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First federal grant for psychedelic treatment research in 50 years (hopkinsmedicine.org)
512 points by infodocket 44 days ago | hide | past | favorite | 116 comments

I was a participant (ie, research subject) in one of the previous rounds of studying psilocybin for smoking cessation at Johns Hopkins.

I was randomly assigned to the non-psilocybin "control" group. I still successfully quit smoking -- the "cognitive behavioral therapy" and just general support was great. The researchers showed genuine care, it wasn't like being a lab rat.

Because the study was designed with a "crossover" component, I still got the option, which I took, to return 6 months later for a psilocybin session. The session was interesting, but I wouldn't say life-changing. Probably. I am still a non-smoker, over 2 years after quit date, did the 6-months-post-quit session help? Maybe?

Ask me anything! Although I'm not sure what else there is to say!

Just wanted to pipe in here: I quit smoking tobacco in 1995 due to the influence of psilocybin. We knew back then it worked. I think you need a lot more than just psychedelics to quit smoking, however. The first week was easy. The next 11 months were hard. After a year, I never wanted a cigarette ever again.

Me, the first week was pretty hard, the next 6 months were still hard, the next year was a lot easier -- but I still want a cigarette with some frequency! It's just a "want" I can, now, after two years, fairly easily choose not to fulfill.

But when I see other people smoking in a context I remember being enjoyable, OR when I am especially stressed or depressed -- I definitely still want a cigarette. I don't especially think I'll ever never want a cigarette again.

They are so addictive!

I’m curious, have you ever used psychedelics in a therapeutic context? Such as, I’m going to take x dosage of y drug to work on myself?

Psychedelics tend to break the addiction chain of thought and habit, and as long as you do the work over time, the feeling and emotional content of addiction basically disappears. I don’t want a cigarette because it no longer has any hold over me. Psychedelics helped me get to that point.

You basically retrain your brain intentionally, by working through bad habits and emotional attachments. When you get to the bottom of those, you realize that the tobacco addiction itself is just a placeholder masking other issues altogether. That’s just the first step.

The second step is to overcome the psychological addiction, and that takes time. But there is a light at the end of the tunnel. And when you get there, you make a choice to keep moving on into the light or to go back to the darkness. Psychedelics helps you make the right choice and to stay on the path.

So what I'm curious about then is the practices/experiences the researchers/staff involved used/had in order to provide you with the space that you found supportive enough to help you quit smoking.

What was the dosing for the session with psilocybin? Did they tell you the strain/weight?

They told me the weight, but I forget. It was a large "heroic" dose. The research protocol is perhaps already available somewhere (published paper, pre-print, registered study, not sure) which would have the dose.

They used manufactured/sythesized psilocybin compound in a capsule, not mushrooms or extracted from mushrooms.

I think they tried to take all the 'best practices' for quitting smoking and gave it to all participants, same experience up until quit day. On quit day, "control" group got a prescription for nicotine patch; "psilocybin group" got a session (and no patch!) -- the psilocybin group in this particular study was just one "heroic" dose session on smoking quit day, that's it.

Some of the supportive practices or suggestions included:

* just regular sessions, that were in some ways more or less like a "therapy" session focused on looking at smoking in your life. (whatever that means to you, it really was also just a good therapy session!)

* set your quit day near the beginning, several months before the quit day. Build up to it.

* at one period, every time you want to smoke, note what you feel like and what is precipating it, make a note of it. Develop a sense of what things make you want to smoke and why, and what role is has in your life.

* A "practice quit" day a month or two (I forget) before actual quit day -- just try not to smoke for 24 hours, see what it's like, knowing you can smoke again after that. Now you know what it's like, and that you got through the worst day, and what parts are going to be hardest and can develop more strategies for them.

* Get a clear list of the reasons you want to quit. Think about em. Write it down, to refer to it when it gets hard.

* Make a list of things you can do instead of smoking, after you quit. It doesn't matter if they are unhealthy (junk food or whatever), they're still healthier than smoking.

* after quit day, phone number of a therapist you've been working with, invitation to call or text if you feel tempted and need support and to talk through it. Therapist texted me daily checking in, seeing how it's going. (seriously, why DON'T we use techniques we associate with alcohol and other drug addiction treatment on cigarettes, you know? they are crazy addictive!)

There were other things too, additional like little cognitive-behavioral (I guess?) games/techniques. I don't even remember them all. I should have taken more notes on all of it! Just having people there rooting for you and to whom you feel kind of accountable to is big.

If their study really does show significantly more success in psylocybin group than control group, I find it meaningful that even the control group got really good support from good counselors. (And I still wouldn't say it was easy to quit!)

Awesome, thanks for the lengthy reply. Heroic is usually considered at least 5g - there's a saying you can meet God at 5g; so it was probably an equivalent dose to that in synthetic form.

I am curious myself if there are other diagnostics, health metrics that are easily/non-invasively measured to help determine or predict what experience a person will have for their first experience or to give an idea of how many sessions may be necessary for what level of "breakthrough."

Sounds like a good practical list of things to do - to develop multiple angles of "attack" to build more weight towards the goal, to reference for yourself as support to counter the strength/weight of urges.

In part reminds me of "psychological flexibility" practices - to help allow thoughts to be less rigid, to offer more fluidity to thought - perhaps you already had that open-fluid mind and so you simply needed the practice/guidance for the practice to then benefit from that value; an example is perhaps you normally would tell yourself "I feel happy" but then that might trigger a stress or feeling of cognitive dissonance, and so instead you'd train yourself to acknowledge all aspects of you in that moment and instead say "I feel happy AND sad;" perhaps not the best example or explaining of similarity. I wonder if the researchers first created a survey to determine the level of this kind of psychological flexibility a person has, and then see how those different groups perform in the psilocybin research - if and how the outcome of different groups differ; could perhaps divide it up even further by providing psychological flexibility training to part of the different groups - and see how all the numbers conclude.

