Chuck Shute Podcast

Dr. Matthew W. Johnson and Using Psychedelics to Treat PTSD, Addiction & More

September 13, 2024 Dr. Matthew W. Johnson Season 5 Episode 456

Matthew W. Johnson, PhD, is a senior researcher for the Center of Excellence for Psilocybin Research and Treatment at Sheppard Pratt’s Institute for Advanced Diagnostics and Therapeutics. He is one of the world’s most accomplished scientists on the human effects of psychedelics and has conducted seminal research in the behavioral economics of drug use, addiction, and risk behavior.  The conversation explores the evolution and impact of psychedelic research, particularly psilocybin and ketamine, over the past 20 years. Dr. Johnson highlights the shift from psilocybin's political casualty status to a multi-billion-dollar industry with FDA approval potential. Psilocybin shows promise in treating tobacco addiction, with a recent study doubling nicotine patch success rates. Ketamine, approved for depression, also shows potential in addiction treatment. The discussion touches on the therapeutic settings, the importance of preparation, and the potential for psychedelics to induce profound, lasting behavioral changes. The conversation also addresses the legal landscape, ethical considerations, and the risks associated with psychedelic use.

0:00:00 - Intro
0:00:13 - Interest in Psychedelics and Early Research
0:03:09 - Behavioral Science & Psychedelics
0:05:20 - MK Ultra and Mind Manipulation
0:07:58 - Therapeutic Setting and Regulation
0:10:07 - Comparison with Traditional Treatments
0:13:19 - Psychedelic Therapy Model
0:16:45 - Music and Environment
0:18:44 - Personal Reactions and Screening
0:23:15 - Neuroplasticity and Brain Changes
0:30:27 - PTSD and MDMA
0:33:15 - Ketamine & Addiction
0:51:20 - Realizations Under Psychedelics
0:56:20 - Prince Harry & Psychedelics
0:59:15 - Psychosis Risk & Vulnerability
1:03:05 - Pursuing Psychedelics Use & Legality
1:14:01 - Outro

Dr. Matthew W. Johnson link:
https://www.sheppardpratt.org/why-sheppard-pratt/our-experts/details/matthew-w-johnson-phd/

Chuck Shute link tree:
https://linktr.ee/chuck_shute

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Thanks for Listening & Shute for the Moon!

Chuck Shute:

I'm just glad that you agreed to do this. Like, I mean, you've been on some big shows, the Huberman podcast and Lex Friedman, and

Unknown:

it's pretty cool the biggies. Yeah,

Chuck Shute:

so psychedelics, this is such a fascinating topic. It's really gotten a lot more exposure lately, like a lot more articles and research has been done, and you're kind of on the front lines of this, right? Yeah,

Dr. Matthew W. Johnson:

I've been in the psychedelic area for 20 years, so you know, long before it became popular in the last really, it's really hit hard in the last five years. So kind of seeing that trajectory where, you know, it was kind of called a career killer, and when the world is this so good luck. You know, now we have, you know, multi billion dollar industry, and you know, that's focused on potential FDA approval. And it's kind of easier to name the, you know, number of top medical institutions that don't have a psychedelic program. It's easy to do that and name the ones that do, you know. So it's really just dramatically, you know, shifted. Wow,

Chuck Shute:

that's interesting. So how did you get interested in the topic, uh, 20 years ago. I mean, yeah, like you said that people would have thought you were crazy to go into that. So what made you decide to tackle that? Well,

Unknown:

I became familiar with the older work from the 19 a lot of times we say the 60s, but it's really the 1950s through the early 1970s primarily with LSD, but I discovered in college that, you know, through looking through that history, and this is sort of pre internet, you know, era, you know, it's a at the library, reading, you know, old accounts, and, you know, books and looking through microfiche, if people remember what that was. And, you know, finding the resources and discovering that it's not like, you know, research really looked into it, and the therapeutic work found that it didn't, it squarely didn't work. It was really just, and this was argued with LSD, looking to treat alcoholism and end of life, cancer, distress, other things, but it was more that it was a political casualty. You know, psychedelics, particularly LSD, became very popular in the late 60s. You know, it may or very popular for a while, and till the mid 70s. And they've always been around. They've never gone away. But in that initial, what we think of as the 60s, really kind of starting in the mid late 60s, with the popularity of psychedelics, mainly LSD, that that really was, was why that the therapeutic work, what came to an end, and psychedelics being associated with all kinds of countercultural changes in society and and so much that you know, the medical research, the scientific work in general, was a casualty, and I was a someone with an early interest in behavioral science, psychology, understanding behavior Change. How can we help people to achieve behavior change, to kind of fulfill themselves. And so I had kind of roots in behavioral psychology, and also this growing interest in psychopharmacology, how drugs in general work, everything caffeine, alcohol to cocaine to psychedelics and amongst those, you know, different substances. I mean, they're all fascinating. The sense like, how can you have these little molecules that have such profound effects, good and bad, you know, you know, interacting with the brain and causing changes the way you people behave and think. And I think the psychedelics are just the most interesting example of that, because there's just examples of people saying they took a psychedelic one time, sometimes decades ago, and they could say, oh, you know, they changed my life in this direction. You just don't hear any reports like that with other drugs, like even with cannabis, you know, obviously lots of therapeutic effects and lots of you know, there's a reality there. But I've never heard a single person say, Oh, they, they, you know, they smoked pot one time. You know, 20 years ago. Never touched it since, but they smoked pot one time, and they had this, you know, radical alteration that set their life on this more positive path, you know, and you know that's certainly not the normative or typical psychedelic use, but it's also not uncommon to come across people with those claims. I mean, be there any scientists or people in the tech industry and you know, artists? I mean, just countless music you know, musicians you know, have made claims like that. So it seemed like. There was probably something there, you know, that was just, had just been kind of ignored and, and also, then, you know, there's a reason that the CIA was looking into this stuff for, for many years, you know, as brain on the dark side of, you know, mind manipulation and brainwashing and behavior change. You know, how

Chuck Shute:

does that work? Because MK Ultra, there was all these secret government programs, and I think MK Ultra was one of them, and they were, I mean, they were, what was it like, dosing people and then getting sex with prostitutes or something. So how does a using that as a mind manipulation, if it's more of a, you know, insightful, you have these, you know, eye opening experiences. How does it? How do you use it as an evil, dark way to manipulate people? Well,

Unknown:

I think it's consistent with everything we've learned. And my best formulation of how these work is, you know, they don't fundamentally push one in any of these directions. They don't, you know, inherently, you know, give people sort of, you know, Kumbaya, you know, all as one. You know, this kind of transcendent vision, nor that they make people maniacal, you know, cult followers, but they can do all of the above under the right conditions. So it's more of, like, it's, it's like, you know, an artist puts a, you know, they make a mold, like, it's like a plastic, you know, when you turn up the heat, now it's more pliable, you know, it's like this temporary state that's that makes things more pliable, and depending on the hands of the artist and the conditions, he could do Good things with that, or bad things with that. So it's a rat radically altered acute state that has potentially such power to, you know, alter the person afterwards in good or bad ways. And so that accounts for both the you know, positive effects, as well as the anecdotes, not just of, you know, brainwashing and mind control and Charles Manson and you know, there's a reality there, MK, Ultra, but even just you know, you know, delusional experiences, it does appear that psychedelics can make people worse who have psychotic disorders like schizophrenia. I mean, if you're already kind of, if you're if you're holding on to consensus reality by a thread, probably the last thing you need is a high dose of a psychedelic which can at least temporarily, really kind of disconnect one from consensus reality. And so there can be some long term destabilization of people with disorders like schizophrenia, and so that kind of like that general pliability model is applicable to all of that, the good, the bad, the ugly. I mean, it's been called, you know, non specific amplifier, for example, which is consistent with that. It's another way of saying

