June 18, 2020

From podcast: https://bengreenfieldfitness.com/podcast/brain-podcasts/psychedelic-therapy/

[00:00:00] Introduction

[00:01:32] Podcast Sponsors

[00:04:05] MAPS Capstone Challenge

[00:08:34] Guest Introduction

[00:14:07] The Major Announcement

[00:19:02] The Efficacy Of Psychedelics To “Healthy Normal” People

[00:22:54] The Gold Standard On Microdosing For Enhanced Productivity

[00:32:25] Just In It For The Drugs

[00:35:14] Podcast Sponsors

[00:37:51] How Psychedelic Therapy Can Treat Addiction To Tobacco

[00:49:32] Importance of Music In A Psilocybin Treatment

[00:53:06] Anxiety During The Session

[00:56:50] The Dosage Used For A Treatment Session

[01:00:16] Transitioning From The Session Back To Reality

[01:04:34] The Dark Side Of MDMA And Other Psychedelics

[01:13:45] The Psychedelic Even The Most Hardcore Users Avoid

[01:16:40] The Future Of Psilocybin In Society

[01:21:01] The Future Of Psychedelic Therapy

[01:25:20] Closing the Podcast

[01:26:53] End of Podcast

Ben:  On this episode of the Ben Greenfield Fitness Podcast.

Matt:  The experience itself isn't some oracle that's going to provide all of the answers. One has to sit with that. With their server, they're waking normal state of consciousness. People say things like, “Yeah, this person is –” they're easier-going. They get less stressed out. They're kind of like flowing in the world to a greater degree. There's not the friction and need to go that route. But I think the space is blowing up and it's going to be interesting territory and you're going to see casualties.

Ben:  Health, performance, nutrition, longevity, ancestral living, biohacking, and much more. My name is Ben Greenfield. Welcome to the show.

So, today's episode is pretty interesting for a couple of reasons. First of all, for those of you who've been scratching your head about psychedelic therapy whose only previous experience with mushrooms may have been in a chanterelle, truffle, or a rollicking rock concert or disco, you're going to learn a lot in today's episode with Dr. Matthew Johnson about how psychedelics and the use thereof goes far beyond that and is in fact highly therapeutic. And we walked through what this actually looks like, like what to expect if you go in for a so-called psychedelic treatment.

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Alright, let's go jump into this very interesting episode.

This podcast is timely, and also could indeed involve a call to action for you because of the recent MAPS Capstone Challenge that my friend Tim Ferriss has organized. So, what this means is that the Multidisciplinary Association for Psychedelic Studies is something that Tim in particular is helping to organize a $10 million challenge pledge for. And why is this important? Because tens of millions of people worldwide, as you may already know, suffer from PTSD, and millions more have suffered from emotional and physical abuse, but they've never gotten diagnosed. And on top of that PTSD, as you also may know, is incredibly difficult to treat and to cure. Conventional treatments fail all the time. And at this point in our timeline of history with the pandemic and riots in the streets, protests, et cetera, never before as the treatment of trauma been more relevant in my opinion.

Now, in good news, it appears that one candidate, MDMA-assisted psychotherapy, which is basically very similar in a way to what we're going to talk about today, which is largely focused on psilocybin, but arguably even more effective, can produce results that just defy belief. I mean, if you watch the film “Trip of Compassion,” which is excellent and which I recommend you listen to if you dig this kind of information that you're going to listen to on this show, it says in the words of one patient in that film, I felt like I went through 15 years of psychological therapy in one night.

Now, MAPS has completed Phase 2 trials with 107 participants, and 56% of those people no longer qualified for PTSD after treatment with MDMA-assisted psychotherapy. And at the 12-month follow-up, 68% no longer had PTSD, and most of them just got two to three sessions of MDMA-assisted psychotherapy. And all these folks, they had chronic treatment-resistant PTSD, they'd suffered from PTSD for an average of 17.8 years. So, the FDA granted in 2017 breakthrough therapy designation to MDMA for the treatment of PTSD. So, it's a clear path ahead to make MDMA a legal medicine for millions of people suffering from PTSD. And MDMA will also set precedent and open the door for dozens of other therapeutic compounds including psilocybin.

And the MAPS Capstone Challenge is going to help provide the funds, $30 million total that are needed to complete the studies required for FDA approval of MDMA-assisted psychotherapy for PTSD. So, MAPS has already raised 10 million at the time that you're listening to this. However, if another $10 million are raised by September 10^th, 2020, this is going to unlock a $10 million challenge pledge that Tim Ferriss helped put together. A few others came in on that pledge, and I'm going to put all the details in the shownotes if you go to BenGreenfieldFitness.com/psychedelics. But this pledge was just announced in Tim's recent interview with Rick Doblin, the founder of MAPS, and it's something that you can participate in because every dollar matters.

So, if the spirit moves you and you want to make your own impact towards making this a reality and helping a lot of people with PTSD, then you can go to the shownotes at BenGreenfieldFitness.com/psychedelics. I'll have a link there where you can contribute to this $10 million challenge pledge from MAPS. And I will also put a link in there for any of you with deep pockets who want to really get on a big level and contribute $100,000 or more over two years. There's an actual email address you can email to get involved with that. So, I'm going to put links to all of this in the shownotes at BenGreenfieldFitness.com/psychedelics, and I think it's a really cool opportunity for all of us to make a pretty big impact and push towards approval the studies that are necessary to really make this a reality. So, BenGreenfieldFitness.com/psychedelics. I will shut up now and turn things over to Dr. Matthew Johnson.

Alright, folks. Welcome to today's show, which is actually all about psychedelics. And in celebration of an entire show where we get to talk about drugs, I went ahead and consumed an incredibly, incredibly popular drug this morning. Just finished my giant cup of coffee, black coffee, but I had some shrooms in there. I actually had a little bit of chaga and turkey tail. So, one could say that I am dosed to the gills on America's most popular drug as we get into a discussion on drugs and psychedelics. So, there you have it.

My guest is — he's an amazing guy. I've actually had a chance to meet him. I believe it was at kind of a biohacking futuristic conference up in Canada, and his name is Dr. Matthew Johnson. I first heard about Matt from Tim Ferriss because Tim has been pretty heavily involved in and interested in some of this research on using psychedelics for therapy that has occurred at Johns Hopkins. And it turns out that Matt is the Professor of Psychiatry and Behavioral Sciences at Johns Hopkins, and is not only that, he's one of the world's most published scientists on the human effects of psychedelics and he has conducted a host of research on the behavioral economics of drug use, addiction, risk behavior. He's been working with psychedelics since 2004, you guys, back before pretty much any of us were even thinking about it or talking about it.

And so, he has published the first-ever blinded human research into something called Salvinorin, which we'll talk about today, something in Salvia divinorum. He's done a ton of research on psilocybin for a whole host of effects, published the largest study of psilocybin for treating cancer distress back in 2016, has also done a lot of work on psilocybin and tobacco addiction. And, he is all over the media. This is the guy that folks go to when they need an educated master opinion on psychedelics. You may have seen him in many, many magazines and newspapers. His discussion with Tim Ferriss at the Milken Institute Global Conference was broadcast on Tim's podcast and his research was also featured in Michael Pollan's really good book, “How to Change Your Mind.” You might have come across some of Matt's research there. And the list goes on and on. And if you go to BenGreenfieldFitness.com/psychedelics, that's BenGreenfieldFitness.com/psychedelics, you figure out how to spell that. I will link to Matt's research page and also his comprehensive bio, as well as anything and everything that you hear discussed on today's show. You can just go to BenGreenfieldFitness.com/psychedelics.

Matt, welcome to the show, man.

Matt:  Thanks so much. It's really great to be with you, Ben.

Ben:  I have million-dollar question that — probably the last guy interviewed with as epic a beard as yours was the longevity researcher, Aubrey de Grey, who has a pretty impressive beard in his own right. But are you still rocking your epic beard?

Matt:  Yes, I am, yeah.

Ben:  Amazing.

Matt:  Yeah. One of those is sort of a Samson thing with the beard length and the longevity connection.

Ben:  Yeah. Sign of wisdom — I would dye it gray though. I think if you dyed it gray, people would take you even more seriously than they do now.

Matt:  Right. Really good for the old school professor thing and have a track of pipe hanging out of my mouth, so yeah. William James kind of fits with the psychedelic theme. I like it.

Ben:  Exactly. With lots and lots of stroking. You got to get your beard stroked down to the point where you develop carpal tunnel until you really, really rock the beard stroke. Then you'll be believable.

Matt:  People tell me I do that and I'm unconscious of that to a degree and it's kind of like when someone does the Matt Johnson impersonation in the lab, it always involves like stroking the — even before the beard is long, stroking the chin.

Ben:  Well, you're hold up. We're actually recording this for those of you listening in in May of 2020 during the sheltering in place orders. And Matt, you're quarantined up there in Maryland, right?

Matt:  Right, Baltimore.

Ben:  Okay. Cool, cool. That's pretty much right on the Johns Hopkins Campus, yeah?

Matt:  Right. I live right at the edge of the Bayview Campus, which is just about just a couple miles away from the main Hopkins Hospital in the center of downtown.

Ben:  Beautiful. And dog, wife, kids, all the above?

Matt:  All of the above. One kid, one dog, one wife, one cat.

