Speaker 1: Hi, I'm Ethan Edelman, and this is Psychoactive, a production
Speaker 1: of iHeart Radio and Protozoa Pictures. Psychoactive is the show
Speaker 1: where we talk about all things drugs. But any of
Speaker 1: view is expressed here do not represent those of iHeart Media,
Speaker 1: Protozoa Pictures, or their executives and employees. Indeed, heat as
Speaker 1: an inveterate contrarian, I can tell you they may not
Speaker 1: even represent my own and nothing contained in this show
Speaker 1: should be used as medical advice or encouragement to use
Speaker 1: any type of drug. Hello, Psychoactive listeners. As we continue
Speaker 1: with a fairly intensive delve into the issue of psychedelics,
Speaker 1: I'm delighted and honor today to have on Professor Matthew Johnson.
Speaker 1: Matt is a professor at Johns Hopkins University. In fact, he,
Speaker 1: i think is the first professor academic ever to receive
Speaker 1: a name chair in psychedelic studies. He's the Susan hill
Speaker 1: Ward Professor in Psychedelics and Consciousness, and he's recently stepped
Speaker 1: into the shoes of Roland Griffin's another distinguished professor in
Speaker 1: this area, to become the Director of the Center at
Speaker 1: Johns Hopkins on psychedelic and consciousness research. I mean, he's
Speaker 1: really one of the outstanding researchers in the world these days.
Speaker 1: We've been working on this issue since the early two thousands, mentoring, writing, publishing,
Speaker 1: you name it. So, Matt Hey, it's a pleasure to
Speaker 1: have you at on Psychoactive. Oh, it's my pleasure. It's
Speaker 1: an honor to chat with the Ethan remind me. I mean,
Speaker 1: you know, we've been bumping into another recently at these
Speaker 1: psychedelics conferences, the Wonderland Miami conference in November and then
Speaker 1: the Horizons conference in December, New York. But do you
Speaker 1: recall when was it we first met. Yeah, I believe
Speaker 1: it was when I was president of Students for Sensible
Speaker 1: Drug Policy Chapter at the University of Vermont. I had
Speaker 1: founded that chapter and I invited you to come speak
Speaker 1: for us, which you did, and I believe that was
Speaker 1: the first It must have been two thousand and three
Speaker 1: or so. That sounds about right. Yeah. So, Matt you've
Speaker 1: probably done more studies involving giving psychedelics human subjects than
Speaker 1: almost anybody. Are certainly in the top tier. So can
Speaker 1: you just walk us through what does it involve? Sort
Speaker 1: of launching one of these things, getting the approval of
Speaker 1: the right institutions, screening for the right participants in the trial.
Speaker 1: What is that look like? The first phase, which folks
Speaker 1: normally don't think about it is like hustling up the funding,
Speaker 1: so you know through somebody you've gotten the traditionally philanthropy
Speaker 1: for us but psychedelics, but you hustle up the funding.
Speaker 1: The next one is the Institutional Review Board the i RB.
Speaker 1: They call it an ethics board in England. It's the
Speaker 1: committee at your university that decides whether this research is
Speaker 1: ethical to do or not, and they can require any
Speaker 1: number of changes in or before allowing you to do
Speaker 1: that work. Once you have addressed the i r b
Speaker 1: s questions, then you administer to the f d A
Speaker 1: and then that's the same thing. Any number of experts
Speaker 1: from different divisions of f d A can weigh in,
Speaker 1: maybe you know, chemists and psychologists and others, all weighing
Speaker 1: with other concerns. They have on your protocol and they
Speaker 1: can either approve it or they can put it on
Speaker 1: clinical whold, meaning you have to change things before we
Speaker 1: approve it. And then they approve things. Then you've got
Speaker 1: to go to the d e A you know, the
Speaker 1: drug enforcement people and get permission from them. And part
Speaker 1: of the process for the d e A approval is
Speaker 1: for them to go to an independent section of f
Speaker 1: d A. In yes, I already mentioned we've already gone
Speaker 1: to f d A, but this is redundant. They go
Speaker 1: back to the FDA as far the d A process
Speaker 1: and get the FDA's approval, and then the d e
Speaker 1: A gets back to you. And so those are broad steps,
Speaker 1: that's what it is, and that takes anywhere from like
Speaker 1: six months to a year, depending on how much pushback
Speaker 1: you get on any number of these steps. So it's
Speaker 1: a big bureaucratic process. And then we respect to the
Speaker 1: recruitment and screening of participants in the trials. We have
Speaker 1: fairly a stringent screening criteria, so most people who apply
Speaker 1: don't qualify, and it could be for any number of
Speaker 1: medical including psychiatric reasons, depending on the study. So there's
Speaker 1: a phone screening well actually for most of these now
Speaker 1: there's a a web form as the initial phase of screening,
Speaker 1: and then we call people up on the phone if
Speaker 1: they need initial eligibility criteria and do some more screening
Speaker 1: on the phone, and then for a subset of those folks,
Speaker 1: then they come to the lab for two days for
Speaker 1: these four or five hours at least. So it's a
Speaker 1: substantial investment of time to do these extensive in person
Speaker 1: screening and this is more than say, for example, like
Speaker 1: an undergraduate you know, psychology class experiment might participate in
Speaker 1: where you you know, fill out a form for five
Speaker 1: minutes to screen for it. This is you know, several
Speaker 1: days of extensive medical and psychological evaluation. And so after that,
Speaker 1: if someone didn't qualify eyes with all of you know,
Speaker 1: all of the criteria for the study, then they move
Speaker 1: into a screening phase where they prepare anywhere from four
Speaker 1: to eight hours depending on the study, with the two
Speaker 1: people the guides or the therapist who will be with
Speaker 1: them during their psilocybin session. And then you have the
Speaker 1: psilocybin session or some say there's multiple sessions, sometimes there's one,
Speaker 1: and typically the day after each psilocybin session, there's what
Speaker 1: we call an integration session where we discussed the session.
Speaker 1: I see, and I know there's been some issues raised
Speaker 1: about about their being, you know, a disproportionately low number
Speaker 1: of black people people are generally, but especially black people
Speaker 1: in these trials what's your experience with that and what
Speaker 1: if it challenges and how far have you got in Yeah,
Speaker 1: so it's it's been a challenge across the field. I mean,
Speaker 1: you know, the demographics skew white, and that happens to
Speaker 1: be consistent with the data on who is using psilocybin illicitly.
Speaker 1: It sends to be a white male thing if you
Speaker 1: look at those umbers. That isn't to say that all
Speaker 1: the people that are are are you know, applying our
Speaker 1: people who have used psilocybin, but it just it might
Speaker 1: speak to a common interest for whatever reason. There may
Speaker 1: be more subcultural interest in certain you know, subcultures than
Speaker 1: than in others. So it tends to be more of
Speaker 1: a thing that seems to be of interest in in
Speaker 1: white circles than in say, black circles. We do have representation,
Speaker 1: it's not at the level of minorities, including black folks
Speaker 1: and the research but not at the levels that would
Speaker 1: be you know, proportional to society, you know, to their
Speaker 1: placement in society. So we need to do a better job.
Speaker 1: And you know, kind of like other groups in this area,
Speaker 1: are have been doing a number of things, you know,
Speaker 1: talking about where what what particular, you know where we're
Speaker 1: advertising at. We recently hired a person to help us
Speaker 1: with additional recruitment efforts to in part to help look
Speaker 1: into some of these issues to increase minority representations. It's
Speaker 1: a challenge. There's no you know, over a bullet solution,
Speaker 1: but it's something to keep doing our best on. So, Matt,
Speaker 1: I mean, obviously when you started doing this work fifteen
Speaker 1: years ago, it was hesitant to talk about it. Now
Speaker 1: major research university is not just your own, but I
Speaker 1: think Harvard and Yale and n y U and University
Speaker 1: of California and Impureau College England all setting up these
Speaker 1: major research programs. I mean, now when you talk about it,
Speaker 1: is there a major transformation in the way that other
Speaker 1: academics way outside the field of psychologic study respond to
Speaker 1: this or do do you feel like the words still
Speaker 1: not really out there very much? Oh, there's been tremendous progress.
Speaker 1: I mean we're still not there. There's a lot of
Speaker 1: people that kind of like just kind of don't get it.
