Speaker 1: Hi, I'm Ethan Edelman, and this is Psychoactive, a production
Speaker 1: of I Heart Radio and Protozoa Pictures. Psychoactive is the
Speaker 1: show where we talk about all things drugs. But any
Speaker 1: views expressed here do not represent those of I Heart Media,
Speaker 1: Protozoa Pictures, or their executives and employees. Indeed, as an
Speaker 1: inveterate contrarian, I can tell you they may not even
Speaker 1: represent my own. And nothing contained in this show should
Speaker 1: be used as medical advice or encouragement to use any
Speaker 1: type of drugs. Hello Psychoactive listeners. Back last year, I
Speaker 1: asked a dear friend of mine, who I think is
Speaker 1: one of the smartest thinkers and writers and advisers about
Speaker 1: drugs to join me on Psychoactive to answer questions from you,
Speaker 1: the audience, and a bunch of you left you know,
Speaker 1: some great questions, So we're gonna do that again. My
Speaker 1: friend's name is Dr Julie Holland, and she is a
Speaker 1: psychiatrist and a psychopharmacologist. She has been a willow and
Speaker 1: commentator on National TV. She um has an advisor to
Speaker 1: Psychedelics Company. She has edited or authored five books. Her
Speaker 1: first book was called Weekends at Bellevue, nine years on
Speaker 1: the night shift at the psyche R and her last
Speaker 1: two books. One was called Moody Bitches and the next
Speaker 1: one the most recent, Good Chemistry, The Science of Connection
Speaker 1: from Soul to Psychedelics. So, Julie, thank you so much
Speaker 1: for joining me again as a sort of co host
Speaker 1: and question answer on Psychoactive I'm very happy to be
Speaker 1: here Ethan any time that I can help you educate
Speaker 1: the populace, you know, that's what I love to do. Okay, Well,
Speaker 1: actually let's just start the last two books. Just tell
Speaker 1: me first of all with Moody Itches. I mean, it's
Speaker 1: got a great title. What was that book about? It
Speaker 1: is really about how women are sort of over pathologized,
Speaker 1: over diagnosed, and over medicated in today's sort of psychiatric ecosystem,
Speaker 1: that women uh can't have sort of a natural emotionality
Speaker 1: to them which we can make good use of and
Speaker 1: we don't need to pathologize it. So that's mostly what
Speaker 1: Moody Bitches was. And it was also just giving a
Speaker 1: lot of practical information to women about hormones, about psychiatric medicine,
Speaker 1: about inflammation, which I care deeply about. And the subtitle
Speaker 1: of Moody Bitches, is the truth about the drugs you're taking,
Speaker 1: the sleep you're missing, the sex you're not having, and
Speaker 1: what's really making you crazy and what is really making
Speaker 1: people crazy. What I wrote about towards the end of
Speaker 1: Moody Bitches was about how disconnected we are, disconnected from ourselves,
Speaker 1: from nature, from each other. And this was all way
Speaker 1: before COVID. So the book after Moody Bitch has really
Speaker 1: continued with this idea of connection versus disconnection. What good
Speaker 1: chemistry is all about. It's all about how if we
Speaker 1: are feeling safe and connected, our natural chemistry will make
Speaker 1: us feel good. And the reason why so many of
Speaker 1: us feel terrible and are taking other drugs or medications
Speaker 1: is that we aren't really enjoying that connection that's really
Speaker 1: our birthright and that we're sort of wired for. I'm
Speaker 1: just curious. It's been on my mind recently. I don't
Speaker 1: even know if this is drug related. But when you
Speaker 1: say about inflammation, if that was something you were very
Speaker 1: curious about and thought I had a lot to say,
Speaker 1: what what was the key elements of what you wanted
Speaker 1: to share with people? That the key elements is that
Speaker 1: inflammation underlies almost any disease process you can think of.
Speaker 1: If you don't have inflammation, you won't have diabetes. If
Speaker 1: you don't have inflammation, you won't have arthritis, you won't
Speaker 1: have Alzheimer's, you won't have cancer. So it is in
Speaker 1: the setting of inflammation that a lot of other really
Speaker 1: bad things happen to your body. And it's also true
Speaker 1: with your brain. When your body has any kind of inflammation,
Speaker 1: your brain suffers. And there are times where the brain
Speaker 1: has inflammation and then we're you're going to get into
Speaker 1: issues like anxiety or depression or insomnia. So Moody Bitches
Speaker 1: talks a lot about how to have sort of an
Speaker 1: anti inflammatory lifestyle, and good chemistry does as well. So
Speaker 1: anti inflammatory, you know, most of us know what anti
Speaker 1: inflammatory diet doesn't have flour and sugar. It's just got
Speaker 1: like whole foods that are sort of recognizable that grow
Speaker 1: outside in the sunshine. Anti inflammatory activities will be things
Speaker 1: like yoga or meditation or mindfulness. And then you have
Speaker 1: anti inflammatory medicines. Right, We all know about a leave
Speaker 1: and advil in these kind of name brand anti inflammatories,
Speaker 1: but many of us forget that cannabis and CBD are
Speaker 1: potent and anti inflammatories, as are some psychedelics. They are
Speaker 1: also anti inflammatory. So part of a healthy, anti inflammatory lifestyle,
Speaker 1: besides eating healthy food and staying as relaxed as you
Speaker 1: can be, is the sort of judicious addition of some
Speaker 1: drug as if you're comfortable with them, using things like
Speaker 1: cannabis or CBD or psychedelics, keeping in mind that they
Speaker 1: have anti inflammatory effects and therefore they're actually good for
Speaker 1: your body. You know, I'm curious. I've been thinking about
Speaker 1: doing an episode on sugar as it drunk, and when
Speaker 1: it comes to sugar inflammation, I mean, you see, generally
Speaker 1: a good idea that significantly reducing sugar intake can can
Speaker 1: make some real difference there. Absolutely. I mean what I
Speaker 1: wrote about it in Moody Bitches was really just eat
Speaker 1: the colored foods. Don't eat the white foods. As much
Speaker 1: as they taste good. The bread and dairy products, they're
Speaker 1: really not that great for you. Flour and sugar. White
Speaker 1: flour white sugar, for sure, are pro inflammatory. And sugar
Speaker 1: is its own little uh has got all kinds of issues.
Speaker 1: It is true that it really does act as a
Speaker 1: drug in the brain, and you can get sort of
Speaker 1: a tolerant to it. Or have withdrawal. If you're not
Speaker 1: having it, it does rereak havoc on your pancreas and
Speaker 1: your insulin levels. What's good to remember is that things
Speaker 1: like cannabis and CBD help to balance out your blood
Speaker 1: sugar levels. And you've mentioned the psychedelics would be helpful
Speaker 1: with inflammation as well, So psychedelics, yeah, well, I mean
Speaker 1: the truth is, the most anti inflammatory psychedelic is something
Speaker 1: called d o I, which is not commonly mentioned when
Speaker 1: we think about psychedelics, and for good reason. It actually
Speaker 1: has an incredibly long half life, so it's just not
Speaker 1: a practical thing to take. So, you know, let's go
Speaker 1: to the questions and soviets listeners to call into a
Speaker 1: phone number. The phone number is eight three three psycho
Speaker 1: zero or or A three three seven seven nine two
Speaker 1: four zero and just leave a question. And I'm hoping
Speaker 1: that Julie will be want to do this again with
Speaker 1: me sometime later this year early next and uh, and
Speaker 1: we'll do this again. So let's go to the first
Speaker 1: question from our listeners. Hi there, um, I was wondering
Speaker 1: if you could talk a little bit about substances and
Speaker 1: mental health and how that works differently for different people.
Speaker 1: We're going to psychiatric hospital, and obviously I see a
Speaker 1: lot of negative interactions with regards to certain substances and
Speaker 1: certain mental health diagnoses. So I'm just wondering if you
Speaker 1: can expand a little bit on how this works differently
Speaker 1: for different people and why, and maybe some research that
Speaker 1: might be coming down that UM speaks to these areas.
Speaker 1: I myself suffer from mental health conditions like anxiety and depression,
Speaker 1: and I find substances are very helpful in certain settings
Speaker 1: or context, but obviously I see a lot of negative impacts.
