Taking A Trip Through The Evidence On Psychedelics

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In Tuesday’s newsletter, we asked you for your opinions on the medicinal use of psychedelics, and got the above-depicted, below-described, set of responses:

  • 32% said “This is a good, evidence-based way to treat many brain disorders”
  • 32% said “There are some benefits, but they don’t outweigh the risks”
  • 20% said “This can help a select few people only; useless for the majority”
  • 16% said “This is hippie hogwash and hearsay; wishful thinking at best”

Quite a spread of answers, so what does the science say?

This is hippie hogwash and hearsay; wishful thinking at best! True or False?

False! We’re tackling this one first, because it’s easiest to answer:

There are some moderately-well established [usually moderate] clinical benefits from some psychedelics for some people.

If that sounds like a very guarded statement, it is. Part of this is because “psychedelics” is an umbrella term; perhaps we should have conducted separate polls for psilocybin, MDMA, ayahuasca, LSD, ibogaine, etc, etc.

In fact: maybe we will do separate main features for some of these, as there is a lot to say about each of them separately.

Nevertheless, looking at the spread of research as it stands for psychedelics as a category, the answers are often similar across the board, even when the benefits/risks may differ from drug to drug.

To speak in broad terms, if we were to make a research summary for each drug it would look approximately like this in each case:

  • there has been research into this, but not nearly enough, as “the war on drugs” may well have manifestly been lost (the winner of the war being: drugs; still around and more plentiful than ever), but it did really cramp science for a few decades.
  • the studies are often small, heterogenous (often using moderately wealthy white student-age population samples), and with a low standard of evidence (i.e. the methodology often has some holes that leave room for reasonable doubt).
  • the benefits recorded are often small and transient.
  • in their favor, though, the risks are also generally recorded as being quite low, assuming proper safe administration*.

*Illustrative example:

Person A takes MDMA in a club, dances their cares away, has had only alcohol to drink, sweats buckets but they don’t care because they love everyone and they see how we’re all one really and it all makes sense to them and then they pass out from heat exhaustion and dehydration and suffer kidney damage (not to mention a head injury when falling) and are hospitalized and could die;

Person B takes MDMA in a lab, is overwhelmed with a sense of joy and the clarity of how their participation in the study is helping humanity; they want to hug the researcher and express their gratitude; the researcher reminds them to drink some water.

Which is not to say that a lab is the only safe manner of administration; there are many possible setups for supervised usage sites. But it does mean that the risks are often as much environmental as they are risks inherent to the drug itself.

Others are more inherent to the drug itself, such as adverse cardiac events for some drugs (ibogaine is one that definitely needs medical supervision, for example).

For those who’d like to see numbers and clinical examples of the bullet points we gave above, here you go; this is a great (and very readable) overview:

NIH | Evidence Brief: Psychedelic Medications for Mental Health and Substance Use Disorders

Notwithstanding the word “brief” (intended in the sense of: briefing), this is not especially brief and is rather an entire book (available for free, right there!), but we do recommend reading it if you have time.

This can help a select few people only; useless for the majority: True or False?

True, technically, insofar as the evidence points to these drugs being useful for such things as depression, anxiety, PTSD, addiction, etc, and estimates of people who struggle with mental health issues in general is often cited as being 1 in 4, or 1 in 5. Of course, many people may just have moderate anxiety, or a transient period of depression, etc; many, meanwhile, have it worth.

In short: there is a very large minority of people who suffer from mental health issues that, for each issue, there may be one or more psychedelic that could help.

This is a good, evidence-based way to treat many brain disorders: True or False?

True if and only if we’re willing to accept the so far weak evidence that we discussed above. False otherwise, while the jury remains out.

One thing in its favor though is that while the evidence is weak, it’s not contradictory, insofar as the large preponderance of evidence says such therapies probably do work (there aren’t many studies that returned negative results); the evidence is just weak.

When a thousand scientists say “we’re not completely sure, but this looks like it helps; we need to do more research”, then it’s good to believe them on all counts—the positivity and the uncertainty.

This is a very different picture than we saw when looking at, say, ear candling or homeopathy (things that the evidence says simply do not work).

