Microdosing

Vs macro-dosing

Let’s be clear about one thing up front. I’ve never micro-dosed. The idea does not resonate with me. I think about it in the same way I think about drinking half a beer or leaving a half of glass of wine behind at the dinner table or opening a pint of Haagen Daz and not finishing it. Not something I’m familiar with.

I have however macro-dosed plenty of things. I’ve also mega-dosed.

The Industry of Micro-dosing

There is increased discussion, significant research and development, and ample anecdotal evidence that micro-dosing can be an effective treatment for PTSD, epilepsy, depression, or even addiction and alcoholism. From Ketamine to MDMA to psilocybin to ayahuasca to LSD; there are published pieces in the Lancet, numerous animal studies underway, podcasts like Joe Rogan, influencers on social media, books, and magazine articles lauding the outcomes and benefits of taking hallucinogenic drugs in a controlled and supervised setting. There is a Substack publication called “The Microdose” produced by UC Berkeley’s Center for the Science of Psychedelics. In one recent June 20 dispatch from Denver, they cover the Psychedelic Science Conference taking place. Luminaries like QB Aaron Rogers and singer Melissa Etheridge alongside politicians and scientists speaking on a 3-day agenda covering all aspects of the industry. Much like Colorado did with Amendment 64 legalizing marijuana in 2012, the state’s voters are showing progressive support for new legislation around psychedelics. Last year Colorado passed Proposition 122 legalizing psylocibin state-wide.

Silicon Valley

Steve Jobs once famously said that his life changed forever when he took LSD. Podcaster and author Tim Ferris (“4 -Day Workweek) has said that every billionaire he knows takes hallucinogens on a regular basis. Serious Silicon Valley venture capital has driven IPOs of several psychedelic companies in recent years. Companies like Atai Life Sciences, Compass Pathways, Mind Medicine, Inc. are just a few examples of NASDAQ-listed stocks that have investors and opportunists drooling at the industry CAGR (compound annual growth rate) of over 13%. Regardless of their astronomical valuations, none of these companies are making any money—in fact none of them are losing less than a hell of a lot of money each year. Not a single one of them actually has a product to sell yet. (Remember the old days when a valuation was based on actual earnings?) God what a dinosaur I am.

These companies are all in some stage of R&D or clinical trials. Their causes are noble. Maybe. Take Seelos Therapeutics—their aim is the treatment of ALS and Parkinsons. Others, like Mind Medicine are attacking the more common DSM (Diagnostic and Statistical Manual of Mental Disorders) maladies like generalized anxiety disorder and depression. What they are really trying to do is find a product that they can sell to the public as a magic cure, so that they can get acquired by Pfizer or Glaxo and make billions.

The “thing” vs. management of the “thing”

This essay is not a judgment on my part. I’m not opposed to any treatment that brings people relief. What I am poking at is the industry and practice around it. In America a cottage industry quickly emerges around cultural trends, and if the trends gain more acceptance, the cottage blows up into a mansion. That’s capitalism in 2023. Cause-related and speed-to-viral. Billionaires and venture funds are looking out twenty years into the future and rolling ten dice to get one to turn over with the correct combo. But in this case, we’re being told that R&D around psychedelics is health care. Maybe—eventually. Is the pharmaceutical industry health care? There is zero regulation around this stuff, but a lot of momentum.

Even in addiction treatment, which has nearly 100 years of on-the-ground history, there is strong debate and disagreement about best practices. Some believe in 12-step programs and complete abstinence. Others believe in drug-assisted therapies. Others still believe in focusing on cognitive behavioral change by using moderation management. There are few industry standards.

Expecting the industry itself to police itself or manage a popular cultural trend like psychedelics is to be ignorant of the potential dangers. Money and profit become the driving incentives, just as they have in the pharmaceutical industry, which is under strong legislation and regulatory control, albeit corrupt and heavily influenced. The opioid epidemic, the Sattler family’s collusion with FDA regulators, and the strength of the lobby, are all causal in what is a catastrophic example of an industry addicted to profit at the sake of public safety.

