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Welcome to the Museum of Science.
Thanks so much for coming out and joining us.
The plants of the rainforest and the indigenous people who know them,
are indeed the keepers of many secrets that could transform our world.
Chemical and genetic combinations that could unlock powerful new antibiotics,
cures for diseases like cancer.
And we know now, effective treatments for many mental illnesses.
The use of hallucinogenic plants has been traced back archaeologically
at least 10,000 years.
We know that people have been chewing cocoa leaves for over 8,000 years in Peru.
And some scholars believe that the urge to alter one's consciousness,
is as primal as our instinct to satiate thirst, hunger, and *** desire.
But what's actually going on in our brains has only begun to be revealed in our time.
The word psychedelic translates as mind manifesting.
But the term that was favored by Richard Evans Schultes, the father of ethnobotany,
was enthogenic, which means generating the divine within.
We are extremely privileged to have with us tonight,
four eminent scientists who are blazing trails in their fields,
deepening our understanding of psychoactive substances, and
altering perception of the role they can play in our society.
First up the ethnobotanist.
Please help me give a warm welcome to Dr. Mark Plotkin.
[APPLAUSE] >> Thank you Lisa for setting this up.
Thanks to all of you for turning out tonight.
I want to give you a very brief intro to how I got into this field.
And turn it over to my esteemed colleagues.
Now I start my training 2.4 miles west of here, at the Botanical Museum at Harvard,
which is the mecca of the study of ethnogentic plants.
And what is not very well known by the general public is that
this was started by Louie Agassiz.
What is known by the general public is that Agassiz was on a life long career
pursuit to discredit Darwin.
So this is not a legacy that one would want to have stuck with.
But more importantly, Agassiz launched the first great Harvard
expedition to the Amazon in 1865, it's the Thayer expedition.
And when I worked, in the museum,
in the 1970s, they still hadn't finished identifying all the fish.
So, rich was the biological diversity of the Amazon forest and the rivers.
And speaking of the affect of Amazon.
And amazon plants, and amazon peoples, on the study of the human mind.
Even less known about the Thayer expedition, was that the most important
member was William James, the father of American psychology,
whose experience in the Amazon Rain Forest encountering other realities and
other cultures, had a profound effect on the way he began to study and
understand the human mindscape.
The next great explorer of the Amazon is about half a decade later,
half a century later.
And it was Alexander Hamilton Rice,
the greatest Amazon explorer you’ve never heard of.
Rice went to Harvard as an undergraduate, then went to Harvard medical school,
then decided he got tired of listen to sick people complain all the day.
And decided to become an Amazon explorer.
He ran seven expeditions to the Amazon.
And what is now known as the Yenching Library at Harvard was actually originally
built by Rice, and his wife Eleanor Widener,
as a Harvard Institute of geographic exploration.
They met at Harvard's most important commencement [INAUDIBLE] I think was
in 1915, when Rice was receiving an honorary degree from Harvard, for
his exploration of the Amazon, met and fell in love with Mrs.
Widener, who was there to open the library in honor of her son.
And her husband, who had drowned on the Titanic.
Mrs. Widener was one of the wealthiest people on the planet.
And her money turbo charged Rice's career, and
they began mapping the Amazon from the air.
Harvard, in her infinite wisdom,
didn't see a future in this, closed down the institute.
And I guess Google Earth didn't get the memo that there's no future in mapping
from the air.
The next great explorer of the Amazon from Harvard
was my mentor Richard Schultes seen here taking a break from his research to do
the sacred [FOREIGN] in the north west Amazon.
And here's a connection between anthiogenic plants and
Western medicine, that very few people get.
And I have never, ever, ever met a physician who knew this connection.
About 20 years ago, Schultes and
his wife Dorothy were having dinner with Albert Hoffman, the discoverer of LSD.
And Schultes wife Dorothy took a pill bottle out of her purse,
knocked some pills in her hand.
And Hoffman said what do you got there Dorothy?
He looked at them, he said viscan.
You must have a heart problem.
Did you know that all beta blockers, like this one here, viscan,
were based on compounds, I extracted from the magic mushrooms your husband
collected amongst the [INAUDIBLE] in Oaxaca, Mexico in the late 30s?
So here is a whole class of drugs worth billions of dollars.
More importantly have saved millions of lives,
based on an entheogenic plant from the Oaxaca rainforest,
learned of by an ethnobotanist, but from indigenous peoples.
So the focus here this evening is going to be on these entheogenic plants.
And the way they affect the human mind.
But the point is powerful plants
known by indigenous people have already revolutionized medicine.
And as you'll hear from my colleagues tonight,
we stand on the edge of another revolution that is now just beginning to take place.
Schultes in the Northwest Amazon where he was sent to study aeropoison,
which in 1941, were becoming important, as anesthetics, and abdominal surgery.
But he went on to collect many thousands of plants, and
focused on these antigenic psychedelic plants.
The importance of which is now only beginning to be understood.
And the utility of which is now just beginning to be appreciated.
Schultes work first and foremost in the northwest Amazon in Columbia.
The eastern most extent of his field research was amongst the Yanomami
in Venezuela, on the Venezuela-Brazil border.
And I had the great honor, though I started my work in the northeast Amazon,
in Suriname,
was moving far west to overlap with Schultes research amongst the Yanomami.
20 years ago, this was one of the most remote regions in the world.
And you can see the remoteness of the shabonos, the round houses,
in which they live.
You would come up the river, put on your backpack, and hike in.
I got to the first.
And I explained that I was an ethnobotanist.
And I was there to study their magical plants.
But I just wanted to start out slow.
So I was willing to try the the famous hallucinogenic snuff.
But I only wanted just a little bit.
Well, my wasn't very fluent.
And it turned out, I ended up taking in more than I had expected at the outset.
[LAUGH] >> And
I then spent an extraordinary ethnobotanical afternoon.
>> [LAUGH] >> With my newfound Yanomami colleagues.
>> [LAUGH] >> Schultes always said the difference
between an ethnobotanist and an anthropologist is when the shaman
passes you the pipe, the anthropologist says, no, I can't take a snuff of that,
I'll lose my objectivity, whereas the ethnobotanist basically says, yee haw.
>> [LAUGH] >> And
the focus of his research which is most relevant tonight is gonna be that of
ayahuasca, the sacred vine of the Northwest Amazon.
And I could spend a weekend telling ayahuasca stories, but
I'm just here to introduce the other speakers tonight.
Here you see an ayahuasca shaman with whom I've had the great honor and
pleasure of working for over two decades, this is Don Luciano Mutumbajoy.
He's the head of UMIYAC Union of Yage Healers,
formed with the assistance of the Amazon Conservation Team, my organization,
in the Northwest Amazon over ten years ago and it's still going strong.
Here he is in the middle of an ayahuasca ceremony.
And let me conclude by telling you a story.
I'd taken him up to meet a foundation officer in Los Angeles.
And the officer turned to him, this fellow spoke Spanish, and
said to Don Luciano, you didn't go to medical school, did you?
And the shaman said, no, of course not, I'm a shaman.
And he said, so, well, then what could you know about healing?
You didn't even go to medical school.
And the shaman looked at him, and he smiled, and
he said, if you have an infection, go to a doctor.
He said, but many human afflictions are diseases of the heart,
the soul, and the mind.
Western medicine can't touch those.
With my magical plants I cure them.
Thank you very much.
>> [APPLAUSE] >> Keith.
>> [APPLAUSE] >> Okay,
well, it's a real pleasure to be here.
I'm particularly please to be here because I've been coming to this museum
a lot over the years.
My kids have come here plenty over the years, so it's a real honor for
me to be here.
So today I'm gonna tell a series of stories.
But before I do, in terms of disclosures, I receive my research funding from NIDA,
the Heffter Research Institute, and the NYU School of Medicine.
So the classic drugs we're talking about today, the classic hallucinogens,
include drugs like psilocybin, mushrooms, LSD, ayahuasca, and ***.
Now I wanna start this story by starting in the city of Boston here.
So Mark started with William James up there in the top left.
William James was a philosopher turned psychologist.
In fact, he was the founder of the field of psychology.
In the early 1800s, he was interested in spirituality and mysticism.
And he noticed that these Skid Row alcoholics near Harvard Square were
getting sober through religious conversion.
And he was the first person to describe religion and
mysticism as a treatment for addiction.
The next person to study psychedelics up there was Arthur Heffter.
Arthur Heffter and Louis Lewin in Germany were the first psychopharmacologists
to self-experiment, and they were experimenting with ***.
And Louis Lewin wrote the book Phantastica.
That was actually the first term used to describe psychedelics.
And I think all of the terms are particularly poor.
And that's actually my favorite one,
I think it's more descriptive than any of them.
Then we have Carl Jung over there.
Carl Jung was a psychiatrist who was interested in mysticism.
He grew up in a religious family.
And he entered this deeply meditative state right before World War I, and
this was in between sessions with patients.
And he started to enter this very strange world, this mystical realm.
But he really thought he was going crazy.
He thought this was the beginning of schizophrenia.
And so he wrote all this down, it later it ended up being The Red Book.
But he was so concerned about what was going on with him,
he thought he was going insane.
But he was one of the first people to describe the application
of mysticism to treat individuals.
And Freud very much did not want this new science of psychiatry to be
linked in with religion.
And so the idea of using mysticism as a therapeutic tool had to wait a while.
We have Bill Wilson up here.
Now Bill Wilson was the founder of AA.
And the part of AA that you won't know about is in 1934,
Bill Wilson is hopelessly alcoholic.
He has a doctor at Bellevue, William Silkworth, who says that you're really
gonna die if you continue to drink, and he ends up going to Towns Hospital.
He takes a belladonna alkaloid, and under the influence of this anti-cholinergic
drug, he has this big mystical experience.
He has a white light that penetrates through his hospital room.
And he has a vision of alcoholics forming a chain.
And this is the idea that he has for
Alcoholics Anonymous through this drug-induced mystical experience.
He goes on in the 50s to undergo LSD psychotherapy by Sidney Cohen at UCLA and
wants to introduce LSD into the bylaws of AA, and of course that never happens.
But that's a story of AA you won't hear about.
Now the next part of the story is Albert Hofmann,
and this is when things get interesting.
Albert Hofmann is a Swiss chemist working at Sandoz Pharmaceuticals, and
in 1938 he's working with a series of ergot derivatives,
trying to come up with an agent that will stem blood loss during pregnancy.
And he synthesized a series of lysergamide and kind of leaves them.
And for some reason in 1943 has this kind of this premonition to come back and
accidentally gets some LSD on his finger, takes a bicycle ride home and
starts to experience some sort of strange feelings, aesthetic changes.
He gets home and he thinks there's something majorly wrong with him.
He feels he's possessed by a demon, he thinks his neighbor's a witch, so
the first trip and also the first bad trip.
He calls his physician, the physician finds nothing wrong with him.
He goes to sleep, wakes up the next day, feels refreshed, goes back
to Sandoz Pharmaceuticals and realizes he has discovered something very special.
Sandoz studies LSD on animals and members of Sandoz, and
eventually ends up marketing LSD as a treatment for
a bunch of different disorders, also as a biological basis of psychosis.
The analysts pick it up and start to use this agent, and
this starts really an amazing experiment that goes over the next 25 years,
where psychedelic treatment models become a big part of psychiatry.
But what's really interesting is that this big history was completely erased over
time, so
much so that when I was a psychiatric resident, I learned nothing about it.
But what's really interesting is there really was an enormous amount of research.
There were over 1,000 scientific articles.
There were 40,000 research participants.
And what was most interesting for me when I looked into this in 2006 was that
addiction, my field, alcoholism was the most studied indication.
There were thousands of patients that were treated with LSD-assisted psychotherapy
and there were controlled trials.
The next most common indication was terminal cancer, and
I'm gonna get to that in a little bit.
So what happened next?
What happened next is back to Boston here, so that guy over there is Timothy Leary,
and people in Boston know something about him.
So Timothy Leary starts the Harvard Psychedelic Group in 1960, but
by 1962 he's kicked out of Harvard, he and Richard Alpert, who later became Ram Dass.
And unfortunately Timothy Leary becomes the pied piper of LSD and
he really starts turning all of America on to LSD.
And he starts to thumb his nose at the US government, so much so
that he declares that LSD is more dangerous than the bomb.
The government should be extremely concerned about it.
LSD becomes part of the counterculture, it gets caught up in Vietnam War.
And eventually Richard Nixon gets so upset about it
>> That he declares war against drugs.
He calls Timothy Leary the most dangerous man in America.
