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Does A Medical Setting Affect Psychedelic Treatment?
As psychedelics gain acceptance quickly, laws in different states are changing to accommodate their possession and use. So far though, the only states to legalize have done so with an allowance for use in a medical/supervised setting. How useful is this medical setting to psychedelic treatment, and can it get in the way?
What is a medical setting?
When it comes to using psychedelics, there are no specific rules for what will lead to a good trip, and what will bring on a bad one. Though this can do with individual reaction to the drug, it also has to do with outside factors that can impact our individual reaction. We’re often told ‘set and setting’ play a big role in a trip going smoothly, and this can encompass different factors.
‘Set and setting’ refers to the place you’re having the experience, and the environment around. You could be in the woods, or on the beach, or at a dance club, or alone with your partner. The environment around might include the other people you’re interacting with, how crowded it is, if other people are also having the same experience, if you’re doing something organized or on your own, lighting and sound, and even the weather around you.
A medical setting is another type of setting, but until recently, it wasn’t associated with taking a psychedelic drug, or hallucinogen of any kind. However, as research amps up, and legalizations roll in, that idea of a medical, or supervised setting, becomes that much more important, as it’s the only setting legally available to use the compounds in question.
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A medical setting is not one specific thing. Also referred to as a ‘healthcare setting,’ and expanding into ‘supervised setting’, this term encompasses: “acute care hospitals, urgent care centers, rehabilitation centers, nursing homes and other long-term care facilities, specialized outpatient services (e.g., hemodialysis, dentistry, podiatry, chemotherapy, endoscopy, and pain management clinics), and outpatient surgery centers. In addition, some healthcare services are provided in private offices or homes.”
The last one is important, because it reminds us that our own home can be a medical setting under the right conditions; which is the medical setting most people should automatically be the most comfortable with. And when it comes to ketamine, it is offered by many clinics as an at-home treatment which both cuts costs, as well as gets away from the medical setting that not everyone is comfortable with.
In reality, both current psychedelics legalizations aren’t for medical use, and the legislation uses the term ‘service center’ instead. Considering it’s a formal setting, with a person watching over, it represents essentially the same thing. Perhaps its not so much about a ‘medical setting’ as a ‘controlled setting’, but the same idea of how it can affect a trip, applies. It seems Colorado might understand this a bit better, allowing for treatment outside of authorized service centers, but what this actually entails is not entirely clear.
Does being in a medical setting affect a psychedelic trip?
There isn’t one specific answer to this, and not everyone has the same requirements. For some people, the experience won’t differ greatly depending on set and setting, and for some people it will make all the difference. For everyone in between, well its hard to say. Plenty of trials for psychedelic medications have gone on at this point, and for those, we only get the results of the medical setting. Is it possible that results might have differed if the trials were run in a more familiar, or chosen, surrounding?
I came across an interesting statement when researching the Salvia divinorum plant, and the different ways that users describe the experience. Found in a Wired magazine article, and written by Daniel Oberhaus in 2020, the article details the writer’s own experience as a part of a research study into how the compound salvinorin A affects the brain during use. The trial took place at Johns Hopkins University in Baltimore, a research hospital, and involved being hooked up to an fMRI machine.
Per Oberhaus, “I had just inhaled an unspecified dose of the pure crystalline substance from a hose attached to what one of the researchers characterized as an ‘FDA-approved crack pipe.’” He continued, “My psychedelic experience in the fMRI machine was markedly less otherworldly. On the second round, I saw some colorful pinwheels and felt as though my body had merged with the machine. But I didn’t enter another dimension or dissolve into pure being”.
What are his thoughts as to why his experience in the trial differed from his experience using salvia illicitly, outside of a hospital setting? “This may have been because I received a lower dose. Or it may have been because it’s harder to give in to the experience when you’re inside a giant machine making a racket while it soaks your head in a powerful magnetic field.”
Being in an fMRI machine is much more extreme than simply sitting in a doctor’s office. But consider that most people who do ketamine illicitly, do it by snorting the drug; and one of the more common medical techniques is hooking someone up to an IV. The idea still resonates. Neither being stuck in a tube, or hooked up to an IV in a doctor’s office will likely be the chosen set and setting for many people. And no matter how comfortable you try to make a doctor’s office, it might still have the ability to change the experience.
