The USA has a rather distorted health care and medicine system, in that it's viewed here as a profit center, not as a basic societal necessity. In contrast, police and judicial services are not really viewed as an investment opportunity (let's skip private prisons), just a basic necessity.
Where this comes out in the 'psychedelic treatment' movement is that it's not going to be very profitable, and in fact - if it works as advertised - will mean a lot of people will end up spending much less on anti-depressants on one hand, and alcohol and opiates and cannabis on the other.
This is because psychedelics - administered not as daily microdosing, but rather as infrequent full-dose experiences, ideally under somewhat controlled conditions - show promise in providing treatments for depression and addiction that don't require further daily interventions. The effects of a single dose can last for weeks to months.
From the business end of the health care system, this is a fiscal disaster. Someone spending $50 a day on alcohol, or cannabis, or opiates, or antidepressants and therapy, now spends $50 every few months on a bag of psychedelic mushrooms, with a more postive long-term outcome r.e. depression and addiction.
One conclusion is that a society that views health care as a profit opportunity, rather than a basic necessity, has some serious value problems that end up encouraging unhealthy behavior, i.e. pushing junk food in schools, encouraging obesity and depression and addiction, which then generate further profits for hospitals and pharmaceutical producers.
I always feel like people who make this sort of argument around health care in the US (that the health industry doesn’t want cheap cures because it will reduce their profit from expensive treatments) are forgetting one of the major players in this… the insurance companies.
Health insurance companies love cheap cures, because that means lower costs and more profit for them. They have every incentive to promote cheap cures, and are a huge industry that spends a ton of money on lobbying.
Health insurance companies love collecting insurance money and not paying out. Denying coverage, not covering procedures, not covering full treatments, not covering the full staff needed for a procedure, covering suboptimal but cheap treatments are some of the other tools in their toolset.
Let’s not pretend that installing one more extraction point accountable only to shareholders between patients and their care is somehow driving progress.
I'm all for these suggestions, but they don't address any of the problems listed in the post I was replying to:
"Health insurance companies love collecting insurance money and not paying out. Denying coverage, not covering procedures, not covering full treatments, not covering the full staff needed for a procedure, covering suboptimal but cheap treatments are some of the other tools in their toolset."
Exactly the same problems can and do occur with single-payer, medicaid, etc...
I have enough friend in the UK, Netherlands, and Germany to be grateful for the ability to pay for private insurance and get actual, timely, if expensive, access to doctors and treatment.
But if the coverage runs out while between jobs, it indeed sucks.
I'm saying that, even if somehow all "illness" were cheap and easy to cure[1], we'd still need health insurance for injury, especially sudden and catastrophic injury, such as car accidents.
[1] And defining "illness" as distinct from "injury" isn't all that easy.
The search for quick cures (both by insurance companies and time/money-limited patients) is one of the major reasons that relatively short-acting psychedelics like MDMA, psilocybin and ketamine are popular.
The even faster acting psychedelics like DMT (NN-DMT) and 5-MeO-DMT are also likely to become popular for the same reason.
Their use may eventually eclipse more traditional and slower acting psychedelics, because what could be more convenient than tripping for 15 minutes, being "cured" of your depression, and then going on with the rest of your day?
That is first-order thinking. After all, if healthcare was cheap no-one would be incentivised to pay a lot of premium for health insurance. It's in the health insurance companies interest for people to be frightened of high costs of healthcare that they pay and then to only pay out less than they receive in premium.
To build on your second-order point, under Obamacare, health insurers get to keep a certain percentage of premiums based on what treatments costs but would have to refund the rest. So, it is in the financial interest of insurance companies for medical interventions to be expensive and recurring.
I found this surprising, because, like the poster you are replying to, it does make sense at a first-order level that insurance companies would make more profits if they paid out less for a specific individual's health issue. But the second order effect of skimming a percentage of total costs probably dominates here.
And of course, for-profit medical care systems and individual doctors also generally have no financial incentive to contain costs.
Having cures for chronic, expensive to care for diseases won’t reduce the demand for health insurance, because people can still get injured or get one of the other countless ways to need healthcare.
> The USA has a rather distorted health care and medicine system, in that it's viewed here as a profit center, not as a basic societal necessity. In contrast, police and judicial services are not really viewed as an investment opportunity (let's skip private prisons), just a basic necessity.
The profit center vs societal necessity way of looking at these things is super interesting and definitely new to me (at least in such a concise form). In this framing, I'm not sure I want healthcare to move, since everything I can think of on the societal necessity side of the spectrum is slow moving and underfunded. Police departments tend to be underfunded and slow to adopt new technology (though maybe that's a feature), while hospital facilities and medical treatments seem to advance quickly to adapt to new discoveries/tech despite insane FDA regulations as a barrier.
