps are the most common. Not to mention that they take weeks or months to both start and stop. I'm not at all against antidepressants, and I know several people who have been helped a lot by them. But if there are potential alternatives like ketamine and psychedelics that have lower risk of side effects (ketamine in particular is extremely safe taken in a therapeutic setting) and only need to be taken once to potentially see an immediate effect, even if the science is weak, shouldn't these at least be available for adults to try before putting them on antidepressants?
- Gooblebrai 2y ago
  What about the addiction potential of ketamine?
  - swores 2y ago
    Therapeutic use for treating depression is one dose every several weeks, so there's no chance of addiction forming unless the patient decides to start using it recreationally - and even then, although some people do get mentally addicted to ketamine, it's fairly rare even among frequent users. And my memory of reading up on this is that the current understanding of how ketamine works for treating depression is that it's something about the way the body processes & gets rid of the ketamine, it's not from the effects that the person taking it feels (unlike with psychedelics where it's the effects themselves that open up new neural pathways in the brain allowing therapy to potentially be more effective). And taking ketamine daily won't be more effective for treating depression. So I wouldn't expect many patients to go from the medical treatment to thinking "I want to start using this recreationally" (though if enough people get treated with it, of course a few people are bound to go down that path - but plenty of people already go down the path of choosing to use it for fun).
codr7 2y ago
We have way less experience with antidepressants though. And none of the psychedelics I'm familiar with has anywhere near the same amount/degree of unwanted side effects. Empirical research is also research. That said, I agree. We need more research, which would have happened a long time ago if it wasn't for criminalization.

doctorpangloss 2y ago

I don't know. It's good that we have know conclusive non-effectiveness, right? Is Olga Khazan volunteering $150m to run the first two phases of a drug trial? Should that money be spent on worse bets? Does she have an opinion on which bets were better (no)? IMO, better to live in a world where drug development happens due to good storytelling and we get an answer, good or bad, regardless of macro, rather than drug development only occurring during ZIRP.

z3ncyberpunk 2y ago

[flagged]

dang 2y ago
https://hn.algolia.com/?dateRange=all&page=0&prefix=false&sort=byDate&type=comment&query=%22article%20quality%22%20%22site%20quality%22%20by:dang https://hn.algolia.com/?dateRange=all&page=0&prefix=false&so...
- z3ncyberpunk 2y ago
  Okay, have you not seen the quality of their articles?
  - dang 2y ago
    Like other publications in their category, they occasionally produce a good one that makes for a decent HN submission. Looking at https://hn.algolia.com/?dateRange=all&page=0&prefix=true&query=comments%3E30%20theatlantic.com&sort=byDate&type=story https://hn.algolia.com/?dateRange=all&page=0&prefix=true&que..., it's clear that a bunch of those were too sensational for good HN threads, but there are definitely some worthy threads in there. The recent one on Google Books, for example: https://news.ycombinator.com/item?id=41917016 https://news.ycombinator.com/item?id=41917016.
nabla9 2y ago
Internet rule 23 When one disses the site, the one must mention better site.
deleted 2y ago
[deleted]
perching_aix 2y ago
"credibility of opinions" is wild
- codr7 2y ago

paulpauper 2y ago

I was wrong. sorry about this comment which I am unable to remove

codr7 2y ago
In other words, you've never tried a serious dose of acid or shrooms (not to mention dmt) and now you look like a fool to anyone who has. Most people certainly aren't capable of having the same kind of experience without the substance, goes for all of the ones I mentioned and more. And while we haven't been able to do the amount of science one could wish for, because of criminalization; there's plenty of experience out there and enough science to understand how the drugs deliver their effect.
yarg 2y ago
> The science behind this stuff has always been weak and subjective or due to placebo effects. Give someone a sugar pill and tell them it's psychedelic , and some may actually feel something. (Replying to the comment that you made before completely rewriting it.) You're completely wrong about the sugar pill (or at least whether or not it matters) - it's one of the issues with psychedelic medicines: there's no viable placebo at higher doses, and it's the higher doses that seem to have the deepest and longest lasting impact on depression.

advael 2y ago

Better evidence is always good, but we much more drastically need better policy. Psychadelics' potential benefits are still being explored, but their risks are pretty well-documented and quite minimal compared to a broad swath of substances legal for adults to acquire. There is no reason consenting adults should be criminalized for seeking them out

