The Dr. Hyman Show - Can Psychedelic Medicine Fix Our Mental Health Crisis with Rick Doblin

Episode Date: January 18, 2023

This episode is brought to you by Rupa Health, Cozy Earth, Beekeeper’s Naturals, and Levels.  We’re in the midst of a psychedelic renaissance. Compounds that have long been considered recreational drugs by conventional standards are finally being recognized through science as powerful tools for overcoming hard-to-treat health issues, like PTSD, depression, addiction, and more. Mental health problems are the number one driver of indirect healthcare costs, loss of productivity, and diminished quality of life. Yet, we aren’t very successful at treating them with modern medicine. This is a pivotal moment for turning the treatment of mental health around as we explore psychedelic medicine. Today, I’m excited to talk to a leading expert and advocate in the field of psychedelic medicine, Rick Doblin. Rick Doblin, Ph.D., is the founder and executive director of the Multidisciplinary Association for Psychedelic Studies (MAPS). He received his doctorate in Public Policy from Harvard’s Kennedy School of Government. His professional goal is to help develop legal contexts for the beneficial uses of psychedelics and marijuana, primarily as prescription medicines but also for personal growth for otherwise healthy people, and eventually to become a legally licensed psychedelic therapist.  This episode is brought to you by Rupa Health, Cozy Earth, Beekeeper’s Naturals, and Levels.  Rupa Health is a place where Functional Medicine practitioners can access more than 2,000 specialty lab tests from over 20 labs like DUTCH, Vibrant America, Genova, and Great Plains. You can check out a free, live demo with a Q&A or create an account at RupaHealth.com. Get 40% off your Cozy Earth sheets. Just head over to cozyearth.com and use code MARK40. Beekeeper’s Naturals is giving my community an exclusive offer. Just go to beekeepersnaturals.com/HYMAN and enter code “HYMAN” to get 25% off your first order. By leveraging biosensors like continuous glucose monitors, Levels provides real-time feedback on how diet and lifestyle choices impact your metabolic health. Right now you can join Levels and receive an additional two free months on your annual membership when you order at levels.link/HYMAN. Here are more details from our interview (audio version / Apple Subscriber version): Rick’s early life and introduction to psychedelics (8:36 / 3:55) The history of psychedelic research and the psychedelic renaissance (30:02 / 25:24) Is psychedelic-assisted therapy practical and scalable? (32:34 / 27:55)  Group and couples psychedelic-assisted therapy (36:53 / 30:40)  The economics of providing psychedelic-assisted therapy (38:53 / 34:15) Drug policy reform (39:55 / 35:15)  How psychedelics affect the brain (41:26 / 36:58)  Reframing the public perception of psychedelics (1:02:19 / 57:50)  Moving toward a world of net-zero trauma (1:04:10 / 59:30)  The future of drug policy reform (1:17:47 / 1:08:50)  Learn more about MAPS at maps.org.

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four zero. Just go to CozyEarth.com and use the code MARK40. And now let's get back to this week's episode of The Doctor's Pharmacy. Welcome to The Doctor's Pharmacy. I'm Dr. Mark Hyman. That's pharmacy when at the place for conversations that matter. And if you've known anyone or yourself who's suffered from depression, PTSD, or a myriad of psychiatric illnesses and have tried everything and nothing works, this might be the most important conversation in your life because it's with someone who has been focused on studying how to deal with mental health through a very different lens of psychedelic-assisted therapy, which is a whole different ball of wax than anything we've had in psychiatry to date. And this is going to be a great conversation

with Rick Doblin. He's the founder and executive director of the Multidisciplinary Association for Psychedelic Studies, MAPS. He's received his doctorate in public policy from Harvard's Kennedy School of Government. He wrote his dissertation on medical use of psychedelics. And he really has been part of the whole psychedelic renaissance over the last few decades. He's been in it when no one else was in it. And he has continued on Timothy Leary's work at the Zendo Project at the Timothy Leary's Concord Prison Experiment. He studied with Stenosov-Groff, who really is one of the pioneers in psychedelic therapy. He's written a key book on this we'll talk about. And now Rick has really spent his life focused on how do we make this

therapy accessible to all? How do we take the scary bits out of it? How do we look at it scientifically? And how do we determine whether or not there is a real role for these compounds in health care, in medicine, and in particularly psychiatric care? He founded MAPS in 1986 and resides in Boston with his wife and his puppy and three empty rooms with his college kids have all gone to college. And now really he's, he's really moving through the FDA process with legalization of MDMA or a Molly or ecstasy as you might've heard. So welcome Rick. It's great to see you again. And now you have a lot going on. You're doing so much stuff. You know, you were in the wilderness for 40 years, so no one else is in it. And now, you know, your organization is getting tons of funding.

There's billions of dollars flowing into psychedelic research. And, you know, we're facing the reality of a society that is overburdened with mental health issues. You know, there's, aside from just the human toll of suffering, which is massive, I mean, one in four people suffer from severe depression at some point in their life. We're seeing increasing rates of suicide among all age groups. We're seeing increasing amounts of trauma-related problems like PTSD, but just from even just daily life, living in a divisive, conflicted society. And, you know, as a doctor, the tools we got were pretty crummy. Psychotherapy can be very helpful for some people, but most psychiatric medication is not much better than placebo unless you have really severe problems or for certain conditions. But it's really kind of a

failed experiment. It's the third leading drug class sold, which is psychiatric medication after acid blockers. And then number one is statins. So it's right up there. The cost is staggering. It's the, in terms of not actual healthcare costs directly, but indirect healthcare costs and loss of productivity and quality of life. It is the number one cost driver of, of, of loss of, you know, a benefit to society from people who can show up and be present and connected and actually be happy. So, and do their, do their lives well. So this is such an important moment in the history of mental health and psychiatry, and you're kind of at the leading spear of it. So Rick,

take us back to when the light bulb went on for you, you know, you tell the story of when you were in college and, you know, like many of us back in the seventies or sixties, uh, LSD was popular and you, you kind of had a, a revelation. Yeah, actually 50 years ago or 51 years ago. So, but there's only one thing I wanted to comment on from your introduction, um, where you talked about trying to take the scary bits out of it. And so the scary bits are pretty inherent in it, but it's more about creating a safe context for people to work through the scary bits. Yeah. I was talking about more about like MDMA is going to cause holes in your brain and chromosome damage and make you jump up buildings and propaganda from

the seventies. Timothy Leary is the most dangerous man in America. Well, it's incredible how powerful those thoughts are still in people's mind. And so I'll just say this is kind of a, and then I'll get to my early revelation, but the first date that I had, I've been married 29 years, but the first date that I had, and my wife now didn't even think it was a date. She just wanted to talk to me about a mushroom experience she had in college. And she said, and now this is, we met at, we were students at the Kennedy School of Government. So she's, you know, pretty alert and all. And so this was in 1989. And she we had some good talks about her mushroom experience in college. But then she said that she would never want to have a real relationship with anybody like me. And I'm like,

what's the problem? She said, Well, you've done so much LSD, you probably have terribly damaged chromosomes. So you're not good fatherhood material. Kids would be like giraffes or something. And I'm like, you know, it's now a big family joke, as I said, well, it may be premature, but let me defend my sperm. So she was persuaded that this chromosome damage was not a real thing. Now we like to say that we do have three kids, but the only side, there is some signs of brain damage in them that occasionally they think they know more than we do. And even worse, sometimes they're right. Yeah, that's a scary part.

So, yeah, there's enormous fears. And when actually when she first met me, too, that she thought it was kind of a noble lost cause, you know, trying to bring psychedelics back into society. I mean, yeah. Yeah. So the revelation for me was in the spring of 1982. And so – excuse me, 1972. So the spring of 1972. Yeah. So I was 18 years old, and I was in college at a place called New College in Sarasota, Florida. The college had only started in the 60s. And so it was an experimental college. And it was terrific. It was the principle was that the student's curiosity was the most important thing and that there should be no distribution requirements in your classes that you could do wherever your curiosity went. If you wanted to major in something, you had to do certain prescribed set of classes, but you could do general studies if you want. And a lot of times

schools now, if they let you do general studies, they still have kind of distribution requirements and stuff like that. There was also no grades. There was a written evaluations. Everybody got, everybody had to do a senior thesis, a real emphasis on independent study and tutorials. And, and it was a small school, only about 350 people. And my high school had been about 3,800 people. So I went from a 3,800 person high school to like a 350 person college. But then there was two important things that they did not put in the college brochure that I did not notice. Once I realized what they were, I realized why they didn't put them in the brochure. But they were great attributes for the kids, but not so much for the parents.

