Cash prizes for the best arguments against psychedelics being an EA cause area

tl;dr – Com­ment be­low with ar­gu­ments for why psychedelic re­search & ad­vo­cacy should not be an EA cause area. On June 3rd, the most up­voted ar­gu­ment will win $400. The sec­ond- and third-most up­voted ar­gu­ments will win $200 & $100, re­spec­tively.

1. Back­ground on why I’m mak­ing this post & offer­ing a prize

This effort was in­spired by Grue_Slinky’s prize for the best ar­gu­ment against the EA Ho­tel.

I’m offer­ing a $400 USD prize for the best ar­gu­ment against psychedelic re­search & ad­vo­cacy be­ing an EA cause area. I’m also offer­ing $200 for the sec­ond-best ar­gu­ment & $100 for the third-best.

Un­cov­er­ing an­other high-im­pact cause area seems very valuable, as EA’s im­pact is closely cor­re­lated with the quan­tity & qual­ity of the cause ar­eas it sup­ports. This prize is a small effort to­wards as­sess­ing whether psychedelics should be taken up as an EA cause area.

The pri­mary mo­ti­va­tion here is to sur­face pre­vi­ously un­con­sid­ered ar­gu­ments for why psychedelics should not be an EA cause area. My cur­rent view is that psychedelics are an ex­tremely promis­ing al­tru­is­tic cause area – I’d like to stress-test that view to see what I’ve missed.

Below, I offer some ar­gu­ments for why psychedelics should be an EA cause area.[1] Th­ese ar­gu­ments are pro­vided as a jump­ing-off point for ar­gu­ments against.

2. Speci­fi­ca­tion of the prize

To be con­sid­ered for the prize, add your ar­gu­ment against psychedelics be­ing an EA cause area as a top-level com­ment on this post. (Only top-level com­ments on this post will be con­sid­ered as valid sub­mis­sions.)

On Mon­day, June 3rd, I’ll award $400 USD to the most-up­voted ar­gu­ment against, $200 USD to the sec­ond-most-up­voted ar­gu­ment against, and $100 USD to the third-most-up­voted ar­gu­ment against. I will break any ties, by choos­ing my fa­vorite of the tied ar­gu­ments.

I’ll con­tact the prize win­ners via a Fo­rum di­rect mes­sage to co­or­di­nate the re­mit­tance of their prizes. Once pay­outs are com­plete, I’ll an­nounce the win­ners in a com­ment on this post.

Feel free to up­vote other peo­ple’s sub­mis­sions, even if you sub­mit an ar­gu­ment your­self. (I sup­pose you could also down­vote other sub­mis­sions, though that doesn’t feel very sport­ing.)

To avoid po­ten­tial bias, I will not up­vote or down­vote any prize sub­mis­sions.

You can also com­ment with things that aren’t ar­gu­ments against psychedelics be­ing an EA cause area, though note that such com­ments will not be con­sid­ered as prize sub­mis­sions.

3. Ar­gu­ments for the im­por­tance of psychedelics

To seed dis­cus­sion, here are some ar­gu­ments for the im­por­tance of psychedelics as an al­tru­is­tic cause area.

3(a). Psychedelics are ap­peal­ing to both long-ter­mist & short-ter­mist views

Al­most ev­ery­one in EA holds ei­ther a long-ter­mist view (ev­ery­one who will ex­ist over the en­tire of course of the fu­ture de­serves moral con­sid­er­a­tion) or a short-ter­mist view (only peo­ple who ex­ist be­fore some time hori­zon de­serve moral con­sid­er­a­tion).

If you hold a long-ter­mist view (i.e. all fu­ture peo­ple de­serve moral con­sid­er­a­tion) & you’re a con­se­quen­tial­ist (as far as I know, al­most ev­ery long-ter­mist is con­se­quen­tial­ist), then it’s very difficult to do long-term cause pri­ori­ti­za­tion, be­cause you have limited visi­bil­ity into the out­comes oc­cur­ring 10,000+ years into the fu­ture – and these are out­comes you want to know about when as­sess­ing to­day’s ac­tions. Prac­ti­cally, we’re clue­less about many long-term con­se­quences of our pre­sent ac­tions. You can read more about con­se­quen­tial­ist clue­less­ness here.

Given this the­o­ret­i­cal prob­lem, long-ter­mist cause pri­ori­ti­za­tion should in­clude “ro­bust­ness to clue­less­ness” as a ma­jor fac­tor.

