In this episode of the Psychedelic Medicine Podcast, L.J. Lumpkin III, MA LMFT joins to discuss the potential of psychedelic medicine in the context of sports psychology. L.J. is a therapist, adjunct professor at Pepperdine University, a coach, author, speaker, and the CEO of Nomad Healing Practices.

In this conversation, L.J. shares his personal experience as an athlete and discusses the difficult transition to a new life once an athlete’s career has concluded. He compares the need to reinvent oneself in this context to ego death and explains how psychedelic-assisted therapy may be helpful for navigating this transition. L.J. also discusses the intense pressure athletes are under to perform, mentioning that the drive to win can often overpower the more basic mode of play at the heart of athleticism. This is an area where he finds ketamine to be a particularly powerful medicine, as its dissociate quality can help athletes tune out the high pressure expectations. L.J. also discusses leveraging the critical learning period provided by psychedelic therapies to institute new healthy habits, something which could benefit athletes both on and off the field.

In this episode you'll hear:

• How ketamine-assisted therapy may be able to help athletes with their unique psychological challenges
• Integrating mindfulness to prepare for psychedelic therapies
• Leveraging the somatic component of psychedelic therapies to address pain
• The importance of integration practices and support systems
• The differences between working with psilocybin versus ketamine
• Drowning out critics and sports commentary and getting back to basics with the help of psychedelic therapy

Quotes:

“If you’ve been paid millions of dollars to hit and be aggressive for so long and that’s how you’ve dealt with your emotions—and it wasn’t a problem because you were being rewarded for it—what do you do when you’re not getting rewarded for that anymore? When you have to actually change how you process emotion—there’s not a playbook for that.” [7:46]

“Just talking about [mental health] and normalizing it—all of a sudden you’re allowed to get help, you’re allowed to heal, you’re allowed to go to practices that have been practiced throughout human civilization. We’re bringing [psychedelics] back and I think that athletes are the ones who are really going to be the ship of normalization.” [22:38]

“Especially if you’re off season, those other medicines [besides ketamine] I think they’re going to be even more helpful because that might encourage the rest, it might encourage being able to connect with family systems. I think for some of the more acute stuff, the ketamine does serve a great purpose in that.” [28:16]

Links:

L.J. on Instagram

L.J. on LinkedIn

Nomad Healing Practices website

Psychedelic Medicine Association

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In this episode of the Psychedelic Medicine Podcast, podcast host Dr. Lynn Marie Morski comes on the mic to provide a five-year update on the podcast and share the changes in the legal landscape of psychedelics in the past half-decade. Lynn Marie Morski, MD, JD is the president of the Psychedelic Medicine Association and host of the Psychedelic Medicine Podcast. She sits on the advisory boards of Psychedelics Today, Cybin, VETS, Inc (Veterans Exploring Treatment Solutions), the Oxenberg Foundation, and the Ketamine Task Force. Dr. Morski is a Mayo Clinic-trained physician in family medicine and sports medicine, as well as an attorney and former adjunct law professor.

In this anniversary episode you’ll hear about the legally-accessible forms of psychedelic therapy which have come to prominence as potential mainstream therapeutics in recent years. Dr. Mroski shares Information on the legal adult use framework for psilocybin in Oregon, including licensing, costs, and exclusion criteria. She also discusses programs in Australia and Canada that will allow certain patients to access psychedelic therapies such as psilocybin- and MDMA-assisted therapy. In addition to classic psychedelic medicines, Dr. Morski also shares information on the medicine which is currently most accessible: ketamine. She discusses the difference between S-ketamine and R-ketamine and on-label and off-label uses of this substance. In closing, Dr. Morski presents some of the finer details of the current landscape of insurance coverage for ketamine.

