We're excited to bring you an AMA with three people who have done a lot to increase the profile and prospects of psychedelic research.
Effective altruism has a history of engaging with psychedelics (see these posts, for example) as a promising intervention for mental health issues — one which could sharply reduce the suffering of tens or hundreds of millions of people.
Between Tim, Michael, and Matt, we have many kinds of expertise here — nonprofit investing, journalism, medicine, and more. We hope the discussion is interesting, and useful for anyone who's thought about working or giving within this area.
We'll gather questions for a couple of days. Michael and Matt will answer questions on Sunday, May 16th. Tim will answer questions on Tuesday, May 18th (we've pushed his original date back by one day).
Author introductions
Tim Ferriss
Hi, everyone! I’m Tim Ferriss, and I’ll be doing an AMA here. More on me: I’m an author (The 4-Hour Workweek, Tools of Titans, etc.) and early-stage investor (Uber, Shopify, Duolingo, Alibaba, etc.).
Through my foundation and since circa 2015, I have committed at least $4-6 million to non-profit scientific research and clinical treatments of “intractable” psychiatric conditions such as treatment-resistant depression, opioid/opiate addiction, post-traumatic stress disorder (PTSD), and others. I believe (A) this research has the potential to revolutionize the treatment of mental health and addiction, which the data from studies thus far seem to support, and (B) I’m a case study. Psychedelics have saved my life several times over, including helping me to heal from childhood abuse.
Projects and institutions include the Centre for Psychedelic Research at Imperial College London (the first such center in the world); the Center for Psychedelic and Consciousness Research at Johns Hopkins University School of Medicine (the first such center in the US); MAPS (Phase 3 studies for MDMA-assisted psychotherapy); divisions and studies at UCSF (e.g., The Neuroscape Psychedelic Division); The University of Auckland (LSD microdosing); and others (e.g., pro bono launch of Trip of Compassion documentary on MDMA-assisted psychotherapy).
I evaluate non-profit and scientific initiatives in the same way I evaluate for-profit startups, and I believe some bets in this nascent field represent high-leverage, low-cost opportunities to bend the arc of history, much as Katharine McCormick did for the first birth control pill. Here is one blog post with more elaboration.
I am happy to answer any questions through the AMA. Dr. Matthew Johnson is no doubt better qualified to answer the scientific (and more), and Michael Pollan is no doubt more qualified to answer the journalistic (and more), but I will do my best to be helpful!
Michael Pollan
I'm a journalist and author who focuses on ways that the human and natural worlds intersect — including within our minds.
In 2015, I wrote a New Yorker article on psychotherapy, "The Trip Treatment", which profiled a number of cancer patients whose experiences with psilocybin had reduced or entirely banished their fear of death. This led me to embark on a two-year journey into the history of psychedelic policy and its potential for modern medicine, and to write a book: How to Change Your Mind: The New Science of Psychedelics. My forthcoming book, This is Your Mind on Plants, covers the strange contrast between the human experience with several plant drugs — opium, caffeine, and mescaline — and how we choose to define and regulate them.
I'd be glad to answer questions about anything I've written on the subject. Particular topics of interest:
- The history of drug regulation, and the dynamics that lead to specific substances facing especially harsh regulatory regimes
- The ways in which different cultures incorporate plant drugs, and how that might or might not map to cultures (e.g. in the United States) that have yet to legalize those substances
- The potential of psychedelic therapy to alleviate the worldwide mental health crisis
- My personal experience with psychedelic substances, and how it changed the way I think about my own mind
Dr. Matthew W. Johnson
I’m a Professor of Psychiatry at Johns Hopkins University School of Medicine. I’m an experimental psychologist who has conducted research with psychedelics since 2004, including studies of psilocybin and such topics as mystical experience, personality change, tobacco addiction treatment, cancer-related distress treatment, and depression treatment. I’ll soon start studies on the treatment of opioid addiction and PTSD among others.
I’ve supervised hundreds of psychedelic sessions and have personally guided over a hundred people through psychedelic sessions with psilocybin and other psychedelic compounds. I’ve also conducted research on the nature and treatment of addiction with drugs such as cocaine, methamphetamine, opioids, alcohol, and tobacco.
I’m looking forward to answering questions related to psychedelics, including those about therapeutic effects, risks, mechanisms, and opportunities. You can ask me anything!
New to the EA Forum?
If this is your first time here, welcome!