And what happened? Well, it was all night dance parties until sunrise fueled by psychedelics with breakfast in the center of I.M. Pei, the architect that designed the school, these buildings. There's a big palm court in the center, we could dance all night. So there was that. And there was this strong culture of experimentation with psychedelics, not just in this party setting, but also sort of for spiritual reasons, for personal growth, individual sessions. So there was a lot of tripping going on, not by everybody, but a lot of tripping going on. And then the other part was, I would say, even more astonishing. There was a woman, a faculty member who had studied with Carl Jung.

And she was teaching Jungian psychology. And the school was pretty new, as I said. And her husband was a wealthy developer. And he had donated this Olympic-sized swimming pool to the school. Now, this is, again, in Florida, in Sarasota, Florida, and it's warm. And somehow or other, it had evolved into a nudist colony. So it was a hippie college. Totally hippie college.

And I was just this shy boy from Chicago who could barely talk to a girl, and here I am in this nudist colony at the pool, And I'm like, oh, man, this is terrific. And so there was this sense of these underground energies, you know, sex and drugs that were kind of more brought to the surface. The campus police told us that their job was to protect us from the real police. So that was very reassuring. The campus police had two sets of books about where people were staying in all these dorm rooms, where you were assigned, and then where you actually were. And you could live with your boyfriend or your girlfriend or anything if you switched rooms with people. So it was a pretty amazing setup.

So then in that context, you got to experience LSD? Yeah, yeah. So it was in that. And it was the prior context also had been that I was very much, you could say, a child of privilege. And when I think about it, I think about, now I was born in 53. So I just absorbed this American exceptionalism, you know, that somehow or other America at the height of its

power, we are somehow or other better people than other people. It's like Americans are exceptional. Then I was white. As you can see, I'm male. So I got got all of that i'm jewish i was the chosen people my dad was a doctor my family was well off and we lived in um when i was 12 my parents had a house designed and built by a student of frank leid rights so i grew up in this incredible facility but i was with all of this support um What really happened was that when I heard the stories when I was really little about the Holocaust and about World War Two, and I had loads of Israeli relatives and still do. So I was just educated on the stories of irrational hatred and cruelty and what people can do to other people and how you can have a whole culture go insane in certain

ways or um you know believe the big lie you know now we all understand a lot more about the big lie but then it was like how could people buy into these things and yeah you know now we know it's more tribalism so i was kind of trained as um or educated you say, as part of this historical chain, where in the 1880s, my mother's parents were refugees, came over with nothing from Russia. My father, my grandfather came over from Poland in 1920 with nothing. So it was this idea of these refugees coming to America, fleeing anti-Semitism and poverty, and then finding the American dream, you could say. And actually, my great-grandfather was the classic rags to riches because he actually had a rags business. I know this is leaning back to psychedelics somehow.

Yeah. So I just was thinking that my kind of charge, you could say, from my family was to think about deeper threats that my food and shelter was going to be taken care of. But here it is, this irrational hatred. And then not too long after I was waking up to that was the I was a young boy during the Cuban Missile Crisis. And that was, you know, duck and cover. And I was like, oh, my God, the Russians in the U.S that was, you know, duck and cover. And now it's like, oh, my God, the Russians in the US, we could, you know, blow up the whole world. And then my final confrontation with a sort of irrational hatred that that it came closer, it wasn't the Germans, it wasn't the Russians. Now it's Vietnam, and it's America, you know, doing this imperialistic

supporting dictators that we like. And it was just so so I just studied how do I respond to a world like this, a world where security is very tentative and where the fate of the entire world is at stake. The other thing I should just sort of mention, I think, that was going on in the background now that I reflect on it was going to the moon. And, you know, the moon shots and this, so that you have this darkness of the American spirit. And then you also have sort of the brilliance of the human mind and our ability to start seeing in a cosmic way and moving to the moon and, and all of that was happening at the same time. So it was darkness and light. And i felt like as far as vietnam was going to go that it was my job or at least my understanding that i would um protest and i wasn't a conscient

objector because i wasn't yeah um against all wars i think you know sometimes like we see with russia and ukraine sometimes you got to fight or the naz in Germany, you got to fight. Yeah. Yeah. So I was a draft resistor and I was preparing to go to prison to not register for the draft. And I had read Martin Luther King and Gandhi and Tolstoy and all of this. So I was already sort of separating myself from normal trajectories. And when I told my parents that I was wanting to be a draft resistor, they were sympathetic, but they said, you know, you're going to be a felon and you're never going to be able to get a license to be a doctor or a lawyer or accountant or anything like that. And I'm like, well, that's a real price to pay, but I'm willing to pay that price. So that took all also all of these normal job career trajectories off my

plate. Cause I, you know, I had a passport, I had a social security number, I had a driver's license, I was paying taxes. I was in high school,

you know, I figured they know me, you know, my identity is well known and my birth date is not, you know, a hidden mystery or anything. So I did assume that something would happen and that they'd come catch me, but that I would drain the energy from the system the most.

So that was the thing. Martin Luther King said that the person that sees the law is unjust and is willing to break it and suffer the consequences as an example to others that the law is unjust actually has the highest respect for the law. So he was trying to reframe civil disobedience as patriotism. And so all of that was great. So then when I arrive at this college, and there is this kind of culture of psychedelics,

I didn't really smoke marijuana in high school either. My parents didn't drink, but I decided I would try LSD. And so the first experience that I had was difficult, but because there was a lot of surrendering. Did you do it on your own or were you in a party or how, what was the situation? I did it at first. I didn't want to do it in a party setting. So I did it on my own. Some friends knew that I was doing it. And back in those days, a standard dose was 250 micrograms. Oh, wow. That's a big dose. Yeah. So you go through a period of time where you can't really talk. You're nonverbal. It's, you know, it's in the range, maybe six or seven grams. Not five, you know, somewhere there.

It's a hefty dose of mushrooms, a hefty dose of LSD. And I had this feelings, though, that were really profound, that I had been so much living in my head that I was so out of touch with my emotions. And I felt so the emotions of fear, the emotions of excitement, of anxiety, of, um, and moving beyond your sense of who you are, this dissolution of the ego orientation, and then this opening in a way to a larger world. So our brains are kind of focused on what we need to do to survival or to, according to Abraham Maslow, you know, the hierarchies of needs. But the idea that we've learned from modern neuroscience, this psychedelics reduce what's called the default mode network activity there, the sense of self. So your sense

of self is dissolving and you can have this feeling of connection with something larger. And so even though I had a lot of fear and a lot of anxiety, I had these intimations of this enormous sweep of evolutionary history of just, you know, life and death going beyond my little life and death. And it just felt to me that there was a clue in here, the antidote to genocide and to environmental destruction and to racism and prejudice is that this identification beyond how we think of ourselves in terms of our identities, our nationality, our religion, all the ways that I talked about how I felt in a sense that there's a way in which deeper than all of that is we're part of the human struggle. We're part of evolutionary life on Earth. And if you have that sense of deeper connection in that way,

then you understand how we're all more similar than different. And that, I thought, would be the anchor of a new consciousness, of a new understanding, not just for me. Albert Einstein also said this great thing. He said, the splitting of the atom has changed everything except our mode of thinking, and hence we drift towards unparalleled catastrophe. What shall be required if mankind is to survive

is a whole new manner of thinking. Yeah. What is this new manner of thinking that Albert Einstein is talking about? I think it's this shift from our isolated individual ego identification thinking. Yeah. What is this new manner of thinking that Albert Einstein is talking about? I think it's this shift from our isolated individual ego identification to we're thinking in terms of more the collective. And the thing I want to stress here is that you could be both a deeper part of this collective and also more your own individual self. It's not like you surrender your individuality in the masses. And that's, you could say, certain kind of communism,

certain kind of governments where it's all about the group but not the individual. So when I talk about this unity, we're all more similar than different. It's both, you could say it's even paradoxical in a certain way, that you can feel more unified and connected with everything that is and also more uniquely yourself. And I think that's a real key factor. And so I felt that psychedelics were going to be a key to a new consciousness. after the backlash, after Timothy Leary, as you said, was considered the most dangerous man in America, after psychedelic research was wiped out. And so I realized- Timothy Leary was the Harvard professor that popularized the use of LSD, you know. Yeah, he was-

Drop out, tune in, or whatever he said, you know. Yeah. You know, turn on, tune in, drop out. Exactly, right. you know, turn on, tune in, drop out. Exactly. And also question authority. And he had a lot of things like that. And so, and, but all of this, the idealism of the 60s, the idealism of the hippies, all of that had crashed and burned. Nixon was elected.

