Have your friend research Erowid, a place where people have posted all possible sorts of information about mind-altering substances and their risks.
I'm not sure where "intent" falls on that spectrum. The vast majority of my experiences have been "for fun" or "for the experience" at music festivals, concerts, or at home..
I have also taken ayahuasca and changa with a shaman. I was doing it "for the experience", but how is that different from someone else who was in the same room as me doing it an attempt to treat depression or anxiety? How would the risks be different?
Being an anxious or depressed person in general may increase risk factors of negative experience. This is still not related to intent.
But it's totally possible for an anxious person to end up worse.
>Psychedelics like psilocybin have a remarkably benign safety profile relative to other Schedule One drugs, not to mention very different social, cultural and historical roles. Lumping psychedelics together with powerful opioids like fentanyl misdirects resources, diminishes buy-in from the public and undercuts the legitimacy of federal drug laws.
The author of the article does not specify what risks these drugs have. Simply that they are relatively less dangerous than synthetic opioids.
But being on a very tight Schedule I (like MDMA, also quite safe), worse even than morphine, good luck researching the risks. It's a catch 22: we don't know the risks, so we ban studies about the substance. We don't have studies about the risks, so we cannot unban it.
When LSD was liberally consumed (1960's), there were almost no deaths related to it. And the very few reports are suspiciously "suicides" or "near suicides", which all of them seems to be accidents while tripping, like any drunk commit everyday (and not like LSD makes you suicidal by choice). More serious reports have found zero deaths directly linked with LSD toxicity: https://pubmed.ncbi.nlm.nih.gov/29408722/
LSD on the other hand, yes quite safe (and even good) for your brain, unless you're prone to mental illness or currently suffering from mental illness.
For all practical purposes, none of this applies to LSD, since trips are much more intense and unpredictable. Although there is a small subset of psychonauts who adopt an extreme sports mindset and intentionally push the envelope by taking larger and larger doses.
There was a time when MDMA was prescribed to thousands of people, and nobody had a problem. Of course some people will always abuse any substance, we currently have people killing themselves with food or sugar. But the best solution is not to classify it as Schedule I, which in practice is a full ban even for research.
MDMA is far more neurotoxic than alcohol. The oxidative stress put on the brain is potent. When you add elevated body temperature, which most folks on MDMA are likely to find themselves experiencing (dancing, hot club, lots of people), the damage climbs precipitously. In primates, damage to the brain has been detected after even single use.
If people want to take drugs, that's their prerogative but after “playing” with drugs when I was younger, the only recreational drugs I can recommend are certain psychedelics if people care about their health, physical or mental. You can replace alcohol and ecstasy in many settings with a very low dose of psychedelics and get similar social opening effects with none of the damage of either.
Whenever I look I can only find reference to long term exposure, and meta-studies reviewing more moderate use seem to show minimal, if any, issues, e.g. https://www.sciencedirect.com/science/article/pii/S014976341...
To my knowledge, the one study that people held up as showing damage from MDMA usage after a single dose was later retracted, as they had mixed up the vials of MDMA and methamphetamine. They were never able to replicate the results after resolving this mistake. https://en.wikipedia.org/wiki/Retracted_article_on_dopaminer...
Disclaimer: I have taken MDMA a couple of times over the years, though I have never particularly enjoyed the experience and have never considered doing it regularly.
MisterYouAreSoDumb was a legendary Redditor who frequently commented on the topic of harm. This one's a collection of references and a good TL;DR. [4] It's ten years old now but there's still a treasure trove of material here. Another comment from them that is the beginning of a series. [5] And as I mentioned earlier, the safety protocols required to mitigate the damage are extensive. You cannot rely on users going the distance to have a less-harmful experience. You must assume it's being taken under non-ideal conditions, with plenty of redosing, which is multiplicatively more damaging, as the axon terminals involved will simply run dry.
Hope that's helpful.
I'm not here to judge. I've also taken MDMA in my youth and quite a lot of it. But I do wish we had these resources available then as we do now so I could have made a more informed decision.
My personal, anecdotal, experience is I had a bunch of pretty magical experiences with MDMA in my youth which I've never been able to reproduce since. That was personal confirmation that irrevocable changes had occurred due to use. The internet is chock full of similar stories.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181923
[2] https://sci-hub.se/https://pubmed.ncbi.nlm.nih.gov/12869661
[3] https://www.jneurosci.org/content/jneuro/19/12/5096.full.pdf
[4] https://www.reddit.com/r/Drugs/comments/15ix0s/comment/c7mvi...
[5] https://www.reddit.com/r/DrugNerds/comments/13lp0b/mdma_neur...
Couple of notes I made from my first perusal.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181923
They point out that they showed neurotoxicity in animal studies with doses higher than those typically for recreational users. In studies of human users, they did find evidence of brain structural alteration, but no large-scale cognitive impairment of clinically relevant proportions. Fairly significant evidence of impact to memory.
https://www.jneurosci.org/content/jneuro/19/12/5096.full.pdf
They chose dosages for MDMA here that are extremely high. 80-120mg is the standard recreational dose with anything above 150mg being considered high, but the dosage they chose would be the by-weight equivalent of a 160lb person taking 340mg of MDMA. This looks intentional - they say in the study the selected a dosage that was known to cause brain lesions. The sci-hub study references a species-specific dose scaling chart that explains some of this, but it also disclaims that the science of the dose scaling is disputed. I'm not super sure what to make of it - it stands to reason that too much of anything can be dangerous, but it doesn't seem like the science is close to being settled on whether or not these dosing differences make sense.