Ben:  Nice, nice. How old is your child?

Matt:  Just turned three. It's a fun time to be locked up and quarantined.

Ben:  Oh, yes. Three-year-olds have no energy. You'll be fine, trust me. So, anyways, there's a lot that's been going on. I mean, people would have to be hiding under a rock right now to not really know that there's a lot going on right now in terms of research into psychedelics, and a lot of wheels turning, and things moving, and gears grinding in that sector. And like I mentioned in the introduction, I was first connected to you when I asked Tim Ferriss a few months ago about who the best guy to interview in this world would be and his gut response right off the bat was you, Matt Johnson.

And then, I saw you speak at that conference up in Vancouver and I realized that you really are a wealth of research on this stuff. And the reason that I had initially decided to have some of the pockets to talk about psychedelic research was when an announcement was made at Johns Hopkins. I guess this was late last year. Can you fill people in on what exactly happened there?

Matt:  Yeah. And Tim Ferriss played a huge critical role in that. It was the announcement of our academic center on psychedelics. And so, this is the world's largest center on psychedelic research. So, to be clear, our group has been doing research on psychedelics since the early 2000. I started in 2004. But the center has this special meaning. It sounds generic, but a special meaning in academia, basically means a big pot of money. Enough to really provide the total infrastructure for a large number of studies, and all of the stuff that falls between the cracks, the auxiliary staff, the capital investments. For example, we're building session rooms with the center investment.

So, it was about a $17 million philanthropic donation, which has been the largest donation to this research in its history. And this is really meaningful for us because we've been limping along on a wing and a prayer since the very beginning, and we were at our cancer protocol before there was even any clue that there'd be someone out there to fund it.

Ben:  Now, would that lack of funding be across the board for other centers at Johns Hopkins as well or is it because of the controversy regarding the funding or the research specifically regarding psychedelics, if that would be the case?

Matt:  Well, so often, center level funding is going to be coming in the U.S., going to be coming from NIH. And so, thus far, there has not been any NIH funding of therapeutic research with psychedelics. There's been plenty of research on the harms of psychedelics, a whole lot in terms of MDMA in that regard, but none in terms of using it to help people explicitly. And so, this is where things are a little different. And it takes someone like Tim and the other funders to step up and say, “Hey, something's really falling through the cracks.”

So, to be clear, there have been funders for our research throughout the years. The Heffter Research Institute has been one of the primary ones and they have funded a number of our studies through the years. But these are smaller organizations that are really doing their best focusing on this and so much of — we've put in far more time in terms of professional time percent effort than really has been paid for in this type of funding. So, the center level funding has really allowed us to jump in full time.

Ben:  Okay. So, this means that, for example — and I guess to give people a practical example, when you say something like a treatment room, does that mean that what originally would have been like a couch on an eye mask is now like a NASA-esque chamber with electrodes attached to people's heads? Well, when you say treatment room, for example, what would that mean that you guys were able to add dedicated treatment rooms?

Matt:  Well, we're getting the electrodes really.

Ben:  Okay. Good.

Matt:  The center level funding does include some stuff in that category. So, it includes both neuroimaging, but it also includes EEG measures. So, there's your electrodes, but in increased number of just session rooms even for studies that may not involve those.

Ben:  And actually, I'm serious, like for people who have no clue, if they were to walk into — because I know these things are going to become increasingly widespread, these psychedelic treatment centers. If someone were to walk into, say, a treatment room, what does it look like?

Matt:  It looks like a really comfortable upper end living room.

Ben:  Okay.

Matt:  Nice couch, oriental carpet, end tables. And you got to peek around a little bit like, “Oh, what's that under your coffee table?” “Oh, that's a heart monitor, blood pressure monitor.” So, we tuck away, try to minimize that sort of medical [00:18:52] _____.

Ben:  Right. So, it's basically like going to visit grandmas with technology hidden throughout?

Matt:  Right, right. If grandma has some really killer art on the walls, and yeah, [00:19:02] _____.

Ben:  Okay. Yeah. Modern grandma. Okay. So, there's a lot of places that we can go here, but before we delve into therapy, the reason I want to ask you this question is because I know my listeners and I know that many of them may not feel as though, or even have not had trauma, or may not be carrying trauma with them, some of them although they might be, say, addicted to their CrossFit workout or their ribeye steak at the end of the day might not struggle with drug addiction or opioid withdrawal, or anything that psychedelics are increasingly being looked to for therapy.

And so, my first question for you is, can psychedelics be used for goals like optimal performance, for positive psychology, for, and I have no clue if you've even looked into this, athletic performance? So, walk me through what the world of psychedelics, either microdosing or otherwise would look like for someone who would be looking at the research or trying to find a way to determine whether or not these could be used to enhance oneself from a performance or a positive psychology standpoint?

Matt:  Sure. And actually, a whole lot of our research has been in the realm of positive psychology. So, not to treat this disorder or that disorder. So, that is to say using healthy normals, the code word and research for people that aren't diagnosable.

Ben:  Glad someone could speak to speak. Yes. How would this look for healthy normals? Why would this even be appealing to healthy normals?

Matt:  Yeah. So, I mean, you used the term positive psychology. So, if your listeners know anything about that, and gosh, just common sense, and life experience tells you just because you're not diagnosable for some disorder doesn't mean you don't have problems. It doesn't mean you're living optimally. It doesn't mean you're using the old Maslow language, self-actualized. And so, the work we've done with high-dose psilocybin, looking at mystical experience and the long-term outcomes in these healthy normals, that certainly falls in this category. And we do see signs from the participants from themselves, not only them, but neighbors, spouses, co-workers. People say things like, “Yeah. This person is –” they're easier-going. They get less stressed out. They're kind of like flowing in the world to a greater degree. They got some of the kinks or a bout of them.

So, we see evidence like that. We've conducted research even a little more particular than that looking to see if this could help jump-start a so-called spiritual practices, or jump-start a spiritual practice program including meditation, but also some other activities, journaling, et cetera, and found that it did look like a high-dose psilocybin experience could really help people gain more of the positive outcomes from activities like meditation, particularly the prosocial claimed benefits.

Ben:  Yeah. Well, I'd be curious to hear your take on a couple of things. First of all, beginning in Silicon Valley and then spreading elsewhere, many CEOs, high-end execs, the folks I've talked to have begun to delve into microdosing, microdosing not only with LSD, but sometimes using something like the Paul Stamets Stack has become quite popular of late combining lion's mane with psilocybin and niacin. I know that others are microdosing with things like MDMA to enhance connectivity or compassion. And some schedules that I've seen will even alternate a day on a microdose of LSD, and a day on a microdose of psilocybin, and then a day on some kind of a heart opener like an MDMA-esque compound.

And many folks are using that very similar to how they use a cup of coffee or similar to how they might have used, say, something like modafinil before they would have used LSD or psilocybin in a microdose. And I'm curious what your take is on the safety and efficacy of some of these microdosing schedules and whether there is some kind of a gold standard microdosing schedule for something like enhanced productivity.

Matt:  That's a great topic. Most important thing to say upfront is we've done quite a bit of work with high-dose psychedelics, high-dose psilocybin, and similar work with others who've done with MDMA and LSD. There's been very little research with so-called microdosing. I've actually administered what would be called microdoses in a number of studies, but not in a design that's really allowed to appropriately test the microdose. In other words, the microdose was the control condition. And we didn't have a zero dose to compare it to. And plus, these were just acute models where people were only receiving one, two sessions. So, that's not where the claimed benefit from microdosing is coming from. And the few studies that have actually looked at microdosing in a controlled double-blind way in the lab haven't shown any benefit. They've only shown slight amounts of impairment.

Ben:  Really? Do you know what compounds were studied?

Matt:  Yeah, LSD. Yeah, yeah. LSD is the primary study — a compound that's been studied with this.

Ben:  Did that surprise you? And the reason I asked this is virtually, every athlete who I've spoken to, who has learned to use LSD at a microdose of, say, 10 to 20 micrograms truly feels that there's some increase in stamina and ability, and even the ability to be able to enter something like a flow state. And I've heard very similar feedback from writers or authors who will use it to merge left and right hemispheric activity. Many hunters will — well, not many, but a surprisingly large number of hunters are now using something like a microdose of psilocybin to enhance sensory perception, smell, hearing, awareness, et cetera. Is this just all anecdotal and there's really no research behind any of these microdosing protocols?

Matt:  My bet is that there's something there. So, to be clear, there are thousands of things you could study. And so, none of the things that you just mentioned would have really been tested by the models used in the studies that have been done. So, nothing athletic has been looked at at all. What we've seen so far are sort of standard neurocognitive type tests of executive function, this type of thing. But there's far more work to be done there.

Ben:  I would definitely agree, by the way, because at present, at the time we're talking, psychedelics to my knowledge do not appear on the World Anti-Doping Associations list of banned substances. And I would assume that that has to do with the lack of robust scientific studies into their effects as a performance-enhancing drug, but it's still incredibly, I guess intriguing to me that again, anecdotally, folks are reporting some pretty impressive performance breakthroughs in addition to psychological breakthroughs with this use of microdosing and WADA isn't even paying at this at all.

