[HN Gopher] Psychiatric risks for worsened mental health after p...
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       Psychiatric risks for worsened mental health after psychedelic use
        
       Author : gnabgib
       Score  : 94 points
       Date   : 2024-04-16 05:06 UTC (17 hours ago)
        
 (HTM) web link (journals.sagepub.com)
 (TXT) w3m dump (journals.sagepub.com)
        
       | yieldcrv wrote:
       | > We find that 16% of the cohort falls into the "negative
       | responder" subset.
       | 
       | "they should have known they had a family history of
       | schizophrenia before using it!"
       | 
       | every dismissive psychedelic user that brags about increased
       | empathy in the next breath
       | 
       | but in all seriousness, yes I would like to see more studies so
       | we can _at least_ have side effects printed on the side of the
       | package, so the right people can take informed risks
        
         | moneycantbuy wrote:
         | so 84% had a positive response?
        
           | jjallen wrote:
           | 84% positive and 16% worsened mental health is not the same
           | thing as 84% and the rest neutral or mild side effects.
        
           | mikeyouse wrote:
           | No.. 16% had a negative response, 28% had ~no response, and
           | 55% had a positive response. I think people would be much
           | more hesitant to try psychedelics for their mental issues if
           | you told them it was a coin toss whether it would help or not
           | -- and was an unlucky game of Russian Roulette from making
           | their mental problems worse.
        
             | bennyhill wrote:
             | People take prescribed drugs for less than a 25% chance
             | that it helps and a Russian roulette of side effects. Does
             | sexual dysfunction improve depression?
        
               | yieldcrv wrote:
               | I, for one, would like the same standard applied to
               | psychedelics, instead of worrying about whether bad
               | results lead to its continued prohibition
               | 
               | It seems that right now people are too worried about a
               | bad result messing up their ability to talk casually
               | about their trips
               | 
               | I just want side effects to be based on less conjecture
               | 
               | science lets its beliefs die, faithful die with their
               | beliefs
               | 
               | right now, psychonauts seem to be in the latter group and
               | its not helping the science form at all
        
         | jrflowers wrote:
         | This makes sense because people that have used psychedelics
         | sharing their positive experiences are the bad guys and people
         | that have used psychedelics sharing their negative experiences
         | are the good guys
        
           | yieldcrv wrote:
           | using anyone as a source for side effects is a dumb standard
           | and we should reach parity with how other drugs are studied
           | 
           | just like this study is trying to chisel at
           | 
           | while psychedelic communities are uniquely dismissive
        
             | jrflowers wrote:
             | Exactly! People that say that they've benefited from
             | psychedelics are uniquely dismissive and people that say
             | that those people form a uniquely dismissive community that
             | should be distrusted are not uniquely dismissive
        
               | yieldcrv wrote:
               | interesting commenting strategy, its as if its supposed
               | to spark introspection by strawmanning absolutes that
               | nobody said to discredit their position, while feigning
               | agreement with them
               | 
               | oddly consistent in your other recent posts
               | 
               | dang, is this substantive to you?
        
               | mistermann wrote:
               | At least there's one thing everyone can agree on: what
               | seems to be true is true.
        
         | fleshmonad wrote:
         | Unironirally this. Whenever taking drugs of any kind, but
         | especially with one's that meddle with your reality. There is
         | no excuse for not doing your research. Your consciousness is
         | all you have
        
           | otherme123 wrote:
           | Thing is research has been extremely hindered in the last
           | ~100 years. At least they are trying to do their research
           | instead of going blindly "psychedelics bad, make you jump
           | from roofs and stare at the sun. Take this thingy-zepam for
           | years instead, known to turn you into a zombie, increase the
           | risk of suicide, create dependency and tolerance, and have
           | withdrawal".
        
       | uniqueuid wrote:
       | I find the design and results somewhat underwhelming (weak
       | significance in a N=800 sample with >50% dropout). The authors
       | also mention that they lack power, but the only correct answer
       | then is not to do the study, include more people, more data
       | points, or reduce measurement variance.
       | 
       | That said, I think it's a refreshing perspective, and it seems
       | like a good idea to look at effect heterogeneity in psychedelics
       | use. Thinks like bayesian trees (BART) can help identify
       | subgroups that react differently to stimuli along specific
       | characteristics.
        
         | WesternWind wrote:
         | A lower power study can still lend weight to a good meta
         | analysis.
        
