The "standard" pathways for most substances is to build a tolerance to it (and similar compounds) over time of use. If you drink coffee a lot you don't get hyped by the same dose of caffeine, if you drink lots of alcohol it's harder to get you drunk, etc.
So if anything I'd expect "veterans" to be less sensitive to it. But there are substances that permanently reduce your tolerance to them, usually by causing some form of permanent damage, so it's possible that you might "break" something limiting your experience.
Depends on the dose. If you poison yourself with caffeine later you can get very sensitive to even small amounts of it.
Its such a dellusion that humanity has been "pure" at any point in time. Drug prohition, and all its tenticles, is a political tool of mass control. Nothing more, nothing less. Today we are seeing the reemergance of the teachings that have been passed down for generations by tribes around the world as this viel is lifted.
So please, this is not a trend. Its a rediscovery of aincent knowledge. I appreciate that low dose is how this remergence started, but there its not a cureall, and its not the only way this sustance provides benifits. 20 years ago, these same people were trapped to tables, eletroshocked until they became cataonic. Heroic doeses have their place in therapy.
But some people might be more comfortable saying there's a fundamental need for tripping than saying there's a fundamental need for religion (which usually encompasses transcending death and deep meanings for life).
This is hugely beneficial, until it isn't. Having the ability to utilize multiple lenses to see things in a different perspective allows us to unrecognize the threats from our most used perspective.
The over recognition of threats, particularly those you can't control, plays a major role in depression (rage) and anxiety.
Everyone has a default perspective but getting deeply involved in anything can allow us to gain additional perspectives.
Religion provides an alternate perspective. E.g it is the will of Allah, Jesus died to save me, ending any suffering ends all suffering, etc.
With that when you look at things you can apply those perspective filters and see things differently.
Deep interests are filters as well. An example that is a personal anecdote is when I became involved in woodworking and construction I look at houses and "see" how they were built, I see the components, the connections etc, I see trees as board feet and just intrinsically visualize their milling.
It happens with other things as well and it can bring anxieties too, I'm far more concerned that some buildings are going to collapse at random after I have been involved in construction.
Religion can of course add anxieties.
Any new perspective can. Having a new perspective / different way of thinking, on a physical level is a rewiring of connections in the brain. The perspective can become reflexive, mental muscle memory.
The activity of drugs is to induce this rewiring effect. Changing the actual way the brain works by binding to receptors and forcing new connections or reroutes.
Historically people would play many roles, typically changing with the seasons, each which offered a different focal perspective.
As well they would have a deep guided religious experience, use perspective changing drugs and have a strong notion of either self or community which offered further perspectives.
Today many people follow the same path and pattern far too frequently. Affording very limited development of alternative perspective. This leads to a much more developed recognition of negatives due to lack of diversified perspectives.
What else could happen though, it's often, daycare for 3 years, school for 12/16+ then work for 30-40 years. Perhaps there's a year or even just a couple summers of exploratory travel, then we're relegated to a few weeks of vacation and commercialized cultural holidays.
I would like to chime in a thought about the choice of words... I think that we might be doing us a disservice when reducing the whole discussion down to "trip" or "no trip". Some patients have mild sensory experiences from the treatment, some have unpleasant dissociative-ish experiences, some done feel much at all. My belief is that the subjective experience, or the phenomenology of the treatment, is of importance even if the experience is far from a "trip". My patient who thus far has had the most convincing response did not "trip", but described a calm feeling of "everything will be alright" during the treatment - a response that none of 20-ish drugs or ECT had given.
I'm not sure if I remember correctly but I think I've read ketamine makes neurons groe new dendrites in petri dish. I have no idea how this effect could happen in the brain without making a patient trip.
I interpret you as saying that unless there is a "trip" there is only a placebo effect left on the table so to speak. I think this is somewhat refuted by the fact that the standard ketamine infusion protocol (that does not normaly induce "trips") has an effect size that dwarfs the effect size of placebo (say 0.2 - 0.4). Some studies have shown ketamine approaching ECT-effect sizes. This makes me sound like a ketamine nut, which I am not. I am a bit of an ECT nut though. I have just not excluded the fact that the phenomenology of certain treatments actually mediate the treatment effects in a non-placebo way.