Speaker 1: You just get this smirk when you bring I remember
Speaker 1: one time going to the i r B that the
Speaker 1: review board at the at the United University, you know,
Speaker 1: to get studies approved and just like this this look
Speaker 1: like like you're talking about a Cheech and Chong movie,
Speaker 1: you know, something funny. It's like it's almost like, oh,
Speaker 1: you're trying to get away. We know what you're up to,
Speaker 1: Like like this sort of sideways smirk of like all right,
Speaker 1: you know you're giving people mushrooms up. Of course they're
Speaker 1: gonna feel like they're spiritual and I don't know whatever
Speaker 1: when they're when they're loaded up on mushrooms, you get
Speaker 1: a sense of that. But the more and more people
Speaker 1: I think, I've seen these results and like uh, you know,
Speaker 1: results in jama psychiatry and results these oh gosh, the
Speaker 1: results with cancer patients, and to me, it's just like
Speaker 1: this bizarre thing of like sometimes you get this little feedback,
Speaker 1: like the smirk of like as if this isn't very
Speaker 1: serious or this is a kind of a cute see thing,
Speaker 1: And then like you've just run like say a cancer
Speaker 1: participant and afterwards like they're just you know, crying about
Speaker 1: this opening up this kind of space in their life
Speaker 1: where they're able to talk with their loved ones about
Speaker 1: their dying and how it's transformed their life. And just
Speaker 1: like to square this with the like kind of the
Speaker 1: Cheech and Chong joke level. There's such a contrast between
Speaker 1: those two things. Matt. I've heard you talk about how
Speaker 1: sometimes some of the most difficult parts of a psychedelic
Speaker 1: trip while you're doing a therapeutic session can prove to
Speaker 1: be the most valuable and that patients can even you know,
Speaker 1: come out of a feeling that way. But have you
Speaker 1: had to deal with situations where people were still struggling
Speaker 1: months later as a result of having been in a
Speaker 1: trial not months later, there have been people who have
Speaker 1: have struggled in the days and to a degree weeks
Speaker 1: following the sessions, and this is sort of a difficult
Speaker 1: thing to describe. And the big picture is the process
Speaker 1: I think ideally should be viewed as healthy, like a
Speaker 1: lot of times, especially when dealing with some of the
Speaker 1: issues we're dealing with, Like the treatment is hard, it
Speaker 1: raises difficult issues, and those those things that come to
Speaker 1: mind during the session don't necessarily disappear once the drugs
Speaker 1: out of your system. But this is in common with
Speaker 1: other successful forms of therapy. I mean, I think of
Speaker 1: the treatment of trauma, where the whole point is that
Speaker 1: it's going to be difficult. You have the process that
Speaker 1: the material. So that's I think that's an important backdrop. Now,
Speaker 1: there have been some people, and we warn people in
Speaker 1: our consent that, you know, sometimes people the way I
Speaker 1: think of it is you can have something like a
Speaker 1: midlife crisis, you know, you can really these sessions can
Speaker 1: really prompt questions for someone that sometimes they can be
Speaker 1: stuck psychologically and feel they could benefit from seeing a
Speaker 1: professional to help them process. So, now this isn't not
Speaker 1: talking about anyone deally with any psychotic process or anything
Speaker 1: like that, but folks that really are kind of you know,
Speaker 1: the psychedelics have stuck, have left them stuck in a
Speaker 1: in a in an unresolved space. So we do warn
Speaker 1: people that this can happen and that some people may
Speaker 1: benefit or may feel that they could benefit from seeking
Speaker 1: out additional professional help. In other words, the psychedelic sessions,
Speaker 1: for whatever reason you've come into the study, they can
Speaker 1: potentially raise issues for you that you might feel called
Speaker 1: to then you need to, you know, see a therapist
Speaker 1: over So for example, you might be in a study
Speaker 1: over smoking cessation, but some you might have an experience
Speaker 1: of trauma from decades ago. That's resurfaced that all of
Speaker 1: a sudden you feel like you need to process, and
Speaker 1: in fact that that if that does happen, you're going
Speaker 1: to be best off if you do see a professional
Speaker 1: process that now that may not fit into the time
Speaker 1: frame of a particular study, say a psychedelic study for
Speaker 1: a smoking cessation. So one may reach out and we've
Speaker 1: given some referrals and and this is certainly a minority
Speaker 1: of cases, but of referrals for folks that feel like
Speaker 1: they want to pick up on some therapy with with
Speaker 1: a therapist who is um not going to use psychedelics negatively,
Speaker 1: who's not going to kind of hear their experience and
Speaker 1: then sort of pathologize the experience itself because they used psilocide. Well,
Speaker 1: I'm curious. You know, you wrote a pretty important piece
Speaker 1: a few years ago with I think maybe it's with
Speaker 1: Rolling Griffins and also a very another very prominent drug
Speaker 1: research Kenny Field, in which you talked about where might
Speaker 1: psilocybin and potentially this psychelics fit into the Controlled Substances Act. Right.
Speaker 1: Control subs Act is that fifty year old law that
Speaker 1: determines whether drugs are gonna be put in schedules one, two, three, four,
Speaker 1: or five, where one are drugs that supposedly have no
Speaker 1: medical value and a great risk to the public health.
Speaker 1: And then you know, descending on downward for drugs that
Speaker 1: have a you know, a good medical value but also
Speaker 1: risk to the public and then down to the lowest level,
Speaker 1: which you're seen as relatively non dangerous. The basic idea
Speaker 1: of ranking drugs according to the risk of medical benefit
Speaker 1: makes some sense, but that the Controlled Substances Act, where
Speaker 1: you have drugs like heroin, marijuana, and psilocybin all in
Speaker 1: Schedule one, all notwithstanding you know, fairly substantial evidence that
Speaker 1: they do have medical benefit, and a process where a
Speaker 1: federal police agency, the d e A, has a huge
Speaker 1: amount of say about where drugs are scheduled. What do
Speaker 1: you really think about the Controlled Substances Act. That's a
Speaker 1: great question, Ethan, because the framing of the paper was,
Speaker 1: you know, given the Controlled Substances Act is the way
Speaker 1: these substances are regulated. The question is, if psilocybin, based
Speaker 1: on Phase three data looks safe and efficacious, how should
Speaker 1: it fit into the Controlled Substances Act. And that's kind
Speaker 1: of a narrow framing that's not you know, taking on
Speaker 1: the question of should the Controlled Substances Act exists or
Speaker 1: should it exist in anything like its present form, that's
Speaker 1: a much bigger, you know question, And the Controlled Substances
Speaker 1: Act is not likely to go away by the time,
Speaker 1: you know, within probably the next two three or four years,
Speaker 1: is not going to be you know, it's still going
Speaker 1: to be the law of the land, most likely by
Speaker 1: the time the psilocybin it gets through Phase three trials.
Speaker 1: So it's sort of a very pragmatic in that sense.
Speaker 1: But what I really think about the Controlled Substances Act,
Speaker 1: I mean, as you know, uh, you know, analysis after
Speaker 1: analysis has found in the United States, in the UK,
Speaker 1: and in the Netherlands, in Europe, experts and all of
Speaker 1: these areas, drug experts have been probed systematically, and the
Speaker 1: correlation between the ranking, the scheduling of drugs and they're
Speaker 1: perceived harms by experts is abysmal, you know. And this
Speaker 1: is including both illegal and legal drugs, and so alcohol
Speaker 1: will invariably show up near the top of of these
Speaker 1: lists in terms of harm to self harm to individuals,
Speaker 1: far higher than many of the illegal substances, and psilocybin
Speaker 1: mushrooms consistently fall at the very very bottom, both in
Speaker 1: terms of harm to self and harm to others, so
Speaker 1: that we do make the point that there are risks.
Speaker 1: And when we talk about technically we talk about abuse liability,
Speaker 1: that's a confusing term that that does. Part of that
Speaker 1: is addiction liability, the propensity for that drug to be
Speaker 1: used in a compulsive fashion. We know very very well
Speaker 1: that psilocybin and the other classic psychedelics like LSD, mescaline,
Speaker 1: d MT are not addictive. But abuse liability in the
Speaker 1: context of the Controlled Substances Act also refers to just
Speaker 1: the risk of the drugs, the liability of using the drugs,
Speaker 1: so not necessarily related to addiction potential, but just hey,
Speaker 1: are there dangerous to the drug that can harm the
Speaker 1: self or others? And you know, are showing a signal
Speaker 1: at the public health level. So now, yes, there are
Speaker 1: some harms, particularly people of psychiatric vulnerability, and there's good
Speaker 1: reason to believe people with predisposition towards schizophrenia can be destabilized.
Speaker 1: Anyone can have a so called bad trip, and particularly
Speaker 1: if they're not prepared and if they're at a high
Speaker 1: dose and an archaotic setting around people they don't trust,
Speaker 1: they can freak out, to put it, to use technical language,
Speaker 1: and you know, they could be at a concert and
Speaker 1: they're hauled out by the paramedics and the police, and
Speaker 1: then things escalate. Occasionally there's an accent. Occasionally someone dies,
Speaker 1: should be no surprise, as with any other intoxicating a substance,
Speaker 1: very rare when you plotted against the other. All of
Speaker 1: the other substances legal and illegal, but nonetheless there is
Speaker 1: some risk there. So there is some mild abuse liability,
Speaker 1: getting not a dick liability, but abuse liability in terms
Speaker 1: of having those those dangers. The big problem with the
Speaker 1: Controlled Substances Act, in my opinion, is that it is
Speaker 1: based on two fundamentally distinct categories. Two dimensions. One whether
Speaker 1: there's accepted medical use and number two, um, what's the
Speaker 1: abuse liability. Schedule one is for substances with no accepted
Speaker 1: medical use but high abuse liability. You then moved to
Speaker 1: Schedule two, and this is where things like a lot
Speaker 1: of the opioids and methamphetamine and cocaine are at there's
Speaker 1: accepted medical use at least in narrow circumstances, but there's
Speaker 1: high abuse liability. And then all of the other schedules
Speaker 1: as we go down to the Schedule three to Schedule four.
Speaker 1: The cat definition to all of those is there's accepted
Speaker 1: medical use and there's abuse liability, but less so than
Speaker 1: the higher category. So Schedule three has less abuse liability
Speaker 1: than the substances, and Schedule two and four less than three, etcetera.
Speaker 1: The problem is there is no category for mild or
Speaker 1: moderate call it what you will, mild abuse liability, but
Speaker 1: no accepted medical value, which is the case right now
Speaker 1: because and this was determined through judicial precedent in the
Speaker 1: earlier years, not at the beginning of the c s
Speaker 1: A the Control sums Is Act, but through the courts afterwards.
Speaker 1: Accepted medical value has become to be defined as explicit
Speaker 1: f d A approval, So by definition, regardless of the science,
Speaker 1: until it reaches has FDA approval for a disorder, it
Speaker 1: has no accepted medical use. But right now, again there's
Speaker 1: no category for you know, no accepted medical use, but
Speaker 1: mild to moderate abuse potential, So it has to remain
Speaker 1: right now in Schedule one, which is absolutely absurd. This
Speaker 1: also a catch twenty two aspect of this, because they
Speaker 1: talked about accepted medical use, which requires that they approval.
Speaker 1: But then if you look at something with merril wanted's
Speaker 1: medical value forever and ever of the government was throwing
Speaker 1: up obstacles right allowing it to be approved in that way,
Speaker 1: and even today marijuana persist in Schedule one. And then
Speaker 1: you think about things like pharmaceutical heroin, right, which is
Speaker 1: now being prescribed to people who have been addicted to
Speaker 1: street heroin and half dozen countries in Europe and Canada,
Speaker 1: you know, clear evidence from abroad of its medical value.
