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Went into hospital for foot surgery to prepare for the stage but, as all too often happens, the necessity of pain management during the process, triggered the long-ended addiction. Steve was clear enough to understand what was going on and entered the program to concentrate on his health and recovery. for complete article go to Aerosmith's Steven Tyler Enters Rehab After Relapse (theblast.com)
This is a significant downside of drug use and addiction. Legitimate pharmaceutical use can trigger a relapse. You don't ever fully recover, and you can very much be vulnerable to even basic legitimate pharmaceuticals. This outcome is never on the ‘drugs are fun and manageable, try this’ brochure promoted by the pro-drug advocates.
(See Also DJ AM Tragic Story https://t.co/BetK0kbGwg) https://t.co/vO2TkSS6in https://t.co/hudqULN5XS
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So, When Can I Burn My Bridges Again? Dealing With Toxic Relationships in Addiction Spaces
Moving out and on and using lived experience and earned resiliency to be a proactive agent for prevention, not just recovery.
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Snowflakes, easily triggered or unfairly maligned, the worsening mental health of young people became a sensitive topic during the pandemic lockdowns. In the battles over safety, children became a political football tossed about in debates about re-opening.
However, the Covid-19 pandemic did not cause these issues, but rather revealed and accelerated them.
Self-harm and anxiety disorders among adolescents have already been increasing across the Western world. Just as the pandemic was speeding up historical trends such as digitisation, the statistical rise in youth self-harm, eating disorders and substance abuse was already occurring.
The combination of smartphones and social media is often raised as a key factor, unique to upcoming generations.
The history of consumerism is a greater sophistication of co-opting our primitive psychology towards the usage of goods and services. Fatty food, internet pornography and illicit drugs all prosper from sparking the same neural pleasure pathways. Social media and technology take this to another level by exploiting our insecurities about status, connection and belonging in a hierarchy.
This puts a greater premium on skills previously known as character like a willingness to delay gratification, something which may have been a puritanical norm for our parents but is increasingly lacking for many of our children.
The most effective period for investments in both cognitive and non-cognitive skills are the early years. Nobel laureate and economist James Heckman argues it is when we are the most malleable, flexible and able to be imprinted by parents and culture.
Children used to be useful but are now protected. Before they were teenagers they worked the fields, helped in mills or cared for their siblings. From the moment of birth, people were enmeshed in a complex web of obligations. Now the primary role of parents is to cultivate their children. As Jennifer Senior outlines in her book All Joy And No Fun, no longer are parents custodians of old traditions but are instead required to invent new ones.
Educational psychologist Donna Cross of the University of Western Australia argues that as other sites of community and character formation have declined, schools have acquired more pressures to rectify the fragmentation. Teachers become unofficial parents of children from broken families, especially in lower socio-economic areas. There is a greater therapeutic focus in schools.
In lower socio-economic groups, emotional disturbance may be expressed, especially among boys, through bad behaviour, whereas among the middle classes neuroses is more common. The greater medicalisation of middle-class distress, which adds greater legitimacy and even privileges through disability provisions, is widening the education and character divide.
This is a pointer that the potential decline in character traits is also growing among the wealthy, evidence that affluence can undercut discipline.
An especially important aspect in discussing youth mental health is the paucity in idioms of suffering. Young people have fewer myths to set context to adversity. This may also explain the huge popularity of Harry Potter, a set of stories that is now arguably competitive to the Bible as a sacred text for upcoming generations.
An aspect of psychologist Jordan Peterson’s success is his ability to articulately communicate Biblical stories and Jungian concepts such as universal archetypes. Jung teaches that meaning in life comes not just in “love and work”, as Freud said, but is made intelligible through recurring cultural patterns, namely myths.
We live in times of great prosperity but can lack purpose. There can be a sterility to modern life as we accumulate ever larger amounts of wealth. A sense of the sacred is largely snuffed out, as is the place of ritual which connects us to groups or spirituality. Traditional religions have become vestiges of the past. We are not sure how to revive ancient traditions for a modern polyglot world. The revival of Anzac Day, driven in large part by young people, is evidence of a yearning for such ritual and shared stories.
It was Martin Seligman who said that “poverty is a state of present mindedness”. Overcoming the loss of self-reliance requires ending the dependency feedback loop of a society which encourages safetyism, gratification from the smartphone and the avoidance of all risk. This has the effect of creating psychological fragility and an inability to deal with the vagaries of life, which creates demand for even more protections.
