Matt Johnson on Pioneering Psychedelic Research

One of the outstanding figures in the current Psychedelic Renaissance is Matt Johnson, who recently became the first researcher to be appointed to an endowed chair in psychedelic studies. He is the Susan Hill Ward Professor in Psychedelics and Consciousness at Johns Hopkins University, a university which has played a pioneering role in renewing psychedelic research. Matt and I talked about the politics of psychedelic research, the relative merits of psilocybin versus other psychedelics, the significance of the mystical experience and what he calls the “dope slap effect,” why psychedelic therapy may represent a paradigm shift in psychiatric treatment, the in’s and out’s of conducting psychedelic experiments, and much more.

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Episode Transcript

Speaker 1 (00:00):
Hi, I'm Ethan Edelman, and this is Psychoactive, a production
of iHeart Radio and Protozoa Pictures. Psychoactive is the show
where we talk about all things drugs. But any of
view is expressed here do not represent those of iHeart Media,
Protozoa Pictures, or their executives and employees. Indeed, heat as

(00:23):
an inveterate contrarian, I can tell you they may not
even represent my own and nothing contained in this show
should be used as medical advice or encouragement to use
any type of drug. Hello, Psychoactive listeners. As we continue

(00:44):
with a fairly intensive delve into the issue of psychedelics,
I'm delighted and honor today to have on Professor Matthew Johnson.
Matt is a professor at Johns Hopkins University. In fact, he,
i think is the first professor academic ever to receive

(01:05):
a name chair in psychedelic studies. He's the Susan hill
Ward Professor in Psychedelics and Consciousness, and he's recently stepped
into the shoes of Roland Griffin's another distinguished professor in
this area, to become the Director of the Center at
Johns Hopkins on psychedelic and consciousness research. I mean, he's
really one of the outstanding researchers in the world these days.

(01:28):
We've been working on this issue since the early two thousands, mentoring, writing, publishing,
you name it. So, Matt Hey, it's a pleasure to
have you at on Psychoactive. Oh, it's my pleasure. It's
an honor to chat with the Ethan remind me. I mean,
you know, we've been bumping into another recently at these
psychedelics conferences, the Wonderland Miami conference in November and then

(01:50):
the Horizons conference in December, New York. But do you
recall when was it we first met. Yeah, I believe
it was when I was president of Students for Sensible
Drug Policy Chapter at the University of Vermont. I had
founded that chapter and I invited you to come speak
for us, which you did, and I believe that was

(02:12):
the first It must have been two thousand and three
or so. That sounds about right. Yeah. So, Matt you've
probably done more studies involving giving psychedelics human subjects than
almost anybody. Are certainly in the top tier. So can
you just walk us through what does it involve? Sort
of launching one of these things, getting the approval of
the right institutions, screening for the right participants in the trial.

(02:36):
What is that look like? The first phase, which folks
normally don't think about it is like hustling up the funding,
so you know through somebody you've gotten the traditionally philanthropy
for us but psychedelics, but you hustle up the funding.
The next one is the Institutional Review Board the i RB.
They call it an ethics board in England. It's the
committee at your university that decides whether this research is
ethical to do or not, and they can require any

(02:58):
number of changes in or before allowing you to do
that work. Once you have addressed the i r b
s questions, then you administer to the f d A
and then that's the same thing. Any number of experts
from different divisions of f d A can weigh in,
maybe you know, chemists and psychologists and others, all weighing
with other concerns. They have on your protocol and they

(03:20):
can either approve it or they can put it on
clinical whold, meaning you have to change things before we
approve it. And then they approve things. Then you've got
to go to the d e A you know, the
drug enforcement people and get permission from them. And part
of the process for the d e A approval is
for them to go to an independent section of f
d A. In yes, I already mentioned we've already gone

(03:40):
to f d A, but this is redundant. They go
back to the FDA as far the d A process
and get the FDA's approval, and then the d e
A gets back to you. And so those are broad steps,
that's what it is, and that takes anywhere from like
six months to a year, depending on how much pushback
you get on any number of these steps. So it's
a big bureaucratic process. And then we respect to the

(04:03):
recruitment and screening of participants in the trials. We have
fairly a stringent screening criteria, so most people who apply
don't qualify, and it could be for any number of
medical including psychiatric reasons, depending on the study. So there's
a phone screening well actually for most of these now
there's a a web form as the initial phase of screening,

(04:23):
and then we call people up on the phone if
they need initial eligibility criteria and do some more screening
on the phone, and then for a subset of those folks,
then they come to the lab for two days for
these four or five hours at least. So it's a
substantial investment of time to do these extensive in person
screening and this is more than say, for example, like

(04:44):
an undergraduate you know, psychology class experiment might participate in
where you you know, fill out a form for five
minutes to screen for it. This is you know, several
days of extensive medical and psychological evaluation. And so after that,
if someone didn't qualify eyes with all of you know,
all of the criteria for the study, then they move

(05:05):
into a screening phase where they prepare anywhere from four
to eight hours depending on the study, with the two
people the guides or the therapist who will be with
them during their psilocybin session. And then you have the
psilocybin session or some say there's multiple sessions, sometimes there's one,
and typically the day after each psilocybin session, there's what
we call an integration session where we discussed the session.

