Remember a few weeks back when I talked about how the common Skeptics’ joke “the plural of anecdotes is not evidence” is wrong? Let’s talk a wee bit more about that. A large number of things humanity now scientifically “knows” come from anecdotal data that scientists followed up on. Like scurvy! In the 18th century, doctors thought that scurvy was caused by “ill-digested and putrefying food within the body” which, fun note, is also what alternative health proponents think is the cause of all disease which is why they’re always blasting their assholes with coffee and whatnot.
But even though there’s no known way that it could help, people noticed that citrus fruits seemed to help prevent scurvy. James Lind conducted the first modern clinical trial and found that, yep, when he gave seamen — excuse me, sailors — oranges and lemons or apple cider, they were more likely to get better compared to the sailors he gave vinegar, barley water, or (oh lord these poor men) half a pint of seawater. Many experts continued to dismiss this as “anecdotal” data because really, why would some fruit help with putrefying food? But the Navy said “fuck it,” and despite not knowing shit about Vitamin C they started giving rations of citrus to sailors, who stopped dying of scurvy.
Eventually, more research was done, and doctors figured out what was actually causing scurvy and why citrus prevented and cured it.
Okay, why am I telling you about all this today? Because of LSD. Obviously.
Over the past few years, there have been more and more researchers looking into the benefits of “microdosing” LSD. Because for much, much longer now, hippies and burnouts and, oh, entire populations of indigenous people have been saying “Hey, I took this drug and it was wild, my dog changed color and spoke to me but when I sobered up I felt way better. Less anxious, less depressed, and more connected to the greater fabric of the universe in a way that gave me peace of mind.”
So of course curious scientists would want to know a few things: is that really happening? If it is, how big of an effect is it? How much can we attribute to the drug, and how much to the ceremony and excitement around the drug? What side effects are there? How long does the effect last? And how does this compare to the other interventions we have, like SSRIs or physical exercise or talk therapy?
Oh, and of course drug companies would love to fund this kind of research because hot damn if there’s a free thing people are getting benefits from wouldn’t it be great if we could mass produce it and sell it back to them? Of course! Sorry but that’s often how your science gets made: can billionaires make a shit ton of money from this? Or can militaries use this to kill people better? BAM, research grant.
We don’t know any of those things because we only have anecdotes: sailors who say they felt better after they drank some grog with an orange slice in it (FANCY) but we don’t know if it was the grog, the orange, the sailor’s own humours, or something else entirely.
So we need to study it, but the problem is that our society has determined that psychoactive substances are evil, and so not only can we not let random adults enjoy them on their own time but we also need to restrict the way that scientists study how these substances interact with our bodies. Because if we really wanted to see if LSD helps alleviate, say, depression, a simple way to find out would be to get a bunch of depressed people who aren’t currently using any drugs, legal or otherwise. You give some of them tabs of LSD. You give others plain pieces of paper with a My Little Pony on it (you really want them to think they are taking LSD, and everyone knows the best LSD has cartoon characters on it). Maybe you give another group talk therapy. And then you figure out how depressed all these people are after two days, and two weeks, and two months, and two years. Boom, now you have a pretty good idea whether or not LSD helps with depression, and whether it helps more than licking pictures of Pinky Pie, and whether it helps more than talking to a therapist.
But scientists can’t do that! It would be unethical. Because humans are illogical. Some small studies are able to be done but the amount of red tape they deal with is unreal and even the cost to get the drugs is prohibitive, so nothing has been done on a scale large enough to give us much to work with.
So instead we have “observational” studies, which are great for cases where we can’t do clinical trials because we don’t want to accidentally kill some sailors by making them drink seawater or whatever. In 2019, Australian scientists published a study in which they observed 98 people who already microdosed LSD and asked them to chart their feelings for six weeks. Those people reported feeling less depressed and distracted on days when they microdosed, but the effects didn’t seem to last for long afterward. (They also tended to get more neurotic.) So that’s basically one step better than a single anecdote: it’s a lot of anecdotes. It doesn’t tell us the whole story but it does tell us okay, something is happening here.