Speaker 1: It's also approved for management of pain in some countries,
Speaker 1: but once again still in Schedule one. Right now on
Speaker 1: the thing I see, you know, you look at the
Speaker 1: drug like fentanyl, which is you know, it's death rate,
Speaker 1: it's deadliness in America in recent years and in Canada
Speaker 1: has been astronomical, and it's properly not in Schedule one
Speaker 1: because it does have legitimate medical value. And so in
Speaker 1: a way that almost seems like there's a bias and
Speaker 1: maybe in favor. You know, you can have a fentanyl
Speaker 1: or cocaine with our little problems associated with them in
Speaker 1: Schedule two allowed to be prescribed and limited medical conditions,
Speaker 1: but then these drugs in Schedule one that just I mean,
Speaker 1: it seems to me they should basically eliminate. Is there
Speaker 1: any basis at all? Really are having a category of
Speaker 1: schedule one gosh? I mean you really are getting to
Speaker 1: the question of, in one sense of should there be
Speaker 1: a controlled Substances Act? Well, let me bring you back here.
Speaker 1: So the research at Johns Hopkins. I mean, one of
Speaker 1: the things is that you're at a research institute which
Speaker 1: you know, and both you personally and your colleagues, you know,
Speaker 1: have experience in administering all sorts of controlled substances and
Speaker 1: illicit what would otherwise be illegal drugs, not just to animals,
Speaker 1: non human animals, but to human beings, right, I mean
Speaker 1: Johns Hopkins they're giving you know, not just psilocybin now,
Speaker 1: but also I think cocaine and amphetamine and even heroin
Speaker 1: to to human subjects in very controlled circumstances. Yeah, that's right.
Speaker 1: And in fact, I've been principal investigator or lead scientists
Speaker 1: on studies administering a number of these substances, methamphetamine, cocaine,
Speaker 1: and particularly our group, the Behavioral Pharmacology Research Unit, it's
Speaker 1: been an operation for for almost a half century. I mean,
Speaker 1: all of the substances you've mentioned, all of those drug
Speaker 1: classes um, you know, we're experts at administering them to
Speaker 1: human beings under the right conditions, and it's all about
Speaker 1: what the appropriate conditions are, you know, for s a
Speaker 1: administering cocaine or administering psilocybin, and those conditions are different
Speaker 1: across these different drugs given their different risk. But you know,
Speaker 1: in the early years, I mean back, this is actually
Speaker 1: before you and I even met. But in the late
Speaker 1: nineties early two thousand's, I was involved in an effort
Speaker 1: to get heroin prescription trials going in the US and
Speaker 1: Canada the way that they had been doing in in Europe,
Speaker 1: you know, and prescribing pharmaceutical heroin in a clinic setting
Speaker 1: to people who had been struggling with addiction to the
Speaker 1: street heroin, right, and there were huge health benefits to
Speaker 1: their switching from street drugs into legally produced and prescribed
Speaker 1: pharmaceutical heroin. And so this group we we eventually called
Speaker 1: ourselves NAOMI. WHI stood for the North American Opioid Medication Initiative,
Speaker 1: And among the professors who participated group was one of
Speaker 1: or colleagues fairly distinguished drug researcher named George Bigelow. And
Speaker 1: so I was able to get a little funding and
Speaker 1: to do a couple of little pilot studies, one up
Speaker 1: in Canada and one of Johns Hopkins, where I think
Speaker 1: George was involved in seeing whether or not longtime Heroin
Speaker 1: user street Heroin users could tell the difference between pharmaceutical
Speaker 1: heroine or delouded hydromorphone right in a control, double blind study, right.
Speaker 1: And what he found in this small study was, in fact,
Speaker 1: I think that people could not tell the difference. Unfortunately,
Speaker 1: think you ever published the damn paper. But what struck
Speaker 1: me at that time was that Johns Hopkins, together I think,
Speaker 1: with Columbia and Wayne's State, which at that time had
Speaker 1: a drug program headed by the former head of the
Speaker 1: National Student on Drug Abuse Bob Schuster, were among the
Speaker 1: few places in the country which were administering not just
Speaker 1: schedule to drugs like amphetamine and cocaine to human subjects,
Speaker 1: but also administering Schedule one drugs. Do I have that right? Yeah?
Speaker 1: And in fact I do. I suspect those data were
Speaker 1: published with hydromorphone because I either that or I have
Speaker 1: a really good memory from presentation that George Bigelow has given,
Speaker 1: because I could see those graphs in my head In fact,
Speaker 1: it's just striking to the pharmacologist nerd in me, you know,
Speaker 1: with with the left right adjustment on the dose effect
Speaker 1: curve to use my nerdy pharmacology lingo, they're identical, you know,
Speaker 1: hydromorphone and heroin. In other words, whether you're administering three
Speaker 1: milligrams for it to achieve a certain effect or thirty
Speaker 1: milligrams ultimately like trivial, right, like you give what however
Speaker 1: much you need to give to achieve that certain effect.
Speaker 1: You lay the curves on top of each other, and
Speaker 1: it's they're the same drug, which is really getting back
Speaker 1: to what we're talking about earlier. Hydromorphone is what scheduled
Speaker 1: to you know, but basically, by any any level of science,
Speaker 1: these are the same drug. If you're talking about a
Speaker 1: pharmaceutically pure um supply all right, well, I mean it's
Speaker 1: the basic point that if you were to snap your
Speaker 1: fingers and all the people around America getting hydromorphones allowed
Speaker 1: it in a hospital setting, we're suddenly getting heroin. Nobody
Speaker 1: would have really diff prints. And conversely, if you can
Speaker 1: snap your fingers and all the people taking uh heroin
Speaker 1: illegally or somehow getting uh you know allowed it. Uh,
Speaker 1: you know, they also won't know the difference, right, that
Speaker 1: one was a drug that's essentially demonized in the broader culture,
Speaker 1: the other is the one that's proceeds in a medicalized environment.
Speaker 1: But I think the key point here was that Hopkins
Speaker 1: seemed to have some experience, together with a few other
Speaker 1: research institutions, in allowing or getting permission to do research
Speaker 1: with Schedule one drugs on human beings. And I wondered
Speaker 1: if that's one of the reasons why Johns Hopkins. I mean,
Speaker 1: obviously the fact of Rolling Griffith's being there is being
Speaker 1: a sort of pioneering research in this area. But I
Speaker 1: wonder if that played a role in Johns Hopkins emerging
Speaker 1: as a leader in this area as well, that there
Speaker 1: already was a university experience in doing research with Schedule
Speaker 1: one drugs, which is notoriously difficult to get permission for
Speaker 1: but has always been technically legally possible. Right, Yeah, I
Speaker 1: certainly think that was uh most likely and necessary. I mean,
Speaker 1: you could have technically done it without it, but practically
Speaker 1: a necessary but not sufficient condition. Um So there's not
Speaker 1: a whole lot of folks that have had that experience
Speaker 1: you mentioned Wayne State, which you know STEP programs you know,
Speaker 1: still still running strong, and a few others around the
Speaker 1: country that have very strong human behavioral pharmacology lab programs
Speaker 1: with a minister these types of drugs, including Schedule one drugs.
Speaker 1: But you know, ours was the only group that went ahead,
Speaker 1: and in the early days at least, you know, so
Speaker 1: you had to have the desire to do this kind
Speaker 1: of crazy thing, which you know, twenty years ago it
Speaker 1: did sound kind of crazy, like you know it. It
Speaker 1: sounded more like like a career killer to be interested
Speaker 1: in in psychedelics. You know, good luck getting a grant
Speaker 1: in that, good luck rising through the promotion pathway at
Speaker 1: a place like Hopkins. That's very demanding. So so listen
Speaker 1: as I understand it. You know, you're at University of Remon,
Speaker 1: you're doing your graduate work. You know your mentor there
Speaker 1: is Warren Bickle, a very prominent drug researcher. You're thinking,
Speaker 1: how nice it would be due to psycholics research. You
Speaker 1: land up at Johns Hopkins and you find out that,
Speaker 1: you know, Roland Griffin is this distinguished drug research or
Speaker 1: you know, been working on cocaine, nicotine, a whole range
Speaker 1: of other drugs is actually interested in doing something on psychedelics.
Speaker 1: So what was that like for you in that moment,
Speaker 1: like fifteen years ago. Where it really started was even
Speaker 1: before that, my undergraduate advisor had gone to school with
Speaker 1: Warren Bickle, who you mentioned was my graduate advisor and
Speaker 1: who was a really big deal, not in psychedelics but
Speaker 1: in drug research in general and addiction research. And when
Speaker 1: I literally talked to him on the phone at a
Speaker 1: phone interview for the University of Vermont to be a
Speaker 1: greet his graduate student, he said, Matt, if you do
Speaker 1: if you come here, if you do well, you go
Speaker 1: to Hopkins the Behavior of Pharmacology Research Unit where I
Speaker 1: did my post doc in the nineteen nineties, And you
Speaker 1: do a post doctor and that's the path, and these
Speaker 1: are the conferences you go to and this is the
Speaker 1: post ocuteke and blah blah blah. You know, he very
Speaker 1: much from the very again like I hadn't even gone
Speaker 1: there yet, you know, He's like, if you do grad school, here,
Speaker 1: here's what you do your post doc. And so fast
Speaker 1: forward several years. Had done well in grad school with him,
Speaker 1: and and I had and I had met Roland at
Speaker 1: conferences and whatnot. And and so I had sort of
Speaker 1: an informal interview, like you know, being a couple of
Speaker 1: years out from finishing and but but but this was
Speaker 1: sort of the formal interview where I came down and
Speaker 1: visited you know, the lab at Hopkins and there for
Speaker 1: the total reason that rolling was just known as being
Speaker 1: you know, the one of the world's most important caffeine research.
Speaker 1: He demonstrated the withdrawal syndrome of caffeine and humans. Lots
Speaker 1: of nicotine research, tons of research on sedative hypnotics, played
Speaker 1: a strong hand in developing the abuse liability methods that
Speaker 1: the FDA uses to evaluate new medications that might have
Speaker 1: abuse liability. So just a legend. And the behavioral pharmacology area,
Speaker 1: particularly human behavioral pharmacology. So it was that stuff that
Speaker 1: was the attraction, you know. And and a strong behavioral
Speaker 1: basis to all of the drug stuff, you know, strong
Speaker 1: behavioral psychology basis to ana rising drug effects, which is
Speaker 1: very consistent with my perspective and the training that I have.
