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Incoming cocaine therapy! Seriously though as someone who suffers from extreme anxiety I am eternally grateful for this kind of work. I would really like to s

Incoming cocaine therapy! Seriously though as someone who suffers from extreme anxiety I am eternally grateful for this kind of work. I would really like to see this combined with brain stimulation.

celdon25 1y ago
Give it about 5 years.
SequoiaHope 1y ago
Well MDMA therapy is a real one and probably much more effective than cocaine for these purposes.
- pier25 1y ago
  Psilocybin too
- dns_snek 1y ago
  MDMA (or psilocybin) assisted psychotherapy to be specific. I don't think just taking these drugs has been shown to be an effective treatment :)
  - SequoiaHope 1y ago
    Yes I was referring to MDMA assisted psychotherapy, which I am a huge proponent of. However I’ve found these materials to be quite effecting at healing when taken conscientiously outside of a traditional assisted therapy session. Of course there probably haven’t been a lot of studies on this because formal therapy studies are probably easier to get approved, so I wouldn’t take the absence of evidence as evidence of absence.
roughly 1y ago
What’s interesting here is that in the drug treatment world it’s basically known that drug abuse is almost always a reaction to some kind of psychological trauma or disorder, and an awful lot of drugs (not just cocaine) play heavily with the dopamine pathways. The idea of dopamine as your brain’s signal that you’re safe fits about as neatly with that as can be. (Of course, like everything in biology, dopamine also does about a gazillion other things, too, so it’s not quite that cut and dry, but it rhymes, at least.)
- phren0logy 1y ago
  > in the drug treatment world it’s basically known that drug abuse is almost always a reaction to some kind of psychological trauma or disorder This is incorrect. While this is true for a substantial number of people, I want to offer some resistance to the pop-psychology axiom that "everything is because of trauma." Not only is is unsupported by science, it has lead to an expansion of the definition of the word "trauma" in popular culture that's so broad as to be nearly useless clinically or scientifically.
- foobiekr 1y ago
  I had the unique experience as a youth in attending a school where a substantial portion of the school was funneled there by one of the many 1970s and 1980s troubled teen corporations that spun out of Synanon after it collapsed. This one specialized in drug addicts. Almost all of my classmates (not me, unfortunately) were from exceptionally wealthy families and excepting one none of them ever mentioned any childhood trauma. Instead they were precocious partiers who got into drugs despite being underage and going to the nightclubs in the seedy part of town - no one at the time was turning away hot young women or gay(for pay or real) young men. And the club scene was a drug scene. It still is. I don’t think trauma is actually at the root of almost all drug abusers. The only first class abusers (pot and alcohol in serious quantities daily) that I know at the moment grew up in perfectly fine suburban families and are in good, non-narcissistic/controlling/etc relationships with their families. They’re just addicts who can’t stop. One of them is going to die from it, eventually, given his level of alcohol consumption.
- Aurornis 1y ago
  > in the drug treatment world it’s basically known that drug abuse is almost always a reaction to some kind of psychological trauma or disorder, This is not true in the professional world. People engage in drug use for many reasons, including pure recreation. Trauma can precede relapses or bouts of drug abuse, but it's not a universal explanation. There are a lot of pop-culture ideas that explain everything away as trauma. These are popular on podcasts, Reddit, and other social media websites. There are also types of therapists who learned to treat trauma and then try to apply that to everything. "If all you have is a hammer, everything looks like a nail". These therapists will try to reframe everything as trauma because it's what they know how to teach. They often reverse engineer a traumatic backstory as an explanation even when one doesn't exist. You can find podcasters and therapists who will even claim that being born imparts permanent trauma that explains things long into adulthood. There's no evidence behind this claim, but it's convenient for therapists who need to find a traumatic backstory before they can address something because everyone was born at some point. > The idea of dopamine as your brain’s signal that you’re safe fits about as neatly with that as can be. That idea is completely wrong, though. The study is talking about dopamine signaling in one specific location of the brain. Dopamine is used in other locations in the brain to encode aversive stimuli, among other things. Dopamine (and other neurotransmitters) don't just do one single thing in the brain. They have diverse effects all over. Also, many of the drugs that people associated with dopamine actually have much broader effects, such as on norepinephrine (stimulants) and serotonin (cocaine). There are dopamine agonist drugs that go in and very precisely target different dopamine receptors in the brain, activating them directly. Many people are surprised to learn that a common side effect of these drugs is an irresistible urge to sleep when first taking them, for example.
static_void 1y ago
I would unironically say this is the how of how adderall works for me. I am distracted from work by anxiety. With medication, I'm not distracted.
- gigaflop 1y ago
  Generic Adderall Gang here, and in hindsight, I'm surprised at how little of it I need to realize a much better headspace. Makes me wonder if all of that caffeine in my undiagnosed youth was saying something...
  - static_void 1y ago
    I'd be interested in your thoughts more here. The problem with amphetamine is you pay for every benefit: focus now, lethargy later; energy now, anhedonia later. But taking a small, consistent dose. Does that work? Do you feel you net benefits in life from taking the drug, discounting for withdrawal and/or tolerance?
    - Aurornis 1y ago
      > The problem with amphetamine is you pay for every benefit: focus now, lethargy later; energy now, anhedonia later. > But taking a small, consistent dose. Does that work? Do you feel you net benefits in life from taking the drug, discounting for withdrawal and/or tolerance? There's a reason these medications are supposed to be taken regularly at the same dose in clinical practice. Patients should not be going through cycles of taking stimulants and then withdrawing all of the time. There's a disconnect between the way some people try to use stimulants ad-hoc versus the therapeutic modality. The initial burst of confidence, energy, and positive mood that comes from intermittent use is a side effect, but people confuse it with a primary effect. They can get into cycles of chasing it with dose escalations or taking it on random days while they exist below baseline on others. This isn't a winnable battle over time because the brain will adapt, not to mention all of those off-days start to add up and people around them notice the extremely inconsistent mood and performance. Unfortunately, misinformation about ADHD is all over the internet. I recommend ignoring basically anything that comes out of Reddit, Twitter, or TikTok because it's really that bad. Take medications as directed and set yourself up for some stability. Resist the urge to play with doses, take excess doses on some days, or try to play tolerance games. These never work in the long term. There's a simple heuristic: When you reach stability, you shouldn't really feel the medication. It should be background noise. There's a reason why young people who have been properly titrated on stimulant medications don't understand what the big deal is with their peers taking large doses (without tolerance) and then speeding around for a while. It's where the myth about ADHD people reacting differently to stimulants comes from. Proper treatment will settle to equilibrium and shouldn't produce overt feelings of being drugged or hyperfocused.

