Why Microdosing Cannot Replace Psychedelic Medicine

  • Psychedelic medicine has become a proven commodity, as an increasing body of formal clinical studies and trials demonstrate vastly superior therapeutic benefits versus conventional treatments
  • Proponents of microdosing believe that (to at least some degree) similar health benefits can be achieved through the microdosing of psychedelic drugs such as psilocybin
  • We explain how/why microdosing might be an alternative to psychedelic medicine, but it cannot be a replacement




Microdosing of psychedelic drugs such as psilocybin is big.

It’s impossible to attach precise numbers to those practicing this form of self-help. However, we can infer its popularity by simply observing the vast number of black market/gray market sources for such microdosing “products” that have mushroomed into existence (pun intended) in recent years.

Depending on personal perspective, microdosing of psychedelic drugs is either a “fad”, a trend, or simply the wave of the Future. A recent article from National Geographic explored this trend in depth.
 
National Geographic, itself, refers to this as “a growing phenomenon”.
 
No one knows how many people in the U.S. currently microdose, although its popularity seems to be growing. An analysis in 2018 of a Reddit discussion group devoted to microdosing recorded 27,000 subscribers; in early 2022, the group had 183,000. At a recent business conference focusing on psychedelic drugs in Miami, when audience members were asked how many currently microdose, hundreds of hands went up.

Anecdotal evidence, but you get the idea. The question is: how much real therapeutic benefit is being obtained through this practice? National Geographic raises two important considerations in attempting to answer this question.

Microdosing benefits are difficult to measure/assess

Therapeutic benefits of microdosing cannot be proven through mere anecdotes. But obtaining actual scientific verification is a challenge.
 
A key reason [for therapeutic ambiguity] is that microdosing, as it is done in real life, is challenging to study. Users generally consume a dose for one or two mornings, skip the next one or two, and repeat this regimen for months or years…

That presents a problem for both the scientists and the microdosers. When active users respond to surveys about their experiences for observational research, the scientists can’t be sure each person is taking the same amount.

Where the “quality” of data is low, science can only compensate for this through much larger data samples, stretched over much longer time horizons. Translation: proving (or disproving) the benefits of microdosing is going to take at least several more years.

Beyond this, there is a second complication that is an especially large factor with respect to any form of mental health therapy.

The Placebo Effect clouds the picture

All forms of therapy and self-help are prone to a “placebo effect”: we think the therapy is helping and (as a result) we perceive benefits.

The Placebo Effect is especially large regarding any form of mental health therapy because “improving” one’s mental health is highly subjective, with few objective reference points, and improvements are often subtle/gradual.

For example, with patients who are prescribed antidepressants, roughly 1/3rd of the perceived “efficacy” is merely a Placebo Effect. Without that large Placebo Effect, antidepressants themselves deliver only marginal therapeutic benefits.

National Geographic addressed this issue in specific terms with respect to microdosing.
 
In fact, the best study of microdosing to date shows just this effect. This was a “citizen science initiative” involving some 200 LSD and psilocybin microdosers. Some of the participants were chosen at random by scientists at Imperial College London to swap their drugs for placebos, with neither group knowing for sure which they were getting. After a month everyone was surveyed about their well-being, life satisfaction, cognition, and other factors. Psychological outcomes improved significantly for people taking the psychedelics—but they also did for those downing the placebos.

This was a clever way to study a large number of microdosers in the current regulatory environment, says Garcia-Romeu, who helped to evaluate the research for the journal eLife. The fact that so many placebo-takers reported benefits “calls into question the whole phenomenon of microdosing,” he says.

This Placebo Effect regarding microdosing further muddies the waters concerning actual therapeutic benefits, and will even further delay conclusive research on microdosing.

Meanwhile, a Mental Health Crisis that already affected roughly 1 in 4 people globally before the Covid-19 pandemic is now spiraling out of control.

We need decisive action on mental health today

In the United States, stress caused by oppressive lockdowns and Covid “mandates” has caused the percentage of Americans exhibiting symptoms of depression to nearly quadruple, with 80 million affected.

U.S. drug overdose deaths spiked by 30% in 2020 and then jumped an additional 16% in 2021 – with over 100,000 U.S. deaths.

Meanwhile, one American dies via suicide roughly every 10 minutes.

In Canada, already by September 2020, “nearly everyone” had seen their mental health negatively impacted by Covid lockdowns/mandates.

Microdosing psychedelic drugs might be able to provide relief for some or even most of the people in need of better therapy options today. However, as previously explained, it will take at least several more years to prove this one way or another.

Given the magnitude of the Mental Health Crisis and the rate at which it is accelerating, we simply do not have the luxury of hoping-and-waiting that microdosing can be a significant part of the solution here.

Why psychedelic medicine is the only answer

The Placebo Effect attached to microdosing should not be discounted. If people can consume psychedelic drugs (which are non-addictive) in non-toxic levels, this is a totally safe way to try to address mental health issues.

Microdosing is much, much safer than being prescribed minimally-effective antidepressants, which carry a long list of unpleasant (and even dangerous) side effects – and are frequently addictive. However, because a Placebo Effect is (literally) “all in our head”, such benefits tend to be both temporary and fragile, i.e. any new stress or trauma can quickly erase those perceived benefits.

Conversely, not only is psychedelic medicine showing (in formal clinical trials) that it can be quickly and overwhelmingly effective in treating many types of mental health disorders, new evidence is showing that such benefits are durable.

Johns Hopkins, one of the leading institutions for psychedelic drug R&D, recently published an impressive follow-up study of the benefits of psychedelic-assisted therapy for major depressive disorder (MDD).

After just two doses (and therapy sessions) with psilocybin, 75% of those in the study reported continued benefits and 58% were still in remission after 12 months. Strong and durable results. Proven results.

Psychedelic medicine is generating equally strong results in studies/trials with respect to treating both PTSD and substance abuse: two other areas where conventional therapies have failed miserably in even slowing the death and suffering.

In the time it takes to read this article, another American will have died from a drug overdose – that could have been prevented by psychedelic medicine.

Big Pharma has no answers for these assorted health crises. In fact, multinational drug companies largely quit even trying to come up with better mental health drugs last decade.

Microdosing might be a partial answer, but we won’t know for several more years.

Psychedelic medicine is now a safe and proven way to address the Mental Health Crisis today. It’s simply too late in this worsening catastrophe to hope-and-wait for other options to arise.
 
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