Speaker 1: And so but he tells me there, you know, with
Speaker 1: his office door closed when I'm interviewing, and um, he's
Speaker 1: kind of swears me to secrecy. I don't know, it
Speaker 1: might have been my firstborn that he he wanted me
Speaker 1: to swear, but it was really it was like really serious,
Speaker 1: and Rolling is an intense dude. And I mean like
Speaker 1: he's like he's looking at you in his eye across
Speaker 1: from crossed from the desk, and and and it swearing
Speaker 1: to secrecy. He's you know, he's got this. He has
Speaker 1: just started this just study with high doses of psilocybin
Speaker 1: looking at spiritual experiences in spiritually interested people. And you know,
Speaker 1: I'm just like, get the funk out of here, you know,
Speaker 1: like like well I really like really you know, and
Speaker 1: he didn't want it in the public, uh, anything in
Speaker 1: the public yet because he thought, and I think very wisely,
Speaker 1: that if it had gotten out there, that the study
Speaker 1: might have been shut down prematurely, that there might have
Speaker 1: been sort of sort of this hysteria about it. So
Speaker 1: he did he's very quiet and getting it approved and
Speaker 1: running the study. So anyway, I promised to keep that
Speaker 1: you know, you know secret, and then there was another
Speaker 1: you know, a couple of years had to you know,
Speaker 1: stay secret until that first study was was published. And well,
Speaker 1: you know, one of the things that struck me, I
Speaker 1: mean that first study that rollingk with this and William Richard.
Speaker 1: Do you mentioned Bill Richards, who has been you know,
Speaker 1: key in this field for decades and Bob Jesse, who
Speaker 1: has kind of been a quiet behind the scenes force
Speaker 1: and fellow. I don't think I know. McCann published that
Speaker 1: article in a distinguished journal about psilocybin and mystical experience,
Speaker 1: and I remember wondering, like, in fact, I think you're
Speaker 1: actually acknowledged as a young colleague who's makes some comments
Speaker 1: on this study. And I remember thinking, why did they
Speaker 1: start off with his study about psychedelics and mysticism, Like
Speaker 1: why wasn't a psychedelics and alcoholism or psychedolics and depression,
Speaker 1: or psycholics and PTSD or the things you're seeing talking
Speaker 1: about now. But I think what I'm beginning to understand,
Speaker 1: and maybe I'm wrong about this, so tell me, is
Speaker 1: that it's because that mystical experience and being able to
Speaker 1: validate a quote unquote mystical experience through the scientific method
Speaker 1: turns out to be crucial in understanding why psychedelics is
Speaker 1: so valuable, psycholics are so valuable in all these other
Speaker 1: areas in treating depression and PTSD and anxiety. And you
Speaker 1: name it. I mean, is that right and where they
Speaker 1: think of strategically in that way or am I just
Speaker 1: speculating off base here? So you know, I think it
Speaker 1: turned out such that that was a very useful consequence,
Speaker 1: But I would I have to actually say no with
Speaker 1: the caveat behind this that as we we've described, I
Speaker 1: showed up once that study had started. So I'm filling
Speaker 1: in the blanks to speaking for you know, Roland uh
Speaker 1: who certainly was the heavy player in terms of making
Speaker 1: this this decision. Um it really is because he was, Um,
Speaker 1: I think he would he would endorse this is correct
Speaker 1: as as just absolutely obsessed with understanding transcendental experiences in
Speaker 1: the human being from his own meditation practice and from
Speaker 1: other interests. Just this idea that people report on certain
Speaker 1: drugs that they're describing these states that are purported to
Speaker 1: be indistinguishable to some of these states that people only
Speaker 1: achieve after years of developing a meditation practice and sometimes
Speaker 1: never achieving those states despite really trying to develop those
Speaker 1: practices or in these sort of once in a lifetime
Speaker 1: life changing experiences that are our Our world's history and
Speaker 1: religion and literature is is filled with whether it's you
Speaker 1: know Ebenez or Scrooge or uh Saw on the Road
Speaker 1: to Damascus, these kind of extraordinary experiences that kind of
Speaker 1: transform people's lives. The whole idea that you could like
Speaker 1: increase the chances of that having by by throwing in
Speaker 1: something into someone's stream that's going to have effect on
Speaker 1: a subtype of serotonin receptor. I mean, that's really it,
Speaker 1: you know, like not that the research is going to
Speaker 1: be able to validate the ontological validity or nature of
Speaker 1: those experiences, but but what's going on there, like what
Speaker 1: like these these states that people have been writing about
Speaker 1: from different traditions for thousands of years, these extraordinary experiences,
Speaker 1: and to be clear, I'm talking about outside of drug use,
Speaker 1: both including but the large majority outside of drug use.
Speaker 1: But the idea that psychedelics are a way to kind
Speaker 1: of turn the NAB up on the likelihood of those
Speaker 1: types of experiences and then we can study them and
Speaker 1: do all kinds of things with them. We'll be talking
Speaker 1: more after we hear this ad. When you start doing studies,
Speaker 1: I guess you and folks on YU and other institutions
Speaker 1: looking at the value of psychedelics in helping people deal
Speaker 1: with the anxiety and depression involving struggling with cancer or
Speaker 1: even terminal illness. I mean, for these things to work
Speaker 1: in helping people through such fundamentally transformative and maybe life ending,
Speaker 1: you know, passages in their life, they're just has to
Speaker 1: be something. There has to be something almost mystical or
Speaker 1: something maybe not, but I mean mystical at the core.
Speaker 1: It's part of it explaining why psychedelics are working as
Speaker 1: effectively as they are. Very often that yes, yes, and
Speaker 1: there are exceptions. It's not a perfect correlation, but yeah,
Speaker 1: when it really works, chances are you have one of
Speaker 1: these full monty mystical experiences where they're describing this complete
Speaker 1: sense of oneness with the universe and the timelessness and
Speaker 1: spacelessness and the noetic quality. You know, the person just
Speaker 1: gribing it. And sometimes when like you just you just
Speaker 1: start checking off the categories in your head and they're
Speaker 1: putting it into their own words and whatnot. But god,
Speaker 1: they just like check check check, you know, like you
Speaker 1: just when you see the real deal, it's just it's
Speaker 1: I don't know, it's always such a great reminder about
Speaker 1: why we're doing this, But there's this this sense that like, yeah,
Speaker 1: that that is a and I get scientifically, I don't
Speaker 1: want to say it's necessary or critical, because we do
Speaker 1: see people with lower There's also we've played with this.
Speaker 1: It may be that an insightful experience is a complementary
Speaker 1: but but distinct type of experience, where you can have
Speaker 1: an insightful experience that that's not, let's say, with lots
Speaker 1: of personal realizations that aren't necessarily of the mystical variety.
Speaker 1: So there's other things going on, but certainly for for
Speaker 1: the biggest psychological factor that seems to be uh involved
Speaker 1: and and probably causing, playing a role in that causal
Speaker 1: chain of these really transformative experiences seems to be these
Speaker 1: mystical states. Yeah. So the reason that you're saying that
Speaker 1: people obviously do derive benefits even when they don't get
Speaker 1: into that full blowing mystical state, but that there is
Speaker 1: some correlation between the intensity and maybe I don't know
Speaker 1: whether the beauty is the right word of the mystical
Speaker 1: state occasioned by the psychelic use and being able to
Speaker 1: treat the condition right, Yeah, it's in the way I
Speaker 1: look at it. It's it's amazing enough that the subjective
Speaker 1: experience that we we measure like about six hours after.
Speaker 1: So so I'm basically when it wears often before they
Speaker 1: go home. The nature of the subjective experience there is
Speaker 1: it's amazing that there's any correlation, any relationship between you know,
Speaker 1: the reductions in their cigarette smoking six months later, or
Speaker 1: reductions in their cancer cancer related depression and anxiety six
Speaker 1: months later. But those aren't perfect correlations. Um. So, yeah,
Speaker 1: you do see people with you in somebody. You know,
Speaker 1: you don't get every aspect. Sometimes you don't the oneness,
Speaker 1: but you get some of the ineffability, and you get
Speaker 1: a little bit you know, you get shades of you know, timelessness,
Speaker 1: let's say, for example, and it's and I should say
Speaker 1: this is not I totally consider us in our infancy
Speaker 1: and even understanding this construct of mystical experience. I mean,
Speaker 1: it's it's it's something to work with and and we
Speaker 1: have ways to measure it. But like other subjective experiences,
Speaker 1: you know, we're ultimately measuring just that what people are
Speaker 1: reporting about their experience. You know, in Michael Pollan's book,
Speaker 1: he quotes, I don't know if you regret this or
Speaker 1: not or not that, but he says, yeah, imagine have
Speaker 1: talked about if there's about psych psycholics. It's almost like
Speaker 1: the dope slap effect, right right. I mean there I
Speaker 1: could thank Michael for that highly scientific sounding, um theoretical concept.
Speaker 1: But yeah, like you know, and I think it it
Speaker 1: came and we talked several times during the course of
Speaker 1: those years when he was working on the book. But
Speaker 1: I think I mentioned this in UM in London. Uh,
Speaker 1: We're both there for a psychedelics meeting, and and we
Speaker 1: had dinner and after a few glasses of wine, he
Speaker 1: keeps pushing that's I've learned. That's a good technique that
Speaker 1: you're a journalist wanted, you know. But he's like, how
Speaker 1: does this really work, Matt, how does this you know?
Speaker 1: And and and it's just like people are dope slap
Speaker 1: out of their story. It's like and and that's the commentity,
Speaker 1: like whether that story is like you're stuck in depression
Speaker 1: and I'm a failure and I'm just wired the wrong
Speaker 1: way and God's punishing me and all of this these
Speaker 1: you know, or it's oh, I'm just a smoker. I've
Speaker 1: tried a million times. I quit. I'm not gonna be
Speaker 1: able to quit. I started so young, it's just my
Speaker 1: brains just used to it. Blah blah blah blah blah.
Speaker 1: Story story, story, you know, yeah, good luck keep telling
Speaker 1: yourself that and expecting to step out of that, you
Speaker 1: know pattern. But people are stuck in these suboptimal patterns.