Speaker 1: I'm just wondering if you can elaborate or explain the
Speaker 1: science behind behind some of that, and maybe some of
Speaker 1: the policy that might inform that. Yeah, UM, so where
Speaker 1: would you like to jump in on that one? I'll
Speaker 1: start with what I know. For nine years, every Saturday
Speaker 1: night and Sunday night, I was the doctor in charge
Speaker 1: of the psychiatric emergency room at Bellevue Hospital, and I
Speaker 1: was in charge of it like a fifteen to sixty
Speaker 1: hour overnight shift, and far and away the substances that
Speaker 1: reak the most havoc and in the psychiatric patients that
Speaker 1: I saw in Bellevue number one alcohol, no question and
Speaker 1: number two cocaine, So these are also drugs. They can
Speaker 1: be detrimental. You know, the thing that people always kind
Speaker 1: of forget about alcohol is that it really is a depressant,
Speaker 1: and if you're using a depressant regularly, you're going to
Speaker 1: get depressed and stay depressed. And a lot of the
Speaker 1: people that I saw who had problems with alcohol, we're
Speaker 1: significantly depressed, were suicidal. And you know, part of the
Speaker 1: problem is that once you get to the point of
Speaker 1: being sort of dysfunctional and addicted, you're also not able
Speaker 1: to work or support yourself. You're not able to keep
Speaker 1: up your relationships and your connections, so you become more disconnected.
Speaker 1: Maybe you end up on the street or homeless and
Speaker 1: you have no money, and all of those things are
Speaker 1: obviously going to make you more miserable, more suicidal. But
Speaker 1: far and away, alcohol was the biggest sort of problematic
Speaker 1: drug that I saw in all my work in psychiatry,
Speaker 1: and then with cocaine, and it was really in particular
Speaker 1: crack cocaine that we had people who would come in
Speaker 1: off of binges where they've been smoking crack for days
Speaker 1: and they were very paranoid or they were psychotic, or
Speaker 1: they were crashing from their cocaine binge and they were
Speaker 1: terribly depressed. So from a practical point of view, these
Speaker 1: are the two drugs that I think are most sort
Speaker 1: of problematic for mental health maintenance. But on the flip
Speaker 1: side of that, what we know, or what we're learning
Speaker 1: now is that there are some drugs that people might
Speaker 1: consider them to be drugs of abuse, but they can
Speaker 1: actually be helpful for people who have psychiatric diagnoses. The
Speaker 1: most sort of advanced research I can think of now
Speaker 1: is m d m A assisted therapy for the treatment
Speaker 1: of post traumatic stress disorder. So most of you, I
Speaker 1: imagine know that m d m A is also known
Speaker 1: as as ecstasy or molly. It's methylene dioxy methamphetamine. It
Speaker 1: is typically used, certainly in research context. It is used
Speaker 1: alongside of psychotherapy to make the therapy go deeper and
Speaker 1: be more efficient and more effective. So we're seeing m
Speaker 1: d m A therapy as a potential treatment for psychiatric
Speaker 1: diagnoses like post traumatic stress disorder, possibly also for anorexia,
Speaker 1: possibly also for the kind of existential anks and anxiety
Speaker 1: that comes with a terminal diagnosis. Say you just found
Speaker 1: out that you have cancer and you're trying to sort
Speaker 1: of wrap your head around not existing anymore. So there
Speaker 1: are ongoing clinical studies looking at using m DUMA to
Speaker 1: treat psychiatric diagnoses. And there's also ongoing clinical studies looking
Speaker 1: at psilocybin, the active ingredient in quote magic mushrooms, to
Speaker 1: treat some psychiatric disorders. So there's sort of a wide
Speaker 1: range of an interaction between substances and mental health. You know,
Speaker 1: one of the things I always like to remind people
Speaker 1: is when you're looking at the m d m A
Speaker 1: research or the psilocybin research, keep in mind that anybody
Speaker 1: with a history of psychosis, anybody who carries the diagnosis
Speaker 1: of schizophrenia or has a history of being psychotic, and
Speaker 1: even people who have a first degree relative who has
Speaker 1: a history being psychotic, like say you have a sister
Speaker 1: with schizophrenia or a father who gets psychotic when he's manic,
Speaker 1: You're not going to be allowed into these studies. We
Speaker 1: just don't know yet how what the interaction of psychedelics
Speaker 1: is going to be with people who have got sort
Speaker 1: of chronic, persistent mental illness. So I think it's safer
Speaker 1: to talk about anxiety and depression. But when we start
Speaker 1: talking about bipolar disorder or schizoaffective or schizophrenia, some of
Speaker 1: the really sort of heavy duty psychiatric diagnoses. It is
Speaker 1: probably safer to not partake while we figure out what
Speaker 1: the effects are going to be. Bellvue is a New
Speaker 1: York City hospital, which makes you probably seeing a lot
Speaker 1: more crack cocaine, you know, back in the nineties early
Speaker 1: two thousands. But I mean, could the Saint thing about
Speaker 1: meth amphetamine and people who are smoking or injecting it. Yeah,
Speaker 1: that's really important to mention because you know, there's some
Speaker 1: sort of unwritten law that like east of the Mississippi
Speaker 1: you're gonna see more cocaine, and west of the Mississippi
Speaker 1: you're gonna see more methamphetamine. We never really had a
Speaker 1: huge methamphetamine problem in New York City. Certainly when I
Speaker 1: was at Bellevue, which was like mid nineties to mid
Speaker 1: two thousand's, there wasn't a lot of methamphetamine. But we
Speaker 1: would occasionally see somebody again who was coming off off
Speaker 1: of a run or a binge where they've been using
Speaker 1: methamphetamine for several days, where they would be psychotic or
Speaker 1: paranoid or agitated. And keep in mind that part of
Speaker 1: that agitation and psychosis just comes from sleep deprivation. You
Speaker 1: keep somebody awake for two or three nights, even without drugs,
Speaker 1: you're going to have psychiatric symptoms in that person. So
Speaker 1: it's just that much worse if you're also giving a
Speaker 1: dopamine agonis. But you definitely can get psychotic from methamphetamine
Speaker 1: US and typically the psychosis takes long to clear to
Speaker 1: go away than it does from cocaine, and that may
Speaker 1: just be because the half life of methymphetamine is significantly
Speaker 1: longer than the half life for cocaine. The only other
Speaker 1: form of methamphetamine that I've heard about on and off
Speaker 1: over the years was something that people called ice, which
Speaker 1: is basically like the crack version of meth where it's
Speaker 1: like a smokable methamphetamine. Obviously, people can smoke methamphetamine, they
Speaker 1: can snort it, they can inject it. UM So I
Speaker 1: don't know about it like a particularly super strong meth
Speaker 1: but I honestly think the one we have is sort
Speaker 1: of is strong enough. Um it can really rereak havoc
Speaker 1: on your reality testing, not quite knowing what's real and
Speaker 1: what's not. What about for people who are borderline or schizophrenic. Well,
Speaker 1: we normally tend to think stay away from psychedelics. Um
Speaker 1: is that generally the rule? But are there also cases
Speaker 1: where it actually can be therapeutic? Any? Yeah, Well, I
Speaker 1: mean the first the first answer, the first layer of
Speaker 1: the ant sir, is we don't have all the data yet.
Speaker 1: Then the second layer is that if you have a chronic,
Speaker 1: persistent mental illness or a very serious diagnosis like bipolar
Speaker 1: or schizo effective or schizophrenia, it is probably safer to
Speaker 1: not engage with these drugs. That being said, there is
Speaker 1: definitely research going on. I mean, I'm particularly interested in
Speaker 1: whether m D m A may be able to help
Speaker 1: the negative symptoms of schizophrenia. There was a researcher, Burnt Angrist,
Speaker 1: many decades ago who actually gave methemphetamine to people with
Speaker 1: schizophrenia who had negative symptoms. So, I know when people
Speaker 1: think of schizophrenia, they think of somebody here in voices,
Speaker 1: or being paranoid, or being disorganized. Those things are all true,
Speaker 1: but those are the positive symptoms. The negative symptoms, which
Speaker 1: are harder to treat with medication and more sort of pervasive,
Speaker 1: is things like not wanting to do anything, not having
Speaker 1: a lot of motivation, not thinking a lot, not speaking
Speaker 1: a lot. You know, you're just kind of like a
Speaker 1: bump on a log. And it may be that giving
Speaker 1: m d m A assisted therapy can get people a
Speaker 1: little bit more motivated, a little bit more engaged, and
Speaker 1: also potentially to have more of a therapeutic alliance with
Speaker 1: their therapist. So there are some very small pilot studies
Speaker 1: in early stages of planning to look at whether m
Speaker 1: d M A might be helpful and negative symptoms in schizophrenia.
Speaker 1: In terms of bipolar, I just think people are kind
Speaker 1: of holding off. But I know there's one person who
Speaker 1: feels like ayahuasca might be helpful and bipolar. But I
Speaker 1: know of multiple case studies and people who have gotten
Speaker 1: destabilized from ayahuasca. So I think that if you're bipolar,
Speaker 1: and if you have any history of getting manic, you
Speaker 1: really want to be very very careful and probably air
Speaker 1: on not taking these medicines because they are potentially destabilizing.
