Passie Torsten, Brandt Simon D
Senckenberg Institute for History and Ethics in Medicine, Goethe-University Frankfurt/Main, Frankfurt, Germany.
School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK.
Handb Exp Pharmacol. 2018;252:69-110. doi: 10.1007/164_2018_177.
The purpose of this chapter is to highlight the rich tradition of self-experiments (SEs) with psychoactive substances carried out by scientists and therapists for more than a century. Scientifically inspired controlled SEs dominated until the end of the twentieth century, when ethical requirements minimized controlled SEs and "wild" SEs expanded particularly with the emergence of new psychoactive substances. The review focuses on laughing gas (nitrous oxide), cannabis, cocaine, hallucinogens, entactogens, and dissociative hallucinogens. This is due to the fact that substances that induce "complex" effects such as alteration of space/time experience, ego dissolution, and increased feelings and insights (e.g., hallucinogens, entactogens) represent by far the majority of SEs, whereas SEs with substances inducing "simple" effects such as euphoria, anxiolysis, dissociation, or emotional blunting (e.g., cocaine, opioids) are much rarer or even absent (e.g., benzodiazepines). Complex drug effects are much harder to describe, thus allowing SEs to fulfill a more important function.SEs with psychoactive drugs appeared to emerge in the mid-eighteenth century, which triggered a long-standing tradition throughout the nineteenth and early twentieth century. SEs have been de facto performed for a variety of reasons, ranging from establishing scientific knowledge and gaining philosophical insights to compensating for personal deficits. Self-experimenters can be divided into two general types. Besides their scientific intentions, "exploratory" self-experimenters intend to expand awareness and insight, whereas "compensatory" self-experimenters might aim for coping with psychiatric symptoms or personality deficits. Scientific limitations of SEs are obvious when compared to double-blind, randomized, placebo-controlled trials. Whereas the former might lead to more "realistic" detailed description of subjective effects, the latter lead to more solid results in respect to objectively measurable "average" effects. Possible adverse effects of SEs were identified that resulted in loss of scientific objectivity and decreased control over substance use and addiction, development of isolation, problematic group dynamics, and "social autism."
本章的目的是突出一个多世纪以来科学家和治疗师使用精神活性物质进行自我实验(SEs)的丰富传统。直到20世纪末,受科学启发的对照自我实验一直占据主导地位,当时伦理要求使对照自我实验减少,而“非正规”自我实验尤其随着新型精神活性物质的出现而增多。本综述聚焦于笑气(一氧化二氮)、大麻、可卡因、致幻剂、触觉致幻剂和分离性致幻剂。这是因为能诱发“复杂”效应(如时空体验改变、自我解体以及情感和洞察力增强)的物质(如致幻剂、触觉致幻剂)在自我实验中占了绝大多数,而使用能诱发“简单”效应(如欣快感、抗焦虑、解离或情感迟钝)的物质(如可卡因、阿片类药物)进行的自我实验则要少得多,甚至不存在(如苯二氮䓬类药物)。复杂的药物效应更难描述,因此自我实验能发挥更重要的作用。使用精神活性药物的自我实验似乎始于18世纪中叶,在整个19世纪和20世纪初引发了一个长期的传统。进行自我实验实际上有多种原因,从建立科学知识、获得哲学洞察到弥补个人缺陷。自我实验者可大致分为两类。除了科学意图外,“探索性”自我实验者旨在拓展意识和洞察力,而“补偿性”自我实验者可能旨在应对精神症状或人格缺陷。与双盲、随机、安慰剂对照试验相比,自我实验的科学局限性显而易见。虽然前者可能会对主观效应进行更“真实”的详细描述,但后者在客观可测量的“平均”效应方面能得出更可靠的结果。已确定自我实验可能产生的不良影响,包括丧失科学客观性、对物质使用和成瘾的控制减弱、产生孤立感、出现问题的群体动态以及“社交孤独症”。