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182 - Psychedelics & Recreational Drugs — Whalespan

Content›Video›182 - Psychedelics & Recreat…

182 - Psychedelics & Recreational Drugs

Peter Attia1h 41m · 2021-11-01

Claims Made

168

Claims Supported

90

Support Rate

54%

Support rate

90 of 168 claims supported

90 supported78 partial / not

Claims from this content

107

✓Well SupportedKetamine provides rapid relief for depression, often on the same day of initiation.◐Partially SupportedA clinical trial compared 25mg psilocybin, 10mg psilocybin, and escitalopram over 3 weeks.◐Partially SupportedA psilocybin therapy versus escitalopram trial used escitalopram for six weeks and a very low dose of psilocybin.◐Partially SupportedPsilocybin and escitalopram (Lexapro) treat depression through different mechanisms.◐Partially Supported

More from Peter Attia

Peter Attia on Zone 2 Cardio

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Attia walks back the clinic protocol: too aggressive for healthy adults

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A. Volkovreader

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Bookmarking — the dossier-vs-overview split is the right call. Most of the time I want overview; sometimes I want receipts.

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A 'heroic dose' of mushrooms is approximately 5 grams, translating to about 50 milligrams of psilocybin.

◐Partially SupportedIn Britain, LSD was used in psychotherapy at low, repeated doses to break down psychological resistance.

◐Partially SupportedThe harms of alcohol are considerably greater than the harms of tobacco.

◐Partially SupportedThe default mode network is fundamental to orchestrating self-identity, encoding self-referential memories, plans, and coordinating access to memories.

✕Not SupportedKetamine can be dependence-producing, recreational, and lead to tolerance with regular use.

◐Partially SupportedLSD was banned due to its association with the anti-Vietnam War hippie movement and perceived threat to the American status quo, not solely on evidence of harm.

◐Partially SupportedPsychedelics may help addiction by disrupting overlearned habit circuits.

◐Partially SupportedPsilocybin performed well on measures of well-being in a study comparing it to escitalopram for depression.

◐Partially SupportedStudies of LSD involving 40,000 patients found it to be safe, potentially reducing suicide rates, and effective without causing psychosis.

◐Partially SupportedPsilocybin, at a dose of 25mg, may offer similar antidepressant benefits to Lexapro without the sexual side effects and blunting of pleasure.

✓Well SupportedFentanyl is approximately 50 times more potent than heroin and twice as cheap to produce.

✕Not SupportedThe 2002 study in Science suggesting MDMA neurotoxicity in primates was retracted due to issues including mislabeling of MDMA versus other drugs.

✕Not SupportedCocaine has non-trivial physical risks and does not improve life when not in use, making it a poor choice.

◐Partially SupportedIboga and other plant-based compounds show promise in treating opiate addiction by fundamentally altering brain wiring.

◐Partially SupportedA drug's value can be assessed by its physical risk and its potential to alter traits versus only altering state.

◐Partially SupportedAlcohol is consistently ranked as the most harmful drug overall in Europe, Britain, and Australia.

◐Partially SupportedAlcohol has acute and chronic toxicity, with acute toxicity leading to significant loss of life.

◐Partially SupportedWhile alcohol is ranked number one for overall harm and harm to others, opiates, crack cocaine, and crystal meth are the most harmful drugs to the user.

◐Partially SupportedNoribogaine is being investigated for its potential to mitigate some of ibogaine's risks.

◐Partially SupportedDuring World War II, amphetamine sulfate was used by Allied troops to stay awake, while methamphetamine was used by German and Japanese troops for longer-lasting effects.

◐Partially SupportedEscitalopram (Lexapro) doses of 10mg or 20mg can increase efficacy but also side effects like sexual dysfunction.

◐Partially SupportedRapidly developing tolerance to ketamine requires progressively higher doses with repeated administration in a short time window.

◐Partially SupportedLegislation requiring clubs to serve free water and recommend chill-out rooms reduced deaths from ecstasy.

✓Well SupportedIbogaine treatment requires medical attention, including heart monitoring, for safety.

◐Partially SupportedPsilocybin and LSD are typical psychedelics, MDMA is atypical, ketamine is a dissociative, and ibogaine is a highly atypical psychedelic.

◐Partially SupportedSSRIs like Lexapro can dampen sexual activity by reducing limbic system activity and may blunt overall enjoyment of life.

◐Partially SupportedLSD was instrumental in six trials for alcoholism, showing an effect size of one in a modern meta-analysis, which is twice that of subsequent treatments.