We haven’t been linking individual studies so far, because that book we linked above has many, and the number of studies we’d have to list would be:

n = number of kinds of psychedelic drugs x number of conditions to be treated

e.g. how does psilocybin fare for depression, eating disorders, anxiety, addiction, PTSD, this, that, the other; now how does ayahuasca fare for each of those, and so on for each drug and condition; at least 25 or 30 as a baseline number, and we don’t have that room.

But here are a few samples to finish up:

In closing…

The general scientific consensus is presently “many of those drugs may ameliorate many of those conditions, but we need a lot more research before we can say for sure”.

On a practical level, an important take-away from this is twofold:

  • drugs, even those popularly considered recreational, aren’t ontologically evil, generally do have putative merits, and have been subject to a lot of dramatization/sensationalization, especially by the US government in its famous war on drugs.
  • drugs, even those popularly considered beneficial and potentially lifechangingly good, are still capable of doing great harm if mismanaged, so if putting aside “don’t do drugs” as a propaganda of the past, then please do still hold onto “don’t do drugs alone”; trained professional supervision is a must for safety.

Take care!

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    What you need to know  On February 3, New Mexico health officials warned against consuming raw milk products following the death of a newborn from Listeria infection. Authorities said the baby’s infection was likely linked to the mother’s consumption of raw milk during pregnancy.  Then on March 15, the Food and Drug Administration announced it…

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  • Apple vs Apricot – Which is Healthier?

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    Our Verdict

    When comparing apples to apricots, we picked the apricots.

    Why?

    In terms of macros, there’s not too much between them; apples have a little more carbs and fiber, but the margins are slight and we’ll call this round a tie.

    Micronutrients, however, set these two fruits apart:

    In the category of vitamins, apples are not higher in any vitamins, while apricots are higher in vitamins A, B1, B2, B3, B5, B6, B9, C, E, and K—in most cases, by quite large margins, too. All in all, a clear and easy win for apricots.

    Looking at minerals, apples are not higher in any minerals, while apricots are higher in calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc. There’s simply no contest here.

    Adding up the sections makes the conclusion clear: if an apple a day keeps the doctor away, then an apricot a day will give the doctor a nice weekend break somewhere!

    Want to learn more?

    You might like to read:

    Top 8 Fruits That Prevent & Kill Cancer

    Take care!

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  • How To Recognize Perfectly Hidden Depression

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Dr. Margaret Rutherford shares her insights from 30 years of professional experience:

    There’s only one way to know

    In this video, Dr. Rutherford discusses several (presumably pseudonymized) cases of people who came to her therapy office seeming to have their lives very much together when they very much didn’t, including the woman who came in with symptoms of mild anxiety, and then tried to kill herself, and the man who was outwardly an overachiever while consumed with feelings of guilt and shame.

    She discusses how even the most skilled mental health professionals will tend to miss hidden depression, as they focus on visible symptoms from the DSM criteria, which may not reflect the patient’s reality, especially for those hiding their struggles.

    So, the crux becomes: why do people hide their struggles? One does not go to the emergency room with a broken limb and then say to the doctor “I’m fine thank you; how are you?” so why do people do that when it comes to mental health issues?

    The reality is that the shame of revealing feelings like shame itself, fear, and self-loathing keeps people silent, and in particular, research (Schneiderman et al.) shows that emotional pain plays a central role in suicide, and (per Blatt et al.) perfectionism can drastically alter the presentation of depression, making it even harder to diagnose through standard criteria than it already was.

    As for what can be done about it? Dr. Rutherford advocates for a cultural shift where talking about emotional pain, including suicidal thoughts, is seen as normal and not shameful. That people need to feel safe expressing these feelings, to prevent tragic outcomes. Instead of judging or dismissing someone with suicidal thoughts, she encourages a compassionate and accepting approach to open up dialogue and understanding.

    In short, that everyone can contribute to a culture that views transparency and vulnerability as strengths, helping reduce the stigma around mental health struggles.

    And that’s the only way we’ll ever be able to recognize perfectly hidden depression—if people no longer feel that they have to hide it.

    For more on all of this, here’s Dr. Rutherford herself:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Take care!

