[bwest87]

A friend and I did a "guided" psychedelic session earlier this year. We did it individually over one weekend. It was great. She did it for more therapeutic reasons. I did it more for philosophy/spiritual reasons. But the two main things I took away are 1.) Guided sessions are qualitatively different than recreational sessions, and 2.) It is such a crying shame that this isn't an accepted "tool in the toolbox" for therapists.

It's not about having crazy life altering, world-bending experiences (though that can happen). It's just about helping you get into a state of mind that allows for an effective therapy session. Sort of like... would you want to do your therapy session in a crowded bar, next to your mom? No, probably not. We all recognize that such a setting would not be conducive to good therapy. So similarly, we should be able to recognize that having the right setting, both mentally and physically can affect the quality of your session. Psychadelics can do exactly this.

It's also worth noting my friend has done "regular" therapy for 2 years, and she felt like there was a step change after the guided session. Her therapist noticed it as well.

When you consider that pain meds have ruined literally millions of lives through addiction, and that also virtually (maybe literally?) no one has ever died due to overdose of psilocybin, it's very confusing why one is prescribed all the time, and the other is considered incredibly dangerous. The U.S.'s perspective on drugs is so very backwards.

[drawkbox]

> The U.S.'s perspective on drugs is so very backwards.

The War on Drugs is a flaw that needs to end but at least with psilocybin US is moving slowly in the right direction. The only countries where psilocybin is legal are Brazil, Jamaica, Nepal, Samoa, Netherlands (truffle format), British Virgin Islands and the Bahamas [1].

Many places are illegal but unenforced though still illegal.

US psilocybin is decriminalized in many places now including all drugs in Oregon. More states need to get more like Oregon definitely.

However, in most states spores are legal and so are grow kits for other types of mycology.

Grow kits and spores legal in most states, full cultivation decriminalized in Seattle, Washington, Ann Arbor, Michigan, Denver, Colorado, Santa Cruz, California, Somerville and Cambridge, Massachusetts, Oregon and Washington D.C. [1]

Legal in Oregon for mental health treatment in supervised settings since 1 February 2021 [1]

Full legalization needs to happen for marijuana and psychedelics. Decriminalization needs to happen for all drugs minimum as well.

As far as marijuana, psilocybin and LSD, they are the least toxic and less dependency forming of most drugs, even caffeine, aspirin and more. It is a tragedy and a drug dark age that they are in the Controlled Substances Act. I believe drugs should have to be toxic or cause death to actually be on that list. Marijuana, psilocybin and LSD are very safe when it comes to toxicity and drug overdoses are non-existent, all would be better as legal safer production products.

Legality makes everything safer, increases harm reduction and reduces black market unsafe production as well as reduces funding of cartels/mafias/bratvas. Their criminality truly makes no logical sense except to invite problems.

[1] https://en.wikipedia.org/wiki/Legal_status_of_psilocybin_mus...

[taurath]

Just wanted to add that the US led the criminality to spread across the globe via the UN.

https://en.m.wikipedia.org/wiki/Convention_on_Psychotropic_S...

[matheusmoreira]

Yeah. The US pretty much exports its laws. It uses its vast economic leverage to impose US laws on everyone else via trade agreements, treaties.

It did the same thing with intellectual property. It will put sovereign countries in a literal naughty list when they don't accomodate US company interests.

[joshspankit]

I wonder how much of the imposed laws are also a direct result of the Disney company (who pushed the US who pushed others)

[matheusmoreira]

They are a direct result of the lobbying of companies like Disney. It's plain to see in the naughty list I mentioned.

https://ustr.gov/sites/default/files/2019_Special_301_Report...

Search the document for "interest". Plenty of talk about interested parties, rights holders. Euphemisms for US corporations using the might of the US government and its military to interfere in foreign countries. I've read some US documents discussing my country like it's a problem to be solved. Like it's a new planet they intend to terraform. It's surreal. Documents essentially saying things like "these places continue to be a problem, the local authorities aren't doing what we want them to do".

Essentially the US has "concerns" and it expects and "urges" other countries to address them by criminalizing anything that hurts the profits of US corporations, which they call "US economic interests". Yeah, because we totally have room in our prisons to lock up my country's entire population for copyright infringement. They must think we have nothing better to do.