If we flipped a switch and made law enforcement a profit center, what would that look like? I'll go first, but I sincerely want to hear your take, as I'm sure I'm missing something. I assume they still have to enforce local/state/federal laws, but they will somehow be subject to the same tug of war over tech/efficiency advances and regulations around safety/civil rights. I hope we pay them directly/willingly, rather than them simply making bank on speeding/redlight cameras or parking tickets. Maybe we have to pay some kind of crime insurance, where rates (i.e. risk) changes depending on crime stats in the area defined by the insurance companies, which could incentivize the police to meaningfully reduce crime. Insurance would pay out when crimes are solved, and any attempts to fudge the numbers by the police would be insurance fraud. Sounds wild.
Also related on problems with the current model, a 2015 book:
"Deadly Psychiatry and Organised Denial"
https://www.amazon.com/Deadly-Psychiatry-Organised-Denial-Go...
"Deadly Psychiatry and Organized Denial explains in evidence-based detail why the way we currently use psychiatric drugs does far more harm than good. Professor, Doctor of Medical Science, Peter C. Gøtzsche documents that psychiatric drugs kill more than half a million people every year among those aged 65 and above in the United States and Europe. This makes psychiatric drugs the third leading cause of death, after heart disease and cancer. Gøtzsche explains that we could reduce our current usage of psychotropic drugs by 98% and at the same time improve patients' mental and physical health and survival. It can be difficult, however, to come off the drugs, as many people become dependent on them. As the withdrawal symptoms can be severe, long-lasting and even dangerous, slow tapering is usually necessary. In his book, Gøtzsche debunks the many myths that leading psychiatrists - very often on drug industry payroll - have created and nurtured over decades in order to conceal the fact that biological psychiatry has generally been a failure. Biological psychiatry sees drugs as the "solution" for virtually all problems, in marked contrast to the patients' views. Most patients don't respond to the drugs they receive but, unfortunately, the psychiatrists' frustrations over the lack of progress often lead to more diagnoses, more drugs and higher doses, harming the patients further."
And from 2013 by the same author:
"Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare" by Peter Gotzsche
https://www.amazon.com/Deadly-Medicines-Organised-Crime-Heal...
"Prescription drugs are the third leasing cause of death after heart disease and cancer. In his latest ground-breaking book, Peter C Gotzsche exposes the pharmaceutical industries and their charade of fraudulent behaviour, both in research and marketing where the morally repugnant disregard for human lives is the norm. He convincingly draws close comparisons with the tobacco conglomerates, revealing the extraordinary truth behind efforts to confuse and distract the public and their politicians. The book addresses, in evidence-based detail, an extraordinary system failure caused by widespread crime, corruption, bribery and impotent drug regulation in need of radical reforms. "The main reason we take so many drugs is that drug companies don't sell drugs, they sell lies about drugs. This is what makes drugs so different from anything else in life...Virtually everything we know about drugs is what the companies have chosen to tell us and our doctors...the reason patients trust their medicine is that they extrapolate the trust they have in their doctors into the medicines they prescribe. The patients don't realise that, although their doctors may know a lot about diseases and human physiology and psychology, they know very, very little about drugs that hasn't been carefully concocted and dressed up by the drug industry...If you don't think the system is out of control, please email me and explain why drugs are the third leading cause of death...If such a hugely lethal epidemic had been caused by a new bacterium or a virus, or even one-hundredth of it, we would have done everything we could to get it under control.""
A 2009 book with some hopes for reform:
"Why Our Health Matters: A Vision of Medicine That Can Transform Our Future Hardcover" by M.D. Andrew Weil (Author)
https://www.amazon.com/Why-Our-Health-Matters-Transform/dp/1...
"The second myth is that having the most elaborate and expensive medical technology in the world must translate into medical excellence. The reality is that medical technology has helped us in certain areas like the management of trauma and critical conditions. It has, however, served us very poorly in terms of creating cost-effective health care. In fact, one of the main reasons American health care is so expensive is that our interventions are based in expensive technology--including pharmaceutical drugs. There are many low-tech methods of intervening in disease that our doctors simply don't learn. Also, our entire health-care system is geared toward intervention in established disease, yet the vast majority of that disease is lifestyle related and therefore preventable. ... I think our efforts at prevention are feeble because we work from a model of prevention that is not very robust. The cornerstone of prevention should be lifestyle medicine. That means teaching people how to make better choices about how they eat, how they exercise, how they rest, how they neutralize stress. This is primarily something that needs to be done in terms of education, but the whole society has to pull in the same direction. The government and corporations both have to work to make the right lifestyle choices affordable and easy. You can't have the federal government telling people to eat more fruits and vegetables while at the same time making unhealthy foods cheap and healthy foods expensive through its patterns of crop subsidies. Also, a lot of our preventive efforts are very limited in that they have a lopsided preference for pharmaceutical drugs, like statins to prevent heart attacks or bone-building drugs to prevent osteoporosis. This is not the most cost-effective way to prevent disease. We need to think about prevention in new and better ways."
