a philosophical review of the antidepressant tapering guide from Psychedelic Passage
by Ballard Quass, the Drug War Philosopher
August 22, 2024
TO: Jimmy Nguyen and the Psychedelics Passage1 team
FROM: Brian
DATE: August 22, 2024
SUBJECT: Your "Medication Interaction and Tapering Resource" guide
Dear Jimmy and team:
I just read your excellent and informative guide entitled "Medication Interaction and Tapering Resource." It is a timely document for me personally as I have just retired and am planning to spend the next year or two in getting off antidepressants (specifically, Venlafaxine) while profiting from natural medicines like psilocybin to the extent possible. I have chosen this path not just for mental health reasons but because I am a philosopher by temperament and William James himself said that we philosophers must study altered states to discover what they might tell us about consciousness and the nature of ultimate reality. Of course, drug law has made this almost impossible, especially with the latest attempts to criminalize nitrous oxide, the substance that first awakened James to the limited nature of what we call our sober perceptions of the world. At the risk of bragging, I should point out that I am the only one in the world who has formally complained to the FDA about this new censorship on behalf of academic freedom, a depressing fact that suggests the extent to which modern philosophers have been brainwashed by the drug-demonizing ideology of the Drug War. But I am determined to take the risks that are necessary so that the anti-scientific Drug War does not completely bar me from philosophical investigations of this kind, at least not for the absolute entirety of my time hear on planet Earth.
That said, I hope you do not mind if I make some comments on some specific aspects of your guide. Your document had much to teach me, but it left me with a few philosophical concerns that I would like to share with you.
Sincerely Yours,
Brian
The apologetic tenor
I had to laugh a little while reading, because it seemed to me that almost half of the document consisted of apologetic suggestions that readers should contact "health professionals" (i.e. medical doctors) for true and final answers on these topics. That's wrong from my point of view. These professionals are the same people who got me dependent on antidepressants for life in the first place. They never told me they caused dependence. And when they discovered this to be the case, they did not apologize. Instead, they flipped the script and told me that I had a medical duty to take these pills for the rest of my life. So to me, relying on professionals in this case is like asking an arsonist to put out a fire that they themselves have started. The problem is, all these professionals approach the subject from the perspective of a reductive materialist. That means in practice that they ignore all anecdotes and history of positive use and draw their conclusions about efficacy from molecular studies. In short, they are ideologically committed to ignoring all glaringly obvious benefits of such drugs in the real world around them.
Of course, I understand the apologetics. You have to adopt such a tone in order not to be sneered at by materialists, who are, after all, calling the shots today when it comes to psychedelic medicines and who refuse to give up their role as supposed experts on these topics. But there are more motivations at work here, thanks to the century-long brainwashing of Americans in Drug War ideology, according to which all talk of positive drug use must be censored or banned. This brainwashing has convinced us that psychoactive drugs are somehow dangerous in a way that nothing else is: not free climbing, not parachuting, not even driving a car. But in a world where we educated people about medicines as a matter of course, we would surely not be apologizing for talking about them just because we are not a board-certified doctor. I see no analogous apologies in books about free flying or skateboarding or riding a motorcycle. And when climbers tell me some great ways to climb a rock face, I do not consider them to be glorifying a dangerous activity but merely giving me their ideas based on their own actual experiences. But when it comes to drugs, we must write apologetically, as if our audience consists of children who are incapable of handling the truth.
Also, let's look at the track record of these professionals, like the doctors who approve (or rather disapprove) drugs at the FDA. They have recently told us that MDMA is not yet proven to be of benefit for people with PTSD. I would argue that the FDA could only come to that conclusion by consciously ignoring all obvious signs of MDMA's healing power. The use of MDMA (especially Ecstasy) brought peace, love and understanding to the dance floors in 1990 Britain. This was totally unprecedented in the history of the UK, if not the world: all sorts of ethnic groups, skin colors and religions were getting together happily in one place.
The mood of that time is nicely captured by a handful of quotes from the documentary "United Nation" by promoter Terry Stone:
• "It was the first time that black-and-white people had integrated on a level... and everybody was one." -- DJ Ray Keith.
• "It was black and white, Asian, Chinese, all up in one building," -- MC GQ.
• "Everyone's loving each other, man, they're not hating." - DJ Mampi Swift.
In short, everybody just wanted to "cuddle," according to event security expert Adrian Saint.
But the British government never considered this situation to be a benefit. To the contrary, they cracked down on the use of Ecstasy (supposedly because of the death of one single 100-pound girl who was not properly hydrated, a fate that would have been avoided had Drug Warriors preferred education over demonization). The result of this crackdown? Dancers switched to alcohol and the dance floors became so violent that concert organizers had to hire special forces troops to keep the peace. Special forces!