Spivak 2y ago
Yep, we even have a name for substances that are generally recognized as safe, are consumed regularly by lots of people, and live a de facto decriminalized state— party drugs. We're doing people a disservice by not providing them in an above-board pure form, and bucketing them in with "not-even-once" drugs. How we didn't see that normalizing business dealings with criminal enterprise and then selling diy testing kits at the pharmacy wasn't a good way to handle this is beyond me. We could have taken the hint that once they're legalized in 1-2 states the safety and quality across the US jumps for some unknown reason.
- kelnos 2y ago
  Drug policy is often more about finding excuses to punish certain types or groups of people the state doesn't like, than it is about safety and health.
SpicyLemonZest 2y ago
The risks of extended-release oxycodone were well-documented and minimal too - but it turns out that causing a widespread addiction crisis isn't a side effect that shows up in clinical studies. Unsupervised courses of addictive drugs are inherently dangerous.
- dunefox 2y ago
  Good thing psychedelics aren't addictive.
  - eth0up 2y ago

crtified 2y ago

The articles point that fanaticism and 'belief' are no standalone basis for medical attention is entirely fair. However, the article also contains many opinion statements by the journalist, some of which are written for effect. For example, it opens by claiming No psychiatric treatment has attracted quite as much cash and hype as psychedelics have in the past decade - really?? Nobody would seriously believe that, of the entire pharmaceutical world, the largest $ slice goes to psychedelic research. Not even close. Or, Suggesting that people should get off proven medications in order to try MDMA or psilocybin is dangerous unless those drugs are backed by airtight evidence - this is an arguable claim, in the wording semantics, because it implies that it's standard for regulated medications to be risk-free, "airtight" idealisms with only good possible outcomes, when the reality is quite far from that! - a % of SSRI patients routinely experience seriously unpleasant or debilitating side effects and withdrawal ordeals. To exclude effective treatments by way of special, higher ethical barriers to entry is not necessarily scientifically sound practice.

epcoa 2y ago
> Nobody would seriously believe that, of the entire pharmaceutical world, the largest $ slice goes to psychedelic research That’s not what it said though. It said “no psychiatric treatment”. I’m a little behind on the antipsychotic pipeline but I’m not sure the statement as written - past decade, psychiatric - is too far off the mark.
- kelnos 2y ago
  I think that statement in the article is still unlikely to be true even if we restrict ourselves to the psychiatric sphere.
shadowmanifold 2y ago
It is a ridiculous article but did you really expect more? Journalism is really a type of opinion piece, social lubricant in 2024. The purpose is so you and I have something to talk about and connect when we would not have other wise. Did either of us learn anything? Of course not but only an idiot would expect to learn anything based on the title. If I want to learn something I will just browse arXiv myself.

slibhb 2y ago

Psychedelics boost your mood in the days, weeks, and even months after taking them. Source: I've used them. It's really dramatic. However, eating a piece of chocolate also makes you feel good. Doesn't mean chocolate is an effective treatment for depression. Whether psychedelics are effective treatments for various psychological conditions, I don't know. Whether the risks outweigh the benefits, I don't know. I've grown more conservative about drug use over the past few years. I hope we keep up the research but it is very clear that -- as the article argues -- these drugs have been overhyped.

readthenotes1 2y ago
I have a friend who refuses to find the counsel of a licensed therapist because hens so proud of the insights received while tripping. Sadly, hen and hens family desperately need help.
- codr7 2y ago
  So, you think you know better how your friend should live his/her life? How would you feel if the tables were reversed and you were being pushed into tripping instead of therapy? These are the kinds of choices that we have to learn to respect, for all of us, which means less judging. There may be other ways to help if that's really what you want to do.
  - slibhb 2y ago
    This idea that we have to respect other people's decisions is so stupid. There is nothing in the world wrong with believing that someone else is making a mistake. We have brains so we can make these sorts of judgements.
    - codr7 2y ago
      You are certainly entitled to an opinion. But it would be wiser to base it on empathy and understanding than ego.

