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Speaker 1: Before we get started. A brief correction from last week

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Speaker 1: when I was talking about the photic sneeze response, I

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Speaker 1: said that there was cross talk between the optic nerve

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Speaker 1: and the ophthalmic nerve. Oh my gosh, you guys, of

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Speaker 1: course it was the optic nerve and the trigeminal nerve.

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Speaker 1: So sorry about that. I'm sure you were all asking,

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Speaker 1: you know who got fired after that episode. But let

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Speaker 1: me come on again.

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Speaker 2: So, Perry, we went to college together, and when we

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Speaker 2: were in college, how frequently did you do psychedelics?

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Speaker 1: I am embarrassed to admit that I have never done

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Speaker 1: a psychedelic. I no mushrooms, no mushrooms, no LSD, no DMT,

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Speaker 1: no ketamine. I know. I was like, no even any

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Speaker 1: not even not even it. I was pure PCP all

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Speaker 1: the time. That's it for me. Angel dust was the

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Speaker 1: drug of choice.

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Speaker 3: Bath seats and nothing, nothing pans.

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Speaker 1: Why my only way of getting in and out of

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Speaker 1: the dorm was by crashing through the window, you remember,

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Speaker 1: I think?

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Speaker 2: And even more embarrassing, so I also perhaps we are

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Speaker 2: not the best people to do an episode in psychedelics.

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Speaker 3: I've also never done any psychedelics.

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Speaker 2: And for me, I think it's even more embarrassing because

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Speaker 2: I once in high school I went to a three

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Speaker 2: day fish content.

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Speaker 3: Oh my god, like and I still have never right.

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Speaker 1: Probably did it. Probably got enough LSD on you that

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Speaker 1: you tripped a little bit, just like by proxy.

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Speaker 2: Yeah, so we can use that and that can be

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Speaker 2: That's our our main experience is proximity to LSD.

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Speaker 3: Use that's as good as it's going to get.

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Speaker 1: I think we're the perfect people for this to give

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Speaker 1: a real unbiased take on what the data says about psychedelics.

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Speaker 1: Let's do it.

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Speaker 2: I'm Emily Astro, I'm an economist and a data expert.

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Speaker 1: And I'm Perry Wilson, I'm a medical doctor.

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Speaker 3: It's Thursday, May fourteenth, twenty twenty six. And this is wellness.

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Speaker 1: Actually, because you're getting a staggering amount of health and

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Speaker 1: wellness information nowadays from every source imaginable, and some of

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Speaker 1: it is awesome and.

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Speaker 3: Some of it is well actually both.

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Speaker 2: Fortunately we are both people who know how to read studies,

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Speaker 2: how to parse the data, and can tell you what's

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Speaker 2: worth thinking about and what you can safely ignore.

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Speaker 1: But before we dig in, a note that this podcast

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Speaker 1: is for educational purposes and should not be construed as

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Speaker 1: medical advice. We don't know your unique situation, so talk

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Speaker 1: to your doctor for personal health decisions.

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Speaker 2: This week we're asking what's the deal with psychedelics? Perry

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Speaker 2: and I will give the official smasher pass and we'll

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Speaker 2: get to your question of the week. But first, let's

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Speaker 2: do the health news roundup after the break. And now

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Speaker 2: for the health news of the week. We covered this

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Speaker 2: last week, but I think we got to go back

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Speaker 2: to haunt of virus. Perry, give us what is happening

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Speaker 2: with the haunt of virus?

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Speaker 3: Now?

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Speaker 1: Yeah, it's a developing situation. So just FYI you're listening

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Speaker 1: to this. The earliest you're listening to this is May fourteenth,

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Speaker 1: but we're recording this on Tuesday, May twelfth. So at

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Speaker 1: this point, the cruise ship is largely evacuated. People have

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Speaker 1: returned home and including about twenty or so to the

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Speaker 1: United States. The current status is that there are seven

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Speaker 1: or eight people on the cruise ship who have tested

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Speaker 1: positive for hauntavirus, with another couple developing symptoms that don't

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Speaker 1: have test results back yet. I think the thing I

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Speaker 1: want to think about now is looking at this particular

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Speaker 1: virus and these virus and the risk for human transmissibility.

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Speaker 1: All of these people are being quarantined for six weeks

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Speaker 1: because there's quite a long latent period of this particular infection,

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Speaker 1: so you might not develop symptoms for that period of time.

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Speaker 1: There's a new England Leernal of Medicine study from twenty

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Speaker 1: eighteen that catalogs a human outbreak of Andy's virus in Argentina,

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Speaker 1: and what had happened was someone got infected, they got

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Speaker 1: their wife infected, the original infected person died at the funeral,

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Speaker 1: like ten people got infected that and then they finally

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Speaker 1: realized what was going on, never got put in quarantine,

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Speaker 1: and the outbreak stopped. So this was the primary epidemiologic

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Speaker 1: evidence for person to person spread. And Emily, we've talked

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Speaker 1: about the basic reproduction number before. This is the average

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Speaker 1: number of people that an infected person spreads the virus

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Speaker 1: two and in that in that outbreak they calculated it

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Speaker 1: to be about two. Any number greater than one means,

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Speaker 1: you know, you can do the math like if one

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Speaker 1: person had spread it to more than one person, it

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Speaker 1: can spread. That's without quarantine. And then once things were

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Speaker 1: put in quarantine, obviously it dropped below one. And everything

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Speaker 1: went back to zero. One bit of positive news. This

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Speaker 1: is likely not spread when people are asymptomatic, in contrast

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Speaker 1: to COVID. By the way, COVID's basic reproduction number prior

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Speaker 1: to vaccination is like ten.

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Speaker 3: So just measles it is twelve. So this is it

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Speaker 3: at very different scale.

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Speaker 1: Even very different scale. People are using the term airborne

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Speaker 1: for this. I don't think that's correct. It looks like

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Speaker 1: this is potentially spread by droplets, which are things like

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Speaker 1: from you know, coughing, spit saliva, which yes, it comes

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Speaker 1: out of your body and goes into the air, but

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Speaker 1: it's heavier than air, so it falls to the ground

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Speaker 1: as opposed to like spreading through air vents and stuff

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Speaker 1: like that, like coronavirus would. The risk remains very low,

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Speaker 1: but we're watching, Yeah.

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Speaker 3: People are watching.

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Speaker 2: I mean I think it is worth like a lot

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Speaker 2: of what I have seen on Twitter as people being like,

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Speaker 2: oh my god, should I be afraid for my children?

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Speaker 2: And like like there'res the pandemic. Epidemiological risk of this

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Speaker 2: remains incredibly low, and so you know, it is something

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Speaker 2: that people are going to watch, but it is not

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Speaker 2: something you should be, you know, thinking too much about

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Speaker 2: it in a terrified way in my view.

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Speaker 1: Yeah, that's correct, But we'll give you updates as they

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Speaker 1: come in.

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Speaker 3: We'll gep you updated.

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Speaker 1: All right. Moving on, the shakeup at Health and Human

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Speaker 1: Services continues potentially now it looks like FDA Director Marty

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Speaker 1: McCarry is in the hot seat. There's been multiple reports

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Speaker 1: last week that Trump had potentially signed off on a

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Speaker 1: measure to fire him, and then that didn't happen. But

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Speaker 1: now new reports are saying, oh, no, he still might

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Speaker 1: be Emily, what's going on at FDA and what are

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Speaker 1: we seeing here? Is this more backlash against the Maha agenda.

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Speaker 2: I don't know that it's more backlash against the MAHA jena.

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Speaker 2: I mean, it's always very hard to tell what's happening

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Speaker 2: inside the administration. The latest thing I saw it again,

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Speaker 2: it's Tuesday the twelfth, was that Marty McCarey has said

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Speaker 2: he is not going to leave or he is not.

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Speaker 2: No one's asked him to leave, and so he's not

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Speaker 2: planning to leave. It seems like some of the reportings

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Speaker 2: suggested that part of the problem is he has been

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Speaker 2: unwilling to follow through on some of the requests of

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Speaker 2: the administration, including a request to approve fruit flavored vapes.

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Speaker 3: He didn't want to approve fruit flavored vapes.

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Speaker 2: Because it seemed like they would be appealing to children,

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Speaker 2: which seems right to me. But the administration wanted fruit

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Speaker 2: flavored vapes, and I think they have now been approved,

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Speaker 2: So I'm not sure. I mean, as generally, people who

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Speaker 2: are threatened to leave the administration are not long for

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Speaker 2: this world of the administration. And so my guess is,

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Speaker 2: you know, by the time we meet again next week,

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Speaker 2: he will be out, but fruit flavors vapes will perhaps

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Speaker 2: be in. Uh.

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Speaker 1: Yeah, that seems like just not a great idea. And

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Speaker 1: also like what a weird thing for the White House

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Speaker 1: to lobby paramount, you know, like you.

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Speaker 3: Know, he was into approving mint, but he didn't want

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Speaker 3: to approve mango. And that's it because you need a

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Speaker 3: mag Also, who wants a mango?

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Speaker 2: I'm sorry we could like get is like, why, dore's

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Speaker 2: your vpe need to be mango flavored?

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Speaker 1: Yeah, I'm not sure. Yeah, it doesn't okay.

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Speaker 2: Last thing, I wanted to ask about a new study

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Speaker 2: that said the GLP one drugs reduce the risk of

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Speaker 2: breast cancer recurrence by like an astronomical amount seventy percent,

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Speaker 2: reducing all cause mortality by ninety one percent. I think

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Speaker 2: the phrasing for this would be amazing if true, So Perry,

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Speaker 2: if true.

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Speaker 1: If true, GLP one drugs like ozepic are the greatest

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Speaker 1: breakthrough in breast cancer treatment in history. Like that's that's

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Speaker 1: the magnitude of this kind of change, and so that

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Speaker 1: should write away clue you in that this is probably

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Speaker 1: not true. This is a study that came out in

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Speaker 1: JAMA Network Open. It's not a randomized trial. It was

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Speaker 1: a study that used administrative data to look at eight

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Speaker 1: hundred thousand women with breast cancer stage one to stage

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Speaker 1: three so no metastatic disease, some of whom got GLP

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Speaker 1: ones through their normal course of care, and some who didn't.

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Speaker 1: And the women who got GLP ones INDI had a

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Speaker 1: ninety one percent reduction and all cause mortality and a

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Speaker 1: substantial reduction in breast cancer recurrence. Now, correlation isn't causation.

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Speaker 1: We say that all the time. People who get GLP

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Speaker 1: one drugs are different in lots of ways than people

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Speaker 1: who don't. They tend to be wealthier, more educated, more

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Speaker 1: access to care, all sorts of things. That are going

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Speaker 1: to also associate with better outcomes after breast cancer. The

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Speaker 1: authors say, no, no, we controlled for this. We used

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Speaker 1: a technique called propensity score matching to sort of take

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Speaker 1: people that are on GLP ones. I know you won't

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Speaker 1: like it, take people on GLP ones and match them

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Speaker 1: to kind of very similar people are not on JLP ones.

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Speaker 1: That's all well and good. It's not perfect. But if

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Speaker 1: you look at this paper, I actually I have to say,

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Speaker 1: like I was, like, I don't understand how this got

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Speaker 1: published at all. I'll give you some examples. If you

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Speaker 1: look at Table one, the description of these women, it

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Speaker 1: says after a diagnosis of stage one to three breast cancer,

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Speaker 1: four percent of them got a mastectomy and two percent

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Speaker 1: of them got a lumpectomy. Six percent got surgery after

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Speaker 1: a diagnosis of breast cancer that's treatable with surgery. Like

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Speaker 1: that is not correct, and this is supposed to be

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Speaker 1: a nationally representative sample. Okay, let's say maybe you believe

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Speaker 1: that that's remotely possible. They report like eight percent of

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Speaker 1: them being estrogen receptor positive and twelve percent or something

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Speaker 1: being eschgen receptor negative, leaving eighty percent to be some

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Speaker 1: third type of like undefined eschen receptor status. What all

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Speaker 1: this is is missing data, and not a small amount

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Speaker 1: of missing data, an enormous amount of missing data. Like

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Speaker 1: most of these women, they couldn't figure out what their

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Speaker 1: essen receptor status was. They didn't even know what kind

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Speaker 1: of surgery they had. So when you say, like, oh,

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Speaker 1: we matched them, you can't match on data you don't have.