At least it is what authors of this study consider.
Also consider the difference between high and low doses of alcohol: just because having 1 beer won't make you blind drunk doesn't mean that the effect is a placebo.
I do not have experiences with psychedelics, but I do have quite some mileage with meditation, in particular approaches that aim at shifting the "way of looking". Those practices can lead to experiences that lead to profound shifts in the usual day-to-day way of looking at the world, but the experiences themselves are more subtle than what I expect a full blown trip to feel like. So I can totally picture that the experience, even if just subtle, can be a big part of the transformation.
I only say all of this to ask: Is there a scientific or medical definition for a trip? Is the medical community still trying to decide what constitutes a trip, or is that well defined?
In this way, your psychiatrist friend is simply the next iteration of a priest, and the portrayal of her patients as greedy fools only furthers this divide and pushes ever more people towards the other side of the law. I'll see you in _my_ cow field with a woven basket!
_edit_: think of it this way. An internal urge drives people to your friend in search of a meaningful experience. Your friend consults her good book and returns to them with information: no, you cannot have your meaningful experience.
And anyways, your statements ignore that there's plenty of hippies on Instagram peddling their mushrooms and Ayahuasca in intense spiritual experiences for only 1500$ a pop. Does the Catholic church control them too?
Somehow you turned someone's subjective spiritual exploration into them limiting themselves...
Dostoevsky made observations like this, too.
"It was not you who ate the idea, but the idea that ate you"
"Men need to bow down to something; whether another man or an idea.”
I think Ernest Becker explored similar ideas in The Denial of Death, though through a different context.
The customer is not always right. Just because the customer wants something or believes something doesn’t make it true.
This really isn’t about being a lawful authority trying to buzz-kill society as much as it is about having principles as a doctor.
If I had someone coming into my IT department saying they heard that dipping their laptop in maple syrup would speed up their processor, and to please proceed to dip their computer in maple syrup, my noncompliance doesn’t make me a gatekeeper like the medieval catholic priests.
What I broadly mean is that modern society has done a relatively poor job at helping to produce integrated humans that have the capacity, tools, and know-how to navigate their inner journey. I know this sounds woo to a lot of people here. That the new wave of psychedelic interest is reified as purely medical treatment is a continuation of this trend. That is what I'm trying to articulate.
I have a deep suspicion that you can't simply sterilise the transformation at the heart of these experiences.
When people tell me about their psychedelic trips, I am like, so? I’ve been doing it my whole life without drugs!
However, my tendency to go on these trips are highly affected by environmental variables. So the only thing I would add is, it’s a mix between the spiritual and the material And we cannot negate either.
So all these therapist and psychiatrist trying to cure me are taking the wrong tact. What I learned is I needed to understand it, and understanding it alone is the cure.
Not to mention, the language you use is really cruel.
Pop culture "obsession" may have been useful for overcoming blanket bans on research, funding, etc. It was obsession that created these bans in the first place, and obsession that triggered them.
Now obsession it's interfering with science and (especially) science communication.
Meanwhile, parent comment (the "trip" is the active substance) is a hypothesis... on the face of it. A reasonable hypothesis that needs to be considered, and if possible tested.
There's probably no getting around obsession here. This is literally the namesake "culture war," dating to 60s counterculture.
Ketamine dosed at levels used in a lot of the original depression studies won’t result in anything resembling a “trip”. Many of the more responsible clinics will carefully administer IV ketamine infusions over 40 minute (IIRC) spans at levels that only result in a little dizziness.
The association between ketamine depression therapy and “tripping” is a more recent development, pushed partially by clinics and influencers seizing on the trend in the most dramatic way possible. Some of the clinics will now dose people with excessively high doses with the goal of inducing trips and overt experiences, even though this isn’t supported by the literature.
I’m actually growing concerned that the pop-culture obsession with tripping and the over zealousness of ketamine providers is going to result in regulatory crackdown on the whole process.
A few months ago I was discussing the topic with a psychiatrist friend. She had tried prescribing ketamine for several patients, optimistically. However, a number of them complained that it wasn’t enough because they weren’t having full on hallucinations like they had read about online or in books. Several of them also started trying to demand higher and very early refills, despite her explaining up front that she was only willing to follow the dosing protocols used in studies.