Welcome to mind body health and politics. I'm your host, Dr. Richard Louis Miller. The mission of mind body health and politics is to enhance your physical and emotional well being, and encourage community. And I stress encourage community, because I believe that we human beings are friendly, collaborative tribal animals. And when we associate with one enough, and one another, in small enough groups where we know everybody by name, or at least by face, we love to do things together, we cooperate with one another, whether it's sewing circles, or watching bowl games, or playing together, eating together, we love to eat together in circles and sit around and have fun and enjoy human beings, our tribal, we love to be with one another. We like to collaborate, cooperate. At the very same time, it's imperative that we remind ourselves that there is a small percentage of us who are very different. They are avaricious predators. They have been with us right from the beginning. They are part of who we are, and we must stay aware of them. These are the people who when we came out of caves, with a strong men in the cave, they became the kings. And then they became the head of countries. And in many cases, they became actual kings. They then connected with the church, as you know, and they ruled by what was called Divine Right. And they ruled the rest of us, and they called us subjects. But over a couple 100 years ago, our country became the first country since the Greeks and the Romans experimented with democracy. And we overthrew the king, and we turned against their ruling by divine right, and we became citizens. And it's our task now, to maintain this democracy. And this republic is not a given that we have forever. And it's a fragile document. It's a fragile way of living democracy, one person, one vote, Republic, everyone equal before the law. To maintain it, we must stay aware, and I implore you all who listen to spread the word of the importance of staying aware, in the words of one of my heroes, Thomas Jefferson, eternal vigilance is the price of liberty. Today on mind, body health and politics. I have the privilege of interviewing Dr. Charley Grobe. Dr. Charley Grobe psychiatrist and scientist at the University of California, Los Angeles for many years, is one of the founding fathers of the psychedelic Renaissance. His work has been seminal. Go to Google, research Dr. Trolley Grobe, find out about him, and certainly listen to other YouTubes other interviews, in addition to the one you can hear today, I had the privilege of interviewing Charlie, I think back in 2005. We're looking for that archive. I know I interviewed him after his groundbreaking seminal research that was published in 2010. Welcome to mind, body health and politics, Charlie, good to see you again, Richard. It's been a while it's been a while too long, but we'll see each other soon. As we discussed in June, at the maps conference, in Denver, Colorado, this June.
That's right. I wouldn't miss it for anything, I wouldn't
either. Were to begin with you. The two topics that I'd like to focus on the most today are end of life, end of life healing, with with psychedelics, and depression and anxiety. In general, with psychedelics. We need we need a lot more work. And we need a lot more research. I know that, but I want you to share some of your insights going back over the years. With regard to oh, there was one other topic I just missed two that I want to discuss very important today, in addition to the end of life, anxiety and depression. I want to discuss adverse effects with you. And there's a reason for that I feel that I'm going to be I'm doing a book on adverse effects of psychedelics And the reason I'm doing it, Charlie, and I know you're in favor of it, is because as we well know, the pharmaceutical companies do their best to hide their negative effects. You know that I know that. And I think it's our responsibility in this new wave of psychedelic science and research, to do just the opposite, to be totally transparent, to tell the public everything, The Good, the Bad, and the ugly. And so I want to talk to you about adverse effects today. Let's talk about end of life first, because that is a topic that's on everybody's mind. Great.
Well, let me first say that the the work we did, we we drew heavily on the research conducted by the previous generation of investigators, as I call them, the Pioneer Generation of psychedelic researchers, Stan Grof, and his contemporaries and even those older, so the use of a psychedelic treatment model for people experiencing a significant anxiety approaching end of life really started in the early 60s with Eric cast, a physician in Chicago, who was a pain specialist, and who, around 1960 heard of a, an unusual and novel compound that had been discovered and synthesized by Sandoz pharmaceuticals, in Basel, Switzerland. And in those days, you didn't need a protocol, you didn't need to go through an elaborate regulatory process. To get hold of experimental drugs, all you needed to do is write to the manufacturer, and inform them that you are an investigator, this is what you wanted to look at. And could they please send you an ample supply of whatever material it was that they that you are interested in? So this is what Cass did, he got a got a big bottle of LSD 25 in the mail was no no instructions, no guidelines to speak of. So he just went around, when he saw his patients in the hospital, gave each of his patients a pill and said, Look, this is a new drug. We don't know much about it. But why don't you take it later today. And tomorrow, when I make my rounds, you can tell me what it did. So that's what happened. And but you know, cast on hearing the reports of his patients quickly realized that there, there had to be a better way to administer the drug a more controlled and a safer way. So he, he did some consultation with some psychiatrists who had worked with with LSD and related compounds and and learned very quickly, the importance of optimizing set and setting to facilitate the best possible outcome and the least likelihood of severe adverse effects. So with set it was, you know, the person's psychological disposition, how they're prepared for the experience, and what is their intention? I think this is very important issue. What is the intention of someone wishing to take a psychedelic, it doesn't have something to do with healing as a spiritual issue, and need to answer a question get some insight, or does it have to do simply with having fun having a recreational experience? Because what that that said is is going to play a significant role in determining outcome setting then would be who you take it with, where you take it with? How well protected Are you? Do you do have provisions to handle unexpected occurrences like someone banging at the door, you want somebody straight with you, and someone who could kind of take charge of a tough situation. So cast understood this understood how to administer the drug. And he went about treating a large series of patients with chronic unremitting pain and found good results very good, very impressive results on their amelioration of pain, and they're less than need for narcotic pain medication. He also found improved mood, lessened anxiety and improve overall quality of life. Now, a colleague a few years later,
let me interrupt your Charlie, before we go on, because what you're talking about this Eric cash work, I want to point out took place in 1964. And evidently what you were doing in the 2000s, early 2000s was manifest Steve, one of what you come up with, and I know you have in your work sort of six principles that we're going to talk about later. And one of your principles is learn from the past. So you you are learning from, from the past and what was going on there? Oh, exactly. I
think we owe a great debt to the investigators from, you know, 60 years ago, from that whole whole generation, as well as we have a lot to learn from the truth. The authorities, amongst indigenous native peoples, who for whom utilizing plant psychedelics is a tradition that stretches back over millennia. And these are the people who kept the secrets alive, who kept the mysteries extent, while in the face of terrible persecution, by often by the European invaders of the New World.