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Speaker 1: In my kind of line of work, when we use

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Speaker 1: electronic health record data, we typically draw the line at

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Speaker 1: about ten percent missing data before we start like saying, Okay,

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Speaker 1: we're probably getting out of over our skis and making

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Speaker 1: any inference will sort of tolerate some percent is ridiculous.

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Speaker 1: So I'm sorry. I mean, GP ones might be great,

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Speaker 1: but like this, this society tells us nothing.

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Speaker 2: Yeah, I think it's an interesting It's an interesting example

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Speaker 2: because we often talk about like one of the things

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Speaker 2: you're looking for in a paper to know if it's

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Speaker 2: a good paper or to evaluate is the size of

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Speaker 2: the sample.

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Speaker 3: And this is a case in which the sample size

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Speaker 3: is very very.

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Speaker 2: Large, but the data is quite weak because it isn't

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Speaker 2: electronic medical records, it's billing code data. So you don't

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Speaker 2: actually know that like surprisingly don't know that much about

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Speaker 2: people's about people's health. So it is a good example

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Speaker 2: where I do think reasonably people could ask how could

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Speaker 2: this study get published?

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Speaker 3: And the answer is, actually, this is not a very

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Speaker 3: good journal, honestly.

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Speaker 1: I mean I have published in that journal, but I've

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Speaker 1: published in lots of journals.

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Speaker 2: It's well, I think people get I will just say

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Speaker 2: people get confused because there is a very good journal

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Speaker 2: called JAMA, the Journal of the American Medical Association I published,

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Speaker 2: and there are some very good Yeah, okay, great, now

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Speaker 2: this is gonna be a list of let's read Perry

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Speaker 2: CV and then but and then there is there are

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Speaker 2: some sub journals in JAMMA that are not as strong,

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Speaker 2: of which JAMMA Network Open is one, And this paper

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Speaker 2: is not very good. So GLP ones do not reduce

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Speaker 2: the risk of breast cancer also cause mortality by ninety

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Speaker 2: one percent.

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Speaker 1: Sorry, that's it for the health news of the week.

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Speaker 1: After the break, what's the deal with psychedelics?

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Speaker 3: I've actually also published in JAMA.

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Speaker 1: Oh well, you're not gonna you're not jumping in on

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Speaker 1: that one.

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Speaker 3: Come on, not gonna mention it.

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Speaker 1: And we're back. What's the deal with psychedelics? Emily. Psychedelic

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Speaker 1: medicine is an incredibly new field, boosted on the bats

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Speaker 1: of some really interesting data that we're going to talk about,

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Speaker 1: and then a whole lot of influencers and marketing and

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Speaker 1: amazing anecdotal stories.

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Speaker 2: So I let me just say before we get into this,

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Speaker 2: I think that this has really now stepped into more

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Speaker 2: of the like the mainstream, you know, the Daily The

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Speaker 2: New York Times podcast, which is a very serious podcast

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Speaker 2: frequently about you know, China and stuff, had a whole

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Speaker 2: episode with a reporter who had sort of gone down

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Speaker 2: to Mexico to do us to have a psychedelic experience

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Speaker 2: and to talked about like this being transformative for his

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Speaker 2: relationship with some childhood trauma. So I think this has

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Speaker 2: gotten between that and Michael Poland's book, and so I

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Speaker 2: think this has gotten into the zeitgeist even beyond like

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Speaker 2: influencers on the Internet, who for sure are also talking

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Speaker 2: about it.

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Speaker 3: So good topic.

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Speaker 1: Yeah, absolutely, And the way I want to kind of

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Speaker 1: approach this is first, like let's do some science. Let's

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Speaker 1: talk about how psychedelics work, right, and then we'll kind

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Speaker 1: of go and like if they work for various conditions,

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Speaker 1: we'll hit on a few mental health conditions like PTSD

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Speaker 1: and depression and addiction, which I think a lot of

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Speaker 1: the data is really interesting. But then I think it's

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Speaker 1: worth talking about, like what about people who or otherwise healthy,

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Speaker 1: Like are there potential benefits to you know, supplementing supplementing

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Speaker 1: with psychedelics from time to time.

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Speaker 2: It's not like vitamin D though, don't there's not an

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Speaker 2: unsupervised experience.

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Speaker 1: I want to think about psychedelics starting with neurobiology, and

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Speaker 1: there are three functions that the brain does that psychedelics

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Speaker 1: mess with, and I think if you understand those functions,

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Speaker 1: you get why the psychedelic experience is the psychedelic experience.

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Speaker 1: The first one is called reality testing. So have you

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Speaker 1: ever noticed, Emily that in real life, when like your

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Speaker 1: door burst open and a goblin carrying machetes jumps through,

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Speaker 1: you're like, that's probably not real. But if that happens

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Speaker 1: in a dream, you're like, yeah, that's of course, Like

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Speaker 1: these things happen right right. Your brain is reality testing

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Speaker 1: all the time. When you're conscious and awake. It is

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Speaker 1: getting stimuli from all over the place, not just the

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Speaker 1: you know, it's not just the things you see and

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Speaker 1: feel and smell, tons of stimuli, but also just like

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Speaker 1: random electrical firings in your brain that are happening all

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Speaker 1: the time, and there's a whole system designed to like

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Speaker 1: make sure that the inputs correspond with your knowledge of

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Speaker 1: the world right, like things don't fly up into the

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Speaker 1: air unexpectedly like all of those things. That's what reality

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Speaker 1: testing does. It gets shut down during dreaming, which is

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Speaker 1: why your dreams can be so believable even though bizarre

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Speaker 1: things are happening. It is also shut down by psychedelics,

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Speaker 1: and so all of a sudden, all those inputs that

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Speaker 1: normally your band would filter out. Is like, that's not

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Speaker 1: consistent with reality. It's like, yeah, sure that makes sense.

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Speaker 1: Sure that tree can be melting, Like why not? So

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Speaker 1: that's number one. Yeah.

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Speaker 2: So this is sort of like if I'm in my

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Speaker 2: conscious mind and I out of the corner of my eye,

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Speaker 2: I see something that looks like, you know, buffalo running

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Speaker 2: down the street. My brain is sort of like, well,

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Speaker 2: that's obviously, like is coding, that's obviously.

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Speaker 3: Not a buffalo.

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Speaker 2: And I either look again or I just am like, na,

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Speaker 2: obviously we must have been a dog.

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Speaker 1: It might not even raise to conscious awareness, like you

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Speaker 1: might not even know that you saw a buffalo out

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Speaker 1: of the corner of your eye.

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Speaker 3: Yeah, okay.

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Speaker 1: The second thing, and something I think is really interesting,

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Speaker 1: is technically known as salience, which is that your brain

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Speaker 1: assigns a level of meaning to every experience you have,

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Speaker 1: like is this important. So evolutionarily salience is like you

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Speaker 1: ate some berry and then you get like horribly sick,

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Speaker 1: and your brain will attach a little tag to that

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Speaker 1: memory like this is an important memory, right, Like this

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Speaker 1: is meaningful, and those memories get processed differently, they get

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Speaker 1: stored differently, so it's like, Okay, in the future, you're

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Speaker 1: not gonna eat that berry again. Whereas like walking from

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Speaker 1: your car to your office every day, your brain process

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Speaker 1: is that and it's like this is not important, Like

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Speaker 1: we don't need to remember this, This is nothing important

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Speaker 1: is happening right now, and this is really important because

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Speaker 1: otherwise your brain gets full and you're like that guy

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Speaker 1: in the Far Side cartoon. Psychedelics ramp up the salience

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Speaker 1: metric of everything that is happening, which is why if

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Speaker 1: you're sitting quietly on your couch and nothing in particular

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Speaker 1: is happening, but your brain is saying, like this is

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Speaker 1: really important. Right, you have to like have some explanation

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Speaker 1: for that cognitive dissonance. And one of the ways people

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Speaker 1: explain that is they're like, I'm in the presence of

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Speaker 1: something bigger than me, right, Like God is here, or

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Speaker 1: like an entity is here, because this very banal thing

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Speaker 1: sitting on your couch all of a sudden feels really

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Speaker 1: really important and meaningful. This lack of reality testing and

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Speaker 1: increase in salience is also seen in paranoid schizophrenia, which

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Speaker 1: is why paranoid people have hallucinations. And also, you know,

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Speaker 1: if you're just sitting there, like watching TV and it's

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Speaker 1: just a newscast, but your brain is saying this is

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Speaker 1: incredibly important, you can see how you might jump to

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Speaker 1: the conclusion like, oh, they're talking to me, right, this

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Speaker 1: is about me.

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Speaker 3: Right.

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Speaker 1: So, in fact, the psychedelics when they were originally discovered

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Speaker 1: were called psychoto memetics, like things that give you psychosis.

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Speaker 1: But fortunately with the psychedelics it is temporary, and with

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Speaker 1: schizophrenia obviously it's permanent. So I think this is a

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Speaker 1: good way to start thinking about, like what's actually happening here?

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Speaker 3: That is very cool. So these the compounds. One of

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Speaker 3: the things that's interesting about psychedelics.

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Speaker 2: Is that these compounds have been around and used for

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Speaker 2: I think probably all of human you know, almost all

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Speaker 2: of human history. So you know, we associate in the

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Speaker 2: kind of modern era, we associate this the LSD with

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Speaker 2: I believe it was discovered by Albert Hoffman, but we associate.

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Speaker 1: It with tim Timothy Leary.

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Speaker 3: Timothy Leary, thank you, associated with Timothy Leary.

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Speaker 2: But many of the compounds that are sort of used

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Speaker 2: in some of these psychedelics are from plants or mushrooms

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Speaker 2: or whatever and have been in use, presumably again for millennia.

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Speaker 3: Do we have a sense.

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Speaker 2: Of what people use these for before like using it

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Speaker 2: for PTSD, I assume just for hallucinating because it's fun.

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Speaker 1: I mean, in a lot of indigenous cultures, they're used

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Speaker 1: for spiritual purposes. I think ayahuasca is you know, maybe

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Speaker 1: the one that people will be most familiar with where

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Speaker 1: the idea is commune with something greater than yourself, you know,

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Speaker 1: not just to like have a crazy trip, and you know,

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Speaker 1: there's a whole social fabric around it, and which is

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Speaker 1: which is really interesting and I think even potentially part

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Speaker 1: of the therapeutic benefit that can occur with some of

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Speaker 1: these is like what surrounds the experience. In fact, a

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Speaker 1: lot of the studies and we'll talk about like really

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Speaker 1: need to couple the drug with something, whether it's like

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Speaker 1: psychotherapy or something like that to kind of allow the

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Speaker 1: effects to take route. There's a lot of psychedelics out there.

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Speaker 1: You've alluded to a few, so I think we should

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Speaker 1: just sort of like maybe say a couple of them.

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Speaker 1: I mean we could listen. I don't know, you want

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Speaker 1: to do you want to give us a rundown of

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Speaker 1: like what you see people talking about, Emily in terms

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Speaker 1: of what psychedelics we mean?

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Speaker 2: Yeah, so I think the there I would sort of say,

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Speaker 2: there's a couple of categories that I hear talked about

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Speaker 2: a lot. So one is the kind of psychocybin psilocybin. Yeah,

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Speaker 2: maybe I begin where people talk about usage in a

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Speaker 2: kind of like a true like tripping state we see.

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Speaker 2: I think a lot of discussion of ketamine. I would

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Speaker 2: say ketamine is the one where I hear people both

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Speaker 2: on the Internet and actually in my life talk about

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Speaker 2: using ketamine. So if you hang out in la at all,

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Speaker 2: everyone will talk about how they're doing ketemine in not

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Speaker 2: literally everyone, but all the people that I've encountered recently

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Speaker 2: in LA. You know, we're explaining like this as a

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Speaker 2: sort of standard part of kind of a psychological treatment.

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Speaker 3: And then MDMA, which.

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Speaker 2: Is it's ecstasy, right, I mean yeah again sort of

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Speaker 2: not so much for the therapeutic uses, but almost like

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Speaker 2: for relationship improvement. Interesting, now that we're adults, I feel

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Speaker 2: like everybody who talks to me about psychedelics is talking

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Speaker 2: about it, not for like this is going to make

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Speaker 2: my rave more fun, but like, here's how I'm going

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Speaker 2: to improve my marriage.

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Speaker 3: Ling ecstasy with my partner. Okay, that's what it is

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Speaker 3: to be forty six Perry.

