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Abstract
Background and aims
Psychedelic-assisted psychotherapy (PAP) is currently being studied as a possible treatment option for multiple disorders. Despite promising safety and efficacy findings, the high costs of the current PAP model makes it questionable if the treatment will be scalable. Non-hallucinogenic psychedelic analogs have been developed as a potential cost-effective alternative, but it is unclear what psychedelic users perceive as a reasonable cost for treatment and whether they would be open to trying a non-hallucinogenic analog.
Methods
We queried a large sample of people using psychedelics naturalistically (N = 1,221) about their attitudes regarding the role of altered states of consciousness in PAP outcomes, costs of treatment, and their openness to trying a non-hallucinogenic psychedelic analog for treating a mental health condition.
Results
We found that most (76%) participants considered altered states of consciousness as very or extremely important to the therapeutic effects of psychedelics. Despite this, most (61%) were also moderately, very, or extremely likely to try a non-hallucinogenic substance if given the chance. Lastly, participants considered approximately $70–80 per hour to be a reasonable cost for various aspects of psychedelic services (e.g., preparation, integration, and dosing sessions).
Conclusions
Participants valued the role of altered states of consciousness in therapeutic changes attributed to psychedelics, but were still open to trying a non-hallucinogenic analog. Notably, the price participants considered to be a reasonable amount for PAP is well below current market projections. Future research is needed to address limitations of the study as well as to identify ways of lowering treatment costs.
Abstract
Background and aims
This qualitative ethnographic study of a psychedelic integration group in the Southeastern United States contributes to an understanding of the role of supportive communities in processing psychedelic experiences. This article proposes the concept of ‘social efficacy’ to capture the importance of social relationships to the efficacy of psychedelics. Social efficacy refers to a source of efficacy that includes not just the immediate social environment in which psychedelics are experienced and processed, but also the broad range of social relationships and political economic and historical contexts that frame their use.
Methods
This year-long ethnographic research project took place with a psychedelic integration group in an urban center in the Southeastern United States. It was based on observation, interviews, and a focus group.
Results
Overall, the participants in the integration group see the group as critical to their ability to effectively process their psychedelic experiences. The group is important as a supportive community of like-minded people that facilitates enduring cognitive and affective transformation.
Conclusions
Community-based non-therapeutic integration groups can play a vital role in the positive integration of psychedelic experiences, improving mental health and quality of life for users. The important role of community-based groups has significance for both the legalization and the medicalization of psychedelics. It highlights the need for safe and legal spaces in which people can talk about their psychedelic experiences and for medical models of efficacy that include social, relational elements.
Abstract
Over the past decade, numerous open-label studies and early clinical trials have shown that psychedelics hold promise for the fast and possibly lasting relief of a wide range of conditions ranging from major depressive disorder, end-of-life anxiety, and obsessive-compulsive disorder to smoking, alcohol use, and eating disorders. Among the questions still to be resolved in this endeavor are questions related to the importance of the metaphysical and phenomenological aspects of the psychedelic experience. Are the hallucinatory experiences engendered by classical psychedelics necessary to their therapeutic action, or could a trip that doesn't go anywhere have the same effect on depression and other conditions? This commentary considers the value of the phenomenological psychedelic experience and asks the larger question, what are any of our phenomenological experiences for?