Incoming cocaine therapy! Seriously though as someone who suffers from extreme anxiety I am eternally grateful for this kind of work. I would really like to see this combined with brain stimulation.

celdon25 1y ago

Give it about 5 years.

SequoiaHope 1y ago

Well MDMA therapy is a real one and probably much more effective than cocaine for these purposes.

pier25 1y ago
Psilocybin too
dns_snek 1y ago
MDMA (or psilocybin) assisted psychotherapy to be specific. I don't think just taking these drugs has been shown to be an effective treatment :)
- SequoiaHope 1y ago
  Yes I was referring to MDMA assisted psychotherapy, which I am a huge proponent of. However I’ve found these materials to be quite effecting at healing when taken conscientiously outside of a traditional assisted therapy session. Of course there probably haven’t been a lot of studies on this because formal therapy studies are probably easier to get approved, so I wouldn’t take the absence of evidence as evidence of absence.

roughly 1y ago

What’s interesting here is that in the drug treatment world it’s basically known that drug abuse is almost always a reaction to some kind of psychological trauma or disorder, and an awful lot of drugs (not just cocaine) play heavily with the dopamine pathways. The idea of dopamine as your brain’s signal that you’re safe fits about as neatly with that as can be. (Of course, like everything in biology, dopamine also does about a gazillion other things, too, so it’s not quite that cut and dry, but it rhymes, at least.)

