Hacker News new | past | comments | ask | show | jobs | submit login
Compass Pathways has set itself up to be the first legal provider of psilocybin (qz.com)
214 points by jelliclesfarm on Jan 4, 2019 | hide | past | favorite | 156 comments

This is an interesting article for HN. It's spun as a negative, using terms like "threatening", "monopoly", "controversial", and "retribution".

You could write it the other way, where an immigrant-founded[1] startup is disrupting the mental health industry.

Frankly, most of this seems like par for the course. Of course the company is seeking to push their product to market and commercial viability--and the potential downsides to that rush. And it's (unfortunately) not surprising that the legal term pursued by the company are more onerous than standard--that seems to be a common over-step, and I'm glad attention is drawn to it. A good portion of this seems to be (and excuse my ad hominems) hand-wringing by crunchy-granola "psychedelic experts" worried about the "community".

([1] I'm assuming Ekaterina Malievskaia is Russian based on her medical degree from St Petersburg Medical Academy, and bring it up here because of similar discussions.)

did you read the article completely? there are 9 critics that worked with them, 6 ceased doing so. the company formed and closed it's non-profit venture and they are using typical pharma tactics, creating patents around it. spin is one thing but those facts do tell a story on it's own.

> These experts are further troubled by the company’s business structure: Having first registered as a charity, Goldsmith and Malievskaia set up a for-profit corporation working towards the same ends just one year later, and closed their non-profit less than two years after that. And all 9 of these critics charge that Compass Pathways has relied on conventional pharmaceutical-industry tactics that could help them dominate the field, including blocking potential rivals’ ability to purchase drugs, filing an application for a manufacturing patent, and requiring contracts that give Compass power over academics’ research and are restrictive even by pharmaceutical-industry standards.

Yes, I did.

To me, there's an undercurrent here that some of the psychedelic experts have specific, subjective viewpoints (à la Richard Stallman). That these people have concerns is interesting, but the case that they're material or even right wasn't proven.

Again, no surprise that they shuttered the nonprofit: it's a corporate structure that precludes you from raising traditional VC, among other limitations. And since they are now a competitive pharmaceutical company, is it any surprise that they're using... competitive pharmaceutical tactics? And, again, is that material? Or is it just tsk-tsk'ing "the way things ought to be"?

These things do tell a very interesting story about pharma practices, research, start-up risks, a subculture going mainstream, etc. I think that story can be told more clearly.

I think you're purposefully ignoring the other issues that the writer has illustrated quite well in the article.

I was going to spend time citing points but you should be well aware of them by this point and I'd rather get back to work.

unfortunately, that's precisely how mainstream culture works: it allows any of your objections to be recast in terms of "sanctioned" procedures.

That's why we need to protect our culture from the "dominion" ideology where abject utilization (some would say exploitation) is a _protected_ activity or process. but we currently allow stepping on ppl or traditional entheogen culture because it's part of a "business process." "the law allows it." "it will help ppl so i deserve money for it."

ironically, i would like to see how these perspectives change after a generation of psilocybin "consumers."

They contracted a bunch of academic "psychedelic experts", and later on didn't tell them about changes to their business organization. Without more information, I don't know if that's bad or not. Should they have? Were they required to? From the article it sounds like in at least one case the researcher already hadn't been working together for several months when the change happened.

They definitely burned some bridges, but worse things happen all the time. The text you quoted even calls it "conventional pharmaceutical-industry tactics". Sounds like sour grapes to me.

You can spin it any way you want, but to me, expropriating the intellectual property of the non-profit (obtained under the pretense of being a non-profit) and exploiting it for private gain is the issue here. Even though that part is apparently legal. (Unless challenged in court somehow. We'll see.)

Isn't exploiting the intellectual property of a non-profit for financial gain the business model for essentially every single tech company in existence?

That is, at least every tech company that has open source software somewhere in their stack - which is presumably all of them.

Touché, and you could argue that every big success story from the last couple centuries was based on exploiting some kind of freebie. (I'm thinking of the Rockefellers, Carnegies, and Vanderbilts of the world.) Although there are some OSS licenses that address this by restricting commercial uses more heavily. I dunno... if everyone goes into it with eyes open, that seems fine to me. It's when they pull the ol' bait-and-switch that makes me go hmmmm...

> every tech company that has open source software

Can you name one that piled patents on top of the open source IP?

But this isn't just an accusation of using the IP of a non-profit, it's an accusation of making a 'fake' non-profit to get things under false pretenses.

I'm so tired of comments like "startup is disrupting the [xyz] industry." No they don't disrupting anything. They didn't invent anything. They are just planning to grow and sell mushrooms. Growing mushrooms is well know process.

They aren't planning on growing anything ... they have to synthesize the compound as the 'grown' versions are not pure enough for the FDA.