The Forum is a space for discussing topics related to effective altruism — a research field and social movement which uses science and careful reasoning to work out how we can maximize our social impact.
You can see our user guidelines on this page. (You don't need to read that to ask an AMA question, but it has some "good to know" info about the site.)
If you want to learn more about effective altruism, we recommend:
- Checking out the introductory content and resources on effectivealtruism.org.
- Listening to Tim's interview with Will MacAskill, a founder of the movement.
- Looking up your local EA group, if you want to try a virtual or in-person meetup.
First of all, I'd like to say I've been excited about this topic for some time and have been following each of you, and your (excellent) work individually, so it's a very pleasant surprise to have you all here!
Question: what is your thinking on how cost-effective, from a donor perspective, additional resources are if put towards psychedelics compared to other problems, e.g. the GiveWell-style health and development interventions?
Follow up: How valuable do you think additional detailed research on this would be (to you)?
This is primarily for Tim, seeing as he's really putting his money where his mouth is!
Background: I run the Happier Lives Institute and I want us to take look, in the near-future, into funding psychedelics.* Psychedelics seems very promising, but it's unclear exactly how promising.
One generic issue is that it's hard to sensibly model the cost-effectiveness of systemic interventions, e.g psychedelics, to 'atomic' ones, e.g. handing out cash transfers to one person at a time, because you have to make so many assumptions about how funding one thing might impact an entire society. The best analysis currently is from Founders Pledge, who compared funding... (read more)
Thank you very much for the thoughtful questions and kind words, Michael. I’m familiar with your writing and so a bit nervous to share much of this for the first time, but I hope it’s somehow helpful. I’m also open to improving my thinking, so please consider this all a rough draft! Please note that I use the words "invest" and "investment" to refer to non-profit donations, gifts, grants, etc. I think "investment" is the right way to think about how you place certain bets, whether for-profit or non-profit. To date, I have deliberately not made any for-profit investments in the psychedelic space.
My thoughts are inline below, I've bolded my replies, and apologies for any typos:
Question: what is your thinking on how cost-effective, from a donor perspective, additional resources are if put towards psychedelics compared to other problems, e.g. the GiveWell-style health and development interventions?
TIM: Broadly speaking, I’m both/and instead of either/or, as I view the nature of these “investments” as quite different. I’m a big fan of GiveWell. I view GiveWell and its recommended recipients as well-vetted “late-stage” options for donors, defined as such because so many varia... (read more)
Tim,
Thanks enormously for this very thorough write-up - shared despite your nervousness(!) -
which was insightful, not just for your thinking about psychedelics, but also about non-profit and for-profit investing.
You said lots. I'm just going to focus on two things here.
1. (Dis)analogies between investing and donating
You drew the analogy that GiveWell-recommended charities - evidence-based 'micro-interventions' - are like index funds, whereas funding research is more like angel investing. I agree with you that the risk-return structure is similar, in the sense we think the former has lower variance and lower expected value and the latter has higher variance but also higher expected value. Crucially, 'value' here is being used ambiguously: for investing, we're interested in financial value; for philanthropy, in moral value. Because of this, the analogy isn't exact and it doesn't follow we should think about investing and philanthropy the same way.
From an investor's perspective, it does make sense to make both sorts of investments, but only because there are diminishing marginal returns to income on well-being. If there were no diminishing marginal returns to income on... (read more)
1) Where do you see untapped opportunities for nonprofit entrepreneurs in the space of mental health?
2) What role do you see entrepreneurs (vs. established organizations) play in this field, including incubation programs like CharityEntrepreneurship.com that has incubated mental health charities before?
3) How do you assess the potential of new mental health treatments for the Global South? Is this sufficiently prioritized and do you see particular roadblocks to rapid adoption?
What is the best case against psychedelics being an important area?
I'll preface this by stating that I obviously believe psychedelics are an extremely important area. I'll focus on challenges. One is that they are not FDA (or international equivalents) approved for treatment yet, so for therapeutics as a field we need to continue to follow the regulatory pathway with larger and more definitive studies. Another is that at least as currently conducted this is a pretty expensive treatment due to professional time. However I think that is more than off set by the large success rates - it pays for itself in the long run so long to the degree that the payer is incentivized to care about long term costs. And more scalable and safe treatment models need to be explored in studies. Another challenge is that given that people often grapple with the "big questions" during psychedelic sessions, there is a potential that therapists coopt the patient experience (intentionally or unintentionally) toward the therapists' own metaphysical belief system. At the extremes this can lead to cults, but the risks are present even short of the extremes. Another legitimate question and challenge is determining how many people would want and benefit from the... (read more)
How could psychedelics-assisted therapy be scaled up? Isn't this super hard because you need at least two trained professionals on multiple lengthy occasions? Where will those people come from?
