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FDA Agrees to New Trials for MDMA as Relief for PTSD Patients (nytimes.com)
345 points by victorbojica on Nov 30, 2016 | hide | past | favorite | 175 comments



The fact that one of the doctors in the article compares the dangers to opioids is misleading or misguided. MDMA has an exceptionally small potential for long term abuse when compared to most other drugs. Despite having studied brain damage in chronic users (not very many of these), I doubt the doctor has ever personally done opiates and MDMA. Anyone who has had any significant experience with both would laugh at the comparison when it comes to potential for abuse.


> I doubt the doctor has ever personally done opiates and MDMA

Well it's a good thing that's not a prerequisite to getting someone's opinion.

I'm all for sensible drug policy, and you may be right that MDMA and opioids are completely different classifications of substances, but the fact that the doctor hasn't personally done both is no reason to dismiss his statements out of hand.


You're right. Although I am much more likely to trust someone who has had significant experience with both (especially if they have also managed to become a doctor or something similar).

I don't have much information, but based on the article, I believe this doctor is biased by the fact that he has focused only on the very rare cases of individuals which develop an obsession with the drug and continue to use it even after it's primarily sought-after effects have stopped working. If you use MDMA every day for a prolonged time, then you are definitely going to get brain damage.

The reason this generally isn't a problem with MDMA is that, long before this happens, you will use up all your serotonin (temporary) and the drug essentially stops working, even with increased dosage. This usually means that people stop taking it before any major damage is done. Contrast this with opiates, where you can keep upping the dose and keep the high going indefinitely over a prolong time (until you overdose).

I dismiss the doctors statements not just because he hasn't done these drugs himself, all I need to do is look at the number of heroin addicts in rehab vs the number of chronic MDMA users.


Is there any proof that serotonin issues are temporary with MDMA? I've heard of people having severe long-term consequences after frequent (> once a week) use for as little as 3 months. Also, I disagree about the potential for abuse. I've heard of many people abusing MDMA, with daily use for long periods of time (all of which have reported memory issues and other permanent problems).


There aren't many good studies in the US precisely because of it's scheduling under the DEA. But serotonin levels are definitely restored. Most estimates range anywhere from a few days to six weeks before serotonin levels are fully restored. Not that permanent damage is impossible with frequent or high enough doses. More than once a week is definitely too much. More than once every month is probably still too much if you want to be safe. Most recommend 2-3 months for maximum safety.

I don't believe there are 'many' people who take MDMA daily for long periods of time, unless they only want negative side effects. They definitely aren't getting the same experience after the third day, regardless of how much they take. You only have so much serotonin. Perhaps these people are not actually taking what they think they are?

Here is an article about a decent study from the UK:

http://newatlas.com/study-effects-ecstasy/10995/


Obviously it's the minority (<1%) of users who are abusing the drug at anywhere near that level. I'm sure that the positive effects are long gone by that point, but I think people who abuse to that extent have become dependent on MDMA in order to feel normal (or have convinced themselves that this is the case). While I'm sure most of these people aren't consuming pure MDMA, there's likely some cases where it is still what's really being used.

Anyways, I've seen many people claiming to have done this (or having friends who have done this) on Reddit:

https://www.reddit.com/r/Drugs/comments/45sgbe/daily_mdma_us... https://www.reddit.com/r/Drugs/comments/1ldmka/so_really_how... https://www.reddit.com/r/MDMA/comments/2765jb/i_used_100mg_o... https://www.reddit.com/r/MDMA/comments/211jkj/ive_been_rolli...

Lots of these cases may be false, but there still seems to be at least a few real cases of this. Of course, that's no reason to make the substance illegal (and especially not a reason to stop studies attempting to use it). Better regulation as a controlled substance is probably the best solution (i.e. enforcing the 2-3 month rule by only allowing MDMA to be purchased at those intervals).


I wouldn't put too much stock in these Reddit testimonials. I agree, there are definitely cases where individuals have used MDMA chronically, but I believe the percentage is much, much less than 1% of users.

There are also cases of individuals who believe they need to eat glass on a daily basis.

Anyone can convince themselves of anything if they want to believe it badly enough. I would be willing to bet that most of these chronic users would not exist in the first place had they sufficient knowledge about the drug.


> I've heard of many people abusing MDMA, with daily use for long periods of time (all of which have reported memory issues and other permanent problems)

I've heard of many people abusing alcohol, with daily use for long periods of time (all of which have reported memory issues and other permanent problems).

Still legal though.


1. You are correct about the potential for long term damage. However the evidence I have seem indicates the permanent damage is due to neurotoxicity while the serotonin is depleted, while the serotonin depletion itself is temporary. Contrary to other posts here, the serotonin depletion can last in the order of 2 years, however, although this is usually in extreme cases.

2. When speaking about potential for abuse, it's worth making a distinction between drugs which cause dependency and/or chemical craving, and drugs that don't. You can develop habits without dependence or craving, but that can apply to almost anything, and is much less of an indicator that the thing is harmful. MDMA certainly had Prentiss for habitual use, usually as part of a multiple-drug-abuse condition, but in and of itself does not have dependence or craving properties.


Fortunately, both of your arguments make clear the need for more research, and thankfully it's finally happening.


While I tend to agree with you, I think the opiate epidemic is salient as an illustration of unintended consequences. Do I think this will lead to addicts? No. Do I think people will get hurt? Most likely; it's not exactly a brisk cup tea in terms of physiological AND psychological effects. Will it get abused? Of course. People abuse sugar.

My point being, there's a line between caution and fear mongering. I think you COULD interpret this as being cautious rather than illustrating an irrational fear.


I agree, I don't think the doctor is intentionally fear-mongering. I think this doctor is probably just biased from his own second hand experience with a very, very small and unrepresentative portion of MDMA users. Misguided.

My issue with the doctor's statements is concerning only the potential for abuse/addiction (which is not even worth talking about when compared to opioids). The potential for harm is definitely worth being cautious over.


The comparison with opioids is erroneous because prescribed opiates are given to a patient to take home, allowing abuse and diversion. MDMA use will take place at a medical practice. No abuse or diversion will take place (barring theft).


> MDMA has an exceptionally small potential for long term abuse when compared to most other drugs.

(Citation Needed)


See my additional reply to DINKDINK's comment, further below for source/citation.


Source?


Primary. Can confirm. Not even in the same ballpark.

If you've ever been in love and been with with that person and it feels like a moment could stretch on to eternity and everything is perfect... thats what opiates feel like.

With MDMA everything seems unique, there is a pronounced clarity of mind including insight, and vision. Tactile senses are heightened - it is a full, wholistic high. Perspective often shifts from minutae to space/time. Heightened senses (tactility) and feelings of empathy, understanding, oneness are universal. You may want to dance, sit down, look at the carpet, hug a friend.

The difference may seem subtle to a drug-naïve individual but they are two totally different head spaces


I want to try a light psychedelic but not sure where to start. Never taken any sort of drugs before, including alcohol. Any suggestions?

Edited


LSD is not a "light" psychedelic by any sense of the word. It's pretty great in many ways, but one of the big downsides is the duration of the drug. Mushrooms would be a better first bet, solely because the duration is significantly shorter. "light" is a hard term to use for any psychedelic as most can put you into total, terrifying ego loss. That being said, safe and sane mushrooms are your best bet IMHO. Just read trip reports to get an idea of the proper set and setting to get the most from the experience.


I'd have to disagree, despite being a proponent of occasional mushroom use. Any significant dose of psilocybin has the potential to turn into a VERY overwhelming experience. Especially for a first time user.