Matt:  That's surprising because I know it doesn't take much research at all to end up on that list. I know some of the nootropics that with not much research behind them end up on that list. So, yeah, we'll see. Maybe they'll hear something about it and add it to the list. One of the things that doesn't surprise me about this is that if people will add a high enough dose, ratings of stimulation will be increased. I mean, people will feel something at a certain level. I mean, we know caffeine has ergogenic effects that, particularly if you don't have tolerance to it — you mentioned modafinil. There's so many compounds that will provide an athletic boost.

One of the big questions I have, whether it would be for athletics or for pure cognitive performance, and of course there's a connection between the two, is what's the relative efficacy. Let's put these under double-blind conditions and compare it to a decent dose of — just a small dose, five milligrams amphetamine, or known as Adderall, for example, or modafinil, or caffeine, and really see. Now, a lot of people will say, “Well, psychedelics are special because you don't get tolerance to them.” Well, you're using them every three or four days. Are you switching between compounds? If you use stimulants that way, you're not going to get tolerance either.

So, I'm not saying that there's nothing there. My best bet is that a chunk of it is the placebo effect, is expectancy effect, and I bet a chunk of it is real. And my big question with microdosing in contrast to high-dose psychedelic effects, which are clear, they're in the unique category and they're very powerful. My question with microdosing is how special are they? Is this in the realm of a modafinil effect, or even a good caffeine effect if you're not tolerant?

Ben:  Right. Well, a lot of people don't really — caffeine was banned by WADA all the way up 'til 2004 based on its very similar effects to something you would get from psychedelic or any other type of the drugs you mentioned like modafinil or Adderall.

Matt:  I had read back, I think from Michael Colgan, back when I — about 20 years ago that there was sort of a limit that you could get away with like 200 milligrams, but over that —

Ben:  You know what, I heard that high concentrations — and it was very high. I mean, we're talking I think somewhere in the realm of like 10 milligrams per kilogram were something that that they were looking at, but I don't know if even that wound up on the list. And so, as you know, we're talking like five to six pretty good-sized cups of coffee for pushing like the 500 to 600 milligram mark. But I mean, a lot of the research studies done on caffeine, you go through a removal phase of anywhere from two to four weeks, and then a large bolus, 400 up to 600 milligrams I've seen in some studies to harness some of the ergogenic effects of caffeine. And I guarantee, if I were to not drink coffee for two weeks and then consume 500 milligrams, I would probably feel very similar to how I'd feel on at least 50 micrograms of LSD. So, I mean, there's some definite crossover there, I would imagine, but it's intriguing to me that there is — and I didn't even know until you just told me that there's that little research actually being done on some of these microdosing schedules or these compounds that seem to be becoming more and more popularly used amongst, again, not just CEOs but also athletes.

Matt:  Right, right. And I used to use caffeine like that back in college when I was using it just for athletic performance and for working out. I mean, just taking it twice a week and not the other days, wow, I mean, it's firing, yeah. And so, is taking a small dose of LSD every few days, is it like that? Maybe it's something better, but I suspect a part of this is that people are so excited and enthusiastic about psychedelics that they're bringing this rigor to their use of the psychedelics that they wouldn't normally use with these other compounds. Like if you really just use the modafinil or the caffeine or what have you, the Ritalin, the Adderall, every third or fourth day, and only under those circumstances where when you're doing the heavy workout, when you have to be really in a high-demand cognitive situation, would you get similar effects?

Again, maybe there's something special, but that's what I'd really want to see because it doesn't surprise me much that a small dose of a drug would give you a little pep in your step. And that's what people are saying. You're more in the flow, but that's just also so ripe for the placebo effect. You go to the grocery store, at least back when you weren't wearing a mask during COVID, you smile a little more to the checkout person and he or she smiles back a little more to you. There's this constant feedback from the environment. If you go into this expecting, “Oh, I've taken this thing that's giving me this boost where I'm going to be more in the flow,” you're going to be in the flow, and we all have those days where we're more in the flow. That's why you really need double-blind conditions with this to tease it out. And again, I really want to see comparative pharmacology studies. Amphetamine is pretty amazing. And you're talking about facilitating different forms of cognition and athletic performance. So, is it more special than that? Maybe it is.

Ben:  Yeah. And you can feel free to of course plead the fifth, say, “No comment.” And as a respected researcher with a very impressive beard, I know there are things you can and cannot say, but have you personally ever done much in terms of experimenting within these microdosing schedules?

Matt:  Well, I will plead the fifth. I usually joke that I give the politicians answer, which is the non-answer.

Ben:  It's one of those things that I think about sometimes. I've actually never heard this question asked to an actual researcher in psychedelics, but I've heard this thrown around before, almost in like a cocktail party-esque way.

Are all these researchers just using this as an excuse to get high or to justify their own drug use? Or, are these children of the '60s who are just trying to make their use of psychedelics seem somehow respectable? And I'm curious if you've ever come across that thought pattern or if you have any kind of a reply to the people who might question the research and think this is just an excuse for a bunch of people to get high?

Matt:  This is really funny because it crashes, that expectation crashes into the reality of research. And it reminds me of this meme that went around social media a few years ago, at least amongst academics, sort of like where you'd have these six panels that — and there's different versions in different fields. So, there was one that went around for psychedelics, like, this is what my students think I do and it's the person tripping out, going back to his office and being blasted out after smoking DMT or something. And this is what my wife thinks I do and it's like the hot undergrad leaning over the desk and everything.

And this is what you need. Go through these different panels, and then the last one is like what I really do, and it's a stack of damn paperwork. So, I red tape — it's how I feel about this. It's like this would be a really poor way to just — I mean, I'm not encouraging anybody, but drugs aren't that hard to come across. So, this would be a really inefficient way just to have an excuse to use drugs. One certainly wouldn't — if they were going to use any of these things, they wouldn't use their own supply. That's regulations. So, no. And in fact, I think it's really wise for folks getting into this field. And a lot of students contact me interested in this area.

I really advise folks to really keep it away from any potential use, whether someone's used or not. If you say hypothetically like, “Yeah, I had some experiences back in college,” a whole lot of people would say, “Man, you're biased. You already know the answer. You're just trying to fit your pre-existing biases.” And if you said, “No. In fact, maybe I've been curious, but I've never done these things.” And so, no experience. I just want to be pure and not taint myself. You'd have a whole other range of people saying, “Man, that's completely unethical. You have no right to do this to people unless you know what it's like in yourself.”

And so, I think it's best to just not address the question. I think the most important underlying question that appoints to is like, “Do you have an empathy for the magnitudes of these experiences, particularly with high doses that can sometimes unfold?” And just because you've had a psychedelic experience doesn't mean you've had this particular person's psychedelic experience.

Ben:  Hey, I want to interrupt today's show to tell you about something I do every single day. There's a lot of things I do every day. I eat every day, mostly. I poop every day. I exercise just about every day, do a sauna almost every day. But I also use this infrared and red light, full-body, strip off all my clothes, walk into my office, do 10 to 20 minutes. And the research on so-called photobiomodulation is profound for skin rejuvenation, for enhancing muscle recovery and performance, for reducing joint pain and inflammation, for sexual libido and testosterone, for sleep. You can use it to simulate sunrise, sunset, the list of benefits of this biohack goes on and on.

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The majority of researchers who I've come across in this sector are actually dedicated to either finding very safe and effective ways to get people off of the arguably more harmful addictions that you studied such as, let's say cigarettes or opioids, or if they do engage in the use of these psychedelics themselves, seem to be doing so in about the most responsible way that I have ever heard in terms of truly respecting the setting, the potential effect on neurotransmitters, the correct dosing, et cetera. And so, I would say if anyone were justified in the use of a psychedelics protocol, it would be the person who's done the most digging themselves, these researchers, including folks like yourself.

That's why I actually want to turn to some of I think the more important and world-changing topics that I wanted to ask you about. And of course, I think the perfect place to start would be something that you have been researching — I believe it was in 2014 you published the first research on psychedelic treatment of tobacco addiction. And obviously, that's a big issue. There are many people addicted to cigarettes. There are many people addicted to chewing tobacco, to nicotine sprays, the nicotine patches as well. So, boots on the streets, what have you found in terms of the psychedelic treatment of tobacco addiction? And also, from a very practical standpoint, what would be a psychedelic approach to alleviate something like a tobacco addiction? And finally, not to throw too many other questions at you, but I'd love to hear how that might compare to other methods, like let's just say switching from someone from a cigarette to a patch, or gradually, decreasing the milligram dosage of something like nicotine.

Matt:  So, so far, our line of research looks really promising. The first pilot study, we gave people two or three psilocybin sessions. Most folks had three. And it was a small study of 15 people, didn't have a control group, didn't have enough money at that time, but it was just a pilot feasibility study. And these were pack-a-day smokers smoking on average 30 years. We saw an abstinence rate biologically confirmed through two different methods and self-report. So, biologically confirmed success rate that exceeded anything that had ever been published in the scientific literature. At six months, 80% of the people in this small sample were biologically confirmed as smoke-free.

And then, we did a year-long follow-up, and then a very long follow-up at two-and-a-half years. At two-and-a-half years, 60% were still biologically smoke-free. Nicotine replacement typically gets anywhere — at six months will get anywhere from, depending on how it's done, 5% to 20%, the best stuff medication out there.

Ben:  Okay. So, 5 to 20, what did you say your percent was?

Matt:  Eighty.