Some x-risk in­ter­ven­tions seem pretty ro­bust to clue­less­ness, e.g. Eliezer Yud­kowsky’s work rais­ing aware­ness of the AI al­ign­ment prob­lem. Eliezer’s ad­vo­cacy work seems ro­bust be­cause in al­most ev­ery sce­nario you can imag­ine, it’s good for more re­searchers to be aware of the AI al­ign­ment is­sue.[2]

In­ter­ven­tions that in­crease the set of well-in­ten­tioned + ca­pa­ble peo­ple also seem quite ro­bust to clue­less­ness, be­cause they al­low for more er­ror cor­rec­tion at each timestep on the way to the far fu­ture.

Ra­tion­al­ity train­ing pro­grams like CFAR & Paradigm Academy are aimed at in­creas­ing the num­ber of well-in­ten­tioned + ca­pa­ble peo­ple.

The psychedelic ex­pe­rience also seems like a plau­si­ble lever on in­creas­ing ca­pa­bil­ity (via re­duc­ing nega­tive self-talk & other men­tal blocks) and im­prov­ing in­ten­tions (via ego dis­solu­tion chang­ing one’s meta­phys­i­cal as­sump­tions).

I com­pare the mechanisms of im­pact of the psychedelic ex­pe­rience and of pro­grams like CFAR & Paradigm be­low.

By “chang­ing one’s meta­phys­i­cal as­sump­tions,” I mean that the psychedelic state can change views about what the self is, and what ac­tions con­sti­tute act­ing in one’s “self-in­ter­est.” Con­sider Michael Pol­lan’s ac­count of one of his psilo­cy­bin trips, in How to Change Your Mind:

“I” now turned into a sheaf of lit­tle pa­pers, no big­ger than Post-its, and they were be­ing scat­tered to the wind. But the “I” tak­ing in this seem­ing catas­tro­phe had no de­sire to chase af­ter the slips and pile my old self back to­gether. No de­sires of any kind, in fact. Who­ever I now was was fine with what­ever hap­pened. No more ego? That was okay, in fact the most nat­u­ral thing in the world.
For what was ob­serv­ing the scene was a van­tage and mode of aware­ness en­tirely dis­tinct from my ac­cus­tomed self; in fact I hes­i­tate to use the “I” to de­note the pre­sid­ing aware­ness, it was so differ­ent from my usual first per­son.
Where that self had always been a sub­ject en­cap­su­lated in this body, this one seemed un­bounded by any body, even though I now had ac­cess to its per­spec­tive… Every­thing I once was and called me, this self six decades in the mak­ing, had been liquefied and dis­persed over the scene. What had always been a think­ing, feel­ing, per­ceiv­ing sub­ject based in here was now an ob­ject out there.

Like Pol­lan de­scribes, peo­ple of­ten ex­pe­rience ex­tremely al­tered self-aware­ness dur­ing psychedelic trips. This is part of the “mys­ti­cal ex­pe­rience,” which ap­pears to be cor­re­lated with the ther­a­peu­tic benefits of psychedelics (see Rose­man et al. 2017, Griffiths et al. 2008).

To sum up, un­der a long-ter­mist view, psychedelic in­ter­ven­tions are plau­si­bly in the same bal­l­park of effec­tive­ness of other in­ter­ven­tions that in­crease the set of well-in­ten­tioned + ca­pa­ble peo­ple. This is be­cause these in­ter­ven­tions seem quite ro­bust to con­se­quen­tial­ist clue­less­ness – the ex­treme difficulty of con­fi­dently as­sess­ing far-fu­ture con­se­quences of to­day’s ac­tions.

If you hold a short-ter­mist view (i.e. only peo­ple who ex­ist be­fore some time hori­zon de­serve moral con­sid­er­a­tion), men­tal health ap­pears to be a cause area on par with global poverty, i.e. if global poverty in­ter­ven­tions meet the crite­ria for be­ing an EA cause area, so too should men­tal health in­ter­ven­tions.

Men­tal ill­ness ap­pears to cause more suffer­ing than poverty in de­vel­oped coun­tries, and it seems to cause roughly as much suffer­ing wor­ld­wide as poverty does. Un­like poverty, the men­tal health bur­den isn’t shrink­ing. (See Michael Plant’s cause pro­file on men­tal health for an anal­y­sis of how men­tal ill­ness causes roughly as much suffer­ing as global poverty.)

