Microdosing Psychedelics

Does it do anything?

Psychedelic drugs have been capturing the attention of doctors and patients alike, for their increasingly demonstrated potential to effect long-lasting improvements in the mental health of people who are suffering from conditions such as treatment-resistant depression, addiction, OCD, or end of life anxiety. Microdosing of psychedelic substances such as LSD or psilocybin involves taking a fraction of a regular dose that is much lower than one would take if one wanted to "trip" or hallucinate on these substances. A microdose is usually intended to be a subperceptual dose, so there are no visual distortions or mystical experiences. People commonly microdose psychedelics daily, or several times a week, without any major interruption to their daily schedules.

It is widely believed among psychedelic afficionados that microdosing with psychedelics enhances one's mood, creativity, concentration, productivity, and ability to empathize with others. This is a huge deal, if true.

Microdosing has gone mainstream with articles in the Wall Street Journal about how fun and successful people are who microdose. Personally, I tried microdosing of shrooms, at a variety of doses, and I couldn’t, for the life of me, feel any difference in my mood, affect, creativity, or anything else. I might just as well have been taking a sugar pill.

Is there any scientific evidence for the benefits that many thousands of people claim from microdosing? Or, can the perceived benefits be explained as an "expectancy effect"? This means that people who take a daily pill that they fervently expect will help them feel happier and smarter will feel that they are happier and smarter — just from taking the pill, regardless of what's in it, via the placebo effect (which can be extremely powerful).

What is microdosing?

There isn't a single, clearly recognized definition of microdosing for any psychedelic drug, and this has complicated attempts to perform research. One definition is that a microdose is approximately 1/5 to 1/20 of a recreational dose. From anecdotal experience this is accurate, as a medium-strength dose of psilocybin is 2 to 3 grams of dried mushrooms, and a microdose is typically around 0.1 to 0.3 grams. One obstacle to microdosing is that the potency of mushrooms can vary greatly, as they are not regulated outside of clinical trials, and they are often bought on the illicit market, so this isn't an exact science. Likewise, LSD can be difficult to microdose as it is an invisible, tasteless, odorless substance that usually comes embedded into a piece of paper to be slipped under the tongue, though sometimes it is found in liquid form which might make it easier to accurately titrate.

Given the current illegality and lack of regulation of all of these substances, there is no good way to know what dosage you are taking unless you have an extraordinarily reliable supplier. LSD is an extremely powerful and long-acting drug – taking a full dose results in about 8 hours of intensive hallucinations. One doesn’t want to make a mistake and take more of it than intended, especially before work, driving, or other adult responsibilities.

To further complicate matters for the microdosing community, psychedelics such as psilocybin and LSD can produce physiological tolerance, which suggests that, even if microdosing does help, there could be diminishing returns if one stays at the same dosage. This is why people typically avoid microdosing every single day and take days off from microdosing.

Is microdosing safe?

We don't know as much about the safety of psychedelics as we might have learned if not for the War on Drugs, which, along with the perceived excesses of some of the psychedelic leaders at the time, curtailed much of the research into psychedelics starting in the late 1960s. This research has been renewed over the last ten to twenty years, during our current “psychedelic renaissance”. Many medical centers are conducting research on the therapeutic potential of psychedelics, though most often on regular dosages, not on microdosing. Psilocybin is generally thought to be safe in low dosages and has been used for centuries by indigenous peoples. However, if one takes too large a dose by mistake it can result in an intense and possibly terrifying — even traumatic — experience.

Psilocybin is a compound produced by almost 200 species of fungi (mushrooms), and the mushrooms for any psychedelic experience must come from a trusted source. It is very easy to poison oneself with the wrong type of mushroom, as there are many types of mushrooms in nature that can look quite similar to each other. Some can harm your liver, causing severe illness or even death.

Evidence for microdosing of psychedelics is mixed

Does microdosing work? In short, the jury is still out. Some studies indicate a very real and significant benefit from microdosing, whereas others are much less convincing and show little to no benefit. One recent study used a naturalistic, observational design to study 953 psilocybin microdosers compared with 180 nondosing participants for 30 days, and found "small to medium-sized improvements in mood and mental health that were generally consistent across gender, age, and presence of mental health concerns." This study, and others like it, appear to confirm anecdotal reports of the multitudes of people who swear by the benefits they have experienced from microdosing, though these types of study designs are not the gold standard.

