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Published: 20 April 2022

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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:

1. The reasons people are so excited about psychedelics for mental illness are not necessarily related to how much evidence there is for the treatment;
2. 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;
3. 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;
4. 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;
5. 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 15^th April 2022

 For complete article

Further Reading

• The Ethical Implications of Psychedelics
• Blinding and expectancy confounds in psychedelic randomized controlled trials: Expert Review of Clinical Pharmacology: Vol 14, No 9
• The problem at the heart of modern psychedelic clinical research
• Taking the ‘Novel’ Out of New Psychoactive Substances

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Published: 16 March 2022

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Published: 08 March 2022

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What Are Date-Rape Drugs?

Date-rape drugs are substances that make it easier for someone to rape or sexually assault another person. They include alcohol and some medications. The person who’s attacked might become confused, have trouble defending themselves, or not be able to remember what happened later.

“Date rape” doesn’t always happen on a date. An attacker could be someone you just met or someone you’ve known for a while.

Common Types of Date-Rape Drugs

An attacker can use several kinds of drugs or medications to overpower someone else or cause them to forget an incident. The most common date-rape drugs are:

• GHB (gamma-hydroxybutyric acid). This is a depressant that has many nicknames: easy lay, Georgia home boy, liquid X, liquid ecstasy, liquid E, grievous bodily harm, Gib, G-riffic, scoop, soap, salty water, organic Quaalude, or fantasy. Doctors sometimes prescribe it to treat a sleep disorder called narcolepsy.
• Rohypnol (flunitrazepam). This is a strong benzodiazepine (a class of tranquilizers) also known as Mexican Valium, circles, roofies, la rocha, roche, R2, rope, and forget-me pill. It’s not available legally in the United States. In other countries, doctors sometimes use it as anesthesia before surgery.
• Ketamine. This is a dissociative drug that makes you feel detached from reality. Its nicknames include Special K, vitamin K, and cat Valium. Doctors and veterinarians use it as anesthesia. Researchers are also studying it in people who have severe depression.
• Alcohol. Many attackers use one of those three drugs along with alcohol. It can boost the medicine’s effects. But alcohol by itself can also keep someone from defending themselves, knowing what’s happening to them, or remembering it later.

Date-Rape Drug Effects

• GHB can make you sleepy, forgetful, or weak. It can also cause seizures, slow heartbeat, slow breathing, and a coma. The effects start in 15 to 30 minutes and last 3 to 6 hours.
• Rohypnol relaxes you. In high doses, it can cause trouble controlling your muscles, amnesia, loss of inhibitions, and loss of consciousness. Its effects usually start within 30 minutes and peak about 2 hours after you take it. As little as 1 milligram can affect you for 8 to 12 hours.
• Ketamine might make you hallucinate or feel woozy. It can also cause an upset stomach, vomiting, high blood pressure, changes in your heart rate, seizures, or a coma. It usually takes effect within 30 minutes and lasts an hour or two. But you could be affected for a day or more.
• Alcohol may make you relaxed, chatty, and confident. As you drink more, your emotions become unstable, and you lose control of your body. Drinking too much can put you in a coma. Alcohol usually enters your brain within a few minutes.

How to Avoid Date-Rape Drugs

A few tips can help keep you safe when you’re out:

• Pour your own drinks. Avoid open containers that could be spiked, like punch bowls. Don’t accept drinks from other people.
• Keep control of your drink at all times. Carry it yourself, even if you have to take it to the bathroom with you.
• Don’t drink anything that tastes strange.

• Stick with your friends. Ask them for help if you start to feel odd

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Published: 08 March 2022

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Evidence links e-cigarette use with increased odds of prediabetes

New study in the American Journal of Preventive Medicine challenges the promotion by some of e-cigarettes as a “safer” smoking alternative, especially for current cigarette smokers

“Our study demonstrated a clear association of prediabetes risk with the use of e-cigarettes,” explained lead investigator Shyam Biswal, PhD, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. “With both e-cigarette use and prevalence of prediabetes dramatically on the rise in the past decade, our discovery that e-cigarettes carry a similar risk to traditional cigarettes with respect to diabetes is important for understanding and treating vulnerable individuals.”

According to the Centers for Disease Control and Prevention (CDC), traditional cigarette smokers are 30% to 40% more likely than non-smokers to develop type 2 diabetes, which increases their risk for cardiovascular diseases such as atherosclerotic disorders, stroke, and peripheral vascular diseases

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