--:-- [Sound of alarm clock]
--:-- Sean Ramos: Good morning. It's about 7 a.m. And I'm about to measure out my microdose for the day.
--:-- [Sound of a scale being measured]
--:-- Sean Ramos: I've got my little scale. It's kind of like an envelope scale. You can measure down to the tenth of a gram. Even lower than that, but I just need it down to the tenth of a gram.
--:-- Sean Ramos: I've got some mushroom powder. Basically, I took the mushrooms that I buy And put them in a coffee grinder Ground them down into a powder I tend to just pour it into water And then just kind of mix it up As you hear me doing
--:-- Sean Ramos: The promise of microdosing ahead on Today Explained.
--:-- [Sound of a commercial break]
--:-- Sean Ramos: All right, so I'm now going to head off to work.
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--:-- Sean Ramos: It's Today Explained. I'm Sean Ramos. At the top of the show, you heard from an everyday microdisser. And we're going to keep him anonymous because while microdosing is becoming popular in the United States, it is yet to become legal in most places.
--:-- Sean Ramos: On the show today, we wanted to understand the mainstreaming of microdosing. So we reached out to Dana Smith. She's a freelance science journalist who recently wrote about the phenomenon and whether or not it really works for The New York Times.
--:-- Dana Smith: Microdosing is instead of taking a large amount of a psychedelic where you're going to have the kind of classic hallucinogenic trip, it's taking a very, very small amount. So really just 5 to 10 percent of a normal dose. And people take it in the morning like a cup of coffee.
--:-- Dana Smith: You really don't feel high. People describe it as kind of like everything's a little bit sparkly, a little bit shiny. You know, one person described it as kind of like life in high definition.
--:-- Dana Smith: So the goal is not to feel like you're high. It's not to feel like you're tripping. It's really just to have a little bit of a boost throughout the day, potentially in kind of cognitive processes like attention, creativity, focus, things like that. And then also for just kind of well-being.
--:-- Dana Smith: And some people are also using it to treat mental health disorders.
--:-- Sean Ramos: What got you interested in microdosing?
--:-- Dana Smith: I got a Ph.D. studying drug addiction about eight years ago. And I was doing my Ph.D. in England. And Imperial College London is one of the kind of main research hubs for psychedelic research.
--:-- Dana Smith: They were the first to put people in an fMRI scanner while they were on LSD or psilocybin and actually see what was happening in the brain. So all that research was happening while I was getting my PhD up the road in Cambridge, also studying drugs, but focusing on cocaine and heroin as kind of the more classic kind of problem drugs, quote unquote.
--:-- Dana Smith: So yeah, so I got interested in kind of the potential of psychedelic therapy from kind of a research standpoint. And then when I made the transition to science journalism, kind of kept my eye on it as just getting a bigger and bigger trend and with more and more solid research behind it.
--:-- Sean Ramos: Micronessing has been a trend for about the last 10 years or so. It's really come onto the radar of popular culture with a lot of people in Silicon Valley doing it.
--:-- Dana Smith: But you take Aviato. That's not a name that I found. It's a name that found me on a vision quest. largely for people wanting boosts in creativity or energy or kind of the main claims around it.
--:-- Dana Smith: I'm not going to eat a bunch of drugs and sit out in the desert and hope the name randomly pops in my head. Well, then I question your leadership.
--:-- Dana Smith: The history kind of goes back even further because it's kind of the resurgence or the renaissance of psychedelics.
--:-- Dana Smith: The goal of this trip is ecstasy. So psychedelics and psychedelic therapy are having a huge moment right now because they're showing kind of legitimate possibility as therapies for depression and PTSD and some other mental health disorders.
--:-- Dana Smith: Despite its bad reputation, we need to ask the question, what does this mushroom know that we don't? What does it do that we can't?
--:-- Dana Smith: It seems to kind of fall into three camps. One is for kind of as almost like a performance enhancer. So this was the initial claims that people saw out of Silicon Valley where you know everyone talking about a little bit of increased attention better focus
--:-- Dana Smith: Creativity is another big one that people say is that it you know helps them see connections that they might not otherwise have seen
--:-- Dana Smith: Another main reason is for just kind of improved well just feeling better People are using it to self-medicate if they have depression or anxiety, and they say that it helps with their mood and helps with their symptoms.