(05:27):
I see, and I know there's been some issues raised
about about their being, you know, a disproportionately low number
of black people people are generally, but especially black people
in these trials what's your experience with that and what
if it challenges and how far have you got in Yeah,
so it's it's been a challenge across the field. I mean,
you know, the demographics skew white, and that happens to

(05:51):
be consistent with the data on who is using psilocybin illicitly.
It sends to be a white male thing if you
look at those umbers. That isn't to say that all
the people that are are are you know, applying our
people who have used psilocybin, but it just it might
speak to a common interest for whatever reason. There may

(06:11):
be more subcultural interest in certain you know, subcultures than
than in others. So it tends to be more of
a thing that seems to be of interest in in
white circles than in say, black circles. We do have representation,
it's not at the level of minorities, including black folks
and the research but not at the levels that would
be you know, proportional to society, you know, to their

(06:33):
placement in society. So we need to do a better job.
And you know, kind of like other groups in this area,
are have been doing a number of things, you know,
talking about where what what particular, you know where we're
advertising at. We recently hired a person to help us
with additional recruitment efforts to in part to help look
into some of these issues to increase minority representations. It's

(06:57):
a challenge. There's no you know, over a bullet solution,
but it's something to keep doing our best on. So, Matt,
I mean, obviously when you started doing this work fifteen
years ago, it was hesitant to talk about it. Now
major research university is not just your own, but I
think Harvard and Yale and n y U and University
of California and Impureau College England all setting up these

(07:20):
major research programs. I mean, now when you talk about it,
is there a major transformation in the way that other
academics way outside the field of psychologic study respond to
this or do do you feel like the words still
not really out there very much? Oh, there's been tremendous progress.
I mean we're still not there. There's a lot of
people that kind of like just kind of don't get it.

(07:42):
You just get this smirk when you bring I remember
one time going to the i r B that the
review board at the at the United University, you know,
to get studies approved and just like this this look
like like you're talking about a Cheech and Chong movie,
you know, something funny. It's like it's almost like, oh,
you're trying to get away. We know what you're up to,
Like like this sort of sideways smirk of like all right,

(08:03):
you know you're giving people mushrooms up. Of course they're
gonna feel like they're spiritual and I don't know whatever
when they're when they're loaded up on mushrooms, you get
a sense of that. But the more and more people
I think, I've seen these results and like uh, you know,
results in jama psychiatry and results these oh gosh, the
results with cancer patients, and to me, it's just like

(08:25):
this bizarre thing of like sometimes you get this little feedback,
like the smirk of like as if this isn't very
serious or this is a kind of a cute see thing,
And then like you've just run like say a cancer
participant and afterwards like they're just you know, crying about
this opening up this kind of space in their life
where they're able to talk with their loved ones about
their dying and how it's transformed their life. And just

(08:49):
like to square this with the like kind of the
Cheech and Chong joke level. There's such a contrast between
those two things. Matt. I've heard you talk about how
sometimes some of the most difficult parts of a psychedelic
trip while you're doing a therapeutic session can prove to
be the most valuable and that patients can even you know,

(09:10):
come out of a feeling that way. But have you
had to deal with situations where people were still struggling
months later as a result of having been in a
trial not months later, there have been people who have
have struggled in the days and to a degree weeks
following the sessions, and this is sort of a difficult

(09:31):
thing to describe. And the big picture is the process
I think ideally should be viewed as healthy, like a
lot of times, especially when dealing with some of the
issues we're dealing with, Like the treatment is hard, it
raises difficult issues, and those those things that come to
mind during the session don't necessarily disappear once the drugs
out of your system. But this is in common with

(09:52):
other successful forms of therapy. I mean, I think of
the treatment of trauma, where the whole point is that
it's going to be difficult. You have the process that
the material. So that's I think that's an important backdrop. Now,
there have been some people, and we warn people in
our consent that, you know, sometimes people the way I
think of it is you can have something like a

(10:12):
midlife crisis, you know, you can really these sessions can
really prompt questions for someone that sometimes they can be
stuck psychologically and feel they could benefit from seeing a
professional to help them process. So, now this isn't not
talking about anyone deally with any psychotic process or anything
like that, but folks that really are kind of you know,
the psychedelics have stuck, have left them stuck in a

