Posts by Russell Brown
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Hard News: Splore 2019 – Please Don't…, in reply to Emma Hart,
That’s not the problem. The problem is that there wasn’t really anything else available.
Yeah, that’s the problem. Maia Szalavitz is pretty compelling on this – pointing out that 12 Steps does alienate people and doesn’t have a better success rate than other therapies. She actually thinks it should be separate from treatment, available for people who find it of benefit.
Beth Macy’s book Dopesick also identifies the ubiquity of 12 Steps-style abstinence therapy as a problem in America’s opioid epidemic. It fails a lot of people, but it’s generally all there is – particularly in circumstances where people are sent to treatment through a court process. Same problem here. If you want to take the opportunity offered by the AOD Court, you have to embrace 12 Steps, or you're barred.
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For practical reasons, expensive residential treatment centres that house a broad spectrum of vulnerable and potentially volatile people, can’t afford to fuck around with fat heads.
That’s not really what it’s about though. It means that the only way to enter a judicial process and stay out of jail is to formally declare a spiritual belief. I think that’s a bit of a problem.
It’s hard to argue about these things with a man who has an honorarium. But It would be nice if David was will to be challenged on some of this.
I’m happy to see if he wants to respond. But I would point out that he’s someone who works every day at the sharp end of this, both independently and with Waipareira. And he’s not the only person I’ve spoken to about the dominance of the 12 Steps model in treatment.
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For some reason, this 2017 Vice story on one of the Imperial College studies (perhaps one of the ones Suresh worked on, I haven't checked) washed up in my Facebook feed.
"Several of our patients described feeling 'reset' after the treatment and often used computer analogies," Robin Carhart-Harris, who led the study, said in a statement. "For example, one said he felt like his brain had been 'defragged' like a computer hard drive, and another said he felt 'rebooted.' Psilocybin may be giving these individuals the temporary 'kick start' they need to break out of their depressive states and these imaging results do tentatively support a 'reset' analogy. Similar brain effects to these have been seen with electroconvulsive therapy."
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Hard News: Psychedelic Therapy: an…, in reply to andin,
Suresh is a real treasure :-) by the sound of it
He's great. And I respect that fact that he's determinedly not an advocate, just an open-minded scientist.
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Hard News: These things we must now change, in reply to Ian Dalziel,
I assume thats the one where she just repeats what some ‘Journalist’ at The Australian says, or should I say where she echoes what she’d like to say from out of the pages of a Murdoch Newspaper.
That column was an embarrassment. Just hapless.
Audrey Young’s column in the Herald today is also pretty weird – like it’s written through gritted teeth or something. The gallery stalwarts do flounder when the story moves beyond their turf.
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If anyone wants some Saturday viewing, the 1966 NBC feature on the Spring Grove Experiments is worth a look:
The outcomes from nearly 20 years of treating mental illness and alcoholism were largely (but not universally) positive. But watching it now, I was horrified at times by the style of the treatment, which leans heavily on a kind of psychotherapy (especially the dynamic between patient and therapist) that's not fashionable now. I was thinking "Get your hands off that woman!" and "Back the fuck off, man!" quite a lot as I watched it.
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Hard News: Psychedelic Therapy: an…, in reply to ,
Bill Wilson, the founder of Alcoholics Anonymous experimented with psychedelic therapy.
He was a huge fan and actually tried to persuade his colleagues in the organisation to embrace it.
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Hard News: Psychedelic Therapy: an…, in reply to Bart Janssen,
Fascinating discussion. I’m strongly reminded of discussions about toxins – the rule is that everything is toxic, it just depends on the dose. And the same thing kept coming up here – it’s the dose that’s important for the effect.
The obvious problem is that without good trials you can’t get a handle on the dose or worse find out if dose is different for different people.
The interesting thing with psychedelics is that dose isn’t related to toxicity as we usually understand it. LSD is active at the microgram level and a tripping dose is 75-100 micrograms.
We literally don’t know what the LD50 for LSD is, but given that high doses cause vasoconstriction and raised body temperature there must be one. One estimate cited here on Erowid’s page on the question is 14,000 mcg, or 140 high doses. (As Geoff notes, ibogaine is in a separate category, because there is a documented cardiac risk at high therapeutic doses.)
