Placebo Problems: Boundary Work in the Psychedelic Science Renaissance

Hendy, Katherine

doi:10.1007/978-3-319-76720-8_9

Cited by 10 publications

(7 citation statements)

References 27 publications

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“…For MDMA, another compound with somewhat similar subjective effects, although not visual ones, unblinding measured by guesses of therapists and patients was reported at 59% (averaged) (Oehen et al, 2013), around 80% (Ot’alora et al, 2018), or even 100% (Mithoefer et al, 2011). This raises the crucial question around the epistemic authority attributed to double-blind designs which consistently result in being unblinded (Hendy, 2018).…”

Section: Consequences For Biomedical Researchmentioning

confidence: 99%

Overcoming epistemic injustices in the biomedical study of ayahuasca: Towards ethical and sustainable regulation

Schenberg¹,

Gerber

2022

Transcult Psychiatry

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After decades of biomedical research on ayahuasca's molecular compounds and their physiological effects, recent clinical trials show evidence of therapeutic potential for depression. However, indigenous peoples have been using ayahuasca therapeutically for a very long time, and thus we question the epistemic authority attributed to scientific studies, proposing that epistemic injustices were committed with practical, cultural, social, and legal consequences. We question epistemic authority based on the double-blind design, the molecularization discourse, and contextual issues about safety. We propose a new approach to foster epistemically fair research, outlining how to enforce indigenous rights, considering the Brazilian, Peruvian, and Colombian cases. Indigenous peoples have the right to maintain, control, protect, and develop their biocultural heritage, traditional knowledge, and cultural expressions, including traditional medicine practices. New regulations about ayahuasca must respect the free, prior, and informed consent of indigenous peoples according to the International Labor Organization Indigenous and Tribal Peoples Convention no. 169. The declaration of the ayahuasca complex as a national cultural heritage may prevent patenting from third parties, fostering the development of traditional medicine. When involving isolated compounds derived from traditional knowledge, benefit-sharing agreements are mandatory according to the United Nations’ Convention on Biological Diversity. Considering the extremely high demand to treat millions of depressed patients, the medicalization of ayahuasca without adequate regulation respectful of indigenous rights can be detrimental to indigenous peoples and their management of local environments, potentially harming the sustainability of the plants and of the Amazon itself, which is approaching its dieback tipping point.

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Section: Consequences For Biomedical Researchmentioning

confidence: 99%

Overcoming epistemic injustices in the biomedical study of ayahuasca: Towards ethical and sustainable regulation

Schenberg¹,

Gerber

2022

Transcult Psychiatry

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“…The immense influence of set and setting during psychedelic experiences creates difficulty in establishing appropriate placebo controls and blinding investigators and participants. Attempts have been made to work around these expectations, but have not been very successful 27 ( Hendy, 2018 ). This challenge also occurred in the first wave of psychedelic research, when conducting pharmacological research with controls was first popularized.…”

Section: Lessons For Psychiatric Sciencementioning

confidence: 99%

“… 27. Ritalin and niacin (vitamin B3) (which makes participants feel flushed) have been used as placebo controls in psilocybin trials, while zinc sulfate (which leads to nausea) was used as a placebo control in an Ayahuasca trial ( Hendy, 2018 , p. 158). In other cases, lower doses of the study drug have also been used as a control.…”

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confidence: 99%

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Psychosis and psychedelics: Historical entanglements and contemporary contrasts

Friesen

2022

Transcult Psychiatry

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Experiences of psychedelics and psychosis were deeply entangled in scientific practices in the mid-20th century, from uses of psychedelic drugs that could model psychosis, to detailed phenomenological comparisons of endogenous and drug-induced madness. After the moral panic of the 1960s shut down psychedelic research, however, these two phenomena became disentangled. In the decades following, the science of psychosis transformed, shedding the language of psychoanalysis, and adopting the new scientific veneer of psychiatry. Today, as psychedelic science re-emerges, the research programs surrounding psychosis and psychedelics now stand in stark contrast. Here, I look closely at how these research programs respond to questions related to what is worth measuring, what is worth investigating, and how we ought to respond to these experiences. This comparison reveals radically different assumptions and values that guide each research paradigm and shape clinical practice. While psychedelic research often includes scales that seek to capture experiences of mysticism, meaningfulness, and ego dissolution, research related to psychosis focuses on the measurement of pathological symptoms and functioning. Research into psychosis primarily seeks universal and reductionist causal explanations and interventions, while psychedelic research embraces the importance of set and setting in shaping unique experiences. Responses to psychedelic crisis involve warmth, compassion, and support, while responses to psychotic experiences often involve restraint, seclusion, and weapons. I argue that these differences contain important lessons for psychiatry. However, as psychedelic research struggles to meet regulatory requirements and fit within the paradigm of evidence-based medicine, these differences may quickly dissolve.

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“…There is a lack of a deeper engagement with anthropological literature on the subject or with Indigenous intellectuals and leaders. The authors tackle issues already developed by the academic literature, such as the argument that it is difficult to create placebos for psychedelics, that the brew is not the same as freeze-dried ayahuasca, that context matters, that the rituals and the setting make a difference, and that animal research does not take into account that humans vomit ayahuasca, among other issues (Gomes, 2016; Hendy, 2018; Labate, 2011b; Labate & Bouso, 2013; Labate et al, 2008).…”

mentioning

confidence: 99%