Psychedelics in psychology, psychiatry, and psychotherapy

Keith Jones76 said:Exactly. My only suggestion would be to make them do it at their own risk. In other words, if they end up getting sick, they should foot the entire medical bill themselves. We shouldn't be draining the taxpayers—people who actually work for a living and rightfully avoid this stuff—just to subsidize someone else's choices. It comes down to a simple choice: do you find meaning in being responsible and keeping your feet on the ground, or is the "meaning of life" found in "receptor confusion" and mystical trips? (If that isn't an oxymoron, I don't know what is.)
If anyone still thinks this sounds like a great idea, go for it!

True. By that logic, you could apply it to anyone living life on the edge—reckless drivers, people with terrible diets, extreme athletes... the list goes on forever.

Yeah, I’m with you on that. Same goes for smokers and everyone else.

James Ramirez10 said:True. By that logic, you could apply it to anyone living life on the edge—reckless drivers, people with terrible diets, extreme athletes... the list goes on forever.

Look, in any actually civilized society, lifestyle choices matter when you're calculating insurance premiums. But here? We’re stuck with this damn Medicare monopoly. Their whole goal seems to be squeezing every last cent out of us, without making any distinction between someone actually looking after their health and someone living life on the edge.

But how are you going to determine who is actually being watched? How can you distinguish between someone dealing with high cholesterol due to genetics versus someone whose levels are purely a result of their diet?

It’s not like the definition of "healthy" stays still. One year everyone is praising red meat, and the next, you're told to stay far away from it. It isn't nearly as straightforward or obvious as people make it out to be. Besides, should people living in crowded, high-traffic cities have to pay higher insurance premiums?? Because at the end of the day, they could just move out to the countryside for a healthier lifestyle...

There’s a massive amount of data you can pull from this.
Take someone struggling with obesity who’s been told to watch their diet but just isn't seeing the scale move—you could bet they're dealing with high cholesterol and all the fallout that comes with it. And so on.

What would you do about people struggling with bulimia? Or those with binge eating disorder? Would you bump up their premiums too?

I have to be honest—the idea of you being a doctor who decides certain people deserve more help than others makes me incredibly uncomfortable.

It’s not about saying some people deserve more than others; I’ve just seen enough to have a bit of a more realistic perspective on the situation.
Most ER calls end up being nothing more than unnecessary nuisance calls. About 60% of X-rays don't even result in a diagnosis—so I guess those are just wasted money at that point. Then you have the massive overprescription of antibiotics that patients ignore, or worse, they don't even finish the full course like they're supposed to. All of this creates these massive systemic costs, which means there isn't enough funding left for actual life-saving surgeries and critical procedures.
Personally, I’d look at reducing Medicare coverage for those types of avoidable cases. That money could be redirected toward people dealing with things like eating disorders, where current treatment options aren't nearly sufficient to meet the actual need. At least then we wouldn't be draining funds for oral surgeries for alcoholics who refuse to follow medical advice in the first place.

Keith Jones76 said:It’s not about saying some people deserve more than others; I’ve just seen enough to have a bit of a more realistic perspective on the situation.
Most ER calls end up being nothing more than unnecessary nuisance calls. About 60% of X-rays don't even result in a diagnosis—so I guess those are just wasted money at that point. Then you have the massive overprescription of antibiotics that patients ignore, or worse, they don't even finish the full course like they're supposed to. All of this creates these massive systemic costs, which means there isn't enough funding left for actual life-saving surgeries and critical procedures.
Personally, I’d look at reducing Medicare coverage for those types of avoidable cases. That money could be redirected toward people dealing with things like eating disorders, where current treatment options aren't nearly sufficient to meet the actual need. At least then we wouldn't be draining funds for oral surgeries for alcoholics who refuse to follow medical advice in the first place.

But honestly, this isn't really a patient issue. It's more about primary care physicians ordering unnecessary tests and pharmacists dispensing meds that aren't needed, right? 🤷

We've drifted pretty far off-topic here, but I felt I had to weigh in. It breaks my heart to think anyone would want a system where people might lose their health insurance just because they aren't considered "profitable patients."😢

You missed the point entirely.

but this isn't really about the patients, right? It's more about the primary care doctors ordering unnecessary tests and the pharmacists handing out meds they shouldn't be, isn't it?

