Plant Medicine Podcast

In this episode of the Psychedelic Medicine Podcast, Steven Radowitz, MD joins to discuss the state of the research into ketamine treatments for PTSD. Dr. Steven Radowitz is the Chief Medical Officer and Co-Founder, Nushama. He believes psychedelic medicine’s framework of neuroscience, mystical experience, and integration therapy is the future of mental wellness, and current solutions often fall short, treating symptoms without addressing underlying issues. Dr. Radowitz and the Nushama team have administered thousands of ketamine journeys for mood disorders and are known to be best-in-class and among the most experienced globally.

In this conversation, Dr. Radowitz shares the journey of his career in medicine and how he got involved in the treatment of mood disorders with ketamine. He discusses the way he works with patients to determine the best dosing of ketamine for their unique therapeutic needs and the way dosage intersects with the durability of the changes. Dr. Radowitz emphasizes how ketamine promotes neuroplasticity, which allows patients with PTSD to open a critical response window when confronted with triggers and re-code memories of trauma. In closing, Dr. Radowitz discusses the importance of integration and highlights the way psychedelic therapies empower patients to be their own healers.

In this episode you'll hear:

• Using both psycholytic and psychedelic doses of ketamine and how therapeutic approach differs between the two

• Stories of transformation from Dr. Radowitz’s ketamine practice

• The practices Dr. Radowitz recommends for patients following ketamine infusions

• How Dr. Radowitz uses music in his ketamine practice

Quotes:

“As much as we segregate all these mood disorders into separate disease entities… there’s actually a common seed for them all—there’s just different manifestations. But I say about 95% of the people who come in here [for ketamine treatments] have some type of trauma.” [4:56]

“The dose doesn’t always correlate with the experience—it usually doesn’t. I can give people the same dose, with the same music, same everything, and they'll have completely different experiences each time.” [13:23]

“What we do here is to create a medically safe and an emotionally safe environment for [patients]. But the medicine is them—they’re the therapists in the end. … I want them to realize it’s all coming from them. They have everything they need within themselves to heal.” [32:15]

Links:

Nushama website

Nushama on LinkedIn

Nushama on Instagram

Nushama on Facebook

Nushama on TikTok

Dr. Radowitz on Linkedin

The Untethered Soul: The Journey Beyond Yourself by Michael A. Singer

Letting Go: The Pathway of Surrender by David R. Hawkins

Psychedelic Medicine Association

Porangui

In this episode of the Psychedelic Medicine Podcast, Rick Strassman, MD joins to discuss the topic of endogenous DMT. Dr. Strassman is adjunct associate professor of psychiatry at the University of New Mexico in Albuquerque and author of DMT: The Spirit Molecule and The Psychedelic Handbook. His DMT and psilocybin studies in the early 1990s initiated the renewal of human research with psychedelics in the U.S.

In this conversation, Dr. Strassman discusses the finer details of DMT, from endogenous production in humans and animals, to visionary experiences and theological implications. Dr. Strassman also covers the research that's been done regarding endogenous DMT, clarifying what we do and don’t know about the role of the pineal gland and how this might relate to what is reported during near-death experiences. He also discusses the personal and relational quality of psychedelic experiences induced by DMT, mentioning that unitive mystical experiences were actually rare in the trials he conducted, with more experiences having a personal quality, drawing upon the life experiences and interests of the participants. In closing, Dr. Strassman shares his thoughts on the origins of the visions that many report during DMT use. 

In this episode you'll hear:

• The overlap between psychedelic experiences and meditation techniques

• The relationship between fear, self-awareness, and difficult DMT experiences

• The placebo effect and psychedelic research

• Dr. Strassman’s thoughts on non-hallucinogenic psychedelics

• DMT as a possible treatment for strokes to prevent damage and speed recovery

• Effects of microdosing in animals and humans

Quotes:

“I think the best term for these compounds is psychedelic, which means mind manifesting or mind disclosing, because only one of our fifty-five or so normal volunteers had what one might call a mystical unitive state. … Everybody basically had an experience that was totally dependent on them. It was not inherent in the drug.” [9:45]

“You could still speculate that to the extent that non-drug states resemble those brought on by giving DMT… that DMT plays a role in the production of those states. But the data aren't there yet. That's why we need more people doing this research.” [24:16]

“If psychedelics are super placebos and if we have a psychedelic drug in our brain, it's attempting to speculate that normally the placebo effect could be mediated by endogenous DMT.” [27:42]

“If you starve neurons of oxygen they start dying, but if you add DMT they survive much longer. So there seems to be some neuroprotective effect of DMT on ischemic damage to neurons, at least in the test tube.” [32:27]

Links:

Dr. Strassman’s website

The Psychedelic Handbook by Dr. Strassman

DMT: The Spirit Molecule by Dr. Strassman

DMT and the Soul of Prophecy: A New Science of Spiritual Revelation in the Hebrew Bible by Dr. Strassman

Dr. Strassman on Facebook
Previous episode: Exploring DMT Entities with Matthew Johnson, PhD

Psychedelic Medicine Association

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In this episode of the Psychedelic Medicine Podcast, Stephanie Knatz Peck, PhD joins to discuss the research on psilocybin for anorexia nervosa. Dr. Stephanie Knatz Peck is a clinical psychologist and Associate Clinical Professor at the University of California, San Diego with an expertise in eating disorders. She conducts clinical research on novel treatments for eating disorders and has been involved with clinical research evaluating psychedelics across a variety of mental health indications in the capacity of researcher and therapist. She also published the first ever report on a clinical study evaluating psilocybin for anorexia nervosa. 

In this conversation, Dr. Peck discusses the difficulties of treating eating disorders and the emerging evidence around the safety and efficacy of psychedelic-assisted therapies for these conditions. She discusses the results from a study she conducted on the safety and tolerability of psilocybin therapy for females with anorexia nervosa, finding that the treatment was safe and generally well tolerated amongst the trial group. The study additionally found positive treatment outcomes following the psilocybin therapy in a number of participants. In closing, Dr. Peck discusses how psychedelics are able to open a “behavior change window” following dosing sessions—something which may be crucial to their efficacy in treating eating disorders.

