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This is a first-person account from a psychiatry resident (me) enrolling in a clinical trial of psilocybin. Somewhere between a trip report, an overview of the pharmacology of psilocybin, and a review of the clinical evidence suggesting pronounced benefits for depression.
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Notes -
Good post but bruh…
Frankly: I hate all this clinical trial bullshit around psychedelics and mushrooms. They definitely have anti depressive effects, but anyone that does drugs knows that the set/setting of these clinical trials is absolutely awful and retarded. You’re tripping and they just have you watching ig reels and tv?
Take 2 gs of real mushrooms and go for a forest walk and think about life. You’ll actually have some real insights about what’s making you that way. Treating these substances like just another pharma substance isn’t the way.
Drug prohibition is a crime against humanity!
We don't really have a good idea how different individuals will react, this guy seems to have pretty badly f*cked up his life https://www.theguardian.com/us-news/article/2024/aug/23/us-pilot-magic-mushrooms-plane-engines (tldr pilot takes some mushrooms for depression, 2 days later is riding in the jump seat of plane [as a passenger, not flying the plane] has a bit of mental breakdown and tries to turn off the plane's engines to wake up, the interactions with the crew are odd and suggest to me more of a break with reality [could be due to the shrooms, or not, hard to say definitely] then a murder/suicide but ymmv).
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I see people out there getting absolutely wasted on kratom, acting like lunatics, wasting huge amounts of money on it, not washing, being aggressive, getting in fights. Maybe drugs should be legal for people who are not idiots.
Kratom provides a kinda-sorta opiate-like buzz the very first few times its used that taper off pretty fast and generally stop around the 3rd-4th use. It is a fantastic pain reliever though, and a godsend for people with chronic pain who cant get medical pain management from a doctor. The pain relief doesn't go away with repeated use like the buzz does.
There is a predictable profile for the people we see who have problems with kratom (I volunteer at a local rehab). They are opiate addicts, usually heroin, pretty deep into it. They get off dope but are struggling with terrible withdrawal. They learn that in the cultures that kratom is native too people use it to get off dope, that it blunts the withdrawal symptoms. This is true, its great for this. Then, the first time they use it they get sorta opiate-like buzz and a lightbulb goes off in their heads: "I've found a loophole! I can keep getting high! I'll still pass my drug tests!" But as mentioned the psychoactive effects fade very fast. This can temporarily be countered by taking more, so they move from the capsules to the liquid extracts then the more concentrated extracts. Still by the end of the first week the buzz is entirely gone. It still offers relief from withdrawal but thats not why they're using it now. This stuff got them high once, why isn't it working anymore? This is where the huge amounts of money kick in. The individual bottles of the concentrated extract cost $20 each or so and they're taking 5-10 a day chasing that buzz that isn't coming back. Way more than they ever spent on heroin (which has been dirt cheap for a while now) Many go back to dope at this point. We see a lot of ODs at this point; having been clean for a while, even just 1 month sometimes, is enough to reset their opiate tolerance but they still dose based on their previous habit, which is now too much.
Kratom is a very effective treatment for pain. Its also very good as alleviating withdrawal, but those first few doses that provide a ersatz high for recovering addicts ruins this use case for some people leading to the observations in the above post.
Only ever saw one guy using it. Young guy, 20-something. A place where I worked part time, one of the temp workers loading the containers. He stank, literally stank so bad I could smell him - I have somewhat impaired sense of smell. Apparently he washed very rarely.. and this was summer.
Later I learned he was homeless, living in a tiny garden colony hut he broke into and even though he could have washed, he didn't. Everyone hated him because he acted aggressive, sometimes talked to himself, kept pacing all the time, was unreasonable... and stank. About every hour he'd mix a kratom drink using a lot of various powders he had there and then drink it. I guess because the labor force situation being what it is, he kept working there for several months.
Once caused a fire alarm because he lighted up a joint or cigarette in the toilets, but the place was so shoddily run they didn't know who was the culprit and he got away with it. Not sure what caused the company to blacklist him eventually.. probably got in a fight with someone.
I really don't think his was 'initial high'. As far as I know, he was persistently agitated this way, which, even more than the smell, caused others to hate him. Maybe he was mixing something else into those drinks though.
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Yeah same with alcohol bro. How many people die from drunk driving every year?
Alcohol is way too widespread to really ban, in addition relatively easy to make at home.
Cannabis is even easier tho...
It's pretty hard to beat, "I left some fruit (that I'm legally allowed to buy and have) in the cabinet for too long."
"I dropped some seeds in the bush someplace" isn't bad...
It's much harder to explain how you legally acquired said seeds. Especially with the effort that it takes to get the kind of cannabis people want (not talking any bullshit about roadside trash grass).
"Roadside trash grass" is about the equivalent of the Jungle Juice you are talking about -- making any kind of decent alcohol at home takes a lot more effort than growing good weed -- which is basically just gardening with extra steps.
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I brought my own entertainment. The study design only offered "relaxing music" and an eye-cover if you were feeling overwhelmed. The music would have worked okay in an elevator or a Thai spa, but was absolutely not to my taste haha.
It's hard to blame them, really. Getting IRB approval for a clinical trial is a PITA on a good day, I strongly suspect that if they wanted to offer entertainment or a walk outside, they'd be raked over the coals, leaving aside the increase in liability and the demands on personnel. I'm certainly interested in trying shrooms in a more congenial environment!
Agreed, clinical trials are just a bullshit way to approach these drugs/medicines imo.
For you personally, yeah go on a forest walk and get into nature. That’s the real way to experience these drugs and most likely to have a positive life changing experience.
If you’re really ADD and need stimulation, maybe just go to a music festival then?
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Can you give us some more details about what the set and setting was for the session?
I had had to head down to London twice to attend the sessions. Beyond that? Not much to say, it was a bog-standard NHS hospital.
You go in, they take your vitals and your measurements, primarily focusing on making sure your blood pressure is okay (psilocybin affects it, not that the risk is notable). By that point in time, you've gone through phone screening, but on arrival, they conduct drug screening. They're looking for any illicit substances that might confound their results.
Once you get the all clear, you swallow a dose, then head to a clinic room. I was alone, but I think I saw a few other people who were probably participants. They had extremely dull music playing, and offered me eye covers if I wanted them. I had a pressure cuff on, with continuous monitoring. A nurse would swing around every few minutes at the staff to make sure I was okay, but eventually I told her I felt fine and she didn't really bother. There was also a psychologist on staff, but I told them I didn't need anything in particular at the time.
Once 8 hours was up (I think they could have let me leave earlier, but I didn't want to risk it since I was unsure about the come down), they took another set of measurements and I was good to go.
Overall, very boring and clinical. Not that there was much else to do, it was a rainy day out there.
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