Startups are betting on a psychedelic gold rush(vox.com)
vox.com
Startups are betting on a psychedelic gold rush
https://www.vox.com/recode/22716491/psychedelics-ketamine-mental-health-research-fda
27 comments
Sasha and Ann Shulgin famously believed that dissociatives (e.g., ketamine, xenon, phencyclidine) have no safe role in psychedelic therapy:
For example, see D. M. Turner's "The Essential Psychedelic Guide". Before he died in his bathtub (after injecting ketamine), he wrote the following (https://www.ketamine.co.uk/dmturner/index.html):
"We are strongly prejudiced against psychedelic drugs which cause such mind-body separation, as we are against any drug which causes separation from feelings and emotions. However, we acknowledge that the ketamine state can be highly instructive for researchers trying to understand the functions of the human mind."
For example, see D. M. Turner's "The Essential Psychedelic Guide". Before he died in his bathtub (after injecting ketamine), he wrote the following (https://www.ketamine.co.uk/dmturner/index.html):
"A major concern regarding safe use of Ketamine is its very high potential for psychological addiction. A fairly large percentage of those who try Ketamine will consume it non-stop until their supply is exhausted. I've seen this in friends I've known for many years who are regular psychedelic users and have never before had problems controlling their drug consumption. And I've seen the lives of several people who developed an addiction to Ketamine take downward turns."
"After about two years of once-per-week Ketamine use I even found that I had developed an addiction. Although it was less severe than what I've described above, it took considerable effort to break the cycle of repeatedly using it, even though I was aware of detrimental effects that it was causing. Since that time I've used Ketamine only occasionally, but find that I must continually exercise a high degree of will power to prevent myself from falling into a pattern of regular use. Amongst those I know who use Ketamine, I've seen very few who can use it in a balanced manner if they have access to it."
Ketamine's antidepressant effect doesn't require any dissociation or psychedelic effects to work.
Many of the legitimate clinics keep the doses low enough to produce only mild dizziness at most.
Unfortunately many of the alternative-medicine style providers have gone to the other end of the spectrum, embracing excessive doses and promoting the psychedelic component as part of the therapeutic process.
Many of the legitimate clinics keep the doses low enough to produce only mild dizziness at most.
Unfortunately many of the alternative-medicine style providers have gone to the other end of the spectrum, embracing excessive doses and promoting the psychedelic component as part of the therapeutic process.
Experienced drug users (loosely using that term, don’t want to call them drug addicts :p) will tell you not to even attempt a psychedelic if you are not in the right headspace. You’ll have a bad trip. Is that still not the case? Isn’t depression about as bad a headspace you can be in to try this stuff?
From what I have read, following the topic for many years, the key is to have a (human) guide to help you if they see you heading in the wrong direction. Psychedelics can be thought of as emotional amplifiers; feed them bad thoughts for too long and you get a runaway spiral to permanently scarring your emotional well being. The same, however is true for good thoughts, leading to euforia, transcendental thoughts, etc., which I guess is why many folks come back to do them again (once they have rebuilt whatever reserves are needed). What any one person may experience on the same dose of the same chemical may vary wildly though, I imagine due to the levels of other chemicals already in the body, and the current emotional state.
This is why being in a safe and comfortable environment with a friend that you trust is very important!
Bad trips are intense emotional states, but can be powerful learning experiences too. A safe, loving environment can let someone work through the thoughts/emotions/memories that may underlie their depression. It makes it easier to see the negative patterns and find a different path.
Bad trips are mainly Really Bad when you're in both a bad mindset _and_ a bad setting, whether that's due to bad vibes, bad friends, being out in public, etc.
Bad trips are intense emotional states, but can be powerful learning experiences too. A safe, loving environment can let someone work through the thoughts/emotions/memories that may underlie their depression. It makes it easier to see the negative patterns and find a different path.
Bad trips are mainly Really Bad when you're in both a bad mindset _and_ a bad setting, whether that's due to bad vibes, bad friends, being out in public, etc.
Set and setting are 100% drivers of the experience you'll have with psychedelics. You have to be in a good state of mind, and you have to be in a safe, stable environment. Psychedelics will amplify and loop experiences of your trip, so if you're in a negative headspace, that will feed back into itself. Confronting the inner darkness is a thing, and experienced users will have gone through at least one "bad trip" which they'll view as horrible at the time, but valuable because of the insight into the workings of tsensory.
There's been some recent trends among psychedelic communities in saying there's no such thing as a bad trip, only difficult ones. I tend to agree, but only in the context of responsible use.
Being depressed doesn't mean you can't prepare and manufacture a headspace and experience with psychedelics. It does mean you need an experienced guide who will be by your side through the experience. It must be someone who you trust and feel comfortable with, and who you've told the truth about your state of mind and intentions. Never try tripping alone in a negative headspace.
Much like skydiving with squirrel suits, you need a teacher and experience before you should attempt anything risky or complex. An experienced guide can also "show" interesting and beautiful and profound places in your mind and sensorium.
