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A Really Good Day Page 4
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It’s wrong to say I was sure I was having a heart attack, but I definitely considered it a possibility.
What kind of a wretchedly irresponsible idiot was I, taking an illegal drug, especially one so widely considered to be dangerous? I am a mother, for God’s sake! How could I even consider taking these risks? My mind jumped ahead to when EMTs would be strapping me to a gurney, asking, “Ma’am, are there any drugs you are taking that we should know about?” and me, in the midst of my heart attack, being like “Funny you should ask. Have you ever heard of microdosing?”
The reason I didn’t use as many drugs as so many of my college contemporaries was that I was afraid not just of losing control but of losing my mind or my life. Of all the drugs on offer, LSD was the one I was most terrified of. I believed LSD to be on a par with heroin and methamphetamine, or perhaps even more dangerous. Lying in bed last night, I felt that fear overwhelm me. I tried to breathe, to remind myself that I had carefully researched the drug before beginning this experiment. In my mind, I ran through everything that I had learned.
Though I don’t consider myself a gullible person, and though my work in drug policy reform has made me more familiar than most people with the way drugs have been represented and misrepresented throughout history—with some harms downplayed, others exaggerated—before beginning this experiment I had swallowed without question all the stories I had heard about LSD. I believed that people who took LSD experienced lifelong “acid flashbacks” that prevented them from leading normal lives. I believed they flung themselves off the roofs of buildings under the illusion that they could fly. I even believed a rumor I’d heard in high school, that a person who uses LSD more than seven times inevitably becomes psychotic. I was flabbergasted when I met my husband and he told me he’d dropped acid nine times. He’s pretty much the least psychotic person I’ve ever met. In fact, he’s almost disturbingly sane.
Those fears, I told myself sternly as I felt around in my wrist for my pulse,*1 are not borne out by the facts. Whatever I and so many others have heard, in the nearly eighty years since the drug was first synthesized, at least twenty million Americans and many more millions of people around the world have used LSD, to very little ill effect.
Moreover, the Swiss research chemist who first synthesized the drug, and who consumed it and other hallucinogens frequently throughout his life, including microdosing during his last decades, lived to be 102 years old!
When he discovered LSD in Basel in 1938, Dr. Albert Hofmann was employed by Sandoz Pharmaceuticals, a company founded in the middle of the nineteenth century that was, among other things, one of the earliest producers of saccharin, the sugar substitute beloved of little old Jewish ladies the world over. (My grandmother kept a pill dispenser of saccharin on her kitchen table, and another in her purse, to guarantee ready access to calorie-free Sanka that tasted vaguely like aspirin.) Hofmann was the lead Sandoz researcher investigating ergot, a fungus that had visited periodic plagues of madness and misery on medieval cities. During the Middle Ages, ergot would infest grain stores, leading to widespread outbreaks of ergotism, commonly known as St. Anthony’s Fire, named for the order of monks devoted to treating its victims. Victims of ergotism suffered two different forms of the illness. The gangrenous form caused full-body blistering and the rotting away of limbs. The convulsive form caused seizures, delusions, and death.
In small doses, ergot also causes uterine contractions, and was thus a common, if dangerous, abortifacient.*2 All of this made the compound very interesting to chemists like Hofmann, whose work involved altering chemicals to make them useful in treating disease. Hofmann worked with the ergotamine molecule, synthesizing subtle variations in search of one with medicinal applications. As he worked, he numbered his variations. The two diluted drops I placed under my tongue two days ago were his twenty-fifth variation, LSD-25.
When Hofmann first created this iteration of the chemical and tested it, he found that it had a uterine contracting effect, but not as much as other ergot compounds he had synthesized. He noticed that the lab animals tested with LSD-25 became highly excited, but since he was focused on discovering a substance that would stimulate circulation and respiration, that effect held no interest for him. He put LSD-25 in the metaphorical cupboard along with LSD-1 through 24, and moved on with his ergot research, eventually producing an ergot alkaloid known as Hydergine, which improved circulation and cerebral function and is still used in the treatment of dementia and Alzheimer’s.