In this episode:

• Dr. Peck’s work treating patients with eating disorders

• The lesser known diagnostic categories orthorexia and eating disorder not otherwise specified (EDNOS)

• Genetic predisposition for eating disorders

• Why the participants in Dr. Peck’s study thought they could benefit from additional psilocybin dosing sessions

• How transformative psychedelic experiences can help shift values and identities to promote eating disorder recovery

Quotes:

“We think that there are specific personality features that predispose someone to engage in dietary restrictive processes or behaviors or actions or modify their lifestyle around exercise and food—and then they fall into anorexia. And the thing that distinguishes those people is that sometimes they have these predisposing factors like a lot of anxiety or preoccupation, an ability to be highly self disciplined… There’s a lot of processes in place that can cause a diet to go awry and turn into anorexia.” [12:29]

“Something that distinguishes anorexia from other psychiatric illnesses is that it is an illness that really results in a lot of physiological vulnerability—across all body systems. And so while it might be fine to just assume that with some other psychiatric illnesses we can reliably assume safety, with this particular population there’s cardiac issues, there’s serotonergic things that affect cardiac issues that we really needed some safety data on.”  [19:13]

“We really need better treatments [for eating disorders] that treat from the inside out, meaning like what is happening on an underlying psychological level, neuropharmacological level, that’s causing someone to want to engage in these behaviors and I think that is the value of these [psychedelic] treatments is that we are treating from a different direction.” [27:25]

Links:

Dr. Peck’s study: Psilocybin therapy for females with anorexia nervosa: a phase 1, open-label feasibility study

Current eating disorder studies at UCSD

BrightMind Therapy website

Dr. Peck on Twitter

Psychedelic Medicine Association

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In this episode of the Psychedelic Medicine Podcast, Ben Malcolm, PharmD, MPH joins to discuss why he prefers the term “psychosomatodelics” for psychedelics. Dr. Malcolm is a psychopharmacology consultant, psychedelic educator, founder of Spirit Pharmacist, LLC and a board member of the Psychedelic Medicine Association.

In this conversation, Dr. Malcolm shares the meaning of the term psychosomatodelic as well as the history of the different terms used to refer to psychedelics. He emphasizes the ways that these substances manifest mind and body together, rather than only focusing on the mind-altering aspects of the experience. He also suggests that the line between side effects and therapeutic opportunities is blurry in psychedelic therapy, discussing the ways in which nausea and purging in the context of ayahuasca ceremonies can contribute to the sense of healing and psychosomatic catharsis. In closing, Dr. Malcolm suggests some directions for future research regarding serotonergic psychedelics' interaction with the gut-brain axis and the autonomic nervous system.

In this episode:

• The meanings of more newer, more specified terminology such as psychoplastogen, entactogen, and more

• Trauma-resolving aspects of psychedelic experiences

• How psychedelics impact transmodal cortices of the brain

• The somatic side effects of psychedelics

Quotes:

“The psychedelic experience is inherently larger than either brain or mind, and it’s more of a mind-body kind of experience. And it would be worth recognizing the mind-body contribution that is happening as far as the types of experiences persons are having, and maybe even the ways that psychedelics are working to provide a true, felt sense of relief for persons.” [3:51]

“Why do we wear a blindfold for psychedelic therapy? Well, you’re actually trying to limit the sensory input from certain unimodal sensory cortices like vision and you’re trying to amplify sensory content—maybe from the body, maybe from the viscera, maybe from inside. It’s to heighten the internal landscape. That’s why you’re actually shutting out these kinds of external sensory inputs.”  [17:19]

“Particularly if you’re approaching psychedelics for healing of trauma, then thinking of them as energetic purgatives that have a psychosomatodelic, or full mind-body manifesting type of experience, might allow you to wrap your head around the psychedelic experience or what its doing a little bit easier.”  [31:53]

Links:

Spirit Pharmacist website

Spirit Pharmacist on Facebook

Spirit Pharmacist on Instagram

Spirit Pharmacist on YouTube

Previous episode: Medical Literature Regarding Psychedelics, Pregnancy, and Breastfeeding with Ben Malcolm, PharmD

Psychedelic Medicine Association

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In this episode of the Psychedelic Medicine Podcast, Nick Brüss, EdD, LMFT joins to discuss the possibilities of leveraging ketamine-assisted psychotherapy for accelerated growth. Dr. Brüss is a psychedelic therapist licensed in CA, NY and TX. He was a MAPS clinician and supervisor on the historic phase 3 MDMA for PTSD study, and is the director of psychedelic medicine advocacy for the TREAT California ballot initiative. 

In this conversation, Dr. Brüss explains the intricacies of the internal family systems (IFS) model of therapy which he uses in conjunction with ketamine to help lead clients towards transformation and growth. Dr. Brüss explains how he helps clients work with their various “parts” both leading up to ketamine experiences and while they are under the influence of the dissociative, explaining how the ketamine experience helps to facilitate this work. He emphasizes the non-pathologizing, self-compassion focus of the IFS model and sees this as a natural fit for psychedelic-assisted work. In closing, Dr. Brüss shares details of the TREAT California ballot initiative, which has the potential to provide five billion USD in funding for research and affordable access to mental health treatments using psychedelic medicines.

