Let Us Bring an End to the Epidemic of Opioid Use Disorder through "Self-Empowering Mutual Aid!"
This conversation is a cross-post of selections from the annual "State of the World" discussion with Bruce Sterling & Jon Lebkowsky @ The WELL (01/3-16/02023). My initial post has been collected here:
https://aethyrflux.livejournal.com/594814.html
In response, Bruce Sterling did give me a sideways compliment in the first part of this statement:
"Since this is the WELL, it's pleasant to see a long paean to the benefits of psychedelics, but this isn't an era that's about 'mind-expanding drugs.' It's an era that's all about 'pain-erasing drugs,' namely opioids, and the body-count there is spectacular."
And after my final reply, Bruce's last words are rather grim prognostications about what he thinks is coming in the next year(s)... a series of gruesome visions, which culminated in this:
"In summary, 02023 will be much like '20, '21, & '22... 02024 will also probably be much like this year. It's like a signature period flavor of elderly stodginess with material disaster and poorly-handled emergency. Somewhere on the far side of this is a quite strange society, without a 'Republican Establishment,' without consumerism, shopping malls, maybe without a middle class or a rule of law, very little regard for Judaeo-Christian ethics or organized churches, indifferent to sobriety and to prurient sex scandal -- much beset with environmental ruination, but not at all dead, just really messy, strange and different. I'm not an enthusiast or booster for it, I can just kinda smell it. It's not here yet, though.
In retrospect this period will be understood as an Indian summer of the old world, a winter that didn't know it was a transformative winter because it felt too warm."
--
Meanwhile, here is the text of my final reply...
--
Regarding the extreme epidemic of Opioid Use Disorders in the US & elsewhere, all over the world... Ironically, there are "psychedelic" & "oneirophrenic" medicines that have shown some utility in treating Opioid Use Disorders... particularly, ibogaine & psilocybin have shown the most promise in this regard (there are also indications in some but not all studies regarding LSD, DMT/Ayahuasca, Ketamine & others that could possibly also be used similarly)
A systematic literature review of clinical trials and therapeutic applications of ibogaine (December 30, 2021)
Ibogaine/Noribogaine in the Treatment of Substance Use Disorders: a Systematic Review of the Current Literature (Oct 17, 2022)
Treating drug dependence with the aid of ibogaine (September 29, 2014)
DemeRx and Atai get MHRA nod to start trial of ibogaine for opioid use disorder (March 10, 2021)
First-Ever Clinical Trial with Ibogaine for Opioid Dependency (Apr 14, 2022)
However, looking for a medicine to provide the cure in of itself is actually a large part of the Western problem... and this blind spot may be part of the root cause that has led so many people in the US (and in many other places) towards this epidemic crisis of opioid use disorders... although a medicine may be able to provide an interrupt for a cycle of abuse... it is the integration practices before, during & after such a session that can provide context for what is likely be an extremely unfamiliar experience for most people... that context integration can really make a profound difference in people's lives and determine whether or not they actually find healing...
Psychedelic integration: An analysis of the concept and its practice
One of the original pioneers of Ibogaine as a treatment for substance use disorders was Howard Lotsof, who championed the cause from the day when it cured him of a heroin addiction in 1962 until his death in 2010 (at the age of 66, from liver cancer)... consider this perspective from 1996:
"Ibogaine appears to offer a unique tool to both the patient and the clinician to allow the elimination of physical withdrawal characteristics and the accessing of repressed memories in a non threatening manner by which the majority of patients can gain an understanding of the trauma underlying their chemical dependence and to achieve accomplishments necessary to give them a sense of self worth without which it would be more difficult to break the cycle of substance use disorders. Most important, for many of the patients, Ibogaine allowed them to understand the benefit and role required of a psychosocial support structure including medical professionals, counselors, self-help organizations and the ability to tap into their own inner strength to allow normalization into and survival in a prohibitionist society."
--
_Why Ibogaine Is Not the Answer to the Opioid Crisis_
"Ibogaine clearly illustrates the error behind the implicit goal of the so-called psychedelic renaissance, which is to mainstream these therapies. If the idea is that we simply place ibogaine into the nightmare of the American treatment industry and its predatory capitalism, it would be an attempt to try to resuscitate an industry that is proven to be ineffective, cruel, and capricious.