           | uniqueuid wrote:
           | That is true, but there are also conditions where low-powered
           | studies degrade meta-analyses. For example, if the panel
           | attrition is caused by self-selection on unobserved
           | variables, then the study contains bias that is not (and
           | cannot be) accounted for, which skews the meta analysis. But
           | yeah, those concerns are mostly about measurement not sample
           | size.
        
           | coldtea wrote:
           | Meta-analyses are even less rigorous than a low power study
        
       | exodust wrote:
       | Interesting that OCD is the winning disorder, with zero negative
       | responders.
       | 
       | Recalling my mushroom days.... Okay, I think I get it.
       | Psychedelic experience is, in part, about embracing the beautiful
       | chaos of the universe. Surrendering to the charms of free-flowing
       | wild information at scale so huge there's no chance of imposing
       | your own orderly corrections - as you might in normal every day
       | life via OCD. That's my armchair take anyway.
       | Psychiatric history | Negative responders (%) | Non-responders
       | (%) | Positive responders (%)             OCD | 0.0 | 25.0 | 75.0
        
         | otherme123 wrote:
         | The _n=16_ is ridiculously low, though. Psychotic disorder,
         | with 25% /25%/50%... _n=4_. The only number from Table 2 that
         | makes sense is the aggregate. Even  "history" vs "no-history"
         | the differences are not that big, and slightly suggest that
         | having a history of psychiatric illness has better outcome.
        
           | exodust wrote:
           | Yes true, I left out n=16 for my casual observation.
           | 
           | It's a murky subject due to the traditional way being far
           | removed from clinical environments. Anything artificial like
           | therapy props would stand out under the influence of
           | psychedelics, but I guess they've thought of that. Good luck
           | to them.
        
         | int_19h wrote:
         | My subjective take is the opposite - psychedelics make you see
         | order (patterns) emerge out of seeming chaos pretty much
         | everywhere you look.
        
           | exodust wrote:
           | Yeh the infinite latticework does reveal a kind of order, I
           | know what you mean. Perhaps it calms the OCD person seeing
           | all those patterns.
           | 
           | Although while under the influence of psychedelics you're
           | unlikely to arrange your sock drawer with compulsive order.
           | You're more likely to free the socks from captivity.
        
       | AnarchismIsCool wrote:
       | You know when you see HN discussion on some subjects where you
       | have significant background and it's hyper cringe?
       | Psychology/neurology is one of those areas where the community's
       | commentary is almost always extremely...factually challenged. Be
       | very careful making health decisions based off of HN comments.
       | Lots of people with strong agendas and weak subject matter
       | knowledge. Also, be careful not to over-estimate your ability to
       | interpret random study results. It's kinda like trying to get a
       | project to build you downloaded from sourceforge.
        
         | 2four2 wrote:
         | I've found this to be generally true. Engineers are passionate
         | and intelligent people, but frequently make the mistake of
         | thinking this means they are experts in everything.
        
           | rokkitmensch wrote:
           | Dentist's curse.
        
           | tivert wrote:
           | > but frequently make the mistake of thinking this means they
           | are experts in everything.
           | 
           | That condition has a name, and it is "Engineer's Disease" or
           | "Engineer's Syndrome."
        
             | fragmede wrote:
             | which tbh isn't fair to the doctors and lawyer who also
             | suffer from the disease
        
               | tivert wrote:
               | > which tbh isn't fair to the doctors and lawyer who also
               | suffer from the disease
               | 
               | Even if that's the case, I think framing it as
               | "Engineer's Disease" is pretty critical for HN, which at
               | times can become a literal orgy of it.
               | 
               | Also, SV culture amplifies Engineer's Disease into a
               | destructive force only rivaled by its counterpart in
               | finance. Doctors and lawyers who suffer from something
               | similar are far more limited in their effects.
        
               | fragmede wrote:
               | Doctors and lawyers can become programmers far more
               | easily than programmers can become doctors and lawyers
               | though, so though the SV amplification is real, doctors
               | and lawyers can also wreak havoc outside their
               | discipline.
        
               | tivert wrote:
               | > Doctors and lawyers can become programmers far more
               | easily than programmers can become doctors and lawyers
               | though, so though the SV amplification is real, doctors
               | and lawyers can also wreak havoc outside their
               | discipline.
               | 
               | I think that's kind of missing the point. Also, I don't
               | think many doctors are making the switch to engineering.
               | Why would they? There are probably _far_ more engineers
               | becoming doctors than vice versa (though the total
               | numbers in both directions are likely small).
               | 
               | The specific problem with Engineer's disease, is that
               | engineers have the job of building things for others, and
               | thus have the opportunity to force their half-baked ideas
               | onto them. SV has amplified that and turned it into a
               | monster, by elevating things like "disruption" into
               | something like a moral imperative.
               | 
               | The counterpart in finance and the closely related
               | managerialism rival it because those jobs involve control
               | of others.
               | 
               | Doctors though? If they get arrogant about some other
               | field, they usually just end up hurting themselves or a
               | few others (like they learn to sail, get in over their
               | heads, and sink their ship in a storm). They don't have a
               | mechanism to do more damage.
        
