A kaleidoscopic flock of kindred spirits donning rainbow jackets and magic mushroom hats meanders towards me. The air is thick with the unmistakable aroma of cannabis. This auspicious day, April 20, marks the beginning of the sixth Breaking Convention, the eclectic gathering of psychonauts in Exeter.
At the opening ceremony, the conference directors share the history and motivation behind the conference: the harmonization of psychedelic science and culture.
Alexander Beiner, who will later speak on the intersection of DMT and AI, imparts a gentle warning: it is of paramount importance to remain mindful of how the mainstreaming of these substances unfolds. Hattie Wells implores Western science to embrace the indigenous wisdom that’s accrued over centuries. These clarion calls for nuance stand in stark contrast to the hypeful and sensationalized conferences that have proliferated across the U.S. in recent years.
Jules Vayne, a mystic occultist, author, and ecstatic dancer, takes us on a poetic tour through the surrounding pastoral lands, reminding the audience of the region’s hidden treasures—liberty caps grow just miles from the conference grounds. As the opening ceremony concludes, all gathered hold hands for a grounding meditation ritual, connecting everyone to the core of the earth and outer regions of space. This is no conference for suits.
A few conference highlights: Celia Morgan, Professor of Psychopharmacology at the University of Exeter, who highlights the launch of a graduate program in psychedelics—a world-first, she claims (some US institutions might beg to differ).
Chris Timmermann, who delves into the effects of prolonged DMT infusion, and how psychedelic experiences may transform an individual’s worldview.
And Deborah Mash, a Professor of Neurology and Molecular and Cellular Pharmacology and the founder of DemeRx, who explains that the mission behind her ibogaine research is to combat the death toll of fentanyl, which she describes as a “chemical weapon attack on our country.”
The Great Microdosing Debate
On the second day, at the event press conference, an impassioned discourse unfolds between renowned mycologist Paul Stamets and esteemed academic researcher David Erritzoe.
Stamets’s assertions have weight because of his many contributions that have significantly advanced the field. He says that microdosing has been unfairly maligned within academia. Rather than utilizing the whole mushroom, in which the so-called entourage effects are argued to yield positive outcomes, 70% of research studies focus solely on psilocybin, the potent molecule at the core of these magical fungi.
Stamets makes a compelling point when he highlights the distinct contrast between the swift onset and abrupt return to terra firma experienced with psilocybin pills or injections, as opposed to the more gradual and harmonious effects of whole mushrooms. Nevertheless, he swiftly pivots to cite survey studies and a microdosing investigation conducted in 2021 by Joseph Rootman and colleagues that I have previously criticized for sensationalizing mere correlations, which often become conflated with causation.
In the Rootman study, there are correlations between those who microdose and some, though far from all, mood outcomes. One of the study’s strengths is that it relies on a large dataset: 8,000 people participated. However, its shortcomings are many. Without reiterating my earlier criticism, I will leave you with two observations. First, the article mentions stacking multiple times, which refers to taking a microdose in conjunction with Lion’s Mane and niacin. Second, Stamets is a minority investor in the tracking app which was used – Quantified Citizen – and the founder of MycoMedica which is commercializing this very stack of compounds.
Erritzoe has actually conducted research around microdosing in the way Stamets calls for – outside the lab, using the Fadiman protocol. In 2021, Laura Kaertner and colleagues, including Erritzoe, conducted the first prospective survey of 81 microdosers. The researchers began following the microdosers before they started, asking them questions about their mood and expectations before engaging in microdosing.
Most participants followed Fadiman’s protocol by microdosing once every third day over the course of several weeks. After four weeks of microdosing, participants saw positive changes in wellbeing, depressive symptoms, state anxiety, and emotional stability. So far, this is something everyone agrees on.
What Stamets does not adequately explain is what comes next in Erritzoe’s study:
“Consistent with our main hypothesis, positive expectations measured at baseline were found to be significantly predictive of the main improvements,” write the researchers. In other words, those who expected benefits were the ones who saw the largest increases in wellbeing, social connectedness, and other measures.
While the word “expectation” is absent from the 2021 Rootman study, it is cited numerous times in a follow-up study conducted by Rootman in 2022. Both studies had large cohorts. The sheer size of the group studied contributes significantly to the validity and reliability of the research findings. But from my perspective, the 2022 Rootman, while addressing expectancy, is not able to directly measure the effects of expectancy effectively because the control group consists of people who do not microdose, not people taking placebo pills, which I think would create a more robust double-blind study.
Minimizing the Risks of Psychedelic Medicine
This psychedelic renaissance, though enchanting, is not all shimmer and rainbows. Nearly every speaker acknowledges the challenging path that lies ahead. Daan Keiman, formerly the Director of Program and Product Development and facilitator at the now-defunct Synthesis, cautions against the surge of less qualified guides and coaches emerging from the numerous online courses that have sprouted like mushrooms in recent years.
