A re-examination of our conversation on psychedelics
The war-on-drugs has done more harm than good. One result of this unfortunate crusade was the unfair labeling of psychedelic substances as schedule 1 drugs. This has, in turn, created a blockade on research and encouraged the sale of impure or false substances on the black market. We need to rethink our conversation around psychedelics. By focusing on safety and science we can reduce the risk and increase the benefits.
What are the risks and dangers of psychedelic substances?
Are these substances dangerous? First, it’s important to step back for a moment and consider what a “drug” is. Drugs are simply molecules that interact with our bodies. The label of “drug” can be problematic as it is laced with cultural fear and stigma. Consider for a moment that many substances we call “drugs” are produced endogenously such as norepinephrine, Dimethyltryptamine(DMT), serotonin, adrenaline, dopamine and more. Moreover, compounds found in supplements can be just as potent and dangerous as the substances we call “drugs”. When the bias that comes with the term “drug” is removed and it becomes easier to examine this issue in a more rational way. Because of the near infinite complexity of the human body everything we come in contact with has multiple effects on our biology. This includes food, supplements, iron utensils, prescription drugs, “illicit” drugs, the atmosphere, differing wavelengths of light, and everything else. Psychedelic substances have effects on us as well. Some are positive, some are negative. This goes for prescription drugs as well. The reason we agree to take prescription drugs is because we perceive their benefits to be worth the risk. After a little re-education it should be a simple matter to treat psychedelic substances with the same cost-benefit analysis.
There are many factors to examine when considering the risk of any substances. Some of these risk factors are: Lethal dose, lethal concentration, physical side effects, physiological side effects, and psychological side effects. Despite all the hype about the dangers of psychedelics the general body of research indicates that most of these substances are relatively non-toxic and non-addictive. LSD, for example, is non-toxic and medically safe at standard dosages which range from 50 - 200ug (Nichols et al). The lethal dose of LSD is incredibly high and is estimated to be well above 20,000ug. To reach this one would have to consume more than 200-400 street blotters. The few negative incidents reported as being caused by LSD were either due to massive overdose, LSD taken with other substances, or entirely different substances all together but were mistaken for LSD, usually research chemicals. To this day there is not a single case of death due to LSD at standard doses. Moreover, it is estimated that about 31 million people have ever taken LSD (Nichols, et al). Most deaths related to LSD (and other hallucinogens) are not related to toxicity, instead to actions by intoxicated individuals that place them in dangerous situations. This is one of the reasons why set-and-setting are so important when taking psychedelic substances. In a small subset of people who use LSD there is a risk of flashbacks or Hallucinogen Persisting Perceptual Disorder (HPPD). However this usually occurs in individuals who have used excessive amounts of LSD over time (Nichols, David E. and Charles S. Grob). The risks of psilocybin are similar to LSD. The risk of death via toxicity is all but absent in psilocybin, but like LSD, the greater risk comes from making bad decisions while under the influence and/or from mushrooms or mushroom products laced with other substances. One risk unique to mushroom based psychedelics is mis-identification of mushroom species. There are millions of mushroom species and many look similar to one another. Some species even professional mycologists have difficulty telling apart. This is particularly problematic when one mushroom could be fatal. This is a problem in black market dealing of psychedelic mushrooms as well as personal harvesting. Additionally. almost all psychedelic substances, have little to no potential for physical or psychological dependence (Reiche, Simon, et al). Like all hallucinogens there is a small risk that certain individuals will experience negative psychological effects. It is not yet clear exactly how genetics, epigenetics, psychology, physiology, and set-and-setting play a role in these incidents. However it is clear that the physical and social environment as well as one’s preparation and attitude going into an experience play a large role in the outcome of the set-and-setting. These effects need further studies.
There are a few other factors worth noting in regard to the dangers of these substances. First, contrary to what one might believe the prohibition of these substances actually makes the market more dangerous (Balko, Radley). If there is demand it will be filled, if not by a regulated industry then by the black market. The black market is not the safest place to get substances and this is a major cause for negative incidents. Second, a lack of science and compassion based education in the conversation on drugs as a whole. When experimenting with substances, many do so with mostly street knowledge. The criminalization of drug’s biggest obstacle to implementing honest education programs that focus on safety and danger management as well as programs to aid those who are having negative experiences with drugs at events and parties. The Drug Policy Alliance and the Safer Partying organizations are working hard to turn these into a reality, but until drugs are decriminalized these programs will prove difficult to implement which is unfortunate because many people die or get hurt because they don’t know better, can’t get their drugs tested, or are shuffled into the less than helpful criminal justice system.
What are the benefits of using psychedelic substances?