An earlier book from 1982 on this sort of issue, including the disempowering psychology of our current medical system:
"Medical Nemesis: The Expropriation of Health Paperback" by Ivan Illich
https://www.amazon.com/Medical-Nemesis-Expropriation-Ivan-Il...
""The medical establishment has become a major threat to health." with this opening assertion, Ivan Illich - one of the most brilliant social critics of our time - launches a devastating analysis into "iatrogenesis" (doctor-made illness), examining what medicine really does, as opposed to the myth that has been built around it. "Medical Nemesis" poses some basic questions not only about the medical profession but about the direction of modern society and its dependence upon a maintenance system that is categorically robbing us of power, money, dignity - even life itself."
From 1927: https://web.archive.org/web/20070222213243/https://soilandhe...
"At this time in 1927, Dr. Shelton is already being harassed in his Hygienic practice by advocates of The Medical Mentality and by the police. In 1927, Dr. Shelton is jailed for the first time for "practicing medicine without a license" and is fined $100.00. This same year of 1927, a second arrest takes place, under similar circumstances and with charges of $300.00. His money is so tight this second time, he has to borrow to be released. Also, in 1927, the New York Evening Graphic lets Dr. Shelton go because he will not co-operate with their advertisement policies and insists on running an anti-smoking article. Still, during this time, Dr. Shelton's Hygienic practice grows; he is respected and admired for his efforts. The third arrest also occurs, all in New York, for "practicing medicine without a licence." The great irony is that Dr. Shelton would never "practice medicine"! Still, that is what the authorities call it when someone tells people how to live, how to sleep, how to eat, and how not to take medicines!"
Given all that context, it is hard to imagine psychedelics being that much worse than current treatments for mental conditions -- even if some might be mostly placebos.
The fact is, most mental ill health (not all, but most) can be inexpensively addressed by recognizing and then acting on this key fact:
https://tlc.ku.edu/
"We were never designed for the sedentary, indoor, sleep-deprived, socially-isolated, fast-food-laden, frenetic pace of modern life. (Stephen Ilardi, PhD)"
A related book by Ilardi:
"The Depression Cure: The 6-Step Program to Beat Depression without Drugs" by Stephen S. Ilardi
https://www.amazon.com/gp/product/B0097DHV94/
"In the past decade, depression rates have skyrocketed, and one in four Americans suffer from major depression at some point in their lives. Where have we gone wrong? Dr. Stephen Ilardi sheds light on our current predicament and reminds us that our bodies were never designed for the sleep-deprived, poorly nourished, frenzied pace of twenty-first century life. Inspired by the extraordinary resilience of aboriginal groups like the Kaluli of Papua New Guinea, Dr. Ilardi prescribes an easy-to-follow, clinically proven program that harks back to what our bodies were originally made for and what they continue to need with these six components:
Brain Food;
Don't Think, Do;
Antidepressant Exercise;
Let There Be Light;
Get Connected;
Habits of Healthy Sleep.
The Depression Cure's holistic approach has been met with great success rates, helping even those who have failed to respond to traditional medications. For anyone looking to supplement their treatment, The Depression Cure offers hope and a practical path to wellness for anyone."
Now, I know this all may sound like complete craziness to anyone who has bought 100% into the mainstream medical model -- but Virta Health is an example of one company growing quickly by using various non-drug interventions via telemedicine to get people off of diabetes medications:
https://www.virtahealth.com/
"Our approach helps people lower blood sugar and lose weight, even while eliminating the need for medications, including insulin."
This is potentially a huge growth area in the future for a great use of Y-Combinator-esque internet-based high-technology to support low-tech health interventions -- to help many people recover from chronic illnesses including diabetes, heart disease, and mental illness. Maybe not all -- but a lot. Essentially, the current Western Medical model is ripe for profitable-to-internet-based-company "disruption" or Peter Drucker's "Creative Destruction". Trillions of dollars that are being spent right now every year on "health" care (really "sick" care) in the USA are increasing in-play as they get redirected to new possibilities -- like Virta Health shows. Maybe psychedelics will play a part in this shift too (or maybe not). But change is possible -- and it seems to be gathering momentum.
I'm worried that we're going to split into a two-tiered system where people with money can go to clinics for recreational or therapeutic treatments, and people who don't want to spend that money can go to jail.
That's already the situation for ketamine clinics.
>Dr. Robert Freymann, whose discreet East 78th Street clinic was conveniently located for Jackie Kennedy and other wealthy Upper East Siders from Fifth Avenue and Park to stroll over for their vitamin B-12 shots, which also happened to contain a massive dose of amphetamine.