The scientists followed that up by asking a bunch of microdosers what they thought microdosing was good for. The subjects reported far-ranging effects, but interestingly there was no connection between the things they thought it was good for and what the previous study showed it actually was good for. That gives us a hint that it might not just be a placebo effect.
There have been several other studies like that, many of which provided more and more evidence that there is something to the idea that low-dose psychedelics can help with a variety of psychological issues (but mostly depression). Endeavours like the Beckley / Maastricht Psychedelic Programme and the Centre for Psychedelic Research at Imperial College London were created to dig more deeply into the matter, including looking at brain scans to determine how positive iterations of “ego death” (a common result of psychedelics that is described as being the loss of your sense of “self”) may lead to therapeutic outcomes.
Those two programs I mentioned, Beckley and Imperial, have teamed up to attempt to do one of the first placebo-controlled, blinded studies of microdosing, which finally published their first paper this week. How do you get a blinded, placebo-controlled study when you can’t actually give subjects the drug in question? Well, it’s pretty clever: they recruited 191 people who already microdose and guided them through the process of creating their own identical placebo to match their LSD. The subjects then placed each into an envelope marked with a QR-code that was noted by the scientists. They mixed up the envelopes, picked one, and took what was inside. Exciting! It’s like Russian Roulette but fun instead of depressing!
Thanks to the QR code, the researchers knew whether the subjects were taking the LSD or the placebo. Over the course of four weeks, they tracked the psychological wellbeing of the subjects, and what they found was just what the observational studies predicted: those who took the LSD enjoyed significant improvements in a broad range of psychological effects, like well-being, mindfulness, life satisfaction, and paranoia (which decreased, which is probably why so many microdosers told strangers about their illegal drug use in the first place).
However, they also found that the subjects who took the placebo but thought it was the LSD enjoyed almost exactly the same benefits. DAMN YOU PLACEBO EFFECT!
Interestingly, those who took the LSD but thought it was the placebo didn’t benefit nearly as much. The people who did the worst were those who took the placebo and knew it.
Because that was part of the problem, here: these subjects were already microdosers. They were asked to guess if they took a microdose or a placebo and 72% of them guessed correctly — much better than a random guess would be. That’s going to throw off the results, which is why the researchers separated “took a placebo and knew it” from “took a placebo and didn’t know it.” So it’s tough to say from this that placebos worked just as well as microdoses — if the subject didn’t actually know they were taking a placebo then it was just as good as the microdose. Which, if you think about it, is actually a circular argument and kind of meaningless statement. If the subject takes a placebo and feels as good as they feel when they microdose, then they think they took the microdose and therefore the placebo is, to them, just as good as the microdose. If they take the placebo and nothing happens they say “oh, this is a placebo. It’s not as good as the microdose.”
The researchers point out this problem, along with the not insignificant problem of not being able to control for what drug the subjects were even taking. Like, they didn’t evaluate the chemical makeup of the subjects’ drug or the amount and intensity of the drug. It was just, “oh, you managed to score some acid? Great, put it in this envelope.”
So yes, the conclusion of this study was that they were unable to distinguish the positive effects of microdosing LSD from a placebo. But the real conclusion is JESUS CHRIST can we please treat adult humans like adult humans and let them study this shit properly? I’m not saying we should remove all ethical restrictions, but as Professor David Nutt (former government advisor on drugs and currently affiliated with the Imperial program) says, stop classifying LSD the same as heroin. It’s not nearly as dangerous, and there is evidence of medical use. And yes, Nutt was fired from his government position for saying as much and yes, it was very funny at the time that all the headlines said “Nutt Sacked.” It was very funny, but also pathetic that a country would fire someone who was just stating the current scientific consensus, which is what he was hired to do in the first place.
The good news is that these studies are growing in number and pressure is building on countries like the UK to relax restrictions so that we can finally get ot the bottom of whether or not tripping balls can make us happier.