[HN Gopher] First federal grant for psychedelic treatment resear...
       ___________________________________________________________________
        
       First federal grant for psychedelic treatment research in 50 years
        
       Author : infodocket
       Score  : 490 points
       Date   : 2021-10-18 21:54 UTC (1 days ago)
        
 (HTM) web link (www.hopkinsmedicine.org)
 (TXT) w3m dump (www.hopkinsmedicine.org)
        
       | cletus wrote:
       | Here's a fun fact: since 1968, only one US institution, the
       | University of Mississippi, has had a Federal license to grow
       | marijuana for medical research [1], although this may be
       | (finally) changing [2]. The barriers to Federally funded medical
       | research of cannabis remain significant [3]. It's almost like the
       | University of Mississippi and the Federal government are doing
       | everything they can to stymie research and limit access.
       | 
       | Also, cannabis remains a Schedule 1 drug at the Federal level.
       | Schedule 1 drugs are "drugs of abuse" that have "no accepted
       | medical use" [4], the same as methamphetamine and crack cocaine
       | (and of course it's worth mentioning that powdered cocaine is the
       | less serious Schedule 3).
       | 
       | All the while ~18 states have legalized recreational and/or
       | medical cannabis at the state level [5].
       | 
       | The case for the continued criminalization is beyond ridiculous.
       | 
       | I fully support decriminalization and further study of the effect
       | of psychedelics but I'm not confident that the US government,
       | even with a Democratic president, a Democratic House and a
       | (notionally) Democratic Senate won't make this as difficult as
       | possible.
       | 
       | The roots of US criminalization of cannabis and psychadelics is
       | rooted in racism (eg crack cocaine vs powder cocaine), cracking
       | down on counterculturalism and anti-Vietnam protesters (ie the
       | hippy movement of the 60s and 70s) and virtue signaling to a
       | conservative and fearful voter base under the guise of "law and
       | order" and "family values".
       | 
       | It's truly ridiculous we're still here some 50+ years later.
       | 
       | [1]: https://www.drugdiscoverytrends.com/nations-only-
       | federally-a...
       | 
       | [2]: https://mjbizdaily.com/dea-preparing-to-ok-companies-to-
       | grow...
       | 
       | [3]: https://cen.acs.org/biological-chemistry/natural-
       | products/Ca...
       | 
       | [4]: https://www.dea.gov/drug-information/drug-scheduling
       | 
       | [5]:
       | https://en.wikipedia.org/wiki/Legality_of_cannabis_by_U.S._j....
        
         | tclancy wrote:
         | I'm 100% with you, but this country will forever be legislating
         | the fact their neighbors might be happy and enjoying life. And
         | then the fact so much race enters into it too as you mention,
         | just makes it addictive for certain people. It's like crack or
         | something.
        
         | wk_end wrote:
         | Although there may be more nefarious reasons behind why crack
         | is penalized more harshly under the law than cocaine, that
         | scheduling is at least technically correct: powdered cocaine is
         | indeed used as a medical anesthetic, whereas crack isn't used
         | for anything medically.
         | 
         | The classification of marijuana as not having any medical use
         | despite being used to treat all sorts of ailments all over the
         | country is, of course, ridiculous.
         | 
         | Now that I think about it - regardless of your stance on
         | recreational drug prohibition - it does seem strange to tie
         | penalties for illicit use or sale of a drug with whether or not
         | the drug has so-called legitimate uses.
        
           | cletus wrote:
           | It's worth adding that the DEA scheduling classification is a
           | little weird. Example: fentanyl is a Schedule 1 drug but it's
           | an extremely potent opiate that is prescribed typically to
           | end-stage cancer patients and others in extreme pain.
        
             | seattle_spring wrote:
             | Fentanyl is schedule 2, as is methamphetamine [1]. I'm not
             | sure why certain users repeatedly claim they are schedule 1
             | despite being able to easily verify that they are not. This
             | isn't the first time I've had this back and forth on HN.
             | 
             | [1] https://www.dea.gov/sites/default/files/2020-04/Drugs%2
             | 0of%2...
        
         | nick__m wrote:
         | Meth is not schedule 1, it's sold under prescription under the
         | name of Desoxyn !!! According to the weird US federal drug
         | schedule weed is more abusable that Meth...
        
           | throwaway0a5e wrote:
           | Don't forget Adderall which is very similar.
        
       | thedudeabides5 wrote:
       | Drugs are bad. But alcohol is good for you and you should
       | definitely drink to make friends and influence people.
        
         | encryptluks2 wrote:
         | Don't forget cigarettes as well. Time to get your mandatory
         | vaccination cause the government cares so much about health.
        
           | yjftsjthsd-h wrote:
           | Are you saying cigarettes are good, or vaccines are bad? I'm
           | not following.
        
             | encryptluks2 wrote:
             | I'm saying that government doesn't have your health in
             | mind, whether it be the vaccine, cigarettes, alcohol,
             | sugar, health care, etc. They laugh all the way to the
             | bank.
        
             | Apocryphon wrote:
             | The nicotine vaccine, surely.
        
       | sexy_seedbox wrote:
       | One can only _hope_ for something close to this in Southeast Asia
       | : (
        
       | bwest87 wrote:
       | A friend and I did a "guided" psychedelic session earlier this
       | year. We did it individually over one weekend. It was great. She
       | did it for more therapeutic reasons. I did it more for
       | philosophy/spiritual reasons. But the two main things I took away
       | are 1.) Guided sessions are qualitatively different than
       | recreational sessions, and 2.) It is such a crying shame that
       | this isn't an accepted "tool in the toolbox" for therapists.
       | 
       | It's not about having crazy life altering, world-bending
       | experiences (though that can happen). It's just about helping you
       | get into a state of mind that allows for an effective therapy
       | session. Sort of like... would you want to do your therapy
       | session in a crowded bar, next to your mom? No, probably not. We
       | all recognize that such a setting would not be conducive to good
       | therapy. So similarly, we should be able to recognize that having
       | the right setting, both mentally and physically can affect the
       | quality of your session. Psychadelics can do exactly this.
       | 
       | It's also worth noting my friend has done "regular" therapy for 2
       | years, and she felt like there was a step change after the guided
       | session. Her therapist noticed it as well.
       | 
       | When you consider that pain meds have ruined literally millions
       | of lives through addiction, and that also virtually (maybe
       | literally?) no one has ever died due to overdose of psilocybin,
       | it's very confusing why one is prescribed all the time, and the
       | other is considered incredibly dangerous. The U.S.'s perspective
       | on drugs is so very backwards.
        
