The Dementia Microdosing Protocol - A Mindful Approach to Dementia & Psychedelics
The Dementia Microdosing Protocol captures what we have found to be an optimal microdosing rhythm for my husband’s ongoing Alzheimer’s trajectory. The Protocol varies from other, more common microdosing practices, as it is specifically tailored to those with mild cognitive impairment from Alzheimer’s. As a trained microdosing coach, I oversee his microdosing process and have observed the effectiveness of this Protocol for my husband and for my clients with mild or moderate cognitive impairment.
This Dementia Microdosing Protocol is being shared in the spirit of information and harm reduction; it is not medical or professional advice. Consent by the person ingesting should be given, and an advance directive can be made before the person is no longer able to give consent.
Daily ingestion is to be overseen by a caregiver and guided by a competent microdosing coach,* establishing a team approach. The dose is given on a daily basis. There are natural breaks rather than pre-established days off.** Continual adjustments are made, and the protocol may become more nuanced based on individual needs.
*A competent microdosing coach will have you fill out a thorough intake form, which will review medications, medical status, and any possible contraindications. All these factors and more should be considered before starting any microdosing protocol, including the Dementia Microdosing Protocol.
**Breaks tend to happen naturally, including when the supply runs out, when ingestion is suspended during travel, during medical interventions, if the person is feeling sick, or during other common occurrences.
FOLLOWING THE MICRODOSING DEMENTIA PROTOCOL
Introduction
Microdosing is an individual process. When the person ingesting has dementia, it is important that someone else oversees the process. That person should have a basic understanding of psychedelic microdosing, including how the substance being used works, dosage levels, sweet spots, and the pragmatics of the overall process. Ideally, this person should be trained in microdosing or be under the guidance of a trained microdosing coach. This approach ensures safety as well as the ability to tailor the microdosing process to the individual’s needs. In the near future, we can hope for the rise of a cadre of competent microdosing care providers able to service those with Alzheimer’s and other types of dementia.
Intention
Having a sankalpa as a guiding intention (see webinar: Your Intention as a Sankalpa) is of particular importance, especially in the early stages of working with Alzheimer’s or other types of dementia. Here are some examples of a sankalpa, including some my husband suggested:
I live with ease in my journey.
I flow in the nature of impermanence.
I am one with the world.
I am one with the boundless nature of love.
I am at ease in my heart.
Guidance
The caregiver overseeing the process should be keenly attuned to the person ingesting, noting observations and reflections and making mindful inquiries. In conjunction with a competent microdosing coach, all benefits as well as any challenges should be continually noted, and adjustments made accordingly. A team approach, helpful in any caregiving situation, provides an optimal level of support.
CONSIDERATIONS
#1 Daily Ingestion
When considering the context of dementia, daily routines with consistency make everyone’s life easier—both for the person with dementia and the caregiver. The basic idea, then, is to keep to a continuous routine of daily microdosing to the best of the individual’s and caregiver’s ability. Anything else—thinking about some days as being dose days and other days not being so—would be confusing for the person with dementia. Similarly, for the caregiver, keeping track of which days are on days and which days are off days is an added (and ultimately unnecessary) responsibility.
However, even when purposefully following a daily microdosing schedule, it is not uncommon for one day or another to occasionally be missed. Missing a day or so here and there is not an issue, and knowing that it is a daily routine better supports consistency and routine, which are so helpful for those with dementia and those caring for them.
#2 Natural Breaks
Daily ingestion—without days off—is at the core of the Dementia Microdosing Protocol. This is different from what has become standard microdosing practice, which often involves taking one or more days off after a day on, as well as longer breaks after several weeks of microdosing.
The Dementia Microdosing Protocol assumes two things. First, that there will be natural breaks, as described above, rather than a predetermined break. Even if those breaks do not occur for months at a time or are relatively minimal, the Dementia Microdosing Protocol remains effective and continues to have positive benefits. Second, because microdosing is widely regarded as being inherently safe and having a high reward-to-risk ratio, for those with dementia the benefits of a daily protocol outweigh any negative outcomes or possible harm.