Chuck Shute:

the same thing. Yeah, so, I mean, just disclaimer here. I'm not, we don't condone the use of psychedelics. I'm only you know this is you're doing this under the supervision of in a therapeutic setting. So explain how you all

Unknown:

the approvals, DEA, FDA, you know, institutional reviews, legal at the state, federal and every level. Yeah. So

Chuck Shute:

what if someone comes into your clinic and they want to have this experience? What does the therapeutic setting look like like? Is there psychedelic posters and things, or is it just very clinical, just like white walls or what does it look like? Something

Unknown:

in between that. Okay, so first thing to keep in mind is that it's not like the days of the early days of LSD research in the 60s, where Sandoz pharmaceuticals will just send anybody, any doctor, a vial of LSD, and you could try it on your patients. And it's these have to be high, highly regulated and approved research study. So, for example, right now I'm doing research on I'm using psilocybin, which is the agent in magic mushrooms, to treat tobacco addiction. And that's a lot of research I've had for over 15 years. It looks very promising. So one, you know, for that, one signs up for this trial. They decide whether they want to be in this study, like a current study, it's comparing psilocybin to a placebo in the context of cognitive behavioral therapy, a talk therapy to help people overcome their smoking addiction. And you know, we're screening, not everyone qualifies, you know, and there's informed consent. And if someone's passes screening and they sign up, then, you know, there's a lot the session, there's they're not It's not take. Take two and call me in the morning. It's okay with people that they've developed a rapport with they trust.

Chuck Shute:

So how are the results of that compared to like, Chantix or so because that that drug kind of, is that the one that could cause suicidal ideation or, I mean, there seems like some very Yeah, curious side effect, box

Unknown:

warning surrounding that and so so far, and it's always, you know, we haven't, for example, there done a head to head comparison with chantic. So yeah, as a scientist, I always want to have the caveat is, okay, can't speak super conclusively until you have that, like randomized head to head comparison. But I've recently wrapped up a head. Comparison to nicotine patch, oh, which is sort of in typically, Chantix works a little better, although I would argue side effects more serious, as you alluded to risk, yeah. I mean, in the same ballpark of efficacy in terms of works, you know, something between, typically, between 20, 30% for both and so recently did a head to head comparison, and more than doubled the success rates of nicotine patch. So it's looking very and that's long term. That's at six months, with most people being quit six months later, which you know, the typical study is that, you know, the large majority of people are still smoking and even a successful treatment, you're talking the favorable outcome is typically, oh, you know, 20% in the treatment group is smoke free, and you know, 10% in The in the control condition is smoke free. So, yeah, that's an effective treatment. It's doing better, yeah. So statistically, is that 80 90% of people are still smoking or room for improvement, so it doesn't and nothing's going to be nothing's going to work for everyone, to be clear. So, you know, I always want to remind people that this isn't, not everyone's going to be interested. In this. Not everyone's going to qualify. I do think it's a fundamentally different treatment paradigm that could help a lot of people that haven't been helped so far, and the way it works is fundamentally differently. I think it has far more to do with psychology. It's this, again, this temporary, radical alteration of brain function, which the mind is very different during the the experience, the trip. But then the interesting thing is that can be such a profound experience that it can have lasting impacts on the way the person thinks and behaves afterwards. So when it works, it looks like good psychotherapy more than it looks like your typical psychiatric drug, which is treating symptoms. So

Chuck Shute:

as part of the treatment, like you give them psilocybin, and then do you, like you say certain things to them while they're on the psilocybin, like you don't need cigarettes. Or, you know, is that part of the therapy, you just give them the psilocybin and then let them kind of have their own journey. It's

Unknown:

sort of the latter, yeah, yeah. So we have the Clockwork Orange sort of programming during, well, you know, if it's not ethically, I'm all for that. You know, research, I like to see the results. Want to make sure they consent to what those messages are, yeah? Well, yeah. But the model so far. And this dates back to the work that was done in really, dating back to the late 1950s where it was these researchers in Saskatchewan, Canada that first came up with this psychedelic therapy model. I mean, LSD had been used in different ways before there, but this particular way of using it was developed in the late 50s by those folks. And we're doing, you know, the same type of stuff with psilocybin, which is in the same category as LSD, in terms of the way it works in the brain, but it's you prepare somebody. So you know, if you give it to someone who's not prepared, and they're with people that they don't know, well, they're with strangers. A lot of times it looks more like a psychotic experience, temporarily, some of the very earliest research was done in a white padded room and with, again, without really any preparation. And what you get under those conditions is, you know, people look temporarily crazy, like you're mimicking psychosis, but under conditions where they're prepared for things like, yeah, like, this is can be an overwhelming experience. You could feel like you're going to die. Physiologically, it's very safe, and we've screened you for the few things that we think could be dangerous, like if you're at severe risk of heart disease, simply because it raises your blood pressure, typically, modestly. But you know, you know, we think it's a very you know, aside from you being screened, we're also, you know, monitoring, and so there's a physician on hand who could administer rescue medication. So you know you're going to be we're going to keep you safe physically, but we let them know, like, yeah, you could feel like you're dying. Like it feel like you know, you know you could have your mind could go anywhere, good, bad, ugly. So you prepare them for that, and you develop a trust and rapport with you have something. It's ranged typically from four to eight hours and meeting time. But with those people, sometimes they're called guides or the therapists, the people that will be there during the session with you. So you're not going into the idea is, like with with strangers, you could delve into paranoia. It's more likely to have a paranoid reaction. And you see that sometimes people take some shrooms or acid at a concert, and, yeah, they're surrounded by mostly strangers. And sometimes people do freak out. They're like, who is that person? You know, what were they? And, in fact, you can't trust everyone. You shouldn't make sure you're, you're wild, and your person, you're, I mean, you know, like people are sometimes sexually assaulted and they're while it's stolen, and, you know, bad things can happen. So you know, one is very vulnerable when they're in this state. So it's really, really important to have someone, ideally, with in a situation where they're they completely trust what's happening. They know they're being kept safe. The person's they're not going to be left

Chuck Shute:

alone. So does it typically bring in a spouse or a girlfriend or boyfriend or something like that? No,

Unknown:

although that could be looked at in future research, and then you'd want to train that person about how to respond, so it complexifies things. But typically, that person will sometimes be brought in at the end of the session, once the effects have worn off, and so kind of handing off to a loved one for them to, like, drive them home, or be with them that evening, and be with them at home and feel like they're a part of the process. But, but, yeah, it's, it's, it's typically with a, again, a therapist that's developed this rapport, and during the experience, there's not like, you know, talk, you know, like, you know, programmed experiences where you're giving them messages. It's just where these eyeshades we're going to, the music is programmed. But it's very general. It's different. Studies have done different things. But wait,

