What Does Being Sober Mean Today? For Many, Not Full Abstinence

Ernesto Londono

The New York Times

Originally posted 4 Feb 24

Here are two excerpts:

Notions of what constitutes sobriety and problematic substance use have grown more flexible in recent years as younger Americans have shunned alcohol in increasing numbers while embracing cannabis and psychedelics - a phenomenon that alarms some addiction experts.

Not long ago, sobriety was broadly understood to mean abstaining from all intoxicating substances, and the term was often associated with people who had overcome severe forms of addiction. These days, it is used more expansively, including by people who have quit drinking alcohol but consume what they deem moderate amounts of other substances, including marijuana and mushrooms.

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As some drugs come to be viewed as wellness boosters by those who use them, adherence to the full abstinence model favored by organizations like Alcoholics Anonymous is shifting. Some people call themselves "California sober," a term popularized in a 2021 song by the pop star Demi Lovato, who later disavowed the idea, saying on social media that "sober sober is the only way to be."

Approaches that might have once seemed ludicrous-like treating opioid addiction with psychedelics - have gained broader enthusiasm among doctors as drug overdoses kill tens of thousands of Americans each year.

"The abstinence-only model is very restrictive," said Dr. Peter Grinspoon, a primary care physician at Massachusetts General Hospital who specializes in medical cannabis and is a recovering opioid addict. "We really have to meet people where they are and have a broader recovery tent."

It is impossible to know how many Americans consider themselves part of an increasingly malleable concept of sobriety, but there are indications of shifting views of acceptable substance use. Since 2000, alcohol use among younger Americans has declined significantly, according to a Gallup poll.

At the same time, the use of cannabis and psychedelics has risen as state laws and attitudes grow more permissive, even as both remain illegal under federal law.

A survey found that 44 percent of adults aged 19 to 30 said in 2022 that they had used cannabis in the past year, a record high. That year, 8 percent of adults in the same age range said they had used psychedelics, an increase from the 3 percent a decade earlier.

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Ethical principles of traditional Indigenous medicine to guide western psychedelic research and practice

Celidwen, Y., Redvers, N., Githaiga, C., et al.

(2023). The Lancet Regional Health

Americas, 18, 100410.

https://doi.org/10.1016/j.lana.2022.100410

Summary

The resurgence of Western psychedelic research and practice has led to increasing concerns from many Indigenous Nations regarding cultural appropriation, lack of recognition of the sacred cultural positioning of these medicines, exclusionary practices in research and praxis, and patenting of traditional medicines. Indigenous voices and leadership have been notably absent from the Western psychedelic field currently widely represented by Westerners. An Indigenous-led globally represented group of practitioners, activists, scholars, lawyers, and human rights defenders came together with the purpose of formulating a set of ethical guidelines concerning traditional Indigenous medicines current use in Western psychedelic research and practice. A global Indigenous consensus process of knowledge-gathering was engaged which identified eight interconnected ethical principles, including: Reverence, Respect, Responsibility, Relevance, Regulation, Reparation, Restoration, and Reconciliation. A summary of the work is presented here with suggested ethical actions for moving forward within Western psychedelic research and practice spaces.

The way forward

To help orient this consensus process more directly towards solutions, we further summarize in Table 2 additional recommended practical solutions within Western psychedelic research and practice. This consensus process emphasized that by continuing the extraction and commercialization of various traditional Indigenous medicines, Western institutions are destroying the core themes of Indigenous life in the following important ways: (i) the glorification of psychedelics excites harmful narratives of exceptionalism that result in spiritual consumerism and exploitative tourism that is very often managed by Westerners; (ii) the unsustainable foraging of Indigenous medicines make them increasingly unavailable for local use; (iii) Indigenous Peoples are exposed to extreme violence from the infiltration of drug cartels into traditional territories that often source raw materials from forest habitats (e.g., MDMA); (iv) the spreading of false information about a particular plant medicine being the one key pill to human enlightenment. While these medicines may contribute towards powerful and transformative solutions to the health and planetary crisis, they can also lose their meaning when deprived of their cultural container. We hope that the eight ethical principles detailed here spark important conversation and action within the psychiatry and psychedelic research community towards better, more respectful relations.

The info is here.

Disintegrating and Reintegrating the Self – (In)Flexible Self-Models in Depersonalisation and Psychedelic Experiences

Ciaunica, A., & Safron, A. (2022, March 13).