             | piuantiderp wrote:
             | Midwitism and lack of culture
        
           | rpastuszak wrote:
           | Reminds me of this article by Dan Luu:
           | https://danluu.com/cocktail-ideas/
           | 
           | > A line I often hear from programmers is that programming is
           | like "having to build a plane while it's flying", implicitly
           | making the case that programming is harder than designing and
           | building a plane since people who design and build planes can
           | do so before the plane is flying1. But, of course, someone
           | who designs airplanes could just as easily say "gosh, my job
           | would be very easy if I could build planes with 4 9s of
           | uptime and my plane were allowed to crash and kill all of the
           | passengers for 1 minute every week".
           | 
           | We tend to think that some problems are only as complex as
           | our understanding of them.
        
         | RamblingCTO wrote:
         | This argument is moot as we know jackshit about halucinogenics
         | and research isn't very rampant in this area. And what we have
         | is weak bs like this. So both sides are lacking I would say.
        
         | smt88 wrote:
         | Your entire comment is about HN, not the article. Do you have
         | anything substantial or interesting to say about the study?
        
           | emsixteen wrote:
           | It's a valid comment, you don't need to be offended.
        
             | smt88 wrote:
             | I'm not offended. I'm curious if this person actually has
             | an interesting angle on the article or is just grinding an
             | axe.
             | 
             | It's also against HN guidelines to comment about the site
             | itself instead of something substantial that promotes
             | discussion.
        
       | cupcake-unicorn wrote:
       | This really just feels like fearmongering because this is a
       | threat to big pharma. I mean, several commonly prescribed
       | antidepressants have black box warnings about increased risk of
       | suicide. When they trialed Prozac on people with no history of
       | mental illness, someone committed suicide out of the blue. Fairly
       | certain someone could cobble together a much more compelling meta
       | analysis about even worse adverse effects of psych meds on
       | similar populations, but due to NAMI and big pharma I think
       | there's pressure not to draw those lines too clearly.
       | 
       | I think there's a clear bias in cases of big pharma approved meds
       | to jump to "Oh, it wasn't the medication, the condition just
       | worsened" and with psychedelics/weed to jump to "The substance
       | use is causing this". Even when there is proof of RX medication
       | worsening mental health conditions, it's common to have these
       | relationships straight up denied by the prescribing doctor.
       | 
       | This isn't to say that there isn't a similar relationship in
       | psychedelics, but it feels really disingenuous to me to be
       | mentioning this outside of the wider context of psychiatric meds
       | which somehow get a free pass for causing a much wider and
       | dangerous range of side effects. If psychedelics cause less harm
       | than commonly prescribed drugs in the same population, isn't that
       | a good thing? We should understand these harms, but the bias of
       | Big Pharma needs to be taken out of the picture.
        
         | swores wrote:
         | > _When they trialed Prozac on people with no history of mental
         | illness, someone committed suicide out of the blue._
         | 
         | I hadn't heard about this before, and while I'm sure it is
         | possible for any drug that messes with brain chemicals to cause
         | someone to decide to kill themselves, I've always been told &
         | read a different explanation for the suicide warning that comes
         | with most (or all?) antidepressants:
         | 
         | Which is that a depressed person while at their lowest might
         | think about suicide but not have the energy or willpower to do
         | anything, but if they start taking a drug that partially fixes
         | it, so they start having energy again, but doesn't fix their
         | root problems so they still think that suicide would be
         | preferable to life, and suddenly have energy to make that
         | happen.
         | 
         | Which is also the reason that modern guidance is for
         | antidepressants to be co-prescribed with talk therapy, to try
         | to use drugs to let the person be able to work on their issues,
         | rather than just hoping the drug can fix all issues.
        