What makes micro-dosing even more vulnerable to exploitation and misuse is the fact that practitioners are often wellness clinics, gurus, or coaches. Licensing in this industry is nearly nonexistent. A licensed therapist or medical doctor would be a step in the right direction, but we’ve also seen copious evidence of abuses by them around prescriptions and drug therapies over recent decades. Can experts really proclaim knowledge of anything other than experience? Efficacy and Effectiveness are two different things. Getting something done vs. getting something right. I know one example of a good friend who recently tried micro-dosing Ketamine in a supervised setting. The supervisor was his romantic partner. What the fuck could go wrong in that scenario? Nothing bad did happen—but that’s hardly the point.

Benefits and Risks

Let’s look at some of the reported benefits:

• improved focus, concentration, and mindfulness

• improved energy, wakefulness, and stimulation

• cognitive benefits, such as enhanced problem-solving

• social benefits

• reduced anxiety

• creativity

• reduced stress

• improved mood, and in increase in optimism

• improved body functioning

• self-efficacy, including improved ambition, productivity, and motivation

Some of the associated risks are:

• reduced focus

• reduced energy

• increased anxiety

• worsened mood

• uncomfortable sensations or feelings

• psychotic episodes

• addiction

Experts also say that some people with underlying mental health disorders should avoid micro-dosing. Those with anxiety disorders might find that the practice actually exacerbates their issues. But this is the exact population where there is the most potential benefit of micro-dosing.

The Legal Question

Look what has happened around the legalization of marijuana and the decriminalization of harder drugs. Let me state right here that I’m in support of decriminalization and legalization. Our history with prohibition is clear. We have created millionaires out of gangsters and billionaires out of cartels. But let’s not set unrealistic expectations. States have had mixed results and very few have achieved outcomes that they may have expected. There are few, if any, controls on potency and fewer still controls on manufacturing. Even the expected outcomes on distribution, where the black market was going to somehow go away in states due to legalization have not been proven out. There’s no moral argument for continued prohibition that stands up. The one surefire outcome of all of this is the money made by those in position to capitalize on the appetites of Americans. Let’s not fool ourselves into thinking it’s any more than that. At least with legalization, we could tax the hell out of it and hopefully direct some of that money towards treatment and prevention. One way or another people are gonna get what they need to get through the day.

Microdosing’s current legality depends on the substance being consumed, and the state its being consumed in, and the amount of substance held by the individual. Psilocybin and LSD, for example, are commonly cited in micro-dosing research. Both are classified as Schedule I substances under the Controlled Substances Act, making them illegal to consume in any quantity. But in several states where they are technically illegal, much like marijuana, prosecution is not encouraged.

The illegality of micro-dosing substances limits research opportunity and quality. It also means people who are consuming these substances do not have access to a controlled, safe supply. This means that consumers—even therapeutic practitioners—are often reliant upon black market or foreign providers. Same as it ever was…for now.

I’ve had smart and reasonable friends make an otherwise well-intentioned comment to me about my arduous addiction treatment journey. “Dude why didn’t you just try ayahuasca or shrooms or something?” And they’d talk about how they heard about someone they knew or had heard about someone from someone who had stopped a decades-long drinking habit by having one controlled psychedelic experience. Good for them. I’ve already written about this previously in another essay: “There are no Shortcuts to Spiritual Fitness.” I’ve also known several people who struggled for years to get sober, suffering relapse after relapse. From the big book of AA, Chapter 5 How it Works: Those who do not recover are people who cannot or will not completely give themselves to this simple program, usually men and women who are constitutionally incapable of being honest with themselves. These individuals will be the first ones to try a weed protocol, or a micro-dosing program. “At least I’m not drinking.” There is that, but they are most definitely not working on the fundamental reasons why they drank or drugged so excessively in the first place. The path towards recovery is above all about knowing yourself. It is hard work. It is worth it. There is no magic pill.

My own experience with psychedelics

There was a time in college when I tried peyote with some close friends. We’d heard about the visual intensity of it, the centuries -old spiritual experiences that Native Americans had incorporated into their rituals, and we decided to try it. The suggested usage was to drink it as a tea—which we did. Then we sat down to watch an afternoon NFL game. (not in the handbook, but it’s what we had). The intestinal discomfort was immediate and long-lasting. Several trips to the bathroom for dry heaves and some not so dry. After a couple of hours, we turned off the game and put on some music and decided to ride out the discomfort, figuring that we’d screwed it up somehow and there’d be no effect at all. We were wrong.

