B.C. doctor told to stop using hallucinogenic tea to help addicts

[FluffyMcDeath]

Thought that was a pretty cool headline and when I followed the link I found a picture of someone I knew. In fact (and I don't think this violates privileged since it's my history) I was a client for a short period way back when.
I did not, however, get anything as fancy as this special tea from him. Mind you, I also wasn't seeing him for addiction - but had I known it might have been worth faking.
And, by the way, I'd vouch for him. He's a decent caring professional person.

 

[Robert]

Hmmm... not sure about this one, mostly because the article is a little thin on facts.
i.e. no statistics on the effectiness or otherwise of the treatment, side effects, etc.

Personally, I think any person should be allowed to imbibe whatever they want and the idea of "controlled" drugs just rubs me up the wrong way. Having said that, a doctor prescribing something is different - the patient has to trust the Dr.

 

[cecilia]

“People have given up sex addictions. People have given up cocaine addictions. People have given up their heroin and crystal meth use. People are relocating from the Downtown Eastside. People have reconciled with their families and that kind of thing,” he says.

that sounds like it's worth investigating

 

[FluffyMcDeath]

Hmmm... not sure about this one, mostly because the article is a little thin on facts.
i.e. no statistics on the effectiness or otherwise of the treatment, side effects, etc.

Nor will you get much data without allowing the testing.

However, these chemicals have been used for long time in Shamanism and the rituals are as important as the chemicals. Many maladies of mood and addiction are amenable to psychedelic experiences and ritual. If you can change the mindset with which you approach your problems you can start to see how they may be overcome - and the ritual itself is important - but the chemistry can disarm your natural rational/western scepticism so that your mind is more amenable to the emotional intent.

Depression, for example, can be treated with almost any pill. There is a large placebo effect simply from the idea of receiving treatment - other mental maladies are also influenced by placebo treatments - I say placebo rather than fake because the effect is very real and clinically useful.

 

[faethor]

Nor will you get much data without allowing the testing.

The test should be well designed with appropriate control groups. If this is an interest to him he should be formally purposing rigorous testing to ascertain the validity of the treatment.

However, these chemicals have been used for long time in Shamanism and the rituals are as important as the chemicals.

Which is interesting and holds no value to their operational effectiveness.

Depression, for example, can be treated with almost any pill. There is a large placebo effect simply from the idea of receiving treatment - other mental maladies are also influenced by placebo treatments - I say placebo rather than fake because the effect is very real and clinically useful.

It appears you're arguing doctors should use the placebo effect. If so they could use things such as sugar pills which have no known side-effects. Unlike psychelidic treatments with an unknown effect or side effect. Personally I aruge they should not use placebos it's akin to lying to the patient and does greater harm to trust than any positive impacts. Instead if you want lies go see a homeopath.

 

[FluffyMcDeath]

The test should be well designed with appropriate control groups. If this is an interest to him he should be formally purposing rigorous testing to ascertain the validity of the treatment.

Yes, but he is a psychiatrist and that is outside of the tradition. It's also outside of the drug companies tradition too. Testing helps exclude drugs that kill too many people too quickly, but since the placebo effect is so strong in certain psychiatric disorders it also means that dangerous substances that are roughly as effective as placebos get given to patients. Sugar pills would be better medicine but sugar pills have very small mark ups. Industry testing is notoriously slack since profit is such a necessary part of business - tests will lean heavily towards findings of effectiveness and safety. Things would be very different if there were independent testing but who would pay for that?

 

[FluffyMcDeath]

The test should be well designed with appropriate control groups. If this is an interest to him he should be formally purposing rigorous testing to ascertain the validity of the treatment.

Yes, but he is a psychiatrist and that is outside of the tradition. It's also outside of the drug companies tradition too. Testing helps exclude drugs that kill too many people too quickly, but since the placebo effect is so strong in certain psychiatric disorders it also means that dangerous substances that are roughly as effective as placebos get given to patients. Sugar pills would be better medicine but sugar pills have very small mark ups. Industry testing is notoriously slack since profit is such a necessary part of business - tests will lean heavily towards findings of effectiveness and safety. Things would be very different if there were independent testing but who would pay for that?

 

[faethor]

Yes, but he is a psychiatrist and that is outside of the tradition.

Psychiatrists are medical doctors who treat mental conditions. As such they should be pulling from science on their solutions. Certainly science has lots of work to do to learn more on how the brain works and how to fix it. However, things such as medicine should only be used if it's proven to give statistically better results than a placebo. It's not a license to do use scientifically unproven treatments in hopes that's the answer.

It's also outside of the drug companies tradition too...Industry testing is notoriously slack since profit is such a necessary part of business

I agree that big pharma is less likely to support testing of something that's inexpensive. However, not building a formal experiment and failing to apply is using this as an excuse to not do the science.

