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The Alkaloid #35: The Shorter Trip Still Needs a Clock

A mebufotenin trial found an antidepressant signal and early discharge readiness. Its protocol still required four hours at the clinic. Those are different findings.

A shorter acute psychedelic experience does not necessarily mean a shorter clinical appointment. Illustration, not a depiction of trial participants.

Science, culture and capital — one dose at a time

The Dose

A psychedelic treatment can wear off quickly without making the medical appointment quick. A phase 2b trial published in JAMA on October 26 gives that distinction an unusually useful test: intranasal mebufotenin, a formulation of 5-MeO-DMT, improved depression scores compared with a low-dose comparator, and most participants receiving the higher doses were assessed as ready for discharge within two hours. [1]

The protocol nevertheless set the earliest actual discharge at four hours after dosing. Readiness was a measurement; permission to leave was a separate decision. That is worth keeping intact before a promising result becomes a promise of cheaper, easier treatment. [2]

Quick Hits

Cannabis and sleep: A Cochrane review found nine studies involving 537 adults with insomnia, but the evidence remains very uncertain. Its October publication date should not obscure its April 2025 search cutoff. [3]

Support outside the clinic: An October 30 Science Advances paper describes 25,419 Fireside peer-support interactions. These are records of people seeking help, not a representative sample from which to rank the risks of different substances. [4]

That's the news. The analysis is below — Science Desk, Market Watch, and a closing thought.

Comic illustration of a curator holding a record sleeve at a wooden desk, with an amber ribbon flowing toward an empty recliner and headphones in an adjoining room.

The Alkaloid #36: Who DJs the Trip?

Who chooses the soundtrack for psychedelic therapy? An analysis of eight playlists finds only weak evidence for a shared musical arc, without testing whether the music helps patients.

Comic spread of a caller on a sofa and a headset-wearing listener at a laptop, joined by an amber line. Anonymous record cards overlap across the foreground.

Field Notes #15: What a Support Line Can Tell Us

A new database describes 25,419 Fireside peer-support interactions. It offers a view of help-seeking, not a league table of drug risk or proof that support works.

Comic illustration of a person sitting awake on a bed, looking toward a moonlit window. Moonlight crosses scattered papers beside a notebook with a cannabis-leaf motif.

Field Notes #14: Cannabis and Sleep, Still an Evidence Gap

Nine studies, 537 adults, and a very uncertain answer. A Cochrane review on cannabis for insomnia shows why feeling sleepy and treating insomnia need separate evidence.

Comic illustration of a customer studying overlapping chemical graphs beneath three cannabis jars labeled INDICA, SATIVA and HYBRID.

The Alkaloid #34: The Label Isn’t the Chemistry

Indica, sativa, hybrid: familiar labels, unreliable predictions. What cannabis chemistry research can tell us—and what it cannot.