CHARLIE I, one of the many things I've learned from you. One of them is how much the indigenous people going back hundreds, if not 1000s of years, knew about getting a person ready for the experience, and then doing what we now call integrating work thereafter, I had no idea that they did those such things.
Yeah, it was all very well organized, there was the there is always a good reason to have this experience, why there is a healing issue and initiation issue. The people were were prepared by the elders who had had vast experience. They were closely monitored during the experience. And in the days and weeks afterwards, they would process what they experienced, they would process what they saw, what were their visions, what stories did they tell these were essentially visions with a theme, thematic visions with eyes closed, played out a story as if it were a waking dream. And for these people, this was the heart of the matter, to learn from these visions, and to be instructed on whatever it was that you needed, needed to understand. It's really
quite something to learn and to know that they did that. I also, you know, I've learned from you how the keys to doors in the 17th century who were Christians really brutalized these people for their beliefs and their use of these special medicines?
Oh, absolutely. In the year 1616, there was an edict from Spanish authorities and any native person or any, any Spanish settler in the new world, who would dare utilize these, these taboo plants for the for their own, in a sense, religious purpose that they were dabbling and heresy, and they would be condemned with the harshest punishments of the acquisition, which meant torture and very painful deaths. I cause a very brutal time for the, for the native peoples and the perpetrators were the this, for the most part, the Spaniards and the Portuguese coming into the new world, conquering it, dominating it and taking control of the assets.
I couldn't help drawing the connection between the way those people were brutalized for using the medicines, and when and the way people are in this country and around the world. were brutalized in the 60s and 70s for the very exact same thing. Yeah.
Yeah. Yeah, very sad legacy that we had, that our contemporaries often through poor timing, poor luck, have found themselves at the mercy of a, of a fairly venal state or venal policy that is engaged in very, very harsh punitive acts. And for what now we look back on us as as not necessarily problematic. In fact, the same behavior that people were severely punished years ago is now being legalized in many cities and states around the country.
So you're telling us how in your, in your early research, in the in the 2000s, you were you were quite knowledgeable about the work of caste and of Walter panky and 69 Oh, thank you
very important player, a psychiatrist at Harvard also a had a Doctorate of divinity from the Harvard School of Divinity. He came up with this. He had the observation that his subject his patients who had advanced cancer, who had the best outcomes in terms of ameliorating anxiety and improving mood, that the best outcomes were associated with those subjects who had during the course of their Often one session, over many hours had a powerful mystical level experience. They had a mystical mimetic experience as at work, a psycho spiritual epiphany, where that seemed to propel them into a greater likelihood of sustained improvement in the psychological target symptoms.
CASS work is particularly interesting to me personally, because I'm a chronic pain patient, I've got I've got a compressed DISC DISC and degenerative disc situation, which gives me a great deal of pain. And I have found that LSD is very helpful with the pain, I've microdose quite a bit and the micro dosing can be helpful, slightly larger doses are even more helpful, keeping them you know, at a dose that's functional without going into a major psychological changes.
Yeah. Cass's psychological mechanism, mechanism of action for why psychedelics seem to lessen pain is he called it is a process of the attenuation of anticipation. Yes, it's suggesting that individuals in chronic pain are not only struggling with the the actual pain in the moment, they're also anticipating the pain in the future that is most assuredly to come by their own experience. And he found that the psychedelic seemed to break that cycle, and people were able to step out of that anticipatory loop and just be in the moment, which, and as a result, reported significant reductions in level of pain and significant reductions in the need for narcotic pain medication. This is a consistent finding with CAS with a semicolon Walter panky, and also another great researcher from that era. And kind of my personal hero, who had a big influence on my early career was Stanislav Grof, the, you know, the Czech psychiatrists who transplanted to to Maryland in the late 60s, he was actually in the US on a on a research fellowship for a year during that year, the Prague Spring ended as the Soviet tanks rolled rolled in, and he had no place to go back to So he figured he'd stay in the US, which turned out to be a tremendous of benefit for the field of psychedelic research, given the level of productivity of Stan Grof and his and his writings, which have been voluminous and of great value,
I can tell you on a personal level regarding that attenuated anxiety, that I do have it. And when that diminishes, the anticipation of the pain diminishes, and I'm only dealing with the pain, the overall subjective experience of the pain is diminished. There's no question about it, because sort of a big component has been taken away. But I'm still left of course with the physiological aspect of it. Yeah. So back to your work. And your famous study of 2010. We want to hear a bit more about it. I know you've said it so many times, but it's worth hearing about again, with the with the your end of life work.
Yeah, yeah. This This is always the study I dreamed of doing. You know, I had, but I was searching around looking for how I was going to direct a career. I heard Stan give a Stan Grof give a talk in New York City, around 1972 73. About his his clinical experience of Spring Grove, Maryland, the Maryland State Psychiatric Research Center, treating people with terminal cancer with LSD or with DPT with extraordinary result. Very, very moving. Presentation. Years later, when I was again, at a crossroad, I discovered his book that he wrote with Joan Halifax, his ex wife, human encounters with death, summarizing in some detail, his prodigious work with with dying patients. So that's that was always my dream to replicate that the opportunity rolled around in the early 21st century. It really came out of some discussions I had with my colleague on the hefter Research Institute board, David Nicholls, oh, who was kind of complaining that what really needed to happen in the field, which was very, very nascent, at that point, was replicating some of the old studies and I said, Yeah, this is something I'm very interested in. We got to talking. And I realized that I'm I was sufficiently motivated and inspired and empowered, that I initiated the process to put together, you know, all the necessary documents for submission for regulatory approval, which I was able to do. We conducted our study from around 2004, to very early 2008. And we negotiated successfully with the FDA, the DEA, the research advisory panel of California, our own in house, IRB or human subjects research committee was I was able to get over each hurdle, not as quickly as I would have liked, but we got over it, we did a lot of negotiation with the regulatory officials and had to compromise on certain issues. But there was there was a healthy, collegial dialogue. And I think in the end, the regulatory reviewers really helped us to develop an even stronger protocol.