I haven't yet had a chance to go through all the references from the reddit post, but I'll work through them.
I think it's pretty compelling evidence that there is risk in taking MDMA long term, or in very high dosages on more acute timescales. I don't know that what I have read so far counters the science in the meta-study I linked around more moderate use, since that did draw primarily on observational studies that included imaging of human users. I'm no expert, though, and hopefully no one reading this is taking my understanding of the science as anything resembling authoritative.
It does further highlight a lot of the potential risks in taking street drugs, though - you never know the actual potency or chemical composition of what you're being sold.
>My personal, anecdotal, experience is I had a bunch of pretty magical experiences with MDMA in my youth which I've never been able to reproduce since. That was personal confirmation that irrevocable changes had occurred due to use. The internet is chock full of similar stories.
Hmm. There's a lot of experiences I found magical at one point in time that I've never been able to reproduce, none of them related to drugs. I think it's hard for humans to disentangle their perceptions from the novelty of new experiences, the impact of their mental state, point in life, etc. etc.
At any rate, thank you again for the wealth of information.
In fact they have an answer specific to your question on mushrooms: https://www.erowid.org/ask/ask.php?ID=1606
In short, there is very little risk but whether or not someone should choose to take something should still be an informed choice. As far as risk to life, there's been few or no reported deaths purely due to ingesting psilocybin. However, there are small risks around operating heavy machinery (e.g. driving) after as well as small risks around ensuring you are actually ingesting a safe psilocybe mushroom as opposed to a different toxic mushroom.
I personally know someone who has suffered visual distortions post trip for 20 years and counting at this point.
There is a foundation looking to understand why/how this happens and what we can do to moderate/manage it: https://www.perception.foundation/
No, there is a lot of strong evidence that psychadelic trips can trigger underlying issues such as schizophrenia, etc.
However, some portion of these people would have it triggered these latent illnesses regardless of the use of these substances. The hard to answer question is how many people would develop these conditions without the drug use, if the drug use significantly accelerated it, etc.
On the subject of HPPD, I am more skeptical. It's very poorly understood, and there's been correlation shown for just about any sort of psychoactive substance, SSRIs, etc. Studies have claimed that anywhere from 5% to 25% of people who have taken recreational psychoactive drugs are impacted by it. Which, well, I have not done and am not qualified to do such a study, but having spoken to hundreds of users of psychadelic drugs over several decades and never encountering a single person who claimed to experience HPPD, it's hard to square up my anecdotal experiences with some of the reports.
Something is going on there - there's enough people that report the symptoms that I don't believe it's made up or anything like that - but it doesn't seem to be nearly as simply as "Anyone that does recreational drugs has a chance of developing HPPD"
Think that through.
Schizophrenia was already there, the trip made it apparent.
Associating “psychedelics” with CAUSATION is absolutely irresponsible
That is exactly what they are saying.
However I work with doctors, and through that have had the ability to discuss the site with various medical doctors. In general, they have also noted it as a good resource. They've also noted there is limited ability for them as medical doctors to assess the medical side effects of various drugs due to the illegality of them in their jurisdictions. Thus, the need for resources such as Erowid. If you want your medical doctor to be able to give you medical advice about psychedelic drug use then help push for continued legal reclassification of and access to psychedelics for medical researchers.
The fact of the matter is that a lot of researchers depend on the folk knowledge that is stuffed into Erowid for their own research because it's one of the higest quality sources of information on the actual effects of various substances that people have been putting into their bodies. Much of the research on these substances cannot be funded easily (federal law in the US bans the use of federal funds to research LSD, marijuana, etc due to their classification by the DEA of "intractably bad for society, useless for medicine, and not worthy of academic study.") This means that researchers have to turn to these contemporaneous accounts.
Nobody calls Erowid "medical advice." It's the tripper's notebook, shared and amalgamated by many a substance user. It's the closest thing we have to a Merck Manual for things that alter your mind.
I think I may have read this exact post 10+ years ago. Reminds me of old homes that have since been sold. What links to this Q&A?
This is an example of some of the better sources of info on that site: https://www.erowid.org/chemicals/lsd/lsd.shtml
The more popular psychedelics become the more bad actors will take advantage of this.
A trip sitter is a great idea in theory but just rarely actually happens.
The deepest thing I have learned on psychedelics though is that the very idea there are experiences that are "fun" and experiences that are "spiritual" is complete nonsense. The person sitting alone in a room on a spiritual quest of some sort looking down on the person dancing at a rave is an utter fool.
Some drugs are fine for 99% but there may be a 1% chance of permanent psychosis for some people - with no current way to predict why.
I.e. depending on the drug, the risks can be super high but rare, like BASE jumping.
What risks are they exposing themselves to? I'd hate to have a friend hurt themselves.