[HN Gopher] Everything you need to know about psychedelics and m...
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Everything you need to know about psychedelics and mental illness
Author : DantesKite
Score : 136 points
Date : 2022-04-15 13:14 UTC (9 hours ago)
(HTM) web link (stuartritchie.substack.com)
(TXT) w3m dump (stuartritchie.substack.com)
| Skilbucks wrote:
| Do you think a disturbed work life balance could be a reason for
| mental illness as well?
| ActorNightly wrote:
| From knowing a whole bunch of people with ranges of issues, my
| personal opinion is that it seems that certain people are just
| simply not "tuned" to their lifestyle/environment, and the
| mental health issues stem from a certain part of that psyche
| not wanting to change their environment.
|
| Not that this would get past any ethics board, but it would be
| an interesting experiment if you took someone suffering from
| severe depression, fed them 10 grams of shrooms to reset their
| brain, and then put them in a remote village in South America
| with no phone or internet where basically their entire day has
| PURPOSE - i.e wake up, do work with fishing/farming/hunting
| construction, socialize in the evening, all as a group
| activity.
| kayodelycaon wrote:
| Well... yes? Any stressor can be severe enough to cause
| problems in other areas of your life. It can also reveal
| undiagnosed mental illnesses.
|
| Not sure how this relates to the article.
| outime wrote:
| Not OP but if I read between lines it might mean that it is
| way cheaper to give people some _soma_ than addressing the
| actual root problems certain societies have.
| leemoore wrote:
| One challenge around studying these drugs is efficacy is often
| linked to expectation. Some speculate 1 key mechanism at work is
| an amplification of the placebo effect. If this is the case then
| clearly testing of these drugs using traditional techniques to
| eliminate the placebo effect will be problematic
| lighttower wrote:
| The author says > Quite a few psychedelic drugs are naturally-
| occurring, and have been used for hundreds of years (this doesn't
| include synthetic ones like LSD, obviously).
|
| LSD occurs naturally in the Ergot mushroom: > The ergot fungus
| contains a number of highly poisonous and psychoactive alkaloids,
| including lysergic acid (LSD), which was synthesized from the
| ergot fungus in 1938 by chemist, Albert Hoffmann [1]
|
| What the author means is that it's synthetically made these days.
| Psilocybin can also be synthetically made these days.
|
| psychedelics are the best hope humanity treating refractory
| mental illness. I know at least 5 people personally that have
| embarked on psychedelic voyages to treat their demons. Some of
| them are renowned psychiatrists.
|
| [1]
| https://www.fs.fed.us/wildflowers/ethnobotany/Mind_and_Spiri....
| after_care wrote:
| The US Forest Service is just wrong on this. Ergot does not
| contain LSD, although it contains very similar psychoactive
| alkaloids. Ergot cannot be called a mushroom, it is a fungus
| that grows on wheat, rye or other grains/grasses.
| ada1981 wrote:
| I think the confusion here is that LSD was initially
| synthesized from ergot fungus.
|
| Ergot is not a mushroom and it does not contain LSD. But LSD
| is derived from the ergot alkaloids.
| ki85squared wrote:
| Parent used the term mushroom, but the article does not.
|
| It's correct that the fungus does not contain LSD the
| chemical, but it does contain lysergic acid which is
| colloquially LSD the drug. For a short, layman-targeted
| article I'm inclined to give the US Forest Service a pass on
| this one.
| LordDragonfang wrote:
| >but it does contain lysergic acid which is colloquially
| LSD the drug
|
| The chemical differences between "lysergic acid" and LSD
| areas significant as the differences between morphine and
| heroin, if not more so. Pure lysergic acid is closer to
| LSA, which is still categorically not the same thing as LSD
| - to the point that many people will refuse to take the
| former when a test kit reveals they got that as opposed to
| the latter. They are not colloquially equivalent.
| sam2426679 wrote:
| LSA is naturally occurring in Hawaiian Baby Rose seed. LSD is
| not naturally occurring anywhere afaik.
| zafka wrote:
| LSA is also found in quite a few Morning Glory seeds
| "Heavenly blue" is one of the commonly mentioned varieties.
| drooby wrote:
| I don't fully understand the issue with blinding.
|
| How is it different than trying to double blind talk therapy.
| Obviously someone knows that they are getting talk therapy,
| likewise, people obviously know they are getting psychedelics.
|
| Yet we are still able to get experimental results supporting talk
| therapy and no one complains, right?
| hannob wrote:
| > Yet we are still able to get experimental results supporting
| talk therapy and no one complains, right?
|
| Wrong. https://blogs.bmj.com/bmjebmspotlight/2020/10/07/seeing-
| is-b...
|
| I think this is a problem that is generally recognized. Also
| the science on psychological interventions is generally quite
| messy.
| mountainriver wrote:
| Also don't get this, how would you ever possibly isolate that?
| Give them a drug which kinda feels like MDMA? But what about
| the individualized effects of that drug?
|
| It feels more like they are just looking for a critique. All in
| all it looks eons better than most SSRIs we prescribe willy
| nilly every day.
| tasty_freeze wrote:
| Give non-alcoholic beer to 100 people who don't drink beer. I
| don't know the number, but I would be surprised if there
| weren't at least 10% who reported feeling tipsy and acting in
| stereotypically drunk ways.
|
| I know that some psychedelic researchers use a suitable dose
| of niacin as the control arm. The person will experience some
| flushing and a faster heart rate. If they are new to
| psychedelics, they don't what psychedelics are supposed to
| feel like, and so they assume it is the real thing.
| lukasb wrote:
| Yeah I don't really get this either. The author suggests asking
| a lot of detailed questions about which arm participants
| thought they were in. What happens if participants (as you
| would expect) make very accurate guesses?
| umvi wrote:
| Why are these articles so popular with HN? Any article about
| treating mental illnesses (including depression) with
| LSD/shrooms/cannabis/[drug] immediately shoots to the top, and I
| see articles like this every other day at the top of HN. Is it
| just people wishing for a silver bullet that will cure their
| mental problems? At any rate, the number of mentally ill people
| on the internet must be _much_ larger than I am estimating.
| IgorPartola wrote:
| To your first point, I suspect that hacking your own brain and
| pituitary gland fits with the ethos of hacker culture. What's
| cooler than going to the doctor and getting the same SSRIs as
| every other chump when you can hack together your own
| medication?
|
| In reality this is why we need serious research into these
| drugs. I am sure there are therapeutic benefits and also yet
| unknown risks. Would be nice to study them formally.
|
| To your second point: I know very few people _without_ mental
| illness. GAD and generalized depression account for a large
| part of it, but so do neurodivergenicies like autism. Chances
| are much higher than you think that you yourself have one or
| more condition like this. That's not to say I wish for you to
| have one, just that statistically speaking lots of people have
| them, so much so that the current advice is to establish mental
| healthcare same as you do with a primary care physician and
| have at least yearly checkups.
| drooby wrote:
| Did... you read the article? It's highly critical of the hype
| around psychedelic research and how we have been interpreting
| it.
|
| Anyways. In general, HN is a community that is highly focused
| on emerging technologies, and undervalued, overlooked or novel
| solutions.
|
| Psychedelics, in my opinion is fertile ground for discovery and
| just super interesting, so it gets my upvote.
| [deleted]
| [deleted]
| ada1981 wrote:
| I liked the article and tend to agree there is a lot of pressure
| to rush psychedleics to the mainstream.
|
| This is from a person who used MDMA to heal bipolar /
| schizophrenia in an underground setting; ran an underground
| clinic for 3 years; took funding from Dr. Bronner to found a non-
| profit to decriminalize plant medicine; and was featured in a PBS
| documentary administering MDMA in an underground setting.
|
| Also, the author obviously hasn't done psychedelics ;) and he
| states as such.
|
| "I'd think about taking them if I had a relevant condition and
| the evidence they worked was convincing." You could argue that
| the relevant condition is that you are a living human, and we've
| evolved to be in relationship to altered states of consciousness.
| mountainriver wrote:
| Yeah I have the same impression. The author wouldn't have even
| written the article if he had tried psychedelics, which are
| often reported as the most significant experience in peoples
| lives.