There's a lot of good work being done on this important question. Several new training programs have been started, but there is also research to see if there are other, more efficient models of therapy besides the traditional two facilitator model-- group therapy is one; designing treatment suites where one therapist can guide several patients at once, etc. But the Psychedelic Science Funding Collaborative estimates that 100,000 facilitators will be needed in the next decade, so this is a potential bottleneck to scaling psychedelic therapy. It's also an opportunity for philanthropy.
For everyone: What are your thoughts on the effective altruism movement? What do you like about it, and what do you not like about it?
Thanks for the question, Brian. I'm a big fan of the effective altruism movement and have tracked it for some time. That said, I am by no means an expert, so my answers are those of a casual observer. Caveat lector!
THINGS I LIKE:
*Keeping it simple: I like forums where people can stress-test their ideas, assumptions, and arguments in the service of pursing good. The more rational, evidence-based decision makers we have, the better off the world will be, whether in non-profit work or any other field. EA provides concepts and tools, as well as a community within which to test them. Last but not least, the EA movement encourages people to think deeply about their impact in and on the world. This is a wonderful thing.
THINGS I HAVE PONDERED:
*Does the EA community tend to overemphasize philanthropy? If so, why? If you look at the etymology of phil-anthropy, it is literally "man-loving." Many of the causes favored in the EA community seem to focus on the well-being of humans (and animals). While I strongly support causes that focus on human well-being -- psychedelic science is certainly an example -- I simultaneously believe that there are many worthwhile causes with measurable benef... (read more)
I suspect Tim would be the most relevant expert here given his role as a philanthropist. So, I can't really offer any critique. I can just say from my knowledge I love and admire the idea of being strategically and empirically informed as to how a given amount of philanthropy can improve the world.
Really appreciate your taking the time to do this AMA — I badly want to see this cause area succeed, largely thanks to your writing (Michael), advocacy (Tim), and research (Matthew). Thanks for leading the way.
In a recent conversation with Tim, Hamilton Morris worries out loud about how the psychadelic pendulum has recently swung towards hype, with lots of trendy op-eds and new capital:
How do you think about setting expectations here? Are you concerned about this resurgence in interest repeating some of the mistakes of the 60s? And, this time, what can we be doing to establish things for the much longer term?
I share Hamilton's concerns that psychedelic therapy can be over-hyped. Many of the researchers are sounding a more cautious note, but there's so much capital chasing so few good ideas right now, and the media is so positively disposed to psychedelics that a correct is bound to happen, and should. Some of these over-valued new companies will crash; there will be adverse events in the drug trials: if you trial hundreds of depressed patients, some of them are likely to commit suicide, and because the pre-existing narratives about psychedelics, this will be a big media story, even though suicides happen getting on and off SSRI's all the time.
But in the end, it is the research that will determine whether psychedelic therapy earns a place in mental health treatment or not. I don't think we'll see a disabling backlash as we did in the 1960s. The need for new therapeutic tools is so desperate that the mental health establishment will embrace psychedelic therapy if the phase II trials are anywhere near as good as the phase II.
Hi, very cool that you're doing this, thanks! Here goes my question:
How likely is it that taking psychedelics makes patients weird? Scott Alexander wrote up some anecdotes about many early psychedelicists getting weird as they experimented with these substances. He emphasizes it's all very speculative and of course subjective. And it probably involved pretty high doses / frequencies. But my very superficial understanding is, that it's hard to find good studies on this sort of thing, precisely because of the regulatory environment. Is that accurate or am I missing something? So should patients seriously consider the risk that their personality, motivations and view of the world would be significantly altered in a way their current self wouldn't necessarily endorse? Would that be a bad thing?
How much evidence is there for microdosing having an effect significantly larger than placebo? From this conversation with James Fadiman I got the impression that it is more underwhelming than I thought.