Unfortunate hype cycle. Ironic indeed given that opening the doors of perception is supposed to give one a cosmic perspective, a gaia hypothesis model of the world. And this is in every way self-serving. Best thing is just to show the trip live, like an ayahuasca diary reality show demonstrating marked behavioral progress over 6-9 months or so ;)
“We are all wired into a survival trip now. No more of the speed that fueled the 60's. That was the fatal flaw in Tim Leary's trip. He crashed around America selling "consciousness expansion" without ever giving a thought to the grim meat-hook realities that were lying in wait for all the people who took him seriously... All those pathetically eager acid freaks who thought they could buy Peace and Understanding for three bucks a hit. But their loss and failure is ours too. What Leary took down with him was the central illusion of a whole life-style that he helped create... a generation of permanent cripples, failed seekers, who never understood the essential old-mystic fallacy of the Acid Culture: the desperate assumption that somebody... or at least some force - is tending the light at the end of the tunnel.”
- Hunter S. Thompson, Fear and Loathing in Las Vegas
I know a lot more people whose lives have been deeply enriched by acid, than those who've ended up on the ends of those proverbial meat hooks.
That being said, casualties are real and can happen, it's great work that Psymposia is doing shining a light on the uncomfortable dark corners of psychedelic enthusiasm. Especially when it comes to corporate interests and influence in the space.
I hope that this time around, we can keep psychedelics in their right place as valuable tools for humanity. Not elevated to culty worship, nor demonized.
What most people fail to realize is that nature isn't humanoid in any capacity. I've lived long enough and seen enough synchronicities to know that reality is far more entangled than a cause and effect standpoint would have you believe. But nature being quite tightly coupled instead of locally isolated, doesn't mean nature has a humanoid intent. It just means that everything is connected. If the universe is a spider web, it doesn't do us any favors to assume we are being taken care of by some benevolent spider.
This video is the world we live in. It's difficult to watch a komodo dragon eat a pregnant deer. But I challenge you to watch this, because this is what reality actually is:
https://youtu.be/oHJuzE0k1V8
Reality is intimately connected through time and space. Reality is beautiful, dark, ruthless, dreary but it is not kind.
> I've lived long enough and seen enough synchronicities to know that reality is far more entangled than a cause and effect standpoint would have you believe.
I've no idea what you mean by that.
> This video is the world we live in.
Reality includes komodo dragons, just as it does kindness. You say nature isn't "humanoid" and then ascribe to it qualities like ruthlessness. You're just as biased and delusional as whoever you're criticizing.
> You say nature isn't "humanoid" and then ascribe to it qualities like ruthlessness.
Definition of kind: "having or showing a friendly, generous, and considerate nature."
One can argue that non-humanoid processes or things are kind without violating basic precepts. For instance, a crane machine at an arcade might be viewed as kind or forgiving if its claws don't drop items so easily. Or the machine might be viewed as ruthless if its claws drop items all the time.
> You're just as biased and delusional as whoever you're criticizing.
Fucking rude, dude. My post wasn't criticism - it was an explanation..
Coincidentally someone mentioned this video to me the other day (this clip is eight seconds, but maybe you don't want to watch it):
"Tiger attacks mahout on elephant!"
https://www.youtube.com/watch?v=1n-3cFIuQBc
Spoiler: the mahout is OK although he had to go to the hospital. But what surprises me is that you literally can not see the tiger in a big grassy field until a couple of seconds before it leaps onto the guy on the elephant (although one commenter says he could spot it by the grass waving differently where the tiger is). So if you can actually see the tiger, you may be safer in that sense.
I was also very surprised that a tiger would attack someone on an elephant. I expected to see something more like this with the elephant deterring the tiger -- but that is in a different location without tall grass so the tiger can't get close enough to quickly ambush (given cats are mainly sprinters):
https://www.youtube.com/watch?v=fd-SROLWvAw
Or in the USA (where cougars and bobcats drop out of trees):
"Father fends off mountain lion that attacked his three-year-old son in California"
https://www.reuters.com/article/us-california-cougar-attack-...
"Foy said that mountain lion attacks on humans were “extraordinarily rare,” noting that just 16 cougar attacks on people had been documented in California in the past 100 years."
So, that is some proof that your fears of large cats are definitely justified -- at least in certain contexts. It is prudent fears like that which have kept people alive for many thousands of years.
Black bears on the other hand, at least in the lower 48 states of US America, tend to be fairly shy and will almost always run away from you -- unless you are between them and a door to escape or between a mother and her cubs. This is because the black bears that did not were all killed long ago and probably eaten by humans. That is not so true up in Canada though, where bears -- especially grizzlies -- have not had that same level of selective pressure recently. Those you should be (prudently) scared of too.
Related:
https://bear.org/why-are-black-bears-so-timid/
"For hundreds of thousands of years—until about 10,000 years ago—North America was home to saber-toothed cats, American lions, dire wolves, and giant short-faced bears. Black bears didn’t stand a chance against any of these predators in a fight, but the black bear was the only one of them able to climb trees. Black bears stayed near trees and lived by the rule “Run first, ask questions later.” They develop a mind more like that of a prey animal than a predator. Today, the black bear’s timid attitude aids survival in the face of grizzly bears, timber wolves, and people."