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Speaker 1: I love this. I love this so much, so great.

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Speaker 1: I think it's worth saying that the hallucinogens like psilocybin, LSD,

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Speaker 1: MDMA all work in part on a specific receptor in

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Speaker 1: the brain, the serotonin two A receptor. Ketamine is not

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Speaker 1: quite a hallucinogen. It doesn't work on that receptor. It's

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Speaker 1: a what's called a dissociative anesthetics. So that experience, as

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Speaker 1: I understand it for ketamine is is more just like

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Speaker 1: you're you feel like you're not really in your body,

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Speaker 1: like you're not kind of a participant in reality, So

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Speaker 1: it's definitely an altered state, but it's not quite the

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Speaker 1: same reality testing salience stuff that we talk about with

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Speaker 1: the hallucinogens. So Emily we've gone through kind of a

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Speaker 1: big list of psychedelics. There are others that we won't

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Speaker 1: even get around to mentioning because there's not as many

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Speaker 1: studies on them. But I think one thing that I

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Speaker 1: often hear is like people kind of draw a line

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Speaker 1: between something like mushrooms, which it's like, oh, that's from nature,

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Speaker 1: like an ayahuasca, which is, you know, something that grows

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Speaker 1: versus something like LSD or MDMA, which are synthesized chemicals.

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Speaker 1: Do you think that safety goes along with the fact

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Speaker 1: that something comes from nature versus a synthesized and a

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Speaker 1: lab or like, how do you think about these or

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Speaker 1: do you not divide them at all?

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Speaker 2: I think that most of that division is kind of

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Speaker 2: fake in people's heads. I mean, these are all working

435
00:22:56,680 --> 00:22:59,400
Speaker 2: on some they're all like sort of chemical processes. They're

436
00:22:59,400 --> 00:23:01,480
Speaker 2: working on a brain receptor, and often on the same

437
00:23:01,640 --> 00:23:04,720
Speaker 2: brain receptor as each other. It is true that the

438
00:23:04,800 --> 00:23:08,119
Speaker 2: synthesized versions tend to be much more potent and a

439
00:23:08,200 --> 00:23:10,560
Speaker 2: much smaller amount, and so I think there's a sense

440
00:23:10,560 --> 00:23:14,200
Speaker 2: in which, like it's more difficult to take too many

441
00:23:14,320 --> 00:23:17,360
Speaker 2: mushrooms than it is to take too much LSD, because

442
00:23:17,480 --> 00:23:20,119
Speaker 2: you could pretty easily take like quite a lot of

443
00:23:20,240 --> 00:23:23,199
Speaker 2: LSD without realizing it, and the mushrooms, like you know,

444
00:23:23,240 --> 00:23:28,360
Speaker 2: there's a little more processing of the experience. But up

445
00:23:28,400 --> 00:23:31,280
Speaker 2: to that issue, I think these are very like it's

446
00:23:31,359 --> 00:23:33,040
Speaker 2: just a chemical and so it's not like one of

447
00:23:33,080 --> 00:23:34,680
Speaker 2: these is natural and one of them is not natural.

448
00:23:34,760 --> 00:23:37,360
Speaker 2: They're just chemicals that are like produced in different ways.

449
00:23:37,800 --> 00:23:38,760
Speaker 1: Can I tell you should say?

450
00:23:38,760 --> 00:23:42,200
Speaker 2: The ketamine is a schedule like most of these drugs

451
00:23:42,240 --> 00:23:46,199
Speaker 2: are Schedule one, which means they are not they are

452
00:23:46,240 --> 00:23:50,119
Speaker 2: not legal outside of a research context, I believe, and it's.

453
00:23:49,960 --> 00:23:52,600
Speaker 1: Even really hard in research to get the approvals.

454
00:23:52,119 --> 00:23:52,399
Speaker 3: To do it.

455
00:23:52,480 --> 00:23:55,560
Speaker 2: Yeah, ketemye is Schedule three drug, which means it can

456
00:23:55,600 --> 00:23:57,359
Speaker 2: be used in certain circumstances.

457
00:23:57,480 --> 00:23:58,960
Speaker 1: Oh yeah, we use all the time for Oh my god,

458
00:23:58,960 --> 00:24:01,560
Speaker 1: we use it for kids when they broken bones the

459
00:24:01,600 --> 00:24:04,200
Speaker 1: first time. I yeah, yeah, the first time I had

460
00:24:04,200 --> 00:24:06,320
Speaker 1: a kid in the er when I was a med student.

461
00:24:06,320 --> 00:24:08,520
Speaker 1: I guess, no, yeah, I guess I must have been

462
00:24:08,520 --> 00:24:12,480
Speaker 1: a med student. Kid had a broken forearm. Little kid,

463
00:24:12,480 --> 00:24:15,240
Speaker 1: the poor guy, and you know, the orthpedic surgeon was

464
00:24:15,240 --> 00:24:16,679
Speaker 1: going to come in and like reset it and put

465
00:24:16,720 --> 00:24:18,480
Speaker 1: it in a cast. And they gave the kid a

466
00:24:18,520 --> 00:24:22,680
Speaker 1: little bit of kenemine. He like zones out, like not asleep,

467
00:24:22,840 --> 00:24:27,000
Speaker 1: just like not not there, and they they like you know,

468
00:24:27,080 --> 00:24:29,160
Speaker 1: do his arm and everything, and he was totally chill.

469
00:24:29,200 --> 00:24:30,480
Speaker 1: It's really great. It's a great drug.

470
00:24:30,640 --> 00:24:32,600
Speaker 2: Actually, now that I think about it, they use ketamine

471
00:24:32,640 --> 00:24:35,000
Speaker 2: all the time on the pit ketamine and rock I

472
00:24:35,040 --> 00:24:38,080
Speaker 2: believe it is Doctor Robbie is primarily so for those

473
00:24:38,119 --> 00:24:40,520
Speaker 2: of you who are not yourself set a small child's arm,

474
00:24:40,680 --> 00:24:43,720
Speaker 2: you can think about doctor Robbie doing awesome.

475
00:24:44,240 --> 00:24:47,920
Speaker 1: Just a brief tangent on the MDMA for relationship status.

476
00:24:48,760 --> 00:24:54,879
Speaker 1: There is a totally amazing study of octopuses.

477
00:24:54,680 --> 00:24:57,480
Speaker 3: Where it's octopi but fine, oh.

478
00:24:57,400 --> 00:25:00,200
Speaker 1: Okay, I believe it's octopoda.

479
00:25:00,240 --> 00:25:03,919
Speaker 3: Actually, go ahead, all right.

480
00:25:04,480 --> 00:25:12,520
Speaker 1: Current Biology, twenty eighteen. They used these octopuses that are okay,

481
00:25:12,560 --> 00:25:16,040
Speaker 1: the two spot octopus, which are notoriously anti social and

482
00:25:16,119 --> 00:25:18,640
Speaker 1: like attack each other and stuff like that, and they

483
00:25:18,680 --> 00:25:21,359
Speaker 1: put them in a tank together. But there was MDMA,

484
00:25:21,680 --> 00:25:26,960
Speaker 1: like this ecstasy stuff in the tank, and the octopuses

485
00:25:27,000 --> 00:25:30,680
Speaker 1: like got gentle and were like stroking each other's dctacles

486
00:25:30,760 --> 00:25:33,440
Speaker 1: and stuff like that. So when you say it's good

487
00:25:33,520 --> 00:25:39,560
Speaker 1: for like a marriage, I am, I'm on board, okay.

488
00:25:39,680 --> 00:25:42,639
Speaker 2: So there are many things one could say about the

489
00:25:42,680 --> 00:25:46,600
Speaker 2: detailed chemical structures of these different of these different drugs,

490
00:25:46,640 --> 00:25:48,520
Speaker 2: but I think much in some ways much more interesting

491
00:25:48,560 --> 00:25:52,920
Speaker 2: and practical for people is the question of whether they

492
00:25:53,040 --> 00:25:58,719
Speaker 2: are effective we used in treatment of various things, and

493
00:25:58,760 --> 00:26:00,600
Speaker 2: also the question of whether you would like to take

494
00:26:00,600 --> 00:26:02,600
Speaker 2: them even if you are not looking for a treatment.

495
00:26:03,000 --> 00:26:05,080
Speaker 2: So I would say we should turn to that. And

496
00:26:05,119 --> 00:26:07,400
Speaker 2: I actually wanted to start with sort of two sort

497
00:26:07,440 --> 00:26:12,879
Speaker 2: of big picture pieces of this, maybe three. So one

498
00:26:13,000 --> 00:26:18,439
Speaker 2: is that by and large these medications are used not

499
00:26:18,840 --> 00:26:23,320
Speaker 2: like you would use tilinol or even you know, a statin.

500
00:26:23,680 --> 00:26:26,520
Speaker 2: Like it's not like somebody gives you a bottle of

501
00:26:27,160 --> 00:26:29,679
Speaker 2: you know, MDMA and every day you take it. And

502
00:26:29,680 --> 00:26:33,880
Speaker 2: we can talk about micro microdosing, but most of this

503
00:26:34,080 --> 00:26:39,000
Speaker 2: is like a one time, a couple of times small

504
00:26:39,080 --> 00:26:42,720
Speaker 2: number of treatments under the supervision of a doctor. Many

505
00:26:42,760 --> 00:26:44,760
Speaker 2: of these things people are doing in other countries because

506
00:26:44,760 --> 00:26:47,119
Speaker 2: the drugs are scheduled one, and so this is like

507
00:26:47,160 --> 00:26:50,879
Speaker 2: a sort of pretty fundamentally different idea behind you know,

508
00:26:50,920 --> 00:26:54,640
Speaker 2: does this treat the following disease because it's not an

509
00:26:54,720 --> 00:26:58,359
Speaker 2: ongoing kind of pill form treatment like we often talk about.

510
00:26:59,000 --> 00:27:02,720
Speaker 2: I think the second thing is we've talked before about

511
00:27:02,760 --> 00:27:06,919
Speaker 2: placebo effects. This is a place where placebo effects I

512
00:27:06,920 --> 00:27:11,560
Speaker 2: think are incredibly complicated even to conceptualize, because we are

513
00:27:11,600 --> 00:27:14,400
Speaker 2: talking about things that are happening in your brain, which

514
00:27:14,480 --> 00:27:16,400
Speaker 2: is where a placebo effect also happens.

515
00:27:16,960 --> 00:27:20,840
Speaker 3: And in these cases it's almost impossible to double blind.

516
00:27:21,160 --> 00:27:23,960
Speaker 2: So you know, these these trips when you talk about this,

517
00:27:23,960 --> 00:27:27,200
Speaker 2: but people describe these as like the most meaningful experience

518
00:27:27,240 --> 00:27:30,200
Speaker 2: in my whole life. It's hard to be like, well,

519
00:27:30,280 --> 00:27:31,920
Speaker 2: do you know if you had like how would they

520
00:27:31,960 --> 00:27:32,760
Speaker 2: know if they had.

521
00:27:32,640 --> 00:27:33,000
Speaker 1: It or not?

522
00:27:33,040 --> 00:27:33,879
Speaker 3: It's like one card.

523
00:27:35,520 --> 00:27:38,520
Speaker 1: Sugar pill, right, like you know.

524
00:27:38,600 --> 00:27:40,840
Speaker 2: And and I guess the third piece about placebos here

525
00:27:40,880 --> 00:27:44,320
Speaker 2: is I'm not even it may not even matter. I guess,

526
00:27:44,359 --> 00:27:46,360
Speaker 2: like the maybe the whole thing is a police I'm

527
00:27:46,400 --> 00:27:48,440
Speaker 2: not really sure how to conceptualize it, but it's worth

528
00:27:48,440 --> 00:27:51,600
Speaker 2: thinking about. Almost none of this can be truly placebo

529
00:27:51,680 --> 00:27:54,720
Speaker 2: controlled the way we would placebo control, a vaccine or

530
00:27:54,760 --> 00:27:57,280
Speaker 2: a medication where you give people a sugar pill. You know,

531
00:27:57,359 --> 00:28:00,600
Speaker 2: you see if they there's cholesterol goes down.

532
00:28:00,640 --> 00:28:03,080
Speaker 3: And that's just like easy chounders.

533
00:28:03,160 --> 00:28:05,320
Speaker 1: And when you're talking about mental health as we will

534
00:28:05,359 --> 00:28:08,520
Speaker 1: be like place he boat like if you who cares?

