I watched a good friend freak out in front of me on a bad trip. Almost thirty years later he's still not the same and needs antipsychotic medication to function. This kind of thing isn't common but it can definitely happen.
I would suggest that psychedelics cannot take a person with zero risk of developing psychosis, and make them psychotic. There are many apparent triggers for mental illness eg a failed relationship, a drug binge, losing your job, giving birth etc, and we don’t treat these as causal events. Psychedelics are most likely no different. People at risk of developing psychosis may have a greater willingness to try psychedelics as well, creating a biased sample.
If we ever do get regulated access to psychedelics, it will need some process to exclude ‘at risk’ persons. This will be crude and highly exclusionary at the start. Over time, genomics and brain imaging may allow more careful selection of those who can take psychedelics safely.
Psychosis is an episodic condition caused by metabolic failure. Contributing factors include malnourishment, alcohol withdrawal, chronic stress, certain prescription and OTC drugs, street drugs, etc. People would recover from psychosis if given supportive treatment - good nutrition, B-vitamins (liver, yeast, etc), appropriate pro-metabolic prescriptions, naltrexone to keep them off alcohol, etc.
My observations of the standard treatments forced on "psychotic" patients is that they are only useful for preventing the patient's recovery. My aunt's friend was always sort of 'off', now she's dying of liver failure. Didn't know until now that she's been on maintenance antipsychotics for decades, even though the trigger for her episode concluded decades ago.
If I prescribe penicillin to a patient with a pcn allergy, the fact that I “uncovered an underlying flaw” is irrelevant. Pcn is dangerous to them and should not be prescribed to them.
This is true, in one sense or another, of the majority of adverse effects people have from medications given in therapeutic ranges. It’s basically what having an adverse effect -means-.
It doesn’t mean that medication shouldn’t be given when appropriate, but it’s not a rationale for deflecting attention from the risks of the medication.
Psychedelics bring these issues to the forefront, but they don't necessarily cause mental health issues, as the same issues could happen without LSD. I understand what you're trying to express with your example of penicillin, but it's not the same thing.
In my opinion, it would be more accurate to compare psychedelic drugs to activities like meditation and fasting, which also have a risk of anxiety, discomfort, and bringing out dormant mental health issues in some people.
This is precisely what makes them such useful tools for things like PTSD and why it can be a bummer if someone does Molly at a rave and winds up with a memory of being molested and her friends are too busy doing K to talk with her.
In a safe and supportive setting, this is exactly what can help people heal.
It’s when things get uncovered but not fully released and processed they can occupy ones life.
A good psychedelic therapist or sitter should be able to help someone integrat a current or former bad trip.
I've done all 3 of these (meditation as in mindfulness), and I disagree.
Of these 3, meditation is the most harmless. It is relaxing, not discomforting (I'll hook into this again at the end of my post).
Someone can start meditating or fasting without guidance (though I recommend guidance in both cases, especially concerning fasting) and resume normal life whenever they feel like it. With psychedelics, that one doesn't fly and if you do meditation in a group such as a 10 day Vipassana course or are in a religion or cult being forced to fast then you might also feel the same pressure. But that's an outlier; in general, meditation doesn't have such -or any- pressure. It is relaxing.
Finally, I've followed a mindfulness course for people with autism and there is no such thing as that with regards to psychedelics. The psychedelics also affected my autism, and in some situations made it much worse. All of that while I wasn't aware I had autism!
Meditation practice is not relaxing at all. The effect after meditating might be in part feeling relaxed, but in general meditation is pretty hard work.
This is probably a very common misconception, you see all the pictures of people meditating at the beach in front of a beautiful sunset and think that meditating is like going to the spa, when in fact meditating is much more like the mental equivalent of going to the gym.
Also, in many occasions (especially during a 10 day retreat like Vipassana), it can be very uncomfortable if not outright physically painful (although usually never dangerous).
Especially the effect after it makes that work more fruitful, since for various hours I'll be less tense and more focused. For example, it'd make socializing more relaxing.
Those are 2 very valid reasons for me to call it relaxing. Then again, I find running and listening to certain music also relaxing. Because after a while, I get in an automated flow ("trance") akin to meditating.
The 3rd reason is that if I'm rather tired, mindfulness can potentially get me to sleep. I often (almost daily) do it before I go to sleep, and it aids me to get to sleep. I much prefer it over: overthinking, fantasizing, or masturbating/sex.
Its already painful for me to meditate whilst sitting instead of lying but one gets used to that. Its just untrained muscles getting trained. As long as you don't strain yourself, you're fine.
Even if it's true that someone has some kind of latent / dormant condition that is ultimately triggered by the LSD, then the act of taking the LSD itself was the catalyst, and the person would have been far better off not ever having taken the drug.
The drug is illegal, and the argument growing up was that the "government was suppressing free thought" or whatever nonsense was being pushed, but the reality is that such a drug is dangerous and absolutely does hurt people. Whether connected to a predisposition of mental illness or not, it's not a hard connection and people should be extra cautious when considering whether to engage in such behavior.
We do not know if LSD was in fact the catalyst. We don’t know if the people who got ruined after taking a single tab of LSD actually took LSD or some research chemical (which are quite commonly sold off as LSD).
>but the reality is that such a drug is dangerous and absolutely does hurt people.
With this reasoning, skydiving, base jumping, and even the act of simply driving a car should should also be illegal. We let people do far more dangerous things, yet keep them legal. There is another reason LSD & most psychedelics are illegal. What that is, I don't know.
We can make random guesses all day about what’s a good outcome but how about we leave it to medical researchers to actually figure out what’s safe and beneficial?
Only in certain contexts (ie. some instances of interstate commerce).
I suspect your friend had latent psychotic tendencies. Would be interesting to look at family history.
These are powerful drugs that seem capable of both helping and doing harm. They should definitely be used with care, studied, and not abused.
Of course what the war on drugs did was to ban the scientific study of these things and push them exclusively onto the street where they did get abused.
Family histories are not always clearly diagnosed. That hypothetical uncle you've never met and no one talks about? Unknown mental health flag.
Self-diagnosis of a mental/emotional state that calls for drug-taking is itself a clue that not all is so normal in the individual's mind--or is it something wrong in the world the person wants to relate to better? Who can know but the one supposedly experiencing an unnaccepted state? Observing/deciding/dosing by the selfsame suffering/diagnosing/tripping individual sounds risky, because if the downside is a long future of some degree of insanity, it is only a variety of Russian Roulette.
To allow scientific studies, fund them, possibly create therapies is to also conquer the stigmas involved in substantial ways and that process is tectonically, multi-generationally slow (or impossible).
What was going on in his life at the time?
Who was with him and how did they work with his “freak out”?
It sounds like he lacked the set, setting and support to integrate that experience in a healthy way.