Fun fact: the co-founder of Alcoholics Anonymous actually wanted the first step to be everyone do LSD/acid.

> Heroic is usually considered at least 5g

5g of actual mushroom fungus bodies? Yeah, this was just chemical psilocybin on it's own nothing else, and if I remember right the dose was consequently measured I think in mg rather than g, but they did use the phrase "sometimes called 'heroic'" when I asked about the dose, so, yeah, something like that. (They were clear that it was going to be a very large dose -- informed consent!)

> So instead you'd train yourself to acknowledge all aspects of you in that moment and instead

The counselors/guides involved definitely had a sort of Buddhist philosophy, with regard to quitting smoking as well as the psilocybin session.

I find Americanized (not to be pejorative, just we're always in our culture) Buddhist philosophical approaches to be increasingly popular among therapist and mental health experts generally. But they definitely were here. I have an interest in them myself.

I do not actually think I have a particularly "open-fluid" mind, compared to others, but I guess I'm trying (-without-trying). :)

> I wonder if the researchers first created a survey to determine the level of this kind of psychological flexibility a person has, and then see how those different groups perform in the psilocybin research

They definitely gave me all sorts of survey instruments, at various points in the study. Most of them multiple times, at various points before and after the session. It sometimes seemed obvious what they were "for" from the questions, other times mysterious. My sense is that while some of it may be, like you say, to see what kinds of people might have different outcomes -- more than this, I think a lot of it was to see if the psylocybin session changed people in what ways.

I don't think it actually changed me in a way that would show up on the survey instruments (I was kind of hoping it would!), but I haven't seen the analysis of my survey instruments, and I didn't keep copies of my answers!

I wonder if you can follow up with them and ask for your survey details, and perhaps how they compare to others?

How much nausea did you have from pharmaceutical grade psilocybin?

I didn't exactly have any nausea.

But, I mean, my body did not feel... normal, including digestively. It did not always feel "right". I definitely went through some weird body things, and weird relationship to my body experiences.

It was a very large dose.

I have eaten mushrooms on my own before (although not for years), much smaller dose, and had nausea, so I know what you mean. This was a different sort of experience, that did not involve a 'normal' kind of nausea, my guess is that's because it was pure synthetic psilocybin, yeah.

My dad is a professor of psychiatry at JHU medical school and has been telling me about this psilocybin study for years. He was always pretty strict about me doing drugs growing up, but now he's excited about the amazing results they're seeing in this study. He's even been asking me about my own hallucinogen experiences that I had growing up. The world is truly changing.

My parents were real strict about drugs growing up too. Even in my late 20s I would dodge the question about drugs. Idk what changed in the last couple years. They both have gotten more open about it. More so my dad, whos now growing mushrooms and microdosing, and gave dmt and mdma a try. I showed him how to do dabs and hit a bong correctly lol. He cant get around the idea snorting something so no ketamine yet and is having trouble finding time for acid. I think Michael Pollans book helped a bit. Its crazy to see though.

I used to be pretty shy about my drug use, but i try talking about it more if it comes up. I like to think it helps get rid of the stigma.

>They both have gotten more open about it. More so my dad, whos now growing mushrooms and microdosing, and gave dmt and mdma a try. I showed him how to do dabs and hit a bong correctly lol.

Wow. That sentence escalated quickly! (Actually if DMT reports are anything to go by, the sentence peaked there...)

I'm happy for you and your dad, and for our country - we need little victories, and this a big one for everyone. The science part has to be uniquely thrilling, though. Your dad's in a wonderful place in space and history.

I worry that this is NIDA-funded. That institution has history of commissioning nonsense studies to maintain prohibitions. [1] They're also probably responsible for a series of (failed) propaganda pieces focused on maintaining an arbitrarily anti-drug culture [2]

1 http://www.ukcia.org/research/gettman.htm 2 https://slate.com/technology/2006/09/a-white-house-drug-deal...

A) it is; "The grant, totaling nearly $4 million, is funded by NIH’s National Institute on Drug Abuse."

B) your first link is 404ing

a - Put more precisely, I worry because this is Nida-funded

b - thanks. It's too late to edit, so...


edit redux: still 404-ing. rats.

A friend and I did a "guided" psychedelic session earlier this year. We did it individually over one weekend. It was great. She did it for more therapeutic reasons. I did it more for philosophy/spiritual reasons. But the two main things I took away are 1.) Guided sessions are qualitatively different than recreational sessions, and 2.) It is such a crying shame that this isn't an accepted "tool in the toolbox" for therapists.

It's not about having crazy life altering, world-bending experiences (though that can happen). It's just about helping you get into a state of mind that allows for an effective therapy session. Sort of like... would you want to do your therapy session in a crowded bar, next to your mom? No, probably not. We all recognize that such a setting would not be conducive to good therapy. So similarly, we should be able to recognize that having the right setting, both mentally and physically can affect the quality of your session. Psychadelics can do exactly this.

It's also worth noting my friend has done "regular" therapy for 2 years, and she felt like there was a step change after the guided session. Her therapist noticed it as well.

When you consider that pain meds have ruined literally millions of lives through addiction, and that also virtually (maybe literally?) no one has ever died due to overdose of psilocybin, it's very confusing why one is prescribed all the time, and the other is considered incredibly dangerous. The U.S.'s perspective on drugs is so very backwards.

> The U.S.'s perspective on drugs is so very backwards.

The War on Drugs is a flaw that needs to end but at least with psilocybin US is moving slowly in the right direction. The only countries where psilocybin is legal are Brazil, Jamaica, Nepal, Samoa, Netherlands (truffle format), British Virgin Islands and the Bahamas [1].