535
00:28:08,520 --> 00:28:10,200
Speaker 1: Like if you tell me you're not depressed anymore?

536
00:28:10,280 --> 00:28:11,439
Speaker 3: Like I guess it worked.

537
00:28:11,600 --> 00:28:14,760
Speaker 1: Okay, great, you know, like as long as it as

538
00:28:14,840 --> 00:28:18,439
Speaker 1: long as it works and it lasts. And yeah, so

539
00:28:19,000 --> 00:28:24,800
Speaker 1: I thought maybe we start with PTSD. And the reason

540
00:28:24,840 --> 00:28:27,000
Speaker 1: I want to start here is because this has gotten

541
00:28:27,040 --> 00:28:31,919
Speaker 1: a lot of press recently because of President Trump meeting

542
00:28:31,960 --> 00:28:35,800
Speaker 1: with Joe Rogan to specifically discuss psychedelics. And I'm going

543
00:28:35,840 --> 00:28:39,600
Speaker 1: to play you a clip now of President Trump talking

544
00:28:39,600 --> 00:28:41,240
Speaker 1: about ibogaine.

545
00:28:41,920 --> 00:28:47,880
Speaker 4: It's called I bogaine treatment, ie bogaine. Remember the name.

546
00:28:48,120 --> 00:28:51,400
Speaker 4: Is that pronounced relatively properly? When you said, I don't

547
00:28:51,400 --> 00:28:54,040
Speaker 4: want to get it wrong, I bogang because it's so

548
00:28:54,120 --> 00:28:58,200
Speaker 4: important and experienced an eighty to ninety percent reduction incmptoms

549
00:28:58,240 --> 00:29:02,880
Speaker 4: of depression and then niety within one month. Can I

550
00:29:02,920 --> 00:29:07,080
Speaker 4: have some, please, I'll take you.

551
00:29:08,000 --> 00:29:12,480
Speaker 1: I'll so, first of all, does anyone else like, whenever

552
00:29:12,520 --> 00:29:15,200
Speaker 1: you hear eyebogain, are you like I spent the past

553
00:29:15,200 --> 00:29:17,480
Speaker 1: few years building up an immunity to iebo gain powder.

554
00:29:17,560 --> 00:29:22,400
Speaker 1: Is that? Does anyone know? Okay, that's the Princess Bride.

555
00:29:22,440 --> 00:29:27,040
Speaker 1: How are you welcome? It's okay, the Princess Bride. I know,

556
00:29:27,080 --> 00:29:32,520
Speaker 1: but eyebogain always sounds like that. So Emily, President Trump

557
00:29:32,600 --> 00:29:37,800
Speaker 1: is referring to a paper in Nature Medicine that had

558
00:29:38,040 --> 00:29:42,880
Speaker 1: I mean, I have to say, pretty pretty incredible effect

559
00:29:42,920 --> 00:29:45,320
Speaker 1: sizes here for for eyebogain, for PTSD. Do you want

560
00:29:45,360 --> 00:29:47,360
Speaker 1: to run us through that one? Yeah?

561
00:29:47,400 --> 00:29:50,120
Speaker 2: So these guys are talking about a paper in Nature

562
00:29:50,240 --> 00:29:54,240
Speaker 2: Medicine from twenty twenty four in which they're looking at

563
00:29:54,440 --> 00:30:00,400
Speaker 2: treatment for traumatic brain injury, which is unfortunately only can

564
00:30:00,440 --> 00:30:04,160
Speaker 2: be common in veterans and is associated with depression, anxiety,

565
00:30:04,440 --> 00:30:08,640
Speaker 2: PTSD other kinds of functional disorders. This has proven to

566
00:30:08,680 --> 00:30:11,880
Speaker 2: be very difficult to very difficult to treat. So they

567
00:30:11,920 --> 00:30:17,160
Speaker 2: took thirty men with I was a mild mild traumatic

568
00:30:17,320 --> 00:30:24,760
Speaker 2: brain injury, and they treated them with magnesium IBI game.

569
00:30:25,840 --> 00:30:28,800
Speaker 2: The paper is not a it's not a clinical trial,

570
00:30:28,840 --> 00:30:32,080
Speaker 2: so it's not a randomized trial. They took these thirty people,

571
00:30:32,080 --> 00:30:34,640
Speaker 2: they treated them all, and so again we sort of,

572
00:30:35,240 --> 00:30:37,600
Speaker 2: you know, it's hard to separate from what might have

573
00:30:37,680 --> 00:30:44,959
Speaker 2: happened anyway. However, the improvements in functioning were really quite big.

574
00:30:45,480 --> 00:30:49,880
Speaker 2: They have improvements in depression scales, improvements in PTSD, improvements

575
00:30:49,920 --> 00:30:55,160
Speaker 2: in anxiety. And these are pretty large, pretty large increases.

576
00:30:55,200 --> 00:30:58,440
Speaker 2: I'm not sure exactly how we want to like size them,

577
00:30:58,640 --> 00:31:02,520
Speaker 2: but they are all incredibly significant and a very difficult

578
00:31:02,560 --> 00:31:03,600
Speaker 2: to treat area.

579
00:31:03,680 --> 00:31:06,640
Speaker 1: Yeah, I mean, if you look, I'm like just looking

580
00:31:06,680 --> 00:31:08,520
Speaker 1: at the graph with a paper, and of these thirty

581
00:31:08,520 --> 00:31:11,240
Speaker 1: people you have, yeah, you have like twenty eight of

582
00:31:11,280 --> 00:31:16,000
Speaker 1: them with like who went from moderate PTSD to minimal PTSD,

583
00:31:16,080 --> 00:31:19,840
Speaker 1: which is which is which is amazing after a single

584
00:31:19,920 --> 00:31:24,840
Speaker 1: dose of this Eyebogain therapy. I think it's worth saying that, Hey,

585
00:31:25,560 --> 00:31:29,520
Speaker 1: it's just one paper. There was another Ibogain trial. It's

586
00:31:29,520 --> 00:31:33,040
Speaker 1: not a randomized trial. There was another Ibogain study of

587
00:31:33,360 --> 00:31:36,120
Speaker 1: PTSD that actually did not show quite a strong effects.

588
00:31:36,120 --> 00:31:38,560
Speaker 1: Still showed effects, but not like this dramatic and so,

589
00:31:39,080 --> 00:31:42,600
Speaker 1: and there's no randomized trials whatsoever. Basically, if you look, okay,

590
00:31:42,640 --> 00:31:45,120
Speaker 1: if you look, you'll find one randomized trial of eyebogain.

591
00:31:45,160 --> 00:31:47,440
Speaker 1: But it was a safety study, so they're randomizing just

592
00:31:47,440 --> 00:31:49,520
Speaker 1: to dose, so it's not like there's a control or

593
00:31:49,560 --> 00:31:53,600
Speaker 1: anything like that. This is clearly a great area for research,

594
00:31:53,640 --> 00:31:58,000
Speaker 1: and I'm actually enthusiastic that the administration is considering rescheduling

595
00:31:58,040 --> 00:31:59,680
Speaker 1: some of these drugs so that they can be easier

596
00:31:59,720 --> 00:32:02,560
Speaker 1: to REA search. But you know what we want in

597
00:32:02,600 --> 00:32:05,720
Speaker 1: these types of trials is, yes, we want placebo controls,

598
00:32:05,720 --> 00:32:08,720
Speaker 1: even though it's incredibly hard to control, but we also

599
00:32:08,800 --> 00:32:12,160
Speaker 1: want longer turn them outcomes. Right, Like a month is great,

600
00:32:12,280 --> 00:32:15,640
Speaker 1: but you know six months, a year, two years, what's

601
00:32:15,680 --> 00:32:17,440
Speaker 1: the mental health of the people who got treated?

602
00:32:18,040 --> 00:32:20,080
Speaker 2: Yeah, and I think that there's a there's a I

603
00:32:20,080 --> 00:32:24,440
Speaker 2: mean people have experimented with treatment with MDMA, with stilocybin,

604
00:32:24,720 --> 00:32:27,239
Speaker 2: with I began, like all three of these have come

605
00:32:27,360 --> 00:32:31,880
Speaker 2: up in this treatment. Relaxing the rules about this would

606
00:32:32,000 --> 00:32:36,600
Speaker 2: let researchers figure out things about randomizing, but also dosing

607
00:32:36,680 --> 00:32:39,040
Speaker 2: and what is the best approach to dosing and how

608
00:32:39,080 --> 00:32:40,920
Speaker 2: many times you need to do this and does it

609
00:32:40,960 --> 00:32:43,120
Speaker 2: need to re up you know, every six months or

610
00:32:43,280 --> 00:32:46,160
Speaker 2: like what is the sort of treatment protocol. The other

611
00:32:46,280 --> 00:32:49,680
Speaker 2: issue is, of course, like when you only have three

612
00:32:49,720 --> 00:32:53,400
Speaker 2: studies of something and they are all significant. One worries

613
00:32:53,440 --> 00:32:55,720
Speaker 2: a little bit about like our you know, did someone

614
00:32:55,760 --> 00:32:58,480
Speaker 2: did actually twenty five different studies of this get run

615
00:32:58,840 --> 00:33:02,000
Speaker 2: and only three of them and publish. That's where you

616
00:33:02,080 --> 00:33:06,400
Speaker 2: need like pre registered, large randomized controlled trials, which are

617
00:33:06,440 --> 00:33:08,520
Speaker 2: only going to happen if.

618
00:33:08,520 --> 00:33:12,080
Speaker 3: These drugs are easier to use in a trial setting.

619
00:33:12,680 --> 00:33:12,880
Speaker 2: Yeah.

620
00:33:13,080 --> 00:33:16,400
Speaker 1: Yeah, absolutely, so we'll close the book on PTSD. I

621
00:33:16,520 --> 00:33:20,560
Speaker 1: begain kind of interesting, some good data for MDMA, and

622
00:33:20,680 --> 00:33:24,120
Speaker 1: very preliminary data on psilocybin. Just to run through the

623
00:33:24,400 --> 00:33:28,240
Speaker 1: psychedelics that are being used here. Let's move on to depression.

624
00:33:28,280 --> 00:33:32,400
Speaker 1: That depression, Yeah, I mean this is obviously incredibly common

625
00:33:33,040 --> 00:33:37,200
Speaker 1: and a place where there are current therapies. Obviously there

626
00:33:37,240 --> 00:33:41,320
Speaker 1: are multiple therapies for depression, both pharmacologic and non pharmacologic,

627
00:33:41,440 --> 00:33:45,520
Speaker 1: and so but I think the public understands that, you know,

628
00:33:45,560 --> 00:33:48,120
Speaker 1: the standard of care right now for major depression disorder,

629
00:33:48,120 --> 00:33:54,120
Speaker 1: which are the SSRIs, are moderately effective and come with

630
00:33:54,160 --> 00:33:58,560
Speaker 1: some side effects that people find not great. And so

631
00:33:58,720 --> 00:34:02,520
Speaker 1: if you did something else, you might be open to

632
00:34:02,560 --> 00:34:03,880
Speaker 1: something else. Is that fair to say?

633
00:34:04,040 --> 00:34:05,240
Speaker 3: Yeah, I think that's fair to say.

634
00:34:05,240 --> 00:34:08,720
Speaker 2: I mean I think the administration has recently been quite negative.

635
00:34:08,960 --> 00:34:11,680
Speaker 2: RFKJ has been quite negative on SSRIs, and I think

636
00:34:11,719 --> 00:34:15,719
Speaker 2: that you know, that's probably some of his statements are overstated,

637
00:34:15,719 --> 00:34:18,479
Speaker 2: but I think it is it is true that these

638
00:34:18,480 --> 00:34:20,399
Speaker 2: have not proven to be a magic bullet for many

639
00:34:20,400 --> 00:34:23,360
Speaker 2: people with depressions. They have been very helpful for a

640
00:34:23,440 --> 00:34:26,840
Speaker 2: large number of people, but not so amazing that we

641
00:34:26,840 --> 00:34:28,880
Speaker 2: should not be looking for other approaches.

642
00:34:28,960 --> 00:34:30,960
Speaker 3: Is how I would is how I would put it.

643
00:34:31,640 --> 00:34:33,000
Speaker 3: And this is a place I don't know if you

644
00:34:33,000 --> 00:34:33,880
Speaker 3: want to talk about.

