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I dont have a problem with the study or its conclusions, just the parent post I was replying to.

>Recreational drugs make you feel good temporarily. That's literally why people do them.

The point Im making is this is true for a ton of psychiatric or even non psychatric treatments. And to be perfectly clear Im not saying you should be treating your anxiety with weed, even if it does help you

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> The point Im making is this is true for a ton of psychiatric or even non psychatric treatments

That point wasn't intended to be taken in isolation.

I was making statements about how long-term treatment of an underlying condition is not the same as taking a drug which temporarily masks a problem or induces altered mood states.

The fact that a drug has acute effects, good or bad, is separate from any conversation about chronic effects.

For depression, anxiety, and other conditions it's the chronic effects that matter. The acute effects almost become side effects at that point. For some drugs, getting to long-term treatment involves tolerating the acute effects while your body adapts


You keep ignoring the fact that what you just said applies to current medications used to treat depression and anxiety. They do not treat the underlying issue long-term, and if you stop them, you are worse off than before due to rebound effects, and even if those effects subdue, your depression and anxiety returns. And just to add to this for clarification, antidepressants may treat depression, but it does not cure it either.

Same with amphetamines for ADHD. And yes, if you take much more, you will experience side-effects ("cause harm when abused"). Opioids are not an outlier at all.

> Recreational drugs make you feel good temporarily

Drugs are only recreational if you take them recreationally, there is nothing that makes them inherently recreational.

And we have not discussed MDMA, which is considered a hard "recreational" drug, yet there are lots of benefits for treatment of PTSD, for one, similarly to psychedelics.

... or ketamine for depression, which is now approved by the FDA, even.


The difference between your positions is not about acute vs chronic, it's about tolerance. If a drug for a long term condition has short term effects the first few times and then they fade under regular use, it's less of a valid treatment. Especially if there is a withdrawal effect, and any negative side effects of regular use.

We absolutely overprescribe a lot of psychiatric meds that do not have significant beneficial long term effects. "Stabilizing" a patient in an inpatient hospital psych ward may as well involve a Magic 8-Ball picking the particular antipsychotic for its short term effects, while on the other hand doctors and nurses put people on Seroquel at the drop of a hat in reported sleep problems, and don't take them off until natural death or until the essential tremors get reported decades later.


This is a fair point but there’s also truth to the fact that “I feel better” does not automatically mean it’s an effective/good treatment.

Lots of depressed people turn to alcohol to provide a mood lift. But you can’t be drunk all the time and function, and when the alcohol wears off you feel even worse. So it’s a terrible treatment.

People talk a lot about cannabis like it’s a great treatment for all kinds of stuff. But is it closer to a drug you can take on a schedule that boosts your mood essentially all of the time with acceptable side effects? Or is it closer to a drug that lifts mood very short term and then makes it worse?


> “I feel better” does not automatically mean it’s an effective treatment.

Of course, I agree with that.

I also agree that you cannot be drunk to function, but there are many other "drugs" that people would oppose that do not make you dysfunctional.

Personally I would not use cannabis because I know that it makes me dysfunctional, but it may not be the case for some people for all I know.

FWIW I take opioids for my chronic condition, and it also helps with my emotional volatility, depression, and anxiety, too. I have not experienced any side-effects either.


Alcohol is so terrible, especially when severely abused, that "better than alcohol" absolutely cannot be a meaningful standard for being a proper treatment.

> there are many other "drugs" that people would oppose that do not make you dysfunctional.

People oppose these drugs because they do tend to make you dysfunctional, at least when abused. And when people are severely depressed, the depression itself makes it more likely that they will abuse their drugs.


The problem with your argument is it's whataboutism. Your argument's conclusion should be that even prescription drugs aren't necessarily good.

Really what is wrong is that most prescription drugs do show less tolerance. Yes, prescription drugs have tolerance, but not as fast as recreational drugs taken at recreational doses.


> You keep ignoring the fact that what you just said applies to current medications used to treat depression and anxiety. They do not treat the underlying issue long-term

Those do cause improvement in self-reported feelings long term, i.e. they lower the baseline levels over a long period of time, rather than just for a short period right after you take the drug.

But you'd be right to say that they're not very good, i.e. that doesn't help your life very much. If there's an actual underlying cause, like sleep apnea, treating that will help a lot more.

Ketamine is a harder case, it really does cause improvement, but it lasts about two weeks. It also can cause psychosis, which is very dangerous. The s-ketamine the FDA approved for use in treatments is also via an inhaler, so it's both purer and via a different route than other a lot of other ketamine usage and it was approved because it actually showed a measurable effect in studies.

But it's really awful to use and if you find out that, say, sleep apnea was actually causing the issues, treating that will do a lot more good than inhaling s-ketamine ever did.

As you may have inferred, I write this based on personal experience.




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