Many places are illegal but unenforced though still illegal.

US psilocybin is decriminalized in many places now including all drugs in Oregon. More states need to get more like Oregon definitely.

However, in most states spores are legal and so are grow kits for other types of mycology.

Grow kits and spores legal in most states, full cultivation decriminalized in Seattle, Washington, Ann Arbor, Michigan, Denver, Colorado, Santa Cruz, California, Somerville and Cambridge, Massachusetts, Oregon and Washington D.C. [1]

Legal in Oregon for mental health treatment in supervised settings since 1 February 2021 [1]

Full legalization needs to happen for marijuana and psychedelics. Decriminalization needs to happen for all drugs minimum as well.

As far as marijuana, psilocybin and LSD, they are the least toxic and less dependency forming of most drugs, even caffeine, aspirin and more. It is a tragedy and a drug dark age that they are in the Controlled Substances Act. I believe drugs should have to be toxic or cause death to actually be on that list. Marijuana, psilocybin and LSD are very safe when it comes to toxicity and drug overdoses are non-existent, all would be better as legal safer production products.

Legality makes everything safer, increases harm reduction and reduces black market unsafe production as well as reduces funding of cartels/mafias/bratvas. Their criminality truly makes no logical sense except to invite problems.

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

Just wanted to add that the US led the criminality to spread across the globe via the UN.


Yeah. The US pretty much exports its laws. It uses its vast economic leverage to impose US laws on everyone else via trade agreements, treaties.

It did the same thing with intellectual property. It will put sovereign countries in a literal naughty list when they don't accomodate US company interests.

I wonder how much of the imposed laws are also a direct result of the Disney company (who pushed the US who pushed others)

They are a direct result of the lobbying of companies like Disney. It's plain to see in the naughty list I mentioned.


Search the document for "interest". Plenty of talk about interested parties, rights holders. Euphemisms for US corporations using the might of the US government and its military to interfere in foreign countries. I've read some US documents discussing my country like it's a problem to be solved. Like it's a new planet they intend to terraform. It's surreal. Documents essentially saying things like "these places continue to be a problem, the local authorities aren't doing what we want them to do".

Essentially the US has "concerns" and it expects and "urges" other countries to address them by criminalizing anything that hurts the profits of US corporations, which they call "US economic interests". Yeah, because we totally have room in our prisons to lock up my country's entire population for copyright infringement. They must think we have nothing better to do.

They'll even put Canada, their neighbor and ally, in the watchlist. They write things like:

> Right holders also report that Canadian courts have established meaningful penalties against circumvention devices and services.

It's so incredibly surreal. "Yeah, our corporations have been saying you've been a good little country, Mr. Canada. Keep doing what they tell you and we might just take you off the naughty list next year." I don't even know what to say. Imagine being a politician who has to swallow language like this from world powers like the US all the time.

Ugh. The wording in this document is disgusting. It reads like it’s from the evil teacher from a movie: “The United States remains deeply troubled by the ambiguous education-related exception added to the copyright law”.

Deeply troubled? Like “We’re very concerned with your daughter’s inability to submit assignments as requested. We suspect there’s trouble at home and hope we don’t have to involve the authorities.” “You mean when you asked her to draw a cat and she drew a cat then coloured it purple?” “Yes, exactly! She must be either developmentally delayed, or poorly parented. In either case it’s very concerning.”

>pain meds have ruined literally millions of lives through addiction

Unpopular opinion: opioids are massively under-prescribed for those that actually need them.

Addiction is a mental illness. That's whats killing so many, but why is to so few question what is actually causing such terrible emotional pain that must be self-medicated with incredibly potent medicaments?

Why is it that instead of acknowledging the rather uncomfortable root cause of those deaths, we just default to the so much simpler scapegoat, pills (the active ingredient in which has been with us in one form or another since 5000 BC), and pretend everything else is just rainbows and unicorns?

> opioids are massively under-prescribed for those that actually need them.


While reports of ODs are endlessly bullhorned, millions in pain get demonized by algorithmic opioid blacklists, get ignored by news orgs/legislators addicted to opioid hysteria and get gaslighted by a public who only hears the bullhorning.

I have a lifelong friend with visibly crippling arthritis. He lost access to effective pain meds after the state passed a 3-day-max on opioids (passed >10 years after the pill-mill problem abated). Over the year that followed the law's passage, every Dr in his network (along with most Drs in the state) ~stopped Rx opioids. The (now fewer) pain mgt clinics are overloaded and not accepting patients.

His remaining avenues for pain relief no longer involve Dr's.

I had emergency abdominal surgery this year and had to convince the discharging Dr to prescribe Tramadol. Our new normal is for ERs/Hospitals to undermedicate patients in pain with OTC analgesics.

So yeah. Shout out to folks who are hand-waving away millions in pain - because pharma is greedy or because folks can't differentiate responsible Rx opioids from street fentanyl (that many in chronic pain turned to in desperation after they were cut off from safer pain relief).

> why is to so few question what is actually causing such terrible emotional pain that must be self-medicated with incredibly potent medicaments?

> Why is it that instead of acknowledging the rather uncomfortable root cause of those deaths, we just default to the so much simpler scapegoat, pills

Missing from these arguments is the role of criminalizing addiction versus treating it as the mental health issue you accurately described. And ignoring the pharmicuitical and lobbying industries behind the same pills.

I don't think it's a valid argument to reassign blame from the potency and availability of pills, to unmet mental health needs. They are related and intertwined, sure, but correlation != causation.

Case in point, the Purdue Pharma Sacklers settled for $billions (which also bought their immunity from future prosecution) precisely because they were pushing hard drugs and preying on those same people mental health issues [0]. Predatory, sociopathic behavior. But pill are a scapegoat? Sorry, that's a hot load of b.s.