Speaker 1: I mean, even cannabis can be destabilizing in some of
Speaker 1: these patient populations. M You know, there was this article
Speaker 1: in late May in New York Times about new approaches
Speaker 1: emerging in terms of mental illness and about patients and
Speaker 1: patient advocates saying, you know, rather than trying to suppress
Speaker 1: the voices we're hearing, maybe it's more about learning to
Speaker 1: live with these voices. I saw that. I saw that
Speaker 1: article and this this was a really brave, unusual article
Speaker 1: that they're talking about that there are groups of people
Speaker 1: who carry a diagnosis of schizophrenia who don't want to
Speaker 1: take the medications and want to find other ways to
Speaker 1: manage their symptoms. So the big risk when you hear voices,
Speaker 1: it really comes down to who you think is speaking
Speaker 1: to and whether you're going to do what they say
Speaker 1: or not. And you know, the joke I sort of
Speaker 1: make is like, you know, usually do what your mother
Speaker 1: tells you, right, So if it's your mother's voice and
Speaker 1: she's saying, you know, kill someone, and that that's really
Speaker 1: a much more dangerous situation. Then like let's say you
Speaker 1: think it's the voice of the devil, but you know
Speaker 1: you're a good Christian or something, and then you're not
Speaker 1: going to be following the voices. So this idea of
Speaker 1: like a delusional framework within like what is the context
Speaker 1: of these voices? How do you perceive the voices? I
Speaker 1: had a patient who bit off his fingertips because he
Speaker 1: thought that it was the voice of Buddha telling him
Speaker 1: to prove his worth as a disciple to Buddha, and
Speaker 1: he felt that this was a way to prove his
Speaker 1: worth as a disciple. He clearly believed that the voice
Speaker 1: was the voice of buddhas So who who you think
Speaker 1: is speaking to has a lot to do with how
Speaker 1: you're going to behave. It's a complicated, sort of dangerous
Speaker 1: area to talk about somebody who's psychotic, who doesn't want
Speaker 1: to take medicine. But the bottom line is that you know,
Speaker 1: this is America, and we have a lot of freedoms here,
Speaker 1: We have a lot of civil liberties here. And I
Speaker 1: don't think people should be medicated against their will under
Speaker 1: any circumstances. But the truth is, at Bellevue, there was
Speaker 1: a certain amount of people getting medicated against their will
Speaker 1: where they were dangerous to themselves or they were dangerous
Speaker 1: to other people's and at least temporarily, we had to
Speaker 1: sedate them just to sort of defuse the situation, to
Speaker 1: make things safer. So I was really intrigued by that article.
Speaker 1: I like that there are places, you know, there are
Speaker 1: places in Western Massachusetts that if you have schizophrenia and
Speaker 1: you don't want to take medication, that maybe you can
Speaker 1: go and they will help you learn how to live
Speaker 1: with your voices or how to manage your symptoms without meds.
Speaker 1: It's nice to have all of these options. Well, it
Speaker 1: made me think also just about you know, m d
Speaker 1: n A assisted psychotherapy, because you know, a big part
Speaker 1: of m d n A is the ability to listen
Speaker 1: in ways that one does not normally listen to a lover, partner, friend,
Speaker 1: whatever it might be. And I was wondering, you know,
Speaker 1: to imagine m d NA with people in schizophrenia. Has
Speaker 1: anybody ever tried that? Or would one never get submission
Speaker 1: to do such a study? So I edited a book
Speaker 1: about m d m A called Ecstasy the Complete Guide,
Speaker 1: back in two thousand and one. I have a chapter
Speaker 1: on using m d m A in psychiatry and a
Speaker 1: chapter on using m DMA in the treatment of schizophrenia.
Speaker 1: And in that chapter I told the story of I
Speaker 1: think it was a four sort of case studies. You know,
Speaker 1: people who had gotten in touch with me, people who
Speaker 1: had a diagnosis of schizophrenia, who had had m d
Speaker 1: m A, who had a respite from their symptoms, their
Speaker 1: voices got quieter, their paranoia came down, they felt that
Speaker 1: sort of heart opening toward their family or toward their caregivers.
Speaker 1: So I have been saying, you know, for thirty years,
Speaker 1: like this is something we should look at. I mean,
Speaker 1: I also talked about the very first time I ever
Speaker 1: took M d m A, my head was so quiet.
Speaker 1: It's not that I hear voices, but you know, there's
Speaker 1: a little bit of chitter chat to chat, you know,
Speaker 1: there's like a little inner, inner monologue going on. And
Speaker 1: when the M D M A came on, I was
Speaker 1: like luxuriating and how quiet my head was. And one
Speaker 1: of the first things that I thought of was, wouldn't
Speaker 1: this be lovely for somebody who's hearing voices to just
Speaker 1: have that quiet, Like, even if it didn't do anything else,
Speaker 1: even if it just gave you quiet for an hour
Speaker 1: or two, that would be a lovely gift to give someone.
Speaker 1: So these studies haven't been done. There is a schizophrenia
Speaker 1: researcher named Stephen Martyr at U c l A I believe,
Speaker 1: who is starting to look at this. And there's another
Speaker 1: schizophrena researcher named John caine on Long Island, and they
Speaker 1: are going to start to look at whether m d
Speaker 1: m A might be helpful. But the first group of patients,
Speaker 1: and that my recommendation was find people who have a
Speaker 1: lot of negative symptoms, because I don't think you're going
Speaker 1: to make them worse. But we just don't know. I
Speaker 1: guess the only thing I would maybe at, you know,
Speaker 1: she asked about drug policy, how how drug policy is
Speaker 1: reflected in this intersection between mental health and substance abuse,
Speaker 1: And I would say that we are seeing, first of all,
Speaker 1: many sort of municipalities and cities around the United States
Speaker 1: America are decriminalizing possession of some psychedelics or at least
Speaker 1: de prioritizing any sort of persecution from a legal perspective.
Speaker 1: But then you have Oregon, which is actually really trying
Speaker 1: to formulate a new way of thinking about psilocybin mushrooms
Speaker 1: as be therapeutic. And Oregon is starting to look at
Speaker 1: using using psilocybin therapeutically in various patient populations, not just
Speaker 1: post traumatic stress disorder. So I think that is a
Speaker 1: real example of a big change in our drug policies,
Speaker 1: going from you don't take this, it's dangerous it's gonna
Speaker 1: give you psychiatric symptoms to you may be able to
Speaker 1: use this to ease some of your psychiatric symptoms. You know,
Speaker 1: it's very interesting in Oregon now because I think there's
Speaker 1: a very serious, mature effort to try to make sure
Speaker 1: the rollout of this Oregon psilocybin you know, medical psilocybin initiative.
Speaker 1: You know, it kind of rolls out effectively and carefully,
Speaker 1: and I think there are plans under way to do
Speaker 1: similar sorts of initiatives in other states. Yeah. Well, I
Speaker 1: will tell you that I I was contacted by some
Speaker 1: policymakers in Washington State who were really watching what Oregon
Speaker 1: was doing and thought that they would go next. We'll
Speaker 1: be talking more after we hear this add Okay, let's
Speaker 1: go to question number two. Hey, I am a gay
Speaker 1: man in New York, and I've been noticing a growing
Speaker 1: trend in the gay community here around the prevalence of
Speaker 1: the drug g hb UM. I've always known the combination
Speaker 1: of g HP and alcohol can be deadly, and I
Speaker 1: guess what I'm now seeing is men swearing off alcohol
Speaker 1: entirely and instead taking g HP regularly, almost with the
Speaker 1: same frequency as just regular social drinking. Many of these
Speaker 1: guys are even citing their physical health and their ability
Speaker 1: to stay in shape and avoid hangovers as the motivation.
Speaker 1: I guess I was wondering if you could talk to
Speaker 1: the overall health and safety around g HB. I mean,
Speaker 1: obviously alcohol is unhealthy for a whole host of reasons,
Speaker 1: but is g HB significantly better? What can you tell
Speaker 1: us about g h B? And it's you know, safety margin,
Speaker 1: safety levels and risks. Well, first of all, it is
Speaker 1: kind of funny how things come around. It was very
Speaker 1: big at the nine Dies, and then it somehow sort
Speaker 1: of fell off the map, and now it's coming back around.
Speaker 1: So look in terms of safety. Unfortunately, and you know,
Speaker 1: this is often the case that because of our drug policy,
Speaker 1: because of our nation's drug policy, these things end up
Speaker 1: less safe and more dangerous. The biggest issue with g
Speaker 1: HB is that you don't always know what you've got, right.
Speaker 1: It's a clear, colorless liquid. I mean typically it's a
Speaker 1: powder that is dissolved into water. How much powder and
Speaker 1: how much water is going to decide how strong that is.