What makes ibogaine a bad fit in the treatment industry is also its biggest advantage: the expansiveness of time. The experience just takes so long. In Gabon, the centuries-old consumption of iboga (the plant source of ibogaine) has given rise to the elaborate, rich, and varied spiritual practice known as Bwiti. In both of our travels and participation in this tradition, we have experienced a deep honoring of the individual, intensive care, and extensive time given by the entire community.
This is not a call to use Bwiti as drug treatment or for any other purpose removed from its traditional intent in Gabon, but simply points to its artistic and vigorous celebration of that expansiveness of time. It is just an example of what emerges when released from the constraints of efficacy in terms of time, expense, and result. This type of co-created celebration, play, spiritual technology, and performance art as healing art, could be one of those expressions that replaces treatment. It should be treated with that kind of reverence because ibogaine is a big deal, and so are human beings."
--
Meanwhile, as I pointed out in my previous post, the pharmaceutical side of the psychedelic medical industry will continue to attempt to produce research chemicals which they will pitch as the magic bullet to kill everyone's demons, and people will continue to line up for the off chance that they are able to find the desired effect! Please pardon my extreme skepticism, for I dearly want people to be well. I must admit that in my understanding of the copious evidence: the cure will still require work by not only the individuals, but also their families, communities, governments & other institutions becoming more life-affirming, in general. I do love the way of life practiced by the Bwiti, but not everyone is fortunate enough to be familiar with how to participate in such communities built around, "self-empowering mutual aid!" Obviously, each of us only really has control over our own selves, so that's a great place to start... & perhaps we can build coalition strength after each of us has improved our own personal foundations?
--
FWIW, regarding the scientists who are synthesizing these non-psychedelic research chemicals derived from psychedelics, in the belief that they will produce favorable results... they are not necessarily wrong!
"The reason psychedelic drugs have been found to alleviate symptoms of depression and PTSD in clinical trials, it is thought, is due to signaling of the 5-HT-2A receptor, which sparks what’s called neuroplasticity. Neuroplasticity helps the brain form new neural connections, which is believed to generate rapid and sustained positive mood effects. In studies, psilocybin-assisted psychotherapy has provided almost immediate reductions in depressive symptoms after a single high dose and antidepressant effects that last as long as six months in some participants.
Olson says that the root of many neuropsychiatric conditions, including addiction, is the atrophy of neurons in the prefrontal cortex. But drugs that trigger neuroplasticity are like Miracle-Gro, helping the brain rewire healthy neural pathways."
Cameron, L.P., Tombari, R.J., Lu, J. et al. A non-hallucinogenic psychedelic analogue with therapeutic potential. Nature 589, 474-479 (2021).
--
But not only do our brains need better fertilizer, they also benefit from permacultural environments and to be tended with care by ourselves & others. Meanwhile, not everyone has access to such treatments with sacred entheogens (even if they are available in your area, they may currently be cost prohibitive); and even if you can't find a Bwiti temple in your neighborhood, you can still nurture your own growth through some form of "self-empowering mutual aid!" Not everyone is familiar with what that looks like, unless they have been through an experience of emergency management &/or disaster relief. But perhaps that's a good place for us to start? I have seen & participated in mutual aid working wonders, even recently in Texas during the Snowpocalypse of 2021!
We don't have to wait for a national disaster to engage in such activities of "self-empowering mutual aid!" For some people it involves creating music & art & dance. For other people, it may be community gardening or a wilderness survival adventure group. Certain people may prefer to study martial arts, learn a meditative tradition, perhaps even attend religious ceremonies, or otherwise engage in spiritual practices with others in their community. Many people benefit from team sports or other competitive play, while some prefer cooperative skill-sharing or charitable volunteer projects. There are many other specific therapeutic forms useful for recovery listed in the article I highlighted above concerning psychedelic integration. Part of the point that I am leaning into is that healing the individual is extremely difficult within a sick society. And there is a long tradition of promoting "victim self-correction as a panacea" throughout human history. However, I have also seen glimmers of hope that humans are able to evolve beyond the horrors of the Anthropocene towards something that some people have started calling the Symbiocene... and although this transition will also certainly still pose many challenges... I believe we can strategically align our forces towards the production of mutually beneficial results!