Sugar pills would be better medicine but sugar pills have very small mark ups.

Assuming the Dr. knows they're relying on the placebo effect and feel justified lying to their patient they should at least try to follow the Hippocratic Oath. As such using a placebo with known effects (none) and known side effects (nearly none) of sugar is vastly superior to a treament that has unknown effects and unknown side-effects.

Things would be very different if there were independent testing but who would pay for that?

Don't know if this is right in Canada but in the USA we have such testing and it's paid by taxpayers. For example the US Gov has tested, and has several european govs, to find no statistically significant effects. Another example, the US Gov has done double blind studies on accpuncture to find it has limited benefits, at best, for a small subset of conditions.

 

[Glaucus]

It's an interesting thing he's doing. However, here's the thing - even if he's getting good results, there's a good chance it only works on people who already believe it will work. Yes, the placebo effect. My point is, this treatment may not be a universal treatment, skeptics will likely not benefit from it at all. With that in mind we must also then consider the fact that if THIS doctor is allowed to use it, then so shall other doctors. That effectively opens up a can of worms since there are no official guidelines for the drugs use. Part of the testing that goes on for pharmaceutical drugs is to come up with usage guidelines. Without that, you can have dosages that are off the chart, the ritual component may vary greatly or be eliminated completely. And if this guy ever gets onto Oprah/DrOz/DrPhil then every quack Dr will want to cash in on it regardless of actual results.

 

[FluffyMcDeath]

Psychiatrists are medical doctors who treat mental conditions. As such they should be pulling from science on their solutions.

Should, but as I said, it's not in the tradition - psychiatry came from a very hand-wavy background. I know in the last few decades it's turned into a very prescribe happy field but chemical psychiatry is fairly new - and since we don't really understand all the things the brain can do for itself to change the way it responds it remains very difficult to figure out what part of drug changes are due to belief in treatment and what is due to the drugs. Drug companies like to interpret the results in favour of their patent medicines and many psychiatrists are happy to take the commissions from moving the drugs. I've met some who are really nothing but pushers.

Assuming the Dr. knows they're relying on the placebo effect and feel justified lying to their patient they should at least try to follow the Hippocratic Oath.

Coincidentally in the last couple of days I have finished reading the "Heal Thyself" article in the August 27th edition of New Scientist (I am well behind in my reading) and they talk about studies in which the placebo works even when you tell the patient that it is a placebo, provided you tell them why you expect it to work.
There is also a sidebar in the same issue about how use of psychedelics have been shown to elevate mood in terminal cancer patients and how the new perspective acquired has given people the ability to change their lives and their outlooks.
Here is a small new scientist video with an overview of the article.
http://bcove.me/gzpfqvvt

Don't know if this is right in Canada but in the USA we have such testing and it's paid by taxpayers.

Unfortunately, while it can be an improvement, pharma companies have become big enough to significantly influence the outcome of such testing. People who don't get the right results get fired from government almost as easily as they get fired from private companies and threats and bribes still work.

 

[faethor]

Should, but as I said, it's not in the tradition - psychiatry came from a very hand-wavy background.

I'd argue medicine itself was very hand-wavy. It's through application of scientific rigor that it's improved and standardized. Psychiatry needs to shed hand waviness and instead focus on what has the best evidence of working.

Drug companies like to interpret the results in favour of their patent medicines and many psychiatrists are happy to take the commissions from moving the drugs. I've met some who are really nothing but pushers.

I'd agree for profit medicine focuses less on the patient and more on the profit. However, this doesn't change that for a double blind study the 'it works' test group should only exist if a statistically larger number of 'healed' people exist than the control group. This isn't a few percent difference.

Coincidentally in the last couple of days I have finished reading the "Heal Thyself" article in the August 27th edition of New Scientist

Good article. Though so very positively written it seems to convey people can believe they'll grow a new arm and will. Turns out healthy life habits and a positive caring self is a postive but still not a guarantee.

I am well behind in my reading) and they talk about studies in which the placebo works even when you tell the patient that it is a placebo, provided you tell them why you expect it to work.

Interesting aside the Mayo Clinic did one of the best double blind studies on prayer. Turns out those being prayed to get better actually had slightly worse outcomes. http://www.mayoclinicproceedings.com/content/76/12/1192 -- Turns out at best prayer is a placebo.

There is also a sidebar in the same issue about how use of psychedelics have been shown to elevate mood in terminal cancer patients and how the new perspective acquired has given people the ability to change their lives and their outlooks.

I doubt anyone thinks drugs can't elevate mood. If you have a terminal or near terminal illness I'd assume you're more likely to be sad or depressed. It'd be interesting to see if cancer patients with happy pills have better or the same outcomes than those without.