Tack onto that the cost of the treatments, and this could make patients apprehensive about the outcome of their treatment, which could also affect experience. When getting a service is so expensive, you can’t mess around with it, and for people scraping to make this happen, there’s increased pressure to ‘get it right’. A less controlled environment could pose cost reduction ability, and make users more comfortable about what they’re spending.
My own experience in a medical setting for psychedelic treatment
On this particular topic, I can throw in my own opinion, as I did receive ketamine treatments in a doctor’s office, as well as having previously used the drug on my own illicitly. I’ll take a second to remind that ketamine is a dissociative hallucinogen, not a psychedelic. It is used for therapy in a similar way to psychedelics, and is currently the only legal way to get such treatment, as neither state thus far that legalized any form of a hallucinogen, started services yet.
I ended up in the office of a psychiatrist in Guadalajara, Mexico, which is one of the only places in Mexico that provides ketamine treatments. Most of the doctor’s business is for pain. I went because of sleep issues, which falls under psychiatric. There are very few people who do this there. As such, the procedure isn’t established like it is in American facilities; and from the beginning I was left to feel like not everything was being covered. I made the most of the experience, but looking back I can see how badly it went.
I was hooked up to an IV, and I sat in a comfortable enough place, but was it really? It was a kind of cold office, with no blanket offered, dim lighting, and no window. I was on a couch facing a desk, with very little around me. Sure, it was okay, but I wasn’t super comfortable. Nor did I like having an IV hooked up to me, or seeing the blood squirt out when they had a hard time getting my vein (both times!) I left with blood stains on my pants the second time. I didn’t enjoy the actual drug experience at all; it left me feeling queasy, shaky, and incredibly anxious. And while this could represent my own personal reaction to ketamine, there’s a problem here…
I did ketamine plenty illicitly. I used to do lines with an ex-boyfriend frequently enough to have a great idea how the drug affects me. I liked it back then. Not my favorite of all drug experiences, but very interesting. I used to feel like I was floating, disconnected, like my brain was pulling in different directions. But not bad. And at no point with the anxiety and discomfort I suffered in the doctor’s office. An anxiety so bad the doctor did not push me for another appointment (or even contact me again for follow-up…I would never got back to that provider).
The experiences were so wildly different, that it makes me wonder how much of my negative experience in the medical setting with the psychedelic-like drug, was related to being in that setting, rather than a place I am more comfortable with. My experience gives a huge amount of credence to the idea of at-home ketamine therapy, and the ability to do the treatment in the comfort and privacy of your chosen location. Perhaps under other circumstances, I would not have been a non-responder.
Conclusion
It’s not for me to say what works for other people. But when it comes to expensive treatments, or ‘services’, how many people want to pay out for something that isn’t what they’re looking for? And how much do we damage our own understanding of the usefulness of something, when the controls for use are so extreme? It’s not like these drugs are used illicitly in a medical setting; and people turn out just fine when using a psychedelic on their own, or in a less restrictive way. Maybe that’s something that should be remembered.
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Summer is the time to head outdoors and have fun. Whether swimming, pickle ball, sports, gardening or maintaining your walk/run schedule…the weather is bright, the days are long and you aren’t bundled up in heavy coat. But sometimes the heat can make it daunting…and with more heat waves, you have to take some precautions. Here are teh best tips for outdoor exercise in the heat.
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Common sense says be careful and avoid the hottest part of the day. Usually around 4 pm is when the heat peaks, so between 1-5 is the worst time. You shouldn’t exercise with the same intensity and take frequent breaks, which is perfect if you are playing a sport or gardening. Water is essential, so drink plenty of fluids. Dehydration is a key factor in heat illness. Fluids helps your body sweat and cool down by staying well-hydrated with water. In fact, sweating can release endorphins in the brain which make people feel good.
Manage your day, do activities in the early morning or late afternoon/evening. According a study, during hot days, the best option is to run in the early morning. This is especially true in urban locations which have concrete buildings soak up the sun throughout the day and may make late in the day runs hotter than expected.
In order to acclimatize to the weather successfully, the process must be gradual. Head out for your run earlier than usual, with your water bottle, and complete your a shorter and gentler version of your workout. Check your heart rate and your level of heat and continue to do this until you feel like you’re feeling back to normal.
In order to acclimatize to the weather successfully, the workout process should be gradual. Start your activities earlier than usual, with your water bottle, and complete your a shorter and gentler version of your sports/workout/ tournament. Consider a “warm up period” where you aren’t keeping score.