Psychedelics are show­ing a ton of promise as treat­ment for a bat­tery of chronic men­tal health is­sues: anx­iety (see Gasser et al. 2015, Griffiths et al. 2016), de­pres­sion (see Carhart-Har­ris et al. 2018, Palhano-Fontes et al. 2019), OCD (see Moreno et al. 2006), and ad­dic­tive di­s­or­ders in­clud­ing smok­ing (see John­son et al. 2017) & al­co­holism (see Bo­gen­schutz et al. 2015, Krebs & Jo­hansen 2012).

For a sum­mary of some of these find­ings, see dos San­tos et al. 2016, a sys­tem­atic re­view of the men­tal health effects of psychedelic ther­apy.

So, un­der a short-ter­mist view, psychedelic in­ter­ven­tions are plau­si­bly in the same bal­l­park of effec­tive­ness as global poverty in­ter­ven­tions.

In sum­mary, psychedelic re­search & ad­vo­cacy seems par­tic­u­larly com­pel­ling as a cause area, be­cause it performs well un­der both short-ter­mist and long-ter­mist wor­ld­views. Given our un­cer­tainty about moral­ity, this ap­pears to make psychedelics more ro­bust than cause ar­eas that rely on a sin­gle se­quence of rea­son­ing to jus­tify their im­pact.

3(b). Com­par­i­son of ra­tio­nal­ity train­ing to the psychedelic experience

As above, both ra­tio­nal­ity train­ing and the psychedelic ex­pe­rience seem to be lev­ers that in­crease the num­ber of well-in­ten­tioned + ca­pa­ble peo­ple. This is plau­si­bly ro­bust to clue­less­ness (the difficulty of as­sess­ing out­comes that oc­cur 10,000s of year in the fu­ture), be­cause well-in­ten­tioned + ca­pa­ble peo­ple can course cor­rect as we head into the fu­ture.

Com­par­ing ra­tio­nal­ity train­ing pro­grams (e.g. CFAR, Paradigm Academy) to psychedelic ex­pe­riences is tricky. It’s hard to make an ap­ples-to-ap­ples com­par­i­son, be­cause the in­ter­ven­tions are op­er­at­ing on very differ­ent lev­els of ab­strac­tion.

The ra­tio­nal­ity train­ing pro­grams I know of op­er­ate al­most en­tirely on the con­cep­tual level (though I be­lieve Paradigm uses some body­work modal­ities also). The ba­sic struc­ture of con­cep­tual ra­tio­nal­ity train­ing is some­thing like:

  • In­struc­tor says some words about a ra­tio­nal­ity topic

  • Trainee hears these words & tries to in­ter­nal­ize the topic

  • Trainee prac­tices their in­ter­nal­ized ver­sion of the ra­tio­nal­ity topic (by them­selves, with other trainees, or with the in­struc­tor)

    • In­struc­tor pro­vides feed­back to trainee to im­prove the trainee’s in­ter­nal­ized model of the topic

I think this struc­ture can work re­ally well for in­for­ma­tion & tech­nique trans­fer, es­pe­cially when the trainee is en­gaged & the in­struc­tor is skil­lful.

The ba­sic struc­ture of a psychedelic trip is very differ­ent:

  • Trip­per thinks about and ar­tic­u­lates the in­ten­tions & ex­pec­ta­tions they have about their up­com­ing psychedelic ex­pe­rience (to them­selves, or to a fa­cil­i­ta­tor)

  • Trip­per in­gests a psychedelic (by them­selves, or with a sober fa­cil­i­ta­tor pre­sent)

  • Trip­per has a psychedelic ex­pe­rience. This ex­pe­rience can in­clude a wide range of sub­jec­tive el­e­ments:

    • Old mem­o­ries can come up and/​or be­come salient

    • New per­spec­tives on re­la­tion­ships with friends, fam­ily, one’s im­me­di­ate en­vi­ron­ment can be adopted

    • Emo­tions can be felt very in­tensely, es­pe­cially emo­tions about salient peo­ple & top­ics in the one’s life

    • In­sights can be had about the trip­per’s psy­chol­ogy, so­cial as­sump­tions, epistemic as­sump­tions, and meta­phys­i­cal assumptions

    • New per­sonal nar­ra­tives (“this is the story of my life; this is what my life’s about”) can be adopted

  • Once sober, trip­per in­te­grates the ex­pe­rience (by them­selves, or in di­alogue a fa­cil­i­ta­tor)

    • How did the ac­tual trip match up to your ex­pec­ta­tions about the trip?

