1 00:00:10,680 --> 00:00:14,360 Speaker 1: Welcome to the Therapy for Black Girls Podcast, a weekly 2 00:00:14,400 --> 00:00:19,160 Speaker 1: conversation about mental health, personal development, and all the small 3 00:00:19,200 --> 00:00:22,360 Speaker 1: decisions we can make to become the best possible versions 4 00:00:22,360 --> 00:00:26,960 Speaker 1: of ourselves. I'm your host, Doctor Joy Harden Bradford, a 5 00:00:27,040 --> 00:00:32,120 Speaker 1: licensed psychologist in Atlanta, Georgia. For more information or to 6 00:00:32,159 --> 00:00:35,720 Speaker 1: find a therapist in your area, visit our website at 7 00:00:35,760 --> 00:00:39,519 Speaker 1: Therapy for Blackgirls dot com. While I hope you love 8 00:00:39,600 --> 00:00:43,440 Speaker 1: listening to and learning from the podcast, it is not 9 00:00:43,600 --> 00:00:46,400 Speaker 1: meant to be a substitute for a relationship with a 10 00:00:46,479 --> 00:00:57,680 Speaker 1: licensed mental health professional. Hey, y'all, thanks so much for 11 00:00:57,800 --> 00:01:00,360 Speaker 1: joining me for session three twenty of the Therapy Black 12 00:01:00,360 --> 00:01:03,760 Speaker 1: Girls Podcast. We'll get right into our conversation after a 13 00:01:03,760 --> 00:01:09,640 Speaker 1: word from our sponsors. Which friend are you? And your 14 00:01:09,680 --> 00:01:14,040 Speaker 1: sister circle? Are you the wallflower, the peacemaker, the firecracker 15 00:01:14,240 --> 00:01:17,319 Speaker 1: or the leader? Take the quiz at Sisterhoodhels dot com 16 00:01:17,319 --> 00:01:20,039 Speaker 1: slash quiz to find out, and then make sure to 17 00:01:20,080 --> 00:01:22,880 Speaker 1: grab your copy of Sisterhood Heels to find out more 18 00:01:22,920 --> 00:01:25,240 Speaker 1: about how you can be a better friend and how 19 00:01:25,280 --> 00:01:27,479 Speaker 1: your circle can do a better job of supporting you. 20 00:01:28,000 --> 00:01:37,520 Speaker 1: Order yours today at Sisterhoodheels dot com. When you think 21 00:01:37,560 --> 00:01:40,920 Speaker 1: of psychedelics, what comes to mind? Is it images of 22 00:01:41,000 --> 00:01:45,960 Speaker 1: magical mushrooms and colorful hallucinations. Did you know that psychedelics 23 00:01:46,000 --> 00:01:48,640 Speaker 1: are being used in the healthcare space to treat individuals 24 00:01:48,640 --> 00:01:53,120 Speaker 1: who suffer from chronic pain, anxiety, and depression. To dive 25 00:01:53,160 --> 00:01:56,400 Speaker 1: into the world of psychedelics in their medical utility, I'm 26 00:01:56,480 --> 00:01:59,840 Speaker 1: joined by doctor Danielle Doyle, a double board certified in 27 00:02:00,120 --> 00:02:05,600 Speaker 1: caesiologists and pain doctor dedicated to providing comprehensive and integrated wellness, 28 00:02:05,880 --> 00:02:10,280 Speaker 1: psychedelic education and services for individuals dealing with chronic pain. 29 00:02:11,200 --> 00:02:15,000 Speaker 1: Danielle is also the co founder of Culture Therapeutics, a 30 00:02:15,040 --> 00:02:20,080 Speaker 1: specialized ketamine and psychedelic practice that offers comprehensive solutions for 31 00:02:20,200 --> 00:02:25,639 Speaker 1: mental health and chronic pain to underresourced populations. In our conversation, 32 00:02:26,200 --> 00:02:29,680 Speaker 1: doctor Doyle and I discussed how psychedelics such as ketamine 33 00:02:29,720 --> 00:02:33,160 Speaker 1: are effective for patients who deal with chronic pain, how 34 00:02:33,200 --> 00:02:35,840 Speaker 1: doctor Doyle and others are working to increase equity in 35 00:02:35,880 --> 00:02:39,760 Speaker 1: psychedelic care, and how to discover if ketamine care is 36 00:02:39,760 --> 00:02:43,359 Speaker 1: the right course of treatment for you. If something resonates 37 00:02:43,400 --> 00:02:46,520 Speaker 1: with you while enjoying our conversation, please share with us 38 00:02:46,520 --> 00:02:50,720 Speaker 1: on social media using the hashtag TVG in Session or 39 00:02:51,080 --> 00:02:53,079 Speaker 1: join us over in the sister Circle to talk more 40 00:02:53,080 --> 00:02:56,119 Speaker 1: about the episode. You can join us at community dot 41 00:02:56,120 --> 00:03:02,960 Speaker 1: therapy for Blackgirls dot Com. Here's our conversation. Thank you 42 00:03:03,000 --> 00:03:05,000 Speaker 1: so much for joining us today, doctor Doyle. 43 00:03:05,200 --> 00:03:06,920 Speaker 2: Thank you for having me on, Doctor Joy. 44 00:03:07,400 --> 00:03:09,160 Speaker 1: So I want to hear a little bit about your 45 00:03:09,200 --> 00:03:12,639 Speaker 1: formal education in how you got introduced to the world 46 00:03:12,680 --> 00:03:13,480 Speaker 1: of ketymines. 47 00:03:13,840 --> 00:03:17,560 Speaker 2: Sure. So, I'm doctor Doyle and I'm a double board 48 00:03:17,600 --> 00:03:23,000 Speaker 2: certified anesesiologist and pain doctor. I'm from the DC, Maryland area. 49 00:03:23,480 --> 00:03:26,600 Speaker 2: I'm a proud Howard University graduate and I went to 50 00:03:26,600 --> 00:03:29,200 Speaker 2: the University of Maryland for med school and I also 51 00:03:29,240 --> 00:03:32,960 Speaker 2: went there for my Interventional Pain fellowship. And while I 52 00:03:33,080 --> 00:03:35,960 Speaker 2: was there, I had one of the only black women 53 00:03:36,000 --> 00:03:39,680 Speaker 2: as a fellowship director, doctor Thelma Wright, and I had 54 00:03:39,680 --> 00:03:43,640 Speaker 2: an interest in Ketymine therapy and she encouraged me to 55 00:03:43,840 --> 00:03:47,920 Speaker 2: study that for my fellowship project. And I saw how 56 00:03:47,920 --> 00:03:51,520 Speaker 2: many people could get relief and benefit with Ketymine for 57 00:03:51,600 --> 00:03:57,320 Speaker 2: pain management. As an anesthesiologist, I had used Ketymine in 58 00:03:57,320 --> 00:04:00,640 Speaker 2: the operating room and I'd had patients for cover from 59 00:04:00,680 --> 00:04:05,680 Speaker 2: catastrophic injuries and their pain was so well managed with ketymine, 60 00:04:06,280 --> 00:04:10,240 Speaker 2: and it really left an impression upon me. And also 61 00:04:10,280 --> 00:04:14,040 Speaker 2: I have an interest in health equity, and I wanted 62 00:04:14,320 --> 00:04:18,880 Speaker 2: this medication and these sort of substances and medicines to 63 00:04:18,920 --> 00:04:22,720 Speaker 2: be available for all people with our full consents and 64 00:04:22,760 --> 00:04:26,960 Speaker 2: with our full permission. So most recently my role as 65 00:04:27,000 --> 00:04:32,800 Speaker 2: an assistant professor in DC, and I helped teach residents, patients, 66 00:04:33,120 --> 00:04:36,760 Speaker 2: and medical students about pain management and about ketamine care. 67 00:04:37,360 --> 00:04:40,720 Speaker 2: And I helped run DC's most inclusive ketymine care program 68 00:04:40,800 --> 00:04:43,920 Speaker 2: for the last several years and it was just amazing 69 00:04:44,000 --> 00:04:46,480 Speaker 2: being able to help patients with pain and mental health 70 00:04:46,480 --> 00:04:47,039 Speaker 2: in that way. 71 00:04:47,440 --> 00:04:50,719 Speaker 1: So what is kenemine, doctor Doyle? And it feels like 72 00:04:51,320 --> 00:04:52,800 Speaker 1: we are going to get into this, but it feels 73 00:04:52,839 --> 00:04:55,440 Speaker 1: like there's a lot of misinformation about what it is 74 00:04:55,480 --> 00:04:57,520 Speaker 1: and how it's used. But it's clearly something that has 75 00:04:57,560 --> 00:04:59,880 Speaker 1: been used in medical settings. You're saying you've used it 76 00:05:00,200 --> 00:05:02,800 Speaker 1: as a part of your work as an anesthesiologist. So 77 00:05:02,880 --> 00:05:05,640 Speaker 1: what is ketamine and how is it traditionally used? 78 00:05:05,960 --> 00:05:09,080 Speaker 2: Ketamine is a medication. It's considered what we call an 79 00:05:09,080 --> 00:05:13,000 Speaker 2: anesthetic medication. So it was originally developed in the early 80 00:05:13,120 --> 00:05:17,480 Speaker 2: nineteen sixties, so about sixty years ago. Ketamine is considered 81 00:05:17,520 --> 00:05:21,680 Speaker 2: by the World Health Organization as an essential medicine, so 82 00:05:21,760 --> 00:05:24,320 Speaker 2: that means that it's a medicine that they think every 83 00:05:24,360 --> 00:05:27,840 Speaker 2: patient should have access to. And when they used it 84 00:05:27,920 --> 00:05:32,240 Speaker 2: for anesthesia for humans and for animals, they noticed that 85 00:05:32,440 --> 00:05:37,080 Speaker 2: patients were getting intense pain relief. And also along the 86 00:05:37,120 --> 00:05:39,559 Speaker 2: way they noticed that it really helped with mental health 87 00:05:39,600 --> 00:05:43,440 Speaker 2: and depression. And so now it's very common to use 88 00:05:43,520 --> 00:05:47,679 Speaker 2: ketamine in the hospital to treat acute and sometimes chronic pain, 89 00:05:48,279 --> 00:05:50,480 Speaker 2: and it's also being used more and more in the 90 00:05:50,520 --> 00:05:55,040 Speaker 2: mental health setting to treat depression anxiety PTSD along with 91 00:05:55,120 --> 00:05:56,680 Speaker 2: other mental health conditions. 