◐Partially SupportedIbogaine shows potential for treating opioid addiction, but its cardiac risks require further investigation.

◐Partially SupportedBill Wilson was instrumental in six trials of LSD for alcoholism in the US.

◐Partially SupportedA 2022 New England Journal of Medicine paper compared psilocybin dosages, including microdosing, against citalopram.

◐Partially SupportedCrystal meth use can deplete dopamine systems, potentially leading to a state where normal functioning requires the drug.

◐Partially SupportedA framework for evaluating drugs should consider harm to the individual, harm to society, addictiveness, and physiological dependence.

◐Partially SupportedLegislation in Britain requiring clubs to serve free water and recommending chill-out rooms effectively reduced deaths from ecstasy.

◐Partially SupportedDrugs are classified as Schedule I by the DEA if they have a high potential for addiction and no accepted medical use.

◐Partially SupportedCocaine is not Schedule I because it has an accepted medical use as an anesthetic, particularly in the nose.

◐Partially SupportedCrystal meth is likely more neurotoxic than amphetamine sulfate due to its longer acting properties.

✕Not SupportedThe science purportedly proving MDMA's harm has been of very poor quality.

◐Partially SupportedNicotine can both calm individuals and improve attention.

◐Partially SupportedSome individuals may use cocaine once or twice a year without significant issues if they do not have serious cardiac problems.

◐Partially SupportedOregon voted to legalize psilocybin mushrooms as medicine, with implementation expected in two years.

◐Partially SupportedCocaine use leads to the release of dopamine and noradrenaline in the brain, causing a 'spiky' effect.

◐Partially SupportedCrystal meth may damage dopamine pathways to the frontal cortex, impairing judgment and executive function.

◐Partially SupportedThe default mode network can become over-engaged with negative thinking, depression, or compulsive drug seeking.

◐Partially SupportedEsketamine, a nasal formulation of ketamine, can be used a couple of times a week for depression, with decreasing frequency to avoid tachyphylaxis.

◐Partially SupportedUnlike heroin and ketamine, psychedelics do not allow tolerance to be overcome by increasing the dose, and the effect disappears almost completely after two or three doses.

◐Partially SupportedThe US government discovered that LSD had no effect on troops by the third day of administration due to rapid tolerance.

◐Partially SupportedOregon's vote to make mushrooms medicine may lead to mushrooms, rather than psilocybin, becoming the medicine.

◐Partially SupportedThe effects of psychedelics disappear between one and two weeks due to temporal tachyphylaxis.

◐Partially SupportedPsilocybin may be the first psychedelic to have its scheduling changed due to ongoing multi-center studies for depression.

◐Partially SupportedSocial factors are hugely important in the development of addiction.

◐Partially SupportedOpioid dependency likely has a polygenic genetic susceptibility.

◐Partially SupportedCompass Pathways' research, based on David Nutt's initial study, is likely to provide sufficient evidence for psilocybin to become a medicine within David Nutt's lifetime.

◐Partially SupportedIf LSD had helped 10% of the over 100 million people who have died prematurely from alcohol use disorder in the 50 years since its ban, it could have saved 10 million lives.

◐Partially SupportedPsilocybin, MDMA, and LSD are classified as Schedule I drugs by the DEA.

◐Partially SupportedPrior to its scheduling, LSD had been studied rigorously, with over 130 grants issued, 40,000 patients studied, and 1,000 papers published.

◐Partially SupportedPeople use drugs like cocaine, crystal meth, and psychedelics recreationally, to alter pain perception, or for insights.

◐Partially SupportedResponsible alcohol consumption (e.g., three drinks per week) may have no relative cost for some individuals.

✕Not SupportedAny amount of tobacco use will negatively impact the pulmonary and cardiovascular systems.

✕Not SupportedThere is no benefit to tobacco use, though nicotine may help some people calm down and cope with nerves.

◐Partially SupportedSuper fentanyl derivatives like para-fentanyl are a thousand times more potent than heroin, making them difficult to measure and dose safely.

◐Partially SupportedLen Bias died of sudden cardiac arrest due to cocaine use.

◐Partially SupportedProlonged high-dose methamphetamine use can lead to sleep deprivation, paranoia, and severe hallucinatory states.

◐Partially SupportedFentanyl is not Schedule I because it has medical use for pain relief despite high addictiveness.

◐Partially SupportedCocaine and crystal meth can lead to sensitization, loss of control, and addiction.

◐Partially SupportedPsilocybin mushrooms may become a significant medical intervention.