And the criminalization of addiction, the Controlled Substance Act, which has led to
the U.S. being the world's biggest jailer mostly of minority, nonviolent drug
offenders was unfortunately a war against consciousness expansion, LSD, but
ended up being a real nightmare for those of us that treat addicted individuals.
So, as the U.S. goes, the rest of the world goes.
The U.S. gets the U.N.
essentially to adopt our Controlled Substance Act and the scheduling system.
What's really interesting is the most damaging drugs, alcohol and tobacco,
are completely absented from this Controlled Substance Act.
So that gives you a sense of, sort of the politics behind this.
So, everything stopped, and anyone who was doing psychedelic research had to stop.
But then, in the early 90s,
Rick Strassman over here at the University of Mexico, starts everything up again.
Even though the psychedelics were Schedule 1 drugs,
there was a pathway for them to be studied.
And Rick Straussman ends up getting approval to give IBDMT
to participants in New Mexico.
And that really starts it.
And then, overtime, Charlie Grope, and Charlie's gonna talk tonight.
And UCLA start psychedelic research at UCLA.
Francisco Merano at the University of Arizona does the psilycybin for OCD trial.
And Roland Griffiths at John Hopkins starts a series
of psilocybin studies there.
What's really interesting about the psychedelics
is that we already make these compounds in our brain.
It appears that our pineal gland makes DMT.
DMT's a very potent hallucinogenic.
What’s also interesting is the serotonin receptor system, we have this 5-HT2A
receptor, and if you activate this system, you profoundly alter your consciousness.
And you can undergo these mystical or spiritual states.
So it’s interesting that there’s these plant-derived compounds.
But we already make these molecules and have receptors in our brain.
Similar to the endogenous cannabinoids and the cannabis plant, and
the endogenous opioids in the *** plant.
All right.
So, I wanna talk about a group at NYU.
We've been doing psychedelic research since 2006.
That's Jeff Gus on the left and Tony Bossas.
And through some serendipity, we started a group in 2006.
It was mostly gonna be a reading group, but we soon ran into Charlie Grobe.
And I had gone to UCLA for medical school, but
I never met Charlie when I was at UCLA.
But I was introduced to him after,
and Charlie really encouraged our group to get involved in psychedelic research.
And I thought this was a really bad idea, but
Charlie insisted and he really encouraged us and helped get us started.
So, since 2006, we have completed a phase two clinical trial using psilocybin
assisted psychotherapy to help cancer patients that have psychological and
existential distress.
And I'm gonna go over the data of that study.
It took nine years to complete, but we're finally done with it.
We also did a qualitative study.
I'm the director of the NYU Addiction Psychiatry Fellowship.
So, as a fellowship director, I realize that this is such a unique, specific form
of psychotherapy that we really had to create a training program for
psychedelic therapy.
So, over the last several years we trained over 40 people to become
psychedelic therapists.
And I think, ultimately, if psilocybin's rescheduled,
you're gonna need people who are specifically trained in this modality.
In addition, we have started a randomized controlled trial
of using psilocybin assisted motivational interviewing to treat alcoholism.
And psychedelic studies to treat addiction have restarted.
We have, Matt's gonna talk about psilocybin and tobacco.
And there's a trial at University of Alabama using psilocybin to treat
*** addiction.
And the other trial that's really interesting that's about to start
is a Johns Hopkins NYU collaboration administering psilocybin to religious
professionals.
The Good Friday Experiment happened in the early 60s here at the March Chapel.
Walter Pahnke and Timothy Leery ran that.
And Johns Hopkins had pioneered a series of trials giving psilocybin to spiritually
oriented individuals, and now we're gonna take a look at religious individuals.
So, I want to ask people, where do people want to die?
Who wants to die in a hospital in an ICU?
Raise your hand.
Who wants to die in a nursing home?
Who would like to die in a hospice?
So some people.
Who'd like to die at home with family members, having a good death?
So, unfortunately-
>> [INAUDIBLE] >> What?
>> A bad *** explosion.
>> Yeah, that's what happens to too many young people.
[LAUGH] >> So, what's really interesting is
that the human encounter with death in the United States has been
assigned to medicine.
The problem is medicine is not properly trained to help those that are dying.
So, too many people die in intensive care units.
About 60% of people in America die in hospital settings.
In settings like this.
So, one of the aims of this study is to sort of think
about this construct of a good death.
Cancer is incredibly common.
About 1 out of 2 of us will get it over the course of our lifetime.
And it's a really frightening thing to be diagnosed with.
And the rates of distress associated with cancer are very high
in terms of depression and anxiety and spiritual distress, as well.
So Eric Cast, this guy here, was an internist at University of Chicago.
What's really interesting, he was studying patients that had terminal cancer and
pain syndromes.
And the was before we knew anything about set and setting, about using psychedelics.
He got some LSD from Santos.
And he would come in the morning and
he would ask his terminal cancer patients who were in pain, stick out your tongue.
He would give them a dose of LSD and come back at the end of the day.
And he did this hundreds of times.
And what he found is in addition to having an anti-pain effect, their patients
reported decreased depression, decreased anxiety and decreased fear of death.
It was mostly open label research.
Stan Groff over here and Walter Phanke at Spring Grove also gave
LSD to about 60 patients that had terminal cancer and anxiety.
And it was open label, and what they found were the same things.
They were gonna do control trials, but
the Control Substance Act hit and everything stopped.
So in the modern era we've reopened using psychedelic
treatment of patients that have terminal cancer.
Dr. Grobe will tell you about his study, published in 2011,
treating 12 cancer patients with a dose of 0.2 milligrams per kilogram.
So I wanna talk a little bit about our group at NYU and Bellevue.
Our trial represented a really interesting collaboration between the NYU School of
Medicine and the College of Dentistry.
I'm a Bellevue guy.
I've been at Bellevue for 15 years.
But Bellevue was having difficulty
giving psychedelics to minority patients who were dying.
The long arc of Tuskogee,
that minority patients really had to be protected from certain kind of research.
So, the dental school ended up opening their arms to us, and
we did the study there which was quite interesting.
So we recruited 29 individuals.
We gave them one dose of psilocybin versus one dose of niacin.
They had psychotherapy, they had preparatory,
where we reviewed the narrative of their life, the narrative of cancer.
We prepared them for the session.
The session was eight hours.
They're very long days.
And then we did integration afterwards.
We included people, initially, we included people that had terminal cancer.
But we soon realized that you could have any stage of cancer,
including being in remission, and still have distress associated with your cancer.
So we included people with all stages of cancer.
We excluded people that had major medical illness.
So, even though they had cancer, they couldn't have end organ damage.
They couldn't be in acute heart failure or renal failure.
And, this is really important, we excluded people that had major mental illness.
Psilocybin can exacerbate psychosis in individuals who have schizophrenia.
So, it's really important to rule out those individuals, which we did.
We measured anxiety, depression, pain,
spiritual measures, quality of life, and death anxiety.
So, it took about two years to get approval.
It was very complicated to get approval, but there is a pathway And
you really just have to be meticulous and keep going.
The problem is these studies are not funded by the federal government.
Even though they'll give approval, the federal government is not yet
willing to fund these trials, so these are all funded by venture philanthropists.
And this is what our room looks like.
It's a living room setting.
We make the couch into a bed, on the dosing days.
And it's really important to have a nice, pleasing setting, and
to not have a sort of dingy, hospital-looking room.
So we screened 108 individuals, we enrolled 42, we randomized 31.
Half went to the niacin, first group.
Half went to the psilocybin group.
And you can see the demographic here.
Now, the NYU Clinical Cancer Center is much different than Bellevue.
So, the typical patient was a woman who was caucasian, who was in her 50's,
who had never done a psychedelic, who had a metastatic gynecologic cancer.
That was the norm patient that we had.
Now what we found, is that there were some adverse events in terms
of non-clinical increases in blood pressure.
There were some individuals that got headache and nausea.
From a psychiatric perspective, about 17% of the individuals had transient anxiety.
And this actually ended up being therapeutic for a lot of individuals.
When they would often have encounters with cancer, and they would feel anxious or
nervous about it, we instructed them to go into that, and
go towards the things that were most fearful.
But there's a cautionary note, that even when you can carefully screen individuals,
there is transient anxiety and psychotic-like symptoms,
that it's important to manage.
But the important thing is we found no serious adverse events.
There have been 2,000 doses of psilocybin administered in the United States and
Europe over the last 15 years, and there have been zero SAEs.
Nobody's become psychotic, or addicted, or
even needed a pharmacologic intervention during the treatment.
So, if you carefully screen individuals,
there's a good safety profile with these agents.
Now, in terms of our findings, what we found,
these were our main outcome measures.
And you can see here, I
don't know if this is pointing correctly, but if you see the baseline there, 16.71,
16.87, the individuals that we saw in the trial had a lot of anxiety and depression.
And you can see in the first line there, has total, the day before,
the psilocybin group goes from 12.8 down to 5, and then two weeks later,
it's about 6, and about six weeks later, it's about 7.
The placebo group, you can see has a small bump down, but
then it goes back up to baseline.
And I wanna show you this graphically.
The group at the bottom, and maybe you can, is the pointer hidden?
No. The group at the bottom is
the psilocybin group.
And you can see, when they get one day before to one day after,
when they get psilocybin, their distress drops down dramatically.
And you can see that there's a big difference between the placebo group
on top in red, and the psilocybin group.
And the effect sizes there are very large.
Effect size measures the magnitude of difference between two groups.
And we found effects between 1 and 1.7, which are really huge effects.
For something to be an FDA approved medication,
you only have to have about 0.3.
So these were very large magnitude effects.
And we essentially found them for all of our outcome measures.
That the psilocybin group, the distress comes down dramatically.
And there's a difference between the two groups, at two weeks and six weeks.
What I find even more interesting, is the data for eight and a half months.
So, they get psilocybin there, and then the last point over there is eight and
a half months later.
So you can see that when they get psilocybin, even though
this was a crossover trial and both groups ended up getting the other condition,
it appears that the effect may be longer than six weeks, and
maybe on the order of more like eight and a half months.
And all of the outcome measures essentially look like this.
The group at the top, the red one, they get psilocybin over there,
one day pre-dose too.
And you can see when they get psilocybin, you start to have within group
differences, in terms of clinical distress.
We also found that psilocybin induced mystical type experiences,
versus the placebo.
And we also found the intensity of the mystical experience
was correlated with clinical Improvement.
So the other interesting thing, and I'm almost done here,
is when we asked the participants,
68% said this was the singular top five most meaningful experience of their lives.
So these were highly salient, spiritual, memorable events.
So in the end, we were able to show that we could safely administer psilocybin.
That it was an acute acting antidepressant and
anti-anxiety agent, with a large magnitude difference between the placebo,
with effects lasting for weeks, if not longer than that.
And that there were improvements in enduring positive changes in cognition,
mood, and behavior.
So, the next step would be to do a phase III trial, and a phase III
trial is gonna be very expensive, and it's gonna require 2 to 300 patients.
We're looking for funding now, but
we need to find out if the FDA is gonna move in that direction.
But if they do, it puts psilocybin, potentially to be on the path
to be rescheduled and available to be used in medicine.
Not to be able to get at a pharmacy, but to go to a psychedelic clinic and
get the treatment by psychedelic therapists.
In one more minute, I just want to talk about the future.
The future for us is doing phase III trials with suicide and cancer.
We also want to extend the treatment to care providers, like oncologists and
family members.
We're gonna do a series of studies using psilocybin to treat addiction.
We're gonna extend from alcohol into other drugs and abuse,
including behavioral addictions.
We're planning on doing LSD assisted psychotherapy trial for alcoholism.
We're gonna eventually move towards eating disorders, personality disorders,
mood disorders, post-traumatic stress disorder.
And we're gonna do studies looking at ibogaine, ketamine, and salvia.
We're close at NYU to creating a new research center
that'll have this provisional name, that'll be the first
academic center to largely focus on the use psychedelics as therapeutic agents.
And we also want to study creativity,
to see if psychedelics can enhance the creative process.
And lastly, we want to do group therapy.
And these are not necessarily within the domain of medicine,
but it'd be interesting to think about the use of these agents,
to enhance spirituality, and even conflict resolution.
I think we need some of that in the world.
So, with that, I wanna introduce Dr. Matthew Johnson.
Matt is really amazing.
He's part of the Johns Hopkins' team,
that really is the premier team that has dosed more individuals than anyone.
Matt is an associate professor of psychiatry.
And Matt is an amazing colleague.
Dr. Johnson, please come up.
>> [APPLAUSE] >> Thanks, Steve.
Can you guys hear me?