92 00:05:57,080 --> 00:05:59,720 Speaker 1: Got it and what kind of class of medicine is it? 93 00:06:00,040 --> 00:06:03,919 Speaker 2: So it's a Schedule three medication legally, that means you 94 00:06:03,960 --> 00:06:07,280 Speaker 2: need a prescription for the medicine. It is a medicine 95 00:06:07,320 --> 00:06:10,760 Speaker 2: that is made in a lab. It's synthesized in a 96 00:06:10,839 --> 00:06:14,480 Speaker 2: lab by chemists and experts, so that means that it's 97 00:06:14,680 --> 00:06:17,359 Speaker 2: made in a very controlled way, So that means somebody 98 00:06:17,400 --> 00:06:19,960 Speaker 2: comes in, there's a protocol on how to make it. 99 00:06:20,040 --> 00:06:22,599 Speaker 2: They have a certain mixture of chemicals, there's a certain 100 00:06:22,640 --> 00:06:26,240 Speaker 2: protocol that everyone's washing their hands, bottling the medicine in 101 00:06:26,279 --> 00:06:29,760 Speaker 2: the same way, putting an expiration date on it, storing 102 00:06:29,839 --> 00:06:33,040 Speaker 2: the medicine in a certain way, and then there's regulations 103 00:06:33,080 --> 00:06:36,200 Speaker 2: on how the medication should be dispensed and used and 104 00:06:36,360 --> 00:06:37,640 Speaker 2: also disposed of. 105 00:06:37,800 --> 00:06:41,560 Speaker 1: Gut it okay, okay. So how does kenamine impact the body? 106 00:06:41,960 --> 00:06:45,239 Speaker 2: So Kennybine can be taken into the body in several ways. 107 00:06:45,680 --> 00:06:48,120 Speaker 2: I've prescribed it as a cream that patients can put 108 00:06:48,160 --> 00:06:50,680 Speaker 2: on the skin if they have nerve pain. It can 109 00:06:50,720 --> 00:06:53,839 Speaker 2: be used internasally through the nose for pain or for 110 00:06:53,920 --> 00:06:57,240 Speaker 2: mental health. It can also be taken by mouth as 111 00:06:57,279 --> 00:07:00,359 Speaker 2: a tablet or a pill. And it's most powerful, and 112 00:07:00,400 --> 00:07:03,520 Speaker 2: the way that I prescribe it most commonly is through 113 00:07:03,560 --> 00:07:06,840 Speaker 2: an iv or an intravenous route into the body. That's 114 00:07:06,880 --> 00:07:09,080 Speaker 2: if you get blood drawn, or if you look and 115 00:07:09,120 --> 00:07:11,000 Speaker 2: you see the veins in your hands, that means we 116 00:07:11,040 --> 00:07:13,080 Speaker 2: put a little iv in and we give the medicine 117 00:07:13,120 --> 00:07:16,360 Speaker 2: so it can flow through the body. When that ketamine 118 00:07:16,720 --> 00:07:20,080 Speaker 2: hits your bloodstream, it is absorbed by the brain and 119 00:07:20,080 --> 00:07:23,000 Speaker 2: by the spinal cord, and that is really where things 120 00:07:23,000 --> 00:07:26,080 Speaker 2: start to get interesting. It works in the brain on 121 00:07:26,160 --> 00:07:30,680 Speaker 2: a receptor called the NMDA receptor, and it causes a 122 00:07:30,840 --> 00:07:37,160 Speaker 2: downflow effect that increases a substance called BDNF, or brain 123 00:07:37,400 --> 00:07:42,400 Speaker 2: derived neurotrophic factor, and that factor helps kind of almost 124 00:07:42,560 --> 00:07:46,000 Speaker 2: make some of the connections in the brain very malleable 125 00:07:46,480 --> 00:07:50,000 Speaker 2: or changeable. And it means that for mental health and 126 00:07:50,040 --> 00:07:53,280 Speaker 2: for pain, some of those processes in the body that 127 00:07:53,320 --> 00:07:57,040 Speaker 2: are perceiving pain, that are perceiving the way you interpret 128 00:07:57,040 --> 00:07:59,960 Speaker 2: your mental health or the way your body processes move 129 00:08:00,240 --> 00:08:02,240 Speaker 2: it can help change those processes. 130 00:08:02,640 --> 00:08:04,760 Speaker 1: Got it, And that is how you use it most often. 131 00:08:04,800 --> 00:08:06,320 Speaker 1: And your work is with chronic pain. 132 00:08:06,520 --> 00:08:09,680 Speaker 2: It's with chronic pain. There's a lot of overlap with 133 00:08:09,800 --> 00:08:14,400 Speaker 2: chronic pain and depression and anxiety. So chronic pain is 134 00:08:14,480 --> 00:08:17,720 Speaker 2: if you have pain for more than three to about 135 00:08:17,800 --> 00:08:21,680 Speaker 2: six months. At that point, the pain can sometimes get 136 00:08:21,760 --> 00:08:25,680 Speaker 2: almost ingrained into the nerves and into your nervous system. 137 00:08:26,040 --> 00:08:27,760 Speaker 2: It's kind of like if you get a shirt with 138 00:08:27,800 --> 00:08:30,560 Speaker 2: a stain on it. The longer it sits there, the 139 00:08:30,600 --> 00:08:33,480 Speaker 2: harder it is to get out. The body treats chronic 140 00:08:33,520 --> 00:08:36,040 Speaker 2: pain the same way. So if we're not able to 141 00:08:36,080 --> 00:08:38,920 Speaker 2: treat and cure that pain immediately, and sometimes it can 142 00:08:38,960 --> 00:08:42,520 Speaker 2: get harder and harder to treat. So I'll typically use 143 00:08:42,600 --> 00:08:46,439 Speaker 2: ketamine for chronic pain, but most of my patients, unfortunately, 144 00:08:46,480 --> 00:08:50,079 Speaker 2: once you get into that chronic pain setting, about seventy 145 00:08:50,120 --> 00:08:53,880 Speaker 2: five percent of people will develop depressive and anxiety symptoms. 146 00:08:54,160 --> 00:08:57,400 Speaker 1: You mentioned that you typically like to prescribe it intravenously 147 00:08:57,480 --> 00:08:59,920 Speaker 1: as opposed to like appeal. Is there a peal form 148 00:09:00,160 --> 00:09:00,680 Speaker 1: of ketamine? 149 00:09:01,080 --> 00:09:04,280 Speaker 2: There is a pill form of ketamine, and ketamine can 150 00:09:04,320 --> 00:09:08,120 Speaker 2: be made by a compounding pharmacy into a pill form. 151 00:09:08,480 --> 00:09:11,840 Speaker 2: It's not a brand name medication. It's not an over 152 00:09:11,920 --> 00:09:15,480 Speaker 2: the counter medication. So if your doctor even gives you 153 00:09:15,520 --> 00:09:19,079 Speaker 2: a pill prescription and you walk into your average pharmacy, 154 00:09:19,120 --> 00:09:22,120 Speaker 2: they probably won't have it. But it is made into 155 00:09:22,160 --> 00:09:26,360 Speaker 2: a pill form by special compounding pharmacies, and I have 156 00:09:26,559 --> 00:09:30,679 Speaker 2: used it for patients sometimes that use ketamine infusions, but 157 00:09:31,000 --> 00:09:34,440 Speaker 2: the effects wear off after a few months. Sometimes I'll 158 00:09:34,440 --> 00:09:37,760 Speaker 2: prescribe a ketamine by mouth or pill to take several 159 00:09:37,800 --> 00:09:39,800 Speaker 2: times a week until they can get in for their 160 00:09:39,840 --> 00:09:43,600 Speaker 2: next infusion. So I've used it a lot that way, 161 00:09:43,640 --> 00:09:46,240 Speaker 2: but I've used it a little more in the infusion form. 162 00:09:46,559 --> 00:09:49,640 Speaker 2: It's also available as an injected form, so we can 163 00:09:49,720 --> 00:09:53,160 Speaker 2: just inject it into the muscle. And so that's another 164 00:09:53,200 --> 00:09:54,880 Speaker 2: way that we can use ketamine as well. 165 00:09:55,240 --> 00:09:58,200 Speaker 1: Got it okay? And who is typically going to be 166 00:09:58,320 --> 00:10:01,200 Speaker 1: a good candidate for kenemi as treatment? 167 00:10:01,559 --> 00:10:05,000 Speaker 2: So typically with ketamine therapies, we want someone that is 168 00:10:05,000 --> 00:10:10,120 Speaker 2: not allergic to ketamine, no history of severe heart disease issues. 169 00:10:10,440 --> 00:10:15,320 Speaker 2: That means no heart failure, no irregular heart rhythms, no 170 00:10:15,480 --> 00:10:18,680 Speaker 2: severe kidney or liver disease. You don't want to be 171 00:10:18,760 --> 00:10:22,040 Speaker 2: pregnant while you're taking ketamine. You want to make sure 172 00:10:22,120 --> 00:10:26,280 Speaker 2: patients that have a history of psychosis or schizophrenia that 173 00:10:26,360 --> 00:10:30,840 Speaker 2: you closely evaluate those patients for ketamine candidacy and will 174 00:10:30,880 --> 00:10:34,440 Speaker 2: often collaborate with their psychiatrists or psychologists to make sure 175 00:10:34,480 --> 00:10:37,320 Speaker 2: that that's a possible choice. Many times it may not be, 176 00:10:38,120 --> 00:10:40,560 Speaker 2: and so you want to do a full medical screen 177 00:10:40,640 --> 00:10:44,320 Speaker 2: before you introduce ketamine. But ideally the patient has a 178 00:10:44,360 --> 00:10:47,880 Speaker 2: reason to use ketamine, meaning that they have a chronic 179 00:10:47,920 --> 00:10:52,440 Speaker 2: pain syndrome like nerve pain. Things like diabetes or radiation 180 00:10:52,679 --> 00:10:56,920 Speaker 2: therapy autoimmune diseases sometimes can increase risk for nerve pain, 181 00:10:57,440 --> 00:11:01,280 Speaker 2: cancer related pain. I've used it for sickle sell related pain, 182 00:11:01,760 --> 00:11:08,760 Speaker 2: pain after amputations, migraines, fibromyalgia, or mental health issues like 183 00:11:08,840 --> 00:11:10,240 Speaker 2: depression or anxiety. 