         | inter_netuser wrote:
         | >pain meds have ruined literally millions of lives through
         | addiction
         | 
         | Unpopular opinion: opioids are _massively_ under-prescribed for
         | those that actually _need_ them.
         | 
         | Addiction is a mental illness. That's whats killing so many,
         | but why is to so few question what is actually causing such
         | terrible emotional pain that must be self-medicated with
         | incredibly potent medicaments?
         | 
         | Why is it that instead of acknowledging the rather
         | uncomfortable root cause of those deaths, we just default to
         | the so much simpler scapegoat, pills (the active ingredient in
         | which has been with us in one form or another since 5000 BC),
         | and pretend everything else is just rainbows and unicorns?
        
           | WarOnPrivacy wrote:
           | > opioids are massively under-prescribed for those that
           | actually need them.
           | 
           | Absolutely.
           | 
           | While reports of ODs are endlessly bullhorned, millions in
           | pain get demonized by algorithmic opioid blacklists, get
           | ignored by news orgs/legislators addicted to opioid hysteria
           | and get gaslighted by a public who only hears the
           | bullhorning.
           | 
           | I have a lifelong friend with visibly crippling arthritis. He
           | lost access to effective pain meds after the state passed a
           | 3-day-max on opioids (passed >10 years after the pill-mill
           | problem abated). Over the year that followed the law's
           | passage, every Dr in his network (along with most Drs in the
           | state) ~stopped Rx opioids. The (now fewer) pain mgt clinics
           | are overloaded and not accepting patients.
           | 
           | His remaining avenues for pain relief no longer involve Dr's.
           | 
           | I had emergency abdominal surgery this year and had to
           | convince the discharging Dr to prescribe Tramadol. Our new
           | normal is for ERs/Hospitals to undermedicate patients in pain
           | with OTC analgesics.
           | 
           | So yeah. Shout out to folks who are hand-waving away millions
           | in pain - because pharma is greedy or because folks can't
           | differentiate responsible Rx opioids from street fentanyl
           | (that many in chronic pain turned to in desperation after
           | they were cut off from safer pain relief).
        
           | jdc wrote:
           | > Why is it that instead of acknowledging the rather
           | uncomfortable root cause of those deaths, we just default to
           | the so much simpler scapegoat, pills (the active ingredient
           | in which has been with us in one form or another since 5000
           | BC), and pretend everything else is just rainbows and
           | unicorns?
           | 
           | Okay, I'll take mushrooms, which have _actually_ been with us
           | since then, and you take synthetic intravenous opioids and we
           | 'll see who fares better.
        
             | inter_netuser wrote:
             | My comment was specifically about people that _need_ them
             | _prescribed_. For pain relief, injuries, chronic pain, and
             | so on. Opioids are very effective and are vilified for no
             | good reason, along with a few other classes of substances.
             | 
             | Not as in substitution therapy, like methadone. I do hope
             | that mushrooms help people come off of long-term
             | substitution.
        
             | refurb wrote:
             | Opioids (opium) have been around as long as mushrooms. Just
             | because they are synthetic variations doesn't mean they are
             | that different.
        
               | jdc wrote:
               | Alright, go ahead and get on a regular IV fentanyl regime
               | and let me know how that goes for you.
        
               | snovv_crash wrote:
               | It has nothing to do with the synthetic, people destroy
               | themselves on straight-from-the-poppy-plant heroin as
               | well.
        
               | honkdaddy wrote:
               | I think you're underestimating how destructive fentanyl
               | is compared to almost any other opioid.
        
               | refurb wrote:
               | Generally I've heard fentanyl is a poor substitute for
               | heroin.
        
               | WarOnPrivacy wrote:
               | What does fentanyl have to do with people who were cut
               | off, people who - for years/decades - responsibly used Rx
               | opiods to manage chronic debilitating pain?
               | 
               | Unless you're talking about people in pain who were
               | forced to the street, after Dr's were (en masse) hazed
               | into stopping pain treatment. In that case, I get your
               | point.
        
           | stadium wrote:
           | > why is to so few question what is actually causing such
           | terrible emotional pain that must be self-medicated with
           | incredibly potent medicaments?
           | 
           | > Why is it that instead of acknowledging the rather
           | uncomfortable root cause of those deaths, we just default to
           | the so much simpler scapegoat, pills
           | 
           | Missing from these arguments is the role of criminalizing
           | addiction versus treating it as the mental health issue you
           | accurately described. And ignoring the pharmicuitical and
           | lobbying industries behind the same pills.
           | 
           | I don't think it's a valid argument to reassign blame from
           | the potency and availability of pills, to unmet mental health
           | needs. They are related and intertwined, sure, but
           | correlation != causation.
           | 
           | Case in point, the Purdue Pharma Sacklers settled for
           | $billions (which also bought their immunity from future
           | prosecution) precisely because they were pushing hard drugs
           | and preying on those same people mental health issues [0].
           | Predatory, sociopathic behavior. But pill are a scapegoat?
           | Sorry, that's a hot load of b.s.
           | 
           | [0] https://www.npr.org/2021/09/01/1031053251/sackler-family-
           | imm...
        
