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DoubleBlind: Image of finger holding microdose of LSD tabs. In this article, DoubleBlind explores the costs, potential risks and side effects of microdosing psychedelics.
DoubleBlind: Image of finger holding microdose of LSD tabs. In this article, DoubleBlind explores the costs, potential risks and side effects of microdosing psychedelics.

Are there Disadvantages to Microdosing Psychedelics?

Microdosing has been celebrated as a mood enhancing, anti-depressant, tool for creativity. But is it actually a panacea?

Bailey Rahn // July 29, 2020

Microdosing psychedelics has received overwhelmingly positive attention from curious experimenters and mainstream media outlets alike. And why wouldn’t it? Online community forums have become a hotbed of powerful testimonials where individuals frequently credit their professional success or mental health recovery to a regular microdosing routine. Though in its infancy, research on microdosing has begun to reinforce claims that microdosing may offer benefits to those struggling to alleviate depression, lethargy, and stubborn creative blocks. 

Afterall, a small dose of chemicals supporting productivity, creativity, and elevated moods is not entirely unlike normalized routines of supplemental vitamins or a daily antidepressant. However, when taking something so regularly, it’s fair to want high-quality research that reassures you microdosing psychedelics like LSD and psilocybin is in fact safe and effective. (For what it’s worth, there is little insight available on the long-term adverse effects of drugs like SSRIs, and research has shown that efficacy is often weighed against unpleasant side effects.)

As beloved and important your microdosing routine may be, it’s worth asking the question that studies have yet to explore in more depth: Are there disadvantages to microdosing?

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What Is Microdosing?

Microdosing is a practice of regularly taking psychedelics at small, sub-perceptible doses with the intent to gently boost mood, creativity, productivity, and cognitive skills. For this reason, microdosing famously boomed in Silicon Valley, where small psychedelic doses became a cherished “vitamin” for tech minds. Others have also approached microdosing with the intent to manage anxiety, depression, or other mental health issues.

LSD and psilocybin are two of the most popularly microdosed psychedelics, but they are by no means the only two. Cannabis, DMT, ketamine, and mescaline are among the long list of plants, chemicals, and entheogens that have made it into microdosing routines.

There’s no official rulebook that dictates the dose or cadence of a microdosing regimen, but a popular schedule consists of taking a small dose regularly—every two or three days. Those looking for a vetted approach to microdosing may want to check out Dr. James Fadiman’s method

Access and Cost Limitations of Microdosing

Let’s start with the first and most obvious downside of microdosing psychedelics: In most areas of the world, it isn’t legal (nope, not even in tiny amounts). Although some countries and states have relaxed or nuanced laws around possession, cultivation, and/or use of various psychedelics, many people may purchase or ingest their microdose with some shadow of anxiety hanging over them, thanks to prohibition. 

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In addition to finding a safe and reliable source, you’ll also want to take into account the monetary cost of regularly microdosing. If you were to microdose an eighth of mushrooms over the course of a month, depending on market price, you might expect to spend $30-40 each month to maintain your regimen. For those of us who aren’t successful Silicon Valley devs, that can start to add up.

Getting the Right (Micro)dose

Another potential disadvantage of microdosing psychedelics is not always knowing that the amount you’ve taken is in fact “micro”. We don’t yet live in a world where LSD, psilocybin, and other microdose-able drugs come with a promise of potency, stamped by your local lab (well, with the exception of legal cannabis). Instead, you are responsible for determining how strong your substance is based on prior experience, anecdotal reports from your source, and threads of knowledge posted throughout the interwebs.

The imprecise science of dosing psychedelics is a universal struggle, an attunement process that can take time, experience, and research to fully dial in. The difficulty many people encounter with their own calibration process will be laughed off over dinner with friends or in memes, but what might be seen as a psychonaut’s rite of passage for one is an intimidating risk to be carefully considered by another.

Reported Side-Effects of Microdosing

When considering any possible downsides to microdosing, you might be leery of potentially harmful side effects. Without rigorous studies establishing the safety of using small doses of psychedelics over long periods of time, it’s not possible to describe what risks microdosers run long down the road.

However, there is an abundance of self-reports describing possible short-term side effects. A 2019 report, which surveyed 278 self-selected participants, quantified commonly experienced “benefits” and “challenges” to microdosing LSD and psilocybin. Some of the side effects derived from this survey include:

  • Physical discomfort
  • Impaired focus
  • Impaired (i.e., excessive or dampened) energy
  • Impaired mood
  • Increased anxiety
  • Cognitive interference
  • Social interference

This report isn’t without limitations and biases, but it does reflect some of the subjectively experienced side effects one might expect when microdosing. You may notice that some of the challenges listed are in direct contradiction to popular microdosing intentions. Why the paradox? As one study noted, LSD may have varying effects throughout its duration—however, this has yet to be demonstrated in human studies of microdosing.