Chuck Shute:

what kind of music are we listening to, typically

Unknown:

classical music. But different things have been done. Sometimes I've done music with, like, lots of gongs and drones and sort of this sort of overtone based, you know, did you redo and kind of out there things I did a little work comparing that to classical music family basically performed about the same. So, I mean, I think lots of music could be brought to bear to it, but the idea is that music provides some psychological structure, and it can, kind of obviously, music by itself, can be inspirational, and can, you know, work with emotion and heighten emotion. And so that's that's the reason that for the music. But the typical model has been wearing earphones through which that music is played. They're not sort of playing DJ and say, Oh, now play this and play that. It sort of pre selected six hours worth of music, and then the therapist is really there for as a safety net. If all goes well, there's hardly anything said, but if the person says, Oh man, I'm, I'm starting to freak out. I didn't know I'd feel like this. It's like, oh, this is I'm not feeling right. It's what do you do? Yeah, at that point, well, interpersonal reassurance, and that's where the rapport comes in handy. Or rhyme and say, Hey, I'm, you know, it's mad. I'm, I'm here. I'm not leaving me alone. It's really powerful to, like, just take their hand and you prepare them for that and get consent to that. But that also addresses an issue. Like, you know, there have been sexual abuses in the field, and I think it's important to just leave it at the hand. So, like, you know, you're not feeling well or doing body work, which some of this hippy stuff where it's like, yeah, man, you're going to have some creeps involved that are going to take advantage of that. And like, so like, make it very clear, it's just going to be your hand, or I've been, like, with the hand or the shoulder, but you know, that could be very powerful. You know, just say, I'm with you. I'm not leaving you. You're okay. We're not leaving you alone. That's where it can be useful to have two people, because even if you know six hour experience, you know someone's going to need to go to the bathroom, but so that other person is in the room. And there's also models where probably more realistic in terms of clinical dissemination, where you have one person in the room, but during those times when they can, they have to leave. They can call in a, you know, someone, you know modern technologies, send them a text, or whatever. It's like I need you come in the room, push your button, whatever. They can come in pinch. Hit for you, they've also have some rapport with the person. So, you know, then you could go, you know, whatever, urinate, do what I need to do. Five minutes, come back, yeah, and be with them. So you don't leave the person alone. They're always with someone. Always with someone they trust. Yeah, and you have a physician on hand. They don't have to be in the room, but you know, they might be in the building. You know whatever you know. So you're my occasionally monitoring blood pressure at a set time intervals, in case the blood pressure gets too high, which rarely, but sometimes happens. And they can always come and administer a medication that can bring that down some. And in worst case scenario, it's had to be done sometimes, but not typical. But if anxiety becomes overwhelming, they could be given, you know, something like a Xanax type drug as a pain to to take the edge off.

Chuck Shute:

Yeah, because I know some people, and you talk about having an intention and then making sure they're in the right place to do this, but some people, I feel like, like myself, I feel like I'm just this kind of shit always like, it gives me anxiety. You know, I think, like, some people love roller coasters and some people hate it. And I think it's the same with psychedelics. Some people love it, and they can't. I just remember my friends in high school, they were doing acid like every day. And I was like, Well, how do you guys go through school, just like a regular school day on acid like that is insane to me, you know, I could take a little bit of, you know, point five milligram of weed, and I'm like, Oh, my God, I'm freaking out. The world is going, you know, like, so there's different personalities, right? So how do you you kind of screen that beforehand?

Unknown:

Well, you know, part of that's that level of screen where it's, frankly, more self selection, like someone who, you know would never want to do it is probably never going to call up for that study, you know, because this isn't obviously picking people off the street, oh yeah. But

Chuck Shute:

it's like, see, because there's, a part of me that's like, oh my god, I hate psychedelics, so scary. But then when you talk about the benefits and these breakthroughs, then I'm kind of go, well, maybe I need to just push through it and try it, you know, right? And that's

Unknown:

where you know, that's where you know. You really have to prepare the person when they come in at the consent process, you do warn them. It's like, hey, like, a lot of people get the impression, oh, like this is medical research. So you guys are probably using a pretty light dose. And actually, no, you know, this is a heroic version. Is even typically taken in a recreational context,

Chuck Shute:

40 milligrams of psilocybin, 3040,

Unknown:

milligrams of psilocybin, which is equivalent to the classic, I don't know if you're familiar with the heroic dose of five dried grams of Selassie cubensis mushrooms, which which Terence McKenna, who was sort of a psychedelic philosopher of sorts, used to kind of recommend, like, that's the real deal, like the heroic dose. And so it's, it's, it's bigger than what most people like. If people are familiar with mushroom dosing? You know, someone might buy an eighth ounce of dried mushrooms, split it two or three ways. They're going to it's not a microdose, like they're going to have a real experience, but it's going to be moderate, five dried grams, or the equivalent of about 30 milligrams of pure psilocybinism, somewhere in between an eighth ounce and quarter ounce of mushroom. So it's not splitting that eight ounce two or three ways. It's actually taken more than than an eighth ounce, like for one person. So it's a pretty high dose for I mean, most people don't want to take this dose at a concert. And to be clear, why people not recommending any of the, any of the above, but I'm just describing, you know, for people who had to use these things some reference point, you know, not recommending people do these things on their own or outside of illegal, yeah. But

Chuck Shute:

besides, yeah. So besides, like, the the psychological component explain the like, physiological component in the brain, or how? Because I know. So here's what happened, actually, like a part of the reason I got interested in this topic is my dad fell off a ladder, and he had a head injury, and he was given some sort of prescription drug, and it was causing him all these side effects. He could barely walk. And then he started doing his own research, which I know you're not supposed to do, but he said that he was reading up about these NHL players, and I found an article too, and the NHL players are using psilocybin with head injury. So he started micro dosing mushrooms, which, if you know my dad, this is like crazy. This guy is very grow I grew up in a very conservative household where, you know, very anti drug, and he swears by it. He said it changed. The doctors were baffled when they looked at his brain scan, there was like, there was no evidence of the concussion a year later, and they said he was at risk if he didn't take this anti seizure medication, he was gonna have a seizure, and never had any issue. Now it's been like, I think it's been like, two years, and he's had totally fine. So what is going on? Psilocybin help head injuries. So,

Unknown:

and we don't know for sure, because these are anecdotes, but that it could very well be real, and I take it very seriously. And again, like you, I'm not encouraging people to do this, but I'm always. I do survey work, and I talked to plenty of people. And, you know, I keep my ears open for you know what those anecdotes are. And Dan Carcillo, you know, he reached out years ago. He's was, you know, notable. You know, NHL player retired now, but through both neurological issues and psychiatric you know. Know, depression and substance use issues like just said, psychedelics changed everything for him, and there's a number of those examples across a number of sports. And so we do know that in rats that psychedelics, including psilocybin, lead to different forms of neuroplasticity. We don't know yet for sure whether that's happening in humans, but it's a very good bet. I mean, you kind of have to cut up in people's, you know, animals brains, to see if really direct so, you know, we tend to not want to do that to people, but you can do it to rats, yeah, sure. So that's why we don't have direct evidence, but it's a very good bet that it's that's part of what it's doing in people. We don't do we do. What we do know is that it's activating a subtype of serotonin receptor, serotonin two, a that has downstream effects and other neurotransmitters like glutamate. We know that that at the broader level of like what's called Brain network activity, the communication patterns across the brain, but what that receptor level activation leads to is this massive change in the network activity, the communication patterns of the brain, where there's more cross talk between areas that don't normally talk as much, and in Other instances, there's less communication amongst hubs or local networks that do talk to each other. I kind of liken that to the internet coming into society, where you know beforehand, maybe you had, you know, you're going to talk more to the people, your neighbors, people you're part of town, and now it's a for better or worse, you might not know your neighbors, but you know, you play chess with some kid in Pakistan because you're both in the chest, you know. So it's like, right? Just like scrambling of the normal communication. And that can, again, come with good stuff and bad stuff, you know. Okay, try to cross the street on a high dose of psychedelic. The other thing with your dad's anecdote is that he sounds like he's talking about micro dosing, which hasn't been looked at much in research. There may very well be, you know, it's not the heroic dose model, the high dose. Oh, he said