Coyotes can be scary too:
https://en.wikipedia.org/wiki/Coyote_attack
"Coyote attacks on humans are uncommon and rarely cause serious injuries, but have been increasing in frequency, especially in the state of California. In the 30 years leading up to March 2006, at least 160 attacks occurred in the United States, mostly in the Los Angeles County area. Data from the USDA's Wildlife Services, the California Department of Fish and Wildlife, and other sources show that while 41 attacks occurred during the period of 1988–1997, 48 attacks were verified from 1998 through 2003. The majority of these incidents occurred in Southern California near the suburban-wildland interface."
Anyway, this is all is not completely idle curiosity for me as I live in a nature park with bears and bobcats and coyotes and such -- and was concerned especially about bobcats and coyotes when my kid was young.
Realistically though, dog attacks in the USA are way more common these days:
https://en.wikipedia.org/wiki/List_of_fatal_dog_attacks_in_t...
"Fatal dog attacks in the United States cause the deaths of about 30 to 50 people in the US each year, and the number of deaths from dog attacks appears to be increasing. Around 4.5 million Americans are bitten by dogs every year, resulting in the hospitalization of 6,000 to 13,000 people each year in the United States (2005)."
If you ever have been attacked by something, one possible way to deal afterwards with the trauma -- not involving psychedelics -- is Se-REM, an audio version of EMDR:
"A Self-Help Version of EMDR Could Make Healing from Trauma Easier"
https://www.madinamerica.com/2021/07/self-help-emdr/https://se-rem.com/
I wish he could've elaborated about this piece of writing. Does he mean all the people who took acid in the 60s are all burnouts? If one out of every ten people who dropped acid had an enriching experience and the rest got severe mental illness does that mean the acid movement failed?
As for the 'old-mystic fallacy' of acid, there are people who actually got enlightened from the stuff without having to spend ten years meditating in a monastery. As McKenna said: 'but the ferry costs a nickel'
Pfft. There is significant evident of CBD's efficacy as a powerful anti-convulsant, the fact that it does not get you high makes it an attractive option for the treatment of childhood epilepsy.
Perhaps it's a little premature to be so dismissive of those who are afraid of getting high.
Now that said, I have personally found that the long term impact of one very large dose (12 grams dried) of mushrooms far exceeds that of several single doses; I've gone from having several suicidal thoughts a day, down to being a regularly depressed dude - a hell of an improvement.
But I'm not going to dismiss the possibility that in less extreme circumstances, microdosing could be preferable to a night hanging out with spider demons at the end of time.
I see it as at least partly an overcorrection of the past. I still can’t search something as benign as Kava without websites swearing to me it’s more dangerous than hard drugs and telling me I should to pay for their addiction treatment for a non addictive substance.
Not directly related to the article. But I'm just glad we as a society have come back around to psychedelic's.
It was clear in the 1960's that these drugs have massive potential to help treat mental illness, but we all know what Nixon did. I was watching a documentary about it the other day and it just made me sad, imagine where we would be today with mental health treatment had Nixon not made these drugs illegal.
It seems that we as a society are starting to overcome the sins of the past. The problems mentioned in this article are real problems, but I almost look at it as a "good problem". If we're at the point with Psychedelics where our biggest issue is how the capitalists market it, I think we're doing alright.
I knew a guy who fell in with some folks selling drugs & self-improvement scams back in the 90's in the Bay Area.
You get some charismatic drug dealers, throw in whatever pseudo-profound quasi-religious beliefs are popular at the moment, and include a few techniques that have some kind of effect (like hyperventilation) and presto! You can charge people $$$ for your "classes" and then sell them MDMA at your house party later on.
My friend spun out of control, started abusing nitrous oxide, lost his job, his girlfriend (who was in the same group of druggies), and his mind. He wound up wandering the streets of Berkeley wrapped in a blanket for a few years. His "spiritual" druggie friends abandoned him.
So one the one hand, it is good that we are not criminalizing drugs themselves, but on the other, it really is a big challenge to integrate these powerful chemicals into our lives, our communities, and our ways of healing each other.
Yeah, I've started buying some drugs and had to deal with actual "junkies"... and it's been rather eye opening. I can see why they just blanket ban stuff.
It seems many, if not most, people, just can't control themselves. Ironic, since I've got major self-control issues myself. But seeing someone use stimulants for relaxation, take a week's worth of it in 3 hours, then beg for more, that's insane.
And a few kept trying to give me advice on how to "properly" use them. It couldn't fit in their heads that I am not in it for the high (which is shit imo). I guess it affects "normal" people differently.
It is hard for those who can benefit from all the great medicine out there. I wish I could get a licence to use anything at my own responsibility, I don't use official healthcare anyway (I'm glad I can get treated if I break an arm or get into a car accident, but beyond that... useless). Why am I risking prison time for trying to fix myself and make my life better?