Such a crackdown was possible only because doctors had never championed the obvious benefits of Ecstasy, in fealty to the flawed assumption that reams and reams of anecdotal evidence from the experience of actual users are somehow irrelevant.
Tapering
Nor are materialist doctors experts on the withdrawal process. Sure, they can tell us a lot about serotonin uptake inhibitors and "receptor occupancy," but such data out of context tells us nothing with certainty about the actions and motivations of real people in the real world. Science always wants to abstract such facts and claim them as some kind of proof about how people will feel, will they or nil they. But people do not live in an abstracted world, and receptor occupancy is only one factor in a multifaceted world of inputs that affect each person's psychology in a unique way based on their attitudes, their philosophy of life, and their current place in life's journey, etc.. But science, in its pretensions to universalism, claims that it has the answers for us thanks to conclusions drawn from carefully abstracting specific physically identifiable factors like these from the rich milieu of inputs amongst which they typically reside and without reference to which their roles in our life cannot be properly understood.
The only expertise that medical doctors have in my view is identifying physical dangers to psychoactive drug use. They are totally incapable of making a cost/benefit analysis of such use, for the simple reason that they are doctrinally obliged to ignore any benefits of use that are "merely" obvious. Such benefits are "mere anecdote," to their way of thinking. They prove nothing.
I'm reminded in this connection of a piece by materialist doctor Robert Glatter in Forbes magazine in 2021 in which he speculated uncertainly about whether laughing gas might help folks with treatment-resistant depression. He was not sure because he could not be convinced by the sound of mere laughter alone - he wants to know if laughing gas will "REALLY" help people - which is really a metaphysical or a religious question, not a scientific one.
This is really the nub of the problem here: when materialist doctors set themselves up as the authorities on psychoactive medicine they are practicing a kind of pharmacological colonialism with respect to healing as understood by indigenous tribes across the ages. The Mazatec and related tribes of Mexico did not need to place their psilocybin mushrooms under a microscope. The proof of their efficacy was extant in the positive effects of use that were clearly seen by the community.
Who's the real expert?
I have suffered the effects of this materialist blindness for a lifetime now, most recently after visiting my psychiatrist to talk to him about tapering. In my mind, my plan made perfect sense from a psychological point of view. It had what philosophers would call a "prima facie" chance of working, and I was determined to give it a go.
The idea was simple: All so-called "experts" on the topic of antidepressant withdrawal agree that there is a long list of negative feelings that one will almost certainly encounter during the process. My question was, are these downsides truly necessary? Could not one taper a drug like Effexor AT THE SAME TIME as they were increasing the use of other drugs like psilocybin -- and ideally other indigenous plant healers as well like San Pedro Cactus and Salvia divinorum? It may not completely obviate the downsides of withdrawal, but it may well make them tolerable by helping to improve the determination of the user. The tapering in my plan would be performed incrementally, with a tiny decrease per day, with the help of a compounding pharmacist, such that one could get off an antidepressant in n days by decreasing the dosage amount daily by 1/n. For instance, if one chose to get off the antidepressant in 365 days, the antidepressant would be compounded such that each pill contained 1/365th less medicine than the previous one. This struck me as common sense.
Unfortunately, I had forgotten that common sense means nothing to materialist doctors.
After hearing my plan, my psychiatrist (this "expert") simply told me that he had never heard of such a thing, and then went on to recommend dosage drops of 37.5 mgs of Venlafaxine at a time, which was convenient for him since pharmaceutical companies do not provide smaller doses for that drug. Apparently, when doctors talk about the best way to get off drugs like Venlafaxine, they mean the best way for themselves, not for their patients. He warned me that I may have some negative effects from this withdrawal scheme, which immediately begged the obvious question: "if so, then why are you deep-sixing my plans to lower the dosage more incrementally!" He then went on to praise Venlafaxine on the grounds that it is not addictive! Somehow it's horrible to him that I should crave a drug, but it's okay if I should merely feel horrible after stopping it.
I think that some of the pushback against my plan comes from the fact that critics have an unacknowledged Christian Science belief in the anti-drug philosophy of Mary Baker-Eddy. Your own guide unapologetically recommends exercise and meditation for coping with withdrawal, but the only drug you unequivocally recommend is Tylenol, which is presumably a "med" rather than a "drug" in the pejorative sense of that term. This, I maintain, is a bias: It's the adoption of the view of Pizarro himself with respect to holistic medicine, that the efficacy of indigenous medicine is unproven at best, and non-existent at worst, except perhaps when it comes to the fostering of spiritual experiences that the staid and puritanical westerner would slander as demonic behavior.