Chuck Shute:

it was micro dosing. Then he said he is supposed to. It says on the he got these chocolate bars, I guess, and it said, take one or two squares. He said he ate the whole thing, which, like, when I talked, that's crazy, like, and my dad said, I don't know, I felt fine. I didn't have any sort of he's like, all he said Is he felt a lot of gratitude. He said he always feels gratitude. But when he took, you know, the bigger dose of psilocybin, he said he just that that feeling of gratitude just amplified, basically, right?

Unknown:

Yeah, that sounds like a little more than a microdose, but, and that's one of the issues with microdosing is, and for those who don't aren't aware, my dose is supposed to be so low of a level that you could go about your daily business. In fact, microdosing say, you know, take it a couple of times a week and you again, you're doing the normal things. Like, part of the issue is like, you know, yeah, you might think it's a microdose. And then the the walls start waving, and you're like, Okay, you know? And then it's a problem if people are out there driving and they're taking care of little kids and, you know, obviously all kinds of things making the important decisions at work. Um, you know, but we don't know for sure whether the micro dosing is really having the therapeutic effects. I'd say that there's a very good chance that a subset of these claims are something very real. Um, but it's just that this appropriate studies haven't done, haven't been done yet. Um, there's been a few studies, the best kind of studies, they haven't they so far, they haven't validated some of the psychiatric effects, um, that have been claimed that it's like, more like an ADHD treatment, and it it, there's so many caveats, because it also these haven't been done in clinical like populations that have disorders to treat. Plus there's a myriad of different things being treated. Like, you know, you're talking about concussion, which is a neurological disorder which may be fundamentally different than improving your depression or your anxiety, which is what is, what we call psychiatric affect. What about issue

Chuck Shute:

with PTSD? There is research on that, and that would make sense, given what you're talking about, how the brain is able to talk to other people, you know, because I think, isn't it PTSD, they're they're blocking out that trauma right when they take the the psilocybin, then they're allowed to access it and process it better. Is that what's going on? Yeah,

Unknown:

that's a good description. Um, now the most advanced kind of clinical work has been done with MDMA, which is a different type of a psychedelic sometimes is on the street, is Molly or ecstasy. Psilocybin is the compounded mushrooms, which is sort of it's called a classic psychedelics. Some scientists don't consider it a real psychedelic. Some people call it a psychedelic. Some people don't. Ultimately, that's just semantics. It's similar, but works in somewhat of a different way. It's release. Says serotonin in the brain, rather than kind of mimicking, you know, activating the same receptor that serotonin normally activates in the brain, like a classic psychedelic does, but nonetheless, very psychedelic, like people in terms of effects, people will describe as more of a kind of an emotional trip, rather than a, you know, reality is unzipping, and so it's not like the full trip, less potential for it would seem that for a so called bad trip, you know, more of a an emotional experience, rather than having these, you know, more fundamental kind of changes in, you Know, one's perception of reality. But that was unfortunately rejected by the FDA pretty recently for the treatment of PTSD, and a lot a lot of folks were up that it would be approved. I think it's very likely that it will be approved eventually, but FDA is requiring more work, and it's probably more related to the way this, the sponsor had conducted some of the trials, rather than just a sort of a block, you know, just the the idea that, you know, the government is so opposed that they're never going to accept this. It came down to some nuanced issues. And there were some issues that clouded the case, like, there were some cases, like, there was a case of sexual abuse where a therapist started sleeping with the patient, you know, after the formal treatment was over. And it you know. And these are real risks, actually, you know, because people can say this is, like, one of the most meaningful experiences of their life, and they're in these very vulnerable psychological states, and that can, you know, people can fall into this trap of, you know, thinking that the normal rules don't apply because you're, you know, you're connecting with this person at this fundamental level. I'd say that's all the more reason to cling to these traditional boundaries of like, yeah, don't, don't sleep with your patients. Don't keep any potential romantic keep all that stuff in check. You're an adult. You know there are real consequences to things, and you know that stuff goes on too much and just in therapy in general. Forget psychedelics, but I would say it's amplified with psychedelics. So that clouded the case somewhat. And there were also some questions about the nature of the psychotherapy that they had used, and some issue about, well, was this driven all by placebo people's high expectations and the fact that you can tell whether you're on the drug or a placebo, a sugar pill, or not. I think these are surmountable obstacles. But I think a lot of the other sponsors that are going forward with that with psychedelic treatments to the FDA, they're they're going to come in much better positioned. And this sponsor itself, Lycos, is the name. I think they're going to, you know, come back with doing additional research, and very likely get approval, but it's been somewhat of a setback, okay, I think over time, we're going to see psychedelics approved by the FDA,

Chuck Shute:

yeah. What about with ketamine? Because I know. I mean, obviously people know the case of Matthew Perry was ketamine to take home, which I don't think you're supposed to do that. I think it's often doing a supervised environment, but it can be powerful and insightful to some people. And I guess in Russia, they used high doses of ketamine to work with heroin and alcohol addiction, they had

Unknown:

great results. So yeah, kravitzky's old work, yeah, that's great that you're familiar with that, unfortunately, that was mainly in the the 90s, or, I think maybe those publications, some of them, were still coming out in the early 2000 they had to stop that work when Russia rescheduled ketamine as essentially what we would call schedule one rug put it in that category where it was virtually impossible to do any medical work with it, even research and so but that did look very promising. Now, ketamine was approved, and a version of ketamine called S ketamine was approved. Oh, gosh, what are we coming upon? Eight or more years ago now, was approved for the treatment of depression. Might have been more recent than that, but, you know, over five years ago was approved called spravato, the brand name, it's a nasal spray which has a one of the one version of ketamine. One of the issues is you don't have intellectual property on ketamine, what's called racemic ketamine. And so the company Johnson and Johnson, the pharmaceutical company Janssen, which is part of Johnson and Johnson, had this, the intellectual property on this one version of ketamine. So anyway. Like, you know, you get into this realm with pharmaceuticals, where there a lot of it's about proprietary intellectual property, but they approve this, you know, nasal spray. Now, ketamine is very psychedelic. You get it, but it's like this. It's like what I said about MDMA. Some scientists will say this doesn't even count as a psychedelic. Well, it's at least a relative. It's very at high doses, it's very psychedelic like at least, and it works as in a different pathway through the glutamate system. As I said before, the classic psychedelics, like psilocybin, initially activate an aspect of the serotonin system, but there's downstream effects like one of the further dominoes that fall on the chain of the cascade of brain changes is on the glutamate system. So it may be that the glutamate system is a common pathway for some of these different classes of so called psychedelics. But ketamine was approved for the treatment of depression. One of the issues is that it's not treated, really, as a psychedelic at the time, when, during the approval, that's back when psychedelic therapy wasn't as popular, wasn't that was it was now. So they really try to distance themselves. And the framing isn't that, oh, you're going to have these different insights. It's going to you're going to learn from this. The framing was, No, it just does some stuff in your brain. Ignore, you know, ignore, you're going to feel weird, but ignore that, and it just going to have, kind of have this automatic effect more analogous to a traditional psychiatric medication. And it does appear to have some effect in using it like that. It's a pretty modest dose, a ton of typically, not typically, an overwhelming psychological dose. But, you know, I would argue, if they treated it more like a what we call psyched up therapy, where the point is to gain insights and learn from this altered state of awareness, you know, I would say there's a decent chance the effects would be longer lasting. That would last, on average, more than a week, which is how long the antidepressant effects last for ketamine, for for s ketamine bravado now, because ketamine has been approved for decades as an anesthetic, non proprietary ketamine, which is pretty cheap medically, because it's, it's used In anesthesia and other, you know, surgeries, etcetera, that there's lots of physicians that are given, in fact, most of the ketamine treatment for depression is done not with spivato, but with, you know, generic ketamine, and that can be done through intramuscular injections, or they could formulate their own nasal spray. Or sometimes it's given in lozenges, different formulations, but sometimes that is sent home with people legally. So there's a lot of discretion with that, and because it's done off label, you know, it's up to the physician, but, and there's companies even built upon sending patients home with with, um, you know, ketamine lozenges and other forms of ketamine. So