The war in Vietnam was, you know, escalating at this time. And so in my confusion, and this is how it really happened, I went to the guidance counselor at school. And the guidance counselor, you know, took me seriously. I mean, you go to a guidance counselor right now at college and you're like, hey, I'm struggling with my LSD experiences. They seem more important to me than my studies. Even this class with Jung, or this woman that studied with Jung, it felt too tame. I was like in all this ruckus. So I asked him for help. And he took me seriously. And he gave me this book to read,

which changed everything for me. And it was Stan Grof's Realms of the Human Unconscious. And now the most amazing part is this book was not published until 1975, but my guidance counselor had a manuscript copy from Stan directly. And so when I read this book, so what was so important about it was that it opened my eyes up to the scientific research that had been done with psychedelics. I didn't really trust religion as kind of a guide for understanding the world. I felt there was a lot of myths and things that are there. But Stan was looking at mystical spiritual experiences from a scientific lens. And I trusted the scientific lens. So realms of the human unconscious included, you know, spiritual aspects, birth trauma, you know,

things that happened during your life. And I think what most did it for me was that, birth trauma, things that happened during your life. And I think what most did it for me was that Stan had within his whole approach was therapy. So it's not like it was a reality check. Because you have all these spiritual masters and you can read encyclopedias about the spiritual world and what they're saying. And, but how do you move from here to there? How do you, what's the process? So Stan actually with psychedelics had a process of both therapy and spiritual evolution grounded in science and in experiments to demonstrate whether people with substance abuse, with alcoholism or heroin addiction or anxiety about life-threatening illnesses, that you could actually help. So it was this entire package that really said, this is what I want to do. And I thought,

because I'm going to be arrested any soon for being a draft resistor and I'll have this felony and stuff, that I can be an underground psychedelic therapist. You know, you're not going to need a license for that. That'll be my career. So that's how at age 18 in 1972, all this came about. And actually my guidance counselor, I said, I wanted to write a letter to Stan Groff to ask for advice on what my education should be. And he was an MD, PhD at Hopkins, and he was in his 40s and had been an illustrious career, and his research was being shut down. So I actually wrote him a letter,

and to my utter astonishment, he wrote me back. So, you know, I'm this confused 18-year-old, and he said it was important that I pursue this interest and that he was offering a workshop later that summer out in california with joan halifax and he invited me to attend that workshop and i hitchhiked across america and you know and and i i want to make an homage to my parents so at that point once i read stan and i was in the middle of my first year of college i'm the oldest of four kids, too.

So I'm the first to leave the nest. And then I called home and I'm like, I'm sorry, but I want to drop out of college. It's not important to me anymore. This emotional balance is spiritual balance is more important. I want to study LSD and I want you guys to pay for it. You can imagine that that caused a little bit of consternation. But in the end, they agreed to do it. And, you know, my dad was tremendous. He was, he said, he was a doctor, he's a pediatrician, he was, to give you a sense, he was an only child, and his parents were very poor. They had a bookstore and they, he learned how to read a book without breaking the spine so that they could

sell it after he had read it, you know, just, just so that, and so he was programmed by his parents from the age of three or four to be a doctor, you know, the classic Jewish doctor. And he loved being the doctor, but he decided that he wanted to raise his own kids in a different way, that he would help us find out what we really wanted to do and help us do that. And so he was convinced that it was a mistake, what I was doing, but he said, you're a stubborn kid. And if you don't get help from us, it's going to take you longer to realize it's a mistake. And then you're not going to want to admit it because then your parents would have been right. So therefore,

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which is unbelievable. Like Colorado just legalized psilocybin. Oregon did a few years ago. There's clinics bopping up all over. there's literally billions of dollars of research money uh and investment money flowing into the space across the world i mean some of it's a little shady but it's it's fascinating how much is this psychedelic renaissance and you know michael pollan has been on the podcast uh wrote the book how to change your mind talking about this and that sort of got this more in the zeitgeist and it's how to change your mind a television series on on Netflix also is very powerful. So I think this is reaching a moment where we're recognizing that the massive failure of traditional psychiatry and the ways in which these drugs work or these compounds work is to me mind blowing. I mean, just on a metaphysical level, how do these compounds in plants know exactly how to open up our neural pathways

and increase neuroplasticity? And, you know, Charles Schultz is from Harvard who studied these plants called the plants of the gods. It's quite amazing from ayahuasca to iboga to San Pedro mescaline to psilocybin. I mean, these are quite extraordinary molecules. And then there's even animal molecules like the toad, people 5-MeO-DMT, which is called the God molecule. And all these compounds work in very similar ways. And when I started still looking at some of the research on this, what struck me most, Rick, was that these typical psychiatric drugs you're taking for life, right? And you're taking multiple compounds and they kind of blunt the symptoms, but they don't really solve the problem. Whereas these compounds seem to like in one dose or two doses seem to relieve anxiety, depression,

PTSD, to deal with addiction. Iboga literally can overnight shut down the physiology of heroin withdrawal, which is just as a doctor, it makes me wonder what's going on here. And we've had Debra Mash on the podcast as well as doing all the iboga research so to to me we're in this moment where we're we're kind of seeing the failure of traditional psychiatry as we see the psychedelic renaissance and i'd love you to sort of comment on on how you see this rolling out because you know currently the problem with with these therapies is that you know and you can talk more about it, it's a lot of the research is you take a dose of psilocybin and it's like six hours or MDMA,

it's four or six hours. And so it's a whole day for one therapist with a patient, which isn't really practical and scalable. So the question is, how do we begin to bring this to people who really need it? Because there's so much suffering. Yes. Well, I think it is practical and scalable. We have eight hour MDMA sessions actually. So that, and we have two therapists for one person. So you need to really look at the outcomes and then look at the cost to society that's being averted. And then that's going to be the story to insurance companies. For sure. It doesn't fit into the normal model of therapy or psychiatry where you have a one hour meeting or, you know, if you're lucky, a one hour and a half meeting or

whatever this is, you know, we give MDMA and then about two hours later, we give half the initial amount precisely to increase the length of the session. So I do believe that it's going to be demonstrably worth the time and money of the therapist when you look at the outcomes. The cost savings for sure, because it's like, you know, the biggest cost driver of healthcare costs, direct and indirect, is mental health issues. But, you know, still you're trying to figure out how to get millions of people treated by therapists. We don't have millions of people treated by therapists we don't have millions of therapists that's the problem well there's two parts of that well actually just say that michael midhofer our lead psychiatrist doctor he was an emergency room

physician and he saw that he would patch people up but people would keep coming back and he realized that a lot of it was their mental attitudes that put them in these situations and so that's where he switched to sort of get closer to the core of a lot of the problems i mean there's a lot of trauma that you have car accidents not related to second second dogs i also wanted to just um before i get into the scalable just say one point about you mentioned ken kesey and yeah really what what really it was stan groff's book that sort of solidified things but in my senior year of high school I read this book a friend of mine gave it to me to read and I loved it and I handed it back to him and he said do you realize that the author wrote some of this book

under the influence of LSD and I'm like that's impossible LSD makes you crazy it's a delusion it's hallucination you know you take it six times you're certifiably insane and all of this. And he said, no, it's true. Check it out. And it turned out he was right. And it was One Flew Over the Cuckoo's Nest by Ken Kesey. And so it was that book that started shattering the propaganda that I had received. All right. So how is this then scalable? First off, what we're doing, what everybody is doing pretty much is individual therapy. Yeah. And that's after we have to start out. Well, two on one. We actually and most. Yeah, even the psilocybin often has two people in the room or one person in the room and another person watching on video or something like that. So the question is, first off, group therapy. And we're just at the early stages of starting to explore group therapy. We have a project at the Portland, Oregon Veterans Administration

that's going to be group therapy. So our normal approach is two therapists, usually a male-female team, but not always, with one patient. And the way we've negotiated this with the FDA, and it's taken a lot of negotiations and a lot of money and lawyers and formal dispute resolutions, but the first person of this two-person co-therapy team needs to be licensed as a therapist. The FDA for a while wanted the first person to be an MD or a PhD. We knocked that out. The FDA wanted somebody to have a doctor on site rather than a doctor on call. We knocked that out. The doctor needs to do the screening and the prescribing. So those were poison pills that would make it not scalable at all if it had to be an MD, PhD as the lead person, or if a doctor had to be on site. All right. So then the second person

doesn't need a license. But the group thing is really interesting, right? Because then you can do a group and you can have people in a group. So it's a bigger number. Yeah. Now I don't think, well, yeah, in certain circumstances, the groups may not work as well when people are dealing with guilt and shame and they need a lot of time to work through it. And on the other hand, groups can sometimes help in that way, where if somebody else is acknowledging a similar kind of a problem, then you can feel that you can do it too, in a way. So we have a lot to discover about group therapy, But the second person needs to have a bachelor's degree. We think that's unnecessary. And the second person either has to have 1000 hours behavioral health experience, that's kind of vaguely undefined, or they need to be in a program to get a license. So while it's a two person team, we want to try to make it so that the second person doesn't cost as much as the first person.