Speaker 1: So if you haven't made this batch yourself, you're really
Speaker 1: relying on somebody else to figure out how many grams
Speaker 1: is in how many milli leaders, and that's gonna have
Speaker 1: everything to do with how potent it is and what
Speaker 1: your effect is. But it's true that you shouldn't mix
Speaker 1: JHB with alcohol, and it may even be true that
Speaker 1: if you know exactly what your doses that it is
Speaker 1: sort of harm reduction to use g HB instead of alcohol. However,
Speaker 1: the harm comes from not knowing what your dosage is.
Speaker 1: You know, it's not legal to buy, so you have
Speaker 1: to kind of go to the black market or at
Speaker 1: least a gray market when you're purchasing these things. So
Speaker 1: you just back in the nineties, I think it was,
Speaker 1: and it was more use and I think DA or
Speaker 1: whoever you know, then scheduled it in two thousand one
Speaker 1: or so, right, there was a time when when you
Speaker 1: could buy it online and it went by all sorts
Speaker 1: of names. It was like a computer keyboard cleaner. That
Speaker 1: was one of the ways, like clean your keyboard with
Speaker 1: this special cleanser. So there were ways to buy it online.
Speaker 1: So because it's clear and colorless, someone can put it
Speaker 1: in your drink and you're not going to know it,
Speaker 1: so and that way it could be dangerous. But like
Speaker 1: let's say you knew exactly how much you were taking.
Speaker 1: I still sort of take issue with this idea of
Speaker 1: regular use. There's don't thing called g b L, which
Speaker 1: uh I know that some bodybuilders were using g b L,
Speaker 1: you know, scoops of g b L in sort of
Speaker 1: a smoothie as a way to build muscle. And I
Speaker 1: did want to see a guy at Bellevue who abruptly
Speaker 1: stopped using g b L and was completely delirious and
Speaker 1: basically psychotic because he was in withdrawal. So I believe
Speaker 1: that it is safe for me to say that if
Speaker 1: somebody is using large amounts of g h B day
Speaker 1: after day after day and they abruptly discontinue it, there
Speaker 1: is going to be a withdrawal syndrome that is going
Speaker 1: to be pretty hard to predict exactly what's going to
Speaker 1: happen for user. So the big issue at g h B. Yes,
Speaker 1: it makes you feel sort of floaty and less anxious,
Speaker 1: um and maybe a little separated from your body, but
Speaker 1: it higher doses. It's basically just gonna put you to sleep.
Speaker 1: It induces an un arousable sleep, which which some people
Speaker 1: will call a coma because it is really hard to
Speaker 1: get somebody out of the state of sleep, but you
Speaker 1: do eventually wake up. So it's just really comes down
Speaker 1: to the dosage and safety, knowing what you have, knowing
Speaker 1: what the dosage is, figuring out what works for you
Speaker 1: where you maybe feel a little relaxed but you're not comatose.
Speaker 1: It is dangerous to mix with alcohol, and it is
Speaker 1: dangerous to use regularly. I think I would say, I
Speaker 1: don't know, Ethan what you want to add that, well,
Speaker 1: you know, I just think you know, we obviously we
Speaker 1: say that, you know, so many overdose fatalities, especially before
Speaker 1: the advent of fentanyl. We're not actually, you know, pure
Speaker 1: heroine or pharmaceutical overdoses. They were typically drugs being mixed
Speaker 1: with alcohol or ben zones. And of course, I think
Speaker 1: when quick could say is that when when mixes opioids
Speaker 1: and alcohol in lower doses, it can be a remarkable high.
Speaker 1: And the danger is is that if you simply go
Speaker 1: double or triple that it may stop you breathing. And
Speaker 1: I wonder what g HB is. It's similar that g
Speaker 1: HB combined with alcohol and very low doses may give
Speaker 1: especially nice high, but that the toxicity ratio you know
Speaker 1: the amount that will kill you. That's you know, that
Speaker 1: much more than the normal dose is a very risky thing.
Speaker 1: You know, I don't know exactly, you know, the bottom
Speaker 1: line is you have to keep breathing right and if
Speaker 1: you're if you're really drunk and you're sort of face
Speaker 1: down on a pillow, you can stop breathing. And you know,
Speaker 1: your brain is set up to always remind you to breathe,
Speaker 1: and there's conscious reminders and sort of unconscious reminders that
Speaker 1: you keep breathing. And when you start combining depressants, you
Speaker 1: lose the conscious reminder to breathe, and then eventually you
Speaker 1: also lose the unconscious reminder. Now, opiates are very particular
Speaker 1: and that they really suppress the drive to breathe more
Speaker 1: than most other drugs. Obiit's like even in sort of
Speaker 1: safe medical dosages, you're breathing less frequently. So combining any
Speaker 1: depressants and you increase that risk of not breathing. Like
Speaker 1: Heath Ledger was was a terrible accident. It was an
Speaker 1: accidental overdose. He wasn't trying to kill himself, and he
Speaker 1: had a number, Yeah, he had a number of depressants
Speaker 1: in his system. He also had a lung infection, and
Speaker 1: he was also faced down on the bed. It's if
Speaker 1: any of those things were different, if he didn't have
Speaker 1: a pneumonia, if he was lying on his side, if
Speaker 1: he had taken one fewer depressant than he would probably
Speaker 1: still be with us. So that it's it's often a
Speaker 1: confluence of events, multiple drugs, and other sort of extenuing
Speaker 1: circumstances that that lead to these problems. So let's go
Speaker 1: to the next question. Okay, Hey, Julian Ethan, this is
Speaker 1: Matt from Chattanooga, Tennessee. Big Fann, you both, thank you
Speaker 1: for everything that you do. My question is do you
Speaker 1: view the war on drugs as a house of cards
Speaker 1: that could topple if we chip away at it consistently?
Speaker 1: For example, m d m A becoming a medicine, psilocybin,
Speaker 1: mushrooms gaining popularity and even decriminalization in some places, and
Speaker 1: federal legalization of cannabis seemingly around the corner. What do
Speaker 1: think the tipping point is or is it going to
Speaker 1: be more of a bitter fight to the end incrementally
Speaker 1: substance by substance, state by state. Let me know what
Speaker 1: you think. Okay, Well, Julie made I'll start off on
Speaker 1: this one and then hand it over to you. Yeah,
Speaker 1: I definitely want you to start off. I mean, I'll
Speaker 1: tell you with the line I've used for many, many
Speaker 1: years is that when it comes to ending drug prohibition,
Speaker 1: there is no eighteenth Amendment of drug prohibition that will
Speaker 1: repeal this alcohol prohibition was with the twenty first Amendment,
Speaker 1: And there is no Berrilin Wall of drug prohibition that's
Speaker 1: gonna come crumbling down in the way the Berlin Wall,
Speaker 1: did you know, back in was or whatever exactly that was.
Speaker 1: So I think it is inevitably an incremental process. I
Speaker 1: think we can see very clearly the ways in which
Speaker 1: starting with the legalization of marijuana for medical purposes back
Speaker 1: in ninety six, first through the initiative process and then
Speaker 1: through the state legislative process, really did transform the broader
Speaker 1: popular discussion around marijuana in ways that he you know,
Speaker 1: result in marijuana getting legalized first in Colorado and Washington,
Speaker 1: uh in twelve and now and I think nineteen states
Speaker 1: around the country. And in fact, I've oftime said that
Speaker 1: if you ask, how could it be that the United States,
Speaker 1: which was the great champion of the drug war for
Speaker 1: so long, including the War on Marijuana. Nonetheless, became the
Speaker 1: world leader on decriminalizing and legalizing marijuana, first for medical
Speaker 1: and other purposes. It was because we did that sort
Speaker 1: of incremental process with medical marijuana and then moving into
Speaker 1: marijuana decriminate, attacking marijuana arrest, and the ultimate legalization. And
Speaker 1: you can see to some extent the ways in which
Speaker 1: that has evolved. It's clearly inspired some of the reforms
Speaker 1: that are going on on psychedelics, especially the decriminalization element.
Speaker 1: It's also inspired the push for a broader decriminalization of
Speaker 1: all drug possession. Right Oregon did not just legalize psychedelic
Speaker 1: therapy in but they also became the first state to
Speaker 1: basically legalize the Portugal model of decriminalization where nobody goes
Speaker 1: to jail ample for drug possession. Now how far that
Speaker 1: goes and how that relates for the fentinel crisis going
Speaker 1: on now you see legislators introducing all kinds of stupid
Speaker 1: drug war legislation to increase penalties, impose mandatory minimum penalties
Speaker 1: to punish the boyfriend who gave it to a girlfriend
Speaker 1: or vice versa where one of them, you know, died
Speaker 1: of an overdose. You know, there is, there is a
Speaker 1: spillover effect. It does carry that way, but I think
Speaker 1: it's going to be a long time process, and they're
Speaker 1: gonna be periods where we roll backwards and the pendulum
Speaker 1: swings back the other way, as it you know and
Speaker 1: inevitably does in any area of social policy. But what
Speaker 1: are your thoughts. I agree with everything you said. Just
Speaker 1: like cannabis, which went sort of state by state, first
Speaker 1: a lot of medical cannabis, then more legalization, I think
Speaker 1: you're going to see the same thing with psychedelics, where
Speaker 1: it's going to kind of go state by state and
Speaker 1: first you're going to see medical and de krim and
Speaker 1: it's going to take a longer time to do legalization.