My first indication was when I saw clef notes coming out of the Alpine floor speakers. I saw a complete C-scale go by with a baritone F clef on the third line floating across the room as big as cartoon characters, and their movement was in perfect rhythm to the music. “Do you guys see that?” I asked. “See what?” “Never mind.” Everyone came on at different speeds, but then all hell broke loose in our visual consciousness. The tone of skin, the color of the wall paint and carpet, the length of my own fingers. Most interesting is that it wasn’t frightening…just stunning.

At some point we went outside. All of us were Ultimate frisbee players, playing on a competitive team together. It made sense at the time to grab a frisbee and go outside to the apartment complex parking lot and start throwing it around. Except that it was 9 o’clock at night and pitch black out. Didn’t seem to matter in the least. The light that was coming into my retina and being interpreted by my brain was plentiful. The setting was a bit like looking through night vision goggles but not green…just a little diffuse. We played and laughed and happened to notice other people watching us as they got out of their cars and went into their apartments. They’d stop and stare and wonder what the hell we were doing. When we went back and out and reconstructed the scene a couple nights later, there was no way. None of us could pick up the flight of the frisbee once it left our hands. We’d listen for the familiar scraping on the pavement or the metallic thunk on the side of a car. (No…a frisbee cannot damage a car). But on that magical night in peyote-land we never let it hit the ground. Not once.

I’m not sure any of us ever did it again. The four hours of misery for approximately the same amount of time in wonderland didn’t seem worth it. Then again, if one was in the middle of a desert in a sweat lodge or watching nature on a mountaintop it might have been fun. I never sensed danger or felt out of control. It felt revelatory in how it expanded my senses and opened input from the World around me. There wasn’t any introspection whatsoever.

There have been a few similar experiences with mushrooms. Although the expansion of light was also a byproduct of the experience, it was less visually intense and affected all the sense equally. The experience with peyote could reasonably be described as a “vision” because I saw things that weren’t actually possible in the physical world. With shrooms it seemed to create more of a mental shift, where I simply lost fear, barriers melted away, and the idea of loving everything and everyone could exist. I’ve been on several camping trips many years ago involving shrooms, and the experience of it in nature is profound. I once saw David Byrne and his merry band of music makers at Red Rocks while lightly tripping. It was religious.

Have sex with someone you love while on mushrooms and you will see God and the Universe. Listen to an average club band in the same heightened emotional state and you’ll be begging to buy their albums and nominate them for the Rock and Roll Hall of Fame. There’s a reason that ecstasy and MDMA are called the love drug.

Abstinence and Moderation

In my limited experience with hallucinogenic drugs, I can clearly see the idea of opening up the neural pathways of a mind that may have been blocked or damaged. I can also see the potential for therapeutic outcomes in a controlled setting. Personally, I’m not a good control for this experiment. The premise is flawed for a person like me. I don’t do anything in small doses. Could I benefit from a supervised environment and a really small dose? Maybe but why would I?

There’s an old tried and true maxim in recovery from drugs and alcohol: If you go to a barbershop often enough—you will eventually get a haircut. For a person with very little ability to moderate, abstinence is the only way. It’s fundamentally easier for me to just not do something than it is for me to do just a little and then stop. Even back then I knew—a guy with no skills of moderation—that messing with these powerful psychedelics beyond a little bit of experimentation wasn’t a good long-term play.

We cannot or will not ever escape the power of drugs in our culture. Humans want what they want. For so long in this country we’ve focused on fighting the supply, rather than addressing the appetite. “Time Out of Mind” is what we often seek in this stressful world we live in. As Fagen and Becker so aptly sang;

“Children we have it right here
It's the light in my eyes
It's perfection and grace
It's the smile on my face”

“Be vewwwyy qwuiet…it’s wabbit season…”

We should always be skeptical of “miracle” drugs. Although it would be appropriate to do so, there’s very little chance that we will be very quiet and scientifically careful about this exploration. There is no magic pill, despite what the proponents of Ozempic may say. There is no magic shortcut to spiritual fitness either. What drugs provide to us, legal or illegal, fun or addictive, is temporary relief. Sometimes it works. Sometimes it doesn’t. There are always downstream consequences that aren’t obvious until it’s too late. Be wary of pseudo-scientists. Question experts with a stake in it. Challenge corrupt government regulators. Ignore wealthy investors and venture capitalists leading the way on anything that affects our brains so profoundly. They don’t live like we do. To them you are both the product AND the consumer.

Don’t believe the hype. Believe the results. And those take time.