The other aspect of this is now we've moved into what's called cognitive behavioral conjoined therapy. Now, conjoined means couples or dyads. And it's a form of treatment for PTSD where one person has PTSD and it affects the relationship and both people are brought into the therapy. So it's in a way some couples therapy, but also focused on PTSD. And we've done some studies there where both members of the dyad get MDMA. So that was where there was two people getting MDMA, one a patient, and two people providing support. Then the group therapy is going to be four, excuse me, it's going to be, yeah, four therapists for six PTSD patients. So we're starting to change the ratios, and then we will study more over time as group therapy. All right. The other part of this is that there's going to be, our goal is to train

25,000 therapists in this decade. There's 12 million PTSD patients just in America alone. I know. So how do we address that? I think that we need to start slow. We need to start getting really good results with very well-trained therapists. The key is going to be insurance coverage. And so can we really get insurance coverage? And I think the answer is yes, because there are people that are in, you know, to give somebody SSRIs is not that expensive to do, but if it doesn't work that well and you need to do it for 20 or 30 years, and you're muted your emotions, and you have sexual side effects, and you know,

so you have to take a longer view from the economic aspect of it. But also people with moderate to severe PTSD, a lot of times they can't work, they're not paying taxes, they're needing extra care, they have other high-stressed illnesses. They go to the emergency room for panic attacks. It's an expensive condition. Yeah, for sure. It's very expensive. So I think that it will be scalable. The other part, just to say, is that what we're doing is two-parallel strategies. One of them is drug development. And we talked about this, making MDMA into a medicine. The other is drug policy reform.

And so what we believe is, as you noticed, what's going on in Colorado and what's going on in Oregon and so many cities that are starting to decriminalize plant medicines, is that we want to embed in the culture. We think it'll take us another decade or so, actually probably more than a decade, decade and a half, to have thousands and thousands and thousands of psychedelic clinics, tens of thousands, potentially hundreds of thousands of patients telling their stories. And we think that we can then embed in the culture with honest drug education, with harm reduction, with pure drugs, with treatment on demand, with taxes on the drugs that people are paying, you know,

purchasing to pay for all this, to build kind of a psychedelic literate society. And that will be a lot of both for preventative medicine, you know, to catch things early, but also for spiritual use for other purposes than just medicine. So I think that the scalability, the drug policy reform is going to keep the check on the for-profit pharma companies. Yeah.

And that's all important work and getting it covered and dealing with the public policy around it. And I want to explore a little bit in addition to really that, which is really amazing that we can actually scale this up, that it's going to become legal very soon, that there be, you know, really a pathway for insurance and payments. That's just an incredible amount of work you've done. But I kind of want to dive into the biology of these molecules. How do they work? What do they do to the brain? You know, from some of the studies I've seen, they literally can change the structure and function of your brain cells, the neuroplasticity, neurogenesis. And, you know, it doesn't even make sense that one dose or a few doses can have such profound impact, but it does. And in long lasting impact. So can you share about how these compounds work? Are they, you know, how do they, how are they different from one another? What is used for what? And just kind

of take us down that rabbit hole a little bit. Okay. Yeah. The first thing I'll say is, you know, I'm not a neuroscientist. I'm more of a, in fact, I'm not even, we like to say, I'm not even really a scientist. We do political science, you know, in that how we choose our drugs, how we choose our patient population, all of that, because it's been a political struggle. But the other thing I'll just say is that to make a drug into a medicine, the FDA wants you to prove safety and you have to prove efficacy, but you don't have to have a theory of how it works. You know, it helps if you have a theory of how it works, but it's not necessary. So as a consequence, we have not really put much money at all into figuring out how they work. We figured

if we can show that they work, all sorts of other people will try to figure out how it happens. So there is a fair amount of knowledge, quite a bit of knowledge about how they actually work. And I think the key to it is this idea of neuroplasticity, that psychedelics can produce new neural connections. But also what they do is they shake up patterns. So one question is to say, how does electroconvulsive therapy work? You know, we don't even really know that much. But sometimes people that are in refractory depression, you just sort of give them a shock to the brain. And it's not as frightening as it used to be in one floor of

the cuckoo's nest with the, you know, with the electric ECT. Now they give people medication so they don't have the, the shocks to the body and the muscles and don't break bones. I mean, it was, yeah, it was very barbaric in those days. But ECT somehow changes your orientation. It breaks a pattern. You've got a pattern and we all know, you know, your computer gets caught in some kind of patterns. You turn it off, you turn it on, it works better.

So what psychedelics do is they break up these kind of patterns of thought. But let me start with MDMA, which fundamentally acts different than the classic psychedelics. Yeah, it doesn't give you the hallucinogenic kind of properties and distortion of reality and things like that. Yeah. So if you have PTSD, PTSD changes your brain. And what you have with PTSD is you have a hyperactive amygdala, which is the fear processing part of your brain. You have reduced activity in your prefrontal cortex where you think logically. The frontal lobe is the grownup in the room. You know, a sound, you know, people with PTSD will automatically say, oh, that's a gunshot or something that you don't

have that period of time. You're so hypervigilant to process it. Also, there's reduced activity in the hippocampus where we're putting things into long-term storage for memory. So the trauma is always sort of about to happen or happening or easily triggered or people hypervigilant and high stress. And what MDMA does is that it reduces activity in the amygdala. Now, if you were to design a drug to treat PTSD, these are the things that you would design it for. But, you know, chemists have figured out, made hundreds and hundreds and hundreds, particularly Sasha Shieldman of, you know, psychedelic drugs and through trial and error,

the same way that indigenous people have figured out for ayahuasca that you put, you know, roots and vines together and you get this psychedelic component that you don't get from either one. You know, people have learned a lot about other things. So what we find, though, is that MDMA increases activity in the prefrontal cortex and it increases connectivity between the amygdala and the hippocampus so that you can, first off, experience things that have been previously fear-based and overwhelming. So with the fear muted, you can recall things in a way that at the time, you know, they were so overwhelming, they were suppressed. You can think more logically about them and you can then put them into long-term memory storage so that they're not always right about to happen. And then there's the release of oxytocin. So oxytocin is of love and

nursing mothers, love and connection and MDMA releases oxytocin. So you're filled with this sense of self-love of self-acceptance and of, um, you're not, your ego is not so vulnerable. The sense of self acceptance is that in a couples therapy context, you really want to hear what people have to say. You're not so guarded in your sense of ego defensiveness. And a neuroscientist, Gould Dolan at Johns Hopkins showed that in the mice, when you end up giving MDMA, it's the oxytocin release that triggers the new neural connections. Oh, interesting. So oxytocin is sort of like a fertilizer for your brain in a sense for good things of healing your brain. Yeah. Yeah. That's a great way to think about it. And so

I always want to say one thing before you kind of continue, because I, you know, I think what most of us don't realize is the difference between the mind and the brain. The brain is the structure and function of your nerve cells. The mind is what those nerve cells and brain connections are doing to our thoughts and feelings and emotions and beliefs. And so the healing the brain is very connected to healing the mind. And, you know, I often hear the quote medicine that neurologists pay no attention to the mind and psychiatrists pay no attention to the brain. And they need to kind of start thinking about them as one continuing, continuing phenomena. But I think that the, the, the beauty of these compounds is they seem to sort of reorganize the brain in ways that traditional psychiatric drugs don't. And they seem to have these long lasting

things that may be helpful. And I listened to Paul Stamets talked about, for example, the research on microdosing psilocybin and the effect on Parkinson's or Alzheimer's, which is fascinating to me. So this is not just about depression, but it's all the different kinds of brain diseases that may not be related to psychiatric problems. Yeah. Although I would say that this idea that neurologists, you know, pay no attention to the mind and, you know, psychiatrists pay no attention to the mind and psychiatrists pay no attention to the brain. That's psychiatrists of the olden days of the Freudian kind of psychoanalysis. And the problem that we have is that psychiatry has been captured by the pharmaceutical industry. And it's all about here, let me adjust your biochemistry.

And they don't even talk anymore. Psychiatrists often meet with people for 15 minutes. It's to adjust your medications. Because of the discredited aspect of a lot of the Freudian theories that the psychiatrist and the psychoanalysis that you see from like Woody Allen movies of going through analysis four or five times a week and all that. So the problem has been that psychiatry has also abandoned the mind and the psychedelics are bringing it back. So that's like, and I think that's the healing that we're needing.

