Investigation of self-treatment with lysergic acid diethylamide and psilocybin mushrooms: Findings from the Global Drug Survey 2020

Background: Growing numbers of people are using psychedelics for personal psychotherapy outside clinical settings, but research on such use is scarce.
Aims: This study investigated the patterns of use, self-reported outcomes and outcome predictors of psychedelic ‘self-treatment’ of mental health conditions or specific worries/concerns in life.
Methods: We use data from the Global Drug Survey 2020, a large online survey on drug use collected between November 2019 and February 2020. In all, 3364 respondents reported their self-treatment experiences with lysergic acid diethylamide (N = 1996) or psilocybin mushrooms (N = 1368). The primary outcome of interest was the 17-item self-treatment outcome scale, items reflecting aspects of well-being, psychiatric symptoms, social-emotional skills, and health behaviours.
Results: Positive changes were observed across all 17 outcome items, with the strongest benefits on items related to insight and mood. Negative effects were reported by 22.5% of respondents. High intensity of psychedelic experience, seeking advice before treatment, treating with psilocybin mushrooms and treating post-traumatic stress disorder were associated with higher scores on the self-treatment outcome scale after averaging values across all 17 items. Younger age, high intensity of experience and treating with LSD were associated with increased number of negative outcomes.
Conclusions: This study brings important insights into self-treatment practices with psychedelics in a large international sample. Outcomes were generally favourable, but negative effects appeared more frequent than in clinical settings. Our findings can help inform safe practices of psychedelic use in the community, and inspire clinical research. Future research can be improved with utilisation of prospective designs and additional predictive variables.

Usona Institute

As a medical research organization, the Usona team collaborates with scientists, clinicians, and leaders worldwide to help expedite the knowledge and the work. These collaborations have inspired a number of Usona programs that complement clinical research including: Medicinal Chemistry, Investigational Drug Supply, and Training/Education.

The Usona team brings a range of proven and published expertise. Our scientists, clinicians, researchers and clinical administrators hold advanced skills in psychiatry, integrative medicine, medicinal chemistry, pharmaceutical manufacturing, quality assurance and regulatory affairs in multiple countries.

The RiverStyx Foundation

The RiverStyx Foundation is a charitable organization that strives to work at this boundary place. Through grant-making and seeding non-profits, Riverstyx attends to the places in society and our psychology which have been relegated to the shadows- out of fear, ignorance, and puritan influence- recognizing that which is repressed only festers and breeds pathology in its unnatural separation.

The goal is not to rid life of its darkness, but rather to reconcile it into our lives, to make relationship, and to honor both light and dark as necessarily two sides of the same coin.

In doing so, may we come into greater balance, beauty, and belonging.

What Happens When Psychedelic Treatment for PTSD Turns Into a Bad Trip

I lay flat on my back, pouring sweat and heart racing, in a hotel room with a woman who had just overdosed me.

Let’s call her Sarah. To be clear: Neither of us was here to party. Sarah, in fact, was a therapist, a licensed clinician. Outside of her office hours, she offered patients like me psilocybin and MDMA, for PTSD and treatment-resistant depression. She did this at fairly extreme risk to her career, because, as she said, she believed in it. This was my second time trying a guided, high-dosage cocktail of psychedelics to address my ongoing PTSD, a result of my surviving the 2008 terrorist attack on the Taj Mahal Hotel in Mumbai.

The goal with such an experience is to “go inside” yourself, surrender the trappings of the ego, and through that process transcend or soothe damage caused by a fundamental trauma. The idea is fairly simple: By letting go of yourself (commonly known as ego loss, or ego death), you become one with everything else. Put another way, you can experience a sense of wholeness that transcends yourself, and that wholeness can be very healing. In conversations with underground practitioners, I learned this was achieved through taking a combination of “medicines.” (For example: MDMA, the main ingredient in what is commonly referred to as ecstasy, paired with psilocybin, otherwise known as magic mushrooms.) But equally important, they said, was the guided support for the experience itself, followed by integration (processing of the experience) with that same guide. My first trip had been very positive and had resulted in a sense of peace and calm with respect to the particular anguish I had been experiencing for years. Indeed, recent scientific research increasingly supports the potential for MDMA-assisted psychotherapy to be “an innovative, efficacious treatment” for PTSD.