[0] https://www.npr.org/2021/09/01/1031053251/sackler-family-imm...

I don't disagree there are bad actors. Dissolving Purdue (I thought they were dissolved, not just fined?) is great. Bad actors should be punished. And yes, criminalizing medical issue such as addiction is terrible. All of these are fairly obvious, which is why I didn't spell them out.

As I'm sure you know, many cases of mental illness are triggered by some sort of precipitating event.

I don't believe for a minute the fact that someone gave those addicts an opioid pill was the actual trigger. Instead it was something that happened way before that: some emotional trauma, PTSD, disadvantaged background, chronic illness, no life/career prospects, war, despair, etc, etc, so many stressors this life can bless you with. The Big Bad Pill is just what the addicts came across and realized it helped them feel okay for a moment, that's all it is.

E.g. a war veteran ends up getting PTSD and becomes an addict(let's assume he has no chronic pain). Aren't the circumstances around his life that led him to enlist and then develop PTSD are the much more relevant trigger? Barring that event, would they even begin using in the first place?

Who gave them that precipitating event? Other humans did.

The ugly truth is that the cause of this all is simply us, humans stressing other humans. Like other primates, we are intelligent enough to the point it takes very little effort to provide for our basic needs, and so we spend the rest of our time engaging in social status games at the expense of others.

Most people who use opioids do not actually become addicted. Those who used heroin in Vietnam, most of them stopped after they returned and circumstances changed from war to normality: https://pubmed.ncbi.nlm.nih.gov/12873239/

"After their return, most of the men who had used heroin in Vietnam used it very occasionally or not at all."

"Possible post-Vietnam correlates of heroin injection were no job or school enrolment, alcohol problems, depression, absent or transient marriage, association with illicit drug users and other Vietnam veterans."

The real root cause is that humans are nothing but selfish machiavellian apes. We all are about me-me-me-me-me, and dig just a bit deeper, most are just as predatory and sociopathic as Purdue/Sacklers/whatever, just not as capable at getting their way.

We just look away and walk past the addicts in meatspace. We are no saints, and the real cause of most human suffering is not some processed alkaloid - it's other humans.

Not some pharma company or some evil billionaire clan that capitalized on this, I'm sure they contributed. There would be nothing to capitalize on or sell, if it weren't for humans psychologically injuring other humans for fun and profit.

Personally, it seems to me that we can recognize and accept a physical disability/injury much more readily than emotional/psychological one. Same goes for inflicting injuries: attempts to fracture someone's limb, a grave physical injury, seem too repulsive to even think about, and hopefully bystanders will attempt to rescue the victim should anyone ever try to do this to anyone. Harassment, bullying, hazing, belittling someone "just for laughs" on the other hand? All too often, others are more than happy to join in on the "fun" and even will gleefully laugh at the actual victim.

Of course, nobody likes to think of themselves in that way, much too unpleasant, and so we point our collective fingers elsewhere. It's always "them", and never "us".

I can only hope that one day we will evolve to finally dish out just as harsh punishment for psychological harm as we do for bodily harm, and hold each other accountable for it.

A bunch of things are conflated here that need to be untangled. Not all trauma is going to lead to an addiction. Not all addiction is to pills or drugs. Not everyone who takes opioids is going to form an addiction. Not all trauma is intentional and deserves punishment.

The expert in this area is Dr. Gabor Maté. He is highly respected in this field. If anyone is interested learning about the role of trauma in addiction, he literally wrote the book on it, "The Realm of Hungry Ghosts" [0]

From Maté [0]:

> Turning to the neurobiological roots of addiction, Dr. Maté presents an astonishing array of scientific evidence showing conclusively that:

> 1. addictive tendencies arise in the parts of our brains governing some of our most basic and life-sustaining needs and functions: incentive and motivation, physical and emotional pain relief, the regulation of stress, and the capacity to feel and receive love; > 2. these brain circuits develop, or don’t develop, largely under the influence of the nurturing environment in early life, and that therefore addiction represents a failure of these crucial systems to mature in the way nature intended; and > 3. the human brain continues to develop new circuitry throughout the lifespan, including well into adulthood, giving new hope for people mired in addictive patterns. Dr. Maté then examines the current mainstream.

[0] https://drgabormate.com/book/in-the-realm-of-hungry-ghosts/

Having both witnessed the whole opioid debacle first hand, first the sleezy over-prescription, then the reactionary under-prescription, which has caused, in my opinion, at least, as much, if not more, suffering and death than the over-prescription. Reading these comments is the first really sensible debate over the issue I've encountered and very encouraging.

For quite a while I've thought that the via media on the Rxs and an honest, more intensive treatment of the causes of 'deaths of despair' (which would certainly only partly be medical in nature) is by far the most humane (and medically ethical) way toward treating the problem. I know MDs who feel the same way but whose agency is very limited by this opioid Thermidor -- both in acting and speaking on the issue. I hope this is a sign of a changing trend in the public and political debate on the issue.

> Why is it that instead of acknowledging the rather uncomfortable root cause of those deaths, we just default to the so much simpler scapegoat, pills (the active ingredient in which has been with us in one form or another since 5000 BC), and pretend everything else is just rainbows and unicorns?

Okay, I'll take mushrooms, which have actually been with us since then, and you take synthetic intravenous opioids and we'll see who fares better.

Opioids (opium) have been around as long as mushrooms. Just because they are synthetic variations doesn't mean they are that different.

Alright, go ahead and get on a regular IV fentanyl regime and let me know how that goes for you.

It has nothing to do with the synthetic, people destroy themselves on straight-from-the-poppy-plant heroin as well.

I think you're underestimating how destructive fentanyl is compared to almost any other opioid.