Ben:  And which psychedelic treatment was being used for that?

Matt:  Psilocybin.

Ben:  Okay.

Matt:  Most people had three sessions with psilocybin. And now, we've moved into a much larger randomized study where we're answering the question that you posed exactly comparing it to nicotine patch. Patch works better than placebo, but in those studies for patch, you might get 20% or say 15% versus 8%. Fifteen is better than eight, but you got a lot more room for improvement. So, we're comparing them head-to-head. We scaled back to just one session for experimental reasons because we're doing brain imaging before and after, but just one session, high dose of psilocybin comparing that to a normal FDA standard label approach to nicotine patch. And we're randomizing 80 people and 40 people into each group. And so far, the most recent data, it's in progress but the 43 people who have gotten to their one-year follow-up, our current success rate in psilocybin is 57% biologically confirmed, abstinent, with one psilocybin session compared to 27% with the nicotine patch at one year, which is very good for the nicotine patch. I think we're doing very good with that.

Ben:  So, for people who again would have no clue what this would look like, someone's addicted to cigarettes. They go to a treatment center and you said three sessions. So, in terms of what that would look like, walk me through what happens when someone walks into the clinic. I mean, how much psilocybin are they receiving? Are they then laying down on a couch? People would love to hear what this looks like practically.

Matt:  Right. It's preceded by about eight hours of preparation sessions where they are not getting the drug, where they're going through both the preparation for psilocybin, which is standard in the field for any psychedelic research, at least for the high dose.

Ben:  Which would look like what?

Matt:  Really rapport building, getting to know this person, the two people who are going to be with them in that room when they're having the effects, like really establishing rapport, having the participant discuss their life, their childhood, their romantic relationships, their job, their career, what they spend their time doing, and their worldview, whether it's religious, spiritual, none of the above, like, what are your big thoughts about what's going on in life? And we combined that with telling them, “Here's what you can expect from psilocybin,” which is basically a laundry list of could be like this, could be like that, because it's the variability. It could be hellish, it could be majestical, it could be both, often is.

But then we combined that with what you'd call cognitive behavioral therapy for smoking cessation, CBT. So, CBT is the typical backdrop to most smoking cessation programs if you call one of the 1-800 state quit lines or get on the American Cancer Society website. All of that content is going to be primarily CBT-based. And we know that using those types of techniques work. And one of those techniques is to assign a target quit date, several weeks of time. Don't just quit on the fly, but keep smoking as normal. But then as you're still smoking, you keep your eyes on the price, you're mentally thinking about that target quit date coming up, approaching ever closer. And your target quit date is on the same day as your first psilocybin session.

Ben:  Now, I'm going to stop you right there before you come in because I know if I'm wondering this, a lot of other people are too. Is there a control group that goes through those similar eight weeks but without the psilocybin treatments, or something that allows you to compare whether or not there is an effect from the protocol leading up to the actual administration of the psychedelic versus not?

Matt:  Right. And we are doing that in our current randomized study. The randomization is done right before the final preparation session that distinguishes, that just has the psilocybin specific content. So, all of the standard CBT that's going to be important for everyone, those are in the preliminary prep sessions and we only randomized at that point. And so, the contact time at that point is very similar.

Ben:  And when you say CBT, that's cognitive behavioral therapy?

Matt:  Right.

Ben:  Okay. So, that's the flavor of the therapy that someone's doing for those eight weeks leading into the actual administration of the psychedelic?

Matt:  Right. And it's some standard stuff. It's nothing magic.

Ben:  Any preliminary results coming out yet from comparing with versus without?

Matt:  So, yeah, yeah. So, at one year after the target quit date. Right now, it looks like 57% abstinent with psilocybin, 27% with nicotine patch. So, more than doubling the success rate.

Ben:  And did both those groups have the cognitive behavioral therapy?

Matt:  Right, right. We don't have a group without that.

Ben:  Okay. So, that's what you're currently studying?

Matt:  Right.

Ben:  Okay.

Matt:  And the next study that we want to do, and I'm trying to get some funding from the National Institute on Drug Abuse for this, is to do a double-blind study, which is what you need to do. All of these research methods really complement each other, but doing a double-blind study.

Ben:  Yeah. Meaning, the researchers are also blinded?

Matt:  Right. And so, that's what the double-part means. The study we're doing now isn't even single blind, it's randomized, but it's what you would call a comparative efficacy study. It's how you typically study a novel psychotherapy where you can't blind something. And so, psychedelics are somewhere in between a medication. They clearly are a medication, but they work more like a psychotherapy. They invoke psychotherapeutic process. So, the best answer probably comes from these comparative efficacy studies. What does it look like? Randomized people, but forget about the blinding, what does it look like comparing to a known standard?

Now, you also need blinded studies. You definitely need it for the FDA pathway for approval, and you get your best scientific answer from triangulating between different study designs. But on the ground, this type of study that I'm doing now is really going to tell you how it's going to work and roll it out in the clinic where it's, you're not going to be sitting on a couch saying, “This could be the most intense experience of my life or I could just stay here and fall asleep because it's a dud.” That's not going to happen when we really roll these things out clinically.

Ben:  Yeah. I would imagine. Even a single blind study is going to be difficult if someone knows what kind of study they're in. I suppose if participants were completely unaware of the nature of the study, it could be done. But if you know you're in a study on psychedelics and you give one group high-dose MDMA, another group sucralose flavored water, it's going to be pretty obvious to both groups, which dose they received. So, I would imagine that presents some amount of difficulty.

Matt:  Right. And there's no perfect solution to that. Our group has had some success there and at least throwing some noise into the [00:47:49] _____ stimulant, methylphenidate or Ritalin as a comparator in people who have never used a psychedelic. So, you can fool a decent chunk of people, even an experienced psychedelic guide observing the participants, but nothing is going to be perfect.

Ben:  So, back to when I interrupted you, you're talking about, after someone goes through these eight weeks, they then go into the treatment room, and what happens then with something like psilocybin treatment for tobacco?

Matt:  Right. And that's where the psychedelic treatment is really going to look like all of our other psychedelic treatments. And so, all of the tobacco-specific stuff really happens outside of the psilocybin session experience. They come in, check their blood pressure, they fill out five minutes of questionnaires. And we have a brief discussion with them. They take the capsule in almost a ceremonial like — I mean, it's very generic, but it's like we present the psilocybin in a spirit of thankfulness and remind them that we're there to take care of them and that we're wishing them the best, reminding them that we're going to be with them, that we're in this together.

So, they take the psilocybin. It's going to be anywhere from typically 20 minutes to an hour before they feel anything. So, often during that time, we'll look through some art books, have some light discussion. They usually bring pictures of their family, which we asked them to. And so, we spend that time setting them up on the coffee table and whatnot. And then when the person starts to feel something, we invite them to lay down on the couch, we put headphones on them through which music is played. They're not playing DJ. So, all of the musical selections are already made and they're really not playing decision-maker at all.

Ben:  Alright, rabbit hole, possibly a deep rabbit hole, but the music. I know that's incredibly important from both personal experience, and also seeing how a lot of these protocols are created. Who is designing the music? Is this a researcher putting tracks together? Is this a Spotify playlist out of Sedona, Arizona? I mean, like where's the music coming from?

Matt:  So, we've done some different things across studies. We've typically used a classical music playlist, largely classical music. It's evolved, but the primary and original person that put that together was Bill Richards, who was a psychedelic therapist back in the '60s in the earlier era and had some experience with using music during these sessions. So, a lot of Brahms, Samuel Barber. And the music sort of follows the expected time course of psilocybin. So, you start with some light flute and string to music, very simple and inviting, and then it deepens up. You get into some more evocative pieces. And then you reach a crescendo in terms of the intensity of the musical experience at the peak of the experience.

Ben:  I was going to say, so you're timing crescendo in music to peak at the same or at least close to the moment where you're anticipating peak activity of the compound?

Matt:  Right.

Ben:  Okay.

Matt:  And then, it remains there while it settles down a little bit. Then at the very end of the day, you have some very — in a more lighthearted music again. And so, we've played with that. And for the smoking pilot, I did actually switch up the playlist where on some sessions we had — and it's all typically non-vocal, at least during the peak. Sometimes at the very end, we have some vocals that's fine. But had a playlist where there was a lot of overtone-based musical instruments. So, Tibetan singing bowls, gongs, didgeridoo, human harmonics, vocal. People really liked that, didn't have large enough sample size to really compare, look to perform about as well in terms of people's response as the classical music playlist. But to be clear, there's a whole science to be done just right there, which we haven't — no one has done —

Ben:  Oh, yeah. I know that all over, if you look on Spotify or elsewhere, there are all these tracks that have been created for so-called psychedelic journeys. And you are right, I think the term is hermeneutic contamination when they want to remove the rational mind from following the content of words. So, most of them are word-free. But aside from that, it seems to span the gamut from Bill Richards' flavor of more classical Bach, Mozart, Vivaldi, all the way down to the didgeridoos and the deep Amazonian soundtrack. So, it seems like the music's just all over the radar right now. That in and of itself is a ripe area for research.

Matt:  Right. There are empirical questions. At the top of our list, and what we can get funded for, there's no one out there so far that says, “Here's a million dollars to compare the same psilocybin effect under classical music versus world music jazz, EDM.” That'd be a great study to run. And we or someone else will run it at some point or at least a variation of that.