184 00:11:11,200 --> 00:11:13,800 Speaker 1: So it doesn't sound like ketamine is necessarily like a 185 00:11:13,840 --> 00:11:18,319 Speaker 1: first choice for pain, Like you may try a couple 186 00:11:18,320 --> 00:11:20,800 Speaker 1: of things before you go to ketymene. Or would you 187 00:11:20,840 --> 00:11:25,280 Speaker 1: start somebody at ketamine even on their initial appointment, not as. 188 00:11:25,200 --> 00:11:28,559 Speaker 2: An initial therapy. I would hold off on using ketamine 189 00:11:28,679 --> 00:11:32,440 Speaker 2: until the patient has tried traditional therapies. But you want 190 00:11:32,480 --> 00:11:37,160 Speaker 2: to make sure that traditional therapies are tried carefully. So 191 00:11:37,360 --> 00:11:41,400 Speaker 2: as an interventional pain doctor, I take a very multidisciplinary 192 00:11:41,520 --> 00:11:45,320 Speaker 2: approach to pain management. So someone comes in, I want 193 00:11:45,360 --> 00:11:48,520 Speaker 2: to ask them, have you tried physical therapy? What kind 194 00:11:48,559 --> 00:11:50,920 Speaker 2: did you try? If you didn't like that kind, let 195 00:11:50,920 --> 00:11:53,840 Speaker 2: me find you a kind that will better suit your needs. 196 00:11:54,200 --> 00:11:57,640 Speaker 2: Have you tried medications? There are several classes of medicines 197 00:11:57,640 --> 00:12:00,880 Speaker 2: that we often use for migraines, nerve pain, cancer pain. 198 00:12:01,400 --> 00:12:03,920 Speaker 2: If you've tried them, were you on the correct dose 199 00:12:04,000 --> 00:12:06,000 Speaker 2: for the correct amount of time to give it an 200 00:12:06,080 --> 00:12:11,400 Speaker 2: adequate trial. Also, I've done a lot of interventional injections 201 00:12:11,440 --> 00:12:14,839 Speaker 2: and implants for chronic pain syndromes, and I see if 202 00:12:14,840 --> 00:12:17,199 Speaker 2: the patient wants something like that, or if they want 203 00:12:17,240 --> 00:12:20,840 Speaker 2: to trial that, sometimes that can be effective too. So 204 00:12:20,880 --> 00:12:24,720 Speaker 2: it's really having an open and honest dialogue with the 205 00:12:24,800 --> 00:12:27,320 Speaker 2: patient to say, these are all the things that I 206 00:12:27,360 --> 00:12:30,760 Speaker 2: can do to help treat your chronic pain, and you 207 00:12:30,800 --> 00:12:33,679 Speaker 2: can kind of choose the things you're comfortable with, or 208 00:12:33,760 --> 00:12:37,000 Speaker 2: if you're uncomfortable with something, let's have a conversation about 209 00:12:37,000 --> 00:12:41,679 Speaker 2: maybe why you're uncomfortable, and then we work collaboratively to 210 00:12:41,760 --> 00:12:44,720 Speaker 2: come up with the plan. And I may mention that, yes, 211 00:12:45,040 --> 00:12:47,840 Speaker 2: we do have ketamine as an option, so we'll start 212 00:12:47,880 --> 00:12:52,679 Speaker 2: with option A option b obstion C. But typically ketamine 213 00:12:52,720 --> 00:12:56,359 Speaker 2: is reserved for patients that don't respond to traditional therapies. 214 00:12:56,640 --> 00:12:59,560 Speaker 1: Got it, And the list of things that you shared 215 00:12:59,600 --> 00:13:02,200 Speaker 1: when I who would be a good candidate and the 216 00:13:02,240 --> 00:13:04,680 Speaker 1: kinds of things you're screening out for leads me to 217 00:13:04,720 --> 00:13:07,200 Speaker 1: believe like this is a pretty strong medication, right, Like 218 00:13:07,280 --> 00:13:10,240 Speaker 1: it sounds like there may be some heart impact, like 219 00:13:10,400 --> 00:13:12,760 Speaker 1: kidney and so it sounds like it can be a 220 00:13:12,760 --> 00:13:14,560 Speaker 1: pretty hard medication on the body. 221 00:13:14,920 --> 00:13:18,959 Speaker 2: It depends. It's all dose dependent, so all substances can 222 00:13:18,960 --> 00:13:21,680 Speaker 2: be dangerous if they're not used at the right dose 223 00:13:22,400 --> 00:13:26,800 Speaker 2: with the right patient, with the right supervision. That's something 224 00:13:26,920 --> 00:13:30,600 Speaker 2: I explained to patients when I have them undergoing anesthetic. 225 00:13:30,880 --> 00:13:34,600 Speaker 2: Like many years ago, everybody was very scared of propofol 226 00:13:34,679 --> 00:13:38,040 Speaker 2: because of everything that happened with Michael Jackson. Propofol is 227 00:13:38,080 --> 00:13:40,760 Speaker 2: a wonderful medication. If you're giving me or my family 228 00:13:40,760 --> 00:13:43,800 Speaker 2: member a general anesthetic, I would prefer you use that 229 00:13:43,920 --> 00:13:47,040 Speaker 2: versus the alternatives. But when patients come to me with 230 00:13:47,080 --> 00:13:49,880 Speaker 2: that concern, you really have to validate them and say, 231 00:13:49,960 --> 00:13:53,680 Speaker 2: I understand why you would be apprehensive about using something 232 00:13:53,800 --> 00:13:58,319 Speaker 2: like that, But because I know your medical history, I 233 00:13:58,360 --> 00:14:01,520 Speaker 2: know exactly the dose to you, I know exactly how 234 00:14:01,559 --> 00:14:04,199 Speaker 2: to monitor you, and how to treat any side effects 235 00:14:04,240 --> 00:14:07,360 Speaker 2: of the medicine, we can come up with a plan 236 00:14:07,400 --> 00:14:09,320 Speaker 2: that's going to be the safest for you. 237 00:14:10,280 --> 00:14:23,080 Speaker 1: Got it more from our conversation after the break. So 238 00:14:23,160 --> 00:14:26,640 Speaker 1: what do these sessions typically look like with a patient? 239 00:14:26,720 --> 00:14:28,880 Speaker 1: Like if you're doing an infusion, what do the sessions 240 00:14:28,920 --> 00:14:29,240 Speaker 1: look like? 241 00:14:29,440 --> 00:14:32,080 Speaker 2: So it depends on the indication or the reason that 242 00:14:32,120 --> 00:14:35,760 Speaker 2: we're doing the session. So in my new company that 243 00:14:35,800 --> 00:14:40,040 Speaker 2: I've co founded, Culture Therapeutics, we're bringing safety, expertise and 244 00:14:40,080 --> 00:14:43,840 Speaker 2: culture to the ketymine care experience, and so we want 245 00:14:43,880 --> 00:14:47,920 Speaker 2: to have a setting that is conducive for all types 246 00:14:47,960 --> 00:14:51,200 Speaker 2: of people to benefit from keteviine. So we pay a 247 00:14:51,240 --> 00:14:54,960 Speaker 2: lot of attention to the setting where the patient is 248 00:14:54,960 --> 00:14:57,520 Speaker 2: getting the infusion. So you want to meet with the 249 00:14:57,520 --> 00:15:01,880 Speaker 2: patient beforehand, do a careful medical screening. You want to 250 00:15:02,000 --> 00:15:05,560 Speaker 2: have a setting where the patient feels relaxed, feels comfortable 251 00:15:05,600 --> 00:15:09,960 Speaker 2: and respected, and they know what to expect. Generally, if 252 00:15:09,960 --> 00:15:13,640 Speaker 2: you're using ketamine for pain relief or for mood, we'll 253 00:15:13,680 --> 00:15:17,880 Speaker 2: set an intention with the medication and we'll say this 254 00:15:17,960 --> 00:15:21,120 Speaker 2: is what we can reasonably expect to happen. Do I 255 00:15:21,160 --> 00:15:25,000 Speaker 2: have a particular therapeutic goal? Do you want to sleep better? 256 00:15:25,560 --> 00:15:27,160 Speaker 2: Do you want to be able to walk a little 257 00:15:27,200 --> 00:15:30,520 Speaker 2: bit further? Do you want to have more social interactions? 258 00:15:30,960 --> 00:15:32,320 Speaker 2: Do you just want to be able to kind of 259 00:15:32,360 --> 00:15:35,640 Speaker 2: sit and watch TV without as much pain? Because we 260 00:15:35,880 --> 00:15:38,640 Speaker 2: have shown with ketamine that setting an intention can be 261 00:15:38,760 --> 00:15:42,720 Speaker 2: very powerful. And then during the infusion itself, we try 262 00:15:42,760 --> 00:15:46,720 Speaker 2: to have things around that are comforting to the patient, 263 00:15:46,800 --> 00:15:50,320 Speaker 2: so we may provide call me music and music is 264 00:15:50,560 --> 00:15:54,160 Speaker 2: very often personal and cultural in nature, so we make 265 00:15:54,200 --> 00:15:57,600 Speaker 2: sure that that is something the patient can really benefit from. 266 00:15:58,120 --> 00:16:01,400 Speaker 2: A lot of times when people think about psychedelics or 267 00:16:01,680 --> 00:16:06,360 Speaker 2: ketamine therapies, they kind of imagine like more eurocentric euro 268 00:16:06,440 --> 00:16:10,640 Speaker 2: American type music, Pink Floyd and things like that. But 269 00:16:10,760 --> 00:16:14,760 Speaker 2: we use more traditional drum therapies, more R and B, 270 00:16:14,960 --> 00:16:19,400 Speaker 2: more soul music for patients or whatever their preferences. And 271 00:16:19,800 --> 00:16:22,720 Speaker 2: after the infusion, we have the patient do some after 272 00:16:22,840 --> 00:16:25,320 Speaker 2: work and that means they kind of go back to 273 00:16:25,360 --> 00:16:28,760 Speaker 2: that initial intention that they set and they start keeping 274 00:16:28,800 --> 00:16:32,360 Speaker 2: track of their pain scores and their mood scores, especially 275 00:16:32,360 --> 00:16:35,280 Speaker 2: for the first seventy two hours after a session. 