Microdosing could hurt you long term

What is the price you are willing to pay?

Psychoactive substances become business mainstream. Breakthrough therapy designations by the FDA and early results of phase II trials indicate that we are entering a new phase in psychiatric disorders treatment. Therefore, efficient protocols (way more complicated than conventional pharmacological treatment) and production of psychoactive substances are attracting Silicon Valley investors.

Somewhere along with this rise of interest in psychedelics usage, microdosing also became a topic of business meetings. “Rolling Stone” magazine in 2015 published a story entitled “How LSD Microdosing Became the Hot New Business Trip” about young professionals using small doses of psychedelics to enhance productivity and creativity. In the following months and years, The New York Times.The Economist.The Washington Post also covered the topic. In online forums, people were reporting improvement in conditions like depression or migraine headaches. A study by Fadiman and Korb showed an increase in productivity, concentration empathy, and problem-solving skills. Additionally, many pain-related symptoms apparently improved without a good reason to do so.

Given results of some early research, the idea that a small amount (hence microdosing) of psychoactive substance, not enough for a trip, would give you an edge at work (creativity, relaxation, etc.) sounded plausible.

For some people, in their tired lives of struggling business selves, it seemed more than attractive. If not the obvious issue of the legality of this method, they would already be trying.

Should you try it?

Following Taleb’s precautionary principle I prefer to err on the safe side. Therefore, each time new hype is storming medical world I’m looking for downsides.

Fadiman and Korb study (referred to that above) reported that up to 20% of study participants reported negative or neutral effects of microdosing (interestingly, they don’t break this down into categories). We don’t know what “negative” means, but other studies give as a clue. In the more systematic analysis, Polito and Stevenson, notice a systematic (albeit small) increase in neuroticism. Increased anxiety is also reported (see side effects summarized by Hutten and colleagues).

These results don’t stand in opposition to previous studies reporting positive effects of psychoactive substances in neurotic disorders. The critical difference is long term usage.

Our brains do not handle overstimulation for extended periods very well, whether sensory stimulation we face every day or chemical stimulation like with psychoactive substances. Studies on long term use effects of alcohol or marijuana are also pointing to neuroticism. Why should microdosing be different?

Erica Avey, writer who microdosed for two years described recently why she did quit microdosing (emphasis mine):

In the summer of 2019, after two years of dosing, my final few microdoses shot me into extreme anxiety and unease. I haven’t microdosed since.

It’s not a systematic study, but a single isolated case. Nevertheless, it shows, like some systematic studies mentioned above, that microdosing has its costs.

If you do consider microdosing, please do yourself a favor. Don’t. You cannot beat biology. I’m not advocating any other modality of taking psychoactive substances, but in this particular case evidence points to a risk too high for my taste.

Monkey mind (overwhelmingly racing thoughts) can also be triggered, if you wish, by an excessive amount of coffee.