    • What came up? What was in­ter­est­ing? What was triv­ial, or silly?

    • Did any­thing come up that’s worth in­cor­po­rat­ing into your ev­ery­day life?

(See the Psychedelic Ex­plorer’s Guide for more on how to struc­ture an effec­tive, safe trip.)

I think this struc­ture can be re­ally helpful for sur­fac­ing emo­tional blocks (e.g. things that gen­er­ate akra­sia, i.e. act­ing against one’s bet­ter judg­ment), as well as for re­solv­ing known emo­tional blocks.

The psychedelic ex­pe­rience can also help change one’s as­sump­tions, in­ter­nal monologue, and per­sonal nar­ra­tive. (See the above Michael Pol­lan quote for an ex­am­ple of this. Also note that the psychedelic ex­pe­rience doesn’t do this au­to­mat­i­cally, it can just help “loosen you up.” The trip­per still has to in­ten­tion­ally work to­wards chang­ing these things.)

So, to the ex­tent that the EA com­mu­nity is limited by in­for­ma­tion & tech­nique trans­fer, I’d ex­pect con­cep­tual ra­tio­nal­ity train­ing to be more lev­er­aged.

To the ex­tent that the EA com­mu­nity is limited by emo­tional blocks & un­helpful per­sonal nar­ra­tives, I’d ex­pect the psychedelic ex­pe­rience to be more lev­er­aged.

My cur­rent view is that the EA com­mu­nity is more limited by emo­tional blocks & un­helpful per­sonal nar­ra­tives. The 2019 Slate Star Codex reader sur­vey offers some data here: 17.4% of sur­vey re­spon­dents have a for­mal di­ag­no­sis of de­pres­sion (an­other 16.7% sus­pect they are de­pressed but haven’t been di­ag­nosed); 12.6% of re­spon­dents have a for­mal di­ag­no­sis of anx­iety (an­other 18.7% sus­pect they have anx­iety but haven’t been di­ag­nosed).

3(c). In­ter­lude – on quan­ti­ta­tive comparison

The above is merely a the­o­ret­i­cal com­par­i­son – a quan­ti­ta­tive com­par­a­tive anal­y­sis would be helpful for think­ing through the po­ten­tial of psychedelics rel­a­tive to other causes. Here’s one at­tempt at quan­tify­ing the benefits of a psychedelic in­ter­ven­tion us­ing DALYs, con­clud­ing that the in­ter­ven­tion has a cost-per-DALY-averted of $472.

Note that DALY & QALY frame­works prob­a­bly un­der­weight men­tal health in­ter­ven­tions due to the ret­ro­spec­tive sur­vey method­ol­ogy used to con­struct their weight­ings.

Also note that there aren’t many quan­ti­ta­tive analy­ses that com­pare across EA cause ar­eas. (e.g. com­par­ing an­i­mal welfare in­ter­ven­tions to global poverty in­ter­ven­tions, or com­par­ing x-risk in­ter­ven­tions to an­i­mal welfare in­ter­ven­tions.) Michael Dick­ens’ cause pri­ori­ti­za­tion app at­tempts this, though as far as I know it hasn’t been used to drive much de­ci­sion-mak­ing.

3(d). Trauma alleviation

Child­hood trauma is plau­si­bly up­stream of sev­eral bur­den­some prob­lems. See this ex­cerpt from The Body Keeps Score, a pop-sci re­view of aca­demic trauma re­search (on p. 150):

The first time I heard Robert Anda pre­sent the re­sults of the ACE study, he could not hold back his tears. In his ca­reer at the CDC he had pre­vi­ously worked in sev­eral ma­jor risk ar­eas, in­clud­ing to­bacco re­search and car­dio­vas­cu­lar health.
But when the ACE study data started to ap­pear on his com­puter screen, he re­al­ized that they had stum­bled upon the gravest and most costly pub­lic health is­sue in the United States: child abuse.
[Anda] had calcu­lated that its over­all costs ex­ceeded those of can­cer or heart dis­ease and that erad­i­cat­ing child abuse in Amer­ica would re­duce the over­all rate of de­pres­sion by more than half, al­co­holism by two-thirds, and suicide, IV drug use, and do­mes­tic vi­o­lence by three-quar­ters. It would also have a dra­matic effect on work­place perfor­mance and vastly de­crease the need for in­car­cer­a­tion.