Ben:  Yeah. Okay. So, back to the experience, someone is dosed, they're listening to music, they have some kind of a — what do you call it, like a sleep mask or something that would walk —

Matt:  Yeah, an eye shade.

Ben:  Yeah, an eye shade. And then what happens from there?

Matt:  There is a guy that — it's really interesting because you're really just — there is the safety net. And I've guided over 100 sessions. So, it's not what I spend most of my time doing. So, I know what it's like to be in the room with the person. If it's smooth sailing, there's not much to do, but you're present with them, which is a way of saying you're just paying attention. And the real work comes in where the person starts to have some anxiety, which about a third of folks will, about a third of folks will have some strong anxiety. And part of the preparation is for them to tell you, like, “Let me know,” even if it's just a few butterflies. Even if you can't bring up the words because you're so freaked out, stick out your hand. We'll know what it means.

Ben:  Anxiety like, “I don't know what's happening,” or anxiety-like, “I'm suffocating, I feel like I'm going to have a heart attack,” or does it span the gamut?

Matt:  The whole gamut. I mean, everything from, “I just don't quite feel right,” to like, “I feel like I'm going to die. I didn't know it was going to be like this. You guys warned me, but holy shit, I feel like I'm dying. This is not what I signed up for.”

Ben:  Wow. Do you ever get concerned as a — like, have you guys ever been physically challenged? Has there ever been any kind of physical aggression where someone stands up, they want to fight you, they want to run out of the room, those type of things?

Matt:  No, not physically aggressive, but sometimes folks do want us stand up or wand around, or indicate that they want to leave. And that's where really the work during preparation I think comes in handy in terms of you've already told them, like, “This is the place we're going to be. We're not going to walk around.” And if someone does that, you come over and you feel the situation out for where they are at, but put your hand in your shoulder, say, “Bob, everything's going great. You're doing fine. Let's just sit here. Remember, we're staying on the couch today. How are you feeling?”

You gently bring them back. And you don't force anything. There's an art to guiding these sessions. We want most of the time spent in the default position with the eyeshades on, going inward, listening to the music. But if the person tears off the headphones and says, “Guys, I don't know what's happening here, this is like I got to –” you don't force anything. You got to be cool with the person. At some point if they're, say, 10 minutes late or if they're starting to feel better, you invite them. It's like, “What do you feel about laying back down now? I think that would be a great thing to do. You want to give that a try?”

Yeah. You're just very gentle with the person throughout the process. And that's very successful. It's just amazing what — I mean, you could read papers in the 1960s where they say, in terms of dealing with bad trips coming into the ER, the best thing to do if you have the personnel, bring them into the back room, turn down the lights, and have someone just look in the eye and talk with them. And I've done this at Burning Man and the Bad Trip Tent type setting where you don't even know the person, you don't even have a rapport. But if you just are heartfelt and you show that you're really concerned for their well-being, and you look them in the eye, and you sit down with them, it works better than a sedative in terms of bringing someone down.

Ben:  Yeah.

Matt:  And you're not bringing them down, but it's better than bringing them down because they're still having the experience, which you want, but helping them to roll with it.

Ben:  And with something like psilocybin, what kind of dose is being used if some were to come in for, let's say something like tobacco addiction?

Matt:  It's a high dose. So, 30 milligrams bodyweight adjusted. What that means for folks that are used to mushrooms, it's about five dried grams of Psilocybe cubensis.

Ben:  Okay.

Matt:  This is what Terence McKenna would call the heroic dose. This is not screwing around. We've also done a number of studies where the participants are psychonauts. The research we talked about thus far are people — or the treatment studies were — and maybe someone used years ago in college or maybe they didn't, but you're not going for that. We've done the connoisseur studies where we want the psychedelic user. And plenty of those folks have said, “Even though we warn them, we tell them.” Afterwards, they said, “Holy shit, you guys were not kidding around.” Many of these people have said that's the strongest psychedelic experience that they've ever had.

Ben:  And is that because of the purity of the compounds that you are using or simply the setting?

Matt:  I think it's both. For some of the folks, it's the first time they've really gone completely introspective with the experience. Not just for five minutes shutting your eyes in the corner and then getting up or walking around, but like for quite a while, for hours, just going inward deeper and deeper and deeper.

Ben:  Yeah. That's a very good point, by the way, too. Even with microdosing, which I'll come right out and say I've tried many of these microdosing schedules, distinct difference between working at a computer and banging out a whole host of emails while on a microdose of LSD versus putting on an eye-blocking mask, some headphones, laying in bed on your back and being alone with your thoughts while on that same microdose. It's a night and day difference. Both have their utility, but you are correct. I mean, the setting is a huge determinant of the overall feeling during the experience.

Matt:  What's really interesting is reading the accounts of psychedelic researchers back in the '50s and '60s as they were figuring this out and discovering. I mean, there were two papers by this group in Saskatchewan, Canada that published papers I think a year or two apart where they reported effects in alcoholism before this method. And then afterwards, they were actually turned on to this method of introspection by this guy, Al Hubbard, who's very interesting character in the history of psychedelics. But this whole idea of just introspection, eyeshades, headphones, high-dose, and just be there for support. The skilled psychotherapists have to defy all of their instincts to jump in and start like, “No. Shut up, sit back, and be the safety net.” Reassure them when they're having a problem, but don't get in the way, plenty of folks.

This was really described well in the book “The Secret Chief” about Leo Zeff, who became an underground therapist once these things were made illegal. And he made the transition and realized, “Man, nothing I could say during these experiences seemed to do better than just making the person comfortable and letting them do their own work.”

Ben:  What was the name of that book did you say?

Matt:  “The Secret Chief”, and the most recent version is called “The Secret Chief Revealed“. I believe that MAPS has —

Ben:  Are you saying chief or sheaf?

Matt:  Chief.

Ben:  “The Secret Chief.” Okay. Gotcha. I'll find that and put it in the shownotes. Again, I'll take notes to everything we talked about you guys and put them at BenGreenfieldFitness.com/psychedelics.

When someone is getting towards the tail end of this experience, which as you've already outlined, in a case like this would be three such experiences. What's happening then? How are they taken out of the experience? What's the transition like?

Matt:  Yeah. Well, they're invited to, when it seems like the effects are largely gone, they can sit up, take the headphones off and the eyeshades, and we can start talking about the experience. Something to be careful though is people will say earlier than this, “Oh, it's over. I think it's over.” And as folks who have experience with high-dose psychedelics, sometimes someone thinks it's over and it's not. There can be sort of a loopy up-and-down effect at the end. And so, you really want to make sure it's largely over, and it's typically not at the first instance of the person wanting to get up.

But once it seems like they're at that point, then you have a good discussion around it. And I think it's really critical as a guide for these sessions and to keep in mind, you don't have the answers, they've had an experience. And the experience itself isn't some sort of oracle that's going to provide all of the answers. It's an experience and one has to then use that, one has to sit with that, with their sober, their waking, normal state of consciousness for a while before making any big decisions in their life aside from the goal of quitting smoking in this case, which was the intention going into it.

But so often, people just, these experiences can be so dense and so intense, and so much has come up. They have a hard time even starting to wrap their head around it. So, just having some discussions around it. And then their homework that night is to write a narrative, and it can be a few bullet points to like 20 pages, and we've had everything in between. But that's to start this process of — it's a hand-wavy turn but integration, taking the experience seriously, working with it in as many modalities as you can, discussing it, journaling about of it.

Ben:  Yeah.

Matt:  Coming back into the next day, using the journal entry as a point of discussion with the guides.

Ben:  Mm-hmm, okay. And then, there would be how long of a period of time before their second and third return to the treatment center?

Matt:  So, in our pilot study, we had a two-week period between the first two sessions, and then it was another eight weeks between the second and the third.

Ben:  Now, it's common I know for folks to be concerned about the biological impact of such a journey. And many people will take things like 5-HTP or methyl precursors like SAM-e or trimethylglycine, or sometimes use some type of an antioxidant for some of the potential neuroinflammatory effects like liposomal vitamin C or something like that. When someone does something like this, are you doing anything from a supplementation or replenishment standpoint?

Matt:  No, we're not. And I think it's too early in the research. We wouldn't really have a best guess. And then we would really need — if we were to include that, we would then want to include like a control group to actually produce some data on like, yeah, do people feel better the next day with these supplements? And then you're getting away from the main thing you want to study. And so, we haven't. I would say broadly speaking, I would be most interested in looking at that with MDMA where there's relatively speaking more of a concern about this just heavy neurological load that you're taking and the effects of — and certainly, it's dose and frequency-dependent, but we certainly know at the extremes that there can be very long-term serotonergic changes that come from MDMA administration. I mean, to be clear, I think what's been done clinically is absolutely very reasonable with a risk-benefit ratio in mind. But it would be nice to see some research looking at antioxidants and other things as this research progresses, particularly with MDMA.

Ben:  So, yeah. I actually wanted to ask you a little bit about MDMA because that's obviously another form of therapy that I think is becoming more and more common. My friend Tucker Max wrote a pretty viral article on Medium, which he described how it pretty much reinvented his entire life and shattered his ego doing like a higher dose MDMA therapy. And I know many people are interested in that. And yet the research that you've done, I believe you published data in 2017 about MDMA pill testing. And rather than focusing this on what the protocol itself would look like, as we did with psilocybin, I want to focus more on what you found regarding the safety of many of these compounds that are just floating around out there using MDMA as an example. So, how big is a problem when it comes to tainted MDMA? And what are some other dark side issues related to that or other psychedelics that you think people should know about?