_Exiting the Anthropocene and Entering the Symbiocene,_ by Glenn Albrecht & Gavin Van Horn
"E.O. Wilson, and before him, Erich Fromm, gave us the concept of “biophilia” as something to hope for in human nature. Our instinctual love of life and life-like forms would/could prevail over necrophilia and possible ecocide. However, although “bio” means life, it is often seen in the context of a reductionist science that pulls things apart and isolates particularities. I now offer “sumbiophilia” (the love of living together) as an addition to biophilia. Since we evolved within a pre-existing ecological matrix as an intensely social species and lived in relative harmony with all other life forms, sumbiophilia must also be deeply ingrained within us. If I am correct, then exiting the Anthropocene and entering the Symbiocene, will be a satisfying experience for most humans. As the politics of sumbiocracy play out and we live by symbiomimicry in all our technologies and habitats, the Earth will breathe a huge sigh of relief."
Furthermore, I believe that this echoes the references I made in my previous post to the work of Bruce Damer (& David Deamer, et alia)...
"The hot spring hypothesis scenario and empirical evidence behind it... suggests how evolution originated and predicts the nature of the first evolving chemical systems and their path to living cellular communities. This path begins with a primordial form of niche construction, adds a network effect, adaptation through distribution across a landscape, and a resulting stepwise evolution of polymer systems which ultimately combine to support the transition into the first living cellular communities. The meta-system which enables this process is the aggregation of simpler individuals, sharing of resources across aggregations, and growth and evolution at the level of the aggregation to drive increasingly robust innovations within the individuals. After rise of living cellular forms within these aggregations they remain dependent and indivisible from their surrounding microbial communities. Evolutionary theory has historically rested heavily on the study of animals, interpreting their behavior as individuals competing “red in tooth and claw” to pass on their genes. Yet from its origin and for most of its evolutionary history, life has been dominated by niche construction and networks of resource sharing between collaborating organisms, primarily microbial consortia. Animals are completely dependent on grazing on the products of these consortia to act out the drama of their lives. It therefore behooves science to consider that perhaps life, and evolution itself, actually rests on a platform more broadly based on niches and collaborative networks than the strict competition between individuals struggling to pass on their genetic lines."
<x-posted to The WELL State of the World discussion 2023>
https://aethyrflux.livejournal.com/594814.html
In response, Bruce Sterling did give me a sideways compliment in the first part of this statement:
"Since this is the WELL, it's pleasant to see a long paean to the benefits of psychedelics, but this isn't an era that's about 'mind-expanding drugs.' It's an era that's all about 'pain-erasing drugs,' namely opioids, and the body-count there is spectacular."
And after my final reply, Bruce's last words are rather grim prognostications about what he thinks is coming in the next year(s)... a series of gruesome visions, which culminated in this:
"In summary, 02023 will be much like '20, '21, & '22... 02024 will also probably be much like this year. It's like a signature period flavor of elderly stodginess with material disaster and poorly-handled emergency. Somewhere on the far side of this is a quite strange society, without a 'Republican Establishment,' without consumerism, shopping malls, maybe without a middle class or a rule of law, very little regard for Judaeo-Christian ethics or organized churches, indifferent to sobriety and to prurient sex scandal -- much beset with environmental ruination, but not at all dead, just really messy, strange and different. I'm not an enthusiast or booster for it, I can just kinda smell it. It's not here yet, though.
In retrospect this period will be understood as an Indian summer of the old world, a winter that didn't know it was a transformative winter because it felt too warm."
--
Meanwhile, here is the text of my final reply...
