Psychedelic enthusiasm must be more honest about the reality of the risks.

As always all the aforementioned warnings apply

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New Research Reveals LSD’s Mind-Altering Power To Enhance Learning and Exploratory Thinking

Tim McMillan

Researchers report they have uncovered remarkable new effects of the potent psychedelic drug lysergic acid diethylamide (LSD) on human cognition, according to findings detailed in a new study. 

Published in Psychological Medicine, the study sheds light on LSD’s ability to accelerate learning when coupled with feedback and promote exploratory behavior.

Researchers say the findings may hold the key to unraveling the enigmatic cognitive mechanisms that underlie the potential therapeutic benefits of LSD.

Many recent studies have shown LSD-assisted psychotherapy to offer promising results in treating mental health conditions, including anxiety, depression, and post-traumatic stress disorder...

[Laird]

Lindy has a terminal illness. Psilocybin, the compound found in 'magic mushrooms', is helping her face death by Greg Hassall / Australian Story in ABC News on Mon 22 May 2023

The TGA's decision put Dr Ross and Dr Dwyer in an awkward position. Having witnessed first-hand the extraordinary potential of this treatment, they want to advocate for its use. But, at the same time, they feel the need to sound a note of caution.

"Although I can see the benefit in it, I can also see that it's not for everybody," Dr Dwyer says. "It's a very confronting process. I'd like to see a much greater appreciation of who this is actually for and who it's not. And I don't think that we're there yet."

Before they began the trial, they anticipated objections that never eventuated. Instead, they've witnessed a growing evangelism around psychedelic therapy that worries them. Dr Ross thinks it's got to the point where people are "exaggerating the benefits and completely dismissing the risks, which is a problematic place to be".

Their greatest concern is how and by whom the drug will be delivered. The TGA recommends that the minimum standard of training for a therapist be at the level of a clinical psychologist, but the decision ultimately lies with the ethics committees at the institutions delivering the treatment.

"The work has required every minute of training I've ever had and then it's forced me to learn a lot more as well," Dr Dwyer says. "To do this work properly, I think the therapists need to be people with the highest possible levels of training and accreditation."

"You need a bit of seasoning as a therapist," says Dr Ross. "Things can come up for people that are really quite tricky so you need to be able to know how to pivot and respond to that very quickly."

[...]

Dr Ross and Dr Dwyer struggle to see how enough therapists can be trained to deal with the demand if psychiatrists start prescribing psilocybin from July 1.

"We really need to establish safe and clear guidelines about who can offer this work with people who are really quite vulnerable," Dr Ross says.

"Going along and simply doing a week-long course into the use of psychedelic medicine, it's the same as going and doing a course on how to replace one of the valves in the heart and then thinking you can just go out and do those procedures," Dr Dwyer says.

"You need to be a highly skilled cardiac surgeon before you get to the replace the valve operation. And I think this is the same."

[Laird]

Episode 18 of the ABC show Compass Psychedelics - Healing The Spirit? follows up on the above article, now that the (world first) decision of the Therapeutic Goods Association (TGA) here in Australia to legalise psychedelic-assisted therapy has come into effect. An account is required to watch online, but registration is free, and when I registered (some time ago) I was able to use a throwaway email address from mailinator.com.

The episode doesn't add all that much to the discussion, but might be of interest to some. Alternatively (or additionally), much of the content in the episode is available in writing in today's (Wednesday, 26 July, 2023, AEDT) ABC News article by Rosemary Bolger and Louise Heywood promoting the episode, Australia legalises psychedelics to treat some mental health conditions, but therapists warn it is no miracle cure. Some excerpts:

The traditionally conservative Therapeutic Goods Administration's (TGA) decision to legalise them for persistent mental health issues took many researchers by surprise.

"My greatest concern is that there's been far too little time given for the workforce that is going to step forward to deliver this treatment, to equip themselves to train up," Dr Liknaitzky says.

The TGA says psychiatrists will need to show they have the necessary training, competency, and evidence-based treatment protocols in place to control the risks to patients.

The results of the pilot study show one-third of participants are doing well, one-third are doing really badly, and one-third have mixed experiences.

"The important thing here is that this isn't the miracle cure for some people and finding out why it doesn't work for some people is going to be really important because this intervention is going to be expensive," Professor Rossell says.

Estimates of the cost of treatment suggest it could be as high as $20,000 or $30,000 per person.

Professor Rossell says the worst-case scenario is that the TGA decision actually proves to be a setback.

"There are people who have had bad trips, there are people who commit suicide post bad trips, and it just sets everything back and they change the legislation and make research even harder to do," she says.

The Ether Dreams of Fin-de-Siècle Paris

Mike Jay

Those who sipped or sniffed ether and chloroform in the 19th century experienced a range of effects from these repurposed anaesthetics, including preternatural mental clarity, psychological hauntings, and slippages of space and time. Mike Jay explores how the powerful solvents shaped the writings of Guy de Maupassant and Jean Lorrain — psychonauts who opened the door to an invisible dimension of mind and suffered Promethean consequences.

People with depression are increasingly taking LSD, and research suggests it may help when used under supervision

John Titlow

Scientific evidence on the mental health benefits of psychedelic drugs is piling up. MDMA and 'magic' mushrooms also have shown promise in treating conditions like anxiety and PTSD

It's not really clear more people are taking LSD for depression or if this even works.

LSD, formally known as lysergic acid diethylamide, can increase body temperature, heart rate and blood pressure while also impairing depth and time perception, and the ability to make sound judgments, according to the Drug Enforcement Administration. Some users may suffer so-called "flashbacks" of their drug experiences days afterward.