Speaker 1: I also, I know when it comes to the sort
Speaker 1: of the poisoning overdose crisis, people want to do something,
Speaker 1: and the knee jerk reaction is just to do what,
Speaker 1: you know, what they've always done before, with mandatory minimums
Speaker 1: and sort of you know, cranking up the rhetoric. I
Speaker 1: am less, sort of optimistic. I think just about our
Speaker 1: government in general and how effective or efficient our our
Speaker 1: government is going to be these days, and you know,
Speaker 1: some of it depends on the mid terms. And what
Speaker 1: happens in the next election. You know, this is a
Speaker 1: very slow process. I have been championing cannabis and m
Speaker 1: D m A and psychedelics since the mid eighties, you know,
Speaker 1: it's like thirty something years, knowing that it was going
Speaker 1: to be a slow process, knowing I had to be
Speaker 1: very patient, and that if I wanted to be alive
Speaker 1: to see like the fruits of my labors, I was
Speaker 1: going to have to follow an anti inflammatory diet and
Speaker 1: watch my blood pressure in my cholesterol. Um, it's a
Speaker 1: it's a long game. It's a slow game, and it
Speaker 1: is definitely fits and starts, and one step forward to
Speaker 1: steps back. I mean, the major area we need to
Speaker 1: see some big reform now is in dealing with the
Speaker 1: overdose crisis and the fact that a hundred thousand people
Speaker 1: died last year, the majority involving fent at all, basically
Speaker 1: an unregulated drug supply, invroving a very dangerous form of
Speaker 1: an opioid, very highly potent one. You see British Columbia
Speaker 1: just recently, I think in early June, getting permission from
Speaker 1: the federal government of Canada to basically implement a safe
Speaker 1: supply approach where a decriminalization approach, whereby people are not
Speaker 1: going to be getting busted for possessing small amounts of
Speaker 1: any drug. Now, the activists will say the amounts that
Speaker 1: they allow her too small, and it's still still too restrictive,
Speaker 1: and it's time limited and all this sort of stuff.
Speaker 1: But I think if there's gonna be a significant movement
Speaker 1: in the US, the next stage will probably be in
Speaker 1: people getting more innovative and in responding to the overdose crisis.
Speaker 1: By great frustration has been that we've not seen you know,
Speaker 1: heroin maintenance, heroin prescribing trials going on in the United States,
Speaker 1: like like we've in Europe, you know, for the less
Speaker 1: thirty years, to the point where this is now national
Speaker 1: policy in many European countries, but still nobody in the
Speaker 1: US is doing that. But I do think that could
Speaker 1: be the next frontier. I would really like to see
Speaker 1: that happen. I mean, I have been pushing for supervised
Speaker 1: injection facilities for a very long time, and there's finally
Speaker 1: one open in New York. But I think anything that
Speaker 1: we can do to create a safer supply, you know, again,
Speaker 1: it's because of our nation's drug policy that we are
Speaker 1: having some of these problems, So it makes sense that
Speaker 1: that's where we have to have some of the solutions
Speaker 1: is through problems. Well, next question, Hi, My question is
Speaker 1: is if there's any research into tolerance and also perhaps
Speaker 1: withdrawal symptoms from cannabis. Use my own personal experience, and
Speaker 1: this is in recent years. Is I only need a
Speaker 1: small fraction of a Graham smoking it to yet a
Speaker 1: very desirable high effect, like I'm talking like four or
Speaker 1: five hits in a bowl. And I know other people
Speaker 1: who smoke massive, massive amounts. For me, I bought an
Speaker 1: ounce of medical grade uh, you know, medical marijuana, and
Speaker 1: and it actually lasted me an entire year. Uh. And
Speaker 1: I know other people who might go through that in
Speaker 1: you know, perhaps a month. And what is it that's
Speaker 1: different about people? Why does my physical tolerance for the
Speaker 1: drugs seem to reset every weeking day? Why do other
Speaker 1: people need massive amounts? And and you know, is there
Speaker 1: much research going on? Has the research been done? I
Speaker 1: also when I stopped, I had no physical withdrawal symptoms.
Speaker 1: And of course I know other people have reported significant
Speaker 1: you know, sleep disruption, appetite disruption and everything else. So
Speaker 1: so what's the difference? And I the special snowflake or
Speaker 1: are the other people a typical ones? Thanks well, Julie.
Speaker 1: As the editor of a book called The Pot Book,
Speaker 1: what's your answer to this fellow's questions, We are all
Speaker 1: special snowflakes, I guess would be the first answer. So
Speaker 1: there has been some clinical research on cannabis tolerance and withdrawal.
Speaker 1: Most of it came out of um a unit at
Speaker 1: at Columbia Hospital in New York City where they would
Speaker 1: keep people on the unit and then give them cannabis
Speaker 1: a lot and then abruptly stop and see how they did.
Speaker 1: And they were able to show for some people there
Speaker 1: were withdrawal symptoms along the lines of irritability, more difficulty
Speaker 1: initiating sleep, less of an appetite. They're pretty short lived.
Speaker 1: They're not in any way dangerous. I mean, I always
Speaker 1: one of our mind people. If you're a heavy drinker
Speaker 1: and you drink every single day and you abruptly stopped drinking,
Speaker 1: that is potentially a life threatening situation. It's very medically dangerous.
Speaker 1: There is a chance that you can have seizures, and
Speaker 1: if you start having seized years, there's about a thirty
Speaker 1: percent chance that you will not stop having seizures and
Speaker 1: you will actually die. So if you are heavily addicted
Speaker 1: to alcohol and you abruptly stop, that is potentially fatal.
Speaker 1: So if you compare that with some irritability and lack
Speaker 1: of appetite and difficulty falling asleep for a night or two,
Speaker 1: it's just nowhere. It's not not even comparable. But I
Speaker 1: also want to talk about this issue of tolerance. Um
Speaker 1: Some people talk about trying to take a tolerance break
Speaker 1: where they stop smoking for some amount of time so
Speaker 1: that they can sort of reset and use a lower dose.
Speaker 1: And there's a cannabis doctor in Maine, Dustin Sulac, who
Speaker 1: has sort of figured out that for most people they
Speaker 1: really only need to stop for about four full days
Speaker 1: and that is enough to reset the tolerance. So some
Speaker 1: people are more tolerant than others. A lot of people
Speaker 1: switch between strains which they think will help to delay
Speaker 1: or defer the tolerance from happening. But I think it's
Speaker 1: safe to say that it's not clinically significant. It's not
Speaker 1: medically significant. If people have a withdrawal, it is not
Speaker 1: in any way dangerous, And lots of people don't have tolerance,
Speaker 1: don't have withdrawal, I think to some degree it depends
Speaker 1: on how much you smoke and how frequently you smoke.
Speaker 1: Is that is the case with any tolerance or withdrawal,
Speaker 1: But it is certainly possible that some people are more
Speaker 1: sensitive to tolerance and withdrawal than other people are. And
Speaker 1: you know, one of the things they showed in like
Speaker 1: cannabis with driving is that people who are regular smokers
Speaker 1: being intoxicated with cannabis didn't really have a negative impact
Speaker 1: on their driving. But if you had somebody who was
Speaker 1: not a regular smoker who was having a large response
Speaker 1: to the cannabis and wasn't used to those effects, it
Speaker 1: would have more of an impact on their driving. I
Speaker 1: also want to say one thing about dreams and remembering dreams,
Speaker 1: because I've heard this from so many patients. If you
Speaker 1: are a regular pot smoker, you you don't always dream,
Speaker 1: or you think you're not dreaming, or you don't remember
Speaker 1: your dreams. And then when people abruptly stop, they will
Speaker 1: report very vivid dreams and they will report remembering their dreams.