There have been 3 laboratory based double blind, placebo controlled studies of microdosing. None of them have shown evidence for any of the positive effects reported anecdotally, other than feeling just a tiny bit high (which could be considered potentially positive regarding potential antidepressant effects, but could also be considered through the lens of abuse liability). Results range from no effect to slight impairment. It could have been that these studies did not measure the outcomes that would show an effect, or that some of them only looked at acute effects rather than a chronic dosing regiment such as those many endorse (e.g., taking it once every 3 or 4 days). Nonetheless, so far there is no evidence of benefit. I also think that the benefits anecdotally reported for microdosing are especially prone to placebo effects. Surely part of reported success is due to placebo effect, but that is true for most medical interventions. What you get in the real world is a combo of direct underlying efficacy (or whatever you wan to call it) and the placebo effect. The challenge is to see if any of the benefit is not due to the placebo effect. My best guess at this point is that ... (read more)
MDMA-assisted couples therapy has been studied a bit. Could MDMA also be useful for interpersonal conflict resolution more generally, such as for enabling more constructive conversations between people with very different perspectives?
+1. I believe this to be well worth exploring.
I think the potential for using MDMA to solve conflicts is a rich area of exploration. I know Rick Doblin at MAPS has a longstanding interest in this. (In the 1980s he sent hundreds of doses of MDMA to the Russian leadership, hoping to advance arms negotiations!) I believe there are some projects along these lines underway or planned in Israel.
I agree this is a worthwhile area for research.
For Tim: Have you considered having a page on your website as a public tracker with how much you intend to give per year, and/or how much was each donation you've made to each project? Why or why not?
I think having a public tracker could help your audience know that you are a thoughtful and generous philanthropist, and it might encourage them to be public and thoughtful about their giving too.
Thanks for doing this!
For all three – how would you like to see EA participate in the psychedelic renaissance? What do you think a good marriage of the two communities would look like?
Hi Milan! It would be great to see increased discussion of the most attractive target projects related to psychedelics, as well as perhaps donation campaigns to reach critical mass for specific purposes. It's really remarkable how much can be done for how little at the moment. If there is interest, I might be able to help by drafting a blog post with some of the candidates I consider very high-leverage and worthwhile.
For Tim: If for some reason you were unable to donate to scientific research and clinical treatments of "intractable" psychiatric conditions over the last few years (and in the future), what would you instead be donating that money on? I'd love to know about what other causes or projects you prioritize, whether they are mental health related or not.
Here are a few areas of interest:
What do you think of drug policy reform more broadly, and where do you see your work on psychedelics fitting into that?
(Disclaimer/hopefully-acceptable-self-promotion: Peter Singer and I argued, in the New Statesman, in favour of full legalisation a couple of weeks ago. We didn't mention psychedelics specifically, but full legalisation would, amongst other things, make research into and the therapeutic use of psychedelics easier).
How do you feel about people flying to e.g. Jamaica and going on psilocybin retreats? Is this a net positive or could it be a problem for changing the image of psychedelics towards a legal medicine?
I never thought I would see Tim Ferriss do an AMA on the EA Forum. I am such a fan.
For Tim:
Imagine, two or three decades from now, that all your hopes about psychadelic-assisted therapy materialise — it works at scale, and it becomes about as neglected and unhelpfully politicised as hip surgery and antibiotics.
What do you picture? How did these remarkable early studies scale to a system which fully lives up to their promise and reaches milions of people? And just how ubiquitous (in your more imaginative moments) do you see these treatments becoming?
More personal question: what reactions have you gotten from other people, such as your friends and family, when/if you've told them about your use of psychedelics? Was anyone shocked and appalled?
I was nervous about this. But the reactions I get are more curious than judgmental, even from my mother and son. In general I expect much more pushback --both personal and professional-- than I actually received. I've come to the conclusion this is one of those issues --like gay rights-- where it is vitally important for people to come out of the closet, discuss their experiences in an unsensational way, and when they do the public will listen and shift its views. This is how anything gets normalized-- by ordinary people telling their true stories.
No one has been shocked and appalled by the fact that I've used psychedelics, and this was true even decades ago. As Michael said, the response is uniformly more curious than judgmental. For better and worse, you can't visit a yoga class or order a green juice these days without bumping into a rent-a-shaman, so it's all the more normalized.
I struggled with IV heroin addiction for a decade and got clean, with psychedelics playing a major role. I went back to school and got a computer science bachelor’s, but realized I want to dedicate my life to helping both the psychedelic movement and others with addiction and/or mental illness. I am considering applying to med school in my 30s in the hopes of becoming a psychiatrist. Is this foolish? If so, how else can I contribute to the cause?
Should psychedelic researchers have personal experience with the substances? It could be a source of bias, but also help one design studies.