And that was around 2009, or before published, we published in 2010. That was around
the end of 2004, we treated our first patient
because I remember, you're on a panel that I chaired in 2011, in Oakland at a Maps conference. And I remember distinctly that the woman sitting next to you, a psychiatrist, talked about the draconian methods that the government used on her when she wanted to do some MDMA research and what they put her through for a little tiny vial. Do you remember that story, where she said she had to build a room with cement walls cement for
the DEA is very, very clear specifications for if you want to possess a schedule one drug, for a research study, it has to be in, you have to get a safe with their specifications, a very heavy safe, it needs to be bolted either into the wall or the floor, it needs to be in a locked room. And that locked that small locked room needs to be within a larger locked room. That to basically deter the likelihood of any any of the drug escaping the lab.
You remember her story how she said to armed men delivered the little tiny bottle to her. Then when they saw her room, which was concrete walls, concrete ceiling and concrete floor? They said no, they wouldn't give it to her. And she said why not. And they said, because the back wall is shares a wall with another building. And people could break through the other building and in this wall and come in and they made her build another wall. And then I read how times have changed, where you're talking about getting along quite cordially with them. And they're being helpful, and it's a different mentality, a different
ballgame. But even back when I started doing schedule one research, we did the first MDMA phase one study, and Rick Strassman in New Mexico had just gotten permission to do his DMT study. And he had a lot of scary stories about how, you know, formidable the DEA investigators would be and and he described to me the the the things I told him which frightened him about what what could happen if any of the drug was diverted? My experience was these are very collegial people. They were very friendly. Very helpful and did not at all, try to intimidate me. What was the point of that be in any event, but okay. I couldn't complain about how except that Yeah, it took a long time. But I think that's just part. That's the nature of the beast. That's what you just have to work
with. Well, that's one of your six principles, and that is learn how to navigate the regulatory obstacles. I wrote that down. Very important. So why did you pick psilocybin? I mean, I know why, but I'd like our listeners to know why you chose psilocybin rather than LSD
or MDMA or MDMA? Yeah, the LSD LSD issue. You know, most research in the 50s and 60s, it's the early 70s with LSD. But you know, why we chose psilocybin was over Ellis's LSD lasts much longer, that's an eight to 12 hour experience psilocybin more along the lines of four to six. So we felt, you know, eight to 12 hours would be pretty exhausting for both subjects and, and facilitator. So, and an LSD is spent more difficult to control a bit more likely to induce anxiety or even paranoia, but also most important, maybe the most important issue is LSD did not psilocybin rather did not carry the reputation of LSD. LSD was the taboo drug from the 60s Was he, you know, the mainstream had repudiated it. It was a taboo compound where psilocybin people hardly knew what it was. And therefore, the old reputation, which had had very little love, really in the modern world, would not get in the way. Now why we chose it over MDMA, which was more practically I had considered an MDMA protocol for end of life. And in fact, I had submitted a couple of protocols that were not accepted using MDMA. But on reef, there are a couple of reasons why I felt MDMA would be not not as not as good a medicine as psilocybin, and MDMA is that by in the late 90s, when we were submitting these protocols, there was a huge controversy over MDMA neurotoxicity, it was even suggested that young people who were taking MDMA for whatever reason that they were going to run the risk of not only having serotonergic ly related disorders, but even dopaminergic pathology, like Parkinson's disease. I remember that and now what happened,
I was at Ricard. He's one of his lectures when he gave that that misguided information, very misguided.
And, you know, he published a paper which was headlined around the world and the journal Science most prestigious journal and all of science, basically saying that monkeys he had injected with what he said was MDMA had had serotonergic damage or dopaminergic damage. But then a year later, that he printed a retraction was kind of like buried on a on an inner page was a little box, I oops, we made a mistake that wasn't MDMA, we injected the monkeys with it was methamphetamine, what you'd expect a call dope, cause dopaminergic changes, even if severe enough, leading to Parkinson's. So after that, that debacle, the neurotoxicity position started to weaken. And much of their research, I thought was seriously flawed. I've written articles back back in the 90s and early 2000s, critiquing the neurotoxicity model, so well, but when I was submitting these protocols, you couldn't get a fair hearing for MDMA, because nor talk, the specter of neurotoxicity was this cloud hanging over the whole field.
I think, Charlie, one, just check and I want to come in. I think that's a great example, for all of us to learn from, with regard to the power of disinformation, you have, because it Riccardi published that we're back in the 80s. So I was at one of his lectures, it's 22 and 37 years ago, and the specter of the possibility still exists out there, as as a result of that one piece of disinformation.
That's right. Now, not he had, he had preclinical studies using laboratory animals, he had human studies, up and down the line, there were severe flaws and in virtually all of them. And, and I actually, for years, I, the main kind of paper I would publish would be critiques of the neurotoxicity model. And eventually it unraveled them of its own accord, when somehow or rather, there was this transfer of drugs, and the wrong drug got into the royal labor bottle. Yeah, how that happened. I know I'm sure
that's like 40 of Putin's top people accidentally die. Just a big accident. Just all toppled out. I never trusted him about that. And that suppose that mistake, but I can tell you on a very personal level, I had been taking MDMA in my therapists office in the early 80s, when it was illegal, illegally administered, and I was quite taken with not only with the effect that it had on me personally, but what I saw immediately as a medicine for couples therapy.