They can just as easily cause mental illness. Marijuana can cause psychosis [1] but the cannabis lobby pretty much won and there's nothing on the packaging indicating this risk. Cannabis is involved in approximately 50% of psychosis, schizophrenia, and schizophreniform psychosis cases. Thats significant, wouldn't you say?
In the same vein, DMT raped my brain and I felt like a fucking husk for two years after breaking through.
These things are oversold. We should legalize them, but lets not kid ourselves about how potent and powerful these substances are.
> Cannabis is involved in approximately 50% of psychosis, schizophrenia, and schizophreniform psychosis cases. Thats significant, wouldn't you say?
Absolutely not. Alcohol is involved in 60% of the snake bites in the US. It’s easy to see the causal link. But that isn’t a reason to avoid alcohol or that alcohol puts you at a significant risk of being bitten by a snake. And that’s because alcohol consumption is common and snake bites are rare. Similarly, cannabis consumption is common and the conditions you list are rare. Even if there is a causal link there, and that’s a big if, that’s not a reason to avoid cannabis. There’s no reason to assume or even worry about being in the sub-1% group.
It's not rare at all. Every practicing psychiatrist I've talked to that works part-time at mental hospitals, have told me they see cannabis related temporary psychosis on the regular. The studies show it to be common. Anecdotes show it to be common. And yet, it's not common - what gives?
Studies absolutely don't show it to be common. Here's a meta analysis [0] of many that, as I mentioned, shows it below 1% of the population. That's rare. Don't confuse it being easy to find with it being common. Whenever you have a large number of people, you're going to reliably find rare traits and conditions.
The majority of cannabis legalization has occurred in the last few years.
The paper you linked uses decades old data and provides statistics on overall incidence of schizophrenia with varying durations of prevalence.
Bayes rule applies here - not everyone will go buy cannabis and use it daily. Unless a study is accounting for these factors, it's useless in making a determination on the connection between psychosis and cannabis.
Your own point applies, frequency must be adjusted for, by an understanding of priors.
“ Cannabis is involved in approximately 50% of psychosis, schizophrenia, and schizophreniform psychosis cases. Thats significant, wouldn't you say?”
Maybe, maybe not. Nicotine was (is?) a very common self-medication for schizophrenia. So much so that it became a trope in movies, etc (e.g. “Clean, Shaven”). If a majority of people with schizophrenia smoked cigarettes, would we argue that nicotine is implicated in the development of that condition?
My instinct is certainly that you’re right, but the direction of causality could simply be backwards too.
Thank you for highlighting the issue of correlation vs causality vs backwards causality.
Nicotine is an antipsychotic, so psychosis generally leads to nicotine use as it's much more user-friendly than prescription antipsychotics.
About the movie tropes, nicotine is an acetylcholinergic agent similar to caffeine. These agents act as nootropic stimulants hence the movie tropes. Both natural and synthetic insecticides have been known to poison people due to their potent acetylcholinergic activity. [1]
THC is a different beast. It's well accepted that THC is psychedelic enough to bring out latent schizophrenia. What most folks don't know about is the temporary psychosis it can cause.
Cannabis is... overrated. It is rather similar to alcohol in that it helps a bit, but with prolonged use or regular abuse the downsides quickly overtake the benefits.
It was a bit useful for me for a while, but there are better alternatives out there. And choosing a good strain is nigh impossible these days unless you grow it yourself - the high THC low CBD stuff preferred by sellers even in regions where it's legal is only good for fun/recreational use, not helping with depression, anxiety or pain.
For a marijuana risk I’ve not seen mentioned often:
I fainted in my hallway while going to bed thanks to orthostatic hypotension which is made significantly stronger when I smoke.
I still don’t consider it worse than alcohol though. It’s well known to be neurotoxic, hepatoxic, and addictive. And if you do get addicted, the withdrawals are worse than many hard drugs. The positive effects are generally pretty nice, but almost invalidated by the next morning.
Alcohol (note comment about horrific withdrawals), marijuana may or may not be toxic to different organs but the threshold for serious damage is a higher.
I have a family member that’s still strongly against any form of legalization because he swears up and down “marijuana destroyed his family”, yet has no qualms sipping on beer and bourbon despite multiple people in our family having been killed or ruined by it
Let's adjust the statement a bit.
It's overrated. Still phenomenal compared to alcohol -- which is one of the weakest drugs per unit mass or volume. Literally only 2% of blood ethanol gets to the brain, so most of what folks drink is actually performing organ damage, not CNS effects.
Like you said, Cannabis is a wildly diverse plant. Cannabinoids like CBG, CBC, and CBDV are extraordinary anti-inflammatory and anti-neoplastic agents.
