Today, Explained - Microdosing goes mainstream

Episode Date: March 31, 2022

There is growing support for psychedelics as performance enhancers, mood boosters, and a shortcut to therapy. The science is mixed. This episode was produced by Miles Bryan, engineered by Paul Mounsey, fact-checked by Victoria Dominguez, and edited by Matt Collette and host Sean Rameswaram. Transcript at vox.com/todayexplained   Support Today, Explained by making a financial contribution to Vox! bit.ly/givepodcasts Learn more about your ad choices. Visit podcastchoices.com/adchoices

Good morning. It's about 7 a.m. and I'm about to measure out my microdose for the day. I but I just need it down to the tenth of a gram. I've got some mushroom powder. Basically, I took the mushrooms that I buy and put them in a coffee grinder, ground them down into a powder. I tend to just pour it into water and then just kind of mix it up. The promise of micro dosing ahead on Today Explained. Alright, so I'm now going to head off to work. Get groceries delivered across the GTA

from Real Canadian Superstore with PC Express. Shop online for super prices and super savings. Try it today and get up to $75 in PC Optimum Points. Visit superstore.ca to get started. It's Today Explained. I'm Sean Ramos-Firm. At the top of the show, you heard from an everyday microdoser. And we're going to keep him anonymous because while microdosing is becoming popular in the United States, it has yet to become legal in most places. On the show today, we wanted to understand the mainstreaming of microdosing,

so we reached out to Dana Smith. She's a freelance science journalist who recently wrote about the phenomenon and whether or not it really works for The New York Times. Microdosing is, instead of taking a large amount of a psychedelic, where you're going to have the kind of classic hallucinogenic trip, it's taking a very, very small amount. So really just 5% to 10% of a normal dose. And people take it in the morning like a cup of coffee.

You really don't feel high. People describe it as kind of like everything's a little bit sparkly, a little bit shiny. You know, one person described it as kind of like life in high definition. So the goal is not to feel like you're high. It's not to feel like you're tripping. It's really just to have a little bit of a boost throughout the day, potentially in kind of cognitive processes like attention, creativity, focus, things like that. And then also for just kind of well-being. And some people are also using it to treat mental health disorders. What got you interested in microdosing?

I got a PhD studying drug addiction about eight years ago. And I was doing my PhD in England. And Imperial College London is one of the kind of main research hubs for psychedelic research. They were the first to put people in an fMRI scanner while they were on LSD or psilocybin and actually see what was happening in the brain. So all that research was happening while I was getting my PhD up the road in Cambridge, also studying drugs, but focusing on cocaine and heroin as kind of the more classic kind of problem drugs, quote unquote. So yeah, so I got interested in kind of the potential of psychedelic therapy from kind of a research standpoint.

And then when I made the transition to science journalism, kind of kept my eye on it as just getting a bigger and bigger trend and with more and more solid research behind it. So it's something that I've been interested in and written about a couple of times as a journalist now. Microdosing has been a trend for about the last 10 years or so. It's really come onto the radar of popular culture with a lot of people in Silicon Valley doing it. But you take Aviator. That's not a name that I found. It's a name that found me on a vision quest. Largely for people wanting boosts in creativity or energy or kind of the main claims around it.

I'm not gonna eat a bunch of drugs and sit on the desert and hope to name randomly pops in my head. Well then I question your leadership. I guess the history kind of goes back even further because it's kind of the resurgence or the renaissance of psychedelics. The goal of this trip is ecstasy. So psychedelics and psychedelic therapy are having a huge moment right now because they're showing kind of legitimate possibility as therapies for depression and PTSD and some other mental health disorders.

Despite its bad reputation, we need to ask the question, what does this mushroom know that we don't? What does it do that we can't? It seems to kind of fall into three camps. One is for kind of as almost like a performance enhancer. So this was the initial claims that people saw out of Silicon Valley where, you know, everyone's talking about a little bit of increased attention, better focus. Creativity is another big one that people say is that it helps them see connections that they might not otherwise have seen. Another main reason is for just kind of improved well-being, just feeling better. People are using it to self-medicate if they have depression or anxiety, and they say that it helps with their mood and helps with their symptoms.

And then third camp is just kind of recreational. You know, it's still a recreational drug. People do it because it feels good. So some people are using it in the evening to unwind instead of, you know, having a beer or a glass of wine, say. What drugs are people microdosing? The main ones are LSD and psilocybin, which is the key hallucinogenic component of magic mushrooms. For LSD, it's like 10 to 20 micrograms. And then for mushrooms or for psilocybin, it's about like one to three milligrams of psilocybin.