In this episode you'll hear:

• The difference between decriminalization and legalization
• The FDA decision to deny the Lykos Therapeutics’ new drug application for MDMA-assisted therapy for PTSD
• The upcoming Colorado psilocybin program
• Psychiatric licenses to administer MDMA and LSD to patients in Australia
• The Special Access Program for psychedelic therapies in Canada
• Legal ketamine access in the United States
• How the Psychedelic Medicine Podcast chooses guests

Quotes:

“I wanted to focus mostly on what is legal because we know that’s the way things are going to be the most monitored and therefore safely accessible.” [20:45]

“People are in this industry because they want other people to feel better and they want to help and they’re so generous with their time” [25:31]

Links:

clinicaltrials.gov - the place to find information on upcoming clinical trials for psychedelic medicine for which you may qualify

Insurance Coverage for Psychedelic Therapy by Vincent Joralemon

SPRAVATO withMe Patient Support Program

Enthea insurance

Previous episode: How to Choose A Psychedelic Facilitator or Retreat Center with Joël Brierre

Previous episode: Warning Signs When Selecting a Psychedelic Facilitator with Juliana Mulligan

Previous episode: Ketamine Scientific Research with Dr. Jason Wallach

Psychedelic Medicine Association

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In this episode of the Psychedelic Medicine Podcast, Dr. David Rabin, MD, PhD joins to discuss whether genes can be predictive of one’s response to MDMA Therapy. Dr. Rabin, a board-certified psychiatrist and neuroscientist, is the co-founder & chief medical officer at Apollo Neuroscience. In addition to his clinical psychiatry practice, Dr. Rabin is also the co-founder & executive director of The Board of Medicine, and a psychedelic clinical researcher currently evaluating the mechanism of psychedelic-assisted psychotherapy in treatment-resistant mental illnesses.

In this conversation, Dr. Rabin shares his research into epigenetic responses to MDMA-therapy, exploring topics of trauma, gene expression, and personalized, data-driven medicine. He discusses the seminal discovery that trauma can cause epigenetic changes in the structure and function of the cortical system and his own research findings that uncovered a reversal of these changes associated with MDMA-assisted therapy. Dr. Rabin hopes further research in this area may allow for leveraging epigenetic data to determine which psychedelic medicine a particular patient may be most likely to respond to and track how effective a given treatment has been. In closing, he expresses excitement about bringing objective biological precision to mental health treatment, drawing a parallel to the discovery of antibiotics which allowed for much more tailored treatments of infections which has saved countless lives.

In this episode you'll hear:

• Response rates to psychedelic-assisted therapy for PTSD versus conventional therapies
• The consequences of ineffective treatment for PTSD
• MDMA-assisted therapy as preventative care and the societal cost savings involved
• Genetics, epigenetics, and gene expression
• Using epigenetic data from simple saliva swabs to better gauge response to MDMA-assisted therapy for PTSD

Quotes:

“Most of the treatments we have available today for PTSD—that are the FDA-cleared, considered gold standard treatments—only actually induce remission from illness… in about 30% of people. So of the 100% of the millions of people every year that are getting treated for PTSD, with the best treatments that we have that are currently available, only 30%—at best—are getting better long term. Everyone else has a diagnosis of PTSD for life.” [3:55]

“MDMA-assisted therapy for people with PTSD is having an effect that’s similar to what we saw with the discovery of antibiotics for infection.” [8:07]

“Folks with severe PTSD who went through this trial, when they received MDMA-assisted therapy, [the researchers] saw a statistically significant change—in terms of repair—of the cortisol receptor’s epigenetic code which reflects improved structure and function of that receptor site. But not only that—we saw that the amount that people got better… was directly correlated with… the amount of remodeling and repair at the receptor site.” [18:36]

“Epigenetic code is actually something that can be modified by experiences in our environment. And trauma—or PTSD diagnoses, a series of significant traumas over time—can in fact change epigenetic code of the cortisol receptor gene. And that changes how the cortisol receptor gene gets made, and it changes its function.” [29:52]

“PTSD is a disorder of learned fear. How do we treat PTSD? In animals and humans, we provide the same stimulation that they were getting that they are now afraid of in the context of safety. That’s how exposure therapy works, that’s how MDMA therapy works to some extent—all of these tools and techniques work to treat PTSD effectively… in the same way. It’s called safety conditioning.” [36:48]

Links:

Dr. Rabin’s article: Pilot study suggests DNA methylation of the glucocorticoid receptor gene (NR3C1) is associated with MDMA-assisted therapy treatment response for severe PTSD

Dr. Rabin’s website

Dr. Rabin on LinkedIn

Dr. Rabin on Instagram

Dr. Rabin on Twitter

Apollo Neuroscience website

Psychedelic Medicine Association

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In this episode of the Psychedelic Medicine Podcast, Mark Braunstein, DO joins to discuss the promise and the peril of ketamine. Dr. Braunstein graduated medical school in 1997 then completed a General Psychiatry Residency at the University of New Mexico and then a fellowship in Child and Adolescent psychiatry at Maine Medical Center in 2002. Upon graduation from his fellowship and becoming board certified in general psychiatry he established a private practice in Durango, Colorado where plant medicine became part of his everyday integrative psychiatric practice.

