Comment by _fat_santa

2 days ago

We need to push to make this stuff legal. I wouldn't go so far as to say lets sell it OTC vape pens at gas stations but a middle ground where you can go to a doctor to have this treatment performed.

I personally have never taken DMT though from everything I've read and heard on podcasts it's not something to be taken lightly. I think having a sort of "DMT Clinic" that you can go to would be the best middle ground of allowing the public access to these substances while also ensuring that there is a trained professional there to guide you through the process.

Saying "trained professional" in this context feels wired because this stuff has been underground for so long but I think it's starting to bubble up into the mainstream enough that we need to start bringing all that "into the light". Lets have training programs that teach people how to administer this stuff properly, how to deal with the negative side effects, etc.

One of the things that while I find understandable is ridiculous is the fact that Bill had to use a pseudonym in the community. I feel like if were at the point where you have C-suite types at Apple taking this stuff, it's time to think about making it available to the broader public.

Fwiw, "DMT" usually refers to nn-DMT, which is a lot different than 5-MeO-DMT (or bufo).

Last year I underwent treatments for my treatment-resistant major depression using Ketamine. It was a clinical setting, where you'd get wired up to blood pressure, pulse-ox, and other monitors while you were monitored by an RN via video camera. This was IV Ketamine, so not the inhalants that are available now. According to the clinic, the inhalants (which they also offered) are also generally less effective than IV, and the IV was safer in my case because I have other medical conditions where being able to "shut it off" was a good thing - you can turn an IV off, but once you inhale, you're on your own.

So... this clinic was not entirely unlike what you're proposing w/ DMT.

FWIW, the results were incredible. I was effectively "cured." But unfortunately my insurance changed, and it became no longer covered, and I couldn't afford the $2000 every six weeks for the treatment anymore. And it's not super convenient to take two hours off from work to go to the trip-sitter's to get the treatments.

I hope that they figure out what it is in psychadelics that make them effective at treating stuff like depression and PTSD and make it more accessible because it seems like there's so much potential there.

(Also: fuck Elon Musk for making Ketamine a punchline)

  • > being able to "shut it off" was a good thing - you can turn an IV off, but once you inhale, you're on your own

    How does it work? Is the half-life of it shorter when administered IV?

    • I had a Ketamine infusion done at a clinic in Miami.

      It was $600 (discounted) for the first infusion.

      You go through a pre-evaluation with the doctor, where they determine a dosage for you based on prior experience and bodyweight.

      My clinic also offered to co-administer IV benzos to prevent panic attacks or negative experiences, which was a HUGE plus for me.

      During the experience you're given a button, which you can press to call them and have the drip turned off or turned down.

      If it wasn't so expensive or covered by my insurance, I would've certainly repeated it.

      Highly recommend.

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    • Only a little. Not enough to serve as an escape hatch. It depends on the infusion rate, of course, but you’re talking a difference of maybe 15-20 minutes.

  • I like the potential healing value of Ketamine.

    But that doesn't make replacing every instance of ketamine with "horse tranquilizer" any less funny.

  • Fun fact: the cost of the ketamine in that $2000 treatment is about $1. Even factoring in trained staff to monitor, you’re up to a few hundred bucks for the hour. It’s mostly just the failings of the US medical establishment, and, of course, arbitrarily constrained supply that results in gouging.

    Just go buy $100 in street ketamine (still marked up 100x, fwiw, also because laws) from someone reputable, test it for fentanyl, and blow lines of it. Same deal, $1900 less cost. Breaking some dumb rules is far preferable to living with untreated depression.

    • You're much safer and cheaper buying Ketamine from the darknet via a reputable vendor.

      You get to decide whether you want racemic or S-Ketamine, and your money is held in escrow until you've got the product and release the funds to the vendor.

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"I think having a sort of "DMT Clinic" that you can go to would be the best middle ground "

Well, Ayahuasca (with DMT as the active ingredient) retreats seem more and more common and are for some reasons tolerated more and more in europe. Technically it is illegal, but I can still book them online.

But I won't, as I don't trust the competence of the average new age "shaman".

  • I dislike the idea of potential life threatening toxicity, the constant vomiting, the feeling like shit for days.

    Ayahuasca trips seem to be like edging with poison. But maybe the documentary I saw was biased.

    • "But maybe the documentary I saw was biased."

      Seems like it.

      I did it one time and there was no vomitting and feeling great the day after.

      But that maybe was, because the plant that was used was apparently not so strong. So yes, it is from natural plants, that can have very different concentrations. I suppose this is what the documentary means with life threatening poisening? Getting a plant that had a unusual high concentration?

      But I never heard of those horror stories from people who do it regulary. (Vomitting is quite normal, though) Otherwise I have limited knowledge in that area, but I do know with mushrooms for example, you can use different ones of the same species to mix them to average out concentration differences. I assume the same can be done with Ayuahasca. But like I said, I would not recommend the commercial retreats anyway.

      (I did it when I was invited into a ceremony in a remote place by people who were not frauds)

    • With pharmahuasca or ayahuasca analogues maybe. With a normal/traditional brew it's essentially impossible to overdose (think like 3-4 liters of the stuff). Analogues like syrian rue are a lot easier to overdose though, it's a pretty small amount of material needed.