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  • The High-Protein, High-Fiber Superfood Salad You’ll Want To Enjoy Daily

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    This salad from Nisha Vora at Rainbow Plant Life has 30g protein and takes minutes to prepare, while being tasty enough to look forward to eating each day:

    Easy preparation

    Prepare the toppings first; you can do a week’s in advance at once:

    • Roasted chickpeas:
      • Drain, rinse, and dry two cans of chickpeas.
      • Toss with olive oil, salt, and pepper.
      • Roast at 425°F for 30–35 minutes.
    • Roasted walnuts:
      • Chop and toss with olive oil, salt, and pepper.
      • Roast at 350°F for 12 minutes after chickpeas finish.

    As for the salad base:

    • Kale:
      • Remove tough stems, slice thinly.
      • Wash and massage with lemon juice and salt to soften.
    • Cabbage:
      • Slice thinly with a knife or mandolin.
      • Store in a sealed bag in the fridge for up to a week.

    Red wine vinaigrette dressing:

    • Key ingredients: red wine vinegar, lemon juice, red pepper flakes, garlic, olive oil.
    • Can be stored in the fridge for up to 10 days.

    Putting it all together:

    1. Toss kale and cabbage with vinaigrette by hand.
    2. Add roasted chickpeas and walnuts for crunch.
    3. Include a protein source like tofu (store-bought curry tofu recommended).
    4. Mix in fresh vegetables like grated carrots, sliced bell peppers, or beets.
    5. Add extras like sauerkraut, avocado, pickled onions, and such.
    6. Top with fresh herbs (she recommends parsley, basil, or dill).

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    Want to learn more?

    You might also like:

    21 Most Beneficial Polyphenols & What Foods Have Them

    Take care!

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  • Keeping Your Kidneys Healthy (Especially After 60)

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Keeping your kidneys happy: it’s more than just hydration!

    Your kidneys are very busy organs. They filter waste products, balance hydration, pH, salt, and potassium. They also make some of our hormones, and are responsible for regulating red blood cell production too. They also handle vitamin D in a way our bodies would not work without, making them essential for calcium absorption and the health of our bones, and even muscular function.

    So, how to keep them in good working order?

    Yes, hydrate

    This is obvious and may go without saying, but we try to not leave important things without saying. So yes, get plenty of water, spread out over the day (you can only usefully absorb so much at once!). If you feel thirsty, you’re probably already dehydrated, so have a little (hydrating!) drink.

    Don’t smoke

    It’s bad for everything, including your kidneys.

    Look after your blood

    Not just “try to keep it inside your body”, but also:

    Basically, your kidneys’ primary job of filtering blood will go much more smoothly if that blood is less problematic on the way in.

    Watch your over-the-counter pill intake

    A lot of PRN OTC NSAIDs (PRN = pro re nata, i.e. you take them as and when symptoms arise) (NSAIDs = Non-Steroidal Anti-Inflammatory Drugs, such as ibuprofen for example) can cause kidney damage if taken regularly.

    Many people take ibuprofen (for example) constantly for chronic pain, especially the kind cause by chronic inflammation, including many autoimmune diseases.

    It is recommended to not take them for more than 10 days, nor more than 8 per day. Taking more than that, or taking them for longer, could damage your kidneys temporarily or permanently.

    Read more: National Kidney Foundation: Advice About Pain Medicines

    See also: Which Drugs Are Harmful To Your Kidneys?

    Get a regular kidney function checkup if you’re in a high risk group

    Who’s in a high risk group?

    • If you’re over 60
    • If you have diabetes
    • If you have cardiovascular disease
    • If you have high blood pressure
    • If you believe, or know, you have existing kidney damage

    The tests are very noninvasive, and will be a urine and/or blood test.

    For more information, see:

    Kidney Testing: Everything You Need to Know

    Take care!

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  • War in Ukraine affected wellbeing worldwide, but people’s speed of recovery depended on their personality

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    The war in Ukraine has had impacts around the world. Supply chains have been disrupted, the cost of living has soared and we’ve seen the fastest-growing refugee crisis since World War II. All of these are in addition to the devastating humanitarian and economic impacts within Ukraine.

    Our international team was conducting a global study on wellbeing in the lead up to and after the Russian invasion. This provided a unique opportunity to examine the psychological impact of the outbreak of war.