As others have mentioned I'd recommend starting with cannabis, which in my opinion very much qualifies as a psychedelic.


For sure, as I mentioned, it's hard to call any common psychedelic light or casual for that reason. But, 3 hours of too much is much much better than 6 hours of too much :)


Speaking of duration: it can be really long, way longer than regular 10 hours. Once a trip on piracetam+L was 40 sleepless hours. Shrooms for starters.


Completely unrelated. Not comparable. I suggest you visit http://bluelight.org/ to learn more, including a lot about safety.


I'd also recommend https://www.erowid.org/ .


I second erowid. Fantastic resource.


Thanks, I'll start there.


First of all, if you have a family history of mental disorders, like schizophrenia or bipolar, I would highly recommend not trying any psychedelic. There exists a possibility of uncovering a latent genetic mental disorder that otherwise would not have appeared.

That said, I wholeheartedly recommend starting with Marijuana. It's not a psychedelic in the traditional sense, but it's a good introduction to mind-altering drugs.

From there, either LSD or Mushrooms. These are more typical psychedelic experiences, with long durations. LSD can last 8-12 hours depending on the dose, mushrooms is 6-10, depending on dose and species. I personally prefer LSD, but you should be cautious and ensure you get legitimate stuff. Taking precautions and purchasing off the internet from a reputable vendor is the safest method in my opinion.

When it comes to LSD, I always recommend swallowing over just leaving it on your tongue, especially if purchased from an irreputable source. The common Research Chemicals sold as LSD are only activated sublingually (through the mouth/gums), whereas LSD is sublingual and oral. For a newbie 100ug I believe is considered a light dose, although you could go down to 50ug and still feel Something.

General trip advise would be to ensure you're in a positive mindset, and in a secure, safe, comfortable setting. Taking a walk through nature is nice, as well. Set and setting is important.

I would advise against trying any research chemicals (25X or 2C-X, where X=[A-Z]), just because they are newer and less known, but with the right research and precautions you could be okay.

Avoid mixing until you know what you're doing. A lot of people like to mix marijuana and lsd/shrooms, and I find it definitely intensifies the experience, while clouding it a little.

Overall, you should conduct a lot of research and read people's trip reports so you know what you're getting into. Tripsit.me is a wonderful resource, and includes an IRC channel for support and conversation while tripping. Erowid is a popular site for information as well.


A friend of mine actually discovered his latent schizophrenia through Marijuana usage. So yeah, not as safe as people want to believe. I honestly think that there is less mental health risk in taking MDMA, Speed or Alcohol compared to THC.


Interesting point about schizophrenia and bipolar. I'm still in the "curious" phase, so I'll definitely be doing more research. Anyhow, thanks for the other tips man; I've saved this to my HN favorites.


Besides family history of mental illness, i remember reading that a "bad childhood" , or a period of very high stress are also risk factors to getting mental illness with marijuana.


I would recommend starting with LSD; it's much easier to take compared to something like mushrooms, and it's easy to reduce dosage.

I often took a 1/4 hit when I was in college; aka cut a normal hit into 4 pieces. I found this to be a really nice, 'mellow' (well for LSD anyway...) trip; You won't hallucinate much (probably none at all), and so you'll still be able to function and get around, go on a hike, that sort of thing. You'll still have an incredible experience full of self discover and personal insight, but of course each persons milage may vary.

At some point once you have a feel for it you'll want to take a full hit and experience the full effect. But that takes more planning and you should definitely find a designated 'watcher' because you can make some really irrational decisions on this stuff, esp. if you are inexperienced. Always good to have a straight friend around to stop you from making phone calls to family (bad idea), going out for a hike in a blizzard (also attempted this one), you get the idea.

Mushrooms in my experience are much more unpredictable and given the option I personally always chose LSD.


A big problem with LSD it that it can last an insanely long amount of time. The first time I took it I was tripping 16 hours later.


True, my first full trip was similar. That's also why I recommend taking a small dosage the first time (hell most times); my 1/4 hit trips last around 6-8 hours. I also found I could sleep without trouble on that dosage as well, another major issue if you take a full hit (you tend to not be able to sleep at all that night).


I find I can't sleep while I'm affected by the drug, but when I am able to sleep again, I know the drug's worn off. I also try to plan accordingly and drop earlier in the day


Do you know what the dose was? If it was a tab, what did it taste like? Did you swallow or leave it under the tongue?

Unfortunately, there are a lot of Research Chemicals that are sold as LSD. They can have wildly different effects and durations, and are much less 'known' compared to LSD.

My first trip was 10 or 11 hours and that was on ~200ug.


cannabis.

it's incredibly non-toxic, cheap, easy to get, actually legal in some places, easy to confirm that what you bought is what you think it is, and will produce a pleasant and mild high that has some attributes in common with psychedelics (though it isn't a true psychedelic in the classical sense).


Hmm I guess that's something to consider. Thanks.


imo Cannabis is far and away more physically harmful than LSD and MDMA despite being orders of magnitude more commonly available


LSD is also incredibly non-toxic. it's such a strong drug though that even though it's very safe for your body I really can't recommend that a person uses that for their first ever experience with drug-altered consciousness.

MDMA is just objectively more toxic than cannabis. this isn't really subject to your opinion.

if what you're referring to is the fact that cannabis is frequently smoked, that's not a fair comparison. oral cannnabis products exist too.


Smoked cannabis is harmful to the lungs and oral cannabis is easily overdosed.

No matter how you spin this one, you have to be careful with whatever road you choose to go down.


remember, you started this as a comparison of the relative dangers of cannabis vs. lsd or mdma. stay focused. you tried to make a point and I disagreed with it. accusing me of spinning is disengenuous.

are you really going to start talking about "easily overdosed" when the drugs you're comparing it to are lsd (active in the microgram range) and mdma (active in the milligram range)?

seriously, you feel like you can get away with claiming that cannabis is more dangerous than a drug that most people encounter as mystery pills at a party? get real.


You are of course completely correct. But given one hit of acid vs one hit of a cannabis brownie, people are more weary of the hit of acid and tend to subdivide it into pieces whereas novices typically trust cannabis brownies to be weak or they eat multiple of them and receive an overwhelming dose more often than not. Or maybe not. Your thoughts?


my thoughts are that cannabis is remarkably safe in general, but that everyone using it should be well informed and not be taking edibles that they don't know the content of.

in legal states you can buy properly labeled edibles at a shop. if it's homemade stuff, you really have to be a lot more careful. either make it yourself or really trust your supplier. personally I would never take edibles bought from a dealer unlabeled. that's a real risk of an uncomfortable experience.

I think smoking (or vaping if you're sensitive to the smoke) is by far the safest and most effective way to take cannabis though.

LSD and MDMA there are really no safety tips that can possibly help. you either trust your source or you don't. if you trust your source and follow the dosage guidelines it's fine. both of those drugs are very safe at appropriate doses.


WTF!?!

You CANNOT overdose on cannabis. As in it will not kill you.

The only way you could say that is if you have some weird definition where by having a "bad trip" counts as an overdose.


I think he literally meant unknowingly taking so much that it overwhelms you.


This


As someone who has dabbled with all three I'd recommend starting with cannabis then MDMA and finally, in a safe environment, LSD. With one-off doses toxicity isn't your major concern, it's potential self harm through being unacquainted with different states of mind and control. Start on the more familiar end and work your way up if you're confident in your state of mind and sense of control.