645
00:34:34,239 --> 00:34:37,320
Speaker 2: My favorite thing here is the twenty twenty three JAMA paper,

646
00:34:37,520 --> 00:34:38,840
Speaker 2: because Jama is such a great journal.

647
00:34:38,840 --> 00:34:40,239
Speaker 3: Do you know that one time Perry published in that.

648
00:34:41,360 --> 00:34:44,480
Speaker 1: I understand that you've also published in Jamma.

649
00:34:44,560 --> 00:34:48,680
Speaker 2: Emily, I do it dous about the large clinical trial

650
00:34:48,719 --> 00:34:51,520
Speaker 2: in Jamma of silas ivan, on which matter of us

651
00:34:51,520 --> 00:34:52,839
Speaker 2: as an author, but we still like it.

652
00:34:54,120 --> 00:34:57,680
Speaker 1: Yeah. So this is a study in twenty twenty three

653
00:34:58,040 --> 00:35:02,000
Speaker 1: which took one hundred and four or adults with major

654
00:35:02,000 --> 00:35:05,080
Speaker 1: depressive disorder and randomize them to a single dose twenty

655
00:35:05,080 --> 00:35:09,480
Speaker 1: five milligrams of psilocybin. And also, and as I said,

656
00:35:09,520 --> 00:35:13,080
Speaker 1: this was important, eleven hours of psychological support, which included

657
00:35:13,160 --> 00:35:17,120
Speaker 1: like preparation for the psilocybin dose, support on the dosing day,

658
00:35:17,160 --> 00:35:20,160
Speaker 1: and then after that what they call integration, which is

659
00:35:20,200 --> 00:35:23,680
Speaker 1: like processing the experience that you had. They did do

660
00:35:23,719 --> 00:35:28,160
Speaker 1: a placebo control one hundred milligrams of nyasin, which is

661
00:35:28,200 --> 00:35:31,319
Speaker 1: a vitamin. But at that dose it's going to cause

662
00:35:31,360 --> 00:35:34,200
Speaker 1: some flushing. Now I don't think flushing is quite the

663
00:35:34,239 --> 00:35:38,520
Speaker 1: same as a psilocybin trip, but it's not nothing at least,

664
00:35:38,560 --> 00:35:40,520
Speaker 1: so they you know, if you if they didn't know

665
00:35:40,560 --> 00:35:42,600
Speaker 1: what psilocybin was like to begin with, maybe they thought

666
00:35:42,600 --> 00:35:43,680
Speaker 1: they were getting I thought.

667
00:35:43,520 --> 00:35:45,920
Speaker 3: I just made them hot. Okay, yeah, I don't know.

668
00:35:46,719 --> 00:35:50,760
Speaker 1: But they also got that psychological supportive protocol. The primary

669
00:35:50,800 --> 00:35:55,479
Speaker 1: outcome was a score, a depression score, and I won't

670
00:35:55,480 --> 00:35:57,160
Speaker 1: go through the score, but I'll tell you it went

671
00:35:57,239 --> 00:36:02,880
Speaker 1: down by twelve points, which was a highly significant difference,

672
00:36:02,880 --> 00:36:05,480
Speaker 1: Like that is a clinically meaningful difference, a twelve point

673
00:36:05,520 --> 00:36:08,480
Speaker 1: reduction in depression scores, and that was out at day

674
00:36:09,080 --> 00:36:13,840
Speaker 1: forty three. The sustained response rate, which meant like you

675
00:36:14,600 --> 00:36:17,480
Speaker 1: had sustained improvement in symptoms out that far at day

676
00:36:17,520 --> 00:36:20,319
Speaker 1: forty three, was forty two percent in the psilocybin group

677
00:36:20,400 --> 00:36:24,799
Speaker 1: versus eleven percent in the niosin group. So this was,

678
00:36:25,200 --> 00:36:30,439
Speaker 1: you know, a trial that said, okay, we've got something here.

679
00:36:31,040 --> 00:36:33,759
Speaker 1: Yes you're integrating it. But remember it's only one it's

680
00:36:33,760 --> 00:36:36,040
Speaker 1: a single dose at one time. There's a bit of

681
00:36:36,080 --> 00:36:40,600
Speaker 1: biology here. These drugs that stimulate the serotonin to eight

682
00:36:40,640 --> 00:36:44,839
Speaker 1: receptor might increase neural plasticity, which means you can form

683
00:36:44,920 --> 00:36:49,640
Speaker 1: new neural connections. So psychiatrists are psychologists are wondering if

684
00:36:49,680 --> 00:36:52,239
Speaker 1: like that initial dose kind of like shakes up your

685
00:36:52,239 --> 00:36:55,360
Speaker 1: brain a little bit, and then it's actually that integration

686
00:36:55,560 --> 00:36:59,239
Speaker 1: phase where you know, now the patient is sort of

687
00:36:59,560 --> 00:37:03,040
Speaker 1: ready to make those cognitive changes that's going to improve

688
00:37:03,080 --> 00:37:06,160
Speaker 1: their underlying status. So it's both the drug and then

689
00:37:06,239 --> 00:37:08,319
Speaker 1: like which kind of shakes things up and then you

690
00:37:08,440 --> 00:37:10,680
Speaker 1: kind of put things back together in a better way

691
00:37:10,719 --> 00:37:14,160
Speaker 1: moving forward. That's all hypothetical obviously, but pretty pretty exciting results.

692
00:37:14,680 --> 00:37:15,880
Speaker 3: Yeah, I thought that was exciting.

693
00:37:15,960 --> 00:37:19,719
Speaker 2: I mean not everything in this space is as exciting,

694
00:37:19,840 --> 00:37:24,360
Speaker 2: and in particular, there's a Nangeum paper from around the

695
00:37:24,360 --> 00:37:28,560
Speaker 2: same time which did a trial of stilocybin versus a

696
00:37:28,640 --> 00:37:30,760
Speaker 2: standard antidepressant.

697
00:37:31,320 --> 00:37:34,440
Speaker 1: Yeah. Oh yes, an SSRI I this is a better control,

698
00:37:34,520 --> 00:37:35,400
Speaker 1: like act.

699
00:37:35,239 --> 00:37:38,280
Speaker 2: A better control, not just flushing, but something is actually

700
00:37:38,640 --> 00:37:44,279
Speaker 2: think so the primary outcome in the paper does not

701
00:37:44,440 --> 00:37:49,279
Speaker 2: show differences in efficacy. There are some secondary outcomes which do,

702
00:37:49,360 --> 00:37:50,880
Speaker 2: although they test many of those.

703
00:37:51,000 --> 00:37:53,000
Speaker 3: So I would say the results in this one were

704
00:37:53,040 --> 00:37:54,600
Speaker 3: decidedly more mixed.

705
00:37:55,120 --> 00:37:57,120
Speaker 2: But both of these together tell me, Okay, you know,

706
00:37:57,120 --> 00:38:00,239
Speaker 2: we're doing these trials with sixty you know, sixty year

707
00:38:00,280 --> 00:38:03,719
Speaker 2: one hundred people. We need to do these trials with

708
00:38:04,360 --> 00:38:08,200
Speaker 2: a thousand people. And for depression unlike you know PTSD,

709
00:38:09,280 --> 00:38:11,719
Speaker 2: there certainly are a thousand people you could find with

710
00:38:11,920 --> 00:38:13,799
Speaker 2: depression who one could experiment on.

711
00:38:14,440 --> 00:38:19,359
Speaker 1: Absolutely absolutely. The issue versus SSRI is like you want

712
00:38:19,400 --> 00:38:21,400
Speaker 1: to be a little skeptical when you hear people saying,

713
00:38:22,080 --> 00:38:25,080
Speaker 1: you know, oh, these things blow SSRIs out of the water,

714
00:38:25,320 --> 00:38:27,840
Speaker 1: like SSRIs don't work and psilocybin does. You know, the

715
00:38:27,920 --> 00:38:31,400
Speaker 1: actual trial here says like they're close. But again there

716
00:38:31,400 --> 00:38:33,520
Speaker 1: are other reasons that you might you know, a single

717
00:38:33,600 --> 00:38:36,480
Speaker 1: dose of psilocybin might feel a lot better to people

718
00:38:36,640 --> 00:38:40,520
Speaker 1: than a daily dose of an SSRI going on forever

719
00:38:40,640 --> 00:38:42,759
Speaker 1: with you know, the attendant side effects that one might

720
00:38:42,800 --> 00:38:45,880
Speaker 1: have with those the sort of flip side, not the

721
00:38:45,880 --> 00:38:49,000
Speaker 1: flip side. I always think of depression and anxiety together

722
00:38:49,120 --> 00:38:52,759
Speaker 1: the two most common psychologic disorders affecting people in the

723
00:38:52,880 --> 00:38:56,600
Speaker 1: United States. Anxiety when it comes to psychedelics always made

724
00:38:56,680 --> 00:39:01,280
Speaker 1: me a little nervous, just in principle, I think, because

725
00:39:01,560 --> 00:39:04,480
Speaker 1: like the psychedelic experience, as I understand, it can be

726
00:39:04,520 --> 00:39:08,799
Speaker 1: anxiety inducing. In fact, some of the adverse events that

727
00:39:08,800 --> 00:39:12,160
Speaker 1: were reported in some of those depression trials were like anxiety.

728
00:39:12,320 --> 00:39:14,640
Speaker 1: And you can sort of imagine that if you're an

729
00:39:14,640 --> 00:39:16,440
Speaker 1: anxious person already and then all of a sudden the

730
00:39:16,520 --> 00:39:18,520
Speaker 1: walls are melting and you feel like you're like melting

731
00:39:18,560 --> 00:39:21,520
Speaker 1: into the floor or whatever, Like maybe that's not great

732
00:39:21,560 --> 00:39:26,000
Speaker 1: for you. But even here, and I should say, like,

733
00:39:26,400 --> 00:39:29,400
Speaker 1: we don't have nearly as much data in anxiety yet

734
00:39:29,440 --> 00:39:32,440
Speaker 1: as there is for major depression disorder. But I was

735
00:39:32,480 --> 00:39:36,040
Speaker 1: looking at this twenty sixteen study from the Journal of Psychopharmacology.

736
00:39:36,040 --> 00:39:39,879
Speaker 1: Did you see this one, Emily that seemed like there

737
00:39:39,920 --> 00:39:41,399
Speaker 1: might be some use here.

738
00:39:41,440 --> 00:39:43,480
Speaker 3: This was Yeah, I mean they're treating.

739
00:39:43,360 --> 00:39:44,640
Speaker 1: High dose of psilocybin.

740
00:39:45,080 --> 00:39:50,000
Speaker 2: Yeah, they're treating people with cancer related anxiety and depression.

741
00:39:50,200 --> 00:39:54,360
Speaker 2: So it's a kind of combo group and they're giving

742
00:39:54,400 --> 00:39:59,279
Speaker 2: them a really highly dosi slocybin, but it does seem

743
00:39:59,360 --> 00:40:02,719
Speaker 2: to have improved anxiety depression and they're kind of decreasing

744
00:40:02,760 --> 00:40:04,640
Speaker 2: cancer related demoralization.

745
00:40:04,760 --> 00:40:09,240
Speaker 3: That's from the paper, So you know, positive, there.

746
00:40:09,360 --> 00:40:11,520
Speaker 1: Not enough data to be sure, and I think, if.

747
00:40:11,480 --> 00:40:14,080
Speaker 2: Not enough data to be sure, which is the tagline

748
00:40:14,080 --> 00:40:15,240
Speaker 2: for this episode, if.