Years later, for no reason that Hofmann could explain, he felt called to return to his experiments with LSD-25. In his book LSD, My Problem Child, Hofmann said he experienced “a peculiar presentiment—the feeling that this substance could possess properties other than those established in the first investigations.” It might simply have been a scientist’s instinct; it might have had something to do with the laboratory animals’ unusual reaction to the compound. Hofmann, however, believed that something more mysterious drove him to return to that particular variant. It was as if the drug wanted to be found. Believe that or not, five years after first synthesizing LSD-25, Hofmann did so again.
As he worked with the compound in his laboratory, Hofmann began to feel dizzy and restless. Then he began to hallucinate. He wrote, “I perceived an uninterrupted stream of fantastic pictures, extraordinary shapes with intense, kaleidoscopic play of colors.”
Assuming correctly that he’d accidentally ingested the chemical, and intrigued by those fantastical and vivid images, Hofmann decided to try the drug again, this time in a controlled experiment with a verified dose. Three days later, in the company of a group of lab assistants, he stirred 250 millionths of a gram (250 micrograms) into a beaker of water and drank it down. This is approximately twice what became the average dose for a “trip.”
Within half an hour, Hofmann began again to experience the same hallucinatory symptoms, but with a disturbing intensity. He asked one of his assistants to accompany him home, and they made the curious decision, which Hofmann attributes to its being wartime and his having no car, to ride their bicycles. This was, it turned out, a bad idea. According to Hofmann, “Everything in my field of vision wavered and was distorted as if seen in a curved mirror.” When his research assistant helped him into his room, things became even worse. “A demon had invaded me, had taken possession of my body, mind, and soul….I was seized by the dreadful fear of going insane. I was taken to another world, another place, another time. My body seemed to be without sensation, lifeless, strange. Was I dying?”
The very question I had asked myself, after taking 4 percent of the dose he had taken!
And yet Hofmann’s research assistant found that he was in no physical danger. “Pulse, blood pressure, breathing were all normal.” Then things changed. Hofmann stopped panicking and began to “enjoy the unprecedented colors and plays of shapes that persisted behind my closed eyes.” The day after that dizzy bicycle ride and its aftermath, Hofmann was himself transformed. “A sensation of well-being and renewed life flowed through me.”
Thus was launched the era of human experimentation with LSD. Sandoz made the drug available to scientists for traditional analytical research as well as for more unusual experiential experiments. In the materials that accompanied the drug, Sandoz suggested that psychiatrists who took the medication might gain insight into the minds of their patients. LSD could help them understand what it was like to be insane.
From the 1930s through 1968, when the United States and other governments criminalized LSD and effectively terminated research, scientists throughout the world experimented on thousands of volunteers, both healthy individuals and the mentally ill. They tried LSD on alcoholics and catatonics, on schizophrenics and depressives, and, most notably, on themselves. Many LSD researchers became their own subjects. It’s easy to understand why. How many of us have enough willpower to turn away from a “sensation of well-being and renewed life”? Not so much chasing the dragon as reaching for the cuddly kitty of contentment.
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During the heyday of LSD research, scientists published more than a thousand research papers and dozens of books. They held symposia and conferences to discuss and compare their findings. The outcomes were overwhelmingly positive, though some scientists did report subjects who had negative experiences. Some people experienced “bad trips,” which caused them distress. A few researchers, notably Timothy Leary and Richard Alpert, abandoned established modes of scientific study for incense and mantras and The Tibetan Book of the Dead—a disturbing development, not to the researchers themselves, but to those who paid their salaries. But in none of those experiments did anyone die or suffer serious injury.
In fact, contrary to what I believed before I began my preparatory research, contrary to what the vast majority of people probably believe, LSD is, as drugs go, safe. In terms of morbidity, it’s a lot more like marijuana than heroin. According to a thorough review of the drug’s pharmacology published in 2008 in the peer-reviewed journal CNS: Neuroscience & Therapeutics, “There have been no documented human deaths from an LSD overdose.”
Chill out! I told myself, in an attempt to stem the tide of panic. Do you imagine that, having taken a fraction of the dose of a drug that tens of millions of people have consumed, you will be the first ever to die? You, Ayelet, are not that special.
Surprisingly, haranguing myself proved useless in alleviating my anxiety attack, so I pulled out my research notes and pored over a report of a 1972 incident in which eight people were admitted to San Francisco General Hospital after taking a massive quantity of LSD, the highest reported dose ever consumed by humans. This group of partiers had snorted lines of what they believed was cocaine but what was actually LSD. This is an astonishing dose. Recall that all it takes to trip is a tiny amount diluted on a dot of blotting paper. The huge overdose made them terribly sick. When they arrived at the hospital, they were vomiting, had hypothermia, and showed signs of internal bleeding. Five slipped into comas; three needed to be intubated to breathe. And yet, within twelve hours, they had all completely recovered. It’s taken me longer to get right after a Pilates class.
In evaluating how toxic a substance is, scientists attempt to determine its median lethal dose (known in scientific parlance as “LD50”). LSD is psychoactively powerful; minute dosages, starting at a millionth of a gram, produce noticeable effects. And yet, even a dose of two thousand micrograms, two hundred times the dose I took, twenty times the typical “tab,” causes no discernible biological side effects at all. The fact that there has never been a documented death from LSD overdose makes it impossible to determine its human LD50 with absolute assurance, but Hofmann, extrapolating from animal studies, estimated that it must be hundreds of times the typical dose. A textbook entitled Haddad and Winchester’s Clinical Management of Poisoning and Drug Overdose, published in 1990, reports the LD50 to range from 0.2 mg/kg to more than 1 mg/kg.*3 I weigh about fifty-eight kilograms, which means that, to be having an LSD-caused heart attack, even in that volume’s very conservative estimation, I would have had to ingest at least 11,600 micrograms, not ten. I wasn’t dying. But what about my mental health? In my quest to feel better, was I risking permanent psychic injury?
One of the first American researchers into the effects of LSD, Dr. Max Rinkel, a psychiatrist at the Massachusetts Mental Health Center, reported that healthy subjects (notably his colleagues, on whom he experimented) experienced marked personality changes while under the influence of LSD. Some became withdrawn, even exhibiting autistic behaviors. Others became manic. Some became suspicious and hostile; others experienced deep ecstasy. Rinkel characterized these personality changes as mimicking schizophrenia or psychosis. Once the drug’s effects wore off, however, so did these changes.
Over the course of eighteen months between 1966 and 1968, when recreational use of the drug was at its peak, a survey of doctors and hospitals in Los Angeles found that at least forty-one hundred people had experienced acid trips disturbing enough that they sought a doctor’s help. The majority of their adverse reactions were merely transitory anxiety or depression, but there have been reports of more serious problems.
No phenomenon causes me more anxiety than the specter of “LSD psychosis,” generally defined as a reaction to the drug that is prolonged, lasting days to months, or one that requires hospitalization. According to the research, however, the majority of individuals diagnosed with LSD psychosis have a history of psychiatric illness, have taken a substantial cumulative amount of the drug, and have histories of polydrug abuse. The first category could theoretically apply to me. I have a history of PMDD and a misdiagnosis of bipolar disorder. My emotional pain is the very reason I started down this path. Neither other element is present in me, however, and, like the song says, two out of three ain’t bad.
Still, in a 1984 paper, Dr. Rick Strassman, a research physician for the University of California, Davis, wrote, “There are occasional reports of severe and prolonged reactions occurring in basically well-adjusted individuals.”*4 He cited a study from the 1970s in which two young women were admitted to psychiatric hospitals weeks after taking average doses of LSD. According to the authors of that study, both women were “normal” before trying the drug, and both ended up profoundly depressed, and in one case allegedly homicidal. (She said she wanted to kill her mother, but, then, what twenty-one-year-old woman doesn’t?) After multiple treatments with ECT (electroconvulsive therapy), the two girls recovered and were discharged.
And yet Strassman, after a thorough review of this study and others, concluded, “It appears that the incidence of adverse reactions to psychedelic drugs is low, when…patients are carefully screened and prepared, supervised, and followed up, and given judicious doses of pharmaceutical quality drug.” His conclusion is in line with other, more recent research, as well as what mid-twentieth-century scientists found.
One of the most important things the early LSD pioneers discovered is that the personality of the researcher administering the drug had a profound effect on the experience of the patient. If the examiner was cold and distant, the subject occasionally became hostile, even paranoid. The subjects of a warm and gentle researcher almost universally experienced feelings of love and joy. What are the implications of this finding in terms of my administering the drug to myself? No one is meaner to me than me. I was probably being cold and distant with myself when I hit the dropper!
In response to this discovery, researchers articulated the concept of “set and setting” in influencing subjective drug experiences, not just of LSD but of all drugs. Set refers to the subject’s own subjective mental state. How stable is she? What does she think she will experience? Setting is the environment in which she takes the drug. If the environment is threatening and chaotic, or clinical and cold, she’s more likely to have a negative experience. If the environment is safe and supportive, she is more likely to have a meaningful, positive experience. Not, for example, a sweaty bed freak-out in the middle of the night.
Though I’d much prefer to undertake this experiment in an official setting, supervised by psychiatrists and using pharmaceutical-grade LSD, I don’t have that option. The last decade has seen a renaissance in research into the effects of psychedelic drugs, including LSD, but microdosing is not being researched by anyone in the world. Though some might be in the early planning stages, there are at this time no studies going on, double-blind or otherwise. Dr. Fadiman’s collection of notes from experiments like my own is the closest approximation to a study out there. It’s the Wild West, and I’m running my own saloon.
I reminded myself that Dr. Fadiman has collected hundreds of reports, and though a few individuals have experienced some anxiety while microdosing, no one has ever lost her mind. Nor could anyone lose her mind from such a dose. Not even me.
I put aside my notes and took a few deep breaths. I was not dying of a heart attack. My preparation for this month-long experiment had been as thorough as possible. I did my research and took as many precautions as I could. There is risk,
certainly, but so is there with any medication or drug. As a point of comparison, according to a thorough review of the literature by ProPublica, more than three hundred people in the United States die every year from taking acetaminophen (that’s Tylenol) and another forty-four thousand end up in the emergency room. Compared with this, LSD seems almost harmless.
Those stories I heard about people flinging themselves off the roofs of buildings, convinced that they can fly? Those are urban legend, not fact. And what about suicides? According to the 2008 literature review, “The incidence of psychotic reactions, suicide attempts, and suicides during treatment with LSD…appears comparable to the rate of complications during conventional psychotherapy.” There have been reports of people falling while on LSD, some fatally, but most likely because of disorientation and confusion. The myth of the flying tripper probably began with television host Art Linkletter’s twenty-year-old daughter, Diane, who committed suicide in 1969. Her father, perhaps unwilling to admit or confront her history of depression, was convinced that an experience with LSD six months before had caused her to jump to her death. He became a committed anti-drug campaigner, helping to spread the myth that people on LSD jumped off buildings to their deaths.
In fact, a recent study published in the Journal of Psychopharmacology found that psychedelic use is correlated with lower rates of suicidal thinking and suicide. According to researchers, “Lifetime classic psychedelic use was associated with a 19% reduced likelihood of past month psychological distress, a 14% reduced likelihood of past year suicidal thinking, a 29% reduced likelihood of past year suicidal planning, and a 36% reduced likelihood of past year suicide attempt.”*5
Given all the evidence of its safety, why is LSD so maligned? It’s most certainly because of the way, in the 1960s, LSD came to be associated with youthful rebellion and social upheaval. When Timothy Leary, a psychologist and former Harvard lecturer and early researcher who advocated widespread recreational LSD use, told the children of the middle class to “Turn on, tune in, and drop out,” they did, terrifying their parents. People were horrified to see their children protesting the war in Vietnam, joining in the civil-rights movement, smoking pot, and taking LSD. White America began to view their country as a fractured and scary place. They latched on to drugs, and especially LSD, as a symptom of the problem.