Speaker 1: I've heard this from a number of people, so I
Speaker 1: am assuming it is true. I don't know if there's
Speaker 1: any medical literature on it, but it is sort of
Speaker 1: one of the more interesting things to me about withdrawal
Speaker 1: is that you have more intense dreams or you remember
Speaker 1: your dreams. I'm curious also when it comes how dose
Speaker 1: connects to this. If you're using it much higher doses
Speaker 1: on a regular basis, is it more likely that you'll
Speaker 1: have more substantial withdrawal symptoms after that or is this
Speaker 1: independent of the level of dose. Well, based on Louis
Speaker 1: tolerance and withdrawal works, you should have more of issues
Speaker 1: if you're smoking more. You know, if you're a heavy
Speaker 1: smoker and you're smoking more frequently, you're more more likely
Speaker 1: I think, to get withdrawal symptoms. Then if you're not
Speaker 1: smoking a lot or you're not smoking frequently as with
Speaker 1: other drugs. To me, though, it's a little bit of
Speaker 1: a moot point because it's not like you really see
Speaker 1: these things chemically, you know, or clinically. It's not like
Speaker 1: vomit the psyche are I have somebody coming in and
Speaker 1: they're an acute cannabis withdrawal and you know they're in
Speaker 1: this life threatening state. It's just it doesn't rise to
Speaker 1: the level of being an issue clinically or medically. Let's
Speaker 1: take a break here and go to an ad do
Speaker 1: you know, I mean, now with all this stuff emerging
Speaker 1: with tirpenes and things like this, if you hold the
Speaker 1: THHC level of the marijuana of different types of marijuana constant,
Speaker 1: but you're shifting around the turpines and other things like that,
Speaker 1: is there any research suggesting that when you switch to
Speaker 1: a different type or brand or type of marijuana with
Speaker 1: a different set of turpines and all the other things
Speaker 1: that you know, affect the flavor and taste of the marijuana,
Speaker 1: that it may actually get you high. Yeah. I mean,
Speaker 1: that's totally what I was saying about, like switching strains
Speaker 1: like fence. It's medical cannabis patients that really need their
Speaker 1: medicine every day. Sometimes they will be told to switch
Speaker 1: strains around a little bit so that they can avoid tolerance.
Speaker 1: H So that would you're saying, I have to ask
Speaker 1: you this question. Actually, you know, for me, um, you know,
Speaker 1: as I've got a little older, I noticed that my
Speaker 1: body doesn't tolerate alcohol quite as well, and I don't
Speaker 1: enjoy drinking as much as I used. I might have
Speaker 1: maybe a glass, but having multiple doesn't feel right anymore.
Speaker 1: So I might use five milligrams an edible marijuana just
Speaker 1: for a sort of social to be in a social environment.
Speaker 1: And I might take ten milligrams if I was going
Speaker 1: to go for a long massage or something like that.
Speaker 1: And you know, if and if if it's a cannabis
Speaker 1: infused dinner. I had the cannabis chef Nicki Stewart on
Speaker 1: some months ago and she was talking about how you know,
Speaker 1: if you're eating it during the course of of course
Speaker 1: of a meal. You know, people can take thirty milligrams,
Speaker 1: maybe even more, and it doesn't have the impact of
Speaker 1: swallowing fifty milligram gummy or something like that at one time.
Speaker 1: But then I know a couple of people who are
Speaker 1: basically consuming a thousand millah graham's a gram of th
Speaker 1: HC daily And these are very high functioning people. And
Speaker 1: one of the most brilliant human beings I've ever known
Speaker 1: is now consuming between three thousand and five thousand milligrams
Speaker 1: of th HC daily. And I mean, there's absolutely no
Speaker 1: research out there right about what kind of effect this has,
Speaker 1: whether it's negative or beneficial or I mean, do we
Speaker 1: know anything about No. I'm I am really not familiar
Speaker 1: with those high doses. I'm definitely familiar with high dose
Speaker 1: CBD in the psychiatric literature and that being potentially beneficial
Speaker 1: even for things like bipolar disorder or schizophrenia. Like most
Speaker 1: people when they take CBD, they may take like five
Speaker 1: or fifteen or twenty five milligrams, but the psychiatric literature
Speaker 1: people are taking six d eight hundred or a thousand milligrams,
Speaker 1: which is a gram. But I actually haven't heard about
Speaker 1: these ultra high th HC doses, but I know that
Speaker 1: you can build up to any dose that you can,
Speaker 1: you know, be tolerant. And in terms of like the dinner,
Speaker 1: the infused dinner, I think if it's over several hours
Speaker 1: and you're eating, it's gonna sort of slow down the
Speaker 1: absorption of how much t HC is going to get
Speaker 1: into your system. So it's again it's like you're saying,
Speaker 1: you're not taking it all at once. When you orally
Speaker 1: ingest th HC, your liver creates a new chemical which
Speaker 1: is eleven hydroxy th HC, and eleven hydroxy takes longer
Speaker 1: to come on, last longer, and is more psychedelic than
Speaker 1: th HC itself. And one other thing I want to say,
Speaker 1: just in case we've got any real kind of wonky
Speaker 1: nerds listening who care about receptors. You know, the five
Speaker 1: H T two A receptor, which is the receptor that
Speaker 1: is sort of tickled by most psychedelics. If you have
Speaker 1: enough th HC, if you take a high enough dose
Speaker 1: of th HC, you will start to tickle that five
Speaker 1: H T two A receptor. Because the cannabis receptor, the
Speaker 1: c B one receptor UH makes a receptor pair with
Speaker 1: the five H T two A upter, and those two
Speaker 1: receptors together they make what's called the dimer the cannabis
Speaker 1: receptor c B one and the serotonin two A receptor.
Speaker 1: When they make a dimer. That is one of the
Speaker 1: reasons why higher dose t HC ends up feeling more psychedelic,
Speaker 1: is that you are actually agonizing that psychedelic receptor, the
Speaker 1: serotonin two A. Okay, well, in that highly technical note,
Speaker 1: which I appreciate, let's turn to the next question. Hi,
Speaker 1: I just listened to the episode with Brian ear on
Speaker 1: Love Drugs. They really liked it, but there's something missing there,
Speaker 1: and that is, of all the drugs they talked about,
Speaker 1: what they didn't talk about was cannabis, which is perhaps
Speaker 1: the most popular aphrategi act of all. So that's my question,
Speaker 1: what about cannabis when it comes to Love Drugs? Thank you,
Speaker 1: bye bye, Julia. I'll tell you. I mean when I
Speaker 1: interviewed this from Biolysis is Brian was fascinating his book
Speaker 1: Love Drugs, and it covered a whole spectrum of things, right,
Speaker 1: including not just peep M D M A and things
Speaker 1: like that, or alcohol for that matter, but also the
Speaker 1: ways in which people can use different types of drugs,
Speaker 1: or their studies that you can forget unpleasant memories, things
Speaker 1: like that. But at the very end, I said, what
Speaker 1: about cannabis? And he said, yeah, I I left it out.
Speaker 1: But what's your sense about you know, your professional sense, uh,
Speaker 1: the review of the literature sense about cannabis and love, Well,
Speaker 1: it's it's so highly variable. First of all, people's reactions
Speaker 1: to cannabis is very variable. I mean, you can put
Speaker 1: five people in a circle sharing a joint and maybe
Speaker 1: some people are gonna get horny, and some people last
Speaker 1: thing they're gonna want to do is have sex. You know,
Speaker 1: there's tremendous variability from person to person when you're using
Speaker 1: the same cannabis. And then if you've got two or
Speaker 1: three different strains, you're going to have even more variability.
Speaker 1: So the first thing I would say is hard to predict,
Speaker 1: hard to control a lot of variables in that there
Speaker 1: are so many different kinds of strains of cannabis, and
Speaker 1: there are so many different people's responses. And I have
Speaker 1: definitely heard from a number of women who tell me
Speaker 1: that hash in particular, Hash seems to work better for
Speaker 1: them than cannabis as sort of a pro sexual agent.
Speaker 1: And I don't know if it's because the CBD t
Speaker 1: HC ratio is a little bit more favorable in hash
Speaker 1: than cannabis. But some people swear by using cannabis before
Speaker 1: they have sex. I have a patient who she sort
Speaker 1: of will only have sex with her husband if they smoke.
Speaker 1: So some people need it, some people like it. Some
Speaker 1: people find that it really gets in the way um.
Speaker 1: Sometimes cannabis makes it more difficult to climax. Sometimes cannabis
Speaker 1: puts you so much in your head and you're so
Speaker 1: busy thinking thinking that you're not really in your body.
Speaker 1: You're not totally appreciating everything that your body is doing
Speaker 1: for you. Some people get horny, but they can't climax.
Speaker 1: And then the other thing I wanted to say about
Speaker 1: cannabis was that for some people it's a real heart opener.