             | inter_netuser wrote:
             | I don't disagree there are bad actors. Dissolving Purdue (I
             | thought they were dissolved, not just fined?) is great. Bad
             | actors should be punished. And yes, criminalizing medical
             | issue such as addiction is terrible. All of these are
             | fairly obvious, which is why I didn't spell them out.
             | 
             | As I'm sure you know, many cases of mental illness are
             | triggered by some sort of precipitating event.
             | 
             | I don't believe for a minute the fact that someone gave
             | those addicts an opioid pill was the actual trigger.
             | Instead it was something that happened way before that:
             | some emotional trauma, PTSD, disadvantaged background,
             | chronic illness, no life/career prospects, war, despair,
             | etc, etc, so many stressors this life can bless you with.
             | The Big Bad Pill is just what the addicts came across and
             | realized it helped them feel okay for a moment, that's all
             | it is.
             | 
             | E.g. a war veteran ends up getting PTSD and becomes an
             | addict(let's assume he has no chronic pain). Aren't the
             | circumstances around his life that led him to enlist and
             | then develop PTSD are the much more relevant trigger?
             | Barring that event, would they even begin using in the
             | first place?
             | 
             | Who gave them that precipitating event? Other humans did.
             | 
             | The ugly truth is that the cause of this all is simply us,
             | humans stressing other humans. Like other primates, we are
             | intelligent enough to the point it takes very little effort
             | to provide for our basic needs, and so we spend the rest of
             | our time engaging in social status games at the expense of
             | others.
             | 
             | Most people who use opioids do not actually become
             | addicted. Those who used heroin in Vietnam, most of them
             | stopped after they returned and circumstances changed from
             | war to normality: https://pubmed.ncbi.nlm.nih.gov/12873239/
             | 
             | "After their return, most of the men who had used heroin in
             | Vietnam used it very occasionally or not at all."
             | 
             | "Possible post-Vietnam correlates of heroin injection were
             | no job or school enrolment, alcohol problems, depression,
             | absent or transient marriage, association with illicit drug
             | users and other Vietnam veterans."
             | 
             | The real root cause is that humans are nothing but selfish
             | machiavellian apes. We all are about me-me-me-me-me, and
             | dig just a bit deeper, most are just as predatory and
             | sociopathic as Purdue/Sacklers/whatever, just not as
             | capable at getting their way.
             | 
             | We just look away and walk past the addicts in meatspace.
             | We are no saints, and the real cause of most human
             | suffering is not some processed alkaloid - it's other
             | humans.
             | 
             | Not some pharma company or some evil billionaire clan that
             | capitalized on this, I'm sure they contributed. There would
             | be nothing to capitalize on or sell, if it weren't for
             | humans psychologically injuring other humans for fun and
             | profit.
             | 
             | Personally, it seems to me that we can recognize and accept
             | a physical disability/injury much more readily than
             | emotional/psychological one. Same goes for inflicting
             | injuries: attempts to fracture someone's limb, a grave
             | physical injury, seem too repulsive to even think about,
             | and hopefully bystanders will attempt to rescue the victim
             | should anyone ever try to do this to anyone. Harassment,
             | bullying, hazing, belittling someone "just for laughs" on
             | the other hand? All too often, others are more than happy
             | to join in on the "fun" and even will gleefully laugh at
             | the actual victim.
             | 
             | Of course, nobody likes to think of themselves in that way,
             | much too unpleasant, and so we point our collective fingers
             | elsewhere. It's always "them", and never "us".
             | 
             | I can only hope that one day we will evolve to finally dish
             | out just as harsh punishment for psychological harm as we
             | do for bodily harm, and hold each other accountable for it.
        
               | stadium wrote:
               | A bunch of things are conflated here that need to be
               | untangled. Not all trauma is going to lead to an
               | addiction. Not all addiction is to pills or drugs. Not
               | everyone who takes opioids is going to form an addiction.
               | Not all trauma is intentional and deserves punishment.
               | 
               | The expert in this area is Dr. Gabor Mate. He is highly
               | respected in this field. If anyone is interested learning
               | about the role of trauma in addiction, he literally wrote
               | the book on it, "The Realm of Hungry Ghosts" [0]
               | 
               | From Mate [0]:
               | 
               | > Turning to the neurobiological roots of addiction, Dr.
               | Mate presents an astonishing array of scientific evidence
               | showing conclusively that:
               | 
               | > 1. addictive tendencies arise in the parts of our
               | brains governing some of our most basic and life-
               | sustaining needs and functions: incentive and motivation,
               | physical and emotional pain relief, the regulation of
               | stress, and the capacity to feel and receive love; > 2.
               | these brain circuits develop, or don't develop, largely
               | under the influence of the nurturing environment in early
               | life, and that therefore addiction represents a failure
               | of these crucial systems to mature in the way nature
               | intended; and > 3. the human brain continues to develop
               | new circuitry throughout the lifespan, including well
               | into adulthood, giving new hope for people mired in
               | addictive patterns. Dr. Mate then examines the current
               | mainstream.
               | 
               | [0] https://drgabormate.com/book/in-the-realm-of-hungry-
               | ghosts/
        
         | louis___ wrote:
         | Would you maybe like to elaborate on what was the details of
         | the "guided" aspect of your sessions ?
        
         | agumonkey wrote:
         | One session means one time or a few times in one week ?
         | 
         | Do you or her plan to keep doing it ?
        
         | [deleted]
        
         | colhom wrote:
         | How are you going to sustain the largest economy on earth if
         | your populace isn't hypnotized? Most of the work that needs to
         | be done is not intrinsically or spiritually fufilling.
         | 
         | So there must be an alternative synthetic rewards system- which
         | inevitably requires some form of mass hypnosis to remain
         | dominant in the aggregate psyche.
         | 
         | It's no coincidence that all the research in this space was
         | shut down in a hurry right around when the CIA figured out that
         | LSD and the pikhal family weren't going to help with this at
         | all.
        
         | f0rgot wrote:
         | I've always wanted to try a guided session, but I have no idea
         | how to even start looking for a guide. I'm in Illinois.
        
           | zhengyi13 wrote:
           | Medical tourism? Elsewhere upthread there are specific places
           | called out where psilocybin is legal or decriminalized.
           | Poking around on the web for therapeutic providers in those
           | areas might be an effective strategy.
        
         | elromulous wrote:
         | >it's very confusing why one is prescribed all the time, and
         | the other is considered incredibly dangerous. The U.S.'s
         | perspective on drugs is so very backwards.
         | 
         | The lobbying system. Aka legalized corruption.
        