Oh, it's wonderful. It's wonderful for people who are a alexithymia who have trouble articulating their feelings, and has trouble facilitating healthy and therapeutic communication, like between couples who are whose relationship has hit the rocks. It's a marvelous drug for that also, I think it's a A very good fit for PTSD. However, I did feel that when it came to addressing end of life issues, that the classic psychedelics like LSD, or psilocybin, or mescaline would be more what? What would be a value to someone go through that experience, I think they hit deeper and hit more of an existential level, they hit more than it getting down to the bare bones, like life and death. And so it together with David Nicholls, we hatched a plan to, to rewrite my protocols, but you put using psilocybin instead of MDMA. And that's how we came up with psilocybin
here in the Bay area of San Francisco. Some of the guides are using a combination of psilocybin and MDMA. Yeah. And they find finding it very effective in the sense of, they're getting the, the defences down the heart opening up, but the mystical and the and the connectedness experience of the of the psilocybin.
Yeah, that's an interesting model. I mean, I think also the MDMA, you know, sometimes the psilocybin, as you're getting off, you could feel some angst, some anxiety, you can go through some rough patches, the MDMA
diplomatically shed, because, you know, some people get up and throw up during that period. Yeah.
But the MDMA will ease I think, ease that transition and Main and help to maintain a very positive effect throughout, it also seems to really consolidate the memory even stronger. I wanted, that's an important Yeah, that's important to have some memory of what the experience is all about. So you could work with it later in therapy, or in your own meditative process, or whatever.
I want to talk a sum now more about your 2010, the seminal experiment, because one of the of the many brilliant things you did is that you took the the room that would ordinarily look like a hospital room. And in so much of the early research that you see on film, it looks like a very sterile room. And that's bothersome to me, because on the one hand, we're telling people set and setting and how important the setting is. And then we're putting them in a room that looks totally sterile, that could scare the heck out of anybody. And what you did was you made hospital rooms look like people's homes, you said I got you got some help from your wife on that. From my research or your research associate, yeah,
had a good time, good flair for designing internals, interior spaces. Now what we did start off with it with a drab room on the research floor. But we we transformed it, you know, we have, you know, colorful fabrics, you know, for what normally is a curtain around the beds go we had stuff on the walls, a lot of flowers in the room, we it was once we went in there, you can see our patients were cocooned into their space with a lot of really very, very aesthetically pleasing objects around them. Very different than that old model of the, the Stark, you know, drab, a hospital. Yes,
at the very same time, I mean, actually earlier that when you were doing this, I had an impact on hospitals with regard to birthing rooms, and make trying to make the rooms that the husbands came into look more like a home and a home delivery than just a sterile hospital room. Right? It changes the psychology dramatically.
And I think setting setting can really has a role, I think, many aspects of, of, of medicine and, and certainly psychotherapy.
Now, the model you used in that experiment, there was one therapist with the person who took the psilocybin or to, to Tokay. There was two and I know Roland Griffiths in John Hopkins uses to also route right. I've always guessed that the reason you did this had more to do with the government than reality. Because in reality, we cannot offer a medicine to people that you have to hire two professionals to administer and sit with you for six to eight hours. It'll only be for the billionaires.
Right, right. It does. It does ask at a cost. We felt a bit. First of all, that was the model often use in the 60s. So we were looking very carefully at those models. But it also having the that second person in the room is a provides another safety factor. You know, really to ensure ongoing safety. You know what if the single person in the room had to get up and go to the bathroom? You never Want to leave somebody unaccompanied in the room?
I see. But what about what are people supposed to do in the real world?
Well, the real world is different. Here, we're creating a best case scenario in the real world, there may need to be some compromises. There may be one may need a single facilitator model with a second facilitator, maybe observing through some kind of video hookup, who, where they could see into the room, or where they could be called in what yeah, that people have got to people have to go to the restroom. Periodically, someone needs to come into the room behind them. But we also felt ideally, having two people in the room really just created great, greater kind of depths and strength of the therapeutic presence.
Well, certainly, if it's a male, female team, then it creates a kind of family parental kind of feeling. Yeah,
yeah, that's a traditional model. Now today's world, you know, there's kind of gender fluidity and with some subjects that they may have a preference for, to female or to male or, or what have you. So I think in today's world, you're trying to oblige that. But the standard go to model is a male facilitator, partnered up with a female facilitator
is the holy grail of psychedelic substances to come up with molecules that will have the same effect, but will last for shorter periods of time? Wow. I mean, well, what's your thinking on the length of time involved? And how important is that for the experience?
So I mean, there's a lot of interest in DMT, maybe even more so on five, Mao DMT, which are very, very short acting by comparison. But you know, my experience, it's kind of like being shot out of a cannon. And by the time you realize where you are, you're already coming back. I think a lot of the value of the psychedelic experience is being able to, to learn how to navigate that interior terrain, and psychic terrain, be able to look around and being able to understand what's going on. Remember, this is an opportunity to ask questions, and then to be receptive for what the answers are. This all takes time. And I think the four to six hour experience is optimal and far more likely to yield the kind of therapeutic outcome you're looking for compared to a 1520 minute, oh, cannon shot
I wasn't made. No, I wasn't meaning at all, to compare it to quickies like me, oh, and DMT. Because for me, I find those experiences to be like Coney Island, but I don't get to bring them and I'll get to bring any goodies back. Whereas psilocybin experience is like going into a goldmine. I bring out the nuggets, and I can work on them for the next months and so on.
Right, right. So you're asking, is there like a one or two hours? Yeah,
something that maybe two hours or three hours. But I think I think the six to eight hour model. It's off putting for a lot of people in terms of the length
of time. So by the way more? Well, I find with LSD,
which happens to be my favorite of all the psychedelics that when I get out to the seventh and eighth hours, it starts to feel a bit relentless. It's sort of like yeah, you know, I think I'd like to rest.
