Plant Medicine Podcast
121 episodes
Psychedelic Therapies for Pain with Joel Castellanos, MD
Psychedelic Therapies for Pain with Joel Castellanos, MD
In this episode of the Psychedelic Medicine Podcast, Joel Castellanos joins to discuss the emerging topic of psychedelic therapies for pain-related conditions. Dr. Castellanos is a Board certified physical medicine and rehabilitation and pain management physician and an associate professor in the department of anesthesiology at UC San Diego school of medicine. He earned his medical degree from University of Toledo college of medicine and has since completed a two year program in healthcare administration during his residency at University of Michigan, as well as a fellowship in pain medicine at UC San Diego school of medicine. Most recently he completed the integrative medicine fellowship from the University of Arizona.
In this conversation, Dr. Castellanos introduces the topic of psychedelics as a therapeutic modality for various pain conditions. Dr. Castellanos explains that much of the pain management field focuses on neuromodulation as the basis for particular therapeutic techniques, so psychedelics—which have profound modulating effects within the brain—naturally seem promising.
However, research into this topic is still developing, with studies from the seventies providing some initial data which is now being corroborated and expanded by contemporary research. Dr. Castellanos shares the details of this work, explaining how combined psychedelic treatment and mirror box therapy could prove to be particularly efficacious for individuals suffering from phantom limb pain.
In light of the upcoming trials led by Dr. Castellanos and his colleagues at the Psychedelic Health Research Initiative at UC San Diego, he also discusses certain special considerations for working with amputees as guides or facilitators of psychedelic therapy. The double blind randomized controlled trial investigating the efficacy of psilocybin therapy for phantom limb pain will be conducted first and is currently enrolling. This study seeks to test the efficacy of psilocybin therapy for this condition as well as elucidate its potential mechanism of action through brain imaging. Click here to enroll.
In this episode:
An overview of the literature on psychedelics and pain
Albert Lin’s experience treating his phantom limb pain with combined psychedelic and mirror box therapy
Why psychedelics may be a great alternative to many current treatment options for chronic pain
Stories of healing resulting from psychedelic therapy in patients who have suffered with chronic pain
How to enroll in Dr. Castellanos’ upcoming trial for patients with phantom limb pain
Quotes:
“It’s really interesting to me that neuromodulation - modulating the nervous system - is such a big part of pain medicine—and no one had really looked at psychedelics as an option when they are something that really modulates the nervous system in a profound way.” [4:24]
“I don’t want people to think that this is going to be a panacea, that this is going to be the cure for everything and everyone’s pain because we need to do the research, we need to do the work and really answer the clinical question on who this is going to be most efficacious for.” [7:50]
“Where there has been the most evidence so far and the most work done is in the headache patient population, which is definitely needed. There are so many people who suffer from migraines, from cluster headaches, and it can be really debilitating.” [17:45]
“In the same way that patients who have had PTSD or have severe anxiety or depression it helps to do some talk therapy with those [psychedelic therapy] sessions, maybe some movement therapy during the psychedelic sessions may be beneficial [for treating pain].” [23:26]
Links:
Enroll in Dr. Castellanos’ upcoming study through PHRI at UCSD
Psychedelic Health Research Initiative at UC San Diego
MDMA-Assisted Therapy for PTSD with Rick Doblin, PhD
MDMA-Assisted Therapy for PTSD with Rick Doblin, PhD
In this episode of the Psychedelic Medicine Podcast (formerly the Plant Medicine Podcast), Rick Doblin joins to discuss the past, present, and future of MDMA-assisted therapy. Rick Doblin is the founder and executive director of the Multidisciplinary Association for Psychedelic Studies. He received his doctorate in public policy from Harvard and has also studied under the father of transpersonal psychology Stanislav Grof. Through MAPS, Rick aspires to develop legal contexts for beneficial uses of psychedelics and marijuana as prescription medicines, but also for self-development and personal growth in otherwise healthy individuals.
Rick begins this wide-ranging conversation discussing the early days of MDMA. The compound was originally synthesized by famed chemist Alexander "Sasha" Shulgin and, unlike the classic serotonergic psychedelics, it was not scheduled under the Controlled Substances Act in the early 70s. It was during this period of legality that therapeutic uses of MDMA were first developed and it was only later that the drug became repurposed as a recreational substance to be used in social settings, which consequently led to its emergency scheduling by the DEA.
Rick recalls his own initial experiences with the empathogenic compound, stating that he was initially skeptical of its value, prior to gaining first-hand experience. Following this experience, however, he became convinced of its therapeutic potential and he shares some of his own early experiences of using MDMA to help people heal, including a very touching tale of his own grandmother’s struggle with depression.
From here, Rick discusses the founding of MAPS and his decision to pursue education in policy in order to better understand strategies for furthering MDMA-therapy even while living under prohibition. Since that time, MAPS has gone on to do incredibly impactful work in developing studies researching the safety and efficacy of MDMA-assisted therapy, specifically for post-traumatic stress disorder. Rick shares the progression of these studies, highlighting the results from the most recent phase three investigations which are the last step prior to FDA approval for the therapeutic protocol. These studies show high statistical significance and an amazing effect size resulting from MDMA-assisted therapy, with results being mirrored at all research locations and showing durability over time.
Because of this amazing progress, Rick believes we are at the final stretch prior to full FDA approval for MDMA use in a therapeutic context for PTSD, and subsequent rescheduling of the substance by the DEA, which he believes will take place in mid to late 2023. This development will have broad global impacts, spurring other countries to promptly follow suit.
Rick closes out this discussion by emphasizing the need for mass mental health in our day and age, and sharing MAPS’ lofty goals of training thousands of therapists to hopefully bring psychedelic therapy to millions of patients in the coming decades.
In this episode:
Rick Doblin’s personal journey
The history of the MDMA’s synthesis and legality
Rick’s first experiences with MDMA and early experiments with MDMA therapy
MAPS’ “two-pronged” strategy for mass mental health
Early efforts to get an MDMA therapy protocol approved by the FDA following prohibition
The politics of concerns about MDMA neurotoxicity and how this impacted MAPS’ early approach
The results of the first phase three studies of MDMA for PTSD
How FDA approval of MDMA will lead to an international cascade of approval and rescheduling
Rick’s predictions for psychedelic medicine in the years to come
Quotes:
“What a lot of people don’t know is that MDMA was a therapy drug before it was a party drug. And it was the party drug nature of it that really got it criminalized.” [7:38]
“Seeing what it was like when it was legal and experiencing that, and experiencing situations where people would take it, the kind of experiences and healings, and learnings that people would have, was amazing.” [19:12]
“What we need is, I believe, legal access to medicinal MDMA, covered by insurance, by trained professionals, and psychedelic clinics. And we also need a whole different kind of drug policy for non-medical use that involves honest drug education, access to pure substances, harm reduction, peer support, and also treatment on demand.” [21:08]
“The irony here is that the first legal move against MDMA was illegal. The DEA did not have the authority to emergency schedule drugs.” [23:43]
“FDA is legally bound to approve MDMA for PTSD if these [phase 3] studies generate statistically significant evidence of efficacy, and there are no new safety problems.” [40:27]
“We think by the third quarter of 2023 we will have FDA approval assuming the second phase 3 study goes well. And then by the fourth quarter, the DEA has to reschedule [MDMA].” [51:18]
“What’s even greater is the 12-month follow-up data was 67% no longer had PTSD. So people kept getting better—not only was it durable, but they kept getting better.” [55:00]
“The thing to emphasize here is that MDMA is not the treatment. The treatment is therapy. The MDMA makes the therapy more effective and there can be different kinds of therapy that are used with it.” [1:01:38]
Links:
Trip of Compassion Documentary
The Way of the Psychonaut Books by Stanislav Grof
Upcoming MAPS Psychedelic Science Conference 2023
Becoming an MDMA-Assisted Therapist with Shannon Carlin, MA, LMFT
Psilocin vs. Psilocybin: Differences & Potential Clinical Uses with Josh Woolley, MD, PhD
Psilocin vs. Psilocybin: Differences & Potential Clinical Uses with Josh Woolley, MD, PhD
In this episode of the Plant Medicine Podcast, Dr. Josh Woolley joins to discuss the differences between psilocin and psilocybin, and to share upcoming clinical research which will further clarify the safety profiles, subjective effects, and clinical uses of these psychedelic substances.