Compounding problems
I thought to myself, "Fine, I'll just find some other doctor who will compound Venlafaxine for me in the way that makes sense to ME!" Little did I know that this would prove impossible. Medical doctors are not happy to take what they perceive to be chances, and they believe that materialist doctors know what's best for me when it comes to tapering. The result? I cannot find anyone who will write me the kind of prescription that I want. I can get empathy from sites like Psychedelic Passage or Right to Heal, but at the end of the day, I have to find a materialist doctor who will write the prescription I want. I did find one doctor listed on the Mad in America website (see below) who seemed to have some understanding of my dilemma, but he told me that he did not have time to "take on" another patient. I replied that I did not want a new doctor: that was the whole problem, I was trying to stop SEEING doctors. I just wanted a prescription. But that's not the way medicine works these days, so asking for a compounded drug is asking for the entire rigamarole of becoming a new patient and then hoping that the doctor one has signed up for will have the courage and understanding to fulfill my requests viz. the withdrawal process. Thanks to this status quo, finding the right doctor for my needs could take years and cost thousands of dollars - and as a 65-year-old pensioner, I have neither the years nor the money left to pursue that course.
Surviving Antidepressants
So I visited the site that you yourself recommended called "Surviving Antidepressants." I posted my story about my plans for withdrawal, while making it clear that I did not seek input about the plan itself; I was searching for practical help in finding a physician who would approve the compounding of Venlafaxine in the way that I desired. The response from the moderator reminded me that it is not just doctors who consider psychoactive substances first from a materialist point of view. The moderator could see no common sense in my idea whatsoever, and was worried instead about the interaction of the drugs in question. Of course, it's no wonder that materialists dislike the combination of drugs because this adds to the variables they must allow into their abstract analyses and so impedes their ability to pretend to absolute knowledge on the topic in question. They would rather that their patients suffer a little than to have their clinical studies muddled up by excess variables.
I tried to explain this to the moderator, but she seemed to think that I should trust medical science on these questions. Again, we see this complete aversion to common sense ideas in favor of the abstract reckonings of materialists.
Sure, there is a risk to anything, but science cannot help me decide if a risk is worth it, first because they do not even acknowledge the existence of the benefits that I seek from use, and second because they have no idea of my aspirations and goals in life. Maybe I am a hypochondriac who wishes zero risk, but then again I may be a Jack Kerouac who wishes to live large, yes, even at the chance of dying in my efforts to do so. This reminds me of a quote attributed to Avicenna when tasked about his enthusiastic use of opium:
"I prefer a short life with width to a narrow one with length."
Mad in America
Not yet discouraged, I submitted my "personal story" to Mad in America, a website devoted to people like myself who have seen through the myth of the chemical imbalance and are now trying to find their way in life without the help of antidepressants. The response I received was even more jarring than that I encountered from Surviving Antidepressants. At least the latter site published my comments. The woman at MIA told me that my personal story might be interpreted as "prescriptive" by her readers and so could not be published. I replied that it was the Drug War which tells us that people cannot handle the truth about substances. If I write honestly about my plans to climb the North Face without hiking equipment, I am scarcely exhorting my readers to do the same. But when I talk honestly about my plans viz. drugs, I must write apologetically while nodding to materialist science (as noted above) as the true authorities in this area.
I then contacted a guy in Costa Rica that works with mushroom retreats. We talked for about an hour, and he had some useful insights. But he too could see nothing in my merely common-sense plan to get off Venlafaxine incrementally. Like most retreat guides, he wanted me to get off the antidepressants first and only THEN take psilocybin. Such advice for getting off antidepressants reminds me of Steve Martin's prescription for becoming a millionaire in the movie The Jerk. "First," says Steve, "get yourself a million dollars."
I should probably explain here why my plan makes psychological common sense to me. I always assumed that it was obvious, but that is apparently not the case, at least not in the age of the Drug War.
When one decreases a drug incrementally, they are unlikely to blame any particular uneasiness on the withdrawal process itself. Whereas if I have a bad day after dropping 37.5 mgs overnight, I would very likely experience that badness as being caused by the large, sudden reduction of Venlafaxine dosage, even if, technically speaking, the two things were simply correlated and not related causally. This would cause me to distrust the whole withdrawal process and perhaps even to abandon it. As for the psilocybin, it is useful first and foremost because I believe in it and I know from experience that it has the power to boost my resolve and my level of insight about the dilemmas that face me. It makes me FEEL like "I CAN DO THIS!" I simply "know" that it would help me get off Venlafaxine, don't ask me how. For, as Blaise Pascal once wrote, "The heart has its own reasons."