All right, I think we're good.
Wow, I really can see no one here.
This is pretty crazy.
This is maybe like being on a couch on psilocybin with those blindfolds on.
>> [LAUGH] >> Let me get just a couple things set
up here.
One thing, I'm told that my sound is set up.
[SOUND] You guys hear a ding?
[SOUND] Nice, okay good.
That's good.
All right, cool. Well, hold on.
What's this?
>> [INAUDIBLE] >> Okay, all right.
Now we're cooking.
So I wanna thank the Museum of Science for the invitation.
It's so incredible that you decided to focus on this topic.
And it's an honor to be invited, and
it's great to present with these wonderful colleagues.
And I'd like to thank all of you.
Clearly, there's a lot of interest for this.
I see all of these seats filled, so that's really awesome.
Sometimes I tell people what I do in my job, giving people drugs of various types,
and they really say, you do what for a living?
And who pays for that?
>> [LAUGH] >> And for what reason, like what?
I'll break it down a little more, what I kinda do in psychedelics, and
outside of psychedelics.
So, I'm a psychopharmacologist.
I have a PhD in experimental Psychology focusing on psychopharmacology,
that's the study of drugs that affect mind or behavior.
I've been conducting academic drug research for
18 years, I've published over 60 scientific papers,
23 specifically focused on psychedelic compounds.
I've been principal investigator for 7 NIH grants, totaling about $6 million.
I'm the Director of the Johns Hopkins Behavioral Economics and
Health Laboratory, where we use economic concepts to try to
understand the decision-making that underlies addictive disorders.
And we also use those same concepts to try to understand *** risk behavior
underlying addiction to things like ***, alcohol, and methamphetamine.
And to study a lot of drug effects, we administer drugs to people.
And so basically if you name the drug,
I've probably conducted a study administering that drug.
Or at least likely a close cousin in the same drug class, from ***, caffeine,
nicotine, tobacco, all of these different psychedelics I'll talk a little bit about.
And also develop new treatments for addiction.
So I hope you can see, I basically, I'm a drug guy.
I study drugs, all aspects of drugs, the good, the bad, everything in between.
I developed, went over that.
And finally, aside from the scientific stuff I'll let you know, clinically,
I have served as a psychedelic session guide, or a monitor in these sessions,
for over 100 sessions.
Often with extremely intense psychedelic effects, and
literally there holding a person's hand and helping them through that experience.
So first, yeah, safety.
Safety is really primary in all of the work that all of us are doing.
So several years ago, in 2008, I published with colleagues at Hopkins
a paper which really proposed guidelines for this kind of emerging field.
How do you safely conduct psychedelic research in humans?
And so, this has assisted in the approval of psychedelic studies by new scientists
and universities and
it's been cited over a hundred times in the academic literature.
Now there's two biggies, there's a lot more of this, but
there's two biggies you've got to think about with the safety of these compounds.
One, as Steve mentioned, you don't want to introduce them to everybody.
Folks who have predisposition or active psychosis, they can be harmed.
The other biggie, and this is applicable to anyone receiving a high dose of these
compounds, is the challenging experience or the so-called bad trip.
Okay, this stuff is gonna happen.
You prepare people, you build a trust with them, you work with them,
you have follow up care, so these procedures are in place.
This is the type of stuff that, it's rare but
sometimes out there in unstructured settings, people panic,
they became fearful, they'd do something stupid, and they get hurt.
Those things are squarely addressed in the type
of structured setting that we're talking about.
And as part of that structured setting,
we have, like Steve said, this isn't you're typical research lab.
A place you wouldn't mind hanging out for a day.
Okay, so some of the first studies we conducted at Johns Hopkins,
was administering psilocybin to healthy normals,
or people who didn't have a problem per se.
But we were exploring the basic effects.
And so some of the things that have come out of this couple of papers exploring
this work, is that it is indeed,
as Steve mentioned, safe to administer these in the structured type of setting.
And then remarkably, over 60% had a full mystical experience
as defined by scales that had been developed in the psychology of a religion,
that tap into that mystical type experience that Steve talked about.
And amazingly, folks rated the psilocybin
experience as among the five most meaningful experiences of their life.
And that was the majority of people in the study.
And we also documented improvements in mood and quality of life well over a year
after sessions, not just from participants but also from folks around them.
We followed up on this by very carefully looking at different doses of psilocybin.
Four different doses compared to placebo and we found that increasing
the psilocybin dose has an orderly effect on mystical experience,
challenging experiences, and long term positive attributions.
Such as what I'm showing you here is this really beautiful dose related increase
in the degree to which the percentage of people endorsing, that this experience was
among the 5 most spiritually significant events of their life.
Topping out at around close to 80% with the highest dose.
So it's really beautiful and
you really know that there's some real pharmacology underlying these effects
when you get these types of results under double-blind conditions.
And William James keeps coming up.
This is kinda like, we wore the same dress to the party.
>> [LAUGH] >> This is a nice dress to bring to
the party.
It's critical to this field.
So we've done a lot of work with the primary mystical experience.
Something we've done with that, in the context of psilocybin work is we've
developed the first validated scale to specifically assess
mystical experiences from drugs or other acute experiences.
So we just published our last paper pretty recently within the last month on this.
So we've developed these types of scales.
This is something William James was interested in over a hundred years ago,
particularly mystical-type states coming from *** or nitrous oxide.
Another paper that we published analyzed psilocybin results.
And showed, to our knowledge, this is the first experimental demonstration ever
of a laboratory experiment changing a validated personality construct.
So psilocybin increased the personality trait of openness.
Never been shown before.
And we showed it wasn't just psilocybin, specifically it was the people who had
one of the strong mystical experiences under psilocybin that drove that effect.
We also published some research showing that psilocybin can cause
temporary headaches.
Ranging from mild to moderate, typically not a problem for conducting research.
But we also think this might be a clue to understanding
how psilocybin can be a treatment for
cluster headaches, something that other researchers are exploring.
Worsening increases in headache, but kinda sometimes tinkering with the same system
in different types of people can drive the effects in different directions.
So we haven't just worked with psilocybin.
We've worked with a number of very strong hallucinogens.
And we actually conducted the first controlled human blind research
with the active agent in Salvia divinorum, very strong drug.
We had most participants at the higher doses were reported interacting
with entities that the others of us in the room couldn't see.
>> [LAUGH] >> At very powerful experiences,
this is a picture of the plant in the mountains of Oaxaca, Mexico.
A shamanist working, preparing the plant.
But you might be more familiar perhaps with Miley Cyrus who was caught
smoking a big old *** full of Salvia several years ago.
And even though I don't think she intended it, this viral video came out just a few
days after we published that first in human study.
So I really had to thank Miley Cyrus because all of a sudden,
this study that would have been completely ignored, there was like CNN and
New York Times calling us up.
>> [LAUGH] >> What the heck is this stuff,
is this even real?
She just thought it was weed and she was lying, she made up some name,
some other drug, who knows?
So another powerful hallucinogen we've worked with, Dextromethorphan.
You might know this in your over the counter cough preparation.
So kinda the take home from the few studies we've kinda conducted with this,
Dextromethorphan is very, very psychedelic.
It's very much in the range of Psilocybin experiences.
Quite intriguing.
Okay, I recently published a analysis paper with some Canadian colleagues, which
really made the argument that psychedelics represent a novel or reemerging paradigm.
And that it’s really different from standard,
psychiatric medications in a couple of ways.
This is medication-facilitated therapy.
Not just kind of an automatic pharmacological band aid.
And also, different than certain psychiatric meds, the benefits
last long after the medication has been metabolized or has left the body.
That's really unheard of, especially to the long lasting degree that we're seeing
and such as David that Steve just showed you and that I'm gonna show you.
And a little bit here.
I worked with another colleague, Mike Bogenschutz,
in a review paper that reviewed this literature, now with various substances,
that classic psychedelics could be used to treat addiction.
Really exciting, cuz it could be effective across these classes.
Not something common in addictions medicine treatment.
Let's see, this was an editorial that I published with my colleague in England,
Ben Sussa, in the British Journal of Psychiatry, respected journal.
Making the case for psychedelic treatment of addictions and
really arguing that it's critical to study these.
Given the very pretty low success rates, we have things at work that there's so
much room for improvement.
Then some of the existing therapies.
And what was really cool is that, and been really pull a coup here and that,
was able to get the journal to include on the cover that included our issue,
Alex Grey's painting of Sasha Shulgin and his wife, Ann.
If you're not familiar with Sasha Shulgin, he is a chemist who developed hundreds
of psychedelic compounds, tested them in himself, starting at minuscule doses and
working over years and decades, published in a scientific literature,
wrote these two amazing books PCAL and TCAL.
You should look into this guy.
This is a photo of the first time I met Sasha back in 2007 at his lab.
A gracious gentlemen, he passed away a little over a year ago.
He's a character you'll want to check out, if you haven't heard of him.
So, some other work in publishing.
[LAUGH] Criminal Lindsay Lohan,
you may have, she has a little bit of a history
with drug-related criminal activity.
>> It has been a really eye-opening experience and it was really intense.
Then I saw my whole life in front of me, and I had to let go of
past things that I was trying to hold onto that were dark in my life.
And physically, I felt, when I had this experience like I saw myself die.
It was insane.
I saw myself being born.
And that, I feel different ever since that.
Being okay with the wreckage of my past and letting that go, and starting fresh.
And it's just I'm in a good place,
and I don't wanna mess with that, cuz it feels good.
I'm happy.
>> Well you might believe her or not that is one individual case, but
I can tell you one thing with my colleague Peter Hendricks and others.
We analyzed some data on almost 26,000 drug-involved criminal offenders,
and found that those individuals who had a history of psychedelic use in their
lifetime were less likely to violate probation by drug and other crime.
And also found, and
this is a real kind of cincher, we found that virtually every other drug or
drug class that was represented was associated with an increased risk.
All of the other drugs with addiction potentials so we think something
very interesting going on here that needs to be looked at in the future more.
Okay, also, with my colleague Peter Hendricks at the University of
Alabama-Birmingham, we've looked at psychedelics and suicide.
And if you asked John Q Public about this topic,
they would probably assume that psychedelics increase suicidal tendencies.
But that's not what we found, we actually found the opposite.
We found that psychedelic users were less likely to have contemplated or
attempted suicide recently, and that again,
all the other drug classes tend to be associated with increased risk.
This one isn't like the others.
Okay.
So now, I'm gonna jump to our cancer data.
Steve's given you a great background on this, so
I'll just jump to our study really quickly, and our findings.
We ended up with, in our study, 51 cancer patients.
Their psychiatric disorders, about a third of them had depressive symptoms, about
a third had anxiety, and about a third had both anxiety and depression symptoms.
And half had tried medications for these things in terms of the cancer,
about two thirds had recurrent metastatic disease,
and the other third had a possibility of recurrence.
I'm just listing the types of cancers that were featured amongst the participants.
These folks had a lot to be worried about.
They were facing serious illness.
Here's our basic study design.
Everyone received two Psilocybin sessions.
Five weeks apart.
One was a very low dose.
You can ignore the 70 kilogram thing.
It's just body weight adjusted.
It's basically 1 milligram, very low dose, essentially a placebo
is what it was designed to essentially be, versus a moderately high dose.
People who had screening, we prepared them.
People are randomized to be in this group or in this group.
This group just received the high dose first, low dose later, vice versa for
this group.
There was a five week follow up after each of the sessions.
And then everyone had a six month follow up.
There were no series adverse events attributable to Psilocybin in the study,
and here are our data.
These are two gold’s standard.
Anxiety ratings.
We see that people had clinically severe ratings of anxiety at base line.
This is the high dose group so this is after the first session.
This group saw a drastic reduction in anxiety.
This other group, they've only received the low dose,
they see some improvement that's probably due to the placebo affect,
but also high level of interpersonal support we provide.
But then after the cross over, after both groups had received Hydocilicide,
then, bam, they're down at the same level.
Drastic reductions.
And then this is the, this is.
This is unbelievable.
I mean it's just like the data Steve just showed you.
You just don't see this.
Same results six months later.
We hadn't been giving them a drug for six months.
It's astonishing.
You just don't see this.
The closest thing we see is with like Ketamine, where you see a response for
a few weeks now.
And that's considered revolutionary.
And this looks to be blowing that out of the water.
Same thing with our other measure, large depression measures right here.
Two gold standard depression measures, same general pattern.
These beneficial effects are lasting.
Here, just showing you improvements in self-report ratings of well being,
quality of life, after the low dose high dose session,
then unchanged essentially after six months.
