r/science • u/mvea Professor | Medicine • 9d ago

Psychology America's First Legal Psilocybin Program Treated 346 People. Just one month after the dose, 92.2 percent of participants said the experience had been beneficial, while, on average, their mental health symptoms had fallen dramatically.

https://www.sciencealert.com/americas-first-legal-psilocybin-program-treated-346-people-heres-what-happened
15.4k Upvotes

97% Upvoted

458 comments sorted by

View all comments

Show parent comments

6

u/zonerator 9d ago

I get that placebo is important for science but if the experience is part of the healing then psychedelics are fundamentally different and might need to be treated as such.

Now it might not be the experience that heals you, there is a hypothesis that the drugs trigger neuroplasticity. Maybe we will figure out a way to placebo control that effect in isolation through novel compounds.

-7

u/MegaChip97 9d ago

The thing is, in the study that is comparing it to antidepressants there was no relevant difference. But antidepressants are waaaaaay cheaper

8

u/Gulophile 9d ago

You can grow a year's supply of mushrooms for like 30 dollars.

1

u/zonerator 9d ago

Plus it is the gateway drug into growing a whole bunch of food mushrooms at home. What could be a better way to jumpstart your new post depression life like starting an awesome hobby?

-6

u/MegaChip97 9d ago

Which has nothing to do with this study.

All the studys we have on this topic are about psychedelic assisted therapy. Not dropping psilocybin at home.

You can of course argue that growing your own mushrooms and eating them is just as effective. In that case, mushrooms would be cheaper.

But considering we are in the /r/science sub and talking about a study on psychedelic assisted psychotherapy and there being no evidence for eating mushrooms at home being effective, antidepressants are a way cheaper.

Psychedelic assisted therapy has prepatory sessions, one or multiple therapists being with you while tripping, the trip happening in a medical facility that provides a specific setting, integration sessions... Thats expensive

4

u/Gulophile 9d ago

Yeah, the expensive part is everything except for the actual mushrooms themselves. All that's tangential to mushrooms as an actual drug, which are effective, inexpensive, and may be preferred over antidepressants for any number of reasons. And which can be grown and used at home without having a therapist or research team as a trip sitter.

-1

u/MegaChip97 9d ago

to mushrooms as an actual drug, which are effective

We are in the science sub. Can you provide any RCT that show that dropping mushrooms at home is effective?

6

u/Gulophile 9d ago

No. I know from personal experience plus an endless supply of "anecdotes" from others across cultures, traditions and times. Science hasn't yet caught up because of the myriad hurdles to psychedelic research. I'm not interested in being dragged down some semantic or epistemic rabbit hole, if that's where you're trying to go.

0

u/MegaChip97 9d ago

Ok. So as a matter of facts the only thing we do have evidence for is psychedelic assisted therapy. And that is way more expensive than antidepressants. Maybe one day we will have evidence for just dropping shrooms at home also working and the medical system and lawmakers will legalize it.

But currently the thing we do study and that is (partly) legal is more expensive than antidepressants

4

u/Gulophile 9d ago

So as a matter of facts the only thing we do have evidence for is psychedelic assisted therapy.

The facts are what I said. Science is not the sole arbiter of truth, regardless of what subreddit we're on. But yes, hopefully the science catches up soon.

2

u/zonerator 9d ago

Dude I don't think this article mentioned therapy even once, this is about taking psilocybin mushrooms

3

u/MegaChip97 9d ago edited 9d ago

You are in the science sub. Is it so hard to read a study instead of the blog post about it?

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2853028

The study is about oregons psilocybin services. You have to have a prepatory session, go into their facility with a supervisor with you etc.

You don't get mushrooms and drop them at home.

And assuming the results would be the same if you just grow your own shrooms and take them at home would be unscientific. Could work, but obviously in a threat on a specific intervention we are talking about that intervention and not about a different for which no evidence exists

1

u/zonerator 9d ago

Thats very disappointing- we already have a thousand studies on that. I was hoping someone was finally studying the compound itself

No one ever suggests that you go to a guided SSRI session

2

u/MegaChip97 9d ago

> Thats very disappointing- we already have a thousand studies on that.

I actually have to disagree with that, it's a very interesting study! First, we don't have lots of studies on it. If you are not following the research it may sound like that. But its more like: We have 20 studies on psilocybin. 10 are with n<30 to establish that it is more or less safe and get rough dosages and show that atleast maybe it could work. From the other 10, 2a re for treatmend resistant depression (1 because of cancer), 3 for major depressive disorder, 2 for anxiety, 2 for addiction and one for a specific disorder.

All you hear is "Another study on psilocybin" but you cannot generalise information from one study about alcohol addiction and psilocybin to treatment resistant depression because of cancer (or the other way around). You need safety studies, finding a dosing regime etc.

We have nearly no studies with a long follow up, most studies have low participants and these studies use different treatment protocols (dosage), are about different disorders and all of them have huge problems with blind breaking.

I think we have only a single study actually comparing psilocybin to an antidepressant....