           | cupcake-unicorn wrote:
           | I can understand why you would have that reasoning, but SSRIs
           | are commonly prescribed off label to populations for non-
           | mental health related reasons, for example ED or urinary
           | incontinence, and in these populations the relationship
           | holds, leading to some governments and regulatory bodies to
           | recommend or warn against use for these conditions.
           | 
           | "Although duloxetine reduced the symptoms of stress urinary
           | incontinence and improved women's quality of life, the harms
           | related to suicidality and violence were 4 to 5 times more
           | common with duloxetine than with a placebo, a meta analysis
           | using patient level data by researchers from the Nordic
           | Cochrane Centre showed."
           | https://www.bmj.com/content/355/bmj.i6103
        
             | swores wrote:
             | Wow, TIL, thanks!
             | 
             | Any idea if the logic I wrote about is also true? Or is it
             | the same as how many doctors will talk about SSRIs working
             | because depressed people "have too little serotonin", a
             | myth that remains commonly believed despite research not
             | backing it up?
        
               | skissane wrote:
               | It is possible multiple processes are at work-it is
               | possible that SSRIs increase violence risks independently
               | of their antidepressant effect, and simultaneously their
               | antidepressant effect also increases it. The two
               | explanations aren't necessarily mutually exclusive
        
               | cupcake-unicorn wrote:
               | Sure, but if that's what's going on, it should be
               | researched further and taken seriously during
               | prescribing. 100% guarantee that when psychedelics hit
               | the market, doctors will fall prey to overstating the
               | harms from studies like this while turning a blind eye to
               | the wealth of evidence of greater likelihood of harms in
               | prescriptions they churn out without blinking an eye.
               | 
               | I'm not anti medication, and I'm not saying that there
               | are cases where the benefit doesn't outweigh the harm,
               | but I do think the potential harms of each medication
               | should be thoroughly investigated equally. Large
               | companies with the ability to withhold damaging trials,
               | sway the public opinion, and have a giant PR team and
               | legal team at their disposal shouldn't be impacting our
               | understanding of the real risks and science.
        
               | skissane wrote:
               | > Sure, but if that's what's going on, it should be
               | researched further and taken seriously during
               | prescribing.
               | 
               | Well I mean, it is, at least to some extent. The FDA has
               | officially put a "black box" warning on antidepressants
               | that they can increase the risk of suicide, especially in
               | the young, and so have its counterpart agencies in
               | several other countries. All doctors know about it -
               | whether they all take that risk seriously enough is a
               | matter of opinion, some are much more hesitant about
               | prescribing them than others are. And it remains an
               | active area of research.
               | 
               | > 100% guarantee that when psychedelics hit the market,
               | 
               | Here in Australia, they only let psychiatrists prescribe
               | them (started in July last year for psilocybin and MDMA),
               | and only for individually approved psychiatrists who have
               | completed a training programme in psychedelic treatment.
               | This is similar to our existing restrictions on
               | prescribing psychostimulants-which most Australian states
               | only permit psychiatrists and paediatricians to prescribe
               | absent special approval-albeit even stricter. They'll
               | likely relax the rules over time, but very unlikely non-
               | psychiatrists will ever be legally allowed to prescribe
               | them (outside of exceptional circumstances).
               | 
               | From what I understand, the approach in the US is
               | different, as far as the DEA is concerned, theoretically,
               | any doctor can get a DEA number which lets them prescribe
               | any Schedule II/III/IV controlled substance. However, in
               | practice, there are a number of drugs which very few US
               | doctors would dare write a script for, even though by the
               | letter of the law they are allowed to do it, because they
               | don't want the "extra attention" the DEA will give them
               | if they do - methamphetamine is a good example.
               | (Technically, any Australian doctor can legally write a
               | script for methamphetamine, but it is almost impossible
               | to fill, because unlike the US, it isn't approved for
               | sale in Australia-not because it is a controlled
               | substance, rather because it lacks our equivalent of FDA-
               | approval-the only way to actually fill the script would
               | be to get a government permit to import it for an
               | individual patient, and there is zero chance they'd
               | approve such a permit unless the prescriber was a senior
               | psychiatrist.)
        
               | PedroBatista wrote:
               | Seems like a pretty good system as letting doctors
               | prescribe "psychedelics" can mean everything under the
               | Sun.
               | 
               | Also the training and approval is paramount, they are
               | doctors not magicians and many don't even have a good
               | understanding of nutrition let alone this type of drugs.
        