yarg 2y ago

Bullshit. The reason that psychedelics are under-researched is that the corrupt medico-governmental chimera has a vested interest in blocking the substances and preventing the research that should have taken place decades ago. I know, from repeated personal experience, that psychedelics (or mushrooms at least) can be highly effective against even severe depression. They have been the single most effective anti-depressant that I have ever taken. Now, I haven't had the depression curing wonder of an experience that some people claim; It never pulled me out right out of it - but it pulled me back from suicide (on multiple occasions) and a single (rather large) dose is effective for 3 or 4 months before I find myself spiraling back down. And if we're gonna have a conversation about anti-depressants that are being used despite scant evidence in their favour, perhaps we should start with SSRIs - which not only made my depression worse, but also left me almost asexual for ~20 years.

hn_throwaway_99 2y ago
Yeah, it's one thing to say "the evidence for psychedelics is weak", but if you look at the data for, say, SSRIs, the effect size is generally extremely modest, yet those are multi-billion dollar blockbuster drugs.

crmd 2y ago

>as evangelists whose enthusiasm for the drugs compromised the integrity of their findings. The integrity of most drug research is compromised by commercial incentive. Molecules like psilocybin, MDMA, and DMT can’t be patented. I am more skeptical of commercial evangelism than whatever is currently going on with psychedelic research.

yosame 2y ago
They absolutely can be patented, look at what happened with esketamine. If these molecules work, pharma will just change them slightly (or reformulate) and sell them at a premium.
- pantalaimon 2y ago
  The funny thing is that this is already happening with LSD to create a legal version (1P-LSD, 1cP-LSD, 1V-LSD, 1D-LSD, 1S-LSD) until that gets banned again and a new prodrug has to be created

23B1 2y ago

You can stop reading at "Psychedelics are by nature challenging to research because most of them are illegal" because... no duh. True for any 'new' thing be it drugs, LLMs, or kids and devices. The Atlantic is clickbait for the professional-managerial class.

deleted 2y ago

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willtemperley 2y ago

I'm a bit upset by this article. What exactly does Matthew Perry's sad and untimely death have to do with psychedelic research? I seriously doubt there are any researchers that believe injecting someone with ketamine 27 times in a week is a good idea. The reality is people were profiteering from a vulnerable person, using fraudulent prescriptions [1]. I agree the science is weak, but it is promising [2]. Let's be more specific and avoid emotional language like in this article. [1] https://edition.cnn.com/2024/08/20/us/matthew-perry-death-5-charged/index.html https://edition.cnn.com/2024/08/20/us/matthew-perry-death-5-... [2] https://pubmed.ncbi.nlm.nih.gov/39106989/ https://pubmed.ncbi.nlm.nih.gov/39106989/

codebolt 2y ago
Was the ketamine not prescribed to him? That makes it an example of the kinds of abuse/misuse we could expect more of if these things become more widespread, if nothing else.
- kelnos 2y ago
  > Was the ketamine not prescribed to him? Yes and no. He was being dosed under the supervision of a doctor, but he acquired the "extras" from some other people who saw him as an easy, vulnerable mark who would pay them a lot for it. > That makes it an example of the kinds of abuse/misuse we could expect more of if these things become more widespread, if nothing else. Sure, and that's something to consider, but I don't think we should stop testing things that could be lifesavers for some people because they can be misused. If that's how we're going to do it, we need to go back to prohibition and just ban everything, including alcohol and tobacco. That certainly worked out well the last time we tried it... Perry also didn't die of an overdose in the "traditional" sense: the large amount of ketamine in his system acted as a sedative and he drowned. If he hadn't gone in the water, he probably would not have died that day.
Joel_Mckay 2y ago
In general, getting high is a maladaptive coping strategy chosen by some people, and technically it is against the Hippocratic Oath to assist giving them a chemical lobotomy. The opioid epidemic helped erode away ethics in medicine, as many physicians partnered with drug-dealers/Sackler-family to exploit users knowing full well the "medication" had serious side-effects. As I watch the squirrels getting high on the poisonous mushrooms, and howling at a passersby in the yard this time of year... it reminds one that the methodology of self-harm is an irrelevant detail. Drug addicts have an endless supply of excuses why they think their behavior is justified. Indeed, there are an ecosystem of unethical people willing to help them along the wrong path. I don't think people should go to jail for seeking an artificial cathartic experience, but rather be forced to join the Native shamans in a 2 week Datura fueled experience. However, facing insanity while hallucinating and rolling in your own excrement naked for 2 weeks is not popular for some reason... =3

