PT572 – The Potential of Buprenorphine, the Risks of Ketamine, and How Psychedelics Could Prevent Nuclear War, with Howard Kornfeld, MD
Dec 10, 2024
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Howard Kornfeld, a renowned pain medicine expert and addiction specialist, discusses the promise of buprenorphine as a treatment for both addiction and chronic pain, comparing it to MDMA. He shares insights on the historical context and potential of ketamine, while also warning about its risks. Kornfeld provocatively connects psychedelics to nuclear disarmament, citing their ability to change minds and promote peace. The conversation emphasizes the need for innovative research and responsible use of psychedelics in addressing global challenges.
Dr. Kornfeld highlights buprenorphine's journey from stigma to FDA approval as a crucial analogy for advocating MDMA's therapeutic potential for PTSD.
The podcast delves into ketamine's rise as an effective treatment for mental health, while addressing concerns about its potential for misuse and dependency.
Kornfeld connects psychedelics with anti-nuclear activism, suggesting these substances might foster dialogue and healing amid escalating global tensions.
Deep dives
The Role of Psychedelics in Addressing Global Issues
Psychedelics are increasingly seen as potential tools for addressing major global challenges, including nuclear tensions and mental health crises. Dr. Howard Kornfeld discusses the historical context of psychedelics alongside anti-nuclear activism, drawing parallels to movements that seek dialogue and healing in today's politically charged environment. The conversation highlights a significant shift in societal attitudes towards psychedelics, which were once stigmatized but are now being recognized for their therapeutic potential. This evolving perception reflects a hope that these substances could foster peace and well-being amid escalating global threats.
The Lessons from Buprenorphine for MDMA Approval
Dr. Kornfeld provides insight into the development and societal acceptance of buprenorphine as a treatment for opioid addiction, comparing its journey to that of MDMA. Both substances are recognized as controlled and potentially addictive, but they offer significant benefits for serious health conditions. Buprenorphine faced initial barriers due to stigma surrounding addiction, yet it ultimately received FDA approval based on its potential to reduce fatalities. This experience serves as a crucial analogy for advocating MDMA's potential for treating PTSD, emphasizing the need for similar diligence and understanding in regulatory processes.
Exploring the Ketamine Phenomenon
Ketamine has gained prominence as both a psychiatric intervention and a treatment for chronic pain, marking a paradigm shift in the approach to mental health. Initially used in emergency and surgical settings, its ability to provide rapid relief from severe depression and suicidal ideation catalyzed the rise of ketamine clinics across the country. However, with its increasing popularity, concerns regarding ketamine use disorder have emerged, highlighting the delicate balance between beneficial and harmful use. Dr. Kornfeld stresses the importance of responsible prescribing practices and further research to understand ketamine's long-term effects.
Navigating the Complexities of Research and Regulation
The approval process for psychedelic substances like MDMA involves navigating complex scientific and regulatory landscapes, which can be influenced by societal perceptions. Dr. Kornfeld discusses how traditional clinical trial designs may not be well-suited for studying psychedelics, suggesting alternative methodologies to evaluate their safety and efficacy. He draws attention to the variations in regulatory progress across different countries, noting that many states may soon consider their own legislation to facilitate the compassionate use of psychedelics. The aim is to establish a balanced approach that prioritizes both patient safety and access to innovative therapies.
The Intersection of Psychedelics and Activism
Dr. Kornfeld's commitment to activism extends beyond the realm of psychedelics; he actively participates in initiatives aimed at reducing nuclear risks and promoting peace. He reflects on the historical connections between psychedelic use and social movements, revealing a potential role for altered states of consciousness in fostering unity and transformation. Kornfeld envisions a future where the principles of healing inherent in psychedelic therapies can influence broader societal issues outside mental health. This narrative emphasizes the importance of recognizing the interconnectedness of personal healing and global peace.
In this episode, Joe interviews Howard Kornfeld, MD: renowned pain medicine expert, addiction specialist, early pioneer in psychedelic medicine, and currently the director of recovery medicine at Recovery Without Walls.
As a leader in the utilization of buprenorphine, he talks about how it came about as a treatment for addiction and chronic pain, its similarities to MDMA, and how its fast-tracked FDA approval could give us clues on how to get MDMA approved. He also dives into the history of ketamine, its unique effects compared to other substances, its potential for abuse, and what can happen with overuse. And he talks a lot about the connection he sees between psychedelics and the prevention of nuclear war, inspired by Sasha Shulgin’s opinion that nothing changes minds faster than psychedelics. He points out that when there is darkness, there is light: Albert Hofmann’s famed bicycle trip on acid happened 3 months after the nuclear chain reaction was invented. Can the growing use of psychedelics inspire the kind of change we need to save the world?
He also discusses:
The need for new study designs as we come to terms with the fact that double-blind studies don’t really work with psychedelics
Criticisms of the FDA’s denial of MDMA: Was the process unfair?
His predictions that advocates will begin pushing to decriminalize MDMA at the state level
The books, Tripping on Utopia and Drugged
How he played a part in prisons ending the practice of killing prisoners with cyanide gas