After enjoying an explosion of popularity in the 60s, psychedelic use declined with the emerging “War on Drugs,” and research was completely halted for 20 years starting in 1972. Fast forward to today, and we’re now seeing some form of psychedelic renaissance, with growing interest in their ability to “change minds” for the average person and to potentially help people with a variety of ailments. For those of us who are keen to minimize the risk of entering another psychedelic drought, and who have experience with launching nonprofit startups, what type of nonprofit psychedelic advocacy group do you think could do the most good?
Many thanks for your important work, and for doing this AMA.
What's the current state of research into 'bad trips' and hallucinogen-persisting perception disorder?
There seems to be this weird disconnect between people saying "but what about bad trips?" and psychedelic researchers basically shrugging their shoulders and replying "we actually don't see these in clinical trials". Is one explanation that clinical trials screen out certain people, eg those susceptible to schizophrenia, who are most liable to react badly to psychedelics?
In terms of bad trips, this is not an accurate reflection of the science. Many studies have reported bad trips (challenging experiences). We have done so many times at Hopkins. We have even developed a validated scale to assess them. They happen on about 1/3 of sessions at a high dose, which doesn't mean it lasts the whole session but that can happen too (although far more infrequently). However I call them challenging in this context because most folks report valuing these experiences and learning from them in the long run, and because with the safety guidelines in place, the really bad outcomes like harming themselves or others are substantially mitigated. We have done extensive survey work on bad trips in non-clinical use as well. For example: https://pubmed.ncbi.nlm.nih.gov/27578767/ , https://pubmed.ncbi.nlm.nih.gov/28781400/ , https://pubmed.ncbi.nlm.nih.gov/27856683/ . HPPD is a different topic. This is complex but the take homes are these. We have never seen this in the thousands of participants in either the modern era or older era (50s-early 70s) of clinical psychedelic research. So this very rare disorder likely has something to do with rare predisposition a... (read more)
Within the field of psychedelics, where do you think additional action is most urgent, and why?
Thanks so much for doing this! I'm a massive fan of all of yours.
Michael, you've written that, as well as being used to treat mental health issues, psychedelics could be used for the 'betterment of well people'.
For anyone: currently, how much good evidence is there that psychedelic use can change healthy people in ways that are generally positive (by making them more open, empathetic, rational, etc.)? I'm never sure what to make of claims in this area.
One of the other comments here says there might be some evidence of microdosing not doing much. One of my friends swears that a 'hero's journey' is orders of magnitude more impactful or effective than simply doing a normal dose. 1. Is there research being done on heavy one time usage? 2. If it turned out the most effective way to use psychedelics was to use a large amount at once, would this be politically feasible?
What are your thoughts on chronic anxiety and DP/DR induced by psychedelics? Do you have an idea of how common this kind of condition is and how best to treat or manage it?
For Michael (or others): Do you think there might be a connection between (responsible) Psychedelic use and altruism? And if so, do you think this is a promising research avenue or future application for psychedelics?
In How to Change Your Mind, you reference the sense of 'oneness' and global community that often follows a psychedelic experience. I imagine these same feelings motivate many altruists, so psychedelics' ability to dial them up could potentially lead to some inspiring ethical change; the change that has motivated many players in the... (read more)
What do you think of the research chemicals scene (e.g. r/researchchemicals)?
Hi! Thanks for doing this. I read How To Change Your Mind a few years ago and quite enjoyed it, which lead me to following this space since then. A few questions come to mind right now but I'll post them separately. Feel free to answer what is interesting and ignore what seems less important.
First off: How do you see the regulatory environment around psychedelics changing in the next decade? IIRC from this podcast with Rick Doblin, it looks like MDMA could be decriminalized in the US in the next years and psilocybin might follow a few years after that. Is this correct?
How do you balance your efforts between helping others and taking care of yourself?
I've recently been feeling burnt out in a way that is making me less effective in both areas, and I think this is a somewhat common feeling in the EA community because there really is no limit to the amount of good you could do and how hard you could work for it.
Hello and thank you for doing this AMA! I am an aspiring PhD student working on "neurorights", which is a branch of human rights research trying to formulate the rights and liberties of the individual over its mind. It mainly look at recent developments in neurotechnologies but therapeutic and recreational uses of psychotropics are defenitely concerned.
How do you see the legal landscape evolving in the coming years? Be it internationaly, in the UK or in the US ?
On a personal note, I would love to contribute to this body of research, and later partici... (read more)
Thank you for your work and doing AMA! I have two somewhat related questions:
-
... (read more)Do you think that psychedelics have the potential to improve the lives/wellbeing of people not suffering from any mental illnesses? Very anecdotally and only in the context of non-assisted/recreational use, one person I know claims that taking LSD substantially improved their default mood and wellbeing. Where "substantially" means that the contrast between past and present is obvious, "x2" improvement in their own words. While the reports of most other users I know were much mo
Thanks to all of you for your work in this space, and for doing this AMA.
Question for anyone. In the spirit of Effective Altruism — where are donations best placed in this space? Is it simply about giving to MAPS, USONA, JHU, Berkeley, Neuroscape, etc. and letting them use as they see fit?
Or is there a taxonomy or framework of giving opportunities potential donors should consider such as monitoring and litigating potential abuse in the patent landscape; scaling training for facilitators; harm reduction; public education campaigns; funding specific research studies ? Does it depend on how big the donation is?
Hi all, thank you for everything you have done in this area.
Do you think it will be difficult for North American/European cultures (bit vague, sorry) to integrate the experiential aspect of these drugs? The clinical results are amazing and will speak for themselves but the black box that is the mystical-religious type experience with it's unitive consciousness, self transcendence, union with "God", entity interactions etc etc
I fear this aspect of the drugs (IMO the most interesting/profound aspect!) will be hard to integrate with wider culture. Do you have this fear? How have you thought about how this can be integrated and taken seriously and not dismissed as a delusion/hallucination ?
Regards
I'm interested in your thoughts on the use of psychedelics for the treatment of Autism. I have an older brother (58), 1st child of my mother, who has worked most of his life as a service clerk at a grocery store. I have felt if he could break free of the fearful loops of his default mode network, so much more could open up for him. My mother was diagnosed as having toxemia during her pregnancy with my brother. I feel my mother's fears may have also been conveyed to my brother during pregnancy. Do you feel psilocybin or mdma could be useful to treat my brothers Autism, and are you aware of any trials looking for candidates? Thank you, Patrick
Successful legalization of psychedelics simply cannot happen without commercialization - but advocacy for psychedelic-assisted therapy has gone from being driven largely by medical academics, philanthropists, and various grassroots enthusiasts, to being dominated by entrepreneurs and investors. Shareholders seem prone to accepting company press releases regarding ethical concerns rather than questioning the approaches being taken by the relevant pharma startups they are stakeholders in. What can supporters of psychedelic therapy effectively do to ensure that healing, safety and accessibility get prioritized over ROI and market control?
Do you think harmala alkaloids alone have any potential in this developing field of psychedelic medicines?
What do you see as the best path toward mainstream adoption of psychedelics? Do you think that parts of the “psychedelic culture” (think: ritual, emphasis on hallucinatory experience, etc.) will be adopted into the mainstream, and do you think they should be? What do you all think about the idea of “non-hallucinogenic” psychedelics?
Thanks for doing this to you three! Two questions:
Hi Tim, Michael, and Matthew. Thank you for doing this.
My question: Has there been any research that looks at how a person's pre-existing belief structures might affect a psychedelic experience? I've heard some anecdotal evidence that an extremely rigid set of beliefs (religious fundamentalism, in particular) can be a substrate for a very bad trip, because of a refusal to accept a frightening encounter during the experience as anything but the presence of real evil. Of course a "bad trip" can be extremely useful regardless, and these experiences ("good" or... (read more)
What’s the best way to get in touch with a trustworthy guide? Is there a community of reliable people who we can begin to explore with?
I have a 57-year-old sister with treatment-resistant depression (since age 12). Esketamine provides limites relief. What is the best way to get her into a trial or program to try psilocybin? Or, the more generalized question, how does one go about finding practitioners of psychedelic-assisted treatment?
Long comment; TLDR at the bottom.
Thank you all for doing this AMA. You three have done incredible things for the world of psychedelics. Michael—I loved How to Change Your Mind and I'm looking forward to getting my hands on This is Your Mind on Plants when it comes out. Tim—I love your podcast and have been listening to it almost daily for the past two months. Dr. Johnson—your podcast with Lex Fridman was incredible.
The question:
What are your thoughts on someone with Bipolar 1 taking psychedelics for non-therapeutic purposes? ... (read more)
Most folks who receive psychadelic-assisted therapy do so now because of a known and often severe issue — like depression, PTSD, or a form of addiction. Can either of you speak to an experience (personal or otherwise) of first realising or appreciating some issue through the use of psychadelics, in a way which helped resolve that issue?