749
00:40:15,080 --> 00:40:18,600
Speaker 1: You're an anxious person, this is maybe not the thing

750
00:40:18,680 --> 00:40:23,120
Speaker 1: to jump right into quite yet. The other big category

751
00:40:23,120 --> 00:40:25,879
Speaker 1: before we get to just the you know, healthy people

752
00:40:25,920 --> 00:40:32,759
Speaker 1: who are curious alcohol addiction. So what Joe Rogan was

753
00:40:33,120 --> 00:40:36,640
Speaker 1: talking about in when he was meeting with Trump actually

754
00:40:36,880 --> 00:40:40,680
Speaker 1: was was not Ibogain's effect on PTSD, but Ibogain's effect

755
00:40:40,680 --> 00:40:43,239
Speaker 1: on addiction. And like all things Joe Rogan, he has

756
00:40:43,280 --> 00:40:45,560
Speaker 1: some story like it's always an anecdote with him, which

757
00:40:45,600 --> 00:40:48,240
Speaker 1: is like he had this guy was addicted to heroin

758
00:40:48,840 --> 00:40:51,719
Speaker 1: and everything was horrible and then you know, single dose

759
00:40:51,719 --> 00:40:55,839
Speaker 1: of IBA gain and cleaned himself up and were off

760
00:40:55,880 --> 00:40:59,160
Speaker 1: to the races again. There is no randomized trial for

761
00:40:59,320 --> 00:41:04,239
Speaker 1: eyebo gain whatsoever. There's some open labeled data though I

762
00:41:04,360 --> 00:41:07,600
Speaker 1: found there's a study of one hundred and ninety one

763
00:41:08,320 --> 00:41:13,640
Speaker 1: people who were using opioids or cocaine, and they did

764
00:41:13,680 --> 00:41:17,560
Speaker 1: show that a single dose of ibogain diminished withdrawal symptoms

765
00:41:17,560 --> 00:41:21,480
Speaker 1: and drug cravings at one month follow up. This comes

766
00:41:21,520 --> 00:41:24,960
Speaker 1: from Frontiers in Pharmacology in twenty eighteen. You know, this

767
00:41:25,000 --> 00:41:28,520
Speaker 1: is open label, there's no control here. It's a little

768
00:41:28,520 --> 00:41:33,080
Speaker 1: hard to say any thoughts on ibogain for addiction.

769
00:41:34,200 --> 00:41:36,880
Speaker 2: I mean, again, I think this is a space where

770
00:41:36,920 --> 00:41:42,960
Speaker 2: people are is very treatment resistant, and so having something

771
00:41:43,040 --> 00:41:47,600
Speaker 2: to try is interesting. We also worry that when people

772
00:41:47,680 --> 00:41:50,080
Speaker 2: get to the point, at least in this case, I worry.

773
00:41:50,120 --> 00:41:51,680
Speaker 2: So you get to the point where you're like I'll

774
00:41:51,680 --> 00:41:53,960
Speaker 2: try anything, I'm going to go to ibgain, maybe you are.

775
00:41:54,000 --> 00:41:57,279
Speaker 2: That actually is a signal of sort of motivation to

776
00:41:57,320 --> 00:41:59,040
Speaker 2: fix things. And so if you thought of this as

777
00:41:59,080 --> 00:42:00,719
Speaker 2: like we're just going to sign this random, like we're

778
00:42:00,719 --> 00:42:02,480
Speaker 2: going to sign this to people, it might it might

779
00:42:02,480 --> 00:42:03,480
Speaker 2: show up differently.

780
00:42:03,800 --> 00:42:07,600
Speaker 3: There's actually a bit better data for silocybin in alcohol

781
00:42:07,680 --> 00:42:08,320
Speaker 3: use disorder.

782
00:42:08,880 --> 00:42:12,040
Speaker 2: I was trying to think this is from randomized trial data,

783
00:42:12,239 --> 00:42:15,440
Speaker 2: and we see you know, a production uh sort of

784
00:42:15,440 --> 00:42:21,400
Speaker 2: a larger reduction in heavy drinking days with silocybin versus

785
00:42:21,480 --> 00:42:23,600
Speaker 2: the in this case in versus.

786
00:42:23,239 --> 00:42:26,440
Speaker 1: The control used to benadryl as a control in this

787
00:42:26,640 --> 00:42:29,080
Speaker 1: in this study, which is another It's like, I kind

788
00:42:29,080 --> 00:42:31,600
Speaker 1: of it's sort of like it's fun to imagine these

789
00:42:31,600 --> 00:42:33,239
Speaker 1: scientists being like, what the hell are we going to

790
00:42:33,360 --> 00:42:35,040
Speaker 1: use as a control, Like, let's give someone.

791
00:42:36,440 --> 00:42:39,320
Speaker 3: Your cabinet? Should we try pepsid?

792
00:42:39,680 --> 00:42:45,799
Speaker 1: No? Like that makes you feel weird but not too weird?

793
00:42:47,760 --> 00:42:49,799
Speaker 2: And then I mean I wondered here about how large

794
00:42:49,840 --> 00:42:51,879
Speaker 2: this effect is relative to g lp ones, which we're

795
00:42:51,920 --> 00:42:56,319
Speaker 2: constantly talking about, like you know, like for the alcohol stuff.

796
00:42:56,320 --> 00:43:00,520
Speaker 2: It seems like we're increasingly having some other other options. Okay,

797
00:43:00,560 --> 00:43:04,279
Speaker 2: can we talk about healthy forty somethings like us and

798
00:43:04,320 --> 00:43:06,680
Speaker 2: whether we should have this experience?

799
00:43:07,080 --> 00:43:10,960
Speaker 1: I have to say I wrote about a new article

800
00:43:11,040 --> 00:43:15,760
Speaker 1: that just came out recently was looking at the effect

801
00:43:15,920 --> 00:43:20,359
Speaker 1: of a single dose of twenty five milligrams of psilocybin

802
00:43:20,680 --> 00:43:24,920
Speaker 1: in healthy forty somethings who were psychedelic naive. So like

803
00:43:25,440 --> 00:43:30,520
Speaker 1: I yes, I was like Spiderman meme like that that's me, Like,

804
00:43:31,120 --> 00:43:33,600
Speaker 1: you know, who are these people? Because all these prioritizes,

805
00:43:33,640 --> 00:43:36,200
Speaker 1: even the studies in healthy people in the past, like

806
00:43:36,320 --> 00:43:39,399
Speaker 1: many of them are are people who have had experiences

807
00:43:39,400 --> 00:43:42,399
Speaker 1: with psychedelics, and so it's like, maybe it affects your brain,

808
00:43:42,400 --> 00:43:45,600
Speaker 1: but it already did affect your brain anyway, Right, this

809
00:43:45,760 --> 00:43:48,799
Speaker 1: is a super cool study, So psychedelic benive otherwise healthy

810
00:43:48,840 --> 00:43:52,239
Speaker 1: forty somethings. They got twenty five milligrams of psilocybin or

811
00:43:52,320 --> 00:43:54,600
Speaker 1: one milligram of psilocybin, which is sort of a sub

812
00:43:54,640 --> 00:43:58,439
Speaker 1: therapeutic dose, which they gave them first, and then they

813
00:43:58,719 --> 00:44:02,160
Speaker 1: did egs of their brain and a functional MRI a

814
00:44:02,200 --> 00:44:04,160
Speaker 1: month later. So the question was like, we're there are

815
00:44:04,160 --> 00:44:06,200
Speaker 1: acute changes in your brain waves and then where they're

816
00:44:06,280 --> 00:44:10,759
Speaker 1: lasting changes one month down, small studies. Still twenty eight

817
00:44:11,280 --> 00:44:15,000
Speaker 1: volunteers for this, to your point, twenty seven of the

818
00:44:15,080 --> 00:44:18,880
Speaker 1: twenty eight rated it as the single most unusual conscious

819
00:44:18,960 --> 00:44:23,120
Speaker 1: state of their entire lives. YEA, one guy didn't, who's

820
00:44:23,160 --> 00:44:25,000
Speaker 1: like awesome, obviously.

821
00:44:25,880 --> 00:44:27,040
Speaker 3: Guys having a lot of grain.

822
00:44:27,719 --> 00:44:29,319
Speaker 1: I said it was in the top five. I'm like,

823
00:44:29,440 --> 00:44:30,320
Speaker 1: in the top.

824
00:44:30,760 --> 00:44:33,000
Speaker 3: I would be curious about what number two was.

825
00:44:33,360 --> 00:44:37,640
Speaker 1: Yeah, So to break this down, the EG finding is

826
00:44:37,680 --> 00:44:40,600
Speaker 1: really interesting. What they showed acutely was a reduction in

827
00:44:40,680 --> 00:44:43,440
Speaker 1: alpha power, which is alpha is are the waves that

828
00:44:43,520 --> 00:44:47,160
Speaker 1: are sort of like they're like the lid on your brain.

829
00:44:47,440 --> 00:44:50,839
Speaker 1: They're the they're like our self control almost, like they sort

830
00:44:50,840 --> 00:44:53,960
Speaker 1: of tamp down all the crazy stuff that's going on

831
00:44:54,120 --> 00:44:58,080
Speaker 1: under the surface. So it's like calm, RESTful consciousness is

832
00:44:58,080 --> 00:45:00,719
Speaker 1: alpha waves. That power goes down, which sort of means

833
00:45:00,760 --> 00:45:04,759
Speaker 1: like the lid is off, and then the EEG complexity

834
00:45:04,840 --> 00:45:09,200
Speaker 1: went way up, so you know, all of a sudden,

835
00:45:09,440 --> 00:45:11,080
Speaker 1: just like the stuff that was coming out of the

836
00:45:11,080 --> 00:45:13,920
Speaker 1: brain was much crazier than what had come out of

837
00:45:13,920 --> 00:45:15,839
Speaker 1: the brain with a one miligram dose.

838
00:45:16,560 --> 00:45:21,520
Speaker 2: Sounds right, it's so it makes me so curious.

839
00:45:22,000 --> 00:45:24,759
Speaker 1: That's exactly I was, like, that sounds that sounds kind

840
00:45:24,760 --> 00:45:30,560
Speaker 1: of amazing. Now, one month later, they did some stuff

841
00:45:31,480 --> 00:45:34,680
Speaker 1: they didn't fMRI, and honestly, it didn't show very much,

842
00:45:34,719 --> 00:45:37,920
Speaker 1: Like it didn't show like dramatic structural or functional changes

843
00:45:37,920 --> 00:45:41,080
Speaker 1: in the brain, Okay, which is different than what has

844
00:45:41,120 --> 00:45:45,840
Speaker 1: been shown in some like depression related studies of psilocybin.

845
00:45:46,040 --> 00:45:48,799
Speaker 1: Maybe because maybe if your brain is kind of like

846
00:45:48,840 --> 00:45:50,960
Speaker 1: functioning normally to begin with, like I don't know what's

847
00:45:51,000 --> 00:45:52,759
Speaker 1: going to change as much or something like that, But

848
00:45:52,800 --> 00:45:58,160
Speaker 1: they didn't show that. But psychological well being was significantly

849
00:45:58,239 --> 00:46:01,120
Speaker 1: higher one month after the twenty five million dose versus

850
00:46:01,200 --> 00:46:05,360
Speaker 1: the one milligram dose, and they measured the day after

851
00:46:05,480 --> 00:46:09,520
Speaker 1: you took the thing. They gave people a survey of insight,

852
00:46:09,680 --> 00:46:12,759
Speaker 1: so they ask questions like do you feel this experience

853
00:46:12,880 --> 00:46:16,360
Speaker 1: led you to think about yourself differently? Like there's you know,

854
00:46:17,120 --> 00:46:20,160
Speaker 1: have you learned important new ways of thinking about yourself

855
00:46:20,200 --> 00:46:23,520
Speaker 1: and your problems. That's a measure of insight. And the

856
00:46:23,520 --> 00:46:27,520
Speaker 1: people who had hire insight had hire well being at

857
00:46:27,520 --> 00:46:29,799
Speaker 1: the one month mark. So there's this little bit of

858
00:46:29,840 --> 00:46:33,200
Speaker 1: like a mechanistic like you take the drug, you kind

859
00:46:33,239 --> 00:46:36,280
Speaker 1: of think about it, you think, you work through some stuff,

860
00:46:36,320 --> 00:46:37,920
Speaker 1: you kind of shake up your brain, and then a

861
00:46:37,960 --> 00:46:40,440
Speaker 1: month later you're doing better. What I can't tell you

862
00:46:40,520 --> 00:46:44,480
Speaker 1: is because there's no like, yes, it's different than the

863
00:46:44,480 --> 00:46:47,880
Speaker 1: one milligram dose, but like obviously that's not It's a

864
00:46:47,960 --> 00:46:50,920
Speaker 1: totally different experience, right, Like twenty five milligrams is the

865
00:46:50,920 --> 00:46:53,520
Speaker 1: most unusual conscious state of your entire life. One milligram

866
00:46:53,520 --> 00:46:56,799
Speaker 1: they had like no sensations whatsoever. You're feeling better a

867
00:46:56,800 --> 00:47:00,280
Speaker 1: month later, is that because something fundamentally about you has changed?