Speaker 1: And I think of it all his addiction, whether it's
Speaker 1: a nominal substance use disorder addiction, or it's addiction to
Speaker 1: a certain way of thinking, and but whether it's depression
Speaker 1: or it's uh, substituted disorders. It's like there's both behavioral
Speaker 1: and you know, emotional cognitive manifestations. It's it's primarily behaviorally
Speaker 1: defined and an addiction by behavior, you know, like you're
Speaker 1: taking the substance, but obviously with the cognitive and emotional
Speaker 1: um uh you know, whole you know um syndrome that
Speaker 1: surrounds it. And and just the opposite with the depression.
Speaker 1: So I see these as sort of like very much
Speaker 1: more related disorders than than modern psychiatry would would would admit.
Speaker 1: And I think one of the cool derivative benefits of
Speaker 1: psychedelic research is they may because they seem to be
Speaker 1: working for these different disorders and and and dope slapping
Speaker 1: people out of their story, they're perhaps helping us to
Speaker 1: understand the nature of these disorders. What are those transagnostic
Speaker 1: commonalities between the supposedly separate disorders. You know, there was
Speaker 1: something about that quote that reminded me of the story
Speaker 1: about Bill Wilson, right. You know that one of the
Speaker 1: founders of alcoholics anonymous and who you know, many people
Speaker 1: will know the story that in his later years he
Speaker 1: begins to experiment with psycholics may mccameras lst or not
Speaker 1: and starts to talk about how this could be useful
Speaker 1: at helping people in a achieve the kind of spiritual
Speaker 1: self awareness that is an essential part of freeing themselves
Speaker 1: of their addiction to alcohol. I mean the Wilson obviously
Speaker 1: was persuaded by his colleagues a day to stop talking
Speaker 1: about that, but it seemed like it was a fundamental
Speaker 1: early insight analogus to the dope slap effect you're talking
Speaker 1: about here, right, And I think it's important to remind
Speaker 1: people of that history and that the fact that he
Speaker 1: advocated for it, so after so many decades of the
Speaker 1: existence of a a this thing that he was foundational
Speaker 1: and creating, and part of the dogma that built up
Speaker 1: is no you know, you know, medication or substance use,
Speaker 1: you know, you know, as part of treatment period. But
Speaker 1: I mean here he was his experiences were so profound
Speaker 1: that I mean he told folks, Yeah, folks that don't
Speaker 1: get that, that whole thing about giving up to something
Speaker 1: bigger than yourself, like like, here's something for them, right,
Speaker 1: Like they can they can at least have a shot
Speaker 1: at getting that step if they try this under the
Speaker 1: right conditions. I mean, it's just I'm just so impressed
Speaker 1: that he even made that attempt, you know, at the time,
Speaker 1: and uh, yeah, it's unfortunate, but it's good to remind
Speaker 1: folks of well he didn't I guess during an error
Speaker 1: in the fifties, when are really interesting people, famous people, right,
Speaker 1: we're experimenting with LSD or or mescal and or psilocybin.
Speaker 1: I think, right, it was the first psychelic renaissance back
Speaker 1: in the late fifties early sixties before it got shut down.
Speaker 1: And then right now, see re emerging folks like Carry
Speaker 1: Grant were saying they were getting LSD in therapy and
Speaker 1: it was amazing, you know, I mean, lots of celebrities.
Speaker 1: Then we're talking about early you know, having had this
Speaker 1: therapy and that it really benefited them and you know that.
Speaker 1: I mean, yeah, folks, forget that history. It's like that
Speaker 1: this is before it showed up on the street at all.
Speaker 1: You know, there's another quote that you in Michael's book
Speaker 1: about where you said that in some of Speaks, doctors
Speaker 1: and researchers play the same role as shamans and elders.
Speaker 1: And on the one hand, you know, you're warning against
Speaker 1: the guru complex that can come into the whole psychedelics
Speaker 1: therapy area and and the need for professionals in this
Speaker 1: area to stay grounded in scientific integrity and professional therapeutic integrity.
Speaker 1: But you do make the analogy to shaman's and elders,
Speaker 1: and I wonder if you could just elaborate on that
Speaker 1: a bit. I think the commonality is that we have
Speaker 1: to place these substances are best used, most optimally used
Speaker 1: in in a in a in a rich cultural context,
Speaker 1: one in which there's ideally sanctioned use. There are experts
Speaker 1: and there's a framework for using them. There's sort of
Speaker 1: a lot of commonalities there. You know, the whole idea
Speaker 1: that a lot of us may have been ex bosed
Speaker 1: in this society. You know, something one does when they're
Speaker 1: a teenager led by another clueless teenager. It's the idea
Speaker 1: is like, no, no, this is something that you actually
Speaker 1: get the society's experts if it's a young person doing
Speaker 1: it there with the elders of that society of whatever type,
Speaker 1: whether it's in in the modern era, we're talking about,
Speaker 1: you know, the professional someone with a you know, someone
Speaker 1: who was a psychiatrist or a psychologist, etcetera. UM. In
Speaker 1: the clinical context, so there are some commonalities, but I
Speaker 1: think there's a whole lot of dangers and over um, like,
Speaker 1: we can't pretend that we're we're shaman, right, that's not
Speaker 1: our tradition in modern medicine. If psilocybin's approved as a
Speaker 1: as a therapeutic, I think there's all kinds of dangers
Speaker 1: and sort of adopting frameworks that were not experts in
Speaker 1: that we don't you know, have a claim of of
Speaker 1: that cultural tradition and there's nothing right like, we have
Speaker 1: our own culture, and there's a whole lot of wisdom
Speaker 1: in these sort of subcultures that we have, so that
Speaker 1: that the ethics that are taught within the practice of
Speaker 1: medice and within clinical psychology, within social work, within nursing,
Speaker 1: you know, these sort of the professional boundaries and the
Speaker 1: framework that is that exists and is being developed for
Speaker 1: psychedelic therapy. I mean, you know, this is our sort
Speaker 1: of like our our modern day I don't want to
Speaker 1: say there's no, no, not perfect terms because I say
Speaker 1: modern day, but like indigenous society still exist. And I
Speaker 1: don't want to say western because that doesn't you know,
Speaker 1: you see what I'm doing at But like whatever we
Speaker 1: call modern medicine, you know, we bring psychedelics into modern medicine.
Speaker 1: There's gonna be some you know, commonalities with shamanistic practicals,
Speaker 1: but not much. And we have to have the right
Speaker 1: Goldilocks level of of yes, you know, there are those
Speaker 1: some kind of common wisdom lessons, but we also gotta
Speaker 1: rely on on the on the strength of our own
Speaker 1: cultural traditions, uh that are supervising the use of these substances.
Speaker 1: And and we don't want to be insulting to other
Speaker 1: cultures by pertaining that we're part of something we're not.
Speaker 1: But I mean, you know, I mean, obviously you have
Speaker 1: huge optimism here. I saw you voted saying that it
Speaker 1: seems fair to characterize psycholic therapy as a paradigm shift
Speaker 1: in psychiatric treatment, and that, aside from therapeutic psycholics hold
Speaker 1: incredible potentially, you said, as tools for psychological and neuroscientific inquiry.
Speaker 1: I mean, so, do you really see this revolutionizing psychiatry
Speaker 1: within the next generation. Yeah, And in fact, you know
Speaker 1: that that second part you said, Ethan, really you know,
Speaker 1: makes it an even larger statement in the sense that
Speaker 1: not only I think it's gonna like transform psychiatry, but
Speaker 1: even that kind of small potatoes compared to what it's
Speaker 1: really what it's poised to really tell us, you know
Speaker 1: about like the nature of the mind. I mean, that's
Speaker 1: i mean, arguably the most important thing we could possibly
Speaker 1: ever know, right, you know, because it underlies everything else.
Speaker 1: But yeah, I think it's poised that psychedelics are poised
Speaker 1: to be a paradigm shift in psychiatry. Does that mean
Speaker 1: that they're gonna work for everyone? Know, you know, doesn't
Speaker 1: mean that there that there aren't any risks to their use, no, um,
Speaker 1: But I do think so based on the data, there's
Speaker 1: a good shot that they're gonna be able to help
Speaker 1: a larger portion of people for a number of disorders
Speaker 1: who haven't been helped by traditional you know, existing treatments.
Speaker 1: Including medications, and the other aspect of them being paradigm
Speaker 1: shifting is that the treatment model is one where you're
Speaker 1: only a ministering one two or three times and you're
Speaker 1: seeing effects that are lasting in many cases, you know,
Speaker 1: six months a year, and presumably for a lot of
Speaker 1: folks like the rest of their lives. So that's the
Speaker 1: paradigm shift, especially because we're getting to the psychological underpinnings
Speaker 1: of these disorders. Tobacco addiction is more than just you know,
Speaker 1: quelling the response at the nickotine receptor. It's about the
Speaker 1: role of this substance is playing in your life, the
Speaker 1: priorities in your life, the examples you're setting for your kids,
Speaker 1: all these things that run through your mind when you
Speaker 1: tell yourself you want to quit smoking, you know, and
Speaker 1: and that's just you know, quote unquote just smoking. I mean,
Speaker 1: that's not even like you know, heroin addiction or heavy
Speaker 1: alcohol addiction, which you know, the tobacco is more deadly
Speaker 1: in the long run. You know, these are other addictions
Speaker 1: with stronger destruction of quality of life. But I'm curious
Speaker 1: in your research, right, it's been almost entirely about psilocybin,
Speaker 1: and mostly one sees psilocybin, and then to something said
Speaker 1: m d M A quasi psychedelic as the two principal
Speaker 1: drugs of investigation and the two that are most likely
Speaker 1: to be approved in the next few years for treatment
Speaker 1: of PTSD in the case of m d M A
Speaker 1: and for treatment of attractable depression in the case of psilocybin.
Speaker 1: But I'm curious, and I've heard people say, well, the
Speaker 1: problem with l s D is it's a lot like um,
Speaker 1: you know, uh, psilocybin. But you know, because the experience
Speaker 1: is like, you know, twice as long, if not more.
Speaker 1: Just simply connecting research with it, I mean, having to
Speaker 1: pay the clinicians and keep people there and the whole thing.
