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How psychiatrists got serious about using psychedelics to treat mental health (robbreport.com)
26 points by spansoa on July 24, 2022 | hide | past | favorite | 21 comments



I've taken many different psychedelics in different settings and had both good and bad experiences. Psychedelics can be a very helpful tool if used intentionally while open to new experiences. They can also amplify negative experiences. I'd never drop acid at a heavy metal concert for example, but that's just me.

Most people use some form of mind altering substance, the most common being nicotine, caffeine and alcohol. It really is up to the person and that's how it should be with psychedelics. I am free to alter my perceptions and learn from it.

The problem I have with the recent push to decriminalize is that the experience is wrapped up and controlled by a therapist. They have to package it this way to get the laws relaxed. But do I want some recent college graduate with a psychology degree to be in charge of my experience? Um, no.


> do I want some recent college graduate with a psychology degree to be in charge of my experience? Um, no.

This strikes me as a very strange way of framing things. When you phrase it that way, I'd also reflexively say "no," but on the other hand, would I want a well-trained and compassionate professional, whose judgement I trust and who is following what the medical community has decided are best practices, to guide me through a psychedelic experience? Well yes I would, and that's not really much different than the bar I set for therapists and other medical professionals.

edit: It occurs to me that maybe your point is more that this isn't a good route to full legalization (or at least a national push towards rescheduling/decriminalization), rather than about the efficacy/prudence of psychedelic-assisted therapy. On that front, in defense of the shrinks, this is basically following the same model as cannabis, whose decriminalization has been on whole a pretty successful effort so far IMO.


I said that because psychedelic therapy is an emerging treatment so you're going to get a lot of young therapists at first. There aren't enough older ones with psychedelic experience to go around.

I've done psychedelic therapy with an experienced therapist at a precursor to MAPS Santa Cruz [1] and I felt the therapist got in the way. She was mostly there to keep me safe, which I didn't need. Then she projected her own experience in interpreting mine.

That said, for the average person who doesn't do psychedelics (my mother for example) the therapist patient setting is the way to go. That model also provides the best path for legalization.

I'm not going to complain about how it gets legalized because I understand how to compromise. My complaint is that I shouldn't have to go to a therapist to do it legally, but that's further down the road. As you said, that process has been successful for marijuana.

[1] Multidisciplinary Association for Psychedelic Studies https://maps.org/


> But do I want some recent college graduate with a psychology degree to be in charge of my experience?

As far as I know, psychologists can't prescribe drugs for their patients, only psychiatrists can. And psychiatrists are MBBS / MD doctors. If these kinds of drugs are made legal, even for recreational purpose, I would obviously ofcourse like a doctor to prescribe it and advise me on its usage!

Edit: I looked it up, and even in the US where some states allow psychologists to prescribe medicine, the requirements are quite high:

In Louisiana: Psychologists must first complete a postdoctoral master's degree in clinical psychopharmacology before they can prescribe medications. In New Mexico: Psychologists must complete 450 hours of didactic training and 400 hours of supervised practice in psychopharmacology. In Illinois: Psychologists must receive specialized training in psychopharmacology. In addition to this training, they must complete a supervised clinical rotation that lasts 14 months and covers a variety of settings including hospitals, prisons, and mental health clinics. In Iowa: Psychologists must complete a postdoctoral master's degree in clinical psychopharmacology. They also need relevant clinical experience in assessment and pathophysiology. In Idaho: Psychologists need a postdoctoral master's degree in clinical psychopharmacology. There are no specific hourly requirements for training.

Source: https://www.verywellmind.com/can-psychologists-prescribe-med...


It was serious before Nixon decided psychedelics in the hands of hippies were a threat to the social order and villainized them.


California made lsd illegal in 1966,three years before Nixon was president in 1969


Hippies were white. I believe that spared them the bulk of Nixon’s wrath.


It's anecdotal, but if anyone is interested in an in-depth account of an ex Navy Seal using psychedelics to successfully treat PTSD: https://m.youtube.com/watch?v=asrnXJ-xCzs


I understand that a lot of readers of HN like solutions and read those stories with enthusiasm. But they are often that: stories, anecdotes. They rarely include properly set-up double-blind trials, even if the same actors could easily set trials up with the same circumstances.

And the article has quote hoping for trials… except tests _have_ happened. Spoiler: they were not as conclusive those stories would have you think. Reviewers from serious psychiatric publication are a bit tired of that story. Vice (not the paragon of scientific rigour) or Netflix (same) going after them only adds to the already transparent evidence that those PR efforts are paid for by Big Pharma trying to cash in, again, on a new trend.