Psychedelic ther­apy seems very promis­ing for re­solv­ing PTSD, which could plau­si­bly break the cy­cle of abuse that cre­ates new trau­matic ex­pe­riences. (Trauma ap­pears to trans­fer from gen­er­a­tion to gen­er­a­tion via mul­ti­ple path­ways.)

In par­tic­u­lar, MDMA-as­sisted psy­chother­apy for PTSD is yield­ing ex­tremely promis­ing re­sults in re­cent ran­dom­ized con­trol­led tri­als (see Mithoefer et al. 2012, Mithoefer et al. 2018, Ot’alora et al. 2018). From the ab­stract of Mithoefer et al. 2018:

At the pri­mary end­point, the 75 mg and 125 mg groups had sig­nifi­cantly greater de­creases in PTSD symp­tom sever­ity (mean change CAPS-IV to­tal scores of −58·3 [SD 9·8] and −44·3 [28·7]; p=0·001) than the 30 mg group (−11·4 [12·7]). Com­pared with the 30 mg group, Co­hen’s d effect sizes were large: 2·8 (95% CI 1·19–4·39) for the 75 mg group and 1·1 (0·04–2·08) for the 125 mg group.
PTSD symp­toms were sig­nifi­cantly re­duced at the 12-month fol­low-up com­pared with baseline af­ter all groups had full-dose MDMA (mean CAPS-IV to­tal score of 38·8 [SD 28·1] vs 87·1 [16·1]; p<0·0001).

A Co­hen’s d of 2.8 is ex­tremely large (“Co­hen sug­gested that d = 0.2 be con­sid­ered a ‘small’ effect size, 0.5 rep­re­sents a ‘medium’ effect size and 0.8 a ‘large’ effect size” source). Here’s a good re­source for in­ter­pret­ing Co­hen’s d.

In this study, 30 mg of MDMA was used as an ac­tive placebo, and the in­ter­ven­tion groups were given 75 mg or 125 mg of MDMA.

From Mithoefer et al. 2012, a long-term fol­low-up of the first MDMA RCT:

We found the ma­jor­ity of these sub­jects with pre­vi­ously se­vere PTSD who were un­re­spon­sive to ex­ist­ing treat­ments had symp­tomatic re­lief pro­vided by MDMA-as­sisted psy­chother­apy that per­sisted over time...

MDMA helped re­solve se­vere PTSD symp­toms in pa­tients who had not re­sponded to other treat­ment reg­i­mens. For 86% of pa­tients, this benefit per­sisted 17+ months af­ter the MDMA ses­sion.

3(e). Other (spec­u­la­tive) ar­gu­ments for im­pact

Below are a few other mechanisms by which psychedelics could be highly im­pact­ful. Th­ese are spec­u­la­tive and I sug­gest hold­ing them weakly – most of my own in­ter­est in psychedelic re­search & ad­vo­cacy as an EA cause area is driven by the ar­gu­ments given above.

Psychedelics may boost cre­ativity & prob­lem-solv­ing. See Har­man et al. 1966 – 27 white-col­lar pro­fes­sion­als took mescal­ine and worked on a prob­lem they had been stuck on.[3]

Out­comes for the prob­lems par­ti­ci­pants had been stuck on:

  • A com­mer­cial build­ing de­sign, ac­cepted by the client

  • De­sign of a lin­ear elec­tron ac­cel­er­a­tor beam-steer­ing device

  • Eng­ineer­ing im­prove­ment to a mag­netic tape recorder

  • A chair de­sign, mod­eled and ac­cepted by the manufacturer

  • A math­e­mat­i­cal the­o­rem re­gard­ing NOR gate circuits

  • De­sign of a pri­vate dwelling, ap­proved by the client

Anec­do­tally, Steve Jobs said that tak­ing LSD was “one of the most im­por­tant things in my life.”

Eric We­in­stein (math­e­mat­i­cian, ven­ture cap­i­tal­ist), Sam Har­ris (pub­lic in­tel­lec­tual), Al­dous Huxley (writer), Kary Mullis (in­ven­tor of the polymerase chain re­ac­tion), and Dou­glas En­gelbart (com­puter sci­en­tist, in­ven­tor of the com­puter mouse) have all spo­ken highly of psychedelics and/​or are known to use them.