If you don't understand the correlation graphs, don't worry.
What I'm essentially showing you here is that the more mystical type the Psilocybin
experience was, the greater the reduction in anxiety.
And reduction in depression.
Okay, switching quickly to the addiction treatment work.
First, it's very important to let you know these classic psychedelics like psilocybin
are very well known not to be addictive.
They can be abused,
meaning used in a dangerous way, like most things, but they are not addictive.
But why do we think they would work?
Well there's a very strong pool of data from anthropological
evidence documenting that ceremonial psychedelic use amongst
indigenous groups is associated with addiction recovery.
And also there's this older research with using LSD to treat alcoholism.
And the well controlled randomized trials within that older literature showed
a clear beneficial effect of LSD doubling the odds of success for
alcoholic patients at their first follow up.
So, we went with smoking.
We figured it works for addiction,
why wouldn't it work for tobacco, nicotine addictions.
So we didn't have much in the way of resources so
we started with an open label.
Meaning there was no blinding, everyone knew what they were getting.
Open label study in 15 folks.
Probably don't have to tell you, but smoking is really bad.
[LAUGH] Half a million people die in the US a year,
five million worldwide attributable to smoking.
Most people, at least in the US,
who smoke want to quit, but even the best medications fail to help
the large majority of people remain smoke-free for even a year.
But I know what a few of the people in the audience are thinking, I know one or
two cats out there that love smoking
when they're tripping on one of these compounds.
Has anyone, I can't see, but has anyone known someone.
Like before, not you, your friend, some cats out there that love these.
This cat right here.
>> [LAUGH] >> Ate a quarter ounce of mushrooms,
told me she is absolutely loving it.
This is the mystical experience right here, for her.
>> [LAUGH] >> I'm joking but, in seriousness,
it's very important that this is medication facilitated therapy.
It's not surprising at all that some people, if the intention isn't there, and
the structure isn't there, you're not likely to get these types of effects.
So it's not sort of an automatic kind of direct pharmacological effect the way
some other medications may be working.
So, important thing about our study participants,
they smoked almost a pack a day.
They'd been smoking for over 30 years, these are real smokers.
It was a 15 week protocol.
We combined it with cognitive behavioral therapy,
not during the psilocybin sessions, but during the preparation and follow up.
Three psilocybin sessions over eight weeks, moderate to high doses.
First psilocybin session was on the target quit day.
Here are the data, this is a biological measure of smoking carbon monoxide.
You blow into a machine, you can't lie to that thing.
These are all a study meetings before the target quit date,
before the first psilocybin session.
This is our clinical cutoff for smoking or not.
And these, this is after psilocybin.
So this is what we teach in grad school, you don't need statistics to tell you,
you have an effect here.
>> [LAUGH] >> Yeah, and
just to show you why we're so very excited about this.
I don't want you to, take this with a grain of salt, these data are drawn from
different studies using different methods so it's really not fair.
But I just wanted to show you something to indicate why we're so excited.
Our absolute success rate is so far above what you typically see.
We think something very special's going on, we think we're onto something.
We published the results, it was widely covered in the media.
Including, I have to say, we absolutely do not encourage illicit use of anything
in any way, but I have to say, particularly, this is a lot of mushrooms.
>> [LAUGH] >> I certainly hope that nobody is,
yeah, Newsweek should have really done their homework.
I mean, I don't know if you could use the fork and
a knife after a few minutes of that.
We published another paper from that study
showing that mystical type experiences were related to success.
I think you're probably starting to see a theme here.
So related to success of the smoking cessation, say just like the personality
openness change, a change just like the cancer, anxiety, and depression.
But also for alcohol, so
Mike Bogenschuetz looked at alcohol recently in a very similar study.
Saw drastic reductions in drinking days and
heavy drinking days following moderate to high psilocybin sessions.
Is it medically realistic that a single experience causes
lasting changes in behavior.
That sounds kinda silly, right, who would buy that?
Well, a lot of, basically all of medicine would buy something very similar to that.
What about PTSD?
We know very well that a single experience or small number of experiences can change
your behavior for a lifetime and it's mediated from very real brain effects.
We think the same type of thing, not the same exact mechanisms, but
same type of thing is going on here, except a positive experience
having lasting positive changes in your behavior over time.
Okay so very quickly, psilocybin meditation.
We've been doing some work with psilocybin meditation.
I don't have time to go into these different studies that different
colleagues have published.
But there's an emerging story that similar brain changes
are occurring from both long term meditation and from acute psilocybin.
And particularly, reductions in activity
in brain areas involved with basically thinking and remembering about yourself.
So people have said for a long time that one gets things like ego loss or
they feel like ego death or they've stepped outside of their sense of self.
They've seen themselves from a broader perspective.
We think we're finally perhaps seeing a biological signature
that kind of explains this kind of more loosey-goosey kind of terminology.
So this is really exciting, so we think there's a kind of commonality, though,
between meditation effects and psilocybin effects.
So we conducted the study to see whether psilocybin,
what those effects were like with novice meditators.
Does psilocybin increase meditation engagement and
pro-social beneficial effects of meditation.
So we had 75 participants, little or no history with mediation or psychedelics,
two or three psilocybin sessions over the six, seven month study.
Three groups we varied both dose, a low trivial dose,
essentially a placebo, or a high dose.
But we also varied whether they had sort of standard support.
So, whether they got just sort of a standard six meeting kind of with staff,
kinda of support throughout the experience, including instruction for
meditation and encouragement.
Or an enhanced support condition with 26 meetings on top of the high dose.
So this essentially what we got.
We found that in terms of mystical experience, it's really about the drug.
So we got about the same level of participants endorsing a full-blown
mystical experience on the two high dose conditions regardless of support,
compared to the low dose.
But on virtually all of the other measures,
we did see an interaction where we saw some benefit, a clear benefit of dose.
But then, we saw that the extra levels support interactive with
that to show even greater benefit over time.
A measure of altruism, ratings of personal well-being, and
this is all six months later I should say, ratings of positive behavior change.
So, to wrap it up, current and future directions.
Just same thing that was Steve was describing, we're doing it together.
Developing a Phase 3 trial with the FDA.
We're running a randomized trial comparing psilocybin to nicotine patch for
smoking cessation right now.
And looking at brain imaging before and after to see what kind
of brain changes are associated with success in these trials.
We're also conducting and actually writing up the first of these internet surveys of
addiction recovery after psychedelic experience.
I've given a number of these talks where people have come up to me afterwards
saying, this happened to me ten years ago.
I stopped smoking, I stopped doing this.
Sometimes very long ago.
So, we've collected thousands of reports from people across the world at this point
reporting these things happening naturalistically.
We're running a study on long-term meditators with thousands of hours
of experience on psilocybin with brain imaging,
including when they're on psilocybin, which is really interesting.
And then as Steve mentioned also, in conjunction with
NYU running a study on psilocybin effects and religious professionals.
So I wanna thank a really large number of individuals on this, a phenomenal team.
I really just want to highlight Roland Griffiths my post doctoral mentor who I
continue to work with since 2004 and we've just done some incredible work together.
I love these guys this is an incredible effort.
Everyone has their hearts in it.
And really wanna thank the funding from a number of really courageous organizations
to back up this research.
So, thank you.
>> [APPLAUSE] >> And,
at this point, it's really my, his talk is already up here.
It's really my pleasure to introduce Dr. Charlie Grob.
So Charlie is really a, let's see, how are we, there we go.
Charlie's really been a hero in this field.
He got his doctoral degree back when essentially the rug
was being lifted out, pulled out from under all the psychedelic research.
And he's really amongst a handful of researchers who, under very difficult
circumstances, have kept this candle alive through the darkest years of the 80s and
90s, when there was really no support of any type for this type of research.
So please help me welcome Charlie Grob.
>> [APPLAUSE]
>> Thank you,
it's really a pleasure to be here today with you to talk about a topic that
I've been fascinated with for many years.
When we were preparing these presentations, Lisa asked me to talk about
how I got involved in this area.
So I guess it starts at the beginning, which is I grew up during the 60s.
I went to college in 1968 and I tell you,
it was a topic that you just could not avoid.
It was there, it was all over, it was pretty overwhelming.
And as a yet, very young, somewhat curious,
adventurous college kid you know, I felt I needed to check this out.
But I very quickly realized that taking a psychodelic
in a college dormitory room was not the ideal setting.
So I put my interests aside feeling this was not the right time,
not the right place.
A few years later, I had left college for awhile, I guess,
to find myself as many in my generation were doing.
And I traveled a lot, then I came back to New York.
I got a job at the Maimonides Medical Center.
A dream research laboratory as the research technician
who stayed up all night monitoring EEGs and recording dream reports.
And I had lots of opportunity to read.
And one of the investigators, Stanley Krippner had a tremendous
library full of everything written to date on psychedelics.
You know, tremendous collection of books and
articles in the professional literature.
And I just devoured this stuff.
Staying up all night,
reading this, monitoring the EEG, going back to my reading.
And around that time my father, he was a physician.
He was very concern about what he perserved as to my lack of direction.
So he said, son,
when you figure out what you wanna do with your life, I want you to call me.
I don't care what time of the day or night it is, I want you to call me and
tell me what you've come up with.
So one night at three in the morning,
I was reading this tremendously inspiring material.
I got it.
I knew what I wanted to do.
I wanted to study psychedelics.
He said call him any time.
>> [LAUGH] >> I called him.
And I said Dad, I figured out what I want to do.
Well, what's that son?
What do you want to do?
I said, I wanna study psychedelics.
Why is that?
I said, well, they're fascinating.
There's so much we can learn about the mind, the mind brain interface,
about mental illness.
And there are these remarkable treatment models that are effectively
treating people for whom conventional treatments are not working.
So he said, well son, there might be something to what you say, but
no one will listen to you unless you get your credentials.
So I knew at that point I needed to go back to school.
So I went back to school, went to Columbia.
Did all my pre-med.
Went on to medical school, and
in the second year of medical school we had an assignment.
Everyone in the class had to select an article from anywheres in the medical
research literature, and create a summary and present it to the class.
So I found Stanislav Grof's 1973 article in the International Journal of
on treating terminal cancer patients with LSD and DPT,
dipropyltryptamine, another serotonergic psychedelic.
And it was a remarkably moving paper.
I was just, really one of the most beautiful,
brilliant papers I had ever seen.
I put together a really good presentation.
I was very excited,
what kind of questions would they ask, what kind of discussion would we have?
I gave my presentation, I think I did a good job.
And then utter silence.
>> [LAUGH] >> This was like 1977, 78,
this was a taboo topic.
You were not allowed to talk about this.
So I kept my interest to myself.
This was the days before PubMed and the Internet.
So, every month at the beginning of the month,
I knew which day the new Index Medicus would come.
And I'd go there at the beginning of the month and
look up terms such as lysergic acid diethylamide and there was nothing,
really, aside from what was going on in the cat retina or salamander reflex.
>> [LAUGH]. >> There was nothing of much interest.
But I plugged away and as my father told me I got my credentials.
I became a psychiatrist, I became a child psychiatrist,
I stayed on in academic positions and
then I was at Johns Hopkins for a number of years.
And then I moved out west to the University of California and
I came in contact with some very, very supportive colleagues.
First and foremost Roger Walsh at UC Irvine, who I got to be friendly with and
shared with him some of my disgruntlement about mainstream psychiatry.
And he said, Charlie what would you do if you could anything?
I said, I know exactly what I'd do but I don't think it's possible,
I'd want to study psychedelics.
And he said, well you know that's a very important topic.
It's high time we got back to it.
So, with Roger and support of other colleagues,
I started to put together a series of studies, along with With my day job.
I should also add that at Harvard UCLA Medical Center, I run a large child and
adolescent psychiatry clinical training programs.
And I try, but I sit for
all of our sessions along with my co-therapist, Alicia Danforth.
There's no time during the week, so we do all of our treatments on Saturdays.
We do Sunday integrative sessions, and these are long weeks, but
very, very worthwhile.
And over the years, it's been now almost 25 years since I've been involved in this
field, I have managed to accomplish at least a few studies.
And also, I wanna also say how delighted I am to see this field take off and
to see the work that Steve at NYU and Matthew at John Hopkins are accomplishing.
And I'm telling you, the future looks very, very bright indeed.
So, I'll just present, I just brought a few slides with me.
Of course, this first slide isn't amended.
I have received support from Maps for my NDMA studies and
the Heffter Research Institute for my ayahuasca and silison work.
So ayahuasca, so in the early 1990s, I made the acquaintance
of Dennis McKenna, a ethnobotanist who has become a great friend.