Dr. Woolley is an Associate Professor in Residence in the Department of Psychiatry and Behavioral Sciences at the University of California, San Francisco (UCSF) as well as a staff psychiatrist in Mental Health at the San Francisco Veterans Affairs Medical Center (SFVAMC). He is Board Certified in Psychiatry by the American Board of Psychiatry and Neurology. He is the Director of the Bonding and Attunement in Neuropsychiatric Disorders (BAND) lab at UCSF that focuses on understanding and treating social deficits in neuropsychiatric disorders including schizophrenia, substance use disorders, and mood disorders. He is also the Director of the Translational Psychedelic Research (TrPR) Program at UCSF, which brings together scientists and care providers across disciplines to understand how psilocybin, LSD, ketamine, MDMA, and related compounds impact the brain and other organ systems.
In this conversation, Dr. Woolley begins by sharing a bit about TrPR and the upcoming research they will be conducting on psychedelics as a treatment for depression in individuals living with Parkinson's disease. Dr. Woolley then introduces the main topic of psilocin, psilocybin, and the differences between these two compounds. He explains that psilocybin is a prodrug for psilocin, meaning that the human body metabolizes psilocybin into psilocin, which is the compound responsible for the psychoactive effects produced by psilocybin-containing mushrooms.
Dr. Woolley’s upcoming research will provide more concrete data on the differences between these two compounds, as TrPR will be testing both psilocybin and psilocin in healthy volunteers, giving each participant both substances on different occasions so that effects can be studied both across the sample pool and within individuals. Dr. Woolley hypothesizes that psilocin could have certain clinical advantages over psilocybin: it could produce more consistent effects person-to-person at a given dose as individual differences in metabolism would be less relevant; it may more quickly induce a psychedelic experience, particularly when administering psilocin sublingually; and it is possible there may be fewer side effects related to the gastrointestinal tract.
Dr. Woolley closes out the discussion by sharing other upcoming research to be conducted by TrPR. In addition to the study investigating psilocin and the research into psychedelics for Parkinson's disease, TrPR is also investigating the use of psychedelics to improve quality of life for individuals suffering from chronic pain and they will also be further investigating the interaction between psychedelics and bipolar disorder.
In this episode:
The approach of the Translational Psychedelic Research (TrPR) Program and its upcoming research
The pharmacological differences between psilocybin and psilocin and how the experience induced by the substances may differ
In-subject study design and how it is used in Dr. Woolley’s psilocin trials
The mechanisms for tolerance with using psychedelic drugs
Data on the contraindication of psychedelic use for individuals with bipolar disorder
Quotes:
“For a long time, when you make [psilocin] synthetically—[...]—psilocin wasn’t stable. So, even if you made psilocin synthetically you would then turn it into psilocybin so it would be stable and then people would take it and it would get turned back into psilocin.” [8:39]
“You can’t do sublingual psilocybin because it won’t get broken down easily. But, sublingual psilocin doesn’t need to be metabolized and it can go across your buccal membrane, skipping the gut. That theoretically could be useful because then you might skip the first pass metabolism, it doesn’t have to go to the liver, and it might be faster that way and maybe again more consistent. And fewer side effects—maybe you won’t get any GI side effects if it doesn’t go to the GI tract.” [19:58]
“We think that psychedelics—psilocybin in particular—might be able to change people’s relationship to their [chronic] pain. It might be an analgesic too—it might make the pain go away, that would be great. But even if it doesn’t do that, we think that it should allow people to basically find the pain less impairing.” [41:22]
Links:
The Translational Psychedelic Research (TrPR) Program at UCSF
Delta-8 THC: Your Questions Answered with Dr. Carey Clark
Delta-8 THC: Your Questions Answered with Dr. Carey Clark
This episode of the Plant Medicine Podcast features a conversation with Dr. Carey Clark, discussing delta-8 THC. Dr. Clark is a registered nurse and an expert in cannabis care nursing. She holds a PhD from the California Institute of Integral Studies and is the immediate past president of the American Cannabis Nurses Association. She is also the editor and author of the first nursing textbook on medical cannabis Cannabis: A Handbook for Nurses and has over thirty publications in academic journals. Currently Dr. Clark serves as a professor at Pacific College of Health and Science where she also developed the first college-level, academic certificate in medical cannabis.
In this conversation Dr. Clark introduces delta-8 THC, discussing its chemistry, pharmacology, and legal status. She begins by sharing that delta-8 is a minor cannabinoid which exists naturally in small quantities within cannabis and hemp. Delta-8 THC is chemically very similar to delta-9 THC—the primary cannabinoid within cannabis which is known for its mind-altering and medicinal properties—and in fact, delta-9 naturally degrades into delta-8 under certain conditions. Due to the structural similarities, delta-8 produces similar effects to delta-9, and may have similar medical applications.
Dr. Clark mentions that delta-8 may be synthesized from CBD, allowing for this compound to be readily produced from legal components. However, the delta-8 which results from these synthesis methods contains traces of unknown compounds, perhaps as a result of the particular solvents used in the reaction, so Dr. Clark cautions that consuming these products could have certain risks, though the delta-8 cannabinoid itself is thought to have a similar safety profile to delta-9 THC. Instead. Dr. Clark emphasizes that whole plant medicines are likely the ideal for patients seeking to treat medical conditions with cannabis, but since delta-8 may be more readily available in certain areas due to its murky legal status it may be the best option for some individuals.
While scientific research into delta-8 is currently lacking, Dr. Clark shares the results from a few studies which use animal models and one study looking at the effects of delta-8 in the context of pediatric oncology. In addition to these published studies, Dr. Clark also shares anecdotal reports from patients, saying that these experiences are crucial, preferring to think of these reports as qualitative data which has yet to be systematically studied.
In this episode:
What delta-8 THC is and how it is made
Potential safety concerns with delta-8 products
The current research on delta-8
The legal grey-area of delta-8 THC and states which have banned the cannabinoid
Differences in the doses and effects of delta-8 and delta-9 THC
Quotes:
“My hope as well is that people who are able to access whole-plant medicine can really use whole-plant medicine safely and effectively and they have access to safe, effective medicines. That would be my recommendation—if somebody had a choice—over choosing a really synthesized medicine at this point because of the safety issues.” [15:30]
“[T]there’s still very little research and most of the patient experience we’re hearing is really anecdotal.” [24:52]
Links:
Dr. Clark’s faculty page at Pacific College of Health and Science
Psychedelics and Breathwork with Kyle Buller
Psychedelics and Breathwork with Kyle Buller
This episode of the Plant Medicine Podcast features a conversation with Kyle Buller on psychedelics and breathwork. Kyle is co-founder and host of the Psychedelics Today podcast and he has studied breathwork since October 2010 with Lenny and Elizabeth Gibson of Dreamshadow Transpersonal Breathwork. Kyle earned his BA in transpersonal psychology from Burlington College where he focused on the healthing potential of non-ordinary states of consciousness, exploring topics such as shamanism, reiki, plant medicine, and holotropic breathwork. He has also earned an MS in clinical mental health counseling with emphasis in somatic psychology and has since worked with at-risk teens in crisis and individuals experiencing an early episode of psychosis.
Kyle opens this discussion by providing a basic definition of breathwork and sharing his own journey with this modality. He discusses how breathwork can refer to a wide variety of practices, but what unites these disparate techniques is utilizing the breath to induce specific physiological states and experiences. The holotropic style of breathwork has roots in transpersonal psychology and the work of Stanislav Grof and it is this modality which is often compared to psychedelic experiences.
Kyle discusses how holotropic breathwork can be an incredibly powerful practice for trauma-healing and inducing visceral experiences—similar to the classical psychedelics. He recounts his own experiences with this practice, describing how he was able to relive the experience of being born in the state conditioned by the method of breathing. Due to the synergy with the psychedelic experience, Kyle mentions that there is a lot of potential for breathwork to help individuals integrate or prepare for psychedelic experiences, as well as being a powerful tool for clinicians involved in psychedelic-psychotherapy to better understand the non-ordinary states of consciousness their patients will be experiencing.