Still, advocates say psychedelics like LSD can be medically beneficial when used under appropriate supervision, and the buzz around psychedelics in the U.S. has exploded in recent years...

In June, the U.S. Food and Drug Administration issued its first guidance for the study of psychedelics for medical purposes. Although several psychedelic drugs, including LSD, remain classified by the federal government as Schedule 1 illegal drugs due to their high potential for abuse, many researchers see the new guidance as a sign that federal policy on psychedelics may be softening. 

For many, this shift may prove to be beneficial over time. With rates of depression exploding to new highs in the United States and traditional treatment failing to provide relief for as many as 30% of patients, the demand for new, effective mental health treatments may increase. And whether it's administered medically or independetly, researchers suspect LSD may become a more common piece of the therapeutic puzzle.

[Laird]

Leading psychedelic trainer Ben Sessa suspended over relationship with vulnerable former patient

For the ABC by national health reporter Elise Worthington and the Specialist Reporting Team's Mary Lloyd on 7 March, 2024.

Dr Sessa admitted he provided care and treatment to the patient between 2019 and 2021 and ended the professional treating relationship in order to engage in a sexual relationship with her.

Dr Sessa also admitted to treating the patient at a pub whilst she was drinking despite his knowledge of her alcohol problems.

The tribunal heard evidence the patient had repeatedly made attempts to end her life, and that Dr Sessa knew of her psychiatric history, including self-harm and deliberate overdoses when he decided to begin a relationship with her.

The patient has since taken her life.

As briefly discussed earlier in the thread, these sort of incidents are not necessarily unique to psychedelic therapy, but psychedelics might make patients more vulnerable to them.

As always all the aforementioned warnings apply

A Case for Psychedelic Scepticism

Sam Woolfe

One of the reasons I wanted to write a book on the philosophy and psychology of psychedelic experiences was to defend a sceptical attitude towards these experiences. (You can find preorder links and more information about my book here.) The book’s title, Altered Perspectives, is partly related to this motive. Just as psychedelics can alter our perspectives about a number of things, we can also take alternative perspectives on what certain experiences mean, i.e. whether we jump to conclusions or adopt an approach of doubt, questioning, and critical thinking. Essentially, a philosophical approach towards altered states is a way of changing our perspectives towards an experience that (perhaps radically) changed our subjective experiences.

What I try to defend in the book, however, is an open form of scepticism, not the kind of knee-jerk, closed-off scepticism that dismisses the more profound, mystical, and alien aspects of psychedelic experience. There is always a risk that the value of scepticism becomes hardened into an attitude of closed-mindedness, or a kind of scientism, which asks us to trust the efficacy of the scientific method to resolve non-scientific (e.g. philosophical) problems. Sometimes, certain questions are not – or are not currently – amenable to the scientific method of empirical investigation. But this does not make them pseudoscientific (since these questions are not intended to be scientific, or not wholly scientific, in nature). Pseudoscience, in contrast, consists of beliefs that a person claims to be scientific, or based on the scientific method, but which aren’t.

There are other methods of investigation we can use to test the truthfulness of a claim, such as working out how parsimonious, consistent, and coherent it is. If claims lack these features, and instead commit logical fallacies (of which there are many), then we have good reason to doubt their veracity. Thus, we can apply psychedelic scepticism in cases in which empirical evidence doesn’t serve as a guide to truth. At the same time, we should also consider whether there is available empirical evidence that points to one theory being more parsimonious or likely to be true than another.

I would like to summarise some of the aspects of the psychedelic experience that I apply scepticism to. Part of the reason why I want to defend psychedelic scepticism in this book is because I feel there are certain kinds of experiences, and certain narratives around these experiences, that have not been questioned enough.

All aforementioned warnings apply.

Endorsement of metaphysical idealism mediates a link between past use of psychedelics and wellbeing

Jussi Jylkkä, Andreas Krabbe & Patrick Jern

It has been proposed that psychedelics promote wellbeing through spiritual-type transformations, involving changes in metaphysical beliefs. Past empirical research shows a link between the use of psychedelics and the endorsement of non-physicalist metaphysical beliefs. However, non-physicalist beliefs encompass a wide range of metaphysical ideas, and their links to wellbeing and psychedelics use remain unclear. We utilized a cross-sectional Internet survey to probe the metaphysical beliefs of participants (N = 701) with past experience of classical psychedelics, using a novel 42-item questionnaire (Core Metaphysical Beliefs, CMB), encompassing a wide range of metaphysical beliefs. Factor analysis of CMB revealed two factors, Idealism and Materialism. In network analyses, Idealism was linked to psychological insight in a past psychedelic experience (E = 0.24) and average use of psychedelics (E = 0.16), and predicted wellbeing (Es = 0.13 and 0.22). Mediation analyses showed an indirect link from past psychedelics use through Idealism to wellbeing (ps ≤ .005). Non-Physicalist Beliefs or Materialism were not significant mediators. The results indicate that Idealism specifically, not non-physicalist beliefs generally, mediate a link between the use of psychedelics and wellbeing. Future research is required to establish whether the link is causal, and to understand what the Idealism factor means.

All aforementioned warnings apply.

Endorsement of metaphysical idealism mediates a link between past use of psychedelics and wellbeing

Jussi Jylkkä, Andreas Krabbe & Patrick Jern

They have forgotten about Neutral Monsim! But then, I suppose it's not a major theory in the history of metaphysical stances. It's still sort of rather new, compared to even Dualism.