Powerful substances in tiny amounts An interview study of psychedelic microdosing

CONCLUSION

The purpose of this study was to explore how "ordinary" users of psychedelics approach psychedelic microdosing. The selection of users included in this study was not, however, representative of the population of psychedelics users, and the findings of the study therefore have no claim to general validity. Despite this shortcoming, the findings may serve to acquaint researchers with the, as of yet, understudied phenomenon of psychedelic microdosing. The microdosing practices reported in this study generally conformed in regimen and dose to the recommendations published by, although some users experimented with daily microdoses. LSD and psilocybincontaining mushrooms were most commonly used, but some respondents also microdosed a wide range of lesser-known psychedelics and other psychoactive drugs. Respondents for the most part reported what they regarded as positive effects from microdosing, with few side effects. Microdoses most commonly served as mood and cognitive enhancers, allowing people to function at what they felt was a higher level than usual. There are clear parallels between psychedelic microdosing and the use of cognitive enhancement drugs among healthy individuals for performance improvements described byand, as both forms of drug use can be motivated by a wish for enhanced performance in the workplace or in academic study. However, there was also a therapeutic motivation for psychedelic microdosing among some of the respondents in this study who suffered from conditions such as anxiety or depression. These findings are congruent with reported effects from full doses of psychedelic drugs on conditions of depression and anxiety. Reports about the efficacy of microdosing practices for conditions such as substance dependence, OCD, and PTSD also have parallels in research on therapeutic effects from psychedelics in full doses. It should be noted, however, that in the present study these observations were limited to one or a few individuals. Clinical research on microdosing should probably first look into putative anxiolytic and antidepressive effects, but need not end there. The lack of a clear distinction between therapy and enhancement that has been pointed to by anthropologists and sociologists who study enhancement technologiesis echoed in this study. Some respondents pointed to specific deficiencies that their use of psychedelic microdoses was intended to address, but there was an overlap between the use motivated by such therapeutic effects and the use motivated by an effect of enhancement. In either case, the desired effect from microdosing was to be lifted out of a state of relative limitation into a state of higher functioning. The difference was that in therapeutic use, the state of limitation corresponded with a specific medical diagnosis. One respondent explicitly challenged the notion that his "normal" or pre-microdosing state of being deserved the designation "healthy", even though he had not been diagnosed with any specific ailment. Some respondents experienced no effects from microdosing at all, however, and several others emphasised that, despite their positive experience, microdosing is no miracle cure. There were some indications that psychedelic microdoses might not retain their perceived beneficial effects over longer stretches of time, and that the use should therefore be constrained to phases, which was indeed the most common approach to microdosing among respondents with extensive experience. This reduction of effect over time might limit the medical value of microdosing psychedelics, and would seem to be an important area of investigation for subsequent clinical research of microdosing. The most commonly reported challenges with microdosing were overdosing and insomnia. Overdosing in this case means going beyond microdose territory into a mini-dose that has some intoxicating effect. Such mini-doses are not by themselves overly problematic for experienced psychedelics users, but might have serious negative consequences for users who combine microdosing with work, driving a car, and other activities not compatible with drug intoxication. The overdosing problem applies both to LSD and to psilocybincontaining mushrooms. The former is fully active in doses of a hundred micrograms, and a microdose is often obtained, rather inexactly, by cutting a blotter into separate pieces. Mushrooms for their part may be subject to a natural variation in psilocybin content. Clinical applications of microdosing could solve this problem by supplying standardised microdoses, but would have to trust their clients not to take several doses at the same time. The few negative reports about microdosing in this study were not apparently a result of overdosing, nor is there any other obvious explanation for their occurrence. While these negative experiences constitute a minority, it is important to note that some people may experience distinctly unpleasant effects as a result of microdosing. The reported "bad trip" might appear to be a product more of cannabis use than of the LSD microdose, but damagereduction publications such as tripsafe.org often warn that cannabis might potentiate psychedelic drugs. The question of whether microdosing of psychedelic drugs should be characterised as "abuse", which waslabel for piracetam use among healthy individuals, or as "functional drug use", whichargued is the best way to understand the use of cognitive enhancement drugs, is not easily answered. Psychedelics are designated as drugs of abuse in most of the world, but there is a substantial research literature that indicates that their use may have therapeutic effect. It is possible that microdosing may allow users to procure some of the perceived positive effects of these drugs while avoiding the problems that may follow from taking them in full doses. As a social phenomenon, we can perhaps understand psychedelic microdosing in light ofobservation that the cultural authority of medical experts may be subject to change. Much medical knowledge is now readily available on the Internet, and electronic fora for psychedelic users serve as knowledge repositories that integrate shared user experiences with medical and neuroscientific information. This has resulted in increased knowledge availability (or at least in the perception of increased knowledge availability), which may have caused a corresponding decrease in the cultural authority of medical experts. The growth of microdosing may therefore reflect a social development in which ordinary people use the Internet for medical advice and feel empowered to take personal responsibility for their medication needs, pursuing therapy and enhancement through means that the medical establishment does not recognise and would perhaps frown upon. There are no published studies on microdosing with which the findings of this study may be compared. The reports of therapy and enhancement, which constitute the majority here, conform to the findings of previously published anecdotal reports, while the reports of no effect or negative effect are, as far as I can determine, without counterpart. This may reflect a bias towards beneficial effects in anecdotal reports, whichfound to be a problem for media reports about enhancement drugs, or perhaps it may be that the method used in this study has been more conducive to obtaining balanced information. There is no way to differentiate between drug effects and positive or negative expectation effects (placebo/nocebo) in these data, but the study affords an understanding of how "ordinary" users of psychedelics approach psychedelic microdosing. Several respondents expressed nuanced views about the relative benefits and disadvantages of microdosing that were not in any obvious manner indebted to placebo or nocebo effects. They also reported discovering specific practices that have worked well for them, compared to others that were found to be ineffectual or subject to negative side effects. Confidence in the reports is therefore increased by their high degree of specificity, as curative or symptom-abating effect was often reported only for one of several drugs that respondents used. Another overall finding from this study is the value of tapping the psychedelic Internet community for academic studies. It is unknown whether this segment of Internet-active users is representative of the general psychedelicusing population, but the discussion fora frequented by these users are probably among the best recruitment arenas available to researchers. The respondents in this study were reflective, knowledgeable, and fully capable of expressing their views, and their participation would be an asset to any study of psychedelic drug use. It is possible, however, that a less erudite group of psychedelics users would have a less constructive and self-reflective approach to microdosing, and the study has nothing to say about the attractions of microdosing to women. The findings from this study should therefore be taken to reflect the microdosing experiences of a resourceful group of male psychedelic users, and have value primarily to the extent that they may provide subsequent investigations with research questions and hypotheses.