Speaker 1: I have this experience a lot, like you know, I'll
Speaker 1: be in a fight with Jeremy and I'll have a
Speaker 1: puffer two and then I will go right back up
Speaker 1: to Dermy and just being a completely different open hearted
Speaker 1: You're right, I'm wrong. I see, I see now what
Speaker 1: you're saying. Like, you know, I was so closed and
Speaker 1: now I'm so open. So I think anything that sort
Speaker 1: of opens your heart, it is bound to help you
Speaker 1: connect with somebody. But sex is super complicated, and you know,
Speaker 1: for some people it is about heart opening and intimacy,
Speaker 1: and then for other people it's much more purely purely
Speaker 1: physical and and there's no intimacy involved, you know. And
Speaker 1: it really depends on your childhood experiences with sex or
Speaker 1: how you were taught about masturbation, or if you masturbate,
Speaker 1: or if you were taught that that was bad. You know.
Speaker 1: For some people having a drink or having some pot
Speaker 1: and they feel a little bit less inhibited, the brakes
Speaker 1: are off, you know, and then that an opportunity to
Speaker 1: have more pleasurable sex. But you need gas and brakes,
Speaker 1: you know. So I'm wondering, actually, if you and Brian
Speaker 1: ever spoke about a compound called to c B, which
Speaker 1: to me is sort of the most pro sexual of
Speaker 1: the psychedelics. And I was wondering if maybe that came up.
Speaker 1: I don't remember if we talked about two CP, and
Speaker 1: I don't know if I want to share my personal
Speaker 1: experiences on this podcast, well, can you share anything about
Speaker 1: cannabis and sex? Then I guess that was well, I mean,
Speaker 1: I'll tell you a funny story Julie. Years ago, before
Speaker 1: marijuana was legal anywhere. This must have been I don't know,
Speaker 1: I'm guessing two thousand seven, eight nine, something like that.
Speaker 1: We're trying to figure out how to move public opinion
Speaker 1: further along, and by by that period, I think there
Speaker 1: was beginning to be a slight majority of men who
Speaker 1: were in favor of legalizing marijuana for adults. But there
Speaker 1: was almost between five and sometimes almost ten point gender
Speaker 1: gap in support for marijuana legalization, with men much more
Speaker 1: likely to support it. And so I came up with
Speaker 1: this idea, which was marijuana and sex, especially among older women.
Speaker 1: And I knew anecdotally many women who were in their forties, fifties,
Speaker 1: sixties who say that basically that marijuana played an absolutely
Speaker 1: essential role in their sexual and intimate relationship with their
Speaker 1: husband of many decades, and they say, you know, but
Speaker 1: for marijuana, we probably wouldn't been having sex anymore. Now.
Speaker 1: In the end, I never proceeded with that. It would
Speaker 1: have been a hard campaign for DPAH Alliance as a
Speaker 1: policy organization to launch. But I will say that anecdotally,
Speaker 1: I've been struck by how many people, especially women I
Speaker 1: have encountered, who just feel that cannabis and sex go
Speaker 1: hand in hand, like basically nothing else you asked before
Speaker 1: about two c B, right, And in the book by
Speaker 1: Sasha and Sikal right, and I think almost did a
Speaker 1: disservice in that because she writes about when she and
Speaker 1: Sasha are first experimenting with two c B and she
Speaker 1: takes two c B and she falls into perhaps the
Speaker 1: most devastating depression in her life and just can't even
Speaker 1: pick herself emotionally up off the floor whatever. And then
Speaker 1: Sasha in the other room and he comes in the
Speaker 1: door and she sees him and he's like glowing in
Speaker 1: her you know, because two CB is somewhat psychedelic and
Speaker 1: all of a sudden thing flips in the other direction,
Speaker 1: and she describes having the most extraordinary multi orgasmic sex
Speaker 1: of her entire life with Sasha under the influence of
Speaker 1: two CB. And I think what happened was that then
Speaker 1: people said, oh my god, let's just get some too CP,
Speaker 1: and we'll have this amazing multi orgasmic sex. And of
Speaker 1: course it doesn't just work like pivotal. Yeah. I mean,
Speaker 1: I can say this much. My own personal experience was
Speaker 1: that when it came to two C B and sex
Speaker 1: that on the one hand, the negative side was that
Speaker 1: the sen sile, the touch felt much clammy or not pleasant,
Speaker 1: not appealing. On the other hand, there was a kind
Speaker 1: of colorization of sexual sensation that was sort of erotic
Speaker 1: and pleasing and all that. But that was my own experience,
Speaker 1: and I really said, varies dramatically from one person to
Speaker 1: the next. Well, I will say I'm doing a lot
Speaker 1: of consulting for psychedelic companies, and I have spoken to
Speaker 1: a couple of companies that are really really looking at
Speaker 1: sort of women's sexual pleasure, and you know, to CB
Speaker 1: is certainly one of the things that comes up as
Speaker 1: as a possible sort of catalyst for this process, but
Speaker 1: it's just too complicated for it to work in everybody,
Speaker 1: you know. But I would say in general, I have
Speaker 1: sampled quite a few psychedelics and last forty something years
Speaker 1: and two CB is the only psychedelic that I've ever
Speaker 1: ingested where I would even consider feeling sexy, wanting to
Speaker 1: have sex, like feeling horny, anything like. Usually it's just
Speaker 1: not even on the table. But it's also possible that
Speaker 1: I was very much influenced by pikal Okay, okay. So
Speaker 1: let's go to the last question we have from our listeners.
Speaker 1: Hiathan and Julia. I really appreciate the important work that
Speaker 1: you're doing, and I love the show. If you had
Speaker 1: a time machine and you could go a hundred years
Speaker 1: into the future, how do you say or imagine drugs
Speaker 1: being integrated and accepted into the broader culture in Western
Speaker 1: countries in Australia where a little bit behind the times,
Speaker 1: and it's very frustrating. So I'm just wondering your thoughts
Speaker 1: on on how you say the future painting out so
Speaker 1: truly you want to take a first crack at that
Speaker 1: or should I. Honestly, I really can't stim and these
Speaker 1: questions come up. I'm just I don't know what my
Speaker 1: problem is, but I'm not very good at like imagining
Speaker 1: or envisioning how things are going to go. Um, I'd
Speaker 1: love you to start and then maybe it'll give me
Speaker 1: some ideas. Yeah, I mean, first of all, to think
Speaker 1: a hundred years forward too, when you know, God knows
Speaker 1: what shape planet Earth will be in, what shape human
Speaker 1: kind will be in. Um, I just find it impossible
Speaker 1: to answer at that level. What I do think is
Speaker 1: that we are obviously going to continue to see a
Speaker 1: growing proliferation of psychoactive substances. I mean, I remember, even
Speaker 1: going back thirty years ago Julie, people would say, oh,
Speaker 1: we're going to see the replacement of cocaine by synthetics,
Speaker 1: replacement of this by synthetics, blah blah blah blah blah.
Speaker 1: And I think people always expected that to happen sooner
Speaker 1: than later. But I do think over time we're head
Speaker 1: of that direction. So one question it raises is whether
Speaker 1: the classic plant psychoactive substances, right, cannabis, coca you know,
Speaker 1: which becomes cocaine, opium which becomes opiates, tobacco which becomes nicotine,
Speaker 1: and some of the psychelics. Whether in fact those things
Speaker 1: will continue to play, I have to imagine they're going
Speaker 1: to play an ever diminishing role in the broader consumption
Speaker 1: of psychoactive substances as synthetics get developed that offer us
Speaker 1: more and more of the potential upside to these substances
Speaker 1: and less and less of the downsides. That's one I
Speaker 1: think fairly safe prediction. On the other hand, the fact
Speaker 1: that these substances have been around, these plant products from millennia,
Speaker 1: sometimes ten thousand years, um, makes me think that they
Speaker 1: really do have some powerful staying power. Secondly, UM, you know,
Speaker 1: the notion of how these substances are going to become
Speaker 1: more and more integrated. You know, it's like when you
Speaker 1: imagine just jumping forward a few decades, even imagining Prozac
Speaker 1: generation seven and m d m A generation four, or
Speaker 1: when you look at what some of the psycholics research
Speaker 1: companies are more and more trying to do of developing
Speaker 1: different psychedelics that give you the upsides without some of
Speaker 1: the downsides of nausea or physical discomfort or what have you. Um,
Speaker 1: whether or not we basically see alcohol get essentially displaced.
Speaker 1: I mean, alco obviously has so much to do with
Speaker 1: taste and flavor and culture that I'd be surprised if
Speaker 1: alcohol really disappears in any substantial way from our society. UM.
Speaker 1: It's also hard to know whether we'll continue with drug
Speaker 1: prohibitions or whether some innovations will simply happen that make,
Speaker 1: you know, the absurdity of prohibitions just so readily apparent
Speaker 1: that governments give up. I also wonder about other types
Speaker 1: of things, you know, virtual reality experiences and things like that,
Speaker 1: that may in fact offer you know, safer forms of
Speaker 1: altered states of consciousness than we get from the plant
Speaker 1: substances and the synthetic drugs. The one thing I feel
Speaker 1: highly confident of is that people are going to continue
Speaker 1: experimenting with and using it, consuming for a broad, almost
Speaker 1: infinite variety of reasons, all sorts of psychoactive substances, and
Speaker 1: that the notion of ever there ever being any kind
Speaker 1: of drug free culture, drug free society is utterly absurd.