And Dennis told me about connecting with a Brazilian ayahuasca church,
the Uniao de Vegetal, or the UDV, who had encouraged him to put
together a protocol to study the effects of ayahuasca in their long term members.
I should also say that the UDV received permissionl from the Brazilian government
to use ayahuasca as a psychoactive sacrament for their religious ceremonies.
And this is actually the first time since the year 395 AD,
when Alaric the Visigoth sacked Ellucis, that it has been permitted by
a governmental body that non-indigenous people had
permission to use a psychedelic for a religious purpose.
So a tremendous precedent was set.
The UDV had done remarkable work.
But they were great believers in science, and they wanted to see the science.
So along with Dennis, we developed a protocol,
went down to Brazil to study the use of ayahuasca.
Ayahuasca, for those who don't know, is a decoction of two different plants,
one containing DMT, the Psychotria viridis,
another containing harmala alkaloids in the Banisteriopsis caapi.
Neither are effective when ingested separately.
But when brewed together, it creates a very, very powerful decoction,
facilitating a four hour strongly visionary experience.
And the UDV took ayahuasca twice monthly, on the first and
third Saturday evenings of every month,
only utilized it within the context of their religious practice.
We went down there and had their full cooperation.
We went to their temple in Manaus in Amazonia and
recruited 15 long-term users of ayahuasca who were randomly selected.
And we had 15 match controls who lined up on all parameters,
except they had never been exposed to ayahuasca.
We did basic medical work-ups, psychiatric and psychological work-ups,
looking at such phenomena as nerve site function, personality testing.
And we did very, very extensive interviews with our subjects.
And we did an experimental session, where we drew bloods frequently,
blood pressure measurements to really assess for acute medical safety and
also long-term medical and psychological outcomes.
And we got some great results, we published in a variety of places
in the medical and earth sciences in the FM Botanical Literature.
It was a very, very rewarding experience.
I tell you what, one example was, we're faced with this dilemma.
Mark had alluded to it, what do you do when you go down into a remote area,
and you're studying the use of indigenous plants among the people there and
they invite you to participate in a ceremony?
Do you turn your back on them?
I thought that was rather rude, so.
>> [LAUGH] >> I didn't wanna hurt their feelings, and
I was also intensely curious to see what this would be.
So, I attended their ceremonies, and they were quite remarkable.
There was a very, very solemn, very, very disciplined,
structured, the congregation facing a few of the mastries,
singing individually their religious songs.
The mastry's giving sermons.
Dialogue between the mastries and the congregation.
For the first ceremony I attended, there was this active dialogue going back and
forth at about the three, four hour point between the mastry and the congregation,
and my Portuguese wasn't that good.
My interpreter had lapsed off into silence, so
I felt I need to understand with what this dialogue is.
It will help me better understand what are the effects of this compound.
So I asked her what they were talking about, and she said well,
what they're talking about is how important it is
when you say you'll be some place at a certain time, you be there.
And I went whoa, this is South America, not known for punctuality, I guess.
And as I interviewed our subjects and
talked with many other people, I was very impressed with their life stories.
Many of them were very, very high functioning, very successful, but
they had often started at the lower rungs of society.
And really, their involvement with this church that uses powerful
psychoactive sacrament that enhance, I think, suggestibility
really had allowed them to become far more industrious and ethical because
the precepts of the church have a lot to do with responsible behavior.
To be good parents to your children, be respectful to your parents,
be good employees, be good employers, be good to your spouse.
And it was remarkable the transformation these people had undergone.
I remember one night also, after another ceremony, after it was over,
I was looking around.
And there were these multigenerational groups kinda just,
session was over and people of the church were talking,
and their grandparents, parents, adolescent children.
And I turned to Dennis, who I was sitting next to,
and I just pointed this out to him, how remarkable this was.
It was so harmonious.
And he said to me, that's right, Charlie.
It's just like the Mormon church, only on psychedelics.
>> [LAUGH] >> So I was very impressed.
I could tell stories all night, but I know we have some time limits and
I've got other stuff to get to.
This was in the temple that they allocated.
I should point out Glockisdesu Brito as a physician,
our main Brazilian colleague who did heroic work
organizing all the logistics for us.
Glockis is very ill at this point, so sending him prayers for
health, for healing.
A remarkable man, always positive, optimistic,
who could accomplish the impossible.
As we found out Conducting a rather sophisticated study under
fairly primitive circumstances.
It's just some other, we did electrocardiograms,
we had intravenous catheters drawing bloods every 20 minutes,
looking at blood pressures and some other measures as well.
And here's Dennis sitting to my right and
Jace Callaway from the University of Cupio in Finland.
Who published a fascinating paper from our study looking at serotonin platelet
transporter up regulation, which we think is a very interesting phenomenon.
We're looking forward to that being followed up on, I should also say that
research with ayahuasca suddenly taking off, not in this country,
sadly but in Spain with Jordi Riba and Brazil.
On Tuesday, at my hospital, I invited to give our departmental grand rounds,
[FOREIGN] de Araujo from the Federal University dol Rio Grande do Norte.
Who came and talked about treating severely depressed patients
who are refractory or non-responsive to conventional treatments and
presenting some very, very impressive preliminary data.
So it's really very gratifying to see this field take off to the degree it is.
Also some interesting articles Mark showed me today just came through in
the Huffington Post looking at a punitive role for
ayahuasca in autoimmune disorder, an entirely new area opening up.
We've always looked at its role in treating psychiatric conditions,
might it have some role in treating
diseases typically relegated to the world of internal medicine.
There may be some potential and this merits some intense examination as well.
So moving on to psilocybin and
my work was supported by the Heffter Research Institute.
A group of like minded colleagues, we formed in 1993,
and we've also been involved in helping to support some of the Hopkins at NYU work.
And really without the Heffter this would not have been accomplished.
We did a study of 12, this was actually the first study of
using a psychedelic treatment model for terminal cancer anxiety,
since the late 60s, early 70s, when the final studies were shut down.
And we went to the FDA with a proposal to work with a high dose psilocybin model.
They said hold up, no one has worked in this area for many decades,
go with a more modest dose.
So we went back and forth, back and forth,
and we settled upon a moderate dose of 0.2 milogram per kilogram.
Not as high as Steve and Matt's dose, but still high enough to yield some
impressive findings, and we've published in the archives of general psychiatry.
It has the highest impact factor of all psychiatric journals.
It's gotten excellent reception by the mainstream field and again,
speaking to the mainstream I feel is really critical.
For years and years and years the community was talking to itself but
now it's time to get out there and present our work.
And we have some wonderful work, especially the Hopkins and
NYU findings to present to our colleagues far and
wide who are becoming increasingly interested in what we're doing.
We treated that 12 subjects,
curiously 11 of the 12 were women, I'm not sure I how to explain this.
We certainly screened the number of men but for
whatever the reason that it was the women who stepped up in the end to do the study.
And we got, here's our article in the archives of General Psychiatry in 2011.
The study was done between 2004 to 2008, very difficult study to recruit for.
It took a long time, many individuals who were interested were
really not well enough to come into the hospital and
to kinda go through all of the work-up we needed them to do.
My first research nurse, Mary C Haggerty was quoted in a local paper,
alternative paper as saying we're looking for healthy dying people.
>> [LAUGH] >> I don't know, so
I would also say that all of our subjects have passed on by now.
We looked at a depression inventory, we found acutely not much of an effect.
But if you looked over time,
a sustained improvement in mood that reached a significant proportion at
the six month point which, for such a small and we were surprised and
gratified to find significant, certainly a trend towards improved mood.
And the Hopkins at NYU data using a higher dose with more subjects are finding,
certainly, a stronger drug effect.
We looked at the Spielberg State Trait Anxiety Inventory,
we found the state findings, meaning what's your
anxiety right now in this moment, not to be that changed over time.
But looking at trait, very interesting,
this is how you see yourself in an ongoing manner.
And again we found a sustained improvement,
lessening of anxiety reaching significance at the one and three month periods but
sustaining for the entire six month followup.
So with this study we found I think quite positive results.
Really first and foremost we establish feasibility,
we could get all the regulatory sanctions, it took years, but we got them all.
We were able to raise a sufficient funding, we did it on a very,
very tight budget but we were able to come up with what we need.
And we were able to conduct a study safely,
no adverse outcomes, and as the icing on the cake,
we found some indication of efficacious outcome.
I'll give you one story of one of our subjects, this was a woman entirely naive.
The model was, we had them in a nice room, eye shades, headphones,
I checked in every hour to see how they were doing, do a blood pressure ask them.
But mostly I wanted them to go as deeply as possible.
This woman after the first hour nothing happened, and
second hour nothing had happened, and third hour nothing had happened.
And I'm thinking this was her second session and
all subjects were their own controls.
The order is randomized what they would get either the experimental drug or
the placebo, but they get one of each.
This is her second session.
I was fairly sure that she had gotten a placebo the first time and
I'm concerned that could the research pharmacist have made a mistake?
Could she have given me a second placebo?
Because after the three hour point, she's telling me nothing is happening.
So I told her, we went in for another hour,
four hours still, nothing was going on.
So I said to one of my residents who was working with me as a co-investigator,
I had him in charge of the music.
I said I think the music you're playing is too mellow,
don't you have anything with a little more oomph to it?
So he said well not up here but in my car I have Dead Can Dance.
A lot of dissonance, driving and intense, that's perfect, go get it.
He goes down into the parking lot, pops it in the cd player,
within minutes the floodgates had opened, she was sobbing and sobbing.
But I just let her go through her process,
assuming that she was crying about her limited life expectancy.
But when I checked in at the hour point it was nothing like that at all.
She was crying because she had a vision of her father who had passed away many years
before.
And she said she and her father loved each other very much, but
they were constricted.
They could never express themselves, so the tears were communicating with her
father, and finally expressing to him how much love and appreciation she had.
And I was very moved by that report.
We had other situations like that.
We had another report of a woman who had a powerful and
pathogenic experience to her husband.
Her life improved noticeably in her remaining time.
Became no longer a recluse, but went out, socialized more,
went to the concert which she loved.
And we really saw in a remarkable way how it impacted the course of somebody's life.
So MDMA also in the early 90's, with the support of maps,
we did the first phase one MDMA study with normal volunteers.
We treated 18 subjects each coming in for three sessions,
two different dosages of MDMA, one a placebo, the order was randomized.
We had one individual who had a very rough time.
His first session, he got very anxious,
kept telling us taking X in a hospital setting,
I'm picking up all the bad vibes in the hospital man, this is not cool.
And I said, you know, part of your agreement was to stay here all day and
all night for safety's sake, but when you leave in the morning,
you don't have to come back for follow up workup, or the two follow up sessions.
So he elected to drop out of the study.
We felt since he had dropped out,
we felt that we needed to break the blind to see how much MDMA we had given him,
and to our utter amazement, turned out to have been a placebo.
>> [LAUGH] >> So
never underestimate the power of the placebo response.
>> [LAUGH] >> There were no adverse psychological
events with MDMA.
We did have two high blood pressure reactions.
One was a telling story on a relatively high dose.
A young man who it's his third session,
so he'd had the active drug on at least one other occasion, tolerated it well.
On the third occasion,
his blood pressure jumped from 120 over 80 to over 210 over 120.
And boy, my blood pressure started to go up at that point.
We treated the blood pressure, and I said something must be different about today.
And he said yeah, there is.
I don't want to bother you with the detail, but
he tells us to get to the hospital early, because we started early in the morning.
He stayed at a friend's house who lived close to the hospital.
His friend had a cat.
He was allergic to the cat.
He developed problems with breathing, so his friend said here,
try some of my asthma medication, you'll breathe better.
So it points out to us the relative risks of adverse drug interaction,
and the dangers that young people may take or people of whatever age.
But particularly young people, who are into this whole recreational scene about
mixing drugs and mixing these kinds of drugs with
prescription medication or over-the-counter medication.
There are some potential problems that can ensue.
So we did the phase I study in the early 90s.
And then more recently, we've developed a new study.
Looking at the use of an MDMA treatment model in
adult autistics with social anxiety.
My collaborator for this study is my co-investigator, Alicia Danforth,
who I've worked with for years, and who is indispensable to my operation.
And we published a rationale, and the methodology,
and progress of neuro psycho farm and biological psychiatry.
It's impressive.
It'll be out I think very, very shortly.
I'll run you through a little bit of the structure of this.
We're not treating autism.
We're not seeking a cure for autism.
We see autism as a neurologic variant, and there is no cure per se.
But many autistics are overwhelmed and made terribly dysfunctional by their
flooding social anxiety for which there are no effective conventional treatments.