More broadly, Keiman warns of the fledgling market’s attempts to assist those who seek healing. Yet with proper guidance, he says, we can avoid finding ourselves as disoriented as Alice in Wonderland. Keiman uses the analogy of a wisdom tooth extraction – we know what to anticipate, our colleagues understand how to express empathy upon our return to work, and we are well-shielded from malpractice. According to him, these crucial elements, among others, are absent in the burgeoning psychedelic landscape.
“To effectively alleviate suffering and offer adequate psychedelic care, we need to consider what is required to achieve this aim,” Keiman tells me. “It is important to acknowledge that psychedelic use can result in harm, even when done correctly, as demonstrated by the work of David Luke and the Challenging Experiences project by Jules Evans [both also presenters at BC]. Additionally, much of the harm that arises from psychedelic use is due to inadequate implementation and incompetent guides.”
Keiman goes on to stress the importance of building a framework that provides comprehensive training for psychedelic professionals, and developing “an ecosystem that supports safe and effective care.” He draws an important distinction between online education and actual training, and emphasizes the importance of “regulatory structures that prioritize patient safety and ethical considerations.”
Issues of legal and systemic barriers that hinder access to medicine and funding research must also be addressed, says Keiman, including research into non-clinical forms of psychedelic care. “Ultimately, the goal is to create a healthy ecosystem that can provide individuals with access to safer, more effective, and more culturally appropriate psychedelic care.”
This will require a collaborative effort among various stakeholders in the field, including policymakers, researchers, healthcare professionals, and community representatives and advocates. “By working together towards this common goal, we can increase the potential benefits of psychedelic medicine while minimizing the risks,” says Keiman.
Daniel Ingram, a devoted meditator and former ER physician approaches this issue from the perspective of the medical establishment. In his rapid-fire talk, he outlines the multitude of steps necessary before physicians and psychiatrists can become competent allies for those navigating psychedelic experiences, or what he broadly terms “emergent phenomena.”
Ingram envisions raising over $1.5 billion in funding to bridge these gaps. The Emergent Phenomenology Research Consortium (EPRC), a name scarcely recognized in the broader psychedelic sphere – so obscure that even I, having cataloged over 3,000 stakeholders, was unaware of them – harbors ambitions that, if realized, would outshine the efforts of MAPS’ Rick Doblin by more than a factor of ten.
MAPS Optimistic Despite Funding Challenges
Doblin, founder and president of MAPS, concludes the conference with a speech outlining the developments MAPS has undergone since MDMA’s prohibition. For seasoned psychonauts, no new information was presented. Yet he went a half hour over his allotted time discussing MAPS’ plans.
Though Doblin envisions a world of “net zero trauma” by 2070, he’s confronted with formidable challenges as funding for nonprofits in this space wanes. An economic analysis of potential costs for MDMA-assisted therapy, presented earlier that day by Elliot Marseille, startled some attendees, including many researchers. If these far-from-definitive numbers are applied, MDMA will account for over half of the treatment costs, exceeding $6,000. The infrastructure Ingram desires, including insurance reimbursement, is far from guaranteed when the drug, obtainable for $10 on the street, is marked up so drastically.
But this didn’t deter Doblin from radiating optimism. Others likely would have abandoned hope five, ten, even 20 years ago. As confidently as he claims that his following ten slides will take “just one more minute,” Doblin will continue battling for a future where psychedelic-assisted therapy is a reality.
Two tasks remain: the closing ceremony and the after party. With a feather in his hand, the robed playwright and poet John Constable invoked the four elements in a communal ritual “to celebrate the Spirit in the Flesh, the Sacred in the Profane, Eternity in Time.”
Afterwards, the attendees migrate to the university bar bedecked with inflatable mushrooms, disco balls, and LCD screens showcasing psychedelic patterns. On the dance floor, esteemed researchers transform into whirling bodies. The psychedelic curious visitors increase their microdoses to macrodoses and dance into the night. Bosses shift into colleagues, colleagues metamorphose into friends, friends into humans, until the entire assembly sways in unison with hands in the air. Just hours earlier, Constable had asked everyone to lift their hands and “spread the mycelial spores.” It seems here everyone has heeded the call.
As dawn breaks the next day, it’s time to return to reality – one with steeper hills to scale than the marked ascent to the university grounds. While living through history, one can’t say where we stand, but it appears we are gradually awakening from a dark night of the soul.
Update: An earlier version of this article implied that the word “expectation” was absent from the Rootman studies on microdosing. It has been updated to clarify that Rootman’s 2022 study did address expectancy.
Featured image: Panelists at Breaking Convention 2023. (Photo by Peter Sjo, pictured far right.)