You want to have an easy way to tell the difference, if you are not a board-certified psychiatrist? Addiction, PTSD, etc. most of the Western World has an issue with those. The larger share of the Western World (EEA, Canada, Australia, NZ; Singapore, South Korea and Japan if you want to include them in there) has state-financed medicine. There’s no organised interest for those, even in the most forward-thinking countries. One country has not effective price controls and medicine with ruinous costs —— literally, people die of the consequence of their medical debt. If those stories about wonder drugs only happen to patients from that one country, you can tell what’s pushing the press (and the shill account promoting that on social media) is a profit motive, not the passion of a few aging hippies.

Don’t get me wrong: there’s nothing wrong with a well-financed effort to make a profit and fix a problem. Mark Cuban trying to screw over Big Pharma —— I’m sure he has a marketing budget, and some of that goes to making sure there’s press. But if there’s no institutional support, it’s not because doctors hate patients getting healthy.

I’m hoping that, on top of stories, readers of HN also like and understand the scientific progress, and know that psychiatry is desperate for new, effective drugs. They hear about street drugs every day. They’ve tried.

No one working in that field would snub a molecule because it’s associated with “bad people”, aka patients: they routinely, successfully prescribe heroin (well, opioids) to surgery patients and meth (well, amphetamines) to ADHD sufferers. Doctors, pharmacist and nurses do _not_ care for how “society” sees their method. They routinely deal with people writing on the walls with their own shit, screaming all day long and trying to kill themselves to know what’s important. Hitting enough keywords to impress the editorial board of _Vice_ isn’t it.


> No one working in that field would snub a molecule because it’s associated with “bad people”, aka patients

Not directly, perhaps. But I can't imagine it's very conducive to research when some ignorant, cynical, and/or purity-obsessed law enforcement bureaucrat decides that a novel molecule is merely an "analog" or "designer drug" that we need to wipe out (lest those people commit the unpardonable sin of getting away with it).


If it takes scientific studies and regulated psychiatry to bring the benefits to the masses so be it. I can accept that. But I recently caused a controversy on Twitter when I suggested psychedelic therapists have some experience with the drug itself. Apparently, this is a taboo topic and speaking about it openly might endanger the efforts to wrap it up in a legal doctor-patient type relationship.


The drug is nowhere as innocuous as the people selling you make you think.

You can tell surgeons that they need to ride a bike before they should operate on people after crashes but you won’t have a great reaction either.


> You can tell surgeons that they need to ride a bike

That's not a good analogy. Fixing broken flesh and bones has nothing to do with knowing how to ride a bike

A better analogy would be getting a sponsor in A.A. because you could get a sponsor who wasn't an alcoholic (and some do) but it's accepted that it takes an alcoholic to help an alcoholic. In other words, it takes some experience with the drug at hand to help someone with that drug.

> The drug is nowhere as innocuous as the people selling you make you think

There have been some famous acid casualties, such as Syd Barret of Pink Floyd. I'm sure we all know someone who did too much. However, there have been millions, perhaps billions of psychedelic trips taken over the last 60 years, yet the psyche wards aren't overflowing with people made sick by their trips.


> yet the psyche wards aren't overflowing with people made sick by their trips.

[Citation needed. Because, yes there is.]


I'm getting Ketamine as treatment for depression in Australia, it works.


how would you propose setting up a double-blind trial for a psychedelic?


Most of the setup described here includes conditions similar to sensory-deprivation tanks. Those can induce hallucination without psychedelics.

More importantly, I would match the amount of therapy: all those offer an astounding level of discussion with people that might be professional, trained therapists or not. That’s the massive difference between a lot of different treatments, not the molecule — surprise, they lead to massively different outcomes.


We got the Soylent, we got the Panopticon, here's the Soma.


The fictional Soma as described by Huxley was a tranquilizer to make people numb to discomfort. Since you compare Soma to psychedelics, I can deduce with some confidence that you've never taken psychedelics.


>I can deduce with some confidence that you've never taken psychedelics.

You're wrong though. I have consumed Magic Mushrooms and LSD on several occasions. In my personal opinion psychedelics make people "malleable" for lack of a better word, susceptible to external influencing and messages. That's why I avoid to watch TV or browse the internet while tripping like Huxley.


The so-called Soma came a long time ago with Xanax and various other benzodiazepines that are over-prescribed. Psychedelics are a vastly different thing that can _cure trauma_ without dependency. Please understand the implications of that.




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