The development of such skills, which may have once been called character, is arguably the central task of any civilised society.
The non-cognitive skills of character – particularly of persistence, prudence and the deferral of gratification – are being undermined. In combination with a lesser capacity to make sense of suffering and adversity, future generations are ill-equipped to cope with the avalanche of instant gratification vehicles that are now perpetually accessible.
For complete article (The Australian 24/4/22)
Also see “Drug Policy: Building or Demolishing Community Resilience?”
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Psychedelics: The New Panacea – Just Like Cannabis, it will Fix Everything, Won’t it?
Everything you need to know about psychedelics and mental illness
The science of psychedelics is everywhere – but we should treat it with serious scepticism
Research is me-search
It’s the same for psychedelics. This is just an anecdotal account, but there’s an interview with the psychedelics researcher Manoj Doss, who says that he “only know[s] one psychedelic researcher who’s never done psychedelics”, and notes (in an encouragingly self-critical way) that this is a conflict of interest. He’s right! Just as you’d feel extra-sceptical if all the research showing that pork is unhealthy was written by Muslims who’d already decided for religious reasons not to eat pork, you should be worried about the sheer number of studies by psychedelic researchers who are themselves aficionados of the drugs.
(You might wonder if they’re into psychedelics precisely because the research shows such impressive benefits, switching around cause and effect. But as we’ll see below, that evidence doesn’t exist yet. That particular horse is coming way after the cart).
This isn’t just the view of one researcher. Reading the literature on psychedelics, you continually encounter concerns about the “over-exuberance” of some scientific advocates of the drugs. There are also discussions of conflicts of the financial kind: we know that there are a lot of psychedelic-drug companies springing up all over the place, and we know they pay consultation fees to psychedelics researchers because these are disclosed in research papers (see e.g. the section near the end of this paper, which we’ll discuss in more detail below).
There are all kinds of problems—from outright publication bias to more subtle “questionable research practices”—that can creep in when researchers have a conscious or unconscious bias in one particular direction. It doesn’t take much to push the statistical results in a field towards unreliability and false-positivedom. One 2020 paper suggests methods, many of them from Open Science, that psychedelics researchers should consider using to try and reduce these biases. I doubt many papers on psychedelics use them already.
Yikes. He even lists the papers he’s reviewed on his website, so we can have some idea of which ones we might wish to be extra-sceptical about (Sessa has also been criticised on social media for a graph he made that, without clearly informing the reader, combines the results of two studies as if they were one).
But even if the specific scientist running a psychedelics trial isn’t themselves a “psychonaut”, there’s still the more mundane kind of bias, a bias that almost all scientists have: towards finding positive, cool, encouraging, exciting results (as opposed to null, shrug-inducing, disappointing, boring ones).
Here’s an example – and it happens to concern one of the most important psychedelic trials yet performed. In April 2021 the psychedelics researcher Robin Carhart-Harris (now at UC San Francisco; back then at Imperial College London where he still has an affiliation) wrote an article in The Guardian entitled “Psychedelics are transforming the way we understand depression and its treatment”. It was part of the publicity for a new randomised controlled trial (RCT) he’d co-authored, which had just been published in the world’s top medical journal, the New England Journal of Medicine.
The psychedelic in question was psilocybin, the main active ingredient from magic mushrooms. Before we get to the 2021 trial, it’s worth backtracking slightly to look at what evidence on psilocybin and depression existed beforehand. Here are the trials:
- A “pilot study” from 2011 of psilocybin in advanced-stage cancer, including 12 patients, which found no statistically significant results on depression measures;
- A “feasibility study” in 2016. This had 12 patients and no control group, so can only really be used to, as the authors put it, “motivate further trials”;
- A double-blind RCT from 2016 in 51 patients with life-threatening cancer which found that psilocybin had very positive effects on mood that lasted for up to 6 months;
- Another double-blind RCT, also from 2016, in 29 patients with life-threatening cancer that again found beneficial effects on depression symptoms over 6 months;
- A final RCT from 2020, in 27 patients with major depression (of whom 24 actually finished the study) that found “large, rapid, and sustained antidepressant effects” over 8 weeks.
