Psychedelic Medicine Podcast with Dr. Lynn Marie Morski

In this episode of the Psychedelic Medicine Podcast, Balázs Szigeti, PhD, joins to discuss his research on the intersection of microdosing psychedelics and the placebo effect. Dr. Szigeti studied physics at Imperial College, after which he earned a PhD in computational neuroscience from the University of Edinburgh. He has worked as a biomedical software engineer at the Icahn Genomics Institute and he has conducted the largest placebo-controlled study on psychedelics to date. In his research, Dr. Szigeti uses novel statistical and experimental techniques to explore the intersection of psychedelics and placebo effects. Dr. Szigeti begins this conversation by discussing the design of his placebo-controlled microdosing study, “Self-blinding citizen science to explore psychedelic microdosing” which appeared in the journal eLife in March 2021. For this study, Dr. Szigeti and his team employed citizen science to collect placebo-controlled observational data from participants, allowing this experiment to take place outside of a clinical environment. Participants self-blinded by preparing identical psychedelic and placebo microdose capsules and data was submitted using QR codes so that the researchers were knew whether the participant was in the psychedelic group or the control group, while the participants themselves remained in the dark. The results from this study showed a statistically significant improvement of wellbeing among both the microdose and placebo groups, with no statistical significant difference between the two groups in terms of any of the outcomes. Dr. Szigeti talks about the media reception of his research, which tended to present the findings as suggesting microdosing is ineffective since there was no difference between the two groups. However, Dr. Szigeti has a different takeaway. He suggests that the practice of microdosing can indeed lead to improved wellness as the study showed—the takeaway is simply that this effect is harder to distinguish from a placebo than originally anticipated. He emphasizes the very real medical power of this placebo effect, and discusses how triggering one’s own placebo effect either through microdosing or some other practice can be transformative.  However, beyond what the data may suggest about the impact of microdosing psychedelics, Dr. Szigeti emphasizes the broader takeaways from his study, which bring into question the efficacy of placebo-controlled studies as a gold-standard in the context of psychedelic trials. Because psychedelics cause notable shifts in perception, trial participants will quickly become aware whether they are in placebo or psychedelic groups, particularly in the case of trials exploring doses beyond the microdose range. This causes an immediate unblinding effect, and makes control groups less useful than in other contexts where a participant does not find out which group they were a part of until the trial’s conclusion. Dr. Szigeti affirms the methodology of placebo-controlled trials as an essential tool for researchers which deserves its reputation for providing high-quality evidence, but he urges the field of psychedelic studies to pay closer attention to questions of methodology, as there may be yet undiscovered modes of scientific investigation which would be better-suited to psychedelic trials.  Dr. Szigeti is currently working on a follow-up blinded study on microdosing which he hopes will address some of the shortcomings of the original investigation. In particular, he mentioned that the participants in the original study had high levels of well-being already at the start of the trial, so improvements may have been less significant than in a population with a lower level of well-being to start. As such, he and his team hope to recruit a more diverse sample in this upcoming trial to further explore the extent of both placebo and microdosing impacts on wellness. Information for the upcoming study can be found at the website: https://selfblinding-microdose.org/   In this episode: How Dr. Szigeti set up his self-blinded placebo-controlled study of microdosing outside of a clinical environment What is “citizen science” and how this differs from other methodologies The issue of tolerance in microdosing and how this may differ between LSD and psilocybin How Dr. Szigeti uses statistical analysis to further interpret data where participants realize which group of the study they are in   Quotes: “The results of this microdose trial were mixed because you can make an argument that this change over time is the more important outcome and that was statistically significant, but the comparison of the magnitude of change in the placebo group versus the magnitude of change in the microdose group, that was not significant anymore. It was not significant on any of the scales, I should add.”  [14:45] “Nobody ever checks whether the placebo control was really working as intended, which is just like—I don’t know how it could have happened. There is such a big emphasis on the methodological superiority of placebo-controlled trials and then nobody is checking whether its really working or not.” [21:09] “With psychedelics this issue [of placebo groups] is going to come to the forefront because, yes with microdosing there is some wiggle room in people recognizing their treatment, but when it comes to 200μg of LDS versus placebo, there is zero uncertainty. Everybody will recognize when you’re in the active placebo treatment.” [28:13]   Links: Upcoming trial website Dr. Szigeti’s study: “Self-blinding citizen science to explore psychedelic microdosing" Dr. Szigeti’s recent article: “On the fallibility of placebo control and how to address it: a case study in psychedelic microdosing" Dr. Szigeti on Twitter Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Joshua White returns to discuss the first year of the psychedelic peer-support line, Fireside Project. 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. Joshua begins this conversation by sharing the success of Fireside Project in its first year of operation. The peer support line has been called over 3,100 times in the 14 months since the launch of Fireside Project, where callers have been able to receive open-ended support from compassionate peers as they navigate a psychedelic experience or attempt to integrate a previous experience.  Joshua also shares some details about the kinds of calls the line has received, such as which psychedelic substances were involved in the caller’s experience, how callers were describing their experiences, and what mental health conditions callers self-reported. In terms of substances, psilocybin was the most commonly used by callers, though a wide range of different psychedelics were reported. For mental health conditions, PTSD stood out as the most frequently mentioned, though depression and anxiety were also common. Joshua mentions that he’s hopeful that this data may be incredibly useful in further developing harm reduction strategies, as the dataset may help uncover previously unknown correlations.  Another aspiration for Fireside Project is ensuring equity through their Equity Initiative, which allows callers to process past psychedelic experiences with someone of a similar background. Joshua shares that this initiative will also produce original research on this topic, showing for example the kinds of benefits a caller from the BIPOC community might get through having the opportunity to integrate a past experience with a BIPOC peer.  Joshua closes this conversation with powerful words about integration and harm reduction, saying that integration is a form of harm reduction. To that end, Joshua is hopeful Fireside Project can continue offering crucial harm reduction and integration services as the organization grows and reaches beyond the niche of psychedelic enthusiasts.    In this episode: Who has been calling the peer-support line and what kind of support they are seeking How Fireside Project could potentially offset the burden on emergency services in the case of negative psychedelic experiences The diversity of Fireside Project volunteers The problems of facilitator abuse and neglect in the psychedelic space The future of Fireside Project   Quotes: “Reflective listening—which is the core, the foundation of holding space—this is really a skill that we can continue to cultivate.” [8:03] “My hope is that there’s no barrier, there’s no stigma, and there’s no shame to reaching out.”  [12:53] “All of the lessons we learn, we really just want to share those with the public in the hope that this will lead to less risky and more fulfilling psychedelic experiences.” [17:30] “One of the things that I’ve noticed is—that we’ve noticed is—even though every single call is different in its own way, especially when someone reaches out to us in a heightened state, really validation, normalization, and reassurance often happen at the very beginning.” [25:34] “It’s amazing how some of our calls are just so short because someone just wants to know that we are there.” [28:44] “As a psychedelic community, people need to stop saying that psychedelics are ten years of therapy in one night. It’s just not true, and it sets people up for serious disappointment and can even be really dangerous for that reason.” [30:01]   Links: Fireside Project website Fireside Project app Fireside Project Instagram Fireside Project Twitter Fireside Project Tik Tok Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Dr. Felipe Malacara joins to discuss the safety considerations surrounding ibogaine therapy. Dr. Malacara is the chief clinical operations director for Beond, a Mexico-based Ibogaine clinic. He is also a general practice physician with a medical degree from Universidad Autónoma Metropolitana in Mexico City and has over 17 years of experience treating over 1,200 patients with Ibogaine therapy.  In this conversation, Dr. Malacara shares important safety information about ibogaine, starting with major contraindications to using the powerful substance. These contraindications fall into three main groups: heart issues, electrolyte deficiencies, and liver problems. As Dr. Malacara explains, all of these have the potential to make Ibogaine dangerous due to the way it interacts with the heart, particularly if there is a metabolism issue. In terms of negative outcomes, cardiac issues are the most common as ibogaine can cause bradycardia—a dangerous slowing of the heart rate.  Due to these potential risks, Dr. Malacara encourages a thorough evaluation prior to ibogaine therapy, including full blood work, an EKG, and occasionally an ultrasound of the heart. Another crucial part of the evaluation is taking an inventory of the patient’s prescription medication and drug use. Dr. Malacara explains that patients may need to be weaned off a particular drug or be given a shorter-acting alternative so that they can come into the ibogaine therapy without any substances in their system which could lead to dangerous interactions or render the treatment less effective. In particular, Dr. Malacara notes that SSRIs could interact with ibogaine to produce serotonin syndrome, and while this can be straightforward to treat, diagnosis can be difficult, so avoiding this entirely by weaning off the medication under the direction of a physician is strongly suggested prior to treatment.  In closing, Dr. Malacara emphasizes that Ibogaine is not a magic bullet despite its unique efficacy for treating addiction. The will to change on the part of the patient is still crucial, especially as preparation for ibogaine therapy itself requires a lot of commitment and dedication. If that is present, however, Dr. Malacara maintains that the treatment can be extremely effective.   In this episode: How Dr. Malacara got involved in Ibogaine therapy The inherent risks of Ibogaine What patients should be evaluated for prior to receiving Ibogaine therapy Weaning patients off drugs or onto different, shorter acting substances in preparation for Ibogaine The types of addictions may be successfully addressed by Ibogaine Monitoring a patient’s heart following Ibogaine, and when they can be released   Quotes: “In the event [that a patient] is not able to metabolize ibogaine in an appropriate way, the risk of heart toxicity of the Ibogaine increases.” [9:25] “Something which is important is drug screening before the treatment. We need to know that the patient has no traces of the drugs that we are going to treat in the system, because otherwise the treatment will be more difficult, the recovery will be more difficult, or it will be even ineffective.”  [26:48]   Links: Beond Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Wyly Gray and Dr. Andrea Lucie join to discuss the issue of healing military sexual trauma (MST) through ayahuasca. Wyly Gray is a former Marine and founding executive director of Veterans of War, a nonprofit which connects teams of veterans to psychedelic-assisted guided group therapy designed to heal the scars of war in community. Dr. Andrea Lucie is a native of Chile and a third generation healer who has been traditionally and non-traditionally trained in ancient healing practices in the United States and Mexico. She also holds a PhD in mind-body medicine. This conversation begins by discussing the tragic phenomenon of military sexual trauma and the current treatment modalities available for veteran survivors. Wyly explains that the current treatments, which primarily take a talk therapy approach, often fall short of what survivors need as they focus on treating the symptoms as they arise rather than being able to address these conditions at their root causes. Dr. Lucie explains the science behind ayahuasca as a treatment for trauma, highlighting the profound neurological and psychological impacts of this psychedelic medicine.  Seeing the particular need for better treatment options among the veteran population, and the potential for ayahuasca to have such a profound positive impact, Wyly founded Veterans of War with the hope of better addressing this need. He shares the details of the six-month fellowship program, which involves a small cohort of veterans who do significant preparatory work together prior to a communal ayahuasca ceremony, followed by many integration sessions after the ceremony. Dr. Lucie explains different forms of mind-body work that may be effective supports before and after ceremony, citing things such as Tai Chi, meditation, and even close relationships with animals.  Towards the end of this conversation, Wyly shares some profound stories of transformation he has witnessed first-hand through his work with Veterans of War. He has seen veterans who’ve struggled profoundly with panic attacks become incredibly joyful people, and others who were on the brink of suicide begin to heal and form deep and meaningful relationships. In closing, Wyly discusses plans to establish a healing center in Oregon for Veterans of War to further increase access to these opportunities without the need for international travel.   In this episode: The problems of the civilian service-member divide, and how ayahuasca can help break down these barriers The importance of supportive community in the context of ayahuasca therapy for veterans with MST Mind-body practices that can support veterans working through MST before and after an ayahuasca ceremony How trauma changes the brain and the neurological effects of psychedelics that can help reverse these changes Why tackling issues of sexual assault within the military can be so difficult    Quotes: “I think that Ayahuasca is unparalleled in its ability to create a safe and effective path towards recovery, but I deeply believe it also needs bookends on either side, or a structure to get the most out of it.” [8:19] “Sometimes we just don’t want to talk. We just want to feel and when we feel and we identify where in the body the trauma is stuck—because the trauma gets stuck in the body—then we know how to release it with movement.” [27:16] “Our response to trauma has seemed to be very one-dimensional. This is an effort to shift that, to start looking at people as whole units and at the same time, start speaking to the needs of that whole unit. If you are able to heal the trigger point of that trauma, you don’t have to heal its expression.” [31:18]   Links: Veterans of War website Veterans of War on Instagram Veterans of War on Twitter Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Dr. Sam Gandy returns to discuss the topic of psychedelic-induced mystical experiences, looking specifically at how to predict and potentiate these experiences. Dr. Gandy holds a PhD in ecological science from the University of Aberdeen and has conducted field research across the globe. He is a researcher and science writer who is also a collaborator with the Centre for Psychedelic Research at Imperial College London, with a research interest in the capacity of psychedelic substances to influence individuals’ connection with nature. Dr. Gandy begins this conversation by defining the topic of mystical experiences. He explains that while there are a number of competing terms for how to best address this subject, what is important is that the research has consistently shown that these types of experiences are closely correlated with beneficial therapeutic outcomes. Whether brought on by psychedelics or not, mystical experiences tend to produce positive psychological changes, so it is important for psychedelic researchers to take this topic seriously and thoroughly investigate these experiences and where they come from. However, Dr. Gandy notes that there are a number of hurdles to addressing this topic scientifically. Because of the mystical or spiritual quality of these peak experiences, it can be difficult for researchers to develop sufficiently neutral language in surveys while maintaining accurate descriptions of the qualities of the altered states. Similarly, Dr. Gandy explains that therapists have to walk a fine line between not introducing spiritual or religious bias into the session through decoration or suggestion which may prioritize a certain religious tradition, while also preserving a certain type of spiritual atmosphere which is conducive to mystical experiences and thus beneficial therapeutic outcomes.  Dr. Gandy then goes on to explain variables which can be predictive of psychedelic mystical experiences. Set and setting are of course crucial, but there are a number of additional parameters to consider. Dr. Gandy explains that dose, of course, is particularly important, stating that a standard has emerged in the research around psilocybin which has found that 25 milligrams of pure synthetic psilocybin is a sweet spot for encouraging mystical experiences without leading to additional adverse reactions due to the intensity of the experience. Additionally, different psychedelic substances produce mystical experiences at different rates, with 5-MeO-DMT being the most likely to lead to these experiences. Besides dose and substance, Dr. Gandy has also found that intention as well as the personality trait known as absorption are both predictive of mystical experiences in psychedelic therapy. To conclude this conversation, Dr. Gandy shares three possible potentiators of psychedelic mystical experiences: music, meditation and spiritual practice, and nature-based settings. Each of these items, if integrated into the experience intentionally can encourage a more immersive and intense mystical experience. For all of these, Dr. Gandy encourages further research for how they could best be integrated into psychedelic therapy practices.    In this episode: The psycho-social changes which often follow mystical experiences The connection between mystical experiences and “spiritual emergencies”The difficulty of working with a spiritual element in the context of psychedelic therapy and research How the typical Western protocols for psychedelic therapy encourage an inward experience Why people who rank highly in the personality trait absorption are more likely to have mystical experiences, both spontaneously and while under the influence of psychedelics Ways to train psychological states of surrender and acceptance prior to high-dose psychedelic therapy which can encourage mystical experiences and prevent adverse reactions   Quotes: “What makes psychedelics quite interesting is that they—under the right, appropriate conditions and contexts—they can reliably elicit these [mystical] experiences.” [4:39] “The psychedelic 5-methoxy-DMT is definitely an interesting substance to highlight here. … The data that is there shows that when it’s used in a supportive context, it can predict mystical experiences—three quarters of cases, over that in two separate studies that have been done so far.” [31:22] “Entering the experience with an emotional intent or a spiritual motivation seems to predict greater likelihood of mystical experiences” [34:36] “There’s this aspect that negatively predicts mystical experience called mental barriers. And this is where you enter the experience with in some sense an overly rational, analytical way of viewing things, and if you enter the experience like that that’s a potential block on mystical experiences happening.” [44:21] “People with meditation experience or with an ongoing practice, they seem more liable to report states of oceanic boundlessness tied to the mystical experience.” [49:16]“Nature-based settings seem to be quite conducive to mystical and spiritual states, just inherently.” [57:00]   Links: Dr. Gandy on Twitter Dr. Gandy’s article: predictors and potentiators of psychedelic-occasioned mystical experiences Dr. Gandy’s Research Gate profileCentre for Psychedelic Research at Imperial College London  Previous episode: Psychedelics and Nature: The Symbiotic Relationship with Dr. Sam Gandy Previous episode: Avoiding the Pitfalls of Psychedelic Medicine with Matthew Johnson, PhD Psychedelic Medicine Association Porangui

On this episode of the Psychedelic Medicine Podcast, Dr. Pedro Teixeira joins to discuss the emerging research about the effects of psychedelics on health behavior change. Dr. Teixeira is a professor of physical activity and health at the University of Lisbon and the director of research for the Synthesis Institute in the Netherlands. He holds bachelors and masters degrees in exercise science and a PhD in nutritional sciences. As an academic, Pedro’s main research interest is health behavior change, a field which he is now trying to put into conversation with the latest psychedelic science.  In this conversation, Dr. Teixeira shares the basics of the field of health behavior change, which seeks to study how and why people end up developing positive-health-conscious behaviors. This is a field that is of particular interest to clinicians, as doctors are always looking to encourage healthful behaviors in their patients. When it comes to research on the impact of psychedelics on health behavior change, Dr. Teixeira explains that much of the current data is secondary, though some evidence can be drawn from studies that primarily examined psychedelic therapy for tobacco and alcohol cessation. The data that does exist, however, paints a very promising picture, with many psychedelic users reporting positive changes in diet and exercise following experiences with these mind-altering substances—an effect which Dr. Teixeira notes is often observed even if there was no intent for health behavior change prior to the psychedelic experience.  However, more research is needed to substantiate these preliminary results. To that end, Pedro shares the idea of “behavioral psychedelics”—a new methodological paradigm in psychedelic research that will focus more on collecting data on concrete behaviors following psychedelic therapy as opposed to the primarily psychometric data which has dominated the field.  Dr. Teixeira also emphasizes that the field of health behavior change could be an important vehicle for emphasizing the role of psychedelics as tools for preventative health, taking the field beyond the current paradigm which sees psychedelics as primarily useful for their potential to address acute mental health conditions.  Dr. Teixeira can be reached at ​​pteixeira@fmh.ulisboa.pt   In this episode: The emerging field of health behavior change Types of health-related behaviors that could be encouraged by psychedelic experiences The new paradigm of “behavioral psychedelics”  Possible preventative health roles for psychedelics The evidence from tobacco and alcohol cessation trials for health behavior changes following psychedelic use   Quotes: “[Recent observational studies] seem to show that for some reason psychedelic users are not only healthier from a physical health perspective, but there’s also indications that that is caused by some of their behaviors.” [13:13]   “What better way to convince future politicians or policymakers than to show that people are actually improving the quality of their lives and their health habits and saving healthcare costs and eating more sustainable diets perhaps, if indeed the studies in Oregon and in the future in other places are showing that there is a preventative aspect, there is a lifestyle enhancement aspect to these experiences.” [21:57]   “When you behave from a self-determined perspective, or when you’re motivated more internally as opposed to being more externally motivated, your outcomes will be better. Your behavioral outcomes, but also your health outcomes.” [26:21]   Links: Dr. Teixeira's research group website Dr. Teixeira's paper: Psychedelics and Health Behavior Change Lucid News coverage of Dr. Teixeira’s article Study: Effects of Naturalistic Psychedelic Use on Depression, Anxiety, and Well-Being: Associations With Patterns of Use, Reported Harms, and Transformative Mental States Article: Behavioral Psychedelics: Integrating Mind and Behavior to Improve Health and Resilience Article: Ayahuasca and Public Health: Health Status, Psychosocial Well-Being, Lifestyle, and Coping Strategies in a Large Sample of Ritual Ayahuasca Users Dr. Teixeira’s talk at INSIGHT 2021: Can Psychedelics Improve Diet, Exercise, Meditation, and Weight Control? Self-Determination Theory website Previous episode: Psychedelics and Nature: The Symbiotic Relationship with Dr. Sam Gandy Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Frederick Barrett joins to discuss setting and the research into how this variable can affect psychedelic experiences. Fred is an associate professor of psychiatry and behavioral sciences at Johns Hopkins School of Medicine where he is also the associate center director of the Center for Psychedelic and Consciousness Research. He has been conducting research at Johns Hopkins since 2013 and is currently leading a number of ongoing studies to better understand the psychological, biological, and neurological mechanisms underlying therapeutic efficacy of psychedelics. In this discussion, Fred unpacks his recent article “Effects of Setting on Psychedelic Experiences, Therapies, and Outcomes: A Rapid Scoping Review of the Literature” which appeared in the February 2022 edition of Current Topics in Behavioral Neurosciences. For this study, Dr. Barrett and colleagues gathered as many studies as they could find which dealt with the topic of the role of setting in psychedelic experiences. While they found over 1,000 articles which discussed the topic in some capacity, the researchers eventually narrowed the selection down to just 43 articles which provided empirical data on this variable. Fred mentions that while ideas of set and setting loom large in psychedelic discussions, this is actually a topic which has received comparably less attention in research contexts. This is beginning to change, however, as researchers have become more certain in the overall efficacy of psychedelic therapies for treating a variety of conditions and are now turning to more specialized investigations, such as looking more closely into the impacts caused by various tweaks to the setting of psychedelic therapies. When it comes to the state of current research on setting, Dr. Barrett reports that music is by far the most studied variable. He discusses different approaches which psychedelic therapists have taken in investigating this topic, with research investigating familiar vs unfamiliar music, or having music vs not having music in a session. He also shares research about expert meditators and how these subjects responded differently to music while under the influence of psychedelics when compared to typical patients.  Another variable which Fred discusses is the element of ritual, which is especially prominent in more traditional contexts of psychedelic use. This variable is also interesting because it interacts with participants' expectations, blurring the distinction between set and setting as distinct categories. In closing, Dr. Barrett shares some of his own thoughts about the blurriness of set and setting, suggesting that our understanding of these categories may evolve as empirical research further investigates the roles they play in guiding psychedelic experiences.   In this episode: The relationship between ritual and set and setting The difficulties of rigorously studying all the variables of setting in the context of psychedelic experiences The different aspects of setting in traditional, ritualistic contexts for psychedelic experiences versus the context of modern psychedelic therapy Music as an important aspect of setting during psychedelic journeys The blurry distinction between set and setting   Quotes: “Out of all of this literature, the one thing that became clear to us was that everybody talks about set and setting, and many papers affirm set and setting are important, but very few actually empirically test an element of set and setting.” [6:49] “One of the elements of set and setting in general that we found to be addressed across a number of different studies was the question of specific ritual or ceremonial settings.” [15:04] “Music seems to play an overwhelming role in shaping—and some people think driving—their psychedelic experience.” [22:25] “Set and setting are both mutable. Your experience at one point in a session, I would argue, is going to influence, or at least has the opportunity to influence the things that happen next.” [41:03]   Links: Dr. Barrett’s paper: Effects of Setting on Psychedelic Experiences, Therapies, and Outcomes Johns Hopkins Center for Psychedelic & Consciousness Research Fred on Twitter Previous episode: Can Ayahuasca Help Promote Palestinian-Israeli Reconciliation? with Dr. Leor Roseman & Antwan Saca Previous episode: The Latest Research on Psilocybin for Depression with Matthew Johnson, PhD Previous episode: Avoiding the Pitfalls of Psychedelic Medicine with Matthew Johnson, PhD Previous episode: LSD Scientific Research with Dr. Katrin Preller Psychedelic Medicine Association Porangui

On this episode of the Psychedelic Medicine Podcast, Dr. Rick Barnett joins to discuss when to not proceed with a planned psychedelic journey. Rick is a licensed clinical psychologist and licensed alcohol and drug counselor, trained in psychedelic therapies and research by the California Institute for Integral Studies. He is the cofounder of the psychedelic society of Vermont while also consulting with patients curious about psychedelic research and therapies, including helping people understand the processes of preparing for, experiencing, and integrating the intentional use of psychedelics for personal growth and healing. Dr. Barnett also works with patients in a traditional psychotherapeutic group practice and has also recently begun offering low-dose ketamine therapy. In this conversation, Rick expounds on his recent LinkedIn article of the same title, exploring the various biological, psychological, and social experiences which provide legitimate reasons for postponing a planned psychedelic experience. On the biological side, Rick explains that sudden illness or injury could absolutely constitute sufficient reason to reschedule a therapy session, and that consulting closely with your therapist or guide is essential if the decision isn’t clear cut, as in the case of something which could be a stomach bug or just nervousness manifesting as digestive discomfort. When it comes to the psychological side of things, Rick mentions that it is often a difficult circumstance to navigate, as mental distress is often the reason a patient is pursuing psychedelic therapy in the first place. However, Rick makes a distinction between the typical levels of depression and/or anxiety a patient is accustomed to experiencing, and a much more intense fear which is also qualitatively different that can arise before a session. Again, this is a situation where open communication between patient and therapist or guide is essential in order to help the patient make the best decision, but Rick also stresses that because this is a wholly internal experience, that prudent introspection is ultimately what will guide the decision making.In terms of the social reasons for not proceeding, Rick cites turmoil in personal relationships, traumatic contemporary events, and also recent experiences of death. These can all lead to an individual having a particularly heavy emotional burden going into a session, causing potentially difficult experiences during the psychedelic journey. While sometimes difficult experiences can be very healing in the long term, especially following effective integration, these external stressors have the potential to take people’s focus away from the intended inner work, so postponing until the person is confident they aren’t bogged down by these social factors could be prudent. With all these factors, Rick stresses that a patient can always return to a psychedelic journey at a later time if they decide not to proceed. A good guide or therapist will accommodate and even proactively support a patient in ensuring they are coming to the experience at the right time.    In this episode: The importance of examining refund policies of psychedelic retreats or therapy practices Rick’s bio-, psycho-, and social considerations for not proceeding with a psychedelic journey Why these considerations are often molecule-specific What kinds of interpersonal conflicts may warrant postponing a psychedelic journey Distinguishing between overwhelming fear and typical anxiety prior to a psychedelic experience The impacts of traumatic political or social events on mental health and postponing a journey   Quotes: “When you speak to a guide, when you speak to a coach, when you speak to a researcher, my hope is and my experience has been that it is always an option on the table at the last minute if you don’t feel quite right that you have permission to opt out.” [5:24] “Ketamine, when it comes to physical illnesses might be a different judgment call because ketamine—dissociative anesthetic, you kind of lose sense of your body—if there’s something going on physically, that might be okay to go ahead with… because you’re not with your body as much, but psilocybin, other high dose classic psychedelics and physical illness or physical pain, that could be different.” [17:59] “People need permission to say ‘you know what, it’s gonna happen’—you’ve done all the preparation, you’ve done all the work. If it’s not going to happen right now, it’s still going to happen.”  [32:57]   Links: Psychedelic Society of Vermont Rick’s LinkedIn Article: When NOT to Proceed with a Planned Psychedelic Journey Rick on LinkedIn Rick on Twitter Psychedelic Medicine Association Porangui

In this episode of the Plant Medicine Podcast, Matt Johnson, PhD returns to discuss previous survey research he conducted regarding DMT entities. Dr. Johnson is the associate director at the Center for Psychedelic and Consciousness Research at Johns Hopkins University, where he also works as a professor of psychiatry and behavioral sciences. He has published widely in the field of psychedelic science and has guided over one hundred psychedelic experiences. In 2019 Dr. Johnson was the president of the psychopharmacology division of the American Psychological Association, and he currently serves as the president of the International Society for the Research on Psychedelics. In this conversation, Dr. Johnson shares findings from his 2020 publication of survey research which investigates peoples’ experiences with DMT entities. To preface these findings, however, Dr. Johnson first lays the groundwork by explaining the limitations of scientific investigation into these kinds of psychic phenomena. He explains that science is unable to answer questions of whether or not DMT entities are ultimately real, or what the fundamental nature of these experiences is. It can, however, employ rigorous methods for analyzing reports of entity encounters in order to document common features of these experiences and the types of effects they can have on individuals. In the survey, around twenty five hundred respondents shared their experiences of encountering an entity during a DMT experience. From the data collected, Dr. Johnson shares some of the common features of these entities. The beings are typically perceived as benevolent though there was a wide variety of ways the entities were conceptualized, ranging from aliens and machine elves to spirits and angels. Often participants believed the entities revealed metaphysical realities and the presence of these beings was frequently accompanied by extrasensory phenomena such as telepathic communication. Due to the dramatic nature of these experiences, Dr. Johnson’s research found some lasting impacts as reported by respondents, and he concludes by briefly discussing the effects of entity encounters on religious belief.    In this episode: What questions science can and can’t answer, and the boundaries good scientific research has to take when investigating something such as DMT entities The findings of Dr. Johnson’s survey research—some general trends regarding the qualities of entities described Effects of entity encounters on religious belief   Quotes: “My bet is that if people believe that there’s some sort of reality to these disincarnated entities—that it’s not just in their mind—there are certain people that can hold that experience in a positive way that might benefit them… and probably some of these over 2,000 folks, there’s probably some people that—again, aside from whether we know it’s true or not—believing in things that no one else can prove are there is probably a bad thing.” [12:38] “The machine elf thing, I mean, that was Terrence McKenna’s trip. And he described it—and I think he was very honest that that was his experience—and I think people who’ve heard his experience, a good number of them have had machine elf experiences because they heard Terrence McKenna’s experience.” [16:17] “Before the experience, 28% of these people identified as atheist, and then after the encounter that dropped to 10%.” [20:53]   Links: Center for Psychedelic & Consciousness Research at Johns Hopkins (contribute to survey research here) Dr. Johnson’s DMT Entity Study: Survey of Entity Encounter Experiences Occasioned by Inhaled N,N-Dimethyltryptamine: Phenomenology, Interpretation, and Enduring Effects Psychedelic Medicine Association Porangui

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