More generally, how do you think about using psychadelics for treating the 'well'?
If you reran U.S. history from (say) 1960 to the present day, how likely does it feel to you that drug laws shake out in the way they did? Is there something about the way psychadelics ended up getting regulated that feels inevitable, or could the story easily have turned out differently? What could that tell us about hopes for influencing sensible regulation that lasts for > a decade?
What is especially neglected but promising within psychedelic science?
Dr. Johnson
Question: For an 18yr old with treatment resistant depression, how do you stack psilocybin assisted treatment (or others you are actively researching) against current standards of treatment with respect to risks/side effects? If this were your child, would you consider this and where would you point a parent for more resources?
Additional context: My son who turns 18 this month has been struggling with treatment resistant depression (3 different ssri’s, snri’s) and some social anxiety triggered and exacerbated by covid realities... (read more)
What new psychedelic drugs are being invented, or are in planning stages? What would be the characteristics of the "perfect" psychedelic drug (regarding duration, intensity, etc). How might new, as-yet unheard of substances change the potential for psychedelic therapy?
Thanks for doing this, guys, and for all the great work you’re doing in this field. As someone who is in serious need of these therapies, I’d like to submit that there is a huge piece of the puzzle that seems to have been ignored to this point. When it comes to treating TRD with psilocybin, has there been research done on the most effective method for transitioning patients off of their existing antidepressants and the implications of doing so? I, like many others, have tried and failed numerous times to get off of SSRI’s/SNRI’s. It’s a serious problem (se... (read more)
Is the renewed interest in psychedelic research & psychedelic-assisted therapy happening only in Western countries? Are other countries more worried about these substances for some reason(s)?
What would you say to journalists who may (or may not) be:
Which treatment type do you expect to see approved first? Do you think it will open doors for additional treatment types?
What's your stance on veganism since emission/deforestation caused by animal agriculuture/fishing are among the most destructive anthropological forces going on right now?
Hey all, thank you so much for your time. I think the implications of psychedelic research could revolutionize mental health care.
My question for you involves the use of psychedelic therapy for prisoners and those who find themselves on the wrong side of the law. Our current system of punishment and incarceration does very little to help actually rehabilitate those who commit crimes, which creates a vicious cycle of recidivism. I am wondering if the three of you share similar hopes as me for the creation of a more compassionate form of law enforcement whic... (read more)
Tim - I'd love to know which aspects of set and setting you're most interested in seeing researched via the forthcoming work at Adam Gazzaley's lab?
What changes would need to happen to interest for-profit entities to invest in this field?
If you could get a influential US senator to introduce a bill targeted at changing the legal landscape within which psychedelics use happens, how would such a bill look like?
Hello and thank you all for the amazing work and awareness being brought to this field. My question; Has there been any studies or correlations seen in studies with the length of time a person has been diagnosed with PTSD, addiction, depression and the results of their psychedelic assisted therapy?
A friend and I were discussing this because most articles/studies we read, the person mentioned has been diagnosed with PTSD for 10+ years before being part of the trial. I know from my own experience with addiction (coming up on 4 years sober) generally speaki... (read more)
Which lifestyle practices show the most evidence or potential to have similar effects to psychedelics?
Tim - I don't recall you announcing your next book but being an avid listener of your podcast, my guess would be that you're working on a new book on the topic of psychedelics and mental health. What's the strangest thing you've come across in your research related to psychedelics?
Also - Thanks for calling attention to the sustainability (or lack thereof) of various psychedelic substances in your blog as well as reminding people that we needn't fill a psychedelic passport with stamps. These are topics that deserve attention as things are getting hyped.
Hello Tim - Thank you for your work in this arena. You are a huge supporter of the movie Trip of Compassion. Are you interested in supporting additional projects in the works which tell the true positive stories of people who have used MDMA therapy to heal trauma? As this therapy helped me I have been inspired to share with the world dozens of stories of healing and transformation that I have researched. The stories are amazing. As Michael Pollan stated in a comment below - the press will go negative, and I believe there will be pushback. I sent an email t... (read more)
Question for anyone: What is the next big book about the future of psychedelics that you hope gets written?
Thanks for all of your work in this area and for doing this AMA.