So we developed an MDMA assisted therapy model.
We are going to recruit 12 participants.
We've treated 9 so far.
That they've got to be at least 21 years or older, MDMA naive.
They are high functioning on the spectrum, with at least two years of college or
the equivalent.
It's a randomized double blinded placebo pilot study.
Subjects are randomized either into the active drug group, and
they get two sessions.
Or they're randomized into a placebo group.
And it's double-blinded, so we don't know either if they get the same
preparatory therapy, the same treatment sessions, the same integrated therapy,
the same six month follow-up.
If at the end of the sixth month, if they've hung in there with all the data
follow-up, and that we break the blind, and we find that they've been randomized
to placebo, their eligible for two open label MDMA sessions.
We are out to establish safety, feasibility.
I'll say so far, safety has been very strong, both psychologic and medical.
We are using a moderate dose.
I'd like to hang in the moderate dose end of the drugs I work with,
really to amplify safety, minimize risk.
So it ranges for 75 milligrams to 125 milligrams.
Two MDMA-assissted treatment sessions spaced a month apart.
They're preparatory and integrative sessions.
We do six month data of follow up.
I mentioned the placebo group can have an open label sessions after data follow up,
and we do various measurements during the session,blood pressure,
heart rate, temperature.
The primary outcome measure we're looking at here is a social anxiety scale,
which is administered at various top pre and post times, and
also other measures looking at depression, anxiety, stress,
self-esteem and other interesting questions, quality of life.
Also, from the biological end, we're looking at what we're
particularly interested in, the putative role of Oxytocin.
There's a lot of interest in Oxytocin in the autism research community,
but there are problems with Oxytocin.
When administered, passing beyond the blood brain barrier,
MDMA's been identified as increasing endogenous secretion of Oxytocin.
So this may be another method to get an Oxytocin effect.
This may have a role.
And so far, nine participants treated.
No serious adverse events.
And the early trends are towards positive outcomes.
So I could go on all day or all night, I should say, talking.
I could tell you more stories, but I'm sure my time is up or over.
Again, it's very gratifying to be here, to talk about this field,
to see it having grown from being shut down in its entirety by the early 70s,
to slowly, with the help of maps, and the work of Hefter,
to slowly start to build up in the 90s, into the 2000s.
And then to see the remarkable studies being done especially at Hopkins and
NYU, I have great hope for the future.
I think we are really on the cusp of this field opening up and
being acknowledged of having great importance and of great significance.
Moving on into the future and for future generation.
So, thank you today.
>> [APPLAUSE]
>> So, I think,
now it's the time I'm going to invite the other speakers to have a seat.
We're going to do a little Q and A, and
then we're going to open it up to the audience.
I was also asked to ask the first question.
So Mark, many years ago you shared with me your work on
creating an organization called The Union of Colombian Iowa Scarabs
among the indigenous people from it was a long tradition.
I'd like you to share with us the purpose of such a union and
how things have evolved with your work with that group.
>> Sure, Charlie.
I'm very excited by what I've seen here as I expect everybody is.
My first question is,
how soon can we get fluoride out of the water and put this stuff in?
>> [LAUGH] >> As somebody who's been studying and
since 1974, I thought I'd seen or heard it all.
Impotence, cancer, insomnia, acid reflux, but
any drug that can get Brazilians to be punctual is truly,
truly a miracle preparation that we need to learn more of.
The problem,
the bad news as you all know is that the forests are disappearing and the really,
really bad news is that the masters of these plants are disappearing much faster.
In the 20th Century, 90 cultures went extinct in the Brazilian Amazon, and
those are cultures we know of.
None of their ethnobotany was documented and
we can only imagine how many more disappeared in the meantime.
Now all of these substances you're showing, Salvia Divinorum,
magic mushrooms, were first learned of not by ethnobotanists from UCLA,
Harvard, Yale, Cambridge, or Oxford.
They were learned from real geniuses, which are the themselves.
So, I'm heartened by the results you guys are presenting, but
I'm very depressed by the fact that the Shamanic cultures and
Shamanic traditions are disappearing much, much faster.
There is some good news.
I run the Amazon conservation team and I got in this business thirty years ago,
thirty some odd years ago,
there were groups like the World Wildlife Fund that I started to work with,
it was all about protecting rain forests, plants and animals.
And there were groups like International Cultural Survival,
here at Harvard, devoted to focusing on these Shamanic cultures, but,
they never talked to each other.
So, when I established the Amazon Conservation Team, 20 years ago,
it was to protect rain forests, and rain forest cultures,
because you can't have rain forest cultures without rain forests, and,
I think, you can't really have rain forests without rain forest cultures.
Who have the biggest stake, material.spiritual as well
as you gentlemen have demonstrated in scientific terms.
We set up the union of Yaha healers, Umiak.
Specifically established to protect not only the plants, but
the knowledge of how to use these plants from which all virtually all this research
got it's start.
Ten years on, it's flourishing.
Not only do we have Shamans, but we have Shaman's apprentices.
Of course every time I give a lecture in Berkley,
everybody wants to sign up for the program.
>> [LAUGH] >> But
the real danger is that the cultures themselves are losing these traditions
because kids want iPads and GPS's, as all kids do.
And what we've done with set this up so that the kids who learn the healing
traditions get the iPads and the GPS's, to plot the location of these plants,
these sacred groves, and protect these cultures.
It's not the microchip or the medicine man.
The sweet spot is somewhere in between.
So, what's missing here tonight, are the Shamans.
And I challenge all of you MDs to a contest.
I wanna set up some healing trials to have you guys in your lab coats and these guys
in their *** strings with some of the same Shamans, some of the same patients,
some of the same diseases, and let's see what we can learn from each other.
Because while the results are spectacular,
there's still a lot of information that's missing.
There's still a lot of plants that aren't going in to this because we
don't know them.
And every Iowaska Shamen worth his or her salt, adds
different things to the recipe, everybody uses Iowaska, everybody uses Chekruna.
But they're sneaking some other stuff in there as well.
And I'll finish with one story.
I had some colleagues who went to Nigeria to study diabetes.
I'm Jewish.
Both my grandmothers died of diabetes, so I'm obsessed with diabetes.
And they said to the Shaman,
who was renowned for treating diabetes very effectively.
Will you give us the plants used to treat diabetes which we'll pay you for?
And, he said, sure and he gave him the three plants.
They took it back to the lab, they tried species A, it didn't work.
They tried species B, it didn't work.
They tried species C, it didn't work and then they said, eureka!
Boil them together and then they tried it.
It didn't work.
A year later they went back and talked to the Shaman.
This was a ethnobotanist and a physician, and they said, hey,
that stuff didn't work.
He said, well you tested the patient's blood sugar level.
You told me I was dropping the stuff through the floor.
And they said, well we wanna watch you make the preparation.
So he boiled up species A oiled up species B, oiled up species C.
And just as he was ready to take it out from the fire, he threw in a crab.
And he asked said wait.
What's what?
And he said, it's a crab.
>> [LAUGH] >> And
they said you didn't tell us that was part of the recipe.
And he said,
you asked me if I'd give you plants I used to make the potion and I did.
>> [LAUGH] >> [LAUGH] So we Americans, we Westerners,
wanna cut to the chase, and we're often in a hurry to get back to the lab, and
sometimes miss an important part of the potion.
So I would challenge you and all of us to expand our vision and
bring in some of these healers, and their plants and animals.
>> Which we know will be used.
And see how much of this knowledge we can capture and
learn from in a way which benefits us, which benefits you,
which benefits these people and the forest in which they live.
[APPLAUSE] So I would like to ask our
physicians on the panel if you could wave
a magic wand and cut all that red tape.
How would you start to bring this to the masses and
what diseases would you start to focus on?
>> Well one needs a lot of patience to work through this process.
I've been at it for 25 years.
It, the process is moving quicker than it did,
but we have to be very respectful of the regulatory agencies and
we have to establish good rapport, and we cannot offend them in any way whatsoever.
We also need to be very careful about safety issues in the public and
abuse liabilities and this opening up too rapidly and
people wanting to jump in and get involved in unsafe situations.
But in terms of applications, some of the strongest work from the 50's and
60's showed remarkable efficacy in treating alcoholics,
Matt and Steve are involved in such projects.
OC, obsessive compulsive disorder.
No one is looking at eating disorders,we
also talked earlier about the auto-immune disorders.
That has never been touched and these are areas longing for an application.
I think we need to recognize perhaps we've come to the limits of some of
our conventional mainstream pharmaceutical industry supported models.
That we need to look beyond Prozac and see how this treatment model,
when conducted under optimal conditions,
With optimal safety parameters in place, what might the outcomes be?
I think we might be very impressed.
>> Yeah I think it is important not to oversell the data, and
to say that this is a cure or it's gonna be the most amazing thing ever.
It's really important to follow the science.
I think I'm very excited to do the alcohol trial because the data is
the strongest there.
I'm an addiction psychiatrist, but having done the cancer related research,
there really is something interesting going on there.
In the beginning, I really thought that all of the participants of our trial had
been planted, cuz they kept saying things I didn't quite believe, that soon after
taking the psilocybin or what we thought was psilocybin, they felt so much better.
They had decreased death anxiety, their depression was better.
And it lasted for not only the next day, but weeks and then months.
I really like puzzled, like wow, this is hard to understand.
But when we did about 30 individuals, we all had a sense,
wow there's something interesting and special going on here.
And we don't have any treatments that deal with death anxiety or
existential distress.
So there seemed to be something particular about that.
And when you put all the data together between UCLA, Hopkins, and NYU,
you have 80 individuals who have been in rigorous control trials.
So I think we cannot declare that this is an effective treatment yet.
We know that we can safely do it, there's a very promising signal so far.
And if we do large-scale trial phase three trial and we show what we've shown,
then we can start to talk about the applicability and
the translatability into medicine.
But it's important to be cautious.
Researchers in the past really weren't cautious and
weren't scientific and got in trouble.
It's really important to pay attention to the history.
>> Yeah, I'd agree there's probably the most egregious example overstated claims.
I think Tim Leary said, I believe in Playboy,
that LSD would invariably give a woman 1000 orgasms [LAUGH].
So this field is filled with these incredible hyperbole, and
then folks like Leary, once he was kinda kicked out of the Academy,
then just completely having free reign and just kinda going off the rails.
We've gotta be realistic.
We have to be careful that the results aren't overwhelming.
But at the same time,
we have to effectively communicate that these results really kick ***.
These are big effects, and so we're sticking to the data, but
we do have some data.
And so we need all the other indications,
it's very compelling that you have these different addictive disorders.
And it really flies in the face of most addiction's medication that you're really
treating this higher level psychological and biological process of addiction.
You're not just quelling drug effects at one particular receptor,
like methadone or nicotine patch do.
So it's really exciting to think, we have something that is really about more
of this, I think the science of addiction doesn't really fully appreciate now,
that addiction has more to do with some of these issues that come with sessions,
like who are you in life?
What is life about?
What is this world about?
What about your relations to the people you love in life?
You know what's it all about?
What's important to you?
And those things are not addressed, or at least not addressed well,
certainly not by any of the medications that are used to treat addiction.
So at the same time we have to not overstate but there is this incredible,
there is good reason to be very excited about the potential.
So we have to kind of ride that kind of edge and make sure that
we're, yeah not going off the rails on one side or the other.
But I think, there's so many things you mentioned, eating disorders, basically,
I mean, broadly speaking I'm interested in behavior chain.
And so I mean it's like everything to do.
So many of the world's biggest problems relate to things we do.
I don't think many of our problems aren't gonna be technological solutions.
Or maybe it will be behavioral technological solutions.
We need to change our behaviors.
And I think potentially this stuff could be brought to bear to a whole
lot of things.
But we have to individually test all of them and be cautious in each step.
>> Yeah I see its application in patient populations that do not respond well to
conventional treatments.
I think that's where we should be focussed.
I also see, as alluded to, these are existential medicines.
They really address an entirely different level than conventional treatments.
And to that end, let me just ask a question about
the use of a psychedelic treatment model for alcoholism.
Talking about William James, one of, the founder of American psychology,
once said the best treatment for dipsomania, the old term for
alcoholism, the best treatment for dipsomania is religiomania.
So I'd like to ask you guys, especially Matt, who's been doing this work with
Rollin for some years now at Hopkins, looking at this spiritual dimension.
To what degree does the spiritual experience determine treatment outcome,
from your work and from the work of your predecessors back in the 60s,
like Will Panke, Stan Grof, Bill Richards?
>> It seems to be the one underlying theme that the data
keeps jumping out and telling us.