It's very important to draw on the experience of others, to have a sitter, and to educate yourself about psychedelics in general and the substances you are going to use in particular.
Mushrooms are a wonderful starting point, and Terence McKenna a great resource to learn about the experience of using them. They're nominally the safest and most forgiving psychedelic to start with with a huge array of people to learn from.
Ultimately psychedelics are tools that can give you access to internal perspectives. They operate on the fundamental workings of intelligence and consciousness, mirroring and modifying your neural signals into strange loops and unexpected activations, which can break your mind free from all sorts of negative patterns.
Above all else, learn as much as you can about safe use and harm reduction. A little effort and responsibility goes a long way towards guaranteeing the success of what can be the most profound and moving experiences you can have as a human.
There's been some recent trends among psychedelic communities in saying there's no such thing as a bad trip, only difficult ones. I tend to agree, but only in the context of responsible use.
Being depressed doesn't mean you can't prepare and manufacture a headspace and experience with psychedelics. It does mean you need an experienced guide who will be by your side through the experience. It must be someone who you trust and feel comfortable with, and who you've told the truth about your state of mind and intentions. Never try tripping alone in a negative headspace.
Much like skydiving with squirrel suits, you need a teacher and experience before you should attempt anything risky or complex. An experienced guide can also "show" interesting and beautiful and profound places in your mind and sensorium.
It's very important to draw on the experience of others, to have a sitter, and to educate yourself about psychedelics in general and the substances you are going to use in particular.
Mushrooms are a wonderful starting point, and Terence McKenna a great resource to learn about the experience of using them. They're nominally the safest and most forgiving psychedelic to start with with a huge array of people to learn from.
Ultimately psychedelics are tools that can give you access to internal perspectives. They operate on the fundamental workings of intelligence and consciousness, mirroring and modifying your neural signals into strange loops and unexpected activations, which can break your mind free from all sorts of negative patterns.
Above all else, learn as much as you can about safe use and harm reduction. A little effort and responsibility goes a long way towards guaranteeing the success of what can be the most profound and moving experiences you can have as a human.
Why not let the free market work its magic? If ketamine doesn’t work, the word will get out and these places will go out of business. People will self medicate with whatever is available to them. If you lock up ketamine, people will reach for alcohol.
> Why not let the free market work its magic?
the literal snake oil market? no thanks.
the literal snake oil market? no thanks.
Look, I think that ketamine has some great potential... but the medical (especially pharmaceutical) industry has shown time and time again that regulation is absolutely necessary.
From what I've gleaned, low-dose ketamine is quite effective at reducing treatment-resistant suicidal ideation, which can be a literal life-saver and has very low risk. The alternatives include doing nothing and hoping for the best, and antipsychotics.
High-dose ketamine (k-hole) is a significantly riskier proposition: people can grow dependent on it, and it does significant long-term damage to the body (and in the short term, apparently, walking out of the clinic tripping balls and getting injured). As an emergency emergency remedy (treatment-resistant depression), paired with talk therapy, the high-dose treatments may be promising.
A real risk is blowback: if the industry is too cavalier, then there will be actually good reason to clamp down on it. If the industry can get their shit together and be careful, then there's no need for strict regulation. If the industry blows its chance with public sentiment now, we won't have a chance to see the positive effects for another few generations.
From what I've gleaned, low-dose ketamine is quite effective at reducing treatment-resistant suicidal ideation, which can be a literal life-saver and has very low risk. The alternatives include doing nothing and hoping for the best, and antipsychotics.
High-dose ketamine (k-hole) is a significantly riskier proposition: people can grow dependent on it, and it does significant long-term damage to the body (and in the short term, apparently, walking out of the clinic tripping balls and getting injured). As an emergency emergency remedy (treatment-resistant depression), paired with talk therapy, the high-dose treatments may be promising.
A real risk is blowback: if the industry is too cavalier, then there will be actually good reason to clamp down on it. If the industry can get their shit together and be careful, then there's no need for strict regulation. If the industry blows its chance with public sentiment now, we won't have a chance to see the positive effects for another few generations.
Tell that to China’s 100 years of shame.
What stocks should I buy?
Pretty sure any company in the legal marijuana business will immediately add this product if it starts becoming more legal.
Not ticker: MINE.
The sale of drugs to non-addicts just doesn't scale.
Startups selling psychedelics want repeat customers.
Terence McKenna said he would take magic mushrooms less than once per year.
I don't know what John Hopkins advises, but I would be surprised if they advocated even greater than annual dosing after initial treatment.
Startups selling psychedelics want repeat customers.
Terence McKenna said he would take magic mushrooms less than once per year.
I don't know what John Hopkins advises, but I would be surprised if they advocated even greater than annual dosing after initial treatment.
Microdosing treats psychedelics like supplements/vitamins, such consumers are the epitome of a repeat customer.