868
00:47:00,440 --> 00:47:02,920
Speaker 1: Or like do you feel good a month after a

869
00:47:03,000 --> 00:47:05,080
Speaker 1: nice vacation, right, Like, is it just the memory of

870
00:47:05,080 --> 00:47:08,080
Speaker 1: this very cool, unusual experience just kind of like breaks

871
00:47:08,120 --> 00:47:10,040
Speaker 1: up the monotony of your life for a little bit

872
00:47:10,560 --> 00:47:11,560
Speaker 1: and does it even matter?

873
00:47:12,120 --> 00:47:14,719
Speaker 3: I don't know, Yeah, I don't know. I mean I

874
00:47:14,719 --> 00:47:15,040
Speaker 3: think that.

875
00:47:15,120 --> 00:47:17,680
Speaker 2: What's so what I find so compelling about this is

876
00:47:17,719 --> 00:47:20,399
Speaker 2: like I could not tell you right now.

877
00:47:20,480 --> 00:47:21,120
Speaker 3: Now that's not true.

878
00:47:21,160 --> 00:47:23,000
Speaker 2: I could tell you, but like if I think about,

879
00:47:23,000 --> 00:47:27,360
Speaker 2: like what is the single most like unusual and meaningful

880
00:47:27,440 --> 00:47:30,000
Speaker 2: experience of my life, it is heavy. It is birth

881
00:47:30,040 --> 00:47:32,840
Speaker 2: of my children. Yeah, the experience of like producing a

882
00:47:32,920 --> 00:47:35,960
Speaker 2: new person. It was not comfortable, It wasn't like a

883
00:47:36,120 --> 00:47:37,560
Speaker 2: you know, which I think is also true, but like

884
00:47:37,600 --> 00:47:41,160
Speaker 2: it was a very unusual experience that I still could

885
00:47:41,760 --> 00:47:44,279
Speaker 2: I could tell you almost to the minute in both

886
00:47:44,320 --> 00:47:44,600
Speaker 2: of the.

887
00:47:44,560 --> 00:47:47,360
Speaker 3: Births, like exactly what happened.

888
00:47:47,320 --> 00:47:50,680
Speaker 1: Because your salience system was rev so high, and.

889
00:47:50,719 --> 00:47:52,400
Speaker 2: Like I could I usually like could tell you who

890
00:47:52,640 --> 00:47:53,880
Speaker 2: you know, who was in the room at each of

891
00:47:53,920 --> 00:47:56,120
Speaker 2: these moments exactly exactly what happened.

892
00:47:56,680 --> 00:48:00,399
Speaker 3: And so I'm I'm so curious about I find this.

893
00:48:00,320 --> 00:48:03,279
Speaker 2: Whole thing very curious, like totally interested to have an

894
00:48:03,280 --> 00:48:05,480
Speaker 2: experience like that where you didn't also have to push

895
00:48:05,520 --> 00:48:08,880
Speaker 2: an person out of your vagina, which has some negatives

896
00:48:08,920 --> 00:48:11,440
Speaker 2: in the long run, and you know, I mean positives.

897
00:48:11,480 --> 00:48:14,640
Speaker 1: Also, you wouldn't be worried that like it would push

898
00:48:15,000 --> 00:48:18,640
Speaker 1: the meaningfulness of those experiences down right. You'd be like, yes,

899
00:48:18,680 --> 00:48:21,560
Speaker 1: the birth of my children was the second most important

900
00:48:21,560 --> 00:48:22,520
Speaker 1: thing that ever happened to me.

901
00:48:22,920 --> 00:48:28,600
Speaker 2: Sitting on a couch like staring at the re here and.

902
00:48:30,400 --> 00:48:33,640
Speaker 1: Sorry, you're not that replaceable, Sorry, kiddos.

903
00:48:34,360 --> 00:48:36,560
Speaker 2: All right, two other things before we end, I think

904
00:48:36,560 --> 00:48:38,400
Speaker 2: we should touch on. So one is I hear a

905
00:48:38,440 --> 00:48:41,960
Speaker 2: fair amount about microdosing. But my read, which is like

906
00:48:42,360 --> 00:48:45,440
Speaker 2: maybe I take a little bit of my mushrooms every

907
00:48:45,480 --> 00:48:48,160
Speaker 2: single day to improve some aspect of well being, my

908
00:48:48,320 --> 00:48:51,399
Speaker 2: read is actually, people have tried a little.

909
00:48:51,040 --> 00:48:53,320
Speaker 3: Bit of this and it doesn't work.

910
00:48:54,840 --> 00:48:58,640
Speaker 1: Yeah, the studies of micro and microdoses, you know, first

911
00:48:58,640 --> 00:49:01,640
Speaker 1: of all, there's no great definition of this, Like in theory,

912
00:49:01,880 --> 00:49:04,200
Speaker 1: a microdose should be a dose low enough that you

913
00:49:04,239 --> 00:49:09,040
Speaker 1: don't experience the psychedelic effects, like you're not supposed to

914
00:49:09,040 --> 00:49:11,279
Speaker 1: feel much if you're really microdosing. And I'm not sure

915
00:49:11,280 --> 00:49:15,560
Speaker 1: that's how people are doing it, right, yeah, you know,

916
00:49:15,600 --> 00:49:18,520
Speaker 1: it's like it's like I'm microdosing wine by only drinking

917
00:49:18,520 --> 00:49:22,720
Speaker 1: a glass, Like, well, that's not really so, but yeah,

918
00:49:22,800 --> 00:49:26,680
Speaker 1: the studies that have looked at microdosing, my read is

919
00:49:26,680 --> 00:49:30,080
Speaker 1: that it does show some improvement in well being on

920
00:49:30,160 --> 00:49:34,160
Speaker 1: the day people microdose, but it doesn't persist to the

921
00:49:34,200 --> 00:49:37,560
Speaker 1: next day, and it certainly doesn't persist in the long term,

922
00:49:37,719 --> 00:49:39,800
Speaker 1: which also feels like drinking a glass of wine to me.

923
00:49:40,520 --> 00:49:41,640
Speaker 1: So maybe that's what it is.

924
00:49:42,440 --> 00:49:46,360
Speaker 2: Yeah, maybe, or maybe it's just a placebo effect of.

925
00:49:46,239 --> 00:49:49,000
Speaker 1: It could definitely be a placibo effect, which is also

926
00:49:49,200 --> 00:49:52,800
Speaker 1: what a glass of wine. To some extent.

927
00:49:53,080 --> 00:49:55,319
Speaker 3: There are some safety concerns we should run through.

928
00:49:56,680 --> 00:50:00,360
Speaker 2: People who are schizophrenic should not use these medications.

929
00:50:00,560 --> 00:50:02,600
Speaker 3: They're also illegal. They're illegal.

930
00:50:04,360 --> 00:50:06,799
Speaker 1: Oh yeah, so that's I have to say. As I

931
00:50:06,840 --> 00:50:08,720
Speaker 1: was reading all this stuff, and especially about the healthy

932
00:50:08,719 --> 00:50:11,560
Speaker 1: forty somethings and it being this incredibly meaningful experience, it's like,

933
00:50:11,600 --> 00:50:14,719
Speaker 1: you know, I'm curious, like I would probably want to try,

934
00:50:14,800 --> 00:50:18,120
Speaker 1: and then I'm like, oh, I have literally no idea,

935
00:50:18,320 --> 00:50:21,600
Speaker 1: like how to obtain a psychedelic Like short, have you

936
00:50:21,719 --> 00:50:23,120
Speaker 1: been to a fish concert?

937
00:50:24,080 --> 00:50:27,720
Speaker 3: Have you been to a fish concert do they still exist?

938
00:50:28,080 --> 00:50:31,520
Speaker 5: That's the But I think that that relates to the

939
00:50:31,560 --> 00:50:34,720
Speaker 5: second point, which is, of course, like these drugs are illegal,

940
00:50:34,760 --> 00:50:36,480
Speaker 5: and so if you decided you're just going to go

941
00:50:36,520 --> 00:50:39,120
Speaker 5: out and get yourself some you know, silos ibin on

942
00:50:39,200 --> 00:50:41,560
Speaker 5: the on the street corner, and like do it, do

943
00:50:41,640 --> 00:50:42,200
Speaker 5: it yourself.

944
00:50:42,400 --> 00:50:45,040
Speaker 3: You don't know that that's what it is, and so

945
00:50:45,280 --> 00:50:47,400
Speaker 3: you know, please do not do not do that.

946
00:50:47,960 --> 00:50:51,960
Speaker 1: Yes, adulterated stuff particularly, I mean, I guess mushrooms kind

947
00:50:52,000 --> 00:50:54,319
Speaker 1: of look like mushrooms. But first of all, mushrooms are

948
00:50:54,360 --> 00:50:57,320
Speaker 1: very scary because some mushrooms look like other mushrooms and

949
00:50:57,360 --> 00:51:00,200
Speaker 1: some are toxic. So there's just mushrooms, donty mushrooms. And

950
00:51:00,560 --> 00:51:06,280
Speaker 1: then LSD is so potent, Like an amount of LSD

951
00:51:06,719 --> 00:51:10,960
Speaker 1: the size of a grain of table salt is a

952
00:51:11,040 --> 00:51:14,160
Speaker 1: real dose of LSD. It is a thousand times more

953
00:51:14,239 --> 00:51:17,839
Speaker 1: potent than psilocybin at the serotonin two A receptor. So

954
00:51:17,840 --> 00:51:20,640
Speaker 1: that's that's fine if it's being like synthesized and careful

955
00:51:20,680 --> 00:51:23,279
Speaker 1: and everything is proper, but like it does mean that

956
00:51:23,440 --> 00:51:26,600
Speaker 1: you can't inspect it, like you're trusting that whatever's not

957
00:51:26,760 --> 00:51:28,640
Speaker 1: like dissolved on this piece of paper you're putting on

958
00:51:28,640 --> 00:51:31,640
Speaker 1: your tongue is what people tell you it is. And yes,

959
00:51:31,680 --> 00:51:34,960
Speaker 1: things absolutely get adulterated, so be careful out there. The

960
00:51:34,960 --> 00:51:37,480
Speaker 1: psychedelics increased blood pressure a little bit. We should say that,

961
00:51:37,560 --> 00:51:39,319
Speaker 1: you know whatever, if you have blood pressure problems, be

962
00:51:39,360 --> 00:51:41,640
Speaker 1: aware of that. And then yeah, you want to be

963
00:51:41,640 --> 00:51:44,160
Speaker 1: in a you know, safe place. You're not going to

964
00:51:44,160 --> 00:51:47,680
Speaker 1: be operating vehicles, folks, you got to be got to

965
00:51:47,680 --> 00:51:48,160
Speaker 1: be careful.

966
00:51:48,800 --> 00:51:52,719
Speaker 3: Gotta be careful, all right, Perry, smash your pass on

967
00:51:52,760 --> 00:51:53,760
Speaker 3: the psychedelics.

968
00:51:54,320 --> 00:51:59,560
Speaker 1: I'm smashing psychedelics. I mean as someone as again as

969
00:51:59,560 --> 00:52:01,960
Speaker 1: someone who's ever done them. I think that the data

970
00:52:02,000 --> 00:52:04,719
Speaker 1: for mental health is highly compelling. Obviously I want to

971
00:52:04,760 --> 00:52:08,040
Speaker 1: see more research here, but I'm so excited that that

972
00:52:08,239 --> 00:52:11,160
Speaker 1: is potentially opening up that that that a new door

973
00:52:11,239 --> 00:52:14,160
Speaker 1: is opening for people who suffer from these conditions. Super exciting,

974
00:52:14,480 --> 00:52:18,040
Speaker 1: you know. In terms of general wellness, I'm mostly curious,

975
00:52:18,120 --> 00:52:20,719
Speaker 1: Like I don't I don't certainly think it would ever

976
00:52:20,760 --> 00:52:24,719
Speaker 1: become part of my you know, wellness routine. But like

977
00:52:25,440 --> 00:52:29,240
Speaker 1: I am, I going to die never having experienced the

978
00:52:29,400 --> 00:52:31,920
Speaker 1: single most unusual conscious state of my life. That doesn't

979
00:52:31,960 --> 00:52:36,560
Speaker 1: seem like a good idea.

980
00:52:33,280 --> 00:52:33,360
Speaker 6: And.

981
00:52:35,680 --> 00:52:37,440
Speaker 3: I am also a smash on this.