276 00:16:36,040 --> 00:16:37,440 Speaker 1: How long did the session last? 277 00:16:38,200 --> 00:16:42,040 Speaker 2: It depends for mood. Usually the session will last forty 278 00:16:42,040 --> 00:16:45,760 Speaker 2: five minutes to an hour. For chronic pain will often 279 00:16:46,080 --> 00:16:49,040 Speaker 2: go up to three to four hours, And for chronic 280 00:16:49,080 --> 00:16:51,240 Speaker 2: pain often our doses much higher. 281 00:16:51,680 --> 00:16:53,520 Speaker 1: And is it kind of like you would if you 282 00:16:53,560 --> 00:16:55,960 Speaker 1: were getting like a blood infusion, Like you're just laying 283 00:16:56,000 --> 00:16:59,360 Speaker 1: there with the ivy and like letting the ketymene kind of. 284 00:16:59,400 --> 00:17:02,720 Speaker 2: Drip exactly, so the ketemy would be given over an 285 00:17:02,760 --> 00:17:07,000 Speaker 2: exact certain period of time through the ivy infusion. Like 286 00:17:07,080 --> 00:17:10,320 Speaker 2: if you know anyone who gets iron infusion, or hydration 287 00:17:10,520 --> 00:17:13,640 Speaker 2: infusion or if you know you're feeling dehydrated, and people 288 00:17:13,720 --> 00:17:17,879 Speaker 2: will go and get IV hydration infusions. It infuses in 289 00:17:18,040 --> 00:17:20,600 Speaker 2: over that time and then when it's done, you remove 290 00:17:20,640 --> 00:17:23,399 Speaker 2: the IV, put a band aid on. The patient will 291 00:17:23,440 --> 00:17:26,359 Speaker 2: be evaluated for about a half hour to an hour, 292 00:17:26,440 --> 00:17:28,400 Speaker 2: and then they have someone take them home. 293 00:17:28,720 --> 00:17:31,600 Speaker 1: Got it. And when you said for those like first 294 00:17:31,640 --> 00:17:34,119 Speaker 1: seventy two hours after the session, are they kind of 295 00:17:34,160 --> 00:17:37,040 Speaker 1: like journaling? Are they meeting with somebody every day? How 296 00:17:37,040 --> 00:17:37,640 Speaker 1: does that work? 297 00:17:37,720 --> 00:17:40,159 Speaker 2: So, depending on what their diagnosis is, they may have 298 00:17:40,200 --> 00:17:44,040 Speaker 2: a meeting with their psychologists, they may do some afterwork 299 00:17:44,080 --> 00:17:47,280 Speaker 2: and therapy workbook that we have for the patient. And 300 00:17:47,359 --> 00:17:50,680 Speaker 2: it doesn't have to be an extensive set of homework. 301 00:17:50,720 --> 00:17:53,760 Speaker 2: It's not meant to burden the patient, but it's really 302 00:17:53,800 --> 00:17:56,760 Speaker 2: just taking some time during the day to think about 303 00:17:56,840 --> 00:17:59,639 Speaker 2: what happened and to think about the therapeutic goals. 304 00:18:00,080 --> 00:18:04,880 Speaker 1: Got it? And typically, how are people reporting feeling after sessions? 305 00:18:04,920 --> 00:18:07,359 Speaker 1: Like what can someone expect after they've had a session. 306 00:18:07,600 --> 00:18:09,960 Speaker 2: So the day of the infusion or the day of 307 00:18:10,000 --> 00:18:12,440 Speaker 2: the session, you may have a little bit of grogginess. 308 00:18:12,720 --> 00:18:14,920 Speaker 2: So we tell patients not to drive or to sign 309 00:18:15,000 --> 00:18:17,760 Speaker 2: any contracts that day, and you may want to go 310 00:18:17,840 --> 00:18:20,359 Speaker 2: home with someone with you, eat a light dinner or 311 00:18:20,400 --> 00:18:22,800 Speaker 2: a light snack later in the day, be on the 312 00:18:22,800 --> 00:18:25,200 Speaker 2: lookout for any nausea. Some people get a little bit 313 00:18:25,240 --> 00:18:28,720 Speaker 2: of nausea with ketamine, but usually I would provide an 314 00:18:28,720 --> 00:18:31,680 Speaker 2: anti nausea medicine to either go home with or take 315 00:18:31,720 --> 00:18:34,840 Speaker 2: before they leave. And then patients usually report that they 316 00:18:34,880 --> 00:18:37,760 Speaker 2: sleep very well that night because they're still a little 317 00:18:37,800 --> 00:18:40,760 Speaker 2: bit sleepy, and over the next several days they really 318 00:18:41,040 --> 00:18:43,880 Speaker 2: pretty much feel like back to baseline. 319 00:18:43,480 --> 00:18:46,920 Speaker 1: Got it okay? And as they are getting the infusion, 320 00:18:47,040 --> 00:18:49,480 Speaker 1: are you or someone else sitting there talking to them 321 00:18:49,680 --> 00:18:51,679 Speaker 1: or is it kind of like a silent thing and 322 00:18:51,720 --> 00:18:53,679 Speaker 1: they're just listening to like the music list that they 323 00:18:53,760 --> 00:18:54,520 Speaker 1: may be prepared. 324 00:18:54,680 --> 00:18:58,760 Speaker 2: Typically it's the music list they've prepared, so if they 325 00:18:58,800 --> 00:19:02,880 Speaker 2: have depression or exactnciety or PTSD, sometimes we do provide 326 00:19:03,080 --> 00:19:08,280 Speaker 2: additional guidance during the infusion itself. People can get varying 327 00:19:08,359 --> 00:19:13,000 Speaker 2: levels of sedation with it, and sometimes getting stimulation or 328 00:19:13,040 --> 00:19:16,080 Speaker 2: talking to them too much during it can be a 329 00:19:16,119 --> 00:19:20,080 Speaker 2: bit too much, so I'll usually say make sure your 330 00:19:20,080 --> 00:19:22,600 Speaker 2: morning's really calm. If you tend to be in an 331 00:19:22,600 --> 00:19:25,000 Speaker 2: anxious state, will be with you. And if you feel 332 00:19:25,040 --> 00:19:27,920 Speaker 2: a little anxious during the infusion, because sometimes it does 333 00:19:28,000 --> 00:19:31,240 Speaker 2: cause a little bit of anxiety. Sometimes people might see 334 00:19:31,280 --> 00:19:35,520 Speaker 2: really mild hallucinations. It can be a very vulnerable time 335 00:19:35,520 --> 00:19:39,200 Speaker 2: for the patient. So if someone is feeling a little anxious, 336 00:19:39,240 --> 00:19:43,000 Speaker 2: will evaluate them for an anti anxiety medication that they 337 00:19:43,040 --> 00:19:45,600 Speaker 2: can receive, and we'll kind of just talk to them 338 00:19:45,640 --> 00:19:48,080 Speaker 2: a little bit and we'll say, hey, doctor Doyle, I'm 339 00:19:48,119 --> 00:19:51,439 Speaker 2: sitting right here with you. I'm feeling fine. You're in 340 00:19:51,480 --> 00:19:54,840 Speaker 2: the office, you're safe, your vitals look perfect. Take a 341 00:19:54,840 --> 00:19:57,879 Speaker 2: couple deep breaths, and if you're not feeling better in 342 00:19:57,920 --> 00:20:00,600 Speaker 2: a minute or two, I'll give you an anti anxiety medicine. 343 00:20:00,920 --> 00:20:04,159 Speaker 2: But you're doing great, And usually that works about ninety 344 00:20:04,160 --> 00:20:05,080 Speaker 2: percent of the time. 345 00:20:05,800 --> 00:20:09,000 Speaker 1: Okay, And how soon would they need another session? Like 346 00:20:09,040 --> 00:20:11,840 Speaker 1: how long do you expect the impact to last? 347 00:20:12,160 --> 00:20:16,440 Speaker 2: So at culture Therapeutics, we typically follow the best evidence 348 00:20:17,080 --> 00:20:21,440 Speaker 2: treatment protocols. So for chronic pain, when I was a professor, 349 00:20:21,520 --> 00:20:24,359 Speaker 2: we would do two to three sessions of a higher 350 00:20:24,440 --> 00:20:27,960 Speaker 2: Joe's ketamine within a week and patients would get good reliefs. 351 00:20:28,040 --> 00:20:31,879 Speaker 2: Sometimes for three to six months with that. For mental 352 00:20:31,920 --> 00:20:37,399 Speaker 2: health conditions, the typical protocol is six sessions over about 353 00:20:37,440 --> 00:20:40,560 Speaker 2: three weeks, and that can last up to six to 354 00:20:40,600 --> 00:20:42,600 Speaker 2: twelve months depending on your response. 355 00:20:43,200 --> 00:20:47,240 Speaker 1: Got it okay? So in your experience, have you noticed 356 00:20:47,359 --> 00:20:51,919 Speaker 1: or observed a reluctance from black patients to trying ketamine. 