--:-- Dana Smith: And then third camp is just kind of recreational. You know, it's still a recreational drug. People do it because it feels good. So some people are using it in the evening to unwind instead of, you know, having a beer or a glass of wine, say.
--:-- Sean Ramos: What drugs are people microdosing?
--:-- Dana Smith: The main ones are LSD and psilocybin, which is the key hallucinogenic component of magic mushrooms. For LSD, it's like 10 to 20 micrograms. And then for mushrooms or for psilocybin, it's about like one to three milligrams of psilocybin.
--:-- Dana Smith: Mushrooms, it's harder to get a precise amount because you don't actually know how much psilocybin is in a mushroom and you don't know how concentrated it is and kind of like where in the mushroom it is.
--:-- Sean Ramos: How much do you feel it? Comparing this to like an anti-anxiety medication, what's the experience?
--:-- Dana Smith: It varies a little bit. In some of the literature, it says that you shouldn't feel it at all, that it should be really sub-threshold. So you're taking so small of a dose that you might not be aware that it's working, but you just trust that something is happening.
--:-- Sean Ramos: On the other side, some people are taking it, so they do want to feel something.
--:-- Dana Smith: I oftentimes have a kind of general anxiety in the morning that started to go away as I was driving to work. That anxiety was replaced with kind of general sense of euphoria and peace and calm and and in the moment-ness or present-ness all the all the kind of uh cliche things that people say.
--:-- Dana Smith: One person I talked to said that on a scale of one to ten he aims for about a two or a three so he's aware that he's taking it things feel a little bit different a little bit you know kind of shinier happier uh but it's definitely you know far from a full full psychedelic high
--:-- Sean Ramos: You wrote about this in the New York Times, and you talked to a couple people who microdose recreationally. What do they say keeps them coming back?
--:-- Dana Smith: They say that it helps them. You know, most of the people I talked to were using it because they had symptoms of depression or anxiety, and they really didn't want to be on a standard SSRI or antidepressant drug.
--:-- Dana Smith: And they said that it really helped them and improved their mood. They just felt a little bit happier. They felt a little bit more kind of in control of their feelings and just really had kind of an emotional boost throughout the day.
--:-- Sean Ramos: And so they're taking it, you know, maybe a couple times a week. So it's not every day. It's not like a medication that you take every morning, but you would take it, you know, maybe one to three times a week.
--:-- Sean Ramos: I just finished teaching my first two courses of the day and still feeling very good. I actually think that when I microdose, it actually helps me to be a better teacher, actually, because I can kind of be more, I know this is cliche to say, but I'm a little bit more in the moment and not really thinking about all the other things I need to do.
--:-- Sean Ramos: I can just kind of focus on the moment about what the students need, what the discussion needs at that point. And I think I can foster just a better teaching environment.
--:-- Sean Ramos: I have a couple more classes to teach later today. I'll send another update after I teach my next two classes this afternoon.
--:-- Sean Ramos: The science of microdosing is up next on Today Explained.
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--:-- Sean Ramos: Today Explained, we're back, and it's time to dig into the science of microdosing with science journalist Dana Smith.
--:-- Dana Smith: Yeah, the science is really interesting with microdosing. So a lot of the research that's happening is by those scientists who were studying the large doses to begin with.
--:-- Dana Smith: And it's interesting because it's a case of the science really following the trend. So researchers were studying the large doses and found a lot of efficacy for people with depression, PTSD, and other mental health disorders.
--:-- Dana Smith: It's pretty clear that things like psilocybin and potentially LSD and MDMA really can help people with mental health disorders. And so then they saw the trend just like the rest of us did, and so they started studying microdosing as well.
--:-- Dana Smith: And it's a little bit trickier there. So a lot of the early studies are just plain surveys. So you just ask people who microdose kind of why they do it and what benefits they feel.
--:-- Dana Smith: And then people report a lot of things they mentioned earlier, you know, better well-being, better attention, better cognition. But that is really tricky because it's all self-reports. There's no placebo. You're not actually testing anything.