Even though that's the case, what they're doing isn't novel. There are a number of syntheses for psilocybin that are well known in the literature that are potentially suitable for industrial production. In fact, there are a few available in Shulgin's famous TiHKAL. It seems quite unlikely to me that the synthesis they will be doing is novel or "disruptive" in any way.

That sounds dumb. Any citation on why it's so?

I don't have a citation for you, but the mechanism here is that it's difficult to extract just the alkaloid you want when a plant has a number of chemically similar alkaloids. So when you do an extraction, you get a number of different compounds, often mixed in slightly different proportions.

When will there be an ANN to remove spin and motivated reasoning?

It's becoming so tiresome to filter it. Maybe people should try hard to write a factual and forthright account of what they're talking about and then have a note at the end saying "I'm a granola-faith healer, and I think the above is a good idea" or "I'm an old-school conservative lung surgeon, and I hope that you too conclude that this is bullshit".

The ANN will have bias because it won’t have sprung into existence de novo, but will have been programmed and deployed by humans.

I agree for the most part, however there are legitimate concerns about their inability to handle criticism and the training of the therapists

I agree wholeheartedly. I'll note, however, that the topic ("A prickly response to criticism") isn't raised until 70% of the way into the 7,200-word article.

Is it a good or bad thing that it is immigrant-founded?

I'll leave that argument to others. I only raised the point because of the related discussion on HN. I'm specifically thinking of discussion ~6 months ago about how half of US startups had immigrant founders:

https://news.ycombinator.com/item?id=11309080 https://news.ycombinator.com/item?id=13858597

Not the OC, but I'm guessing they mentioned it as a likely contributor to the "hand-wringing".

You'll be hard pressed to find people in the US who think that someone (legally) immigrating to the US and starting a business is a bad thing.

> You'll be hard pressed to find people in the US who think that someone (legally) immigrating to the US and starting a business is a bad thing.

Then why do we keep hearing about Republicans introducing measures to reduce permitted legal immigration, especially outside of the employer-need-driven categories? Those politicians, or at least the audience they are catering to, certainly seems to think that people coming to the US for purposes other than to reduce existing firms labor costs are a bad thing.

You'd think, especially with U.S. population growth and fertility rates being so low.

In reality, the current administration is actively working to reduce legal immigration as well.[1][2] Although the policies are opposed by most, it's not difficult to find people who support reducing legal immigration as well.

[1] https://en.wikipedia.org/wiki/Immigration_policy_of_Donald_T...

[2] https://www.cato.org/blog/house-gop-bill-cuts-legal-immigrat...

> In reality, the current administration is actively working to reduce legal immigration as well.

the chart in that second link shows the family based, diversity and asylee immigration being cut, but all of the employment/skill-based immigration being boosted.

that strikes me as at least trying to reflect approval of business-starting immigrants, though with a preference for younger ones.

The proposals last year included massive cutbacks on H1 and L1 visa programs, among other things. As I recall, their purported replacements for the work visa track were much more constrained, so the result was a reduction in skilled immigration.

But we know that's what that crowd wants, anyway. They haven't exactly held back in op-eds. CIS, for example, is explicitly arguing for pre-1992 annual levels specifically for the skilled category, which would imply massive cuts.

Crying when confronted with critical questions, as an apparent strategy to dodge genuine concerns? Stalking social media profiles and tattling on MAPS employees who "liked" critical posts? Showering lavish attention and then suddenly and coldly ending it when they get what they need? It certainly feels underhanded. This may be par for the course in big business, but it's all the more dissonant when the compound in question is meant to make users more compassionate and open.

There has to be a profit motive to get something to market. There have been 18 years of small studies on Ketamine for TRD with little progress.

Unless you look at the other psychedelic with breakthrough status - MDMA, which Rick Doblin has brought through clinical trials as a non-profit.

Doblin has no profit motive and is stoked with his $70k a year salary. His goal is changing culture, that is his motive.

MAPS’ MDMA is also commercialised by a for profit company.

As far as I know, the company is independent and not the Mozilla approach (Mozilla Foundstion owns Mozilla corporation).

A for profit company that is wholly owned by the MAPS non-profit.

I know Rick Doblin and have donated a good amount of money to MAPS.

There is no comparison between maps and compass.

Believe it or not, some people just want to make the world a better place.

Profit motive _can_ help to motivate people if there is a lack of motivation. However, it is not true that there _must_ be profit motive.

Right now, there is no lack of motivation to get this stuff out there. It is the questionable government prohibition that is holding things back.

The experts/critics seem to be questioning that motivation. They're implying that profit-motive (regardless of any other motive) is inherently bad.

The "crunchy-granola" dog whistle in another thread is telling. Psychedelics and FOSS histories are intertwined. If that doesn't register, you're in for a bummer of a trip. The article seemed to do a pretty good job of exposing C.O.M.P.A.S.S./Compass for the exploitive carpetbaggers they appear to be.

Can you cite an instance of this?