         | drawkbox wrote:
         | > The U.S.'s perspective on drugs is so very backwards.
         | 
         | The War on Drugs is a flaw that needs to end but at least with
         | psilocybin US is moving slowly in the right direction. The only
         | countries where psilocybin is legal are Brazil, Jamaica, Nepal,
         | Samoa, Netherlands (truffle format), British Virgin Islands and
         | the Bahamas [1].
         | 
         | Many places are illegal but unenforced though still illegal.
         | 
         | US psilocybin is decriminalized in many places now including
         | all drugs in Oregon. More states need to get more like Oregon
         | definitely.
         | 
         | However, in most states spores are legal and so are grow kits
         | for other types of mycology.
         | 
         |  _Grow kits and spores legal in most states, full cultivation
         | decriminalized in Seattle, Washington, Ann Arbor, Michigan,
         | Denver, Colorado, Santa Cruz, California, Somerville and
         | Cambridge, Massachusetts, Oregon and Washington D.C._ [1]
         | 
         |  _Legal in Oregon for mental health treatment in supervised
         | settings since 1 February 2021_ [1]
         | 
         | Full legalization needs to happen for marijuana and
         | psychedelics. Decriminalization needs to happen for all drugs
         | minimum as well.
         | 
         | As far as marijuana, psilocybin and LSD, they are the least
         | toxic and less dependency forming of most drugs, even caffeine,
         | aspirin and more. It is a tragedy and a drug dark age that they
         | are in the Controlled Substances Act. I believe drugs should
         | have to be toxic or cause death to actually be on that list.
         | Marijuana, psilocybin and LSD are very safe when it comes to
         | toxicity and drug overdoses are non-existent, all would be
         | better as legal safer production products.
         | 
         | Legality makes everything safer, increases harm reduction and
         | reduces black market unsafe production as well as reduces
         | funding of cartels/mafias/bratvas. Their criminality truly
         | makes no logical sense except to invite problems.
         | 
         | [1]
         | https://en.wikipedia.org/wiki/Legal_status_of_psilocybin_mus...
        
           | taurath wrote:
           | Just wanted to add that the US led the criminality to spread
           | across the globe via the UN.
           | 
           | https://en.m.wikipedia.org/wiki/Convention_on_Psychotropic_S.
           | ..
        
             | matheusmoreira wrote:
             | Yeah. The US pretty much exports its laws. It uses its vast
             | economic leverage to impose US laws on everyone else via
             | trade agreements, treaties.
             | 
             | It did the same thing with intellectual property. It will
             | put sovereign countries in a literal naughty list when they
             | don't accomodate US company interests.
        
         | stadium wrote:
         | What area are you located, and how did you find your guide?
         | Word of mouth?
         | 
         | Not looking so much for specifics, more to understand the
         | process.
        
       | vmception wrote:
       | Its always so interesting to me to run into people conditioned to
       | have a blanket juvenile "anti drugs" view, especially if they are
       | US citizens
       | 
       | They cant even tell the difference between substances to say why
       | or why not
       | 
       | If thats you, why is that? And is there any specific authority
       | you would need to hear from to take another look?
        
       | pksebben wrote:
       | I worry that this is NIDA-funded. That institution has history of
       | commissioning nonsense studies to maintain prohibitions. [1]
       | They're also probably responsible for a series of (failed)
       | propaganda pieces focused on maintaining an arbitrarily anti-drug
       | culture [2]
       | 
       | 1 http://www.ukcia.org/research/gettman.htm 2
       | https://slate.com/technology/2006/09/a-white-house-drug-deal...
        
       | throwaway990909 wrote:
       | I was a participant (ie, research subject) in one of the previous
       | rounds of studying psilocybin for smoking cessation at Johns
       | Hopkins.
       | 
       | I was randomly assigned to the non-psilocybin "control" group. I
       | still successfully quit smoking -- the "cognitive behavioral
       | therapy" and just general support was great. The researchers
       | showed genuine care, it wasn't like being a lab rat.
       | 
       | Because the study was designed with a "crossover" component, I
       | still got the option, which I took, to return 6 months later for
       | a psilocybin session. The session was interesting, but I wouldn't
       | say life-changing. Probably. I am still a non-smoker, over 2
       | years after quit date, did the 6-months-post-quit session help?
       | Maybe?
       | 
       | Ask me anything! Although I'm not sure what else there is to say!
        
         | sammalloy wrote:
         | Just wanted to pipe in here: I quit smoking tobacco in 1995 due
         | to the influence of psilocybin. We knew back then it worked. I
         | think you need a lot more than just psychedelics to quit
         | smoking, however. The first week was easy. The next 11 months
         | were hard. After a year, I never wanted a cigarette ever again.
        
         | loceng wrote:
         | So what I'm curious about then is the practices/experiences the
         | researchers/staff involved used/had in order to provide you
         | with the space that you found supportive enough to help you
         | quit smoking.
         | 
         | What was the dosing for the session with psilocybin? Did they
         | tell you the strain/weight?
        
           | throwaway990909 wrote:
           | They told me the weight, but I forget. It was a large
           | "heroic" dose. The research protocol is perhaps already
           | available somewhere (published paper, pre-print, registered
           | study, not sure) which would have the dose.
           | 
           | They used manufactured/sythesized psilocybin compound in a
           | capsule, not mushrooms or extracted from mushrooms.
           | 
           | I think they tried to take all the 'best practices' for
           | quitting smoking and gave it to all participants, same
           | experience up until quit day. On quit day, "control" group
           | got a prescription for nicotine patch; "psilocybin group" got
           | a session (and no patch!) -- the psilocybin group in this
           | particular study was just one "heroic" dose session on
           | smoking quit day, that's it.
           | 
           | Some of the supportive practices or suggestions included:
           | 
           | * just regular sessions, that were in some ways more or less
           | like a "therapy" session focused on looking at smoking in
           | your life. (whatever that means to you, it really was also
           | just a good therapy session!)
           | 
           | * set your quit day near the beginning, several months before
           | the quit day. Build up to it.
           | 
           | * at one period, every time you want to smoke, note what you
           | feel like and what is precipating it, make a note of it.
           | Develop a sense of what things make you want to smoke and
           | why, and what role is has in your life.
           | 
           | * A "practice quit" day a month or two (I forget) before
           | actual quit day -- just try not to smoke for 24 hours, see
           | what it's like, knowing you can smoke again after that. Now
           | you know what it's like, and that you got through the worst
           | day, and what parts are going to be hardest and can develop
           | more strategies for them.
           | 
           | * Get a clear list of the reasons you want to quit. Think
           | about em. Write it down, to refer to it when it gets hard.
           | 
           | * Make a list of things you can do _instead_ of smoking,
           | after you quit. It doesn 't matter if they are unhealthy
           | (junk food or whatever), they're still healthier than
           | smoking.
           | 
           | * after quit day, phone number of a therapist you've been
           | working with, invitation to call or text if you feel tempted
           | and need support and to talk through it. Therapist texted me
           | daily checking in, seeing how it's going. (seriously, why
           | DON'T we use techniques we associate with alcohol and other
           | drug addiction treatment on cigarettes, you know? they are
           | crazy addictive!)
           | 
           | There were other things too, additional like little
           | cognitive-behavioral (I guess?) games/techniques. I don't
           | even remember them all. I should have taken more notes on all
           | of it! Just having people there rooting for you and to whom
           | you feel kind of accountable to is big.
           | 
           | If their study really does show significantly more success in
           | psylocybin group than control group, I find it meaningful
           | that even the control group got _really good support_ from
           | good counselors. (And I still wouldn 't say it was _easy_ to
           | quit!)
        
