Microdosing is the latest trend captivating the dinner party crowd. It involves consuming a small amount of a substance instead of a full dose. This practice has sparked massive discussions and seems to be gaining popularity.
It has come from LA, of course. Just after the pandemic I visited a friend there and saw how enormously popular it was.
Now, increasingly, Brits are trying it, too.
At a dinner party before Christmas, two out of the ten guests confessed to doing it with psychedelic drugs.
They weren’t hippies or artists – one was a lawyer and the other a TV producer.
When people talk about microdosing they usually do mean a psychedelic drug such as LSD or psilocybin (the active substance in ‘magic mushrooms’).
The concept behind microdosing is that by taking a reduced amount, individuals can still experience the mental health benefits associated with the drug. These benefits include enhanced confidence, focus, creativity, improved mood, and empathy, all without the hallucinogenic effects.
The doses will often be around five to ten per cent of the dose needed to get someone ‘high’.
When discussing microdosing, it typically refers to the consumption of psychedelic substances like psilocybin, the active component found in ‘magic mushrooms’.
The issue, of course, is that with psychedelic drugs – aside from the fact that they’re illegal – there is no ‘treatment dose’.
A substance such as LSD is often delivered as a colourless liquid soaked on to paper.
It isn’t manufactured in a pharmaceutical laboratory, and it’s impossible to gauge purity levels at any dose, micro or not.
The potency of mushrooms, meanwhile, varies greatly.
More than 200 types contain psilocybin, and there’s no way of knowing which mushroom you’re taking or how much psilocybin you are consuming. When I asked my dinner party friends about this, both admitted to having on occasion taken more than they meant to, and beginning to hallucinate.
Taking too large a dose can lead to a frightening and even traumatising experience.
Besides which, there’s no clear evidence of real mental health benefits associated with microdosing LSD or psilocybin, and there are clear risks, so it’s not something I would ever recommend.
However, the concept of microdosing is an interesting one.
It’s not well known that doctors do it all the time – not take LSD, of course, but prescribe medicines to their patients in micro doses.
Lots of drugs have undesirable effects, or simply more side-effects, at high doses, so we go lower.
I microdose myself with a prescribed drug. I take Roaccutane – a medication used to treat acne.
Usually, Roaccutane is given in a course lasting four to six months at 0.5 to 1mg per kg of body weight daily.
I first took it 12 years ago on a dose of 80mg per day for nine months. But after I stopped, the acne came back.
So my dermatologist prescribed another six-month course. This second bout cleared up my skin perfectly – and when the course ended, my dermatologist suggested that I stay on it indefinitely to prevent any relapses. But this time, at a ‘microdose’ level.
I now take 20mg a week to keep acne at bay – a fraction of the 560mg a week I took on the full dose.
My doctor has lots of patients on this microdosing regime.
Roaccutane can have unpleasant side-effects, including very dry, flaky skin, itchy eyes, problems seeing at night and sensitivity to the sun, all of which I suffered from, plus more serious problems with the liver, kidneys and pancreas, mood changes, and joint pain, which thankfully I did not experience.
But a microdose is just enough to keep skin clear without any of these side-effects.
There are other examples of microdosing, of course.
Taking small doses of Ozempic is increasingly popular, for example.
People take enough to dampen appetite – or to quash the desire to drink alcohol – but not so much that they start to drop weight. And on several occasions I’ve prescribed medicines in this way at my clinic.
Many of my patients who have had an episode of psychosis have been on high doses of antipsychotics for a year or so to treat their symptoms.
These are strong drugs with occasionally nasty side-effects and people often want to try a period off them.
With some patients I’ve gradually reduced the dose over a few months, and, if they don’t develop psychosis again, maintained them on about a tenth of their full dose.
This way, they tend not to get the side-effects but do get some of the antipsychotic properties.
It also means that they are more likely to actually take the medication.
Doctors do have to be careful, though, when considering prescribing much lower doses of drugs.
The drug may not be licensed for use at a lower dose, and we don’t always know if something taken in a low dose is still effective, or if the benefits are just the result of placebo.
With skin, of course, the benefits are very visible, and I’m grateful my microdosing regime works so well.
Richard Hammond with his wife Mindy in October 2023 at the premiere of The Bikeriders
Richard’s split after 28 years
Richard Hammond and his wife Mindy are reportedly getting a divorce after 28 years. That’s a very long time to be married.
Divorce can be a dreadful shock regardless of the length of a marriage, but after all those years, it’ll take time for both of them to adjust.
I’ve seen patients who divorce after decades of marriage and never seem to quite get over it. Their world has collapsed and they now have to rebuild without the one person they relied on for support.
The longer you’re together, the more you’ve been through as a couple. And no matter how much one partner desires it, disentangling yourself from all that shared history is never easy.
It takes a minute to sign the divorce papers, but it can take years to feel yourself again.
Smokers and obese patients face being ordered to the back of the queue for operations under plans to slash NHS waiting lists.
This makes me very uncomfortable and is a dangerous slippery slope. We shouldn’t do it.
Is it time to consider very radical reforms to the NHS?
A survey by the think tank Policy Exchange last week found that access to GPs and good treatment for life-threatening diseases were judged by the public to be more important priorities than cost-free care for all services.
I have always been a passionate believer in the principle of free NHS care at the point of delivery, but frankly the health service in its current shape is barely fit for purpose. For the first time since I started to work in the NHS, aged 16, I would now seriously consider the idea of some form of payment or insurance.
DR MAX PRESCRIBES… Phone a friend
A study has found loneliness can kill people because it increases proteins that fur up the arteries and may trigger early death. There have been so many advances in medicine in the past few decades, but it strikes me as shocking that something as simple to address as loneliness still seems such a problem. You don’t need to be a doctor to help tackle this. We can all do our bit by simply phoning a friend.