Because of the wide variety of breathwork techniques, Kyle discusses the possibilities of tailoring practices to the specific experiences of a client. Everyone has a unique “window of tolerance” depending on their background and constitution, and some people will benefit more from techniques which downregulate the nervous system and allow for peace and relaxation, while others may find more value in techniques which are highly stimulating and provide deeper, emotionally complex experiences that allow for self-exploration.
In this episode:
What breathwork is an how it relates to psychedelics
The origins of holotropic breathwork and Stanislav Grof’s transpersonal framework
Breathwork vs meditation
How to use breathwork to integrate and prepare for psychedelic experiences
The effects of different types of breathing on the nervous system
Quotes:
“[Breathwork] offered a really great tool for training, for understanding how to sit with people in non-ordinary states of consciousness.” [8:49]
“Some breathing techniques, like these more deeply cathartic techniques, they’re bringing up a lot of emotional memory and people are starting to work through a lot of somatic sensations, they are working through trauma.” [13:38]
“We really need to look at somebody’s whole picture, where they’re at, how they could potentially benefit, look at their nervous system, attune to that, and really think about what they could tolerate, what’s going on in somebody’s psyche.” [30:29]
“The breath is this flexible tool, it’s a vehicle—we can help to regulate our nervous system with it and explore it.” [39:38]
Links:
Psychedelics Today Education Center
Dreamshadow Transpersonal Breathwork
Avoiding the Pitfalls of Psychedelic Medicine with Matthew Johnson, PhD
Avoiding the Pitfalls of Psychedelic Medicine with Matthew Johnson, PhD
In this episode of the Plant Medicine Podcast, Matt Johnson, PhD returns for the final installment to discuss his recent paper “Consciousness, Religion, and Gurus: Pitfalls of Psychedelic Medicine.” Dr. Johnson is the associate director at the Center for Psychedelic and Consciousness Research at Johns Hopkins University, where he also works as a professor of psychiatry and behavioral sciences. He has published widely in the field of psychedelic science and has guided over one hundred psychedelic experiences. In 2019 Dr. Johnson was the president of the psychopharmacology division of the American Psychological Association, and he currently serves as the president of the International Society for the Research on Psychedelics.
In his paper, Dr. Johnson explores some concerns around certain norms which have developed in psychedelic therapy, and how these could have potential negative effects. Dr. Johnson raises two main concerns in this conversation. The first is how therapists, guides, and scientific researchers could advance various spiritual or religious beliefs within the therapeutic context or offer metaphysical interpretations of psychedelic experiences beyond what the client suggests.
The second concern involves how psychedelic medicine is presented, both on a cultural level and even materially within therapeutic settings. For example, Dr. Johnson suggests that it is inappropriate to have statues of the Buddha displayed in clinical settings, unless this is something requested by the client. He suggests that if psychedelic therapy embraces a certain “New Age” aesthetic wholesale, it could dissuade people who don’t identify with the subculture from taking advantage of these therapies, especially as these medicines become more widely accessible.
Additionally, Dr. Johnson points out that not all patients would have the same associations with the Buddha statue in the example, and that the inclusion of any particular religious iconography should be something chosen proactively by the client, rather than assumed by the therapist. Dr. Johnson concludes this conversation by again stressing a client-centered approach to psychedelic therapy, suggesting that this approach is best suited to circumvent these concerning pitfalls.
In this episode:
The issue with psychedelic therapists or guides bringing their own metaphysical beliefs into the psychedelic experience or its interpretation
How the current culture around psychedelic medicine subtly presents these therapies as being for specific kinds of people
How a client-centered approach from humanistic psychology can present an effective framework for psychedelic-assisted psychotherapy
Quotes:
“I think it’s critical that therapists—and scientists at this research phase we’re at now—be client-centered in terms of the therapeutic approach. In other words, not making any assumptions for the participants, for the patients, about what the interpretation of these experiences should be.” [4:36]
“You’re there to support them, you’re there to let them lead. If there’s any metaphysical meaning to be made, they are in the driver’s seat. You’re there to create a safe container, to care for their wellbeing, and to allow them to have their experience.” [11:08]
“It’s not that you’re denying any of this stuff—it very well may be that any of these people’s framework is ground truth—it’s just not your role to say and we don’t need to.” [15:06]
Links:
Dr. Johnson’s Paper: Consciousness, Religion, and Gurus: Pitfalls of Psychedelic Medicine
Exploring DMT Entities with Matthew Johnson, PhD
Exploring DMT Entities with Matthew Johnson, PhD
In this episode of the Plant Medicine Podcast, Matt Johnson, PhD returns to discuss previous survey research he conducted regarding DMT entities. Dr. Johnson is the associate director at the Center for Psychedelic and Consciousness Research at Johns Hopkins University, where he also works as a professor of psychiatry and behavioral sciences. He has published widely in the field of psychedelic science and has guided over one hundred psychedelic experiences. In 2019 Dr. Johnson was the president of the psychopharmacology division of the American Psychological Association, and he currently serves as the president of the International Society for the Research on Psychedelics.
In this conversation, Dr. Johnson shares findings from his 2020 publication of survey research which investigates peoples’ experiences with DMT entities. To preface these findings, however, Dr. Johnson first lays the groundwork by explaining the limitations of scientific investigation into these kinds of psychic phenomena. He explains that science is unable to answer questions of whether or not DMT entities are ultimately real, or what the fundamental nature of these experiences is. It can, however, employ rigorous methods for analyzing reports of entity encounters in order to document common features of these experiences and the types of effects they can have on individuals.
In the survey, around twenty five hundred respondents shared their experiences of encountering an entity during a DMT experience. From the data collected, Dr. Johnson shares some of the common features of these entities. The beings are typically perceived as benevolent though there was a wide variety of ways the entities were conceptualized, ranging from aliens and machine elves to spirits and angels. Often participants believed the entities revealed metaphysical realities and the presence of these beings was frequently accompanied by extrasensory phenomena such as telepathic communication. Due to the dramatic nature of these experiences, Dr. Johnson’s research found some lasting impacts as reported by respondents, and he concludes by briefly discussing the effects of entity encounters on religious belief.
In this episode:
What questions science can and can’t answer, and the boundaries good scientific research has to take when investigating something such as DMT entities
The findings of Dr. Johnson’s survey research—some general trends regarding the qualities of entities described
Effects of entity encounters on religious belief
Quotes:
“My bet is that if people believe that there’s some sort of reality to these disincarnated entities—that it’s not just in their mind—there are certain people that can hold that experience in a positive way that might benefit them… and probably some of these over 2,000 folks, there’s probably some people that—again, aside from whether we know it’s true or not—believing in things that no one else can prove are there is probably a bad thing.” [12:38]
“The machine elf thing, I mean, that was Terrence McKenna’s trip. And he described it—and I think he was very honest that that was his experience—and I think people who’ve heard his experience, a good number of them have had machine elf experiences because they heard Terrence McKenna’s experience.” [16:17]
“Before the experience, 28% of these people identified as atheist, and then after the encounter that dropped to 10%.” [20:53]
Links:
The Latest Research on Psilocybin for Depression with Matthew Johnson, PhD
The Latest Research on Psilocybin for Depression with Matthew Johnson, PhD
In this episode of the Plant Medicine Podcast, Matt Johnson, PhD joins to discuss the latest research of psilocybin as a treatment for depression. Dr. Johnson is the associate director at the Center for Psychedelic and Consciousness Research at Johns Hopkins University, where he also works as a professor of psychiatry and behavioral sciences. He has published widely in the field of psychedelic science and has guided over one hundred psychedelic experiences. In 2019 Dr. Johnson was the president of the psychopharmacology division of the American Psychological Association, and he currently serves as the president of the International Society for the Research on Psychedelics.
In this conversation, Dr. Johnson shares findings from his recent study in psilocybin treatment for depression and summarizes other major studies investigating this psychedelic’s clinical applications. First, however, he discusses ongoing survey research he is conducting at the Center for Psychedelic and Consciousness Studies. The Psychedelic Change Survey for Anxiety, Depression, or PTSD is seeking volunteers who have intentionally used psychedelics (ayahuasca, mushrooms, LSD) or MDMA to treat these mental health conditions to collect data on the efficacy of these interventions. Dr. Johnson and his team are interested in collecting a variety of responses, so you are encouraged to participate to share your experiences with these substances and whether they provided beneficial results, led to negative outcomes, or anything in between.
