Psychoactive substances helped spur Andean civilization

Heroin (IV) ~6x

GHB ~8x

Ethanol ~10x

Methamphetamine ~10x

DXM ~10x

Cocaine ~15x

MDMA ~16x

Codeine ~20x

Methadone ~20x

Mescaline ~24x

Flunitrazepam ~30x

Ketamine ~40x

Phenobarbital ~50x

Nitrous oxide ~150x

LSD ~1000x

Cannabis/THC ~1000x or greater

Citation: Gable RS. Comparison of acute lethal toxicity of commonly abused psychoactive substances. Addiction. 2004;99(6):686–696. doi:10.1111/j.1360-0443.2004.00744.x

> The problem with psychoactive drugs, as I understand it, is not the lack of positive results. There are plenty of well recognized cases.

There is a long way to go toward solid research on this topic. The studies that exist have small sample sizes and usually very limited monitoring periods after the dose, which makes them extremely prone to placebo effects. There’s no real blinding in a study with powerful psychedelics, so long-term comparisons against active comparators (therapy, other antidepressants) are needed.

There is a lot of reporting that would make the studies seem like slam-dunk, case closed results, but every study I’ve read so far has felt very weak compared to traditional antidepressant studies. That’s expected for early stage research, but it’s going to take a lot more to quantify the treatment effects.

> The problem is the the unpredictability, because there are plenty of catastrophic results too, and we don't really know why.

The studies go to great lengths to have controlled circumstances like therapists monitoring and guiding the situation for hours, including integration sessions afterward in a lot of the studies.

This helps control the situation for those studies, but it’s hard to translate that to real world practices. If the current proliferation of poorly-run ketamine clinics by cash grabbing providers is a clue, it would be really hard to ensure the level of trained therapist oversight that happens in these studies if this every becomes mainstream.

There’s also the big problem of occasional majorly negative outcomes, as you noted. There are a lot of reports around the internet of even seasoned psychonauts who eventually had a trip that left them depressed or dissociated for months. For the longest time these anecdotes were dismissed as having triggered an underlying mental health disorder as a way to avoid blaming the drug. The advice was always that people with mental health problems shouldn’t take the drugs. Well now that we’re talking about using these as antidepressants (maybe) then it would be exclusively people with severe mental health conditions taking them.

I don’t think it would take very many severely negative public cases to shut it down or at least severely restrict it.

Well given "therapeutic index" I had said "medication" as opposed to "commonly abused substances". I think your list skews heavily due to psychedelics tending not to be acutely toxic to the same extent as other chemical species.

Statins for example are probably 10x to 20x (quick napkin math based on an animal study I found). Tylenol is 10x and is OTC.

Personally I consider alcohol to be much safer than many other substances given the form it typically takes. Utterly irresponsible binge drinking aside, most people will suffer serious adverse effects long before they're in danger. Compare that with pills or injections where an OD can be entirely inadvertent even when observing basic common sense.

The top comment when I clicked it does not agree with the narrative:

@rkozakand 10 months ago

The so called "southwestern motif" is found wherever people weave. Our native rugs in the mountains of Ukraine use the exact same motif, only in different colors. It is a natural outgrowth of weaving techniques, which encourage triangles. We also have ancient pottery from what is called the Trypillian culture, which includes spirals and what you call 'zen tangle' motifs, which we call 'bezkonechnyk'. This pottery looks very similar to Southwest American pottery, even being executed in the same colors. I therefore doubt that they are as tied to specific plants as you think, although patterns repeat in nature, and maybe we have similar plants.

I'm aware of the theory. I'm not aware of any explanation offered by the theory as to how those who first experienced consciousness via psychedelics managed to pass consciousness on to their descendants. It doesn't make any sense. If you cut the tail off a rat, it doesn't have tailless children.