yowayb 2y ago

Around the beginning of the micro-dosing trend, I went to Colorado for a String Cheese Incident concert, and met a group of people that follow the band on your and attend multiple shows. Some of these people had been frying acid for 4 days in a row, and doing nothing of consequence. Using psychedelics to improve anything (except maybe some forms of art) seems to me like when writers would drink to help them write. There's never going to be any rigorous evidence for any benefit.

block_dagger 2y ago
My personal experience with LSD as a youth was positive, therapeutic, mind opening. However, I saw others abuse it or react negatively, including a close acquaintance jumping out of a moving car while tripping, resulting in his death. Your mileage will vary greatly.

hn_throwaway_99 2y ago

While I agree with parts of the sentiment of the article, and that better science is needed, I think the headline is almost clickbait in that it attempts to dismiss something that clearly has been life changing for a lot of people. I am someone who has suffered bouts of depression, sometimes severe with consistent thoughts of suicide, since I was a child. I had been in therapy for over a decade (which was immensely helpful for me), and I had tried a couple different antidepressants. This spring, partially due to some particularly bad sleep issues, I had an unusually bad bout of depression where I was borderline non-functional. As a "last ditch" effort I went in for ketamine infusion therapy at a clinic. Before the therapy they have you take a "depression assessment" questionnaire, the PHQ-9. The scores range from 0 to 27, and I went in as a 25 (basically, ready to jump off a bridge). Without exaggeration, my initial ketamine session, which lasted about 2 hours, was the most profound experience of my life, and I firmly believe it saved my life. Not only that, it completely changed my understanding of my mental illness. Mental illness is hard to separate from your vision of "you", because if you, say, break your arm, nobody considers you a different person, but your mind is really what people most consider to be "you" - when it's broken, it's hard to not feel like you are broken. With my depression, the best way I could explain it is not just that things that used to make me happy no longer did, not even that I could no longer feel joy, but that I couldn't remember what joy itself actually felt like. When you can't even remember what the emotion of happiness feels like, existence feels pretty bleak. What ketamine did for me is essentially "broke the damn", and I felt an enormous rush of actually being able to feel emotions again. The analogy I like to use is that my depression was like "brain atherosclerosis", i.e. my emotional channels were "clogged", and the ketamine therapy was like "brain angioplasty" - it felt like it broke up all the "clot" in my brain so that my neurons could talk to each other again and I could feel. It was the first time I actually understood my mental illness as a physical disease. At the end of my session I was literally balling for like 30 mins just because the flood of emotions felt so intense. The next morning I was singing in the shower, and a couple days later when I retook the PHQ-9 I was a 3. It's been about 9 months since my first session, and while I don't always feel as awesome as I did right after it, I do feel like my completely changed view of my depression has made me much more resilient, and also much more willing to ask for help. In my initial series I had 4 sessions spaced over about 3 weeks (the recommendation for an initial series is 6, but for me after the 4th one I was like "no, I'm totally good" - I didn't want to "get used to" the ketamine trip because it was such a powerful experience for me). I had one "booster" session of ketamine about 3 months ago when I was feeling not great, and it was very helpful. Now, I know that I was extremely lucky - my shrink calls me a "ketamine responder". The problem with depression is that it's not a disease, it's a symptom, and since doctors don't often know the underlying cause, a lot of the treatment is just "throw things at it and see what works". I have a friend that got very little depression release from ketamine, but TMS (transcranial magnetic stimulation) was what was helpful for him. So I'm very, very wary of ketamine getting oversold as a "wonder cure" - it may work for some people, but not others, and I've already seen how CBD and marijuana shops have popped up all over basically planning to cure every symptom under the sun since marijuana was legalized. At the same time, I'm also wary of psychedelics being dismissed in a similar way to how they were dismissed and demonized about 50-60 years ago. I fully understand that the plural of anecdotes is not data, but I'm also not trying to find the statistically significant treatment for your average person - I'm just trying to not die. For me, I have all the evidence I need, and I feel it would be a tragedy to take away that option for other people before we know more.