They'll even put Canada, their neighbor and ally, in the watchlist. They write things like:

> Right holders also report that Canadian courts have established meaningful penalties against circumvention devices and services.

It's so incredibly surreal. "Yeah, our corporations have been saying you've been a good little country, Mr. Canada. Keep doing what they tell you and we might just take you off the naughty list next year." I don't even know what to say. Imagine being a politician who has to swallow language like this from world powers like the US all the time.

[joshspankit]

Ugh. The wording in this document is disgusting. It reads like it’s from the evil teacher from a movie: “The United States remains deeply troubled by the ambiguous education-related exception added to the copyright law”.

Deeply troubled? Like “We’re very concerned with your daughter’s inability to submit assignments as requested. We suspect there’s trouble at home and hope we don’t have to involve the authorities.” “You mean when you asked her to draw a cat and she drew a cat then coloured it purple?” “Yes, exactly! She must be either developmentally delayed, or poorly parented. In either case it’s very concerning.”

[inter_netuser]

>pain meds have ruined literally millions of lives through addiction

Unpopular opinion: opioids are massively under-prescribed for those that actually need them.

Addiction is a mental illness. That's whats killing so many, but why is to so few question what is actually causing such terrible emotional pain that must be self-medicated with incredibly potent medicaments?

Why is it that instead of acknowledging the rather uncomfortable root cause of those deaths, we just default to the so much simpler scapegoat, pills (the active ingredient in which has been with us in one form or another since 5000 BC), and pretend everything else is just rainbows and unicorns?

[WarOnPrivacy]

> opioids are massively under-prescribed for those that actually need them.

Absolutely.

While reports of ODs are endlessly bullhorned, millions in pain get demonized by algorithmic opioid blacklists, get ignored by news orgs/legislators addicted to opioid hysteria and get gaslighted by a public who only hears the bullhorning.

I have a lifelong friend with visibly crippling arthritis. He lost access to effective pain meds after the state passed a 3-day-max on opioids (passed >10 years after the pill-mill problem abated). Over the year that followed the law's passage, every Dr in his network (along with most Drs in the state) ~stopped Rx opioids. The (now fewer) pain mgt clinics are overloaded and not accepting patients.

His remaining avenues for pain relief no longer involve Dr's.

I had emergency abdominal surgery this year and had to convince the discharging Dr to prescribe Tramadol. Our new normal is for ERs/Hospitals to undermedicate patients in pain with OTC analgesics.

So yeah. Shout out to folks who are hand-waving away millions in pain - because pharma is greedy or because folks can't differentiate responsible Rx opioids from street fentanyl (that many in chronic pain turned to in desperation after they were cut off from safer pain relief).

[stadium]

> why is to so few question what is actually causing such terrible emotional pain that must be self-medicated with incredibly potent medicaments?

> Why is it that instead of acknowledging the rather uncomfortable root cause of those deaths, we just default to the so much simpler scapegoat, pills

Missing from these arguments is the role of criminalizing addiction versus treating it as the mental health issue you accurately described. And ignoring the pharmicuitical and lobbying industries behind the same pills.

I don't think it's a valid argument to reassign blame from the potency and availability of pills, to unmet mental health needs. They are related and intertwined, sure, but correlation != causation.

Case in point, the Purdue Pharma Sacklers settled for $billions (which also bought their immunity from future prosecution) precisely because they were pushing hard drugs and preying on those same people mental health issues [0]. Predatory, sociopathic behavior. But pill are a scapegoat? Sorry, that's a hot load of b.s.

[0] https://www.npr.org/2021/09/01/1031053251/sackler-family-imm...

[inter_netuser]

I don't disagree there are bad actors. Dissolving Purdue (I thought they were dissolved, not just fined?) is great. Bad actors should be punished. And yes, criminalizing medical issue such as addiction is terrible. All of these are fairly obvious, which is why I didn't spell them out.

As I'm sure you know, many cases of mental illness are triggered by some sort of precipitating event.