100% agree with you and the literature does too. Daily use of high THC / low CBD cannabis is the main driver of the temporary psychosis we are seeing across cities that have legalized marijuana.
Studies show that CBD is actually antipsychotic whereas THC is the opposite, so we have essentially bred the plant into a tripping device versus what it used to be, a more cerebral relaxing experience.
> Let's adjust the statement a bit. It's overrated. Still phenomenal compared to alcohol -- which is one of the weakest drugs per unit mass or volume. Literally only 2% of blood ethanol gets to the brain, so most of what folks drink is actually performing organ damage, not CNS effects.
Most people don’t consume alcohol because of its efficiency. If they did, they’d be doing everclear shots or boofing it. They wouldn’t be mixing cocktails, aging whisky for decades, or pairing wines with food.
Weed as a drug isn’t “phenomenal” compared to alcohol, unless you ignore most of the reasons people drink.
Go buy a legal spore syringe and you can grow more mushrooms than you could eat in a decade for $100 with the uncle Ben tek or the poor boy tek or whatever.
You don't need to pay big pharma 1000x price by weight for the same stuff
It takes equipment, time, effort, and knowledge -- things most people don't have and don't want.
This is the same reason most cannabis users don't grow their own supply, though it's supposedly "easy". Also the same reason most people go to grocery stores instead of growing their own food, and go to liquor stores instead of brewing their own beer.
Most people want to offload the growing to others, and prefer the ease and convenience of buying premade and prepackaged goods. The huge variety of preparations and (in an ideal world) quality of commercial products is unlikely to be equaled by amateurs who dabble in growing on the weekend either. Also, advertising and packaging is going to draw people to commercial products.
They might not technically "need" these, and maybe with enough time and effort the average person might be able to grow their own, but most certainly don't want that. They want a quick and convenient, commercially made and packaged product.
A pan with a lid, some rice and some Mason jars, a plastic tote and one bag of substrate. Really not all that much. The fact that it can all be bought for 50-100 bucks says it all.
And these simple teks require watching a few you tube video and maybe some trial and error.
We are talking about minimal commitment in terms of time and money.
I get why we need big pharma but mushrooms grow out of the ground ready to consume. We need big pharma for psychsdrlids as much as We need big pharma to grow bananas and zucchini
Most people won't even buy a pot of basil to grow on their window sill that requires nothing but watering every now and then. They'd rather buy their basil from the grocery store. Same with pretty much all the other "simple to grow" plants.
No way are most people going to invest all that money and watch hours of videos and then spend a lot of time, trial and error, probably more time to engage with the community to find out if they're doing it right or if the growth they're seeing is normal or contaminated, etc... it's just way too much trouble for most people.
Sure, some enthusiasts will do it anyway (just like some people like to brew their own beer) but they will always be in the minority.
One thing I could see happening is non-profit coops developing, with some interested people growing and then distributing their crop to non-growers for free or minimal cost... at least if the regulations that spring up around this allow them to do that. Even then, though, they will be in the minority.. just like food coops that do this sort of thing are in the minority now, even without all the regulation that will doubtlessly surround psychedelics.
> What problem, are these companies solving again?
If I had to guess visibility. I may be wrong but at the very least it seems research is being done intro drugs that haven’t had the most or best research done. I one time gave my self a serotonin syndrome scare and was concerned by the lack of quality research and information on the serotonergic affects of many drugs.
Selling ads to teen girls isn't my problem but if you're a skin care company than maybe it is your problem and you need the help.
Mushrooms are already widely available and easy to grow. There is literally nothing for pharma to do here besides provide the same service in a way that makes it OK for rich people to do something which we don't want poor people to do.
No need to pay the premium, just go buy the readily available mushrooms.
We’re at the point in the cycle where dollars donated to Psymposia will get better ROI than dollars to MAPS. Psychedelics aren’t going away at this point. Powerful tools must be handled with care, lest they cause more harm than good.
At this point it seems like Psymposia’s MO is that MAPS is the scandal, and is generating bad science. Not sure I 100% agree but I think it’s a point worth considering.
I’m wondering if increased visibility into DXM is going to get it RX only’d. I read somewhere that the only reason it is OTC is because the best alternative was Codeine, not sure if it’s true.
Even the most cursory examination of the topic would reveal to you that psychedelic drugs are (allegedly) beneficial when taken in a controlled manner, in safe environments - not exactly in line with the homelessness experience.
Your statement is even less accurate, somehow, than saying "well if chemotherapy really works then why don't we just hand out random chemotherapy drugs to homeless people."
I won't bother quoting any studies, because they wildly contradict one another, but the conventional wisdom is that some drugs can be beneficial in some circumstances. And often the benefit is harm reduction, ie managing pain with cannabis rather than opioids.
Nobody¹ is claiming that "drugs and microdosing" are a "holy grail that heals anything."
HN decorum says we're supposed to assume best intentions on everyone's part. So I'll assume there is an honest misunderstanding on your part.
