Disclaimer

Off-label Insight is an independent publication by a layperson with lived experience and a research habit. It is not written by a physician, pharmacist, or licensed medical professional. Nothing on this site is medical advice, diagnosis, or treatment. If you are planning to change what you put in your body based on something you read here, talk to a qualified clinician who knows your full history first.

What this site is

• A record of what I have learned while trying to understand the compounds that affect my own body and brain.
• A translation layer between primary research, package inserts, and people who want to be informed.
• An opinionated editorial voice. I draw conclusions and make recommendations. Those recommendations are based on the evidence I can find at the time, filtered through my own reasoning and my own experience.

What this site is not

• A substitute for a relationship with a physician, psychiatrist, pharmacist, or therapist.
• A comprehensive review of any given substance. Every article has a scope. I leave things out.
• Guaranteed current. Research changes. Product formulations change. Legal status changes. The date at the top of each post is the best indicator of when the information was accurate.
• An invitation to use any particular substance. Reading an article is not consent to take what it describes.

Before you act on anything you read here

If you are considering starting, stopping, combining, or changing the dose of any substance based on something I wrote:

• Consult a clinician who knows your medical history, current medications, and any relevant conditions.
• Check for interactions against every prescription you take. Drug-drug interactions can be serious and are not always obvious.
• Check for contraindications against any condition you have.
• Verify the legal status of the substance in your jurisdiction. I live in the United States and I write primarily with that context in mind; laws vary by state, by country, and sometimes by year.
• Start low and go slow. Individual biology varies enormously. A dose that is routine for one person can be excessive or inert for another.

On "off-label" and experimental use

Many of the compounds I write about are either prescription medications being used for purposes outside their FDA label, or unregulated substances with no label to speak of. "Off-label" is legal when prescribed by a physician and common in psychiatry, but it is not automatically safe, and it is not something you should pursue without supervision simply because an article discusses it.

The existence of a post about modafinil, kratom, psilocybin, or any other compound is not an endorsement of using that compound outside of medical or legal settings. It is a description of what is currently understood about the substance, who uses it, and what the evidence suggests about its risks and benefits.

On legal status

Laws around the substances covered on this site are inconsistent, jurisdiction-specific, and change frequently. Modafinil is prescription-only in the United States but sold over the counter in other countries. Kratom is banned in several U.S. states. Psilocybin is Schedule I federally and decriminalized or legal for therapy in a growing number of cities and states. Cannabis is federally illegal and legal in more than half of U.S. states.

I try to note the legal context where relevant, but I am not a lawyer and the note you read may be out of date. You are responsible for knowing and complying with the laws that apply to you.

Individual variation

Pharmacology is not one-size-fits-all. The same dose of the same compound can produce different effects depending on genetics, liver enzyme expression, body composition, sleep, diet, other medications, hormones, age, tolerance, and a dozen other variables. Case reports and personal experience - including mine - are data points, not prescriptions. A supplement that works well for one person can do nothing for another and cause harm in a third.

Harm reduction, not endorsement

Where I discuss recreational or unsanctioned use of any substance, I do so from a harm reduction perspective: if you are going to do something, here is how the evidence suggests you can do it with less risk. That is not the same as saying you should do it. It reflects a pragmatic view that people make decisions about their own bodies regardless of what a blog tells them, and that they are better off with accurate information than without it.

Errors and corrections

I try to cite primary sources and to be clear about the limits of what is known. I will still make mistakes. If you spot a factual error - a misread study, an outdated dose recommendation, a missing contraindication - email me and I will correct it, dating the correction at the bottom of the article. Evidence-based writing is only credible if it is willing to be wrong out loud.

In an emergency

Nothing on this site is a substitute for emergency medical help.

• United States: call or text 988 for the Suicide and Crisis Lifeline. Call 911 for medical emergencies.
• United States poison control: 1-800-222-1222.
• Outside the U.S.: your local emergency number and your country's poison control line.

If you or someone you know is having a bad reaction to any substance, including supplements, get help first. The article can wait.

Liability

To the extent permitted by law, Off-label Insight, any contributors, technical associates, and site owners including Aaron Cohen are not liable for any consequences resulting from decisions made in reliance on information published here. You read and act at your own risk.