Psychedelics may ex­pand one’s cir­cle of moral con­cern. As far as I know, there hasn’t yet been a ran­dom­ized study of the re­la­tion­ship be­tween psychedelic use & al­tru­ism. (Though I’d love to see one!)

Lerner & Lyvers 2006 found that psychedelic users scored higher on em­pa­thy scales than non-drug users, though non-psychedelic drug users also had higher em­pa­thy scores than non-drug users, so it’s not clear if there was an effect driven by psychedelic use.

Anec­do­tally, see this es­say by anony­mous philan­thropist Pine, who at­tributes their de­ci­sion to set up the Pineap­ple Fund to a psychedelic ex­pe­rience: “I’ve had the idea to donate a large por­tion of my bit­coins for a while, and it is through this jour­ney of dis­cov­er­ing my­self [with the help of psychedelics] that made me ac­tu­ally com­mit to it.”

Info haz­ard. Fi­nally, there’s a path­way to im­pact that I give some weight to, but can’t dis­cuss pub­li­cly due to con­cern that talk­ing about the path­way would be an in­for­ma­tion haz­ard. If you’re in­ter­ested in learn­ing more about this con­sid­er­a­tion, shoot me an email.

(Note that this con­sid­er­a­tion is only a small part of why I’m ex­cited about psychedelics, and I’d still be bullish about psychedelics as an EA cause area in its ab­sence.)

4. Ne­glect­ed­ness and tractability

How do psychedelics perform un­der the im­por­tance, ne­glect­ed­ness, tractabil­ity frame­work? The “im­por­tance” con­sid­er­a­tion is dis­cussed above. Ne­glect­ed­ness and tractabil­ity are con­sid­ered be­low.

4(a). Neglectedness

In short, psychedelic re­search is ne­glected. As dis­cussed here, sci­en­tific re­search is very ex­pen­sive, and cur­rent psychedelic re­search is hap­pen­ing only be­cause a hand­ful of pri­vate donors are fund­ing it. (For more back­ground, see this list of Open Phil analy­ses of the sci­en­tific re­search fund­ing land­scape.)

Govern­ments are a ma­jor driver of sci­en­tific fund­ing (NIH in­tends to grant $39.1 billion in 2019), and gov­ern­ments have not funded psychedelic re­search at all (pre­sum­ably due to con­cern about op­tics, as well as bu­reau­cra­cies be­ing gen­er­ally slow to up­date their stance).

From con­ver­sa­tions I’ve had over the past two years, psychedelic re­search seems highly fund­ing con­strained, such that more money would con­vert into more re­search.

Roughly $40 mil­lion has been com­mit­ted to psychedelic re­search since 2000.[4]

In com­par­i­son, the Open Philan­thropy Pro­ject has granted $104 mil­lion to sci­en­tific re­search since 2011.

Another com­par­i­son point: Open Phil’s grant to es­tab­lish CSET ($55 mil­lion) is larger than the to­tal amount spent on psychedelic re­search in the last 20 years, wor­ld­wide.

4(b). Tractability

I’ve spent the last two years learn­ing about the var­i­ous pro­jects go­ing on in the psychedelic com­mu­nity. My gen­eral con­clu­sion is that there are many tractable pro­jects that could be hap­pen­ing but aren’t, due to lack of fund­ing & ca­pac­ity.

Here are the most im­por­tant lines of psychedelic work cur­rently hap­pen­ing:

  1. MDMA is be­ing shep­herded through the FDA ap­proval pro­cess for PTSD treat­ment by MAPS.

  2. Psilo­cy­bin is be­ing shep­herded through the FDA ap­proval pro­cess as a treat­ment for de­pres­sion by both Com­pass Path­ways and the Usona In­sti­tute (in­de­pen­dently).

  3. State-level poli­ti­cal cam­paigns to liber­al­ize psychedelics are un­der­way in Ore­gon & Cal­ifor­nia. The city of Den­ver re­cently de­crim­i­nal­ized psilo­cy­bin, by a nar­row mar­gin.

Both MDMA for PTSD & psilo­cy­bin for de­pres­sion have re­ceived break­through ther­apy des­ig­na­tion from the FDA, which in­di­cates that the FDA thinks that these treat­ments “may demon­strate sub­stan­tial im­prove­ment over available ther­apy.”

