On with Kara Swisher - Psychedelics with Joe Green

Episode Date: January 18, 2024

From therapeutic-assisted MDMA to decriminalized psilocybin and microdosing, movements to legalize psychedelics are everywhere. California-based Joe Green is a prominent voice in the movement, as the co-founder and President of the Psychedelic Science Funders Collaborative (PSFC). Kara asks him about the recent unfavorable headlines (including concerns over Elon Musk’s potential drug use and Matthew Perry’s death from ‘acute effects of ketamine’) and poses a question from Investigative Reporter Olivia Goldhill about how proselytizers can be held to account.  Questions or comments? Email us at [e-mail] or find us on social media. We’re on Instagram/Threads as @karaswisher and @nayeemaraza Learn more about your ad choices. Visit podcastchoices.com/adchoices

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We scheduled this interview a while back, but it could not be better timing. There's been new reporting recently by the Wall Street Journal about Elon Musk's alleged use of illegal drugs, including psychedelics. Friends star Matthew Perry's death was blamed on ketamine, and back in October, an off-duty pilot who was allegedly hallucinating after a psilocybin trip tried to turn off a plane's

engines mid-flight. But it's not all this is your brain on drugs. There's been a lot of hype and promise about psychedelics being used to treat a slew of mental health issues, from anxiety to eating disorders to depression and addiction. Colorado has decriminalized personal use of psilocybin and other psychedelics. In Oregon, you can legally go on a mushroom trip at a healing center without a prescription. Last month, President Biden approved defense spending for research into using psychedelics to treat active military service members. And perhaps most importantly, the FDA is currently deciding whether to review or fast track an application to use MDMA, the drug in ecstasy, to treat PTSD.

Some of that research has been supported by tech entrepreneurs, which is where I first heard about it many years ago when several of them offered me a trip and they weren't talking about going anywhere in their private planes, including my guest today, Joe Green, who actually never offered me any drugs. So there's that. Joe's been a social tech entrepreneur for decades. He co-founded the site Causes, which helps people make an impact and worked on immigration reform through the platform Forward. Now he's the co-founder and president of the Psychedelic Science Funders Collaborative, which also supports efforts to legalize psychedelics for non-prescription purposes. But in addition to these philanthropic efforts, a bunch of venture capitalists, of course,

have also been dumping a lot of cash into psychedelic companies. I've spoken about psychedelics at length with Michael Pollan, bestselling author of How to Change Your Mind, who suggested Olivia Goldhill as our expert of the week. My name's Olivia Goldhill. I'm an investigative reporter at the publication Stat, and I'm also writing a book on the psychedelic industry for Bloomsbury. And the big topic I'd love to hear discussed is power and accountability. So, you know, philanthropists, of course,

believe in the good of what they're doing, and I think a lot of people working in psychedelics really believe in that too. But it is important to note that donors have influence. They have access to drug developers, their bankrolling ballot initiatives. And, you know, this is a field like any other, you know, there are going to be scandals, there are going to be problems. There are going to be scandals, there are going to be problems, and some of the people with the money have a lot of sway in terms of what gets examined, what gets kind of overlooked. And so I'd love to hear how Joe is navigating that world, the specifics of his own financial ties to psychedelics, and whether there's a need for outside accountability bodies or more transparency. That's a good one, Olivia. Accountability is an issue I talk about a lot and it needs to happen here. We'll talk to Joe about that and more after the break. Fox Creative. This is advertiser content from Zelle. When you picture an online scammer, what do you see?

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We've been talking for years about this topic and other topics, too. And first, we're recording this on January 8th, just days after the Wall Street Journal article came out about Elon Musk's drug use. I know you and I texted about this. It's been reported that he had a prescription for psychedelic-like ketamine, but according to the journal, Elon is allegedly regularly using illegal psychedelics like LSD, magic mushrooms, and ecstasy. Using illicit drugs could violate the SpaceX Pentagon contract. Musk lawyer Alex Spiro told the journal that Elon is, quote, regularly and randomly drug tested at SpaceX and has never failed a test. But people inside Tesla and SpaceX are all allegedly worried about some of his erratic behavior. The tweets, the interviews might be because of drugs.