Speaker 1: It just makes it usually more onerous. But I'm curious,
Speaker 1: are you looking at do you think you do you
Speaker 1: see yourself looking at other psychedelics? And are the reasons
Speaker 1: why I don't hear you talking as much about d
Speaker 1: MT or ketamine or mescalin. YEA, so absolutely interested in
Speaker 1: these other psychedelics. The UM In the short term, uh so, Uh,
Speaker 1: we're going to be starting a study of LSD in
Speaker 1: the treatment of chronic pain. UM. We're probably within a
Speaker 1: couple of months from starting that study. So we're at
Speaker 1: that sort of the last steps of hopefully getting that approved.
Speaker 1: It's with the f d A you know right now,
Speaker 1: but fingers cross as we moved through that process. I
Speaker 1: absolutely think you know that well. I would say, you
Speaker 1: know the time course, you know, the five or six
Speaker 1: our time course for psilocybin is is a big reason
Speaker 1: why a lot of the modern research has has usial
Speaker 1: cyber rather than LSD. But frankly, the most important reason,
Speaker 1: at least at the beginning, was that LSD was more
Speaker 1: controversial now pharmacologically, like right there, Other than the time course,
Speaker 1: they're basically identical in terms of any practical in any
Speaker 1: risk benefit ratio analysis. I've heard you refer to se
Speaker 1: these drugs and I think some others. Is the classic psychedelics?
Speaker 1: What are the classic psychedelics? And how does that How
Speaker 1: is that difference in the non classic psychedelics. Yeah, it
Speaker 1: means that they activate a subtype of serotonin receptor in
Speaker 1: the brain, the serotonin two A receptor. But people will
Speaker 1: recognize when I start to list what these classic psychedelics are,
Speaker 1: that they basically feel the same, or if you've heard
Speaker 1: or experienced them yourself, so so psilocybin, l S D,
Speaker 1: mescalin and and and d m T, which is in ayahuasca.
Speaker 1: Those substances more or less they feel similar to each other.
Speaker 1: People now smoke d m T is going to be
Speaker 1: more intense, But when one takes d MT in the
Speaker 1: form of ayahuasca um, which is really active, it's very
Speaker 1: much in that category of those others, the L S
Speaker 1: d UM, psilocybin, mescalin um, and then so those are
Speaker 1: sort of the core, you know, the classic psychedelics, the
Speaker 1: ones that aren't classic psychedelics. A couple of big categories there.
Speaker 1: One are the n M d A antagonists, so the
Speaker 1: ketamine the PCP family, and then another big one. It's
Speaker 1: sort of in a class by itself in terms of
Speaker 1: what you people actually take out out there in the
Speaker 1: real world. But m D m A, so it's a
Speaker 1: serotonin releaser, so it's it's it's a serotinergic psychedelic. In
Speaker 1: other words, it has effects on serotonin like the classic psychedelic,
Speaker 1: but it interfects interacts with the serotonin system in a
Speaker 1: different way. Rather than activating and mimicking serotonin as a
Speaker 1: subtype of serotonin receptor. It causes serotonin to be released
Speaker 1: from a number of of of receptors, and so for you,
Speaker 1: do you see yourself doing research in the future on
Speaker 1: d MT or kennemine or gin. Yeah. Absolutely. We did
Speaker 1: the first blinded research with salvon orna, which is another
Speaker 1: you could consider it a non classic psychedelic. It's an
Speaker 1: opioid antagonist. UM. That's very very in one sense, very
Speaker 1: similar to d M T and five mouth oxy d
Speaker 1: M T V smokable triptomine psychedelics. UM. Salvinorin a is
Speaker 1: smokable and that's how we minister it will vaporize UM.
Speaker 1: So I have a lot of interest in these Yeah, mean, gosh,
Speaker 1: who couldn't. Who wouldn't be interested in a compound where
Speaker 1: someone like smokes it and then a few minutes later
Speaker 1: starts talking about seeing aliens. I mean, if you're interested
Speaker 1: in behavior of pharmacology, it's like, what the hell like?
Speaker 1: That's yea. So absolutely I'm fascinating not only in terms
Speaker 1: of the just understanding those effects, but but also their therapeutics.
Speaker 1: But absolutely, I mean the reason the research has largely
Speaker 1: been with psilocybin is just one of precedent and one
Speaker 1: of I've recently made the argument and the pitch of
Speaker 1: the FDA. Hey, look, twenty years with psilocybin has proceeded
Speaker 1: safely with the right you know, uh safeguards. Hey, it's
Speaker 1: now time to to do research with LSD because in
Speaker 1: fact there's more of a safety record still with LSD.
Speaker 1: Far more people were given LSD in those earlier years. Opinion.
Speaker 1: You know, I've heard people say, and I don't know
Speaker 1: if it's true or not, that one thing about I
Speaker 1: began is that whereas most of the psychedelics, mostly what
Speaker 1: they're doing is they're, as you put, a sort of
Speaker 1: sort of resetting the story, breaking an old destructive narrative
Speaker 1: right through that mystical inside or other types of inside
Speaker 1: or whatever it might be, especially when done in the
Speaker 1: therapeutic context. But that I be gain maybe does that,
Speaker 1: and it does something else to the human organism, unlike
Speaker 1: the other psychedelics, um that may have a more lasting impact.
Speaker 1: Is there anything to that or do we just not
Speaker 1: know there might be? There might be, and in fact
Speaker 1: it maybe not just the human organism. And the thing
Speaker 1: that's actually pretty compelling is in is in the rat
Speaker 1: that even the the what you see in the rat
Speaker 1: is that after I be gained, there's there's a normalization
Speaker 1: of the meso limbic dopamine system. I'll translate that. What
Speaker 1: that means is that the dopamine is a neurotransmitter that's
Speaker 1: involved with reward and it's basically thrown out of whack
Speaker 1: with heavy levels of addiction. So instead of having mild
Speaker 1: fluctuations that regulate behavior, you see these white, wild fluctuations
Speaker 1: of a lot of dovamine and then like nothing, and
Speaker 1: you almost no dovamine, and then a lot again. You know,
Speaker 1: so these wild fluctuations um which you get more of
Speaker 1: these wild fluctuations even when you get a rat addicted
Speaker 1: to you know, an opioid. But but after I begin
Speaker 1: you see a normalization in other words, of narrowing. Instead
Speaker 1: of wildly fluctuating, it's fluctuating within a normal range of
Speaker 1: you know, it goes a little bit up and a
Speaker 1: little bit down, which it's supposed to do. That might
Speaker 1: be basically the rat version of you know, the person
Speaker 1: saying that there you know, what do they say with
Speaker 1: ibogaine it's an addiction interrupter that they just feel like
Speaker 1: their addiction has is gone. You know, they're not at
Speaker 1: this crazy low where they're at this low hedonic state
Speaker 1: where they're willing to do anything to get themselves out
Speaker 1: of it. So now I will say, though I would
Speaker 1: like to see more research. We don't know necessarily that
Speaker 1: drugs like psilocybin don't do this to at least a degree,
Speaker 1: I'd like to see more of these drugs in a
Speaker 1: head to head comparison. I have seen Kate some cases
Speaker 1: where and it's not the norm, but but where folks
Speaker 1: will say even the physical withdrawal from smoking that they've
Speaker 1: gotten basically no withdrawal. I mean when we're thinking, say,
Speaker 1: let's talk focus about addiction, addiction to different substances, and
Speaker 1: there's anything substances. Obviously addiction could be two behaviors in
Speaker 1: ways of thinking that are destructive as well, but some
Speaker 1: form of dependence that's self destructive. Let's summarize addiction in
Speaker 1: that way. Do you do, you do your gut sense
Speaker 1: or Some of the research suggests that certain types of
Speaker 1: substances are gonna be better or worse for certain types
Speaker 1: of addictions, so that ones that you know have a
Speaker 1: kind of withdrawal, you know, whether it's nicotine or or
Speaker 1: or opioids, or for some people alcohol if you don't
Speaker 1: do it every day. UM that maybe some psycholic substances
Speaker 1: will better for those addictions, whereas substances like cocaine or
Speaker 1: others where there's a kind of you know, radical up
Speaker 1: and down and maybe less the daily need uh for
Speaker 1: the drugs, that other psycholic substances would be better for
Speaker 1: dealing with stimulants. What do you think I would not
Speaker 1: make that prediction now, I my speculation is that that
Speaker 1: at least within the classic psychedelics, that yes, there's there
Speaker 1: are certainly variations and how there's a coloring of different
Speaker 1: effects across these different substances. But I my working hypothesis
Speaker 1: is that therapeutically, there's that they all have the same
Speaker 1: thing in common. Now, again this is speculation. I could
Speaker 1: be wrong about that, um, but but there that there's
Speaker 1: nothing as specific such as, oh, well, psilocybin is going
Speaker 1: to be better help people quit smoking, but you know,
Speaker 1: mescaline is going to be better to help people quit cocaine.
Speaker 1: The mechanisms by which they're ultimately working, I think the
Speaker 1: meaningful uh level of analysis are these the these sort
Speaker 1: of profound psychological transformations related to the subjective experience and
Speaker 1: I think that's you know, potentially there with all of
Speaker 1: these substances, So I don't I think there's probably more
Speaker 1: of a future entailing way different ways to use these substances,
Speaker 1: you know, So not just you know, differences between molecules,
Speaker 1: but different ways of using There might be more of
Speaker 1: a potential difference between let's say, using you know, psilocybin.
Speaker 1: I don't know, uh oh gosh. At one extreme we
Speaker 1: haven't even explored in the modern era. Let's see how
Speaker 1: it looks as a psychedelic therapy versus a psycholitic in
Speaker 1: other words, meaning a high dose, were overwhelming dose where
Speaker 1: the person is quiet and then we talked about it afterwards,
Speaker 1: which is most of the modern research with psychedelics, or
Speaker 1: one where we give a lower dose and facilitate talk therapy.
Speaker 1: I mean, we could go back to the older research,
Speaker 1: and I mean that was the predominant model in Europe.
Speaker 1: We don't know that that doesn't work better, So we
Speaker 1: can do that even within the you know, so called
Speaker 1: psychedelic or high dose research. You know, like like with
Speaker 1: the treatment of addiction with smoking, we've used cognitive behavioral therapy.