In this conversation, Dr. Braunstein shares some of the developments in the world of ketamine in the past three years since his previous episode, drawing on his own experience providing ketamine-assisted therapies. He stresses issues of grandiosity that can arise both when working with ketamine and when taking the medicine—issues which in the worst case and fuel ketamine use disorders. Dr. Braunstein stresses the importance of clinicians providing ketamine treatments being realistic and upfront about the potential harms of ketamine when advising prospective patients. In closing, he warns against the dangers of being in an echo chamber which reinforces potentially pathological substance use, especially for clinicians in the ketamine space.

In this episode you'll hear:

• Why ketamine has an addictive potential and how ketamine addiction presents
• Ways to treat ketamine use disorder
• The importance of informed consent
• What patients should look for when seeking a ketamine provider
• The importance of ketamine providers working with multiple modalities and having multiple tools in the toolbox besides ketamine

Quotes:

“Here’s what’s scary to me about ketamine: these people that I’ve seen having problems [with ketamine use] are largely lifetime recreational psychedelic/drug users without problems. And these are people who have made it to age fifty, smoking [cannabis], tripping a little bit, their whole life without having a problem—then at fifty years old, find themselves hooked on something for the first time.” [12:30]

“[Ketamine] is not a microdosing medication… There is no such thing as ketamine microdosing. You think of microdosing as sub-perceptual. Everyone that I’ve met that’s abusing ketamine, it was not a sub-perceptual effect—they were very much abusing it to have that perceived effect. Maybe not a psychedelic effect—usually an intoxicated wonky effect is what they’re going for. And people refer to that as microdosing. It’s not microdosing. It’s abusing small doses.” [17:11]

“What do I see that makes me concerned with someone I’m talking to—a clinician or a client? That grandiosity. So that gets me concerned right away when I hear about these ‘downloads’ because that’s where … other psychedelics can have dependency too. You see people … they go for aya ceremonies every week after week after week. So there can be an addiction to the download or to the release.” [34:35]

“The people I know that have been successful in this line of work (from a patient standpoint), whether they’re a clinician or not, have been the ones that have embraced the work. And just knowing that this is going to be a process and I’m in it to win it, for life. I’m working on myself.” [35:40]

Links:

Dr. Braunstein on LinkedIn

Ketamine Research Foundation website

NeuPath Mind Wellness website

Ketamine Training Center website

Previous episode: Ketamine for Alcohol Use Disorder with Steven Mandel, MD

Previous episode: Avoiding the Traps of Psychedelic Self-Absorption with Adam Aronovich, PhD(c)

Previous episode: Navigating Psychedelic Narcissism with Adam Aronovich

Previous episode: Psychedelic Therapy: Slow Down to Heal Faster with Sunny Strasburg, LMFT

Psychedelic Medicine Association

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This episode of the Plant Medicine Podcast welcomes Dr. Angela Carter (they/them) to discuss the intersection of the LGBTQIA2S+ community and psychedelics. Dr. Carter is a queer, transgender, and genderqueer naturopathic primary care physician who also works as a midwife, sexual assault examiner, and health equity advocate in Portland, Oregon. They also serve as both the vice-chair and the equity in training subcommittees co-chair of the Oregon Psilocybin Advisory Board. In addition to these positions, Dr. Carter serves as the chair of the Transgender Health Program Community Advisory Board at Oregon Health & Science University. They also volunteer with many organizations including the Fireside Project, Black Rock City Emergency Services, and Queerdome.

Dr. Carter begins this conversation by sharing exciting new research currently being conducted which involves LGBTQIA2S+ individuals and psychedelic therapies. While this particular area of research remains small, it is growing and the fruits of these studies will be an important step for better understanding how these new therapies can serve gender and sexuality minorities, and help facilitators understand the unique concerns of people in the LGBTQIA2S+ community. Dr. Carter illustrates these types of concerns by discussing the prevalence of gender binaries within psychedelic spaces. They describe how in a clinical setting it is prevalent to have both a male and a female facilitator, but this leaves no room for gender-nonconforming people to guide experiences—something which could be preferable if the patient themselves shares this identity.

Dr. Carter also discusses this gender binary in traditional contexts. It is common for ayahuasca ceremonies to provide separate spaces for men and women, again leaving no space for gender-nonconforming people. This reification of the gender binary and the often patriarchal organization of the ayahuasca ceremony can have serious impacts on the set and setting, especially for people in the LGBTQIA2S+ community. Dr. Carter emphasizes the importance of making space for folks in the community so that they are able to receive therapy, attend ceremonies, and participate in integration with others who share similar identities. This shared identity, they emphasize, ensures that LGBTQIA2S+ people don’t feel out of place in contexts that ought to be healing. Dr. Carter closes by discussing how members of the LGBTQIA2S+ community experience disproportionate rates of mental illness, further illustrating the crucial importance of equity in accessing psychedelic medicine.

In this episode:

• Problems of representation and access for LGBTQIA2S+ individuals in the psychedelic space
• Current research being done on the intersection between psychedelic therapies and unique issues faced by gender and sexuality minorities
• Preparations to take before guiding a psychedelic experience for LGBTQIA2S+ people, particularly if you do not come from the community
• How plant medicines could have unique benefits for the LGBTQIA2S+ community
• Issues of poverty faced by marginalized peoples and how to support equity of access to emerging psychedelic therapies

Quotes:

“For some people that idea of melding, of becoming one and losing all of those unique pieces of themselves, doesn’t fit their paradigm of a spiritual connecting experience.” [10:47]

“It’s precious, that centering of our community—to be able to sit with people who just understand.” [19:42]

“Psychedelics offer the opportunity for connection of the self to something greater, something outside, a bigger community, spirituality, and really do a huge amount to heal peoples’ relationships with substances.” [25:20]

“Marginalized communities have been really impacted, largely, by the war on drugs, which has put millions of people in jail for drug offenses and stolen their ability to make income, stolen their ability to connect with community and we really need to heal that.” [33:34]

Links:

Chacruna Institute Queering Psychedelics 2019 Conference

Queerdome on Facebook

Portland Psychedelic Society

Psychedelic Medicine Association

Porangui

In this episode of the Psychedelic Medicine Podcast, Dr. Hans Eriksson joins to discuss the potential of non-dissociative ketamine. Dr. Eriksson, Chief Medical Officer at HMNC Brain Health, is a highly respected drug developer and clinical psychiatrist with over 20 years of pharmaceutical experience. Prior to HMNC Brain Health, Dr. Eriksson served as Chief Medical Officer at COMPASS Pathways and previously as Senior Director of Clinical Research at Lundbeck and Medical Science Director at AstraZeneca.

In this conversation, Dr. Eriksson shares what inspired him to move from clinical practice to drug development, and why he sees so much potential in developing non-dissociative forms of ketamine. He discusses the ways the dissociative effects of ketamine decrease the accessibility of this treatment due to the fact that these changes in perception are undesirable for a significant portion of patients. Dr. Eriksson also shares results from preliminary studies of non-dissociative ketamine which showed efficacy in inducing anti-depressant effects. In closing, Dr. Eriksson discusses why he thinks the experiential element of the classical psychedelics play an important role in their efficacy as mental health treatments, but why this might not be the case when it comes to ketamine.

In this episode you'll hear:

• The history of ketamine
• The pharmacology of ketamine’s dissociative effect
• The relationship between ketamine dose and antidepressant effect
• The possibility of bladder issues and addiction with ketamine and whether non-dissociative forms of ketamine would also have these potentials
• How Dr. Eriksson thinks about combining psychotherapy with ketamine treatments

Quotes:

“We are aiming for a similar exposure to the drug as you achieve with, for instance, an intravenous administration, but we are achieving a much lower peak concentration, maximum concentration of the compound. So that is one of the characteristics of our formulation.” [10:58]

“Our view is that it's probably better to try to use the metabolism in the body as a tool to achieve very low exposure to ketamine but high exposure to the downstream metabolites.” [23:19]

Links:

Dr. Eriksson on LinkedIn

HMNC Brain Health on LinkedIn

HMNC Brain Health website

Previous episode: Potential Benefits of Non-Hallucinogenic Psychedelics with Kurt Rasmussen, PhD

Psychedelic Medicine Association

Porangui