Chuck Shute:

was that common then? Because I think that the family of Matthew Perry is suing the doctor like he wasn't supposed to do that.

Unknown:

Yeah. So I would it's, you get in a lot of these situations where it's not, there's not exactly, uh, a rule against it, but it's sort of like the use of opioid analgesics if you're a physician and you're writing 1000s of scripts. Man, you don't be surprised if you get some attention from the DEA and the FDA and so you might be pushing the bounds of what's considered and your state, you know. So the practice of medicine is is regulated by the state, not at the federal level. So don't be surprised if you you know, people want to pull your your your state medical license up for, you know, call it into question and bring you up on charges. So there is kind of a gray area, even if it's technically legal or there's not an explicit rule against it. It is in the zone where, you know, some people would call it malpractice and dangerous. Okay, I would certainly say it's not a good idea to be doing self treatment ketamine at home, if it's prescribed by one. And some of these, like companies are it's sort of like, you know, you can get ADHD drugs like this, or TRT testosterone replacement like this, where, you know, you with the right money, you got the credit card, you can call up, you can have a, you know, a five minute zoom call with a physician who will make the prescription. And I'm wondering about what percentage of people are denied, you know, as long as their credit card goes through, you know, and you'll get the script, and it was prescribed by a physician, and they'll mail it to you, and you get your TRT, or whatever, or, Oh, and Viagra is probably the biggest example of this. You can get red dysfunction drugs like this, or whether it's that, or testosterone or ADHD meds, there's a lot of these companies that focus on this kind of quick. You know, kind of, especially with telemedicine gotcha and then sending it home. And so if I was those companies, I would be worried, because of the case of Matthew Perry. I think a lot of people should pay attention. I think there's a lot of open questions, like, apparently he was getting it from, you know, both from my understanding, only from what I've read, I don't have any inside information, but from what I've read in the press, you know, from both, you know, prescriptions from doctors as well as, you know, the traditional whatever recreational ways of whatever scoring it from, you know, people on the illicit market or diverted from medical use. And, yeah, it's there definitely risks to ketamine, like there are with all substances, you know. And he, you know, passed out. I mean, he could lose consciousness. And, yeah, that doesn't mix well with water. I don't mean to make light of it at all. I mean, he, you know, he drowned when he was just, you know. And, and that's actually a thing with ketamine. There are some notable cases in the history of people that are really into the psychedelic recreational use of ketamine, that have even drowned in their bathtub. It's kind of been a thing where, apparently the effects, it's sort of like if you know of float tanks, or people, you know, people have combined ketamine with even, which is like, floating in their own bathtub, okay, at home, where, apparently, that, you know, can magnify this kind of out of body sensation. So like, people have drowned in, like, you know, 10 inches of water. Wow, you same way if you're drunk, like, yeah, like, don't, you know, it's like people say, turn the person on their side, is, like, if they vomit, they could choke in their own vomit. Like, you know, you're super intoxicated. Like, bad, bad stuff can happen. Man,

Chuck Shute:

yeah. Well, besides, like, so the ketamine was looked at with addiction. What other psychedelics can be used to help people with addiction? And like, could people use that process now? Because I know there's a lot of people who have been through rehab, a bunch that didn't work. They've tried counseling, they've tried all these other things, and they're kind of at the end of their rope. So if for those kinds of people who want to try something else and want to try a different thing, what can they do to deal with addiction in terms of using psychedelics?

Unknown:

So psilocybin looks promising for addiction. So now I mentioned the tobacco addiction work, which is interesting, because it's, you know, tobacco is different that you know, it's typically like, you know, your life hasn't crumbled, your wife hasn't left you, you haven't ruined your career and wasted your life fortune. You know, it's like, but it's a very real addiction. Talk to anyone who's really tried, yeah, okay. And some people will say it's just as bad, if not worse, than the biggies. You know that opioids and cocaine or it's right? And

Chuck Shute:

didn't you do an episode about food addiction and psilocybin?

Unknown:

Yeah? Yeah, I think there's incredible promise there, because, and that's kind of gets to the point about tobacco and alcohol and coke. I've got a good colleague that soon worked with cocaine, that the reason that it seems to be working across these different forms of addiction, which is different than most addiction medications, which are typically substitute treatments. They work at the surface level, like like methadone or suboxone for opioid addiction, it kind of quells your craving for the drug, but in a more sustainable, less yo yo fashion, very similar to nicotine gum or nicotine patch or nicotine lozenge, and frankly, even though it's not technically considered medication, you know, it's like, you know, taking Zen pouches or or even e cigarettes, it's, it's a safer form of getting the same substance in but This is fundamentally different because it's working across these different addictive drugs. And I would say, because it hits that psychology that ties them across. So it's not about the surface level, like withdrawal and quelling the physiological cravings for these substances. It more gets at what I think is the bigger aspect. It's like addictions. You know, the threads of addiction are more like that iceberg with like, you know, the part you see poking above that might be the withdrawal, you know, surface level effects of like tobacco or alcohol or coke. You know, most of it is like this underneath the water. It's that, and it's more the realm of psychotherapy and more kind of philosophical and about like, what's the narrative of my life? What? How much attention Am I devoting to this thing versus, you know, my family and, you know, these, these principles that I hold in life about being healthy, and I want my kids to be healthy, and I want the people around me. It's like, you know, so many people in my smoking work, it said, like, man, it's crazy. It's like, I exercise and i i buy freaking organic food because I think it's healthier. But why the world can I do this? Like, I'm still smoking this crap? You know? It's like, it's inconsistent with who they are. It's like. And you might think, like, smoking's even a little different than the others, because, again, you know, have that degree of life destruction, but it can be, in a way, very palatable. It's like, this is not who I am. I hate this aspect about me, because it's it just all of this, you know, it causes all of these harms. And the harms of the different drug they're different, you know, like, yeah, you know, with alcohol, it's going to be very different than smoking. But they all have their categories of harms, and this inability to say, I know this is not, ultimately who I am or what I want from life. If you ask me, 20 years from now, what did you you know, am I going to be proud that I just kept I always told myself 1000 times, I'm gonna, I gotta stop this, and I never could. It's like, that's not who I am. It's like, and so it's that kind of you could call that spiritual, although it doesn't necessarily need to come with, it can come with or without, religious or supernatural, you know, a threat that's a

