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“ You can earn a living from what you get, but you can only get a life from what you give.  ” - Andy Ripley

Psychedelics: again the pilgrimage - current experience, low/moderate dose

             "The universe is full of magical things patiently waiting for our wits to grow sharper."   Eden Phillpotts

                 "You'll never enjoy the word aright, until the sea itself floweth in your veins,                                                                         till you are clothed with the heavens and crowned with the stars."       Thomas Traherne

A couple of days before I had taken a classic high-dose psychedelic trip, complete with eye shades, headphones, playlist and trip-sitter ... described in this earlier post.  And that experience was immense for me ... deeply special.  But today I was interested in doing something more low key and a bit more off-piste.  So I took a 15gm dose of truffles and did some exploring of the Hague on my own.  Now this isn't necessarily a great idea.  As I've said about walking alone in the Scottish mountains ... "I may get killed or badly damaged doing this, but I don't want to get into trouble out of stupidity.  So I may take some risks, but only when I've planned them, taken precautions, and decided the balance of gain over risk is reasonable for me."  And that pretty accurately described my approach to this lower dose trip.  I knew fairly well what this batch of Cosmic Connector truffles was like (having taken 30gm a couple of days earlier).  I was only taking half the dose, but actually it was even weaker than that as my brain 5-HT2AR receptors were down-regulated due to taking the high dose a couple of days before.  I have once taken just 5gm of truffle to test its effects at very low dose - for me, the experience was subtle and slight (a little quieting of the 'ego' and some mild increases in sensitivity to nature, emotions, and other people).  Of course, people do vary a good deal both in how they metabolise psychedelics and how they react to the changes that are produced.  I estimate this 15gm, taken two days after 30gm, was equivalent to what maybe 10gm would have been like - taken clear of any earlier trip effects.  It was certainly a good deal stronger than 5gm - when taken well clear of any other intake - has been.  I already had plenty of experience from my student days of navigating the world on considerably higher doses of psychedelics than this.  And I also waited for over 90 minutes after taking this 15gm dose to assess how high I'd gone and how functional I was - see the diagram below from the recent 2018 paper by Geiger & colleagues on the metabolism & pharmacology of psilocybin.  So a bit risky, but not very risky.

And how was it?  Fascinating ... and a lot richer than I'd expected.  Interestingly I had a lower key version of the turbulence I reported at about 60 minutes into the trip on the high dose a couple of days earlier.  This time though, I simply 'waited it out', and after another quarter of an hour or so I was out and into a quieter, calmer state again (suggesting the experience - slightly upsetting body sensations & anxiety - was partly due to a stage of the psilocybin absorption sequence with this particular batch of truffles).  Over 90 minutes after taking the 15gm of truffle tea, I decided I was pretty competent and made my way carefully down the stairs and into the street.  Great to be outside.  Interestingly, if anything, I felt a little safer than usual ... in that I was very present and paying lots of attention to my surroundings.  Walking across grass where there was occasional dog shit, I clearly felt that I was less likely to step into it than usual!  I wasn't off into day dreams and thought patterns, my ego activity felt quietened ... while my senses, emotions, sensitivity to others felt heightened.  In a strange, very interesting way, I felt a better version of myself.  On this moderate dose of psilocybin, I was happy, full of wonder, joyful.  The buddleia had never smelt so delicious.  Seeing young children reuniting with parents at the end of their school day was precious & moving.  The trees were so alive and beautiful.  Crossing roads took up clear attention in a way that felt safe.  I remember thinking, this is what I have hoped mindfulness meditation practice could help me be (and which with my nearly 50 years of meditation practice I haven't reliably achieved).  Here's the picture I drew the next day:

And I walked to the GEM - the museum of contemporary art.  I laugh with happiness just remembering it.  Although this was my first outside-in-the-world (moderate dose) trip for decades, I was routinely out in the world when I took LSD as a student, so I'm sure this experience was much easier for me than it would have been for someone naive to these states.  And the art gallery was so moving, rich, multi-multi-layered ... my 'best art gallery visit ever'.  Breathtaking, in some ways outside time ... but later, when I scored myself on the Mystical Experiences Questionnaire (MEQ30), I was nothing like as high as I had been on previous high-dose trips with eye shades, headphones & led by the path of the music playlist.  Such different experiences in many ways.  And on my way back to my Airbnb (coming down off the trip now) I stopped at the delightful Blossom Cafe and such a precious, fun, delicious stop-over it was.

So what did I learn?  Personally, in some ways, this moderate dose trip was easier than the high dose trip to link to my day to day life.  In some ways it highlighted understandable, internal changes I can maybe make or slip into, that are more obviously applicable to daily life than the more deeply extraordinary, ego-dissolved high dose experiences.  Note this was a low/moderate dose trip ... not at all microdosing which involves taking only 5-10% of a usual full psychoactive dose.  So microdosing would involve maybe taking only 1gm of truffles ...  or very roughly 1mg psilocybin ... while today I was taking at least 10 times this dose.  For more on this see, for example, the 2019 papers by David Nutt & colleagues "Microdosing psychedelics: more questions than answers?  An overview and suggestions for future research" and by the Sydney-based Australian pair Polito & Stevenson "A systematic study of microdosing psychedelics" ... and Torsten Passie's recent book "The science of microdosing psychedelics".  Microdosing is very intriguing ... it cries out to be better researched ... but this wasn't the territory I was exploring today.

