Dear Friends,
When I first interviewed Dr. David Nichols - the renowned psychopharmacologist and Distinguished Professor Emeritus at Purdue University - he shared a striking fact: not a single overdose death had been attributed to LSD. From a pharmacological and physiological perspective, it would be one of the safest medications (if legalized).
In our recent conversation, Dr. Nichols had to revise this statement slightly, accounting for exactly one known death from a man who ingested 340 milligrams – or 340,000 micrograms - over 2,000 times more than a standard large dose of 100-150 micrograms. This exceptional case only underscores the relative safety of LSD when used responsibly.
If the substance is so safe, why has there been so little research allowed? I believe LSD to be one of the psychedelics with the most potential for doing inner work, yet psilocybin has been much more successful in terms of getting clinical trials approved.
Dr. Nichols explains:
"I think there are probably two explanations. The first has to do with just the political environment. When I started doing research with psilocybin, I was on an airplane with a psychiatrist and I said we were using psilocybin in studies. He said, 'Psilocybin, what's that?' I said, 'Well, have you ever heard of magic mushrooms?' He said, 'Yeah.' Well, psilocybin is the active ingredient there. So there was less, I would say, name recognition to begin with."
He continues:
"More importantly, perhaps is the length of duration. When you start talking about doing a clinical study, the people that do psilocybin research now, you can bring people in the morning and you can give them psilocybin as a medicine. You can do your therapy and then they can usually be discharged by the end of the day. You don't have the overnight stay. With LSD, it's much longer acting, 10, 12 hours."
This duration presents logistical challenges for research, but it's precisely this extended journey that I believe holds such profound therapeutic potential. In my experience as a clinician, there's a "sweet spot" dosage of LSD that allows for deep inner work without completely dissolving the ego. This is where the real healing happens.
As I explained to Dr. Nichols:
"There's a significant difference between high dose LSD and high dose psilocybin in terms of internal effects. And as a clinician, in terms of being able to reach deeper into corners, if you will, of the consciousness to reach out to submerged or encapsulated material."
At this optimal dose, the ego remains intact but flexible, allowing individuals to confront and process their fears, anxieties, and traumas. It's a delicate balance – too low a dose, and the transformative potential is diminished; too high, and one risks bypassing the crucial psychological work in favor of cosmic experiences that, while profound, may not translate to lasting behavioral change.
We also discussed the recent FDA decision not to approve MDMA for PTSD – a disappointment for both of us. Dr. Nichols shared his perspective:
"I, like many people, were very disappointed. In my opinion, it was a political decision. I think that the advisory committee that they selected was not appropriately educated about the effects of these drugs."
This setback highlights the ongoing need for education and advocacy in the field of psychedelic medicine. There's still work to be done in highlighting and removing the "bad apples" (unethical therapists) and emphasizing the potential risks to establish a track record of impeccable safety and transparency.
Despite these challenges, both Dr. Nichols and I remain cautiously optimistic about the future of psychedelic medicine. As he eloquently put it, "Don't give up. It's going to take patience and persistence. But I said, we are going to get there because this stuff works."
The renaissance in psychedelic research is well underway, and while progress may be slower than we'd like, the potential for healing and transformation is too great to ignore. Let's stay committed to uncovering the full potential (and dangers) of these remarkable substances.
Until next time,
Dr. Richard Louis Miller
P.S. Don't forget to check out our archives. And if you're on Instagram, give me a follow and comment "be happy" for some free literature. Let's spread the word and help people benefit from these free health tips!
Coming Soon: Psychedelic Medicine at the End of Life
You can now pre-order my latest book, Psychedelic Medicine at the End of Life: Dying Without Fear (release date: November 5). This work represents a culmination of my decades-long journey as a clinical psychologist, exploring how psychedelics can transform our approach to death and dying.
The book examines how substances like LSD, MDMA, and psilocybin can be powerful tools in confronting our fears of mortality, ultimately leading to richer, more fulfilling lives. I'm honored to include insights from renowned experts in the field, as well as my own experiences.
Here's what some esteemed colleagues are saying:
James Fadiman, Ph.D., calls it "a deeply uplifting, clear, and compassionate guide to dying and how psychedelics, used correctly, diminish our fears about approaching the door that opens at the end of our life."
Charles S. Grob, M.D., describes it as "a masterful overview of an area of vital importance to our modern world... a valuable resource and contribution to the growing field of psychedelic medicine."
Julie Holland, M.D., notes that "Psychedelics may offer a mini-death rehearsal, offering a glimpse of spiritual oneness, enabling us to be less afraid at the end of our lives."
I hope this book will inspire meaningful conversations and new perspectives on how we approach the end of life.
My Books:
Psychedelic Medicine at the End of Life: Dying Without Fear (release date: November 5)
Freeing Sexuality: Psychologists, Consent Teachers, Polyamory Experts, and Sex Workers Speak Out
Psychedelic Wisdom: The Astonishing Rewards of Mind-Altering Substances
Psychedelic Medicine: The Healing Powers of LSD, MDMA, Psilocybin, and Ayahuasca
Integral Psychedelic Therapy (co-edited with Jason A. Butler & Genesee Herzberg)
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