    As we explain in a new study published in Nature Communications, we learned the toll on people’s wellbeing was evident across nations, not just in Ukraine. These effects appear to have been temporary – at least for the average person.

    But people with certain psychological vulnerabilities struggled to recover from the shock of the war.

    Tracking wellbeing during the outbreak of war

    People who took part in our study completed a rigorous “experience-sampling” protocol. Specifically, we asked them to report their momentary wellbeing four times per day for a whole month.

    Data collection began in October 2021 and continued throughout 2022. So we had been tracking wellbeing around the world during the weeks surrounding the outbreak of war in February 2022.

    We also collected measures of personality, along with various sociodemographic variables (including age, gender, political views). This enabled us to assess whether different people responded differently to the crisis. We could also compare these effects across countries.

    Our analyses focused primarily on 1,341 participants living in 17 European countries, excluding Ukraine itself (44,894 experience-sampling reports in total). We also expanded these analyses to capture the experiences of 1,735 people living in 43 countries around the world (54,851 experience-sampling reports) – including in Australia.

    A global dip in wellbeing

    On February 24 2022, the day Russia invaded Ukraine, there was a sharp decline in wellbeing around the world. There was no decline in the month leading up to the outbreak of war, suggesting the change in wellbeing was not already occurring for some other reason.

    However, there was a gradual increase in wellbeing during the month after the Russian invasion, suggestive of a “return to baseline” effect. Such effects are commonly reported in psychological research: situations and events that impact our wellbeing often (though not always) do so temporarily.

    Unsurprisingly, people in Europe experienced a sharper dip in wellbeing compared to people living elsewhere around the world. Presumably the war was much more salient for those closest to the conflict, compared to those living on an entirely different continent.

    Interestingly, day-to-day fluctuations in wellbeing mirrored the salience of the war on social media as events unfolded. Specifically, wellbeing was lower on days when there were more tweets mentioning Ukraine on Twitter/X.

    Our results indicate that, on average, it took around two months for people to return to their baseline levels of wellbeing after the invasion.

    Different people, different recoveries

    There are strong links between our wellbeing and our individual personalities.

    However, the dip in wellbeing following the Russian invasion was fairly uniform across individuals. None of the individual factors assessed in our study, including personality and sociodemographic factors, predicted people’s response to the outbreak of war.

    On the other hand, personality did play a role in how quickly people recovered. Individual differences in people’s recovery were linked to a personality trait called “stability”. Stability is a broad dimension of personality that combines low neuroticism with high agreeableness and conscientiousness (three traits from the Big Five personality framework).

    Stability is so named because it reflects the stability of one’s overall psychological functioning. This can be illustrated by breaking stability down into its three components:

    1. low neuroticism describes emotional stability. People low in this trait experience less intense negative emotions such as anxiety, fear or anger, in response to negative events
    2. high agreeableness describes social stability. People high in this trait are generally more cooperative, kind, and motivated to maintain social harmony
    3. high conscientiousness describes motivational stability. People high in this trait show more effective patterns of goal-directed self-regulation.

    So, our data show that people with less stable personalities fared worse in terms of recovering from the impact the war in Ukraine had on wellbeing.

    In a supplementary analysis, we found the effect of stability was driven specifically by neuroticism and agreeableness. The fact that people higher in neuroticism recovered more slowly accords with a wealth of research linking this trait with coping difficulties and poor mental health.

    These effects of personality on recovery were stronger than those of sociodemographic factors, such as age, gender or political views, which were not statistically significant.

    Overall, our findings suggest that people with certain psychological vulnerabilities will often struggle to recover from the shock of global events such as the outbreak of war in Ukraine.The Conversation

    Luke Smillie, Professor in Personality Psychology, The University of Melbourne

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Brain implants allow us to move and talk. But they could also be hacked

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    The human brain is remarkably complex, with trillions of connections that control how you move, think and feel.

    Yet it’s still vulnerable to debilitating conditions such as paralysis, stroke, epilepsy and various neurodegenerative diseases.

    Scientists are investigating if a kind of technology, known as the brain-computer interface, could help patients move and communicate better.

    So how does it work? And what are the potential risks?

    EThamPhoto/Getty

    What is a brain-computer interface?