In this episode:

• Different forms of ketamine-assisted therapy

• The importance of preparation for both psycholytic and psychedelic forms of ketamine therapy

• Why Dr. Brüss finds the combination of IFS and ketamine therapy so powerful

• Working with “parts” using IFS

• Stories of client healing and transformation following ketamine-assisted therapy with IFS

• The meaning of “protector parts” and “exile parts” in IFS and how to work with these

• The mechanisms of ketamine “softening protector parts” and facilitating self-love

Quotes:

“[Internal family systems] is so synergistic with psychedelic-assisted work because it holds as part of one of its assumptions that we all naturally have this multiplicity of minds… And we also hold this capacity, this inner-knowing that we can open to and relate to and even bring a loving, compassionate embrace to all of our parts.”  [4:59]

“This work is a training for people to get to know themselves, so we work with the biggest pieces, the things that have been holding them down or blocking them in some way—blocking their full expression—and after that, they are now trained to work with any number of parts.” [26:52]

“One of the things that I wish I could have told my earlier, younger self is to really focus on these areas where if there’s a part of myself that I can’t love or care for or deeply respect, then that really needs my attention.” [33:52]

“Even with the most seemingly scary parts, as we get to know them, we can learn from them.” [36:00]

Links:

Dr. Brüss website, A Practice of Freedom

TREAT California ballot initiative website 

Dr. Brüss on Instagram

Dr. Brüss on LinkedIn

Your Symphony of Selves: Discover and Understand More of Who We Are by James Fadiman and Jordan Gruber

Psychedelic Medicine Association

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In this episode of the Psychedelic Medicine Podcast, Erica Siegal, LCSW returns to discuss the important topic of supporting survivors of psychedelic abuse. Erica is a psychedelic-assisted psychotherapist, community organizer, and harm reduction advocate. In 2019 she founded NEST Harm Reduction, a California-based mental health and psychedelic support organization that provides psychotherapy, outreach, education, and integration. Erica also recently founded SHINE Collective to support survivors of psychedelic harm and abuse. 

In this conversation, Erica unpacks the complexities around various forms of abuse that exist in psychedelic spaces. One major form of abuse she identifies is financial coercion, where clients of psychedelic facilitators come to feel that one’s spiritual access has a paywall, or that they are having to make major financial decisions while under altered states of consciousness. Erica also discusses problematic sexual and romantic dynamics that can arise, drawing a clear line in the sand that there should never be any form of sexual contact between psychedelic facilitators and clients. In closing, she shares more about the work SHINE Collective is doing to support survivors of psychedelic abuse, and discusses ways that listeners can help support this important work. 

In this episode:

• What inspired Erica to start SHINE Collective

• Issues of financial coercion in psychedelic spaces

• Different forms of spiritual abuse

• Ways identify the dynamics of spiritual abuse and guard against them 

• Why Erica is skeptical of husband-wife teams of psychedelic therapists or facilitators

• Issues of sexual dynamics between psychedelics facilitators and clients

• Training and integration needed prior to skillfully and safely facilitating psychedelic experiences

• What SHINE Collective is doing to support survivors of psychedelic harm

Quotes:

“You also see people who are like ‘oh well if you want to keep working with me it's this price’ and then all of a sudden the access to psychedelics—the spiritual access—now becomes ‘well I have to be paying this person $1,000 a month to just be on their mailing list because they are the person that is acting as the point between me and my spiritual access.’” [11:19]

“If you’re facilitating, you should have a consultation group of other facilitators in which you consistently welcome constructive feedback. … And be able to have case consultations, and be able to have reflection.” [26:43]

“Psychedelic facilitators should not be having sex with people they are facilitating psychedelic ceremonies for.” [30:35]

Links:

NEST Harm Reduction website

NEST Harm Reduction on Instagram

NEST Harm Reduction on Twitter

SHINE Collective website

SHINE Collective on Instagram

Erica on LinkedIn

Erica on Instagram

Previous episode: Avoiding the Traps of Psychedelic Self-Absorption with Adam Aronovich, PhD(c)

Article by Jules Evans and Joseph Holcomb Adams: “Blurred Lines: improving the ethics of psychedelic fund-raising”

The Emerald Podcast by Joshua Michael Schrei on Spotify

Psychedelic Medicine Association

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In this episode of the Psychedelic Medicine Podcast, Kyle Buller and David Drapkin, LCSW of Psychedelics Today join to discuss psychedelic training and education. David is a licensed clinical social worker, the director of education and training at Psychedelics Today, and one of the creators of their 12-month training program, Vital. Kyle is the co-founder of Psychedelics Today and VP of training and education. 

In this conversation, Kyle and David share an overview of the current state of psychedelic training programs and education. Kyle shares his own background with psychedelic education, discussing how he got involved in this field and what he’s found most beneficial and effective in psychedelic training. Kyle and David also discuss the complexities of weighing different programs, considering medicine-specific versus general programs, programs focused on specific modalities, programs geared towards specific professions, and more. They also discuss the details of how they created Psychedelics Today’s training program, Vital. In closing, David reiterates the value of diversity in psychedelic education, both in enriching the learning experience and extending the impact of this education. 

In this episode:

• The variety of psychedelic education programs

• The vision behind the Psychedelics Today Vital course

• What to look for in psychedelic education programs

• Equity and diversity in training programs

• Medicine-specific vs. medicine-general programs

• Dealing with the uncertainties around working with psychedelics as legal landscapes develop

• Psychedelic training program scholarships

Quotes:

“Something we put a lot of emphasis on with Vital, is that it be experiential and inner-directed—a process of understanding self and coming out of Vital with more refined questions and a clearer sense of where to go next.” [8:31]

“If the psychedelic movement is going to continue to grow, we need people to be educated in all realms so that we can help to reduce the stigma.” [11:42]

“If you want to start working with these medicines, building those foundational elements is so important. Like learning how to work with your body, learning how to use your breath to navigate experience.” [31:12]

Links:

Psychedelics Today website

Psychedelics Today Vital course

Psychedelic Medicine Association

Porangui

In this episode of the Psychedelic Medicine Podcast, Adam Aronovich, PhD(c) returns to discuss issues of psychedelic self-absorption—and how to avoid these traps. According to Adam, he is a PhD candidate in medical anthropology, the creator and curator of Healing from Healing, a trophy husband and dad.

In this conversation, Adam revisits his previous discussion of psychedelic narcissism and explains why he’s now somewhat more critical of the term. However, Adam still sees issues around cultivating epistemic humility and acknowledging the political dimensions of healing in psychedelic contexts. He explains the issues he takes with forms of New Age, Neoliberal spiritual perspectives he sees as pervasive and typically unacknowledged amongst many engaging with psychedelics. He also discusses how some pop psychology terms have worked their way into the psychedelic realm and what impacts that has had.

