Question 1

How important is client diagnosis in interventions where psychedelics are being used?

William Richards · Accepted Answer

Clinical research projects tend to be designed to investigate the impact of a treatment regimen (i.e. psilocybin-assisted psychotherapy) on a limited sample of persons suffering from a specified diagnosis (i.e. alcohol addiction, depression, post-traumatic stress disorder, etc.).

Thus, diagnosis (generally in accord with current nomenclature and codes used for billing insurance companies) is important in the research world.  In the broader picture, however, most human beings do not neatly fall into diagnostic categories.

Psychedelics appear to have significant promise in the treatment of an increasing number of medical conditions, but they also may have educational and religious value when competently used, perhaps contributing someday to what Robert Jesse has named “the betterment of well people.”

Question 2

Which parts of the brain do psychedelics act on?

William Richards · Accepted Answer

Investigations including fMRI scans by such researchers as Robin Carhart-Harris, Franz Vollenweider and Frederick Barrett have noted decreased activity in the “default mode network” of the brain, which is generally understood to be the area associated with our everyday ego-related activities.

These studies and others of similar nature constitute a fascinating frontier in our understanding of the relation of the brain to consciousness, but it is only a beginning and the fundamental mystery of the “mind-body problem” is far from solved.  What is causation and what may be correlation?  What is going on in our brains right now without psychedelics?

Question 3

Question 4

Are there particular demographics that are precluded from psychedelic use?

William Richards · Accepted Answer

Each research project is designed with specific selection criteria, approved by the local Institutional Review Board and the FDA.  Thus there’s a specific age range for a particular study and various exclusion criteria in realms of physical and mental health.  Most studies to date have been designed to exclude people with prior forms of severe mental illness (i.e. schizophrenia, bipolar disorder, brain tumors, etc.), or often those with family histories that may reflect genetic tendencies related to psychoses.

This is to standardize a specific sample of research participants and avoid possible risks of adverse or prolonged reactions to the psychedelic substance.  This does not mean we know that some of these people could not benefit from a well-designed psychedelic experience; it could be that some could benefit, but may require more hours of preparation and integrative assistance than the particular research project is able to provide.  Eventually, new research projects will investigate some of these unanswered questions, but at the present time our knowledge is limited.

Question 5

Which demographics have the strongest evidence base for therapeutic use of psychedelics?

William Richards · Accepted Answer

Here’s a potential thesis topic for someone!   One could look both at particular research projects, each with their own selection criteria, and also at communities where psychedelic substances are administered in religious contexts.  Prior research has generally included adult participants of differing educational, racial and occupational groups, both men and women.  What appears to matter most when psychedelic therapy is effective is not demographics, but the quality of the therapeutic relationship that has been established prior to drug administration.

Question 6

Question 7

What is psychedelic treatment?

William Richards · Accepted Answer

Generally “psychedelic treatment” refers to psychotherapy assisted by one or a few administrations of a psychedelic drug in a supportive environment.  Historically, the word “psychedelic” implied moderately high or high dosage, contrasted with “psycholytic treatment” which employed the use of low doses of psychedelic substances, often on several days during the week, in a more psychoanalytic framework.  “Psychedelic” means “mind-manifesting”; “Psycholytic” means “mind-releasing.”

Question 8

What do you wish more people knew about psychedelics?

William Richards · Accepted Answer

There are many answers to this question.  Above all, I look forward to the time when the promise of psychedelics in medicine, education and religion (when used with skill and respect) will be more fully appreciated in mainstream Western culture, irrespective of whether or not an individual person chooses to take whatever risks may be entailed in their use.

Substances like psilocybin are not addictive and they are essentially non-toxic; however they need to be administered with attention to purity and appropriate dosage in supportive contexts if safety and efficacy are to be maximised.   Akin to activities like downhill skiing, it is wise to learn some skills of navigating in inner experiential worlds and to be well prepared before beginning to explore the non-ordinary states of awareness that may emerge during the action of psychedelic substances.

In many ways it is helpful to view the experiences that occur, not as being “in the drug”, but rather “in the human mind.”  Thus the ingestion of a psychedelic provides an opportunity, but what one does with that opportunity depends on one’s psychological structure and on preparation, or what is known as “set and setting.”

As is accepted as baseline in religious communities that value ayahuasca, psilocybin mushrooms or Peyote, these substances appear to be intrinsically sacred and their use needs to be approached with wisdom and respect.

In psychedelic research we are not only exploring the potential use of different substances in the treatment of different human conditions (i.e. depression, post-traumatic stress disorder, addictions, end-of-life anxiety, inhibited creativity, etc.); we are also exploring the mysteries of human consciousness—the nature of what we are.  This is a frontier, not only of neuroscience and medicine, but also of philosophy and religion.

Question 9

Can you talk about microdosing?

William Richards · Accepted Answer

This is a new area of research, still in its early stages.  It is not my own area of expertise, but the results of surveys and other investigations are being published and available on the web.  Early findings suggest it may be helpful for some people, perhaps those who are basically well-integrated, for limited time periods.   Google James Fadiman, Microdosing for more information.

Question 10

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