Finally, there is therapeutic power in euphoria. It is just plain common sense. If I am going through hell from drug withdrawal and yet I know with certainty that an upcoming drug experience will lessen the pain and give me peace and insights, even for the course of one afternoon, that mere knowledge will be therapeutic for me. It will make me more willing to bear the present downsides of withdrawal. And yet amazingly, this kind of drug benefit is invisible to most Americans, probably because it is invisible to the doctors, our so-called "experts" on these topics, who are obsessed with molecules rather than the world of living, breathing human beings.
It's at this point that I look to my interlocutor for a little sign of acknowledgement, but, alas, in vain. So far everyone shakes their heads, apparently saddened by my inability to accept the expertise of "science" in these areas. Suddenly the risks of doing things my way, of decreasing Venlafaxine incrementally, are touted as insuperable barriers, notwithstanding the fact no one considers the risks of horseback riding to be a knock-out blow against equestrian sports, nor the fact that boats sink a sign that boating should be banned.
I respond to such incredulity by pointing out that I myself am the expert on how I feel about these things, and that it is the feelings of the user that ultimately determine how and if such untested protocols as mine would work. No doubt my proposed experiment is something new to the American sensibilities, but why should I not be able to offer myself as a guinea pig in the service of an idea that makes perfect psychological sense and accords with the time-honored holistic practices of indigenous people around the world, especially given the fact that the standard withdrawal protocols have such a dismal recidivism rate for long-term users (95% after three years in the case of Venlafaxine)? Instead, I'm told to seek out "experts" among today's scientists, the same scientists who have told me for 40 years now that it's too dangerous for me to use the natural medicines that grow at my very feet.
The downsides of antidepressants
Your guide treats antidepressants rather gently, implying that they have no downsides, except maybe for folks who demand a full psychedelic experience, one not dampened by the use of SSRIs and SNRIs. But based on 40 years of use, I would say that antidepressants have a long list of downsides, at least two of which have never been fully elucidated by anyone. You mention one of them, although you do not characterize it as a downside, but rather as a sort of possibly inevitable quirk: namely...
1) The fact that antidepressants interfere with one's very ability to benefit from indigenous plant teachers. That means that, for those of us who believe in the existence of sacred natural medicines, these antidepressants are actually evil: imagine, if you will, a drug that makes it impossible for you to appreciate a rainbow - or that keeps you from appreciating it in any profound way. Is not that drug evil in a sense, at least for the humanitarians among us, and should it not be denounced rather than discussed apologetically - or even with praise?!
2) The other downside bothers me more than anything else, and that is the fact that antidepressants have turned me into an eternal patient. These pills have turned me into the Ancient Mariner, who must hove into Mental Health Harbor every three months of his life to tell his personal story to strangers, some of whom are one-third his own age, all for the privilege of being able to buy an expensive medicine that he does not even want to be taking. This is HUGELY disempowering, and yet I have never heard a psychiatrist acknowledge this downside, much less apologize for it. True, they may let a senior like myself go for as long as six months without an appointment, but if they assign a new psychiatrist, I must come in again ASAP so that he or she can get to know me. Nor can I ever get more than a three-month supply of "meds" at a time, even though I have shown for 40 years now that I am not a risk for selling them on the black market - as if such sales would even make sense to me. In short, those who are stuck on these drugs are treated like children, and that's about as disempowering a healthcare arrangement as possible.
MAOI inhibitors
You tell us the following two apparent facts:
1) Those taking antidepressants tend to have trouble having full psychedelic experiences
2) MAOI inhibitors increase responses to psilocybin
This begs the obvious question: "Could not MAOI inhibitors be used advisedly by at least some people on anti-depressants - at some dose, in some setting, at some times, etc. - in order to let them have a full psychedelic experience?"
You basically tell us that the answer is no. Why? Because it's dangerous to combine MAOI inhibitors with antidepressants?
Yes, but how dangerous? At what doses is it dangerous? For whom and in what circumstances? Is it still dangerous if taken this way once a month, at a small dose?
Your lack of specifics reminds me of the Drug Warrior practice of assuming that a drug can be banned for use in any circumstance provided only that it appears to be dangerous in one single situation. And so if a drug could be potentially misused recreationally by a white suburban teenager at one dose and in one context, then it must not be used by anyone, anywhere, at any dose, in any context.
My point here is not to say that MAOI inhibitors COULD be used with reasonable safety at low doses in order to help the dependent drug user appreciate a full-blown psychedelic experience. I know nothing about that. But the fact that the combination of MAOI and antidepressants is dangerous means nothing by itself. You have to first say "How dangerous is it, and at what doses is it dangerous?" And even then, the potential dangers of use must be weighed against the potential psychological benefits anticipated by the would-be user, who alone knows the extent to which risk makes sense given his or her own feelings about the status quo.