Dr. Johnson also spends some time discussing study design, as psilocybin research has begun to move into more sophisticated forms of clinical research. He describes the function of a randomized clinical trial such as his own study, and details the double-blind double-dummy setup of the recent psilocybin study at NYU. In his study, Dr. Johnson’s participants were randomly selected for the immediate treatment group or the delayed treatment group, which served as a control. All participants were provided with two sessions of psilocybin assisted psychotherapy, and the data showed that there were large reductions in depression following treatment and these results remained statistically significant at follow ups.
In the NYU study, Dr. Johnson describes that participants were given either a genuine psilocybin treatment followed by a placebo antidepressant to take regularly, or they were given a placebo in place of psilocybin followed by an approved antidepressant. This large study is particularly interesting as it directly compares psilocybin treatment for depression with traditional pharmaceuticals used to treat this condition. Here again, Dr. Johnson reports that the psilocybin treatment showed extremely promising results.
In this episode:
Conditions for participating in Dr. Johnson’s current survey research
How Dr. Johnson designs his studies and chooses how he analyzes the data collected
The results of the first randomized study examining the use of psilocybin for depression
How the preparation process for psilocybin-assisted therapy may be clinically useful as a standalone treatment
Quotes:
“We and the group at NYU published larger studies with a high dose of psilocybin and found these very large reductions in both depression and anxiety in cancer patients, so that sorta paved the way for, hey if this works in cancer patients let’s look more broadly.” [19:42]
“I kind of view psychedelic therapy as sort of having everything we know about general psychotherapeutic processes under a magnifying glass.” [23:12]
“I think it’s fallen out of fashion, but if we just had people laying on couches all day with therapists they’ve developed a relationship with—if that was more of a thing, even without psychedelics or placebo psychedelics, that has real benefit.” [28:30]
Links:
People of Color and Psychedelics with Ifetayo Harvey & Mary Sanders, LCSW
People of Color and Psychedelics with Ifetayo Harvey & Mary Sanders, LCSW
In this episode of the Plant Medicine Podcast, Ifetayo Harvey & Mary Sanders, LCSW join to discuss people of color and psychedelics. Ifetayo is a writer, advocate and speaker who founded the People of Color Psychedelic Collective. She has also previously worked with both MAPS and the Drug Policy Alliance. Mary Sanders is a licensed clinical social worker whose work focuses on addressing trauma in communities of color and marginalized populations. She is a founding board member at the People of Color Psychedelic Collective and is a trained psychedelic-assisted psychotherapist from both CIIS and MAPS. Mary is also certified in trauma-focused cognitive behavioral therapy and is currently enrolled at the somatic experiencing trauma institute.
This conversation with Ifetayo and Mary touches on many of the important topics in the intersection of the unique experiences of people of color and the use of psychedelic medicines. One immediate concern which has begun to be discussed more openly is that of POC representation in psychedelic spaces. Ifetayo and Mary both discuss this issue, mentioning how representation is especially crucial for something as vulnerable as psychedelic experiences, where facilitators are responsible for navigating a wide range of emotions which naturally arise in a ceremony or therapeutic setting. Having someone from one's own community in these spaces can facilitate healing, as there is less anxiety around needing to explain specific experiences or trauma.
Despite these shortcomings of representation, psychedelic medicines have a lot of potential to provide healing for people of color in particular. Ifetayo and Mary discuss the experience of intergenerational trauma in communities of color and how psychedelics are able to shed light on this phenomenon. Ifetayo shares powerful experiences from the first People of Color Psychedelic Collective retreat before the pandemic and explains her own coming to consciousness of the brutality of slavery and Jim Crow and how dysfunctional behaviors which perpetrate intergenerational trauma originally developed as survival mechanisms for the black Americans who lived under these racist systems.
Mary also emphasizes that psychedelic healing for people of color needs to emphasize building community and creating strong interpersonal bonds. While the individual experiences provided by plant medicines are incredibly beneficial, the healing will be even more profound if it can be processed and integrated collectively, as people of color aren’t only healing individual ailments, but collective traumas rooted in shared histories of oppression.
In this episode:
The unique needs of POC not typically addressed in psychedelic ceremonies or integration circles
The disconnect between the Western therapeutic paradigm of healing individuals vs the more communal approaches to healing in traditional black cultures and how to bridge this gap
How People of Color Psychedelic Collective creates community and fosters opportunities for people of color involved with psychedelics
The intersection of intergenerational trauma and psychedelic healing for people of color
Quotes:
“Taking a medicine is a vulnerable state, where we have to be cautious: am I going to be minimized, are my visions going to be acknowledged and held with support and love and care?” [8:27]
“Healing is relational and it’s so important that we not only do the work in the therapy space but that we’re out and about with our friends and our family and our community members, especially our community members that have similar life experiences and histories.” [19:24]
“There’s a very very strong stigma around addiction [and] overdose because our communities have been harmed in so many ways by policing and bad drug policies.” [25:22]
“I think it’s really about uplifting the people who are already doing the work and then also supporting the folks who want to do the work, like providing them with resources, education, mentorship. Things like that will help usher in a new generation of [POC] healers, practitioners, leaders.” [39:35]
Links:
People of Color Psychedelic Collective
National Harm Reduction Coalition
Can Ayahuasca Help Promote Palestinian-Israeli Reconciliation? With Dr. Leor Roseman & Antwan Saca
Can Ayahuasca Help Promote Palestinian-Israeli Reconciliation? With Dr. Leor Roseman & Antwan Saca
In this episode of the Plant Medicine Podcast, Leor Roseman and Antwan Saca join to discuss their recently published paper: Relational Processes in Ayahuasca Groups of Palestinians and Israelis. Leor is a postdoc at the Centre for Psychedelic Research at Imperial College London, where he also received his PhD and masters under the supervision of Dr. Robin Carhart-Harris. Leor has diverse research interests related to psychedelics, ranging from the neuroscientific and therapeutic, to the phenomenological and psychosocial. Antwan is a graduate of the Arab American University of Jenin with a BA in public law and has extensive experience working for justice in Palestine. He has served as the director of programs at Holy Land Trust in Bethlehem and as a program coordinator for Holy Land Christian Ecumenical Foundation. Antwan has also worked as a research assistant for urbanization and geopolitical monitoring at the Applied Research Institute—Jerusalem.
In this episode, Leor and Antwan discuss the details of the recent paper they co-authored which deals with impacts of ayahuasca on interpersonal peace building in the context of the Israel-Palestine conflict. The study consists of 31 in-depth interviews with Israelis and Palestinians who’ve participated in joint ayahuasca ceremonies and looks to investigate the impact of this psychedelic experience along three relational themes: unity-based connection, recognition and difference-based connection, and conflict-related revelations. Through open-ended interviews, Leor and Antwan were able to collect qualitative data from participants which allowed research conclusions to arise organically.
In the interviews, participants disclosed experiences of profound political revelations, connection with the land, and empathy for the other. Leor and Antwan stress that the initial motivations of the participants typically had little to do with notions of political peace-building and instead they were most often participating in these psychedelic ceremonies for reasons related to personal growth, so these outcomes arose naturally as a result of the intense interpersonal connections spurred by the psychedelic experience.
Though these ayahuasca ceremonies had significant positive impacts for both the Israelis and the Palestinian participants, Antwan notes the disparity of access to psychedelic healing for Palestinians and emphasizes that the “love for the other” the Palestinian participants experienced through the ayahuasca ceremonies is complicated due to the pervasive political supression and percarity experienced by Palestinians in their day-to-day lives. The study, however, demonstrates that profound experiences of connection through the use of psychedelic medicines are possible even in the context of a deep and traumatic geopolitical conflict. This opens the door for further study of the potential of psychedelics to facilitate conflict resolution and peace-building.