The Entropic BraIn: A Theory of Conscious States

Entropy is a dimensionless quantity that is used for measuring uncertainty about the state of a system but it can also imply physical qualities, where high entropy is synonymous with high disorder. Entropy is applied here in the context of states of consciousness and their associated neurodynamics, with a particular focus on the psychedelic state. The psychedelic state is considered an exemplar of a primitive or primary state of consciousness that preceded the development of modern, adult, human, normal waking consciousness. Based on neuroimaging data with psilocybin, a classic psychedelic drug, it is argued that the defining feature of “primary states” is elevated entropy in certain aspects of brain function, such as the repertoire of functional connectivity motifs that form and fragment across time. Indeed, since there is a greater repertoire of connectivity motifs in the psychedelic state than in normal waking consciousness, this implies that primary states may exhibit “criticality,” i.e., the property of being poised at a “critical” point in a transition zone between order and disorder where certain phenomena such as power-law scaling appear. Moreover, if primary states are critical, then this suggests that entropy is suppressed in normal waking consciousness, meaning that the brain operates just below criticality. It is argued that this entropy suppression furnishes normal waking consciousness with a constrained quality and associated metacognitive functions, including reality-testing and self-awareness. It is also proposed that entry into primary states depends on a collapse of the normally highly organized activity within the default-mode network (DMN) and a decoupling between the DMN and the medial temporal lobes (which are normally significantly coupled). These hypotheses can be tested by examining brain activity and associated cognition in other candidate primary states such as rapid eye movement (REM) sleep and early psychosis and comparing these with non-primary states such as normal waking consciousness and the anaesthetized state.

The Therapeutic Potential of Psychedelic Drugs: Past, Present, and Future

Plant-based psychedelics, such as psilocybin, have an ancient history of medicinal use. After the first English language report on LSD in 1950, psychedelics enjoyed a short-lived relationship with psychology and psychiatry. Used most notably as aids to psychotherapy for the treatment of mood disorders and alcohol dependence, drugs such as LSD showed initial therapeutic promise before prohibitive legislature in the mid-1960s effectively ended all major psychedelic research programs. Since the early 1990s, there has been a steady revival of human psychedelic research: last year saw reports on the first modern brain imaging study with LSD and three separate clinical trials of psilocybin for depressive symptoms. In this circumspective piece, RLC-H and GMG share their opinions on the promises and pitfalls of renewed psychedelic research, with a focus on the development of psilocybin as a treatment for depression.

Novel Psychopharmacological Therapies for Psychiatric Disorders: Psilocybin and MDMA

4-phosphorloxy-N,N-dimethyltryptamine (psilocybin) and methylenedioxymethamfetamine (MDMA), best known for their illegal use as psychedelic drugs, are showing promise as therapeutics in a resurgence of clinical research during the past 10 years. Psilocybin is being tested for alcoholism, smoking cessation, and in patients with advanced cancer with anxiety. MDMA is showing encouraging results as a treatment for refractory post-traumatic stress disorder, social anxiety in autistic adults, and anxiety associated with a life-threatening illness. Both drugs are studied as adjuncts or catalysts to psychotherapy, rather than as stand-alone drug treatments. This model of drug-assisted psychotherapy is a possible alternative to existing pharmacological and psychological treatments in psychiatry. Further research is needed to fully assess the potential of these compounds in the management of these common disorders that are difficult to treat with existing methods.

Psychedelic Psychiatry’s Brave New World

After a legally mandated, decades-long global arrest of research on psychedelic drugs, investigation of psychedelics in the context of psychiatric disorders is yielding exciting results. Outcomes of neuroscience and clinical research into 5-Hydroxytryptamine 2A (5-HT2A) receptor agonists, such as psilocybin, show promise for addressing a range of serious disorders, including depression and addiction.