Psychedelic Medicine Podcast with Dr. Lynn Marie Morski

Lynn Marie Morski, MD, JD
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May 24, 2023 • 39min

Considerations for Safety When Working with 5-MeO-DMT with Joël Brierre

In this episode of the Psychedelic Medicine Podcast, Joël Brierre joins to discuss the important topic of safety when working with 5-MeO-DMT. Joël is the founder and CEO Tandava Retreats and co-founder of the 5-MeO-DMT education and training platform F.I.V.E. Joël and his team are focused on shepherding 5-MeO into the world in a safe and effective manner. In this conversation, Joël shares his expertise on the screening that should be done prior to 5-MeO-DMT experiences, discussing both physical and psychological considerations. He also talks about synthetic 5-MeO-DMT vs the extract from the Bufo alvarius toad and explains why his retreat center only uses the synthetic version. In closing, he discusses the nuances around drug-drug interactions and how he navigates these with participants, exploring the nuances of the pharmacology involved. In this episode: What inspired Joël to start F.I.V.E. The physical medical considerations when screening patients for 5-MeO-DMT Why it is theorized that 5-MeO-DMT could trigger conditions like multiple sclerosis to recur Psychological red flags for people seeking 5-MeO-DMT experiences Joël's thoughts on navigating psychedelic narcissism Safety considerations working with patients with significant trauma Determining the dosage of 5-MeO-DMT and why Joël thinks there's a lot of value in lower doses Alternative routes of administration for 5-MeO-DMT other than smoking Quotes: "It's very important to us that [5-MeO-DMT] is shepherded out into the world in a safe and effective way, with a good understanding of how it can go wrong—because another bad headline can really harm the progress that it has seen." [7:14] "Where we used to feel you really had to work your way up to 5[MeO-DMT], we found with the right amount of prep and with a good individualized approach it's right for anyone—as long as they're in the right place for it. So if they make it through the screening and intake process, we're good to go." [23:09] "There's no need to turn it into a goal-oriented thing where [the participant] needs to get to a full release. We see plenty of full resolutions happen where we never even have to take a participant to a mystical experience." [29:43] Links: Tandava Retreats website F.I.V.E. website Previous episode: How to Choose a Psychedelic Facilitator or Retreat Center with Joël Brierre Previous episode: Navigating Psychedelic Narcissism with Adam Aronovich Psychedelic Medicine Association Porangui
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May 10, 2023 • 42min

The Role of Peer Support in the Psychedelic Ecosystem with Joshua White, JD

In this episode of the Psychedelic Medicine Podcast, Joshua White returns to discuss the role of peer support in the psychedelic ecosystem. Joshua (he/him) is founder and executive director of Fireside Project and has prior experience as a volunteer counselor on a hotline and as a volunteer at the Zendo Project. He has also practiced law as a deputy city attorney at the San Francisco City Attorney's Office, where he focused on suing business exploiting vulnerable communities. He also co-taught a nationally-renowned clinic at Yale Law School. In this conversation, Joshua shares updates from the first two years of Fireside Project, the psychedelic peer support hotline. He mentions that the hotline has grown nearly 1,000% since their first month, with the number receiving 1,500 calls this past month. Joshua also discusses the intricacies of peer support, sharing why he thinks this form of support is particularly well-suited to psychedelic experiences and how he understands the relationship between psychotherapy and peer support. In closing, Joshua reminds listeners that Fireside Project is available to take calls from anyone working through a psychedelic experience—whether they are in the midst of an altered state of mind or seeking to integrate a past experience. In this episode: When to call the psychedelic peer support hotline The history of peer support and when it may be helpful Why Joshua believes its important for peer support volunteers to have had their own psychedelic experiences The ways peer support and psychotherapy differ The limits of peer support How peer support is similar to the methods used in MDMA-assisted therapy Critiques of peer support Joshua has heard and his responses The relationship between peer support and theoretical frameworks in psychotherapy Quotes: "In non-psychedelic peer support, often the peer-ness starts with a pathology—alcohol use disorder, tobacco use disorder, etc. Psychedelic peer support, the idea is that having had a psychedelic experience by itself is the layer of peer-ness that's needed to go deeper with someone regardless of other aspects of your identity you may have." [8:55] "One of the, I think, key parts of peer support is that we don't interpret a caller's experience for them. We are present with them so that they can interpret their experience and we can create a safe and non-judgmental space for them to engage in that kind of interpretation." [18:32] "I think especially with an experience as vast as the type that can be precipitated by psychedelics, having multiple forms of support is essential." [22:23] Links: Fireside Project website Fireside Project on Instagram Fireside Project on Twitter Previous episode: Insights Gained from the First Year of Fireside Project with Joshua White Previous episode: Fireside Project: The World's First Psychedelic Hotline with Joshua White and Hanifa Nayo Washington Psychedelic Medicine Association Porangui
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Apr 19, 2023 • 36min