In this episode:
How Leor and Antwan developed the idea for this study based on their personal backgrounds
Different themes which came up in interviews with the Israelis and Palestinians in the study
The moving story of a former Israeli military officer and how he experienced the pain of the Palestinian people during an ayahuasca ceremony
How music and prayer in the ceremonies helped to encourage empathy and cultural connection among participants
Quotes:
“It’s not questionnaires, it’s not about measuring things, it’s about listening to stories and making meaning out of them.” [13:24]
“Because the rituals were participatory and music and prayers were shared, a lot of times these opened up for people the strong connection to the other culture or the other people and that was very meaningful for many people.” [21:34]
“A lot of us Palestinians end up in the interviews telling you ‘this is all amazing’ and yet there is the reality, yet we live under this kind of suppression.” [29:11]
“Not all people that came to the ceremonies came from the peace camp or from left-leaning camps. They come for psycho-spiritual growth, or even for physical illnesses… And they go there regardless of their politics.” [31:37]
Links:
Full Article: Relational Processes in Ayahuasca Groups of Palestinians and Israelis
Psychedelics and Nature: The Symbiotic Relationship with Dr. Sam Gandy
Psychedelics and Nature: The Symbiotic Relationship with Dr. Sam Gandy
This episode of the Plant Medicine Podcast welcomes Dr. Sam Gandy to discuss the symbiotic relationship between psychedelic experiences and connection with nature. Dr. Gandy holds a PhD in ecological science from the University of Aberdeen and has conducted field research across the globe. He currently works as a research assistant at the Synthesis Institute and as a senior science writer at Wavepaths. He is also a collaborator with the Centre for Psychedelic Research at Imperial College London and was previously a scientific assistant to the director of the Beckley Foundation.
In this conversation, Dr. Gandy shares insights from his research into psychedelics and nature relatedness with special emphasis on his 2020 publication “The Potential Synergistic Effects between Psychedelic Administration and Nature Contact for the Improvement of Mental Health” (linked below). Dr. Gandy discusses the numerous overlaps between the experience of nature relatedness—the personal sense of being connected with the natural world—and the experiences induced by psychedelic substances. These overlaps cover a range of domains and all work to promote wellbeing. For example, Dr. Gandy reports that neuroticism decreases both as a result of positive psychedelic experiences and from spending quality time in nature. As high neuroticism can correlate with mental illnesses such as depression and anxiety, interventions that can impact this trait have significant therapeutic potential.
In addition to specific overlaps between the psychedelic experience and nature relatedness, Dr. Gandy also discusses how psychedelics and psilocybin in particular seem to increase a sense of nature relatedness. Considering these overlapping benefits and the symbiotic relationship between psychedelics and nature relatedness, Dr. Gandy provides some speculations for how nature can be more intentionally integrated into psychedelic therapies and ceremonies to maximize the therapeutic benefits of both. He mentions that even something as small as decorating a clinical setting with artwork depicting nature can have positive impacts for patients undergoing psychedelic psychotherapy in the space.
In this episode:
Eudaimonic vs hedonic well being
The neurobiological and psychological overlaps between nature relatedness and the psychedelic experience
How both psychedelics and nature relatedness promote mindfulness and experiences of awe
Ideas for combining psychedelic therapy and experiences of nature to enhance health benefits
Quotes:
“Nature connectedness is a mediator for some of the benefits to cognition and mood obtained from actually spending time in nature, having contact with nature.” [6:57]
“There was a study published last year by a Finnish research group and one of the most common after effects of psychedelic mystical experiences they found was this sustained, positive shift in peoples’ relationship to nature.” [17:35]
“Psilocybin has this capacity to facilitate this fairly robust, rapid, but most importantly sustained increase in nature relatedness. And the really mysterious and interesting thing is that it can do this even when it's administered in a clinical setting.” [22:47]
“The restorative effect of nature obviously benefits both the person having the therapy and the therapist, and it potentially allows for the outdoor nature-based setting to become part of the therapy itself.” [31:00]
“If you’re going to do any kind of psychedelic nature connection, nature immersion therapy, it’s very important to have a cozy, secure structure that people have got as a safe place.” [35:31]
Links:
Kratom: Research Findings and Methods of Use with Dr. Oliver Grundmann
Kratom: Research Findings and Methods of Use with Dr. Oliver Grundmann
This episode of the Plant Medicine Podcast features a conversation about kratom with Dr. Oliver Grundmann. Dr. Grundmann earned his bachelors in pharmacy and European pharmacy license from University of Münster in 2004, after which he pursued graduate studies at the University of Florida, where he is now a clinical professor in the College of Pharmacy. His research interests focus on investigating the use of natural products as novel treatments for a variety of physical and mental conditions. Dr. Grundmann is a leading kratom researcher and has published numerous articles on the substance, examining the plant medicine and its use using a variety of methodologies.
In this episode, Dr. Grundmann introduces kratom (scientific name mitragyna speciosa) and discusses its pharmacology and potential as both a medicine and a drug of abuse. The kratom tree is native to southeast Asia and belongs to the same botanical family as the coffee plant. The leaves of the kratom tree contain a wide variety of active alkaloids and they are consumed orally to produce a psychoactive effect.
Dr. Grundmann explains that kratom is unique because the primary alkaloids mitragynine and 7-hydroxymitragynine are opioid agonists, yet the substance does not fit neatly into the opiate category as it lacks certain properties of the classic opioids such as morphine or heroin. For example, respiratory depression is not observed with the use of kratom, while this is a hallmark effect of opioids at high doses—and one of the major dangers associated with the use of these drugs.
Another way in which kratom is unique is that its effects are highly dose dependent. At lower doses, Dr. Grundmann explains, the plant tends to have a more energizing effect, while higher doses lead to a more sedating experience.
In this conversation, Dr. Grundmann also shares insights into kratom use in America based on survey research he has conducted. While scientific research into kratom remains a small field, this type of survey research helps to give insight into the potential kratom has as a plant medicine through data which shows the variety of conditions people are attempting to treat through kratom use.
As kratom consumption increased in the United States and the plant gained notoriety, its use became associated with the treatment of chronic pain and opioid withdrawal. Dr. Grundmann’s research has been showing, however, that users are also turning to kratom for dealing with conditions such as depression, anxiety, and PTSD. These initial findings provide fertile soil for further research into kratom’s potential medicinal applications.
In this episode:
The pharmacology of mitragyna speciosa
The legality of kratom in the United States
The current state of scientific research into the effects of kratom consumption
Contraindications for kratom use
Potential uses for kratom to treat both mental and physical ailments
Various methods for kratom consumption
Quotes:
“Just because a substance binds to an opioid receptor doesn’t mean that it shows all of the same properties as, for example, morphine, or oxycodone, or fentanyl, or heroin.” [14:20]
“When we talk here one to five grams per dose, three times a day—the potential to develop a use disorder, kratom use disorder, basically, is relatively low. When we talk about really taking high amounts of an extract or also of the powder for example, let’s say above eight grams, ten grams per dose, more frequently—four, five, eight times a day—then there is the potential to develop a dependence on it.” [18:52]
“Between 70%–85%… [of] folks were in the range of one to five grams and didn’t have to go above five grams to maintain alleviation of their symptoms for which they are using kratom… That indicates to me that there’s no risk of tolerance up to five grams per dose.” [22:53]
“Surprisingly, we had a large group now in the second survey who were using it to treat—self-treat—symptoms of ADHD or PTSD and nothing else aside from that. So it’s really a very diverse population of users that we’re seeing with kratom.” [25:09]
Links:
Dr. Grundmann’s Profile at the University of Florida
Psychedelics and the LGBTQIA2S+ Community with Dr. Angela Carter
Psychedelics and the LGBTQIA2S+ Community with Dr. Angela Carter
This episode of the Plant Medicine Podcast welcomes Dr. Angela Carter (they/them) to discuss the intersection of the LGBTQIA2S+ community and psychedelics. Dr. Carter is a queer, transgender, and genderqueer naturopathic primary care physician who also works as a midwife, sexual assault examiner, and health equity advocate in Portland, Oregon. They also serve as both the vice-chair and the equity in training subcommittees co-chair of the Oregon Psilocybin Advisory Board. In addition to these positions, Dr. Carter serves as the chair of the Transgender Health Program Community Advisory Board at Oregon Health & Science University. They also volunteer with many organizations including the Fireside Project, Black Rock City Emergency Services, and Queerdome.