During my training as a microdosing coach through MDI, our cohort—one of the first to be trained worldwide—was honored to have Dr. James Fadiman give a masterclass. Dr. Fadiman describes microdosing psilocybin as a boost to the immune system and the overall health of a person. When taking a break from a microdosing protocol, a person may feel that the benefits have brought such a degree of health and well-being that they may no longer feel the need to microdose.
This is not the case with a degenerative condition like Alzheimer’s and other types of dementia. Microdosing is valuable in many ways, helping those with dementia attain a greater state of health, well-being, and presence. However, while it may seem to slow the rate of decline and ease the process, it does not prevent further decline. In a sense, then, the Dementia Microdosing Protocol can be viewed as palliative care.
In the same masterclass, Dr. Fadiman informed us that there was no scientific evidence showing a build-up of tolerance when microdosing psilocybin, the most popular substance being microdosed in North America. It was noted that psilocybin leaves the system in twenty-four hours. Some people, however, do feel they build up a tolerance, which might be seen as a reason to take a break from daily microdosing. If a build-up of tolerance is suspected in someone with Alzheimer’s or other types of dementia, the dosage can be increased (just slightly) or days off can be taken.
Again, breaks tend to occur naturally rather than needing to be programmed within a specific time frame. Travel to family, visits to medical facilities, sickness, not having a supply on hand, or simply forgetting all tend to occur naturally, thus providing breaks. In sum, a continuous natural process of microdosing best supports the needs and lifestyle constraints of those with Alzheimer’s and other types of dementia.
#3 Ethics
I am constantly asked about ethical considerations. Is it right to give someone in advanced stages of Alzheimer’s or other dementia a microdose without their knowledge? I have deeply delved into mindful inquiry over this question during the last few years and believe each caregiver must answer this question for themselves. Here are a few contemplations for you to consider:
Have you looked deep into your heart and felt that the decision is for the other person’s greatest good? It is said that many people with dementia have no knowledge of the pharmaceuticals administered to them. How is microdosing any different?
In the Beckley Foundation case, in which the caregiver and family members consented to a microdose of LSD being given to a 97-year-old woman (considered to be in an almost vegetative state) with Alzheimer’s and vascular dementia, her seemingly miraculous ability to “be herself again”—regaining her wit and sense of self—was so reassuring that the microdosing protocol was continued. Based on this case—and the Beckley Foundation now supporting an LSD microdosing clinical study with Alzheimer’s patients in different stages of dementia—is the proven promise of microdosing for dementia now greater than ever?
On the other hand, is it ethical to bring someone back when they are in an advanced stage of Alzheimer’s or another type of dementia? Whose interests are being served here?
Should Alzheimer’s or other types of dementia be seen as a deficit or a natural unfolding of the later stages of life for some people?
Am I trying to fix something by bringing psychedelic microdosing into the mix?
Is my heart further opening to acceptance and greater understanding?
Can I accept and understand (e.g., as a spouse and a caregiver) that I am part of the journey? That this is for my own greater good?
Might a person with Alzheimer’s be on a different plane of existence unknown to me?
Who am I to judge?
Mindful inquiry enables me to contemplate the many facets of bringing psychedelic microdosing to those with dementia. The heart of mindfulness—literally, the expansion of my heart—has been my compass along this challenging but also heart-opening journey.
A host of other practical and ethical concerns must be considered. Which substance is best in the case at hand for the person ingesting? Plants? Fungi? Synthetic alternatives? How is it sourced or cultivated? Is it legal or illegal? And so on.
Personally, I find my husband’s inability to legally access psychoactive mushrooms for his Alzheimer’s both immoral and unethical. Similarly, what about the stigma others feel over legality issues, thereby preventing someone who is afflicted from accessing their right to improve their condition? Is that ethical?
CONCLUSION
We are at the frontier of learning how mindful microdosing can benefit those with Alzheimer’s and other types of dementia. My husband is helping pave the way by demonstrating how microdosing psychedelics has helped him in his Alzheimer’s journey. Advocating on his behalf has led me, as a trained microdosing coach, educator, and writer, to share his story in support of the millions now living with Alzheimer’s and the tens of thousands more who will be diagnosed with dementia every single day throughout the world. Creating and putting forth the Dementia Microdosing Protocol is part of this pioneering effort.
- Lauren Alderfer, PhD.
