Postcard from San Francisco
Is the psychedelic industry ready for lift-off?
After I was at Esalen, I spent a few days in San Francisco. I live in a little beach town in Costa Rica, which is lovely, but wow it’s a pleasure to be back in a big city every now and then, especially one that is a little colder than the tropics, pedestrian-friendly, has great Asian food and is always buzzing with new ideas. I walked around like a country bumpkin, staring with a goofy grin on my face.
I also had some great meetings - I put out a call to my Substack readers and several got in touch and met up with me. Some even gave me gifts - thank you!
A highlight of the trip was meeting Marsha Rosenbaum. She’s a legend in drug reform and harm reduction. Marsha was a sociologist at UCSF, and got an NIDA grant to do the first sociological study of MDMA in 1985. She and colleagues interviewed some of the first users of the drug and published their stories in Voices of Ecstasy. Just like today, people used and experienced the drug in all kinds of different ways - to dance, to uncover trauma, to have wild sex, and so on. She then worked at the Drug Policy Alliance with her then-husband, Ethan Nadelmann, working with people like George Soros and Graham Boyd (now head of the Psychedelic Science Funders Collaborative) to get marijuana legalized in many US states.
It started with approval for medical use then quickly spread to approval for recreational use. Now, whenever you visit a US city, the sickly smell of weed hits you in the streets. One psychedelic researcher I met in San Francisco predicted psychedelics would follow a similar route - first medical, then recreational. There are already mushroom dispensaries in San Francisco, openly selling many varieties of shroom - they call themselves churches. You join the church by filling in a form on your phone, then in you go and buy your shrooms.
Meanwhile, evidence increasingly suggests marijuana doesn’t have the medical benefits that were touted in the campaigns of the 1990s and 2000s. I wonder if psychedelics will also turn out to have fewer medical benefits than was predicted five or ten years ago. Another researcher I met from SF is publishing a commentary that will point out the effect sizes of psychedelic treatments (which in some cases are quite small) might be smaller still, because people can tell when they receive the placebo so, ironically, the ‘placebo response’ only works in the treatment arm. That, he suggests, is exaggerating the effect of the psychedelic, because trials measure the gap between the treatment arm and the control arm. Privately, he wonders if psychedelic medical treatments will turn out to be a damp squib. Maybe…but by that point perhaps they will already have become normalized and available in thousands of dispensaries.
Anyway, the reason I wanted to meet with Marsha Rosenbaum was to learn about a drug harm reduction initiative that she launched in the 1990s called Safety First. It was / is a school and college program set up after the notoriously-ineffective DARE, which tried to educate young people about safe drug use rather than telling them ‘just say no’. Hundreds of thousands of young people have taken the course or read the booklet. I came away from our conversation thinking ‘wow, that’s proper impact, that’s a serious drug education project’.
It made me ponder how to increase the public’s awareness of our research on post-psychedelic difficulties and how to recover from them. I want everyone who experiences serious post-psychedelic problems to find the help they need - how can the Challenging Psychedelic Experiences Project increase its bat signal? We have been so focused on academic research this last three years but I wonder if it’s time to shift to a focus on communication. It’s horrible to think of people suffering alone when there is help available.
As it happens, while I was in San Francisco, I was emailed by a Ukrainian lady called Helena, who experienced severe difficulties after an ayahuasca experience. She feels, quite rightly, that there is too little information about the risks of extended post-psychedelic difficulties on the internet. Helena happens to be a marketing expert, and she’s been kindly helping me to optimise our website and YouTube channel so we reach as many suffering people as possible. She found us through ChatGPT, which is encouraging.
Preparing for lift-off
Next up, I met a reader, now a friend, who works in the psychedelic industry. I’m not going to say which company, but they - like many companies - are preparing for the launch of FDA-approved psychedelic treatments either later this year or early next year. Is the industry ready to offer these treatments? Is the training and infrastructure in place? My friend thinks possibly not - he suggests some pharma executives seem intent on treating psychedelics as just another pharma intervention, like Spravato or Ritalin or TMS. It feels to me like the early years of the psychedelic renaissance were dominated by individuals and organisations who did too many psychedelics, while the later years are dominated by individuals and companies who don’t do psychedelics at all!
My friend pointed out that, as we approach market launch, there’s still a lot to do around education and training both for providers and for the general public. For example, should there be education for the partners and families of people receiving psychedelic treatments, so they know to expect sudden personality shifts? The fact is, the person who comes back from the clinic in the afternoon could be very different to the person who went to it in the morning. They might have different emotions, different memories, different worldviews, different metaphysics, different feelings towards their career, or towards you, they might have a different sexuality entirely.
‘The man who comes back through the Door in the Wall will never be quite the same as the man who went out.’ - Aldous Huxley
The friend added that psychedelics are still very popular among the tech crowd in San Francisco, particularly ayahuasca, and at-home ketamine lozenges from Joyous, which many people are taking recreationally, apparently.
On cults, entities and AI spirituality
I also had the pleasure of meeting up with Don Lattin, a former San Francisco Chronicle reporter on religion, and the author of best-sellers including The Harvard Psychedelic Club and Distilled Spirits. He has a great Substack called Messiahs I Have Known. Don has been reporting on Californian religion and spirituality since the late 1970s and has seen it all. It was interesting hearing his take on various legendary figures of the scene, like Ram Dass (‘nice guy, sex addict’).