Even when we're not necessarily looking for it.
And the change in personality structure,
the success in cancer, anxiety and
depression treatment, addictions treatment.
It's really remarkable, and one concern I have in
going forward is that we appropriately kind of frame what we mean.
This is really hard by these kind of spiritual effects.
I've talked to hundreds of volunteers after sessions and sometimes,
you ask them the same type of thing.
Someone will talk about I went through every aspect of my life, and
I examined my relationships with my loved one, and what my purpose in the world is.
And you said, well, was it a spiritual experience?
Well, no, I didn't see any angels, or any gems or crystals, or
any of that, I'm not into that stuff, but wow.
You talk to the next volunteer, that says exactly the same thing, pretty much, and
it's like, and their answer is, did you not listen to what I just said?
Of course it was spiritual.
What else would you say?
So there is a huge, we have this, our society has moved,
a lot of folks have moved from this, from religious to spiritual but not religious.
But then we have you know plenty of folks that sort of in that spiritual category,
they lump a lot of woowoo and stuff they think is a bunch of baloney.
I think this stuff is most appropriately framed, and I think we need to make sure
it's framed broadly so it's meaningful to as many people as possible,
particularly when plugging into medicine.
I think these are quintessential human experiences.
This is about being a human being.
It has nothing to do with one's, I think people have different experiences.
One's world view, religious or not, can influence the nature
of the experiences and perhaps how they're described.
But I think at the heart, we're touching on elements that are meaningful to all of
us as human beings, what is our place in the world, and our connection to others.
And so I think As we, again, especially in medicine,
we need to really be careful in how our language kind of shapes.
Plenty of people might think, I'm not into that stuff.
I'm not into that stuff, but
if they're having existential crisis with cancer, I think this stuff can help them.
>> Some of the most impressive, a lot of impressive work your group has done,
but one study in particular stands out.
Which is the fact that you've demonstrated that under optimal conditions
you can pretty much reliably facilitate a mystical level experience.
And what we've learned from investigators even going back to Humphrey Osmond,
the Canadian researcher in the 50s, was that a mystical level experience seemed
to be the strongest predictor of positive outcome.
And Osmond was studying alcoholism, so your outcomes are easy to measure.
Have you established and maintained sobriety, or have you not?
And it seemed that the mystical experience was most predictive.
>> Yeah I think one of the shortcomings of our medicine,
look I think western medicine is the most sophisticated system
of healing ever devised but it's full of holes.
Where's the cure for cancer, where's the cure for depression, where's the cure for
stress?
You talk to shamans what kills white people,
the shaman told me worrying about worry, that's what kills white people, stress,
there's no cure in western medicine.
But we've compartmentalized healing, if you're sick you go to your doctor.
And if that doesn't work she sends you to the specialist.
And if that doesn't he sends you to the psychiatrist.
And if there's a spiritual component you go to the imam or the rabbi or the priest.
With a shaman it's one stop shopping.
Because they are the physician, and they are the psychiatrist,
and they are the psychopomp, the bearer of souls to the underworld.
That's why they sometimes, sometimes, sometimes can cure things that we can't.
And there's another component of healing where I've seen shamans succeed that
physicians have failed.
Here's what they told me.
If you're seven years old and you fall down and you hurt your knee, it heals.
And it stops hurting.
If you're 57 years old you fall down and you hurt your knee, it heals.
But it still hurts because your body's hanging on to that to punish you for
all the stress.
Sitting in front of the computer, sitting in front of traffic,
fighting with your spouse, fighting with your employers.
That we compensate by holding on to pain which physiologically shouldn't be there,
and shamans can release that.
So here is something they can do with these magical plants that we don't yet
understand and may never understand.
But who cares, if it works.
>> [LAUGH].
>> [COUGH] Well, sure, yeah, I think we're close.
I think we're at or beyond time, so
I think we probably should take questions now from the audience.
>> [INAUDIBLE] >> [LAUGH]
>> Folks we do ask that you limit yourself
to one question, we want to get in as many as we can.
So, thank you.
First question will be right here.
There you go.
>> My question is, I understand that you have to start with smaller studies in
well defined groups, but, what is the pathway to get to studies?
These psychedelics in, for example, treatment resistant depression or
generalized anxiety or depression itself, or et cetera, or
because those from a public health perspective are of tremendous importance.
>> Well, David Nutt's group and Robin Carhart-Harris at Imperial College
in London have recently completed a study with and treatment of major depression.
And I saw their preliminary results very recently at a meeting in Europe,
and they're very impressive.
And so I think some other groups, including ours are, and
we've been dealing with depression, but in the context of cancer.
And really, there's no reason why it shouldn't work for garden
variety, for people who are dying of cancer.
Absolutely I think this all needs to be looked at.
>> There's growing interest within the mainstream now just in the last year or
two we're hearing from numerous individual psychiatrists, psychologists,
and academic centers from around the country.
Steve is fielding a lot of calls, interested
groups want to participate in a multi-site trial of cancer anxiety.
And there's a very positive article in the New Yorker last year by Michael Pollen.
So my sense is we're right at
the threshold of this area taking off within the mainstream.
So hopefully, sooner, hopefully the pace will pick up in research in this area.
>> We have our next question over here.
>> Thank you for a wonderful program.
My name's Laura Perry Fernandez and I'm a geriatrician,
a physician who specializes in the care of frail, older patients.
And the vast majority of the patients that I see on a regular basis have dementia,
and talk about a patient population that does not respond to
conventional Western medicine, and that is full of existential crises.
Not only the patients themselves are affected by this disease, but
their caregivers face I think what is
one of the worst existential crises that you can face.
Which is the loss of a loved one while they're still alive.
I wonder if there's been any thought to the use of these particular substances in
the treatment of patients with dementia, or in their caregivers.
To help ease some of the burden, and especially to help develop
an understanding of what their loved one is going through.
And if so, it probably won't be one of the ethically trickiest studies to conduct,
but what are the plans going forward?
>> We have actually probed this area.
We have a very good colleague at Hopkins who's a dementia expert.
Who helps to run a clinic and runs clinical trials and
he's become very interested in our results.
And so we've begun discussion surrounding this.
The idea being the quality of life, what we're seeing in cancer.
And what we're learning from his is that so
much of your clinical progression has to do with,
well psychological orientation.
The idea that people who are at the same, maybe there are some memory loss but
like a lot of our cancer patients.
If they went like bound up and
obsessed and completely shut down by the fear of the future.
They actually could have like a nice life right now, like right now everything is
fine, same thing with a lot of these folks so yeah, I think it's very promising.
And maybe if we can improve that quality of life and reduce this type of
existential terror, which I could imagine could be worse than dying, the idea
that your loved ones would be treating you and you'd be like a vegetable.
I mean, this is terrifying.
So I think there's a lot of promise.
And then what you talked about with the caregivers,
this has been talked about in the older research back in the 60s.
Like, wow this would really be good for people's families too.
And so we've discussed that.
We don't have any concrete plans but
this is something certainly a number of us in the field have looked at.
And I can tell you in the cancer trial we ran,
we have seen some really transformed lives.
Like folks that really, yeah, like there are ripple effects.
People that, like a 30 year old guy with pancreatic cancer, terminal,
that just have never talked to his family at all about things.
I mean just completely things just ended up being on the table and
it just incredibly catharsis Kind of, transformation.
And then you have folks that are incredibly ill,
and their families are seeing them suffer.
And then they have this kind of experience.
And they see this one particular guy I'm thinking of in our cancer study that was
our most severely ill person in that study.
His psychological orientation his last month or
two of life really just changed his wife and his
daughter's quality of life, really I think to this day and he's long since past.
So yeah I think treatment models where we actually administer to folks,
caregivers, that's not the first thing among the priorities, but
I think that needs to be done.
>> Just like to add a caveat, that I'd be a little concerned giving psilocybin or
psychedelics to people that have neurologic injury.
I certainly would not want to give psilocybin to someone
who had frank dementia.
They'd probably get delirious.
So, we don't really know what happens when people with neurologic
illness get psychedelics.
We've had people who have had strokes before and have enormous existential
distress and want to know can they be involved in the clinical trial.
That area is gonna be very tricky.
The FDA in particular didn't want us to take brain metastases
because we just don't know exactly what will happen.
So I think we have to be careful.
They're similar to adolescent population,
I think that's probably a population that really should not be studied
at all of these agents, especially when the brain is developing.
In terms of the caregivers, cancer is really family system illness.
So it effects more than just the patient, it effects the family members and
it effects the treatment providers.
If you look at prevalence of distress scores in terms of depression and
anxiety family members have the same levels of distress.
So the next trial that we'll form at NYU is a similar design to this but
it's gonna be for family members and other care providers.
And then the other thing we're gonna do is design a trial for the oncologists,
nurse practitioners, social workers,
other people that take care of the cancer patients.
Who develop burn out and sort of lose sort of
their ability to help people over time because the illness overwhelms them.
So I think it's important to think of any serious disease,
not just treating the patient but the system of care.
>> A point.
A bit of a prediction here.
There's so much interest now with these great results.
On the other hand you have people who are desperate.
Cancer patients, dementia, all these other things that are considered incurable.
It's ripe for a lot of abuse.
It kinda reminds me as where we were 30 years ago when all these good news stories
were coming out and everybody wanted to try everything with no controls.
There's a lot of flim-flam artists who've already jumped into this.
Selling you can buy on the Internet.
Okay, and thank goodness for maps and Rick Doblin and
Charlie that kept the flame alive in a very dark period.
Now we're coming back to sort of where we were.
There's great promise and there's great potential, but
as the demand grows and we try to do this scientifically and carefully.
There's gonna be stories coming out of people who died because people
without morals, people without scruples, sold somebody something,
gave somebody something.
In the Northwest Amazon there's a code of ethics.
If you're a shaman, you can't sell medicine.
If somebody comes to you and says I have cancer, I have AIDS,
I have migraines, you can't charge them.
Now, if they treat you, you can give them a chicken.
You can give them a car.
You can give them lots of money.
But you cannot charge up front.
Unfortunately, that's the exception rather than the rule.
And that's where the abuse comes in.
And I think it's gonna get worse before it gets better.
>> Here >> Hi, thank you so much.
So I know a women that had,
well a girl that had severely mitochondrial disease, autism,
she had dental procedure, and afterwards for a period of time was rather normal.
Also, my young son when he was about two after a dental thing,
he was barely talking at the time.
And afterwards, he explained a very hallucinogenic experience, flying and
all that and really, really talking a lot.
So many words came out.
And I just wonder if there's any kinda.
I don't know if this has anything to do with what you do.
But you reminded me of it when you were talking.
And it certainly is something about the brain.
>> Yeah, you're probably talking about the receipt of nitrous oxide.
In fact, William James wrote his variety of religious experience and
it wasn't just his intellect, he was a user of nitrous oxide.
Nitrous oxide is a potent NMDA antagonist similar to ketamine and
dextromethorphan and ***, so it's a very potent, short acting hallucigen.
And so it's possible that these individuals had some psychedelic or
mystical experience or some kind of other biologic change that may have had
beneficial therapeutic effects.
But if it was, it was most certainly nitrous oxide.
Dentists have done a lot of research with nitrous oxide showing it's an anesthetic,
but not much as a therapeutic agent.
With as terms of psychedelic properties.
>> [INAUDIBLE] >> There is
a lot of interest now in using ketamine to treat a variety of psychiatric disorders.
To my knowledge, it's never been applied to the autism spectrum,
but maybe at some point.
I don't know.
But that's interesting information you provide.
>> [INAUDIBLE] >> We have the next question right
over here.
>> Thank you.
This is actually a question about the Shamanic cultures.
And it's a question about the diversity or lack there of of them,
particularly in light of your comment that they're gradually disappearing.
How in your experience, similar or
different how much overlap is there among traditions?
Are they all a variety of romance languages or is one just speaking Chinese,
one speaking German, and one peaking Finnish?
>> It's a problem and here's why.
Because diversity is greater than we ever imagined.
We all read about the Chinese lady that won the Nobel prize for
her work on antimalarial.
Well, the good news there is that the Chinese not only invented medicine about
four thousand years ago, they also invented writing at the same time.
So that stuff is never gonna be lost.
I did a lot of my work with the trio's but I met a man from the Sakana tribe,
two tribes over in the North East Amazon and
they said, he's the Shayman, he's the Paramount Shayman.
I spent 12 years trying them to get me teach this stuff and they said,
I'm not Shayman they're just pulling your leg.
12 Years go by.
I'm working on skin diseases.