--:-- Sean Ramos: When you get people into a lab, again, without a placebo, they report the same thing. So even on cognitive tests, they'll show better performance. They'll show better scores on a depression score, for instance.
--:-- Dana Smith: But finally, there have just in the last year started to be placebo-controlled trials. And all of a sudden, those effects went away. So if you give people either a microdose or a placebo and you don't tell them which one they get, everyone in the study improves.
--:-- Dana Smith: But that means that there's a placebo effect happening. So if you improve when you have a placebo and there's no greater improvement compared to the microdose, then it's really hard to say that there's actually an effect of the drug that's happening.
--:-- Sean Ramos: It's just your expectation. And in one of the studies that came out of Imperial, they actually asked people what they thought they had taken at the end of the study.
--:-- Dana Smith: And people were more likely to see an improvement in their mood and well-being if they thought they had taken a microdose regardless of what they got. And they were less likely to show an improvement if they thought they had taken a placebo, regardless of what they got.
--:-- Sean Ramos: So the expectation effect was really a bigger driver than the drug itself in terms of how people improved over the course of the study.
--:-- Dana Smith: Okay, so in what we know so far, there's a real expectation effect, a placebo effect here for people when we're talking about a microdose.
--:-- Sean Ramos: Is there science out there for when you bump it up to a full dose?
--:-- Dana Smith: Yes. Yeah, there's a lot of research on that. Those are very controlled experiments. It's really hard to do a placebo for a full dose of a hallucinogen. You pretty quickly know what you've gotten or not.
--:-- Sean Ramos: But there is a lot of rigorous research around psychedelic therapy, where people have several intensive therapy sessions, then they have a therapy session while they're receiving a very large dose of LSD or psilocybin, and then they have follow-up appointments afterwards.
--:-- Dana Smith: And there have been a couple of clinical trials that have shown that people actually have as much of a benefit as they do with kind of standard SSRIs or, you know, kind of typical antidepressant drugs.
--:-- Sean Ramos: So there are numerous studies that have come out now that really do show a pretty clear benefit of psychedelic therapy with those large doses.
--:-- Sean Ramos: It's just that the microdoses, it's not quite as clear cut. And should we assume that until the science is a little more clear here, there isn't going to be sort of this mainstreaming of microdosing across the country?
--:-- Dana Smith: Well, for one thing, I mean, these drugs are illegal. So, you know, you could say that in some ways it already is mainstream because we're even talking about it.
--:-- Sean Ramos: You know, like this is a pretty big trend that's happening. The question is, will microdoses be FDA approved to treat anxiety or depression?
--:-- Dana Smith: Those larger clinical trials for the larger doses, that's kind of already in the works for FDA approval of psilocybin. You know, it's not happening yet, but that is what people are kind of anticipating and hoping for by the end of the decade.
--:-- Sean Ramos: The question then becomes, can you market or prescribe a microdose of psilocybin? And that's where you really want to see that it works, because you can't prescribe something that's no better than a placebo.
--:-- Sean Ramos: There are really big ethical implications there. So that's why it's really important to do this research now to see if the benefit is really real or not, or if it's just an expectation effect.
--:-- Dana Smith: One thing I will say is that it's not quite as simple as just placebo-controlled trials didn't see anything, therefore it doesn't work.
--:-- Sean Ramos: Because there are a couple studies that are looking at what microdoses of psychedelics do in the brain. And there it's pretty clear that something is happening.
--:-- Dana Smith: So with kind of larger microdoses, about 10% of a full dose instead of 5%, you can see that there are changes happening in the brain in terms of people's activity, in terms of the serotonin receptors.
--:-- Sean Ramos: That is the primary target that the drugs are working on in the brain, and you can see that something's happening there that's kind of similar but just smaller than a full dose of a psychedelic
--:-- Sean Ramos: So it's not that the microdoses are doing nothing. They're doing something in the brain. It just a question of whether that corresponds to them doing something for people in terms of behavior and mental health and things like that.
--:-- Sean Ramos: So it's a really interesting conundrum right now of whether the effect is real or not.
--:-- Dana Smith: You mentioned these drugs are still legal, but they're not illegal everywhere. I know Oregon has at least legalized mushrooms.