I understand you don't want to comment about individuals, but this sort of puts focus on the topic a lot. And there's been a couple of other stories. Matthew Perry, that pilot who was on psilocybin. Just overall, what do stories like this do? And on Pivot, I talked to my brother about it, and he said it demonizes some of this stuff in not a great way. But I'd love to get your thoughts on this, given how famous Musk is. a lot of really good research happening with psychedelics, with alcohol use disorder, and the government was funding it. And then in the late 60s, partially due to the Nixon administration, the Vietnam War protests, but also a very small number of stories really entered this dark ages where we've had these treatments that we know are incredibly impactful for mental health.

treatments that we know are incredibly impactful for mental health. And they've been unavailable for certainly my entire lifetime. And what I'm focused on is the therapeutic use of psychedelics, which really is psychedelics as a tool that's an adjunct to therapy. You know, and I received the, you know, DARE drug education, which basically had no nuance and just said all drugs are bad. And I think the important thing is all different substances all have different characteristics. They have risks, they have benefits. And I think we need a different policy where we're really educating people in an honest way. Because people are going to use drugs recreationally. Again, that's, you know, luckily, the way that these drugs are both most efficacious and safest is in the therapeutic container. And so, you know, my hope is certainly that that's

what people focus on. But, you know, I don't want to deny that there are real risks with using these in an uncontrolled way. In an uncontrolled way. What happens when stories like this happen? Because there's been a series of them recently, and there weren't that many, actually. People were sort of starting to embrace the idea of psychedelics, Michael Pollan's books. Does it set you back when that happens, you know, in the case of Matthew Perry or the pilot? I mean, I think it doesn't seem to have set us back with the FDA. I mean, the FDA, luckily, is really looking at evidence. And MDMA-assisted therapy for PTSD, the drug was just submitted to FDA after two very successful phase three trials, where in one trial, 67%, and the other one, 71% of people went from

moderate or severe PTSD to having no diagnosable PTSD. And that's just amazing. And I think that it just reinforces the need for that safe therapeutic container, right? So I think when these stories happen, it just reinforces how important it is to have good regulated legal access so that people are not turning to more dangerous uses. There was also an article last summer in the Journal that made it sound like almost everyone in Silicon Valley is currently tripping or coming off a trip or planning their next one. It's certainly where I heard about it for the first time, including getting offered an ayahuasca trip, come microdose with me. I was like,

I'd like to do nothing less than microdose with you. I promise I'm not going to push psychedelics on you, Cara. I promise. No, you never have. Of all the psychedelic people, you never have, which is fantastic. Someone even bought a lunch with me for a lot of money for charity so he could tell me about psychedelic trips. So talk about why the tech world is so fascinating because a lot of the funding is coming from the tech world. And again, it was the first place I started to hear about it. I mean, so the group that I co-founded, the Psychedelic Science Funders Collaborative, consists of about 130 philanthropists who are kind of major givers in the space. And so I can speak kind of with some specific knowledge about what I think has gotten them into the space. And some are tech, but plenty of them are not tech as well. them are not tech as well. And what seems to be universally true is that everyone has either had a personally healing psychedelic experience, a healing psychedelic experience of a family member,

or tragically knows somebody who killed themselves or died of an overdose without having access. And then the second thing I think is, you know, these are a, it's always a new technology. And I think people in Silicon Valley tend to gravitate towards things that seem like a big leveraged kind of unlock. Sure. Diet, diet. We're going to build the best raspberry ever, whatever it happens to be. And look, every technology has pros and cons, as you discuss frequently here. And I think that what I think is exciting to people about psychedelics, one of the longstanding researchers, Ben Sessa, said once that mental health today is where we were with physiological health in 1900. We can treat some symptoms, but we don't cure anything. And psychedelics are like the invention of antibiotics.

Wow. and psychedelics are like the invention of antibiotics. And so I think people see, certainly what attracted me to this space, and they see, you know, current mental health is one of the only areas of health where we spend more money and it's getting worse, right? Oncology, cancer, we spend more money and it's getting better.

But 1.6 million Americans in 2022 tried to kill themselves. Every day, veterans commit suicide. And so I think people get the scale of this crisis and how the things that we're giving people, you know, SSRIs are certainly helpful for some people, but we're treating symptoms. And so I think that people that are entrepreneurs that are used to looking for new solutions have gravitated to something. And it's also a sign that has been overlooked for, frankly, dumb reasons. Right. Now, you said in 2000 on a YouTube show called Manny's that your impetus to make the difference in the world as a social entrepreneur was driven by having a deep fear of death as a young child.