Dr. Carter begins this conversation by sharing exciting new research currently being conducted which involves LGBTQIA2S+ individuals and psychedelic therapies. While this particular area of research remains small, it is growing and the fruits of these studies will be an important step for better understanding how these new therapies can serve gender and sexuality minorities, and help facilitators understand the unique concerns of people in the LGBTQIA2S+ community. Dr. Carter illustrates these types of concerns by discussing the prevalence of gender binaries within psychedelic spaces. They describe how in a clinical setting it is prevalent to have both a male and a female facilitator, but this leaves no room for gender-nonconforming people to guide experiences—something which could be preferable if the patient themselves shares this identity.
Dr. Carter also discusses this gender binary in traditional contexts. It is common for ayahuasca ceremonies to provide separate spaces for men and women, again leaving no space for gender-nonconforming people. This reification of the gender binary and the often patriarchal organization of the ayahuasca ceremony can have serious impacts on the set and setting, especially for people in the LGBTQIA2S+ community. Dr. Carter emphasizes the importance of making space for folks in the community so that they are able to receive therapy, attend ceremonies, and participate in integration with others who share similar identities. This shared identity, they emphasize, ensures that LGBTQIA2S+ people don’t feel out of place in contexts that ought to be healing. Dr. Carter closes by discussing how members of the LGBTQIA2S+ community experience disproportionate rates of mental illness, further illustrating the crucial importance of equity in accessing psychedelic medicine.
In this episode:
Problems of representation and access for LGBTQIA2S+ individuals in the psychedelic space
Current research being done on the intersection between psychedelic therapies and unique issues faced by gender and sexuality minorities
Preparations to take before guiding a psychedelic experience for LGBTQIA2S+ people, particularly if you do not come from the community
How plant medicines could have unique benefits for the LGBTQIA2S+ community
Issues of poverty faced by marginalized peoples and how to support equity of access to emerging psychedelic therapies
Quotes:
“For some people that idea of melding, of becoming one and losing all of those unique pieces of themselves, doesn’t fit their paradigm of a spiritual connecting experience.” [10:47]
“It’s precious, that centering of our community—to be able to sit with people who just understand.” [19:42]
“Psychedelics offer the opportunity for connection of the self to something greater, something outside, a bigger community, spirituality, and really do a huge amount to heal peoples’ relationships with substances.” [25:20]
“Marginalized communities have been really impacted, largely, by the war on drugs, which has put millions of people in jail for drug offenses and stolen their ability to make income, stolen their ability to connect with community and we really need to heal that.” [33:34]
Links:
Chacruna Institute Queering Psychedelics 2019 Conference
Psychedelics and Meditation with Nate Macanian
Psychedelics and Meditation with Nate Macanian
This episode of the Plant Medicine Podcast features a discussion of psychedelics and meditative practices with Nate Macanian. Nate is a meditation teacher and psychedelic guide from New York with a background in cognitive neuroscience. He also creates mindfulness content for leading meditation apps such as Calm, Simple Habit, and Wellness Coach, as well as retreat centers such as Synthesis and Omega Institute.
Nate begins this discussion describing how he was initially exposed to meditation and psychedelics. This first exposure came while Nate was a student at the University of Michigan and his immediate passion for meditation led him to found a student organization to further explore meditative and contemplative practices with his peers. Nate also describes guiding friends through psychedelic experiences in his college arboretum, before he had ever even heard of the idea of trip sitting.
Turning to meditative practices themselves, Nate describes how psychedelics can be incorporated into one’s meditation routine in a variety of ways and for a variety of different forms of meditation. What he stresses, however, is to examine the intention behind bringing plant medicines into the practice. But if they are incorporated mindfully, psychedelics can help bring meditative practices into sharper relief—microdoses help to amplify awareness and reveal the habits of the mind while larger doses work to connect one to layers of experience previously hidden to consciousness.
While meditation and psychedelics share certain goals and can both be used for therapeutic ends, there are also differences between them. Nate describes psychedelics as an elevator which takes people directly to a destination, whereas meditation is more like a winding staircase as the practice requires continual effort and consistency to progress. Nate also distinguishes meditation and psychedelic experiences phenomenologically. He stresses that the goal of meditative practices is not to mimic the feeling of a trip. Instead, meditation works to focus the attention on the whole spectrum of human experience, some of which can be boring, tedious, or dull. Psychedelics, on the other hand, provide specific kinds of experiences which are intense and colorful, but these differences are what allow meditative practices and psychedelic journeys to have a symbiotic relationship.
In this episode:
Nate’s journey being introduced to mindfulness and psychedelics
The importance of intention in meditation
Incorporating plant medicines into one’s meditative practices
Psychedelics, meditation, and the default mode network in the brain
Why set and setting is also important for meditation
Quotes:
“If you include a larger dose in your meditation practice, you might find that there are layers that were previously unseen and latent, living under the surface, that start to come up and this is where a lot of shadow work happens.” [14:00]
“When the default mode network is off, we have this increased susceptibility to our immediate environment and this is why it's so important to surround yourself with positive people and be in a nice, calm, safe place.” [22:24]
“I think there’s absolutely a place for psychedelics to be included in your meditation practice as long as it’s intentional and as long as you feel like your success as a meditator is not attached to your use of any substance.” [26:59]
“Meditation as a practice is not about really forcing ourselves to have some experience, but to train our awareness, to become a more whole person, a more fulfilled person, a more loving person.” [33:33]
Links:
Harm Reduction Through Testing Your Psychedelics with Mitchell Gomez
Harm Reduction Through Testing Your Psychedelics with Mitchell Gomez
On this episode of the Plant Medicine Podcast, Mitchell Gomez of DanceSafe discusses how to reduce harm by chemically testing substances prior to consumption. Mitchell is a graduate of New College of Florida and holds a masters from University of Colorado Denver. He joined the DanceSafe team in 2014 and has been serving as the executive director since 2017. In addition to his work at DanceSafe, Mitchell also acts as a harm reduction consultant for MAPS.
In this conversation, Mitchell shares the origin story of DanceSafe and describes the important work they do. He mentions that testing drugs is illegal in many states, but following a precedent set by needle exchanges, the justice system seems to turn a blind eye to DanceSafe’s activity.
Transitioning to the present day, Mitchell discusses the current state of the drug market, sharing information on adulterants and false marketing for a variety of substances from ketamine and LSD to cocaine and MDMA. Prohibition is at the root of these issues, he claims, as this is what encourages things such as selling fentanyl while claiming it is another opioid, as fentanyl is more potent and thus easier to smuggle in smaller quantities. Another government-related issue Mitchell mentions is the data the state gathers on drug-induced medical incidents. This data groups a variety of substances together, making it difficult to determine the actual cause of the medical emergency.
Turning to the importance of chemically testing drugs, Mitchell stresses the benefits of knowing what you are consuming. While a single test with the right reagent can tell a lot about a substance, Mitchell recommends using a wide variety of tests as many drugs are often adulterated even if they do contain the substance they were sold as. Knowing if a drug is cut with another substance and what this substance could be helps people make more informed decisions about what they put in their bodies. Especially in the era of the opioid epidemic, this kind of information can be legitimately lifesaving.
In this episode:
The origin of DanceSafe and the services they provide
How to use fentanyl test strips
Common drugs currently being falsely marketed as MDMA
New opioids which are laid on blotters like LSD
Why using multiple reagents to test substances is a smart idea
Chemically testing mushrooms vs learning mycology to identify species
Quotes:
“One of the things we know is that the speed at which new drugs are entering the market is accelerating.” [15:08]
“Fentanyl, for a non-opioid user, a milligram might be enough to kill you. One milligram. If you’re alone, if there’s nobody there to call 911, that might be enough to impact a non-opioid user’s breathing.” [18:44]
“Nobody has ever been arrested for just having a test kit. That’s never happened. If they find a test kit as part of a larger drug investigation, they will include a paraphernalia charge for that test kit as a means of coercing plea deals.” [21:28]
“These are problems caused by prohibition. We could have fair trade, organic cocaine in twenty-five days if we just ended the drug war.” [33:00]
Links:
Navigating Psychedelic Narcissism with Adam Aronovich
Navigating Psychedelic Narcissism with Adam Aronovich
In this episode of the Plant Medicine Podcast, Adam Aronovich returns to discuss the phenomenon of psychedelic narcissism. Adam is a doctoral candidate at the Universitat Rovira i Virgili in Spain, focusing on Medical Anthropology and Cultural Psychiatry. He is an active member of the Medical Anthropology Research Center (MARC) and part of the Ayahuasca Community Committee at the Chacruna Institute for Psychedelic Plant Medicines. In the last four years he has conducted extensive fieldwork in the Peruvian Amazon, where he has been doing qualitative research in collaboration with ICEERS, the Beckley Foundation, and, more recently, the Centre for Psychedelic Studies at Imperial College. Beyond his work conducting and coordinating research, Adam regularly facilitates workshops at the Temple of the Way of Light, a prestigious healing center in the Iquitos area.