In this episode:

• The “spectacle” of filmed psychedelic experiences on social media

• The intersection of medical and spiritual cultures in psychedelics and how this can create issues of access

• The cheapening and overuse of the idea of “trauma” in popular discourse and the birth of “traumadelic” culture

• Why approaches focusing on excavating supposed repressed traumatic memories from childhood should be approached with a degree of skepticism

Quotes:

“One of the main things with plant medicine—particularly when people are sharing about it—is that people want to be really vulnerable and people want to be very authentic… But at the intersection with the spectacle, that vulnerability and authenticity become part of the spectacle in the sense that they become 100% performative.”  [19:01]

“The people who don’t have that modicum of self awareness and epistemic humility to really understand, with intellectual honesty, the scope of their understanding and knowledge, then it is very easy to overdo it. And then we do a disservice, not only to the actual traditions that we purport to be portraying, but also to the people that we’re working with.” [37:56]

“If you don’t understand that your healing is political, because individual health, and individual happiness, and individual everything is intrinsically related to collective health, and social health, and cultural health, and environmental health, then you need to go back to square one because you haven’t understood anything. ” [40:02]

“If we can’t even fathom that perhaps my own wellbeing is in constant dialogue with the wellbeing of a society, and the wellbeing of a culture, and the wellbeing of an environment—that nobody can be healthy and happy unless everybody else is relatively healthy and happy—then we are in big trouble and we haven’t really learned everything.” [40:20]

Links:

Healing from Healing website

Healing from Healing on Instagram

Healing from Healing on Facebook

Adam on Instagram

Society Of The Spectacle by Guy Debord

Wikipedia entry on the Satanic panic

Previous episode: Navigating Psychedelic Narcissism with Adam Aronovich

Previous episode: How Western Medicine and Indigenous Traditions Differ in their Approach to Mental Health and Healing with Adam Aronovich

Psychedelic Medicine Association

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In this episode of the Psychedelic Medicine Podcast, Dr. Michelle Wiener joins to discuss the research on ketamine assisted psychotherapy for chronic pain conditions. Dr. Weiner is Double board-certified in Interventional Pain Medicine, Physical Medicine and Rehabilitation and the Director of Integrative Pain Management at Spine and Wellness Centers of America. She uses a unique personalized approach to treat the root cause of one's pain using a biopsychosocial model including lifestyle and plant medicine to empower her patients to cultivate health, optimize quality of life and decrease pharmaceuticals.

In this conversation, Dr. Wiener discusses her recent research into ketamine therapy for chronic pain and comorbid depression, which compared psychedelic and psycholytic doses of the dissociative. She emphasizes the importance of a biopsychosocial approach to pain treatment and sees the psychotherapy aspect of the ketamine treatments as crucial to their efficacy, as this approach allows doctors to have a better understanding of the complex etiology of the patients pain beyond just what shows up on imaging and empowers patients to actively take ownership of their pain management. While the results from Dr. Wiener’s study were very encouraging, she mentions that ketamine therapies typically require maintenance and that more longitudinal research is needed to further understand how durable these changes are. 

In this episode:

• The issue of central sensitization in chronic pain

• The difference between psychedelic and psycholytic doses 

• What led Dr. Wiener to study chronic pain and comorbid depression

• Neuropathic, nociceptive, and nociplastic forms of pain

• The influence of trauma and stress on chronic pain

• The intersection of pain and identity

• Dr. Wiener’s biopsychosocial approach to pain treatment

• The differences between cannabis and ketamine as pain treatment medications

Quotes:

“A lot of [patients’] pain is really similar to fear—fear in the brain—and… if we’re not able to understand where this fear is coming from we’re not able to extinguish their pain. So I really changed the way I practice and use ketamine because I started to think more about how the psychiatrists are using it, in terms of preparation and integration.” [6:59]

“What I’ve seen is that ketamine does require maintenance in the sense that even if we do six sessions, a lot of patients do need to come back after a few weeks or a few months for maintenance treatment with ketamine as well as therapy.” [20:09]

“Pain doctors [should try to] be a little bit more aware of the set, setting, and preparation and integration so that we don’t need to use benzos and [patients] can actually have this dissociative experience to allow them to have hope or get out of that fight or flight.” [33:04]

Links:

Dr. Wiener's study: Ketamine-assisted psychotherapy treatment of chronic pain and comorbid depression: a pilot study of two approaches

Dr. Wiener’s website

Dr. Wiener on Instagram

PMA webinar with Dr. Wiener: Treating Pain and Functional Neurologic Disorders with Psychedelics

Spine and Wellness Centers of America 

Psychedelic Medicine Association

Porangui

In this episode of the Psychedelic Medicine Podcast, Dr. Michelle Weiner joins to discuss the research on ketamine assisted psychotherapy for chronic pain conditions. Dr. Weiner is Double board-certified in Interventional Pain Medicine, Physical Medicine and Rehabilitation and the Director of Integrative Pain Management at Spine and Wellness Centers of America. She uses a unique personalized approach to treat the root cause of one's pain using a biopsychosocial model including lifestyle and plant medicine to empower her patients to cultivate health, optimize quality of life and decrease pharmaceuticals.

In this conversation, Dr. Weiner discusses her recent research into ketamine therapy for chronic pain and comorbid depression, which compared psychedelic and psycholytic doses of the dissociative. She emphasizes the importance of a biopsychosocial approach to pain treatment and sees the psychotherapy aspect of the ketamine treatments as crucial to their efficacy, as this approach allows doctors to have a better understanding of the complex etiology of the patients pain beyond just what shows up on imaging and empowers patients to actively take ownership of their pain management. While the results from Dr. Weiner’s study were very encouraging, she mentions that ketamine therapies typically require maintenance and that more longitudinal research is needed to further understand how durable these changes are. 