No reputable person seriously claims that any drug is a miracle cure-all. The most diehard advocates of microdosing is generally beneficial for many/most people. But that is quite a far sight from proclaiming it is a magic cure for anything, let alone everything.
Hopefully now you understand the matter actually being discussed. It's also possible you're trolling and didn't misunderstand things in the first place but I've decided to give you the benefit of the doubt.
For the record I am skeptical re: microdosing. I have no direct experience and no plans to give it a go. It's certainly intriguing though.
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¹ I mean, it's the internet and you can find somebody claiming literally anything. You can probably find a chicken soup recipe that involves Tide Pods.
This is nothing more than a "Rules for thee and not for me" attitude towards the poor. Homeless and doing drugs? OK, you are an addict, you have to get help, you have to get cleaned up, you're ruining your life, etc. Nothing more than a parasite on society.
Wealthy and able to have a "doctor" prescribe you drugs? OK it's fine. You aren't one of those dirty "addicts" because a guy with two letters in front of his name says it OK.
Feels like you are intentionally misreading the comment you’re responding to. Plenty of wealthy people have self-doses drugs and destroyed their lives, their bodies. You really don’t see how medically supervised drug use could be beneficial while the self-dosed, unsupervised drug use could be explicitly destructive?
That is quite the (intentional?) misreading of my comment.
The good news is that I certainly don't believe any of the homeless-bashing things that you said.
I was replying to a poster who claimed that drugs are a sham because -- in their opinion -- if drugs weren't a sham, we could simply give a bunch of drugs to homeless people.
I found their argument absurd for a number of reasons and I told them so. But I certainly don't believe any of the things that you are accusing me of, so at least you and I are in agreement on some things.
The US government literally calls it the "War on Drugs". Given that it is notoriously difficult to maim, jail, or prosecute a chemical we can be assured it is actually a war on people. Having been through the system once myself, I can assure you that it is incredibly oppressive to poor people who cannot afford legal representation.
I'm all for someone deciding they need drugs to function. It doesn't matter to me how you live your life. If you do it with a doctor, fine. If you want to figure it out on your own because you don't have access to medical care, that does not make that person a criminal.
There are plenty of people self medicating with nicotine & alcohol every day, no one says it is necessary to lock them up. The only difference I see is it is a handy source of tax revenue and somehow "socially acceptable".
The person you're arguing with was simply saying "throwing psychedelics at the car window at homeless people won't make them better". They didn't say "lock up the homeless for using mushrooms", he didn't say "homeless people don't deserve treatment".
They were calling out the simplistic nature of the OP comment, and asserting that proper use of psychedelics for medical treatment involves a safe, controlled environment.
Nothing they said or were asserting had to do with US drug policy.
Thank you for further explaining your point of view.
I think also that the US's healthcare is partially to blame - if you had universal healthcare, then poor people would also (in theory) have equal access to drug prescriptions.
I do think that, generally speaking, many drugs are best done under medical supervision. I have a friend of my brothers who died of a heroin overdose, her first time trying the drug. I tell myself that if we lived in a world where foolish college kids have to go to a pharmacy and get their hits administered by a registered pharmacist, maybe she'd still be alive.
I also generally agree that the War on Drugs is bullshit. It didn't work for alcohol during prohibition, and it's not working now. The smart move is legalize, tax and regulate.
I'm the guy you're railing against, and if it helps, I agree with everything you just said.
Also, I'm sorry that you've been through the system. The system sucks in so many ways. But it sounds like it's (at least somewhat) in your past, and I'm happy for that. I hope you are in a good place now, or at least a better place.
The issue with psychedelics has nothing to do with addiction. Google "psychedelics set and setting" and "psychedelics psychosis risk factors" for a start.
Maybe the government should finance and distribute drugs to homeless people. Some people are homeless because they can't afford their prescriptions (drugs).
Where this comes out in the 'psychedelic treatment' movement is that it's not going to be very profitable, and in fact - if it works as advertised - will mean a lot of people will end up spending much less on anti-depressants on one hand, and alcohol and opiates and cannabis on the other.
This is because psychedelics - administered not as daily microdosing, but rather as infrequent full-dose experiences, ideally under somewhat controlled conditions - show promise in providing treatments for depression and addiction that don't require further daily interventions. The effects of a single dose can last for weeks to months.
From the business end of the health care system, this is a fiscal disaster. Someone spending $50 a day on alcohol, or cannabis, or opiates, or antidepressants and therapy, now spends $50 every few months on a bag of psychedelic mushrooms, with a more postive long-term outcome r.e. depression and addiction.
One conclusion is that a society that views health care as a profit opportunity, rather than a basic necessity, has some serious value problems that end up encouraging unhealthy behavior, i.e. pushing junk food in schools, encouraging obesity and depression and addiction, which then generate further profits for hospitals and pharmaceutical producers.