The other thing I just was gonna say is about what's called fear extinction and memory reconsolidation. So fear extinction means that, again, that you have these memories and, you know, in animal models, you know, there'll be an animal in a cage and a certain square in the cage will have an electroshock, you know, and then whenever the animal steps on that place, they get a tiny shock. And so they learn to stay away from that space, even when the shock is no longer there, you know, and so fear extinction

is over time, they can sort of test it out, is it still there or not? And then if it's not there, then the fear of that space or the fear of a memory, you know, no longer is there. And then memory reconsolidation is a more modern understanding of memory in that used to be that memory is like, you take a book off the shelf, you read the book, you put it back. But we know that memory changes over time, a lot of times,

particularly in ways that we wish that the past had been. We start remembering it often in that way. But reconsolidation means that when you have a memory, it's not like it's a unique, discrete thing and then you put it back. You have to rewrite the memory. When you reconsolidate the memory, you're kind of recreating it. And if you've had a memory under a mood and emotion of acceptance and release, when you reconsolidate the memory, you're also reorganizing the way it's stored in the brain. And so you're, again, placing it in the past and you've swapped out what's called the

emotional memory with the episodic memory. So the episodic memory is what happened. And we see that under the influence of MDMA, people can remember their traumas much more in detail because so many parts of it were just too painful. And so then this memory reconsolidation, you're putting the memory into a new location with a different emotion. And then when you recall it again, you recall it with the new emotion of, okay, I've worked on it. I've accepted this. I processed it. So I'd say that's a good way to think about how MDMA works. And one of the things that people have said about psilocybin and the classic psychedelics, both in the work in the 60s and the recent work for the last 20 years, is that there's a correlation between the depth of the mystical experience under the classic psychedelics and therapeutic outcomes. And that was pretty common in almost all of the classic psychedelic studies.

And that also distinguishes it from MDMA. So that in MDMA, we use the same mystical experience questionnaire that's used in the classic psychedelic research that was developed in the Good Friday experiment that Timothy Leary was the sponsor of back in 1962. And this idea that people do have remarkably high, some of them do, mystical experiences on this questionnaire under MDMA, but there is no correlation with therapeutic outcomes. It's about your memory, your trauma, what happened to you, and you need kind of an intact ego for that. All right. So that's a good overview of MDMA. What happens with the classic psychedelics

is this reduction of the sense of self, the parts of our brain, this default mode network. There's also the serotonin 5-HT2B or N2A and 2B that help produce these psychedelic experiences, the visuals, the visual distortions. So that there is a kind of open, Aldous Huxley talked about this actually in the fifties after his first masculine experience. And he talked about the brain as being like a reducing valve, that there's so much information coming to us from our own bodies or from the outside world, or, you know, but that how do we filter it? How do we, we filter it through our focus on what is important for our survival? And again, we can get into Abraham Maslow and the hierarchies of needs, you know, so that, but this idea of the brain being a reducing valve to help us focus on what's important.

And that reducing valve is weakened. This is, again, the sense of self, this default. So you have a flood of perceptions, a flood. And we all know, so you know, as a doctor, and people all know intuitively, that when you hurt your body, the doctor is not actually healing you. The doctor is helping your body to heal itself in different ways. So you get a scratch, your body below your level of conscious awareness will restore the order, you know, and there's limits. We can't restore, we can't regrow a lost limb, but, but there's, there's general that. So the theory that, that we have in the classic psychedelics is that there's this similar self-healing mechanism in the psyche, in the mind, you could say, and that when you take

psychedelics and there's, we all know that at night, we have dreams. And so there's a barrier between the conscious and the unconscious mind. And under sleep, sort of you have more of these, you know, feelings and thoughts, it's irrational in certain ways, but there's kind of an emotional logic to it. So psychedelics also reduce this barrier, the permeability of the barrier between the unconscious and the conscious mind is increased and things come up and memories come up into feelings, sometimes body sensations, where if you're not able to really, if the memory is too traumatic or too difficult,

a lot of times it'll come in the body. We work with Bessel van der Kolk who wrote the book, the body keeps the score, which is somatic therapy, right? Yeah. So come in the body. We work with Bessel van der Kolk, who wrote the book, The Body Keeps the Score, which is- Yeah, the somatic therapy, right? Yeah. So he's the principal investigator of our Boston site. So under the influence of psychedelics, there's this flow of material and the theory of this inner healing intelligence, so that the therapy approach is to support whatever is happening. We don't use the word guide or, you know, we're not the guide to the person. The person's unconscious is the guide. They're their own guide. We know a little bit about the process.

The therapists support the process. But I think what we see is that there's a twofold part. One is this idea of difficult material that needs to be integrated, that emerges under the influence of classic psychedelics. Our conscious control is weakened. So things that we've been repressed or embarrassed about or shameful about or haven't thought about, you know, can come to the surface. And so that's part of the therapeutic potential and the other is this sort of spiritual you spiritual unitive sense of connection that you get more from like the 5-meo dmt from the toad or different and then then you draw strength from that so you can do processing of split off materials and then also draw strength from this sense of connection and i think it's a it's a important way to think about the classic psychedelics are more this ego dissolution

and opening up and then mdma is more ego strengthening in a way that you become less defensive so that then you can also see the wider world interesting yeah it's sort of like uh the the meditators who Tibetans or people have been in a cave for three years or nine years and they, you know, they have 40,000 hours of meditation. They have the same thing that are happening in their brain when they look at them on functional MRI testing. So it's, you know, rather than sitting in a cave for nine years, you can try these natural compounds that have profound effects. There's a fantastic movie I'd like to recommend to people called

descending the mountain it's really good descending the mountain and so it's about it's a movie about the combination of neuroscience and meditation and so it's about lifelong zen meditators who are experts in Zen meditation. And if from the history back in the, you know, back when the backlash came against the psychedelics and in the early seventies, a lot of people were like, okay, the psychedelics are illegal. Now they went into meditation. And so there's a lot of people that were inspired by psychedelics to get into meditation. Yeah. But haven't done psychedelics in decades and decades so this

is a group of zen meditators and they first go to the university of zurich the state the movie is about a experiment that took place in switzerland they go to university of zurich for brain scans then they go to lucerne for a meditation retreat and in the middle of this meditation retreat they all get a pill and it's either psilocybin or placebo. And they're told to meditate through it, whatever it is, you know, during this event. And then at the end of the retreat, they go back and they have another brain scan and then they have a long-term follow-up. And then they do it again, the crossover, all the people that got this placebo can do it again and get psilocybin. All right. So what they showed is that you can meditate for 30 years and you think that you're open to everything and you know, that you're defenseless.

And, but even then we're channeling things in our brain. And so what they showed is that you can have this deeper dissolution under psilocybin for trained meditators. And they reached these states that then they can learn how to get to without the drug. The same way that we talk about the therapy, you only use the drug several times with the therapeutic process. But in this study in Descending the Mountain, what they showed is that people ended up learning how to deepen their meditation practice without drugs because they had this powerful experience with psilocybin.

So again, we're moving towards the synthesis. It's not meditation or psychedelics. It's both. Yeah. You know, it's interesting. I actually studied Buddhism in college and I used to do these long meditation retreats, you know, 10 days where you're meditating 12, 14 hours a day. And I remember coming out of those and you know

you kind of get a half hour day to walk around and i remember feeling like i was on lsd yes yes and i was like holy crap and you know i had also you know went to college in the 70s and got to experience the psychedelic renaissance there and the revolution around mushrooms and LSD. And it really helped me figure out what I was going to do with my life. When we go back and peel the layers back on people who are moving society forward or innovating in different areas or ideas, it's amazing how many people have taken LSD or mushrooms or psychedelics at some point in their evolution.

I found it very powerful for me to shift my childhood framework. And it didn't obviously solve everything, but it really gives you a sense of why you're here, what you're doing, what's important. And I think you said it before, Rick, you said, people have lost the plot line in our society. And I think it helps regain the plot line of what your life is, what the meaning is, where we fit into the bigger context of life and how we can conduct ourselves in ways that actually make us more human, more connected, more loving, more present, more able to do the work we want to do in the world, love the people who are in our lives and actually be free from some of the incredibly difficult parts of being

human that particularly in the, I think, 20th and 21st century have been just so rough. I mean, I mean, I don't think humans have had it easy all along, but I think just the, the amount of wars and violence and I mean, killing, I mean, it was the deadliest century in human history. And the species extinction, when we talk about what's going on with the environmental crisis and all that, but I do have a quick question, which was, I, I, I talked about how, which was I talked about how I had support from my parents. But when you were having these experiences, I'm curious, what was your parents thinking? I don't think I was like sharing a lot of it. I did drop out of college after my first year. And like, this is dumb. And then I, you know,

that's when I did a lot of the Zen retreats and making bagels at five in the morning. And I was like, I don't think I better go back to school. And I ended up studying Buddhism that's when I did a lot of the Zen retreats and was making bagels at five in the morning. And I was like, I think I better go back to school. And I ended up studying Buddhism. So it was OK. It worked out. It worked out. That's great. So you were sort of the classic Timothy Leary of, you know, turn on, turn in, drop out.