In this episode:

• The issue of central sensitization in chronic pain

• The difference between psychedelic and psycholytic doses 

• What led Dr. Weiner to study chronic pain and comorbid depression

• Neuropathic, nociceptive, and nociplastic forms of pain

• The influence of trauma and stress on chronic pain

• The intersection of pain and identity

• Dr. Weiner’s biopsychosocial approach to pain treatment

• The differences between cannabis and ketamine as pain treatment medications

Quotes:

“A lot of [patients’] pain is really similar to fear—fear in the brain—and… if we’re not able to understand where this fear is coming from we’re not able to extinguish their pain. So I really changed the way I practice and use ketamine because I started to think more about how the psychiatrists are using it, in terms of preparation and integration.” [6:59]

“What I’ve seen is that ketamine does require maintenance in the sense that even if we do six sessions, a lot of patients do need to come back after a few weeks or a few months for maintenance treatment with ketamine as well as therapy.” [20:09]

“Pain doctors [should try to] be a little bit more aware of the set, setting, and preparation and integration so that we don’t need to use benzos and [patients] can actually have this dissociative experience to allow them to have hope or get out of that fight or flight.” [33:04]

Links:

Dr. Weiner's study: Ketamine-assisted psychotherapy treatment of chronic pain and comorbid depression: a pilot study of two approaches

Dr. Weiner’s website

Dr. Weiner on Instagram

PMA webinar with Dr. Weiner: Treating Pain and Functional Neurologic Disorders with Psychedelics

Spine and Wellness Centers of America 

Psychedelic Medicine Association

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In this episode of the Psychedelic Medicine Podcast, Jules Evans joins to discuss his work with the Challenging Psychedelic Experiences Project. Jules is a research fellow at the Centre for the History of Emotions at Queen Mary University of London and author of four books including The Art of Losing Control and Breaking Open: Finding a Way Through Spiritual Emergency. He is also the Director of the Challenging Psychedelic Experiences Project and the editor of the substack Ecstatic Integration.

In this conversation, Jules shares how he first became interested in psychedelics and the kinds of ecstatic experiences they can produce, as well as what prompted him to turn his attention to the challenging experiences that can result from consuming these substances. He discusses the initial research from the Challenging Psychedelic Experiences Project, sharing the typical ways challenging experiences manifest, as well as the coping strategies people employ to work through these experiences. In closing, Jules reiterates the newness of the psychedelic field, encouraging more research into difficult forms of ecstatic experience and ways to effectively navigate the challenges these pose. 

In this episode:

• What got Jules interested in the topic of difficult psychedelic experiences

• Common impacts of challenging psychedelic experiences

• Depersonalization vs derealization

• What helped people integrate challenging psychedelic experiences

• How people used “cognitive self care” to process challenging experiences

• The history and meaning of the term “spiritual emergency”

• Psychedelic “flashbacks” and hallucinogen persisting perception disorder (HPPD)

Quotes:

“30% of our respondents reported anxiety, panic attacks, social anxiety—and then all these sub-themes related to fear like fear of losing your mind, fear of dying, fear of the experience repeating, fear of being alone.” [17:04]

“Feeling you don’t have anyone to talk to about [a psychedelic experience] will make extended difficulties more likely. Not knowing the dosage that you take seems like it makes extended difficulties more likely.” [24:44]

“The overwhelming majority [of people who had challenging psychedelic experiences], like more than 85%… still believe in the therapeutic potential of psychedelics.” [32:41]

“Our culture has a lot of ecstatic illiteracy. We’ve lost the maps and guides and safe places to having ecstatic experiences, so we’re ecstatically naive. And we need to develop ecstatic literacy to learn to get better at having these kinds of experiences.” [51:11]

Links:

Challenging Psychedelic Experiences Project website

The first study from the Challenging Psychedelic Experiences Project: Psychedelic integration challenges: Participant experiences after a psilocybin truffle retreat in the Netherlands

Ecstatic Integration Substack

Jules’ book: Breaking Open: Finding a Way Through Spiritual Emergency

Jules on LinkedIn

Jules on Twitter

Jules on Instagram

Centre for the History of Emotions at Queen Mary University of London 

Psychedelic Medicine Association

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In this episode of the Psychedelic Medicine Podcast, Dr. Reid Robison joins to discuss managing medical risk in patients seeking psilocybin therapy. Dr. Robison is a board-certified psychiatrist and Chief Clinical Officer at Numinus, overseeing the company's psychedelic and mental health services across the US and Canada. He has led over 200 clinical trials in neuropsychiatry, including the MAPS-sponsored MDMA-assisted therapy for eating disorders study, and several other psychedelic studies with psilocybin, LSD and DMT.

In this conversation, Dr. Robison begins by sharing how researchers have been determining guidelines for managing medical risks associated with psilocybin and how this guidance may shift as research continues in real-world settings at larger scales. He also discusses the intricacies of psilocybin’s pharmacokinetics and how the substance interacts with common psychiatric medications such as SSRI antidepressants. In closing, Dr. Robison emphasizes the importance of keeping a close eye on potential psychological risks of psilocybin and other psychedelics, especially amid the excitement stemming from the incredible potential of these medicines.

In this episode:

• The emerging medical indications for psilocybin therapy

• How the research into psilocybin has developed in the past few years

• The pharmacokinetics of psilocybin

• Medication interactions with psilocybin

• Risks of serotonin syndrome

• Absolute vs relative contraindications

• Psilocybin’s effect on QT interval and heart valves

• The Psychedelic Medicine Association’s “Psilcobyin-Informed Clinicians” database comprised of practitioners who have completed the course

Quotes:

“There’s a lot to learn [about the interaction of psilocybin and SSRIs] and it's a little bit unpredictable. And some people anecdotally would say that their SSRI interfered with their trip or diminished the experience and others would say it did not.” [26:22]

“Psychological risks are nontrivial, including the risk of a difficult experience—something that may even need some mental health treatment afterwards, something that may be meaningful, nontrivial for the individual for a while, and can coexist with the mystical experience. And having the most meaningful experience of your life can coincide with the most difficult.” [40:43]

Links:

Course: Managing Medical Risk in Patients Seeking Psilocybin Therapy

Dr. Robison’s website

Dr. Robison on Twitter

Dr. Robison on Instagram

Numinus website

Previous episode: Psychedelics for Eating Disorders with Reid Robison

Psychedelic Medicine Association

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In this episode of the Psychedelic Medicine Podcast, Kevin Franciotti, MA joins to discuss the intricacies of psychedelic-assisted therapies for substance use disorder. Kevin Franciotti is a Denver-based writer, therapist, advisor, and thought leader in the fields of psychology, psychedelics, and substance abuse counseling.