Chuck Shute:

very common message that it's like, people could say that, but they don't really believe it. When they take the psychedelics, then it's, they're able to kind of step outside of themselves and look and right, then they actually believe it, right? And

Unknown:

it's not like, and this gets very philosophical, but it's not like, well, that's like, this artificial state. I mean, when I mean, yes, it's, it's an augmented state that's, you know, caused by the the substance in the system. But I think the reason why it tends to stick, not always, but when it does work, why it works well, is that people don't feel it was this artificial thing. They felt like the insights, the that different perspective of themselves. There was a truth to that such a degree, when they're, you know, the next day, when they wake up and the drugs totally out of their system, and a week from then, and a month from them, it's just as valid. And like, once you look, you can't look back. And I think of like with PTSD, it's a good example. It's like, people said, you know, it's like, it's like, you know, they could look at themselves the way they would look at a loved one or even a perfect stranger, you know, who went through this thing, like, you know, they actually shot a kid and, you know, when they were in Iraq. And it's like they just, you know, split second decision, and they feel like this monster. And it's like, you know, anyone else around them, they're like, dude, like you were in this impossible situation. It's like, you're not inherently like a monster. It's like, you know, look at your resilience. You've done the best that you could. Or, you know, a victim of rape, or some you know, it's like, you know, no, you didn't ask for that. That's crazy. Like, no, this was not true. And look at how resilient you have been and look at, you know, the way again you you'd oftentimes afford a stranger more empathy and more understanding and more valid just ground truth, Insight and Truth. Yeah, that makes

Chuck Shute:

sense, almost like common sense.

Unknown:

We're not inherently just broken, right? You know, and someone can have that insight about themselves, knife, yeah, it's not just like this artificial drug high, even though it comes in the context of a of a drug high, but that inside itself is one that I think touches on some psychological ground truth such that can hold on to it. And so that's why, getting back very long about to your original question, that's why I think it's just as applicable to say food addiction or whatever you you know, and I don't want to yes, there's a risk of saying it works for everything. I don't think it's going to work for everything, um, but a whole lot of mental disorders, and I think there's probably exceptions, like, you know, schizophrenia, some other kind of, just for the disorders that are more of like, the end of the continuum, for things we all experience, like anxiety or depression, or, you know, addiction, self control, whether you have a full blown addiction, or just, you know, all of us have self control issues, whether it's with the cookies or something, or just, you know, you wish you didn't respond, you know, to your spouse in a certain way, you know, with the you know, even if it's not over the top, you just wish you were, you know, more patient with your kid. Or we all have these patterns that, like, I wish I did a little better with that. I wish I kind of fall into this same thing. And I didn't tell myself I shouldn't do that, but then I do it again like so you know, whether it's that or depression or anxiety, I think with a lot of that and trauma again, something you may not have full blown PTSD, but if you live long enough, you know something about trauma, you know, you know, we're all Human beings. And I think those things, there is an incredible potential, because they are the things that psychotherapy can work for. And I think when psychedelics work, they work like psychotherapy. People can tell you a story that like, Oh, I saw myself in a different way. I kind of learned these lessons, and now I started. To change the way on a more habitual basis, on a daily basis, the way my habits of thinking about myself and going about life, and then that has a feed forward aspect. It's not like the drug is still in your system if you're less depressed six months from now. And that's one of the burning questions, how the world is just having this long term from one, two or three sessions? How is it having this effect months later? Well, it's because it's like, psychotherapy. It's like, yeah, you can quit the psychotherapy if you've learned those lessons. And now you know things like, you know if you've learned, if you have borderline personality disorder, if you learn, like, with like, one treatment, dialectic behavior therapy, part of his learning like, Oh, I'm in this really emotional, like, kind of hot state right now, just learning times like, Oh, I'll get off the phone with the loved one I'm having an argument with, or I'll rather than escalating a conflict, I'm just going to go home and let myself cool off. Like that can be invaluable. And once you're in the habit of just doing that, it's like self reinforcing, because you realize your life's just better. And so it's kind of like that. You just establish it. Can help you establish better patterns. Yeah, learn something from it. When it when it works, it seems more like that. Okay,

Chuck Shute:

so those are some of the more common reactions, and obviously positive. But what would you say, because people have these life changing experiences doing this treatment, what are some of the more uncommon or interesting realizations that people have had that have stood out to you and made you think and really intrigued you, what they're, you know, realizing about the universe and themselves?

Unknown:

Yeah, well, people have all kinds of amazing, like, very interesting insights about the universe, and now a lot of that is in, I mean, really the realm of that I can't speak to as a scientist. I mean, we don't know scientifically. We might have our opinions, but we don't know ground truth. But, you know, people saying they've interacted with God and the source of the universe, and even people saying, I could see, sort of like the Big Bang, the origin of the universe. And, you know, and now how much of this is, you know, a really interesting and active imagination, essentially, you know, because they know about these things. They know about Big Bang, they know about, you know, this stories of God and, like, what you know in and so it just, I just want to be clear, it's, it's, it's impossible to say whether this is some sort of scientific like window into ultimate reality, which I think we can. I know scientists who have been fooled into really thinking that, you know, it's not that we know that it isn't, oh, this is just brain effect. So it's not. It's neither that you confirm nor deny. We just, we just scientifically, can't speak to that. That's more philosophical, personal question. You can't just, oh, well, that's just some tinkering around in the brain. Therefore, it's not possible that that like, well, you know, philosophically, it's possible you've altered the nervous systems that's more sensitive to some fundamental aspect to the universe. But I also don't know that to be the case in these particular instances. So, you know, but yeah, people have said, you know, I've seen people, you know, overcome the death of or I'd say, have extremely cathartic, seemingly very helpful experiences in overcoming the death of a loved one. People reorienting towards their cancer, did a lot of research with cancer, depression and anxiety. People, you know, all kinds of metaphors for the self, like seeing themselves as like this, this, this plant that's growing and that's that's thriving, that I think the the mind goes places where it's to some degree, like the world of dreams, where it's like it can find ways that are expressing itself, that are more abstract than in that can be really compelling than a normal waking consciousness. So there's all kinds of examples. And just like things that stick with people. Like, I remember one participant saying, actually, a few different participants, different analogies of of how to deal with issues like one like, you know, someone's like obsessive thoughts. They're the stuff that they can't seem to let go of, like with their cancer or other, like they could their image, like some image of of a conveyor belt, and like they could, they can put these issues in a cup and just kind of let it trail off and fall off the edge, like that being okay. But, you know, it sounds kind of weird and just this random

Chuck Shute:

image, but it makes sense to them that's their analogy or metaphor for it,

Unknown:

right? Like you could just like, let go of that, you know. And it's sort of like, you know, there's the things you can affect and things you can't affect. And just saying, like, Look, I can't do anything about that. I'm not going to let it destroy me. And you just like. Bye, you know, and just let it go like again. I think we all something. We can all have trouble with to some degree or another, but it's probably very helpful to have this very memorable, salient experience where, you know, you have kind of more of an anchor on that, because now you have a story. It's sort of like the power of, like, we're humans, like we're, you know, like, narrative is probably more important than anything. It's, it's why, like, you know, you know, much of religion is the power of parable and these stories and, you know, the stuff of myth. And like, when you have something that you could kind of wrap your head around that you could say, Oh yeah, it's like, this, this cup that's kind of going off, and can fall off the conveyor belt. Like, that's something you can remember your teeth into, in a way that just sort of this highfalutin conceptual way of like, well, we can't control all more problems. Therefore we have to, we have to let go. And, yeah, yeah, yeah. Just words. But like, if you can actually, no, no, no, I remember that image, you know, and yeah, during that

Chuck Shute:

time. So it can, they can psychedelics. Can also, they can have different effects for people. Explain this because I just saw this on your Twitter, or something like you were quoted in this article about Prince Harry, and you're saying something about how, you know, taking psychedelics, it could be inspire someone to be estranged from their family, but you said you were kind of misquoted, or or not.