So, pretty tiny studies; some of them in very specific populations. The 2021 NEJM study was the first—and remains the only—study to compare psilocybin to an established, commonly-prescribed antidepressant drug – in this case the SSRI drug escitalopram. As with all the above, it was very small (59 people), but the comparison it looked at was a big deal. That’s because it’s not enough to show the psychedelic drug is better than placebo – after all, we already have treatments for depression. We need to know how it compares to those pre-existing treatments.
The harm
Anyone who’s interested in psychedelics and mental illness should listen to the New York Magazine podcast series “Cover Story: Power Trip”. Among several other stories, the podcast reports investigative work around clinical trials of MDMA (ecstasy) therapy for Post-Traumatic Stress Disorder, run by an organisation called the Multidisciplinary Association for Psychedelic Studies, or MAPS.
The crucial thing here is that it’s not just MDMA: it’s MDMA plus therapy (by the way, MDMA is only sometimes classified as a “psychedelic drug”, depending on who you talk to; but MDMA therapy is almost always classed as “psychedelic therapy”, since some of the effects overlap with drugs that are definitely psychedelics). And as described in the podcast, that therapy can get very weird.
The danger is that psychedelics can make users pliant and suggestible, leading to obvious dangers if a patient is left in the hands of anyone with less-than-noble intentions (there’s a reason so many cults over the years have used psychedelics–including MDMA–to help keep their members compliant). The podcast relates the story of Meaghan Buisson, a PTSD sufferer who underwent intense MDMA therapy with two therapists in a MAPS trial. The therapy was filmed in its entirety – and it’s grim. If you can stomach it, you should watch the video, which was uncovered in the NY Magazine investigation. But if you can’t, here’s a description:
“The therapists, Richard Yensen and Donna Dryer, guide Buisson through three long sessions with follow-ups in between. They give her the drugs and, as she recalls, coax her to relive her sexual assaults. They ask her to spread her legs, and at several points, they lie on top of her and pin her down, sometimes holding her wrists. The two then comfort Buisson by stroking her face and climbing into bed with her. There are periods in the video when Yensen is in constant physical contact with her.”
At other points, Yensen and Dryer blindfold Buisson, gag her with a towel, and ignore her as she screams at them to get off her. Yensen also “admitted to having sex with Buisson after the experimental sessions ended but while she was still enrolled in the clinical trial”. This is a far cry from the friendly, comfortable, hand-holding sessions you see in photos from other MDMA (and psilocybin) therapy sessions. MAPS has said that Yensen and Dryer did not stick to their therapy protocol and that they won’t be working with them again.
Rick Doblin, Executive Director of MAPS—who, incidentally, has argued that psychedelic therapy could have prevented the War in Iraq and will produce a “spiritualised humanity” by 2070, and who encourages his employees to smoke marijuana while doing certain tasks at work—was asked about the potential for sexual abuse by therapists in a recent Q&A session. He had this to say:
“We’re trying to make it so that the source of the healing is inside the patient… that will hopefully make them stronger when there is, um, y’know, pressure perhaps from therapists to, y’know, engage in a sexual relationship.”
Perhaps not ideal.
Hopefully this article has convinced you that there are a lot of red flags in the psychedelic scientific literature, and that you should perhaps set your standards higher than usual when reading about this area. To summarise everything I’ve said, we should bear the following in mind:
- The reasons people are so excited about psychedelics for mental illness are not necessarily related to how much evidence there is for the treatment;
- The conflicts of interest in the psychedelic research field go very deep. It’s completely plausible that these conflicts help bias the studies toward reporting more positive results than are actually true;
- The discussion of psychedelic research in the media often bears only a passing resemblance to what’s actually in the trials – or at least it sounds a lot more certain and optimistic than is warranted;
- Even the best-quality trials are flawed in important ways because—mainly due to problems of expectations and blinding—this is an incredibly difficult thing to study;
- We shouldn’t allow our excitement for psychedelic drug trials to run roughshod over safety concerns, and we shouldn’t be so desperate for a breakthrough mental health treatment that we roll out these drugs before we’ve tested whether they work in high-quality, smartly-designed studies.
We’re nowhere near reaching peak interest in psychedelics. With all the scientific research programmes, and all the companies vying with each other to create the bestselling psychedelic product, maybe there’s a chance some of the above uncertainties will be ironed out in the coming years.
On the other hand, researchers might just continue doing low-quality, hard-to-interpret studies that back up their pre-existing beliefs, giving false hope to sufferers of mental illness. You don’t exactly have to be tripping to imagine that.
By Stuart Ritchie 15th April 2022
Further Reading