In this conversation, Kevin shares his expertise on the existing research on psychedelic medicines for substance use disorder (SUD) and also discusses the limitations of the results of this research. He talks about the difficulties of designing trials and protocols for psychedelic therapies that target SUD, touching on how this disorder can interact with the neuro-physical and psychological effects of psychedelic medicines. He also contrasts emerging psychedelic treatments for SUD with dominant abstinence-based models and shares where he thinks psychedelic therapies may be a healthier alternative. In closing, Kevin reiterates that it is crucial to continue integrating harm reduction perspectives as psychedelic therapy continues to gain more mainstream traction.

In this episode:

• Contraindications which can arise during detox periods which may require a person to be fully detoxed prior to pursuing any psychedelic-assisted therapy for SUD

• The neuro-physical effects and the psychological effects of psychedelic substances

• The role of peer support in psychedelic-assisted therapy for SUD

• The stigma around psychedelic therapies within traditional recovery programs and communities

• How psychedelic therapy protocols interface with current guidelines from the American Society of Addiction Medicine

• The future of insurance coverage for psychedelic therapies

• Issues of “psychedelic exceptionalism”

Quotes:

“Ibogaine has somewhat of a miraculous quality of being able to attenuate some of the most painful, acute symptoms of opiate withdrawal—but that is only specific to opiate withdrawal.” [11:33]

“What’s miraculous about a medicine like ibogaine or even psilocybin… is it's designed to enhance somebody’s ability to confront their underlying issues.” [16:57] 

“The future of addiction treatment embracing psychedelics is really going to hinge on the treatment industry being willing to construct innovative ideas.” [30:37]

“Drugs are drugs. Drugs don’t have an inherent moral quality around them. [What’s important to highlight] is the risk of stratifying people who use drugs as somehow being superior or inferior based on which category of socially accepted drugs that they’re doing.” [42:39]

Links:

Kevin’s website

Kevin on Twitter

Kevin on Instagram

Kevin on LinkedIn

Psychedelics in Recovery

Journey Colab

All Points North (APN)

“Dispelling Lies the Psychedelic Community Believes About Drugs” presentation by Carl Hart, PhD at Horizons 2019

Psychedelic Medicine Association

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In this episode of the Psychedelic Medicine Podcast, Wilhelmina De Castro, LCSW joins to discuss the ways psychedelics may be used to support goals of queer liberation. Wilhelmina is a psychedelic therapist in the San Diego area and serves as a DEI officer for Integrative Psychiatry Institute. She is also lead faculty for the Psychedelic Research and Training Institute and is committed to creating access to psychedelic healing for historically marginalized populations.  

In this conversation, Wilhelmina discusses the major topics at the intersection of psychedelic healing and queer identities. She shares her own journey of how psychedelics helped with self-discovery and acceptance of her queer identity, discussing the ways these substances can help gender and sexual minorities step outside of forms of normativity that are enforced in the culture. She also discusses creating safe spaces for queer folks where they can access psychedelic healing with facilitators and other participants of a similar background. In closing, Wilhelmina reiterates the continuing issues of access and trust queer people face in the current psychedelic landscape, emphasizing the significant work which must be done to improve this situation. 

In this episode:

• How psychedelics can help with self discovery and self exploration

• What inspired Wilhelmina to begin working professionally with psychedelics

• Creating spaces for psychedelic healing tailored to queer-identified people

• Dealing with microaggressions in the context of a psychedelic retreat

• Working with a therapist or facilitator who shares a queer identity

• The queerness of psychedelics

Quotes:

“When I began to explore with psychedelics, there were moments of this connection beyond… the way I was socialized or conditioned to think was normal. I was able to just be myself [and] found that this attraction and this embodiment that I was feeling was actually where I was supposed to be.” [4:41]

“Psychedelics can be really helpful in challenging, in questioning, in dissolving those oppressive narratives that keep people oppressed, that keep them from accessing their liberation. And so if we can do this consciously, and if we can do this in a safe space where harm is not perpetuated, then we actually have this beautiful opportunity for collective liberation” [14:25]

Links:

Wilhelmina's practice, Integrate 

Integrate on Instagram

Integrative Psychiatry Institute

Psychedelic Research and Training Institute

Queering Psychedelics: From Oppression to Liberation in Psychedelic Medicine

SoundMind Institute Psychedelics and Identity Initiative

Queer Psychedelic Society

Psychedelic Liberation Collective

Previous episode: Psychedelics and the LGBTQIA2S+ Community with Dr. Angela Carter

Psychedelic Medicine Association

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In this episode of the Psychedelic Medicine Podcast, Jöel Brierre joins to discuss the important topic of safety when working with 5-MeO-DMT. Jöel is the founder and CEO Tandava Retreats and co-founder of the 5-MeO-DMT education and training platform F.I.V.E. Jöel and his team are focused on shepherding 5-MeO into the world in a safe and effective manner. 

In this conversation, Jöel shares his expertise on the screening that should be done prior to 5-MeO-DMT experiences, discussing both physical and psychological considerations. He also talks about synthetic 5-MeO-DMT vs the extract from the Bufo alvarius toad and explains why his retreat center only uses the synthetic version. In closing, he discusses the nuances around drug-drug interactions and how he navigates these with participants, exploring the nuances of the pharmacology involved.  

In this episode:

• What inspired Jöel to start F.I.V.E.