               | cupcake-unicorn wrote:
               | No problem, I like to spread awareness of this stuff! BTW
               | here are a few more RCTs about the relationship
               | https://www.madinamerica.com/2021/03/antidepressants-
               | still-l...
               | 
               | Honestly it's hard to say and I'm not even sure if you'd
               | be able to study this empirically in this population. I
               | do think that's why doctors fall prey to this bias, and
               | especially so in a stigmatized population. "Ah, they were
               | likely to have these symptoms anyway". It would be
               | interesting to do a wider study, but there already was a
               | history of these companies withholding damaging trials
               | and results so I doubt it would be done, especially given
               | that suicides have occurred in these trials.
               | 
               | I really do believe that these classes of medications are
               | treated differently due to the great power the industry
               | has on this issue. If you look up the background of NAMI
               | it's quite suspect and reminds me about how doctors were
               | getting textbooks that were written by the opioid
               | prescribing company. NAMI goes on to inform public
               | opinion and then this stuff becomes "fact". I'm glad the
               | "too little serotonin" thing is being examined but it was
               | crazy to see how many weirdly defensive memos and
               | articles there were out when it first came out. I see I'm
               | getting downvotes on my original comment but I do think
               | it's extremely important to examine these intuitions and
               | where they came from, because as we've seen some of this
               | stuff has been based on profits/trial P-hacking/junk
               | science.
        
             | mtlmtlmtlmtl wrote:
             | SSRIs are never used for ED. If anything they may cause it.
             | They are sometimes used to treat premature ejaculation
             | though because they tend to cause genital numbing or
             | anorgasmia.
        
           | skissane wrote:
           | That may be a factor, but it is likely more complex than just
           | that.
           | 
           | SSRIs can cause some individuals to become disinhibited,
           | impulsive. It is a particularly common symptom in children
           | and adolescents (which is why many paediatricians and child
           | psychiatrists hesitate to prescribe them), but more rarely
           | can happen in adults too. Probably some people have a genetic
           | susceptibility to it. It isn't purely about ameliorating
           | depression, since the same side effect has been observed in
           | non-depressed children administered SSRIs (which aren't
           | solely used to treat depression, sometimes they are used to
           | treat anxiety too, plus some children can end up being
           | prescribed them when they have neither, due to misprescribing
           | or off-label use.)
           | 
           | Disinhibition and increased impulsivity can increase the
           | risks of suicidality/homicidality/etc
        
             | cupcake-unicorn wrote:
             | I honestly wonder if it isn't less rare in adults or if
             | adults just are more likely to fall through the cracks and
             | to have whatever underlying disorder blamed on the
             | behavior. Children are a more vulnerable group who has a
             | parent who is witness to the obvious behavior changes and
             | can staunchly advocate for their child. Many adults
             | starting SSRIs are isolated, don't have great support
             | networks or friends looking out for them and are meeting
             | with their doctors for the first time. For all the doctors
             | know, behavioral issues were underlying, things just got
             | worse, etc.
             | 
             | Anecdotal, but I've never once met a doctor who adequately
             | described the risks of an SSRI to me as a patient, and even
             | some who have pushed back when I've told them of my own
             | dangerous reactions and other risk factors the drugs have.
             | They really should, as should the risks of new psychedelic
             | based drugs hitting the market. I don't have a problem with
             | the study that's posted. What I do have a problem with is
             | that I feel as if this information is going to be
             | disproportionately used to deny access to RX psychedelics,
             | when existing RXs with similar or worse risk factors aren't
             | discussed in this manner at all.
        
               | skissane wrote:
               | > Anecdotal, but I've never once met a doctor who
               | adequately described the risks of an SSRI to me as a
               | patient,
               | 
               | I've tried SSRIs several times, more than one (and an
               | SNRI and MAOI too). They never did anything for me other
               | than cause unpleasant side effects.
               | 
               | The best cure for depression I've ever found is
               | Vyvanse/lisdexamfetamine. Is that because I was never
               | actually depressed and my real problem all along was
               | ADHD? Maybe... but, on the other hand, I'm pretty sure
               | sometimes my depression has been an independent problem
               | from my ADHD and sometimes a much bigger one. The fact
               | is, psychostimulants have an antidepressant effect, and
               | are sometimes even prescribed off-label to non-ADHD
               | patients in order to treat depression (generally only for
               | "treatment-resistant depression", i.e. "we've tried all
               | the antidepressants and none of them work"). I think it
               | could possibly benefit more people with depression (at
               | least they should try it), but psychiatrists are
               | discouraged from prescribing it for them (here in
               | Australia, psychiatrists actually need per-patient
               | government approval to legally prescribe stimulants off-
               | label). In practice, it is easier to convince a
               | psychiatrist that you have ADHD, than it is to convince a
               | psychiatrist to prescribe you stimulants for something
               | other than ADHD.
        