In this wide-ranging conversation, Adam unpacks some of the darker sides of the modern psychedelic movement, discussing the psychosocial dynamics around psychedelic use which can lead to things such as ego inflation, conspiratorial thinking, and narcissism. Adam recalls his own experiences slipping into messianic fantasies during a period of initial enthusiasm around psychedelic experiences. He views issues of alienation and lack of social support as being instrumental in leading to these types of delusions following profound spiritual experiences. While it is difficult to reach people who’ve slipped into psychedelic narcissism, Adam suggests that communal support is the best safeguard against these dangers and the most effective strategy for grounding people who’ve lost touch with reality.
Drawing on his academic expertise, Adam distinguishes traditional uses of plant medicines from the Western paradigm for approaching psychedelics. He stresses the relational and communal aspects of the spiritual traditions which use psychedelics ceremonially. The pro-social aspects of these wisdom traditions, he claims, help safeguard against the traps of psychedelic narcissism and ego inflation, as there are established mechanisms for keeping people grounded following intense spiritual experiences.
Adam closes the discussion with an insightful analysis of modern gurus and self-proclaimed shamans. Adam encourages people to beware of deeply held spiritual fantasies, where a master can appear as more than human. Instead, he emphasizes that even skillful and well-intentioned healers are themselves nothing more than human beings, so there will always be imperfection and messiness. This does not, however, mean that impactful work cannot happen—in fact, this insight helps protect against the idolization of charismatic psychedelic personalities, which can lead to harmful experiences.
In this episode:
Defining psychedelic narcissism
Clinical vs coloquial understandings of narcissism
The intersections of the psychedelic movement and conspiracy theories
The importance of social and communal support for avoiding ego inflation following psychedelic or spiritual experiences
How psychedelic experiences can actually deepen ego attachments and accentuate narcissistic tendencies
The importance of humor in combating spiritual narcissism
Quotes:
“Many of the underlying ideologies upon which Western cultures were built, like hyper-individualism and so on, kind of predispose us and prime us for certain aspects of narcissism.” [5:36]
“Ego inflation, spiritual narcissism, messianic episodes—all of these are things that are fairly common within both people who are in some sort of spiritual or psychedelic path.” [12:17]
“In traditional societies for the most part really there isn’t such a thing as a self-proclaimed shaman. A person doesn’t wake up one morning and is like ‘oh, I’m the shaman’—that’s a title or a role or a recognition given to that person by the community.” [38:03]
“The best measure of whether somebody is genuine and helpful is not whatever credentials or titles he assigns to himself, but rather what other people feel. So, you know, you will know a tree by its fruits.” [45:08]
“Having these experiences by themselves does not necessarily mean spiritual growth or psychological development or any enhanced benefit if we’re not constantly, painfully, mindful of how we actually integrate and embody those things in daily life over very long periods of time.” [54:29]
Links:
Establishing Safeguards for Psychedelic Therapy with Dr. Julie Holland
Establishing Safeguards for Psychedelic Therapy with Dr. Julie Holland
This episode of the Plant Medicine Podcast is the final installment in a three-part series with Dr. Julie Holland. Dr. Holland is a psychiatrist specializing in psychopharmacology, and she is also the author of many books, including her most recent work Good Chemistry: The Science of Connection, from Soul to Psychedelics which discusses the neurochemistry behind human connection. She is also a medical monitor for several MAPS PTSD studies using MDMA-assisted psychotherapy and has worked for decades on US drug policy reform based on harm reduction principles. In addition to this work, Dr. Holland has nine years experience running a psychiatric emergency room as an attending physician on the faculty of NYU school of medicine and she continues her psychiatric work in her private practice in New York City.
In this episode, Dr. Holland speculates on the future of psychedelic therapy and the emerging issues within the broader psychedelic movement. Lamenting the lack of governing organizations and accountability, Dr. Holland discusses the complexities of regulating an industry with a history of operating underground and in legal grey areas. This raises questions such as how to grandfather-in established psychedelic practitioners now that various coursework in psychedelic therapy and systems for credentials are beginning to emerge.
Another issue related to legality which Dr. Holland discusses is the relation between the medical establishment and psychedelic therapies. The fact that individuals interested in pursuing plant medicines for therapeutic reasons are not able to easily consult with primary care doctors is a huge hurdle to harm reduction, and, as Dr. Holland points out, this leaves the responsibility for ensuring safety entirely on the psychedelic practitioners. Because these practitioners range from underground ayahuasca circles to clinically approved, legally operating therapists the amount of attention and care paid to harm reduction can vary greatly, which is why it will be essential to establish standards and best practices for psychedelic therapy as demand continues to increase.
Dr. Holland also discusses the issues of “psychedelic capitalism” which are coming to the fore as these treatments become more mainstream and more accessible. While there are no clear answers for how to navigate the intersection of psychedelic therapies and capitalist market dynamics, this is an issue that deserves care and attention so that there can be equitable access to these medicines. Dr. Holland closes with a discussion of the parasympathetic nervous system–the “rest and digest” mode–and its importance for not only personal health, but also social well-being.
In this episode:
Why it is essential to begin establishing best practices and safeguards around emerging psychedelic therapies and other practices involving plant medicines
Issues that arise from the intersection of capitalist market dynamics and the emerging psychedelic industry
The future of medical consultations prior to consuming plant medicines
Activating the parasympathetic nervous system and its pro-social impacts
Quotes:
“I think part of it is just this fear that if we admit there are some bad actors, that the whole house of cards is gonna fall.” [9:26]
“Just because of the way capitalism is, there is IP, there is proprietary information, there is anti-competitive behavior. That to me also really needs to be addressed.” [11:31]
“In any interaction there is a choice of being hurtful or helpful, and it’s a choice, everyday.” [20:18]
“Anyone who can out themselves should, because it will move this whole thing along a lot more. If you are a soccer mom who also microdoses, put that bumper sticker on your car.” [24:58]
Links:
Good Chemistry: The Science of Connection, from Soul to Psychedelics
Strategies for Tapering Off Antidepressants with Dr. Julie Holland
Strategies for Tapering Off Antidepressants with Dr. Julie Holland
This episode of the Plant Medicine Podcast is the second conversation in a three-part series with Dr. Julie Holland. Dr. Holland is a psychiatrist specializing in psychopharmacology, and she is also the author of many books, including her most recent work Good Chemistry: The Science of Connection, from Soul to Psychedelics which discusses the neurochemistry behind human connection. She is also a medical monitor for several MAPS PTSD studies using MDMA-assisted psychotherapy and has worked for decades on US drug policy reform based on harm reduction principles. In addition to this work, Dr. Holland has nine years experience running a psychiatric emergency room as an attending physician on the faculty of NYU school of medicine and she continues her psychiatric work in her private practice in New York City.
In this episode, Dr. Holland talks specifically about the nuances of antidepressants and psychedelic medicine. As is commonly known, many prescription antidepressants have contraindications with various psychedelic compounds, meaning there are concerns regarding how people taking such medications will be able to also access psychedelic-assisted therapies.
Dr. Holland discusses the specific contraindications for individual psychedelic medicines and suggests some strategies for safely and effectively tapering off antidepressants in consultation with a medical professional. She suggests various wellness practices, such as regular exercise, as particularly helpful during the course of tapering, and even mentions situations where an additional antidepressant is prescribed to support the tapering process, stressing the complexity and delicacy of this process.
