Tag Archives: Drugs

The Spirit Molecule

I’m just finishing up The Spirit Molecule by Dr. Rick Strassman, a book about his results and experiences administering DMT in a clinical setting during the mid-1990s.

First let me say this: the book is crazy. I question Dr. Strassman’s methodologies from experimental design all the way through to footnoting the book. If you do read it, make sure to follow the footnotes — there’s an effect whereby something footnoted looks more legit, but the notes in this thing trade on that power without backing it. Footnotes like, “I couldn’t find anything to support this.”

Strassman’s theories begin with the scientific and verifiable and end well within the realm of the spiritual and untestable. Part of this is by design, and part of it is because of the nature of the material studied. Strassman believes that a proper study of psychedelics is very nuanced. The first section, for example, begins with a lengthly discussion of the language used to frame psychedelic drug research and how that has the potential to affect the outcomes of that research.

From there Strassman discusses the chemical structures of various psychedelics (it turns out that DMT has a simple, perhaps minimal, psychedelic structure) and the biological processes through which DMT acts on the body and brain.

This leads into Rick’s quest to obtain regulatory approval to produce pure DMT, to get permission to test it on human subjects, and to design the experimental protocols in use through the rest of the book. The dose response study, for example, involved a double-blind series of doses determined relative to body weight, not absolute drug mass.

Then things get weird. Patients start reporting fairly consistent drug experiences, which allows Strassman to guide them with some success. Until, that is, they start meeting entities (machine elves, clowns, and saguaro-beings — the last of which I once encountered). At this point Rick begins discussing them with patients as though the beings are manifestations of internal mental processes. This is never met well by the patients (though my saguaro-demon was a manifestation of my own fear), leading to a loss of rapport with Strassman.

Leary’s set and setting theory governs Strassman’s experimental design — the circumstances of ingestion being as key to the total experience as the actual drug — so a loss of rapport between the experimenter and the subject is a large problem. From then on Strassman decides to take entity contact reports at face value. It is here the book moves from the Pop Sci section of the bookstore to New Age.

So The Spirit Molecule, as indicated by the name, ends up with a lot of pseudoreligion and spiritualistic speculation (some of which I quite like). Strassman’s experiment design was also filtered through his buddhist practice (babysitting a tripper being an exercise in calm mindfulness) and he chronicles his essential excommunication from the community once his research gets close enough to their concerns. For example, can psychedelics offer a shortcut, albeit temporary, to an enlightenment experience — and will we strive not harder for the peak, having once glimpsed the vista?

The final part of the book is on future directions for experimental and clinical uses of psychedelics. These ruminations are very interesting. They indicate that the psychological, psychiatric, spiritual, religious, personal, and social aspects of psychedelics, while worth studying individually, are inextricably tangled. Psychedelics have fewer negative and more positive effects than opponents traditionally assume and also fewer positives and more negatives than proponents typically believe.

Gabor Mate on Ayahuasca for Addictions

After Rick Doblin, Gabor Maté spoke about using ayahuasca to treat addictions. Maté is the closest thing to a celebrity doctor working in Vancouver’s Downtown East Side.

Maté was very careful to distinguish between “ayahuasca” as a ceremony that includes the use of naturally-occurring DMT and the drug itself. He doesn’t really care about experimental design or even the legality of importing psychotria plants into Canada. Much like a safe injection site, he thinks the treatment should be done because there have been positive results.

Someone asked the really interesting question of whether these ceremonies count as cultural appropriation, particularly in light of the popularity of Ayahuasca Tourism. The ceremonies are performed by residents of BC who have apprenticed under Peruvian shamans but Maté mentioned at least one that included BC First Nations ritual elements. Given that many addicts in BC are First Nations and the significant of First Nations in our province’s spiritual culture, I think it would make sense if these evolve into a hybrid ritual.

Maté only briefly compared ayahuasca with ibogaine, another hallucinogenic used in the treatment of addiction in Vancouver. From what I gather, ibogaine cures physical addiction but has less impact on the psychological cause of drug use in the first place. Although patients who participate in ayahuasca still have relapses without a follow-up support structure. Maté mentioned that he would like to try combining ibogaine and ayahausca.

Interestingly, Maté has participated in these ceremonies a number of times, which made me question his distinction between medical treatment, spiritual work and recreational drug use.

Rick Doblin on MDMA for PTSD

I went to a talk by Rick Doblin, the head of the Multidisciplinary Association for Psychedelic Studies, who has bachelor’s in psychology and a PhD in public policy. MAPS’s main project is the use of MDMA combined with talk therapy to treat post-traumatic stress disorder in a small number of sessions.

Doblin had some interesting things to say about strategy. He pictures a progression in treatment groups from the most politically valuable to the least:

  • Veterans of Iraq and Afghanistan Wars, police and firefighters
  • Sexual assault victims
  • Terminal cancer patients
  • Couples therapy (the original therapeutic use of MDMA)
  • Individuals doing self-therapy for emotional issues or spiritual enlightenment (this will effectively require full legalization)

Doblin thinks MDMA is cognitively simpler than hallucinogens and therefore easier to use in therapy. The idea is to get it accepted by the therapeutic community and then introduce other psychedelics. And then once drugs have a history of safe therapeutic use we can start talking about legalization.

The DrugMonkey blog had a lot of criticism of the lack of rigor in MAPS’ initial exploratory testing. Now that they’re seeking US Food & Drug Administration approval, their experimental design has been beefed up:

  • MAPS has developed a specific talk therapy protocol to be used with the MDMA. Therapy sessions are recorded and then scored by observers for adherence to the protocol.
  • They’re comparing between patients who randomly receive one of three different doses: 25 mg, 75 mg and 120 mg. And then giving low-dose patients the opportunity to repeat the intervention with a higher dose.