Brings back fond memories of foraging in the Welsh Valleys every September October, millions of them for free (must be the sheep turds) - they were just as good fresh or dried, mushroom tea - amazing, despite the muddy fragrance, was particularly good for watching comedy films such as Steve Martin’s The Jerk or Airplane - used to be literally rolling on the floor with unstoppable laughter. Of course our Idiotic UK government could not allow such fun to be had, so deemed this wonderful gift from nature illegal and now turds like this couple can make a fortune.

if they're trying to monopolize psilocybin, they probably should have chosen something that isn't replicable by a teenager with access to a pressure cooker and a pasture

If psilocybin has some success in early clinical trials then companies will begin work on metabolites and similar compounds that purportedly have less side effects. That is what is happening with Ketamine right now.

What people seem to miss is that it’s the psychedelic experience itself that holds the healing potential.

We most likely won’t see a pill derived from mushrooms that cures depression but doesn’t get you high.

The altered state of conciousness is the thing.

Unclear. I have close family that is having marked and unprecedented success in treating serious depression by microdosing psilocybin below the psychedelic threshold. The result is profound, sustained, and after trying a dozen different approved psychiatrist prescribed drugs to find help can not be a placebo effect as surely any of those would have been just as effective.

Out of curiosity, have they tried macro-dosing to be ineffective?

Ie instead of ongoing microdosing, having a 2-3g experience once or twice.

I have very little faith in main stream psychiatric care to provide anything other than blunt palliative options (often with lethal conseuences).

They have not yet, because we haven't found a way to provide a safe environment for this person to be in that can be sustained long enough to cover the entire experience. Providing safety would include alleviating their responsibilities, which includes child care, so that gets pretty complex.

Understood. Wishing you an afternoon and the support needed soon.

Also really glad you have found relief with microdosing!

There isn't a clear threshold in regards to microdosing. You're still getting the psychedelic effect from the psilocybin, just proportionally less.

If your state of consciousness is altered by 2% that's just called a normal day.

There is a very qualitative difference between tripping and not-tripping. (With a blurry line but you can easily stay on one side of a blurry line.)

It's uncertain if microdosing a particular ligand has any scientifically-proven evidence of efficacy without studying it. In many instances, it maybe a shared delusion placebo effect and/or socially-reinforced fad.

I'm not saying you're wrong per se but what evidence do you have that there are no beneficial analogs and triggers for similar biochemical pathways that perhaps are not marked by a substantial or profound classically psychedelic experience?

One bit of evidence is that in the JHU studies, improvement correlated strongly with whether the person had a "mystical-type" experience. When you go through an incredibly cathartic experience of remorse and redemption and come out of it a more loving person, it's a good hypothesis that it was the experience that caused the change.

My understanding is that much of mental illness is caused by unprocessed trauma and the way in which we process trauma is in altered states.

This is why various pathways like ayahuasca, mushrooms, LSD, mdma, Holotropic Breathwork, EDMR etc all work from vary different pathways — they all enduce an altered state, in which the nervous system releases the experience and forms new pathways.

Many of those (specifically ayahuasca, psilocybin, and LSD) all work on very similar pathways and structures. MDMA works on different ones and produces are markedly different experience and isn't usually considered a psychedelic.

And yet, the altered state in a therapeutic setting is the thing that helps.

It's much harder to prove a negative. What evidence do you have that there are? If you consider the way these drugs must be administered to be effective - with a co requisite therapy session - it seems obvious that the conscious effects are the beneficial ones.

There is sufficient evidence for both, and there is probably good reason to split them out (body and mind) and see them as different things that also work combined (body + mind). In this you might compare something like kambo to ayahuasca and ibogaine. They have many similar effects but have different ways of getting there (some more physical some more spiritual ,Kambo is probably not going to help with your childhood abuse, but it may help your high blood pressure, ayahuasca may help you process your childhood abuse and as a result lower your blood pressure.) If you look at something like 2cb vs lsd, lsd is found to be considerably more productive/creative than 2cb at subthreshold doses, but people often experience a much better "therapy trip" on high dose 2cb.

Some great books are:

The Psychedelic Explorer's Guide- James Fadiman

Acid Test - LSD, Ecstasy, and the Power to Heal - Tom Shroder

Sacred Knowledge - Psychedelics and Religious Experiences - William Richards

No, that's unknowable conjecture without a safe-as-possible double-blind placebo of the relevant, individual ligands under hospital supervision.

Of course, those studies are certainly underway. And I would bet a non-trivial sum of money that this is the exact result that will be found.

Anyone who has significant experience with healing trauma or mental illness with psychedelics has experienced this phenomenon first hand.

You mean pressure cooker and closet.

Gotta get the manure from somewhere.

Don't need manure-- vermiculite, brown rice flour.

Even coir (coconut husks) work well, and wild bird seed.

Ahh, good old PF Tek

where i’m from the mushrooms grow wild in pastures and one may source spores from them

> Quartz is a guide to the new global economy for people excited by change.