             | gjs278 wrote:
             | how the hell do you have a control group for this? it's
             | obvious if you didn't have the drug
        
             | inter_netuser wrote:
             | How much nausea did you have from pharmaceutical grade
             | psilocybin?
        
             | loceng wrote:
             | Awesome, thanks for the lengthy reply. Heroic is usually
             | considered at least 5g - there's a saying you can meet God
             | at 5g; so it was probably an equivalent dose to that in
             | synthetic form.
             | 
             | I am curious myself if there are other diagnostics, health
             | metrics that are easily/non-invasively measured to help
             | determine or predict what experience a person will have for
             | their first experience or to give an idea of how many
             | sessions may be necessary for what level of "breakthrough."
             | 
             | Sounds like a good practical list of things to do - to
             | develop multiple angles of "attack" to build more weight
             | towards the goal, to reference for yourself as support to
             | counter the strength/weight of urges.
             | 
             | In part reminds me of "psychological flexibility" practices
             | - to help allow thoughts to be less rigid, to offer more
             | fluidity to thought - perhaps you already had that open-
             | fluid mind and so you simply needed the practice/guidance
             | for the practice to then benefit from that value; an
             | example is perhaps you normally would tell yourself "I feel
             | happy" but then that might trigger a stress or feeling of
             | cognitive dissonance, and so instead you'd train yourself
             | to acknowledge all aspects of you in that moment and
             | instead say "I feel happy AND sad;" perhaps not the best
             | example or explaining of similarity. I wonder if the
             | researchers first created a survey to determine the level
             | of this kind of psychological flexibility a person has, and
             | then see how those different groups perform in the
             | psilocybin research - if and how the outcome of different
             | groups differ; could perhaps divide it up even further by
             | providing psychological flexibility training to part of the
             | different groups - and see how all the numbers conclude.
             | 
             | Fun fact: the co-founder of Alcoholics Anonymous actually
             | wanted the first step to be everyone do LSD/acid.
        
       | pkaye wrote:
       | I presume other countries didn't have a ban on such research so
       | there should already be research data from those countries on the
       | benefits of psychedelic treatment?
        
         | cyberpsybin wrote:
         | US forces countries it trades with to align themselves with its
         | drug laws. Just another front in war against drugs.
        
       | dekhn wrote:
       | After many years reading about Leary, I realize now that he set
       | the field back by decades.
        
         | mysecretaccount wrote:
         | Leary was just the fall guy - Nixon sent the field back
         | decades. The narrative about Leary's damage to the psychedelic
         | movement is massively overstated.
         | 
         | Here is a relevant discussion between Michael Pollan and
         | Hamilton Morris about this: https://youtu.be/XvMArmwI10Q?t=2744
        
         | kesslern wrote:
         | Michael Pollen talks about this in his book, How To Change Your
         | Mind. It's insane how irresponsible Leary was. A good example
         | is what's commonly called the Good Friday Experiment.
         | 
         | https://en.wikipedia.org/wiki/Marsh_Chapel_Experiment
        
           | tayo42 wrote:
           | The perspective given in this book was really interesting to
           | read. Way different the typical story you get out of drug
           | communities
        
           | pvarangot wrote:
           | It's hard to blame it on a single person. The Stanford Prison
           | Experiment didn't involve any drugs and was as or even more
           | irresponsible than Leary's messianic psychedelic mania fueled
           | binge. The Stanford Prison Experiment was in 1971, Leary had
           | already been indicted of multiple charges by that year if not
           | in prison already, according to Wikipedia he was fired from
           | Harvard in 1963.
           | 
           | So eight whole years after Learys irresponsibility the
           | ethical standards for human experimentation in psychology
           | were still nowhere near to what they are today.
        
           | gremloni wrote:
           | Intuitively, we learnt a lot about human behavior when we
           | were able to do those unethical experiments back in the 60s
           | and 70s. Set us back yes, but "set us back" by being moving
           | us forward unsustainably.
        
             | dekhn wrote:
             | I am not aware of any long-term legitimate findings in
             | psychology research from the 60s or 70s (that would not be
             | allowed today). Are you? My guess is all, or nearly all,
             | have been debunked, or are non-reproducible for silly
             | technical reasons.
        
               | gremloni wrote:
               | Just off the top of my head, the monkey in the dark
               | funnel study, the mit prison experiment, the Stanley
               | milgram experiment, the rat utopia/dystopia experiment,
               | the little Albert experiment (1919), Leuba's tickling
               | experiment involving his son (1930s) etc.
        
               | dekhn wrote:
               | All of those studies are basically scientific garbage.
               | They're just pop-culture tripe at this point. Each one
               | has been invalidated, repeatedly, and for reasons that
               | have nothing to do with medical ethics.
               | 
               | Also the prison experiment was at Stanford.
        
               | roddyrockets wrote:
               | the Silver Spring monkeys experiment made inroads on
               | treatments for stroke patients I believe
        
               | dekhn wrote:
               | Thanks, I wasn't able to find that experiment based on
               | the previous person's description. That experiment
               | doesn't qualify, as we still do experiments more or less
               | like that, it's animals not humans, and it's
               | neuroscience, not psychiatry.
        
               | gremloni wrote:
               | That's not true. At best you can say the Stanley milgram
               | experiment was reanalyzed with a poor reproduction
               | involving various amounts of money. Not nearly the same
               | and definitely not conclusive.
               | 
               | The little Albert study holds, the tickling study
               | findings are still true, the Stanford prison experiment
               | hasn't been repudiated, the rat experiment has literally
               | been reproduced outside of the US and the pit of despair
               | findings still hold true.
               | 
               | And yes, it was Stanford but it was off the top, I made a
               | mistake.
        
               | disgruntledphd2 wrote:
               | The Milgram obedience studies have been replicated many,
               | many times.
        
             | colechristensen wrote:
             | Most of them didn't really need to be unethical though.
             | 
             | There are things you can learn either extremely slowly or
             | extremely unethically, but it didn't really seem to be the
             | case with psychedelics. Things which could have been done
             | responsibly were done recklessly, and not all that much
             | time or effort was saved.
        