MDMA ther­apy is on track be made available as a pre­scrip­tion medicine in 2021 or 2022. Psilo­cy­bin ther­apy is on track to be made available as pre­scrip­tion medicine some­time be­tween 2022 and 2024.

There’s a huge amount of work that needs to be done to make these reschedul­ing pro­cesses go well. There are in­surance con­sid­er­a­tions, mar­ket­ing con­sid­er­a­tions, reg­u­la­tory con­sid­er­a­tions, and le­gal con­sid­er­a­tions that haven’t been figured out yet but need to be.

There isn’t an ob­vi­ous place for psychedelic ther­apy in the cur­rent US health­care in­fras­truc­ture, so new in­fras­truc­ture will need to be built (e.g. clinics for ad­minis­ter­ing psychedelic ther­apy). There are op­por­tu­ni­ties to ad­dress this from both non-profit and for-profit ap­proaches.

Fur­ther­more, we still don’t gran­u­larly un­der­stand how psychedelics work neu­rolog­i­cally, and we haven’t ex­plored much of the space of pos­si­ble ap­pli­ca­tions of these sub­stances. More re­search is needed – re­search groups at Johns Hop­kins, NYU, Yale, the Heffter Re­search In­sti­tute, and Im­pe­rial Col­lege Lon­don all have deep re­search agen­das they’d like to pur­sue, and they are all fund­ing-limited.

Fi­nally, as reschedul­ing ap­proaches & psychedelics gain pop­u­lar­ity, there’s a mas­sive amount of pub­lic ed­u­ca­tion work that needs to be done. The psychedelic ex­pe­rience is not with­out risk. As a greater num­ber of in­ex­pe­rienced peo­ple have psychedelic trips, it’s im­por­tant to prop­a­gate good guidelines for how to ap­proach psychedelics in a safe & re­spect­ful way.

5. Conclusion

I’m offer­ing three prizes for the best ar­gu­ments against psychedelic re­search & ad­vo­cacy be­ing an EA cause area. Any ar­gu­ment sub­mit­ted as a com­ment on this post will be con­sid­ered for these prizes.

I’ll award $400 to the most-up­voted ar­gu­ment, $200 to the sec­ond-most-up­voted ar­gu­ment, and $100 to the third-most-up­voted ar­gu­ment. Win­ners will be as­sessed on Mon­day, June 3rd.

The driv­ing mo­ti­va­tion for this post is to sur­face ar­gu­ments against psychedelic re­search & ad­vo­cacy be­ing an EA cause area. My cur­rent view is that psychedelics are an ex­tremely promis­ing al­tru­is­tic cause area (on par with global health & x-risk re­duc­tion) – I’d like to learn more about how this might be mis­taken.

If my view about psychedelics be­ing a very promis­ing cause area isn’t mis­taken, I’d like to see more at­ten­tion paid to psychedelic re­search & ad­vo­cacy by the EA com­mu­nity.

Cross-posted to LessWrong. Thanks to the Clar­ity Health Fund for a micro­grant that en­abled me to offer these prizes. This post was in­spired by Grue_Slinky’s prize for the best ar­gu­ment against the EA Ho­tel.

[1]: More ar­gu­ments in sup­port of psychedelics be­ing an EA cause area in these posts: Le­gal psychedelic re­treats launch­ing in Ja­maica, Psychedelics Nor­mal­iza­tion, “A Psychedelic Re­nais­sance” (Chron­i­cle of Philan­thropy)

[2]: Even for this case, you could imag­ine some sce­nar­ios where the in­ter­ven­tion doesn’t re­sult in good out­comes.

To the ex­tent there are not-good sce­nar­ios you could say it’s not ro­bust. It’s prob­a­bly best to model “ro­bust­ness to clue­less­ness” as a con­tinuum, wherein some in­ter­ven­tions are more ro­bust than oth­ers.

[3]: In cor­re­spon­dence with one of the study au­thors, it was re­vealed that some of the study par­ti­ci­pants were also given metham­phetamine. The au­thor said that back in the 1960s, they were con­sid­er­ing metham­phetamine to be similar to caf­feine, so did not think much about ad­minis­ter­ing it. Nev­er­the­less, the study re­sults are se­ri­ously con­founded be­cause of this.

[4]: Es­ti­mate con­firmed via pri­vate cor­re­spon­dence.