Abstract
With a surge in critiques levelled against the evidence generated by randomised controlled trials in the study of psychedelic-assisted therapy (PAT), and the legalization of PAT in select jurisdictions such as Australia, and Oregon and Colorado in the United States, we consider what form the real-world evidence of its effects could take. Specifically, we propose to complement individual-level data-gathering (the usual remit of pharmacovigilance procedures) with evidence of PAT's collective effects. Taking our cue from long-standing claims that psychedelics are agents of social transformation, we draw upon the ‘transformative paradigm’ of evaluation, an approach that is itself oriented around social justice and change vis-à-vis marginalised expertise – or what we approach as ‘the grassroots’. To illustrate the potential of such grassroots evaluations, we offer eight examples of social issues that have been discussed in relation to PAT and psychedelics use and, for each, discuss the kinds of expertise that could be brought into the evaluation team and the kinds of questions that could be asked. We further describe our grassroots approach according to three values inspired by the qualities of grass roots themselves: rhizomatic accountability, dark reflexivity, and more-than-human hosting. We argue that these values align with the contemporary experience, practice, and context of PAT. We hope to generate discussion, innovation, and – ultimately – action toward specific study designs that are adequate to the task of documenting, and working with, the transformative potential of psychedelics in contemporary medicalized societies.
Abstract
Aims
Understanding how gambling harm is distributed is essential to inform effective harm reduction measures. This first national Australian study of gambling harm-to-self examined the extent, distribution, risk factors, and health related quality of life (HRQoL) impacts of this harm.
Methods
A Random Digit Dialling sample of 15,000 Australian adults was weighted to key population variables. Key measures included the Gambling Harms Scale-10 (GHS-10), PGSI, SF-6D, gambling behaviours, and demographics. Analyses included ordinal logistic regression.
Results
Amongst gamblers, 14.7% reported harm on the GHS-10, including 1.9% reporting high-level harm. While high-level harm occurred mainly in the problem gambling group (77.3%), other PGSI groups accounted for most of the more prevalent low (98.5%) and moderate (87.2%) harms reported. Proximal predictors of greater harm were use of online gambling and more frequent gambling on electronic gaming machines (EGMs), race betting sports betting, poker, skin gambling, scratchies, and loot box purchasing. Distal predictors were being younger, male, single, Aboriginal or Torres Strait Islander, and speaking a non-English language at home. At the population level, the greatest aggregate HRQoL impacts were amongst lower-risk gamblers, confirming the results of other studies regarding the ‘prevention paradox’.
Conclusions
The distribution of harm across gambler risk groups indicates the need for preventive measures, not just interventions for problem gambling. Reducing harm requires modifying product features that amplify their risk, especially for EGMs, race betting and sports betting that are both inherently risky and widely used. Gambling harm exacerbates health disparities for disadvantaged and vulnerable groups, requiring targeted resources and support.
Abstract
This commentary addresses the potential for a nocebo effect arising from the public discourse on psychedelics, especially considering the increasing interest and engagement with these substances. The resurgence of psychedelics in the public and scientific arenas has led to a proliferation of discussions, both positive and cautionary, about their use. However, an imbalance in this discourse, particularly a focus on potential harms without adequate contextualisation, might inadvertently create a nocebo effect. This effect could manifest in naturalistic settings, influencing individuals' experiences with psychedelics, possibly leading to adverse outcomes. The paper discusses the importance of a balanced narrative that equally acknowledges the benefits and risks associated with psychedelic use. It advocates for comprehensive and transparent information dissemination to enable informed decision-making by users.
Abstract
The Dark Triad is an important aspect of human personality, and there is evidence that it associated with infidelity. The current research aimed to examine the association between Narcissism, Psychopathy, and Machiavellianism traits and different aspects of infidelity in the Greek cultural context. In particular, using a sample of 509 Greek-speaking participants [57.5% women, mean age 36.5 (SD = 11.7), 42.5% men, mean age 40.1 (SD = 13.1)], we found that higher scores in Psychopathy were associated with higher incidence of infidelity and willingness to be unfaithful to one's partner. Moreover, men and women who scored higher in Psychopathy were more likely to be detected by their partners when unfaithful. Men who scored high in Psychopathy were also more suspicious of their partners for being unfaithful than men who scored low. However, the scores in the Dark Triad traits did not predict the probability to detect a partner's infidelity neither for men nor for women. Overall, in the Greek cultural context, the Dark Triad traits were associated with certain aspects of infidelity.
