[{"data":1,"prerenderedAt":132},["ShallowReactive",2],{"article-\u002Farticles\u002Fwhat-we-mean-when-a-drug-works":3,"article-rel-\u002Farticles\u002Fwhat-we-mean-when-a-drug-works":89},{"id":4,"title":5,"author":6,"authorTitle":7,"body":8,"date":75,"description":76,"draft":77,"extension":78,"featured":79,"heroCredit":80,"heroImage":81,"meta":82,"navigation":79,"path":83,"readingTime":84,"seo":85,"stem":86,"topic":87,"__hash__":88},"articles\u002Farticles\u002Fwhat-we-mean-when-a-drug-works.md","What we mean when we say a drug \"works\"","Dr Alani Reyes","psychiatrist and clinical researcher",{"type":9,"value":10,"toc":67},"minimark",[11,15,23,28,31,37,40,44,47,51,64],[12,13,14],"p",{},"Every few months a headline announces that a psychedelic compound has produced\n\"unprecedented\" results for depression, addiction or trauma. The effect sizes\nare often genuinely large. They are also frequently misunderstood — by readers,\nby reporters, and sometimes by the people running the studies.",[12,16,17,18,22],{},"This is not an argument that the research is weak. Much of it is careful and\npromising. It is an argument that ",[19,20,21],"em",{},"promising"," is a specific, limited claim, and\nthat learning to hear it precisely is the most useful skill a curious person can\nbring to this field.",[24,25,27],"h2",{"id":26},"a-result-is-a-sentence-with-hidden-clauses","A result is a sentence with hidden clauses",[12,29,30],{},"When a trial reports that a single dose \"reduced depression scores by 50 per\ncent at six weeks\", several quieter facts travel underneath that sentence: how\nmany people were studied, who they were, what the comparison group received,\nhow long anyone was followed, and how many dropped out before the end.",[32,33,34],"blockquote",{},[12,35,36],{},"A number without its denominator is a rumour with a decimal point.",[12,38,39],{},"Small early-phase studies exist to detect whether an effect is plausible, not\nto measure it accurately. The honest reading of an exciting Phase 2 result is\nnot \"this works\" but \"this is worth the expense and risk of finding out\nproperly\".",[24,41,43],{"id":42},"the-unblinding-problem","The unblinding problem",[12,45,46],{},"Psychedelics present researchers with an awkward fact: people generally know\nwhether they have taken one. That breaks the blind that ordinary drug trials\nrely on, and expectation is a powerful medicine in its own right. Good teams now\ndesign around this — active placebos, independent raters, careful measurement of\nwhat participants believed they received — but a study that ignores it should be\nread with that gap in mind.",[24,48,50],{"id":49},"what-good-evidence-will-look-like","What good evidence will look like",[52,53,54,58,61],"ul",{},[55,56,57],"li",{},"Larger samples that include the people clinicians actually treat, not only\nthe unusually well and unusually motivated.",[55,59,60],{},"Longer follow-up, because durability is the whole question for a one- or\ntwo-dose treatment.",[55,62,63],{},"Honest accounting of harms, including the difficult or destabilising\nexperiences that averages tend to hide.",[12,65,66],{},"None of this is a reason for despair, and none of it is a reason for hype. The\nfield is young. The most respectful thing we can do for it — and for the people\nwaiting on it — is to describe it accurately while it grows up.",{"title":68,"searchDepth":69,"depth":69,"links":70},"",3,[71,73,74],{"id":26,"depth":72,"text":27},2,{"id":42,"depth":72,"text":43},{"id":49,"depth":72,"text":50},"2026-05-12","Psychedelic trials report dramatic numbers. Understanding what those numbers measure — and what they quietly leave out — is the first step to reading them honestly.",false,"md",true,"Higher Place — original artwork","\u002Fimg\u002Fheroes\u002Fresearch-science.svg",{},"\u002Farticles\u002Fwhat-we-mean-when-a-drug-works",9,{"title":5,"description":76},"articles\u002Fwhat-we-mean-when-a-drug-works","research-science","Tkyz07EdnWjT1kxk7cDMpvnKlOZB3vOj7Jk_bpKGxbo",[90],{"id":4,"title":5,"author":6,"authorTitle":7,"body":91,"date":75,"description":76,"draft":77,"extension":78,"featured":79,"heroCredit":80,"heroImage":81,"meta":130,"navigation":79,"path":83,"readingTime":84,"seo":131,"stem":86,"topic":87,"__hash__":88},{"type":9,"value":92,"toc":125},[93,95,99,101,103,107,109,111,113,115,123],[12,94,14],{},[12,96,17,97,22],{},[19,98,21],{},[24,100,27],{"id":26},[12,102,30],{},[32,104,105],{},[12,106,36],{},[12,108,39],{},[24,110,43],{"id":42},[12,112,46],{},[24,114,50],{"id":49},[52,116,117,119,121],{},[55,118,57],{},[55,120,60],{},[55,122,63],{},[12,124,66],{},{"title":68,"searchDepth":69,"depth":69,"links":126},[127,128,129],{"id":26,"depth":72,"text":27},{"id":42,"depth":72,"text":43},{"id":49,"depth":72,"text":50},{},{"title":5,"description":76},1779224636277]