Disclaimer
Now I will end with my own disclaimer, albeit not an apologetic one. I am not saying that there are no such things as experts when it comes to using psychoactive medicines wisely. But the experts are not materialist doctors. The experts are empathic people with actual experience with such substances and a good knowledge of past outcomes of use in the real world. Moreover, as you yourself acknowledge, we are at a very early stage as westerners in the process of learning how to benefit from these substances wisely, lacking as we do the religious rituals and social context that typically surrounded such use in non-western societies. We only impede progress when we insist that our protocols for psychoactive medicines mirror our protocols for other drugs like aspirin and penicillin, as if the crucial human aspects of the former use should be ignored. And that is precisely what we are doing when we decide a priori that the euphoric potential of psychedelic drugs cannot be leveraged to make the withdrawal process easier and even instructive, for these kinds of substances are called "teachers" in the non-western world for a reason.
We've been taught to fear such thinking as a threat to the safety of young Americans. But our youth are not dying today because of honesty about drugs: they are dying today because of enforced ignorance and an unregulated drug supply that leads to contamination and overdoses.
The Drug War is based on two HUGE lies: 1) that prohibition has no downsides, & 2) that drug use has no upsides.
After over a hundred years of prohibition, America has developed a kind of faux science in which despised substances are completely ignored. This is why Sci Am is making a new argument for shock therapy in 2023, because they ignore all the stuff that OBVIOUSLY cheers one up.
Over 45% of traumatic brain injuries are caused by horseback riding (ABC News). Tell your representatives to outlaw horseback riding and make it a federal offence to teach a child how to ride! Brought to you by the Partnership for a Death Free America.
The front page of every mycology club page should feature a protest of drug laws that make the study of mycology illegal in the case of certain shrooms. But no one protests. Their silence makes them drug war collaborators because it serves to normalize prohibition.
Americans heap hypocritical praise on Walt Whitman. What they don't realize is that many of us could be "Walt Whitman for a Day" with the wise use of psychoactive drugs. To the properly predisposed, morphine gives a DEEP appreciation of Mother Nature.
We need a scheduling system for psychoactive drugs as much as we need a scheduling system for sports activities: i.e. NOT AT ALL. Some sports are VERY dangerous, but we do not outlaw them because we know that there are benefits both to sports and to freedom in general.
If NIDA covered all drugs (not just politically ostracized drugs), they'd produce articles like this: "Aspirin continues to kill hundreds." "Penicillin misuse approaching crisis levels." "More bad news about Tylenol and liver damage." "Study revives cancer fears from caffeine."
The best step we could take in harm reduction is re-legalizing everything and starting to teach safe use. Spend the DEA's billions on "go" teams that would descend on locations where drugs are being used stupidly -- not to arrest, but to educate.
I think many scientists are so used to ignoring "drugs" that they don't even realize they're doing it. Yet almost all books about consciousness and depression (etc.) are nonsense these days because they ignore what drugs could tell us about those topics.
Imagine if there were drugs for which dependency was a feature, not a bug. People would stop peddling that junk, right? Wrong. Just ask your psychiatrist.
Buy the Drug War Comic Book by the Drug War Philosopher Brian Quass, featuring 150 hilarious op-ed pics about America's disgraceful war on Americans
You have been reading an article entitled, Taper Talk: a philosophical review of the antidepressant tapering guide from Psychedelic Passage, published on August 22, 2024 on AbolishTheDEA.com. For more information about America's disgraceful drug war, which is anti-patient, anti-minority, anti-scientific, anti-mother nature, imperialistic, the establishment of the Christian Science religion, a violation of the natural law upon which America was founded, and a childish and counterproductive way of looking at the world, one which causes all of the problems that it purports to solve, and then some, visit the drug war philosopher, at abolishTheDEA.com. (philosopher's bio; go to top of this page)
You have been reading an article entitled, Taper Talk: a philosophical review of the antidepressant tapering guide from Psychedelic Passage, published on August 22, 2024 on AbolishTheDEA.com. For more information about America's disgraceful drug war, which is anti-patient, anti-minority, anti-scientific, anti-mother nature, imperialistic, the establishment of the Christian Science religion, a violation of the natural law upon which America was founded, and a childish and counterproductive way of looking at the world, one which causes all of the problems that it purports to solve, and then some, visit the drug war philosopher, at abolishTheDEA.com. (philosopher's bio; go to top of this page)