US could soon approve MDMA therapy

Edit: Also, as another commenter noted, because very few places allow you to get psychedelics legally, dosage and purity is always questionable; naturally you're going to have a bad time with something that is cut with really nasty drugs if you aren't aware of it and prepared for it, but this is pretty true of most things in life, even those not related to drugs.

Search engines, well, Google at least, are pretty complicit in this too, as it seems that sites discouraging drug use are brought to the top when searching for relatively reasonable things like "safe dosage $drug" or "$drug interaction with $other_drug". Even between different countries, the same search query on google will give quite different results.

I don't think among the people I've talked to that enjoy psychedelics have ever introduced a newbie to any drug without a safety warning and a fair amount of preparation, and in Amsterdam where mushrooms are legal, the shops are quite careful to ensure they are giving you the rundown on what to prepare for, dosages, finding a comfortable and reliable setting, safety, etc.

> but the "how" is largely ambiguous.

Honest question, have you taken any drugs that weren't prescription or alcohol/caffeine/nicotine? Because it's very easy to pinpoint how drugs (especially psychedelics) are life changing, at least for me.

Ecstasy - For a few brief hours, I not only felt good, but thought good thoughts about myself. It was a complete reset after many years of extremely low and dark times in my life, and after that I had a baseline of "hey, I actually _can_ feel good and think good things about myself; I am capable of it." And it was basically all I needed, a single time to break me out of years of depression

Psychedelics - It is an immense spark of creativity and just fascinating to see what your mind can invent and how everything has additional "perspectives", like the color of music, visualizing a world or scene in your imagination that you probably never thought of before, and the good sensations you have amplified by 1000x. Your mind makes connections and associations which sure, with time you could maybe reach sober, but it happens rapidly, effortlessly, and repeatedly on psychedelics, and the experience stays with you. If you've never had a moment of clarity, be it academic, problem solving, etc, then I'm not sure that psychedelics are the biggest concern for you :). These experiences _can_ happen sober, but at least for me, only with guided meditation over many sessions could I reach such an experience.

I'm not sure it's possible to be more specific than this with simple descriptive words, and I think the art and other drug-inspired pieces more than speak for themselves as to how it can be life changing.

This is a very common misconception. Just because MDMA is sold in powder form does not make it less likely to be adulterated, and color is a misleading (and easily manipulated) heuristic.

You can test for the presence of hypothesized adulterants, though most people unfortunately don't, and tests will fail to detect heterogeneous adulterants or adulterants in small quantities. Furthermore, reagants test for the presence of specific hypothesized adulterants; they cannot test for the absence.

The only way to be 100% sure is to use a mass spectrometer, and very few people will have access to use a mass spectrometer for testing street drugs outside of law enforcement (who emphatically cannot be trusted for these purposes[0]). That leaves clinicians, researchers, and a small number of groups who perform drug testing services for recreational users. From those, we have a pretty good sense that unadulterated MDMA is quite rare[1], which means that comparing subjective experiences of recreational (street) drug use to subjective experiences of pharmaceutical drug use is methodologically fraught.

> You can’t just look at the structures or names and assume that fully explains the effects.

I did not say that it fully explains the effects. However, it does provide some information. And in this particular case, the differences are dramatically overstated, due to the massive difference in set, setting, dosage, and chemical composition (possible adulterants).

My point is that you can't compare your subjective experience of these two drugs to draw the conclusion you're drawing, because there are many different confounding variables that would each explain the difference in effect you're describing, let alone in combination.

Again, I do agree that MDMA should not be used as a treatment for ADHD. I'm just pointing out the problem in drawing this conclusion based on subjective personal (and presumably recreational) experiences with the drug.

[0] Law enforcement routinely lies about and misrepresents facts around drugs, for various purposes. It's most commonly seen with regards to fentanyl, but by and large you can't trust LEO claims about tests performed on any drugs seized without independent means of corroboration.

[1] That doesn't mean that the adulterated versions are necessarily harmful, but it does provide an additional wrinkle when using it to draw inferences about hypothetical clinical use (which would not have any adulterants).

This is patently incorrect.

My experience is that MDMA makes one feel emotions much more intensely, with a bias towards positive emotions.

I've personally felt a number of negative emotions on MDMA as well, primarily loneliness when I've taken it alone, or ended up alone after taking it. This makes sense because it makes one strongly desire physical intimacy and physical touch of various kinds (hugs, shoulder rubs, compliments, deep expressions of love, etc)

Even the negative emotions I've experienced on it have however generally occurred at the same time of very positive physical sensations, and a strong sense of connection with myself.

I like mushrooms. I enjoy them recreationally a few times a year. I think there are benefits to be derived from their use. I think I've derived some of those benefits. But I also think, sometimes, it's just fucking fun to be high at a concert, and I don't think there's anything wrong with doing that in a responsible and safe manner.

I want to see us move in a less prohibition direction, and I think that legalizing psychedelics for therapy could be a boon for many people. But I would also like to live in a world where I can be trusted to consume an occasional dose of a non-addictive, naturally occurring substance without the whole thing being medicalized, regulated, and only allowed to happen with the guidance of a psychiatrist.

I sort of like the approach Ann Arbor took, where they're not illegal for personal possession and cultivation, but also not legal for sale. Seems like a decent balance for personal responsibility to me.

I truly understand the fear and caution around these substances. They require serious forethought and care to be used safely. But at the end of the day, I know I'm more than capable of that forethought and care and resent being told that I'm not allowed to grow a mushroom because psychedelics are scary.