--:-- Sean Ramos: What are the ways these drugs are being used therapeutically despite being illegal in most of the country?
--:-- Dana Smith: Look, the state is very libertarian on drug laws, and I do think it's the beginning of something.
--:-- Sean Ramos: Oregon is expected to have a ballot initiative in 2020 that would actually legalize psilocybin therapy, so guided psilocybin experiences and reduce penalties for recreational use.
--:-- Dana Smith: And there's a group in California who would like to get it on the ballot here.
--:-- Sean Ramos: You're right. Oregon was the first state to legalize psilocybin, and a big part of that was the push around their potential as a therapeutic, as an antidepressant.
--:-- Sean Ramos: In a separate 2020 ballot initiative, Oregon voters also opted to legalize psilocybin, the psychoactive compound in magic mushrooms, for use in therapeutic settings. Regulators have until January 2023 to begin issuing licenses.
--:-- Dana Smith: So there definitely are clinicians either through clinical trials, you know, through actually university-led clinical trials where people can enroll to take primarily MDMA for PTSD or psilocybin for depression.
--:-- Sean Ramos: But it's definitely one way that people can seek out and try and get therapy that way and try and use them that way.
--:-- Sean Ramos: There are also, you know, underground networks of therapists who are, you know, prescribing these drugs. So the movement is definitely happening.
--:-- Sean Ramos: They're just not legal on a federal level yet, and they're not FDA approved to be used therapeutically yet.
--:-- Sean Ramos: DC's trying, I know. Maybe if they can pull it off, it'll convince all the federal government to hang with psychedelics.
--:-- Sean Ramos: And then in the psychedelic world, Alexandria Ocasio-Cortez, I hope I said that correctly, I guess people usually just say AOC, has just introduced an amendment to a larger spending bill that would take away this language that has been there since the 90s that basically says you can't use federal funds for any activity that promotes the legalization of any drug or other substance in Schedule 1.
--:-- Sean Ramos: I mean, they just shot down, I think, another effort to legalize marijuana there. So I think that might be a stretch.
--:-- Sean Ramos: She's focusing on psychedelics here and she wants she wants research to really just open up. So that might be the last place to turn over.
--:-- Sean Ramos: I don't know. Like marijuana, though, this could be a pretty big market, right? Which is to say something to tax.
--:-- Dana Smith: Oh, absolutely. I mean, people right now are estimating it's about a two billion market right now, and it could be 10 billion in the next five years.
--:-- Sean Ramos: I mean, this is massive, massive money. They do have a really strong potential of helping people, but there are a lot of questions that still need to be worked out.
--:-- Sean Ramos: And that's why figuring out whether the benefit of microdosing is real or not is a big deal, because there's a lot of money behind this.
--:-- Sean Ramos: People could really start to market this pretty quickly. And so you need to actually show that a drug works and that a specific dose of it works to help people beyond a placebo before companies can start marketing it, promoting it, and prescribing it.
--:-- Sean Ramos: I just finished teaching my last class, and I'm now headed home. I no longer am really feeling any of the direct effects of the microdose, but I still feel pretty positive, happy, still calm, euphoric. Euphoric, all the kind of emotions I mentioned before.
--:-- Sean Ramos: Had a good day of classes. Another positive microdosing day. And I'm going to do it again later this week.
--:-- Sean Ramos: Dana Smith is a freelance science reporter. You can find her and her work at DanaGSmith.com.
--:-- Sean Ramos: Our program today was produced by Miles Bryan, edited by Matthew Collette and me, fact-checked by Tori Dominguez, and engineered by Paul Mounsey.
--:-- Sean Ramos: The rest of the Today Explained team includes Victoria Chamberlain, Will Reed, Hadi Mawagdi, and Halima Shah. Our supervising producer is Amina Al-Sadi.
--:-- Sean Ramos: Our other host is Noel King. Our VP of audio is Liz Kelly Nelson. And we use music from Breakmaster Cylinder and Noam Hassenfeld.
--:-- Sean Ramos: I'm Sean Ramos from Today Explained as part of the Vox Media Podcast Network.
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