Other studies on microdosing are far less sanguine. In one example the researchers conducted a randomized controlled study, which represents the strongest type of evidence because it weeds out the placebo effect. The researchers took 34 patients and randomized half of them to receive psilocybin and half to placebo. While there were some intriguing subjective effects (people felt happier and more creative), and even some changes in brain waves recorded on an EEG machine, they concluded that low-dose psilocybin mushrooms did not show objective evidence of improvements in creativity, well-being, and cognitive function. Studies such as this one support the hypothesis that the effect people receive from psychedelics at these subperceptual doses is mostly an expectancy/placebo effect, and that one needs to consume a higher/full dosage to receive a therapeutic benefit.

Could psychedelics become safer if legalized?

It is anticipated by experts in the field that several psychedelics may become fully legalized — for medical usage, under supervision — within the next two to five years, specifically psilocybin and MDMA (ecstasy). Psilocybin and MDMA have already received breakthrough therapy designations by the FDA to facilitate research. Psilocybin has received this designation for two indications: major depression and treatment resistant depression. MDMA was given it for the treatment of PTSD. More recently LSD (aka ‘Acid’) was given breakthrough therapy designation for general anxiety disorder.

Some policy makers and public health experts believe that the safety of these psychedelics would be enhanced if they were decriminalized, and if their cultivation and production were monitored and regulated. Currently, all psychedelics are illegal from the federal standpoint, but they have been decriminalized on the state level in Oregon and Colorado. Several local municipalities in other states have decriminalized as well. We are voting on state-wide decriminalization in Massachusetts in November (and we’re going to win…).

Some advocates of decriminalization are looking forward to a safer product. They anticipate wider access that could include not necessarily having to see a medical professional to get a prescription, and not necessarily having to be under medical supervision when legally using psychedelics. They feel that people have the right to explore their consciousness as long as they aren’t bothering anyone or neglecting responsibilities.

For example, people ought to be allowed to take shrooms in the woods with friends. Skeptics are worried that uncontrolled access to these drugs might harm patients with mental illness or might even precipitate mental illness such as psychosis or panic attacks in people that are genetically vulnerable.

It is important to mention that the use of all psychedelic drugs should be undertaken with utmost caution — if they should be used at all — in patients with major mental illness such as schizophrenia or bipolar disorder. For safety reasons, these patients are typically excluded from studies involving psychedelic drugs, though this is, to a certain extent, being revisited.

To microdose or not to microdose?

While any medical or lifestyle decision is an individual's choice (assuming that they aren't causing harm to others), I would highly recommend that you educate yourself thoroughly before going ahead and taking psychedelics. They are powerful and strange drugs which result in experiences that can be really fun and meaningful, or quite scary. There are many ways to consume them in a safer or less safe manner. If using a full dose, it is critical to have a friendly and relaxing “set and setting” in which to take them and to have at least one person who is not using them, and who can act as a “trip sitter”. You also might speak with your doctor to explore your decision to take psychedelics and see if there are any medical reasons why you should be cautious or avoid these drugs. It is critical to pay attention to the legality and the quality of your product — you likely can't afford to get into legal jeopardy, and certainly can't afford to poison yourself.

If done properly, microdosing is ‘lower hanging fruit’ in the sense that there is very little chance of an adverse reaction or a “bad trip”. Though – I know one person who tried microdosing with psilocybin and couldn’t sleep for days – it was a disaster. All drugs can have toxicities and cause bad reactions in a percentage of users. Finally, it is important to understand that there isn't yet definitive proof that microdosing is helpful, or even that it is safe in the long term. In these exciting times, psychedelic drugs are becoming better understood and are undergoing a resurgence of research and a more widely accepted use. I applaud this as I believe they have tremendous potential to help us in a myriad of ways. I suspect that, sooner rather than later, we will be able to answer the question: does microdosing help, and what does it help with.