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An icy drink beforehand, like a slushie or a smoothie, might make your outdoor exercise more pleasant. According to researchers, you should aim to drink 16 ounces of cold fluid 20 minutes before you go out for your run or an activities sport. Avoid alcohol until you are ready to cool down.
While it doesn’t keep you from overheating, wearing sunscreen can help you prevent feeling the heat when you are done. You also want to dress in layers and nothing to tight to give your body a chance to breath.
If you are starting to feel nausea, dizziness or cramps, you could be overheating. Check your heart rate and your level of heat and continue until you feel like you’re feeling back to normal. If you have symptoms, stop the workout and seek shade and some tap water. If possible, work out with a partner.
Soldiers have returned with PTSD and other serious ailments. The AMA and science said medical marijuana can help – but time may be running out.
In an acknowledgement from the medical community, the American Medical Association supports the rescheduling of cannabis to a Schedule III because it has proven medical benefits. A portion of the medical benefits help soldiers returning from service with both physical and mental scars. Unfortunately, time may be running out to help.
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Both Health and Human Services (HHS) and the Food and Drug Administration (FDA) did the research and agreed to the rescheduling. They are important organizations being clear it will help are military veterans. PTSD is real to the point of over 30,000 active duty personnel and veterans who have served in the military since 9/11 have committed suicide. That is the roughly the same amount of wiping out all of Fairbanks, Alaska. More veterans committed suicide, almost 100,000, after Vietnam, than in the war (roughly 58,000). Opioid addiction, which medical marijuana can combat, is raging among veterans with PTSD and chronic pain. But leaders like Mike Johnson (R-LA) have worked hard to block help.
While veteran facilities are federal property and therefore do not allow marijuana on premise, even in legal states, they have become supportive of medical marijuana. There have been significant treatment changes including:
- Veterans will not be denied VA benefits because of marijuana use.
- Veterans are encouraged to discuss marijuana use with their VA providers.
- VA health care providers will record marijuana use in the Veteran’s VA medical record in order to have the information available in treatment planning. As with all clinical information, this is part of the confidential medical record and protected under patient privacy and confidentiality laws and regulations.
The clear case for medical marijuana has been proven by science, but with veterans, it is an important step to helping them in a return to civilian life. Representative Johnson has indicted with more control, marijuana could return to the outlaw status and the new GOP VP has stated he is not a fan of cannabis. The DEA must follow the recommendations and make a move quickly for this to happen and to help soldiers.
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Bipartisan congressional lawmakers are seeking to remove a controversial section of a Johnson approved spending bill which would block the Justice Department from rescheduling marijuana.
Like wine with dinner or a beer in the backyard, marijuana is becoming very common.
With almost 60% of adults drinking alcohol, it has been a staple of family events. Relatives including grandparents, cousins, adult grandkids and more have sat at a table and toasted with beer, wine or booze….and now cannabis may be in the mix. As legalization has grown, cannabis is being embraced by more people and is popping at all sorts of family gatherings. And, it seems, marijuana can bond grandparents to family.
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In a third party survey sponsored by Sanctuary Wellness, some interesting data has given hope about intergenerational bonding. There are all sorts of concerns about boomers and Gen Z not relating, but marijuana like music is showing a positive trend. Nearly one in three have tried cannabis, far less than alcohol, but still a significant number. In the survey, Millennials use the most followed closely by Gen X then Gen Z and finally Baby Boomers. And while a whopping 86% of Gen Z and Millennials support the legaization of weed…a full 71% of Baby Boomers do also.
Gen Z is slowly turning away from alcohol and feel they have way more stress than their grandparents. Due to the embrace from the medical community, Boomers are starting to see cannabis as aid in dealing with chronic pain and sleep issues. The plant can be very effective without as many harsh side effects.
Once interesting factor in the survey is the use of gummies. Microdosing has become huge and Gen Z sees it as a way to manage anxiety. With gummies, you see 76% use of Baby Boomers and 72% with Gen Z….far higher than Millennials and Gen X.
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For many Europeans, alcohol is a part of their culture and viewed as a social activity. In Italy for example, children are eased into drinking with a bit of wine at dinner. They’re taught from an early age that alcohol is something to drink casually and in moderation. Alcohol abuse is less coming in Italy and France due to the generation training. Maybe marijuana, which has clear medical benefits, could be another thing which generations share to make for a better life.
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