>marijuana for chronic pain, mushrooms for depression, mdma for ptsd
Is it that much of a surprise that psychoactive drugs treat psychogenic symptoms? In the particular case of pain, the two major available drug classes -- opioids and benzodiazepines -- mimic the activity of addictive recreational drugs opium and alcohol. THC is used per se instead of derivatives because of its price and safety record (contrast opium/alcohol).
For depression/PTSD, psychiatry has thrown the kitchen sink at these conditions. It's more "newsworthy" when MDMA is used for PTSD than propanolol even though both serve essentially the same purpose: allowing the patient to discuss the traumatic experience without experiencing the emotional effects of that trauma, by blocking them physiologically. In this case, "blocking negative emotions" is a naturally desirable effect of a recreational drug (propanolol also blocks many positive emotions, rendering it less fun). Modifying emotions in depression doesn't seem like a surprise either, although psychedelics can be unreliable here (and this is well-documented). I expect some negative side-effects to appear, but I disagree that this is much of a change from the norm, except insofar as it upends a taboo. Methaqualone got its start treating insomnia, and the medical history of amphetamine is too long to fit in this comment.
In fact, during the early history of psychedelics, there were developed "less recreational" analogues of the major drugs, such as diethyl-psilocin ("ethocin") and 5'-methoxy-MDA ("MMDA") which were considered as possibly safer adjuvants to psychotherapy. The rediscovery of these agents might benefit more from attention on their history of bona fide therapeutic use, rather than on their recreational past. Perhaps we shouldn't be so surprised when some psychiatric medications turn out to be recreational, and mitigate the consequences pragmatically, rather than reflexively recoiling from anything resembling euphoria. One thing you learn from Infinite Jest is that the mere materialism of emotion is especially unnerving insofar as it applies to happiness, but reality isn't going away anytime soon.
What happened in this article with ketamine is quite different: test-tube evidence uncovered an effect that modifies a rare hereditary condition. I think the story here is really more about data-mining, and ketamine just happens to be interesting.
> Is it that much of a surprise that psychoactive drugs treat psychogenic symptoms?
The surprising part is the growing narrative that these psychoactive drugs are basically miracle cures without downsides.
Drugs like LSD are being explored as adjuncts to intense therapy spanning many sessions, but the pop-science portrayal of these drugs ignores that intense therapy and instead imagines that tripping on mushrooms or LSD is a cure for psychiatric illness. It also ignores the fact that bad trips are a very real possibility and worsening of psychiatric illness is not uncommon among illicit users of these drugs. There are plentiful reports of psychedelics causing weeks or months of dysphoria or even precipitating long-lasting episodes of major depression, and it’s not hard to find them either.
If we want to get anywhere with these substances, we need to quit exaggerating their positive effects and downplaying their negatives. That’s a setup for failure when they’re further studied and the reality can’t match the unreasonably loft pop-culture presentation of these drugs as miracle cures that act alone without any downsides.
It is, as the grandparent comment said, reminiscent of the early days of opioids when we were bombarded with stories about how they were miracle cures without downsides. The truth is that they’re helpful in controlled circumstances but can be harmful when overdosed or prescribed without supervision, which doesn’t sound that different then the situation with drugs like ketamine.
>we need to quit exaggerating their positive effects and downplaying their negatives.
Who is 'we'? Sure, the media exaggerates the benefits of psychedelics. You can also find plenty of stories exaggerating the benefits of electric cars, veganism, meditation, antioxidants, or martial arts, among other things.
The media loves a narrative with a miracle -- how is that the "surprising part"?
>the early days of opioids
The early days of opioids were in the nineteenth century. I certainly don't recall being bombarded with stories about them. The post-mortem of the opioid painkiller crisis (the "codones") focused on deceitful marketing from pharmaceutical companies aimed at physicians, not pop-psych puff pieces for a lay audience. There is no shortage of exaggeration in the cornucopia of cannabis clickbait, but the situation is not comparable.
Inaccuracy in pop-sci is lamentable, but not historic, and usually the only thing that comes of it are bins of discarded magazines.
Is it that much of a surprise that psychoactive drugs treat psychogenic symptoms? In the particular case of pain, the two major available drug classes -- opioids and benzodiazepines -- mimic the activity of addictive recreational drugs opium and alcohol. THC is used per se instead of derivatives because of its price and safety record (contrast opium/alcohol).
For depression/PTSD, psychiatry has thrown the kitchen sink at these conditions. It's more "newsworthy" when MDMA is used for PTSD than propanolol even though both serve essentially the same purpose: allowing the patient to discuss the traumatic experience without experiencing the emotional effects of that trauma, by blocking them physiologically. In this case, "blocking negative emotions" is a naturally desirable effect of a recreational drug (propanolol also blocks many positive emotions, rendering it less fun). Modifying emotions in depression doesn't seem like a surprise either, although psychedelics can be unreliable here (and this is well-documented). I expect some negative side-effects to appear, but I disagree that this is much of a change from the norm, except insofar as it upends a taboo. Methaqualone got its start treating insomnia, and the medical history of amphetamine is too long to fit in this comment.
In fact, during the early history of psychedelics, there were developed "less recreational" analogues of the major drugs, such as diethyl-psilocin ("ethocin") and 5'-methoxy-MDA ("MMDA") which were considered as possibly safer adjuvants to psychotherapy. The rediscovery of these agents might benefit more from attention on their history of bona fide therapeutic use, rather than on their recreational past. Perhaps we shouldn't be so surprised when some psychiatric medications turn out to be recreational, and mitigate the consequences pragmatically, rather than reflexively recoiling from anything resembling euphoria. One thing you learn from Infinite Jest is that the mere materialism of emotion is especially unnerving insofar as it applies to happiness, but reality isn't going away anytime soon.
What happened in this article with ketamine is quite different: test-tube evidence uncovered an effect that modifies a rare hereditary condition. I think the story here is really more about data-mining, and ketamine just happens to be interesting.