The Dementia Microdosing Protocol - A Mindful Approach to Dementia & Psychedelics
The Dementia Microdosing Protocol captures what we havew found to be an optimal rhythm of microdosing during my husband’s (continued) trajectory of Alzheimer’s. As a trained microdosing coach, I oversee his microdosing process. I have also observed the effectiveness of The Dementia Microdosing Protocol for my clients with mild or moderate cognitive impairment. This protocol varies from other more common practices as it is tailored specifically to those with mild or cognitive impairment in their Alzheimer’s journey.
The information about The Dementia Microdosing Protocol is being shared in the spirit of information and harm reduction; it is not medical 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.
* Filling out a thorough intake form, reviewing medications, medical status, and any possible contraindications should be considered before starting any microdosing protocol, including The Dementia Microdosing Protocol.
** Breaks tend to happen naturally; for example, when the supply runs out, ingesting is suspended during travel, medical interventions occur, the person is feeling sick, or other common occurrences.
FOLLOWING THE MICRODOSING DEMENTIA PROTOCOL
The Process & Oversight
Microdosing is an individual process. When the person ingesting has dementia, it is important that someone else oversees the process. This person should have a basic understanding of what they are doing; for example, how the substance works, dosing amounts, sweet spots, and the overall process. Ideally, this same person should be trained in microdosing or be under the guidance of a microdosing coach. In the near future, having a cadre of competent microdosing care providers to service those with dementia would be ideal.
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 Alzheimer’s. Some examples of a sankalpa, including some that my husband suggested, are:
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 person overseeing the process, the caregiver, is keenly attuned to the person ingesting, noting observations, reflections, and making mindful inquiries. In conjunction with a competent microdosing coach, benefits as well as any difficulties are continually noted, and adjustments are 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. With dementia, it is quite confusing to think about some days to dose and others not to dose; and for a caregiver, it is an added responsibility to keep track of which days are on and which days are off. The basic premise is to keep a continuous routine of daily microdosing to the best of one’s ability. Even if following a daily microdosing schedule, it is not uncommon for one day or another to get missed. Missing a day or so here and there is not an issue, but knowing that it is a daily routine better supports consistency and routine, which is so helpful with dementia and/or caring for someone with dementia.
#2 NATURAL BREAKS
In The Dementia Microdosing Protocol, daily ingestion without days off is the protocol. This is dofferent from what has become standard practice by taking breaks after several weeks of microdosing. The Dementia Microdosing Protocol assumes that there will be natural breaks rather than a predetermined break. Even if those breaks do not occur for months, or if those breaks are minimal, the effectiveness of following The Dementia Microdosing Protocol continues to have positive benefits.
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. Even with microdosing, the decline is not prevented. Perhaps microdosing slows the rate of decline and eases the process, but there is not the same incentive to stop microdosing. Rather, the reason for microdosing is shifted to attaining a greater state of health and well-being while living with dementia and its journey. In a sense The Dementia Microdsing Protocol can be viewed as palliative care.
In the same masterclass, Dr. Fadiman said there was no scientific evidence that proved there was a tolerance build-up when microdosing psilocybin, the most popular substance being microdosed in North America. It was noted that psilocybin leaves the system in twenty-four hours. While some people claim they do build up a tolerance, tolerance build-up would be one reason to take a break from microdosing. If this is suspected with someone with Alzheimer’s, adjustments to increase the amount, even slightly, or take a day off can easily be made.
Natural breaks tend to occur rather than being 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 giving a break. Therefore, a more continuous, natural process of microdosing supports the demands and constraints within the context of dementia.
#3 ETHICS
I am constantly asked about ethical considerations. Is it right to give someone in advanced stages of Alzheimer’s a microdose without their knowledge? I have delved into mindful inquiry about this question over the last few years. I believe each person has to answer this question for themselves. Here are a few contemplations:
Have you looked deep into your heart and felt that the decision is for the other person’s greatest good?
I have heard people reason that many people with dementia have no knowledge of the pharmaceuticals administered to them. 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,” with her wit and sense of self, was so reassuring that the microdosing protocol was continued.
Based on the above phenomenon, and with the Beckley Foundation now supporting an LSD microdosing clinical study with Alzheimer’s patients in different stages of dementia, does this point to the promise of microdosing for dementia?
On the other hand, is it ethical to bring someone back when they are in an advanced stage of Alzheimer’s? Who is it serving?
Do I look at Alzheimer’s as a deficit?
Am I trying to fix something?
Is my heart further opening to acceptance and greater understanding?
Can I accept and understand (e.g., as a spouse, caregiver) that I am part of the journey? That this is for my greater good?
Might a person with Alzheimer’s be on a different plane of existence unknown to me?
Who am I to judge?
As you can see, I continue to contemplate the many facets of mindful inquiry. It is from the heart of mindfulness—literally, my heart expanding—that this has been my compass along this challenging but also heart-opening journey.
There are a host of other ethical concerns or dilemmas. The foremost include these contemplations:
Which substances are being used? Plants? Fungi? Synthetic? How are they sourced? Cultivated? Are they legal? Not legal? I find my husband’s inability to legally access psychoactive mushrooms for Alzheimer’s immoral and unethical. The stigma others may have due to legality issues may prevent them 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 dementias. My husband is helping to pave the way to demonstrate how microdosing and other psychedelics have helped him in his journey with Alzheimer’s. 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 with Alzheimer’s and the millions more who will be diagnosed with dementia every day throughout the world. Creating The Dementia Microdosing Protocol is part of this pioneering effort.
- Lauren Alderfer, PhD.