982
00:52:38,320 --> 00:52:41,080
Speaker 2: I think I like to wait until we get a

983
00:52:41,080 --> 00:52:45,400
Speaker 2: little it gets a little more like you know, regularized.

984
00:52:45,239 --> 00:52:47,959
Speaker 1: Or regulated, like so you know that you're getting a

985
00:52:48,040 --> 00:52:48,920
Speaker 1: safe amount or something.

986
00:52:49,000 --> 00:52:51,920
Speaker 2: Yeah, yes, but I think definitely, you know when I

987
00:52:51,920 --> 00:52:53,239
Speaker 2: feel like when I was in we were in.

988
00:52:53,160 --> 00:52:56,560
Speaker 3: College, like pot was illegal, but now.

989
00:52:56,320 --> 00:53:00,640
Speaker 2: Like there's a drive through like dispensary exactly like on

990
00:53:00,719 --> 00:53:04,759
Speaker 2: the highway, And I feel that when there is a

991
00:53:04,880 --> 00:53:10,279
Speaker 2: drive through silocybin treatment option, I'm going to do it.

992
00:53:11,040 --> 00:53:14,400
Speaker 1: And when that happens, should we do an entire wellness

993
00:53:14,440 --> 00:53:16,520
Speaker 1: actually episode.

994
00:53:17,080 --> 00:53:19,359
Speaker 3: About what happened in the different.

995
00:53:19,080 --> 00:53:21,520
Speaker 1: Gobles I'm saying during.

996
00:53:22,520 --> 00:53:25,560
Speaker 3: During Okay, I think these things are like ten hours long.

997
00:53:25,600 --> 00:53:28,560
Speaker 2: I'm not sure that people's case for us live stre

998
00:53:28,800 --> 00:53:30,319
Speaker 2: but we can edit it.

999
00:53:30,440 --> 00:53:31,360
Speaker 3: We can edit it down.

1000
00:53:34,160 --> 00:53:37,560
Speaker 1: Sounds great. Your question of the week after the break.

1001
00:53:43,040 --> 00:53:44,080
Speaker 3: I am Eily and Perry.

1002
00:53:44,239 --> 00:53:47,960
Speaker 6: This is Meredith in Phoenix, and I have kind of

1003
00:53:47,960 --> 00:53:51,440
Speaker 6: a love hate relationship with tracking, you know, calories and

1004
00:53:51,560 --> 00:53:56,080
Speaker 6: steps and sleep. I think I'll love it and then

1005
00:53:56,160 --> 00:53:57,840
Speaker 6: I get kind of obsessed with it, and then I

1006
00:53:57,880 --> 00:54:01,319
Speaker 6: hate it. So I have a question for you, what

1007
00:54:01,480 --> 00:54:05,720
Speaker 6: is your relationship with tracking? What do you guys each track?

1008
00:54:06,440 --> 00:54:06,920
Speaker 3: Thanks?

1009
00:54:07,280 --> 00:54:09,320
Speaker 2: All right, Perry, I would I would venture this is

1010
00:54:09,320 --> 00:54:12,680
Speaker 2: a place in which we are almost polar opposites for

1011
00:54:12,840 --> 00:54:18,520
Speaker 2: people who otherwise share like a pretty similar like demographic lifestyle.

1012
00:54:19,280 --> 00:54:21,080
Speaker 3: Like you don't do any self tracking, do you?

1013
00:54:21,680 --> 00:54:21,799
Speaker 6: Uh?

1014
00:54:22,800 --> 00:54:26,080
Speaker 1: I'm really trying to think here, what do I track

1015
00:54:26,160 --> 00:54:29,680
Speaker 1: on like a daily basis? Like, yes, I've been tracking

1016
00:54:30,280 --> 00:54:34,560
Speaker 1: our podcast rankings, so hey, everyone leave weave a review

1017
00:54:34,880 --> 00:54:39,200
Speaker 1: and give us a five stars on Apple podcasts selt

1018
00:54:39,239 --> 00:54:42,160
Speaker 1: my daily tracking. No, I don't weigh myself daily. I

1019
00:54:42,160 --> 00:54:44,480
Speaker 1: think my phone tracks my steps, but like I don't

1020
00:54:44,520 --> 00:54:48,600
Speaker 1: know what they are. I don't track calories. Yeah, I

1021
00:54:48,640 --> 00:54:55,200
Speaker 1: am not a tracker. But Emily, how many different spreadsheets

1022
00:54:55,239 --> 00:54:57,720
Speaker 1: do you use to track zero?

1023
00:54:58,040 --> 00:54:59,680
Speaker 3: I'm just going to say it's not zero.

1024
00:55:01,000 --> 00:55:05,120
Speaker 2: I track a lot of things, and I want to

1025
00:55:05,160 --> 00:55:09,320
Speaker 2: explain why because I generally don't think it's a good idea.

1026
00:55:09,520 --> 00:55:11,480
Speaker 2: I feel like this is a like don't do like

1027
00:55:11,600 --> 00:55:13,239
Speaker 2: do as I say that as I do. I think

1028
00:55:13,640 --> 00:55:16,160
Speaker 2: for almost no one is it a good idea to

1029
00:55:16,200 --> 00:55:19,680
Speaker 2: obsessively track a huge number of the things that you're doing.

1030
00:55:19,719 --> 00:55:21,160
Speaker 3: Because I think for a lot of people. It makes

1031
00:55:21,160 --> 00:55:21,840
Speaker 3: it very anxious.

1032
00:55:21,960 --> 00:55:22,600
Speaker 1: Yeah, yeah, yeah.

1033
00:55:22,600 --> 00:55:24,760
Speaker 2: People always tell me like, Okay, I'm tracking my sleep,

1034
00:55:24,760 --> 00:55:26,320
Speaker 2: but like I woke up this morning and my sleep

1035
00:55:26,320 --> 00:55:28,040
Speaker 2: tracker said I didn't sleep good, but I felt like

1036
00:55:28,080 --> 00:55:28,600
Speaker 2: slept good.

1037
00:55:28,840 --> 00:55:29,760
Speaker 3: And now I'm like, worry.

1038
00:55:29,800 --> 00:55:31,800
Speaker 2: Now I'm laying up and I worrying my sleep tracker

1039
00:55:31,840 --> 00:55:34,280
Speaker 2: is going to judge me for my lack of sleep,

1040
00:55:34,280 --> 00:55:36,680
Speaker 2: and that's really bad for your for your sleep.

1041
00:55:36,760 --> 00:55:38,919
Speaker 3: So I think for most people.

1042
00:55:39,880 --> 00:55:44,440
Speaker 2: This there is like no, people don't like it. It

1043
00:55:44,520 --> 00:55:47,520
Speaker 2: makes them anxious and there's not a lot of value.

1044
00:55:47,600 --> 00:55:49,279
Speaker 2: Like if you just said, like I'm interested in like

1045
00:55:49,280 --> 00:55:52,080
Speaker 2: improving my health, yeah for the most part, Like you

1046
00:55:52,120 --> 00:55:53,920
Speaker 2: don't need to do any tracking for that.

1047
00:55:55,360 --> 00:55:56,560
Speaker 3: Why do I do this?

1048
00:55:56,680 --> 00:55:56,839
Speaker 1: Then?

1049
00:55:56,960 --> 00:55:59,000
Speaker 3: Given, I wonder what you do?

1050
00:55:59,120 --> 00:56:01,320
Speaker 1: Give me, Like what thing is that you track?

1051
00:56:02,440 --> 00:56:05,000
Speaker 2: So I have a whoop which tracks my sleep and

1052
00:56:05,040 --> 00:56:07,719
Speaker 2: my recovery. I track the miles that I run and

1053
00:56:07,760 --> 00:56:09,920
Speaker 2: the workouts that I do. I track how much proptein

1054
00:56:10,000 --> 00:56:14,759
Speaker 2: I get. Sometimes I track other macro nutrients. Right now

1055
00:56:14,760 --> 00:56:19,879
Speaker 2: I'm doing that because I wasn't eating enough and now

1056
00:56:19,920 --> 00:56:22,200
Speaker 2: I need to eat more for so I'm tracking my

1057
00:56:22,239 --> 00:56:26,759
Speaker 2: macro nutrients and that's probably it.

1058
00:56:27,640 --> 00:56:29,600
Speaker 1: Okay, right, Yeah, that's not bad.

1059
00:56:29,680 --> 00:56:34,480
Speaker 2: So it's it's a lot of different things. But I yeah,

1060
00:56:34,520 --> 00:56:36,040
Speaker 2: but I will say the two reasons I do this

1061
00:56:37,360 --> 00:56:39,239
Speaker 2: other than being crazy, which is I guess. The third

1062
00:56:39,280 --> 00:56:41,880
Speaker 2: reason is that I really like it. It's like a

1063
00:56:41,880 --> 00:56:43,719
Speaker 2: thing that like it's like a like it's like a

1064
00:56:43,760 --> 00:56:46,640
Speaker 2: thing I enjoy. Like it's to say, but it's like

1065
00:56:47,040 --> 00:56:47,720
Speaker 2: I like it.

1066
00:56:47,719 --> 00:56:51,520
Speaker 3: It's hum. I'm a numbers person. I like data. I

1067
00:56:51,560 --> 00:56:52,080
Speaker 3: liked I track.

1068
00:56:52,120 --> 00:56:54,120
Speaker 2: When my kids were babies, we would like track, you know,

1069
00:56:54,239 --> 00:56:56,320
Speaker 2: the diapers and then now amount of time they slept

1070
00:56:56,320 --> 00:56:59,160
Speaker 2: and all kinds of other stuff because like, even though

1071
00:56:59,200 --> 00:57:00,600
Speaker 2: I realized it was you so this, I just like

1072
00:57:00,600 --> 00:57:04,520
Speaker 2: thought it was fun. Yeah, And I care, as I

1073
00:57:04,760 --> 00:57:07,520
Speaker 2: have previously mentioned four hundred times on every episode of

1074
00:57:07,520 --> 00:57:11,359
Speaker 2: this podcast, I care tremendously about my athletic performance, and

1075
00:57:12,480 --> 00:57:14,520
Speaker 2: a fair amount of the tracking I do is in

1076
00:57:14,560 --> 00:57:18,520
Speaker 2: the service of like trying to link like behaviors to

1077
00:57:18,920 --> 00:57:22,680
Speaker 2: performance out christ Right, So that's it. But I don't

1078
00:57:22,680 --> 00:57:25,160
Speaker 2: think other I'm not. Maybe I'm just saying other people

1079
00:57:25,200 --> 00:57:25,880
Speaker 2: shouldn't do this so.

1080
00:57:25,880 --> 00:57:28,680
Speaker 3: I can run faster than them. Perhaps that's this is

1081
00:57:28,680 --> 00:57:30,240
Speaker 3: a competitive advantage.

1082
00:57:30,360 --> 00:57:34,600
Speaker 1: I would not put it past you. All Right. That's

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Speaker 1: it for us today. Stick with us next week when

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00:57:36,680 --> 00:57:42,600
Speaker 1: we'll ask what's the deal with methylene blue?

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Speaker 2: Wellness Actually is produced in association with iHeartMedia. Our senior

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Speaker 2: producer is Tamar Avisheik. Our executive producer at iHeart is

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Speaker 2: Jennifer Bassett. Our theme music is by Eric Deutsch, and

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Speaker 2: our content is for educational purposes only.

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00:57:58,240 --> 00:58:00,520
Speaker 1: If you like the show, help other people find us,

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00:58:00,840 --> 00:58:03,640
Speaker 1: leave a rating and review on Apple Podcasts or your

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00:58:03,720 --> 00:58:06,479
Speaker 1: podcatcher of choice, and help us spread the word about

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00:58:06,480 --> 00:58:09,520
Speaker 1: the show. You can follow us on Instagram at Wellness

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00:58:09,560 --> 00:58:12,640
Speaker 1: Actually pod and don't forget we want to hear from you.

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00:58:13,160 --> 00:58:15,680
Speaker 1: Head over to Wellness Actually dot fm and leave us

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00:58:15,680 --> 00:58:18,280
Speaker 1: a question for our mailbag or suggest a topic for

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00:58:18,320 --> 00:58:18,959
Speaker 1: a future show.

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Speaker 3: We'll let the influencers have the last word. We found

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Speaker 3: this one swimming naked in the fermentarium. I am eligit,

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Speaker 3: Queen