https://doi.org/10.31234/osf.io/mah78

Abstract

Across times and cultures, humans constantly and intentionally tried to ‘lose’ or to ‘escape’ their familiar, ordinary self, to ‘self-detach’ and to radically change the ways of perceiving oneself and the world. In this paper we explore the contrast between the feeling of ‘losing’ the sense of familiarity with one’s self and body in Depersonalisation experiences (DP) and psychedelics (with some consideration of meditative experiences). We explore these radical changes in self-experiences through the lens of Active Inference Framework (AIF). AIF is a process theory aiming to capture the capacity of biological organisms (e.g. living human bodies) to survive and thrive in volatile and uncertain environments. In line with previous work on depersonalisation and psychedelic mechanisms, we suggest that such experiences can involve a stance with radically altered prior expectations, so providing opportunities for flexibly modulating self- and world models. Specifically, we suggest that controlled acquisition of new self- and world models may enhance the plasticity of one’s perceptual and sensorimotor experiences. This new gained flexibility, we claim, may allow the individual to ‘leave behind’ certain habits, perceptual rigidities that holds him/her ‘stuck’ in certain behavioural patterns. And to open to new ways of perceiving and integrating self- and world-related information. By contrast, depersonalisation experiences point to a uncontrolled phenomenon of non-flexible (rigid) (dis)integration of ordinary/habitual self-models, and a consequent feeling of being ‘stuck’ in one’s mind. While controlled (dis)integration of habitual self-experiences and consequent re-integration may have positive effect, uncontrolled (dis)integration of habitual self-experiences triggered by unpredictable life events may be overwhelming and lead to self-detachment and potentially adverse clinical outcomes. Contrasting these two modes of alteration will allow us to outline the importance of the controlled ability to flexibly integrate, disintegrate and reintegrate multisensory bodily signals, and its impact on the human sense of self and agency.

Conclusion

In these explorations we have considered the experience of ‘losing’ one’s familiar sense of self in Depersonalisation (DP) and psychedelic experiences through the (perhaps often overly opaque) lens of Active Inference. Depersonalisation is characterized by feelings of being detached from one’s self, body, and world.We suggested that acquisition of new self-and world models may enhance the plasticity of one’s perceptual and sensorimotor experiences. This new gained flexibility, we posited, may allow the individual to ‘leave behind’ certain habits, perceptual rigidities that holds him/her ‘stuck’ in certain behavioural patterns, and open to new ways of perceiving and integrating self-and world-related information. This adaptive modelling may be achieved during psychedelic (and potentially meditative) experiences via a flexibly controllable(dis)integration of ordinary/habitual self-models, and a consequent re-integration or re-organisation of the latter via modulatory multisensory information.

By contrast, depersonalisation experiences point to a phenomenon of non-flexible (rigid) (dis)integration of ordinary/habitual self-models, and a consequent feeling of being ‘stuck’ in one’s mind. While controlled (dis)integration of habitual self-experiences and consequent re-integration may have positive effects, uncontrolled (dis)integration of habitual self-experiences triggered by unpredictable life events may be overwhelming and lead to self-detachment and potentially adverse clinical outcomes such as depersonalisation disorder. 

The info is here.

Moral Psychopharmacology Needs Moral Inquiry: The Case of Psychedelics

Langlitz N, et al. (2021) 

Front. Psychiatry, August, 12:680064

Abstract

The revival of psychedelic research coincided and more recently conjoined with psychopharmacological research on how drugs affect moral judgments and behaviors. This article makes the case for a moral psychopharmacology of psychedelics that examines whether psychedelics serve as non-specific amplifiers that enable subjects to (re-)connect with their values, or whether they promote specific moral-political orientations such as liberal and anti-authoritarian views, as recent psychopharmacological studies suggest. This question gains urgency from the fact that the return of psychedelics from counterculture and underground laboratories to mainstream science and society has been accompanied by a diversification of their users and uses. We propose bringing the pharmacological and neuroscientific literature into a conversation with historical and anthropological scholarship documenting the full spectrum of moral and political views associated with the uses of psychedelics. This paper sheds new light on the cultural plasticity of drug action and has implications for the design of psychedelic pharmacopsychotherapies. It also raises the question of whether other classes of psychoactive drugs have an equally rich moral and political life.

From the Conclusion

If moral psychopharmacology took it upon itself to develop forms of psychedelic apprenticeship for the currently sprawling medical and non-medical applications of psychedelics, it would extend pharmaceutical research and development into the extra-pharmacological realm. Such a design process needs to be informed by best practices in clinical psychology and cognate fields, but, intellectually, it cannot hide behind professional prescriptions because what counts as good and bad is precisely what is at stake here. It is an open philosophical question that has to be answered in a recursive process of psychopharmacological experimentation, clinical and ethnographic observation, historical research, and ethical reflection.

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Can Psychedelics Make Us More Moral?

Derek Beres
Big Think
Originally published August 22, 2016

Here is an excerpt:

Could a moral drug enhancement instill empathy in such a person? If so, should it be used? Earp is not ignorant of the ethics of such a drug. Looked at from a broader social perspective instead of an individualist mindset is one important factor. If there’s a possibility that a psychopath could harm members of a society, would such a drug be beneficial, especially if the person desires it? What if they don’t?

Psychopathy is a small but very real instance. What about extending this idea of moral neuroenhancement to people with depression? Anger management issues? Excessive anxiety? This does not imply that a person needs a daily dose. Research has shown that psilocybin has an effect even after one episode...

The article is here.