And that psychedelics helped you get over that to give you, I think you were quoted as saying, a connection to wonder. Talk about your own experience so people can understand, because that was also part of it, not just knowing someone, but experiencing. You know, one of my favorite parts about doing this work is I get to have a lot of conversations where people tell me about their personal healing journeys, and it's a great way to get to know somebody. So I'll share a little bit, not to make it too much about me. But yeah, as you said, when I was a very small child, some of my first memories, I would wake up from naps. And you're in that kind of

liminal space between awake and asleep. And I would, for some reason, I have no idea why, I would contemplate, wow, someday I'm never going to wake up. Someday I'm not going to exist. It's a rather serious four-year-old, but go ahead. I was a serious kid. If you want to dig through, there's a CNN documentary called Kids Under Pressure from when I was 17, where I'm a very, very intense, very pimple-covered teenager. And it really drove me to feel like I need to leave my mark. I need to be remembered.

I also had a lot of trouble making friends. I felt like I was made fun of a lot, and I kind of needed to prove myself. And the models I looked up to were people who were political and social change agents, and it seemed like, okay, the way that you have a positive impact and make your mark in history is through social change. And that led me into the first part of my career, which is building technology companies

around nonprofits and political campaigns. And then after a tragically failed effort to pass immigration reform, I had an opportunity to take like a sabbatical for the first time. This was in 2014. to take like a sabbatical for the first time. This was in 2014. And I just decided I'm going to ask everyone I know, what are the best personal growth,

personal learning things that I can try? I went on my first silent meditation retreat. It was kind of like a tech stereotype. My first meditation retreat and landmark forum, and I did long backpacking trip. And I had my first guided psychedelic experiences, both with MDMA, with ayahuasca. And these are, unfortunately, these are ineffable experiences, kind of by definition.

They are very hard to describe. But I think one of the things for me was realizing I had become so intent on, like, denting the universe that I forgot about appreciating the universe. Like, holy crap, we get to have senses. It's interesting. I've never taken any psychedelics. I don't take drugs, which is, and none of them, almost none of them. But how did that impact your motivation to launch a nonprofit focused on psychedelics? And who are you trying to help this time around? Who are you trying to reach? Like, I get the wow of it.

You know, of course, I listen to Steve Jobs talk about that a lot. But what are you trying to do here? I think for me, like, and this is going to sound maybe overly idealistic, but I want people to be nicer to each other. I want people to be more empathetic and more understanding. Michael Pollan put it to me once that we have two great challenges, tribalism and climate change, and both are due to the illusion of separateness, separateness from other people and separateness from the earth. And psychedelics help to dissolve

the illusion of separateness, as do other spiritual practices. And so I'd say at a core, that is what I hope for. And I got exposed to this. I met, of all things, I met Rick Doblin on the Summit at Sea cruise ship, which is a very bizarre event. Yes, it is indeed. And Rick is the founder of MAPS. It's called, let me call it the Multidisciplinary Association for Psychedelic Studies, which has been a driving force in the research into psychedelics. Rick founded that in 1986. So he's had this same mission for 40 years, which is pretty incredible. So you're on the Lido deck. Go ahead. Yeah. And I heard him talk about taking MDMA through the FDA. And I was like, oh, that's like

a, you know, I didn't think it could happen through like Congress. That's a really clever idea. And then in 2017, I heard about the Psychedelic Science Conference in Oakland, and I just showed up. And it was like I found this buried treasure. There were all of these scientists from Hopkins and UCLA and NYU with all these studies showing these incredible results for people with end-of-life anxiety, with depression, with addiction. And I was like, I think I want to help, but I'm not a scientist. I don't know anything about pharmaceuticals. And at the conference, MAPS announced that they were going to, we were about to embark on phase three, the final phase of FDA trials.

And to me, that seemed like a linchpin moment. And I got invited to a dinner at a home in, a big mansion in Seacliff in San Francisco. And I tend to be pretty direct. And I started asking, well, who's going to pay for this thing? And everyone's like, well, I'm doing this amount. What about that guy? And there was like 10 people in the whole ecosystem that had given over a million dollars to psychedelics. And I thought, okay, well, maybe I can help with that. And so the initial goal was okay, well, maybe I can help with that. And so the initial goal was raise the funds to get MAPS approved with FDA. Now, as we started doing due diligence, we realized there was a lot more

to that. They really had to build a pharmaceutical company. They had to not just get the drug approved. They had to also get it into patient care. And I think that's a really tricky thing here because this is not just a new drug sold at Walgreens, right? This is an entirely new modality of care. It's psychedelic plus therapy. And there's never been like a drug therapy combination treatment before. It fundamentally changes the way therapists practice. They go from 45-minute sessions to eight-hour session. They need to partner with a doctor that's going to prescribe the drug. So you created the Psychedelic Science Funders Collaborative,

and that's a collaborative philanthropic organization that has 130 members? It's a collaborative of philanthropic funders. And then the funders share information and bring ideas to each other. And then we also have a small staff that does research to try to figure out, you know, how can we get smarter together and figure out what are the most impactful things to donate to? So how do you decide then which projects to support? What's the criteria of the organization? It's a great, great question. And anybody who's given a significant amount philanthropically in the psychedelic space, is welcome to join PSFC. And we also then form a point of view. And we form that point of view often driven by our members.