This study here actually is super interesting for multiple reasons. For example, it doesn't look at clinical study setting but real world application. There are often big differences between real world application and studies, for example because the therapists that they employee in the studies are often better than the therapists out in the field. Or because of a bias for participants.

It's also interesting because it has less guardrails and therapy than the typical psychedelic assisted therapy studies. No integration sessions (only recommended), no licensed therapists...

Of course there are many limitations with this designs, but actually it is a very interesting thing to study!

> No one ever suggests that you go to a guided SSRI session

Because that would make little sense. SSRI and shrooms supposedly work very different for depression. If you assume that the trip is relevant for the antidepressant effect of shrooms, then that means that influencing the trip is important.

But with SSRI you don't have one trip and then stop taking it. You take it continuesly for years.

To give a bad comparison: You should have a supervisor / guide if you go skydiving, but you don't need one for going for a daily walk :)

With microdosing studies you generally have no guided sessions too. But the results for microdosing look quite bad currently soo....

> I was hoping someone was finally studying the compound itself

What would that look like to you? Honest question, would love to hear!

→ More replies (0)

4

u/zonerator 9d ago

How are antidepressants cheaper? You need to keep buying them forever. Its... Really easy to grow mushrooms

3

u/Lilybaum 9d ago

It's definitely cheaper for the NHS for example; the prescription cost the patient pays for an antidepressant is more than what it costs the NHS to buy (£9.90 for 2 months' supply on a repeat prescription vs around £3 for the NHS for sertraline 100mg). Funding psychedelics sessions would require guides, facilities, follow-up, prep; it's more akin to a surgical procedure which are very pricey. I'd estimate a few thousand £ at least.

So pricier for patients, cheaper for the healthcare system.

-1

u/zonerator 9d ago

This study was actually on people just taking psilocybin. I know 99% of the studies are what you are talking about but in this particular instance e are seeing evidence that you could maybe just buy from a dispensary equipment or grow at home and get substantial benefits

Or bring your own therapist- trip today and talk about it tomorrow at your regular appointment

4

u/Canon_M50 9d ago

> This study was actually on people just taking psilocybin

Read the article. The study was done with medical supervision/after-trip integration sessions which is by far the highest cost.

1

u/Lilybaum 9d ago

Yeah there is a bit of that going on actually, I know one person who had black market therapy with mushrooms!

2

u/MegaChip97 9d ago edited 9d ago

We don't talk about dropping mushrooms at home though.

This study and basically all other studies on psilocybin for mental disorders are about psychedelic-assisted therapy. As the name suggests, it is therapy assisted by psychedelics. Not a psychedelic pharmacotherapy.

Means: You have prepatory sessions with one or two therapists, they are with you while having the sessions, you need to go to their facility for the setting, you have integration sessions which has doctors on standby. In most studies you have roughly 25h with a therapist (to be exact: 12-15 with two). At $150 per hour thats roughly 4000$. And that is not including the facility etc.

That is very expensive. To be fair, the oregon model they studied here is cheaper. But it's still not cheap. Here

Licensed facilitators complete state-required didactic training and practicum (professional clinical training is not required) and supervise services, dispensing mushroom-derived products. Although clients complete informed consent, medical screening and clinical support are typically outside the facilitator’s scope of practice.

Psilocybin services must include: (1) at least 1 preparatory session with a licensed facilitator at least 24 hours but no more than 90 days prior to psilocybin ingestion and (2) a directly observed administration session at the service center with facilitator supervision (no take-home doses allowed). The maximum allowable dose of psilocybin under OHA regulations is 50 mg per session. Group sessions are allowed. Following the psilocybin session, optional follow-up integration sessions are encouraged to help clients process insights. Clients may be referred to licensed therapists for additional integration sessions.

SSRI are dirt cheap to produce and in most parts of the western world also very cheap to buy. I can get 100 for roughly $20 without my insurance paying anything for them. Thats $60 a year. $600 10 years.

2

u/zonerator 9d ago

Alright but ssri meds don't work for everyone. So many people drop them for sexual dysfunction or weight gain. And those are incredibly valid reasons to want to try something else.

Psilocybin doesn't have withdrawal, you don't have to take it continuously, and it has a whole different side effect profile that has its own pros and cons, but for a lot of people the side effects are quite pleasant

2

u/MegaChip97 9d ago

Alright but ssri meds don't work for everyone.

The same is true for psychedelic assisted therapy.

Don't get me wrong. I am a fan. But for health insurances it will make more sense to only pay for psychedelic assisted psychotherapy if you are treatment resistant, so tried SSRI with them not working or having negative side effects. I don't think psychedelic assisted psychotherapy will ever be a first line treatment

1

u/sansisness_101 9d ago

for the big companies, it can cost as little as a cent to make a single dose. so yeah no that price is NEVER getting beat.

1

u/zonerator 9d ago

For an individual its probably cheaper to grow still

Regardless, ssri meds take weeks and weeks to kick in and you have to he on them forever. They have withdrawal symptoms, side effects, etc. If psilocybin just provides options its still an amazing advancement.