Something like that. Actually, I heard him come to speak at Cornell when I was there. I heard him speak. So, you know, I heard yeah i heard ramda speak and you know it was interesting ramda talks about neem curly baba who is his teacher and how he brought you know loads of lsd and he gave it to him and and it nothing happened like it was just like zero and i you know i don't know if that's true or not or if it's it's kind of a fictionalized tale but i you know it makes me wonder but when you have really have healed your mind and your brain, you have access to these altered states, these, this kind of people I've met in Tibet, these old llamas and meditators,

you know, they really are just joyous and happy and connected and present. It's really quite remarkable. And I think that's the beauty of these compounds is they, they're, they're called entheogens, right? They bring us closer to God, whatever that is. Yeah. Now, I don't actually use that word because I'll say that people have looked at the word psychedelic. And again, how do we do this public reframing? How do we take something so demonized and so beaten down and suppressed? And so a lot of it is framing and public education. So that's where I'm so glad to be talking to you as part of and public education. So that's where I'm so glad to be talking to you as part of this public education. But the word for psychedelics before

that was hallucinogens, psychotomimetics, mimic psychosis. And so entheogen was developed as a counter word to abandon the word psychedelics with all of its cultural connotations, but I think it's propaganda in the positive side. So hallucinogen is propaganda in the negative side that you're going to take this, it's going to be fake. It's going to be a hallucination. It's not going to be real. It's all a delusion, you know, and then entheogen is, oh, it's all about meeting God and you're connected to God. And so I see the value of that word, but I've focused, and you can see that MAPS has the word psychedelic in the title, that our mission was to try to reframe the word psychedelic, reclaim it the same way gay and, you know, has done or queer,

you know, the same way that they try to reclaim these. You quote Stanislav Graf often, you say, you know, the study of psychedelics is what the, you know, telescope was to astronomers and the microscope was to biologists. And I think that's a very interesting frame, it's very helpful to me to think about the ways in which these compounds can really help so many people who are really struggling and suffering. And the amount of trauma is huge. I mean, I think one in four people, and I've talked to us in the podcast, have been sexually abused, you know, including me. And I think that's kind of a really big, big phenomena. And that's a big trauma, but there's so much other trauma. Gabor Mati talks about the micro traumas. There's living in our current society and the macro traumas of real abuse.

And so I think all these compounds have some role to play in our, in our collective healing. Yeah, they do. And so, you know, Bhutan has, the country of Bhutan has developed a national index of happiness and, many people have heard about this. So what MAPS we're talking about now is to develop a national index of trauma. And we just had a meeting with some people at the UN and how we might actually do this. And then the goal is a world of net zero trauma by 2070. So now that it seems like we're maybe two years away or less than two years away from FDA approval of MDMA-assisted therapy for PTSD, it seems likely. Psilocybin,

I think, will be shortly thereafter for psilocybin for depression. And so as we start mainstreaming psychedelics, we already have 500 or hundred or more ketamine clinics in the United States. So we will eventually have thousands, you know, hopefully tens of thousands of psychedelic clinics around the world. And can we over time, over a generation or two, help reduce people's mult-generational trauma, you know, and move to a world of net zero trauma. There's some statistics that I recently have incorporated into one of my PowerPoints about how they're supposedly, or there are predictions that there'll be over a billion climate refugees by

2050. Yeah. Yeah. So the stresses on the human species are going to increase. We're really good at denial. And, you know, that's the classic story of addiction. And so, you know, we still have people in the fossil fuel industry saying, you know, let's do more of this.

So there's, we tend to do things at the last minute and so the crisis the the species extinction is going is increasing the environmental degradation is increasing on the other hand there is this hope of you know through the brilliance of our mind can we sort of remedy some of the problems through the sort of primitive nature of our mind as well. So it's a touch and go situation, I'm sure. It's quite a vision. Yeah. So this idea of 2070, a net zero world that, you know, what we need is this idea of a

spiritualized humanity. So that is really our goal is mass mental health and a spiritualized humanity. You could say that humanity is now like lemmings going over the cliff. And how do we stop that? We need more people to wake up. And so one of the things that I think was also good about Timothy Leary is that he didn't say, oh, we need to give. He did do this, but he did think about giving LSD to leaders. And there's an incredible story about- Put it in the G20 meeting water.

Well, one of the lovers, the mistresses of President Kennedy came to Leary and said that she and some of her friends were sleeping with the major political leaders. This is in the early 60s. And could he help train them so that they could be more effective with their LSD experiences with these guys to help them become more enlightened? So there's some very interesting, there's a book that

Mary's Mosaic is about this woman that supposedly did do LSD with John Kennedy. Wow. Trained by Leary. That's pretty wild. Mary's mosaic. That's pretty wild.

Okay, but the theory for me is slightly different, and I think it was also for Leary, is that you need to ground mental health in the mass of the population, that there's always going to be psychopaths, and that you can, you know, but it's the mass of people that give them their power that make them so destructive, you know, and that they can manipulate people's fears and anxieties.

And if you can help people not have such fears and anxieties or find a process to work through it, then the psychopaths aren't going to do so much damage. So that's for me, the theory of change is more of this idea of mass mental health. And that's why we need drug policy reform. That's why we need, you know, these 25,000 or more therapists trained just in this decade and all these clinics. And so I think it's a vision of hope, in a that that that the human species can pull itself out of this tailspin um hopefully not at the very last minute but but and that's where i think public

education what you're doing and with these podcasts is so important for people particularly i want to say this that there are there's a lot of people committing suicide out of despair. There's there's what's called deaths of despair, which is alcoholism, drug overdoses and suicide. But the message, I think the fundamental message coming from the field of psychedelic psychotherapy and psychedelic research is that there's a reason for hope that it's going to be a while before these things become mainstream, before everybody can have access, before it's insurance coverage. But there are technologies that are being developed that are not actually different from what we've done thousands of years ago. I mean, we as a culture, you could say, as a Western culture, have suppressed the irrational or the emotional, you know, and the psychedelics, both for power reasons to have hierarchies of the churches that are the intermediary between you and church, but also it helped facilitate the flourishing of our rational mind. And we have produced miracles of technology. The fact

that we can talk like this, that I can see you. I mean, this is amazing, you know, so hopefully the brilliance of our mind will be able to overcome the primitive nature of our psyche and help us to evolve. And that's the race that we're in. I mean, these compounds have been used for millennia by humans throughout the world. And even some say early Christianity was influenced by ergot alkaloids that were from kind of mold that was growing on grains and that created these mystical experiences psychedelic experience like lsd so i think you know this is not new to humanity this is just something that's been suppressed and and marginalized but it's actually central to the human experience throughout history that we co-evolve with these plants that's one of my favorite courses i took in college is plants plants and humans it was like all about this stuff, you know, all about the cultural use of plants, but for food is medicine, for psychedelic experience is healing. And I think

we're now kind of seeing, you know, places where people can go and get help. And it's a lot of it's underground right now. There's other countries that are doing this kind of work. For example, in Iboga, which is a you know a west african bark is being used out mexico and these clinics to deal with addiction and can end the physiological addiction but also give these people a really profoundly different way to look at their trauma and their past and seems to reset their neuroplasticity so there's these clinics opening around there's different centers around the world where do you see this sort of besides the United States emerging? Is there places?

Well, it's already in Switzerland. So, you know, again, Switzerland is where Albert Hoffman lived. And he was the one that worked for Sandoz and invented LSD first off in 1938. And then had his unexpected experience where he realized it was all like back in 1943. And then in 58, 15 years later, he got some on his fingers. Somewhere, yes. And then he also was the first one to identify psilocybin in the mushrooms. So there's a tradition of psychedelics in Switzerland of psychedelic discovery. And so in Switzerland right now, they have compassionate use of LSD, MDMA, and there's a group of 30 plus psychiatrists that are permitted to give MDMA and LSD to their patients.