photochemsyn 2y ago

All the psychedelic substances which produce their activity through interactions with the serotonin 5-HT2A - mescaline, LSD, psilocybin, and DMT in particular - are largely banned by governments and their production, distribution and use all have varying criminal charges associated in most countries and regions. These drugs are generally much less addictive than alcohol, nicotine, opiates, and amphentamines, drugs which are considered to have medical uses of some sort and are not criminalized as energetically as the psychedelics, which is a bit odd. I suppose if you want an orderly obedient population not given to asking difficult questions of the established authoritarians (such as 'why are we paying you taxes that you use to live in a big mansion with lots of servants'), then you might be concerned about psychedelic use for reasons having nothing to do with medicine. You might be afraid of losing control, of random ideas popping up and spreading through the population, a questioning of long-established social norms, etc. I really wonder if that's where the control freak hysteria on this topic comes from.

exodust 2y ago

> "weak science" The irony is when you're under the influence of psychedelics, "weak science" is the least likeliest thought you'll have. We know psychedelics change perception and mood significantly. That should be the starting point. I'm surprised anyone bothers with placebos. Lab coats and data analysis only gets you so far. Leary was right, set and setting is crucial. We come from a 'billion years of evolution', and the idea is to reflect on your own humanity and consciousness. If you attempt that within a 4 walled room, you're asking for trouble. Temporary loss of ego is a whole topic that needs to be part of the learning. Big doses push perception outside yourself. That effect alone is beneficial, if unsettling. If in doubt, avoid. Climbing a mountain or going on epic multi-day adventure in nature is healthier anyway if you have the opportunity.

hn-throwaway998 2y ago

Confession: have not read the article. I write in only to say that I’ve taken MDMA under the guidance of a specialist, who had MAPS training and a lot of experience. MDMA is typically not considered to be a psychedelic, but it’s in-family with psychedelic therapy. Two sessions, separated by about 6 months, helped me to see many relationships in my life in a new way. There was intention setting beforehand, and notes taken during session, and integration afterwards. All that seemed very important to the process. Interested people could check out Julie Holland’s book on Ecstacy, or Rachel Nuwer’s book I feel love, or of course Michael Pollan’s wonderful book How to change your mind.

louison11 2y ago

The thing is you also can’t reduce psychedelics to science because they open an innately subjective (often called “mystical”) experience. What is reproached to some of the parties here is to have a spiritual ideology, but that’s precisely what working with these medicines opens up. The healing that takes place is not so much physical, as it is psycho-spiritual, it’s the change in perception of the world - often in the direction of spiritual beliefs, that contributes to the betterment of the person’s mental health condition. So you can’t isolate the two easily. It’s just tricky, and still this article raises important points.

swores 2y ago
For some people, psychedelic use leads to mystical/spiritual/religious thinking. But that's not the main way in which they are able to treat mental health problems, specifically not in the majority (I suspect all) actual scientific research on this subject, but also just for people using them outside medical trials. The key thing, it seems, is that psychedelics temporarily (while you're under the influence) increase the connectivity between different neurons in the brain, and between different areas of the brain. That can help in two ways, the first of which is that some new connections can become not temporary, and keep existing for the foreseeable future. The other is that, while under the influence, those additional neuron connections allow the person to think in different ways than they normally do, to see ideas or problems from a different angle/perspective. And this difference is what allows the therapy administered at the same time as the psychedelic drug (or the self-therapy version of using a drug and then thinking about the subjects that are causing you distress in life) to potentially have a better chance of making a stronger change to how the person thinks about certain things than if the same therapy were provided without psychedelics enabling greater levels of rewiring of the brain.
- pantalaimon 2y ago
  > The key thing, it seems, is that psychedelics temporarily (while you're under the influence) increase the connectivity between different neurons in the brain, and between different areas of the brain. Couldn’t it be that this is what’s being experienced as mystical?

sheerun 2y ago

I wish I had a choice

bob_theslob646 2y ago

>Psychedelics were made out to be a safe solution for society’s most challenging mental-health problems. By whom?

more_corn 2y ago

They should certainly be reclassified since they appear to have medical use and low risk of abuse (being non-addictive), but are still classified as schedule 1.