I was taking a moderate dose trip (10+mg/70kg body weight).  And what does the research say about this?  Back in 2004, Felix Hasler & colleagues from the Heffter Research Centre in Zurich looked at the effects of varying psilocybin doses in eight volunteers in their paper "Acute psychological and physiological effects of psilocybin in healthy humans: a double-blind, placebo-controlled dose-effect study".  The doses they used were equivalent to approximately: Placebo (PL) 0mg; Very Low Dose (VLD) 3mg; Low Dose (LD) 8mg; Medium Dose (MD) 15mg; High Dose (HD) 22mg per 70kg body weight.  The volunteers seemed to have been tracked rather exhaustively over the six or so hours of each of their five trips ... being assessed with a whole series of repeated physical tests and questionnaires (so not, it seemed, the current standard eye blinds/headphones environment of most research/intervention studies).  One of the main measures used was the "Altered States of Consciousness Rating Scale (5D-ASC)".  You can see, from the diagram below how increasing the dose progressively increased scores on the 5D-ASC (I personally had taken somewhere between the LD and MD doses today and considerably higher than their HD dose a couple of days ago).

And more recently, the team at John Hopkins looked at the effects of changing dose strength in eighteen healthy adults in their 2011 paper - "Psilocybin occasioned mystical-type experiences: immediate and persisting dose-related effects".  They used 0, 5, 10, 20 & 30mg/70kg body weight.  Although again the participants were subjected to regular tests during their trips, the researchers were explicit that participants were encouraged to use the typical therapeutic mix of eye shades, headphones & music playlists.  Trained monitors rated the participants regularly on overall behaviour & mood (amongst a series of measures).  Here - on a 0 to 4 scale - are their estimates for the different dose effects over the trips' 6 hour duration:


Of particular practical interest, they gave half the participants the 0-5-10-20-30mg psilocybin monthly dose sequence in ascending order and half in descending 30-20-10-5-0 order.  As is typical in psychedelic research, higher doses are both more likely to be valued and also more likely (at some point during the trip) to produce high anxiety.  As you can see from the chart below showing well-being/life satisfaction rating a month after each trip, taking doses in ascending sequence produced better outcomes.

Ratings (of how personally & spiritually meaningful the experiences were, and of how much sense of well-being & life satisfaction improved) were significant at one month follow-up ... and even more so at fourteen month follow-up!  The researchers commented that "The domains of change most frequently cited were better social relationships with family and others, increased physical and psychological self-care, and increased spiritual practice."  Good ... and overall my own experience and the available research suggests that (if one isn't too daunted by the time & expense) a starting dose of about 10mg psilocybin/70kg body weight (approximately 10gm of truffles) is sensible for those who have no previous experience of psychedelics.  Subsequently one would probably want to increase dose to 20-30mg/70kg body weight (as this increases the chances of transpersonal/mystical/peak experiences, which in turn increases the chances of better long term benefits).  Having taken second doses of psychedelics at two day and three day intervals after high first doses, there seems clearly to be some receptor down-regulation with the second dose ... but less than one might expect (so possibly just a 20% or so reduction in the 'power' of the trip it seems when leaving two clear days between them).

An interesting further question I'm left with is how important for therapeutic benefit from psychedelic trips is the current emphasis on eye blinds, headphones & musical playlists.  There are research papers suggesting considerable value from such practices - see for example "The hidden therapist: evidence for a central role of music in psychedelic therapy" - and quite probably researchers may find it safer to have participants kept to well-monitored therapy rooms.  However the large scale survey - "Predicting responses to psychedelics: a prospective study" - reported (to the investigators' apparent surprise) in the discussion of "Set, setting, and drug dose as predictors for acute psychedelic experience measures" that "According to this study's finding, being in a therapeutic environment did not seem to influence the nature of the psychedelic experience in any particular way.  This somewhat surprising finding might be interpreted as suggesting that it is not necessarily essential that the environment be carefully designed with therapeutic ends in mind, which would put fewer constraints on the requirements for designing the environment for psychedelic experiences.  However, what "being in a therapeutic setting" means to an individual is subjective and variable, and we did not pre-define what we meant by it."  Intriguing.  It's probably going to be a very long time before anyone gets funding for research that contrasts different therapeutic settings, but I personally would be interested in taking a moderately high dose trip in nature and a similar dose trip with blinds/headphones/music to explore more fully the similarities & differences. 

Overall though, the take-home messages for me are the potential value of moderate dose trips both for learning/benefits in their own right ... and also as helpful stepping stones to high-dose experiences.  And for the briefer & final fourth post in this sequence, see "Psychedelics: again the pilgrimage - current experience, lessons".



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