             | Enginerrrd wrote:
             | The last several years, I've noticed there's been a lot of
             | effort to debunk and discredit a lot of those unethical
             | experiments. I'm still inclined to agree with you though.
        
           | dekhn wrote:
           | I'm more concerned about the lack of random sampling:
           | 
           | Leary and Alpert taught a class that was required for
           | graduation and colleagues felt they were abusing their power
           | by pressuring graduate students to take hallucinogens in the
           | experiments. Leary and Alpert also went against policy by
           | giving psychedelics to undergraduate students, and did not
           | select participants through random sampling. It was also
           | problematic that the researchers sometimes took hallucinogens
           | along with the subjects they were supposed to be studying
        
         | tenaciousDaniel wrote:
         | Agreed. I think Alexander Shulgin deserves some blame as well,
         | though maybe not to the same extent.
        
           | dekhn wrote:
           | I recall talking to a guy when I was working at Berkeley who
           | was convinced that you could take shulgin's work and expand
           | it to larger sample sizes and use it as a basis of rational
           | drug design for psychedelics. I see Shulgin as a bit of a
           | different character, and he was embedded in an time and area
           | that had already absorbed LSD and was ready for
           | psychonautical adventures.
        
           | robbedpeter wrote:
           | I respectfully disagree. What Shulgin did simply represented
           | rational science and protocols for self experimentation. He
           | established some of the best possible harm reduction
           | methodologies, and communicated his knowledge to the world
           | through PIKHAL and TIKHAL. Through those books he's saved
           | countless lives and minds as people used and shared his
           | guidelines.
           | 
           | He was a subtle rebel, who played by the rules and they kept
           | changing the rules until they could shackle his research.
           | 
           | The context of the war on drugs and the vastly restrictive IP
           | laws created the current culture of drug development and
           | research. That culture is dominated by the pseudo capitalism
           | and monopolistic death grip Big Pharma has on drugs in
           | general, and their development and manufacture in particular.
           | 
           | People absolutely should be allowed to self experiment, and
           | knowledge should be freely available. Shulgin and his wife
           | showed virtually no I'll effects after a life of responsible
           | drug use - he lived to a vigorous 89, and his wife is still
           | kicking around at 90! I wish their brand of drug use had
           | taken deep root in American culture such that substance use
           | was appreciated and respected and approached with the caution
           | it deserves. If high school children were given drug use
           | education, and pharmacies were a legal source of all drugs
           | without the asinine scheduling prohibitions, so many
           | tragedies could have been avoided.
           | 
           | Even most doctors don't prescribe drugs as responsibly and
           | carefully as they should, and people are ignorant and ill
           | prepared for anything that happens. They could use Shulgin's
           | approach, carefully increasing dosage and providing patients
           | with a common verbal framework with which to describe their
           | experience.
           | 
           | Anyway, sorry to rant. Shulgin is a hero to me - a gentle
           | rebel who made his PhD count for something he believed in.
        
             | tenaciousDaniel wrote:
             | I agree that ultimately, people should be allowed to self
             | experiment. But looking at his situation from a pragmatic
             | perspective in the 70's and 80's, would it not have been
             | wiser to be just a bit more careful with his advocacy?
             | Publishing a book that details how to craft hundreds of
             | untested psychedelic drugs is not quite what I would call
             | subtle.
        
       | yellow_lead wrote:
       | It will be interesting to see the results, which may have built-
       | in reproduce-ability.
       | 
       | > The study will be conducted simultaneously at the three
       | institutions to diversify the pool of participants and increase
       | confidence that results apply to a wide range of people who
       | smoke.
        
         | [deleted]
        
       | standardUser wrote:
       | It's nice to see the cowards and control freaks losing their
       | fight to increase human suffering. But wow it has been a long,
       | expensive road with uncountable casualties.
        
         | sammalloy wrote:
         | Science progresses, one funeral at a time. Most of the
         | opposition to psychedelics eventually just died out.
         | 
         | https://en.wikipedia.org/wiki/Planck%27s_principle
        
       | Miller59 wrote:
       | Thanks for sharing, I am very impressed with your post.
       | https://www.tellthebell.mobi/
        
       | Miller59 wrote:
       | Thanks for sharing, I am very impressed with your post.
       | 
       | https://www.tellthebell.mobi/
        
       | ultra_nick wrote:
       | Watch one of these turn out to a miracle cure for some random
       | disease.
       | 
       | I can understand preventing access to dangerous drugs for the
       | average person, but keeping ourselves deliberately ignorant by
       | blocking research was stupid.
        
         | babyshake wrote:
         | It's impossible to talk about how dangerous psychedelics are
         | without context of the dosage as well as the setting for higher
         | doses. We don't consider alcohol to be especially dangerous
         | only because it requires a very large amount of most forms of
         | alcoholic beverages to result in alcohol poisoning and death.
        
           | Dumblydorr wrote:
           | You vaguely imply psychedelics are dangerous, comparing them
           | to alcohol, yet you provide zero evidence of their dangers.
           | Sounds like you need to flesh out your post, it comes across
           | anti-psychdelic with no reasoning.
           | 
           | Especially odd because we DO consider alcohol dangerous, why
           | else is there a 21 age minimum on it, why else is drunk
           | driving a scourge and menace? The "danger of psychedelics"
           | looks meek by comparison.
        
           | nipponese wrote:
           | Like anything else, doesn't that depend on the concentration?
        
             | colechristensen wrote:
             | Psychedelics have other dangers than acute toxicity. Not
             | that I'm giving medical advice but it is extraordinarily
             | difficult to die as a result of an overdose of most pure
             | psychedelics which aren't strange "research chemicals".
             | (Although I vaguely remember reading about a guy who
             | accidentally took something like tens of thousands of
             | effective doses of LSD being in a coma for quite a while)
             | 
             | However their power is in their ability to reshape your
             | mind... and that they can do in very undesirable ways if
             | done wrong.
        