357 00:20:52,560 --> 00:20:56,639 Speaker 2: I think so, and I think it's justified distrust. I 358 00:20:56,680 --> 00:21:00,400 Speaker 2: think being a doctor, especially a pain doctor especially, I've 359 00:21:00,440 --> 00:21:03,320 Speaker 2: always worked in areas where I'm within my own community 360 00:21:03,359 --> 00:21:07,479 Speaker 2: in DC, or in Baltimore or in Georgia, and so 361 00:21:08,480 --> 00:21:11,840 Speaker 2: I think we do have to acknowledge that it's been 362 00:21:11,920 --> 00:21:16,040 Speaker 2: a very fraught road for black people to deal with 363 00:21:16,080 --> 00:21:18,800 Speaker 2: the medical system, and when it comes to things like 364 00:21:18,880 --> 00:21:22,439 Speaker 2: pain and mental health, we have to really address it 365 00:21:22,680 --> 00:21:26,119 Speaker 2: at the forefront. So at Culture Therapeutics and at my 366 00:21:26,240 --> 00:21:31,919 Speaker 2: prior practice, we always have the idea that you have 367 00:21:32,000 --> 00:21:35,440 Speaker 2: to get belief to get to relief. So it's that 368 00:21:35,600 --> 00:21:38,960 Speaker 2: belief to relief pathway. It's hard to treat somebody for 369 00:21:39,040 --> 00:21:42,160 Speaker 2: something if you don't believe them. So when I often 370 00:21:42,200 --> 00:21:44,359 Speaker 2: sit with the patient, the first thing I do is 371 00:21:44,400 --> 00:21:47,240 Speaker 2: I validate them, and I say, I know you're in pain. 372 00:21:47,520 --> 00:21:50,120 Speaker 2: I know you didn't just get up this morning, put 373 00:21:50,119 --> 00:21:53,360 Speaker 2: your clothes on, get your hair together, get on the metro, 374 00:21:53,840 --> 00:21:57,480 Speaker 2: come to the office, wait, do all the paperwork, and 375 00:21:57,520 --> 00:22:01,479 Speaker 2: then come in here because of nothing. I know something 376 00:22:01,600 --> 00:22:03,639 Speaker 2: is going on. I'm going to be your partner in 377 00:22:03,680 --> 00:22:07,320 Speaker 2: trying to figure out what is going on, and I 378 00:22:07,359 --> 00:22:10,720 Speaker 2: can answer any questions that you have. A frequent question 379 00:22:11,160 --> 00:22:13,600 Speaker 2: or concerned that I get is that a lot of 380 00:22:13,640 --> 00:22:17,120 Speaker 2: Black people they don't want to be experimented on, which 381 00:22:17,160 --> 00:22:20,679 Speaker 2: is very understandable given our history, like with the experiments 382 00:22:20,720 --> 00:22:24,000 Speaker 2: that went on in Alabama with the Tuskegee Airman and 383 00:22:24,240 --> 00:22:27,600 Speaker 2: just throughout our history in the United States. So I 384 00:22:27,680 --> 00:22:31,200 Speaker 2: explained to them that this is the evidence that I have. 385 00:22:31,920 --> 00:22:35,600 Speaker 2: No medication is perfect. No medication works for everyone one 386 00:22:35,680 --> 00:22:38,040 Speaker 2: hundred percent, but there are things I can do to 387 00:22:38,080 --> 00:22:42,399 Speaker 2: safeguard your care and monitor your care. And some patients 388 00:22:42,440 --> 00:22:47,159 Speaker 2: may have a preference for more natural substances, and that's fine. 389 00:22:47,320 --> 00:22:49,320 Speaker 2: You know, for a long time, I was one of 390 00:22:49,359 --> 00:22:53,520 Speaker 2: the only providers in DC who would prescribe medical cannabis 391 00:22:53,560 --> 00:22:57,920 Speaker 2: for paying patients, especially for patients with DC Medicaid or 392 00:22:58,080 --> 00:23:02,200 Speaker 2: medical assistance. That company a lot of African American patients, 393 00:23:02,920 --> 00:23:06,560 Speaker 2: and I think explaining kind of like I did before, 394 00:23:06,640 --> 00:23:09,440 Speaker 2: that it's synthesized in the lab, and this is how 395 00:23:09,440 --> 00:23:11,240 Speaker 2: it's made and this is how it gets to you. 396 00:23:11,400 --> 00:23:13,639 Speaker 2: I think that can help a lot too, And just 397 00:23:13,720 --> 00:23:16,439 Speaker 2: explaining it like I would explain it to any patient, 398 00:23:16,520 --> 00:23:18,719 Speaker 2: and kind of taking the time to answer concerns. 399 00:23:19,000 --> 00:23:21,640 Speaker 1: So why did you feel the need to work as 400 00:23:21,640 --> 00:23:24,479 Speaker 1: a co founder in starting Culture Therapeutics, Like was there 401 00:23:24,520 --> 00:23:27,440 Speaker 1: a concern that maybe black and brown communities were not 402 00:23:27,480 --> 00:23:29,560 Speaker 1: getting this kind of care in other places? 403 00:23:29,920 --> 00:23:34,520 Speaker 2: I think we are always at a disadvantage historically when 404 00:23:34,520 --> 00:23:39,160 Speaker 2: it comes to access to medical care, especially to treatment 405 00:23:39,240 --> 00:23:43,360 Speaker 2: resistant care, and so we face this double barrier where 406 00:23:43,520 --> 00:23:47,880 Speaker 2: we have issues getting the additional therapies, and then if 407 00:23:47,880 --> 00:23:50,399 Speaker 2: we may find that those don't work, then we have 408 00:23:50,560 --> 00:23:57,000 Speaker 2: issues accessing alternative therapies. And we created Culture Therapeutics to 409 00:23:57,080 --> 00:23:59,800 Speaker 2: kind of answer that question, to bring that safety and 410 00:23:59,840 --> 00:24:05,359 Speaker 2: that expertise, and to demystify some of these medicines and 411 00:24:05,520 --> 00:24:08,160 Speaker 2: to let people know that this is a part of 412 00:24:08,200 --> 00:24:11,080 Speaker 2: our history kind of using medicines like this, This is 413 00:24:11,119 --> 00:24:15,800 Speaker 2: not necessarily a white thing or an indigenous thing or 414 00:24:15,840 --> 00:24:18,320 Speaker 2: anything like that. This is also an African thing. This 415 00:24:18,400 --> 00:24:22,200 Speaker 2: is an African American thing, and we formed our practice 416 00:24:22,200 --> 00:24:24,760 Speaker 2: as a love letter to our community because we want 417 00:24:24,800 --> 00:24:27,480 Speaker 2: to make sure that we have a stake in these 418 00:24:27,520 --> 00:24:29,200 Speaker 2: sort of therapies going forward. 419 00:24:30,760 --> 00:24:33,640 Speaker 1: You know, I often hear this kind of stereotype that 420 00:24:33,720 --> 00:24:36,280 Speaker 1: a lot of physicians, it seems, and other medical professionals 421 00:24:36,320 --> 00:24:41,280 Speaker 1: have when they have black patients right about being medicine seeking, right, 422 00:24:41,440 --> 00:24:45,200 Speaker 1: or even having higher thresholds of pain. Can you speak 423 00:24:45,240 --> 00:24:46,800 Speaker 1: to that and maybe any of the work that you 424 00:24:46,880 --> 00:24:49,120 Speaker 1: have to do around spelling some of those myths. 425 00:24:49,160 --> 00:24:53,760 Speaker 2: So definitely, it's definitely a misconception that black patients are 426 00:24:54,119 --> 00:24:57,600 Speaker 2: drug seeking. And I teach medical students and residents. I 427 00:24:57,760 --> 00:25:01,520 Speaker 2: dissuade them from describing patients that way or writing that 428 00:25:01,640 --> 00:25:04,840 Speaker 2: in a medical note, and to say, if they suspect 429 00:25:04,960 --> 00:25:08,439 Speaker 2: someone has a substance use disorder, to ask them and 430 00:25:08,560 --> 00:25:11,600 Speaker 2: discuss it with them in a frank nature. I educate 431 00:25:11,680 --> 00:25:14,760 Speaker 2: everyone that people of color, black people do not have 432 00:25:14,840 --> 00:25:19,160 Speaker 2: higher pain thresholds. We do not make up pain, and 433 00:25:19,359 --> 00:25:22,640 Speaker 2: we do not have higher rates of addiction or substance 434 00:25:22,720 --> 00:25:25,840 Speaker 2: use disorder. Actually, there's some studies that say our rates 435 00:25:25,920 --> 00:25:29,680 Speaker 2: might be slightly lower than other groups, especially in North America, 436 00:25:30,359 --> 00:25:34,479 Speaker 2: but it's definitely something that patients encounter when they are 437 00:25:34,480 --> 00:25:36,840 Speaker 2: in the hospital setting many times unfortunately. 