Paul Appelbaum made an additional important point near the end of his session on psychedelics on May 5, 2024, in New York City. He said that the experience with Ketamine over the past few years as it became widely used to treat depression, was "not encouraging."
Ketamine for depression is virtually unregulated because the drug has been a legal anesthetic since the 1970s, and doctors can prescribe it off-label as they like, without any standards of practice to guide them. New Ketamine infusion clinics open almost every day all over the country; some of those clinics employ real doctors and some don't, but neither the FDA nor anyone else actively monitors what they do. Ketamine pills are easily ordered over the internet (like Viagra or generic ED drugs) after a "virtual medical consultation from your couch" or a simple on-line survey. The Ketamine pills can be delivered by "free and discreet shipping," once prescribed.
Ironically, the only form of this drug which is actually approved for treatment resistant depression, Janssen's esketamine nasal spray Spravato, is strictly regulated to require a minimal amount of counseling or observation along with the administration of the drug. This counseling or observation makes the treatment much more expensive for the added safety. That expense incentivizes the on-line prescription business, and nobody knows who is doing what with this drug.
Appelbaum suggested that if and when LSD, psilocybin, MDMA and other psychedelics are approved for research or treatment of mental disorders, requiring them to be removed from the FDA's Schedule 1 (designating drugs that have no approved medical use), they will rapidly spread out of control the same way Ketamine did. Juxtaposed against the more banal, even jocular attitudes of the presenters in Stephen Ross' session the previous day (which seemed to be that psychedelics are just medicines to be "studied" for endless collection of crunchable statistics and massive amounts of mostly unevaluated "scientific" data), Appelbaum's warnings were even more stark.
A guy sitting next to me laughed out loud when I leaned over and whispered to him, "Hey, wtf... just prescribe shrooms, man!" as a sarcastic response to some presenter's long-winded worry over the complexities of psychedelic assisted therapy and informed consent.
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It really was altogether strange to me that Drs. Brody, Wilkins, Ford and Lake would have been perfectly happy to never mention that staff are just as likely to be the perpetrators of sexual abuse of patients as other patients are. I have to speculate about this glaringly illogical absence of mention, in the session I attended Sunday morning.
The first thing that occurs to me is an oft repeated, supposedly humorous truism: in any psychiatric hospital it can be quite difficult for outsiders to distinguish the patients from the staff, because they are all totally nuts. It turns out they're all about equally perverted, too. The only difference that applies to sexuality is, patients in a secure setting can be controlled, whereas staff must be predicted.
But just as important as the universality of sexual aberration is the last century's history of psychiatry. As I read it, at the beginning of that time, curing mental diseases had been an extremely unsuccessful medical project. Then Freud came along to make everybody think that great hope lay in long, open and honest talk about sex, leading perhaps to development of standard, rational manners on the subject. That didn't work either, and it was definitely never scalable for big profits. After a few decades, psychiatry gravitated back to medicine (drugs).
Part of the historical sequence brought professional embarrassment to an entire generation of would-be doctors, over the quaintly salacious, often fantasy-based details featured in most psychoanalytic therapy sessions. Headshrinkers looked a lot like perverts. To be accepted as real medical experts on the brain (or mind), psychiatrists just had to stop talking about sex.
This severe, still oddly informal and un-admitted proscription is now reflected in byzantine regulations, requirements and policies for reporting every slightest suspicion institutional staff might ever entertain, of possible patient abuse. In Illinois, state employees are required to refresh their training for this every two years, and they all know they must report anything suspicious within four hours.
But guess what, nobody follows the rules. When it comes to sex, nobody wants to know what anyone else is thinking or perhaps doing, because they don't want anyone to wonder what they are thinking or what they might do, themselves. Nobody can safely accuse the person in the office next door, because then they might be asked to leave their own office door open.
To top it off, state-employed "mental health professionals" all have to hide the fact that they have no slightest clue how to really do what the public pays them for: medical cures for emotional, cognitive and behavioral difficulties. They look over their shoulders every day, anxiously wondering, "Who might know that I am incompetent?"
It's a perfect recipe for a slave plantation or mafia culture.
The people who attended the general session on sexual violence Sunday morning in New York certainly had no willingness to confront my honest questions directly on point. Dr. Brody offered only a weak justification for the omission of any perspective or acknowledgement that staff do sexually abuse patients. There were forty or fifty people there, and my impression was that they were all institutional mental health staff. Everyone remained "cheerfully professional," hoping perhaps that they could remain immune to any accusation.
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The connection between psychiatric "treatments" with psychedelic drugs and sexual abuse of patients lies in the fact that substances like psilocybin, LSD, and MDMA are all about no control. No control of thinking, no control of emotion, no control of behavior, no control of supply and demand, no control of the body, no control of therapy, no control of sexuality, no control of law. This is the precise opposite of science or reason.
The essential instinct of psychiatry is not scientific, it's religious. Psychiatrists are selling salvation with much the same pitch as Jim Jones or Charles Manson. They want to play God, or Satan, and their only affinity for science is as a means to power. With psychedelic drugs they would dissolve the personalities of their patients, and wantonly insert their own personalities, which they insist are much better.
They have always failed in that, and they will continue to fail.
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