• The physical medical considerations when screening patients for 5-MeO-DMT

• Why it is theorized that 5-MeO-DMT could trigger conditions like multiple sclerosis to recur 

• Psychological red flags for people seeking 5-MeO-DMT experiences

• Jöel’s thoughts on navigating psychedelic narcissism

• Safety considerations working with patients with significant trauma

• Determining the dosage of 5-MeO-DMT and why Jöel thinks there’s a lot of value in lower doses

• Alternative routes of administration for 5-MeO-DMT other than smoking

Quotes:

“It’s very important to us that [5-MeO-DMT] is shepherded out into the world in a safe and effective way, with a good understanding of how it can go wrong—because another bad headline can really harm the progress that it has seen.” [7:14]

“Where we used to feel you really had to work your way up to 5[MeO-DMT], we found with the right amount of prep and with a good individualized approach it’s right for anyone—as long as they’re in the right place for it. So if they make it through the screening and intake process, we’re good to go.”  [23:09]

“There’s no need to turn it into a goal-oriented thing where [the participant] needs to get to a full release. We see plenty of full resolutions happen where we never even have to take a participant to a mystical experience.” [29:43]

Links:

Tandava Retreats website

F.I.V.E. website

Previous episode: How to Choose a Psychedelic Facilitator or Retreat Center with Joël Brierre

Previous episode: Navigating Psychedelic Narcissism with Adam Aronovich

Psychedelic Medicine Association

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In this episode of the Psychedelic Medicine Podcast, Joël Brierre joins to discuss the important topic of safety when working with 5-MeO-DMT. Joël is the founder and CEO Tandava Retreats and co-founder of the 5-MeO-DMT education and training platform F.I.V.E. Joël and his team are focused on shepherding 5-MeO into the world in a safe and effective manner. 

In this conversation, Joël shares his expertise on the screening that should be done prior to 5-MeO-DMT experiences, discussing both physical and psychological considerations. He also talks about synthetic 5-MeO-DMT vs the extract from the Bufo alvarius toad and explains why his retreat center only uses the synthetic version. In closing, he discusses the nuances around drug-drug interactions and how he navigates these with participants, exploring the nuances of the pharmacology involved.  

In this episode:

• What inspired Joël to start F.I.V.E.

• The physical medical considerations when screening patients for 5-MeO-DMT

• Why it is theorized that 5-MeO-DMT could trigger conditions like multiple sclerosis to recur 

• Psychological red flags for people seeking 5-MeO-DMT experiences

• Joël’s thoughts on navigating psychedelic narcissism

• Safety considerations working with patients with significant trauma

• Determining the dosage of 5-MeO-DMT and why Joël thinks there’s a lot of value in lower doses

• Alternative routes of administration for 5-MeO-DMT other than smoking

Quotes:

“It’s very important to us that [5-MeO-DMT] is shepherded out into the world in a safe and effective way, with a good understanding of how it can go wrong—because another bad headline can really harm the progress that it has seen.” [7:14]

“Where we used to feel you really had to work your way up to 5[MeO-DMT], we found with the right amount of prep and with a good individualized approach it’s right for anyone—as long as they’re in the right place for it. So if they make it through the screening and intake process, we’re good to go.”  [23:09]

“There’s no need to turn it into a goal-oriented thing where [the participant] needs to get to a full release. We see plenty of full resolutions happen where we never even have to take a participant to a mystical experience.” [29:43]

Links:

Tandava Retreats website

F.I.V.E. website

Previous episode: How to Choose a Psychedelic Facilitator or Retreat Center with Joël Brierre

Previous episode: Navigating Psychedelic Narcissism with Adam Aronovich

Psychedelic Medicine Association

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In this episode of the Psychedelic Medicine Podcast, Joshua White returns to discuss the role of peer support in the psychedelic ecosystem. Joshua (he/him) is founder and executive director of Fireside Project and has prior experience as a volunteer counselor on a hotline and as a volunteer at the Zendo Project. He has also practiced law as a deputy city attorney at the San Francisco City Attorney’s Office, where he focused on suing business exploiting vulnerable communities. He also co-taught a nationally-renowned clinic at Yale Law School.

In this conversation, Joshua shares updates from the first two years of Fireside Project, the psychedelic peer support hotline. He mentions that the hotline has grown nearly 1,000% since their first month, with the number receiving 1,500 calls this past month. Joshua also discusses the intricacies of peer support, sharing why he thinks this form of support is particularly well-suited to psychedelic experiences and how he understands the relationship between psychotherapy and peer support. In closing, Joshua reminds listeners that Fireside Project is available to take calls from anyone working through a psychedelic experience—whether they are in the midst of an altered state of mind or seeking to integrate a past experience. 

In this episode:

• When to call the psychedelic peer support hotline

• The history of peer support and when it may be helpful

• Why Joshua believes its important for peer support volunteers to have had their own psychedelic experiences

• The ways peer support and psychotherapy differ

• The limits of peer support

• How peer support is similar to the methods used in MDMA-assisted therapy

• Critiques of peer support Joshua has heard and his responses

• The relationship between peer support and theoretical frameworks in psychotherapy 

Quotes:

“In non-psychedelic peer support, often the peer-ness starts with a pathology—alcohol use disorder, tobacco use disorder, etc. Psychedelic peer support, the idea is that having had a psychedelic experience by itself is the layer of peer-ness that’s needed to go deeper with someone regardless of other aspects of your identity you may have.” [8:55]

“One of the, I think, key parts of peer support is that we don’t interpret a caller’s experience for them. We are present with them so that they can interpret their experience and we can create a safe and non-judgmental space for them to engage in that kind of interpretation.” [18:32]

“I think especially with an experience as vast as the type that can be precipitated by psychedelics, having multiple forms of support is essential.” [22:23]

Links:

Fireside Project website

Fireside Project on Instagram

Fireside Project on Twitter

Previous episode: Insights Gained from the First Year of Fireside Project with Joshua White

Previous episode: Fireside Project: The World’s First Psychedelic Hotline with Joshua White and Hanifa Nayo Washington

Psychedelic Medicine Association

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In this episode of the Psychedelic Medicine Podcast, Hannah Cross, LCSW joins to discuss group ketamine assisted psychotherapy for frontline healthcare workers. Hannah is a licensed clinical social worker and therapist who specializes in trauma healing and psychedelic integration, including work on LSD and psilocybin clinical trials. 

In this conversation, Hannah shares details from the study exploring group ketamine therapy in a cohort of ten frontline healthcare workers, discussing the study design, the intricacies of group therapy, and the specific dosing protocol and therapy regimen for the patients. She reveals the very promising results of this early study and also shares a number of emotional stories of transformation from the patients. In closing, Hannah discusses the early indicators of the durability of positive effects from this kind of ketamine assisted therapy and lists a number of additional on-going and upcoming studies of group ketamine treatments for other populations.