--
Regarding the extreme epidemic of Opioid Use Disorders in the US & elsewhere, all over the world... Ironically, there are "psychedelic" & "oneirophrenic" medicines that have shown some utility in treating Opioid Use Disorders... particularly, ibogaine & psilocybin have shown the most promise in this regard (there are also indications in some but not all studies regarding LSD, DMT/Ayahuasca, Ketamine & others that could possibly also be used similarly)
A systematic literature review of clinical trials and therapeutic applications of ibogaine (December 30, 2021)
Ibogaine/Noribogaine in the Treatment of Substance Use Disorders: a Systematic Review of the Current Literature (Oct 17, 2022)
Treating drug dependence with the aid of ibogaine (September 29, 2014)
DemeRx and Atai get MHRA nod to start trial of ibogaine for opioid use disorder (March 10, 2021)
First-Ever Clinical Trial with Ibogaine for Opioid Dependency (Apr 14, 2022)
However, looking for a medicine to provide the cure in of itself is actually a large part of the Western problem... and this blind spot may be part of the root cause that has led so many people in the US (and in many other places) towards this epidemic crisis of opioid use disorders... although a medicine may be able to provide an interrupt for a cycle of abuse... it is the integration practices before, during & after such a session that can provide context for what is likely be an extremely unfamiliar experience for most people... that context integration can really make a profound difference in people's lives and determine whether or not they actually find healing...
Psychedelic integration: An analysis of the concept and its practice
One of the original pioneers of Ibogaine as a treatment for substance use disorders was Howard Lotsof, who championed the cause from the day when it cured him of a heroin addiction in 1962 until his death in 2010 (at the age of 66, from liver cancer)... consider this perspective from 1996:
"Ibogaine appears to offer a unique tool to both the patient and the clinician to allow the elimination of physical withdrawal characteristics and the accessing of repressed memories in a non threatening manner by which the majority of patients can gain an understanding of the trauma underlying their chemical dependence and to achieve accomplishments necessary to give them a sense of self worth without which it would be more difficult to break the cycle of substance use disorders. Most important, for many of the patients, Ibogaine allowed them to understand the benefit and role required of a psychosocial support structure including medical professionals, counselors, self-help organizations and the ability to tap into their own inner strength to allow normalization into and survival in a prohibitionist society."
--
_Why Ibogaine Is Not the Answer to the Opioid Crisis_
"Ibogaine clearly illustrates the error behind the implicit goal of the so-called psychedelic renaissance, which is to mainstream these therapies. If the idea is that we simply place ibogaine into the nightmare of the American treatment industry and its predatory capitalism, it would be an attempt to try to resuscitate an industry that is proven to be ineffective, cruel, and capricious.
What makes ibogaine a bad fit in the treatment industry is also its biggest advantage: the expansiveness of time. The experience just takes so long. In Gabon, the centuries-old consumption of iboga (the plant source of ibogaine) has given rise to the elaborate, rich, and varied spiritual practice known as Bwiti. In both of our travels and participation in this tradition, we have experienced a deep honoring of the individual, intensive care, and extensive time given by the entire community.
This is not a call to use Bwiti as drug treatment or for any other purpose removed from its traditional intent in Gabon, but simply points to its artistic and vigorous celebration of that expansiveness of time. It is just an example of what emerges when released from the constraints of efficacy in terms of time, expense, and result. This type of co-created celebration, play, spiritual technology, and performance art as healing art, could be one of those expressions that replaces treatment. It should be treated with that kind of reverence because ibogaine is a big deal, and so are human beings."
--
Meanwhile, as I pointed out in my previous post, the pharmaceutical side of the psychedelic medical industry will continue to attempt to produce research chemicals which they will pitch as the magic bullet to kill everyone's demons, and people will continue to line up for the off chance that they are able to find the desired effect! Please pardon my extreme skepticism, for I dearly want people to be well. I must admit that in my understanding of the copious evidence: the cure will still require work by not only the individuals, but also their families, communities, governments & other institutions becoming more life-affirming, in general. I do love the way of life practiced by the Bwiti, but not everyone is fortunate enough to be familiar with how to participate in such communities built around, "self-empowering mutual aid!" Obviously, each of us only really has control over our own selves, so that's a great place to start... & perhaps we can build coalition strength after each of us has improved our own personal foundations?
--
FWIW, regarding the scientists who are synthesizing these non-psychedelic research chemicals derived from psychedelics, in the belief that they will produce favorable results... they are not necessarily wrong!
"The reason psychedelic drugs have been found to alleviate symptoms of depression and PTSD in clinical trials, it is thought, is due to signaling of the 5-HT-2A receptor, which sparks what’s called neuroplasticity. Neuroplasticity helps the brain form new neural connections, which is believed to generate rapid and sustained positive mood effects. In studies, psilocybin-assisted psychotherapy has provided almost immediate reductions in depressive symptoms after a single high dose and antidepressant effects that last as long as six months in some participants.