Not really. Not at all. Though maybe it happens more often because patients basically self-diagnose and then threaten their doctor if they don't get exactly what they want. They demand endless diagnostic testing, or they just don't show up, letting those referrals go to waste—and a referral is essentially taxpayer money down the drain. You have people who won't quit smoking or cut back on salt even if their life depends on it, yet they'll happily pop antihypertensives and other pills, wasting resources that shouldn't be spent. Then there are those preventive screenings organized by the government and sent via mail—less than 50% of people actually showed up for them. What do they care? They’ll just let the state pick up the tab for an expensive surgery later when it's already too late.
And pharmacists just manufacture or dispense drugs; they don't prescribe them.

At its core, this is about basic personal responsibility toward oneself and society. Adults should be prepared for that reality.
If you ask me, I’d be happy to provide everyone with universal healthcare. But once it becomes clear that people are repeatedly ignoring medical advice that was paid for by someone else (because nothing is truly "free," someone always picks up the check), they should have to cover a percentage of the costs themselves next time. If they continue to squander resources that others worked hard to earn, they should receive fewer benefits and end up paying an even larger share out of pocket.

Alright, enough talk about the funding side of things. Let's move on to how psychiatry and psychedelics actually interact.

placidwolf27 said:Most people have probably heard those stories about using LSD to help folks kick an alcohol addiction
I saw this one documentary on YouTube claiming a 50% success rate, but honestly, as far as I can tell, none of that is actually verified—it could just be someone talking nonsense, as the old saying goes...

But what does the actual medical establishment say? What’s the consensus regarding psychedelic substances in general? How do they view the states they induce, what are the potential risks, and has anyone actually documented any real benefits?

What does "psychedelic" even mean, though? Like, what actually counts as a "psychedelic"? We can't really dive into this until we're all on the same page about the definition. For instance, I'm totally lost on it.

placidwolf27 said:So, the prevailing standard seems to be that psychedelic experiences are essentially dismissed as "meaningless"—as if they don't actually count toward a clinical picture. If a client or patient were to sit down and describe a deeply personal, transformative encounter with such a substance, would a psychiatrist or psychologist simply check a box noting a "psychotic episode" and call it a day? Is that really where the conversation ends?

I’m asking whether anyone actually considers the entire cognitive and emotional discourse an individual carries away from such a state—those profound, albeit sometimes chaotic, realizations... or even the specific shape and content of the hallucinations themselves, which could serve as a window into the person's psyche. Or is all of that just brushed aside as nothing more than side effects of intoxication?

Furthermore, how does the psychiatric approach to dreams differ from how they treat psychedelic experiences? One is studied, the other is dismissed... or so it seems.

There are a lot of questions here. No, conventional therapy usually won't treat psychedelic insights as anything of therapeutic value. That’s why the movements within psychology and psychiatry that emphasized those experiences argued that we were ignoring a vital part of the client's subjective experience that could actually lead to healing. The mainstream response is simply that the drug is harmful and the insights are irrelevant.

Dreams get more attention, partly because they don't carry the stigma of being an illegal substance. It really depends on the therapist's orientation, though; you see everything from practitioners who ignore dreams entirely to those who see them as central to mental functioning. Among those who do pay attention, you have the camp believing in universal dream symbolism that needs decoding, versus those who believe dream imagery is purely individual.

And then there's the whole business of working with dreams, hallucinations, or sudden insights. Either the system is built to account for that, or it’s practically pointless. Maybe that's just another purely practical reason why it doesn't work.

It feels like there’s a lot of avoidance happening here, mostly driven by social stigma. It’s entirely possible that cannabis could prove more effective and have fewer side effects for certain issues than many of the "mainstream" psychiatric drugs out there. I have a friend who has cycled through quite a few prescriptions, and honestly, some of those meds seem more dangerous to me than various recreational substances. Even Israel serves as an interesting case study, where they officially cultivate high-quality cannabis that can be prescribed as medication for specific conditions. I’m not saying it’s inherently better—I don't really care enough to make that claim—but I do wonder how much the stigma surrounding recreational use prevents us from bringing these things into a legitimate therapeutic framework, even when there's a valid medical reason to do so.

Look, when we're talking about medical marijuana, it’s mostly used for palliative care—specifically for patients facing terminal diagnoses. In those cases, the long-term risks like potential addiction or cognitive issues down the line don't really matter much, since they aren't expected to be around that long anyway. I'm oversimplifying here, but that's the gist of it.