You know, Dave Nichols, who's really one of the most esteemed chemists in this area in the country has an interesting theory. Evidently, at around proximately, our eight LSD spins off a metabolite, I think it's 11 hydroxy LSD, which is exogenic it causes anxiety. So if you find a consistent experience that around our seven or eight of feeling some an amplification of anxiety, it may have to do with that. That metabolite of LSD,
thank you for that. You know, I thought it was more the amount of time and it's like, Okay, I've learned my lesson. I've got plenty of stuff I can work now. I don't need any more teaching enough
already. Already teaching hours is enough.
Exactly. I see. So what you're saying is that, what is it 11 hydroxy 11 hydroxy LSD. So what that would indicate, is it at about the sixth or seventh to our one might take something else to smoothen out that deceleration. So you get a soft landing rather than a jostle
possibly just to cut to calm that experience down.
Yeah. Are you are you satisfied with what's going on now with regard of a to end of life work with with a psilocybin?
Well, let's see after we did our Our study to groups on the East Coast did similar studies. The group at NYU, we actually gave them our protocol that they copied it, but they got permission for it for it for a higher, a higher dose. And then Hopkins got permission for a higher yet dose, but they had their own protocol, their own methodology. And while you use the same placebo, we use Hopkins use a different model altogether, they both had very good outcomes. They both both of their studies have gotten a lot of positive attention. Subsequently, subsequent to that there is another study at UCSF with Brian Anderson, looking at the use of the psilocybin treatment model with people with chronic HIV who had survived. These are people who've lost much of their community have a lot of survivor's guilt had a lot, a lot of lingering depression. So they were kind of psychologically very beaten down, but they had survived. So that's what that study was geared for. And they had very good outcomes as well. Now, currently, what we're doing, I'm working with Brian Anderson at UCSF, Tony bosses at NYU, and also Alicia Danforth who's worked with me closely on other studies, we are, we're putting together a large multi site study that will take place that probably five, maybe six sites across the country, that we'll use a psilocybin treatment model, we'll have our standard research method, you know, placebo controlled, double blind methodology, and, and hope to treat over over 100 subjects, and perhaps using psilocybin as the the medicinal agent hoping to get sufficient positive outcome and ensure safety to, to the degree that it will allow for a greater opening of this field, including greater access of people who are not necessarily in a rigorous research study, but who, let's say are approaching the end of their lives who might potentially benefit and hopefully will provide sufficient information that could allow the regulatory agencies to approve a, a more open policy.
What kind of subjects will you be using in that large study?
Subjects? Yeah, these are individuals with with advanced age, medical illness, cancer, but not limited to cancer could also be other conditions as well. It's long as, as long as the the prognosis is limited to two years or less.
Now, when you're gathering subjects for a study like that, and it's end of life, a very high percentage of your subjects are going to be older, they're going to be more, they're in their 70s and perhaps 80s. Is that correct?
Right, right. Yeah. And then, absolutely,
I've now I've noticed in your published work, where you make it very clear that diastolic and systolic blood pressure stays within reasonable bounds.
Right. And when it does, we use we had a moderate dose, we, we didn't have any problem with, you know, blood pressure regulation, but you're right as one ages, one's blood pressure regulation becomes more more sensitive. Well, I,
I asked Tony bolsas, about this. And he said, they set parameters for what would be reasonable spikes in in systolic pressure. And none of their subjects came outside those parameters and needed to be medicated because they were prepared to medicate them. And Trump the blood pressure. He said, It just didn't happen. That
didn't happen with us either. I know that 111 outcome of this is that we are raising the up the upper actually we're eliminating the upper age limit. psychedelic research for a very long time, was playing it safe, and basically excluding subjects over 60 or 65. Or perhaps 70. For the for the modern studies, we're taking all comers as long as they fit the overall criteria. So an aide will not be excluded by by, by age. Well, I'm
glad you're not ageist in that regard. So an 84 year old like myself could be
that without you know, there may be other reasons, but not not not by age in and of itself. And I think there's also a greater need to investigate safety parameters in individuals who are older who might be at greater risk. This is a population that might be very interested in having a psychedelic experience as they're approaching the final stages of their life. But you know, the kind of forgot where I was going, Okay, I'm seeing her mom, Fair enough. Fair enough. Now,
what about the relationship between psilocybin and afib? For you, listeners AFib is when your heart goes out of a normal rhythm and it starts doing other things?
Well, that that's a concern. Well, will the AFib you know, we'll say so. So the classic psychedelics, you know, they primarily affect the five HT to a sub receptor. But there are other sub receptors as well, they affect like the five HT to B. And they're those receptors, amongst other places are on heart valves. And they're involved in maintaining the structural integrity and functional integrity of heart valves. Yeah, because if there's damage valve, there's more of a risk for congestive heart failure, but also for serious a arrhythmias. So where you know, where we're going to be monitoring those cases very carefully, and, you know, ready to intervene, hopefully, there won't be necessity intervene. But I think we need to understand to a greater degree, what are the relative risks, I did hear of a case a couple of years ago, out of the community, not a research case, but the case of a 74 year old man, who had never purportedly taken a psychedelic, he had said he was in good health, as far as his doctor know, he was in good health, but they may not have rigorously looked for it underlying a roommate. And in any event, the guy who wanted you know, read some of the popular books out, decided it was time for him to try psychedelic even though he somehow made it through the 60s without ever having done a psychedelic. So he took, he took a psychedelic and, and within, and he did it with a, someone who came well recommended as a facilitator gave him mushrooms a moderate, moderate, high dose of mushrooms, within an hour. So he had, he had expired. And my, you know, the the autopsy report just showed a cardiac arrest. My guess was he had an some underlying a rhythm is quite possibly a fib, which were triggered to go into it your ventricular tech of ventricular fib, you know, with the psilocybin. So it kind of draws home the point that we really don't know a lot about the range of the effect on cardiac function, particularly in people who have underlying vulnerabilities which you're more likely to find, and people who are a little further down the age spectrum.
And those six principles that you put forth that I keep quoting, you're number one is optimize safety. Yeah.
Yeah. Optimize safety, optimize ethics as well, if we, I think that the the capacity of this field to continue and be successful, will will, will, will rise or fall with with our ability to establish and maintain strong safety parameters. I'm going to I think that's critical.
I'm going to take a moment here and read Charlie groves, six principles. He doesn't call them six principles, but but I call him I call him Charlie Grove, six principles. One is to optimize safety. The other implement the lessons of the past, and we've been talking about that. Right. Right, strengthen ethical standards. He just mentioned that absolutely. Report on the need for greater diversity. Well, let's come back to that. Navigate regulatory obstacles. We've talked a bit about that. And, of course, ascending funding options carefully. I want to talk to you about the diversity and the funding options. Those are two important topics, please elaborate?
Sure, sure. So diversity, if you look back on subject populations, they're primarily middle class, upper middle class, Caucasians. And we as with all research, we need to get data from different socio economic strata, and from people with, you know, different racial backgrounds. So there is a need to diversify our patient population, but there's also a need to get greater involvement in the field as a Amongst the professional staff, including the leadership, we need more women, most investigators over the last, you know, since since the 50s, there have been a few women, but for the most part, they're male, for the almost entirely Caucasian, we need to get women involved in the field, but also as taking leadership roles. And we need people of color. It just just because that's where our society is moving. And the field calls calls for that and could benefit. I think we also need a stronger connection with people who descend from indigenous tribal people who may have some, you know, within group within culture, collective knowledge that might be of great value.
Guess Yes. And the last one on your list was the importance of looking over your funding options. And I took particularly note of that, because there's a lot of concern right now about who's going to control these medicines, what kind of profits are going to be made, whether the average person etc, and that relates to funding?
Yeah, you know, this is a very, very important issue and an area that I'm also very concerned about, you know, traditionally, we've been seeking out philanthropic funding, and we've, and periodically someone comes along, who's very generous, and really helps us move our studies forward. But very often we're running this, we were running the studies on a shoestring. In more recent years, there's been the the arrival of for profit companies that want to extract profit extract gain from from running these studies. And I do have a lot of concern there, you know, these the for profits are going to be primarily interested and motivated to enhance return on investments for investigators. And they might be less attentive to optimizing safety parameters, which includes the one versus two people in the room. If it all it takes to get that second person in the room, which is another thing protective safety factor is funding, then we want that funding, we don't want funding pulled away from optimizing the the treatment model. There's also the issue among the for profits of taking out sketchy patents or attempting applying for patents that may really not be sufficiently novel and unique enough to merit patent protection, but in our legal system, you know, anything can happen. So that's a worry. And that's a an inroad, where monopolies might be might be created, there's also the taking out use patents where, you know, putting that were identified, putting a reassuring hand on someone's shoulder, if they're anxious, could be patent protected. That's absurd. That's the model that's, that was utilized. Going back to the very start of this work in the 50s. And I'm sure on many levels was it was present in indigenous tribal settings, as well as Mestizo settings, where it's, they're often used for healing purposes. So I have a lot of concern about this. There was, you know, a couple of years ago, the for profits. So we're, we're becoming very active be seeking out investment. And there were estimates at that time, that the some of these companies were evaluated at well over a billion dollars, and I thought that was horrifying, really, that that they they would be worth so much money and that they would be could conceivably be in a position where they would basically take over the field monopolies monopolize activity in the field, and so doing extract considerable profit for themselves and their investors. What we really need honestly, I think is for the government to step in and create funding mechanisms and really oversight to make sure optimal safety parameters are are utilized, but the government has been very, very hesitant or the funding elements of the government very hesitant to get involved. There was only in the last year or so that NIDA the National Institute of Drug Abuse. Approved its first treat psychedelic treatment study ever. And that was a study that just study at Hopkins with Matthew Johnson extending his work utilizing a psilocybin treatment model for cigarette cessation. And he came ahead come up with very good preliminary data. And the government NIDA says, okay, extend your work, and here's some money to help you do it. And then NIMH in the last year or two, for the first time, I think going back to the early 70s, has agreed to fund a a, a treatment study using a psilocybin model for the treatment of chronic refractory obsessive compulsive disorder. Again, there had been some encouraging preliminary research. So a group at Yale which submitted a a research grant application received a very generous award to carry out that work. At work,
excuse me for interrupting. Is that work at Yale on OCD?
Yes, yeah, that's been Kelmendi is the I'm writing it down. Ben,
how do you spell that?
Kelmendi with a k k l m, en Di.
And before you mentioned Yale, you mentioned another study with
Johns Hopkins on OCD. No, not Johns Hopkins doing the cigarettes that I know the other.
But this guy, Francisco Marino, is he still
he's the light. Yeah, at Arizona, he had done the first reexamination of the utility of the psilocybin bottle to treat OCD. And he found a signal for positive outcome meaning amelioration of the OCD symptoms that sustained over time, even significantly after the drug is, you know, taken and now it's left to left the system. So yeah, and he, you know, I believe the Arizona group had been putting together a new study, I'm not sure what happened to it. But now the the Yale people are stepping up and I think leading the way with, with the treatment of obsessive compulsive disorder, there had been some good work in the 60s, looking at OCD, again, one of the hardest areas in psychiatry and psychology to treat. And I think some Scandinavian investigators in the 60s had reported on some very positive outcomes
with using what substance they're using LSD. You don't really recall the name of LSD? Yes. Do you recall the name of any of those scientists in mind, one of them may have been Ling li Ng
and I look a good source book for it for information for research from the 50s and 60s is Lester Grinspoon. Oh, psychedelic drugs reconsidered, it's a classic, very valuable if you really want to peruse the history that started really with Hopkins discovery and 43, extended to the early Swiss work of the late 40s. And then they're they're informing colleagues around Europe and in the United States of this new experimental drug, which they were encouraging other investigators to, to examine.
