Psychedelics and mental illness

Oh yes, I've had a run in with a "psychedelic enthusiast", and this is so accurate. It was my girlfriend during my late 20s, a woman who was 12 years older, very into psychedelics, and pretty obnoxious about how beneficial they were. Of course, at the time I ate it up because I was kinda lost in life, and let her overcome my better judgement with her guru bullshit.

I'd previously only ever used marijuana, and had mostly negative experiences resulting in anxiety, so had mostly sworn off the idea of trying psychedelics until she came into my life. Long story short, I tried mushrooms once with her, fun for a bit, but then led into a crazy making spiral leading me to be convinced I'd never be the same.

I guess I was a glutton for punishment back then, because I also tried LSD with her twice, and it had pretty similar results. In fact the second trip shook me up in such a bad way that I think it took nearly a year to get the negative bits still remaining out of my head.

Of course her reaction after all this was that I was being too resistant and that I simply needed to have a "corrective experience". Fuck that! She seriously couldn't comprehend the fact that everyone reacts to psychedelics differently and that they might be quite dangerous for some people. Which seemed kinda crazy because she was actually highly intelligent, but possibly too arrogant to look outside her world. I seriously could have ended up in an institution if I had stayed with that woman (can you tell I'm venting a tad :) ).

I've later come to learn that I have a genetic mutation that reduces my ability to degrade dopamine in the prefrontal cortex by 75% (COMT met/met), leading to much higher baseline dopamine levels. After learning about this, it makes a ton of sense why I have such bad experiences with dopaminergic drugs like caffeine and Adderall (euphoria followed hours later by intense anxiety). Now I don't know how LSD and mushrooms impact the domaine system, but it does make me wonder if this genetic SNP, partially explains my propensity to anxiety/psychosis on these drugs. High baseline dopamine leads to hyperfocus, which is great for coding or other technical work, but terrible when you're stuck in a spiral of thinking you're going crazy and will never be the same.

https://www.scientificamerican.com/article/americans-increas...

"In the late 1970s... 10 percent of high school seniors reported ever using LSD, compared with 6 percent today."

Ten percent isn't very much. Americans in the 60's and 70's were far more likely to support endless jail time for drug users than to be one themself.

The article actually discusses that very paper:

> While we’re here, it’s worth talking about the MAPS MDMA-therapy trial itself. In May 2021, to much media fanfare, they published their Phase III clinical trial in Nature Medicine. The trial reported enormous, nearly unbelievable effect sizes: 0.91 of a standard deviation difference in score on a PTSD questionnaire between an MDMA and a placebo group (both groups got therapy). That’s the kind of effect medical researchers fantasise about.

> Are these effect sizes plausible? Nature Medicine also published two critical commentaries on the paper. The first one points out the issue we discussed above: that the blinding was almost certainly compromised in the study, since the control group got a completely inert placebo and the treatment group surely could tell whether they’d been given ecstasy. Expectations could have played a major role, and might explain at least some of the huge difference between groups (the commentary also makes the interesting point that researchers used to be required to collect data on which condition patients thought they were in, but since 2010 this is no longer the case. It might be time to bring back this rule). The second commentary asked for studies with more relevant control groups and longer follow-up periods to check the safety of the treatment. The MAPS researchers also responded, somewhat limply.

> The journal also published an entirely uncritical commentary co-authored by Imperial College London’s David Nutt. Remember him? He was Fired4Truth as a drugs adviser by the UK Labour government in 2009 for criticising government policy on drug classification; he’s now a major psychedelics researcher who co-authored the psilocybin trial we encountered above. The commentary calls MDMA “remarkable” three separate times in about 1,000 words (it’s true the effect sizes in the study are remarkable, but what if they’re due to expectancy bias?). It also says it’s likely that MDMA “will be an approved medication within a few years”.

> So there’s a final potential harm that stems from the breathless hyping and cheerleading of psychedelic treatments way beyond the evidence: it could mean that therapies—which come with their own rare but real dangers—are approved and rolled out to large numbers of patients when we need a lot more evidence that they really are beneficial in the long term.

The chemical differences between "lysergic acid" and LSD areas significant as the differences between morphine and heroin, if not more so. Pure lysergic acid is closer to LSA, which is still categorically not the same thing as LSD - to the point that many people will refuse to take the former when a test kit reveals they got that as opposed to the latter. They are not colloquially equivalent.