         | teh_infallible wrote:
         | I always thought the "war on drugs" was a big pharma turf war.
         | 
         | Nearly every school shooter was on an antidepressant, but
         | somehow that never makes headlines.
        
           | int_19h wrote:
           | In US, the original war on drugs was racial in nature
           | (targeting blacks and Mexicans specifically).
           | 
           | The particularly heavy-handed enforcement from 1970s onwards
           | that spawned the term itself broadened into a war against the
           | social and cultural opposition to the status quo - still
           | partly racial in nature as various black civil rights and
           | black power movements were a significant part of that, but
           | also targeting anti-war protesters, "pinkos" etc.
        
           | randomcarbloke wrote:
           | The tale of Qin Shi Huang
        
       | andy_ppp wrote:
       | N of one but my friend (who always saw the world as very black
       | and white) killed herself not long after doing Ayahuasca. I'm
       | pretty sure it contributed to her death, she became an extreme
       | fantasist about judgement and god, not a formalised religion but
       | a personified fantasy with crazed rules and vengeances. It was
       | not good.
        
         | epilys wrote:
         | I'm sorry for your loss. I'm not a medical practitioner but it
         | sounds like the experience triggered a psychotic "break" in
         | your friend? It's a sad but real possibility with psychedelics
         | that more people should be aware of.
        
           | orbit7 wrote:
           | Devasting when such events occur. This can also occur from
           | doing meditation for some, I'm not sure if anyone has
           | measured whether there is any set means to determine
           | individual level of risk and whether any particular mental
           | conditioning/ study would mitigate that risk. Certainly
           | awareness is important.
        
           | looneytoon wrote:
           | Also not medical but I experienced similar and it sounds like
           | psychosis to me. Personally I had manic episode triggered by
           | taking several doses of acid spread over a week or so
           | preceded by shroom doses spread over prior weeks. This
           | culminated in several nights of insomnia, paranoia and then
           | psychosis - the religious stuff is relatable. I had intense
           | apocalyptic beliefs and "visions" - sort of closed eye waking
           | dream more so then an open eye hallucination. The black and
           | white thing also highly relatable and I think it is splitting
           | (https://en.wikipedia.org/wiki/Splitting_(psychology)) -
           | again not an expert.
           | 
           | Her suicide is very sad but I can relate. Rest in peace.
           | 
           | Personally it took me at least a month to feel functional
           | again and then probably a year to start feeling better. Prior
           | to that I struggled immensely with depression most of my life
           | and abusing substances was my attempt to pull out of it, so
           | to bottom out intensely like that feels extremely hopeless.
           | 
           | Once again giant disclaimer that I'm not authority, but I
           | learned more about how psychedelics work from neuroscientists
           | who research them and it was very illuminating. They are
           | extremely potent in regards to neuroplasticity which seems
           | like why they can be heaven or hell
           | (https://en.wikipedia.org/wiki/Psychoplastogen). My best take
           | away from the scientists was to space trips out by several
           | months similar to what you should do for MDMA. Frequently
           | redosing keeps your brain activity from stabilizing. That's
           | not their advice or strong statements (they were avoiding
           | advice-giving entirely), of course, just what I took away.
           | 
           | Years later and I have done a lot introspection and learning
           | and I have taken psychedelics again. I can identify my own
           | anxiety, paranoia, or bad patterned thoughts creeping up and
           | talk myself back. I don't attribute that traumatic experience
           | or drug use in general to improving my circumstance and I
           | sure as hell don't recommend it but it does seem like my life
           | going to total shit was a step I needed to take to get it
           | back together. Therapy would've been easier.
        
         | jnk345u8dfg9hjk wrote:
         | How do you know she wouldn't have killed herself without having
         | tried Ayahuasca?
        
           | andy_ppp wrote:
           | It's funny, this is the sort of harshness and absolute
           | certainty Jen would have come out with. Nothing is certain
           | but my opinion given the outcome is that it definitely did
           | not help.
        
             | jajko wrote:
             | Psychedelics are extremely strong experience, ayahuasca is
             | supposed to be the strongest. If you have anything broken
             | in your personality, it will come up. Thats why at least
             | initially it should be screened and if OK handled by
             | professionals who can lead, guide or stop the experience if
             | needed.
             | 
             | I've seen lifelong schizophrenia triggered by nothing more
             | than a bit of binge drinking. For some people it takes
             | trauma to trigger bad things, some drugs, some have luck
             | and manage to go through life with such a thing without
             | ever experiencing it. Powerful tool, nothing more, nothing
             | less.
        