               | pvarangot wrote:
               | > and that they can do in very undesirable ways if done
               | wrong.
               | 
               | I think the risk of developing a long term mental illness
               | from psychedelic use are overstated because of societies
               | stigma with temporary psychosis. A healthy person can
               | come back from those "psychotomimetic" episodes really
               | quickly, even quicker than with opioid induced psychosis.
               | It's not really mysterious or undesirable as you make it
               | sound. People that develop long term issues from
               | psychedelic use are also at risk of developing those from
               | basically all other psychoactive substances, specially
               | marihuana and opioids.
               | 
               | The motivations for making psychedelics schedule 1 where
               | political and not related to that risk at all though.
               | Drinking a lot can also create temporary psychosis and
               | long term personality changes. There's also lots of
               | studies about how marihuana also results in psychosis or
               | triggers mania in some people. Neither alcohol nor
               | Marihuana show as promising results for things like
               | fighting depression, fatigue, social anxiety, as
               | psychedelics or at fighting PTSD as MDMA does.
               | 
               | Alcohol and now weed are legal mostly because of other
               | economic and political interests. The sad reality is no
               | one gives a fuck about the people that could benefit from
               | research into psychedelic medicine, except pharmaceutical
               | companies that make billions out of treatments that are
               | 20 years behind, and they want them to be schedule 1
               | forever.
        
               | colechristensen wrote:
               | With drugs you get two choices: ineffective or
               | potentially dangerous, often both.
               | 
               | People want to believe that the thing they like is safe,
               | but every drug that can do anything is dangerous. That's
               | the whole idea, a drug is a lever to make change, not a
               | magical "make everything better" solution. You push the
               | lever too far and you get things you don't want.
               | 
               | It's not just temporary psychosis (which sometimes isn't
               | so temporary). It can trigger major changes in
               | personality, or latent mental illnesses which tend to
               | only manifest with a push (schizophrenia is one).
               | 
               | It's not a coincidence that psychedelics have been used
               | in religious ceremonies throughout human history. They
               | can give people religion, and without direction they can
               | turn people into troubling zealots for just about
               | anything (and often the drug itself). People who
               | experienced this and became cultural icons are part of
               | the reason they got banned. (turn on, tune in, drop out)
               | 
               | There is even a considerable group that want to re-name
               | psychedelics to "entheogens" which has a rough etymology
               | of "to put god into".
               | 
               | I have personally felt this and it scared the fuck out of
               | me.
        
               | totesraunch wrote:
               | Every single thing humans do and consume is 'potentially
               | dangerous'. Existence is dangerous.
        
               | colechristensen wrote:
               | If you extend the definition of the word or phrase to
               | apply to everything it is meaningless and might as well
               | not be used. That is not how I am using it.
        
               | stadium wrote:
               | > With drugs you get two choices: ineffective or
               | potentially dangerous, often both.
               | 
               | What type of drugs? Pharmaceutical or recreational?
               | Natural or man-made? Taken to escape or numb, or with
               | respect and gratitude? Abused or moderated?
               | 
               | There is a wide spectrum of outcomes when consuming any
               | substance. Many more than two.
               | 
               | > They can give people religion, and without direction
               | they can turn people into troubling zealots for just
               | about anything (and often the drug itself)
               | 
               | Religion, politics, or any belief system can breed this
               | without drugs. Selling salvation or enlightenment by
               | taking a substance attracts the emotionally vulnerable.
               | And wouldn't that actually decrease if they could be
               | taken by anyone in a safe and controlled environment
               | alongside a licenced therapist, instead of underground?
               | 
               | What are you advocating for or against? I'm genuinely
               | interested, I sense fear and worry in what you wrote but
               | don't really understand the point you are trying to make.
        
               | colechristensen wrote:
               | >What type of drugs?
               | 
               | All.
               | 
               | My point seems to have not gotten across.
               | 
               | Let me restate. Either a "drug" is fake and worthless, or
               | it is dangerous. There isn't a third direction. If it
               | does anything, it can do too much of it.
               | 
               | >Religion, politics, or any belief system can breed this
               | without drugs.
               | 
               | Hallucinogens are major religious experiences in pill
               | form with proper dosage (or whatever your preferred
               | delivery method). There isn't really a comparison between
               | something that can readily deliver a life changing
               | experience on demand and those other things.
               | 
               | >What are you advocating for or against? I'm genuinely
               | interested, I sense fear and worry in what you wrote but
               | don't really understand the point you are trying to make.
               | 
               | I'm advocating against treating this class of drugs like
               | they are magical perfect safe toys. They are powerful,
               | and dangerous tools that can do a lot of good things, but
               | any powerful tool can be misused or have serious
               | drawbacks. I am not against "dangerous" things, there's
               | no such thing as complete safety. I'm advocating for
               | respect and understanding. There is a reason historically
               | and prehistorically they were almost always used within a
               | structured (usually religious) environment.
        
               | stadium wrote:
               | There is space for respect and understanding in between
               | fake & worthless and dangerous. These are
               | multidimensional problems.
               | 
               | The titled study seems very thoughtfully designed and
               | operated, in a professional, ethical, and scientific
               | manner.
               | 
               | I'm with you on the last point. It's good to be aware of
               | past abuses, but I also see a future where we can
               | integrate what nature has provided into our lives in a
               | respectful and grateful way and grow from it. Definitely
               | not a pill to pop and fix something. A therapy based
               | approach to psychedelics makes a ton of sense to me.
        
               | pvarangot wrote:
               | Besides the "it's not that binary" thing that other
               | people already told you, and that I agree with, there's a
               | few other misconceptions I think:
               | 
               | > It's not a coincidence that psychedelics have been used
               | in religious ceremonies throughout human history.
               | 
               | I don't think the reason is that they are good
               | "brainwashing" drugs and religion is inherently about
               | changing everyone's personality. I think what you are
               | referring to as "religion" was not "religion" back then,
               | but "religion, science, medicine and the state" which
               | where all usually together and perceived as a single
               | entity. The main reason they were using psychedelics may
               | be that they are very effective, cheap, easy to extract
               | from plants, and that they at a large scale work in
               | addressing a lot of maladies. What was tuned for
               | "brainwashing" and "controlling people" where the
               | ceremonies, the drugs don't "do that" on their own.
               | 
               | The CIA conducted a lot of research into using LSD for
               | brainwashing. So did Mossad, to use them for kidnapping
               | people but making it seem like they are willingly going
               | with them. They are not effective for this. Most of the
               | literature agrees that high doses are more likely to help
               | with depression and anxiety than to have any bad
               | consequences.
               | 
               | And yeah they make you easier to manipulate and more
               | suggestible. So do benzodiazepines and alcohol but with
               | no of the benefits. You just need to be a little bit
               | careful when taking them if you are struggling with any
               | mental issue. Just like everything else.
               | 
               | > I have personally felt this and it scared the fuck out
               | of me.
               | 
               | Do you have any experience administering psychedelics or
               | with the vast literature about administering
               | psychedelics? Because yeah, research has been banned in
               | the US for a while, but this things have been around
               | since the 50s. There's a lot of published research and a
               | lot of literature from community use.
               | 
               | I think you may just be projecting your own experience
               | here.
        