Group Ketamine Assisted Psychotherapy for Frontline Healthcare Workers with Hannah Cross, LCSW

In this episode of the Psychedelic Medicine Podcast, Hannah Cross, LCSW joins to discuss group ketamine assisted psychotherapy for frontline healthcare workers. Hannah is a licensed clinical social worker and therapist who specializes in trauma healing and psychedelic integration, including work on LSD and psilocybin clinical trials. In this conversation, Hannah shares details from the study exploring group ketamine therapy in a cohort of ten frontline healthcare workers, discussing the study design, the intricacies of group therapy, and the specific dosing protocol and therapy regimen for the patients. She reveals the very promising results of this early study and also shares a number of emotional stories of transformation from the patients. In closing, Hannah discusses the early indicators of the durability of positive effects from this kind of ketamine assisted therapy and lists a number of additional on-going and upcoming studies of group ketamine treatments for other populations. In this episode: The inspiration for this ketamine study How the frontline healthcare workers in the study were chosen What makes a person a good candidate for group therapy The protocol for the ketamine assisted therapy used in the study Why the therapy began with a low, sublingual dose of ketamine How psychotherapy was integrated with ketamine treatments in this study The reductions in PTSD, depression, and anxiety that resulted from the ketamine assisted therapy Why Hannah sometimes sees an increase in anxiety towards the beginning of the therapeutic process Quotes: "Ketamine can help people access more of that self-healing energy and when that's present in a group setting and people are essentially able to shine this healing energy on each other, there's this exponential healing I think can happen." [7:16] "When you wrap a ketamine experience up in experienced and effective therapy, there is this safety in the container that really allows people to have the inward focused journey under ketamine for that forty-five minutes to an hour." [20:03] Links: Full study: Ketamine-Assisted Group Psychotherapy for Frontline Healthcare Workers with COVID-19-Related Burnout and PTSD: A Case Series of Effectiveness/Safety for 10 Participants Numinus website Group ketamine assisted therapy by Numinus Hannah's private practice, Wild Sunflower Counseling Cedar Psychiatry website Psychedelic Medicine Association Porangui
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Apr 5, 2023 • 29min

Addressing the Stress of Life Transitions through Ketamine Therapy with Arsalan Azam, MD

In this episode of the Psychedelic Medicine Podcast, Dr. Arsalan Azam joins to discuss the potential of ketamine therapy for helping to address the stress of major life transitions. Dr. Azam is a board-certified Emergency Medicine physician and medical director of Daydream MD. He attended medical school as a Dean's Scholar at Case Western Medical School and completed his clinical rotations at the Cleveland Clinic. He has also worked as an emergency medicine physician around the country, including as a relief physician for hospitals impacted by staffing shortages. In this conversation, Dr. Azam shares patient experiences from his own ketamine practice and discusses the complexities of different approaches to ketamine treatment and different indications, including how some individuals may benefit especially from ketamine assisted therapy, while others may be well served by stand-alone ketamine infusions, especially considering the cost differential of these treatments. Additionally, Dr. Azam explores the role integration and peer support can play in the context of ketamine treatments, mentioning these may be less cost-prohibitive ways for patients to get the most out of their experiences. In this episode: The kinds of life transitions ketamine is helpful with in Dr. Azam's experience What kinds of patients Dr. Azam's practice serves The unique mechanism of ketamine Leveraging ketamine treatment to navigate breakups or professional transitions Ketamine assisted psychotherapy vs stand-alone ketamine infusions, and when having the extra support of therapy may be especially beneficial The role of integration and peer support in ketamine treatments The research into ketamine treatment for suicidal ideation How Dr. Azam sets up treatment programs for different kinds of patients Quotes: "The magic of this neurobiology is that, unlike our existing tools which take weeks to kick in often, this one works within hours. And so it really becomes more of a rescue medication or a supportive medication for these transitions of life that works quickly." [8:32] "Think of our mind and our mental patterns as a piece of cold steel—and it's kind of locked in that structure, in that pattern. Psychedelics, like ketamine and others, can heat that steel up, and make it much more moldable and then when it cools back down it'll maintain a persistent new structure. So ketamine assisted therapy is a tool that helps us leverage that hot piece of steel to mold it into something else." [11:56] "Ketamine works very quickly to reduce suicidal thinking and its degree of effect directly corresponds to the degree of symptoms. So someone who has really severe suicidality is more likely to experience a response to ketamine and is more likely to experience a significant response to ketamine." [18:36] Links: Daydream MD website Daydream MD on Instagram Fireside Project website Psychedelic Medicine Association Porangui
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Mar 22, 2023 • 50min

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

In this episode of the Psychedelic Medicine Podcast, Ben Malcolm, PharmD joins to discuss the research surrounding the intersection of psychedelics with pregnancy and nursing. Dr. Malcolm is a psychopharmacology consultant, psychedelic educator, founder of Spirit Pharmacist, LLC and a board member of the Psychedelic Medicine Association. Dr. Malcolm recently wrote an overview article on the existing research into psychedelics, pregnancy and breastfeeding. In this conversation, Dr. Malcolm shares the current state of research that he explored in his article, highlighting the few points where data does exist while emphasizing that there are still major unknowns. Overall, Dr. Malcolm describes how most are very conservative when it comes to psychedelic use while nursing or pregnant, though pregnancy seems to present more concerns than nursing. Dr. Malcolm also discusses ketamine and the interesting findings in patients who were given this substance as an anesthetic for cesarean sections. In conclusion, Dr. Malcolm suggests moving beyond a black and white perspective on this topic, emphasizing that there are also opportunity costs to not pursuing healing. However, in this area especially, more research is needed before clear guidelines can be developed. In this episode: The lack of treatment options for postpartum depression Why it is likely for a fetus or infant to be exposed to psychedelics if a mother ingests them while pregnant or nursing Psychedelics and the developing brain Ritual use of ayahuasca and mushrooms among pregnant women in traditional ceremonial contexts The research into negative impacts of ecstasy use during pregnancy and the variables that confound the results The unknowns about microdosing while nursing The research into whether LSD is a teratogen The effects of psychedelics on hormones Pregnancy as an aspect of set and setting Quotes: "Psychoactive drugs or psychotropic drugs typically end up in breastmilk more than other types of substances because they are usually more fat-soluble. Usually to get into brain tissue they have to be a little more fat-soluble than drugs that act in the periphery." [10:15] "In the nursing period I think that there's more potential to use psychedelics safely and without really taking much risk as far as exposing the [child], whereas in pregnancy, yeah, you just don't really have that choice—the fetus is going to be exposed." [24:42] Links: Dr. Malcolm's recent article: "Psychedelics, Pregnancy, and Breastfeeding" Spirit Pharmacist website Spirit Pharmacist on Facebook Spirit Pharmacist on Instagram Spirit Pharmacist on YouTube Psychedelic Medicine Association Porangui
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Mar 8, 2023 • 43min

Encore episode: Psychedelics and Women's Health with Allison Feduccia, PhD

In this episode of the psychedelic medicine podcast, Allison Feduccia, PhD joins to discuss the intersection of psychedelic medicine and women's health. Dr. Feduccia is a neuropharmacologist, psychedelic researcher, and builder of virtual and in-person communities. She is cofounder of two prominent organizations, psychedelic.support and Project New Day, and is additionally a scientific advisor for Eastra. Alli has been researching psychedelics since 2004 when she first began studying MDMA and has subsequently been involved in the field through work at numerous universities, the NIH, and MAPS. In this work she seeks to spread evidence-based knowledge, connection to resources, and strategies for individuals to maximize potential therapeutic benefits of psychedelics through safe and responsible practices. In this conversation, Alli responds to questions touching on all areas of women's health and the impact psychedelics could have specifically for female patients. A major theme of the discussion is the interplay between psychedelics and hormones. While this is a topic with little in the way of scientific research, Alli shares some interesting ideas about how the neuromodulation of psychedelics could interact with endocrine systems, and how serotonin receptors within the uterus could explain certain anecdotal reports of various effects of psychedelics on menstrual pains or irregularities. In a similar vein, Alli discusses some of the physiological effects of psychedelics, particularly in relation to blood flow, and how these non-experiential features of these compounds could actually be helpful properties for women with certain conditions. This insight leads to interesting avenues for future drug development and also stresses the importance of studying psychedelics at different doses so that the positive health effects can be isolated. Alli also talks about the potential for psychedelic healing in the context of postpartum depression, sharing an evocative family story which illustrates simply how crucial and overlooked this issue has been in healthcare. The advances in mental healthcare coming out of psychedelic research provide a promising path forward for such conditions, however. In this episode: How psychedelics could help with premenstrual discomfort Concerns about taking psychedelic substances while pregnant Psychedelics and postpartum depression How psychedelics could impact hypoactive sexual desire disorder Psychedelics interactions with menopause Potential role for hormones alongside set and setting for impacting the psychedelic experience Quotes: "It may be that psychedelics could really affect women's moods as they go through these different life stages, and help them feel better." [4:45] "Maybe this concept of neurotransmitter modulation with our sex hormones may be a target for drug development work as well." [23:42] "This is also pertinent to transgender women who may be using hormones. This type of modulation on mood or physiological symptoms—this could be really applicable too for helping to really have the body adjust and be more balanced to changes in hormonal fluctuations in the body." [26:59] Links: Psychedelic.support website Project New Day website Eastra Health Psychedelic Medicine Association Porangui
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Feb 22, 2023 • 38min

How Psychedelics Affect the Brain with Manesh Girn, PhD(c)

In this episode of the Psychedelic Medicine Podcast, PhD candidate and psychedelic science YouTuber Manesh Girn discusses his recent research on psychedelic brain action. Manesh is in the final stages of obtaining his PhD in neuroscience at McGill University and is an author on over a dozen peer-reviewed articles on psychedelics and related topics. He is also chief research officer at EntheoTech Bioscience and runs the YouTube channel the Psychedelic Scientist. In this conversation, Manesh discusses his recent article in Trends in Cognitive Sciences titled "A complex systems perspective on psychedelic brain action." He explains the complexity science approach used in the article, which emphasizes the brain is a holistic, interconnected system, rather than individual component networks that can be isolated. From this standpoint, Manesh critiques some simplistic explanations of the neural mechanisms of psychedelics which focus exclusively on interactions with the default mode network isolated from other brain systems. He also explains how individual some of the neural effects of psychedelics are, citing different findings from different studies and observed variations between brain scans of different people. By better understanding these individual differences, and placing these different responses into a complexity science framework, Manesh believes that more individually-tailored psychedelic therapies are possible once the systems involved are more comprehensively understood. Manesh closes this discussion by explaining the difference between genuine complexity and sheer chaos. Complexity, he explains, is a delicate balance of novelty and order, which is why psychedelic experiences can be both destabilizing and productive of novel insights and personal transformation. In this episode: The research into psychedelics and the default mode network Using frameworks from complexity science in psychedelic research Measuring entropy in the brain Differences in neurological effects from taking between different studies and different individuals How a complexity science approach to neuroscience could better inform precision psychiatry Quotes: "You can't just look at a specific brain region or network [in psychedelic research], you've gotta talk about the brain as a whole, in this sense of seeing the brain as a system of interacting parts." [4:49] "The core idea of this paper is that psychedelics put our brain into this state that is more dynamically flexible, it's more diverse in its activity patterns, and it's more sensitive to inputs that come in." [14:17] "What we find in the brain imaging findings is that different studies disagree, but also if you look at individual people, they can have radically different effects on their brain—almost opposite." [21:37] Links: Manesh' recent article in Trends in Cognitive Sciences: "A complex systems perspective on psychedelic brain action" ​​Psilocybin vs Placebo Brain Connectivity Diagram from Dr. Robin Carhart-Harris The Psychedelic Scientist YouTube Channel The Psychedelic Scientist on Instagram The Psychedelic Scientist on Twitter Manesh on LinkedIn EntheoTech website Psychedelic Medicine Association Porangui
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Feb 8, 2023 • 33min

Therapeutic Uses of Ketamine for Adolescents with Johnathan Edwards, MD

In this episode of the psychedelic medicine podcast, Dr. Johnathan Edwards joins to discuss the potential of ketamine treatments for mental health conditions in adolescent populations. Dr. Edwards is a board-certified anaesthesiologist and author with a key focus on treating mental health conditions with ketamine. He has provided ketamine in his practice for over 20 years and has worked with psychiatrist Dr. Sam Zand to help patients with mental health conditions. In this conversation, Dr. Edwards shares the current state of research exploring ketamine for adolescents, mentioning that there are currently 120 studies of ketamine treatments for mental illness in this population. He shares how he works with these young patients to ensure they are well prepared to experience the effects of the dissociative anesthetic, saying that adolescents typically do very well when adequately prepared. From Dr. Edwards' experience, treatment resistant depression, suicidal ideation, and eating disorders seem to be the conditions where ketamine seems to have the biggest effect for adolescents. In closing, Dr. Edwards emphasizes how significant it is to be able to help kids struggling with these hard to treat conditions, especially as teen suicide remains a significant issue, so he's hopeful that pediatricians, psychiatrists, and anaesthesiologists can continue to collaborate to safely bring ketamine therapy to more patients. In this episode: The existing research on ketamine in adolescent populations The danger of airway obstruction during ketamine infusions among people prone to sleep apnea Preparing adolescents for ketamine journeys Historical and cross-cultural precedents for psychedelic journeys in adolescents and young adults Potential indications for ketamine treatments in adolescents Is there an established protocol for adolescent ketamine therapy? Quotes: "I go through a lot to reassure the parents, to reassure the child, 'Hey, this is gonna be a different voyage for you and you're gonna be in a different place but tell yourself at all times you're safe…' and it goes very well." [5:06] "As long as you have a medical clearance from your pediatrician and a medical clearance from the psychotherapist/psychiatrist/psychologist… and you put those two together, along with parental consent, you're pretty well covered to go ahead and do a ketamine treatment on a child… It's not standard of care but again, you're trying to save a kid's life." [24:39] Links: Dr. Edwards' website Dr. Edwards' forthcoming book: The Revolutionary Ketamine: How a Little-Known Drug Can Cure Depression and Prevent Suicide Previous episode: Psychedelics for Eating Disorders with Dr. Reid Robison Psychedelic Medicine Association Porangui
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Jan 25, 2023 • 37min

Optimal Delivery of Psychedelic Experiences with Paul Thambi, MD

In this episode of the Psychedelic Medicine Podcast, Paul Thambi, MD joins to discuss insights on the optimal delivery of psychedelic experiences stemming from his recent trial on psilocybin therapy for cancer patients suffering from major depressive disorder. Dr. Thambi is a medical oncologist with nearly 20 years of experience treating patients in a private practice. He now serves as CMO Sunstone Therapies, a company focused on how to best deliver psychedelic therapies. In this conversation, Dr. Thambi shares the details of the design of his recent study, which involved two preparatory sessions, a treatment session, and two integration sessions. He also discusses the efficiency of delivering psychedelic therapy to a group rather than to individuals, allowing the therapist to help more patients at once while still providing focused one-on-one guidance during the psychedelic experience. Additionally, Dr. Thambi discusses the importance of music and space design to provide an optimal state of mind going into the therapy and while under the influence of the psychedelic. Dr. Thambi is happy to report very positive data from this initial trial, with both patients with active cancers and those with no current signs of disease showing great improvement in depression scores. He looks forward to continuing to work to better optimize the delivery of psychedelic therapies, not only for the patients but also for the therapists. Currently, he is pursuing a new "diad trial" of psychedelic therapy for cancer patients and a loved one which may have the potential to ease the suffering caused to a family system by these diseases. In this episode: The design of Dr. Thambi's study of psychedelic therapy for cancer patients struggling with depression Group versus individual forms of psychedelic therapy Crafting an ideal setting for psychedelic therapy with music, artwork, etc. Changes in depression scores, anxiety, and pain amongst the participants in Dr. Thambi's trial Optimizing the experience for psychedelic therapists as well as patients Dr. Thambi's on-going "diad trial" for cancer patients and a loved one Quotes: "What we were trying to do was create something that… could be used when it needed to be for a lot of people—something that was scalable. So something that was efficient, but still had compassion to it. And that's how we came up with the [study design]." [22:16] "80% of [participants] had their MADRS score cut in half or greater within one week of the treatment. And half of those people had what we called a sustained remission, which means a MADRS score of less than or equal to ten on each of the measurements we took, including the last one, which was done at week eight." [23:54] Links: Sunstone Therapist website "Psychedelics may ease cancer patients' depression, anxiety" article by Manish Agrawal California Institute for Integral Studies (CIIS) Certificate in Psychedelic-Assisted Therapies and Research Previous episode: Psychedelics and the Chemistry of Connection with Dr. Julie Holland Previous episode: How Setting Can Affect Psychedelic Journeys with Frederick Barrett, PhD Psychedelic Medicine Association Porangui
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Jan 11, 2023 • 57min

Psychedelics' Potential to Address Spinal Cord Injury with Joel Castellanos, MD and Jim Harris

In this episode of the Psychedelic Medicine Podcast, Dr. Joel Castellanos and Jim Harris join to discuss the possibilities of addressing spinal cord injuries using psychedelic medicine. Dr. Castellanos is a board certified physical medicine and rehabilitation and pain management physician and an associate professor in the department of anesthesiology at University of California, San Diego School of Medicine. Jim Harris is a National Geographic photographer who suffered a spinal cord injury during one of his adventures who became notable in the psychedelic space with the article in Outside "Jim Harris Was Paralyzed. Then He Ate Magic Mushrooms." Jim starts off by sharing his own backstory of how he broke nine vertebrae in his spine during a 2014 ski expedition in Patagonia, Chile, leading to significant loss of motion and sensation. After some promising success in traditional rehabilitation and physical therapy settings, Jim details his surprising experience of healing with psilocybin. In this vein, Dr. Castellanos discusses the importance of neuroplasticity in healing for spinal cord injury patients. He talks about how forming new neural pathways can help a patient regain function and sensation in a part of the body that had previously been paralyzed, and leveraging this neuroplasticity using psychedelics and other tools may be a promising way to improve outcomes among these traditionally underserved patients. Considering the unique needs of spinal cord injury patients, Jim wonders whether lower doses of psychedelics may be more beneficial for this population, as it would allow them to maintain a greater degree of sobriety and groundedness to pursue physical therapy and rehabilitation activities while under the influence of the substance. Dr. Castellanos expresses excitement about the possibilities of psychedelic therapies for these patients, as not only does early anecdotal evidence such as Jim's story suggest that these substances may be effective in helping to facilitate regain of function and sensation, but also because of the mental changes brought on by a psychedelic experience. Patients may feel more optimistic and eager to apply themselves following a psychedelic experience, which will facilitate healing beyond just what occurs as a result of the effects of the substance itself. He is also encouraged by current research into different forms of neuroplasticity which have different mechanisms. Dr. Castellanos suggests employing these in combination, such as using psychedelic therapy alongside vagus nerve stimulation, may offer more effective treatment options for spinal cord injury patients. At the end of this conversation, Jim poses Dr. Castellanos a fascinating question: whether there may be any downsides to over-encouraging neuroplasticity. Dr. Castellanos responds that there could be certain risks of increasing pain in patients, as neuroplasticity encourages new connections to be formed in the brain, but it matters what specifically becomes more interconnected. As such, there is reason to proceed with caution even as neuroplasticity offers significant benefits. In closing, Jim shares some hard reduction tips for other spinal cord injury patients interested in exploring psychedelic healing. Both he and Dr. Castellanos are optimistic at the possibilities of psychedelic therapies used in conjunction with other treatments for patients like Jim. In this episode: Leveraging neuroplasticity using psychedelics and other tools to help physical medicine and rehabilitation patients regain function Anecdotes of other spine injury patients who've regained function or sensation following a psychedelic experience The connection between spasticity and psychedelics How the response to psychedelics has changed over time for Jim Connecting physical therapy and psychedelic therapy to improve efficacy of rehabilitation How different mechanisms of neuroplasticity may be used in concert to promote recovery Harm reduction tips Quotes: Jim: "[when I first took psilocybin] all of a sudden I had an ability to contract my hamstring and… lift my heel off the ground, like up toward my butt, and I hadn't been able to do that up until that time." [9:12] Joel: "My primary focus is on neuroplasticity and ways that we can creatively modulate the nervous system to optimize recovery and optimize quality of life, whether that's from a pain perspective or a regaining motor strength perspective." [13:34] Joel: "If we can demonstrate that through psychedelics we can optimize and improve and make recovery more efficient, it is something that will be a huge deal for a great number of patients, and make my job as a rehab physician easier." [14:37] Jim: "The reason I've become interested in psychedelics as medicine has been trying to figure out… what are all the ways that I can have some sort of personal efficacy in my own recovery." [19:22] Jim: "I do know of other anecdotes kinda similar to mine, of people—maybe especially it seems like with a first psychedelic experience—suddenly regaining sensory or motor functions." [22:41] Jim: "It seems there's maybe some reason to suspect that some of the nerve plasticity that psychedelics can allow may reopen the critical period of this pivotal mental state where, say having a psychedelic and doing physical therapy in that state and maybe even the days afterwards, might result in a bigger functional change than just doing the therapy alone." [24:28] Jim: "My hypothesis would be that a useful physical therapy dose [of psychedelics] might be a lot less than what Johns Hopkins and other institutions are dosing as a therapeutic dose. It seems to me that maybe a really high dose psychedelic experience is going to make it harder to stay connected to your body, connected to doing a task." [29:17] Joel: "If I can identify three or four different ways to open up neuroplasticity that each have different mechanisms, it allows me to leverage those to give robust functional recovery and that's what I'm interested in." [33:56] Joel: "If psychedelics can reframe someone's cognition and reframe their situation where that gives them a little bit of hope, along with having a supportive therapy team, along with it working on descending inhibition and activating muscles that were previously paralyzed, that's multiple different levels of approaching someone that just had the worst thing in their whole life happen to them… It builds resilience and then it's also working on the neuromuscular pathway to improve functional recovery." [37:30] Joel: "I don't think just taking a psychedelic or other medication on its own is always going to be efficacious in solving that maladaptive pattern. But, when combined with specific and guided therapy, whether that's physical therapy, or psychotherapy, or cognitive therapy, I think that's where you can guide those neurons to a healthier connection through neuroplasticity." [50:17] Links: "Outside article: Jim Harris Was Paralyzed. Then He Ate Magic Mushrooms." Psychedelics and Health Research Initiative at University of California San Diego Dr. Castellanos on Twitter Jim on Instagram Previous episode: Psychedelic Therapies for Pain with Joel Castellanos, MD Fireside Project website Psychedelic Medicine Association Porangui

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