I was surprised recently to see an ad for microdosing psilocybin (it's legal here). They don't even make an extract, just grind it up and put it in capsules so it comes with a disclaimer that the dosages are unpredictable.
Hm, my understanding is that powdering it tends to homogenize the stuff enough to mitigate most of those risks, assuming you do it in large enough batches.
Personally I prefer a lesser processed product than something extracted using solvents and who knows what other industrial processes/opportunity for toxic errors...
Personally I prefer a lesser processed product than something extracted using solvents and who knows what other industrial processes/opportunity for toxic errors...
Psilocin/Psilocybin content can vary radically between mushrooms of the same species or even the same harvest. Microdosing lsd or mushrooms also runs into potential cardiovascular problems (from the same mechanism of action that made fenfluramine dangerous,) and recent studies cast doubt on whether there's any benefit.
https://ecfes.net/science/why-chronic-microdosing-might-be-r...
https://www.drugscience.org.uk/psychedelic-microdosing-lsd-o...
Infrequent, responsible tripping is definitely more beneficial than microdosing, and medical science is finally being allowed to study psychedelics, so not microdosing until the heart health questions are answered seems a smart course of action.
https://ecfes.net/science/why-chronic-microdosing-might-be-r...
https://www.drugscience.org.uk/psychedelic-microdosing-lsd-o...
Infrequent, responsible tripping is definitely more beneficial than microdosing, and medical science is finally being allowed to study psychedelics, so not microdosing until the heart health questions are answered seems a smart course of action.
> Infrequent, responsible tripping is definitely more beneficial than microdosing.
The only thing definite about using higher doses of these substances is increased potential, including risk/negative outcomes, in general.
Your assertion is asinine, unless you meant to say "definitely potentially".
The only thing definite about using higher doses of these substances is increased potential, including risk/negative outcomes, in general.
Your assertion is asinine, unless you meant to say "definitely potentially".
That's implied with the "responsible" framing. Part of that means knowing your mental health situation, if you have family history of schizophrenia or other risk factors, or if your doctor recommends against it.
Another part is self-education. Have conversations, explore the intellectuals and history and science of the subject, and learn your mental health situation. If psychedelics are inappropriate, or if you're uncertain, then the responsible thing to do is to simply avoid them.
At any rate, it looks like microdosing, to our best understanding, lacks evidence of benefit when considered against the possibility of placebo. We also know that the potential for heart damage from microdosing recommends against it. Lastly, we know for a fact that responsible full dose trips are among the most positive and powerful experiences available for people. I'd call that "definite," within the constraints of responsible use.
Another part is self-education. Have conversations, explore the intellectuals and history and science of the subject, and learn your mental health situation. If psychedelics are inappropriate, or if you're uncertain, then the responsible thing to do is to simply avoid them.
At any rate, it looks like microdosing, to our best understanding, lacks evidence of benefit when considered against the possibility of placebo. We also know that the potential for heart damage from microdosing recommends against it. Lastly, we know for a fact that responsible full dose trips are among the most positive and powerful experiences available for people. I'd call that "definite," within the constraints of responsible use.
Ah, that is a good point, at a commercial scale it should be fine.
money wants to tell the story like it is all about money -- who knew?!
I just listened to an interview with the director of the new Center for the Neuroscience of Psychedelics at Massachusetts General Hospital. If you're looking to build up a balanced perspective on this subject worth a listen:
https://www.listennotes.com/podcasts/keep-talking/episode-17...
https://www.listennotes.com/podcasts/keep-talking/episode-17...
Locally, ketamine treatment clinics are popping up all over the place. We have so many in my city that they’re now competing with each other in radio advertisements, inviting people to come on down and get some ketamine for their depression, anxiety, PTSD, or even vague symptoms like stress. One of them even had a frequent visitor pass - Buy five ketamine sessions and the sixth is free! Another was shut down for a while when they were caught leaving patients unattended and one injured themself while on a high dose of ketamine. They were found to not even be performing screenings of patients - Anyone who showed up with cash got ketamine.
But it doesn’t stop there. Internet prescribers are taking advantage of the temporary COVID rules changes for telehealth controlled substance prescribing to give ketamine over the internet. I won’t name the company, but one specific provider is known for providing prescriptions for exorbitantly high doses of ketamine. From what I saw, nobody is turned away. If you’re willing to pay, you get a prescription for a lot of ketamine and you don’t even have to leave your house.
What makes this all worse is that ketamine is very much not a cure for depression. The antidepressant effects of ketamine are famously short-lived, so it’s used as a way to jump-start traditional therapy in normal settings. Not so at these ketamine clinics, which prefer you return to them for more and more expensive treatments each time it wears off, at least until you have such a high tolerance that it doesn’t do anything at all for the depression any more.
Whatever you think about the substances, I am not excited for a wave of “growth hackers” at psychedelic startups brainstorming ways to get people to pay for more and more ketamine or psychedelic sessions to improve their numbers. I hope the regulatory bodies step in and steer this back to sanity before these startups cause so many problems that these substances become untouchable again.