But I would say our North Star has been what is going to get safe access to the most people as quickly as possible. So for example, we chose MDMA because it was the furthest along, right? It was the one that was the closest and needed help over the edge. The second big thing that we focused on, which was really unexpected, has been this state-regulated model starting in Oregon. sadly, passed away, Tom and Cherie Eckert, wrote a ballot initiative to create legal, regulated access to psilocybin mushrooms in Oregon. And when we first heard about it, to be honest, we were like, this is a terrible idea. We need to make sure this doesn't happen. Because why politicize something that is kind of sailing through FDA right now? But as we dug in and realized they were serious people. We did the polling. And we thought about it. A sister group called New Approach, which is PAC, because we're a 501c3, and Graham Boyd, who's my co-founder, ran the vast majority of the marijuana ballot initiatives, and so decided to

pass this Oregon initiative, which was successful in 2020, followed in 2022 with a similar initiative in Colorado, and now we have one in Massachusetts. It's interesting because several people I talked to for this interview said that money might be better spent on research. And some have issues about where you put your money, tons to maps, for example, politics and ballot initiatives, and little to nothing on basic research. How do you, what do you think of that thought? Yeah, I mean, and again, I want to distinguish, you know, our members have given lots of might to research. Then there's the stuff that myself and Graham and our staff have, like, chosen to focus on.

Like, my view is that, okay, MDMA was entering phase three, and we need to make sure it gets approved. If it doesn't, that's a huge problem for the movement. And this is, you know, there's 13 million Americans with PTSD, a million veterans, like it's hugely important. And then once we learned more, realized, oh, this getting approved is not enough to actually get it treating people. So there's all this stuff that has to happen to build this delivery of care system. And so to me, it was like, that seems more important than early research on new substances that are 20 years out from being offered to patients. Now that, maybe not a bias, that is a perspective. It's certainly not the only perspective. And we've had lots of researchers

speak at our events, lots of our members support those researchers. And I am very happy when the research gets funded. Interestingly, speaking of donations to MAPS, venture capitalists Steve and Genevieve Jervitsen were also among the donors for $30 million to MAPS fundraising. The Jervitsen Foundation also funds a lot of psychedelic research. amazing um he also uh the jervison foundation also funds a lot of psychedelic research uh genevieve lists herself on linkedin as the chair of the founders circle at at your organization uh steve is also on the spacex board and in the journal article he was listed one of the people who who who takes these drugs with elon and they're also heavily invested in psychedelic

startups and a few years ago uh j Ripolli said this kind of hybrid charitable giving and investing could revolutionize capitalism. And you were quoted as saying it might be mission creep. Let's talk about what you meant, mission creep, because immediately, I've heard of so many psychedelic startups, they call me all the time. Talk a little bit about that, because you're focused on therapeutics and of course immediately tech people want to start companies so what i was saying in that quote is that i think it's mission creep to totally revolutionize capitalism um for psychedelics i think that um so my view of what philanthropy should fund in general is basically two criteria one One, if for-profit is not interested

and it's important for it to happen, right? So there's a variety of things like treatments for disease in the developing world, right? There's not a good profit to make there. And in 1986, when Rick Doblin wanted to get MDMA passed, there was no prospect of any for-profit funders. So that's the first criteria. And then the second criteria, I think,

or and or if there is something where it would be better done by a nonprofit, right? So when I got involved, which seems like eons ago, but it's just six, seven years ago, there was one for-profit called Compass that I was aware of. There was very little happening in for-profit. And it was just announced on Friday that MAPS's subsidiary drug company, MAPS PBC, which is now called Lycos Pharmaceuticals, raised $100 million equity financing round. Stone campaign, we're partnered with Tim Ferriss, we did this amazing matching campaign. We thought, okay, that's going to get us through phase three, and then we're going to need to raise more money to actually deliver care. And that then got us to a place where we could see what the revenue model would look like, and had to make a choice. Do we continue funding this philanthropically? Or do we move to forprofit funding? There was a combination of factors as to

why we, and I'm on the board of MAPS, I should say, of the parent nonprofit. And the reason we made the decision was one, our number one mission is getting this treatment delivered to people. And to have the money that we think we need to do that, we didn't think it was available philanthropically. I see. Okay. So that feels very – go ahead. Go ahead. Do the second one because it feels very open AI. I'm feeling very open AI vibes. Go ahead. Well, I can compare and contrast that if you want to. But I think secondly, the point is that we were really able to deploy philanthropic capital elsewhere.

