The study was just published in the most prestigious medical journal in the world [1].
Whatever you think of the study, this is rather significant. If you told me even 2 years ago there would be a randomised trial of magic mushrooms in NEJM, I would not have believed it for even a second.
One point not to miss is that they screened 1000 patients to come up with the study population of 59.
Nevertheless, I consider the study result quite promising, considering patients only had 2 doses of psilocybin.
Due to the stigma of psychedelics, there has been a long gap in research, which may have started with 1962 "Good Friday Experiment"
> Almost all of the members of the experimental group reported experiencing profound religious experiences, providing empirical support for the notion that psychedelic drugs can facilitate religious experiences. One of the participants in the experiment was religious scholar Huston Smith, who would become an author of several textbooks on comparative religion. He later described his experience as "the most powerful cosmic homecoming I have ever experienced".
>they screened 1000 patients to come up with the study population of 59
Note that while not ideal this is completely normal for any early stage drug trial. Most drugs get licenced based on data in which the trials would have excluded 90%+ of the typical clinical population. This is certainly true in depression where most drug trials will exclude patients with comorbid MH conditions, and often exclude them for "too many previous episodes". But it's also true in physical health (e.g. asthma).
I'm sure it's even harder when recruiting for an RCT in psychedelics though. A friend was working on clinical applications of MDMA about 15 years ago and a stipulation of the ethics board was that her participants had to have taken MDMA at least 3 times before, but not more than 10 times. Not easy to recruit for that study!
2 doses of psilocybin, vs 6 weeks of SSRI's..! They also seem to cite a big difference in lasting happiness, altough that wasnt the focus of the study.
And some folks have a really tough time coming off SSRIs too, with bad withdrawal symptoms (extreme anxiety, panic attacks, tremor, hallucinations, memory loss, confusion...) even when tapering over several weeks.
The definition of treatment resistant depression is one of the filters that narrows down the list. A subject must have tried at least two different antidepressants for a certain length of time and within the last few years, in addition to therapy. So, someone who has taken antidepressants for years doesn't automatically qualify.
This is crazy. It's like cart manufacturers lobbied government that anyone who want to buy a car would first have to use a horse and a cart and only be allowed to buy a car if the cart and a horse causes significant problem.
Am I the only one seeing corruption here?
Studies are being designed to reduce the possibility that a patient just didn't respond well to one medication but instead shows a general lack of improvement from antidepressants. The goal is to know that the patient improved from psilocybin, specifically. One other problem with this stacked definition of treatment resistance is that doctors are going to be coerced to always try multiple antidepressants and guinea pig the hell out of patients. Doctors are going to refuse initial psilocybin treatment and only use it as a last resort because the studies are going to show that treatment resistance is necessary. Even worse will be if doctors are coerced by regulators and medical institutes to strictly follow their protocol. And this only includes doctors who agree to add psilocybin to their treatment programs. A lot of doctors will resist using it, claiming "unearned wisdom is dangerous wisdom" and so forth. The "unearned wisdom" claim is based on the indoctrinated belief that a patient must undergo many hours of therapy and slowly peel layers of experience in order to truly understand, whereas psilocybin offers a shortcut.
For these reasons and others, I believe that the vast majority of depressed people who haven't healed from traditional methods ought not pursue clinical studies as a viable pathway to psilocybin-assisted therapy.
If your attempted argument is "X helps people who are not helped by other existing treatments", then limiting your selection criteria to those who have tried several existing treatments and not found success seems to follow logically.
(Though the study's construction seems to fail at that argument, since the claim is that all patients, both those given the psilocybin and those given the SSRI, improved markedly.)
When I wrote that, I had in mind a situation in my country that you can be eligible for private medical cannabis prescription if you try at least two other treatments and you find them ineffective. On the surface it doesn't sound too sinister, but for example, when it comes to chronic pain the drugs that are being given are simply nasty. I still have nightmares about the side effects that I experienced (vivid hallucinations, suicidal thoughts, derealization and more). Given how ubiquitous cannabis is, people with various problems often find, including chronic pain, that it helps massively and unfortunately they cannot bypass going through hell just to get prescription for what helps. They cannot even suggest that they look for medicinal cannabis as they still may be branded as drug seekers and be denied treatment altogether.
I can understand the basis for those requirements in general (e.g. for antidepressants, doctors generally won't start you with an MAOI or a TCA, they'll start you with an SSRI or SNRI or similar, then try another one if that doesn't work, then maybe resort to TCAs if a couple of those don't work, then maybe try an MAOI if a couple of _those_ don't work), though I would agree that having a hard requirement of trying several other drugs first with the toxicity profile of cannabis seems...overly harsh at best. (Especially labeling people drug seekers for it - though they might be gun-shy after the fun with opioids and worried about finding a new epidemic of cannabis addicts, which seems...unlikely.)
"One point not to miss is that they screened 1000 patients to come up with the study population of 59."
I'd be curious how many 10,000s if not 100,000s of people pharmaceutical companies go through, along with changing/crafting their selection criteria to keep out people/symptoms they know have more/strong "side"/harmful effects with, until they get acceptable looking results; propaganda using truth - "Misleading with true fact" - https://www.youtube.com/watch?v=lls_2tfWcUI
I have a friend who has experienced magic mushrooms recreationally about half a dozen times in her 20s. After each trip she reported feeling clear headed and more mindful - she described it as though her mind's harddrive had been defragmented.
Fast forward 10 years and that same friend felt low during lockdown over the past 12 months. After reading up online she decided to try microdosing mushrooms rather than the mainstream route her doctor would prescribe - anti depressants.
She has been taking a tiny dose every other day and feels immeasurably better. More optimistic about the future. More energy. More focus. Less sad.
To say it's frustrating to read these official press releases about the positive impact of mushrooms nearly 20 years after she discovered them for the first time is the understatement of a lifetime.
I'm convinced we'll look back at this era as a form of prohibition on drugs that governments threw down as a wide blanket and ultimately society was worse off for.
I know a lot of people whose minds were ruined by psychedelics. It’s something you will see when you spend time in those communities. It doesn’t happen to everyone, but it’s common.
This type of empty fear mongering comment is unhelpful at best. It's a McDonalds of a comment. What's a lot of people? Why are psychedelics so special compared to anything else (sugar, Facebook, gambling). "It doesn't happen to everyone, but it's common" - what does this even mean? "Common" based on what criterion? How should our behaviour as a society change based on your comment?
Agreed, I'm not here to insert my opinion about the therapeutic qualities of psilocybin, but I find vague anecdotal quips like this very frustrating. If there's validity to these treatments, let's let the science prove out. There's no point in trying to discourage folks from having an open mind about something that may turn out to help a lot of people.
Psychedelics can definitely trigger or exacerbate mental health issues. A few years ago my group of friends lost someone to schizophrenia after he started micro-dosing LSD daily.
I've tried many of these substances, and know people who have gone a lot further, so I'm not speaking out of ignorance here. There are risks to these things, and it's not a positive experience for everyone. Giving people a warning about that is entirely reasonable.
It's such a shame because I've seen people lose their minds on psychedelics and the problem is they just can't handle being out of control. If their view on the world is in any way distorted - they cannot handle it. And that's sad because life is ultimately about perception and changing your perception is usually a good thing.
It's not a useful warning, though - what would someone do with that?
It's like saying "driving in a car is dangerous, and many people art hurt every year doing so." Okay, so what? Are you saying everyone should stop driving? It's just not useful - compare it to something like telling people to wear a seatbelt or pointing out that driving in particular conditions is especially dangerous. Those are things that we can use to drive more safely. Saying vaguely that driving can be dangerous doesn't serve any useful purpose.
Because many people in this thread have no knowledge or experience with these substances, so giving them accurate information is useful. I'd say it's even necessary given there's a group of enthusiasts that very clearly over hype the benefits and make absurd claims like it's impossible to have a bad time, to over use them, etc. I want people to have a balanced view of what they may be interested in trying, vs that nonsense. Otherwise they're possibly setting themselves up for a bad trip at the least.
I don’t know if they are “special” compared to those, but you seem to imply they are the same.
You seem so laser focused on the promising side of things that you completely “forget” each substance is different and it’s use has serious consequences if abused, if not then do heroine.
Are you comparing psychedelics to sugar and social media?
Unless psilocybin is thoroughly tested and validated as a treatment that is as safe as SSRI, I don't think it's really worthwhile to jump into the psilocybin train.
In a sense, yes - I believe the damaging effects of sugar and social media on the society is far greater than psychedelics might have if decriminalised.
They definitely don't deserve to be Class A in the UK and Schedule I in the US. Even more so, they shouldn't be classified as Schedule I by the United Nations.
I'm not sure about using it regularly, but people have been using these for ceremonies for centuries. I personally believe the choice should be left with an individual.
Fortunately, "as safe as SSRI" is a pretty low bar.
Should we also compare the risk of addiction/dependence? Oh, yes, lets do!
Hey, while we are at it, shall we also compare effectiveness? 2 doses vs 6 weeks? Oh, wait, that's what the study did.
I wonder how many different types of psilocybin they had to test to find the effect one for these particular patients. Because, you know, getting the "right" SSRI based coctail is actual quite hard, many people go through three or four different variants before finding the one which they think works.
Yes, I'll bet they had to compare at least as many types of psylocybin before they found the combo that worked. Right?
SSRIs are notoriously NOT safe. In younger people, they often increase suicidal ideation. Even in adults, there is a very dangerous period when you first start taking them where suddenly you have more energy, but you are still massively depressed. People die because before they were so depressed they couldn't even take action to suicide, and the drugs give them just enough of a lift that they can.
Apart from that, there's the massive list of side-effects, many of them extremely common.
Complete loss of libido, erectile dysfunction, or worse, your libido is unchanged but you completely lose the ability to orgasm.
Insomnia, cause that's what a depressed person needs, even less sleep and more time for rumination in bed.
Akathisia, which is an uncontrollable need to move your body, think restless leg syndrome but it's your entire body. You literally cannot sit still.
Less life-destroying but still very obnoxious: increased sweating, dry mouth (which can ruin your teeth if you don't manage it with biotene or gum or something), blurred vision, headaches, the list goes on.
This is without even mentioning the risk of serotonin syndrome yet, which can straight up literally kill you if you don't make it to a hospital. It happens when your serotonin level is too high, and can cause seizures, fever, arrhythmia, or death.
This is why research is needed. My gut feeling is that the root cause is overdosing. Just search "How often can I do shrooms" on Quora and you get the gamut from "1 or 2 times per year", to "microdosing everyday, macrodose every weekend, and hero dose every month".
This is why, even though I stand firm behind the fact, that psychedelic experiences changed my life, I stay sceptic about changing body/brain chemistry over longer periods of time.
I used to macrodose and get immensely creative over a week or so. With a happy outlook on nature and all things uncontrollable around me.
But then the high died some day. Lethargy came back. Lack of actual structure and the 'happy go lucky' attitude derailed whatever tied my past with plans for the future.
Microdosing seemed to help from time to time, but mostly I just get distracted with random consumption instead of planned, structured and thought through creation.
Why is this being downvoted? Studies are great, but let's not act like drugs are suddenly safe to use in all cases. I'm sure the studies didn't conclude that.
Be pro-shrooms but don't act like they're safe in every case. Education is required before partaking in anything, let alone shrooms.
Can we point to any data showing that mushrooms or acid (for example) are more dangerous than, say, a coronavirus vaccine or driving a car?
Because generally speaking, unless something is concretely documented as dangerous we don't just assume it is dangerous "because". Especially when that "because" is because of a well-documented, decades-long propaganda campaign by the federal government.
I used to use mushrooms from time to time in my youth, and had some great experiences (which I've written about on HN before).
As far as danger, I think that, as with many things, it's about maturity, education and harm reduction.
I had a single bad experience with mushrooms, and it put me off ever taking them again. I was too young and immature (something like 15/16), and took about 5x more than I'd ever taken before. I can see now that it was obviously very stupid. If I'd been in a different location at the time, god only knows what could have happened to me - I'd say that, if abused, mushrooms can be far, far more dangerous than driving a car.
But - if the science backs it up, psylocilin could do amazing things for those with depression. And furthermore, sensible people can have amazing experiences. So as long as education and harm reduction is in place, I'm all for it.
I have had plenty of negative experiences with the many, many drugs I have done. But the most danger I have ever been in due to drugs has been being the passenger of a drunk driver. That's maybe the only real physical danger I have encountered. I have a hard time even imaging how mushrooms would lead to physical danger.
The subject has been studied. There is no good evidence supporting that.
Cause and effect is not easy to separate and anecdotal evidence is just anecdotal.
People who are not well are known to 'self medicate'.
For example: Increase of alcohol use among people with preexisting problems is well documented. Link between tobacco use and schizophrenia is also well documented. See: "Smoking and schizophrenia" https://pubmed.ncbi.nlm.nih.gov/19794359/"It has been suggested that smoking may be an attempt by schizophrenic patients to alleviate cognitive deficits and to reduce extrapyramidal side-effects induced by antipsychotic medication."
Psychedelics are not the type of drug people keep using if it harms them. If they don't work for you, you really don't want to do them again.
(ps. I would not recommend _regular_ drug use of any kind)
How many is a lot? I've been around a lot of people that do psychedelics, and have done them myself quite a bit. No issues to report.
It is a crime that they've been locked away for so long due to Nixon and scare mongers. So many people in jail because of it. Legalize it already, sheesh.
I mean we could just discuss the issue of freedom and making it illegal for people to grow and consume a mushroom and stop making it about just drugs. Marijuana is the same way. If it isn't for someone then they shouldn't do it and we should make as much information available about something available and provide safe environments, but making it illegal especially when plenty of people have experienced positive effects sometimes profound religious experiences it is just another mechanism of control and taking away freedom and natural rights.
Freedom is indeed one narrative. What is being (re-)constructed here is a narrative about plant medicine. The concepts used in each narrative are very different, so if we discussing both at the same time may confound each other.
True, but the right to life, liberty and the pursuit of happiness as stated in the United States Declaration of Independence has it covered pretty well. Growing your own mushrooms or marijuana does not restrict on other individual rights if they do so willingly, and therefore getting caught up in treating it like a drug that needs to be studied more before they consider making it more accessible seems a bit absurd IMO. They're not being made in labs and grow naturally in many parts of the US.
I'm pretty sure there were formal studies decades ago showing potential use and positive outcomes (I think Stamets books from the 90s reference some formal studies, but i could be wrong). But like a lot of medical research, it never progressed to a market state. I think that's especially true in this case due to the legal classification around it.
Yeah, they were able to bring LSD into therapeutic use before it was essentially outlawed. I believe there was one dominant practice in California that became well known as specialists and there were articles written about them and the celebrities that were treated there.
Not OP, but I've met people that seemed to sort of lost their agency and ambition, because their psychedelic insight was that the universe will sort everything out on its own. Though maybe the causality is the other way round here - they were not ambitious in the first place and psychedelic insight helped rationalise that.
Also disclaimer: I'm not trying to discourage or encourage people from psychedelics. Personally I believe they should not be criminalised, but people should be cautious using them.
Just a personal note, I experienced the complete opposite. I knew I wanted to do great things and accomplish things of importance, but depression was like a black cloud holding me back from doing so. Psychedelics took away that cloud and also infused a deep level of meaning into my everyday life.
I went from depressed and basically dropping off the edge of the world to traveling across the world and starting a startup with new friends in a different continent, which was just now recently acquired.
What might interest you is all the psychedelics I did were technically legal. Shoutout to 4-AcO-DMT and 4-HO-DMT.
Fwiw 4-HO-DMT is psilocin (it and psilocybin are both in mushrooms in varying amounts; and psilocybin metabolizes into it in the body). It probably wasn't legal. 4-AcO-DMT is a bit more of a grey area (probably covered by the analogues act; allegedly also metabolizes to psilocin in the body too).
> What might interest you is all the psychedelics I did were technically legal. Shoutout to 4-AcO-DMT and 4-HO-DMT.
They are both illegal where I live (Poland). The government maintains a huge list of forbidden substances (link only in polish: https://pl.wikipedia.org/wiki/Wykaz_%C5%9Brodk%C3%B3w_odurza...). This is in response to a big designer drugs crisis that started over decade ago. Which most likely than not was caused by tightening of the drug laws happened around two decades ago. It's a bad situation that will take another decade to improve, I suppose.
>but rather that they have different priorities than you and that you're narrowminded and judgemental.
Having been loosely affiliated with the Goa/Psytrance scene, I too, have met some individuals who seemed to have "fried" their brains.
If those "different priorities", how you call it, also include being almost dysfunctional and therefore dependent on constant external support, paranoid and frequently incoherent then, yes, it made me judgmental too.
And this isn't even speaking of phenomena like Hallucinogen persisting perception disorder (HPPD)[1].
The thing is, it's not at all clear this was caused by psychedelics, so much as psychedelics and the lifestyle that goes with it shape the sort of dysfunction we observe.
If they had been in the midwestern USA would they also be dysfunctional but taking prescription painkillers? Mental health problems are common, and confirmation bias is real.
There is also the danger of reverse causation — and this may apply to cannabis. The epidemiology there suggests psychosis may cause people to take cannabis at higher rates, rather than the reverse.
Finally... I've also often wondered what partying so hard would do without the drugs. I've experienced festivals both with and without recreational drugs and it often feels like the sleep deprivation and over-stimulation have as large an effect on my subsequent mood as the drugs did.
>so much as psychedelics and the lifestyle that goes with it shape the sort of dysfunction we observe.
I wondered about this myself.
I think it is hard to pinpoint exactly since festival-goers often also consume a mix of different substances (the infamous "candy flipping") including alcohol instead of just straight mushrooms or LSD.
Funnily enough, I just came across a study of ecstasy use in Mormon kids who didn’t take alcohol or other drugs... not sure if they were staying up all night raving but my prior is not. Apparently they didn’t suffer the same cognitive deficits found in other ecstasy users.
Not OP, but there can be a few things they're alluring to.
Some disassociatives are often put into the "psychedelic," and they can cause addiction. Ketamine begin an example. People begin chasing the previous high, which often means higher doses and more money.
Some more ignorant people put MDMA (and family) of drugs into this category as well. These drugs are highly neurotoxic, and require a lot of "prep" to take to reduce their neurotoxicity (it's arguable to what degree this prep helps). Moreover frequent user of this can in some people (ie people succeptible to depression) cause a long-term disbalance in their serotonin system (some people take weeks to recover from even one usage).
People who have some mental "precondition" (eg such as psychosis, etc) can have some extremely severe response and permanent "side effects" (for a lackeof better expressions) from psychedelics, and never recover.
An extremely small percentage of people have what's called Hallucinogen persisting perception disorder (HPPD). Some people find it fun, some don't mind it, while some can't function because of it.
Quality of substance you acquire can also vary. On the black market things are often mislabelled or cut with other substances that are easier/cheaper to produce. One notable examples is NBOMe being sold as LSD. NBOMe is more dangerous for a few reasons that I won't be getting into in this post. Always test your stuff with test kits, or if you're not comfortable with that, sense a small bit of your batch to a testing lab (there's a few anonymous/free ones in Europe).
Lastly, there's always ignorance or
risk of being too "casual" about taking psychedelic due to familiarity with them. This leads to accidental drug combinations (eg some antidepressants + some psychedelics) don't combined well. Aimee just diminished the other, but people reported more severe symptoms. People also combine things recreationally without researching things properly, which can be a bad combo. Speaking of antidepressants and psychedelics: a notable thing to mention is that Lithium salts and LSD have been reported to lead to terors, seizures, and maybe even death (as reported on erowid).
I'm not trying to discourage or encourage people from psychedelics. In my personal experience, they can be wonderful and provide healing experiences. However, we need to always be careful when using them, because they have such a profound effect on our minds, and we still understand so little about the mind itself. With that in mind (no pun intended), treat them with respect they deserve!
Off-topic: writing long form text on a phone is such a chore. I can't edit the typos anymore, but just to clarify: "Aimee" was meant to be "mostly they". There's also a few words dropped here and there, but it doesn't impact readability as much.
Any psychadelics (and I think cannabis as well, but much more rarely) can cause a psychotic break, which can’t always be recovered from. It seems to be more prevalent if there is a family history of psychosis.
Even with cannabis, states have no FDA that is prepared to do studies and I just wish a basic level of known side effects were listed from the actual FDA which they do for studied and much more harmful drugs, because they were studied
When you add all the other scheduled drugs that have no state level recreational framework, then you no studies and you also have a compounded supply chain problem where nobody knows what they’re actually consuming
There are molecule combinations out there which can cause instant parkinson’s disease
nobody can give a real case about “the friend of friend” who went crazy because of the illegality and imagined or real liability
and its not fair to say “this drug is perfectly safe stop fearmongering, oh wait you should have known about your family history of schizophrenia never mind then lol too late, but everyone else dont listen to that person” this isn’t directed at you, just a collection of things said in the psychadelic community pretty reliably
>nobody can give a real case about “the friend of friend” who went crazy
This is a very good point. I'm not going to suggest that the commonly cited anecdotes are all wrong or misguided, but a lot of well meaning people throw around anecdotes but just like a discussion about flat earthers, everyone knows about them but virtually nobody seems to actually know any personally.
In 2016 the National Highway Traffic Safety Administration (NHTSA) cited 37,461 people died due to automobile accidents. Those are easily traceable numbers because they create a tremendous amount of paperwork and news articles.
But with psychedelics there is a very odd disconnect between the perception of their danger and the extreme lack of actual medical/scientific evidence that actually gets cited.
Not exactly what you're referring to, but after a 15 year-or-so break from cannabis (I used a lot in my youth, starting around 12YO), I've found that I can't use it any more - it gives me the most horrible anxiety! I persisted, but was close to panic attacks, and gave up on it.
It's actually pretty annoying, as I have a health condition that it might help with, and furthermore I used to really enjoy recreational use.
There are some studies on PubMed around this. I remember hearing about one that the DoD did involving soldiers who used cannabis and mental illnesses. I wasn't able to find that, but here's a similar one.
At least some of this could be the tendency of people with pre-existing mental illness to self-medicate. High smoking rates amongst people with schizophrenia is an example. Smoking seems to ameliorate some psychotic symptoms.
I have heard this too, but mostly because there where looking for something that is not there. Example: if finding your true yourself is like peeling of an onion, the can peel a lot, but at some point, the reach the core where there is nothing to peel anymore. I have never reach this state and it is not at all my goal. I think it has something to do with ego. Doing psychedelics makes ego less important. But if you do it too much, you lose your ego too. Living without ego is not possible in my opinion..
I'm not sure what this is responding to. The prior comments were asking about details around potential permanent psychiatric issues. There's some stuff in here about psychosis turning into schizophrenia, etc. It's rare, but we also can't dismiss it.
I know a bunch of people who went totally nuts with the aid of drugs; but I know even more people that never touched any drugs who went off the deep end with the aid of media, romantic relationships, religion, politics, etc.
Setting is definitely important, as is choice. One of the big problems with illegal psychedelics is that people aren't sure what they are getting. For instance, DOB and MDMA both come in pill form, but have wildly different effects.
Some of the worst outcomes I've seen have come when one drug is believed to be another, and this is something that decriminalisation would definitely help with.
That being said, psychedelics have traditionally been combined with ritual, and the lack of said rituals can be a big impediment to useful results.
Here in NL, large festivals have drug testing booths, where the visitors can have their drugs tested so they know what they'll be ingesting. That's possible because of decriminalisation and destigmatization.
Legalization would allow the government to create a testing infrastructure so drugs can be tested/validated before they're sold, that's arguably better. But it's definitely possible to create a safer drug environment with decriminalisation only.
Drug testing is possible here in the US with overt criminalization.
Decriminalization is just marginally safer. Testing is a huge waste of resources unless its a stopgap towards recreational legalization with a reliable supply chain.
I have zero experience with drugs, so I am wondering if there is a sugar/cigarette industry that put a lot of money into promoting it's products, then what will be different when drugs get legalized?
Won't we repeat the history where companies make billions from this products, put them into ads to spread the use and addict people, suppress research into bad side effects etc,.
Personally I think there are some good applications for mushrooms or marijuana but my instinct is that the greedy people would do what they do best, sucker people and make big money.
But psychedelics are very different. They're really, genuinely not addictive -- probably because they're not "fun." In fact, they're exhausting. You may feel a lot better after, the experience may be fascinating, but you're in absolutely no hurry to do it again. The whole thing lasts a few hours, but literally feels like months, with numerous epochs along the way.
It's not like the kind of hollow calories of a bag of Cheetos, it's more like a long, difficult workout. That's hard to productize in that way.
There are really two different things here: physical dependence (which can mean withdrawals on cessation), and psychological dependence (commonly referred to as "addiction").
The nature of psychedelics makes it difficult to overuse them.
Your body will actually build a tolerance to them and they'll stop working if you use too regularly.
You also don't establish a physiological addiction like you do with drugs like nicotine and sugar.
Finally, the dosage required is absurdly small and would be extremely cheap to mass produce. You can grow mushrooms relatively easy in your damn closet. It's not like it's a patented designer drug.
Will people created patented designer psychedelics? Certainly. But it seems to me like it would be a similar kind of problem to people buying Fiji water when nearly the same stuff is flowing out the tap for damn near free.
You can also grow tabacco or make alcohol yourself, so I still expecting a giant industry that will try it's best to hide the side effects, blame the victim when something goes wrong, put billions in ads to make it look cool to use their products.
Why would you take micro doses of mushrooms rather then use an approved anti-depressant treatment? Your home grown mushrooms might differ in concentrations, the one you buy might be low quality...
I have nothing against the product, I am just anxious that it will be promoted as a miracle , "text mushrooms and your anxiety will be gone, your creativity is 10X better, see Joe the developer wrote this cool Rust project fueled just with weed and mushrooms in 48 hours" - I have a bias, I do not trust companies and capitalistic societies, they fuck the society for profit, we need to keep our eyes open on this studies, make impartial ones and maybe do something about misleading ads and posts promoting unsafe stuff.
Of course. And when multi billion dollar marketing budgets are put to work for weed and psychedelics, you can expect the same situation to occur as with tobacco or alcohol.
I’ve seen it suggested that a reasonable legalization framework would be to legalize all drugs but not allow advertising. This would logically include getting rid of alcohol and tobacco advertising too.
Every day isn’t sustainable, but Psilocin/LSD tolerance builds as fast as it diminishes again, typically gone within a week or at most two. If you want to abuse them, the chemicals certainly won’t stop you. And when you’re in the mindset of getting hammered all the time no matter what you can just take Ketamine for a day, do less LSD but mix it with MDMA, and all those things. People can be very creative.
Abuse is a person problem, not a chemical problem.
This is my experience too. I’ve been microdosing about 1.3mg on and off during lockdown. The effects are subtle and hard to describe but I’d say it’s like ‘opening your mind’ or reframing your point of view on things. Definitely different from other drugs which just pump you with serotonin
It temporarily breaks you out of your established mental framework. It's as if your raw consciousness viewing the world without any of the filters that we all use to tune out the noise. That's why the experience can be overwhelming and chaotic and it's useful to be in a safe place with a trip sitter.
I think the magic comes when you discover that something your default mindset was filtering out as noise is actually signal. With that insight, you can more easily make changes to your sober mindset.
That is interesting. So it is a bit like reducing your attention, and expanding awareness?
What you described sounds very similar to the effects of mindfulness meditation. The idea in a sense is to increase awareness - that is, sensing the world as is, without the filters or influence of mental objects. The theory is that meditation can then help you free yourself of past negative conditioning that is no longer relevant and to be more present.
It would be interesting to see more studies on both, but I understand that many things to do with the mind and subjective experiences are difficult to measure and therefore to study.
Definitely. Sam Harris' book Waking Up is what turned me on to psychedelics as a mind expanding tool rather than just a party drug, which I had little interest in.
In it, he talks about how his early experiences with psychedelics turned him on to the fact there was something real worth pursuing in meditation and mindfulness beyond the superstitious bullshit. Most of the book is about using meditation as a tool for spirituality without religious baggage or supernatural explanations.
The way he and others talk about it, is that psychedelics effectively force any mind into an objectively different state of consciousness. Even though it doesn't last long and the memory of it fades, just the awareness that radical mind shifts are possible is enough to help people take mindfulness practice seriously.
At a cellular level, it temporarily vastly increases the connections between the synapses. A lot of what your brain does is travel along well worn synaptic pathways, like running on autopilot. This is when you feel like you're in a rut, it's because your brain for efficiency reasons is just doing what it always does. The temporary frenzy of increased synaptic connections allows people to break out of those ruts
>I think the magic comes when you discover that something your default mindset was filtering out as noise is actually signal. With that insight, you can more easily make changes to your sober mindset.
Regarding microdosing (as described by the OP) this begs the question: Are there perhaps unwanted side effects for running your brain on permanent "debug mode"?
Hard to say. This is the first study I've seen that's tried to learn about microdosing. There's not a lot of good data on it, but it wouldn't be hard for me to believe that there are some side effects.
I'm honestly surprised that you are able feel any effect from such a dose. Based on what i've heard from my friend's uncle's guardener's grandmother's neighbour, this could very much be just simple placebo effect. You know you are taking mushrooms, which have no effect, but you 'feel' better.
Reminds me of the documentary about Addreal and it's prevalence in tech and other high-functioning people. It quickly mentioned (anonymously) a SV tech person that switched to microdosing mushrooms rather than Addreal, and how that made everything better for her (but the documentary cut short on following up her case).
I thought you were going a different direction with that. I don't know if it was the same documentary, but the one I saw was focused on the medical and moral effects and questions around the use of Adderall in the tech population, college students, and children. The main gist I got from it was that people were using it without knowing the possible side effects, like liver issues or mood issues. And that many of the people in tech didn't actually need it but were using it to enhance performance, and found a doctor willing to write to script.
I used to think this but I think society has figured out something better. It has figured out that many people can use drugs effectively and many people are worthless on drugs.
So what it does is that it allows you to use as many drugs as possible when you're something like a high-income professional and sort of criminalizes drug use among working class people.
Your "test" for being a safe drug user is to have a lot to lose.
Drug use is rampant in SF for instance. And I know lots of drug users: cocaine, MDMA, psychedelics.
I used to think "why doesn't society just make you post a bond that lets you act in a slightly more unrestrained manner" and now I've realized society does! You just have to constantly be in a state of having too much to lose.
Personally, I use shrooms frequently (I have some in my fridge right now) and LSD less frequently and MDMA rarely. All of these have been amazing eye opening experiences and I am a much better person for them. Thank God.
This is one of the travesties of drug enforcement and has compounded inequality in America. The imprisonment of the poor for nonviolent drug offenses continues today. That a wealthy drug user would laud this as a good outcome of drug policy is honestly flabbergasting, but perhaps shouldn’t be.
It's really quite awful, isn't it? Completely inequitable and very unfair. But if I had to choose between equal misery and unequal prosperity, I think I choose the latter each time.
I'd like for us to make psychedelics accessible to all, but since lots of people don't want that, I think I'll settle for keeping psychedelics accessible to me.
One way to approach is that a microdose for you is any dose that has no notable psychoactive effect.
Practically, microdosing is often in the 20 - 100 mg range, and the lower threshold of a 'normal' psychoactive dose would be 600 - 800 mg (depending on the individual, eg. their weight, of course).
The drug has dangers, but they seem small compared to those of alcohol, even if largely orthogonal.
It got banned because it wasn't understood in the best case, to curb the counterculture movement from the 60s in the worst, but it's always been hard to justify it with medical reasons; it's been just tagged along with cocaine or heroin and made bad by association.
1. Medical consensus say it's bad, but it's kept legal: tobacco, alcohol, drinking bleach.
2. There's no medical consensus, but it's forbidden anyway: LSD, mushrooms, DMT...
3. Medical consensus say it's bad, and it's forbidden: cocaine, heroin, meth...
4. Medical consensus say it's good, but we ban it anyway: MDMA in the context of psychotherapy [0].
5. There's no medical consensus, but we ban some yet not others that have an identical mechanism of action: poppers
That's without getting into the fact that the federal schedule system is seemingly impermeable, and cocaine or heroin have accepted medical uses, but somehow weed doesn't, despite all the evidence it does.
Do you not think huge quantities of people do it all the time right now? Because, well, they do. Further there were a lot of experiments with psychedelics in the 60s.
Definitely, however it's also disingenuous to say that we have no idea what the long term consequences of shrooms are just because there hasn't been a formal study recently. There's tons of people doing it regularly - for millennia actually, studies from the before-times and a large incentive by the mainstream anti-drug folks to dramatize any adverse consequences.
Should there be studies? Sure. Are we pretty sure it's safe? Yep. Safe enough to legalize? Oh most definitely. Certainly until proven otherwise.
I tend to believe that unless proven otherwise, substances should be legal. The burden of proof IMO is on the folks who want to restrain behavior.
[edit] I don't think that producing a study that shows a lack of harm is going to change anyone's mind. The prohibition is puritanical and ideological, no amount of evidence is going to change that. I think if this was based on a genuine fear, the study would have preceded the prohibition. This feels more like running ourselves in circles to collect evidence, Lucy and the football style.
We already know the LD-50 of mushrooms is 17kg of fresh mushroom for an average size human lol.
I agree but I’m talking tactically. Legalization requires convincing people that don’t think the same way, and the best method for doing that is by rigorous medical study.
The prohibition is puritanical and ideological, no amount of evidence is going to change that
Your insistence that this is the case is itself ideological.
> Your insistence that this is the case is itself ideological.
Haha, ok, well, in that case, on what basis were drugs banned? Specifically psychedelics.
> We’re talking about current attitudes, not the reasons why they were banned in the first place.
The current attitude is "drugs are bad" because of childhood education programs. Drugs are bad because they're illegal. You've seen the PSAs. It was never evidence based to begin with, then the "puritans" (DARE) switched to youth indoctrination. It's been so long now that there "must be a good reason."
It was never logical, or evidence based, and it remains illogical, and not evidence based. Bringing evidence to an illogical conversation IMO is like bringing an inflatable flamingo to a fancy dinner. People will look quizzically, and you won't change minds.
But hey, here's hoping I'm wrong.
After all when Portugal decriminalized all drugs in 2001 all the negative health factors and societal factors associated with drug use fell off a cliff -- and usage did not increase. That's all the evidence I need to follow suit.
But if the current attitudes aren't based on evidence, what makes you think that more evidence will change those attitudes? That's what the GP is asking.
I think the people behind drug prohibition need reckoning. They have caused untold suffering, especially by preventing people from accessing medication they needed.
There is no justification for drug prohibition to continue. If anyone thinks otherwise, then it only means they have not educated themselves enough about the topic, they profit from the current status quo or simply they take pleasure in causing suffering to other people.
Yes the market should be regulated. Some substances can be more dangerous than others so there should be adequate restrictions and support plus raised tax could help with mental health services and education to ensure people can make informed decisions and also receive help if they get it wrong.
Cocaine, Heroin, Meth, and Fentanyl should never be legal. They are too addicting.
Possession in a small amount should be decriminalized using a stick (drunk tank for a couple days) or carrot (state run rehab or classes) method.
Stop the prosecutions and jailing of the users. Mandate a class or whatever like they do for DUIs and provide a state run place to ween them off. Combined with a safe place to do drugs and safe needles.
>Cocaine, Heroin, Meth, and Fentanyl should never be legal. They are too addicting.
I know 10X as many people who threw away their lives working minimum wage and minimum responsibility jobs just so that they can afford enough marijuana to make themselves happy with living without ambition.
Not that I think marijuana should be illegal but if we are going to legalize one we should be consistent and legalize everything.
It comes down to each individual I guess, but I'm doubtful that such people are really very happy. Smoking every day to offload stress can seem nice, until you're looking back on all the time you could've used better, and realize its not making you happy, it just distracts from what makes you unhappy. It can be really fun to add to experiences that are already enjoyable, and every now and then it can be helpful to offload stress during something undesirable, but if its use is too frequent, given my own experience and those around me, it does become a black hole of time. The old South Park explanation was quite spot on, it makes you alright with being bored, when being bored should motivate to do something.
All that said, with conscious planning to use it in a productive way, I've found incredible enhancement of working on creative projects while stoned out of my mind.
The problem with this is it's biased against poor people. Rich addicts can afford to only be users, but poor addicts are the ones that need to deal to support their habit. So if you jail dealers, you're disproportionately jailing poor people.
> Cocaine, Heroin, Meth, and Fentanyl should never be legal. They are too addicting.
Maybe for you, but why should you be the arbiter of what other people do? Make it legal and tax substances to the point that the revenue offsets the potential negatives.
I know I'm just one case, but as someone who's mother got addicted to legally prescribed Fentanyl as well as other opioids as a result of her cancer treatments, and to had serve as caregiver for said mother when said drugs sent her into irrational rages and occasionally made her suicidal (she later admitted to not remembering multiple months of time from the years she was on it), the libertarian individual choice argument is particularly full of shit when it comes to these substances.
There are some things that the average human biology simply cannot handle. Making said substances illegal or regulating them such that they are impossible for the average person to get is perfectly rational and beneficial for society. Naturally treatment centers should be provided for those who manage to obtain them illegally as opposed to jail time, and that's the part we suck at. No rational person with purpose seeks out illegal opioids, it's a symptom of underlying issues and should be treated as such, not punished.
Psilocybin, Marijuana, Tobacco and Alcohol are completely different animals. And yes there are people who can't handle these, but the vast majority of the population is capable of doing so and/or the consequences are less severe when they are mishandled. You can't say that about opioids.
Same reason even in the US while I can own an AR-15, I cannot own a Patriot Missile Battery. One the average individual can be relatively trusted with, the other they cannot.
Except a hundred years of experience has shown us that "regulating drugs until they're no longer in existence" is not possible. What actually happens is drugs become more expensive and more dangerous. You bring up legally prescribed opioids, but those are drugs that people take because they're encouraged to do so by a doctor. Your mother most likely wouldn't have taken Fentanyl if it was just legalized, but not prescribed to her. Most people who would take legalized drugs will also take them when they're illegal.
> Same reason even in the US while I can own an AR-15, I cannot own a Patriot Missile Battery
Au Contraire! Explosives are just very difficult to buy because you must go through an approval process to purchase a "destructive device" and the storage regulations, which vary widely from area to area, are (rightfully) difficult and expensive to comply with.
I was not able to speak to my father, let alone staying in the same room were he was, for about 26 years (~18yr old till recently ~44yr).
The background for this was my choice of leaving an ultra orthodox jewish community and going on my own.
I recently tried that (after 3 years of hesitation) and the magic happened. It affected my structure of feelings in several ways indeed, but in the context of this one, I would say that, at least for me, it was not like "I forgive you", "you owe me, but I let go". Not at all, in my case, it simply earased the "load", the hard feelings, completely.
Beyond the magic psychadelic affects, the trip is an emotional journey that one takes, a journey that you come back with compassion, understanding and rock solid outlook over the world.
“The brain is not a blind, reactive machine, but a complex, sensitive biocomputer that we can program. And if we don't take the responsibility for programming it, then it will be programmed unwittingly by accident or by the social environment.”
> Meditation is the ultimate key though, putting in the hard work and then using shrooms sparingly to cash in on that.
First, that ^ is gold.
Second, I've only had a few experiences with it (MDMA), but as far as I'm concerned, it's a waste doing it with other people versus by yourself. It's cool with people too, but off by an order of magnitude from what you can cash out solo, especially if you're someone who makes that ^ kind of comment. To be clear, I haven't actually done any since I found this document here a few months ago. But I have some shit that needs to be dealt with at the kernel level and I'm going to handle that sooner rather than later.
Speaking to your other comment ^ I think one could also come to meditation from that gate. Someone not into any of this could realize over night that there are all these other layers of reality that are accessible to them and pursue the path inward afterwards. Or realize they are dealing with extra and unnecessary layers of reality, depending on their specific case and how you want to look at it.
I had a very bad trip, my last trip, and it took me years to recover. That was > 2 decades ago.
It's my opinion that we need to recognize that these substances have the power to modify us in extremely powerful, unknown ways. And we need to create a safe environment (how? I do not know, probably regulation, but after seeing how California is handling "legal weed," I am not holding my breath) for people to use these substances in a safe way.
> What's your take on allowing a substance to change you so much?
In the end, it was still positive. But I wouldn't recommend the path that I walked with psychedelics to anyone, regardless of where it brought me. If I had been better educated, more informed, purchasing from a reputable source, etc... I imagine that things would've been vastly different for me than they were.
I wasn't as prepared as I should've been, no, but I did surrender to it. That didn't, however, make it any less terrifying or traumatic (or less embarrassing and humiliating in the time after).
To me, I don't think it's so much about "change" as having your normal day to day experience being clouded by so much emotional pain, conditioning, trauma, rationalization, etc. If you can take a step back from all that, you can understand your deeper feelings.
The substance turns your thought process inward. You think about the thoughts you are having, and the associations behind those thoughts much more deeply than you otherwise would. You think about ordinary, everyday things in a much deeper way. This is what changes you. You could do the same thing with meditation probably.
In my experience, »mushrooms rewire you« does not really do them justice: they mostly help you rewire yourself; more like changing habits (internal) rather than surgery (external).
Here’s a personal example: a couple of years ago I had a very rough breakup, but over the years came to terms with it. More than 3 years later, I internally »met« my ex in a psychedelic dream-like state, both were happy with our new lives, and we said goodbye to each other. It was calm and peaceful. It was also the first positive thought I’ve had about her, undiluted by lingering negativity. I was not rewired, but it allowed me to think a thought I did not think I could ever have, and changed my outlook on the whole situation.
(It was a dose on the low-medium end, and I haven’t attempted repeating it, nor do I plan to.)
I'm open to doing it again, but I have no particular urge to do so. I'm torn between taking it for fun (but unhappy about the lack of depth) or for reflection (which is hard to plan for and exhausting). In the end it's a very intense experience that's a bit hard to anticipate: I need to be outside with good weather, in a good short- and medium-term mood.
I think people should be generally afraid of any substance that can I give long term personality changes with just a few doses, sometimes even with a doctor's help.
I see this argument a lot, and I think it is more hollow than it appears. I am certainly not the same person now that I was 10 years ago. Indeed, I am different than the person I was 1 year ago. Life happens, people change. Directing this change with psilocybin seems like a reasonable choice. Sometimes it may misfire, and you will be a bit worse off; but sometimes humans get depressed, angry, or otherwise negative for lots of other reasons.
I watched a movie once that made me deeply depressed for weeks. Thin may have permanently changed my personality too. Should we ban movies because they make people feel and think things that they haven't felt and thought before? (That's as close as I'll get to cancel culture uproar in this post)
>Life happens, people change. Directing this change with psilocybin seems like a reasonable choice. Sometimes it may misfire, and you will be a bit worse off; but sometimes humans get depressed, angry, or otherwise negative for lots of other reasons.
I think your rebuttal is more hollow than it appears. It ultimately ascribes equal value to all change, and all change no matter how poorly controlled.
I calculate a 99.99% chance you have never tried any such substance and therefore know not what you're talking about. The "long term personality changes" are for the vast majority transformational in a positive way, as in doing away with pathological stuff forever.
I encourage you to take a moment to get acquainted with what is being done clinically ( which to be honest is not what I was referring to ) ;
Matthew Johnson: Psychedelics | Lex Fridman Podcast #145
> I calculate a 99.99% chance you have never tried any such substance and therefore know not what you're talking about. The "long term personality changes" are for the vast majority transformational in a positive way, as in doing away with pathological stuff forever.
You've calculated statistics for things you've made up.
Please please don't quote podcasts as research, and giving me 3.5 hours of homework listening to understand your point is poor communication and ensures the maximum amount of resistance to understanding what you're trying to say.
I did put a rough number on it but I must be pretty close. I reckon it might sound a bit rude which It wasn't intended to be.
As for the podcast, I was proposing it as a gateway into this field, not as a source to substantiate my general point although it does. My point is otherwise based on first hand experience and a large body of anecdotal evidence. You summarily dismissed one of the most promising array of treatments for people going through some rough stuff without any evidence or submitting any source yourself.
You're right about the poor communication bit though and thank you. Here's a 3:57 minute cut-off [0] from that same podcast, dealing specifically with psylocibin interventions.
> Please please don't quote podcasts as research
Well, this is a podcast with a cutting edge researcher ... I think it's fair game, and I didn't call it research.
I can assure you the general idea we're discussing is worth some of your attention, especially if you or someone you know is dealing with just about any type of serious personal issue.
Not all change is equal, not all change is equally controlled. Pretending it is because change occurs sabotages your ability to categorize, analyze, and ultimately judge change.
Most people are not qualified to and cannot make careful informed decisions about the way drugs affect you.
I agree, for people with long term physiological/psychological issues this might be a huge boon, and may be a better alternative than common anti depressants.
But I know many people who have done psylocybin for fun who are probably changed because of it, in an uncontrolled fashion.
I see articles about curing depression from time to time and I have hope but not much. I have lived most of my life as a depressed kid. The most jolting realization that I had as an adult was that around sixth grade I was contemplating suicide without knowing what that word meant. Since then, life has been like a long, slow death march. If you asked most of my friends they'd likely tell you that I'm really happy, funny, quirky, and eccentric but inside I battle the demons of my own mind. I've let those demons shape my understanding of the world before and each day they don't these days is a choice. I've used cognitive behavioral therapy as a tool to do battle against them, I take daily melatonin, and I take long vacations but those things are coping mechanisms. The days I am hit with depression that wants to keep me anchored to my bed are the days I really go to war. I have to keep my mouth shut more because whatever I say on those days will almost assuredly be tainted with tinges of, I hate myself and am discontented with the world tones. I have to pressure myself to focus. When the day is over I throw myself on the couch and hope that tomorrow that veil is lifted.
As someone who also struggled with depression from an early age, taking mushrooms cured it.
I haven't taken them in over a decade and I did get in a funk during the pandemic, but the difference between the day before taking mushrooms and the days after are like night and day.
I would bet money that it would help you. If you decide to try them out, all you need is 3.5 grams and someone experienced to take them with you or at least sit with you. Oh, and put on some Shpongle.
The 1 mg dose wasn't daily, it was 3 weeks apart. From the study:
Patients were assigned in a 1:1 ratio to receive two separate doses of 25 mg of psilocybin 3 weeks apart plus 6 weeks of daily placebo (psilocybin group) or two separate doses of 1 mg of psilocybin 3 weeks apart plus 6 weeks of daily oral escitalopram (escitalopram group); all the patients received psychological support.
I feel like there will also people that have way too many prejudices towards these kinds of "drugs" because that's simply how we learned it. "Don't take drugs kids".
These studies are very helpful especially when shared over general media, but the consumption has to be supervised and controlled to not have overdoses and ruin the whole reputation again. It should be treated like any other anti-depressant, since they are just "drugs" in the end
We need to change the message from "don't take drugs" to "if you choose to take drugs, take them responsibly".
Start with low doses, don't mix (alcohol,benzo,opiates), and remember that unless taken therapeutically, drugs should be an occasional party thing and not an escapism for life.
It's also totally fine to not do drugs. I'm going sober (except a beer or two) for an indefinite period of time, just because that's what I feel like.
Maybe I'll go on a mushroom trip for new years eve, who knows, but drugs shouldn't define your life.
> We need to change the message from "don't take drugs" to "if you choose to take drugs, take them responsibly".
The phrase for this is “harm reduction” and it has been around for a few decades in the pro-drug communities.
The challenge is that harm reduction material is largely targeted at avoiding overdoses or fatal combinations as you mentioned, which can give users a false sense of confidence about their ability to avoid addiction.
I’ve watched a couple close acquaintances slowly decline over time due to what they thought was responsible drug use. You can do all the right things and still end up addicted to and dependent upon addictive drugs. Fortunately they were both able to afford rehabilitation programs that got them back on track.
I visited one of them in the rehab program. The price tag was high so selection bias was obviously at play, but it was interesting to see that every person there was also an adult professional who thought they were smart enough and self-educated enough about drugs to avoid succumbing to addiction, which was clearly not the case.
I don’t have any answers or solutions to the topic, but I do know that addiction is a risk that most addicts seem to downplay at the start of their experiences. Few people go into drug habits expecting to become dependent.
Perhaps more interesting is the uptick in people addicted to psychedelics, partially driven by the growing perception that they’re not addictive. It seems that these patients aren’t addicted in the traditional sense of becoming dependent, but they get hooked on the escapism aspect or the idea that they’re just one or two trips away from a major epiphany. Not all of the rewiring that takes place in these experiences is necessarily in a healthy direction. It can happen, so people should at least be aware of it.
Please don't! If all this research thought us anything, it's that powerful substances are emotional surgery. Not something to attempt in an unsafe environment.
On the contrary, parties can be very safe environments. Much like there are better and worse places to drink, there are better and worse places for taking other drugs. A lot of factors play into the setting. Music is very often a plus, feelings of freedom, being outside, good weather, like-minded people – relaxed open air festivals make for a good example.
You are missing my point. That's exactly what I'm saying: a trusted environment with trusted people VS people taking random substances in a random disco.
> I feel like there will also people that have way too many prejudices towards these kinds of "drugs" because that's simply how we learned it. "Don't take drugs kids".
At least on Internet forums, the trend seems to be the opposite. Many commenters are very pro-psychedelic but anti-medication these days.
It’s important to remember that psilocybin may be promising, but it’s still not a great long-term treatment option. Not only have they not been studied beyond a few doses, but we have a lot of anecdotal evidence that excessive and sustained consumption of psychedelics seems to lead people into increasingly weird thoughts.
Of course we don’t have any controlled trials about long-term psychedelic use and likely won’t any time soon due to the ethical concerns, but it’s worth mentioning that these are not a magic bullet for sustained depression treatment. Traditional therapy is still the way to go.
> excessive and sustained consumption of psychedelics seems to lead people into increasingly weird thoughts
We have lots of _clinical_ evidence even that that’s the case for a lot of medication, which is why we don’t usually administer excessively and sustained, but carefully and controlled.
Indeed, some companies are highly speculative. But in the ETF are also J&J (ketamine nose spray for drug-resistant depression) and AbbVie (acquired Allergan).
Most of the tickers are traded on Canadian exchanges (NEO, TSX.V, CSE). If you’re in the US, I believe Interactive Brokers (and others) will let you buy stocks at these exchanges. You can do all this self-directed, no need to involve a processional.
If your current broker doesn’t allow Canadian venture/OTC stocks, $CMPS is the only ticker traded on NASDAQ so far. $MMED is expected to uplist to NASDAQ in the near future.
> In a phase 2, double-blind, randomized, controlled trial
It seems like you can't blind the participants in this case? It should be obvious if you're getting the treatment because psilocybin is a hallucinogen, unless they're giving such a small dose that it reliably doesn't cause any hallucinations?
This is important because most (70-80%) of the effect of existing anti-depressants is known to be placebo, and there's already concern that you can't blind in regular anti-depressant trials because the participant might know they receive treatment due to feeling the side effects of the drug (e.g. insomnia). The problem of being unable to blind participants would seem to be magnified in a psilocybin trial.
> It seems like you can't blind the participants in this case? It should be obvious if you're getting the treatment because psilocybin is a hallucinogen, unless they're giving such a small dose that it reliably doesn't cause any hallucinations?
An active placebo can be used. For example: a high dose of methylphenidate and hallucinogen-naïve adults.[0]
I'm not an expert in this, but if they gave 25mg psilocybin (not purified) you would probably not hallucinate (of my readings in the reddit posted in another comment here). But I'm not sure if its possibly to purify it, and I'm not sure what effects 25mg of "purified" psilocybin would have.
Note that is 25mg of psilocybin, not mushroom. Dried mushrooms contain about 1% psilocybin, so an equivalent dose of dried mushrooms would be around 2.5g, an amount that's definitely high enough to cause hallucinations. Not sure if this is what you mean by purified vs non purified.
Before anyone rushes to do this: Cultivating these mushrooms is not legal, even if buying the spores might be.
Likewise, self-medicating severe depression with hone grown psychedelics is not a great idea. These studies use controlled administration in supervised environments often with therapy as part of the process. You cannot replicate that at home. Psychedelics also can’t be dosed continuously like traditional antidepressants, making them a poor choice for continued treatment.
To add on to this, these mushrooms should not be taken by anyone with liver problems - I was specifically warned by my gastroenterologist that, behind alcohol and starchy foods, magic mushrooms will screw up your liver very quickly.
Did they mention why? Sounds like FUD to me, since the psilos I know of are mostly water, indigestible chitin, and trace amount of kidney-excreted psilocin/psilocybin.
It's a shame that former MP and Home Office Minister Caroline Flint decided to reclassify psilocybin as a "Class A" drug alongside heroin and cocaine despite no evidence of it causing psychosis.
That really was the peak of New Labour's evidence-less led drugs reforms.
I grew up in rural Scotland, and every Autumn the countryside seemed to explode with mushrooms - even the play park next door to my house was covered in them! After several years, the local council started spraying the park with something to kill them, but there were still an abundance available elsewhere.
Me and my girlfriend are microdosing LSD for the past couple of weeks. We both are very outgoing persons, but due to Corona, our life is really boring which makes our mental state not as positive as it was. We notice that we have more acceptance to the Corona situation. Especially the “bad” days, the microdosis makes the day much more acceptable.. I’m aware that this is a very brief explanation. If you are very interested in this, please let me know, happy to chat or call about it.
Japan had magic mushroom vending machines until they were banned in 2002. The Japanese were concerned about what image they display to the world ahead of the FIFA World Cup 2002, which led to this ban.
Many different explanations are possible, but I do wonder whether there is any connection to their increased rates of depression after 2000. Antidepressants were not accepted in Japan for long time.
To verify it would be good to see some statistics on their usage prior to that. Checking out Super Marios game mechanics, it seems they were in the nations discourse at least ;)
I have had many psychedelics experience during the last 2 years but I've only had the opportunity to try mushrooms once.
They definitely are powerful and healing, however I believe the only safe path shrooms will take in our society is national legalization for use in therapy and not recreational use.
My main argument is the following: legalization for recreational use will trivialize the image of psilocybin in the eyes of the population, and we will start to see an increase in "bad experiences" due to people using it without having a trip sitter or preparation. Therefore, legalizing it only for therapy use will be more beneficial for the general population.
Decriminalization is an option, but legalization ehhh.
It emotionally attaches you to this world, which you belong in. You feel a connection to the eb and flow of the world, which I think depressed people lose. They get caught in their sole perception of their world, caused by neuroticism and past traumas. The brain pathways are hit hard every day, so it's tough for them to get out of it. This substance can be like a tsunami that washes it all away.
What kind of dose are the individuals being given? It says 2 high-level doses over a 6 week period. Are we thinking the antidepressant effects aren't from the trip itself, but from the aftereffects? That's sort of what's being discovered w/r/t ketamine therapy for depression.
> Patients were assigned in a 1:1 ratio to receive two separate doses of 25 mg of psilocybin 3 weeks apart plus 6 weeks of daily placebo (psilocybin group) or two separate doses of 1 mg of psilocybin 3 weeks apart plus 6 weeks of daily oral escitalopram (escitalopram group);
There's been some promising progress on migraine/cluster-headache treatments with psilocybin microdosing. Really happy to see that humanity is slowly starting to realize that blanket bans aren't always the best idea ..
>They gave psilocybin in much lower dose to the placebo group... I wonder what the point of that was
Psylocybin usually comes with obvious hallucinogenic or physiological effects. The placebo group would instantly realize they have been given a placebo if no physiological effects appear at all, hereby making the blind study useless.
The Charité hospital in Berlin is starting a similar study sometime in summer of this year. The setup is that the control/placebo group (instead of Psylocybin) receives a dosage of Niacin [1]. This causes a "flushing" effect[2] in the test subject and in this way can trick them into believing they have indeed received Psylocybin.
This 'news' is scheduled 'blogspam', this article links to prev. article with exactly the same premise and that posted exactly 1 month earlier (15 april, 15 march), while both based on ~2018 research. Moving on.
I don’t want to live in a world where the solution to depression (caused by governments, politicians, or general existence in the modern capitalist world) is a drug. Not a good idea.
Instead, figure out why depression has increased so dramatically in the last ~century and address that.
But you don't mind the current state of affairs where everyone is being ingested with sugar and caffeine? Are those not drugs?
Office productivity is directly corrolated to the coffe machine. The moment that breaks down everything stops. Coincidence, or are we all addicted to a drug?
What I meant was:
"why do you not mind the current state, where the workforce is ingested with "drugs""
Yet you don't like the idea of "drugs" actually making people's live better?
The current world... Capitalism and political systems, is just an emergent result of society's internal stress, it is pendulum between, trying to making it and giving up to depression...what if we can actually balance that with a slight change to our diet of, vitamins, food supplements, neuro stimulants ( coffe, sugar)... Maybe we just need to sprinkle som psylocibin on top?
an anecdote but i think yes. pre-internet you wouldn't know what's happening outside of your community. Now, internet (IG, tiktok, fb, TechCrunch) surfaces the best of the world before your eyes.. it's a constant reminder there exist better people in whatever area you value (could be a skill, appearance, material things)
Ye, it has, and also many other forms of mental illness.
> Were our current guidelines to diagnose depressive episodes with around a century ago?
Certainly not, but researchers are very capable of looking at historical records and detect evidence to treated or untreated conditions.
Furthermore, people have been describing their own emotions and other people's behaviors since recorded history.
There's an army of psychologists, anthropologist, sociologists and geneticists out there studying the history of mental illness. Among many, prof. Sapolsky comes to mind.
We don't know whackadoodle brain chemistry from Adam; it's a massive assumption to attribute depression towards something so misunderstood as our neurochemistry. You might as well say it's due to the phlogiston in our heads.
What causes depression during lockdown? Is it lack of exposure to sunlight? Is it lack of exercise? Is it eating more poorly? Is it people being confined to spaces that may not be that clean that they normally leave during the day, thus exposing them to more mold and germs?
It isn't necessarily dystopian. It may still be a valid and genuine treatment, though I agree it would be better to understand more thoroughly why it works, not just that it works.
