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James Hexter's avatar

My thoughts, which I admit are a bit all over the place:

I can't help but suspect that widespread use of psychedelics would lead society as a whole to trade one kind of mental illness with another -- you may certainly see less depression, anxiety, PTSD, etc., but you may definitely see a dramatic increase in hallucinations, delusions, addiction, brain injury, hallucinogen persisting perception disorder, homelessness, etc. I have no problem with people seeking out psychedelics specifically for recreational and/or spiritual uses, as well as those whose mental illnesses are otherwise extremely treatment-resistant -- however, I believe this group self-selects for people who are more likely to act responsibly around these drugs (although of course there are plenty who don't or won't). If we encourage this kind of use to a larger population, who may not have the experience or personality characteristics to be as responsible, I can see this going the way of widespread prescribing of opiates in the 2000s and early 2010s.

I also can't help but think that this is part of this larger trend of "harm reduction" in the psychiatry and mental health fields these days. The theory behind it makes sense, but we're already seeing the negative consequences play out -- for example:

https://twitter.com/JJ_McCullough/status/1296857079420825603

https://www.washingtonpost.com/opinions/2021/02/22/canada-british-columbia-vancouver-drug-decriminalization/

https://twitter.com/TristinHopper/status/1620490927763771393

And also: I'm a social worker whose job is to provide case management for people with brain injuries receiving specialized services to keep them in the community. I have a number of clients who use or want to use marijuana (medically, therapeutically, or both), and I am willing to go out on a limb and say that none of them are being helped by their use. Many of them were previously addicted to harder drugs and are using the marijuana as a kind of "crutch" that's keeping them from developing coping skills that would make it more likely for them to pursue and achieve their goals, and sometimes the marijuana is interacting with other medications that reduce the effectiveness of both. So forgive me if I don't think psychedelics would be much of an improvement.

Finally:

"Art and culture undergo a renaissance, heavily influenced by the psychedelic experiences of artists. The boundaries of what is considered art expand, with immersive and interactive experiences becoming more common. Music, visual arts, theater, and literature incorporate themes of unity, interconnectedness, and transcendence."

We already had a surge of this in the 1960s and 1970s, and without going into too much detail ... let's just say this didn't have the intended effect. Quite the opposite, in fact.

I'll just leave these links from Scott Alexander, a proponent of psychedelics in psychiatry whose opinions I otherwise respect:

https://slatestarcodex.com/2016/04/28/why-were-early-psychedelicists-so-weird/

https://slatestarcodex.com/2019/05/09/is-there-a-case-for-skepticism-of-psychedelic-therapy/

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Martin Greenwald, M.D.'s avatar

I suspect these effects are strongly influenced by various individuals' priors. I also strongly suspect a publication bias for these kind of results.

I can attest that some people find themselves even more in the materialist/physicalist/naturalist position after psychedelic use than they were before. Many have no changes in metaphysical commitments. We're still in the early stages of this whole thing, much more to be seen and difficult to predict.

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