[pmoriarty]

"It might be too soon to call this "medicine," a word with certain emotional associations. The article includes many interesting and intriguing anecdotes, but to date the described effects haven't been examined in a properly designed double-blind study"

The history of medicine is full of examples of treatments being tested in the clinic long before any double-blind tests are made. Things like the first use of anesthetic spring to mind. If they had waited for double-blind studies that would have satisfied modern science, millions of people would have suffered for another hundred years without it.

The practice of testing treatments in the clinic continues to this day, with doctors prescribing medicines for off-label uses, and with even psychedelics being used in psychedelic therapy by psychologists brave enough to risk their careers and freedom to help people.

Ideally there would be double-blind studies on everything, but those studies cost an enormous amount of money, and in the case of psychedelics have to overcome enormous political hurdles. The cost rises astronomically when we're talking about large, statistically significant double-blind studies.

Furthermore, since a lot of psychedelics, like mushrooms and peyote, can be ingested directly from plants, and many others like LSD have long been out of patent protection, most pharmaceutical companies (which are usually the only ones with pockets deep enough to fund these kinds of studies) aren't interested, as they won't make a profit on something so easily available from other sources than themselves. That's not to mention the political hot potato of psychedelic research as a whole, which is still regarded with suspicion by much of the medical and political establishment.

[lutusp]

All I'm saying is, without reliable double-blind studies, changing LSD's status from an illegal substance to a "medicine" won't fly politically.

[pmoriarty]

Politics is a strange bird, and it's really hard to predict the future. Much of the drug policy in the US is not based on science or medicine, and the US government has repeatedly ignored the advice of prestigious scientific and medical bodies and panels to soften its anti-drug stance, reschedule drugs, and treat drug addiction as a medical issue rather than a legal one.

In the meantime, some states have gone ahead and legalized medical marijuana and even recreational marijuana. This was often done by referendum, where voters got to decide, and how voters decided is a complete mystery. Did they take science in to account? Did they care about double-blind trials? Who knows? But considering the massive ignorance of science by the general public, it probably wasn't science that tipped the balance.

I suspect that if wholesale legalization of some currently illegal drugs does come, it will have little to do with science, and more to do with public perception change, and the dying off of old, rabidly anti-drug legalization opponents from another generation.

[lutusp]

All true, a high-quality comment. It's true about marijuana, and it may eventually be true about some other drugs that turn out to have beneficial uses -- in a process driven mostly by politics and public relations, very little science.

[jksmith]

I doubt any classed manufactured drugs would become legal in US unless major (1st tier) drug companies figured out a way to actually make money with them, no matter their potential benefits to consumers. Profit potential has by far the most influence on what flies politically.

[lutusp]

> Profit potential has by far the most influence on what flies politically.

Very true in nearly all cases. Marijuana yielded to political pressure without Big Pharma having any easy way to make money from it. That may be the exception proving the rule, which I agree is a strong indicator of expected future events.

[jksmith]

Well the hippie lettuce situation is an interesting outlier. Just as much an exception, it's also not in the main workflow of pharma because of the heavy agri origin. But that also means big agri is also probably keeping a close eye on it along the lines of either the delivery method will remain primarily like that of tobacco, or pharma will take a huge chunk of the business selling a synthetic in pill form. Either way, if it turns into big business, I don't see a place for boutique operators. Big agri or pharma will squeeze the the small farmers out somehow. Larger pharmers with thousands of acres might do well with it. Third tier pharma will again be squeezed out unless some investment the magnitude of Berkshire takes an interest.

[pmoriarty]

Another exception is peyote, which is legal to use by members of the Native American Church. Other religious exceptions may be made for other substances, like Ayahuasca. Studies in to the therapeutic potential of psilocibin may eventually lead to enough of a shift in perception of that substance to make it legal for certain limited types of therapy. Then, as was seen with medical marijuana, that may eventually lead to legal "recreational" (ie. non-medical) use.

There could still be a big backlash against all this. I'm holding my breath waiting to see what the Trump administration and their supporters do.

[lutusp]

> I'm holding my breath waiting to see what the Trump administration and their supporters do.

As am I. The politically aware could simply point out how expensive the war on drugs is. In fact I have no idea why this isn't raised as an argument against it, and the incarceration at taxpayer expense of so many people for nonviolent offenses.

The answer to my quandary is probably that most conservatives aren't libertarians -- that being conservative doesn't necessarily mean a person wants to stay out of other people's lives and choices or reduce the cost of government.