Unknown:

I answered, this was some time ago. Gosh, it's over a year ago, I think. But, like, I should have known better than to even comment. I tried my best to, like, See, I know nothing about the you know, the but theoretically, like you know, can you know? Could it put you in a state where you're more manipulable by you know, you know, a family member or other, in a way that can have harmful effects? Yeah, sure. I mean, you know, the CIA used these drugs to brainwash people in the MK Ultra program. You know. Could you know? So, yeah, yeah, you know. But again, I know nothing you know, whether Megan Markle has done that to Prince Harry. Did

Chuck Shute:

he, yeah, did he? Is there some sort of story there? Did he take

Unknown:

so, yeah, yeah. And the thing that I that made me want to comment on it was that he apparently said that he's done ayahuasca, which is one of these. It's in the same category psilocybin or LSD. It's in this it's a sacramental South American Beverage that contains DMT, which is a classic psychedelic, very much like psilocybin. And he says that it helped him overcome the death of his of his mother, um, Diana and, and mildly, the reason I wanted to comment forward is, like, you know, because this was, you know, it sound like, you know, skeptical story. Oh, was that, do you know, is that crazy? And my answer was, again, with the caveat of, like, look, I don't know anything personally about but, you know, you know, is it possible for a psychedelic experience on something like Ayahuasca? Can to be psychologically helpful in someone overcoming and coming to terms with the death of a loved one, like a mother? Like, absolutely, like, that's a plausible story. So don't you know, this isn't like, some crazy thing that's never been said before, like, I've seen this in my hands in my lab, even when that's not the thing you're nominally studying. But like, again, I mentioned earlier, like, the death of a loved one is something that seems to really can be affected by this. And so my only thing was like, Hey, don't sort of just, you know, go tabloid and, like, dismiss that out of hand about some crazy, drug fueled experience that he's been warped into thinking, you know, just again, I don't know his case, you know, individually, but just that's a plausible story from what we know about the drug and so but then, whether, like, you know, Megan was brainwashing him or something, yeah, well, with any internal family drama, even, like, yeah, yeah,

Chuck Shute:

Ayahuasca though, like, I've heard I follow this podcaster, and He seems like a pretty straight laced guy, but he swears by Ayahuasca. But, I mean, from what I can tell, isn't there, like some isn't that a riskier, uh, psychedelic to take, like that could cause some serious psychosis? Would it be temporary or, I mean, wouldn't you permanent psychosis from taking Ayahuasca? Could you

Unknown:

busy? It's rip for the most part. It's in the same category of psilocybin and LSD and so so much of the effects in terms of psychosis risk, that's going to be more about the dose and most importantly, whether has someone has some vulnerability to those disorders. So there hasn't really been any. Case and 1000s of patients that have been treated in the earlier or modern era of formal research, where someone that passed screening that didn't look like they showed any signs of schizophrenia or related disorders, or even pre morbid you know, like, say, early sign, may they have a diagnosis, but you can pick up on early signs, like sometimes they hear voices, this type of thing. It doesn't appear that someone without those indications can become schizophrenic. There are anecdotes where it very much looks credible that someone who has that predisposition, or has active, you know, psychosis, that it's worsened their psychosis. And that's, I find that very credible. There are some areas. So in that sense, it depends on the person, if it depends on the dose of the drug. For the most part, I put Ayahuasca in the same category psilocybin in mushrooms, or LSD. With the exception of ayahuasca, does have multiple things in it, one of which is and it differs by there's different plant concoctions that can make up, so called ayahuasca, but always contains something that contains DMT and other tryptamine, like psychedelics, that's the actual psychedelic. But then it contains another plant that contains like normally, DMT is going to when you swallow it, it's going to be chewed up in the gut, and it's never going to get to your brain. And that's why a lot of times, recreationally, we're outside of research, all times, people will smoke DMT because it can you can ingest it that way, but to swallow it, it will work if you combine it with another substance that inhibits the metabolic system, that normally breaks down the DMT. So these are called MAO inhibitors. So with Ayahuasca, it's typically stuff like harmaline and related compounds that are they they break down the enzymes in the gut that normally degrade the DMT. One of the risks of that is that some medications out there are normally, like prescription medications are normally that Mao system is what degrades their you know, that's that's how they're metabolized. And so if you knock down the Mao system, now you might have like, five fold the blood levels of some prescription drug that you're on, sometimes that can be dangerous or even fatal. So that's why one has to be really careful with Ayahuasca, like, what other medications and drugs are you taking, because there could be some potentially even lethal interactions. So that might be what, in terms of how strong the psychedelic experience can get. I think you know, to me that really comes down to dose. I I don't think it's fundamentally more intense than psilocybin. Some people have that opinion, but there's a lot of opinions. But, you know, you'll find other people to say, oh, like, that's Baloney, like they just haven't taken enough psilocybin. Like they're basing on the the handful of they've taken psilocybin, and the handful of them ayahuasca, they may have just taken more Ayahuasca. Okay, yeah. So if

Chuck Shute:

people are interested in pursuing this kind of experience, whether they're dealing with addiction or depression or PTSD, where can they go pursue this? I mean, is it certain states that it's legal, or does it have to be through research, or the

Unknown:

most accessible thing is going to be ketamine, which is legal so you've got a physician, and so either through like spervata, which you may your insurance may even cover it, they may have require you to having tried anti your traditional antidepressants first, and if you still need treatment. So, but you know this provider, then those are other forms of ketamine, and a lot of which I told you some worst case scenarios were about sending people home with it. There are some, plenty of ketamine providers that sound like they're doing really good, legitimate work that's safe. So I would just say, you know, buyer beware. Be cautious with that landscape. Make sure you're going to get the supervision you want to do it in a clinic with, you know, licensed professionals that you know. And I'd want to make sure that there's a good reputation, you know, probably you know, if you've had a friend or, gosh, better than nothing, you know, just reviews online and people saying, oh, yeah, that clinic really took care of me. They really seem

Chuck Shute:

to care was I been? Is there a clinic for that?

Unknown:

So that you're going to need either in the United States legally, you're going to need to be in a clinical trial, which you can go to clinical trials.gov to now, there's a lot of clinical trials going on, but chances are you're not going to, you know, yeah, you know. You know. Don't hold your breath, you know. But, but it's worth a look, you know. Okay, um, because, you know, it could be that you want to treat whatever, and that there's no study on that like it get we. Just do like, it's not like you have to do a study, like we're treating this specific disorder, and so it's not like we could just, you know, try like, what all you know, one off, what

Chuck Shute:

are you what are you working on right now? You said with smoking, is the current smoking?