               | K0balt wrote:
               | If you shake up a box of poorly packed stemware, you're
               | going to get some breakage.
        
             | jnk345u8dfg9hjk wrote:
             | It's an objective comment on your subjective opinion of an
             | N=1 result. You are free to share your opinion (and I may
             | even be inclined to agree with you) but it holds no
             | scientific value.
             | 
             | Sorry for your loss.
        
               | K0balt wrote:
               | N=1 is perfectly relevant to an individual occurrence
               | when the N and the event in question are one and the
               | same. If I kill myself with a hammer n=1 hammers were
               | fatal to use in my case. I don't see anyone asserting
               | that this means that broadly ayahuasca is dangerous or
               | claiming scientific relevancy.
        
       | optimalsolver wrote:
       | Reminder. Psychedelics can also lead to extremely traumatic
       | experiences:
       | 
       | https://www.reddit.com/r/DMT/comments/gb9ar0/dark_dmt_trip_r...
       | 
       | This doesn't get mentioned in the current "psychedelics as a
       | cure-all" hype wave.
        
         | ssijak wrote:
         | it gets mentioned
        
         | namero999 wrote:
         | Maybe not the best example as the report ends with "I'm doing
         | great now! I think the experience despite being f* terrify was
         | super useful", but I get what you mean. However, serious
         | narrators or researchers usually don't fail to mention that we
         | are not dealing with a panacea.
        
         | jajko wrote:
         | It gets mentioned all the time, everywhere I ever saw anything.
         | If you really see info only in such way, stay away from those
         | sources
        
         | ahiknsr wrote:
         | from the post
         | 
         | > and out of pure immaturity and desire to breakthrough I
         | packed 100mg into the bowl.
         | 
         | https://psychonautwiki.org/wiki/DMT says heavy dosage is 60mg+.
         | 
         | > This doesn't get mentioned in the current "psychedelics as a
         | cure-all" hype wave.
         | 
         | No. You forgot to mention 100mg is way above heavy dosage.
        
         | n4kana wrote:
         | That's a trauma cum redemption story. Sometimes it's just
         | trauma.
         | 
         | RIP Richard Skibinski (July 17, 2022)
         | 
         | https://www.reddit.com/r/Psychedelics_Society/comments/uzed2...
         | 
         | https://www.legacy.com/us/obituaries/legacyremembers/richard...
        
       | rdtsc wrote:
       | It's pretty scary to me that so many people seemingly on whim are
       | willing to upgrade their brain firmware. I often hear stuff like
       | "and then my whole view on reality changed". Unless there's an
       | easy way to upload the previous "factory image" so to speak, it
       | feels pretty risky to experiment with that.
        
         | holoduke wrote:
         | An illusive broken firmware it is. Better stay sober. Also when
         | learning new things being sober is better. You wont get your
         | phd using drugs. You wont get your brains to a new state using
         | drugs. You maybe think you do, but thats a illusional defect of
         | your brains when using drugs. Stay sober.
        
           | mistermann wrote:
           | Is the omniscience pure rationalists experience on vanilla
           | consciousness genuine?
        
         | lukan wrote:
         | It is risky, but life comes with risks. And not facing risks
         | can be risky, too. You might waste your life in boredom,
         | instead of taking off.
         | 
         | You also might "crap on the roof with your ass on the ground"
         | to (miss)quote Castaneda.
        
         | rumdonut wrote:
         | I agree as someone who was previously excited about the idea.
         | Although to be honest, I think people overstate the changes.
         | They did not last. Lots of salesmen in this industry like any
         | other.
        
           | jajko wrote:
           | Reprogramming? Not at all, at least not with intense mushroom
           | experience alone and laying with closed eyes, never did
           | ayahuasca. But understanding way way more about myself,
           | overall brain structure, and ie where religions come from?
           | And by far the most intense and out-of-reality/body/senses
           | experience I could ever go through?
           | 
           | Definitely, those few experiences will be with me till my
           | last breath.
        
           | herbst wrote:
           | You can't pop a trip, go to a music festival and except a new
           | mindset. You can however use these tools to deeply connect
           | with yourself and this is where life altering experiences
           | happen.
        
         | quchen wrote:
         | It's less that you upgrade your firmware, but rather that some
         | thoughts that never occurred to you are thought in such a
         | setting. Having felt connected to nature, or even a specific
         | tree, changes how you view trees and life in general. There are
         | many other ways to gain such insights, like travelling or
         | reading; any insight that resonates with you will >>change your
         | view on reality<<.
        