Speaker 1: I think, even if you imagine, you know, the way
Speaker 1: that China is going now with ever greater uses of
Speaker 1: artificial intelligence and surveillance, and all of this, the innate
Speaker 1: need of a desire of human beings to alter their
Speaker 1: states of consciousness one way or another, and the ways
Speaker 1: in which psychoactive substances kind of facilitate that process better
Speaker 1: than and more effectively, sometimes for good, sometimes for bad,
Speaker 1: than any other forms of ways instigating an ultrasto consciousness.
Speaker 1: I think that even in the most totalitarian and hyper
Speaker 1: control societies will continue to see people using these substances.
Speaker 1: So what do you think? Yeah, No, I as usual,
Speaker 1: I agree with what you're saying. You know, one thing
Speaker 1: I have seen just in advising some of these psychedelic
Speaker 1: companies is that there are a number of companies who
Speaker 1: are looking to sort of tweak the molecules we already
Speaker 1: know about, to make them last longer or be shorter,
Speaker 1: or have some effects and not other effects. So I
Speaker 1: think we're going to continue to see this sort of
Speaker 1: you know, alphabet soup of like new chemical entities twists
Speaker 1: on old molecules. I also think it's worth hoping that
Speaker 1: there is still going to be payote around, that there
Speaker 1: will still be boufoil various around that you know, the
Speaker 1: natural sources that you mentioned, I hope that they don't
Speaker 1: get depleted. People have figured out how to sort of
Speaker 1: preferentially use synthetic mescaline so that they aren't over harvesting
Speaker 1: payote and find other ways to make five M E
Speaker 1: O D M T that don't involve, you know, molesting
Speaker 1: these toads. You know, there was a time member when
Speaker 1: I was talking to Michael Paullen when he was doing
Speaker 1: his New Yorker piece. This is the article that became
Speaker 1: his treatment. Yeah. Well, I mean when he was writing
Speaker 1: that New Yorker article, Jeremy and I are like, you're
Speaker 1: going to write a book, aren't you, Like there's clearly
Speaker 1: enough here for a book. But I remember talking to
Speaker 1: him about this idea of like mental health clubs that
Speaker 1: you know, the same way you can go to a
Speaker 1: gym and there's a lot of different equipment that you
Speaker 1: can get on to work your legs or your arms.
Speaker 1: Like maybe at some point you'll be able to go
Speaker 1: to like a mental health club where you will have
Speaker 1: you know, rooms for meditation or for yoga, but there
Speaker 1: will be a two C B room or an M
Speaker 1: D M A room and you will be able to
Speaker 1: have some sort of psychedelic assistant therapy offered to you. Obviously,
Speaker 1: integration is important, and you know, screening in preparation. But
Speaker 1: I am assuming that these sort of processes of having
Speaker 1: psychedelic assisted therapy available. I am assuming that they will
Speaker 1: become more commonplay ace, and people will be sort of
Speaker 1: more educated about them, and we'll be able to avail themselves.
Speaker 1: But I see that in like ten or twenty years.
Speaker 1: I mean, God knows what's going to happen in a
Speaker 1: hundred years. You know, it's hard enough to sort of predict.
Speaker 1: I mean, we know that f d A is going
Speaker 1: to be presented with some very convincing data on m
Speaker 1: DUMA assistant therapy for ptsd ine, and it's very possible
Speaker 1: that m DMA will be FDA approved in and then
Speaker 1: I think with psilocybin, the data will probably be gathered
Speaker 1: a year or two after that. So even just in
Speaker 1: the in the short term, we're going to have big
Speaker 1: changes where people are going to have access to these
Speaker 1: medicines and it's going to create its own sort of
Speaker 1: cascade of effects. When I talk about the explosive growth
Speaker 1: right now what's happening in the psychedelic space, I always
Speaker 1: talk about pruning. You know, if you're a gardener and
Speaker 1: you've got explosive growth, you need to cut back. You
Speaker 1: need to prune it. It's too big and too bushy,
Speaker 1: and you have to make some hard decisions about what
Speaker 1: stays and what goes. But in the long run, that
Speaker 1: pruning makes for a healthier plant that will produce more fruit.
Speaker 1: So I feel like we are going to be in this,
Speaker 1: in this expansive growth and pruning phase for at least
Speaker 1: the next ten, maybe even twenty years. So I don't
Speaker 1: know what happens if we do all that where we're
Speaker 1: at in a hundred years. I just know you and
Speaker 1: I are not going to be here to see it. Yeah,
Speaker 1: how much do you fear a crackdown of the sort
Speaker 1: that you know, there was obviously that psychelic renaissance that
Speaker 1: have been initially in the fifties and early sixties and
Speaker 1: then was really obliterated by the late sixties early seventies.
Speaker 1: What's your fear about that happening? You know? I sort
Speaker 1: of joke about like too big to fail, or that
Speaker 1: there's an awful lot of momentum right now. So I
Speaker 1: do sort of feel like the two spaces out of
Speaker 1: the tube and you're not going to be able to
Speaker 1: put it back. And there are so many people now
Speaker 1: who who know that these can be used as medicines
Speaker 1: and that these can help a lot of people, and
Speaker 1: that we have got a true epidemic of anxiety and
Speaker 1: depression and suicidality and substance abuse and alcoholism sort of
Speaker 1: stemming from isolation and loneliness and loss of meaning. And
Speaker 1: you know, people are pretty miserable, and COVID did not help.
Speaker 1: So we really are having a mental health crisis and
Speaker 1: we're going to need outside the box solutions for these problems. Um,
Speaker 1: it's just hard to see how everything is going to
Speaker 1: shake out well on that uncertain No, Julie, I want
Speaker 1: to thank you for co hosting Psychoactive with me this
Speaker 1: second time. I want to encourage our listeners in the
Speaker 1: hope that Julie will agree to do this again, that
Speaker 1: if you have questions on your mind, I'll do it
Speaker 1: right now. In fact, just call a three three psycho
Speaker 1: zero or eight three three seven seven nine two four
Speaker 1: six zero three three seven seven nine two six zero,
Speaker 1: leave a question you'd like Julian or I to answer,
Speaker 1: and hopefully we'll get to it the next time we
Speaker 1: do this. But Julius, and thank you ever so much
Speaker 1: for doing this with me. It's an incredible pleasure to
Speaker 1: catch up with you, whether we're doing it with a
Speaker 1: recording like this or just in person. So thank you,
Speaker 1: Thank you anytime, Ethan. It's on my absolute pleasure. If
Speaker 1: you're enjoying Psychoactive, please tell your friends about it, or
Speaker 1: you can write us a review at Apple Podcasts or
Speaker 1: wherever you get your podcasts. We love to hear from
Speaker 1: our listeners. If you'd like to share your own stories,
Speaker 1: comments and ideas, then leave us a message at one
Speaker 1: eight three three seven seven nine sixty that's eight three
Speaker 1: three psycho zero, or you can email us at Psychoactive
Speaker 1: at protozoa dot com or find me on Twitter at
Speaker 1: Ethan natal Man. You can also find contact information in
Speaker 1: our show notes. Psychoactive is a production of Heart Radio
Speaker 1: and Protozoa Pictures. It's hosted by me Ethan Naedelman. It's
Speaker 1: produced by Noam Osband and Josh Stain. The executive producers
Speaker 1: are Dylan Golden, Ari Handel, Elizabeth Geesus and Darren Aronofsky
Speaker 1: from Protozoa Pictures, Alex Williams and Matt Frederick from My
Speaker 1: Heart Radio, and me Ethan Nadelman. Our music is by
Speaker 1: Ari Blucien and a special thanks to a. Brios F.
Speaker 1: Bianca Grimshaw and Robert BP. Next week I'll be talking
Speaker 1: with Rick Doblin, who founded the Multidisciplinary Association of Psychedelic
Speaker 1: Studies otherwise known as MAPS back in and is now
Speaker 1: leading the way for the legalization of m d m
Speaker 1: A as a therapeutic substance. So the journal Science polishes
Speaker 1: a list of what they consider it to be the
Speaker 1: world's top ten scientific breakthroughs of the year, and fore
Speaker 1: they considered our phase three paper published in Nature Medicine
Speaker 1: as one of the world's top ten scientific breakthroughs of
Speaker 1: the year. And it was just so satisfac to really
Speaker 1: speak about m d m A and the therapeutic use
Speaker 1: of m d m A as one of the world's
Speaker 1: top ten scientific breakthroughs of the year. Subscribe to Cycleactive
Speaker 1: now see it, don't miss it.