For the record I've never had a bad experience with any of them. I'd say cannabis and MDMA are my favorite substances, though I mix them with tobacco and alcohol so I suspect there's a synergistic effect where my reward center is being lit up like a Christmas tree. FWIW I don't go out to raves or clubs - I'm old and an introvert - I just hang out with friends in our own homes or outdoors near our homes so the risks are lower.


I would add not to use LSD alone - have a sober 'trip sitter' with you. If things take a negative turn, they might be able to turn it back around, or at least calm you down and stop you doing anything silly.


If I had absolutely no experience with drugs, but had my current knowledge, I would start not with psychedelics, but with low doses of an empatogen (MDAI, preferably, which is hard to obtain but still legal in some countries, if not, then MDMA). This experiecne is much more manageable than psychedelics and if I would meet any resistance (which can happen), it would be easier to climb down. Only after that would I try psychedelics (mushrooms, for a shorter experience or LSD, for a longer one). With an experienced sitter I can trust.


A good first time psychedelic is 2-CB [0] (low dose 10-15mg). It will give you fairly intense visuals, somewhat similar to those on LSD, with virtually no anxious or weird thoughts. As always set and setting are still important, and you should be prepared for the chance of a bad trip, but I would say you're significantly less likely to have a scary experience on 2-CB than LSD.

[0]: https://en.m.wikipedia.org/wiki/2C-B


Note that you need a very accurate scale (measures down to the milligram) to accurately measure dosage for this substance. Please make sure you don't take too much. It is impossible to measure by eye.


it's also ridiculously rare and hard to find (requires well connected sources or pretty complicated darknet/btc/dropsite setup).

in addition to that, you're talking about a white powder drug where the effective dose is in the milligrams range. confirming purity and appropriateness of dose is stuff that requires a lot of experience. this is not beginner stuff.


Educate yourself thoroughly on your options, on the risks, and benefits of anything and everything you might be considering.

There's a lot of really great material written on these substances. erowid.org is a good starting point, but don't stop there! Get some good books on the subject.

Be wary of what some random person tells you. Most people are really misinformed, and there are a lot of myths and urban legends floating around that are bandied about like facts.

Do your own research! Be very thorough. Know what you're getting yourself in to. Be very respectful of the substances, and take them very seriously.


You missed out on the golden age of MXE. God what a drug. Not a psychedelic but with light negatives and high positives.

Take one of the shorter-lived 2C-x drugs and watch Flash Gordon and Heavy Metal.

My preferred combination is AMT and 25C-NBOME (VERY DANGEROUS TO DOSE WRONGLY) with some ethylphenidate. The sight of a rising sun turns from being saccharine to something "beyond man and time". The 25C-NBOME is less for unique effects and more for the fact that you could literally have months worth of trips (1x a week) in a tiny bag.

If you want an escape plan, have a benzo like clonezepam (sp?). It'll tranquilize you out of a nightmare if some fucked up shit appears.

And remember, the interesting thing about psychedelics isn't the "oneness with everything" bull that idiots talk about. That's just a temporary addictive feeling. One of the interesting parts is the enhanced capability for visual modeling and making connections. The other interesting part is that it makes you feel like a golden man Prometheus thing. You conjure up mythologies and struggles from just observing the local area outside.

Also take 200-400 mg of magnesium.


I also recommend having a benzo before taking any psychedelic for the first time. It will bring you out of it for the most part if you start having a bad time.


The best place to start is a substituted phenethylamine rather than a tryptamine, as these compounds tend to be gentler, more euphoric and less reality-shattering. Some research chemicals that are good options:

https://psychonautwiki.org/wiki/2C-C https://psychonautwiki.org/wiki/2C-E

In terms of consciousness expanding, DMT (in the form of Ayahuasca) is probably the most potent psychedelic. It can be emotionally intense though, so not the place to start.


Phenethylamines tend to have more side effects and feel less natural.

The ones you listed, such as 2C-C and 2C-E are quite different different. 2C-C may be gentle but 2C-E can be extremely intense / reality shattering. I will never look at reality the same after a 20mg dose of 2C-E. Also, many of the phenethylamines are now illegal. Including the NBOME series which are extremely toxic.

I'd say stick with the tryptamines like 4-HO/AcO-DMT/DIPT/MIPT, DPT, ALD-52 as they tend to be more enlightening rather than entertaining, IMO.


LSD and MDMA are different things.

Perhaps start by reading wikipedia pages.


Wikipedia is a good source but for those interested recreational drugs I strongly encourage those interested to visit bluelight.org over Wikipedia because Wikipedia provides less practical information for end-users.


If you don't know if there's a difference between MDMA and LSD, your first source shouldn't be something like bluelight. You should have a lot of information before you even consider being an end-user.


Avoid LSD.


Good advice if you aren't in a positive mindset


SOme oif the best times in my life have been on LSD.


I feel that the first chart/plot on this wiki gives a pretty good estimate on the relative potentials for abuse of various drugs.

Note the relative positions of Ecstasy, Cannabis, and Heroin:

https://en.wikipedia.org/wiki/Substance_abuse

PDF for the actual paper containing the chart:

https://www.thevespiary.org/rhodium/Rhodium/Vespiary/talk/fi...


And even heroin as a drug causes less physical harm in principle than stated - proper administration primarily results in constipation and very rarely organ damage. The primary danger come from improper intravenous drug use along with variable concentrations of drug due to buying from a black market, resulting in accidental overdose.

Khat is a funny one - didn't we already go through the racial disparities in prosecuting "crack" and "cocaine" differently? It's too bad the African Khat-using community didn't muster as much political muscle as the kratom community is.


Spoiler for anyone that doesn't want to click through to the first link: MDMA is apparently roughly the same in physical harm as marijuana, but rates lower on the dependence scale. I did not expect that, but then, I've never done MDMA.


That seems highly misleading. I think MDMA is far more physically dangerous than cannabis. Many people have directly died from irresponsible use of MDMA, but no one has (directly) died from any use of cannabis. MDMA can certainly be safe and beneficial if taken responsibility, but:

- Doses should generally be spaced at least 2 (many recommend 3) months apart.

- The minimum effective dose should be taken. Even a light overdose can create an uncomfortable, traumatizing, or even physically dangerous situation.

- Hydration and access to cool environments is important. Overhydration can also be a risk, so it's good to have access to electrolyte-laden drinks (Gatorade etc.). Overhydration, dehydration, and brain overheating are the leading causes of MDMA-related death.

- Supplements should be taken to reduce the inherent neurotoxicity even if you do all of the above things right. Some good examples on http://www.rollsafe.org.

It's true that dependence-wise, cannabis is probably worse, though. It's pretty hard to build a dependence on MDMA, as you'll likely only feel the uncomfortable stimulant effects (and other negative symptoms; this can lead to long-term or permanent neuroreceptor damage and dysfunction) if you take it on a weekly or daily basis.


No one has ever died directly from an MDMA overdose (as far as I know). Yes there have been indirect deaths usually from over-hydration (which causes the brain to swell, with or without MDMA), which usually happens in a rave/dance setting.

I'm sure there have been many indirect deaths from cannabis as well. Lung cancer, car crashes, falling down an elevator shaft, etc.

This is going to be true of any sufficiently powerful psychoactive substance.


If you completely ignore deaths for a moment, many report severe negative symptoms, lasting weeks or more, resulting from dehydration or overheating from MDMA. Overheating is also speculated by many researchers to be responsible for some of MDMA's neurodegenerative and neurotoxic effects.

You probably won't die due to MDMA, but if you're not careful you can certainly cause brain issues. And that makes it more physically dangerous than cannabis.