Speaker 1: Michael Bogan shoots treating alcohol use disorder has used motivational
Speaker 1: enhancement therapy. Is what is one better than the other?
Speaker 1: You know, I see that as maybe perhaps just as important,
Speaker 1: perhaps even more important than differences between compounds. The one
Speaker 1: caveat I would throw into it, though, I do think
Speaker 1: if there's a difference, uh, it might some addictions might
Speaker 1: require more a stronger dose, but it wouldn't really depend
Speaker 1: on what compound. But some might require just a longer experience.
Speaker 1: So I do think in some sense there's a chance
Speaker 1: for LSD to be more therapeutically impactful simply because the
Speaker 1: experience is longer, and there's a greater opportunity that any
Speaker 1: given twenty minutes during that entire experiences is going to
Speaker 1: be a profoundly meaningful experience. Let's take a break here
Speaker 1: and go to an ad M. Well, let me ask
Speaker 1: you this shift shift gears a little bit right here,
Speaker 1: which is that I mean, you were just in the
Speaker 1: news recently because you headed up this study on it
Speaker 1: using psilocybin for smoking cessation, just got a significant grant
Speaker 1: from the National Student on Drug Abuse. And you know,
Speaker 1: as I understand it, you were initially turned down and
Speaker 1: then they came back and said, oh, it turns out
Speaker 1: we have some money to fund this, and it's just
Speaker 1: happened recently, and it's the first grant I think to
Speaker 1: fund psychedelics research apart from Kennemy, which is a legal
Speaker 1: psychedelic but it's the first one to do it with
Speaker 1: psilocybin or any other sort of drug. And so I
Speaker 1: have a bunch of questions about that. I mean, first
Speaker 1: of all, with respect to the National Student Drug Abuse
Speaker 1: why has it taken them so forever long to do
Speaker 1: this and why do you think they did it finally recently? Well,
Speaker 1: I think, you know, kind of going back to an
Speaker 1: earlier part of our conversation, you know, perhaps strategic starting
Speaker 1: off with the focus on mystical experiences with the psilosiban
Speaker 1: research might have may have not have been the most
Speaker 1: strategic in terms of moving it in a medical pathway
Speaker 1: for NIH funding. I don't know, I'm just being I'm
Speaker 1: speculating there, but you know, perhaps if there was something
Speaker 1: you know, more boring that you know, where the research
Speaker 1: crept up, and maybe they would have been more likely
Speaker 1: to fund the clinical research earlier if but but at
Speaker 1: the same time, a lot of the world wouldn't have
Speaker 1: been interested this you know, maybe Michael Pollen wouldn't have
Speaker 1: written his book that's you know, drastically increased interested in
Speaker 1: this area had you know, we and others not focused
Speaker 1: on mystical experience. So you know, it's a little hard
Speaker 1: to you know, kind of you know, yeah, yeah, to
Speaker 1: critique that history. But but yeah, perhaps that's some of it.
Speaker 1: And and and might kind of the mystical aspect might
Speaker 1: highlight the idea that oh this somehow a new a
Speaker 1: g thing, and it's kind of about you know, hippies
Speaker 1: talking about astral planes and whatnot. I didn't, come on, men,
Speaker 1: We're talking here about a scientific agency that has every
Speaker 1: ability to look at the vast research in the fifties
Speaker 1: and sixties and a little bit of research that since then,
Speaker 1: knowing that there was real promise there. I mean, there's
Speaker 1: no reason. I mean, yes, that's the cultural compact text
Speaker 1: and hippie dippiness. But when you look at the amount
Speaker 1: of you know, the all the interesting stuff that came
Speaker 1: out about psycholics and and alcoholism and a whole range
Speaker 1: of other conditions back in the day, um, you know,
Speaker 1: it's I mean, I thought, I really quite frankly think
Speaker 1: that when people reflect back on the role of NAIDA
Speaker 1: National stud and Drug Abuse in dealing with drug addiction.
Speaker 1: They're gonna see this closed mindedness with respect to psychedelics
Speaker 1: until just the last few months really as really a
Speaker 1: major lost opportunity, and that probably one of the reasons
Speaker 1: why people have continued to suffer so long from drug addiction,
Speaker 1: when there were things that could have been really helpful
Speaker 1: out there, but they just weren't doing um. But obviously
Speaker 1: Nora Volca, the head of NIDA, seems to at it now.
Speaker 1: I mean, I'm curious where there are a lot of
Speaker 1: other efforts to get funding from night of beforehand they
Speaker 1: just kept getting shot down, or to researchers like yourself
Speaker 1: and roll In others that of the universities just think
Speaker 1: it wasn't even worth trying. We had a few efforts here,
Speaker 1: and we've had you know, and there have been a
Speaker 1: few others of close colleagues in the psychedelic field, you know,
Speaker 1: outside of Hopkins, and there have been several efforts and
Speaker 1: they've all and some of them have done really well scientifically.
Speaker 1: And for those not familiar, it's it's it's typically a
Speaker 1: two stage process where you have scientific reviewers who were
Speaker 1: independent of like. So, for example, I've served as a
Speaker 1: reviewer for ni H. I don't work for ni H,
Speaker 1: but i H gets scientists out there, and back before
Speaker 1: the pandemic, they would all fly them together to d
Speaker 1: C or whatever. These days it's on zoom but um,
Speaker 1: and you evaluate the grants and then you get a score.
Speaker 1: That's only the first step then, regardless of whether you
Speaker 1: get a great score or a horrible score. Then the
Speaker 1: institution looks at it, and it could get a great
Speaker 1: score and they could decide not to fund it if
Speaker 1: if it's on in their priority mission you know, if
Speaker 1: it they don't want to do it basically, or it
Speaker 1: can have a marginal score like yeah, not great but
Speaker 1: maybe kind of good enough, and they can fund it
Speaker 1: if it's something they really want to do. So there
Speaker 1: had been multiple of those grants into either like really
Speaker 1: good or nearly perfect category that didn't get funded. Um
Speaker 1: you know, involved because they involved presumably because they involved psychedelics.
Speaker 1: Although I wouldn't argue with your I would agree with
Speaker 1: your history, with your characterization, Ethan, and that yeah, looking
Speaker 1: at the history, you know, like, yeah, why why didn't
Speaker 1: an i H jump in sooner? Although I do want
Speaker 1: to throw in. Though. The flip side to that is
Speaker 1: the room for redemption. How thankful I that you it
Speaker 1: is now funded, Like, hey, this is like it's fabulous,
Speaker 1: and to some degree I can understand. It's like, even
Speaker 1: if I disagree, I can understand politically, the National Institute
Speaker 1: on Drug Abuse is gonna be you know, their their
Speaker 1: main thing is looking at at the bad aspects of drugs,
Speaker 1: and they they're you still thinking about psychedelics as drugs
Speaker 1: of abuse, and so yes, there was an uphill hurdle.
Speaker 1: But man, you're in a way, you're in a cash
Speaker 1: twenty two situation because you guys are submitting grants and
Speaker 1: getting near perfect scores from the scientific review process, and
Speaker 1: then they're getting shot down because of what they call
Speaker 1: priority reasons, but which are essentially political reasons and go
Speaker 1: to the profound politicization of drug abuse research funding in
Speaker 1: this country right, which has been a real tragedy and
Speaker 1: something that I think far too few drug researchers have
Speaker 1: really been fully conscious of. But at the same time,
Speaker 1: you and others aren't really in a position to openly
Speaker 1: criticize the politicization of that process because if you do so,
Speaker 1: it may reduce the likelihood of getting future grants or
Speaker 1: being asked to serve on grant review committees. So I
Speaker 1: think it's a you know, it's a way in which
Speaker 1: I could go on on this, and I obviously when
Speaker 1: I had Nora vocal on, I gave her a very
Speaker 1: hard time about this politicized process, which I think is not,
Speaker 1: you know, not what good science deserves in this country.
Speaker 1: But now having broken through, Matt, do you think we're
Speaker 1: going to see many more grants being approved for research
Speaker 1: by IDA for research on using psychelics for treating drug addiction? Oh? Absolutely,
Speaker 1: I mean, if I can do it, I mean I've
Speaker 1: been at it. I'm persistent people that, but you know, like, hey,
Speaker 1: I'm just me, Like, if I can do it, I
Speaker 1: think others can do it. I mean the what I'm
Speaker 1: hopeful for is that I don't know. I think of
Speaker 1: myself like you know, fifteen years ago, seventeen years ago,
Speaker 1: early in this field, you know, I did have folks
Speaker 1: telling me like mentors are very such, are you sure
Speaker 1: you want to do this? There may not be a future.
Speaker 1: You have such a great pedigree, such a great future
Speaker 1: ahead of you in terms of your your career potential
Speaker 1: and and you know, now, I did take the gamble
Speaker 1: of doing the psychedelic research. But I could have gone
Speaker 1: the other way and said, no, I don't want to
Speaker 1: take that gamble. You know, who knows maybe if I
Speaker 1: had had more student loan debt that type of thing,
Speaker 1: and I thought, hot, I want to take that gamble.
Speaker 1: And I don't have a freaking job because you know,
Speaker 1: I made this decision and of this risky research. What
Speaker 1: I'm hopeful for now is the young graduate students in
Speaker 1: the post docs that are going into they're interested in
Speaker 1: this area. They see a path forward. They see the
Speaker 1: fact that you know, not only the NIH grant, they
Speaker 1: see that, you know, John's our Center a couple of
Speaker 1: years ago got a seventeen million dollar grant, the biggest
Speaker 1: philanthropic gift and Johns Hopkins psychiatry department history. They see
Speaker 1: you know, like this, you know, NIH funding to look
Speaker 1: at psilocybin as a treatment for addiction. And they see
Speaker 1: a path forward. This isn't They see companies with like
Speaker 1: literally billions of dollars of investment in this area that
Speaker 1: are looking to fund research. So these are all these
Speaker 1: new developments that I'm I think the real change is
Speaker 1: going to come from these young people that are just
Speaker 1: getting in now, who are seeing this path forward, and
Speaker 1: you're just gonna get us such a larger percentage of
Speaker 1: those folks who move into the field and stay into it.