Read: Why I Quit Microdosing LSD

The first phase of a randomized, double-blind, placebo-controlled study published in December 2019 observed the effects of a low dose of LSD to better understand its safety and tolerability in 48 research participants. The group noted that “the frequency of adverse effects [in the LSD groups] was no higher than in the placebo group,” and that no impairment of cognition, balance, or physical movement was detected in assessments.

And then there’s the potential long-term risk associated with microdosing, which isn’t well understood yet. “You’re tinkering with the [serotonergic] system that is involved with depressive systems, but in unexplored ways,” Johns Hopkins University psychologist Matt Johnson said in an interview with Live Science. One might wonder to what degree microdosing presents more unknown risks than mood-stabilizing pharmaceuticals that increase serotonin availability—the long-term effects of which are also understudied. Weighing the immediate benefits against unknown risks can certainly be a difficult decision in the absence of reassuring studies.

Potential Contraindications with Other Medications 

Quite possibly the entirety of what we know about medication interferences and microdosing we owe to those who have dosed before us. In other words, the evidence is anecdotal.

Dr. Fadiman, author of The Psychedelic Explorer’s Guide, and Dr. Sophia Korb have collected microdosing data from over 1,500 participants spanning more than 59 countries. Mind you, this survey is by no means a double-blind placebo-controlled study—instead, they describe the project’s purpose as mapping the terrain of microdosing experiences. 

On their website, you’ll find a list of roughly 170 medications and vitamins that participants reported as having no perceived interference with their microdosing regimen. Strong caveat, though: A safe experience for one does not guarantee a safe experience for all, and just because someone didn’t perceive an adverse reaction does not mean one didn’t occur. (Note: Dr. Fadiman clarifies in a panel discussion that one participant later reported an adverse reaction with lithium.)

Is Macrodosing Better Than Microdosing?

When it comes to entheogens, which is better: a small but regular dose that softly nudges your brain in new directions, or an occasional but large dose that launches your brain into completely new realms of self-understanding? This question attracts debate in the psychedelic community, but one popular response is, it depends.

Large doses of psychedelics are what precipitate the mystical catalysts that seem crucial to experiments like John Hopkins’ end-of-life anxiety research. Similarly, macrodoses of LSD, psilocybin, DMT, ayahuasca, and ibogaine have long been studied for many different applications including smoking cessation, addiction, and depression. It’s also worth noting that while the dose appears to be an important factor, so is the presence of a trained facilitator to supportively guide the experience.

As you’ve probably heard from countless friends and relatives (and complete strangers at festivals), macrodosing can be a profoundly positive experience for anyone. Whether your intention is best met in one meteoric macrodose or a consistently nurturing microdose is ultimately up to you.

Microdosing Is Not a Cure-All

Whether it is connecting areas of the brain in novel ways or fueled primarily by the natural forces of the placebo effect, many people are reaping some benefits from their practice of microdosing. Many have shared stories about the ways microdosing has enriched their lives (the /r/microdosing subreddit is packed with them), but others have also challenged their relationship with microdosing, wondering if maybe they were too reliant on this daily lift.

“Microdosing reaffirmed my all-too-American tendency to dose through or enhance everything,” author Erika Avey writes in her story Why I Quit Microdosing LSD. “Meanwhile, it also kept me complacent prolonging what I really needed to do: address the root causes of my emotional imbalance.” 

Read: Why Taking Psychedelics While on Antidepressants Could Make Treatment Ineffective

Reliance on any one habit, as Avey points out, can distract us from addressing our health in holistic and sustainable ways. Additionally, some evidence suggests that microdosing might not provide sustained benefits beyond the short-term. A systematic investigation of microdosing published in February of 2019 on PLOS One reported that “in the short term, microdosing led to an immediate boost across a range of psychological variables, but these effects were (mostly) not sustained over multiple days…The pattern of results here is somewhat inconsistent with narrative accounts that claim that the effects of microdosing linger for multiple days.”

The researchers also noted that some participants expressed an uneasy reaction to microdosing, though most expected to feel good. One comment reads, “The first hour was productive but then doubt, confusion, and uncertainty crept in.” 

It’s ultimately up to you to decide if the potential positives you expect microdosing to bestow upon your creativity, health, and happiness outweigh the potential disadvantages and risks. The wait for more quality research on microdosing could be a long one due to restrictive laws that tape off psychedelics, even for clinical investigations that aim to keep us safe. That being said, if you have any hesitation about microdosing, it’s generally advised (and completely okay) to hold off until you feel more certain about it.

Bailey Rahn is a Pacific Northwest-based writer and mental health counselor in training. She has spent the last decade in the world of cannabis, with a majority of that time as an author and editor at Leafly. 

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