I'm a fairly drug-averse person. I have no qualms about other people using them, but it took us over 30 years to really understand the implications of legalized opioids. And that was after a lengthy and expensive FDA process.
So respect to all of the early adopters who have nothing to lose and are willing to put their own sanity at risk. I just don't understand people who in one breath curse the Sackler family but then line up to try the first batch of industrialized psilocybin from Rose City Laboratories.
Do you understand what happened in the opioid crisis, and why people are mad at the Sacklers? They weren’t hapless naive actors that didn’t fully understand “the implications” of the drugs they were selling. The effects of opioid addiction were WELL known when oxycontin was introduced, and Purdue Pharmaceuticals deliberately misrepresented critical information about the drugs they sold and had salespeople lie in a wholesale fashion on a massive scale.
It’s reasonable to have suspicion about companies and regulators in this area, but the opioid crisis is such a different situation in context.
> Dr. Janis Phelps, director of the Center for Psychedelic Therapies and Research at the California Institute of Integral Studies, said she and other researchers had been wary of the decriminalization movement. Many in the field had worked for years to remain strictly scientific, hoping to avoid government crackdowns, and to give the U.S. Food and Drug Administration time to fully review the effects of psilocybin before pressing ahead with efforts to make it legal.
> “I have changed my mind,” she said. While she remains concerned that bad actors could try to enter the industry strictly for profit, or try to take advantage of vulnerable people, she has come to believe that the open door in Oregon could advance the use of psychedelics in ways that methodical approaches cannot.
> Dr. Charles Nemeroff, the chair of the department of psychiatry and behavioral sciences at the University of Texas at Austin, said he continues to be wary. Psilocybin is powerful, with immediate effects lasting for hours, and uncertain outcomes for patients, he said, recalling one patient of his who has experienced protracted psychosis, losing partial connection to reality, after taking doses of mushrooms. The treatments ruined her life, said Dr. Nemeroff, who said he worried about the lack of required medical oversight in Oregon’s program.
Just like the Sacklers, people pursuing psilocybin are fully aware of all of these warnings and problems. And just like Purdue, anyone selling psilocybin right now are willfully misrepresenting the evidence and ignoring medical opinion. Again, Purdue did all of the things they did because they believed they were ultimately helping treat people's suffering.
I am fully aware that time may tell and the concerns may be unfounded. And I get that we are dealing with a completely different drug/mechanism. But one is right and one is wrong only through the benefit of hindsight.
The problem here is that there is no evidence. All the evidence of negative effects so far is anecdotal, which in reality calls for more research in the area [0]. In addition, only about 0.2% report having sought emergency treatment [1] when using psylocibin.
As someone who partakes in psychedelics to a moderate degree, I don’t think it makes any sense at all to dismiss the very many negative outcomes as “no evidence”. Perhaps it’s under-researched, but your comment strikes me as ideological and/or hyperbole.
Like with all treatments, it’s a careful balance of whether the risks are worth the positive health outcomes. But there’s no sense in denying that psychedelics, and thus psychedelic mental health treatment programs, have no evidence of potential issues.
While I agree with what you are saying in principle, I do want to point out that there is a massive difference between anecdotal evidence and _research_. In a purely academic sense, it is not an unreasonable statement to make that there is no evidence. In contrast, in the opioid case there existed scientific evidence of the highly addictive nature of the drugs that was more than just suppressed, they were outright _lied_ about by the pharmaceutical company behind the drug.
> Purdue Pharma created false advertising documents to provide doctors and patients illustrating that time-released OxyContin was less addictive than other immediate release alternatives. Furthermore, they sought out doctors who were more likely to prescribe opioids and encouraged them to prescribe OxyContin because it was safer. They did this because OxyContin quickly became a cash cow for the company. (https://oversight.house.gov/release/comer-purdue-pharma-and-...)
A degree of malfeasance in the same realm as Big Tobacco's denials of the risks and addictiveness of smoking:
I think it is true that it is under-researched. Current clinical research on psychedelics exclude people who are previously diagnosed and/or have a family history of personality disorders, psychosis and bipolar depression. They also control for set and setting. Under those conditions, it seems that the use of psychedelics is very safe, but it doesn't give us a good idea of the risk of recreational use in the general public.
One interesting recent study I've found is this, but it's too small to conclude anything, and it also does not appear to be peer-reviewed yet: https://osf.io/preprints/psyarxiv/yzmcj
Yes, you are right, what I should have written was that there is no peer-reviewed clinical evidence of long term negative effects solely caused by the toxicity of psilocybin.
> very many negative outcomes as “no evidence”. Perhaps it’s under-researched, but your comment strikes me as ideological and/or hyperbole.
Very many people have encountered aliens, but there's still no evidence of aliens. Your comment is more ideological hyperbole than the one you're replying to.
I too am fairly drug-averse. And after 40 years of avoiding all drugs but caffeine and alcohol, I dipped my toe into psilocybin and found not only was it profoundly therapeutic in terms of self-acceptence, self-love, and anxiety-reduction, I found after 3 or 4 uses, I had no further interest in it whatsoever.
Is my experience universal? Of course not, but an anecdote to consider alongside yours.
Same here. Did it once and it saved my life. Point is it was only legally accessible to rich people. I.e. I had to fly to amsterdam pay for pre and post psychotherapy and multi day care. This is so wildly different to recreational use.
Interestingly, mushrooms are actually illegal in the Netherlands, but thanks to a fun loophole the truffles are completely fine :D (for those not in the know, truffles usually have a lower % of psilocybin per gram so you have to eat more to get the same effects but the end result is about the same!)
Most people growing shrooms are not doing it at scale and are generally only selling to friends or acquaintances. For this particular drug- the risk seems pretty low.
I think they mean "was there someone guiding your trip, or did you do it alone". I have never tried psychedelics, but I've heard its helpful to have people with you, because you can have a "bad trip" where your mind goes into awful places, and having a familiar face nearby can help get you out of that state or ameliorate your symptoms.
And like caffeine and alcohol, you can make practical use of psychedelic mushrooms in low doses with far less potential of unpredictable/problematic results. The dose makes the poison.
Same experience here. I did psychedelics maybe 10 times and then simply stopped having the desire. I don't have an aversion to it either. Just kind of got what I wanted out of it.
I think an important difference is that "legal" / manufactured drugs are patented, their formulation a trade secret, production fully in the hands of one party, etc. Weed and mushrooms can be grown by anyone; likewise, alcohol can be produced by anyone, but because of the risks in distilling it's illegal in most places to do so yourself.
My point is that the vilification of 'soft' drugs like mushrooms and weed is because the powers-that-be can't make a profit off of it. Or they could, but they would have to compete with home grown.
That doesn't stop the industry though; in the past few years in my country (Netherlands, famously tolerant but in a weird way to weed) you can get CBD oils and products off-the-shelf, alongside things like melatonin and whatnot. They've made it a consumer product and much more socially acceptable.
At the moment there's trials going on for the legal production of weed in greenhouses; up until then, all production was done illegaly in people's basements / attics, or via skirting the rules: legally you can have... I forgot, 1, 2 or 3 plants in your house (it used to be 7 but then the plants got bigger). There's "companies" now (they call themselves a foundation, charity or private club) that will offer to put a grow tent in your house if you have a spare room, just needs some electricity and water, they'll come and harvest it once it's done and you get a share of it and / or paid for it.
We've had thousands of years experience with psilocybin. We've already synthesized more potent psychedelics for 75ish years. I'd argue that the safety is well understood, but of course effective dosage in clinical trial are not. However, there's plenty of information from psychonauts out there on how to consume shrooms safely.
But neither of these chemicals are magic. A lot of people are looking for magic pills. A lot of companies want to sell you magic pills. Take a couple pills and your problems go away; that's just not achievable anytime soon. We have to get better as a Western society of supporting people on their various, multifaceted journeys through life.
I mean, we could be saying the same thing about psychedelics in 30 years time. "Wow, everyone knew psychedelics were bad for hundreds of years! What were medical professionals doing recommending them in the 2020s?"
I understand that we are not talking about the same specific mechanism (addiction), but I also want to keep my eyes open and not blindly stumble into the same broader category of problem all over again.
Except, we have known for centuries that psylocibe is benign. The Nahua people in Mexico's Central Valley people have been using them for ceremonial purposes for centuries with no addictive side effects ever reported; its use even being described in Spanish colonial codices [0]. They are only "new" to the Western culture. In contrast, we have known for centuries that opioids are extremely addictive. [1]
>but it took us over 30 years to really understand the implications of legalized opioids.
It took the EU all of ten seconds to reject opiates for minor use -- the opioid crisis is very much manufactured and endured in North America and is a regulatory failing of the FDA. The most crucial distinction here is the addictiveness of psilocybin vs opioids, mushrooms are not remotely addictive relative to opioids.
Up until the mid 2000s, psychedelic mushrooms in their natural state were completely legal in the UK. They were banned based on virtual no evidence of harm or widespread abuse despite being used recreationally for decades, just because the government decided that they didn't seem like the kind of thing that should be legal.
That's not quite right, sadly. They banned them because careless traders in places like Camden could buy them cheap from Holland and sell them with zero responsibility to anyone who wanted, including minors.
I know this because I was in part responsible for opening up the gates, with a company that sold them very responsibly, starting in Camden.
Opiods are only legal in some circumstances: We've known about opium addiction for centuries. Heck, we had the Opium Wars.
That's not really what happened with the current pills, though. They were touted as not being addictive in the same way as opium.
And then we prescribed them, didn't (and don't) offer realistic talks about how addiction starts with them, aren't giving people sick time so they are less likely to need them, putting folks in jail for using things like pot instead, and aren't giving folks affordable and medicine-based help if they do happen to get addicted. And then, if they do happen to get addicted, we treat them like a pill-seeking addict for many years, if not for life.
We know other things cause dependency - it isn't just opioids - but we are better at having conversations around them and better at making sure to taper folks (and so on).
> They were touted as not being addictive in the same way as opium
Oxycotin was never touted as "not being addictive".
Hell they had (and still have) a big "WARNING: OxyContin is an opioid agonist and a Schedule II controlled substance with an abuse liability similar to morphine." in their label.
It was a confluence of medical professionals being taught "pain is the 5th vital sign", "pain is routinely undertreated" and "controlled release opioids have a reduced abuse potential".
This was not necessarily bad because many of those things were true and the pendulum had swung back from "just tough it out", "Tylenol is enough for most people", "just one dose of opioids will make you an addict".
Then layer on top pill mill clinics popping up where doctors were dispensing scripts for 120 sixty milligram Oxycotin without so much as a physical examination, the DEA doing nothing despite having ample data in front of them that some doctors were dispensing milions of pills each year and the massive amounts of money doctors made writing the scripts by charging addicts cash.
Sure. But there are all sorts of negative side effects we should also be worrying about besides just dependence.
And we've also known about problems from psychedelic abuse for centuries. And we're talking about dumping them on the market with way less oversight than we did opioids!
It's like that truism about the military always fighting past wars...
I love psychedelics, but this list shouldn’t include psychotic breaks or detachment from reality. I say this from first (second?) hand experience of friends I’m close with.
Not that I disagree with the contents of your list, but the effects of psychedelics are not always positive.
At least "natural" psilocybin can't be compared with opiods at all, other that both are controlled substances. Psilocybin is not addictive, it's way to exhausting and also physiologically not possible.
However, there is still a lot of potential for harm. The biggest one is triggering latent psychosis and other psychological issues followed by possibly dangerous actions under the influence of high doses.
I also believe the "recreational" potential is low but it will probably be very interesting for many people to try at least once.
This is what was said about THC until it was legal and now we know there are physical withdrawal side effects in a decent percentage of people. So I don’t trust advocates pushing this narrative at all
> I also believe the "recreational" potential is low
Laughable. Most people doing magic mushrooms are doing so recreationally. That’s what it’s known for, that’s why there has to be entire talks given about the mental health benefits. Because it’s widely used exclusively as a recreational drug
speaking as someone who has done a fair amount of recreational drug use, including shrooms -
you can totally use shrooms too much, because you're bored on summer break so you eat a bunch to spice up your day. It's honestly not the smartest use of it, but 'overuse'/spending too much time tripping is totally a thing.
We do have some understanding of the safety profile of psilocybin, even if its Schedule I status makes it hard to research. At the very least, it doesn’t have physical dependency like opioids.
However, the lack of significant safety research does make it hard to determine the incidence of development of disorders like HPPD but, unlike opioids, I can’t imagine someone wanting to continue taking psilocybin after developing HPPD.
They said the same thing about weed - that you don’t have any physical dependency.
A quick search on Reddit would show you countless people who say they’re physically unable to function without weed anymore. Withdrawal symptoms include insomnia, depression, brain fog, lack of appetite, lack of energy, shaking, etc.
This is especially true of people who started using it when they were young and people who use high THC products.
I think if you've known anyone who was an alcoholic, a tobacco smoker, or even someone who had to taper off prescription benzos or SSRIs you'd know that cannabis withdrawal symptoms are relatively benign. Caffeine withdrawal is significantly worse.
Those are MENTAL withdrawal symptoms, not PHYSICAL ones. Basically the worst the happens is "Man, I really wish I had some weed right now", not hallucinations or the shakes or seizures, as can occur with alcohol or opiods. That's what people mean by physical dependency.
Also, I'd argue that brain fog, low energy, insomnia, lack of appetite, night sweats, shaking are all physical symptoms, chest pains, heart palpitations.
> Those are MENTAL withdrawal symptoms, not PHYSICAL ones.
That is an interesting line to draw. Are "MENTAL withdrawal symptoms" not neurological in nature? Are "hallucinations or the shakes or seizures" not based in neurology?
The DTs from alcohol withdrawal can outright kill you. That’s the line I draw. Similar for other meds that have very unpleasant effects if you don’t taper off over weeks or even months.
Aside from the other comments, opioids are much more addictive than psilocybin. All drugs have risks, but the risk of death or serious issues (whether psychosis or addiction) are a fraction of what they are with opioids.
So respect to all of the early adopters who have nothing to lose and are willing to put their own sanity at risk. I just don't understand people who in one breath curse the Sackler family but then line up to try the first batch of industrialized psilocybin from Rose City Laboratories.