Unfortunately, while it can be an improvement, pharma companies have become big enough to significantly influence the outcome of such testing. People who don't get the right results get fired from government almost as easily as they get fired from private companies and threats and bribes still work.

I'd be the first to agree that we need to seperate gov and business.

 

[FluffyMcDeath]

I'd argue medicine itself was very hand-wavy. It's through application of scientific rigor that it's improved and standardized. Psychiatry needs to shed hand waviness and instead focus on what has the best evidence of working.

Psychiatrists have all the prestige and money (which they use to maintain their prestige) but the psychologists have the better science, in my opinion.

I'd agree for profit medicine focuses less on the patient and more on the profit. However, this doesn't change that for a double blind study the 'it works' test group should only exist if a statistically larger number of 'healed' people exist than the control group.

Profit motive can change the outcome of a study. Often does.

I doubt anyone thinks drugs can't elevate mood. If you have a terminal or near terminal illness I'd assume you're more likely to be sad or depressed. It'd be interesting to see if cancer patients with happy pills have better or the same outcomes than those without.

Sorry if I was a little terse on the psychedelics/cancer patients thing. I didn't mean to leave the impression that the elevated mood improved outcomes in that study. The patients still died but they lived the last part of their life with less anxiety and a more positive outlook. They were able to enjoy more and find more meaning in their last days. However, other studies with psychedelics have found that the experiences can have profound effects on how patients view their lives and their conditions which can open the door to therapy.
A lot of the time modern psychiatric medicine is devoted to prescribing and then maintaining on the theory that the condition needs lifelong management with medication. This overlooks the plasticity of the mind and sometimes continuing medication merely masks the problem leaving the underlying problem untreated. Therapy techniques can lead to big changes in personality disorders by retraining the way a persons brain responds to situations but they take a couple of years and there is much better money to be had writing prescriptions. Prescribing is quick and you can pack a lot more clients into you day that way.

 

[faethor]

Psychiatrists have all the prestige and money (which they use to maintain their prestige) but the psychologists have the better science, in my opinion.

If true all the more reason that Psychiatrists should focus on proven treatments or formally proving treatments.

Profit motive can change the outcome of a study. Often does.

Perhaps but again if one fails to attempt good science this is simply an excuse to not be rigorous.

Sorry if I was a little terse on the psychedelics/cancer patients thing. I didn't mean to leave the impression that the elevated mood improved outcomes in that study. The patients still died but they lived the last part of their life with less anxiety and a more positive outlook.

Thanks for the clarification. So, we have better moods and no improvement to outcome. The happy pills in this case are just to make a person more happy as the Grim Ripper comes. Nice to know the option is there. It probably does more to help the grieving family to think their loved one isn't suffering quite as much as they think they are. Personally I wish we'd all die in our sleep w/o knowledge and pain that death is knocking. Unfortunately, in my experience their are but a few who are lucky enough f'or this.

A lot of the time modern psychiatric medicine is devoted to prescribing and then maintaining on the theory that the condition needs lifelong management with medication. This overlooks the plasticity of the mind and sometimes continuing medication merely masks the problem leaving the underlying problem untreated. Therapy techniques can lead to big changes in personality disorders by retraining the way a persons brain responds to situations but they take a couple of years and there is much better money to be had writing prescriptions. Prescribing is quick and you can pack a lot more clients into you day that way.

I understand the most effective treatment for depression is a combination of therapy and medication. I hope as we progress we can better understand the electro-chemical needs of the brain. Just as certain bodies have issues with Insulin there are probably bodies which are less efficent at making and absorbing brain chemicals, for example Serotonin. What this psycharist should be doing is if he believes he's found a great answer to some problems is formallizing the study and ensuring he's simply not lying to his patients.

Just because the dude's a Doctor doesn't mean he's not peddling snake oil. External structured scientific confirmation is the best evidence we have that the Dr halfway knows what he's talking about.

 

[FluffyMcDeath]

Thanks for the clarification. So, we have better moods and no improvement to outcome. The happy pills in this case are just to make a person more happy as the Grim Ripper comes.

They are not happy pills. You take the pills, you have an experience, the experience changes your outlook - you don't take the pills any more.

I understand the most effective treatment for depression is a combination of therapy and medication.

And in the case of Matte the tea is an adjunct to traditional talk therapy - it just gives the patient a new perspective on their situation - material for them to work on their problem with the therapist.

Just because the dude's a Doctor doesn't mean he's not peddling snake oil. External structured scientific confirmation is the best evidence we have that the Dr halfway knows what he's talking about.

That's true, but selling snake oil to people who have nothing can help. Just helping helps, and we already know that.

