Many people share the idea that microdosing with psychedelics enhances one’s mood, creativity, concentration, productivity, and ability to empathize with others. Image from Tribune News Service

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Psychedelic drugs have been capturing the attention of doctors and patients alike for their increasingly proven potential to effect long-lasting improvements in the mental health of people suffering from conditions such as treatment-resistant depression.

Microdosing psychedelic substances such as LSD or psilocybin (also called “magic mushrooms”) involves taking a fraction of a regular dose that is much lower than one would take if one wanted to “trip” or hallucinate on these substances.

Many people share the idea that microdosing psychedelics enhances one’s mood, creativity, concentration, productivity and ability to empathize with others.

Or could the benefits be an “expectancy (or placebo) effect”? This means that most people who take a daily pill that they fervently expect will help them feel happier and smarter will feel like they are happier and smarter — just from taking the pill, regardless of what’s in it.

What is microdosing?

There isn’t a single, clearly recognized definition of microdosing for any psychedelic drug, which complicates attempts to perform consistent research.

One definition is approximately 1/5 to 1/20 of a recreational dose. For instance, a medium-strength dose of psilocybin is 2 to 3 grams of dried mushrooms, and a microdose is typically around 0.3 grams.

But the potency of mushrooms can vary greatly, as they are not regulated outside of clinical trials, so this isn’t an exact science.

Likewise, LSD is an invisible, tasteless, odorless substance that usually comes either in liquid form or embedded into a piece of paper to be slipped under the tongue.

Given the lack of regulation, there is no good way to know what dosage you are taking unless you have an extraordinarily reliable supplier. LSD is an extremely powerful and long-acting drug; you don’t want to take more than intended.

Further, psychedelics such as psilocybin and LSD can produce physiological tolerance, which might suggest that, even if microdosing does help, there could be diminishing returns if one stays at the same dosage.

Is microdosing safe?

We don’t know as much about safety as we might have learned if not for the War on Drugs, which curtailed much of the research into psychedelics starting in the late 1960s.

This research has been renewed over the last five to 10 years, and many medical centers, including Johns Hopkins in Baltimore, are now conducting research on psychedelics.

Psilocybin is generally thought to be safe in low dosages and has been used for centuries by indigenous peoples. However, taking too large a dose can result in a terrifying — even traumatic — experience.

Psilocybin is a compound produced by almost 200 species of fungi (mushrooms), but the mushrooms must come from a trusted source. It is very easy to poison oneself with the wrong type of mushroom, as many types of mushrooms in nature can look quite similar to each other, but some are poisonous and can harm your liver, causing severe illness or even death.

Would legalization make it safer?

It is anticipated by experts in the field that some psychedelics may become fully legalized — for medical usage, under supervision — within the next few years, specifically psilocybin and MDMA (ecstasy).

Some policymakers and public health experts believe that the safety of these psychedelics would be enhanced if they were decriminalized and if their cultivation and production were monitored and regulated.

At least one state (Oregon), in addition to many cities around the country, has decriminalized psychedelics at the local level. [Ed. Note: Magic mushrooms are legal in Washington, D.C.]

Skeptics are worried that uncontrolled access to these drugs might affect patients with mental illness, or even precipitate mental illness such as psychosis in people who are vulnerable.

Indeed, the use of all psychedelic drugs should be undertaken with utmost caution — if they should be used at all — in patients with major mental illness such as schizophrenia or bipolar disorder. For safety reasons, these patients are typically excluded from studies involving psychedelic drugs.

Evidence is mixed

Does microdosing work? In short, the jury is still out. Some studies indicate a very real and significant benefit from microdosing, whereas others are much less convincing and show little to no benefit.

One recent study used a naturalistic, observational design to study 953 psilocybin microdosers compared with 180 non-dosing participants for 30 days.

It found “small to medium-sized improvements in mood and mental health that were generally consistent across gender, age and presence of mental health concerns.”

This study and others like it appear to confirm many anecdotal reports of people who swear by the benefits they have experienced from microdosing.

Other studies on microdosing are far less impressive. In one example, the researchers conducted a randomized controlled study, which represents the strongest type of evidence because it weeds out the placebo effect.

The researchers took 34 patients and randomized half to receive psilocybin and half to receive a placebo.

While there were some intriguing subjective effects (people felt happier and more creative) and even some changes in brain waves recorded on an EEG, researchers concluded that low-dose psilocybin mushrooms did not show objective evidence of improvements in creativity, well-being or cognitive function.

Studies such as this support the hypothesis that the effect people receive from psychedelics at these subperceptual doses is mostly an expectancy effect, and that one needs to consume a higher dosage to receive a therapeutic benefit.

To microdose or not to microdose?

Any medical or lifestyle decision is an individual’s choice (assuming that they aren’t harming others). But speak with your doctor before taking psychedelics. Check for any medical reasons why you should be cautious or avoid these drugs.

It is critical to pay attention to the legality and the quality of your product — you likely can’t afford to get into legal jeopardy and certainly can’t afford to poison yourself.

Finally, it is important to understand that there isn’t yet definitive proof that microdosing is at all helpful or even safe in the long term.

With these points in mind, it is fair to say that psychedelic drugs are becoming better understood during a resurgence of research and more widely accepted use.

Peter Grinspoon, M.D., is a contributor to Harvard Health Publications.

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