In the spirit of "80,000 Hours" (the effective altruism approach to using one career to do the most good) — what kinds of qualifications, experiences, or credentials are needed to work in this field? I'm sure there is a range. I'm personally interested in the challenge of scaling the training of facilitators, and I have credentials in learning design, but nothing in clinical psychology or psychiatry. Must one have experience in research or clinical settings to make an impact here? ... (read more)
What are the main reasons the nature relatedness scale is used in psychedelics research?
Dr. Johnson - After reading about your cautions about how practitioner beliefs and/or setting (e.g. use of religious/spiritual symbols, artwork, etc.), I was left wondering about your thoughts, or any evidence you've seen, about the use of nature imagery in psychedelic assisted therapy? Based on the work around nature relatedness and views on the biophilia hypothesis, my hypothesis is that nature imagery could serve as a more neutral setting (i.e. free of religious beliefs) but haven't seen this studied yet with psychedelics. Thoughts on nature imagery during psychedelic treatment?
Have you seen any evidence, or are you aware of research in design phase, that will look at the potential effects of
a) mindfulness practices (meditation, breathwork, etc.) as preparation for using psychedelics as a way to "train" for ego dissolution?
b) journaling intentions many weeks prior to a psychedelic experience as a way to improve outcomes?
Thanks for all of your thoughtful work!
I can think of a few different inter-related lines of effort in advancing the psychedelic movement, that may be most easily divided into:
Do you have a sense of whether the policy work and scientific research are money constrained, talent constrained or both? For someone looking to enter the field what would be
And as far as grassroots work goes, it seems important to keep the movement "respectable" but at the same time it seems important for more people to have personal experiences with psychedelics if they're go... (read more)
Will there be trials of psychedelics-assisted therapy for OCD in future? Do you think psychedelics are a promising treatment option for severe OCD?
Was there some evidence that some psychedelics may have anti-addictive efficacy even at sub-psychedelic doses, or do the anti-addictive effects depend on the psychedelic experience?
I’m 38. Given what you collectively know about LSD and psilocybin and regulation against them in the US will it be my generation or my children’s generation or my grandchildren’s generation who are able to engage with these drugs sensibly and legally?
Do you think that this general normalisation of psychedelic usage is a prerequisite to us reconciling with nature, accepting our dependence on the planet and collectively dealing with the biological collapse and climate change?
Since psychedelics seems to activate and connect the brain, is there any application for senile dementia ? can it be safe for older people?
What's the dividing line between legal and illegal drugs? Like caffeine, alcohol, and the rest?
Hi! It seems like a major challenge in psychedelic research has been finding effective means of double-blinding RCTs in a way where everyone involved actually does not know which participants have received the psychedelic (psilocybin, for example) vs the placebo. Do any of you see possible solutions to this? Also, other than LSD being more "taboo" compared to psilocybin given its history in this country and the 60s era, is the any reason to believe it would be any more/less effective than psilocybin has been? Thank you!
-David S
Therapeutic use of psychedelics seems a surety in the near future. But what framework for legal, personal use of psychedelics could you see being practical - that is, something that can be realized across the developed world, within our lifetimes?
What would you say about trying to crowdfund a PhD in psychedelic science. I am a molecular biologist with a background in genetics and have been contemplating crowdfunding a PhD to elucidate the genetic and biosynthetic background of naturally produced psychedelic compounds. I have a university and professors on board, but I don't know if it's feasible or where to begin. I know there are all sorts of start up oppurtunities as well but that world is so foreign to me compared to the science which is what I actually want to do.
What do you think is the next frontier in psychedelics/drug research? E.g. psychedelics for cluster headaches.
Where would you invest next Tim if you wanted to have the most impact? Or what have you discovered Michael for your upcoming book that we are not aware of? Or Matthew, what would you research if you weren't constrained in any way?
Some Psychiatric medication that has shown widespread use in Russia is unlicensed in Western countries. Some of these medications have RCTs showing benefit, eg. Afobazole showed increased anxiolytic properties when compared to diazepam and no withdrawal. Does this suggest that already existing compounds that patents aren't owned by drug company will not achieve widespread use, how will physcedelics differ? How will physcedelics have RCTs (randomised controlled trials) conducted that compared to pre-existing treatments, look at long term e... (read more)
Hi there, thanks so much for doing this. I'm wondering what your thoughts are on how ketamine (since it is the only approved psychedelic at the moment) might help long-haul covid patients who have inflammation in the brain and other parts of their body. Any thoughts or research that you can point to?