What does fentanyl have to do with people who were cut off, people who - for years/decades - responsibly used Rx opiods to manage chronic debilitating pain?

Unless you're talking about people in pain who were forced to the street, after Dr's were (en masse) hazed into stopping pain treatment. In that case, I get your point.

I'm glad you asked! I've invoked it as a rhetorical device to highlight how different each opiate is from the next.

I'd like to less misery caused by heavy-handed drug policy — and it seems to me that decriminalization (and perhaps even legalization) is the way forward.

Generally I’ve heard fentanyl is a poor substitute for heroin.

My comment was specifically about people that need them prescribed. For pain relief, injuries, chronic pain, and so on. Opioids are very effective and are vilified for no good reason, along with a few other classes of substances.

Not as in substitution therapy, like methadone. I do hope that mushrooms help people come off of long-term substitution.

>it's very confusing why one is prescribed all the time, and the other is considered incredibly dangerous. The U.S.'s perspective on drugs is so very backwards.

The lobbying system. Aka legalized corruption.

How are you going to sustain the largest economy on earth if your populace isn't hypnotized? Most of the work that needs to be done is not intrinsically or spiritually fufilling.

So there must be an alternative synthetic rewards system- which inevitably requires some form of mass hypnosis to remain dominant in the aggregate psyche.

It's no coincidence that all the research in this space was shut down in a hurry right around when the CIA figured out that LSD and the pikhal family weren't going to help with this at all.

Not only has no one ever died of psilocybin but it just doesn't get abused the way that pain killers do. You can't get the full effect by taking it often. If it's a deep session, you don't even want to!

One session means one time or a few times in one week ?

Do you or her plan to keep doing it ?

One session meaning one time. Both of us think it would be valuable to do, but on the timescale of like... once/year or once every few years. But there are people who do it once/month for several months if they have a lot of specific things to work through. Our guide actually works with a number of 'regular' therapists, and they pass clients on to him if they think a guided session is the right move. He says therapists will sometimes say, "please take this person on a journey once / month for the next 3 months" (or something along those lines)

I've always wanted to try a guided session, but I have no idea how to even start looking for a guide. I'm in Illinois.

Medical tourism? Elsewhere upthread there are specific places called out where psilocybin is legal or decriminalized. Poking around on the web for therapeutic providers in those areas might be an effective strategy.

This actually took me a bit of time. I had to search around. But can give advice. If you're serious, email me at bwest87 at gmail.com

What area are you located, and how did you find your guide? Word of mouth?

Not looking so much for specifics, more to understand the process.

I'm located in San Francisco. I asked around a bunch of friends, got intros, and talked to a few potential guides. Eventually got linked up with someone who's been doing it for a number of years, and we vibed. We had a few phone calls through Signal, and then decided on a date/time/place.

Would you maybe like to elaborate on what was the details of the "guided" aspect of your sessions ?

Guided aspects... he sent over a questionairre ahead of time with a lot of broad questions. We then did a one hour zoom call going over the questions and getting to know him. It's all designed to help you figure out what you want the session to be about for you personally at that moment in time in your life. And then the session itself lasts 4-6 hours, and he will ask you many questions, but also will follow the journey wherever it takes you, and there's ups and downs and everything in between. It's all very specific to you and the guide and where you want to go with it. And lastly there's an "integration session" the following week where you talk with him for an hour to go over how it went, and what it means. Can discuss more if you want. Email me at bwest87 at gmail.com if you'd like to discuss further.

It's nice to see the cowards and control freaks losing their fight to increase human suffering. But wow it has been a long, expensive road with uncountable casualties.

Science progresses, one funeral at a time. Most of the opposition to psychedelics eventually just died out.


This is an off-topic comment, but in the title it seems the word "for" was replaced by the letter "4" -- is this a common substitution for NH titles? Was it done because of length constraints?

> Was it done because of length constraints?

Yep, most likely. The title has exactly 80 characters, which is the limit. "Years" was also abbreviated.

Personal opinion, but I think it's time that HN increases the character limit, we are seeing more and more of these sort of things.

It's a tricky business. In terms of raw screen width, we have it. Or do we? Not necessarily on mobile, in portrait orientation.

From a readability/usability perspective, imagine the HN front page being filled top to bottom with titles, some of which go to 150 characters; what would that be like?

(A mock-up could be easily obtained for evaluation; or HN could just experiment with it for a few days.)

Currently, most titles don't strain the existing limit. When we scan the front page now, for instance, there are good many short and medium length titles.

A modest increase, say by +20 characters, might relieve most of the pressure without too many negative effects. Which is to say that maybe the current limit is a bit to the left of the true "sweet spot".

I think I'd be happy with longer titles, since that's an artificial limitation separate from how we vote and judge submissions.

If posts have unnecessarily long titles enough to bother, they'll be systematically downvoted a little more and fall out of practice.

If the system wanted to put a hard limit on wordiness, it should have a good reason why!

We're all wasting a little time on inefficiencies otherwise.

You could also change “receives” to “gets” and eliminate the word “treatment” to remove all need for awkward shortening.

After many years reading about Leary, I realize now that he set the field back by decades.

Leary was just the fall guy – Nixon sent the field back decades. The narrative about Leary's damage to the psychedelic movement is massively overstated.

Here is a relevant discussion between Michael Pollan and Hamilton Morris about this: https://youtu.be/XvMArmwI10Q?t=2744

Michael Pollen talks about this in his book, How To Change Your Mind. It's insane how irresponsible Leary was. A good example is what's commonly called the Good Friday Experiment.


It's hard to blame it on a single person. The Stanford Prison Experiment didn't involve any drugs and was as or even more irresponsible than Leary's messianic psychedelic mania fueled binge. The Stanford Prison Experiment was in 1971, Leary had already been indicted of multiple charges by that year if not in prison already, according to Wikipedia he was fired from Harvard in 1963.