I don't believe for a minute the fact that someone gave those addicts an opioid pill was the actual trigger. Instead it was something that happened way before that: some emotional trauma, PTSD, disadvantaged background, chronic illness, no life/career prospects, war, despair, etc, etc, so many stressors this life can bless you with. The Big Bad Pill is just what the addicts came across and realized it helped them feel okay for a moment, that's all it is.

E.g. a war veteran ends up getting PTSD and becomes an addict(let's assume he has no chronic pain). Aren't the circumstances around his life that led him to enlist and then develop PTSD are the much more relevant trigger? Barring that event, would they even begin using in the first place?

Who gave them that precipitating event? Other humans did.

The ugly truth is that the cause of this all is simply us, humans stressing other humans. Like other primates, we are intelligent enough to the point it takes very little effort to provide for our basic needs, and so we spend the rest of our time engaging in social status games at the expense of others.

Most people who use opioids do not actually become addicted. Those who used heroin in Vietnam, most of them stopped after they returned and circumstances changed from war to normality: https://pubmed.ncbi.nlm.nih.gov/12873239/

"After their return, most of the men who had used heroin in Vietnam used it very occasionally or not at all."

"Possible post-Vietnam correlates of heroin injection were no job or school enrolment, alcohol problems, depression, absent or transient marriage, association with illicit drug users and other Vietnam veterans."

The real root cause is that humans are nothing but selfish machiavellian apes. We all are about me-me-me-me-me, and dig just a bit deeper, most are just as predatory and sociopathic as Purdue/Sacklers/whatever, just not as capable at getting their way.

We just look away and walk past the addicts in meatspace. We are no saints, and the real cause of most human suffering is not some processed alkaloid - it's other humans.

Not some pharma company or some evil billionaire clan that capitalized on this, I'm sure they contributed. There would be nothing to capitalize on or sell, if it weren't for humans psychologically injuring other humans for fun and profit.

Personally, it seems to me that we can recognize and accept a physical disability/injury much more readily than emotional/psychological one. Same goes for inflicting injuries: attempts to fracture someone's limb, a grave physical injury, seem too repulsive to even think about, and hopefully bystanders will attempt to rescue the victim should anyone ever try to do this to anyone. Harassment, bullying, hazing, belittling someone "just for laughs" on the other hand? All too often, others are more than happy to join in on the "fun" and even will gleefully laugh at the actual victim.

Of course, nobody likes to think of themselves in that way, much too unpleasant, and so we point our collective fingers elsewhere. It's always "them", and never "us".

I can only hope that one day we will evolve to finally dish out just as harsh punishment for psychological harm as we do for bodily harm, and hold each other accountable for it.

[stadium]

A bunch of things are conflated here that need to be untangled. Not all trauma is going to lead to an addiction. Not all addiction is to pills or drugs. Not everyone who takes opioids is going to form an addiction. Not all trauma is intentional and deserves punishment.

The expert in this area is Dr. Gabor Maté. He is highly respected in this field. If anyone is interested learning about the role of trauma in addiction, he literally wrote the book on it, "The Realm of Hungry Ghosts" [0]

From Maté [0]:

> Turning to the neurobiological roots of addiction, Dr. Maté presents an astonishing array of scientific evidence showing conclusively that:

> 1. addictive tendencies arise in the parts of our brains governing some of our most basic and life-sustaining needs and functions: incentive and motivation, physical and emotional pain relief, the regulation of stress, and the capacity to feel and receive love; > 2. these brain circuits develop, or don’t develop, largely under the influence of the nurturing environment in early life, and that therefore addiction represents a failure of these crucial systems to mature in the way nature intended; and > 3. the human brain continues to develop new circuitry throughout the lifespan, including well into adulthood, giving new hope for people mired in addictive patterns. Dr. Maté then examines the current mainstream.

[0] https://drgabormate.com/book/in-the-realm-of-hungry-ghosts/

[fourtrees]

Having both witnessed the whole opioid debacle first hand, first the sleezy over-prescription, then the reactionary under-prescription, which has caused, in my opinion, at least, as much, if not more, suffering and death than the over-prescription. Reading these comments is the first really sensible debate over the issue I've encountered and very encouraging.