There's a non-infinite amount of philanthropic capital. deploy philanthropic capital elsewhere. There's a non-infinite amount of philanthropic capital that early stage research, those state initiatives, those are never going to get for-profit funded. And so we wanted to redeploy that capital. And then third, I think this is really important, if Lycos is able to create a good business model, that's going to bring lots of other pharmaceutical companies

into the space, which I think is a good thing because I think that, like it or not, we live in a capitalist system. Most stuff gets done by for-profit companies. And so let's try to set up this ecosystem where it's actually investable. We'll be back in a minute. Thank you. and hiring platform with over 350 million global monthly visitors, according to Indeed data, and a matching engine that helps you find quality candidates fast. Listeners of this show can get a

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Michael Pollan actually suggested this person. Let's play the clip. My name is Olivia Gortel. I'm an investigative reporter at the publication Start, and I'm also writing a book on the psychedelic industry for Bloomsbury. And the big topic I'd love to hear discussed is power and accountability. So, you know, philanthropists, of course, believe in the good of what they're doing. And I think a lot of people working in psychedelics really believe in that too. But it is important to note that donors have influence, they have access to drug developers, their bankrolling ballot initiatives, and some of

the people with the money have a lot of sway in terms of what gets examined, what gets kind of overlooked. And so I'd love to hear how Joe is navigating that world, the specifics of his own financial ties to psychedelics, and whether there's a need for outside accountability bodies or more transparency. Well, the first thing I would say is I've made a decision to make no psychedelic investments. And I'm a donor in the space. I don't receive a salary from PSFC. So this is done as a volunteer.

And I've made no personal investments in the space and plan not to. Everybody on the MAPS nonprofit board has decided to not receive any equity in the Lycos, the for-profit, so that we can be the sort of nonprofit sewers. So that, to sort of answer that part of it. In terms of accountability bodies, I mean, I guess I'm not entirely sure what the question is. I think what she's talking about is outside accountability and transparency of all the philanthropic endeavors like PSFC, who should regulate you?

Other nonprofits are regulated in some fashion. So much of the work has been setting up a regulated program. So, for example, in Oregon, the governor of Oregon appointed an advisory panel. It sits under the Oregon Health Authority. panel. It sits under the Oregon Health Authority. So, you know, it's hard because this is a... Oregon has treated about 750 people in the last six months. And they're also totally inventing all of this from scratch. And so the regulators are doing their very best, and I think are doing a great job, but are creating an entire ecosystem of care from scratch.

And it's one of the things I most, when people ask me, how can I be helpful in the ecosystem besides philanthropic donations? I say, go get involved in creating a business in Oregon, because there's so little operational experience in this field. And these service centers, which is what they call the kind of clinics in Oregon, are incredibly complicated. And they're, you know, federally illegal, state legal, it's incredibly complicated. And so having people that are sophisticated go in. So anyway, I think what I would say to that accountability question is, it's, you know,

each of the organizations has their own boards of directors, in many cases, their own outside regulators. So let's talk about this idea because it's mixed up with regulation, safety, and accountability, right? So last fall, Governor Gavin Newsom vetoed a psilocybin decriminalization bill in California. Newsom didn't dismiss psychedelics altogether, but he said the state needed better treatment guidelines first. So talk about those standards that need to be in place for treatment centers, whether it's guides, facilitators. Yeah, so let me start with Oregon because it's where it starts. And so in Oregon, the Oregon Health Authority issues several types of licenses. So they license the facilitator, who's their term for the guide. They license the producers of the mushrooms and testing labs to test their potency.

And they license the service centers, which are the physical locations. And Oregon, it is different than FDA, right? So when, hopefully, MDMA-assisted therapy for PTSD is approved, you will need a PTSD diagnosis, and you will have to be in a medical context. In Oregon, anybody can go to Oregon and say, I would like to have a guided psilocybin experience. Now, there is health screening to make sure if you're, say, schizophrenic that you will be told that that's not a good idea. But just like therapy, right? You and I can go see a talk therapist without having a doctor tell us that there's something wrong with us. And I think that mental health is much more of a spectrum. It's not like, you know, your kidney failing. And so one thing I think that's very cool about

the Oregon program is that it enables a whole variety of types of care. Somebody who is in hospice, who's on their deathbed with existential distress, people with addiction, et cetera. The guides have to go through a training program. They have to pass a state test. Now, there is a real trade-off that I want to be honest about between safety and access, right?