Mushrooms, it's harder to get a precise amount because you don't actually know how much psilocybin is in a mushroom and you don't know how concentrated it is and kind of like where in the mushroom it is. So it's really a pretty imprecise science. Most people don't actually measure their doses. They just take, you know, a tiny dropper of LSD or just like a little nibble of a mushroom. But the goal is for really like very, very low threshold feeling of a psychedelic high. How much do you feel it? Comparing this to like an anti-anxiety medication, what's the experience? It varies a little bit. In some of the literature, it says that you shouldn't feel it at all,

that it should be really sub-threshold. So you're taking so small of a dose that you might not be aware that it's working, but you just trust that something is happening. So it's been about an hour and a half since I took the dose and I'm already starting to feel the effects. On the other side, some people are taking it so they do want to feel something. I oftentimes have a kind of general anxiety in the morning that started to go away as I was driving to work. That anxiety was replaced with a kind of general sense of euphoria and peace and calm and in the moment-ness or present-ness, all the kind of cliche things that people say. One person I talked to said that on a scale of 1 to 10, he aims for about a 2 or a 3.

So he's aware that he's taking it. Things feel a little bit different, a little bit, you know, kind of shinier, happier, but it's definitely, you know, far from a full psychedelic high. I mean, you wrote about this in the New York Times, and you talked to a couple people who microdose recreationally. What do they say keeps them coming back? They say that it helps them.

You know, most of the people I talked to were using it because they had symptoms of depression or anxiety, and they really didn't want to be on a standard SSRI or antidepressant drug. And they said that it really helped them and improved their mood. They just felt a little bit happier. They felt a little bit more kind of in control of their feelings and just really had kind of an emotional boost throughout the day. And so they're taking it, you know, maybe a couple times a week. So it's not every day. It's not like a medication that you take every morning, but you would take it, you know, maybe one to three times a week. So I just finished teaching my first two courses of the day and still feeling very good. I actually think that when I microdose, it actually helps me to be a better teacher actually,

because I can kind of be more, I know this is cliche to say, but I'm a little bit more in the moment and not really thinking about all the other things I need to do. I can just kind of focus in the moment about what the students need, what the discussion needs at that point. And I think I can foster just a better teaching environment. I have a couple more classes to teach later today. I'll send another update after I teach my next two classes this afternoon.

The science of microdosing is up next on Today Explained. Thank you. Wirecutter AuraFrame to make it easy to share unlimited photos and videos directly from your phone to the frame. When you give an AuraFrame as a gift, you can personalize it, you can preload it with a thoughtful message, maybe your favorite photos. Our colleague Andrew tried an AuraFrame for himself. So setup was super simple. In my case, we were celebrating my grandmother's birthday and she's very fortunate. She's got 10 grandkids. And so we wanted to surprise her with the Aura Frame. And because she's a little bit older, it was just easier for us to source all the images together and have them uploaded to the frame itself. And because we're all connected over text message, it was just so easy to send a link to everybody. You can save on the perfect gift by visiting auraframes.com to get $35 off Aura's best-selling Carvermat frames with promo code EXPLAINED at checkout. That's A-U-R-A-Frames.com promo code EXPLAINED.

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Yeah, the science is really interesting with microdosing. So a lot of the research that's happening is by those scientists who were studying the large doses to begin with. And it's interesting because it's a case of the science really following the trend. So researchers were studying the large doses to begin with. And it's interesting because it's a case of the science really following the trend. So researchers were studying the large doses and found a lot of efficacy for people with depression, PTSD, and other mental health disorders. It's pretty clear that things like psilocybin and potentially

LSD and MDMA really can help people with mental health disorders. And so then, you know, they saw the trend just like the rest of us did. And so they started studying microdosing as well. And it's a little bit trickier there. So a lot of the early studies are just plain surveys. So you just ask people who microdose kind of why they do it and what benefits they feel. And then people report a lot of things they mentioned earlier, you know, better wellbeing, better attention, better cognition. But that is really tricky because it's all self-reports. There's no placebo. You're

not actually testing anything. When you get people into a lab, again, without a placebo, they report the same thing. So even on cognitive tests, they'll show better performance. They'll show better scores on a depression score, for instance. But finally, there have just in the last year started to be placebo-controlled trials, and all of a sudden those effects went away. So if you give people either a microdose or a placebo and you don't tell them which one they get, everyone in the study improves, but that means that there's a placebo effect happening. So if you improve when you have a placebo and there's no greater improvement compared to the microdose, then it's really hard to say that there's actually an effect of the drug that's happening. It's just your expectation. And in one of the studies that came out of Imperial, they actually asked people what they thought they had taken at the end of the study. And people were more likely to see an

improvement in their mood and well-being if they thought they had taken a microdose, regardless of what they got. And they were less likely to show an improvement if they thought they had taken a placebo, regardless of what they got. So the expectation effect was really a bigger driver than the drug itself in terms of how people improved over the course of the study. Okay, so in what we know so far, there's a real expectation effect, a placebo effect here for people when we're talking about a microdose. Is there science out there for when you bump it up to a full dose? Yes, yeah, there's a lot of research on that. Those are very controlled

experiments. It's really hard to do a placebo for a full dose of a hallucinogen. You pretty quickly know what you've gotten or not. So there are not really placebo-controlled trials, as you can imagine. But there is a lot of rigorous research around psychedelic therapy, where people have several intensive therapy sessions, then they have a therapy session while they're receiving a very large dose of LSD or psilocybin, and then they have follow-up appointments afterwards. And there have been a couple of clinical trials that have shown that people actually have as much of a benefit