So that is kind of the advanced place. There are clinics, as you notice, Ibogaine is, because of the zeal of the drug lawyers in America, Ibogaine is illegal in the United States, but it's not criminalized most of the rest of the world. So it's legal in Mexico, it's legal in Canada, legal in England, much of Europe, much of South America. And it's not a drug of abuse. And the irony is that we can have over 100,000 people die of opiate-related and fentanyl-related overdoses, and yet we still have the National Institute on Drug Abuse is not funding research into Ibogaine, even though it's clearly helpful for helping people, you know, overcome dependence on opiates. It resets the brain. It's incredible. And it gives

us psychedelic, therapeutic, spiritual experience. So I think we're at this situation where there is this recognition that there are tools that have been around sometimes for millennium that our that the need for these tools is apparent to more and more people. So, you know, we are involved in Ibogaine research. We've done studies with Ibogaine clinics in Mexico and New Zealand and did long-term follow-ups. There's a for-profit company, Atai, that's trying to work with Ibogaine. There's a study that we've supported in Barcelona with a group called Eye Seers and Claire Wilkins, and they're helping people with methadone with increasing doses of Ibogaine. There's Bruno Rasmussen is this therapist, psychiatrist, and Brazil is doing work with Ibogaine. So it's breaking through in different ways. But I think from the for-profit perspective, from for-profit pharmaceutical companies,

these drugs are in the public domain and the traditional pharma investors want drugs that they patent. So MDMA was invented by Merck in 1912 and is in the public domain. LSD is in the public domain. Psilocybin is in the public domain. LSD is in the public domain. Psilocybin is in the public domain. Ibogaine. So that's been a challenge is to find the resources. And then you have your classic pharma tricks where you try to patent this and that of what you've done to prevent other people from doing it, to justify your hundreds of millions that you got to put into making them into a medicine so you can see both sides of it. So it's- I's a, I mean, one of my questions I have is, you know, these, these compounds are extremely safe. You know, we see the, you know, psilocybin, I'll see there's really no sort of lethal dose.

There's not terrible side effects unless you have some very serious preexisting psychosis like schizophrenia and can kind of trigger things. But what's fascinating to me is that, is it, despite that, you know, safety, they're now trying to come up with these new molecules that are altering the structure of function somehow, but we don't know what the side effects of those will be. So there's like, Oh, they're going to be shorter duration or it'll be this or that.

And I think that worries me a little bit. Yeah. So this gets back to where your earlier question about scaling, you know, and how do we make so, so that a lot of these for-profit companies are thinking, Oh yeah, the problem is that these experiences take longer and we got to squeeze it into the normal therapeutic model that we have, like to have an hour experience. Can we make a psilocybin experience that's 15 minutes or something, or, you know, but you can do that with, with 5-MeO-DMT or, or, or things that are shorter. But I think that there's this assumption that somehow shorter is better, where I don't think that's true. And also, as you say, well, with spice.

So there was a whole lot of interest in cannabis alternatives, cannabis-like molecules that wouldn't show up on drug tests. And there's been, you know, those are more dangerous than the cannabis itself. Right. So a lot of times this search to get away from these tried and true things, produce ones that are, are technically legal, but they're more dangerous in, in many ways. We, we do know, I think it's possible to produce psilocybin likelike molecules, MDMA-like molecules that are relatively comparably safe, I would say. But I do want to say that there's physiological safety and psychological safety. So when we think about the psychedelics, I would say that MDMA and Ibogaine are more physiologically challenging in certain ways. You can take MDMA in non-therapeutic settings. This doesn't happen in therapeutic settings, but you can dance all night, you can

overheat, and people have died from hyperthermia. And sometimes people have drank in too much water as a harm reduction method, then they die from hyponatremia. So I would say that MDMA and Ibogaine have more physiological challenges. Ibogaine has an impact on the heart that you have to be careful of. But the classic psychedelics are safer physiologically. You won't overdose. You cannot overdose on psilocybin. But they're more challenging psychologically.

Yeah. And so I would say it's important for people to realize that you need a safe, supportive context when you're dissolving your sense of self. The set and setting, right? Yeah. Yeah. Also from Timothy Leary, so that we get back to... Now, there's another thing, talk about sustainability that I'll give credit to Timothy Leary for. So what I'm talking about is the future of drug policy reform. One way to think about it is what's called licensed legalization. And so if we think about alcohol, the way alcohol is regulated in our society, it's pretty light, right?

You can, you can go to a bar and you can get a bar fight and, you know, you get busted for that. But the next day you go back and you can go back into the bar and you can buy alcohol or go to a liquor store. You can be arrested for drunk driving and you could lose your driver's license, but you can still get alcohol in a bar or liquor store. So I think there should be a license to do drugs and that particularly for alcohol and other things and also for psychedelics. And that the idea is that it's not that hard to get the license, but if you misbehave, you lose the license and then it makes it a little bit harder and you have to do re-education or something like that.

And it turns out that the person that proposed that was Timothy Leary. Wow. Where he talked about how it's like you need a pilot's license to drive a plane. Well, you should have a LSD license, you know, and it's similar to that. So he did have that kind of relatively conservative theory. And I think the one downside of it is that we don't trust our governments. And a lot of times there's changes in policies. And so if you have a license, then there's a list of everybody that's got the license that the government has. Now, the government has so much information already. They know your credit

cards. They know what you're buying. If you go to a marijuana dispensary, they're, oh, you charge this marijuana dispensary. So I do think that the future, I would say, would be licensed legalization of some kind and that these psychedelic clinics would be a site of initiation. The idea is that you want to have a license for LSD or MDMA, you go to a clinic, you have it basically for free, paid for by all the taxes, and then you understand what it is. And if you don't have a terrible, terrible experience, then you get a license and you can go do it on your own. And that's the same way with driver's license. You have to drive in a car with an instructor making sure you know what you're doing before you get a license to drive on your own. Yeah, it's quite

amazing. And what's really exciting to me and where this is all going is it's expanding in the legitimate world of mental health and psychiatry. And there's articles in New England Journal about psilocybin and treatment for depression. And I think they're at Yale, at Johns Hopkins, at UC Berkeley, and in many other institutions around the country, there's now psychedelic departments of research and inquiry. And this is- Even at Harvard.

Even at Harvard. Yeah. The Harvard Center for the Neuroscience of Psychedelics at MGH, Massachusetts General Hospital. Which is really remarkable considering how marginalized these were. And I guess my question to you is, how do you see traditional psychiatrists interacting with this information knowledge? Are they resistant?

Are they excited? Are they open to it? I mean, I think we really are in a moment where psychiatry is really about to change. And it seems to be potentially a big threat to traditional psychiatric paradigms. In some ways. Well, Max Planck, who is a physicist,

the Planck constant is named after him. He had a saying that I have learned a lot from. And what he said is that science precedes funeral by funeral. Yeah. So you think science, they're the most open to continual inquiry. And, you know, the whole idea of science is you try to disprove hypotheses or to prove hypotheses, you know, that even in science, people get entrenched ideas. And so for Max Planck to say science proceeds funeral by funeral, you know, it's kind of a disappointing indictment. Well, it's like basically it just changes. It's hard to change paradigms for sure. Yeah. So I would say that what we're seeing with traditional psychiatry has been more openness than I would have anticipated.

And I think that it's because a lot of the young generation of psychiatric residents and people in medical schools and psychiatry, they've grown up now over the last 20 years with more and more stories about the therapeutic value and the spiritual value of psychedelics. And they've grown very disillusioned. A lot of people have grown disillusioned with psychiatry, where, as I said before, you know, you see a patient for 15 minutes, you adjust their medications, you know, that's the way you maximize your income, but you're not really relating much on a human way with these patients. So I think that there's also an understanding among a lot of psychiatrists. We do a lot of work at the

Veterans Administration. Also, we're starting, it took us like 30 years or so to get into the VA. You're a patient man, Rick. Well, you know, the resistance was great. And the only way to get through it was being patient. But that there are people that they've seen for 20 years or 30 years or 40 years since Vietnam that they're giving SSRIs to and they're not getting better. So the same way, I think there's a sense in traditional psychiatry that the tools that they have work for a bunch of people, but there's a large bunch of people that they are not helpful for. Yeah. Well, that's are not helpful for. Yeah. But one of the reasons why, when I say we do political science, not regular science, the reason I chose MDMA as the drug that I thought would make it through the system first, rather than psilocybin, let's say, or LSD is because

what we say is that the therapists who are working with the patients will be more effective if they've tried the drug themselves. And we don't say psychiatrists should get ECT, electroconvulsive therapy. They should get psychoanalysis, right? Yeah. But the ECT is the treatment, or you don't want a psychiatrist necessarily to take anti-psychotic drug. But that, but that's where the drug is the treatment. But in psychedelics, it's the therapy that's the treatment that the drug makes more effective. It's the human relationship. So what we've said is that for therapists who are in our program, we have FDA protocols to give MDMA to therapists as part of their training. That's incredible.