Perhaps. Personally if I drew the graph, I would put MDMA and cannabis closer together in terms of physical harm. I think they are dangerous in different ways and it's difficult to say which is more dangerous in absolute terms.

Like you say, if you are careful and informed, you can avoid lots of the dangers of MDMA with responsible use. It's difficult to smoke pot and not do some damage to your lungs, no matter how careful you are. Vaporizers not withstanding, but vaping was probably not considered in the graph.


I think one of the biggest problems with MDMA is that what you are getting is not always MDMA[1]

Better access to drug testing for consumers could help here.

[1] https://www.ecstasydata.org


I agree, but this isn't a problem with MDMA, but with illicit drugs in general. When you buy cannabis, LSD, cocaine, or anything else on the street, you have no way of knowing what's in it for sure unless you have a way to test it.

This is one of the big arguments for legalization / decriminalization. It won't be an issue with the MDMA these trial patients are receiving for example.


that's not a very accurate way of phrasing it. in some scales it's considered similar in abuse potential but that is extremely different than physical harm.

both are considered medium for abuse potential. cannabis is so non-toxic it doesn't even chart for physical harm. mdma is medium toxic, especially with sustained use.


Not according to the graph or the study. Source? Toxicity is not the only measure for physical harm.


Having taken MDMA several times purely for recreational use, it doesn't surprise me at all that used correctly, it could help treat conditions like PTSD.

It is an incredibly powerful drug and I genuinely believe since taking MDMA i've been a much more empathetic & loving person.

Whilst the high may only last a few hours, you tend to remember the emotions you experienced quite well.


How about letting consenting adults free of doing what they want to their own body and legalizing all drugs?


I tend to agree, but I don't think a society should treat all drugs the same. Opiates and crack cocaine are much more dangerous, than say pot or MDMA.

If we legalize everything, we need much better drug education in schools. Let's get rid of "Just Say No" and instead actually teach kids to make informed decisions about what they will and will not put in their bodies.


There are specific drugs out there, that permanently disable your ability to cognitively function in a reasonable manner. Heroin permanently alters the way your brain measures its dopamine levels. PCP causes all sorts of serious mental harm, same with crack cocaine.

These should be regulated the same way we would regulate any other chemical that hard those sorts of toxic affects.

But people wouldn't do those drugs, if there were alternatives available that created similar feelings, that were legal. And that's the crux of it. Many drugs have little to no negative affects (compared to nicotine / alcohol), and could be used without horrid ramifications if they were legal and their purity levels were regulated.

No one would do crack cocaine, if a legal safer variant of cocaine was available, for example.


>any other chemical that hard those sorts of toxic affects.

Like bleach?


Yes, exactly. And in addition to better education, better counseling and support for addicts (including alcoholics) who have fallen into negative patterns of usage.

We could afford a lot of that if we stopped incarcerating people for possession offenses.


I used to think this, but I'm not so sure anymore.

I think probably about 30-40% of the population would be able to make adequate life decisions and control the use of drugs to the point where it would be recreational use only, and they would otherwise be able to live a productive and positive life.

But what about the other 60%? The majority of the public make bad long term decisions in order to get a quick payoff, examples: Payday loan companies, Fast food / obesity, binge drinking, credit cards .. these are (not absolute) but examples of how people "just cant wait" for the long term payoff and take 'fix' and run.

Having > 50% of the population addicted to drugs would be disastrous.

And another point: What of the health costs of all of these consenting adults? Here in the UK, public health care is free though the NHS - should society as a whole bare the cost of the drug addicted and unproductive majority?

I do actually think legalisation is the answer, but I'm not sure how to answer these tough questions first ...

Maybe drugs should be legal but very expensive?

What do you think?


I think keeping them controlled but allowing recreational prescriptions gets you at least part way there. You go to see your doctor, tell him you want to try a particular drug and your reasons for doing so - curiosity or having enjoyed it previously both being legitimate reasons.

The doctor reviews your history, discusses any concerns/conflicts with existing medication, and having ensured that you're fully informed, issues you a prescription which entitles you to purchase the drug at your nearest pharmacy and doubles as your license to carry that specific controlled substance.

That way, safe intervals can be observed (for example, it's generally recommended that you shouldn't take MDMA more than once every couple of months or so), appropriate recovery/preparatory supplements can be recommended, and dependency can be watched out for.


Let's put your thoughts into perspective.

There is no drug drought currently. Anyone that wants to get high can. Current market is not regulated. Anyone can become a seller with a little effort. Sellers are not regulated.

We do not see an addiction rate of 60%, even with the ready availability of drugs from an unregulated market.

Rat Park [1] was an experiment that revealed that everything we know about addiction is wrong. I recommend reading up on it.

[1] https://www.youtube.com/watch?v=ao8L-0nSYzg


I don't believe the "anyone that wants to get high can" mantra. This misses a very important part of the equation which is that they must also be willing to face the consequences and repercussions of said decision including up to loss of freedom, financial costs and deal with the sketchy providers. In addition, it does not take into account the social stigma still associated with some drugs and/or usage in general. I know people who have used all manner of drugs who will talk pejoratively of individuals who still continue to consume, and have not 'straightened out'.

Even with drugs that are pretty available like alcohol, alcoholics have to curb their desire and usage based on many external constraints. And there is definitely no alcohol drought, but there's also no permissive free for all for consumption.


"I don't believe the "anyone that wants to get high can" mantra."

I agree, but my reasoning is different. The simple fact is that not everyone knows which people in their circles could possibly supply drugs. So for the user in their mid-40's that would like to take lsd twice a year now that the kids are off to college, this is a hurdle.

With legalisation, said couple can go to a store and get them, even with all the rest of the stuff still in place - social stigma, financial costs, and even sketchy providers (though that is much less likely).


You're mental model makes some strange and seemingly contradictory assumptions. It seems like your assuming that would be drug users are completely irrational when weighing the intrinsic consequences of drug-use like large ill-health effect, and great risk of addiction, but are very rational when weighing the legal costs of drugs use. Maybe you can help explain this? I would be surprised if the legal costs were even a third of the long term damage done by addiction, not to mention behavioral studies tell us its not the magnitude of the punishment but the likelihood. And judging from people I've met hard drugs are more likely to ruin lives through addiction* than the legal system.

Also when people argue for legal drugs the vast majority are arguing for end-users to have the ability to purchase drugs through a regulated system, not the ability to air drone a pound of heroin to your house at a moments notice. The two most important regulations in my mind should be age restriction(to stop children) and a waiting period(like 3 months to stop impulse buys).

*Knew 4-6 people over my life who had their lives ruined through hard drug use, and no-one who's life was ruined through the direct legal consequences of hard drug use.


I wasn't trying to say all factors apply equally to all people.

Some factors are completely negligible for some users. For example, individuals coming from a high income bracket rarely face significant legal costs due to their drug use. However, the story is much different for those from lower income brackets. None of the people I know that use drugs have faced any legal problems, but people are detained for carrying drugs. Just because I'm not witness to it, does not mean that cost does not exist for some non-negligible part of the population.

In another vein, for some people the legal repercussions are an issue due to their personalities or circumstances (drug testing at work).

I was merely saying that you could want the drugs, but there are still some strong forces (that pull on people differently) that make this decision far from frictionless.


Rat Park doesn't replicate. I generally agree with the rest of your comment.


My opinion:

Drugs should be taxed at a level where their cost is roughly the same as they are on the black market - This is actually a huge tax. Cocaine would be similarly priced to coffee if it was controlled in the same way*

The taxes earned should mostly go towards treatment and education.

Also, legalization doesn't mean completely uncontrolled. Potentially some drugs could only be legal with medical supervision, or not in public places, or not in certain places, etc

edit: * just checked and it's not actually true, it would still be around 100x more expensive


I think recreational drug service companies would be a multi-billion dollar industry.

The wine industry supports sommeliers and winery tours and tastings. Some of its customers are alcoholics. Some are not alcoholics, but still drink wine to excess. And yet the wine industry is not considered a menace in the US and Europe.

Wine contains ethanol. Ethanol is a recreational drug for humans. It does have adverse health effects when consumed to excess, and does produce externality costs borne by people who do not drink it. It is about the same with tobacco.

It seems to me that the problems you mention are not entirely solved, but they are not completely new, either. Society adapts, eventually.

And drugs, if legal, will be both cheap and expensive. In the same way you can buy $2 bottles and $2000 bottles of wine that have the same ethanol %vol, you will likely be able to pay more or less for different brands of cannabis that have the same quantity of a specific chemical in them.


> But what about the other 60%? The majority of the public make bad long term decisions in order to get a quick payoff, examples: Payday loan companies, Fast food / obesity, binge drinking, credit cards .. these are (not absolute) but examples of how people "just cant wait" for the long term payoff and take 'fix' and run.

People do these things, but I'm not sure that's enough of a reason to ban said activities. I think most people agree that banning e.g. 'being fat' or 'eating too much' would be unreasonable. Instead we allow people to make these mistakes, and then deal with the consequences.

> Having > 50% of the population addicted to drugs would be disastrous.

I completely agree with this statement, although I'm not sure I think legalising drugs would actually lead to that. If we were to legalise drugs there would need to be a system in place where people are informed about the effects and side-effects of the drug they wish to purchase. They would not get access to unlimited amounts at a low cost. While some drugs would be potentially quite problematic under this system (e.g. the very addictive and damaging ones such as methamphetamine and heroin) some probably would not. For example MDMA does not carry a large risk of being abused, and neither do psychedelics (they are not addictive, at least not in the physical sense).

Completely legalising drugs has many challenges associated with it, but also many benefits. I think decriminalisation, at least, could be a very good idea. It moves drug addiction from being a crime to be being a medical issue, where the correct response is treatment and not prison. Portugal is an example of a country where this was implemented with positive results.


Perhaps you have to take a test designed to measure self control before being allowed access to addictive drugs?

I think many of these dangers would be much smaller if we had a better educated public when it comes to the differences and specific dangers of particular drugs. I think legalization would increase awareness in this area, but I agree I am not convinced it would be enough for everyone.

Funny though that all of your comparisons are legal. We don't outlaw fast food because some people eat it to obesity. We don't outlaw credit cards because some people use them to drive themselves into unworkable debt.


Here is the thing: Most folks, when they in their late teens or early 20's, know a few folks they can get drugs from. The majority of folks don't. Of those that do, only a few of those use often. And of those, only some get addicted. I do think your 60% is high.

We control the dangers by having very honest public education, and training folks at the dispensaries really really well. Some drugs you can have daily limits on if you'd like, potency controls, and things like that.

"What of the health costs of all these consenting adults?"

You are already paying for a lot of that, as are folks in the US. Taxpayers pay for jails, after all, and those sorts of things effect the families' health as well. And if we are honest with folks and have rehab readily available, perhaps we can treat folks sooner and save some other money there.

"should society as a whole bare the cost of the drug addicted and unproductive majority?" ... Most won't be addicted, and only a few of the folks won't be productive. I think most folks will wind up using pot like alcohol, and the heavier stuff will be for occasional use. It'll be much like: Only a few alcoholics are unproductive citizens.

"maybe drugs should be legal but very expensive?" I've thought about this, and I disagree. At first, they should be a bit less than the black market just so that people are encouraged to buy from there. Then it can match black market prices. After all, you don't want to encourage the black market, otherwise you are selling in vain.

I'd much rather people buy cocaine or heroin from the state run facility. You have chances to intervene for rehab offers to regular buyers (your id would be scanned on purchase), limit daily purchases to safer doses, limit strength, and offer free needles. These all have positive benefits to society at large. The price only needs to be high enough to deter casual use upfront with some drugs - which is why pot should be cheaper than cocaine, for example.


One alternative is the approach where the buyer side is not punished or at most fined for its activities (as long as it doesn't harm others), but the seller side is strictly regulated or even illegal.

It's sort of right in between letting people free to do as they please, and guiding them in a certain direction or curbing excess.

It's how Holland deals with weed and ecstacy, for example, and for the most part it seems to work. That said, personally I think I'd prefer proper legalization with heavy regulation if necessary.


You make a good point, but I think your 60% figure is far too high.


> I used to think this, but I'm not so sure anymore.

Try facts. Google around. "Portugal after legalization".


Actually, I think if anything Portugal as an example supports their comment.

Portugal decriminalized drugs, which is different from legalizing it. Selling is still punished, but possession and use is not, or at least not seriously.

It's similar where I live, at least with some things. I can buy weed, even grow a certain amount, and smoke it in public without being punished. But I can't just start a coffeeshop, and the ones that exist are pretty seriously regulated.

I'm not entirely sure if I prefer decriminalization to legalization; perhaps with most substances full legalization would not be an issue. But at least the former has been shown to be effective.


Portugal has not legalized, only decriminalized.


In my opinion, an important component of the legalization of drugs is to ensure that any who is receiving public money has no drugs in their system.

If you are on food stamps, there is absolutely no reason you should be spending money on any type of recreational drug.

So mandatory drug tests before any social spending.

We'd need to get the cost down and efficacy up for drug testing, though.

If you are destitute and they find drugs in your system, you are sent to rehab.


That's an absurd restriction that would waste a vast amount of public money only to defeat the entire point of legalisation.

Most people still won't do drugs even if they were legal, and of the ones who do, most will obey any restriction you put on them. So you'll spend billions in public money testing everyone who needs any kind of social assistance, only to give about 95% of them their money anyway.

Of course, some will fail. That doesn't necessarily mean they're an addict, any more than a glass of champagne at New Years makes you an alcoholic. Many will be occasional users who will see no benefit whatsoever from enforced rehab. That's taking valuable rehab spaces away from those who genuinely need them. Oh, and when you're forcing treatment on the poorest members of society, they probably can't pay for it themselves. That's more money from the public purse.

Then you've got new applicants who've just lost their job. Are they sent to enforced rehab, or just denied assistance until they can pass a drug test?

Some will be addicts. Unless they actually want to quit, rehab won't fix that. And the ones who want drugs are going to get drugs anyway. You're not going to stop that just by removing their money. What you will do is reinstate the very black market you just got rid of through legalisation.

Which brings us to the deeper problem with your plan. If you remove a persons ability to pay for food and shelter, what do you believe that person will do? They're certainly not just going to crawl into the woods and die quietly - they'll do what they need to do to survive.

Social assistance doesn't just help the person receiving it - it helps society as a whole by removing the need to turn to crime just so you can eat.


Are you including alcohol and cigarettes and caffeine here?


This is the problem with the drug testing argument, the slippery slope leads into caste oriented nanny state territory. Such an argument could conceivably go even further.

EG: Ban any "unhealthy" food from being purchased using public assistance. Require anyone who is on public assistance provide proof of doing 30 minutes of daily exercise. Tie public assistance aid to your credit score. Place monitors in the house so if one is engaging in too much time-wasting activity (video game binges! hours of social media!) your funding is cut.

This could get pretty nightmarish frankly in an Orwellian way, especially if we combine this with the "world is so automated a basic income is absolutely necessary" idea that's floated around here a lot.

Generally, in the states that drug test for "welfare", the results seem to mostly point to a waste of money (typical articles on the phenomenon are here: http://www.forbes.com/sites/judystone/2015/02/17/the-sham-of...). As my above point on reagents, the standard "pee test" involves similar principals; the only way to truly confirm a positive pee test is to send it to a lab for GCMS analysis. This is not cheap.


I feel like it's actually pretty easy to avoid any slippery slope. If you are accepting money from the government, there should be nothing you are spending money on that isn't explicitly sanctioned by the government. I as a taxpayer am not paying for your food so that you can spend the paltry sum you earn on cigarettes.

Also, I don't really the see problem with a "nanny state" in the context of people that are accepting money from the government. If you need the government to provide for you, you should be totally happy with whatever stipulations that help includes.


Let's say the government proposed a rule tying Medicare type payments to your BMI (gradated until >30 BMI = no more Medicare pending graduation from a "weight loss bootcamp"). I can pretty much guarantee a huge amount of people would be totally not happy.

I could use similar harsh, if negatively over-generic, logic to justify the rule ("I'm not paying for the health costs of some fat ass who ate so many donuts in their life they're now having a heart attack on my dime!"). But such an approach will probably not solve very much anyways except make a whole lot of people angry. People would probably hold donut-eating parties in protest. :)

One other point. At present, the current state legislative trend on drug-testing "welfare" recipients is mostly limited to TANF, with occasional forays into Medicaid and SNAP. I have seen no proposals targeting SSDI / Social Security or Medicare. There's a reason I said "caste" -- right now, the context is not people in general that are accepting money from the government, but only the "wrong" people that are accepting money from the government.


How do you define "accepting money from the government"? I assume you're mostly referring to SNAP, TANF, and Section 8 but where do you draw your ideological line? Anyone accessing any Federal Assistance? Does SSI count? Tax credits? Pell Grants? Should drug users be denied access to tax funded infrastructure and emergency services?


Let's not forget tax-expenditures like the home mortgage interest tax deduction.


If feasibly testable, then yes. If you need the government to help you pay your food/medical/housing/whatever bills, you should not be buying alcohol/cigarettes. Caffeine is debatable, because for many people it's not about recreation, it's more about giving you that extra kick so that you're more productive.


> Caffeine is debatable, because for many people it's not about recreation, it's more about giving you that extra kick so that you're more productive.

Oh, how many times I've heard the same thing, except referring to opiates, cocaine, or amphetamines, rather than caffeine.


I agree completely.

I feel like the best thing to do in regards to drug legalization is to try to empirically link each class/type of drug to various societal outputs, like productivity, price of medical care, etc, and then tax the drugs accordingly.

Meth decrease general productivity by 100%? Tax it at a higher rate. Cocaine/MDMA/LSD have benefits and fewer side affects? Tax them at lower rates.


Because that's a simplification of what certain drugs do to the mind.

A consenting adult might be able to make the rational decision to do or not to do MDMA. But when someone, say, becomes addicted to heroin, their mind changes so dramatically you honestly cannot even call them "consenting adults" in the same sense anymore.


The proper response to this is to treat addiction as a disease or disorder, which is to say medically instead of criminally. Interestingly enough, some psychedelics also show signs of being an effective treatment for addiction.[0]

In addition, we know from alcohol prohibition that (besides failing to stop or greatly curtail usage) it tends to incentivize drug producers to push more of the hi-octane stuff because it minimizes their risk: beer was not popular during prohibition while liquor was. If opiates are generally legalized, this evidence shows that the vast majority of people who decide to use them (which is already a tiny minority) will stick with making tea rather than messing with syringes, minimizing the creation of new hardcore addicts. Many benefits come with legalizing all drugs; an exhaustive set of arguments can be found in the book Chasing the Scream by Johann Hari.

[0] See James Fadiman's studies performed in the 1960s before it all got shut down. A collection of these can be found in the Psychedelic Explorer's Guide.


If you're arguing against the legalization of drugs you always have to follow with "But alcohol is ok because...". I didn't see that point in your argument.


> But alcohol is ok because...

It's not okay. It's an evil drug that kills tens of thousands of people in the USA annually, both innocents and users. If we were honest with ourselves we would take a good look at alcohol and its role in our culture/society, but we won't and will look for scapegoats to alcohol-rooted problems in other things.


That position is at least self-consistent :)


    > But alcohol is ok because
It's dramatically dramatically less addictive than opiates.


The literature generally supports that alcohol is moderately less addictive than opioids (see the previously mentioned chart: https://en.wikipedia.org/wiki/Substance_abuse). In addition, methamphetamine, hallucinogens and many other illegal drugs are significantly less addictive than opioids. It's difficult to identify what measurements are due to the intrinsic qualities of a drug vs the environment and methods associated with consumption.

I think part of the bias is that when one thinks of alcohol one thinks of having a beer after work - opiates conjure up images of shooting up heroin. But a massive fraction of people take opioid pain killers on a temporary basis and suffer no ill effects - I'm sure many of them would admit that being under their influence is at least somewhat pleasant. Likewise, media seems slow to cover cases of horrific alcoholism with massive systemic organ failure. In Russia, for example, the life expectancy of men is 64 years old, largely due to a culture encouraging copious alcohol consumption.


This is flat out false. in addition, the physical withdrawal from alcohol addiction is significantly worse than the symptoms from opioid withdrawal. Alcohol withdrawal can actually kill you. My father was a severe alcoholic (i.e. physically dependent) and would have to get hospitalized on a semi regular basis to help him get through withdrawal safely. Opioid withdrawal is terrible but iirc it is not directly life threatening.


Yes, this is the important point. Functioning civilization depends on people being mostly rational most of the time. If using certain drugs both induces irrational, destructive behavior, and also induces you to continue taking the drug, society can't really tolerate it. The only reason we can tolerate alcohol is that only a relatively small percentage of users become both destructive and addicted.


That's simply not true. Firstly, people aren't rational. See this list of "cognitive biases" as an indication: https://en.m.wikipedia.org/wiki/List_of_cognitive_biases

Secondly, there are all sorts of drugs, some addicting, some not addicting, some legal in some places, some illegal in other places, some making people "irrational", some making them more "rational". There's no correllation between these attributes.

Legality depends on historical accidents more than anything. Alcohol is in fact one of the more addicting drugs out there, see the high percentage of "functioning alcoholics" out there.


> Firstly, people aren't rational

That's why I said mostly rational. Out of the thousands of little decisions and behaviors we engage with in a given day, most are rationally chosen to move us towards our goal. Most are basically habit, of course, not some long, drawn-out process. But, still rational.

> There's no correllation between these attributes.

Oh, I'm not arguing that current drug policy is great and sensible. I think it should be liberalized. I just don't think a total free-for-all is a great idea either. Ideally we'd set the status of a drug -- recreationally legal vs medicinally legal vs decriminalized vs illegal -- based on its societal harm, rather than whatever ad hoc method we use right now.


This only works in pure anarchy where behavioral negative externalities are not paid for by others and people do not care whatsoever how much other people suffer, which is defensible, but not realistic.

Also a freedom is not neutral. Legalizing all drugs signals that it's OK to consume them on a certain level, and you run the risk of endangering an entire population. Would you really don't mind if your (18yo+) kids could just buy some crack at the grocery store next door? Furthermore, the concept of consenting adult is very fluid and dangerous. Do you really think an 18yo kid has the mind power to say no to his group of friends? Most don't. And what happens when people deemed underage want drugs? They certainly will, and they will have to go through illegal channels to get them, so you haven't solved the problem of drug dealing at all by legalizing for "consenting adults".


> This only works in pure anarchy where behavioral negative externalities are not paid for by others and people do not care whatsoever how much other people suffer, which is defensible, but not realistic.

I would argue the negative externalities are worse (especially factoring in negative externalities of a black market) under any approach that does not involve full legalization. Plus, legalization does not preclude taxation, which can be used for drug treatment and other programs that combat those negative externalities.


I think people should be allowed with some form of training, just like driving is and having babies should be.


We've seen what happens when opiates are unregulated. I do think we need to legalize more drugs and generally liberalize drug laws, but selling oxycodone in stores for recreational use would end in disaster, just like selling heroin in stores did in the early 1900s.


> just like selling heroin in stores did in the early 1900s

Does anyone have a good resource for reading about what actually happened when they sold heroin in stores? Statistics about addiction, anecdotal reports, etc.


> Just as a large majority of drinkers did not become alcoholics, a large majority of users of these products did not become drug addicts. They used opiates as "props for the unstable nervous system," like a person who drinks wine at the end of a stressful day at work.

That's from Chasing the Scream, with the quoted portion coming from a prominent doctor named Henry Smith Williams in the early 1930s. Here are two more direct quotes from him:

"No one thought of the use of these medicines as having any moral significance."

Many women who used opiates daily are the same ones who "would have gone on their hands and knees to pray for a lost soul had they seen cigarette stains on the fingers of a daughter."

The book reports that 3/4 of self-described addicts (that is, the subset of users who are addicted, as opposed to a generic term for "user") had a stable and reputable job, over 1/5 were wealthy and under 1/12 were poor.


Thank you. I really need to read that book.


Yes, but then not selling it in stores for recreational use ends in heroin being substituted with fentanyl (and other, even more effective synthetic opiates) in the dark market, because fentanyl is cheap to make and transport (way bigger potency for the same weight) and then killing many people who otherwise would not be dead. The case for regulated legalisation is harder to make for opiates than for many other drugs, but still there.


How does the situation today compare to the late 1800s? Do you have any data? I'm genuinely curious, because heroine use is pretty bad right now.


Education on the matter has come a long, long way.


Are these consenting adults going to accidentally harm/kill other non-consenting adults/children when they decide they can drive a car, for example?

If yes -> that's what some people have reservations not necessarily about legalizing drugs, but about making them more accessible (i.e. buy it at CVS or a gas station)

If no - > what about alcohol? That's a legal drug that impairs people and even though driving drunk is illegal, it doesn't stop thousands of people from doing it and killing tens of thousands per year


> How about letting consenting adults free of doing what they want to their own body and legalizing all drugs?

If drugs were legal, and someone suggested making them illegal, I would be against that.

However, a world where drugs have been illegal for decades in most countries is a very different world, and the consequences of legal drugs will be very different.

For example, I think it's pretty clear that legalizing drugs in one US state will result in a number of undesirable things happening in that state, such as drug tourism, increased crime, increased accidental deaths, increased public health spending, taxation of drug sales, government intervention to ensure product safety, etc. Sure, some states have legalized marijuana, but that's a fairly benign drug. Legalizing something like crack or heroin will almost certainly lead to an increase in accidental deaths, which will cost the state money to deal with.

A simple example: the most tolerant places tend to attract the kind of people who are most difficult to tolerate. Look at the homeless situation in San Francisco, and imagine what the crackhead situation would be like there if drugs were legalized. Crackheads would swarm in from all over the country.

So, to prevent the impact of drug legalization from falling disproportionately on certain states, drugs would need to be legalized everywhere at the same time. But even then, the same dynamic may play out between countries (probably less so, because moving between countries is harder than moving between states, but still...)

Furthermore, the libertarian vision of drug legalization will not be the one that happens, if drugs are indeed legalized. We live in a world where governments have public health obligations. We aren't just going to let people die of overdoses in large numbers -- at some point, people will believe that something must be done, and tax dollars will be spent on needle exchanges, rehab, and public health interventions on a large scale. It's not as simple as saying that people can put whatever they want in their bodies and deal with the consequences on their own -- we don't live in the kind of political world where that will be possible. We don't allow that for seat belts or motorcycle helmets, and there is no reason to believe we would allow it for drugs.

You might respond that the kind of public health spending necessary would be lower than the spending that is currently needed to fund the war on drugs, but political debate doesn't take place in a vacuum of pure rationality. Voters have shown time and time again that they would rather spend money to punish than to heal. Until a widespread societal change in moral views takes place, it will be far more difficult to get money for drug treatment than for the war on drugs. So, when faced with the potential costs of drug legalization, most voters will reject it and opt for the status quo, but maybe with more legal weed.



In the UK Gulf War Vets are being given psychiatrists, not the treatment they want or has been demonstrated to offer help, it's a fairly shameful situation with a history to match, if we want to go around starting wars we need to factor in the long term costs...


Divorced, alcoholic and at times suicidal, he had tried almost all the accepted treatments for post-traumatic stress disorder: psychotherapy, group therapy and nearly a dozen different medications.

Once again I have to advocate for EMDR, which is not mentioned here at all. There are very few accepted treatments. Most drugs will only treat symptoms, not the underlying condition.


Personally, I've seen multiple people close to me with trauma histories (some complex) benefit hugely from EMDR. It deserves to be much more widely known and accessible. Other related (and similarly structured) possibilities include brainspotting (https://en.wikipedia.org/wiki/Brainspotting) and yoga nidra (https://en.wikipedia.org/wiki/Yoga_nidra).

While I'm greatly in favor of studying and using psychoactive substances to help people heal in their lives, they're at most a supportive component in an overall treatment strategy. Our society's preference to just medicate problems away doesn't solve things over the long term.


> While I'm greatly in favor of studying and using psychoactive substances to help people heal in their lives, they're at most a supportive component in an overall treatment strategy. Our society's preference to just medicate problems away doesn't solve things over the long term.

All of these studies are treating the psychedelics as a tool for greatly enhancing therapy. No doctors advocating for their use are suggesting that troubled people should be dropping a bunch of acid at parties on the weekends. The general idea is to work with a patient to understand what their ailments are through talk therapy sessions; then to have a comfortable, controlled setting with doctors and therapists present to help guide the patient through the drug experience, assisting them through any difficult portions; and then to follow up with further sessions of talk therapy.

The "LSD will cure the world" craze died out with Timothy Leary, and with good reason--subsequent advocates (albeit with a few exceptions) have been more level-headed about these things acting as consciousness amplifiers that can go flying off in any direction unless they are channeled into helpful ones. The revival of interest that is taking place now follows a much more measured approach.


Thanks for that. I have seen the benefits of EMDR in others but have had little (but some) success with it for myself. I will look into the other options you mention and may give them a try.


Link for anyone else who doesn't know what EMDR means: https://en.wikipedia.org/wiki/Eye_movement_desensitization_a...


Huge fan of EMDR. Worked at a PTSD decompression camp in NH for returning military. Had no experience with that type of treatment till I got to the camp. Blew me away. The changes that can happen after only a few weeks of therapy was impressive.


> The researchers are so optimistic that they have applied for so-called breakthrough therapy status with the Food and Drug Administration, which would speed the approval process. If approved, the drug could be available by 2021. (my emphasis).

The expedited process takes three years. No wonder the only way that most drugs get approved is because the drug is patented and the company that brings them to market can expect huge profits. Existing unpatentable (cheap) drugs usually don't have a backer with deep pockets to go through this process. Our health care market seems to offer perverse incentives at every turn designed to increase cost and decrease effectiveness.


Much (all?) of this work is being funded by MAPS (www.maps.org), which is a non-profit organization that relies on donations for its continued existence. If this research and advocacy is important to you, please consider donating.


Although MDMA was first synthesized by Merck in Darmstadt in Germany in 1914 - https://worldwide.espacenet.com/publicationDetails/originalD... - apparently nobody has yet erected a museum. Surely it would be a tourist draw in Europe?


From the outside, I'm curious if anybody here has any comment on what effect (if any) a Trump presidency could have on this and related research/progress?

In all the noise of the election run, I didn't any position on controlled substances and medical research coming from Trump's side.


Sounds good. I know that a lot PTSD patients feel that they are neglected.


Calling MDMA "Ecstasy" seems like bad journalism. While Ecstasy should contain MDMA it often has all kinds of other things in it.

Nobody would ever allow the use of Ecstasy as a treatment drug.


The funny/ironic part about calling MDMA Ecstasy is that many dealers can't sell pure MDMA because their clientele expect a stimulant buzz along with the good vibes. People getting pure MDMA often think it's poor quality or cut with something, much to the face-palm of their dealers.

Source: Don't worry about it.


i like your sources :)


I've always felt the ecstasy/molly/mdma thing (at least in seller/user circles) was more about branding than anything else.

In the 90's you'd buy "ecstasy" which theoretically contained MDMA as the sole active ingredient but likely did not. Various cheaper actives and inactives were added to make more money for sellers as you'd expect in an underground market so the term became less trusted.

Enter "molly" which implies a more pure product containing only MDMA but still with the potential to be bogus or cut with something else. As with "ecstasy" the only way to tell was to test it.

Regardless of the semantics of illicit drug slang, I just hate when purportedly "serious" pieces use slang terms for the drugs in question. Same as when they use "pot" or "marijuana" in place of cannabis. I can't imagine a serious article that discusses medical studies of alcoholic beverages referring to their "booze" and "hooch" studies.


From Wikipedia on MDMA:history (and a true story AFAIK -- go see their citations):

> Perceiving a business opportunity, Michael Clegg, the Southwest distributor for the Boston Group, started his own "Texas Group" backed financially by Texas friends. In 1981, Clegg had coined "Ecstasy" as a slang term for MDMA to increase its marketability.

Mind you, this was before it became illegal.

Much like Marijuana, that stupid (but successful) name was probably one of the main reasons it did become so popular, and then illegal, in the first place.


As with many illegal street drugs, there is no standard definition of Ecstasy. It's whatever a drug dealer decides to sell you and/or call it It is certainly not bad journalism to call it that. That's what MDMA pills were known as in the late 90's/ early 2000's.

Also, call me an old timer, but I refuse to call it Molly


> It's whatever a drug dealer decides to sell you and/or call it

That's the point. Ecstacy does not have a precise definition. MDMA does. Given this is a trial, it should be labeled what it is.


OK, I have friends of friends who say they take 'MDMA' on a Saturday night out. Is it really pure MDMA, or is it just what we would have called Ecstasy in the past?


MDMA (or Molly) usually comes as a cloudy off white crystal or crystalline powder (if broken up).

Ecstasy comes as a pressed pill (presumably containing some MDMA, with the possibility of other drugs/adulterants and fillers).

The only way to know if they were taking pure MDMA in either case is to test it:

Potentially NSFW: https://dancesafe.org/product/complete-set-of-all-8-testing-...


To be honest, the only way to truly know if one is taking pure MDMA is to run a fairly expensive test (along the lines of GCMS, NMR, or many of the other qualitative analysis).

Reagent tests ala what Dancesafe sells are great harm reduction, if the pill fails the test, the pill certainly has 0% MDMA. However, they will not be able to identify that you are taking pure MDMA. I imagine any MDMA+other substance mixture will flag positive. In addition there are probably a few non-MDMA substances that will false-positive that reagent test.

There's an organization out there (https://www.ecstasydata.org/) that does GCMS analysis of pills, the data on what they find (in terms of ratio of substances) is public. So if you want a bit of a sampling of what type of things get sold as "molly" / "ecstasy" you can look there.


Absolutely. I did not mean to imply that the results are lab grade quality.

To clarify, by "pure MDMA", I did not mean that the substance is 100℅ pure MDMA, but rather that it does not contain other active adulterants.

With reagent tests you can be reasonably sure that a given pill does or does not (most likely) contain only MDMA and (most likely) contain no other (common) adulterants.

If you want to be sure on the actual amount of MDMA and be absolutely certain it contains nothing else, then you absolutely need a lab test.


Agreed- I've known people to send off samples for GCMS and have a pretty good idea then of what they've got in their hands. It costs money, but if you're worried about safety it is possible.

(GCMS doesn't actually cost much to run, places just charge a lot for it.)


You're better off just having a reliable supplier who cares about your health because that means continued business for him.


This is incredibly naive. You are much better off testing any substance you put into your body. Whether you test it yourself, or can confirm that a trusted party has tested it.

What if your reliable supplier was sold cyanide from an unreliable supplier? Better one of you is wise enough to test it.


They may be wrong, technically, and that's fine. A journalist should get it right.


I have friends of friends, who have friends (who I NEVER speak to btw) who say that Ecstacy is never just pure MDMA.


True in the sense that pure MDMA cannot be pressed into a solid tablet alone. It needs to be mixed with fillers/binders to be pressed into a pill and stick together.

However, you can find Ecstasy pills that contain nothing but MDMA and inactive fillers/binders.


Where I'm from those old definitions hold true. Molly is MDMA, ecstasy is MDMA and methamphetamine pressed into pill form. If I bought it back in the day and it tested as anything else, I would've gotten my money back.


You'd get your money back from street pushers. Really.


Anecdotal, but back when I used to use drugs recreationally all of the dealers I used actually placed a very strong emphasis on customer service. Maybe this person has a similar relationship with their supplier. Not all drug deals are conducted from street pushers.


I'm annoyed by the Hollywood depiction implied by this comment. In my version of "back in the day", all the "street pushers" were some of my closest friends, not grumpy thugs.


Correct me if I'm wrong, but you don't usually buy drugs like that literally on the street. It's not unthinkable to have an ongoing relation with a dealer enough to be able to return something that doesn't meet your expectations, if you are an important enough client. Not saying it's common, but I think possible.


Was not buying from street dealers, and yes I would.


If you're dealing with a dealer a bit more upscale than a street pusher, he will have a money back guarantee. It's in his interest since his reputation is everything.


I agree that it makes sense for a journalist in the sense that many people do not know what MDMA is, but they have heard of Ecstasy. However, Ecstasy does have negative connotations that pure MDMA does not. The risk of unknown adulterants is probably the biggest danger in taking illicitly obtained Ecstasy tablets. This danger is completely mitigated with pharmaceutical grade MDMA.

If you don't like Molly. Please just call it MDMA. Not Ecstasy.


> That's what MDMA pills were known as in the late 90's/ early 2000's.

That means there IS a definition of Ecstacy, the meaning hasn't changed. There are just lots of bad pills in circulation. That's why you should always check pillreports.net before using any untested stuff.


> Calling MDMA "Ecstasy" seems like bad journalism. While Ecstasy should contain MDMA it often has all kinds of other things in it.

Yes I was expecting "Molly".


Absolutely, a lot of ecstasy tablets tends to have speed in them as well.


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bad journalism is very nearly the only kind being practiced in 2016




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