as they do with kind of standard SSRIs or, you know, kind of typical antidepressant drugs. So there are numerous studies that have come out now that really do show a pretty clear benefit of psychedelic therapy with those large doses. It's just that the microdoses, it's not quite as clear cut. And should we assume that until the science is a little more clear here, there isn't going to be sort of this mainstreaming of microdosing across the country? Well, for one thing, I mean, these drugs are illegal. So, you know,

you could say that in some ways it already is mainstream because we're even talking about it. You know, like this is a pretty big trend that's happening. The question is, will microdoses be FDA approved to treat anxiety or depression? Those larger clinical trials for the larger doses, that's kind of already in the works for FDA approval of psilocybin. It's not happening yet, but that is what people are kind of anticipating and hoping for by the end of the decade. The question then becomes, can you market or prescribe a microdose of psilocybin? And that's where you really want to see that it works, because you can't prescribe something that's no better than a placebo. There are really big ethical implications there. So that's why it's really important to do this research now to see if the benefit is really

real or not, or if it's just an expectation effect. One thing I will say is that it's not quite as simple as just placebo-controlled trials didn't see anything, therefore it doesn't work, because there are a couple studies that are looking at what microdoses of psychedelics do in the brain. And there, it's pretty clear that something is happening. So with kind of larger microdoses, about 10% of a full dose instead of 5%, you can see that there are changes happening in the brain in terms of people's activity, in terms of the serotonin receptors, that is the primary target that the drugs are working on in the brain. And you can see that something's happening there that's kind of similar, but just smaller than a

full dose of a psychedelic. So it's not that the microdoses are doing nothing. They're doing something in the brain. It's just a question of whether that corresponds to them doing something for people in terms of behavior and mental health and things like that. So it's a really interesting conundrum right now of whether the effect is real or not. You mentioned these drugs are still legal, but they're not illegal everywhere. I know Oregon has at least legalized mushrooms. What are the ways these drugs are being used therapeutically despite being illegal in most of the country? Look, the state is very libertarian on drug laws, and I do think it's the beginning of something. Oregon is expected to have a ballot initiative

in 2020 that would actually legalize psilocybin therapy, so guided psilocybin experiences and reduce penalties for recreational use. And there's a group in California who would like to get it on the ballot here. You're right. Oregon was the first state to legalize psilocybin. And a big part of that was the push around their potential as a therapeutic, as an antidepressant. In a separate 2020 ballot initiative, Oregon voters also opted to legalize psilocybin,

the psychoactive compound in magic mushrooms, for use in therapeutic settings. Regulators have until January 2023 to begin issuing licenses. So there definitely are clinicians either through clinical trials, you know, through actually university-led clinical trials, where people can enroll to take primarily MDMA for PTSD or psilocybin for depression. But it's definitely one way that people can seek out and try and get therapy that way and try and get therapy that way

and try and use them that way. There are also, you know, underground networks of therapists who are, you know, prescribing these drugs. So the movement is definitely happening. They're just not legal on a federal level yet, and they're not FDA-approved to be used therapeutically yet. DC's trying, I know. Maybe if they can pull it off,

it'll convince all the federal government to hang with psychedelics. And then in the psychedelic world, Alexandria Ocasio-Cortez, I hope I said that correctly, I guess people usually just say AOC, has just introduced an amendment to a larger spending bill

that would take away this language that has been there since the 90s that basically says there you can't use federal funds for any activity that promotes the legalization of any drug or other substance in schedule one. I mean, they just shot down, I think, another effort to legalize marijuana there. So I think that might be a stretch. She's focusing on psychedelics here and she wants she wants research to really just open up. That might be the last place to turn over. I don't know.

Like marijuana, though, this could be a pretty big market, right? Which is to say something to tax? Oh, absolutely. I mean, people right now are estimating it's about a $2 billion market right now, and it could be $10 billion in the next five years. I mean, this is massive, massive money. They do have a really strong potential of helping people, but there are a lot of questions that still need to be worked out. And that's why figuring out whether the benefit of microdosing is real or not is a big deal, because there's a

lot of money behind this. People could really start to market this pretty quickly. And so you need to actually show that a drug works and that a specific dose of it works to help people beyond a placebo before companies can start marketing it, promoting it, and prescribing it. So I just finished teaching my last class and I'm now headed home. I no longer am really, you know, feeling any of like the direct effects of the microdose, but I still feel, you know, pretty positive, happy, still calm, euphoric, all the kind of emotions I mentioned before. Had a good day of classes, Another positive microdosing day. And I'm going to do it again later this week.

Dana Smith is a freelance science reporter. You can find her and her work at danagsmith.com. Our program today was produced by Miles Bryan, edited by Matthew Collette and me, fact-checked by Tori Dominguez, and engineered by Paul Mounsey. The rest of the Today Explained team includes Victoria Chamberlain, Will Reed, Hadi Mawagdi, and Halima Shah.

Our supervising producer is Amina Alsadi. Our other host is Noelle King. I'm Sean Ramos for M Today Explained as part of the Vox Media Podcast Network. Thank you.