         | orbit7 wrote:
         | When I had depression I used Salvia Divinorum and re-lived
         | fragments of my childhood, I found that seemed to reset my
         | brain back to last known good state bridging forgotten
         | childhood memory in the short term to feeling like it was only
         | a week ago. Certainly cured my depression though. It felt
         | programmable with music, suspect it maybe more controllable
         | with research. Interesting stuff strangely I found anti-
         | addictive. Though equally could be majorily dangerous for some
         | as it litterally sucks you out of reality and all perception of
         | time for a bit.
        
         | mistermann wrote:
         | > I often hear stuff like "and then my whole view on reality
         | changed". Unless there's an easy way to upload the previous
         | "factory image" so to speak, it feels pretty risky to
         | experiment with that.
         | 
         | Some people say if you keep up to date on global news, the
         | opposite may be even more true.
        
         | fakeart wrote:
         | They say such things of travel too. "It will forever change how
         | you see the world, international travel."
        
       | reify wrote:
       | I am nearly 70 years old.
       | 
       | I have been taking psychedelics for 50 over years. I am retired
       | psychotherapist and I do not have a predisposition to mental ill
       | health. I was also a substance misuse worker and methadone
       | dispenser for over 10 years. I gave up smoking hash when I was 40
       | years old.
       | 
       | I did notice that with the introduction of skunk and the increase
       | of up to 20% more Tetrahydrocannabinol (THC), there were more and
       | more people being sectioned under the mental health act with
       | psychosis. Whereas prior to skunk when people generally smoked
       | good old fashioned, Moroccan, Lebanese and Afghani hashish it was
       | a rarity.
       | 
       | I know a range of people of different ages who partake in
       | psychedelic use and have no trouble, like me, in holding down a
       | professional job role and engaging fully in life.
       | 
       | As with all drugs there is a risk, however, the risks with
       | Psyceedelics are very low in comparison with other drugs.
       | 
       | We must not use individual cases to determine the safety of any
       | drug.
       | 
       | Here in the UK the media went wild over reports that a 18 year
       | old girl (Leah Betts) had died from taking MDMA. Very rarely are
       | the true facts given; The coroner said that "water intoxication",
       | and not an allergic reaction to the drug, was the cause of death.
       | 
       | I have a great deal of respect for Professor David Nutt who is an
       | English neuropsychopharmacologist specialising in the research of
       | drugs that affect the brain and conditions such as addiction. His
       | recommendations to the government to reclassify drugs were
       | rejected and he was sacked.
       | 
       | heroin is top of the list - alcohol is 5th on the list - LSD is
       | 14th on the list - Ecstacy is 18th on the list
        
         | jajko wrote:
         | > heroin is top of the list
         | 
         | Can you please share the list? Went through the article hoping
         | to find one but either I am blind or its not there.
         | 
         | As for rest of the comment - thank you for your work and
         | balanced insight. All this could have been researched to death
         | (and optimal solutions be picked up based on results with
         | regard to population health) if this stuff wasn't illegal for
         | so long and governments acknowledged that people can actually
         | get (a bit) high, since they can already ie drink themselves to
         | death.
        
           | quchen wrote:
           | Nutt's Wikipedia entry has pictures and sources:
           | https://en.wikipedia.org/wiki/David_Nutt
           | 
           | He's been working in the field for quite a while, and many of
           | the drug harmfulness diagrams that pop up every now and then
           | are from one of his papers.
        
       | iammjm wrote:
       | Psychedelics are a force to be reckoned with. Plus people are
       | conflating clinical trials with taking unknown substances, in
       | unknown amounts without considering the proper set and setting.
       | 
       | Controlling for the substance and amount as well as having a
       | professional, caring guide to help the patient through the
       | experience will be a FAR different experience than eating a fist-
       | full of shrooms at a party some stranger gave you while under the
       | influence of other things...
        
         | quchen wrote:
         | I'm also worried about all the self-medication, where people
         | treat serious issues without supervision. But I also want to
         | highlight that there is a place for recreational, responsible,
         | and safe drug use; there is a _lot_ between between
         | clinical/therapeutic settings and random recklessness.
        
       | underseacables wrote:
       | _We infer that the presence of a personality disorder may
       | represent an elevated risk for psychedelic use and hypothesize
       | that the importance of psychological support and good therapeutic
       | alliance may be increased in this population._
       | 
       | Feels like another publish or perish paper.
        
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