Speaker 1: So I have no doubt, Like, how could it be.
Speaker 1: Are we going to write the history and it the
Speaker 1: years and say, Matt Johnson, was that only lucky sucker
Speaker 1: that got that one, you know, psychedelics treatment grant and
Speaker 1: then it all disappeared. That's not going to be the case, right,
Speaker 1: So I'm very hopeful. And Matt, well, I don't want
Speaker 1: that distinction in history. But you broke through and that
Speaker 1: was a key the key thing you did. And my god,
Speaker 1: if it turns out that you know, psychedelics, philocybern and
Speaker 1: psychedelics is incredibly effective in smoking cessation, um, I mean,
Speaker 1: that's gonna be saved. Just monumental numbers of lives, you know,
Speaker 1: speaking of which you know. What I also like is
Speaker 1: the fact that in your research on Nikki, there's not
Speaker 1: that many people interested in both psychedelics and nicotine, and
Speaker 1: obviously you and Roland are among the couple of researchers.
Speaker 1: And it's something that I've been very you know, engaged
Speaker 1: in recent years and stepping down from DPA the issues
Speaker 1: around tobacco harm reduction. And there's a very good journalist
Speaker 1: out there, Mark Gunther, who's writing both about psychedelics and
Speaker 1: about tobacco harm reduction. What's going on there. But you've
Speaker 1: recently sent me a very interesting paper looking at as
Speaker 1: more and more people in the tobacco control field are
Speaker 1: recommending that there'll be a prohibition on selling cigarettes with
Speaker 1: the nicotine yields they have today, and that only low
Speaker 1: cigarettes with very low nicotine yields be allowed to be sold.
Speaker 1: You know, many people are predicting that a substantial black
Speaker 1: market could emerge, and other people are pointing out, well,
Speaker 1: at least the government should be promoting the cigarettes as
Speaker 1: an alternative. But could you just explain that paper you
Speaker 1: did and why you did it and what your find
Speaker 1: things were. Yeah, so we wanted the big picture. I'm
Speaker 1: just you know, I just think it's crazy that we're
Speaker 1: that we're considering a nicotine reduction hypothesis without fully considering
Speaker 1: the potential for an increased black market. I mean, it
Speaker 1: just flies in the in the face of all other Essentially,
Speaker 1: what this means is functionally eliminating nicotine from cigarettes can
Speaker 1: eliminate at to zero level, but it could be at
Speaker 1: a functional zero near zero level. And so when have
Speaker 1: has society ever outlawed you know, a drug? And essentially
Speaker 1: that's what that would be, um, I mean, it would
Speaker 1: be like you know, only being able to buy you know,
Speaker 1: near beer o' duels, you know, alcohols made illegal. You know,
Speaker 1: when have we ever made a substance I legal and
Speaker 1: not seen a drastic increase in black market? We already
Speaker 1: have a black market for tobacco. So that's the backdrop.
Speaker 1: So I use and I've done a lot of work
Speaker 1: over the years with both in lab and also hypothetical
Speaker 1: simulation methods, where in the behavioral economics framework, you you
Speaker 1: ask people, under certain conditions, how many folks would be
Speaker 1: willing and we we found that about a third of
Speaker 1: the folks would be willing to engage in black market
Speaker 1: behavior purchase at least some of their cigarettes for the
Speaker 1: black market. And the other question is, as you increase
Speaker 1: the price of the legal cigarettes, the ones that have
Speaker 1: no nicotine in them, do black market cigarettes have the
Speaker 1: ability to serve as substitutes? In other words, as the
Speaker 1: legal cigarettes become more expensive. Will people pick up black
Speaker 1: market cigarettes as a subst dude, and the data suggests
Speaker 1: they would, So there basically is a signal and it's
Speaker 1: hypothetical methods, So there's limitations. But before moving into a
Speaker 1: policy that's going to affect millions of people, Yeah, we
Speaker 1: need to look more, you know, more at this, at
Speaker 1: this potential for you know, drastically expanding a black market. Yeah. So,
Speaker 1: Matt Lack, last question is you know, most research in
Speaker 1: American around the world on drugs that are primarily illicit
Speaker 1: is funded by the government. With psychedelics, what's different is
Speaker 1: that most of it, at least until you've got this grant,
Speaker 1: has been funded by you know, some of it philanthropically,
Speaker 1: but a lot of it by for profits. You know,
Speaker 1: people are looking to make money. You know, you look
Speaker 1: at Compass other big investment players, who are you know,
Speaker 1: putting money into universities as well. I'm curious what way
Speaker 1: does that affect the research um or anything around the
Speaker 1: research that you do on psychedelics as opposed to if
Speaker 1: all this work was being funded by the government as
Speaker 1: opposed to philanthropists or for profit players, it raises additional contingencies.
Speaker 1: Of course, now I mean, to be clear, I think
Speaker 1: it's a good I mean, hey, I welcome you know,
Speaker 1: the companies that are jumping in that that have credible
Speaker 1: plans to to to develop psychedelics through the FDA and
Speaker 1: international equivalent pathways. But you know, obviously, when you move
Speaker 1: into straight up into the for profit realm, like yeah,
Speaker 1: you know that questions about you know, are the company,
Speaker 1: is the company going to be doing things safe? You know,
Speaker 1: are they going to maximize profit even at the expense
Speaker 1: of safety, which I've tried to emphasize for the field,
Speaker 1: like is actually one and the say it's gonna be
Speaker 1: you know, if people aren't kept safe, like, that's gonna
Speaker 1: hurt your bottom dollar. Like if something someone's on the
Speaker 1: front page of the New York Times, like jumping out
Speaker 1: of a window because you know they were in a
Speaker 1: psychedelic trial that what was was not handed without the
Speaker 1: appropriate safeguard and someone did something and that got themselves
Speaker 1: hurt or something like, that's not good for your bottom line.
Speaker 1: It's certainly not good for the patient. So it raises
Speaker 1: questions like that, questions that are already there. But obviously
Speaker 1: the financial incent of UM just creates more of a
Speaker 1: concern but but you know, this is all addressable and
Speaker 1: to be clear again, I welcome. I mean, I'm going
Speaker 1: to be doing so the company of midusin Innovations Group
Speaker 1: is really motivated to move forward with picking up on
Speaker 1: our smoking cessation research and and and and getting it
Speaker 1: to people. So this is sort of this is sort
Speaker 1: of uh independently can deal along with the sort of
Speaker 1: the night of funding. So we're gonna be doing actually
Speaker 1: multiple trials um uh going forward examining smoke pilcybin for
Speaker 1: smoking cessations. So so I'm I'm very hopeful that they
Speaker 1: get this. You know, that this research is successful. We're
Speaker 1: going to be helping them lead this trial um and
Speaker 1: then you know that it ends up helping patients. But
Speaker 1: you know, in general, again for the you know, the
Speaker 1: various companies, it's a different landscape. It's in some ways
Speaker 1: very exciting, but yeah, it's just you know, clearly there
Speaker 1: are some companies that have come into the space where
Speaker 1: you meet some folks, so you read about them and
Speaker 1: you're like, what the heck is going on here? Man? Yeah,
Speaker 1: they just view this as as cannabis two point oh
Speaker 1: in terms of the money where cannabis was wherever it
Speaker 1: was ten fifteen years ago in terms of the big
Speaker 1: money making opportunities and thinking this is the same thing,
Speaker 1: and it's not the same thing unless you really know
Speaker 1: this area. FDA approval is a different beast. But listen,
Speaker 1: it's been great, great reconnecting with you. It's been great
Speaker 1: hearing you speak of these conferences. I think what you're
Speaker 1: doing is absolutely going to be changing the world. And
Speaker 1: I think your partnership with Rowland and now you're assuming
Speaker 1: the leadership of the Center Johns Hopkins, I mean, you know,
Speaker 1: more power to you. I love the frankness and the
Speaker 1: easy that you discuss all these subjects. So you know,
Speaker 1: I look forward to crossing paths many, many times in
Speaker 1: the future, and I hope that many of your studies
Speaker 1: turn out truly transforming the fields of psychiatry and even
Speaker 1: more broad broadly, our understandings of consciousness and neuroscience. Thank you,
Speaker 1: it's been great. You're welcome. It's been great reconnecting with
Speaker 1: you recently Ethan and and thank you for your leadership
Speaker 1: and drug policy and now more recently and including tobacco
Speaker 1: Alyss Lisa, thank you so much. Thanks. We love to
Speaker 1: hear from our listeners. If you'd like to share your
Speaker 1: own stories, comments and ideas, then leave us a message
Speaker 1: at one eight three three seven seven nine sixty that's
Speaker 1: eight three three psycho zero, or you can email us
Speaker 1: at Psychoactive at protozoa dot com, or find me on
Speaker 1: Twitter at Ethan Naedalman. You can also find contact information
Speaker 1: in our show notes. Psychoactive is a production of I
Speaker 1: Heart Radio and Protozoa Pictures. It's hosted by me Ethan Nadelman.
Speaker 1: It's produced by noa'm osband and Josh Stain. The executive
Speaker 1: producers are Dylan Golden, Ari Handel, Elizabeth Geesus and Darren
Speaker 1: Aronovsky from Protozoa Pictures, Alex Williams and Matt Frederick from
Speaker 1: My Heart Radio and me Ethan Nadelman. Our music is
Speaker 1: by Ari Blucien and a special thanks to Avi Brio,
Speaker 1: s F Bianca Grimshaw, and Robert B. B m. Next
Speaker 1: week I'll be talking with Kat Packer, Executive director of
Speaker 1: the Department of Cannabis Regulation for the City of Los Angeles.
Speaker 1: As I was doing advocacy in the City of Los
Speaker 1: Angeles and really trying to hold the city accountable to
Speaker 1: what I felt were principles and values that we have
Speaker 1: to lead with when we're talking about cannabis policy reform.
Speaker 1: I was tapped by the mayor to take on the
Speaker 1: challenge of advising the city and administering its commercial cannabis
Speaker 1: program in August. Subscribe to Cycleactive now see it, don't
Speaker 1: miss it.