So we’re not really talking about pharmacological deaths. Psychiatric risk? Sure. So care – good old set and setting, assistance if required with integrating the experience – is really important. It seems very significant that severe adverse reactions are basically unknown in the modern studies.
We still don’t really know how a single tiny dose of these drugs can produce lasting changes in cases of depression and addiction. But we do know that they have profound temporary effects on brain activity. From the story last year where I interviewed Suresh:
One particular set of studies described by Pollan, marshalled by British researcher Robin Carhart-Harris, has led to a relatively new theory about why psychedelics work as they do. When subjects were given psychedelics and had their brain activity observed with a technique called magnetoencephalography (MEG), which measures electrical activity, it became apparent that a set of structures in the brain called the Default Mode Network was effectively taken offline.
The DMN is essentially how we get by day-to-day; it deploys a bundle of default assumptions about who we are, what we know and what our senses tell us, based on what they’ve told us in the past. It’s bossy and efficient. But it’s also implicated in undesirable repetitive behaviours like depression and addiction. When it was quieted in the subjects, the other parts of the brain lit up and began communicating with each other and neuroplasticity increased. People became unstuck.
“The thing that amazed me when I first looked at the data was just how massive the effects were,” says Dr Suresh Muthukumaraswamy, a lecturer at the Auckland School of Medicine who did the brain imaging for Carhart-Harris’ psilocybin and LSD studies. “I’d been playing around with giving people drugs and measuring brain signals for a few years at that point and I’d never seen data like this before. What the hell was happening to this person’s brain?
“When we went into the study we weren’t even sure it was going to do anything for us to record. But here were these gobsmackingly massive effects, a profound effect on brain function."
Suresh also noted that the benefits of ketamine in relieving intractable depression manifest the day after, when the patient has no ketamine left in their system. I put it to him that it seemed like a more benign version of ECT, and he didn’t disagree. And like ECT, the anti-depressive benefits of ketamine dissipate and can only be maintained via top-ups.
And yet alongside this kind of “big reset” at high therapeutic doses, we have the even-less-well-understood phenomenon of microdosing (which, at 1/10th of a dose isn’t really all that “micro”), which may increase creativity, openness and a sense of wellbeing. Suresh and Will’s microdosing study is going to be very interesting to watch.
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Legal Beagle: Why the censor's total ban…, in reply to Simon Armstrong,
I still have no idea how you would consider the manifesto deserving of separate treatment to the video.
I do think they represent distinctly different problems.
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Hard News: Psychedelic Therapy: an…, in reply to andin,
Great discussion thanks for transcribing it.
Heh. I just ran the discussion and published it. Emma Hart transcribed it (6000+ words!) and Bart Janssen made the kind offer to pay her for doing so. The drug policy panel from the same Splore session will be next.
What is being looked for in risk assessment for ibogaine? Heart condition, physical or mental health, or does death just drop out of a clear blue sky? So to speak…
Given that the issue is coronary, the first of those. But I don’t know if screening for heart conditions helps.
Did ayahuasca in NZ a very personal experience it was too, no black snakes tho :-) I find myself wondering if ones life up to that point was an influence on the experience a person has? I mean there were elements in common but the experience is unique.
The businessman I interviewed did observe that he may have been able to go into measured contemplation after the initial 45-minute rocket ride “because I haven’t really had any trauma to deal with”.
That may also be why ibogaine experiences are reported as being so challenging. If you’re taking it for drug or alcohol dependence, by definition you’re already at the end of your tether.
MDMA is certainly one of the gentler mind enhancers (if thats right word)
But it is an amphetamine-related drug and thus unsuitable for long-term use. By contrast, I already know someone who apparently successfully manages his long-term manic-depressive condition with more-than-once-a-week LSD microdosing. (In that he’s coherent, happy and runs a successful business.)
It would be good to know more about the difference in effect between microdosing and the now fairly established “big reset” phenomenon of higher doses. Given that Suresh really likes measuring people’s brains, I expect we’ll find out some of that in his study :-)