Matt:  When it comes to just getting MDMA or purportedly MDMA products from some guy at the club, there's very good reason to be skeptical. So, we found that 40% of samples didn't include any identifiable MDMA at all, and we found that a large number of samples had other identifiable psychoactive drugs, the biggest. This type of research hadn't been conducted for years looking what were the adulterants were and ecstasy or E or Molly pills, whatever you want to call them. But we found that the so-called bath salts, which are cathinone analogues, methylone, these types of compounds, those were the most prominent. And then a distant second was methamphetamine. And then there were a number of other compounds that were — even found a little bit of paramethoxyamphetamine, PMA, which is particularly dangerous. But the cathinone compounds were the most likely psychoactive adulterant.

Ben:  Cathinones, by the way, for those not familiar, I think it's named after an actual shrub in Africa, like the khat shrub, K-H-A-T. But typically, from what I understand, I have zero experience with this myself, but people will actually utilize these or get these popularly from bath salts. Meaning that you would actually consumed orally what you would normally use as a bathing salt?

Matt:  Not quite. Cathinone is the product in khat, which is used around the Arabian area, Yemen, other nations. It's sort of like South Americans chewing coca leaf with cocaine in it. This is more like tea and coffee.

Ben:  So, this could be the dumbest question I've ever asked, but can you actually find these type of substances in actual bath salts used in the cosmetics industry?

Matt:  No.

Ben:  Okay. That's the confusion. That's something I've always wondered, so that's completely not true.

Matt:  And the reason that name is sort of stuck and it's really unfortunate, but when they were sold at head shops and even at gas stations and online, they didn't say, “Oh, here is a methamphetamine type drug.” They said, “This is bath salts. Do not consume.”

Ben:  Okay.

Matt:  So, it's like sometimes they were — the main thing that the fake — or the synthetic cannabinoids, the fake cannabis, a lot of times it's called an incense.

Ben:  Okay. Alright. Well, they fooled me because I've always wondered and thought that's strange that one could actually achieve that amount of a chemical reaction in the brain similar to methamphetamine or cocaine from something someone could buy at Bed Bath & Beyond. So, that's good to know. Thanks for clearing that up.

Matt:  [01:08:23] _____ shouldn't snort any lines of that stuff. It's probably not good for you, but —

Ben:  Right. Exactly. Whole different impact on the endocrine and estrogen pathway. So, these synthetic cathinones, you found these in MDMA. And would you say that's a pretty big problem, this type of tainting of many other psychedelics?

Matt:  Oh, absolutely. MDMA is the compound that's supposed to be in there. So, in the stuff that's called Molly or Ecstasy, or they call it MDMA, so often it's not, or it's something like cathinone. So, that's a problem because these compounds all differ in their risk profile and what is safer versus very dangerous doses. And then you have problems from combining these drugs, and so many of these adulterated samples will be a combination of these drugs, including sometimes MDMA. So, it's absolutely a problem. I really think the most dangerous form of drug use is taking an unknown drug.

Now, psilocybin mushrooms back in the '70s, a whole lot of most seized samples were found to be laced with PCP. That doesn't appear to be the case today, probably because of the technology developed growing in jars in the intervening decades. And so, now it's not hard for a college student to grow enough mushrooms for a few dozen friends in the dorm room. And so, most of these — so anything sold as mushrooms are typically real mushrooms. Of course, you never know, there's an exception to every rule, but they are typically real mushrooms.

Now, it used to be back in the day — it's sort of the opposite with LSD. Back in the day, if something was on a microdot or on blotter paper, these are very small media. If it had an effect, it had to have been LSD because there was virtually nothing else that you could fit on a tiny little piece of paper or a tiny piece of gelatin that could have an effect. It would be such a trivial amount of any other substance because no other substance you could only get 100 micrograms, which is a tenth of a milligram and actually expect to have an effect. That's no longer true because for about 15 years or so, there have been a whole wide variety of these penicillamine-based compounds like 25 in bomb and others that do have that sort of high level of potency where you can have a few hundred micrograms that can have an effect and it can fit in some of these media like a small piece of blotter paper.

Ben:  Okay.

Matt:  So, a whole lot of the stuff sold as acid is an LSD these days. And some of these are far more dangerous than LSD.

Ben:  How do you guys know — at a research center like Johns Hopkins, are you synthesizing these yourselves in a laboratory there at Johns Hopkins?

Matt:  The supply that for most of our research has been produced by Dave Nichols, one of the world's best psychedelic chemists, and he created our supply when he was at Purdue University, obviously under completely legal FDA, DEA and FDA approved conditions. So, it's 99 point whatever absurd percent pure and absent of any adulterants. So, it's the pure psychoactive compound psilocybin.

Ben:  Okay. Got it. Alright. So, we know that there are issues, and that obviously, this should make someone think twice when it comes to the sourcing and the purity of their compounds, which again is why I just get incredibly concerned with the increasing prevalence of psychedelic use when self-administered or when someone is just hunting down these compounds on their own, getting them from a friend and trying to oversee their own journey without the proper set and setting. I even know some people who will use high-dose MDMA, but rather than doing it with a facilitator, will take psilocybin beforehand and say, “Well, the psilocybin will walk me through the journey and take me to where I need to go best.”

And I just raised an eyebrow at that. For me, personally, although — like I mentioned elsewhere on this podcast, I have microdosed with many of these compounds. I would not and do not go near them for higher dose therapeutic use without being under the close supervision of a facilitator for multiple reasons. The proper set and setting, the purity of the compound, the legitimacy and efficacy of the experience itself, and even the fact that I personally feel that it is irresponsible to — I call it the fire in the house rule. Meaning that I never want myself to be in a state at my house around my family, near my kids where I would not, if there were a fire in the house or any other thing happened to be without the ability to be able to help anyone. And so, I would never ever go near anything like this without being again in the proper setting with the right facilitator just because it's the same reason I would never get drunk, which I don't, unless I were part of a research study where I was under close supervision of a facilitator who was dosing me the wine accordingly. I do not think it's right to debilitate oneself unless you have someone to take care of you.

I'm going to get off my soapbox now and I want to address a few other little things that I wanted to ask you just in the time that we have left. The first is this salvia that you've studied, salvinorin. Many people might not be familiar with that. What is it?

Matt:  So, it's a psychedelic or hallucinogen, but it's not a classic psychedelic. It works through a different way. So, it works through kappa-opioid receptors. So, these are different than what we typically think of with opioids that primarily hit the mu-opioid receptor. So, like morphine and heroin, oxycodone. This is one of the most powerful psychedelics that exists. People typically smoke Salvia divinorum. And at a sufficient dose people have experiences that are on par with DMT, smoking DMT or smoking 5-methoxy DMT, people are — and we went up to these doses in our research where we had people vaporize it in the laboratory. People will report communication with entities. Call them aliens, call them cartoon-like creatures, whatever, but there's often a complete disconnection from consensus reality, being immersed in another world and self-reported contact in communication with other entities, much like you often get with DMT.

Ben:  Interesting. Yeah. And it's surprising because that one to my understanding is legal in many states still. As an entheogen, I think that's somewhat rare.

Matt:  Right. And there was this wave about — oh, gosh, it's actually been more than a decade now where states, and then even cities were trying to ban it. And there is a whole lot of fuss over not much. It's never been a big public health issue. It's very self-limiting, even big psychedelic fans that are fans of these other compounds. The most typical thing you'll see is people will buy some of this stuff. They'll try it once or twice and say, “Holy cow.” They'll get freaked out. And a joke is that the typical thing is once a year, opening up the drawer with the salvia in it and say, “Maybe again, maybe not,” because they're just very bizarre often to [01:16:11] _____ experiences.

Ben:  Yeah. Which admittedly, DMT can be very much that way, too. It can bring you on an incredibly wild and disturbing ride when used incorrectly. So, yeah. That does not surprise me that it has that type of entheogenic-like property. I have two more questions for you. And again, these are questions that may require a slightly more brief reply in the time that we have left, but that's okay. I want to give you a chance to pipe up on this.

Psilocybin is something that we've already discussed and I would anticipate that based on your own, 2018 psilocybin abuse liability review, in which you recommended placement in schedule for upon potential medical approval, that we may not only see psilocybin treatment facilities popping up with increasing frequency under medical supervision in the U.S., but in some states or cities, and correct me if I'm wrong, it has been given some type of a relatively full legal status. And so, I'm curious if you anticipate us having a future where, for example, supplement companies in a nootropic compound might be including small doses of psilocybin, or in which someone might be able to pull into a gas station by a Ziploc full of shrooms. I mean, where do you see this going in the way that psilocybin is concerned?

Matt:  The few cities that have done something have decriminalized. So, no one has fully legalized these compounds. So, the recommendation is that if they're approved, and that means they go through the Phase 3 research, if this is approved as a therapy that it would be in schedule for. Now, [01:17:52] _____ drugs you can take at home like Ambien. That's the way you take it to sleep. You obviously use it at home. But our recommendation is that there's a strong REMS. This is the FDA system risk evaluation mitigation strategies, which can set auxiliary rules surrounding it. And so, one of those rules would be not allowing take-home use, that it has to be done in the type of setting that I've described here. It's like outpatient surgery. And there are certain drugs like that the doc has to be there. It has to be in the clinic. It's not for sending home for home use.