So eight whole years after Learys irresponsibility the ethical standards for human experimentation in psychology were still nowhere near to what they are today.

I'm more concerned about the lack of random sampling:

Leary and Alpert taught a class that was required for graduation and colleagues felt they were abusing their power by pressuring graduate students to take hallucinogens in the experiments. Leary and Alpert also went against policy by giving psychedelics to undergraduate students, and did not select participants through random sampling. It was also problematic that the researchers sometimes took hallucinogens along with the subjects they were supposed to be studying

Intuitively, we learnt a lot about human behavior when we were able to do those unethical experiments back in the 60s and 70s. Set us back yes, but “set us back” by being moving us forward unsustainably.

Most of them didn’t really need to be unethical though.

There are things you can learn either extremely slowly or extremely unethically, but it didn’t really seem to be the case with psychedelics. Things which could have been done responsibly were done recklessly, and not all that much time or effort was saved.

The last several years, I've noticed there's been a lot of effort to debunk and discredit a lot of those unethical experiments. I'm still inclined to agree with you though.

I am not aware of any long-term legitimate findings in psychology research from the 60s or 70s (that would not be allowed today). Are you? My guess is all, or nearly all, have been debunked, or are non-reproducible for silly technical reasons.

Just off the top of my head, the monkey in the dark funnel study, the mit prison experiment, the Stanley milgram experiment, the rat utopia/dystopia experiment, the little Albert experiment (1919), Leuba’s tickling experiment involving his son (1930s) etc.

All of those studies are basically scientific garbage. They're just pop-culture tripe at this point. Each one has been invalidated, repeatedly, and for reasons that have nothing to do with medical ethics.

Also the prison experiment was at Stanford.

That’s not true. At best you can say the Stanley milgram experiment was reanalyzed with a poor reproduction involving various amounts of money. Not nearly the same and definitely not conclusive.

The little Albert study holds, the tickling study findings are still true, the Stanford prison experiment hasn’t been repudiated, the rat experiment has literally been reproduced outside of the US and the pit of despair findings still hold true.

And yes, it was Stanford but it was off the top, I made a mistake.

OK, fair enough, I made a mistake not verifying the Little Albert study before saying that it didn't hold. I have since checked on that one and I can't say that I consider it valid.

The Prison Experiment's methods were repudiated (in the sense that the methodology as described and carried out is unlikely to answer any sort of true psychological research question). |

I'm not sure what to make of the Milgram experiment.

The Milgram obedience studies have been replicated many, many times.

the Silver Spring monkeys experiment made inroads on treatments for stroke patients I believe

Thanks, I wasn't able to find that experiment based on the previous person's description. That experiment doesn't qualify, as we still do experiments more or less like that, it's animals not humans, and it's neuroscience, not psychiatry.

The perspective given in this book was really interesting to read. Way different the typical story you get out of drug communities

Agreed. I think Alexander Shulgin deserves some blame as well, though maybe not to the same extent.

I recall talking to a guy when I was working at Berkeley who was convinced that you could take shulgin's work and expand it to larger sample sizes and use it as a basis of rational drug design for psychedelics. I see Shulgin as a bit of a different character, and he was embedded in an time and area that had already absorbed LSD and was ready for psychonautical adventures.

I respectfully disagree. What Shulgin did simply represented rational science and protocols for self experimentation. He established some of the best possible harm reduction methodologies, and communicated his knowledge to the world through PIKHAL and TIKHAL. Through those books he's saved countless lives and minds as people used and shared his guidelines.

He was a subtle rebel, who played by the rules and they kept changing the rules until they could shackle his research.

The context of the war on drugs and the vastly restrictive IP laws created the current culture of drug development and research. That culture is dominated by the pseudo capitalism and monopolistic death grip Big Pharma has on drugs in general, and their development and manufacture in particular.

People absolutely should be allowed to self experiment, and knowledge should be freely available. Shulgin and his wife showed virtually no I'll effects after a life of responsible drug use - he lived to a vigorous 89, and his wife is still kicking around at 90! I wish their brand of drug use had taken deep root in American culture such that substance use was appreciated and respected and approached with the caution it deserves. If high school children were given drug use education, and pharmacies were a legal source of all drugs without the asinine scheduling prohibitions, so many tragedies could have been avoided.

Even most doctors don't prescribe drugs as responsibly and carefully as they should, and people are ignorant and ill prepared for anything that happens. They could use Shulgin's approach, carefully increasing dosage and providing patients with a common verbal framework with which to describe their experience.

Anyway, sorry to rant. Shulgin is a hero to me - a gentle rebel who made his PhD count for something he believed in.

I agree that ultimately, people should be allowed to self experiment. But looking at his situation from a pragmatic perspective in the 70's and 80's, would it not have been wiser to be just a bit more careful with his advocacy? Publishing a book that details how to craft hundreds of untested psychedelic drugs is not quite what I would call subtle.

I'd say that Shulgin and the people who worked with him on his mental adventures all had strong egos and had been tested by previous experiences with psychedelics. So there is some selection bias about whether the general populace could enact PIKHAL and TIKHAL.

Watch one of these turn out to a miracle cure for some random disease.

I can understand preventing access to dangerous drugs for the average person, but keeping ourselves deliberately ignorant by blocking research was stupid.

It's impossible to talk about how dangerous psychedelics are without context of the dosage as well as the setting for higher doses. We don't consider alcohol to be especially dangerous only because it requires a very large amount of most forms of alcoholic beverages to result in alcohol poisoning and death.

The active dose to LD50 ratio for alcohol is somewhere about 1:13 depending on tolerance. For Magic Mushrooms or LSD, it is above 1:1000.