           | CryoLogic wrote:
           | The active dose to LD50 ratio for alcohol is somewhere about
           | 1:13 depending on tolerance. For Magic Mushrooms or LSD, it
           | is above 1:1000.
           | 
           | In other words, it is nearly impossible to accidentally kill
           | yourself via overdose on psychedelics - but somewhat easy
           | with alcohol.
           | 
           | https://en.wikipedia.org/wiki/Median_lethal_dose
        
             | agumonkey wrote:
             | You don't need to somatically die. If you end up mentally
             | borked that is enough.
        
             | bagacrap wrote:
             | I think you have to balance that against the fact that the
             | recreational dose of lsd is so infinitesimal that 10000x
             | that dose is still very easy to ingest in the blink of an
             | eye. Not so for alcohol.
             | 
             | That said, even after reading wikipedia's source on the
             | ld50 of lsd, I remain unconvinced that there even is a
             | lethal dose of LSD.
        
               | nitrogen wrote:
               | There are other forms of danger apart from lethality, and
               | before new recreational (or therapeutic) drugs can be
               | accepted by society, those need to be culturally
               | understood.
        
               | [deleted]
        
               | IIAOPSW wrote:
               | An excerpt from the highest ever recorded dosage of LSD.
               | 
               | "Eight individuals who accidentally consumed a very high
               | dose of LSD intranasally (mistaking it for cocaine) had
               | plasma levels of 1000-7000 mg per 100mL blood plasma and
               | suffered from comatose states, hyperthermia, vomiting,
               | light gastric bleeding, and respiratory problems.
               | However, all survived with hospital treatment and without
               | residual effects."
               | 
               | https://maps.org/research-
               | archive/w3pb/2008/2008_Passie_2306...
               | 
               | In short, even on the rare occasion when people have
               | taken 1000x what they should, they didn't die.
        
             | sharkweek wrote:
             | But it sure is a hell of a lot easier THINKING you're going
             | to die while on psychedelics!
             | 
             | I can't handle drugs (as much as I'm curious about them)
             | but I had a "smoked waaaay too much pot"experience in
             | college where I was high for almost 24 hours and I spent
             | the first six hours or so convinced I had broken my brain
             | and was going to die.
        
           | [deleted]
        
           | antonzabirko wrote:
           | It's dumb that this site is designed in a way where I can't
           | downvote this comment.
        
       | eminence32 wrote:
       | This is an off-topic comment, but in the title it seems the word
       | "for" was replaced by the letter "4" -- is this a common
       | substitution for NH titles? Was it done because of length
       | constraints?
        
         | colechristensen wrote:
         | You could also change "receives" to "gets" and eliminate the
         | word "treatment" to remove all need for awkward shortening.
        
         | napsterbr wrote:
         | > Was it done because of length constraints?
         | 
         | Yep, most likely. The title has exactly 80 characters, which is
         | the limit. "Years" was also abbreviated.
        
           | drannex wrote:
           | Personal opinion, but I think it's time that HN increases the
           | character limit, we are seeing more and more of these sort of
           | things.
        
             | kazinator wrote:
             | It's a tricky business. In terms of raw screen width, we
             | have it. Or do we? Not necessarily on mobile, in portrait
             | orientation.
             | 
             | From a readability/usability perspective, imagine the HN
             | front page being filled top to bottom with titles, some of
             | which go to 150 characters; what would that be like?
             | 
             | (A mock-up could be easily obtained for evaluation; or HN
             | could just experiment with it for a few days.)
             | 
             | Currently, most titles don't strain the existing limit.
             | When we scan the front page now, for instance, there are
             | good many short and medium length titles.
             | 
             | A modest increase, say by +20 characters, might relieve
             | most of the pressure without too many negative effects.
             | Which is to say that maybe the current limit is a bit to
             | the left of the true "sweet spot".
        
               | tux3 wrote:
               | I think I'd be happy with longer titles, since that's an
               | artificial limitation separate from how we vote and judge
               | submissions.
               | 
               | If posts have unnecessarily long titles enough to bother,
               | they'll be systematically downvoted a little more and
               | fall out of practice.
               | 
               | If the system wanted to put a hard limit on wordiness, it
               | should have a good reason why!
               | 
               | We're all wasting a little time on inefficiencies
               | otherwise.
        
       | kwertyoowiyop wrote:
       | I heard it prevents Covid. Many people are saying this. The best
       | people.
        
       | jugg1es wrote:
       | My dad is a professor of psychiatry at JHU medical school and has
       | been telling me about this psilocybin study for years. He was
       | always pretty strict about me doing drugs growing up, but now
       | he's excited about the amazing results they're seeing in this
       | study. He's even been asking me about my own hallucinogen
       | experiences that I had growing up. The world is truly changing.
        
         | tayo42 wrote:
         | My parents were real strict about drugs growing up too. Even in
         | my late 20s I would dodge the question about drugs. Idk what
         | changed in the last couple years. They both have gotten more
         | open about it. More so my dad, whos now growing mushrooms and
         | microdosing, and gave dmt and mdma a try. I showed him how to
         | do dabs and hit a bong correctly lol. He cant get around the
         | idea snorting something so no ketamine yet and is having
         | trouble finding time for acid. I think Michael Pollans book
         | helped a bit. Its crazy to see though.
         | 
         | I used to be pretty shy about my drug use, but i try talking
         | about it more if it comes up. I like to think it helps get rid
         | of the stigma.
        
           | klondike_klive wrote:
           | >They both have gotten more open about it. More so my dad,
           | whos now growing mushrooms and microdosing, and gave dmt and
           | mdma a try. I showed him how to do dabs and hit a bong
           | correctly lol.
           | 
           | Wow. That sentence escalated quickly! (Actually if DMT
           | reports are anything to go by, the sentence peaked there...)
        
         | robbedpeter wrote:
         | I'm happy for you and your dad, and for our country - we need
         | little victories, and this a big one for everyone. The science
         | part has to be uniquely thrilling, though. Your dad's in a
         | wonderful place in space and history.
        
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