A former medical professional once told me "The answers you want for how this OTC drug works at the cellular level don't exist. That isn't actually what drug studies cover."
I don't disagree with your aims. I simply disagree with some of your implicit assumptions.
I'm not depressed. I'm a brunette for the first time in a decade or more. I live without a car and the sun typically keeps my hair bleached out to a shade of blonde.
But I have a serious medical condition and already did remote work and germ control is my life.
I had a longstanding issue resolve about six months. For the first time in decades, I'm mostly not suicidal anymore.
To whatever degree depression is biological in origin, drugs may be a reasonable treatment.
Granted, curing sick building syndrome and other root causes may be better in the long run. But it can take ages to confidently identify such things, educate people, find solutions, etc.
In the mean time, a new drug option for a biologically based ailment may do wonders for people in the here and now.
I routinely treat somatopsychic issues with diet and exercise. I also routinely get dismissed by internet strangers as a nutter.
So I'm confident that the answer you want both exists and will take an excessively long time to distribute to a meaningful portion of the human population.
I didn’t know my father’s suicide and my subsequent depression was caused by governments, politicians, or general existence in the modern capitalist world. Thanks for giving me this deep insight.
French call this kind of repetitive, easy to write and not worth reading articles "marronniers" (literally "chestnut tree"), supposedly because some famous tree was worth an annual subject. In case you need to name your project :)
On the other hand, I would prefer to filter out the comments marronniers. You know, the mushroom anecdotes, the quality of the Mac trackpad, ...
On the one hand, HN is terrified of brain-computer interfaces manipulating our brains and emotions, on the other hand, they're totally psyched about using mushrooms to do the same thing.
It's not even remotely the same thing. One is a chemical compound that temporarly messes with the way your brain work, the other is an permanent (?) extension to your brain that allows to manipulate it from the outside. Also, HN is not one person with a single opinion.
If you're going to be this reductive about things, you might as well say every antidepressant and apparently also psilocybin does the exact same thing. Of course, being that reductive isn't useful and ignores a lot of the nuance that actually exists around the subject. Much like what you're saying.
Psychedelic effects could be an advantage, from an evolutionary perspective, that encourages consumption, propagation and cultivation of different species of fungi. I could see that being an agenda.
The jury is out on that. There are mushrooms that infect ants' brains and make them travel to a high place before the ant's head explodes, so that the spores are carried further by the wind.
I can't realistically automate the brain manipulation of millions of people taking mushrooms in a short period of time from the comfort of my evil lair.
Are psychedelics connected to dreaming? I mean, maybe dreams are supposed to somehow reset or recalibrate brains, but on some people it's not working for some reason. Also, there's a connection of what you eat and what you dream, so my wild hypothesis is that gut bacteria is responsible for recalibrating your brain during sleep. There's also quite strong evidence for correlation between gut bacteria and mental health. Somehow these are connected. Also, exercise, especially running has a mental health effect. Maybe it just mixes your gut bacteria.
I don't believe drugs whether prescribed or recreational can cure Mental disorders. yes they may alleviate the symptoms but they don't really work on the root cause which are basically ones mental tendencies, thought patterns or habits acquired over a period of time. here[0] is a different take on what depression is and gives a high level road map to come out of it, for more details this [1] is a book by the same author and for testing out if those methods work here is an app [2] again from the same monk.
p.s i have followed all three & i must say the quality of life has improved considerably
The good news is that studies such as this produce empirical, scientific evidence that supercedes anecdotes and individuals' belief patterns -- whether they're negative or skeptical (as yours) or hyper-positive cure-alls (eg from psychonauts)
Before science can appreciate the mental/causal causes of the depression and related diseases, it needs to find an evidence for and establishes the separation of mind from physical brain. Hopefully an intensive exploration of consciousness and intelligence will lead to some empirical conclusions.
But that’s exactly what psychedelics do, they rewire the brain. In neuroscience terms they disrupt the default mode network. In other words they open your mind up and allow it to break free of the tendencies, thought patterns and habits.
This is why they’re more akin to therapy than recreational drugs
Not all depression is attributable to environmental factors. If it is, the environmental factors is what a psychologist looks at with you. If it's not, you use some sort of medication to solve it. Reducing every kind of thing that you can get medication for that isn't entirely physical to a "mental disorder" is both dismissive and kind of insulting, which really doesn't help the point you're trying to make here.
Which appears to be that some random book has all the answers that somehow nobody else has really figured out. Oh, and there's an app!
Perhaps, but it is a lot easier to take long term action on your mental tendencies if you don't feel the blackness closing in every second.
We have a long century ahead of us to pull out of the mental health slump we are seeing (similar perhaps to the physical health slumps following industrialisation). We will need many tools in the kit.
Friend was treated for "mental disorder". She was fine, except food allergy. If she followed this "bro science", she would be dependent on God knows what, with real mental problems.
Judging by studies on long term use of other mind-altering drugs, I would expect psilocybin to similarly cause decline in cognitive abilities after prolonged use.
Unfortunately (or maybe fortunately), I could not find studies on effect of specifically psilocybin on cognitive abilities.
And please, don't bring up EmoIQ and other non-reasoning related stuff. This is not what the concern is about.
If anything shrooms would be contributing to neurogenesis[0] not destroying brain cells. Opposite to alcohol which is well known to destroy brain cells.
Here in Europe someone gave politicians the idea that they could control a virus. So now we have arbitrary sets of restrictions applied when case numbers of coronavirus go up. If case numbers go down again, they get relaxed. If they go up, add more restrictions are added until they go down. The restrictions are follow the case numbers, but we have convinced ourselves it is the other way around. It's a modern day witchcraft.
Lucky you. Here in Germany, we add restrictions when the numbers go down and relax them when the numbers go up. And I'm not confusing cause and effect.
Measures to contain COVID-19 exist globally and if you have great cosmic insight into the fact that they don't work, perhaps you could share that instead of sarcasm without any basis.
They are saying they do work, but only when they are implemented. They are unimplemented when the numbers get low, which causes them to go back up, and has the effect of starting the cycle again.
No, they are saying that lockdowns do nothing and any appearance that they do is backwards causality: "restrictions are follow[sic] the case numbers, but we have convinced ourselves it is the other way around".
I didn't say they do nothing, lockdowns clearly cause massive harm and suffering yet there is no obvious benefit when compared to places that didn't lock down.
I've seen this claim bandied about, but if you look at Sweden and its neighbors the no-lockdown case has 1000s more deaths. There are perhaps subtle arguments, but "no obvious benefit" seems extremely tenuous.
Looking at the stats now, it seems like it's doing better than a number of European countries, many of which had lockdowns (France, Belgium, Italy, etc.). Then you have countries like Japan, which people have been complaining about being lax for a year but still has lower rates than almost all Western countries.
That's not to say lockdowns aren't effective, but the data doesn't seem to fit any neat narrative at the moment.
Do you know what Finland and Norways lockdown involved?
They closed schools and public buildings. They didn't force people to stay at home. They didn't stop people travelling, or force them to wear masks. They treated their populations as humans. Their responses were a lot closer to Sweden than to most European countries "lockdown" responses.
And did you know that for whatever reason, Finland has 5 times more flu deaths per capita than Sweden on a normal year.
You will also notice the the two countries where masks are apparently the norm, South Korea and Japan have relatively high rates of flu death for developed countries. That implies that the masks don't help.
To use Sweden as an example of lockdown being effective is grasping at straws.
Where is the spike after Texas opened up a month ago? Why is Florida doing better than California, despite an older population?
Well they don't exist globally. Various US states and countries didn't copy China in a blind panic. There seems no correlation between lockdown and the overall outcome, suggesting that they don't "work". Texas opening up a month ago showed no spike in cases.
Considering the massive amounts of suffering these policies are causing, there ought to be a bit of reflection on how effective they are. We have a years worth of data now, and as I pointed out, there seems to be no correlation. There seems to be no consideration of the side effects and harms caused.
Assuming the approach of locking people up works, without taking into account the new data as it comes in is not science. It is faith.
Whatever you think of the study, this is rather significant. If you told me even 2 years ago there would be a randomised trial of magic mushrooms in NEJM, I would not have believed it for even a second.
One point not to miss is that they screened 1000 patients to come up with the study population of 59.
Nevertheless, I consider the study result quite promising, considering patients only had 2 doses of psilocybin.
[1] https://www.nejm.org/doi/full/10.1056/NEJMoa2032994