438 00:25:37,200 --> 00:25:40,000 Speaker 1: M So, it does feel like there is like a 439 00:25:40,119 --> 00:25:42,639 Speaker 1: renewed interest. It feels like maybe people were kind of 440 00:25:42,720 --> 00:25:46,480 Speaker 1: using kenemine maybe years ago, I think specifically in more 441 00:25:46,520 --> 00:25:48,680 Speaker 1: mental health kinds of spaces, and it feels like there's 442 00:25:48,720 --> 00:25:52,000 Speaker 1: now a renewed interest, but also some pushback. Can you 443 00:25:52,040 --> 00:25:53,879 Speaker 1: talk to me a little bit about what's going on 444 00:25:54,000 --> 00:25:56,400 Speaker 1: generally in the field and like what is the field's 445 00:25:56,800 --> 00:26:00,800 Speaker 1: reception to using ketamine for both mental health concerns and pain. 446 00:26:01,119 --> 00:26:02,840 Speaker 2: So, I think right now it's kind of like a 447 00:26:02,920 --> 00:26:07,199 Speaker 2: renaissance period for ketymine and for psychedelic care in the 448 00:26:07,320 --> 00:26:10,560 Speaker 2: United States. A lot of these substances have been around 449 00:26:10,600 --> 00:26:13,760 Speaker 2: for a very long time. Over the last five to 450 00:26:13,800 --> 00:26:18,840 Speaker 2: ten years, you've seen more commercialization of ketymine use. You've 451 00:26:18,880 --> 00:26:23,840 Speaker 2: seen more venture capitalists and larger corporations forming ketamine care 452 00:26:23,920 --> 00:26:28,600 Speaker 2: companies and mailing ketymine out to patients for home use. 453 00:26:29,200 --> 00:26:33,440 Speaker 2: And with the COVID era, there was actually the suspension 454 00:26:33,640 --> 00:26:37,119 Speaker 2: of something called the Ryan Height Act, and the Ryan 455 00:26:37,240 --> 00:26:40,320 Speaker 2: Height Act was something that was put forth about twenty 456 00:26:40,400 --> 00:26:45,800 Speaker 2: years ago to decrease substance misuse from controlled substances, and 457 00:26:45,880 --> 00:26:48,560 Speaker 2: so they put the DEA put certain rules in place, 458 00:26:48,680 --> 00:26:51,199 Speaker 2: like you need to see the patient in person, you 459 00:26:51,280 --> 00:26:53,760 Speaker 2: need to make sure that the patient has a condition 460 00:26:53,840 --> 00:26:58,320 Speaker 2: that qualifies. And some of those rules were suspended briefly 461 00:26:58,440 --> 00:27:01,240 Speaker 2: during the COVID period because you know, people couldn't get 462 00:27:01,240 --> 00:27:05,000 Speaker 2: out of their homes. But now the emergency COVID period 463 00:27:05,240 --> 00:27:08,320 Speaker 2: is being legally ended by the government. So a lot 464 00:27:08,320 --> 00:27:11,560 Speaker 2: of those companies now are some of them are shutting down, 465 00:27:11,880 --> 00:27:15,280 Speaker 2: some of them are having to completely change the way 466 00:27:15,359 --> 00:27:19,439 Speaker 2: that they practice, and a lot of the companies that 467 00:27:19,840 --> 00:27:22,639 Speaker 2: weren't growing organically have shut down. 468 00:27:22,960 --> 00:27:36,120 Speaker 1: Got it more from our conversation after the break So, 469 00:27:36,200 --> 00:27:38,160 Speaker 1: I know I mentioned earlier that it feels like there's 470 00:27:38,200 --> 00:27:42,080 Speaker 1: often a lot of misinformation related to kenemine and psychedelics. 471 00:27:42,240 --> 00:27:44,960 Speaker 1: What are some of the most common myths that you 472 00:27:45,040 --> 00:27:47,720 Speaker 1: hear about ketamine and psychedelics and can you put those 473 00:27:47,760 --> 00:27:48,919 Speaker 1: to rest for us? 474 00:27:49,160 --> 00:27:54,200 Speaker 2: Sure? So common misconceptions that we've seen at Culture Therapeutics. 475 00:27:54,480 --> 00:27:58,800 Speaker 2: One is that ketamine will cause people to lose their sanity, 476 00:27:59,600 --> 00:28:03,840 Speaker 2: or that ketamine is gonna cause some sort of psychotic 477 00:28:03,960 --> 00:28:07,119 Speaker 2: break in patients, and that people who commonly use it 478 00:28:07,400 --> 00:28:09,960 Speaker 2: are going to have that as a very common side effect. 479 00:28:10,600 --> 00:28:14,639 Speaker 2: And traditionally with what we've seen patients who get ketamine 480 00:28:15,119 --> 00:28:18,520 Speaker 2: sometimes there can be some short lasting, you know, agitation 481 00:28:19,320 --> 00:28:23,199 Speaker 2: or anxiety depending on who takes it. But in general 482 00:28:23,280 --> 00:28:26,960 Speaker 2: that's a misconception and that's why we also carefully screen 483 00:28:27,040 --> 00:28:30,879 Speaker 2: to see if someone has psychosis or schizophrenia prior to 484 00:28:30,960 --> 00:28:34,399 Speaker 2: trying a trial of ketamine. I think another myth is 485 00:28:34,440 --> 00:28:37,560 Speaker 2: that it increases the risk for addiction and that people 486 00:28:37,600 --> 00:28:42,000 Speaker 2: will develop an addiction to ketamine immediately. And that's where 487 00:28:42,240 --> 00:28:46,080 Speaker 2: close medical care comes into play. So if someone is 488 00:28:46,120 --> 00:28:50,040 Speaker 2: receiving ketamine, they should be screened like anyone receiving any 489 00:28:50,120 --> 00:28:52,520 Speaker 2: controlled substance, they should be ACTSD. You know, do you 490 00:28:52,560 --> 00:28:56,000 Speaker 2: have a strong family or personal history of substance use disorder. 491 00:28:56,400 --> 00:28:59,680 Speaker 2: Do you have a strong history of adverse childhood events 492 00:28:59,840 --> 00:29:02,560 Speaker 2: or or a history of abuse, do you have a 493 00:29:02,640 --> 00:29:05,920 Speaker 2: history of alcohol use disorder? And you should kind of 494 00:29:05,960 --> 00:29:09,200 Speaker 2: come up with a risk factor or a risk score 495 00:29:09,240 --> 00:29:12,000 Speaker 2: for a patient and let them know that in general 496 00:29:12,280 --> 00:29:15,480 Speaker 2: you may have a higher or lower risk of substance 497 00:29:15,600 --> 00:29:18,560 Speaker 2: use disorder based on your history. It might just be 498 00:29:18,840 --> 00:29:23,160 Speaker 2: a genetic factor, an environmental factor. With that in mind, 499 00:29:23,480 --> 00:29:25,840 Speaker 2: these are the steps we can take to safeguard you 500 00:29:25,920 --> 00:29:29,760 Speaker 2: from that. But by and large, patients who use ketamine 501 00:29:29,800 --> 00:29:35,160 Speaker 2: and a therapeutic setting under physician guidance very rarely develop 502 00:29:35,280 --> 00:29:36,800 Speaker 2: a ketemine use disorder. 503 00:29:37,120 --> 00:29:40,360 Speaker 1: Got it, Got it, so, doctor Doyle. And this may 504 00:29:40,360 --> 00:29:42,400 Speaker 1: be my ignorance because I feel like I hear people 505 00:29:42,440 --> 00:29:44,960 Speaker 1: talk about mushrooms, but I'm not quite sure like how 506 00:29:45,000 --> 00:29:47,240 Speaker 1: that fits into all of this. I feel like maybe 507 00:29:47,240 --> 00:29:51,400 Speaker 1: people are using mushrooms as like a clearly not physician 508 00:29:51,520 --> 00:29:55,400 Speaker 1: assisted psychedelic kind of treatment. Where do mushrooms fit as 509 00:29:55,400 --> 00:29:56,520 Speaker 1: a part of this conversation. 510 00:29:57,240 --> 00:30:01,800 Speaker 2: So, mushrooms are psilocybin, that's the botaqu as psychedelic plants. 511 00:30:01,840 --> 00:30:04,920 Speaker 2: It's a mushroom and it works in the brain on 512 00:30:05,000 --> 00:30:09,680 Speaker 2: the serotonin pathways, and so it can cause patients to 513 00:30:09,760 --> 00:30:16,480 Speaker 2: sometimes hallucinate, dissociate a little bit. It can cause increase sociability, 514 00:30:16,920 --> 00:30:22,040 Speaker 2: and patients can have kind of existential experiences. Some people 515 00:30:22,080 --> 00:30:27,120 Speaker 2: will have ancestral experiences, some people will have profound experiences 516 00:30:27,200 --> 00:30:29,640 Speaker 2: where they gain insight about how they want to live 517 00:30:29,680 --> 00:30:33,600 Speaker 2: their lives. And it's interesting because a lot of those 518 00:30:33,640 --> 00:30:37,840 Speaker 2: medicines do work on the serotonin pathway. A lot of antidepressants, 519 00:30:37,880 --> 00:30:40,920 Speaker 2: a lot of pain medicines work on the serotonin pathway 520 00:30:40,960 --> 00:30:44,000 Speaker 2: in the body, and so does psilocybin, and so do 521 00:30:44,120 --> 00:30:48,800 Speaker 2: chemicals like LSD. So now we're trying to untangle why 522 00:30:48,880 --> 00:30:51,200 Speaker 2: a lot of these things work for mental health and 523 00:30:51,240 --> 00:30:54,040 Speaker 2: why they work for chronic pain. So there are a 524 00:30:54,040 --> 00:30:59,520 Speaker 2: lot of states now like Oregon, that are legalizing psilocybin 525 00:30:59,680 --> 00:31:02,720 Speaker 2: for public use, so patients are able to grow this 526 00:31:02,880 --> 00:31:06,040 Speaker 2: or on their own. And I think that is a 527 00:31:06,080 --> 00:31:09,240 Speaker 2: new area that is going to have a lot of growth, 528 00:31:09,360 --> 00:31:12,840 Speaker 2: just like the cannabis industry and cannabis care industry had 529 00:31:12,880 --> 00:31:14,520 Speaker 2: a lot of growth. I think this is a new 530 00:31:14,600 --> 00:31:17,640 Speaker 2: area for growth. And I just say, you know, have 531 00:31:17,880 --> 00:31:22,520 Speaker 2: healthy skepticism and have safety protocols in place with substances, 532 00:31:22,600 --> 00:31:25,040 Speaker 2: and be careful about what you put in your body 533 00:31:25,400 --> 00:31:28,120 Speaker 2: because again, you may not know dose, you may not 534 00:31:28,320 --> 00:31:32,640 Speaker 2: know potency of what you're taking. And always be mindful 535 00:31:32,720 --> 00:31:35,840 Speaker 2: of what the laws are where you live. There's still 536 00:31:35,840 --> 00:31:38,840 Speaker 2: certain places