Olson says that the root of many neuropsychiatric conditions, including addiction, is the atrophy of neurons in the prefrontal cortex. But drugs that trigger neuroplasticity are like Miracle-Gro, helping the brain rewire healthy neural pathways."
Cameron, L.P., Tombari, R.J., Lu, J. et al. A non-hallucinogenic psychedelic analogue with therapeutic potential. Nature 589, 474-479 (2021).
--
But not only do our brains need better fertilizer, they also benefit from permacultural environments and to be tended with care by ourselves & others. Meanwhile, not everyone has access to such treatments with sacred entheogens (even if they are available in your area, they may currently be cost prohibitive); and even if you can't find a Bwiti temple in your neighborhood, you can still nurture your own growth through some form of "self-empowering mutual aid!" Not everyone is familiar with what that looks like, unless they have been through an experience of emergency management &/or disaster relief. But perhaps that's a good place for us to start? I have seen & participated in mutual aid working wonders, even recently in Texas during the Snowpocalypse of 2021!
We don't have to wait for a national disaster to engage in such activities of "self-empowering mutual aid!" For some people it involves creating music & art & dance. For other people, it may be community gardening or a wilderness survival adventure group. Certain people may prefer to study martial arts, learn a meditative tradition, perhaps even attend religious ceremonies, or otherwise engage in spiritual practices with others in their community. Many people benefit from team sports or other competitive play, while some prefer cooperative skill-sharing or charitable volunteer projects. There are many other specific therapeutic forms useful for recovery listed in the article I highlighted above concerning psychedelic integration. Part of the point that I am leaning into is that healing the individual is extremely difficult within a sick society. And there is a long tradition of promoting "victim self-correction as a panacea" throughout human history. However, I have also seen glimmers of hope that humans are able to evolve beyond the horrors of the Anthropocene towards something that some people have started calling the Symbiocene... and although this transition will also certainly still pose many challenges... I believe we can strategically align our forces towards the production of mutually beneficial results!
_Exiting the Anthropocene and Entering the Symbiocene,_ by Glenn Albrecht & Gavin Van Horn
"E.O. Wilson, and before him, Erich Fromm, gave us the concept of “biophilia” as something to hope for in human nature. Our instinctual love of life and life-like forms would/could prevail over necrophilia and possible ecocide. However, although “bio” means life, it is often seen in the context of a reductionist science that pulls things apart and isolates particularities. I now offer “sumbiophilia” (the love of living together) as an addition to biophilia. Since we evolved within a pre-existing ecological matrix as an intensely social species and lived in relative harmony with all other life forms, sumbiophilia must also be deeply ingrained within us. If I am correct, then exiting the Anthropocene and entering the Symbiocene, will be a satisfying experience for most humans. As the politics of sumbiocracy play out and we live by symbiomimicry in all our technologies and habitats, the Earth will breathe a huge sigh of relief."
Furthermore, I believe that this echoes the references I made in my previous post to the work of Bruce Damer (& David Deamer, et alia)...
"The hot spring hypothesis scenario and empirical evidence behind it... suggests how evolution originated and predicts the nature of the first evolving chemical systems and their path to living cellular communities. This path begins with a primordial form of niche construction, adds a network effect, adaptation through distribution across a landscape, and a resulting stepwise evolution of polymer systems which ultimately combine to support the transition into the first living cellular communities. The meta-system which enables this process is the aggregation of simpler individuals, sharing of resources across aggregations, and growth and evolution at the level of the aggregation to drive increasingly robust innovations within the individuals. After rise of living cellular forms within these aggregations they remain dependent and indivisible from their surrounding microbial communities. Evolutionary theory has historically rested heavily on the study of animals, interpreting their behavior as individuals competing “red in tooth and claw” to pass on their genes. Yet from its origin and for most of its evolutionary history, life has been dominated by niche construction and networks of resource sharing between collaborating organisms, primarily microbial consortia. Animals are completely dependent on grazing on the products of these consortia to act out the drama of their lives. It therefore behooves science to consider that perhaps life, and evolution itself, actually rests on a platform more broadly based on niches and collaborative networks than the strict competition between individuals struggling to pass on their genetic lines."
<x-posted to The WELL State of the World discussion 2023>