In other words, it is nearly impossible to accidentally kill yourself via overdose on psychedelics - but somewhat easy with alcohol.


But it sure is a hell of a lot easier THINKING you’re going to die while on psychedelics!

I can’t handle drugs (as much as I’m curious about them) but I had a “smoked waaaay too much pot”experience in college where I was high for almost 24 hours and I spent the first six hours or so convinced I had broken my brain and was going to die.

I think you have to balance that against the fact that the recreational dose of lsd is so infinitesimal that 10000x that dose is still very easy to ingest in the blink of an eye. Not so for alcohol.

That said, even after reading wikipedia's source on the ld50 of lsd, I remain unconvinced that there even is a lethal dose of LSD.

An excerpt from the highest ever recorded dosage of LSD.

"Eight individuals who accidentally consumed a very high dose of LSD intranasally (mistaking it for cocaine) had plasma levels of 1000–7000 μg per 100mL blood plasma and suffered from comatose states, hyperthermia, vomiting, light gastric bleeding, and respiratory problems. However, all survived with hospital treatment and without residual effects."


In short, even on the rare occasion when people have taken 1000x what they should, they didn't die.

There are other forms of danger apart from lethality, and before new recreational (or therapeutic) drugs can be accepted by society, those need to be culturally understood.

You don't need to somatically die. If you end up mentally borked that is enough.

You vaguely imply psychedelics are dangerous, comparing them to alcohol, yet you provide zero evidence of their dangers. Sounds like you need to flesh out your post, it comes across anti-psychdelic with no reasoning.

Especially odd because we DO consider alcohol dangerous, why else is there a 21 age minimum on it, why else is drunk driving a scourge and menace? The "danger of psychedelics" looks meek by comparison.

Like anything else, doesn't that depend on the concentration?

Psychedelics have other dangers than acute toxicity. Not that I’m giving medical advice but it is extraordinarily difficult to die as a result of an overdose of most pure psychedelics which aren’t strange “research chemicals”. (Although I vaguely remember reading about a guy who accidentally took something like tens of thousands of effective doses of LSD being in a coma for quite a while)

However their power is in their ability to reshape your mind… and that they can do in very undesirable ways if done wrong.

> and that they can do in very undesirable ways if done wrong.

I think the risk of developing a long term mental illness from psychedelic use are overstated because of societies stigma with temporary psychosis. A healthy person can come back from those "psychotomimetic" episodes really quickly, even quicker than with opioid induced psychosis. It's not really mysterious or undesirable as you make it sound. People that develop long term issues from psychedelic use are also at risk of developing those from basically all other psychoactive substances, specially marihuana and opioids.

The motivations for making psychedelics schedule 1 where political and not related to that risk at all though. Drinking a lot can also create temporary psychosis and long term personality changes. There's also lots of studies about how marihuana also results in psychosis or triggers mania in some people. Neither alcohol nor Marihuana show as promising results for things like fighting depression, fatigue, social anxiety, as psychedelics or at fighting PTSD as MDMA does.

Alcohol and now weed are legal mostly because of other economic and political interests. The sad reality is no one gives a fuck about the people that could benefit from research into psychedelic medicine, except pharmaceutical companies that make billions out of treatments that are 20 years behind, and they want them to be schedule 1 forever.

With drugs you get two choices: ineffective or potentially dangerous, often both.

People want to believe that the thing they like is safe, but every drug that can do anything is dangerous. That's the whole idea, a drug is a lever to make change, not a magical "make everything better" solution. You push the lever too far and you get things you don't want.

It's not just temporary psychosis (which sometimes isn't so temporary). It can trigger major changes in personality, or latent mental illnesses which tend to only manifest with a push (schizophrenia is one).

It's not a coincidence that psychedelics have been used in religious ceremonies throughout human history. They can give people religion, and without direction they can turn people into troubling zealots for just about anything (and often the drug itself). People who experienced this and became cultural icons are part of the reason they got banned. (turn on, tune in, drop out)

There is even a considerable group that want to re-name psychedelics to "entheogens" which has a rough etymology of "to put god into".

I have personally felt this and it scared the fuck out of me.

> With drugs you get two choices: ineffective or potentially dangerous, often both.

What type of drugs? Pharmaceutical or recreational? Natural or man-made? Taken to escape or numb, or with respect and gratitude? Abused or moderated?

There is a wide spectrum of outcomes when consuming any substance. Many more than two.

> They can give people religion, and without direction they can turn people into troubling zealots for just about anything (and often the drug itself)

Religion, politics, or any belief system can breed this without drugs. Selling salvation or enlightenment by taking a substance attracts the emotionally vulnerable. And wouldn't that actually decrease if they could be taken by anyone in a safe and controlled environment alongside a licenced therapist, instead of underground?

What are you advocating for or against? I'm genuinely interested, I sense fear and worry in what you wrote but don't really understand the point you are trying to make.

>What type of drugs?


My point seems to have not gotten across.

Let me restate. Either a "drug" is fake and worthless, or it is dangerous. There isn't a third direction. If it does anything, it can do too much of it.

>Religion, politics, or any belief system can breed this without drugs.

Hallucinogens are major religious experiences in pill form with proper dosage (or whatever your preferred delivery method). There isn't really a comparison between something that can readily deliver a life changing experience on demand and those other things.

>What are you advocating for or against? I'm genuinely interested, I sense fear and worry in what you wrote but don't really understand the point you are trying to make.

I'm advocating against treating this class of drugs like they are magical perfect safe toys. They are powerful, and dangerous tools that can do a lot of good things, but any powerful tool can be misused or have serious drawbacks. I am not against "dangerous" things, there's no such thing as complete safety. I'm advocating for respect and understanding. There is a reason historically and prehistorically they were almost always used within a structured (usually religious) environment.