where you can't consume cannabis and in the 537 00:31:38,960 --> 00:31:41,640 Speaker 2: US now, the majority of places there may be some 538 00:31:41,760 --> 00:31:46,120 Speaker 2: legal repercussions for psilocybin use, but hopefully some of those 539 00:31:46,200 --> 00:31:48,640 Speaker 2: laws we think going through Congress right now, there are 540 00:31:48,640 --> 00:31:50,800 Speaker 2: a lot of acts that are passing to provide more 541 00:31:50,840 --> 00:31:51,640 Speaker 2: access to that. 542 00:31:52,080 --> 00:31:54,800 Speaker 1: So what are some safety measures that patients who are 543 00:31:54,840 --> 00:31:58,360 Speaker 1: interested in perhaps having kadamine sessions? What kinds of things 544 00:31:58,360 --> 00:32:00,640 Speaker 1: should they be looking for in safety midas to put 545 00:32:00,640 --> 00:32:03,280 Speaker 1: in police to make sure they're getting good, adequate care. 546 00:32:04,160 --> 00:32:06,880 Speaker 2: So you want to go to a provider that has 547 00:32:06,920 --> 00:32:11,640 Speaker 2: a lot of experience with ketamine care. So at Culture Therapeutics, 548 00:32:11,640 --> 00:32:14,440 Speaker 2: myself and my co founder, we have over two decades 549 00:32:14,440 --> 00:32:19,520 Speaker 2: of experience with ketamine care for pediatrics, adolescents, and adults. 550 00:32:19,640 --> 00:32:21,320 Speaker 2: We've taken care of a lot of patients who have 551 00:32:21,360 --> 00:32:24,920 Speaker 2: medical conditions and ketamine. You want to make sure that 552 00:32:25,040 --> 00:32:29,920 Speaker 2: you know your full health history, allergy history, and once 553 00:32:29,960 --> 00:32:33,000 Speaker 2: you found an expert provider, you want to make sure 554 00:32:33,040 --> 00:32:35,600 Speaker 2: that you have the time and the space to try 555 00:32:35,640 --> 00:32:38,240 Speaker 2: the therapy, so that you have time set aside for 556 00:32:38,320 --> 00:32:41,400 Speaker 2: an infusion and you have time afterwards to do the 557 00:32:41,440 --> 00:32:43,240 Speaker 2: afterwork after the infusion. 558 00:32:43,760 --> 00:32:46,360 Speaker 1: And I would imagine that it sounds like especially you 559 00:32:46,400 --> 00:32:49,040 Speaker 1: know the way that you practice. It's a very team 560 00:32:49,400 --> 00:32:52,360 Speaker 1: oriented thing, and so you're also maybe talking with their 561 00:32:52,400 --> 00:32:56,320 Speaker 1: primary care doctor or other physicians or other medical professionals 562 00:32:56,360 --> 00:32:58,040 Speaker 1: they've worked with. Can you talk a little bit about 563 00:32:58,080 --> 00:32:58,600 Speaker 1: that approach. 564 00:32:58,960 --> 00:33:02,840 Speaker 2: Absolutely, the patient has certain medical conditions, like if they 565 00:33:02,880 --> 00:33:07,360 Speaker 2: have bladder issues or a liver disease history, kidney disease history, 566 00:33:07,480 --> 00:33:10,760 Speaker 2: heart disease history, I would definitely want to see their 567 00:33:10,800 --> 00:33:15,040 Speaker 2: medical records or talking with their primary care provider. If 568 00:33:15,080 --> 00:33:18,520 Speaker 2: they have a psychologist or a psychiatrist that has reservations 569 00:33:18,560 --> 00:33:21,240 Speaker 2: about them using ketamine therapy, I would want to know 570 00:33:21,400 --> 00:33:25,560 Speaker 2: what those reservations might be. If they have prior history 571 00:33:25,600 --> 00:33:28,440 Speaker 2: of treatments that they've tried, I would want to know, Okay, 572 00:33:28,440 --> 00:33:31,840 Speaker 2: what exactly did you try, what worked, and why didn't 573 00:33:31,840 --> 00:33:36,520 Speaker 2: it work? And it really is a multidisciplinary group approach. 574 00:33:36,920 --> 00:33:40,440 Speaker 2: So within psychedelic care and within ketamine care, there are 575 00:33:40,480 --> 00:33:42,840 Speaker 2: people who can serve as guides that can sit with 576 00:33:42,920 --> 00:33:46,320 Speaker 2: the patient during the therapies and do follow up work with 577 00:33:46,360 --> 00:33:51,120 Speaker 2: them on the intentions that they've set. They're psychotherapists, psychologists, 578 00:33:51,120 --> 00:33:54,640 Speaker 2: psychiatrists who are also very interested in the area. They're 579 00:33:54,640 --> 00:33:59,960 Speaker 2: antithesiologists who have experience providing high doses of very potent 580 00:34:00,120 --> 00:34:02,560 Speaker 2: medications and how to provide that to a patient in 581 00:34:02,600 --> 00:34:04,800 Speaker 2: a way that makes sure they're vital signs and their 582 00:34:04,840 --> 00:34:08,239 Speaker 2: overall safety needs are met. So I think it's an 583 00:34:08,280 --> 00:34:11,520 Speaker 2: exciting time and I think it's creating this really wonderful 584 00:34:11,760 --> 00:34:14,680 Speaker 2: mosaic of care for patients that it's going to provide 585 00:34:14,719 --> 00:34:17,520 Speaker 2: a really beneficial therapeutic response. 586 00:34:17,840 --> 00:34:19,520 Speaker 1: So, doctor, do I want to go back to something 587 00:34:19,600 --> 00:34:21,799 Speaker 1: that you mentioned earlier because it just occurred to me. 588 00:34:21,880 --> 00:34:25,120 Speaker 1: So you said that you are sometimes seeing good results 589 00:34:25,160 --> 00:34:29,600 Speaker 1: for mood improvement for clients who struggle with anxiety and depression. 590 00:34:30,200 --> 00:34:34,160 Speaker 1: And is it that the ketamine works on different receptors 591 00:34:34,160 --> 00:34:37,400 Speaker 1: because typically when we hear about medication for anxiety and 592 00:34:37,400 --> 00:34:40,040 Speaker 1: medication they tend to be like SSRIs or some other 593 00:34:40,520 --> 00:34:43,080 Speaker 1: And so are you seeing that it's effective because it's 594 00:34:43,120 --> 00:34:46,120 Speaker 1: working on this did you say B and DF Is 595 00:34:46,120 --> 00:34:48,240 Speaker 1: that the mechanism for why they are effective. 596 00:34:48,520 --> 00:34:50,960 Speaker 2: There are a few reasons we think it might be effective. 597 00:34:51,160 --> 00:34:54,680 Speaker 2: It works on a receptor called the NMDA receptor, there's 598 00:34:54,719 --> 00:34:58,319 Speaker 2: a receptor called the AMPA receptor, and all of those 599 00:34:58,360 --> 00:35:02,360 Speaker 2: things are causing neural plas plasticity, so they're causing a 600 00:35:02,440 --> 00:35:05,560 Speaker 2: malleability almost like if you had clay or plato. So 601 00:35:05,600 --> 00:35:08,560 Speaker 2: we're kind of reforming some of those connections in the 602 00:35:08,640 --> 00:35:11,120 Speaker 2: brain that have gone a little haywire when you have 603 00:35:11,239 --> 00:35:14,160 Speaker 2: chronic pain or depression, and so it's really able to 604 00:35:14,239 --> 00:35:17,719 Speaker 2: reset things. And ketymine is interesting because it works for 605 00:35:17,800 --> 00:35:22,520 Speaker 2: both pain and depression, but it's not that unique because 606 00:35:22,600 --> 00:35:25,000 Speaker 2: a lot of medicines work for pain and depression that 607 00:35:25,080 --> 00:35:30,359 Speaker 2: we currently use, like tricyclic antidepressants, medicines like deloxetine, which 608 00:35:30,400 --> 00:35:34,319 Speaker 2: is symbalta, those use the serotonin pathway and they're very 609 00:35:34,320 --> 00:35:36,120 Speaker 2: commonly used to treat nerve pain. 610 00:35:36,600 --> 00:35:39,400 Speaker 1: Got it, Okay? And I'm also curious, So I know 611 00:35:39,440 --> 00:35:42,840 Speaker 1: a lot of times when psychiatrists and other medical professionals 612 00:35:43,239 --> 00:35:46,000 Speaker 1: are prescribing things for anxiety and depression, they will ask 613 00:35:46,040 --> 00:35:49,279 Speaker 1: about a family history of like other medications that have worked. Right, 614 00:35:49,600 --> 00:35:51,480 Speaker 1: So would it be the case like if I had 615 00:35:51,520 --> 00:35:55,120 Speaker 1: a mom who has had depression in ketamine was found 616 00:35:55,200 --> 00:35:58,120 Speaker 1: to be the most effective thing, would that then make 617 00:35:58,160 --> 00:36:00,520 Speaker 1: me a better candidate? Like if I were strungruggling with 618 00:36:00,600 --> 00:36:03,799 Speaker 1: depression to also maybe start at ketemine because my mom 619 00:36:03,840 --> 00:36:05,560 Speaker 1: has had good experiences with it or not. 620 00:36:06,120 --> 00:36:08,520 Speaker 2: I think it's a really good question. I don't know 621 00:36:08,560 --> 00:36:11,560 Speaker 2: that we've studied it exactly to say that, yes, that 622 00:36:11,600 --> 00:36:14,920 Speaker 2: would happen. But I believe a good family history and 623 00:36:14,960 --> 00:36:18,040 Speaker 2: a good personal history is always really important. So if 624 00:36:18,040 --> 00:36:21,160 Speaker 2: a patient came to me and shared that with me, 625 00:36:21,560 --> 00:36:24,120 Speaker 2: I would certainly think they had every other reason to 626 00:36:24,160 --> 00:36:26,280 Speaker 2: have ketamine. I would say, well, this is a good 627 00:36:26,400 --> 00:36:30,880 Speaker 2: prognostic indicators. That makes me think you might respond because 628 00:36:31,000 --> 00:36:34,560 Speaker 2: perhaps we have similar genetic pathways causing the depression. So 629 00:36:34,960 --> 00:36:37,200 Speaker 2: I think it would be something that would increase your 630 00:36:37,280 --> 00:36:38,800 Speaker 2: risk of getting a good response. 