The more safety requirements, the more training requirements you put requirements, the more training requirements you put in, the more expensive it's going to be. And so we've tried to find this right balance. And I think we've over-indexed on safety to start with because this is so new. This is something Newsom mentioned, medical clearance, underlying psychosis. Respond to him. Yeah. So I'm excited about our prospects in California. So I'm a native Californian. California is sort of the psychedelic capital of the universe. And what Newsom has said is that he is very open to approving a regulated access system, which is like the Oregon system.

And so there is an effort underway in California, a bipartisan effort, to put a bill up. And it would be the first time, if it passes, to do an Oregon-like bill through a legislature. Oregon, Colorado, were both done with ballot initiatives. And so I think we can, through the legislative process, which allows more iterative than a ballot initiative, we can get to a sign that really takes into account public education, like actually having some budget there to educate the public about what these are and how to safely access them, et cetera. I agree with Newsom, and I'm excited that we're going to work with the governor's office to try to get a really good bill through.

But the screening of these guides is going to be critical. And the standards have to be the same, correct? So it depends under what system. So under the FDA-regulated system, the only guides are the ones that have been part of the clinical trials. And Lycos has been offering educational training to guides.

That's going to be the big gating mechanism once the treatment's approved. The hard sort of growth problem is that guides need to have experience guiding people in order, like, the way medical training works is you do residency, right? You need to be, if you're a therapist, you need supervision hours. And that, except in a clinical trial, that hasn't been able to happen thus far because there's been no legal way to do it. MAPS has a training program and

they're working with other educational institutions. And now we don't exactly know what FDA will say. And the tricky thing is FDA actually doesn't regulate therapy. They regulate drugs. So we don't know what they will or won't say. But I think the expectation is that MAPS currently has a two-therapist model. And the expectation is at least one of them will have to be a licensed social worker, therapist, psychologist, psychiatrist. The other might be able to be like in training or something. And the two is also a great way to prevent abuse because you have two people in the room. Yeah. There's already been allegations of psychedelic therapy abuse, including against a couple of very high-profile therapists like Aaron Grossbard

and Francois Zetborzat. What needs to be done to ensure patient safety? Because they're particularly vulnerable here. It's drugs and therapy at the same time. Yeah, I mean, when I first started to hear about this, I remember Googling what percentage of just normal therapists have sex with their patients. And like anonymous survey said something like 10%. And so it is a very common thing, which is pretty scary to think about. And so, you know, and with psychedelics, as you point out, people are even more vulnerable. So I think the two therapist model is a way to do

that. Obviously, another really important thing which PSFC has supported is the creation of certification boards and professional associations. So if you're a licensed therapist and you have consensual sex with a client, as far as I know, you have not committed a crime, but you will lose your license. And so the licensure board and the professional association is a way that behavior is regulated. So actually the same guy I mentioned, Mike Cotton, pointed us to, look, if you want reimbursement, companies have to know who's a qualified practitioner. And so we have supported financially and with expertise a number of our members setting up a professional association and a licensing board in the psychedelic space. In the psychedelic space. Just so you know, many years ago, I interviewed Brian Chesky. Remember

when they had that problem with people having orgies at Airbnbs? And I said, what are you going to do about this? And he said, you know, people have been having orgies in hotels forever. And I didn't think that was an answer, although it was a funny thing to say. You know, this is a much newer thing, and you're going to get a lot more scrutiny. It's like EVs get more scrutiny, even though human drivers are terrible. And you're going to have to take it, right? Presumably. Well, look, I think there is this important compared to what question, right? Nothing is 100% safe. The self-driving cars is a great example of that. So some of it is public education about like, and there's trade-offs, right? Like you can have, the harder you make signed access,

like it's easy to hear about the person who was abused and forget about the person who killed themselves because they didn't have access to treatment. And so that's what you're balancing. You know, in the Oregon system, there's, I think, about 200 licensed facilitators thus far. Now, they're not all practicing yet because there's a shortage of service centers. And the service centers have been holding, as far as I've visited a few of them, quite a high bar. And they have to go through state licensure, and then they have to get a service center that's going to hire them. But in Oregon, the criteria is lower. You don't have to be a licensed therapist. You need to just have a high school degree and go through one of these training programs and then

have some supervised time and be hired by or partner with a service and they're often not employees. And it's really trying to find this balance between access and safety. Sure. Though we're talking about patients under the influence of a hallucinogenic, which isn't typically like sleeping with your doctor. There is some element where people are even more vulnerable. They're emotionally vulnerable and physically vulnerable. Absolutely. Yes, absolutely.