Ben:  Okay.

Matt:  And I don't anticipate at least anytime in the near future that this would be included in supplements. I mean, I just think that's not going to fly with the current framework. I think we're seeing a huge ship societally in terms of whether using a criminal justice approach is the right way.

Ben:  Yeah. But I mean, marijuana seem to go recreational legal so quickly. And obviously, marijuana can debilitate one in a very similar manner as improper use, or at least the use of psilocybin — yeah. I guess I should say the improper use of psilocybin are in the wrong set and setting. With marijuana though, recreational just took off. You don't see that happening with psilocybin?

Matt:  I think they're very different because psychedelics are far more powerful than cannabis. So, I don't think you're ever going to see that level of appetite, and you are going to see more — even if you did, you're going to see more casualties with its use and it's not something that one wants to fly into Denver and they haven't smoked pot since college. Someone could probably do that with little chance — there's always a chance of harm, but they're probably going to be fine. It's a different equation with psychedelics. There are more risks.

And the other thing is that the whole unfolding about the medical cannabis movement leading to recreational use, that all originated because there was just no pathway forward for the medical use of cannabis. It just did not look like it was ever going to happen. We're in a completely different situation here with psychedelics where the FDA is enthusiastic, we're not dealing with any discrepancies between state and federal law. What we're doing with psilocybin is actually more analogous to what happened in the '80s when Marinol or just synthetic THC was approved. And there's just zero controversy surrounding that. It's not the mushrooms, it's a pure compound the way FDA is used to dealing with things through that approval pathway. So, yeah. There's not the friction and need to go that route, but I think the space is blowing up and it's going to be interesting territory, and you're going to see casualties with this —

Ben:  Oh, yeah. I mean, yeah. To a certain extent, I think that as seems to happen, the stupid people will wind up either weeding themselves out or making life horribly difficult for folks who are using something like this responsibly.

And that kind of leads me to I guess will be the final question that I want to ask you, and that is what the future of this type of psychedelic treatment will look like. In terms of rollout of clinics, I personally have been speaking quite a bit with this company Field Trip Health up in Canada. I believe they're rolling out initially ketamine treatment facilities in L.A., in New York, and in Toronto that work briefly retarded in terms of their introduction by the coronavirus pandemic. But I think that they have anticipated rolling out those clinics soon. And possibly, I would imagine those would eventually get into becoming psilocybin treatment centers as well. Well, what do you think gold standard the future of psilocybin treatments or other psychedelic treatment under medical setting is going to look like in the U.S.? Say, if you were to close your eyes and dream five years from now, what the gold-standard scenario would actually look like?

Matt:  It all depends on the data, but my best guess is that this is going to play a huge role in psychiatry and mental health treatment. And in fact, just projecting really forward, I think even beyond psychedelics, I envision and I hope that ultimately, that mental health moves more towards a prevention approach where — just like a physical, like we should all probably be checking in once a year for a mental health checkup, or even maybe once a month. I think those changes are on the horizon.

So, you may actually see in the broad future a large role for these drugs in treating a number of psychiatric disorders. But then maybe also under approved, monitored, safer conditions, the use of these compounds and people without diagnosable disorders. Maybe we find that somehow, they afford the ability to prevent trauma, like we have no idea, but they have huge potential in terms of positive psychology. And I think they're going to be a game-changer in terms of our understanding of mental health. Why in the world would something help with both depression and to addiction, not just to this drug or that drug, but to a bunch of drugs? It's really helping to connect the dots. There's something underneath the surface of these disorders that's in common. And the fact that psychedelics seem to work for all of them is pointing us towards something. So, I think it's going to be big and there's going to be a lot of niches that open up including the need for treatments, novel compounds, et cetera.

Ben:  Yeah. Well, admittedly, I probably asked you about half the things I wanted to ask you, but this hopefully has been eye-opening for at least the people who have no clue, like what's actually going on here in terms of the realm of psychedelic treatment, and also what the future of it might look like, and what experience would be like. I certainly think it's fascinating, the research that you and others are doing there at Johns Hopkins. And I guess if people want to keep their finger on the pulse of what is happening in the realm of psychedelics and psychedelic therapy as a whole, is there a particular newsletter, or a website, or book, or podcast, or anything like that that you think does a good job summarizing all of this or keeping people up to date on it?

Matt:  Well, folks can certainly visit our website at Hopkins, hopkinspsychedelic.org where you can figure out how to volunteer for studies. And although we aren't really focused on the entire field, that's sort of like focused on the work that we are doing. Gosh, in the psychedelics realm in general, certainly, like Erowid is always a very nice resource. There are many out there.

Ben:  Erowid, that's E-R-O-W-H-I-D? Is that correct?

Matt:  W-I-D.

Ben:  W-I-D. Okay.

Matt:  E-R-O-W-I-D.

Ben:  Yeah. And that, from what I understand, is also where many people are piping in on their own personal experience as well, right?

Matt:  Right, right. But they pull together articles and resources on a large number of compounds, and so including user reports and links to other, oftentimes authoritative sources.

Ben:  Got it. Okay. Cool. So, Erowid. I'll link to that. I will also provide links for you guys to anything else that Matt and I discussed or brought up on the show such as that book “The Secret Chief Revealed“, the Johns Hopkins psychedelic research website, some of the information in terms of research studies on everything from these bath salts to the article on MDMA therapy by Tucker Max. If you heard it mentioned on this show, I will link to it. So, go to BenGreenfieldFitness.com/psychedelics if you want to learn more. That's also where you can leave your comments, your questions, and your feedback, and I always read those and love to jump in and point you guys in the right direction. If you have more questions about this or if you see other topics that you'd like to see covered, anything like that, go to BenGreenfieldFitness.com/psychedelics.

Matt, anything else you want to throw in before I let you go?

Matt:  Just I'm not saying to do this at home. There are potential dangers. So, just be wise about these things, but there's a lot to be excited about in this area.

Ben:  Absolutely. Listen to responsible men with beards, you guys, because obviously, that's what it takes to be smart. Well, Matt, thank you so much for coming on the show, for sharing this with us, for the research that you do. And for everybody else listening in, again, you can go to BenGreenfieldFitness.com for all of the podcasts, including this one, and until next time. I'm Ben Greenfield along with Dr. Matthew Johnson of Johns Hopkins signing out from Ben Greenfield Fitness. Have an amazing week.

Well, thanks for listening to today's show. You can grab all the shownotes, the resources, pretty much everything that I mentioned over at BenGreenfieldFitness.com, along with plenty of other goodies from me, including the highly helpful “Ben Recommends” page, which is a list of pretty much everything that I've ever recommended for hormone, sleep, digestion, fat loss, performance, and plenty more. Please, also, know that all the links, all the promo codes, that I mentioned during this and every episode, helped to make this podcast happen and to generate income that enables me to keep bringing you this content every single week. When you listen in, be sure to use the links in the shownotes, use the promo codes that I generate, because that helps to float this thing and keep it coming to you each and every week.

 

 

My guest on today's show, Dr. Matthew W. Johnson, Ph.D., is a professor of psychiatry and behavioral sciences at Johns Hopkins University. He also happens to be one of the world’s most published scientists on the effects of psychedelic therapy on humans and has conducted seminal research on the behavioral economics of drug use, addiction, and risk behavior.

Dr. Johnson has worked with psychedelics since earning his Ph.D. in experimental psychology at the University of Vermont in 2004 and published safety guidelines in 2008 that helped resurrect research on psychedelic therapy.

As principal investigator, he developed and published the first research on the use of psychedelics for the treatment of tobacco addiction in 2014. Dr. Johnson and colleagues published the largest study of psilocybin in treating cancer distress in 2016. His 2018 psilocybin abuse liability review recommended placement in schedule IV upon potential medical approval. He was also principal investigator on funded studies investigating psilocybin for the treatment of opioid dependence and PTSD.

Beyond psilocybin, in 2011 Dr. Johnson published the first-ever blinded human research showing psychoactive effects of salvinorin A, the active constituent in Salvia divinorum. In 2017, he published the first data indicating that MDMA pill testing services may reduce harm, specifically by reducing drug consumption of unknown or undesired adulterants.

Dr. Johnson is recognized for his research in behavioral economics, behavioral pharmacology, and behavior analysis. He has conducted seminal and widely cited research applying behavioral economic principles such as delay discounting and demand analysis to decision making within addiction, drug consumption, and risk behavior. This includes research determining delay discounting to be a fundamental behavioral process underlying addiction across drug classes, using economic demand analysis to determine the roles of nicotine and nonpharmacological factors in the abuse liability tobacco and other nicotine products, and using delay discounting, probability discounting, and demand analysis to understand sexual risk including condom non-use in casual sex situations. He conducted the first research administering cocaine to humans in determining that cocaine increases sexual desire and affects sexual decision making. He has conducted similar research administering methamphetamine and alcohol, examining effects on sexual decision making. He has published studies on drugs across nearly all psychoactive classes, including studies of cocaine, methamphetamine, tobacco/nicotine, alcohol, opioids, cannabis, benzodiazepines, psilocybin, dextromethorphan, salvinorin A, GHB, caffeine, and cathinone analogs compounds (so-called “bath salts”).