|
| This is just reductionist thinking, which can be good to temper
| things and reduce harm, but the authors bias is pretty readable
| nonbirithm wrote:
| I have to wonder how many of our strongly held beliefs can be
| rendered irrelevant to our own minds by something as mundane
| as a few micrograms of a chemical.
|
| I also have to wonder how many of those beliefs can _only_ be
| corrected by something as drastic as a foreign substance
| acting on it against our will.
|
| In some other universe, the world might become a very
| different place if the people in power chose to take LSD with
| an open mind. If so, there would be no "meaning" we could
| attribute to that radical change except that it was the
| result of a chemical formula.
|
| It feels like there is something profound about that related
| to the meaningfulness of all things, but since I haven't
| taken psychedelics, I guess I am still blind to what it is.
| scrollbar wrote:
| The article mentions _Cover Story: Power Trip_ podcast which I
| finished last night and enjoyed so much. It's by New York
| Magazine and the folks at Psymposia. Highly recommend as a
| balancing counterpoint to all the positive hype about
| psychedelics.
|
| For the record, I have been both helped and harmed by
| psychedelics and in net believe their return is positive. I've
| seen enough oddities in the Bay Area psychedelics and mental
| health scenes to warrant some serious caution about the current
| path we're taking.
| monktastic1 wrote:
| This argument seems disingenuous:
|
| > Just as you'd feel extra-sceptical if all the research showing
| that pork is unhealthy was written by Muslims who'd already
| decided for religious reasons not to eat pork, you should be
| worried about the sheer number of studies by psychedelic
| researchers who are themselves aficionados of the drugs.
|
| Perhaps a better analogy would be: just as you'd feel extra-
| skeptical if all the research showing that exercise is beneficial
| was written by exercisers who'd already decided for experiential
| reasons to exercise, ...
|
| It's not like people are born into the religion of psychedelia
| and have strong cultural reasons to conform. If something truly
| is good, _of course_ the people researching it are going to be
| "aficionados" of it. And this doesn't save it:
|
| > (You might wonder if they're into psychedelics precisely
| because the research shows such impressive benefits, switching
| around cause and effect. But as we'll see below, that evidence
| doesn't exist yet. That particular horse is coming way after the
| cart).
|
| Why can't they be into it simply because it _worked_ for them?
|
| There's nothing about the fact that psychedelic researchers are
| excited about psychedelics that _by itself_ is suspicious, as we
| are strongly being led to believe.
| chiggsy wrote:
| >There's nothing about the fact that psychedelic researchers
| are excited about psychedelics that by itself is suspicious, as
| we are strongly being led to believe.
|
| It's also quite possible that they are excited about the
| potential to try a different method of reducing the suffering
| of patients with mental illness with more efficacy, or fewer
| side effects, or some other positive change. Anybody can be
| excited about something while doing another thing. Presumably
| at least some of these people wish to provide aid, um, when
| they are not reeling from acid, and grooving on E's, or
| apparently, assaulting patients, based on the article.
|
| By the way, how does he know they use the drugs? He said some
| guy said he knew a lot of people who did. A valid concern with
| mental health is the difficulty of evaluating statements people
| make about their, or other peoples internal states, and for
| what reason they make such statements. Basically he's saying,
| "They're addicts! Some dude told me!"
|
| That's literally hearsay, although this is not a court
| environment, I suppose. Still, I, for one, would prefer a bit
| more rigorous statement about this endemic drug use among
| researchers.
|
| As for his example, lots of people don't eat pork, for a
| variety of reasons. If someone follows their procedure and
| replicates their results, then does it matter if they were
| Muslims? Skeptical? Have some bacon and do the experiment, see
| if you get what they got. Of course you wouldn't just take it
| on faith, my goodness! Not all, certainly, but some people
| don't allow their desires to supersede their professionalism. I
| don't know, are Muslims even that invested in not eating pork
| as to fake a bunch of studies to fool the masses into not
| eating back bacon?
|
| Actually, given what we know about the replication crisis..
| hmm.
|
| But surely people who take psychedelics have their own
| subculture, right? Dr. Alice and Dr. Bob might spend long
| weekends listening to Cream and obviously Black Sabbath, and
| definitely some jazz, staggering high because they are trying
| acid to wean them off of the Oxy's they were into 3 years ago,
| or the boozing they did under quarantine ... but what if they
| got results that are worth looking into? Anybody who's known
| someone using psychoactive drugs surely... well the drugs
| available now sure seem sub-optimal.
|
| ( What about their kids? They're trippin with the kids? Really?
| REALLY? )
|
| You know, I'm quite unsure about this assumption that the
| researchers need to spread their drug of choice to people
| claiming ( skepticism about the afflicted seems to be a theme
| in the comments? I guess they should just snap out of it? )
| mental defect to a third party, which is a life changing
| decision.
|
| I'm not saying that these things are impossible, or
| inconceivable. Unfortunately. I question the number of people
| who act like this, while maintaining well enough to author
| research papers and do Guardian interviews, vs the number of
| people who are enthusiastic about reducing suffering and are
| pursuing a surprising and somewhat promising avenue to do so.
| They would be in a great position if this work led to a better
| way of treating mental illness. Seems exciting.
| kmod wrote:
| Personally I think it's valid to consider selection-bias
| effects in authorship -- in general, things are written by the
| people who are the most excited about the topic, which leads to
| there being a bias towards excitement. I don't think it
| invalidates the research but it feels like a valid point.
|
| I think an interesting observation is that this anti-
| psychedelics post is written by someone who doesn't even want
| to try them, so this argument of his also says to treat this
| blog post with skepticism.
| monktastic1 wrote:
| My qualm isn't about _whether_ it introduces bias, but _why_
| it does. The example he gave implies that the only possible
| reason is a _religious_ one, and that 's not fair.
| ComradePhil wrote:
| The reality is that people are open to anything that promises
| alleviation of suffering from what os diagnosed as "mental
| illness" because the mental health industry has proven to be a
| complete scam designed to keep people sick and provide them
| lifelong "treatments" that don't work.
| listless wrote:
| Anecdotal but I did LSD when I was 19 and have been a been a huge
| consumer of mental health services, antidepressants and anxiety
| meds ever since. Prior to that horrific incident, I had no issues
| to speak of.
|
| So we can't say that they can cure it, but the most certainly can
| cause it. But perhaps the sword needs to cut both ways to be
| effective?
| VictorPath wrote:
| >> Overall, it is difficult to see how prohibition of
| psychedelics can be justified as a public health measure" > This
| is activism, not science. As I said above, I actually support
| drug legalisation - but it's far from appropriate to include this
| kind of thing so prominently in what's supposed to be a neutral,
| factual scientific analysis.
|
| Scientific studies that ingesting chemicals like THC are one of
| the reasons we have things like the Rockefeller drug laws.
| Activism from some in the scientific community is one reason
| people are rotting in jail for selling marijuana (while tobacco
| companies donate to politicians and in return get trade deals
| where it is illegal to have a law requiring warnings on cigarette
| packs.
|
| People can be arrested for ingesting mescaline from peyote plants
| like Native Americans used to, scientific studies and activism is
| one reason for this, but scientists asking for people not to be
| imprisoned for getting mescaline from a cactus is not
| "appropriate".
|
| (I have never tried mescaline but don't want to be imprisoned if
| I ever do)
| sn00tz00t wrote:
| https://erowid.org/experiences/subs/exp_Mushrooms.shtml
|
| Neat list of mushroom trip experiences.
|
| Ranging from schizophrenic horror unimagined to unenglishable
| religious experiences.
|
| I've had both experiences in the same trip. I'd hate to be on my
| deathbed and have a bad trip tho.
| lioeters wrote:
| > deathbed and have a bad trip
|
| Reminds me of a recent report that human sacrifice victims in
| the Inca empire were given ayahuasca and coca:
|
| Ritual drug use during Inca human sacrifices on Ampato mountain
| (Peru): Results of a toxicological analysis
|
| https://www.sciencedirect.com/science/article/abs/pii/S23524...
| mountainriver wrote:
| Yeah I visited some of their sacrificial sites out there,
| weird vibe. They believed the person being sacrificed would
| be reborn as royalty basically. Parents viewed it as a great
| honor to have a child sacrificed
| eurasiantiger wrote:
| The argument "all but one psychedelics researchers have taken
| psychedelics" is not particularly convincing; many other
| researchers have taken psychedelics, too. Certainly one wouldn't
| expect e.g. liberal arts, sociology or organic chem majors and
| their cohorts to be completely naive to them.
| NoImmatureAdHom wrote:
| The author points out a bunch of problems that are present in
| basically all research involving human behavior. He implies that
| it is particular to research involving psychedelics (except for I
| think a single example involving diet), and that is false. He
| should take a look at the dumpster fire that is Social
| Psychology...
| orangepurple wrote:
| Not mentioned anywhere, but probably the strongest effect of
| psychedelics, is that LSD absolutely kills the desire to drink
| alcohol for months.
| zafka wrote:
| As someone who quit drinking alcohol quite a long time ago (
| which I am quite sure is why I am alive today) I agree that one
| of the "side affects" of LSD is that it helps one to come to
| the realization that they are killing themselves from a bad
| habit. I cannot say that it killed my desire to drink, and I
| did drink for a while after an experience with what might have
| been LSD. An interesting historic tidbit is that the founder of
| Alcoholics Anonymous was introduced to LSD and thought it was a
| tremendous tool to fight Alcoholism. By that time a foundation
| had sprung up around AA, and the board members urged Bill
| Wilson not to proselytize on the subject less it incur bad
| publicity for the organization( one of their traditions is to
| avoid controversy on outside subjects) Since the name of Bill
| Wilson was synonymous with AA he agreed to quit talking on the
| subject.
| orangepurple wrote:
| Months after dosing with LSD drinking alcohol has the appeal
| of drinking department store paint thinner. It works. It's
| sad that people are scared to associate with it due to its
| demonization.
| after_care wrote:
| I concur with the core message -- that the current research on
| psychedelics is not strong. Some of the problem is that the
| research itself was not designed with an eye on earning FDA
| approval. This was hard to do because we'll never have a true
| double-blind psychedelic trial for psychedelics like we can have
| for SSRIs. Spravato recently showed a path for FDA approval,
| because ketamine treatment for depression closely mirrors
| protocols for psychedelics.
| eric4smith wrote:
| I've always wondered...
|
| Do psychedelics cause mental illness or treat mental illness?
|
| Our minds are so weird that I have a simple theory that we are
| all slightly insane in at least some small way.
|
| But from what I have observed from friends who take them - they
| cause them to cope with troubles that are normally difficult to
| deal with.
|
| I guess I'm not brave enough to try them to deal with my own
| troubles myself right now.
| the_only_law wrote:
| I don't think the brain or the drugs themselves are are simple
| enough to be reduced to one or the other.
| zwkrt wrote:
| My strong-man description of your (I think correct!) feeling is
| that we all have a very specific lens through with we look at
| the world. Because all of us have very very limited lenses, but
| the world is actually quite large and complicated, we each end
| up with our own neurotic worries that are in a way over-blown
| when compared with the chaotic complexity of actual reality.
| Just think of that friend you have that always brings up the
| cost of something, or that person in your life who seems to
| always bring the conversation to how their political viewpoint
| would alleviate the problem, or the person who seems to always
| have a new and exciting reason to not have a kid yet.
|
| Psychedelics just allow us to step out of our rigid framework
| for a few hours. For people with flexible/creative minds it
| might not be such a big deal as they are used to looking at
| reality and asking "but what if it were this way...", but lots
| of us have rather rigid conceptions of reality. Taking
| mushrooms and realizing that most of our worries are 'made up'
| in the sense that they don't relate to our basic needs can be
| eye opening.
| mountainriver wrote:
| Yeah this seems intuitively correct. Psychedelics are largely
| playing with your beliefs of the world, which is why it can
| go a lot of ways and is hard to study.
|
| In a good setting with good guides it can be wildly
| transformative in a positive direction.
| ActorNightly wrote:
| The best description that I have heard that most users that I
| have spoke to agree on is that psychedelics have an aspect of
| "flattening" emotional significance of things by making any
| thought that you have just as "prominent" as another
| experience. The reduction of blood flow to the area of the
| brain that is responsible for parsing reality means that your
| thoughts become more prominent, making any thought of change or
| improvement just as impactful mentally as what you believe your
| reality is.
|
| This in turn gives lasting perspectives in the form of "hey, I
| am able to think and feel about things differently and not
| locked into this pattern of thought", which could be the
| necessary catalyst for change.
| drooby wrote:
| If it is true that the mind is "anti-fragile", in that,
| appropriately dosed stressors make it stronger, then perhaps
| its not "or", but "and".
|
| Psychedelics treat mental illness _and_ cause mental illness.
| They treat it by causing it.
|
| Regardless, mental illness seems highly relative to societal
| norms. And psychedelics have a way of minimizing the importance
| of societal norms, so maybe thats a factor too.
| TedShiller wrote:
| Everything you need to know about psychedelics and mental illness
| in one sentence: They make it worse.
| mountainriver wrote:
| Maybe for you, really depends on the person, the illness, the
| drug, and the setting
| zafka wrote:
| I would be very interested to know where Stuart Ritchie's funding
| is coming from these days also. I am rather surprised that he did
| not list all his sources of income in a show of transparency.
| jamal-kumar wrote:
| "This is just an anecdotal account, but there's an interview with
| the psychedelics researcher Manoj Doss, who says that he "only
| know[s] one psychedelic researcher who's never done
| psychedelics", and notes (in an encouragingly self-critical way)
| that this is a conflict of interest." - Yeah that's a good point
| to be honest
|
| I think that some of the most interesting applications for
| psychedelics as medicine target treatments that aren't strictly
| mental health related. Ketamine is already approved for ischemic
| brain damage or stroke, like you better hope that's the first
| thing you get in the ambulance to prevent glutamate
| excitotoxicity from getting really nasty if you fall of a
| motorcycle or whatever - But DMT actually shows a lot of promise
| for recovery too, and I'm actually getting involved in a project
| tangent to that research right now. We're talking sub-psychedelic
| micordoses to build people's neurons back from brain damage, one
| of those things in modern medicine we're still generally hopeless
| about. Pretty interesting stuff! [1]
|
| [1]
| https://www.technologynetworks.com/neuroscience/blog/could-t...
| anomosmarxist wrote:
| stakkur wrote:
| As a counterpoint, I'd read Michael Pollan. Also, a fundamental
| problem with this article is the lumping of 'psychedelics' into a
| neat category so it can be critiqued. In the real world, the
| story of what's happening is diverse.
|
| TL;DR: This is a dangerously biased dismissal of actual science
| and historical progress in understanding of various
| 'psychedelics', and it's exactly the kind of cherry-picking
| dismissal that's been fought against for decades.
| slibhb wrote:
| I like the article. With psychedelics, it's clear that much of
| the excitement comes from people (including scientists) who have
| used them and found their experiences helpful. That's not science
| but that doesn't mean it's wrong. Not everything is amenable to
| clinical study and this doesn't mean we should disregard it.
|
| And the issue isn't just psychedelics being hard to study. Mental
| health is hard to study. An overweight man with no friends who
| plays computer games all day is not depressed unless he feels bad
| about it. Mental health depends on subjective feelings. Hard to
| study that!
|
| My view is that we should continue to think about psychedelics
| from a religious or spiritual perspective. Even if that's
| literally incorrect, it's the correct metaphor. I'm also very
| skeptical of people who think widespread use of psychedelics can
| make society better. Lots of people used LSD in the 60s and 70s
| and as far as I can tell they didn't usher in a new age of love,
| peace, and tolerance.
| mwattsun wrote:
| > Lots of people used LSD in the 60s and 70s and as far as I
| can tell they didn't usher in a new age of love, peace, and
| tolerance.
|
| I would argue that LSD helped end the war in Vietnam. It's also
| not a fair criticism because governments around the world
| demonized LSD and made it a crime to partake, so you took it in
| an atmosphere of fear and paranoia. Hallucinogenics are only
| now given a fair test. There's already lots of anecdotal
| evidence that hallucinogens changed lives for the better (Steve
| Job, Richard Alpert.) A lot more has to change before a new age
| of love, peace and tolerance comes about, things like human
| greed and selfishness. No one is claiming that LSD turns people
| into angels.
| vehementi wrote:
| > as I can tell they didn't usher in a new age of love, peace,
| and tolerance.
|
| Things did improve, but of course how would you attribute it to
| that, and of course, how would you account for the
| effectiveness of the counter forces? Just because something
| didn't succeed completely doesn't mean we can conclude it has
| no effect, especially if it wasn't actually tried at the
| suggested scale. We have this problem in Vancouver with opioid
| addiction and there are some services in place but they are
| mostly shit and the government's overall plan is direly
| incomplete. Then people say "Wow, we spent money on harm
| reduction and still have addicts".
| slibhb wrote:
| > There was madness in any direction, at any hour. If not
| across the Bay, then up the Golden Gate or down 101 to Los
| Altos or La Honda. . . . You could strike sparks anywhere.
| There was a fantastic universal sense that whatever we were
| doing was right, that we were winning. . . .
|
| > And that, I think, was the handle--that sense of inevitable
| victory over the forces of Old and Evil. Not in any mean or
| military sense; we didn't need that. Our energy would simply
| prevail. There was no point in fighting--on our side or
| theirs. We had all the momentum; we were riding the crest of
| a high and beautiful wave. . . .
|
| > So now, less than five years later, you can go up on a
| steep hill in Las Vegas and look West, and with the right
| kind of eyes you can almost see the high-water mark--that
| place where the wave finally broke and rolled back.
|
| That's Hunter S. Thompson on the 60s drug movement. I'm not
| saying it led to nothing but it certainly didn't lead where
| its members expected and its legacy is far from clear.
|
| I think we should continue to study these drugs. I just think
| there's a lot of unwarranted optimism.
| xyzzy123 wrote:
| I don't think that vibe was unique to drugs or the 60's,
| perhaps every generation gets that.
|
| For example, I feel the same way about the 90's Internet...
|
| It's hard to explain the optimism a lot of people felt at
| the time.
|
| It seemed like it could fix the world, what if everyone
| could just talk to each other? Couldn't we fix the
| misunderstandings?
|
| We were gonna route around the censorship and cryptography
| (not crypto...) was going to free us from The Man. State
| control of "the message" through TV and newspapers was
| over.
|
| I look at what we got and there it is, human nature staring
| right back at me.
|
| Anyway, what a sap.
| [deleted]
| tonguez wrote:
| "Mental health is hard to study."
|
| is it? what is mental health?
|
| "I'm also very skeptical of people who think widespread use of
| psychedelics can make society better. Lots of people used LSD
| in the 60s and 70s and as far as I can tell they didn't usher
| in a new age of love, peace, and tolerance."
|
| what was the control in this experiment?
| kayodelycaon wrote:
| > Mental health depends on subjective feelings.
|
| This isn't correct in a lot of places. There is a number of
| diagnostic criteria. The most important being how much it
| affects your quality of life.
|
| This can be directly measured by looking at how the individual
| functions day to day. An example is "Was the person able to
| shower regularly?" (This assumes the person wishes to shower if
| they have the ability and opportunity.)
|
| It's pretty easy to record the number of panic attacks or how
| often the person has suicidal ideation.
|
| ADHD can be measured by asking the individual to preform tests
| under specific conditions.
|
| Significant changes in psychosis and paranoia can readily be
| determined with structured interviews.
|
| The problem is most of these things are not easily and
| correctly measured by a questionnaire. You need more expertise
| to get this information out of a patient.
| slibhb wrote:
| It's worth it to study these things from a behavoral or
| functional perspective but that is also very hard. If only
| because, ultimately, people seek treatment or don't based on
| subjective feelings.
|
| I think there's unavoidably an element of subjectivity here.
| You can attempt to minimize it but it's always there.
| kayodelycaon wrote:
| > If only because, ultimately, people seek treatment or
| don't based on subjective feelings.
|
| Well... yes? You're not going to seek help for mental
| illness if you don't think you have a problem. You're also
| not going to enroll in a study, either.
| dwaltrip wrote:
| I really hate the mental health questionnaires. They did a
| poor job of assessing my difficulties when I was in the thick
| of it (I'm doing much better now). I also found them quite
| stressful to fill out.
|
| I remember getting scores of "mild anxiety" or "mild
| depression" and just kind of sitting there confused and
| somewhat dismayed, thinking... "Why am I having such a hard
| time? What is actually wrong with me?"
|
| Turns out some of my core issues were difficulty knowing and
| connecting with my emotional state, constantly trying to meet
| intense expectations that I believed were necessary
| regardless of how I was feeling, putting (what I imagined to
| be) the needs of others above my own needs, and having deep
| fractures in my sense of self-worth.
|
| Five years ago, I was largely oblivious to all of that. All
| though some pieces of the puzzle had been slowly coming
| together for some time.
|
| Some potentially more informative labels for what I've been
| dealing with: C-PTSD, emotional neglect, and / or highly
| sensitive person.
|
| C-PTSD isn't even in the frickin DSM! I had taken online
| questionnaires (the anxiety and depression ones mentioned
| earlier were from medical professionals) for PTSD. It didn't
| really match up, which makes sense. There is less material
| for C-PTSD compared to PTSD. I did try one or two assessments
| I found online for c-ptsd and I think I got a score that was
| very close to the "clinical threshold". Which was a little
| helpful. But it took me quite a while to get to that point
| and I was still confused and uncertain.
|
| All that to say... The "best in class" assessments, as well
| as our general ability to classify and understand the mental
| health difficulties that people experience, are not very
| good.
|
| We can do much, much better. And doing so would alleviate an
| immense amount of suffering.
|
| P.S. My advice for anyone who relates to this is to find a
| good somatic therapist who knows how to work with complex
| trauma / emotional neglect. It's very difficult to work
| through this on your own. I was pretty skeptical about
| therapy... It took me 4 tries to find a good therapist. The
| first 3 were not that helpful. The somatic approach is
| important. If you haven't found a good therapist, keep
| looking!
| mountainriver wrote:
| Exactly, the reality of the mental health field is they
| know very little and their methodologies are largely
| flawed. I've been diagnosed with so many different things
| based on their "scientific methods" when at the end of the
| day they are just making rough guesses.
|
| I get really turned off by any article that acts like we
| have a clear understanding of these things. Most things are
| actually just reactions to trauma.
| kayodelycaon wrote:
| I definitely agree that scientific understanding mental
| health is pretty low, but I don't believe the
| methodologies are flawed. They are the best we have at
| the moment and they work well enough for the common
| cases. (Drugs vs therapy is a different problem.)
|
| Anyone with a non-trivial case ends up in informed (or
| poorly-informed) guesses territory.
|
| > Most things are actually just reactions to trauma.
|
| I don't think this is quite correct. Mental illnesses
| have a lot of overlapping and contradictory criteria
| because all of the categories are rough patterns.
|
| Many share the same symptoms of trauma and people with
| mental illness are more likely to have trauma.
|
| This does not mean the majority of mental illness is
| caused by traumatic events.
| banannaise wrote:
| > The most important being how much it affects your quality
| of life.
|
| This is unique among illnesses. Whether or not I have a cold
| does not depend on how much it affects my quality of life.
| Why is mental illness different?
| carlob wrote:
| Uh? If the cold didn't affect your quality of life we would
| call it an asymptomatic infection. But active symptoms do
| affect your quality of life...
| tsimionescu wrote:
| Mostly because we know very little about mental illness, so
| we are just guessing.
|
| Previously, we had a terrible habit of identifying "mental
| illness" by external factors, such as meeting social and
| moral norms (so being gay was considered a mental illness,
| as was being troublesome).
|
| To avoid this, and given that our understanding of the
| fundamentals has barely improved, if at all, we have chosen
| to take an approach that is much less likely to cause
| extraordinary distress to people who are perfectly well.
|
| Remember that being labeled mentally ill can durectly rob
| you of your most basic human rights, so this is not a
| diagnostic that should be easily applied.
| kayodelycaon wrote:
| The symptoms of a mental illness can overlap with normal
| variations of personality. It is very important to note
| this is overlap, *not* a spectrum!
|
| A person's baseline can be altered by mental illness but
| not severely enough to be indistinguishable from a
| personality difference. Telling the two apart is damn near
| impossible.
|
| Since we don't have blood tests, we cannot tell the
| difference. So we need to fall back on want little
| objective criteria can be found.
|
| Behavioral criteria can be skewed due to environment. An
| active kid who wants to run around isn't going to do well
| being stuck in a classroom for six hours. A curious kid
| with ADHD, who would otherwise be a good student also won't
| do well because they can't stay on task. These look
| identical. (This is why ADHD is both over and under
| diagnosed.)
|
| This results in family history and quality of life being
| more objective than self-reported feelings.
| zeroonetwothree wrote:
| If you go to a doctor and say "I think I have cold" but
| then you say you have no symptoms I don't think they are
| going to take you seriously...
|
| By definition symptoms affect your quality of life.
| standardUser wrote:
| "Lots of people used LSD in the 60s and 70s"
|
| That's an overblown stereotype. The vast, vast majority of
| people did not use any drugs in that era.
| slibhb wrote:
| "Lots" is not the same thing as "the vast majority". Millions
| of people used LSD between '66 and '80.
| standardUser wrote:
| Millions of people use LSD every year today, in addition to
| a dozen other hallucinogens.
|
| https://www.scientificamerican.com/article/americans-
| increas...
|
| "In the late 1970s... 10 percent of high school seniors
| reported ever using LSD, compared with 6 percent today."
|
| Ten percent isn't very much. Americans in the 60's and 70's
| were far more likely to support endless jail time for drug
| users than to be one themself.
| aaaaaaaaata wrote:
| > Ten percent isn't very much.
|
| It took less than that to bring Pokemon-frenzy into my
| school, and it only takes 1-3% of a population to effect
| revolution.
|
| I don't know, bud.
| slibhb wrote:
| > Ten percent isn't very much
|
| Is this really a hill you want to die on? Seems like a
| rather large sample to me...
|
| Here's a graph from wikipedia: https://en.wikipedia.org/w
| iki/History_of_lysergic_acid_dieth...
| elliekelly wrote:
| > Lots of people used LSD in the 60s and 70s and as far as I
| can tell they didn't usher in a new age of love, peace, and
| tolerance.
|
| Is there any research that attempts to put a number on what
| portion of the population was using LSD at this time?
| slibhb wrote:
| Wikipedia has some sources and a graph (I have no idea how
| accurate it is): https://en.wikipedia.org/wiki/History_of_lys
| ergic_acid_dieth...
| PaulDavisThe1st wrote:
| > Lots of people used LSD in the 60s and 70s and as far as I
| can tell they didn't usher in a new age of love, peace, and
| tolerance
|
| There's a documentary on UK late 90's rave culture that noted
| that perhaps 60-100,000 people in the USA indulged in LSD
| during the period you mention. By contrast, somewhere on the
| order of 10-20 _MILLION_ people dropped MDMA /ecstasy during
| the heyday of UK rave culture.
|
| The documentary went on to note that there are a lot of
| professional, retail and public spaces in the UK that have been
| built in the last 15 years that show particularly strong
| connections to the "chill out room" vibe that became
| significant during the ecstasy+rave period. Even real estate
| agent office (realtors in the US) design is claimed to show
| many elements of chill out aesthetics.
| dkjaudyeqooe wrote:
| > An overweight man with no friends who plays computer games
| all day is not depressed unless he feels bad about it.
|
| This is entirely wrong. You can suffer from depression (and
| anxiety) and attribute it to other things, such as personality
| traits. Many people think "that's just me" with those that know
| them thinking the same. For less acute forms of depression such
| as dysthymia, that's common. People can think they're entirely
| normal and they're just not good at certain things.
|
| If you talk to sufferers of serious and disruptive mental
| illnesses such as schizophrenia and bipolar with psychotic
| features, most of them will deny they're ill at all and
| rationalise their behavior. They'll generally talk about it by
| saying "well my doctors say..." and suggest that their doctors
| have been mislead or have misdiagnosed them.
|
| It's much more complicated than it seems. It's all part of the
| perniciousness of mental illness.
| slibhb wrote:
| > This is entirely wrong. You can suffer from depression (and
| anxiety) and attribute it to other things, such as
| personality traits. Many people think "that's just me" with
| those that know them thinking the same. For less acute forms
| of depression such as dysthymia, that's common. People can
| think they're entirely normal and they're just not good at
| certain things.
|
| My post explicitly says the hypothetical man is happy, not
| that he thinks "that's just me".
|
| If you want to argue against that, you have to define mental
| illness from a behavoral or functional perspective which I
| don't think you've done.
| dr_dshiv wrote:
| I don't know of any mental illness that isn't accompanied
| by intense mental distress
| chiggsy wrote:
| Mania.
| tsimionescu wrote:
| The grand-parent comment was arguing that this distress
| can be objectively catalogued by someone other than the
| patient, and that the patient may themselves be unaware.
|
| This does seem to be true for some forms of mental
| illness, depending on exactly how you define distress.
| For example, someone going through an episode of mania
| (such as in bipolard disorder) is typically subjectively
| extremely happy with their state.
| netizen-936824 wrote:
| What if the subject doesn't realise they're unhappy because
| they've never been happy and have nothing to compare
| against? Your statements seem to assume everyone has the
| same perspective to measure against, but in reality
| people's perspective can be _radically_ different
| slibhb wrote:
| Like I said, you can make that argument, but then you
| need to provide a criterion for saying someone is
| unhappy. That's where behavioralism or functionalism or
| something similar comes in.
|
| > Your statements seem to assume everyone has the same
| perspective to measure against, but in reality people's
| perspective can be radically different
|
| On the contrary, I think people have different
| perspectives. Two people can be in the exact same
| situation and their subjective feelings can be radically
| different.
| netizen-936824 wrote:
| It seems that we agree
|
| We definitely need to make judgements based on both
| behavior and subjective thought processes rather than
| just one or the other
| seanwilson wrote:
| > A few years ago, John Ioannidis (RIP) published an article on
| conflicts of interest in nutrition research. The conflicts you
| get in this field, he said, are different from those in, say, Big
| Pharma-funded trials of new drugs. Not only are there those usual
| kinds of financial conflicts--some research is paid for by the
| food industry; nutrition scientists have diet books to sell--but
| there are "nonfinancial" conflicts, too. If you're a strong
| adherent to the particular kind of diet you're researching
| (vegan, Atkins, gluten-free, etc.), Ioannidis argued, you should
| disclose this at the end of the paper, so readers can be fully
| informed about how the research was produced.
|
| I find it's common to see forum comments like "we know this
| researcher is a big advocate of X so this study is bias". I find
| this critique is usually very shallow and sets an impossible
| standard.
|
| Where are you you going to find researchers pouring years of
| their life into researching a subject they have no interest in or
| opinions of?
|
| If you were studying vegan or Atkins diets for example, it's an
| ongoing personal choice in your day-to-day life if you're going
| to switch to/from that diet or not, where either choice could be
| used to imply bias in your future studies. And after a few years
| of research, how could the evidence you collect not impact your
| personal choice? And if it doesn't, what would that say about
| your belief in your own research?
|
| Researchers are trained to be aware of their biases, to devise
| experiments that reduce these biases, and peer review helps
| identify problems here also. Another part of peer review where
| the media jumps the gun is that other researchers should be able
| to replicate the studies themselves to check the results - if you
| become known for producing highly biased research that can't be
| replicated this is surely going to impact your career (e.g. less
| citations, less funding, distrust from peers) so there's a very
| strong incentive to keep this in check?
|
| I think in general, the real problem here is the dysfunctional
| click-bait approach the media has with scientific reporting
| (exaggerated, sensationalist, premature, lacking any
| nuance/caveats/details) and the public's understanding of the
| scientific method is very broken e.g. the notion that scientists
| are always changing their minds, little understanding of how to
| evaluate how strong evidence is before accepting it as true,
| which includes dismissing everything about a study because they
| can create a story about one researcher being bias.
| kayodelycaon wrote:
| > If you become known for producing highly biased research that
| can't be replicated this is surely going to impact your career
| so there's a strong incentive to keep this in check?
|
| I would strongly say no.
|
| If the vast majority of studies in the "soft" sciences are
| already not reproducible, the risk to a person's career is
| minimal.
|
| This is before accounting for the pattern of prioritizing short
| term gains over mitigating long-term risk, especially if that
| risk is considered to be low.
| SamoyedFurFluff wrote:
| > If the vast majority of studies in the "soft" sciences are
| already not reproducible, the risk to a person's career is
| minimal.
|
| Let's not be so arrogant as to say this is isolated to the
| soft sciences. Soft science is only the most obvious because
| it's much harder to run science experiments in the real
| world. Let's not forget the fact a computer science PhD
| student committed suicide because of the degree of academic
| fakery he was being forced to participate in at an elite
| institution. That we still have nonsense like unreproduceable
| ML papers, and physics has multiple examples of older models
| being wrong and only being held up by the political power of
| the academics who built their careers off them.
| newbamboo wrote:
| It's easier to market "psychedelics" than meditation, prayer or
| something like DBT. We should learn from that and try to make
| more things as popular as psychedelics. "Put this little square
| of paper on your tongue" is much less of an ask than "sit in
| chair for 30 minutes everyday and be mindful of your breathing."
| It's like the McDonald's approach to mental health, and who
| doesn't love McDonald's! Over a billion served. Psychedelics
| scale similarly.
| chiggsy wrote:
| If it works, and that's all it takes, that's fantastic! But you
| have an incredible solution too it seems?
|
| "sit in chair for 30 minutes everyday and be mindful of your
| breathing."
|
| Now this is great advice for everybody. Unless during these
| quiet times the weight of the world lays upon you, or your
| grasp over your inhibitory system is not sufficient to find
| stillness, never mind finding discipline of the breath.
|
| What about the people who's affliction is not due to some
| implied lack of industry or effort? What if the problem is not
| ... sloth?* ... but actually a flaw in the brain, or imbalance?
|
| I guarantee you that there are not a billion people who are
| gagging for psychedelics as a solution to their mental
| problems. The question is: Are they in fact a solution?
|
| Prayer: Unless you are praying to some entity who publishes
| regularly, I feel this avenue has been tried and found to be
| lacking.
|
| [*] I do not endorse this concept. I don't think you can just
| "apply yourself" and heal your mind, any more than you can do
| could with your lung cancer. Sure it helps, but we'd like to
| minimize the suffering, not endure as much as possible.
| ActorNightly wrote:
| Psychs are absolutely not comparable to "sober" activities.
| While things like meditation have benefits, you are still
| largely operating in the same regimes within the neural network
| in the brain.
|
| The main idea behind psychs is that they allow you to operate
| in a vastly different regimes. And, unlike McDonalds, and
| compared to other drugs, they are INCREDIBLY safe. It should be
| a no brainer for anyone needing them to use them.
| cmehdy wrote:
| The article makes a lot of good points. I'm a lover of
| psychedelics, I've apparently managed to be wired in a way that
| has made every single experience one that I don't regret (whether
| joyous, superficial, or intricate, unexpected), but I would never
| make the mistake of assuming my experience directly translates to
| other people's. Hype, cultists and people thinking in absolute
| only do a disservice to what we could extract from those
| experiences.
|
| Serious research with people who are detached from the drugs is
| something we should all want, especially because we've only had a
| short time for detailed records of psychedelics experiences to
| exist at all and most experiences to this day aren't really
| observed scientifically at all. I believe that science is the
| best thing we've got to approach the unknown, psychedelics aren't
| a "godly exception".
|
| I also remain aware that science doesn't always offer answers
| right away and we just keep on going anyway. It's been true for
| most technologies, for a lot of what goes in our food every day,
| for how we've structured society, etc. We accept that there's
| unknown risks, we try to mitigate what comes our way and prepare
| for what we can estimate, and we learn to live through what we
| didn't see. But we still eat the food, use the technologies, try
| social systems, and so on.
|
| I think that attitude is also one to have with psychedelic
| experiences. That happens through testing what you have, guided
| experiences if and when there's a need or uncertainty, "set &
| setting" and discussing them beforehand, being gentle with
| dosage, making a sincere attempt at an inventory of the self
| before deciding on taking the psychs, and so on and so forth. And
| some people try some of it, some people don't, and that's OK as
| long as everyone strives to have an experience they can handle
| with what they know. Just like with everything else.
| wackget wrote:
| Is it true what they say about psychedelics helping people to
| come to terms with their own mortality and death?
|
| Occasionally I'll get crippling anxiety when I think about how
| one day I'm going to stop existing and there's absolutely
| nothing I can do to stop that.
|
| I've heard people say that [some drug] has shown them how to no
| longer fear death and always wondered about that.
| cmehdy wrote:
| I don't think it's possible to make a broad statement like
| that about psychedelics. You'll always just hear one take
| from a person with their experience and the experience of the
| people they might have tried it with or even guided, but the
| spectrum of experiences is too vast to qualify and quantify
| it without the actual research.
|
| My personal standpoint is fairly different from yours because
| my anxiety is permanent and a measure of the "agitation" of
| my existence, to which death is almost a relief really. From
| that standpoint I've never quite had to confront much of
| anything about mortality or death. In fact I've almost always
| felt more alive during trips, at peace with whatever flowing
| model of the self and existence experienced in the moment.
| Psychedelic effects can make our senses feel more 'salient'
| too (for me musical experiences can be very profound), which
| I've used to contemplate extremes (like noise-cancellation
| silence after a roaring musical piece).
|
| The main regularly noticeable thing I experience after just
| about every trip (of various kinds of psychedelics) is severe
| depression being alleviated for anywhere between a couple
| days to a few weeks.
|
| Ultimately though, most of what I would say is just likely to
| be whatever personal theory I've built up this unique stream
| of experiences. That's why we really need people to get in
| there and do the difficult work.
|
| edit: also the "some drug" in question is most likely DMT,
| and I've had extensive experiences with it (on its own or
| not) and absolutely appreciate that others would have
| religious experiences, near-death experiences, etc.. but I
| don't think anybody with any experience of DMT that goes
| beyond a one-shot would testify to the reliability of trips
| of such nature. It can be a very volatile experience, as well
| as being much less predictable from person to person than the
| more mild stuff like low doses of mushrooms etc. Again,
| science might eventually come to the rescue :)
| btilly wrote:
| I agree with the basic point of the article entirely.
|
| However he shows the same kind of bias that he is speaking out
| again by not discussing the best known branch of such research.
| And that is MDMA for PTSD.
|
| It is best known simply because it is, in fact, demonstrating
| that it works. The FDA has been repeatedly calling it a
| "breakthrough therapy" since 2017. It is in multiple phase 3
| trials around the world that are going well, and full approval is
| expected this year. Research papers on it, like
| https://www.nature.com/articles/s41591-021-01336-3, are appearing
| in the top science journal in the world and are no less
| enthusiastic than a press release. Let me quote, "These data
| indicate that, compared with manualized therapy with inactive
| placebo, MDMA-assisted therapy is highly efficacious in
| individuals with severe PTSD, and treatment is safe and well-
| tolerated, even in those with comorbidities. We conclude that
| MDMA-assisted therapy represents a potential breakthrough
| treatment that merits expedited clinical evaluation."
|
| So no matter how much questionable research there may be - and
| I'm sure it is a lot - let's not throw out the baby with the
| bathwater. There is also good research, and these drugs have the
| potential to make a huge difference.
| aw1621107 wrote:
| > Research papers on it, like
| https://www.nature.com/articles/s41591-021-01336-3, are
| appearing in the top science journal in the world and are no
| less enthusiastic than a press release.
|
| The article actually discusses _that very paper_ :
|
| > While we're here, it's worth talking about the MAPS MDMA-
| therapy trial itself. In May 2021, to much media fanfare, they
| published their Phase III clinical trial in Nature Medicine.
| The trial reported enormous, nearly unbelievable effect sizes:
| 0.91 of a standard deviation difference in score on a PTSD
| questionnaire between an MDMA and a placebo group (both groups
| got therapy). That's the kind of effect medical researchers
| fantasise about.
|
| > Are these effect sizes plausible? Nature Medicine also
| published two critical commentaries on the paper. The first one
| points out the issue we discussed above: that the blinding was
| almost certainly compromised in the study, since the control
| group got a completely inert placebo and the treatment group
| surely could tell whether they'd been given ecstasy.
| Expectations could have played a major role, and might explain
| at least some of the huge difference between groups (the
| commentary also makes the interesting point that researchers
| used to be required to collect data on which condition patients
| thought they were in, but since 2010 this is no longer the
| case. It might be time to bring back this rule). The second
| commentary asked for studies with more relevant control groups
| and longer follow-up periods to check the safety of the
| treatment. The MAPS researchers also responded, somewhat
| limply.
|
| > The journal also published an entirely uncritical commentary
| co-authored by Imperial College London's David Nutt. Remember
| him? He was Fired4Truth as a drugs adviser by the UK Labour
| government in 2009 for criticising government policy on drug
| classification; he's now a major psychedelics researcher who
| co-authored the psilocybin trial we encountered above. The
| commentary calls MDMA "remarkable" three separate times in
| about 1,000 words (it's true the effect sizes in the study are
| remarkable, but what if they're due to expectancy bias?). It
| also says it's likely that MDMA "will be an approved medication
| within a few years".
|
| > So there's a final potential harm that stems from the
| breathless hyping and cheerleading of psychedelic treatments
| way beyond the evidence: it could mean that therapies--which
| come with their own rare but real dangers--are approved and
| rolled out to large numbers of patients when we need a lot more
| evidence that they really are beneficial in the long term.
| mountainriver wrote:
| It feels like they actually mostly overlook this study in
| favor of their thesis that psychedelic research is bogus. The
| Nature critiques are less than convincing, either way they
| are doing another phase 3 trial so we will know.
|
| My guess is if this scientist did psychedelics he wouldn't
| have written this article.
| h2odragon wrote:
| I know a lot of cannabis fans (and count myself as one). Very,
| very few of them acknowledge that cannabis affects people
| inconsistently; one person's reaction to it can be very different
| than others. This is inconvenient for calling it a "medicine" so
| let's just ignore it.
|
| Psychedelics are even worse. The same dose of the same drug can
| produce wildly vary effects in the same person depending on
| factors we have trouble nailing down. "Set and setting" and the
| Erowid wisdom are all very well, but they are barely enough to
| describe the area and edges of the therapeutic window in a
| general way. _Your_ trip, today, is still going to be an
| experiment.
| perardi wrote:
| Yup, from experience, you can give the same dose from the same
| batch of a hallucinogenic drug to people who are broadly
| similar in terms of age and overall mental health, and you can
| get a real wild range of results.
|
| _(Except maybe ketamine. Ketamine seems pretty consistent, in
| my anecdotal experience.)_
| netizen-936824 wrote:
| Medicines in general can effect people very differently based
| on their individual biochemistry/proteome
| bitxbitxbitcoin wrote:
| As they say: everyone's endocannabinoid system is different.
| They also say everyone's brain is wired differently. Completely
| agree that every first use whether it is THC or psilocybin is
| at the end personal experimentation with non zero risk.
| asdff wrote:
| IMO the tolerance factor is huge with cannabis. Even for
| experienced daily smokers if you were to take a few days off,
| the effects are very noticeably more powerful. When you have
| zero tolerance, the drug feels like on another planet compared
| to something more familiar like alcohol. When you have a lot of
| tolerance, its a comfortable buzz you can be productive on,
| like a workingman's whisky drunk but without the slop.
| supertofu wrote:
| This is an anecdotal and slightly off topic response to your
| note on cannabis tolerance. I am a frequent cannabis user and
| have been for a long time. While I no longer use psychoactive
| cannabis regularly (not in a fully legal state anymore) but I
| do use CBD, which purports to be non-psychoactive and, by
| law, has THC delta-9 levels of below 0.3%.
|
| What I find fascinating is that CBD absolutely has a
| psychoactive effect on me. I suspect that this is _because_
| of my prolific use of typical cannabis. The components of CBD
| must tickle the same pathways that are so accustomed to
| psychoactive cannabis.
|
| The result is that I often get reasonably high from CBD hemp
| and CBD tinctures.
|
| A high tolerance for cannabis seems to create a stronger
| response to CBD, at least in my case!
| colechristensen wrote:
| I think the opposite is what is happening, the regulated
| CBD products aren't regulated in a way that keeps them free
| of psychoactive components and nobody noticed yet or aren't
| too excited to try to change it, legalization being on the
| menu all over the place.
| [deleted]
| aaaaaaaaata wrote:
| CBN, CBG, and terpenes, are all responsible for medical
| and recreational things that regulators don't have a
| single clue on, and medical folks are only beginning to.
| [deleted]
| jasonvorhe wrote:
| All of medicine has a lot of possible side effects depending on
| the person taking them. Current anti depressants can have
| severe side effects, whether just until they're properly dosed
| or not. No one says we should start handing out shrooms to
| everyone over lunch. But either we allow illegal, unhealthy,
| corruption-causing criminal markets to flourish with a lot of
| negative effects on society or we legalize and control it.
| jamal-kumar wrote:
| It's fun to send this "MAYBE YOU JUST HAVENT TRIED THE RIGHT
| STRAIN" [1] image to friends who don't like weed because it's a
| pretty hilarious embodiment of the downright anxiety the stuff
| engenders in a lot of people. I'm pretty sure it's like a
| genetic thing. I think I remember hearing something about the
| COMT gene being potentially affected if you smoke too much too
| early in life as a teenage stoner or whatever, and how this can
| lead to mental illness down the line... There's a lot we really
| don't understand yet fully about these things.
|
| [1] https://i.imgur.com/mJrlu1C.jpg
| colechristensen wrote:
| I'm not in the anxiety camp or in the fun camp. The general
| experience of marijuana products is something like the sleepy
| lethargy of having eaten an excessively large meal. Not
| wholly unpleasant but neither is it something I'm really
| excited about seeking out. Low doses do mostly nothing. I've
| tried plenty of strains. To be fair I still do it sometimes.
| endorphine wrote:
| Cannabis triggered my first panic attack, which then
| triggered my depression for a few months.
|
| It wasn't the first time I was doing Cannabis, but I haven't
| done any more ever since then.
| standardUser wrote:
| I'm convinced that the "normal" way Americans consume weed is
| basically an overdose for most people. Heavy users drive the
| market and the 30% THC and higher strains are targeted at
| those high-spending, high-tolerance users. I started to enjoy
| weed again when recreational stores opened up and I could
| find 10-15% THC weed that gets me pleasantly high, not
| paranoid and incapacitated.
| supertofu wrote:
| I find that CBD-rich hemp still gets me "high", but the
| effect is extremely therapeutic. I hope low-THC cannabis is
| more widely studied.
|
| High-THC cannabis has a very negative effect on my mind,
| mood, and motivation. But CBD-rich strains with low THC are
| perfect for handling my anxiety and autoimmune symptoms.
| aaaaaaaaata wrote:
| That's moreso "stoned" than "high" -- a calm, vs a
| stimulant sort of thing, with CBD vs THC.
| PragmaticPulp wrote:
| Psychedelic enthusiasts can be even worse in this regard. When
| someone does have a bad trip, they tend to reach for every
| possible excuse to avoid blaming the drug. This ranges from
| criticizing their "set and setting" to blaming "triggering an
| underlying mental health issue". The latter is particularly
| concerning in the context of treating mental health issues,
| because by definition everyone in that category has some level
| of underlying mental health issues.
|
| Research is particularly difficult in this area because the
| study volunteers are self-selecting for psychedelic research.
| Basically, anyone ending up in a psychedelic research study is
| doing so because they think psychedelics are promising for
| mental health and they want to try it out. This creates a
| _huge_ risk of placebo effect when your patients are arriving
| with huge enthusiasm and preconceived notions of efficacy.
| Combine that with the weirdness of a psychedelic trip and it 's
| a recipe for a sort of super-placebo.
|
| However, that's doubly interesting in that maybe the real
| reason psychedelics show efficacy in depression is that they
| are a sort of super-placebo. Put someone through a weird,
| confusing psychedelic experience _and_ tell them that it their
| life will be radically different afterward and maybe they 'll
| believe it so much that it becomes their new reality. Weirdly
| enough, we have the opposite problem with SSRIs right now
| because so many patients will start googling side effects and
| become convinced that they're not going to work before they
| even take the first dose.