Keith Jones76 said:Look, when we're talking about medical marijuana, it’s mostly used for palliative care—specifically for patients facing terminal diagnoses. In those cases, the long-term risks like potential addiction or cognitive issues down the line don't really matter much, since they aren't expected to be around that long anyway. I'm oversimplifying here, but that's the gist of it.

I'm not entirely sure about that. If I recall correctly from the article about that situation in Israel, they were dealing with much less severe conditions; I think asthma was one of them.🤔 I'll dig around and see what I can find.

Then again, how many "FDA-approved" drugs don't have nasty side effects? Even with standard over-the-counter stuff like painkillers or blood pressure meds, I've heard plenty of firsthand horror stories... 😳

Everything you need to know about that is covered in this thread:

Back when Cannabis was approved for medicinal purposes in 1996, the focus was primarily on terminal cancer and AIDS patients. These days, the scope has widened significantly. It’s being utilized much earlier in the progression of various illnesses and for a broader spectrum of conditions, such as Parkinson's, Tourette syndrome, Multiple Sclerosis, chronic pain, and PTSD. Even the mainstream medical community is starting to give more credit to how well Cannabis actually works.

Over at the Mayo Clinic's Bone Marrow Transplantation Department, they're even treating patients—including kids and infants—with drops of oil derived from Cannabis. "It doesn't cause side effects and is largely effective in treating patients," noted the department chief, Professor Reuven. "I'd say it works for about 80 percent of patients, which is quite significant."

Professor Reuven went on to explain, "It helps stimulate appetite and cuts down on nausea and vomiting, which is huge in oncology. It also offers anti-inflammatory benefits, helping with infections or inflammation triggered by radiation. Along with this, Cannabis eases the coping process for patients - it improves their morale and lowers depression, both of which are vital factors for anyone fighting a serious illness."

Currently, about half of the patients receiving Cannabis treatment are in oncology, while roughly a quarter are dealing with chronic pain.

Keith Jones76 said:Everything you need to know about that is covered in this thread:

Hmm, listen... look at something like Dipyrone. I hear—though I haven't checked—that it's banned in many countries due to too many side effects, yet it's still sold here in the States. Or take a friend who gets prescribed some psychiatric med (can't recall the name)... they go to do a little research and find a mountain of side effects paired with the fact that the drug is relatively new (meaning there's a higher chance we don't know all the complications yet). I believe medications are often swapped during therapy because people don't react to everything the same way. In cases I'm aware of, it isn't just about someone being reckless with drugs. I'm not exactly a fan of chemicals, but sometimes it feels unavoidable. Honestly, I'm not sure I see a massive difference between legal and illegal substances in certain instances (aside from better packaging 😁). 🤷 Again, I'm not claiming to know for sure, but I suspect there hasn't been enough research on things that get a bad reputation socially. It probably comes down to what's profitable for Big Pharma. 🤷

They’re supposed to list side effects in tiny 1000:1 doses... honestly, if anyone takes what these forum ladies say at face value, they'll end up thinking doctors are always right.

Let's see what's actually inside a standard Excedrin pill. .

And let's do a little deep dive online to see what these substances actually do and what their potential reach is...
Then you really have to stop and think about whether things are actually going down the way this lady claims.

What happens if someone takes it after using drugs, drinking alcohol, or taking Benadryl? Alcohol can multiply the effects of codeine several times over (it's common knowledge since codeine is a staple in opium, and even traditional opium tinctures are alcohol-based), whereas lemonade only bumps up the absorption slightly. Does the fine print on an Excedrin box say "don't drink lemonade beforehand"? I doubt it. And don't even get me started on how much damage regular coffee can do—people talk about caffeine-induced psychosis—let alone the pure caffeine hit found in those pills. If you mix codeine with Benadryl on top of that, you're looking at more potentiation. Plus, we're talking about a cocktail of different substances here, which means the effects are inherently unpredictable, especially when you mix an opiate (codeine) with a stimulant (caffeine)—that's basically a "speedball." Science itself admits it doesn't fully grasp all the implications of these combinations; the best it can say is that they're "unpredictable." On top of that, these "contraindications" might not even show up immediately... they could hit you 50 or 60 days later.

Basically, Excedrin is a speedball.

So, we really need to consider if it's naive to trust these forum users who claim a medication must list every single possible contraindication.