I pull out a dermatology textbook and
I'm sitting there with all the great Trios Shayman's.
Now Trio Shaymans, if they know a disease, first and foremost they have a name for
the disease in their language.
They'll have five or six or seven plants to treat it.
I'm sitting there with the trios, I'm going through this and
in walks a Sakana guy.
And he's got this big old smirk on his face.
And I said, what are you smirking at?
He says, I know that disease.
And I said, do you have a name for it in your language?
He goes, yeah, we call it mutaiga.
And I said, you know how to treat it?
He says, sure.
I said, how would you treat it.
He says, well, I'd use this plant, or this one, or this one, or this one, or
this one, or this one, or this one.
This one, this one, this one, this one, this one.
18 plants, it's three times what
the Trio Shaman's using, and I said, how do you know so much?
And he said, because I'm the Paramount Shaman.
And, I said, so why did you spend 12 years telling me you weren't?
And, I'll never forget this as long as I live.
He pressed his nose up against mine, gave me this evil smile and
said, I was just pulling your leg.
>> [APPLAUSE] >> Okay, I don't know about you guys, but
I've never played a practical joke where it took me over a decade to deliver
the punchline.
>> [LAUGH] >> This is what ethnobotinsts call Indian
time you can't do it in a hurry So here's the answer to your question.
I said, give me a workup.
He took my pulse and he looked at my tongue.
That's Chinese medicine.
That's never been reported from the Amazon.
He's dead now.
Nobody had ever documented medicine before or
after, but thanks to our Shaman's Apprentice program.
I found him two apprentices and it's all written down.
So, when people ask about Shamans in the Amazon, it ain't all the same thing, okay?
In the Northwest they are Ayahuasca Healers,
in the Southeast they are Tobacco Healers, in the Northeast they are Plant Wizards.
And that's just the tip of iceberg because we haven't worked with every tribe,
systematically.
Hence the importance of Shaman's Apprentice work
where the Shamans are passing the knowledge down to their sons and
daughters and grandsons and granddaughters.
Because they'll never teach white people, or black people,
or yellow people as much as they'll teach their own kids and grandkids.
So the good news is we have a sense of how much is out there.
The bad news is we're loosing is faster than we can write it all down.
So, when people talk about Amazonian chainments,
it ain't one system of Amazon, very clearly.
>> Next question here.
>> Hi guys. Thanks for everything tonight.
I noticed in a lot of these trials, there's often a screening for
psychotic disorders and I think that's a group that's
often enough comes up against existential issues and things like that.
So, I guess I wonder why that often happens and
if there's any hope for these medications for that group?
>> So, the question is the use of psychedelics in patients that have
psychotic spectrum almost like schizophrenia
when LSD was first available common story is someone would go to college take it for
the first time, their 18, 19 year old male, let's say.
And then they would become psychotic and they wouldn't stop and they would remain
psychotic and people erroneously concluded that LSD caused schizophrenia.
But it really unmasked it.
So there's people who were predisposed to psychosis that drugs like LSD,
marijuana can do it as well, amphetamines or
other drugs that can occasion the first onset of schizophrenia.
And if you develop it early, you have a worse prognosis.
So, we know that the serotonergic hallucinogens definitely reproduce
positive symptoms of psychosis without a doubt, and so people who are predisposed
to psychosis, or who have psychosis, these drugs are toxic to them.
Now, I've met people that say, well you know, psychosis is kinda spiritual malady,
so can't psychedelics help them with their spiritual malady, and to integrate it.
But I work at Bellevue Hospital, and we see psychosis all day long, and
these are people that are way too opened up to begin.
And they're the last group that should ever get psychedelics, in my opinion.
>> We have a next question over here.
[SOUND] >> Well, first off, thank you.
My question is, how do people get involved in this?
In just, as a career?
>> [LAUGH] >> I got into it because of Charlie.
>> [LAUGH] >> My dad told me I had to get my
credentials.
>> [LAUGH] >> So I'm telling the same to you.
Get your credentials and be patient and make contacts and do it by the book.
Do it formally through the mainstream, because if real change is gonna happen,
it's gonna have to come from within the mainstream.
>> And I would add to that, it's really consistent with being within
the mainstream, is that develop expertise in something that's completely
complementary, but you're not gonna, maybe you'll be lucky but
you're probably not in the next decade or so gonna get a job.
I wanna be a psychedelic therapist.
That's what I wanna do.
I'm gonna be a psychedelic psychiatrist.
I'm gonna be a, yeah.
Develop expertise in something else that fits with it.
Like whatever disorder you're maybe helping to treat, you know?
So addiction, develop expertise in addiction.
Develop expertise in Oncology,
psychiatric oncology, whatever it is become a physician,
become an experimental psychologist, become a clinical psychologist.
And have a mainstream interest within those areas that can intersect
with your interest in psychedelics.
>> Next question here.
>> My mentor Schultese told me, he said look, let's face it.
These guys in strings know a lot more about plants and
healing than we ever will.
But if you want to be a scientist you need to get those three letters, PhD or
those two letters MD at the end of your name, so people will listen to you.
He says, through the course of your career you will meet somebody who will tell you
three times in the first conversation they never got their PhD and
they never regretted it.
This isn't the first conversation you've had with them.
So, you want to get those credentials and
from there that's the start not the finish, of the work.
>> Next question here.
>> Thank you guys for doing this.
This is really interesting.
I think my question's mostly pointed at Dr. Plotkin.
You mentioned that the Shaman are not really traditional.
And they're more interested in not really Western medicine.
Do you think that this type of treatment would be a better avenue to
maybe look at the doctors of osteopathic medicine,
who look at the whole system instead of a traditional MD?
Do you think that would maybe help you in actually
making this a treatment instead of just a theory?
>> Where it's difficult is deciding where to go.
Because, if I'm in an automobile accident,
I don't want to go to a nutrition therapist, right?
But if I have a sleep disorder, I don't want to go to a doctor.
So you got to know who's good at what.
Part of my frustration is all systems of healing do something well.
30 years ago when acupuncture came on the scene.
People saying, sticking needles in people, that's not science.
Well, I still don't understand but I go to an acupuncturist on occasion.
If Chinese medicine didn't work, how come there's so damn many of them?
>> [LAUGH] >> Right?
Same thing with Ayurvedic medicine.
All systems of medicine do something well and
it's deciding what system of medicine you should go to for what.
I'm an advantage, because I know the best Shamans and I can go to them.
But there's not many people that have access to these people.
At the same time, I'm gladdened by these hard-*** MDs saying the same thing I am.
Some of this stuff works.
We need to learn more of it.
The medical office of the future, if we get it right, is gonna have an MD
and a psychiatrist and a Shaman and an acupuncturist and
nutrition therapist and a music therapist and a pet therapist.
And you're gonna able to go to whatever one meets your needs.
But, the race is on from my side, because of the disappearance of the forest and
the Shamans.
In the meantime, I have access to these people and
I have seen stuff that would curl your tail.
But, often, scientists and physicians say, well that's not science, n equals one.
That doesn't prove anything.
And my response is you don't understand science,
cuz science begins with a hypothesis, n equals one is where you start.
But, again, we're burning the candle at both ends when the forests and
the cultures are disappearing.
How frustrating for me to see these guys cure stuff that we cannot.
How uplifting to hear from these guys that they see it and they get it and
they've got the data to back it up.
But we live in a crazy world where opportunities are presented as
never before, but destruction is happening faster than ever before.
>> We have our last question over here actually, so no pressure.
>> [LAUGH] >> Well,
I guess I have to make this a good one.
Thank you all very much for a very informative evening.
I had a great discussion.
I work in emergency department at a local hospital, so
were sort of on the business end of substance abuse coming through the door.
One of the big frustrations on our side, is that it seems more like a revolving
door in that we have a huge lack of inpatient treatment beds and even when our
patients do go there, oftentimes they're out very quickly and right back with us.
So much so that we know them by name.
I'm not suggesting that we dose patients with psychedelics while they're in
the hallway in the emergency department, but I'm wondering if there's any role for
that type of therapy in that vulnerable moment when they're with us and
we sort of have their attention.
>> The lead investigator at NYU of a trial
that's a partnership between our department and the emergency department.
You know, ketamine has received a lot of attention as acute acting
antidepressant but it's used in the ED a lot more than it's used anywhere
else as a schedule three drug.
So, we designed a trial, a controlled trial,
using single dose IV ketamine vs placebo in the ED setting.
So these are people that come in to the emergency department, and
the decision is made to admit them in patient psychiatric,
and they get one dose of ketamine IV push versus placebo.
They're admitted upstairs and we're measuring depression is and
length of hospitalization you know in ECT psychiatric units,
I think in the future and we actually have permission now to give the academy both in
the ED setting and in the in-patient psychiatric setting.
I think in the future you're gonna want a pharmacologic ECT available.
You'd have to be careful if you deliver it in the ED settings.
Someone comes in depressed, suicidal, you give them a treatment,
they get better they're not suicidal they leave.
And a couple of hours or days later, comes back and they kill themselves.
So you have to be careful what administer in that setting and the kind of follow-up.
And we have pretty poor follow-up in the communities and mental health so
it's an issue.
The ED setting is a place that ED physicians that are psychiatrically minded
you can treat depression, suicidality, addiction in those settings.
>> I'll just add something to that.
My impression is that many of these repeat you know,
customers, if you will, you have some personality disorder going on there.
And something that I think we don't know a whole lot about but
anecdotally I think we need to figure more out about it, but
from hundreds of psilocybin sessions at Hopkins I would, our impression is that.
Folks that are along, sort of, a boarder line, of histrionic disorder and
these are not things that are easy to diagnose.
You know, it takes a long time to get to know someone.
Folks of that nature, so, many of the people have,
you know boarder line tendencies or, you know, repeat customers at the.
Our impression is that those folks don't need.
Psychedelics.
That, in a sense, these are folks that are kinda
addicted to drama, and
given that, there's a lot of drama.
It's been called things, informally, like ego-inflation, things like this.
So, it may be that some of the folks you're talking about are actually I think
what we're starting to wonder is there a personality type that really shouldn't
receive these compounds.
And it's not as black and white as these psychotic disorders that Steve was talking
about but anyway folks that are you know really gets,
you know they see their therapist and they really get off on the kind of.
The kind of relationship with the therapist and
the attention and that can suck a lot of clinical time, so, anyway.
>> I would just add one thing to that.
I think there are certain personality disorders that could be helped,
you see these data increases in altruism,
you see increases in pathic residence with M.D.M.A. so, psychiatric disorders,
personality disorders have core deficits in that like anti social personality and
narcissistic personality which we have very poor grievance for and
certainly no pharmacological treatments.
I think it's worth pursuing those personality disorders.
Borderline personality disorder, I agree, is not a great target.
>> [INAUDIBLE] [SOUND] Let me just say one last thing here.
And that is to thank the Museum of Science.
I grew up in zoos and botanical gardens.
I work my way through college in a museum, and
we're continuously assaulted with the message well in the age of the internet,
museum, zoos, and botanical gardens don't have thier day.
And my response is one word, ***.
>> [LAUGH] >> Okay?
None of this would have happened tonight if it wasn't for the museum.
And all of this stuff that we talked about is available on the Internet,
but here you are.
So I know I can't wait to get back and read all these papers as a backup.
>> [LAUGH] >> So, I want to challenge everybody here.
To join The Museum of Science, if you're not a member already.
And if you are, buy somebody a guest membership.
And I want to encourage everybody to look more into this,
because nobody's here because they're not fascinated by the topic.
And I'm assuming you're leaving here more fascinated by it than you were
when you came in.
I, for one, am for sure.
I work for the Amazon conservation team.
If your interested in the conservation aspects of this,
look us up, because we are part of this equation.
We wanna bring this stuff to the lab, to the pharmacy.
We also wanna make sure there's stuff going into the system, with these forests,
and this knowledge.
And like the shamans always say, it's all connected.
Thanks again.
[APPLAUSE] >> So I wanna thank everybody for
coming out.
We, that was just amazingly wonders conversation and
adaptive information that you guys have I don't know about you all out there,
but I mean I feel like I've almost had a mystical experience.
And if not, it was a very special one.
I mean, the idea of increasing the quality of life, of increasing people's openness.
The idea of A good death.
I mean, psychedelic group therapy?
sign me up.
And, conflict resolution?
I mean, I think there's hope for all of us, even Capitol Hill.
Especially, if we can take control of the water system.
So, anyway, I hope you all will join us.
This is part of our on being human series.
And so I hope you'll come back and join us again.
Thanks again for coming out.
Goodnight. >> [APPLAUSE]