You'd think with that mission statement, their headlines would reflect global and not regional information. AFAICT there are many legal providers of psilocybin:


"Below the fold", past the infinite scroll "edge", many of the articles have country-specific headlines that include "US" in them. Maybe the legality of psilocybin is too marginal to worry about that, but this article does seem to be US-specific and not globally oriented. I do wish that there was a brief intro about legal providers elsewhere in the world. It would add useful context.

Hi, I'm the author of the article. Thanks for reading, and if anyone has questions, I'm happy to answer them.

I found your article very interesting. Thank you very much. One question I had is what and how COMPASS obtained their IP. Surely “distillation” of the psychoactive substance is widely known? It would be a bit like me trying to patent pancake mixture.

You're right - so Compass the for-profit has only filed an application for patent. But it's likely they're trying to patent a method of manufacturing the compound, rather than the compound itself (which, as you say, is publicly know.) As for the IP owned by Compass the non-profit, they didn't respond to comments on what that is, so it's not clear what exactly it entails.

Thanks. I also really appreciate the opportunity to ask questions of a writer whose (very well written) essay one has just read. I have a feeling their patent application will be blocked because the process was not COMPASS’s to begin with. It seems that third parry experts in your article provided them with this knowledge - and it would be abuse of the patent system for them to claim property rights over something not theirs. It’s a bit like inviting yourself round to a neighbour’s barbecue and then filing for property rights over their garden. Well I hope that’s the case!

Are we speculating that the patent filed is on the process for production? Any references here?

Just want to say thanks for this diligent and extensive piece of journalism, as someone who has encountered these people before and felt something was up without knowing what.

What are the downsides of legalizing Psilocybin and/or using it for treating depression?

Disclaimer: I'm pro-legalization.

I think the only downside of legalizing it will be increasing the number of users, and therefor the number of possible bad trips/stupid actions while high.

Being that we let ~88K die in the US due to alcohol, I think we can handle that a couple dozen misadventures from shrooms as well.

I think psilocybin is a great drug to test legalization and it's effect on recreational usage. If I had to guess, I think there would be an initial increase in psilocybin use. Though, over time I think it would decrease back to a number slightly more than today. More than just usage, it would be interesting to see its impact on crime, dui, 'addiction', etc. Just maybe this would lead to a more rational view of drug use and further drug legalization.

> test legalization and it's effect on recreational usage

I'd assume that we have a lot of data with cannabis now. I'm guessing that it is a significant net win.

Drug use is so demonized that it will take a lot of time and easily messaged education to change that.

At the moment, there's nowhere near enough research yet to know the potential downsides of using psilocybin to treat depression. So far, there's only been one study with 19 participants and no control group. It could be hugely successful or, as with any drug, it could come with possible side effects.

What would be the scientific usefulness of a control group? It's my understanding that the effect could not reasonably be confused with placebo. There are plenty of other studies on treatment of depression; although, there is always the slight risk of a general societal upwelling of good feelings or its complement.

Psilocybin treatment is given in a therapist's office in conjunction with therapy so, yes, there could well be very positive effects for patients having that therapy experience with a placebo.

Only one study on psilocybin? Globally? Ever? That's kinda amazing; not even studies in v long-term [mental] health of [former] users?

Edit: Google Scholar shows hundreds of studies, one on the first page (for me) has >700 citations.

On humans using regular consumption? Such research is notoriously hard to get funding and materials for - much easier on animal models, in the US at least. There's a reason much of the current research (which is still too little) into psychedelics is done outside the US.

Can the U.S. (or companies/groups/organizations) within use those outside studies to justify things like this? Or is there some requirement that they be conducted here?

One study on psilocybin as a treatment for depression! Not on psilocybin overall. Link to the one existing study is in my article.

> These experts are further troubled by the company’s business structure: Having first registered as a charity, Goldsmith and Malievskaia set up a for-profit corporation working towards the same ends just one year later, and closed their non-profit less than two years after that.

I’m reminded of the “New-Path” rehabilitation centers in A Scanner Darkly. Not only does New-Path produce Substance D, they distribute it and run rehab centers with burnt out addicts to grow the stuff. Truly scary when you think about it.

This article is the playbook of how big business enters new industries. I went through this all in 2016 when big money started entering the cannabis industry. The invitations to use people's vacation homes, the fancy dinners, etc. were all part of the experience. They studied my business model and replicated it. They hired researchers and pioneers of the industry and then fired them all within 2 years once they learned everything they need to. In the end--it makes sense. We don't fit their culture and they don't fit ours.

Please also read this interview with MAPS (non-profit working on medicinal MDMA) founder Rick Doblin:


It's largely in response to this article.

Very well written and extensive longform!

I found the link at the end also very interesting.


It is not something I have heard about before but is something that is very calming to read and know.

I must say I take a huge amount of joy watching a corporation try to bend over backwards to monopolize a fungus that has been enjoyed by humans for millenia. Is it a surprise that a capitalist industry is more motivated by profits than by the production of useful goods and services? Of course not: but it is good comedy. Maybe laughing at the absurdity of for-profit healthcare will be what saves us all from crippling depression!

The article says they are trying to restrict how research on the drug is done too and that's a catastrophe on its own. No laughing matter here. This might seem ridiculous on the surface, but it's a sinister move.

If you can’t laugh at the news, you’ll cry. Sanity is important.

I'm for it. Just like home brewing and distilling and vinting, growing your own weed or shrooms, you can still do it at home if you have the time, energy, expertise, and equipment. The corporations will hopefully make it easy and accessible to get good quality, safe stuff in a store front. Both options are good for freedom IMO.

That joy will fade when the general public is led to believe that this company is the only "safe" providers, due to a FUD campaign they will finance attacking competitors and lead uncertainty to the safety prospect of growing one's own shrooms. It does not matter what they say, they can make up anything. Their campaign will be executed through multiple parties and will not look like they are behind it.

I am not sure how successful they will be.. The big pharma guys can get into this game pretty easily. The issue will be establishing new FDA approvals. I don't think the chemical process / synthesis is patentable anymore. Even distillation will not be.

> Is it a surprise that a capitalist industry is more motivated by profits than by the production of useful goods and services?

I use the Sriracha company [0] as a model of capitalism done right. The guy (CEO and founder) just wants everyone to have good hot sauce. I often think about what different things (cell phone apps, cars, homes, etc) would look like if people actually cared about who they were selling to and what they were selling. (I mean specifically: "what if profit wasn't the central concern?".)

[0] https://en.wikipedia.org/wiki/Sriracha_sauce_(Huy_Fong_Foods...

I don't see how a company that uses the legal system to get their way is a free market capitalist company. Sounds like an oligarchy enabled by convoluted laws.

We need this. People need this. It's really good medicine.

It is illegal to prohibit oneself from harming oneself.

This is why drug use will be allowed sooner or later. It has been prohibited and it is inconstitutional.

Unfortunately, many people have been arrested for harming themselfs only and not harming others.

If drugged person hurts someone else, then that is a crime. But using any type of substance to hurt oneself is not a crime.

All the bans will eventually be unbanned.

Its inconstitutional.

This is a natural product. One can grow it in the basement of one's home. One can gather it where it grows wild. (Ask me how I know!) No user of this product has ever harmed anyone else as a result of using it. Any restrictions at all on this product could only ever be tyrannical. Let's not abide tyranny, ok?

I'm a huge advocate for and fan of psilocybin but I'd suggest taking some time to read through the Erowid psilocybin trip reports, there are many reports of people inadvertently causing a great deal of grief for others while tripping.

I too am an advocate but willing to bet you some scratch that the incidence of grief, harm, or violence from someone tripping on mushrooms versus a tee-totalling sober population is lower. You went directly to the most formidable source for reporting trips and they even break it down by bad experiences vs good vs etc. so of course you're going to find some stories that exist.

I'd be willing to bet you're right, but I'd also be willing to bet if we go out there playing it loose and fast like Timothy Leary, not much will change, and that would be a damn shame. Just because the risks are low, doesn't mean people shouldn't be educated to the risks, as I'm sure you'd agree, good education on entheogens helps create the foundation for the most important aspects of set and setting. I'm not trying to be a pedantic asshat, I genuinely believe statements like "No user of this product has ever harmed anyone else as a result of using it" are not helpful. Peace. <3

I think I'm on the same side as you, but you don't help your case by making wild claims like:

> No user of this product has ever harmed anyone else as a result of using it

I don't care to make a "case". I'm interested in any examples of contradictions to this claim. So far my interest has not been satisfied in this thread...

The absence of evidence does not indicate evidence of absence.

Physical harm is rare in psychedelic experiences. Psychological harm is very, very real and has destroyed peoples lives when they get too carried away using psychedelics. I agree that these compounds should be legal, but to say they are 100% safe is ridiculous.

I really don't know much about it beyond the anecdotes I've heard from friends and others, but aren't there cases of psychotic behavior (going berserk) and also suicide? BTW, I wouldn't use the term "natural" as an indicator of how benign it is -- the following are also natural: arsenic, anthrax, mercury, water hemlock, and castor beans.

Not to mention Amanita Ocreata or A. Phalloides.

That is why I never eat mushrooms that rely on my ability to identify them.

I do it all the time, though I avoid a few that have poisonous lookalikes. I picked some oyster mushrooms on the way home from the grocery store today in the middle of town. Even a child can safely identify a number of great edible mushrooms.

Would you say antidepressants are not dangerous to anyone even though they cause suicidal ideation in some people? One notable mushroom incident I remember is the tourist in Amsterdam that jumped off a building after using mushrooms.[1] That being said, the solution to the issue is definitely not what the company in the article is trying to do.

[1] http://www.simplyamsterdam.nl/French_tourist_in_Amsterdam_co...

That's not really what I was talking about. The unfortunate French girl harmed herself, but unless your link left out a relevant fact such as her having landed on someone, she didn't harm anyone else.

Her family might disagree that nobody else was hurt. The people tasked with cleaning her of the pavement may disagree, as well.

Not all externalities of drug use are physical.

I'm extremely pro-legalized everything. I find your callous disregard alarming.

Sure, let's have a Drug War to make it easier on the sidewalk cleaners. All the murder, all the injustice, all the expense, it's totally worth it because psilocybin is the only reason anyone ever jumped off a building. "Callous disregard", indeed.

I'm extremely pro-legalized everything.

How did you get from there to, Sure, let’s have a Drug War?

In writing that, I was just paraphrasing GP in an ironic way. Of course I don't support any Drug War. I realize that means that drugs should be legal.

> (Ask me how I know!)

How do you know?

I have gathered this product from wild-growing stands.

> No user of this product has ever harmed anyone else as a result of using it.

That is a ridiculous statement. Anything can harm you, including water. Everything has negative side effects given a large enough dose.

He didn't say anything about it harming the user. People should be allowed to harm themselves if they want to and most methods of self-harm are legal including using alcohol and cutting oneself.

    > People should be allowed to harm themselves if they want to 
As long as they pay for their own medical insurance.

This attitude is the one thing that keeps me from embracing universal government-provided health insurance. People are so quick to use it as a justification for legal restrictions on behavior.

I wouldn't let someone's knucklehead comment dissuade you from supporting something that would do a huge amount of good for people here in America.

My concern is that this is a popular enough sentiment that universal health care would lead to real reductions in freedom for Americans. I think it's reasonable to be concerned about anything that could contribute to current trends toward totalitarianism.

What freedoms does USA have that European countries with universal healthcare do not?

Bear in mind Portugal has healthcare and legalised all drugs.

I don't know the answer to your question. In the US we already have people trying to use welfare as an excuse to mandate drug testing and control what people are allowed to eat. Maybe this sort of thing never happens elsewhere, but the US is often an outlier in how shitty we can be to people.

It's also my understanding that healthcare was a big part of what convinced people in the UK to vote for Brexit.

Hey, local knucklehead here. I don't want to live in a place where folks don't get the healthcare they need just because they can't afford it. OTOH, the idea that our individual choices don't affect those around us is naive. Freedom and responsibility go hand in hand.

Freedom and responsibility going hand in hand doesn't mean that hobbies with negative health consequences should be illegal.

Never said illegal. If I willingly place myself in a high risk category I should pay for that myself. I may buy a wing suit someday, but I won't ask you to pay for my wheelchair.

Should coal miners get health insurance? What about first responders?

Yes. And their employers should bear much of the risk. The actuarial tables should dictate the cost.

What is this fear of paying for higher risk individuals based on? That more people will start bungee-jumping and skydiving or becoming firefighters and police officers? Part of the point of a nationalized system is that the costs offset- the healthier people use less services than they're paying for, but in exchange, you get to live in a society where everyone can get care regardless of employment, hobbies, or pre-existing condition. The young pay for the old. The idea of adding a bureaucracy on top of that to try to parcel out individual risk and surcharge people sounds like it'd be an amazingly complex waste of money in itself. It also sort of reminds me of China's social credit system, but with your healthcare-cost related activities instead. Would you have to start reporting that you play a game of touch football on Thanksgiving, or that you ride your bike instead of driving a car to get to work? Maybe I walk through a neighborhood where I could be mugged and end up in the ER. Now I have a "walks through bad neighborhoods" surcharge? Where does it end?

It is a matter of fairness. The way insurance traditionally worked is that your cost was proportional to your risk; This is what actuaries do for a living. Insurance companies live and die on actuarial tables. I was asked whether I smoked for my life insurance -- that was a fair question. Of course this will always be a crude estimate, but drug use voluntarily puts one in a higher risk category and actuaries can give you the numbers.

Now this should not be the end of the story. I understand there are folks who need medical treatment that can not afford it. There should always be a mechanism to make sure folks get the necessary help. I would hope the church or some other private entity would step up -- and often do. If not, then the final catch is the government.

The government taking over the whole health insurance industry is a naive solution that will result in crappy coverage for everyone. I don't claim to have a complete solution -- it is a difficult problem. I don't like extremes in either direction : completely privatized and completely government run are both bad solutions.

> The government taking over the whole health insurance industry is a naive solution that will result in crappy coverage for everyone.

This is demonstrably false when you consider the quality of coverage in places like France and Denmark.

I find the fairness argument understandable from a distance, but it falls apart when you look closer and realize the amount of overhead involved in managing such a system where we make sure everyone pays according to their risk profile, which itself, would be dependent on numerous subjective measures not to mention the potential for intentional or unintentional inaccurate reporting. As an example, our tax dollars go to pay for infrastructure whether we're driving on the roads and bridges they pay for or not, and we don't pay more or get refunds if we use more or less roads. Would it be fairer to only charge you for roads you use? Absolutely, but it'd also be a ton of overhead to administer.

What if their employers decline to pay for it? Or what if people with dangerous hobbies decide to take the risk and not pay for additional insurance? Are you OK with these people dying because they can't afford to pay for their health care?

Every now and then I hear of someone in a wing suit dying. I don't like hearing about anyone's death, but I realize they knew the risks. I am not sure where I stand on legalization of various drugs, but I do feel they should have a higher insurance rate. I'm am not OK with anyone dying, but my sympathy level does vary. In fact, I have a higher sympathy for folks who are hooked on various drugs and are trapped by their lifestyle. I am not above my own addictions.

> No user of this product has ever harmed anyone else as a result of using it.

I definitely don't agree with this. You are harming your family and friends by harming yourself.

People can care about you.

this isn’t an addictive substance.

Edit: the OP removed statement about addiction

I removed the addictive part. This substance can have dangerous side-effects and bring you to the hospital, so it doesn't need to be addictive to hurt yourself.

> You are harming your family and friends by harming yourself.

What of drinking alcohol? Eating too much food? Riding a bike without a helmet? Taking an antidepressant with known potentially dangerous side effects? Going outside without a jumpsuit made out of Nerf foam? At what point do you get to live your life for yourself instead of avoiding doing things you think others might not want you to do?

Of course. The point is that there is a scale of dangerousness. What are the odds of getting an accident riding a bike vs taking drugs like these ?

I think jumpsuits should be forbidden for the same reason, but that's just a personal opinion.

Surely, but I think your danger meter may need recalibration here. Dying of toxicity of psilocybin is practically unheard of (unlike with alcohol, for example), and while there are no solid stats on injury/death related to behavior while on this drug, it is considered the safest of recreational drugs according to a recent global drug survey: https://www.theguardian.com/society/2017/may/23/study-halluc...

Given the chances you'll be riding your bike among cars piloted by people on prescription painkillers or alcohol, I'd be surprised if riding a bike isn't significantly more dangerous than taking psilocybin, but once again, there are no good stats on psilocybin-related behavioral results so this is just speculation.

What exactly are the dangerous side-effects of psilocybin? Yes, you shouldn't drive or make big decisions while on it, but that's not hard to control for (and is similar to many OTC medicines). What are the side-effects that are sending you to the hospital?

> You are harming your family and friends by harming yourself.

Are you asserting that this is per se the outcome of ingesting psilocybin?

The blind spot here is that no one really understands how it works or the long term implications. It may have a use for patients with treatment resistant medical conditions where the alternatives have failed or side-effects are intolerable.

Why should healthy adults take this substance? Many of the so-called experts interviewed in Michel Pollan's new book took psilocybin and believed the experience revealed the inner truths of the universe. It seemns like it could be quite harmful for more people to embrace meta-magical thinking.

Related: 1) Michael Pollan is interviewed on a podcast by Tyler Cowen. They briefly talk about whether psychedelics have contributed to society through novel discoveries. 2) Robert Sapolsky's lectures and book Trouble with Testosterone touch on meta-magical thinking.

I think it's disingenuous to argue from the stance that magical thinking is bad and should be prevented, and thus that the drug is bad and should be eliminated. I think you'd be surprised just how many functional people have magical beliefs and especially how many scientists and engineers do. The notion that a pattern of thought is dangerous and should be outlawed has probably done more harm to the world than "meta-magical thinking."

Well... I think the oneness effect is interesting where people basically feel interconnected. Kind of like astronauts who see the world from space. That feeling should be a positive one. It's also not clear it is permanent. It may impact your degree of openness.

What I've found interesting in his book is that the suggestions of the therapist lead basically influence the result. So if someone says what will happen on shrooms you basically have a similar experience. That is interesting.

Further along the meta magical thinking idea is the stoned ape hypothesis which basically tries to explain how we were able to transcend "primitiveness" and develop abstract reasoning and as such technological progress by using psychedelics. Whether there is evidence for this or not I don't know.. haven't read the stoned ape book.. It does seem more plausible that magic mushrooms led to religion. I've been reading Pollan's book as well and the part about AA 12 step and Bill's wanting to use magic mushrooms as part of the process is very interesting. Turns out that the board allegedly wanted to keep the straight religion aspect in it for control vs surrendering yourself to mushrooms. This is partly why psychedelics are being tested on reducing alcoholism.

If it can help alleviate depression and anxiety I am 100% behind it. So much time, energy and life is lost to that mindfuck of a state.

* also we don't really understand the long term implication o f a lot of things we eat or drink or the legal drugs we take. Should you eat eggs? margarine? wine? tea? how much coffee? etc..

While it's a fun hypothesis, there's no evidence for that (nor the bicameral mind hypothesis).

On Psilocybin:

Anecdotally, mushrooms are about as likely to disrupt existing patterns of magical thinking as they are to inspire new ones.

The experience of being absolutely certain that your friend in the other room can read your thoughts and the discovery when you come down that no, he was thinking something completely different than you thought is sobering.

The experience of realizing how large the world is, how many people are in it talking at all times, can undermine conspiracy theories that depend on a tiny cabal of people keeping a secret while using hundreds of workers to accomplish a task, like faking the moon landing.

The "inner truths of the universe" that people feel are exposed by mushrooms are so abstract that they're not likely to actually interfere with rational thought. Mushrooms induce a metaphoric mode of thought. Realistically, we are all connected, by atmosphere, ecosphere, society and economy.

It's true that we don't have a solid scientific understanding of the long term implications, but we have a pretty solid population of people who've done mushrooms casually. It's not an uncommon drug.

All that aside, we have an FDA review process so that we can evaluate the safety of a drug. No drug is ever evaluated to see if it has a long-term negative societal effect because of how it alters your world-view. The effects that Depakote, Prozac and Ambien have had on society are likely significant and are largely unknown.

On "metamagical thinking":

I just spent some significant time trying to find out what "metamagical thinking" is supposed to be.

Try it yourself. You'll find many people quoting Sapolsky thus: "It's the shamans who are moving separate from everyone else, living alone, who talk with the dead, who speak in tongues, who go out with the full moon and turn into a hyena overnight, and that sort of stuff. It's the shamans who have all this metamagical thinking." What you won't find is any kind of formal definition of metamagical processes or arguments for the term.

You'll find two places in his book "Biology and Human Behavior" but in each case it is only used as an adjective describing the symptoms of schizotypal personality disorder. In the DSM this is instead described as "magical thinking," no meta involved. In "Trouble with Testosterone" Sapolsky only refers to "magical thinking."

Sapolsky appears to have just added the "meta" as a sort of unthinking affectation for a period of time and to have dropped it later. I'd be interested in evidence to the contrary.

I say all this because Hofstadter invented the term "metamagical" to describe a certain kind of highly intellectual examination of the edges of analogy and meaning in rational systems and it's a hell of a phrase. It's a shame to have Sapolsky's non-use replicating across the internet.

long term implications of a living human being is death. the live human being will create pollution, will kill a couple of ants, might become a murder, a liar. Life is risky.

It's unnecessarily more risky when you do stupid things. You can't use a little risk to justify arbitrarily more risk, you have to make an argument based on the value produced.

The substance of interest is psychedelics. According to what we know, they are pretty safe. Additionally, it is most definitely not "unnecessarily". Introspection, personal growth, and so on is not "unnecessary" to me and to many people. If it is to you, that is fine by me.

Not sure what you are referring to by "stupid things" though.

I think you're focusing on safe from an LD50 perspective? My comment addressed the question of significant changes to the mind.

I don't have any serious qualms with psychedelics. I have a problem with someone arguing that they should be legal solely on the basis that risk is acceptable. By that argument, I should like to wave a loaded gun in your face.

But that would be a stupid and unnecessary risk, so obviously there is more to the question of regulation than what risks people feel like they want to take.

In theory humankind can persist indefinitely, so long as we don't fuck it up, but we are fucking it up, we're destroying the life support systems that sustain us. That's unacceptable risk.

Individuals on the other hand don't live forever, the risk of death is 100% for everyone, so individual risk isn't something we need to get uptight about.

Lots of people have died in car accidents. Many people have died because of knifes. Many people have died because went to the wrong place where wild animals were hungry.

What is the solution in this case ? All the situations here are riskier.

Many people die after they wake up and leave their room. So its risky to leave their room.

You are not a genius.

I literally do not understand what you are responding to right now.

“Therapy” is the biggest legal scam in the US.

Feeling depressed? Here have whatever chemical psychologists happen to be playing with today! Take some mushrooms, no wait, exercise, no wait, take this, no wait that doesn’t work and is dangerous so take this instead.

“Prior to founding Compass, George Goldsmith and Ekaterina Malievskaia, a married couple, did not have experience in psilocybin research or working in the pharmaceutical industry. They’ve made headway thanks to tens of millions in dollars from investors including Silicon Valley libertarian Peter Thiel and former Wall Street-executive-turnedcryptocurrency-investor Mike Novogratz,”

Can’t wait until they get into the chiropractic and homoepathic industries too.

Queue every pot smoker to tell me psyilocybin is a wonder drug and every square that it’s the end of civilization.

Would you please stop posting unsubstantive rants to HN? As you know, we're trying for a bit better than internet default here. Please post civilly and substantively, or not at all.


Thank for your work, dang. Long-form personal opinions seem to be better suited on Medium, Twitter, other social media.


The ones that aren't unsubstantive or flamey are welcome here.

Guidelines | FAQ | Lists | API | Security | Legal | Apply to YC | Contact