phren0logy 1y ago
> in the drug treatment world it’s basically known that drug abuse is almost always a reaction to some kind of psychological trauma or disorder This is incorrect. While this is true for a substantial number of people, I want to offer some resistance to the pop-psychology axiom that "everything is because of trauma." Not only is is unsupported by science, it has lead to an expansion of the definition of the word "trauma" in popular culture that's so broad as to be nearly useless clinically or scientifically.
foobiekr 1y ago
I had the unique experience as a youth in attending a school where a substantial portion of the school was funneled there by one of the many 1970s and 1980s troubled teen corporations that spun out of Synanon after it collapsed. This one specialized in drug addicts. Almost all of my classmates (not me, unfortunately) were from exceptionally wealthy families and excepting one none of them ever mentioned any childhood trauma. Instead they were precocious partiers who got into drugs despite being underage and going to the nightclubs in the seedy part of town - no one at the time was turning away hot young women or gay(for pay or real) young men. And the club scene was a drug scene. It still is. I don’t think trauma is actually at the root of almost all drug abusers. The only first class abusers (pot and alcohol in serious quantities daily) that I know at the moment grew up in perfectly fine suburban families and are in good, non-narcissistic/controlling/etc relationships with their families. They’re just addicts who can’t stop. One of them is going to die from it, eventually, given his level of alcohol consumption.
Aurornis 1y ago
> in the drug treatment world it’s basically known that drug abuse is almost always a reaction to some kind of psychological trauma or disorder, This is not true in the professional world. People engage in drug use for many reasons, including pure recreation. Trauma can precede relapses or bouts of drug abuse, but it's not a universal explanation. There are a lot of pop-culture ideas that explain everything away as trauma. These are popular on podcasts, Reddit, and other social media websites. There are also types of therapists who learned to treat trauma and then try to apply that to everything. "If all you have is a hammer, everything looks like a nail". These therapists will try to reframe everything as trauma because it's what they know how to teach. They often reverse engineer a traumatic backstory as an explanation even when one doesn't exist. You can find podcasters and therapists who will even claim that being born imparts permanent trauma that explains things long into adulthood. There's no evidence behind this claim, but it's convenient for therapists who need to find a traumatic backstory before they can address something because everyone was born at some point. > The idea of dopamine as your brain’s signal that you’re safe fits about as neatly with that as can be. That idea is completely wrong, though. The study is talking about dopamine signaling in one specific location of the brain. Dopamine is used in other locations in the brain to encode aversive stimuli, among other things. Dopamine (and other neurotransmitters) don't just do one single thing in the brain. They have diverse effects all over. Also, many of the drugs that people associated with dopamine actually have much broader effects, such as on norepinephrine (stimulants) and serotonin (cocaine). There are dopamine agonist drugs that go in and very precisely target different dopamine receptors in the brain, activating them directly. Many people are surprised to learn that a common side effect of these drugs is an irresistible urge to sleep when first taking them, for example.

static_void 1y ago

I would unironically say this is the how of how adderall works for me. I am distracted from work by anxiety. With medication, I'm not distracted.

gigaflop 1y ago
Generic Adderall Gang here, and in hindsight, I'm surprised at how little of it I need to realize a much better headspace. Makes me wonder if all of that caffeine in my undiagnosed youth was saying something...
- static_void 1y ago
  I'd be interested in your thoughts more here. The problem with amphetamine is you pay for every benefit: focus now, lethargy later; energy now, anhedonia later. But taking a small, consistent dose. Does that work? Do you feel you net benefits in life from taking the drug, discounting for withdrawal and/or tolerance?
  - Aurornis 1y ago
    > The problem with amphetamine is you pay for every benefit: focus now, lethargy later; energy now, anhedonia later. > But taking a small, consistent dose. Does that work? Do you feel you net benefits in life from taking the drug, discounting for withdrawal and/or tolerance? There's a reason these medications are supposed to be taken regularly at the same dose in clinical practice. Patients should not be going through cycles of taking stimulants and then withdrawing all of the time. There's a disconnect between the way some people try to use stimulants ad-hoc versus the therapeutic modality. The initial burst of confidence, energy, and positive mood that comes from intermittent use is a side effect, but people confuse it with a primary effect. They can get into cycles of chasing it with dose escalations or taking it on random days while they exist below baseline on others. This isn't a winnable battle over time because the brain will adapt, not to mention all of those off-days start to add up and people around them notice the extremely inconsistent mood and performance. Unfortunately, misinformation about ADHD is all over the internet. I recommend ignoring basically anything that comes out of Reddit, Twitter, or TikTok because it's really that bad. Take medications as directed and set yourself up for some stability. Resist the urge to play with doses, take excess doses on some days, or try to play tolerance games. These never work in the long term. There's a simple heuristic: When you reach stability, you shouldn't really feel the medication. It should be background noise. There's a reason why young people who have been properly titrated on stimulant medications don't understand what the big deal is with their peers taking large doses (without tolerance) and then speeding around for a while. It's where the myth about ADHD people reacting differently to stimulants comes from. Proper treatment will settle to equilibrium and shouldn't produce overt feelings of being drugged or hyperfocused.