Dr. Johnson was the 2019 president of the Psychopharmacology and Substance Abuse Division of the American Psychological Association and is the current president of the International Society for Research on Psychedelics, an organization he founded with colleagues. He has received continuous NIH funding as principal investigator since 2009. He has reviewed for more than 75 journals and has served as guest editor on two special issues on psychedelics. Dr. Johnson has reviewed grants for NIH, NSF, the US Military, and multiple governments outside of the US. He is a standing member of the Addictions Risks and Mechanisms (ARM) NIH study section.

Dr. Johnson has been interviewed about psychedelics and other drugs by various media outlets, including the New York Times, Washington Post, Wall Street Journal, Globe and Mail, Daily Mail, Chicago Tribune, San Francisco Chronicle, Denver Post, Baltimore Sun, CNN, CBS News, NBC News, the Atlantic, Newsweek, Marie Claire, Vogue, the Washingtonian, Scientific American, Nature, Vice, Inverse, Healthline, Psychology Today, and others. He has appeared for interviews on numerous television and radio shows as well, including 60 Minutes, CNN’s Wolf Blitzer Situation Room, Fox Business News’ Kennedy, the Dr. Oz Show, PBS’ Retro Report, Labyrint (television show in the Netherlands), Spectrum News NY1, the BBC World Service, NPR’s Morning Edition, NPR’s Kojo Nnamdi Show, New Zealand Radio, and Newstalk Radio Ireland.

Dr. Johnson’s panel discussion with Tim Ferriss at the Milken Institute Global Conference was broadcast on the Tim Ferriss Podcast. His research was featured in an episode of Breakthrough on the National Geographic Channel, produced by Ron Howard, and in Michael Pollan's best-selling book, How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence.

MAPS Capstone Challenge

When I introduce this episode, I also talk about the MAPS Capstone Challenge. My friend Tim Ferriss has helped to organize a $10 million challenge pledge for MAPS, the Multidisciplinary Association of Psychedelic Studies.

Why is this important?

Tens of millions of people worldwide suffer from post-traumatic stress disorder (PTSD). Millions more have suffered from emotional and physical abuse but never get diagnosed. On top of that, PTSD is notoriously difficult to treat and cure. Conventional treatments fail all the time. Never before has the treatment of trauma been more relevant. In good news, it appears that one odd candidate—MDMA-assisted psychotherapy—can produce results that practically defy belief. As one actual patient put it in the Trip of Compassion documentary, “I felt like I went through 15 years of psychological therapy in one night.”

Now, let’s look at data instead of anecdote: In MAPS’ completed phase 2 trials with 107 participants, 56% no longer qualified for PTSD after treatment with MDMA-assisted psychotherapy, measured two months following treatment. At the 12-month follow-up, 68% no longer had PTSD. Most subjects received just 2–3 sessions of MDMA-assisted psychotherapy. All participants had chronic, treatment-resistant PTSD and had suffered from PTSD for an average of 17.8 years. On August 16, 2017, the FDA granted Breakthrough Therapy Designation to MDMA for the treatment of PTSD. There is a clear path ahead to make MDMA a legal medicine for millions of people suffering from PTSD. And just as important: If we succeed on this path, MDMA will also set precedent and open the door for dozens of other therapeutic compounds, including psilocybin.

The MAPS Capstone Challenge will help provide the funds—$30 million total—needed to complete the studies required for FDA approval of MDMA-assisted psychotherapy for PTSD. MAPS has already raised $10 million. If another $10 million are raised by September 10th, this will unlock a $10 million challenge pledge that Tim Ferriss has helped put together, alongside PSFC. Half of the pledge comes from the Steven & Alexandra Cohen Foundation, and the rest is split equally between Tim; James Bailey from Bail Capital; Peter Rahal, the founder of RXBAR; Blake Mycoskie, the founder of TOMS; and an anonymous donor.

This challenge pledge is all or nothing. If MAPS fails to raise $10 million by September 10th, they do not receive the $10 million challenge pledge. There is no partial credit, and there is a real urgency. This $10M challenge pledge was announced in Tim's recent interview with Rick Doblin, the founder of MAPS. Every dollar matters, so if the spirit moves you, please consider giving what you can by clicking here. If you can contribute $100,000 or more over two years, please get in touch with Rick and his team by emailing [email protected].

During our discussion, you'll discover:

-The major announcement made at Johns Hopkins regarding psychedelic therapy and research…14:15

• Academic center for psychedelic research was established (lots of funding for research)
• $17 million donation is the largest in history to psychedelic research
• NIH has not invested in the positive use of psychedelics (they have on the dangers)

-How to explain the efficacy of psychedelics to “healthy normal” people…19:00

• Positive psychology is a substantial part of the research
• Not being diagnosed with a disorder doesn't mean you're living optimally
• Psilocybin leads to lower levels of stress, a more pleasant demeanor
• Jumpstart spiritual practice programs: journaling, meditation, etc.

-The gold standard on microdosing for enhanced productivity…23:05

• Very little research on microdosing thus far
• The few studies done (with LSD) have shown slight impairment, very little benefit
• Evidence suggesting efficacy of psychedelics is mostly anecdotal
• “Relative efficacy” of psychedelics vs. other drugs (amphetamine, Adderall, caffeine, etc.)
• Placebo (expectancy) effect is a possible factor in the anecdotal evidence
• Double-blind conditions are necessary to determine a drug's efficacy

-Matt's response to the suggestion that he's just in it for the drugs…32:40

• It's a very inefficient way to get high
• Using is highly discouraged when researching
• Researchers employ the safest means of taking psychedelics

-How psychedelic therapy can treat addiction to tobacco…38:35

• Small study (15 heavy smokers) were given 2-3 psilocybin doses
• 80% reported they were smoke-free in 6 months
• 2.5 years later, 60% were still smoke-free
• Traditional treatments yield a 5-20% success rate
• 1 session of high dose psilocybin vs. nicotine patch: 57% vs. 27%
• Treatment is preceded by 8 weeks of cognitive behavioral therapy (CBT) for smoking cessation
• Target quit date from the CBT is the day of the psilocybin session
• A double-blind study is forthcoming

-Why the music in a psilocybin treatment is so important…49:35

• Classical music playlist (put together by Bill Richards)
• Start with light, strings
• Progress to more powerful pieces and apex close to the peak activity of the compound
• The music used during sessions is a field of research in its own right

-How to handle participants who experience anxiety during the session…53:07

• Approx. 1/3 of people experience anxiety during a session
• The facilitator is a “safety net”
• Prep the person prior to the session to alert when they feel anxious
• No physical aggression; simply wanting to leave the room
• Simply remain calm and reassuring is often the best option

-The dosage used for a treatment session…56:50

• 30 mg body weight adjusted (5 dried grams of psilocybe cubensis)
• Due to the purity of the compounds as well as the environment
• Book: The Secret Chief Revealed by Myron Stolaroff

-How a person is transitioned from the session back to reality…1:00:15

• It's easy for a person to think it's over before it's really over
• Have a discussion about the experience
• Homework is to write a narrative of the experience (long or short)
• This begins the process of integration, applying it to their life and challenges
• 2 weeks between first and second session; 8 weeks between second and third

-The dark side of MDMA and other psychedelics…1:04:30

• Tucker Max article on MDMA experience
• 40% of MDMA samples from the street contained no MDMA
• Bath salts (cathinone analogues) were also found in the samples
• Psychedelics cannot be found in bath salts you find in Wal-Mart
• Tainted psychedelics on the street is a huge problem
• Phenylethylamine based compounds can be microdosed; previously, only LSD could be microdosed
• The supply of compounds used for research at Johns Hopkins is produced by Dave Nichols

-The psychedelic even the most hardcore users avoid…1:13:50

• Salvinorin
• People report experiences on par with smoking DMT
• Communication with “entities”
• Very self-limiting: people are often freaked out by the experience

-The future of psilocybin in society…1:16:40

• Currently decriminalized in a few cities; different from legalized
• Conditions for legalization: Must be done in a clinic, with proper supervision
• Not likely to be seen in supplements
• Not likely to be on par with marijuana when it comes to legality
• Very little controversy surrounding psychedelics compared to other drugs like marijuana

-The future of psychedelic therapy…1:21:00

• Field Trip Health
• Will play a role in mental health treatment
• Move toward a preventive approach re: mental health
• Center for Psychedelic and Consciousness Research
• Erowid

-And much more!

Resources from this episode:

– Books:

• How to Change Your Mind by Michael Pollan
• The Secret Chief Revealed by Myron Stolaroff

– Other resources:

• Johns Hopkins Psychedelic and Consciousness Research website
• Psychedelics as a Performance-Enhancer in Athletics
• 6 Music Playlists For Psilocybin Journeys
• The “bad trip” tent at Burning Man
• What MDMA Therapy Did For Me by Tucker Max
• Synthetic Cathinones (“Bath Salts”)
• Salvia divinorum
• Field Trip Health
• Dr. Johnson’s panel discussion with Tim Ferriss at the Milken Institute Global Conference
• Erowid.org
• The Tim Ferriss Show

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