First, let’s focus on the potential for psychedelic compounds to treat mental disorders. Luckily there is beginning to be more research done in the field and we have more and more evidence that there is indeed a strong argument for clinical efficacy. In the 60’s as these substances were being discovered and studied by chemists and scientists it quickly became clear that these compounds had potential therapeutic uses.
There are many studies on the effects of psychedelic substances on depression. Studies indicate that many people’s depressive symptoms are greatly reduced after one acute and well controlled experience. Additionally, these symptoms often last long after the initial experience, from a few weeks to months and possibly years. Many recent studies in psilocybin show that there can even be symptom reduction in cancer patients. One such study indicated that a “single moderate-dose [of] psilocybin - produced rapid and sustained anxiolytic and antidepressant effects (for at least 7 weeks but potentially as long as 8 months), decreased cancer-related existential distress, increased spiritual wellbeing and quality of life, and was associated with improved attitudes towards death” (Ross, Stephen, et al.). Another similar study had similar conclusions (Reiche, Simon, et al.). A study on the use of psilocybin in treatment resistant depression also had promising results. This study was measuring the effectiveness of the treatment based on certain factors during the experience like experiencing Oceanic Boundlessness (OBN), and Dread of Ego Dissolution (DED). The results showed that the nature of the individual experience did indeed predict long term positive results in those with untreatable depression (Roseman, Leor, et al.). Many other similar studies have been done and some are being currently carried out.
There is also substantial evidence for the efficacy of psychedelic substances in the treatment of addiction. Psilocybin, ibogaine, MDMA, ayahuasca and more have been studied as a tool to treat nicotine addiction and alcohol dependence. One study cited in an analysis paper showed long term smoke free results in 12 out of 15 participants. At a year follow-up 10 participants were still smoke-free. Many other similar studies show promise in the realm of addiction treatment using a variety of different substances including ibogaine, ayahuasca, and ketamine (Morgan, Celia, et al). Although these studies show great promise. Larger and better studies are needed,some lack in control groups, and many have only a small number of participants.
Studies have also shown possible efficacy of psychedelics in the treatment of PTSD and similar disorders. MDMA has been shown to be efficacious in this regard (Danforth, Alicia L., et al). Additionally, more extreme psychedelic compounds like ibogaine and ayahuasca have been shown to be extremely powerful tools in treating PTSD. More research needs to be done with these substances. James Fadiman Ph.D and Dr. Gabor Mate are both doing incredible work with these compounds in this regard.
Treating disorders is not the only thing psychedelic substances are good for. They can be used as tools to improve one’s life. These improvements can range from creativity and problem solving to more well being, empathy, happiness, and even spiritual understanding. These effects are just as important and powerful in their own right as treating ailments. In fact, the positive effect on many ailments can be attributed to some of these more esoteric results of using the compounds.
Creativity and problem solving is a benefit many individuals have spoken of. Many even attributed at least some of their success to their use of psychedelic substances. Steve Jobs the founder of Apple is well known for this. There have been many others who have reported using psychedelics for similar purposes (Wainwright, Oliver). Currently in Silicon Valley, microdosing of LSD is becoming a common tool for mental performance enhancement (Kuchler, Hannah.). Some claim that psychedelics helped them come up with ideas and connect concepts they wouldn’t otherwise have thought of. This seems to align with the current body of research on how these substances affect the brain. One study of the brain on LSD showed that the brain actually became more connected in ways that it usually isn’t in adults. (Li, Chunyong, et al.). Other studies suggest that these compounds can also impact neural plasticity. Of course many artists and musicians have reported the use of psychedelic compounds in their creative processes as an import tool. Of course, in addition to the utilitarian benefits of psychedelic substances are possible improvements to one’s quality of life. Both anecdotal accounts and research studies indicate that these substances can have a profoundly powerful effect on a person's sense of well being and happiness. Countless individuals have reported that even single experiences using these substances were one of the most, important experiences of their lives.
These compounds do have real risks, but they also have real benefits. The war-on-drugs has done more harm than good in general and in the case of psychedelic substances it has slowed scientific progress down substantially. Additionally the prohibition and criminalization of these substances is largely to blame for the dangers many associate with these compounds. Fear-mongering has also played a large role in increasing the danger of using these substances as well. These substances should not be schedule 1 drugs as they are relatively non-toxic and non-addictive. Their benefits clearly outweigh their risks in both personal lives and in science. We need to change our conversation around drugs, especially psychedelic substances. Only then will we be able to have a true reform of drug policies. Decriminalization and legalization will be extremely beneficial to public safety and science. For now, let’s the conversation away from dogmatism and fear-mongering toward science, safety, and education.
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