 

[FluffyMcDeath]

It's an interesting thing he's doing. However, here's the thing - even if he's getting good results, there's a good chance it only works on people who already believe it will work.

woo woo tea works on everyone. It has real effects. However, the effects aren't the therapy, they facilitate the therapy by giving the patient a new perspective based on a real experience that they have taking the tea.

That effectively opens up a can of worms since there are no official guidelines for the drugs use. Part of the testing that goes on for pharmaceutical drugs is to come up with usage guidelines.

The dosing protocol has centuries of history.

 

[faethor]

They are not happy pills. You take the pills, you have an experience, the experience changes your outlook - you don't take the pills any more.

Fair enough. But, if you life's ending in a few weeks to months what's the difference really?

And in the case of Matte the tea is an adjunct to traditional talk therapy - it just gives the patient a new perspective on their situation - material for them to work on their problem with the therapist.

So it's claimed. I reread the article and the Doctors claims about 150 people treated and some success and some failure. But he didn't track it? So an unlicensed unapproved treatment that has great positive results but he didn't do simple paper count of given, success, and failure? This approach is highly questionable and lacking rigor to even begin on a small scale demonstrate it really does help.

That's true, but selling snake oil to people who have nothing can help. Just helping helps, and we already know that.

I guess it depends when your morals lay. Is it okay to lie to someone in hopes they believe you and get better? If you're a formalized doctor I'd say it's counter to the Hippocratic Oath and immoral.

The dosing protocol has centuries of history.

Perhaps though a quick Bing of Ayahuasca does indicate a couple of deaths. http://www.cognitiveliberty.org/dll/ayahuasca_canada.html I did a bit of reading here's what I found... Ayahuasca inhibits enzymes which degrade the body's ability to rid itself of toxins. It increases heart rate and blood pressure. Psychological effects may be euphoria but may also be fear. -- So it does have some negative effects. Though we don't know how long lived those might be. And while dosing may have centuries of history I wonder how the effects of the Canadian or American Diet and chemical exposure help, or hinder, the effects. Again we don't know.

 

[Glaucus]

woo woo tea works on everyone. It has real effects. However, the effects aren't the therapy, they facilitate the therapy by giving the patient a new perspective based on a real experience that they have taking the tea.

Understood, and I thought I made that clear in my original post. You seem to be focusing too much on this one Dr, the main point of my post was that if this Dr does it, others will follow but perhaps without the complete treatment regimen. Or even worse, people will just order the tea without even bothering to see any specialist at all. By putting it through proper testing, an actual guideline can be made and taught to medical students as well - assuming it's effective.

The dosing protocol has centuries of history.

Are you suggesting that some drugs do not need to be put through a rigorous clinic trial? I think "centuries of history" simply doesn't cut it in the modern world of medicine. I have no issues with this "Amazon tea" being tested both for effectiveness and safety. Not sure why you seem to resist that. Part of the problem here is that you can't get this tea from a pharmacy or grocery store. You're getting it from shady people because it's a controlled substance - and I have a huge list of problems just with that. I think a proper trial may open the door for proper distribution for this tea. Of course, if this drug turns out not to be effective or safe, then this Dr is doing nothing more then turning meth addicts into Amazon tea addicts - which you could argue is an improvement, but far from the cure it's labelled as.

 

[Robert]

They are not happy pills. You take the pills, you have an experience, the experience changes your outlook - you don't take the pills any more.

Although if the experience is interesting enough, there's a fair chance you might want to do it again. At least that's how it works with mushrooms, LSD and all manner of synthetic psychotropics. No day-to-day cravings but lots of repeat users.

 

[FluffyMcDeath]

Fair enough. But, if you life's ending in a few weeks to months what's the difference really?

1. Tell me when you get there.
2. Tell me when someone you love gets there.

 

[FluffyMcDeath]

Part of the problem here is that you can't get this tea from a pharmacy or grocery store. You're getting it from shady people because it's a controlled substance - and I have a huge list of problems just with that. I think a proper trial may open the door for proper distribution for this tea. Of course, if this drug turns out not to be effective or safe, then this Dr is doing nothing more then turning meth addicts into Amazon tea addicts - which you could argue is an improvement, but far from the cure it's labelled as.

It is NOT a controlled substance per se. You get to be controlled by getting on a list - that's the way the law works and that's why there are so many designer drugs - it's to get around the list. The issue is that a) it is a legal gray area, b) it may become a controlled drug, c) nobody wants it to be a useful protocol in case they want to turn it into a controlled drug, d) it doesn't fit with the current governments fundy attitude towards chemicals and morality.

It isn't the transference of addiction because the tea isn't prescribed as an ongoing medication but a one or two time thing as an adjunct to traditional talk therapy.