631 00:36:39,239 --> 00:36:42,520 Speaker 1: Got it. So you mentioned that there are currently legislation 632 00:36:42,680 --> 00:36:45,040 Speaker 1: looking at, you know, expanding some of the laws. Can 633 00:36:45,080 --> 00:36:47,320 Speaker 1: you talk about like some of the roadblocks that people 634 00:36:47,400 --> 00:36:49,879 Speaker 1: like you and other black people in this space are 635 00:36:49,920 --> 00:36:52,399 Speaker 1: facing in terms of getting legislation passed through. 636 00:36:53,239 --> 00:36:56,160 Speaker 2: I think a lot of times with people of color, 637 00:36:56,239 --> 00:36:59,000 Speaker 2: black people who are getting into the industry, a lot 638 00:36:59,000 --> 00:37:00,760 Speaker 2: of times we get there a little a little bit later, 639 00:37:00,960 --> 00:37:03,440 Speaker 2: or we don't have as many resources. I think there 640 00:37:03,440 --> 00:37:06,759 Speaker 2: are a lot of parallels with the cannabis industry where 641 00:37:06,760 --> 00:37:08,839 Speaker 2: in a lot of areas, a lot of the companies 642 00:37:09,080 --> 00:37:13,319 Speaker 2: or wide owned companies or venture capitalists owned companies or 643 00:37:13,360 --> 00:37:18,799 Speaker 2: companies that have received outside grants resources, the majority of 644 00:37:18,840 --> 00:37:22,640 Speaker 2: those funds tend not to flow within our community, so 645 00:37:22,680 --> 00:37:25,759 Speaker 2: that can definitely be a barrier. However, I think with 646 00:37:26,000 --> 00:37:30,279 Speaker 2: ketymine care and psychedelic care, I'm actually been surprised by 647 00:37:30,320 --> 00:37:34,279 Speaker 2: how accepting a lot of legislators have been. So a 648 00:37:34,320 --> 00:37:37,120 Speaker 2: lot of people who work in legislation or work in 649 00:37:37,200 --> 00:37:40,719 Speaker 2: DC have been pretty accepting of this, and I don't 650 00:37:40,760 --> 00:37:44,040 Speaker 2: know if that's because they've had the benefit of ketymine care. 651 00:37:44,520 --> 00:37:46,759 Speaker 2: When I worked in DC and worked at a really 652 00:37:46,840 --> 00:37:49,000 Speaker 2: large hospital and we took care of a lot of 653 00:37:49,160 --> 00:37:53,680 Speaker 2: people who had very high powerful positions in governments and 654 00:37:54,239 --> 00:37:58,640 Speaker 2: a very robust ketymine care program, and it was people 655 00:37:58,719 --> 00:38:02,320 Speaker 2: like doctor Karen William, doctor Paul Dangerfield. They were really 656 00:38:02,400 --> 00:38:06,480 Speaker 2: pioneers and getting patients ketamine care for the last twenty 657 00:38:06,480 --> 00:38:09,640 Speaker 2: to thirty years, and also doctors like may Chin and 658 00:38:09,719 --> 00:38:13,120 Speaker 2: so I think over time, as they themselves have had 659 00:38:13,200 --> 00:38:17,480 Speaker 2: access to the most cutting edge therapies, that has likely 660 00:38:17,600 --> 00:38:21,239 Speaker 2: trickled down to their feelings about some of the legislation, 661 00:38:21,520 --> 00:38:25,359 Speaker 2: because everybody is affected by this. It doesn't matter how 662 00:38:25,400 --> 00:38:28,200 Speaker 2: powerful you are, if you're in the White House, if 663 00:38:28,239 --> 00:38:31,920 Speaker 2: you in Congress. Everybody is affected by pain, everybody is 664 00:38:31,920 --> 00:38:36,760 Speaker 2: affected by mental health issues. You're equally susceptible to those things. 665 00:38:37,000 --> 00:38:40,160 Speaker 2: The difference usually is what access to care that you have. 666 00:38:40,800 --> 00:38:43,040 Speaker 1: Anything we didn't get to, doctor Doyle, that you feel 667 00:38:43,040 --> 00:38:45,640 Speaker 1: like you want to make sure people know, so I just. 668 00:38:45,640 --> 00:38:48,080 Speaker 2: Want them to note it's okay to advocate for yourself 669 00:38:48,080 --> 00:38:50,200 Speaker 2: in terms of pain management. There are a lot of 670 00:38:50,239 --> 00:38:54,080 Speaker 2: disparities in pain management and mental health care, and I 671 00:38:54,120 --> 00:38:57,680 Speaker 2: want people to feel comfortable embracing some of the alternative 672 00:38:57,719 --> 00:39:01,040 Speaker 2: therapies that are available. I don't want people to lose hope. 673 00:39:01,080 --> 00:39:03,319 Speaker 2: So if you've tried everything and there's still things that 674 00:39:03,360 --> 00:39:06,960 Speaker 2: you haven't tried, just know that there's an opportunity there 675 00:39:07,040 --> 00:39:09,440 Speaker 2: and if we can get you to the right provider 676 00:39:09,480 --> 00:39:12,600 Speaker 2: in the right space, you can have a really good result. 677 00:39:12,800 --> 00:39:15,239 Speaker 1: Well, this has all been so incredible, doctor Doyle, I 678 00:39:15,280 --> 00:39:18,400 Speaker 1: really appreciate you sharing this information with us. Tell us 679 00:39:18,440 --> 00:39:20,719 Speaker 1: where people can stay connected with you. What is your 680 00:39:20,719 --> 00:39:23,120 Speaker 1: website as well as any social media handles you'd like 681 00:39:23,160 --> 00:39:23,560 Speaker 1: to share. 682 00:39:23,960 --> 00:39:28,120 Speaker 2: Sure, so again, thank you, doctor Joy. I'm doctor Doyle 683 00:39:28,360 --> 00:39:32,600 Speaker 2: and you can find me at www dot Culturtheapeutics dot 684 00:39:32,640 --> 00:39:38,640 Speaker 2: com and as Culture Therapeutics on Twitter, TikTok, LinkedIn, YouTube, 685 00:39:38,680 --> 00:39:40,520 Speaker 2: and Facebook and Instagram. 686 00:39:40,560 --> 00:39:42,719 Speaker 1: Perfect, well, we should include that in the show notes. 687 00:39:42,760 --> 00:39:44,600 Speaker 1: Thank you so much for spending some time with us. 688 00:39:44,840 --> 00:39:46,920 Speaker 2: Absolutely, thank you for all your great questions. 689 00:39:49,719 --> 00:39:51,920 Speaker 1: I'm so glad doctor Doyle was able to share her 690 00:39:51,920 --> 00:39:54,880 Speaker 1: expertise with us today. So learn more about her and 691 00:39:54,920 --> 00:39:57,960 Speaker 1: her work. Visit the show notes at Therapy from Blackgirls 692 00:39:57,960 --> 00:40:01,160 Speaker 1: dot com slash Session three twenty and don't forget to 693 00:40:01,160 --> 00:40:03,319 Speaker 1: text two of your girls right now and tell them 694 00:40:03,360 --> 00:40:06,080 Speaker 1: to check out the episode. If you're looking for a 695 00:40:06,120 --> 00:40:09,680 Speaker 1: therapist in your area, visit our therapist directory at Therapy 696 00:40:09,719 --> 00:40:13,000 Speaker 1: for Blackgirls dot com slash directory. And if you want 697 00:40:13,000 --> 00:40:15,279 Speaker 1: to continue digging into this topic or just be in 698 00:40:15,280 --> 00:40:18,200 Speaker 1: community with other sisters, come on over and join us 699 00:40:18,200 --> 00:40:20,759 Speaker 1: in the Sister Circle. It's our cozy corner of the 700 00:40:20,760 --> 00:40:23,880 Speaker 1: Internet designed just for black women. You can join us 701 00:40:23,920 --> 00:40:28,160 Speaker 1: at community dot Therapy for Blackgirls dot com. This episode 702 00:40:28,239 --> 00:40:31,800 Speaker 1: was produced by Frieda. Lucas, Elise Ellis, and Zarius Taylor. 703 00:40:32,480 --> 00:40:35,960 Speaker 1: Editing was done by Dinnison Bradford. Thank y'all so much 704 00:40:36,000 --> 00:40:38,440 Speaker 1: for joining me again this week. I look forward to 705 00:40:38,520 --> 00:40:42,359 Speaker 1: continuing this conversation with you all real soon. Take good care. 706 00:40:47,640 --> 00:40:50,200 Speaker 1: Which friend are you and your sister circle? Are you 707 00:40:50,280 --> 00:40:54,480 Speaker 1: the wallflower, the peacemaker, the firecracker or the leader? Take 708 00:40:54,480 --> 00:40:58,160 Speaker 1: the quiz at Sisterhoodheels dot com slash quiz to find out, 709 00:40:58,280 --> 00:41:00,680 Speaker 1: and then make sure to grab your copy Sister Hood 710 00:41:00,719 --> 00:41:02,920 Speaker 1: Heels to find out more about how you can be 711 00:41:02,960 --> 00:41:05,319 Speaker 1: a better friend and how your circle can do a 712 00:41:05,320 --> 00:41:08,880 Speaker 1: better job of supporting you. Order yours today at sisterhood 713 00:41:08,920 --> 00:41:12,360 Speaker 1: Heels dot com.