Security Through Obfuscation

The great comment (slightly edited) below was made on BoingBoing in response to this security fog warning:
fog-generating security equipment

This is actually just one component of a larger security scheme.

The fog contains a debilitating chemical, 3,4-Methylenedioxymethamphetamine.

At the same time that the fog is dispensed, the building lights flash on and off to attract the attention of nearby security patrols. Grids of lasers sweep through the area, to pinpoint where in the fog the perpetrators are.

Meanwhile, incredibly loud, pulsating music plays from hidden speakers to disorient the intruders and prevent them from communicating. A recorded voice instructs the intruders to put their hands in the air (to show law enforcement that they are unarmed) and then repeats the command: “get down, get down, get down”.

Fighting Gateway Drugs

Evidence-based drug policy should discourage use of dangerous, highly-addictive drugs. But the War on Drugs has provided economic incentives for the discovery and marketing of stronger drugs:

  • opium → heroin
  • cocaine → crack
  • speed → meth

This continues with the growing popularity of desomorphine as a heroin substitute in Russia.

Opioid replacement therapy is an example of steering existing addicts to safer drugs; it is usually done with methadone in Canada, although other opiates are used elsewhere and there are good arguments for prescribing medical-grade heroin instead of a substitute drug. There is some evidence that cocaine users voluntarily switched to mephedrone until it was banned in the UK.

Drug policy should also prevent drug users from using the more dangerous drugs in the first place. New drugs and recipes are distributed using the network for existing drugs, and a diversified product line makes drug dealing more economically viable. Given the failure of prohibition, safer drugs, like marijuana, opium, coca leaves, mephedrone and speed, should be legalized with appropriate regulation (more on that in another post). Benefits include:

  • fragmenting the organized black market
  • discouraging legal drug users from gatewaying to dangerous still-illegal drugs
  • bring abusers of the newly legal substances into the open where they can be treated
  • reduce incentives for discovering new drugs
  • reduce issues in opium- and coca-exporting countries

Happy Repeal Day

Yesterday was the 90th anniversary of the repeal of prohibition in BC (by referendum). Fans of alcohol in Vancouver celebrated by getting drunk and having a riot. And that, precisely, is why I think prohibition was good policy.

Alcohol is a hell of a drug with a significant cost to society. Heavy alcohol use has a higher direct health cost than most other drugs and alcohol is unique in its ability to cause injuries, particularly motor vehicle accidents. Because of its legal status, alcohol has free reign to cause domestic breakdown and poor job performance.

The problems with prohibition are that:

  • it was not implemented consistently: many speakeasies continued to operate and the wealthy could easily access smuggled alcohol
  • it was implemented only through regulation: the government did not make an effort to convince people to lower their demand for alcohol both before and after the ban
  • no substitutes were available

The last two points get at the crux of the problem: alcohol is both traditional and vital to our culture. Successfully banning alcohol would require widescale cultural change, cultural engineering if you will. Given that many cultures throughout history have practiced intoxication, it seems that humans might have an inherent desire that would be easier to satisfy with a safer alternative drug than suppress completely. David Nutt, the ex British drug czar, is working on an alcohol substitute based on benzodiazepines (eg: Valium).

I believe that reducing alcohol abuse is an important public goal that the government should be willing to use radical means to achieve.

In Support of Charlie Sheen

I’ve been following the Charlie Sheen saga with half an ear. My lay take on this is that he is incredibly sick and, unfortunately, has the means and mouthpiece to psychically, violently explode, publicly across the worldwide media.

Imagine if you were fevered to the point of hallucination and then were interviewed on national television. If someone cut together clips of all your craziest locutions and worst-lit photos how sane would you appear?

What I’m saying is: remember that the media is profiting of the public destruction of a specific human being here. They’re running a carnival freak show for people to point and laugh at as did Victorian insane asylums.

My watchword in the Sheen saga is compassion, and I take it all with a healthy dose of respect for the editorial distortion power of media. Here’s Drew pop-psych opinion (he’s not a psychologist):

Government Should Use Wikipedia for Public Service Announcements

Some researchers at UBC have brought Canadian media’s attention to the fact that Google search results in the US are rigged. The US National Institute of Health, a government agency, has a deal with Google to place their pages of drug information at the top of searches. Google displays the NIH hit as an “organic” result, below the AdWord results for that search.

This particular issue is unlikely to undermine many users’ confidence in Google’s results. AdWords results are still featured higher, so a side-effect of this policy is a transfer of wealth from pharmaceutical companies to Google. The Institute of Health’s pages are not always up-to-date, because updates to them must be submitted through some bureaucratic maze.

The UBC researchers found that on Google Canada, the top hits for brand names tend to be the websites of US pharmaceutical companies while generic names get Wikipedia. Wikipedia’s information on drugs is often incomplete, although the actual research paper is more optimistic about Wikipedia’s quality improving than the Canadian journalists summarizing it.

My take is that the Institute of Health is messing with the Internet and could be considered to be vaguely censoring*. The correct government policy is to pour resources into improving the Wikipedia articles. Wikipedia is the market leader for providing unbiased information, so using Wikipedia to inform the public is a form of alternate service delivery. The government doesn’t even need a contract because Wikipedia’s already open to government input and can serve as a platform for engagement with other active stakeholders.

How would Wikipedia change if it became important for providing public services? The government could donate to the Wikimedia Foundation to make sure the lights stay on. Government editors could vote for government representatives on the Board of Trustees and start influencing Wikipedia’s editing policies to work in their favour.

* Not that there’s anything wrong with censoring drug companies in the public interest: I want peace, order and good government, not free speech.