There is more resistance in traditional psychiatry to themselves doing LSD or psilocybin, more fear, more anxiety than there is to doing MDMA. But overall, I think that traditional psychiatry is warming up to psychedelics. Like just the last annual conference in New Orleans of the American Psychiatric Association, there's what's, you know, they have like 10 plus thousand or more psychiatrists go to this, but they have a series of, and they have like eight concurrent sessions or whatever, loads of concurrent sessions, but they have a track that's called President's Talks. So the president of the APA can pick certain kinds of topics. And so Julie Holland,

a psychiatrist, and I were chosen to speak about psychedelics. That's amazing. Wow. That's amazing. Wow. That's incredible. And the room was packed. So I think that the traditional psychiatry, people go into psychiatry because they want to help people. And when they see that people are being stuck for a very long time, they look for new things. So I think there's-

That's great. The openness is there in traditional psychiatry. It's there in the regulatory agencies. And all of this is in the background of marijuana legalization and of the questioning of the drug war. So the drug war is what really suppressed the research for a long time. And it was also against the hippies and against the people challenging the latest grow. And so a lot of that has diminished.

So the resistance to psychedelic research has gone, you know, way down. And so what are you most excited about now going forward as we close the podcast? Now, what are the things that you're seeing on the horizon or what do you, what is the vision you have for the future that you're most excited about? Well, you know, when I talk about a world of net zero trauma by 2070, what that really means is that we have to go into refugee camps and migrants. We have to go into prison. We have to work with prisoners and prison guards. We have to go into countries that have like Rwanda, where there's been, you know, genocide that there's still, you know, China, actually, when you think about it, there's one of, I've been to China, Amy

Emerson, the head of our benefit corp, we've been to China during the Cultural Revolution. When we had the psychedelic revolution, China had the Cultural Revolution. And that whole generation is traumatized from that still. And so what I'm looking forward to and excited by is this idea of, first off, regulatory approval, which is going to come over the next four or five years. We think in less than two years, we should have FDA, Health Canada and the Israeli Ministry of Health approval for MDMA assisted therapy for PTSD. We're working with the European Medicines Agency and the MHRA in England. We're in seven countries, 10 sites in Europe. We're in Australia and Brazil. So the globalization of the healing potential of MDMA and other psychedelics is coming.

And the work that we're doing inside the Veterans Administration, I think one day, a couple years from now, maybe four or five years from now, the VA should adopt psychedelics as part of their standard offerings. We want to cross that line into the Department of Defense. So that also we want to cross another line, which is into adolescence. So right now, the FDA is saying to us that we can only work with people that are 18 or older. But if we do succeed in getting FDA approval for MDMA-assisted therapy for PTSD

in people 18 or older, then we are required to do studies in 12 to 17-year-olds with PTSD. That's amazing. So the theory here is you move closer to the trauma rather than, you know, and then it's easier to treat and they don't suffer as long. So we need to move into the Department of Defense. We need to move into adolescence. We need to work with, you know, refugees and prisoners. So I'm really excited about the globalization of all of this. And, you know, also MAPS is trying to do something different. I'm not sure how successful it will be, but we have formed the MAPS Public Benefit Corporation.

That's our pharmaceutical arm. We have about 160 people there and about 35 people at MAPS, the nonprofit. And so what we want to do is show how to market a drug without maximizing profit, but maximizing public benefit. Because the profit motive has warped healthcare in America. Terribly, terribly. In a terribly way. So what I'm looking forward to is also the world's biggest psychedelic conference ever. We're calling it Psychedelic Science 2023, Doorway to a New World. We've had these psychedelic science conferences in 2007, 2010 was the first one in San Jose, then 2013 in Oakland, 2017 in Oakland, and now 2023 in Denver.

It's going to be the Denver convention center. We're hoping for upwards of 10,000 people to come. We've already sold, um, it's more than six months away. We've already sold the 1,250 tickets. Um, so it's also Denver, Colorado just passed the Natural Plant Medicine Initiative. Denver was made mushrooms the lowest enforcement priority. So we're looking forward to this big celebration. We'd like to encourage everybody to come.

There's going to be lots of opportunities to learn and to network. And even we're going to have Stan Groff to learn and to network and to even, we're going to have Stan Grof is coming to do a holotropic breath work. We're having other experiential things. Naropa is a college that's going to do meditation retreats, a lot of sort of spiritual things. But I think what I'm, you know, the key turning point for us is going to be FDA approval of MDMA assisted therapy for PTSD. And that's not just for us, but that's for the whole field. And so we are the leading edge. And, you know, we just would encourage people to check out MAPS,

to consider becoming a member of MAPS. That's maps.org, M-A-P-S.org. Yeah, yeah. Thank you. Thank you for that. And then psychedelicscience.org is the conference, or just go to the MAPS website. But I think where we're really moving to is a recognition that when we think about the Western culture,

and you alluded to this, too, about the early Christian religion involving with psychedelics. There's a book called The Immortality Key by Brian Will Rescue that makes a really good case. So the Eleusinian Mysteries were the world's longest-lasting mystery ceremonies, lasted 2,000 years, from 1600 B.C. to almost 400 A.D. But it was wiped out by the Catholic Church, and that had ergot. That was a psychedelic component. And the early Christianity, the wine was fortified wine with, with psychedelic aspects of it. And

then the church wiped that out. Um, and they wanted to be an intermediary. And then when the, then we have the dark middle ages and they wipe out all the witches. And those are often women that were knowledgeable about plant medicines. And then we get the exploring of the Western world and the conquistadors. And the first people they decided to kill were the shamans and the people that were the center of the culture. So we think about it, many people think about it as, oh, there was the psychedelic 60s, and then there was the backlash. And now that's 50 years ago. And now we're trying to bring psychedelics back after 50 years. But really, what we're trying to do to take a lot larger perspective is after 15, 1600 years, we are trying to mainstream psychedelic consciousness into Western culture at a time of incredible crisis. And I think that there's a

good chance that that'll happen. And I think that regulatory approval is sort of the first stamp of official acceptance that this is moving forward. We have that a bit with ketamine already and once MDMA psilocybin. So that's what I'm looking forward to. That sounds exciting. And then the other thing is we are planning a party. I'll just say this, that April 8th is when I started MAPS in 1986. Okay, so 2024 on April 8th is the 38th anniversary of MAPS.

And that should be right around the time that we get FDA approval. It could be within weeks or days or, I mean, who knows if our schedules are, I've never been right about my estimates of time or money. In any case, April 8th, 2024 is the 38th anniversary of MAPS and the universe has decided to help celebrate with a full solar eclipse through Months of North America. So we're going to try to find a place where we can have private land and we can have a big celebration for the MAPS anniversary and the solar eclipse. So I'm looking forward to that as well. And hopefully we'll get FDA approval the day before that or something. That's exciting.

Well, you know, Rick, I think that, uh, uh, thank God for that guidance counselor who gave you Stanislav Graf's book and that you wrote him a letter and that he wrote you back and that you started this journey because I think it's going to be helping millions of people enter a world of healing and repair of their minds and their brains or hearts and maybe bring a little bit more connection and love to the world than we have right now. Because it just seems like both the best of times and the worst of times. And it feels like this psychedelic renaissance is actually poised to make a huge difference in the global mental health that we see so problematic today. So thanks for your work, Rick. Thank you for doing what you're doing for so many decades.

Tirelessly, you seem more excited than ever actually about doing this, which is amazing. Yeah. I can see that. And thank you, Mark, because what we realized is that public education is the key. It was fear and anxiety in the public that squashed the research for decades. And so now this kind of work that you're doing with podcasts, that we're trying to communicate to people what we're doing so that they can be more excited about the future and understand it more rather than be frightened about it. Well, thank you, Rick. And if anybody listening to this podcast,

love what you're hearing and know people who could benefit, share it with them on all your channels, subscribe wherever you get your podcasts. Leave comments. We'd love to know how maybe you use psychedelics or various compounds to help you heal. And we'd love to know more. And we'll see you next time on The Doctor's Pharmacy. Hey, everybody. It's Dr. Hyman. Thanks for tuning into The Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and introducing you all the experts that I know and I love and that I've learned so much from. And I want to tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter. And in it, I share my favorite stuff from foods to supplements to gadgets to tools to enhance your health. It's all the cool stuff that

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