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Details: Published: 21 March 2023; Hits: 755

Warning of “history repeating,” researchers list ten problems with psychedelic research that make conclusions about efficacy and safety uncertain.
March 20, 2023

Drugs like ketamine, psilocybin (mushrooms), LSD, and MDMA are at the forefront of a new wave of overhyped treatments for mental health problems that may fail to deliver on their promises, according to a new article by researchers Michael van Elk and Eiko Fried at Leiden University, the Netherlands. They write that psychedelic research is plagued by methodological problems that make the efficacy and safety of these drugs uncertain.

Despite the minimal research and its limitations, the drugs have been hyped as “miracle” drugs, with some, like esketamine, even receiving FDA approval—despite failing to beat placebo in five of its six initial efficacy trials (the sixth trial reached statistical, but not clinical, significance). In fact, last year, researchers wrote that the promotion of ketamine/esketamine treatments poses “a significant risk to the public.”
In their new article, published before peer review on the preprint server PsyArXiv, van Elk and Fried focus on the top 10 methodological problems rampant in psychedelic research, how these issues undermine the evidence base, and how researchers can avoid them in the future.

“These problems threaten internal validity (treatment effects are due to factors unrelated to the treatment), external validity (lack of generalizability), construct validity (an unclear working mechanism), or statistical conclusion validity (conclusions do not follow from the data and methods),” the researchers write.

Worse, they add, most psychedelic studies feature more than one of these problems, which makes the studies far more unreliable: “These problems tend to co-occur in psychedelic studies, strongly limiting conclusions that can be drawn about the safety and efficacy of psychedelic therapy.”

For complete article

Also see LOBBYING FOR MEDICINE – AROUND WE GO AGAIN (THIS TIME IT’S PSYCHEDELICS)

Details: Published: 02 March 2023; Hits: 678

Increasingly the addiction treatment field is recognizing the benefits associated with non-abstinent substance use disorder remission pathways. At this same time, this study, and others like it suggest individuals pursuing abstinence-based recovery may experience more psychological and functional gains.

Abstinence was associated with generally better psychological and functional outcomes.

For complete research

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Details: Published: 16 February 2023; Hits: 658

The aim of this study was to better understand the role of social networks in maintaining recovery from opioid use disorder (OUD). Researchers completed longitudinal surveys (2 surveys, 3 months apart) with 106 adults receiving medications for OUD in Delaware who planned to disclose their substance use, treatment, or recovery to a person in their life. Surveys assessed the degree of social support provided, and closeness to—and history of shared substance use with—the person to whom they disclosed.

Participants who disclosed to someone with whom they felt close had increased commitment to recovery. This was stronger among individuals whose close contacts provided higher social support.
Disclosure to someone with whom participants had previously used substances was associated with decreased commitment to recovery.

Comments: Social networks and relationships can influence recovery. This study demonstrates that disclosing substance use, treatment, or recovery to a highly supportive and close person—without a shared substance use history—may be beneficial to recovery.

Elizabeth A. Samuels, MD, MPH, MHS Reference: Brousseau NM, Karpyn A, Laurenceau JP, et al. The impacts of social support and relationship characteristics on commitment to sobriety among people in opioid use disorder recovery. J Stud Alcohol Drugs. 2022 Sep;83(5):646–652.

Details: Published: 20 January 2023; Hits: 688

It is against this backdrop that two further (linked) debates continue to haunt drug policy and in particular the implementation of recovery models:

1. harm reduction versus recovery
2. professional versus peer roles in supporting recovery pathways.

The two debates overlap and are laid out here as choices or dichotomies although there is no reason that they have to be seen as such. In Scotland, the transition from the Road to Recovery (Scottish Government, 2008) to Rights, Respect and Recovery (Scottish Government, 2018) is seen as the pendulum swinging back in the direction of harm reduction in response to drug-related deaths and several of our key informants felt the same was the case for the 2017 UK drug strategy (HM Government, 2017) – seen as a ‘balancing’ of recovery and harm reduction.
But who makes those decisions, particularly the ones about implementation? When we did the research it was very hard – particularly in England – to identify or speak to those who were responsible for shaping and implementing drug policy. Yet this leads to a real concern that power (and money) remains in the hands of vested interests including a small cabal of treatment providers, a cosy network of ‘experts’ and the hegemonic influences of their disciplinary backgrounds and the continuing shadow of the pharmaceutical industry.
Conclusion
The shared concern in both the US and the UK is that increased investment and increased public concern and attention have not led to new ways of thinking but have largely ended up in doing more of the same. More treatment workers, more treatment services and very little of the crucial lessons from recovery – jobs, houses and pathways to community capital and resources. In Scotland, McGarvey (2018) has referred to this as the self-preservation of the ‘poverty industry’
Recovery policies are very hard to implement effectively yet there are great examples from the US outlined in John Kelly and William White’s 2011 book “Addiction Recovery Management”. While there are always opportunities (and needs) to improve treatment, the commitment to meaningful recovery-oriented systems of care is essential if short-term gains are to be translated into lasting and meaningful changes in communities and families. It is notable that almost no funding has been allocated to researching recovery-oriented systems of care in the US or UK in the last decade.

For more Recovery in Policy and Practice on Both Sides of the Atlantic — (rec-path.org)

(The Dalgarno Institute has for over a decade now, argued in a similar fashion that Harm Reduction ONLY ideologies that should lead to drug use exiting recovery, have not. Instead, it appears a cynical strategy has been in play that has seen Harm Reduction hijacked by certain ‘gate-keepers’ of drug policy to simply sustain a ‘damage management’ model that takes a non-accountability stance toward self and community harming drug use.
Even though ‘right’ words are often used and the Australian National Drug Strategy has put Demand Reduction as the priority pillar, we still see interpretation of policy and the continued relentless promotion of harm reduction principles used to enable, equip, and even endorse ongoing drug use, rather that actively facilitating reduction, remediation, and recovery from drug use.
This is not a secret; however, it is entrenched bureaucracy that continues to guard the ‘poverty industry’ mentioned in this article. Political will and a removing of the strangle-hold of pro-drug advocates on policy interpretation is what is needed to see a genuine change, in not only policy direction, but the positive health benefits it brings.)

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