Unknown:

I have some work set up that hasn't started yet, but will soon, using LSD to treat chronic pain. So seeing if that can help people with lower back pain, interesting and and my, my good colleague, Scott aaronson here, and I'll be helping him going forward, has had long standing work on depression. I've done depression work before, but work using psilocybin to treat major depressive disorder.

Chuck Shute:

And where are you? Because you were at John Hopkins, but you're somewhere else now I forget, yeah,

Unknown:

Shepard Pratt, yeah, yeah, appointment at Johns Hopkins, but Shepherd Pratt in Baltimore, Maryland, and so yeah, we've got a number of studies going on here, depression, tobacco use disorder, and like I said, soon to be chronic pain would be the stuff that's going to be going on in the shorter term. But again, also clinical trials.gov. Is a good resource to trials in your area. There are retreats out there in Jamaica and you know, and even the Netherlands either using psilocybin mushrooms or Ayahuasca. I'm not recommending it, but the reality is that some people are interested in those things. I would just caution people to know that there are risks. And you know, some of these retreat centers sounds like they're doing things responsibly. And, you know, screening folks and got a physician on hand, and others sound like the Wild West, so kind of buyer beware. And and also know that a lot of people think it's legal. There is something called the travel Act, which technically makes it illegal to go to another country to do something that's illegal here. Oh, I don't know, yeah, you know, look it up. There's a good Wikipedia page, you know. Now, you know, yeah, I don't know of any instance where, like, you know, for decades, you know, even before, you know, a lot of states here have legalized cannabis, or, you know, you know, I don't, I never know, every single case of when they've been busting people going to Amsterdam and smoking pot, you know. But you know, there's also cases of people, like, if you're a professional, you know, in mental health, and you see this as part of your and you're even playing it up in your credentials that you got through this retreat, or you've this different case, like, I remember CEO several years ago now kind of bragging about my address, and he was canned by his board of directors, because it's like, you know, you're just admitting to schedule one substance use. So I do want to remind people, yeah, there is a legal landscape here and but it's

Chuck Shute:

also possible that legal, yeah, psilocybin and some of these other things may be legal in the future. Like, there's a lot of people are yes now, like you said, it's a money thing, which is also interesting, because don't the drug companies make more of, like, antidepressants than they would like a one time psilocybin thing?

Unknown:

Yeah. So it's a different now, psilocybin is going to be more expensive acutely, because there's a lot of professional time. So, you know, it is sort of swimming upstream, because it goes against the typical, you know, treatment model in this landscape. I should also mention, there's the law in Oregon that's in practice, and also now in Colorado, which I don't think has been started or implemented yet. But of allowing kind of not for treating disorders technically, but exploration. Spiritual use, or just, I forget how

Chuck Shute:

criminalized, right? I think is what? What's that they decriminalize it in Oregon? I know because they

Unknown:

also, Oregon decriminalized drugs across the board, but they also set up a regulated program where they have licensed facilitators, okay? Or suicide and mushroom sessions, okay, I

Chuck Shute:

think they rolled some of that stuff. That's

Unknown:

a little more than decriminalization, Okay, gotcha, yeah, and they might have been rolled back aspects of the actual drug decriminalization, yeah,

Chuck Shute:

I think maybe, like the fentanyl and heroin, maybe they decided, oh, maybe this is a good idea, I don't know, right?

Unknown:

I mean, there's a whole lot of unintended consequences. Is the rule rather than the exception? With drug policy, so whether it's more restrictive or opening things up, you know, it's like you need a lot of wisdom, and there's devils in the details. But you know those things with those state programs, you're in a situation that you know medical cannabis is in much of the country where it's like, Yep, it's legal at the state level. But also do realize it's technically in in violation of federal law. So for most people, that's not going to have a functional consequence. But for some. People it would, and it also may be something that you don't, you don't want to be, you know, vocal about, again, probably depending on who you are and what you do. Um, but, you know, it's a complex landscape. So, you know, I would just generally encourage people to be aware of all of the risks. Yeah, both, you know, the physiological, the bad trip, um, you know. And

Chuck Shute:

for legal purposes, I'm telling everyone to, don't, nobody to do any drugs at all.

Unknown:

So what's that

Chuck Shute:

I said? For legal purposes, I'm telling everyone to not do any drugs at all whatsoever. Don't even take an aspirin, nothing, just all natural, no drugs, water, food. That's what I tell I would say

Unknown:

that it like, truly, not just, it's a funny disclaimer, but truly, ethically, even caffeine, like, there's someone, some people out there that shouldn't, they need to watch their coffee or they'd be best coffees, but that's not good or, or they're suffering, should be the first thing your doctor asks you if you go in for anxiety. It's like, tell me how much caffeine you're drinking, right? So even with that, so I always say I don't encourage any substance use, like, you know, you're responsible for your own health. I'm also not a you know, not, you know, wagging my fingers and more enlisted people. But I'm not encouraging any substance use, legal or illegal, because there's a whole wide range of landscape of risks, both direct and potentially legal, depending on the substance and so but

Chuck Shute:

it could also save someone's life. If someone's suicidal and they're like right on the verge of suicide, maybe taking a psychedelic as opposed to killing yourself, is worth the risk for that person. It could save lives. I mean, especially if we can make this in the supervised setting. I mean, I would advocate for that in the future, but right now, it's, it's kind of a it's, unfortunately, it sounds like it's not really available to

Unknown:

right? And that's and that's a tough place to be. And the only thing we could do is, like, you know, continue the research to hope, yeah, if it's approved as safe and efficacious under the right conditions, you know, make the options available. But like, I remember all kinds of people. I remember one lady in particular, I don't know why, but years ago now, but after we concluded our cancer work, she said, Oh, my husband's got terminal, whatever form of cancer. It's like, can you get this? And it's like, no, we're not doing that trial. I have a colleague at so and so who's hoping to get a trial up and start in the next couple of years. She's like, he's got a few months left. Is there anything? And you just like, yeah, like, you know, it's like, there's nothing legal that I can tell you about. It's just not happening, and it's absolutely heartbreaking, yeah, um, so you know, and obviously you know, you know, you get in the difficult situation, like, if someone's suicidal, I I'd want them to, you know, like, yeah, don't, never give up hope, you know, seek help. Um, there's also a risk in seeing psychedelics as your only option is they don't work for everyone. I've seen people high hopes that have been crushed, like, my god, if this doesn't work, then nothing will that's not the case. You know, this may not be the thing for you, or maybe they've nudged you a long way. You don't know that. Maybe then the next thing might be more helpful, some boring, old standard treatment. So it's like, never give up hope is the real. Don't put your faith in put your faith in bigger things. Absolutely, psychedelics. It's just one other. Hopefully it's an important option we can have on the table in a more of a regular way, regulated, legal way, for people, if it passes the right standards. But it's a mistake to put that type of faith in anything like just, I

Chuck Shute:

agree, yeah, absolutely. Well, you're doing some great research. I hope to see you on like Joe Rogan next, because you've done all Huberman and Lex Fridman. So I feel like Rogan's next for you, and I'll follow your career and look forward to seeing more research. Thank you so much. You're welcome. Alright, I'll talk to you later.

Unknown:

Alright, take care. Thank you.

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