|
| It's an interesting area of research, but I think right now
| there's too much crossover between the research and the pop-
| culture phenomenon of "psychedelics cure everything". It's also
| strange that so few people are questioning why all of the
| previous psychedelic users didn't notice that the drugs were
| treating depression. In fact, the common wisdom among
| psychedelic enthusiasts years ago was that psychedelics were to
| be _avoided_ if someone was not in a good mental state, largely
| due to all of the negative reactions they noticed. It seems
| that telling someone "this will cure your depression" provides
| a different set and setting than just giving them the
| psychedelics without context.
| criticaltinker wrote:
| Listen, your comments on all these threads make it clear
| you're seriously pessimistic about psychedelic medicine, and
| that's perfectly ok.
|
| What bothers me is the incessant pushing of this agenda:
|
| _> anyone ending up in a psychedelic research study is doing
| so because they think psychedelics are promising for mental
| health and they want to try it out _
|
| _> maybe the real reason psychedelics show efficacy in
| depression is that they are a sort of super-placebo _
|
| This amounts to uninformed armchair dismissal that is
| inconsistent with a growing body of scientific evidence, and
| easily refuted by a cursory survey of recent literature and
| clinical trial results.
|
| Surely you're familiar with double blind randomized placebo
| controlled studies? I've linked you to recent ones in other
| comments.
|
| These methods aren't perfect and your concerns certainly have
| merit in general - I just don't understand why you continue
| to make these broad and suggestive claims without any
| supporting evidence.
| tsimionescu wrote:
| I am curious: is it actually possible, even in principle,
| to have a blind placebo controlled psychedelics study?
|
| How can you not be aware of whether you have consumed a
| psychedelic substance or a sugar pill, assuming we are not
| discussing something like micro-dosing?
| criticaltinker wrote:
| It's a valid concern and many folks have raised it here
| on threads concerning this topic.
|
| The short answer is yes: beyond mannitol, niacin, and
| even bespoke substances designed to mimic the
| organoleptic properties of ayahuasca have been used
| effectively as placebos.
|
| At modest dosages (above the threshold of perception but
| within the therapeutic window) the side effects can be
| surprisingly similar in the general population, and thus
| difficult to distinguish for the average joe.
|
| Of course studies vary widely in quality and rigor, so
| one must critique experimental design on a case by case
| basis.
| yourabstraction wrote:
| > Psychedelic enthusiasts can be even worse in this regard.
|
| Oh yes, I've had a run in with a "psychedelic enthusiast",
| and this is so accurate. It was my girlfriend during my late
| 20s, a woman who was 12 years older, very into psychedelics,
| and pretty obnoxious about how beneficial they were. Of
| course, at the time I ate it up because I was kinda lost in
| life, and let her overcome my better judgement with her guru
| bullshit.
|
| I'd previously only ever used marijuana, and had mostly
| negative experiences resulting in anxiety, so had mostly
| sworn off the idea of trying psychedelics until she came into
| my life. Long story short, I tried mushrooms once with her,
| fun for a bit, but then led into a crazy making spiral
| leading me to be convinced I'd never be the same.
|
| I guess I was a glutton for punishment back then, because I
| also tried LSD with her twice, and it had pretty similar
| results. In fact the second trip shook me up in such a bad
| way that I think it took nearly a year to get the negative
| bits still remaining out of my head.
|
| Of course her reaction after all this was that I was being
| too resistant and that I simply needed to have a "corrective
| experience". Fuck that! She seriously couldn't comprehend the
| fact that everyone reacts to psychedelics differently and
| that they might be quite dangerous for some people. Which
| seemed kinda crazy because she was actually highly
| intelligent, but possibly too arrogant to look outside her
| world. I seriously could have ended up in an institution if I
| had stayed with that woman (can you tell I'm venting a tad :)
| ).
|
| I've later come to learn that I have a genetic mutation that
| reduces my ability to degrade dopamine in the prefrontal
| cortex by 75% (COMT met/met), leading to much higher baseline
| dopamine levels. After learning about this, it makes a ton of
| sense why I have such bad experiences with dopaminergic drugs
| like caffeine and Adderall (euphoria followed hours later by
| intense anxiety). Now I don't know how LSD and mushrooms
| impact the domaine system, but it does make me wonder if this
| genetic SNP, partially explains my propensity to
| anxiety/psychosis on these drugs. High baseline dopamine
| leads to hyperfocus, which is great for coding or other
| technical work, but terrible when you're stuck in a spiral of
| thinking you're going crazy and will never be the same.
| newbamboo wrote:
| Some psychedelics are more unpredictable than others, and
| incidentally these seem to be the ones that are hyped the most.
| LSD is much more predictable than mushrooms for instance, and
| is well researched partially because of that. The seems
| generally true for synthetic vs naturally occurring substances
| across the board, though there are plenty of horrible synthetic
| drugs like bath salts, synthetic weed. Advocates seem favor
| this as it allows them a no true Scotsman defense. "You didn't
| get _real_ ayauasca", or with cannabis the hand wavey talk of
| the "entourage effect." The biggest problem facing psychedelic
| research are the researchers involved. They have little
| credibility, almost like that's their intention.
| cmrdporcupine wrote:
| I agree LSD may be more predictable than mushrooms, but it is
| also a crazy intense 12 hour voyage that leaves one with at
| least two days of recovery time after. Vs 4 hours for
| mushrooms.
|
| Both are extremely "set and setting" sensitive. Take either
| on a bad mood day with bad weather, a dirty house, and stuff
| on your mind... and you won't have a good time.
| tsimionescu wrote:
| > Take either on a bad mood day with bad weather, a dirty
| house, and stuff on your mind... and you won't have a good
| time.
|
| That doesnt sound like the start of an apparently very
| promising candidate for treating depression and PTSD. Just
| goes to show how different experiences are, I guess...
| cmrdporcupine wrote:
| Yeah, that's because it isn't (imho a promising
| candidate).
|
| It's an interesting experience, though.
| tsimionescu wrote:
| Sure, I imagined as much. My point was that your
| experience (and others like yours) seems to differ
| significantly from the experience of, for example, the
| people penning these studies.
|
| I personally have no experience with psychedelics (and no
| desire to get any), so I am just looking with a bit of
| wonder at the differences from the sidelines.
| vmoore wrote:
| And we lack _actual_ shamanic centers where we can do this
| stuff safely, where the dose is exact and you know what you 're
| getting, and you can have guides to help you through the trip
| if things start feeling sketchy. And we could even have people
| on standby to administer anti-psychotic medicine in-case you
| have adverse reactions and need to calm down quickly before you
| do something stupid. The illegality of these substances is
| illegal in itself!
| npteljes wrote:
| I agree. And I also think that for the same reasons, the
| psychiatry system, at least the parts that I was exposed to,
| is abysmal. They prescribe according to whatever scriptbook
| is en vogue at the jurisdiction and the substances themselves
| are very far from proven - and also the part where you're
| guided on the trip you're having can be almost completely
| missing. There's a _huge_ room for improvement in this area.
| darod wrote:
| Check out the Cover Story podcast mentioned in the article.
| It's pretty eye opening. They mention a few centers that
| historically you can categorize as unsafe. The key would be
| to find professionals that have your best interests in mind
| but the podcast and this article reveal how surprisingly
| difficult that is.
| suction wrote:
| I think the issue starts with the moniker "shamanic", which
| does not sound like a place many people would trust their
| health to.
| hutzlibu wrote:
| Well, I would rather say there are probably way too many
| people, who would totally trust such a place with their
| whole health, just because of the name and some other
| esoteric buzzwords like indigenous, ancient wisdom.
|
| I do have great respect for "real" shamans. But I met way
| too many fake ones, handing out horrible and dangerous
| advice, while glowing in their self declared illuminative
| state of higher consciousness.
| aaaaaaaaata wrote:
| Where'd you find these?
| hutzlibu wrote:
| All around the world.
|
| Most are quite harmless and you still can have
| interesting conversations with them. Some are more weird
| and even dangerous, like this individual, which I have
| not met personally, but people like him.
|
| https://en.m.wikipedia.org/wiki/Jake_Angeli
| mountainriver wrote:
| Yeah its interesting because I've had absolutely game
| changing experiences with real shamans, and then bad
| experiences with phony ones. If you find a good one,
| stick with them
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