There is space for respect and understanding in between fake & worthless and dangerous. These are multidimensional problems.

The titled study seems very thoughtfully designed and operated, in a professional, ethical, and scientific manner.

I'm with you on the last point. It's good to be aware of past abuses, but I also see a future where we can integrate what nature has provided into our lives in a respectful and grateful way and grow from it. Definitely not a pill to pop and fix something. A therapy based approach to psychedelics makes a ton of sense to me.

Besides the "it's not that binary" thing that other people already told you, and that I agree with, there's a few other misconceptions I think:

> It's not a coincidence that psychedelics have been used in religious ceremonies throughout human history.

I don't think the reason is that they are good "brainwashing" drugs and religion is inherently about changing everyone's personality. I think what you are referring to as "religion" was not "religion" back then, but "religion, science, medicine and the state" which where all usually together and perceived as a single entity. The main reason they were using psychedelics may be that they are very effective, cheap, easy to extract from plants, and that they at a large scale work in addressing a lot of maladies. What was tuned for "brainwashing" and "controlling people" where the ceremonies, the drugs don't "do that" on their own.

The CIA conducted a lot of research into using LSD for brainwashing. So did Mossad, to use them for kidnapping people but making it seem like they are willingly going with them. They are not effective for this. Most of the literature agrees that high doses are more likely to help with depression and anxiety than to have any bad consequences.

And yeah they make you easier to manipulate and more suggestible. So do benzodiazepines and alcohol but with no of the benefits. You just need to be a little bit careful when taking them if you are struggling with any mental issue. Just like everything else.

> I have personally felt this and it scared the fuck out of me.

Do you have any experience administering psychedelics or with the vast literature about administering psychedelics? Because yeah, research has been banned in the US for a while, but this things have been around since the 50s. There's a lot of published research and a lot of literature from community use.

I think you may just be projecting your own experience here.

Every single thing humans do and consume is 'potentially dangerous'. Existence is dangerous.

If you extend the definition of the word or phrase to apply to everything it is meaningless and might as well not be used. That is not how I am using it.

Its always so interesting to me to run into people conditioned to have a blanket juvenile “anti drugs” view, especially if they are US citizens

They cant even tell the difference between substances to say why or why not

If thats you, why is that? And is there any specific authority you would need to hear from to take another look?

It will be interesting to see the results, which may have built-in reproduce-ability.

> The study will be conducted simultaneously at the three institutions to diversify the pool of participants and increase confidence that results apply to a wide range of people who smoke.

Here's a fun fact: since 1968, only one US institution, the University of Mississippi, has had a Federal license to grow marijuana for medical research [1], although this may be (finally) changing [2]. The barriers to Federally funded medical research of cannabis remain significant [3]. It's almost like the University of Mississippi and the Federal government are doing everything they can to stymie research and limit access.

Also, cannabis remains a Schedule 1 drug at the Federal level. Schedule 1 drugs are "drugs of abuse" that have "no accepted medical use" [4], the same as methamphetamine and crack cocaine (and of course it's worth mentioning that powdered cocaine is the less serious Schedule 3).

All the while ~18 states have legalized recreational and/or medical cannabis at the state level [5].

The case for the continued criminalization is beyond ridiculous.

I fully support decriminalization and further study of the effect of psychedelics but I'm not confident that the US government, even with a Democratic president, a Democratic House and a (notionally) Democratic Senate won't make this as difficult as possible.

The roots of US criminalization of cannabis and psychadelics is rooted in racism (eg crack cocaine vs powder cocaine), cracking down on counterculturalism and anti-Vietnam protesters (ie the hippy movement of the 60s and 70s) and virtue signaling to a conservative and fearful voter base under the guise of "law and order" and "family values".

It's truly ridiculous we're still here some 50+ years later.

[1]: https://www.drugdiscoverytrends.com/nations-only-federally-a...

[2]: https://mjbizdaily.com/dea-preparing-to-ok-companies-to-grow...

[3]: https://cen.acs.org/biological-chemistry/natural-products/Ca...

[4]: https://www.dea.gov/drug-information/drug-scheduling

[5]: https://en.wikipedia.org/wiki/Legality_of_cannabis_by_U.S._j....

Although there may be more nefarious reasons behind why crack is penalized more harshly under the law than cocaine, that scheduling is at least technically correct: powdered cocaine is indeed used as a medical anesthetic, whereas crack isn’t used for anything medically.

The classification of marijuana as not having any medical use despite being used to treat all sorts of ailments all over the country is, of course, ridiculous.

Now that I think about it - regardless of your stance on recreational drug prohibition - it does seem strange to tie penalties for illicit use or sale of a drug with whether or not the drug has so-called legitimate uses.

It's worth adding that the DEA scheduling classification is a little weird. Example: fentanyl is a Schedule 1 drug but it's an extremely potent opiate that is prescribed typically to end-stage cancer patients and others in extreme pain.

Fentanyl is schedule 2, as is methamphetamine [1]. I'm not sure why certain users repeatedly claim they are schedule 1 despite being able to easily verify that they are not. This isn't the first time I've had this back and forth on HN.

[1] https://www.dea.gov/sites/default/files/2020-04/Drugs%20of%2...

Meth is not schedule 1, it's sold under prescription under the name of Desoxyn !!! According to the weird US federal drug schedule weed is more abusable that Meth...

Don't forget Adderall which is very similar.

I’m 100% with you, but this country will forever be legislating the fact their neighbors might be happy and enjoying life. And then the fact so much race enters into it too as you mention, just makes it addictive for certain people. It’s like crack or something.

I presume other countries didn't have a ban on such research so there should already be research data from those countries on the benefits of psychedelic treatment?

US forces countries it trades with to align themselves with its drug laws. Just another front in war against drugs.

One can only hope for something close to this in Southeast Asia : (


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