So the idea of monitoring, you think two practitioners at the same time would take care of that, and a screening board, a licensing board. There will be abuses, but... I think that's helpful. And I think another piece is group therapy. So, you know, we've heard a lot about the MAPS model of the two therapists, one patient. But in most indigenous use over history, it's been groups of people. Right. And one of the things that's exciting to me about the Oregon model is it allows for group experiences. And the Jervisons, who you talked about before, have funded a pilot in Oregon. So there's a nonprofit called Heroic Hearts, which works with veterans. And they've

taken veterans to Jamaica and Peru to receive psilocybin or ayahuasca treatment. And I just want to say, it is a national embarrassment that our veterans have to go overseas when our government won't provide the solutions that work. So I just want to say that. And so Jesse Gould of Fat and Heroic Hearts decided, hey, let's try to do this in Oregon. A, from a cost perspective, a group is cheaper to do. Sure. We think it's actually more efficacious because of the community. And I think it's also abuse potential, right?

You have eight people in a room with a therapist. It's much harder for something untoward to happen. Untoward to happen. So you say you're not focused on recreational use, but in Colorado, the law was to decriminalize psychedelics for private use. Are you involved in that, and what do you think about that? And is there a danger if states go forward with legalization without having guidelines in place like Oregon? Totally. So just to be clear, Colorado, the Balladition of the Past in Colorado does two things primarily.

It creates a regulated access system very similar to Oregon, although it offers more plant medicine. So in addition to psilocybin, in the future, they will look at iboga or ibogaine and mescaline cactus. Those are all naturally occurring psychedelic compounds. They also did sort of this decriminalization of possession of these same compounds. Now, I should say that I don't control the drafting of the ballot initiatives. It was done by this group New Approach. Certainly, we're in close relationship with them. Part of this was driven by sort of local activists who cared a lot about the decrim, and it was part of it was the political negotiation to put the coalition together.

You know, I think we can probably all agree that somebody growing mushrooms in their basement and eating them should not lead them to go to jail. That is like not the right way to handle that. Yeah, this is something Michael talked about, growing it and you could be arrested. I think what we're trying to balance is get as many people towards the legal regulated access and also say, look, if you're doing it underground, which is happening, it's happened for a long time, it's going to continue to happen. Let's at least have it in the light of day. So if something abusive happens, people can go to the authorities without, you know, worry of being arrested. Sure, sure. So I think the view is like, this stuff is already happening.

Let's try to, you know, do what we can to make it better. But let's really try to point everyone towards the legal regulated access. Well, let's talk about that because say there's a future in which psychedelics are given FDA approval. They're decriminalized or legalized and made widely accessible. One of the things we've seen with the legalization of marijuana is the potency has dramatically increased. That's throwing a lot of the studies about efficacy side effects of marijuana out the window. There's been also a considerable uptick in marijuana-related emergency room visits, including deaths. Do you see this will happen with psychedelics as well?

You know, do guardrails for potency need to be put in place to protect consumers? It's a great point. So, A, I should say that, you know, our group, like, we do not believe that there should be mushroom stores in the way that there are cannabis stores. We think that these are best used in this guided context. And one of the many reasons we decided to support Oregon was realizing if we didn't shape what was happening, it was going to happen in a worse way. Yeah, it's in front of the CVS in my neighborhood in San Francisco.

But go ahead, go ahead. So I think on the potency side, it's actually, to me, fascinating because in the FDA trials of psilocybin, they use synthetic psilocybin, which is very precise. Natural occurring mushrooms have varying amounts of psilocybin, but the law is written in terms of milligrams of psilocybin, not grams of mushrooms. And so they actually had to do a bunch of potency testing and learn a bunch. And now they have pretty good potency testing in Oregon to know, okay, this is the right amount to offer people. And so I think through this regulated model, people are getting smarter. They have a guide

who can tell them what to do. And look, I think, again, this is why honest education is so important. They're not for everyone. If you have a personal or family history of schizophrenia or bipolar or taking certain medications, you shouldn't do it. If you have a serious condition, depression, PTSD, et cetera, it's particularly important to do in a guided context. Unless you have expert guidance, start with small amounts. Dosage matters. A fourth thing, super guidance, start with small amounts. Dosage matters.