So you think Lester might have mentioned some of those early OCD studies?
Yeah, yeah, I bet he did. That would be the place to find them.
Okay, we're going to switch topics. Now. As you know, there's a proliferation of people around the United States who are referring to themselves as guides, or psychedelic coaches. And these aren't people who are necessarily trained in psychiatry or psychology, or even masters level. mfcc Marital counselors. But there are people who have learned about psychedelics from some other way, or some kind of training course that's offered online, et cetera. And they're basically practicing psychedelic psychotherapy. You're familiar with what you know exactly what I'm for. Sure. And I know exactly and I would I'd like to know your sentiments about that. Well, I'm
kind of have mixed views. On the one hand I I've met I know some facilitators who don't have much in the way of degrees and advanced training who are quite capable, but my my views I tend to veer a bit towards the the conservative, you know, a, what is it? There's this famous quote a, a, I think maybe we're not Adler, a radical mind with a conservative position. You is the only place where the center holds. I see myself kind of like that, I think to play, you know, at this point, as this, as this field starts to evolve and elaborate on itself, I think it's very, very important that we do whatever we can to maintain the highest level for, for safety, and for just for general ability. And I think the advantage of a trained health professional, a trained mental health professional is we have seen a lot of psychopathology, and we're, and if we're, if we're paying attention, we get good at identifying it when we see it. And this may come in very valuable when you're screening subjects. Because you know, you don't you you don't want to allow people with severe access to pathology, severe personality disorders, into these studies, because of the relative risks. You know, I think the greater clinical background one has, the more likely one can ensure safety. So that I kind of get lined up somewhat conservative, but I see at this point in time, you know, I feel we need people with clinical licensure. Also, when you have a license, you've got skin in the game, if you if you mess up, if you take liberties with a subject, if you violate important critical boundaries, you may have to pay a price. There's a terrible case in Canada a couple of years ago, where an individual who was not licensed, committed some serious ethical breaches. But if you know he didn't have a license, there's nothing much to lose, other than what he makes a hit was in a civil case. But you know, if you ain't got nothing, you got nothing to lose, but it doesn't kind of work. Here, I think the the facilitators need to understand there are certain behaviors, which are out of bounds, which are, you know, they cannot engage in. And if they know, in the back of their minds that breaking the rules could lead to losing one's livelihood losing one's license to practice, that might be an added deterrent.
Yeah. As we're talking about safety. I'd like to segue, and please tell us some stories, some really honest stories, they may be hard to hear of adverse effects that you've that you know, of directly or that you've heard of.
Sure. Well, I mean, again, the the sudden, presumed cardiac death of the 74 year old man that I heard of a couple of years ago, his daughters actually wrote a letter and we're sending around to some of the investigators because they felt there, there was a need to alert the community. So So,
okay, so we had one, but it's not certain whether it was the motion or whether it was underlying,
and I've heard of some over the years other cases with some was MDMA. Some of the classical students were individuals. You know, I know of one case of of a couple, who were the methodology of the facilitator was they would go into separate rooms, do individual work with each with their own facilitator, and then come back and, and do some work together. And when they were separated, what what one of the couple expired? Again, presumably a cardiac death, but it was it was Whoa, there was never any formal what would they take a what what medicine had they believe it was MDMA? Yeah. Okay, believe it was, what about,
these are both physiological demand and 74 died, this person died. We don't know what their underlying condition was. What about emotional negative adverse emotional effects? What can you tell us?
Well, let's see. I've had people tell me who, and often they were people with prior histories of PTSD, and told me that something had happened during a recent session, which had retriggered, the old underlying trauma and it exacerbated their, their, their underlying condition. So that would be one problem that, you know, people can be traumatized during sessions and if they have a prior history of trauma, they might even be more vulnerable. Other individuals, prior history.
We have trauma. Well, that relates to a case that I know of where a person went to a guide, I'm not sure at what level but and had MDMA and had a very positive experience on the one hand of illumination, but also felt that his anxiety increased markedly after the experience. So it was sort of a mixed reaction. Very good and very not good.
Well, I know similar case of a middle aged woman who I know socially who came to me a few months ago, just to tell me that she had. She had never taken a psychedelic, but had been kind of inspired by some of the books out there, particularly Michael Pollan's book to try it, she found a facilitator. This session went well it opened up a lot of old memories that had been repressed. But afterwards, she felt she was in a sustained panic episode for quite some time, a lot of anxiety a lot of fearfulness and, and I eventually referred her to someone who did integrative work, simply to help her to process what she had gone through, and help her to understand what might have been so traumatizing about some of the old repressed memories that came up. And I saw this woman the other day, she gave me a big hug, and said, I'm all better now with so and so you're referring to I've worked through these blocks, and I've worked through all of that angst that was that was freezing me up and I'm so much better now. So that was a good outcome but she really had to work for
one of the things that I'm putting forth to people and I'd like to hear your reaction to is I'm telling them to relate to their psychedelic experience the day of the experience like going into a gold mine a personal gold mine and they come out of the experience with nuggets and then the work really continues as they polish up the different nuggets and the polishing process can take weeks months or even longer depending on how much how many nuggets and how big the nuggets are that they took out
right? That's right. Oh absolutely. They they the the interest psychic dazzling jewels yeah you know when when the Spaniards hundreds of years ago going off looking for the lost city of gold that they heard from the indigenous people it wasn't it wasn't it wasn't concrete you know gold is we would imagine gold it was the inner gold from you know probably the native peoples were reflecting on these powerful experiences where they saw palaces light laden with with with emeralds and solar estates be you know, but it was not not literal. Yeah, it's a gold that can be traded on the market make these people rich. They never quite found what they were looking for in that regard. What they did find it and recognize and they ignored it or they vilified it.