    A brain-computer interface works by reading electrical signals produced by the brain, which it translates into digital signals that an external computer can understand. The computer then sends instructions – such as the command to move a cursor, steer a wheelchair or read a sentence aloud – back to the brain. This whole process happens in real time, allowing patients to do tasks more independently.

    There are two types of brain-computer interfaces:

    Non-invasive

    Non-invasive brain-computer interfaces are worn externally, usually in the form of electroencephalogram headsets. An electroencephalogram, or an EEG, is a type of test that measures activity in the brain. This technology is already available on the consumer market, found in everything from meditation apps to video games.

    Invasive

    Invasive brain-computer interfaces are surgically implanted. This involves placing electrodes – devices that carry electrical signals from the body to medical instruments – directly onto the exposed surface of the brain. These interfaces aim to help restore key functions such as speech and mobility in people with a disability, caused by conditions such as stroke or spinal cord injury.

    It is this second category that’s attracting attention from investors and scientists. Several companies – including early developer Blackrock Neurotech, Australian-owned Synchron, and Elon Musk’s Neuralink – are racing to get implantable brain-computer interfaces to patients.

    Under current regulations, only a handful of clinical trial participants globally can access this technology. But this may change as interest grows. The international brain-computer interface market is expected to be worth roughly A$14 billion by 2033, up from its current value of just under $3 billion.

    Their role in health care

    Brain implants may sound dystopian, but they are a promising part of neuroscience research.

    More than three billion people worldwide live with a neurological condition that affects their motor, communication or sensory functions. Examples include stroke, epilepsy, Parkinson’s disease, cerebral palsy and traumatic brain injury.

    Brain-computer interfaces are particularly helpful for communication. In one 2023 study, paralysed patients that used a brain-computer interface were able to communicate up to 78 words per minute. That’s a five-fold improvement from the 15 words per minute achieved by patients in 2021. And recent research shows this technology is still rapidly improving.

    Beyond communication, surgeons are using brain-computer interfaces to map brain activity in real time. This is particularly useful during complex or high-risk procedures, where surgeons must protect key brain regions.

    Sleep researchers are also using this technology to analyse brain signals in people who may have a sleep disorder, such as insomnia or sleep apnoea. Brain-computer interfaces may be a more accurate way to diagnose and treat such disorders, compared to other methods such as sleep diaries that rely on participant reports.

    Scientists are also investigating how these interfaces could be used in rehabilitation, particularly for people with conditions such as depression, epilepsy, stroke and Parkinson’s disease.

    What are the risks?

    Here are three worth noting.

    Physical harm

    Any kind of brain implant can cause physical damage that may affect how neighbouring brain regions work.

    For example, if there’s bleeding in a part of the brain that controls speech or movement, even a small blot clot could impair those functions. And while infections in the brain are rare, they can cause swelling and further complications if not immediately treated.

    Research suggests there are long-term effects of having foreign material inside the skull. Over time, the brain treats the implant as an intruder, forming scar tissue around it in a bid to destroy nearby brain cells and stop the implant from working. Regular movements such as breathing may also create friction between the hard implant and soft brain tissue, causing some brain regions to become inflamed.

    Cybersecurity threats

    One recent study found a large-scale breach of brain-computer interface systems could theoretically allow hackers to access sensitive neural data, such as patients’ thoughts and memories. Hacking may also enable them to impair a patient’s cognitive functions such as the ability to concentrate, or even manipulate motor signals to affect how well they move. That’s a scary prospect, especially if these devices become more common in health care and other sectors. In the United States, some jurisdictions are already working to protect neural data rights in law, but there are still major regulatory gaps.

    Unequal access

    Currently, getting a brain implant will set you back between $50,000 to $140,000. That doesn’t include the cost of ongoing maintenance and follow-up care. So ordinary patients are unlikely to access this technology anytime soon, widening the gap between who can and can’t afford to improve their health.

    Where to next

    Brain-computer interfaces are a promising new technology, but they come with risks.

    We urgently need more high-quality research into the long-term effects – both physical and psychological – of permanent brain implants. Importantly, this research should be funded publicly and not just by a handful of large, profit-driven companies.

    David Tuffley, Adjunct Senior Lecturer, Applied Ethics and CyberSecurity, Griffith University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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