A fourth thing, super simple, don't go solo. Have a friend with you who's sober. Psilocybin, as far as we know, cannot kill you physically, but you could run into traffic and get hit by a car. Sure. So if you have a friend with you who's keeping an eye on you, it helps a lot. And then the last thing is, and I think this is important, which is having reverence that these are very powerful substances. I mean, if you look at the psilocybin research, people describe dying, meeting God, they describe it as the most profound experience of their life. In indigenous cultures, often it was actually the guide who would take the substance, not the client, and then they would heal you while, not the client. And then they would

heal you while they were on the substance. But they would only allow people to take them after studying and being part of a tradition. They weren't just kind of like offered out there. The same way I'm Jewish, you were not allowed to study Kabbalah unless you were 40, married, and had kids. And I think it's really important to have reverence for these substances and to treat them as the powerful, serious things that they are. You should send those guidelines to Elon. Anyway, you don't have to comment. I have one last question.

Are you still afraid of death? It's a great question. Yes. I mean, I have a number of friends who have had experiences with psychedelics where they come out saying, I no longer fear death. I've seen my own death. I've experienced it. I've merged into the consciousness. My own guided psychedelic journeys, many of them have been between difficult and terrifying. I have felt like I went through layers of Dante's Inferno. They have not all been, like, fun by any means. And I think it's important for people to understand, like, I think that my fear is lessened.

And I've had some experiences of touching death. But I don't think it's gone. And I certainly have some graspiness towards that. And it's funny, one of my very good friends, Paul, who's a very serious meditator, just this morning texted me this quote that's been sitting me. Preferencing expansion over contraction is contracting around expansion. And I think people can get very graspy and contracted around wanting to have expanded states.

Yeah. And I think there is, while the sort of classic psychedelics are not physically addictive and don't show kind of normal addiction properties, I do think that like, you can get in a place where it's like, well, I could go to walk in the woods

or I could go on the walk in the woods in acid and that would be like more beautiful. And I do think a big part of the spiritual journey is just learning how to be in normal life experience. And I think these heightened states, one of my friends said this to me early in my psychedelic journey, they can show you like high notes, like being an MDMA can show you what it's like to feel love in a very extreme way and the right response from that is not to do MDMA all the time is to notice in your life okay when am I feeling that a little bit it makes you more self-aware and more able to tune around it but in the end of the day answered if you're afraid of death you still haven't answered

my question I can help you I still am afraid of death. I think I am less so. I think it is less present in my experience. And I think that my orientation of the purpose of life is very different. I think it used to be very judgmental and very like people are valued based on how big of an impact they're having. And look, it's hard to know how much you've changed. And that's why it's great to have friends over periods of time. And I get a lot of positive feedback that I am a more patient, more empathetic person.

And I think this is not just psychedelics. It's meditation. It's a whole variety of things together. As long as you're not scared of death. And I'll help you if you'd like. Yeah. Because I'm not. Oh, I would love your help. I'll give you the not scared of death. And I'll help you if you'd like. Yeah? Because I'm not. Oh, I would love your help.

I'll give you the words of Hank Williams. No matter how I struggle and strive, I'll never get out of this world alive. You don't have a choice. I love Hank Williams. You don't have a choice. So don't worry about it. Anytime, Joe. And I didn't even have to take any drugs to do that, but maybe I will someday.

You're already enlightened. I am. It's true. I'm the Buddha. I'm the Buddha of all time. Anyway, Joe, thank you for being with us. This has been a fascinating conversation. I appreciate it.

And I'm glad we finally got a chance to do it. Yeah, thanks for giving me the opportunity. I really enjoyed the conversation. Thank you. Thanks for giving me the opportunity. I really enjoyed the conversation. Thank you. Today's show was produced by Naeem Araza, Kateri Yochum, Megan Cunane, and Megan Burney.

Special thanks to Andrea Lopez Cruzado. And also, thanks to Hank Williams. Our engineers are Fernando Arruda and Rick Kwan. Our theme music is by Trackademics. If you're already following this show, you're in a heightened state. If not, you're tripping. Go wherever you listen to podcasts, search for On with Kara Swisher and hit follow. Thanks for listening to On with Kara Swisher from New York Magazine, the Vox Media Podcast Network and us. You can subscribe to the magazine at nymag.com slash pod. We'll be back on Monday with more.

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