I just saw a note I made here to ask you about you know something about a Swiss scientists named Peter Gasser
know Peter Gasser Sure sure. What
should he tell us about his work? I don't know much about his Yeah, he's from
Sula turn, start the foot of the foot of the Euro mountains. He did. A he did a study with end of life patients. LSD, LSD, LSD, people approaching the end of life. He got he had some good data as I recall. So I think that was the the LSE says funded by maps, as I read. Oh, he
was okay. That's fine. Thank you.
Yeah. You know, I've met with him a couple of times in Europe. Nice guy, very modest, unassuming, good guy.
We're going to take a pause. Now. I'm going to offer you a pause. And I'm going to do a commercial of sorts. All right. And while I'm doing that, I'd like you to think about what else you might want to add, before we stop for our listeners. And while you're thinking about that, I will say that, I'd appreciate it very much. If you'd go to our website, a mind body health and politics. And feel free to listen to the archives. There's no fee. We'd appreciate it if you'd subscribe. I'm not sure are exactly what subscribed means. But it'll be obvious when you go to the website. And it helps our work because we are self funded. And I'd like you to take a look at my two books. Psychedelic wisdom, which just came out, in which we tell the story of interviews with 20, prominent people who tell this their elders, and they tell the story of 40 and 50 years of sabrosa, experimentation, some very solitary where they were afraid to tell anyone, because they might lose their position at a university, others where they talked openly about it for many years. One man, doctor in Wisconsin took LSD 900 times quite an interesting thing just to listen to that alone. The other book psychedelic medicine in which Charlie Grove appears which came out in 2017, which are a book about the scientists, what do they have to report? Honestly, what did Charlie Grove report and that year, Dave Nichols does Stanislav Grof, and many others, Roland Griffiths is in there as well. I think you'd like to look at those two books. Back to Charlie, what might you want ahead? Before we
start? Yeah, I'm a great lover of history. I mean, that was my my first goal. On school, I was always going to be a history professor, something that didn't happen. But I love reading about the history of psychedelics. And it also reminds me of a quote by the American philosopher George Santiana, who once said, It is important to learn from from from the mistakes of the past, lest we repeat them. So I think there's a lot to learn. From our predecessors, from the early researchers starting in the 50s, I, I establish great friendships with some of the early researchers, Gary Fisher, Ralph best are one of my best friends ever, who sadly passed away several, several years ago who I learned a great deal about these compounds and how to optimally administer them. The these are, these were very, very important teachers that I found who I feel still instruct me through through reading their material, listening to audio tapes, reflecting on my memories. And also, we need to learn from what did the indigenous people How did they conceptualize these compounds? There, they were the original authorities, they had remarkable familiarity with these compounds, you got to figure they would have gotten to understand intimately all of the plant life in the region they lived in, they'd understand what would nutritious plants be? What were the toxic plants and what were the visionary plants or what visionary plants, which would be inactive alone, if you combined together and brewed them in a lengthy process like ayahuasca, that they might yield a profound visionary outcome result? So and how did these? How did these indigenous the so called primitive? So we're not at all primitive, they were far more evolved and advanced than we are? Still are with many of these compounds? How did they conceptualize what these plants meant? What sense did they make of their visions? How did they utilize them? How did they optimize safety? What what can we learn from from those who came before? And look at the end of the day, I simply feel I'm a part of a process of taking, taking the staff or taking the torch from those who preceded me like, like people in Ralph's generate Ralph mestres generation, Gary Fisher's generation, taking that that torch, holding it aloft, keeping it safe, and be ready to pass on to the young guys coming coming behind me. Who are I've met quite a number of these are very, very impressive, younger people very knowledgeable, very committed, and very honorable people who were dedicated to really continuing the mission that our predecessors started passed down to us, and we're passing down to them. And in so doing, and then the great the great question of all time, could these plants could these compounds help help us salvage this world with all of the horrific environmental, you know, crises looming? Could it open our eyes couldn't wake us up to the point where we're at able to take the kind of definitive action that could that could begin to turn the tie. That's going to be critical if there's going to be any really lifeless This planet at all. And one thing I found when I was in Brazil, in the Tsar in the early 90s, and then the early 2000s, writing some Ayahuasca study, I was impressed with the people I met in the Iosco religion, the Ananda vegetarian, the you, they they? How many were environmental activists, like taking these plants, taking it in the context of this remarkable rain forest, they had vast opportunity to commune with the spirits of nature, when it's like, what did they learn? What messages did they receive, and how might they inform us in our moving forward to try to, you know, heal, and protect, and really and salvage this, this beautiful planet for our children and our grandchildren, and those that follow them?
That's beautifully said. The only thing I would add to it surely, is that I would hope that the psychedelics also teach us to be kinder to one another. Because Because so much of the history of our species is a history of warfare, and of killing one another, right. And as we extract from the earth, we're extracting from each other, and people are getting killed at this very moment as we sit here, right. And we sit here in gratitude that we're both here together, unable to have this conversation. And I, and I thank you very much for taking the time of your life, to be with us today here on mind, body health and politics. When you talk about your interest in history, I want to tell our listeners, that Charlie Grove is a historical figure, as I told you at the beginning of the program, I consider him definitely one of the founding fathers of the psychedelic revolution, he likes to go back much further in time than himself. I understand that. So maybe better to use his picture, which is he's bringing forth the torch, he picked it up. And he's carrying it forward. And for that, we all thank you very much, Charlie.
Thank you, Richard. Really, really wonderful to see you again. And we'll look forward to seeing you soon.
See you soon in Denver, Denver. And for all you gentle listeners. Thank you for being with us today on mind, body health and politics. I remind you that we broadcast live every tuesday morning at nine as we have for the past 20 years, but also that you can now listen to any of the programs on the archive, anywhere you are on your phone, in your car or elsewhere. So check in with us. Until next time, this is Dr. Richard Louis Miller reminding you that good health is worth fighting for. And it's essential for life, liberty, and the pursuit of happiness.