In this episode:

• The inspiration for this ketamine study

• How the frontline healthcare workers in the study were chosen

• What makes a person a good candidate for group therapy

• The protocol for the ketamine assisted therapy used in the study

• Why the therapy began with a low, sublingual dose of ketamine

• How psychotherapy was integrated with ketamine treatments in this study

• The reductions in PTSD, depression, and anxiety that resulted from the ketamine assisted therapy

• Why Hannah sometimes sees an increase in anxiety towards the beginning of the therapeutic process

Quotes:

“Ketamine can help people access more of that self-healing energy and when that’s present in a group setting and people are essentially able to shine this healing energy on each other, there’s this exponential healing I think can happen.” [7:16]

“When you wrap a ketamine experience up in experienced and effective therapy, there is this safety in the container that really allows people to have the inward focused journey under ketamine for that forty-five minutes to an hour.” [20:03]

Links:

Full study: Ketamine-Assisted Group Psychotherapy for Frontline Healthcare Workers with COVID-19-Related Burnout and PTSD: A Case Series of Effectiveness/Safety for 10 Participants

Numinus website

Group ketamine assisted therapy by Numinus

Hannah’s private practice, Wild Sunflower Counseling

Cedar Psychiatry website

Psychedelic Medicine Association

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In this episode of the Psychedelic Medicine Podcast, Dr. Arsalan Azam joins to discuss the potential of ketamine therapy for helping to address the stress of major life transitions. Dr. Azam is a board-certified Emergency Medicine physician and medical director of Daydream MD. He attended medical school as a Dean’s Scholar at Case Western Medical School and completed his clinical rotations at the Cleveland Clinic. He has also worked as an emergency medicine physician around the country, including as a relief physician for hospitals impacted by staffing shortages.

In this conversation, Dr. Azam shares patient experiences from his own ketamine practice and discusses the complexities of different approaches to ketamine treatment and different indications, including how some individuals may benefit especially from ketamine assisted therapy, while others may be well served by stand-alone ketamine infusions, especially considering the cost differential of these treatments. Additionally, Dr. Azam explores the role integration and peer support can play in the context of ketamine treatments, mentioning these may be less cost-prohibitive ways for patients to get the most out of their experiences.

In this episode:

• The kinds of life transitions ketamine is helpful with in Dr. Azam’s experience

• What kinds of patients Dr. Azam’s practice serves

• The unique mechanism of ketamine

• Leveraging ketamine treatment to navigate breakups or professional transitions

• Ketamine assisted psychotherapy vs stand-alone ketamine infusions, and when having the extra support of therapy may be especially beneficial

• The role of integration and peer support in ketamine treatments

• The research into ketamine treatment for suicidal ideation

• How Dr. Azam sets up treatment programs for different kinds of patients

Quotes:

“The magic of this neurobiology is that, unlike our existing tools which take weeks to kick in often, this one works within hours. And so it really becomes more of a rescue medication or a supportive medication for these transitions of life that works quickly.” [8:32]

“Think of our mind and our mental patterns as a piece of cold steel—and it’s kind of locked in that structure, in that pattern. Psychedelics, like ketamine and others, can heat that steel up, and make it much more moldable and then when it cools back down it’ll maintain a persistent new structure. So ketamine assisted therapy is a tool that helps us leverage that hot piece of steel to mold it into something else.” [11:56]

“Ketamine works very quickly to reduce suicidal thinking and its degree of effect directly corresponds to the degree of symptoms. So someone who has really severe suicidality is more likely to experience a response to ketamine and is more likely to experience a significant response to ketamine.”  [18:36]

Links:

Daydream MD website

Daydream MD on Instagram

Fireside Project website

Psychedelic Medicine Association

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In this episode of the Psychedelic Medicine Podcast, Ben Malcolm, PharmD joins to discuss the research surrounding the intersection of psychedelics with pregnancy and nursing. Dr. Malcolm is a psychopharmacology consultant, psychedelic educator, founder of Spirit Pharmacist, LLC and a board member of the Psychedelic Medicine Association. Dr. Malcolm recently wrote an overview article on the existing research into psychedelics, pregnancy and breastfeeding.

In this conversation, Dr. Malcolm shares the current state of research that he explored in his article, highlighting the few points where data does exist while emphasizing that there are still major unknowns. Overall, Dr. Malcolm describes how most are very conservative when it comes to psychedelic use while nursing or pregnant, though pregnancy seems to present more concerns than nursing.

Dr. Malcolm also discusses ketamine and the interesting findings in patients who were given this substance as an anesthetic for cesarean sections. In conclusion, Dr. Malcolm suggests moving beyond a black and white perspective on this topic, emphasizing that there are also opportunity costs to not pursuing healing. However, in this area especially, more research is needed before clear guidelines can be developed. 

In this episode:

• The lack of treatment options for postpartum depression

• Why it is likely for a fetus or infant to be exposed to psychedelics if a mother ingests them while pregnant or nursing

• Psychedelics and the developing brain

• Ritual use of ayahuasca and mushrooms among pregnant women in traditional ceremonial contexts

• The research into negative impacts of ecstasy use during pregnancy and the variables that confound the results

• The unknowns about microdosing while nursing

• The research into whether LSD is a teratogen

• The effects of psychedelics on hormones

• Pregnancy as an aspect of set and setting

Quotes:

“Psychoactive drugs or psychotropic drugs typically end up in breastmilk more than other types of substances because they are usually more fat-soluble. Usually to get into brain tissue they have to be a little more fat-soluble than drugs that act in the periphery.” [10:15]

“In the nursing period I think that there’s more potential to use psychedelics safely and without really taking much risk as far as exposing the [child], whereas in pregnancy, yeah, you just don’t really have that choice—the fetus is going to be exposed.” [24:42]

Links:

Dr. Malcolm’s recent article: “Psychedelics, Pregnancy, and Breastfeeding”

Spirit Pharmacist website

Spirit Pharmacist on Facebook

Spirit Pharmacist on Instagram

Spirit Pharmacist on YouTube

Psychedelic Medicine Association

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