◐Partially SupportedFreud used cocaine believing it could help heroin dependence, but he and an associate became cocaine dependent.

◐Partially SupportedDamage to the posterior default mode network can cause personality changes.

◐Partially SupportedIbogaine may be efficacious in relieving opioid addiction, despite potential cardiac toxicity risks.

◐Partially SupportedA single psilocybin trip had good outcomes for one to two months in a trial of 20 people with treatment-resistant depression.

◐Partially SupportedRepeated microdosing of psychedelics (1-2mg, 3-4 times/week for a year) might plausibly protect against a lowering of mood.

◐Partially SupportedPeople can inadvertently cause self-harm while taking LSD by engaging in extreme behaviors, such as jumping from buildings, especially in dangerous environments without supervision.

◐Partially SupportedA study assessed the duration of effects by administering two doses of psilocybin (high or low) at the start and after three weeks, while also measuring mood changes, side effects, and well-being.

◐Partially SupportedPeter Attia's drug evaluation framework considers physical risk and whether a drug alters a trait versus a state.

◐Partially SupportedAmphetamines were originally developed as a synthetic alternative to ephedra for treating asthma.

◐Partially SupportedMDMA was synthesized in 1904 as a potential blood clotting agent and later noted for promoting clarity, warmth, and empathy.

◐Partially SupportedNeuropsychopharmacology is the study of using drugs to understand the brain and treat brain disorders, particularly psychiatric conditions.

◐Partially SupportedMDMA was used by therapists under the name 'Empathy' to help relationships by breaking down irritation and fostering love.

◐Partially SupportedStates with the highest prescription levels of opiates for chronic pain often lack medical cannabis, which is considered a better treatment for chronic pain.

✕Not SupportedRegular use of ketamine can lead to tolerance and severe bladder problems and a psychiatric state mimicking schizophrenia.

✕Not SupportedDaily use of ketamine, potentially 4-5 times a day and 5 grams a day, can lead to addiction and serious brain damage.

◐Partially SupportedOpiates kill primarily through respiratory depression in overdose situations.

✕Not SupportedDuring a cocaine binge, the brain can become perturbed, leading to paranoia, withdrawal, sensitization, addiction, or death.

◐Partially SupportedOpioids pose the greatest physiological risk of acute and chronic mortality, followed by cocaine and amphetamine derivatives.

◐Partially SupportedKetamine is a dependence-producing and recreational drug that is popular in Britain, China, and likely the US.

◐Partially SupportedThe harms associated with ecstasy are primarily from user behavior rather than the drug itself.

◐Partially SupportedThe risk of a fatal arrhythmia from ibogaine use is approximately 1 in 1000.

◐Partially SupportedFit athletes may be as vulnerable as others to the cardiac effects of drugs like cocaine.

◐Partially SupportedIn the US, more people died from opiate overdose last year than in the entirety of the Vietnam War.

◐Partially SupportedTemporal lobe disorders can involve psychotic symptoms and olfactory hallucinations.

◐Partially SupportedMagic mushrooms were legal in Britain until 2005, with regulators allowing their use based on adequate safety evidence.

◐Partially SupportedTobacco kills approximately half of all smokers.

◐Partially SupportedTemporal lobe disorders are related to the experience of smelling fish.

◐Partially SupportedOpiates are not ideal for chronic pain in the absence of physiotherapy or occupational therapy.

◐Partially SupportedWidespread testing of illicit substances to identify fentanyl and the implementation of safer chronic pain treatments like medical cannabis are recommended to address the opioid crisis.

◐Partially SupportedLSD was used in psychotherapy in the US, typically as a single large dose combined with psychotherapy to help patients interpret the experience.

◐Partially SupportedTobacco use kills more people than alcohol, often at a later age.

◐Partially SupportedMixing cocaine and alcohol produces coca-ethylene, a longer-acting and more cardiotoxic version of cocaine.

◐Partially SupportedSSRIs like escitalopram may heal the limbic system via serotonin 1a receptors over six to eight weeks.

◐Partially SupportedDrugs like magic mushrooms, LSD, and MDMA are among the least harmful.

◐Partially SupportedEvidence for significant brain damage from crystal meth primarily comes from post-WWII Japanese soldiers using large, often intravenous doses.

✕Not SupportedIbogaine should not be administered during opioid withdrawal.

◐Partially SupportedTachyphylaxis does not generally occur with acetaminophen.

✕Not SupportedOpiates perform poorly on acute and chronic toxicity measures, potentially causing instant death and damage over time.