To give context to this discussion of psychedelics and antidepressants, Dr. Holland provides an overview of the history of psychiatry over the past forty years, showing how antidepressants came to prominence as a therapeutic tool. She also explores additional considerations, such as how things like hormonal birth control interacts with SSRI antidepressants on a psychopharmacological level. The common thread Dr. Holland weaves through this conversation is the importance of connection, both as support for the tapering process and as the end goal of effective therapeutic practice.
In this episode:
Health and wellness practices which can act as support while tapering off an antidepressant in consult with a medical professional
Contraindications between various psychedelics and antidepressants
The difference between microdosing and macrodosing psychedelics while taking antidepressants
Why falling in love can present a good opportunity to taper off antidepressants under supervision
Why Dr. Holland sees the divide between recreational and therapeutic use as a false dichotomy in some cases
Quotes:
“There was a lot of hand-holding and de-stigmatizing back in the 90s, educating people around antidepressants. But twenty years later most of my work was really around people [who] had been medicated for ten, fifteen, twenty years and wanted to be off meds.” [6:15]
“The people who really responded from MDMA-assisted psychotherapy who had PTSD were the people who’d never been on SSRIs. The people who had a muted response who didn’t get as much better as the other group were the ones who had been on SSRIs.” [9:47]
“Coming off of psych meds is no easy feat. You really have to do a gradual taper, there has to be somebody who is supervising you, and you’ve got to have other things in place.” [10:42]
“You have to have somebody helping you… It’s not the kind of thing you can really go alone. Getting off antidepressants requires somebody who knows what they are doing to help you.” [14:16]
“Your brain learns to be sad, your brain learns to be anxious, your brain can learn to be at ease and learn to have joy.” [21:31]
Links:
Psychedelics and the Chemistry of Connection with Dr. Julie Holland
Psychedelics and the Chemistry of Connection with Dr. Julie Holland
This episode of the Plant Medicine Podcast is the first installment of a three-part conversation with Dr. Julie Holland. Dr. Holland is a psychiatrist specializing in psychopharmacology, and she is also the author of many books, including her most recent work Good Chemistry: The Science of Connection, from Soul to Psychedelics which discusses the neurochemistry behind human connection. She is also a medical monitor for several MAPS PTSD studies using MDMA-assisted psychotherapy and has worked for decades on US drug policy reform based on harm reduction principles. In addition to this work, Dr. Holland has nine years experience running a psychiatric emergency room as an attending physician on the faculty of NYU school of medicine and she continues her psychiatric work in her private practice in New York City.
In this first installment with Dr. Holland, the conversation focuses on the idea of connection she explored in Good Chemistry. Dr. Holland begins by discussing the importance of feeling a connection with oneself and details how many things in modern life can get in the way of this connection. Self-connection is important, she stresses, because if we are not grounded in ourselves, it can be difficult to establish healthy connections with others. Dr. Holland explains how various neurotransmitters such as oxytocin and dopamine are involved in connecting with self and others and how pharmaceuticals such as opiates act on some of these same systems to simulate comfort.
In addition to discussing human connection from a pharmacological perspective, Dr. Holland also explores the topic through a psychological lens, looking at the role trauma can play in muddying opportunities for connection. This is an area where psychedelics can be particularly impactful, as these substances can disrupt the constant ruminations and patterns of behavior which keep people from pursuing or deepening connections.
Dr. Holland then brings some insights from the science of connection to bear on the practice of psychedelic therapy, discussing how group facilitation of psilocybin therapy could be more impactful by allowing the experiences and integration work to happen in community. The conversation closes with a discussion of how psychedelics can impact the connections one feels, especially to the natural world, and some speculations regarding how the feelings of interconnection elicited by psychedelic experiences could impact political convictions.
In this episode:
How distractions and addictions get in the way of our ability to connect with ourselves
How the epidemic of loneliness and the epidemic of overdoses intersect
The pharmacological pathways of oxytocin and the function of the dopaminergic system
How psychedelic experiences “shake up” one’s sense of self and the therapeutic effect of this process
The double-edged sword of the feelings of group cohesion produced by oxytocin
The impact of psychedelics on one’s worldview
Quotes:
“If you’re not in your body, and embodied, and feeling your feelings, you’re not gonna be much use to anybody else in a relationship.” [5:59]
“One of the reasons why opiates are so soothing is they really quell that unease, that anxiety, and they really mimic the chemistry and physiology of what we feel when we are taken care of, held, attended to.” [10:40]
“We are not healthy when we are disconnected. It is a proinflammatory state when we are disconnected, and it is anti-inflammatory when we feel cared for.” [13:35]
“There’s always trauma and everybody carries it around in their bodies to some extent and it really needs to be unearthed and investigated for us to be healthier and happier. So everyone can avail themselves of MDMA-assisted psychotherapy or psilocybin-assisted psychotherapy.” [24:30]
“Oxytocin facilitates neuroplasticity, it facilitates learning. And we learn better in group than we do individually. When we are isolated we do not learn as well.” [29:13]
“There is actual research to show that people who take psilocybin mushrooms and have psychedelic mystical experiences do feel more connected to the planet and do feel more of a sense of obligation to take care of the planet.” [37:23]
Links:
Good Chemistry: The Science of Connection, from Soul to Psychedelics
The Dark Side of Ketamine (and how to Stay in the Light) with Dr. Mark Braunstein
The Dark Side of Ketamine (and how to Stay in the Light) with Dr. Mark Braunstein
In this episode of the Plant Medicine Podcast, Dr. Mark Braunstein returns to discuss potential concerns surrounding the use of ketamine, especially use which is not overseen by a knowledgeable medical professional. Dr. Braunstein is a whole-health psychiatrist with 22 years of clinical experience. He is the medical director for multiple mental health and psychedelic psychotherapy clinics in Colorado, New Mexico, and Utah and he also runs in-patient and out-patient programs for addiction. Additionally, Dr. Braunstein is involved in multiple projects focused on expanding access, awareness, research, and safety in the field of psychedelics.
To begin this conversation, Dr. Braunstein shares how his original exposure to ketamine wasn’t in a medicinal context, but rather as a recreational drug of abuse. However, since then he has seen the transformative effects this substance can have on patients when used in a physician-directed context and for therapeutic purposes. Nonetheless, Dr. Braunstein stresses that this does not mean ketamine use does not come with certain risks.
Ketamine can be addictive and even carries a risk of overdose, particularly when used recreationally in a context where the purity of the substance is unknown. Dr. Braunstein distinguishes recreational and therapeutic uses of ketamine, explaining that recreational doses are often lower and dosing is more frequent, whereas ketamine is used in high doses in a therapeutic context, with extended periods between sessions.
Dr. Braunstein stresses both the responsibility of physicians and of patients to ensure ketamine is prescribed responsibly and used as directed. Despite the dangers posed by recreational ketamine use Dr. Braunstein describes in this conversation, it is still a medicine he believes can have significant positive impacts for patients. This requires, however, that it not be treated merely as yet another quick fix pill. Instead, Dr. Braunstein emphasizes that ketamine treatment ought to coincide with psychotherapeutic work. This combination, he says, will maximize the therapeutic potential of ketamine while also helping to ensure that the medicine is used responsibly, under the close direction of a medical professional.
In this episode:
The addiction and overdose potential with recreational ketamine use
How dosage can dramatically change the effects of ketamine
Responsible prescribing practices for physicians working with ketamine
The psychological and physiological harms of ketamine abuse
How Dr. Braunstein talks to his patients about responsible use before prescribing ketamine
The importance of combining psychedelic medicines with psychotherapeutic work
Quotes:
“Part of why ketamine works is because it lights up your brain in all these different ways and when done occasionally, intentionally, it moves you. But if you’re always doing that, it ends up having the reverse effect, causing damage.” [12:56]
“This is a heavy-duty medication that, if you cross the line, can cause you to stop breathing and then die. So there is an actual, real danger to ketamine.” [16:25]
“I think the organ that is most prone to damage from overuse of ketamine is the same organ we are touting it fixing: the mind.” [18:39]
“When we think about these medications, we should think about combining them with therapy and not just taking these medications as medications… So that’s why with ketamine I’m really recommending it with therapy.” [25:04]
Links: