The "miracles" of microdosing

13/08/2020

A new supplement has hit the mainstream hype. But instead of omega-3 fatty acids and vitamin D, people are beginning to regularly take small dose of a "recreational" psychedelic drug with their breakfast, notably LSD and psilocybin (the key ingredient in magic mushrooms). The consumption of a one-twentieth to a one-tenth dose of these drugs has elicited profound reported benefits in livelihood, and patients suffering a whole host of psychiatric and physiological illness, have found microdosing to be on par, and in some cases even more effective, than their current prescription medications. Hallucinogens in large doses have been used in healing in indigenous cultures for many centuries, however, small regular dosing within the Western world is relatively recent. With more and more people jumping on the trend every day and reporting vast benefits, scientists have begun to investigate whether microdosing really is the miracle drug of the 21st century it is claimed to be.


Whereas a typical psychedelic trip induced by recreational doses of hallucinogens give an intense experience associated with shifts in consciousness and profound visual and auditory alterations, a microdose of these same drugs tend to produce either no notable or very subtle effects. However, a course of microdoses, commonly in a one-day-one, two-days-off protocol for up to several months, has reported to produce marked effects on wellbeing, mood, sleep, focus, cognition and energy. The trend has a huge popularity in silicon-valley, with many tech and start-up company workers using microdosing to boost creativity and productivity. James Fadiman, psychedelic research pioneer, gave a talk in 2019 in which he reported some obscure effects documented by collected reports from microdosers which included things like decreased menstrual pain and icepick headaches, improved ability to drive and play musical instruments, relief from shingles, and even feeling "more comfortable with those awful people at work." One report from an individual who microdosed LSD quotes: "Microdosing has allowed me to unlock my potential and to live fuller, to be engaged in an individual moment, which has in turn allowed me to be more focused and happier. I'm much more empathetic and willing to give people the benefit of the doubt now. I just feel lighter all the time." The reports and claims are rather phenomenal, that such teeny-tiny doses can cause such a huge amount of different lifestyle-enhancing, and potentially healing, effects.

Although the use of psychedelics in treating mental disorders is becoming more evident, the healing powers of these drugs is not a newly discovered phenomenon. Archaeological evidence indicates hallucinogenic plant use by humans' dates to over ten-thousand years ago and has remained apparent in indigenous cultures. Furthermore, before the 1971 war on drugs ban, LSD was one of the most researched chemical compounds investigated in treatment of a whole host of psychological ails including depression, anxiety and addiction. However, the highly intense, and often daunting, experiences of a psychedelic trips can often deter people from seeking psychedelic therapy. Could microdoses offer a solution? One study, investigating over 900 patients with various mental health disorders, found a significant improvement in self-rated scores of effectiveness, disappearance of symptoms and quality of life improvement for microdosing self-medication, compared to their prescribed conventional treatment. Patients with ADHD and anxiety patients saw the most benefits from microdosing. Although better than conventional therapy, a full hallucinatory dose of psychedelics out trumped microdosing for the same measures, suggesting that in terms of therapy, full psychedelic dosing may be a more effective strategy for fast and pronounced outcomes. However, the easy integration of small doses in daily life offers something more approachable. The microdosing reports indicate a seemingly much lower side-effect and withdrawal symptom profile compared to many current psychiatric drugs, which is an important point for consideration. Microdosing could offer a solution to those showing resistance to treatment, such as like depressive disorder where nearly a third of patients show no response to their medication. However, the legality of these drugs and insufficient evidence currently thwarts the possibility of microdosing ever replacing psychiatric medication in a clinical setting.

Unfortunately, the strength of the evidence for microdosing is limited. The data is mainly from online questionnaires carried out by recruited participants. Advertisements to participate are often posted on reddit threads and Facebook groups about psychedelics, meaning those who sign up likely already have an interest in drugs. This makes the data less representative for the whole population and members of these social media groups who take and enjoy psychedelics recreationally could be bias towards reporting positive effects of microdosing and avoiding reporting adversities. One microdosing study asked their subjects prior to the study whether they believed the microdosing would have an effect, to which all responded yes. This raises the question, to what degree are biases and pre-beliefs about microdosing accountable for the reported effects? Problems with the validity of the studies calls for more experiments to be conducted. Studies where patients do not know if they are receiving a microdose or a placebo (a pretend form of the drug) could help resolve issues surrounding pre-existing beliefs and biases, and long-term monitoring of these patients would be important in telling us of any potential harmful side-effects. Tools like brain imaging and fluid analysis could be used to give objective data, less influenced by subjective experience, and show how microdosing over a given time can bring about physiological and chemical changes in the brain. Brain scans have shown that a high dose of psilocybin decreases activity in a group of brain areas which connect to form the default mode network (DMN). These findings have been important in researching psilocybin for mental health treatment, as various disorders, including depression, have been associated with an increase in DMN activity. To see whether microdosing psilocybin could similarly decrease DMV activity would be a worthwhile finding for mental health research and give scientific "backing-up" to the reports of those using microdosing to self-medicate their psychological disorders. From the media, it would see psychedelic drug research is progressing, however, with the drugs still illegal, getting funding and resources for such experiments remains a huge barrier.


If all the reports about the effects of microdosing are true, then microdosing is certainly a wonder drug not only for its vast impact on improving everyday living, but also the ability to treat numerous mental health disorders. Although microdosing is becoming seemingly more mainstream, getting hold of psychedelic drugs still involves breaking the law in most places around the globe. And the legal status of these drugs means the scientific evidence, unfortunately is limited. This means for the scientific community; it is still questionable whether such miracles of microdosing are down to the individual's beliefs and limited by the type of patients who participate microdosing studies. It is known high doses of psychedelics can bring about changes in the brain, does taking the same drug in a small dose over a given period do the same? And for investigating mental health treatment, how much does the difference between a high psychedelic dose and a microdose matter? With the trend rising, this body of research will hopefully grow. And whether as a substitution for a prescription medication, or simply to add sparkle to the day, the future may see a morning microdose as standard as a morning coffee.