      Also the vast majority of people are done purging within a few hours...not "days"

      (Source: work at retreat center and have drank hundreds of times)

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N,N-DMT is very intense and not to be taken lightly - but you could say the same with LSD, psilocybin, etc. Personally, I am much more wary of large doses of LSD/psilocybin than DMT, in part to the substantially longer duration of the former. Ego death and the complete dissolution of reality makes it harder to have a bad trip

  • I'd generally agree with you, but:

      > substantially longer duration of the former
    

    When time stops until the end of this universe gives way to the beginning of this universe and the snake eats it's tail, "longer" doesn't hold much meaning...

Agree, but the proponents of "Big Reality" really really really fight against its disruption.

  • Could you explain what you mean by that? Who are the proponents of “big reality”? How do they fight against its disruption?

    • Psychedelics challenge the post-Enlightenment project of "rational" adulthood. Western civilization has a deep myth: the myth of necessary order - a yoking of rationality, order, and progress together into what forms the basis for modernity. Psychedelics cannot have intrinsic value outside of rationality, so, they must either be accepted on the basis of rationality and order or face rejection. We express this using the rational basis of improved mental health. The contradiction of course is obvious; psychedelics provide us with profoundly irrational experiences that don't obviously fit into our cultural value system.

      The point is that western civilization values rationality, order, and progress in a self-justifying way. The values that our culture provides to us form a feedback cycle of myth and virtue. Every argument that assumes this basis, reinforces its truth.

      "Order is obviously preferable to chaos", is one of many subjective perspectives. Why should it hold more truth than "Plurality of perspectives are obviously preferable to the fragility of one perspective for the sake of objectivity"? The apparatuses of the state[1] all rely on the same cultural myth and promote it in a way that crowds out all possible alternatives. Thus the myth of necessary order has become synonymous with reality.

      Like all deeply rooted cultural myths, this is something that's going to appear obviously true which coincidentally serves as a way of shielding it from honest critique. If there's one thing that I've learned, it's that questioning foundational myths feels like a cultural violation. René Girard’s theory holds; when a community is anxious or unstable, it lashes out most viciously at people who somehow threaten its central, but unspoken, truths or anxieties. The greater the received response that a cultural axiom obviously true; the more certain I am that it reflects a core cultural myth than any semblance of reality.

      1. See Louis Althusser, Ideology and Ideological State Apparatuses, 1970.

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    • It's a joke. People often have conspiracy theories about Big Pharma trying to prevent access to novel drugs that could disrupt their cash cows. The parent was jokingly talking about "Big Reality" as an imaginary group of people who hate to see "reality" disrupted by psychedelic experiences.

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  • That’s an amazing sentence…

    • For those who don't remember what it was like when LSD was still legal, this is an accurate synopsis of what could be observed as it quickly was prohibited to the max degree and categorized along with truly more toxic dangerous drugs like opiates. When things like opiates had been recognized for their potentially devastating effects for thousands of years, while psychedelics were still experimental substances.

      Realistically an entire new agency (DEA) was chartered to enforce the new regulations, and the greatest threats were those thought to disrupt an "ordained" vision of reality that was not to include the kind of experimentation which made clinical evaluation possible.

      Rapidly, before the most thorough experiments could be conducted which would have more accurately informed the established pharma regulation process.

      Rather it was superstition that was included in the new regulations, and the enforcement agency was mustered to fight to preserve more superstition than should ever be allowed.

      This really really stands the test of time, and if kelsey did not personally observe this phenomenon, it's even more amazing than it appears on the surface.

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A wise legalization might help with access & harm-reduction... but legalizations are sometimes bungled.

In the SF bay area – & plenty of other regions around the world – the criminal enforcement against hallucinogens is, de facto, a very low priority as long as you're not flagrantly endangering or inconveniencing others.

5-Meo is kind of nasty because it has a non-linear pharmacology.

the normal dose is 5-10mg, but LD50 in sheep is about 100mg, it might be as low as 30mg in humans.

It absolutely should not be legal, at least to anyone. Perhaps require training in dealing with drugs with a low therapeutic index

  • LD50 in sheep:

    1–5 mg/kg IV

    1–2 mg/kg SC

    85 mg/kg O

    In mice:

    75–115 mg/kg IP

    48 mg/kg IV

    113 mg/kg SC

    278 mg/kg O

    They were administering over 30mg to humans in trials. (Metzner (2013); Shulgin and Shulgin (1997); Ott (2001); Davis et al. (2018); Uthaug et al. (2020a))

    Sheep are susceptible to toxicity from certain tryptamine alkaloids because of their physiology.

    These alkaloids, especially those that are N,N-dimethylated, can trigger neurological symptoms in sheep, such as convulsions, spasticity, and gait issues. The alkaloids are suspected to affect the brain and spinal cord by interacting with serotonin receptors.

    5-MeO-DMT is an N,N-dimethylated compound. Its full chemical name is 5-methoxy-N,N-dimethyltryptamine. That indicates the presence of two methyl groups attached to the nitrogen atom of the tryptamine backbone.

    Stay safe, everyone!

    • The Human-Equivalent Dose for IV administration is roughly ~300mg for a 100kg human.

  • > it might be as low as 30mg in humans.

    That seems quite unlikely given that there are many 30mg dose trip reports, going as far back as TiHKAL.

  • Tell me you never studied basic med chem or pharmacology without telling me...

    You can't use animal models for dose, you have to convert to hED (Human-Equivalent Dosage). You can estimate this generally with allometric scaling:

    https://drughunter.com/practical-pk-calculators

    Also, animal physiology varies.

    Beta-adrenergic agonists like clenbuterol make mice wildly muscular, which unfortunately is not the case in humans, for example.