For quite a while I've thought that the via media on the Rxs and an honest, more intensive treatment of the causes of 'deaths of despair' (which would certainly only partly be medical in nature) is by far the most humane (and medically ethical) way toward treating the problem. I know MDs who feel the same way but whose agency is very limited by this opioid Thermidor -- both in acting and speaking on the issue. I hope this is a sign of a changing trend in the public and political debate on the issue.

[jdc]

> Why is it that instead of acknowledging the rather uncomfortable root cause of those deaths, we just default to the so much simpler scapegoat, pills (the active ingredient in which has been with us in one form or another since 5000 BC), and pretend everything else is just rainbows and unicorns?

Okay, I'll take mushrooms, which have actually been with us since then, and you take synthetic intravenous opioids and we'll see who fares better.

[refurb]

Opioids (opium) have been around as long as mushrooms. Just because they are synthetic variations doesn't mean they are that different.

[jdc]

Alright, go ahead and get on a regular IV fentanyl regime and let me know how that goes for you.

[snovv_crash]

It has nothing to do with the synthetic, people destroy themselves on straight-from-the-poppy-plant heroin as well.

[honkdaddy]

I think you're underestimating how destructive fentanyl is compared to almost any other opioid.

[inter_netuser]

My comment was specifically about people that need them prescribed. For pain relief, injuries, chronic pain, and so on. Opioids are very effective and are vilified for no good reason, along with a few other classes of substances.

Not as in substitution therapy, like methadone. I do hope that mushrooms help people come off of long-term substitution.

[elromulous]

>it's very confusing why one is prescribed all the time, and the other is considered incredibly dangerous. The U.S.'s perspective on drugs is so very backwards.

The lobbying system. Aka legalized corruption.

[colhom]

How are you going to sustain the largest economy on earth if your populace isn't hypnotized? Most of the work that needs to be done is not intrinsically or spiritually fufilling.

So there must be an alternative synthetic rewards system- which inevitably requires some form of mass hypnosis to remain dominant in the aggregate psyche.

It's no coincidence that all the research in this space was shut down in a hurry right around when the CIA figured out that LSD and the pikhal family weren't going to help with this at all.

[say_it_as_it_is]

Not only has no one ever died of psilocybin but it just doesn't get abused the way that pain killers do. You can't get the full effect by taking it often. If it's a deep session, you don't even want to!

[agumonkey]

One session means one time or a few times in one week ?

Do you or her plan to keep doing it ?

[bwest87]

One session meaning one time. Both of us think it would be valuable to do, but on the timescale of like... once/year or once every few years. But there are people who do it once/month for several months if they have a lot of specific things to work through. Our guide actually works with a number of 'regular' therapists, and they pass clients on to him if they think a guided session is the right move. He says therapists will sometimes say, "please take this person on a journey once / month for the next 3 months" (or something along those lines)

[f0rgot]

I've always wanted to try a guided session, but I have no idea how to even start looking for a guide. I'm in Illinois.

[zhengyi13]

Medical tourism? Elsewhere upthread there are specific places called out where psilocybin is legal or decriminalized. Poking around on the web for therapeutic providers in those areas might be an effective strategy.

[bwest87]

This actually took me a bit of time. I had to search around. But can give advice. If you're serious, email me at bwest87 at gmail.com

[stadium]

What area are you located, and how did you find your guide? Word of mouth?

Not looking so much for specifics, more to understand the process.

[bwest87]

I'm located in San Francisco. I asked around a bunch of friends, got intros, and talked to a few potential guides. Eventually got linked up with someone who's been doing it for a number of years, and we vibed. We had a few phone calls through Signal, and then decided on a date/time/place.

[louis___]

Would you maybe like to elaborate on what was the details of the "guided" aspect of your sessions ?

[bwest87]

Guided aspects... he sent over a questionairre ahead of time with a lot of broad questions. We then did a one hour zoom call going over the questions and getting to know him. It's all designed to help you figure out what you want the session to be about for you personally at that moment in time in your life. And then the session itself lasts 4-6 hours, and he will ask you many questions, but also will follow the journey wherever it takes you, and there's ups and downs and everything in between. It's all very specific to you and the guide and where you want to go with it. And lastly there's an "integration session" the following week where you talk with him for an hour to go over how it went, and what it means. Can discuss more if you want. Email me at bwest87 at gmail.com if you'd like to discuss further.