(10:34):
in a in an unresolved space. So we do warn
people that this can happen and that some people may
benefit or may feel that they could benefit from seeking
out additional professional help. In other words, the psychedelic sessions,
for whatever reason you've come into the study, they can
potentially raise issues for you that you might feel called

(10:56):
to then you need to, you know, see a therapist
over So for example, you might be in a study
over smoking cessation, but some you might have an experience
of trauma from decades ago. That's resurfaced that all of
a sudden you feel like you need to process, and
in fact that that if that does happen, you're going
to be best off if you do see a professional
process that now that may not fit into the time

(11:17):
frame of a particular study, say a psychedelic study for
a smoking cessation. So one may reach out and we've
given some referrals and and this is certainly a minority
of cases, but of referrals for folks that feel like
they want to pick up on some therapy with with
a therapist who is um not going to use psychedelics negatively,
who's not going to kind of hear their experience and
then sort of pathologize the experience itself because they used psilocide. Well,

(11:41):
I'm curious. You know, you wrote a pretty important piece
a few years ago with I think maybe it's with
Rolling Griffins and also a very another very prominent drug
research Kenny Field, in which you talked about where might
psilocybin and potentially this psychelics fit into the Controlled Substances Act. Right.
Control subs Act is that fifty year old law that

(12:01):
determines whether drugs are gonna be put in schedules one, two, three, four,
or five, where one are drugs that supposedly have no
medical value and a great risk to the public health.
And then you know, descending on downward for drugs that
have a you know, a good medical value but also
risk to the public and then down to the lowest level,
which you're seen as relatively non dangerous. The basic idea
of ranking drugs according to the risk of medical benefit

(12:23):
makes some sense, but that the Controlled Substances Act, where
you have drugs like heroin, marijuana, and psilocybin all in
Schedule one, all notwithstanding you know, fairly substantial evidence that
they do have medical benefit, and a process where a
federal police agency, the d e A, has a huge

(12:44):
amount of say about where drugs are scheduled. What do
you really think about the Controlled Substances Act. That's a
great question, Ethan, because the framing of the paper was,
you know, given the Controlled Substances Act is the way
these substances are regulated. The question is, if psilocybin, based

(13:04):
on Phase three data looks safe and efficacious, how should
it fit into the Controlled Substances Act. And that's kind
of a narrow framing that's not you know, taking on
the question of should the Controlled Substances Act exists or
should it exist in anything like its present form, that's
a much bigger, you know question, And the Controlled Substances
Act is not likely to go away by the time,

(13:25):
you know, within probably the next two three or four years,
is not going to be you know, it's still going
to be the law of the land, most likely by
the time the psilocybin it gets through Phase three trials.
So it's sort of a very pragmatic in that sense.
But what I really think about the Controlled Substances Act,
I mean, as you know, uh, you know, analysis after

(13:45):
analysis has found in the United States, in the UK,
and in the Netherlands, in Europe, experts and all of
these areas, drug experts have been probed systematically, and the
correlation between the ranking, the scheduling of drugs and they're
perceived harms by experts is abysmal, you know. And this

(14:07):
is including both illegal and legal drugs, and so alcohol
will invariably show up near the top of of these
lists in terms of harm to self harm to individuals,
far higher than many of the illegal substances, and psilocybin
mushrooms consistently fall at the very very bottom, both in
terms of harm to self and harm to others, so

(14:29):
that we do make the point that there are risks.
And when we talk about technically we talk about abuse liability,
that's a confusing term that that does. Part of that
is addiction liability, the propensity for that drug to be
used in a compulsive fashion. We know very very well
that psilocybin and the other classic psychedelics like LSD, mescaline,

(14:50):
d MT are not addictive. But abuse liability in the
context of the Controlled Substances Act also refers to just
the risk of the drugs, the liability of using the drugs,
so not necessarily related to addiction potential, but just hey,
are there dangerous to the drug that can harm the
self or others? And you know, are showing a signal

(15:11):
at the public health level. So now, yes, there are
some harms, particularly people of psychiatric vulnerability, and there's good
reason to believe people with predisposition towards schizophrenia can be destabilized.
Anyone can have a so called bad trip, and particularly
if they're not prepared and if they're at a high
dose and an archaotic setting around people they don't trust,

(15:32):
they can freak out, to put it, to use technical language,
and you know, they could be at a concert and
they're hauled out by the paramedics and the police, and
then things escalate. Occasionally there's an accent. Occasionally someone dies,
should be no surprise, as with any other intoxicating a substance,
very rare when you plotted against the other. All of
the other substances legal and illegal, but nonetheless there is

(15:55):
some risk there. So there is some mild abuse liability,
getting not a dick liability, but abuse liability in terms
of having those those dangers. The big problem with the
Controlled Substances Act, in my opinion, is that it is
based on two fundamentally distinct categories. Two dimensions. One whether

(16:15):
there's accepted medical use and number two, um, what's the
abuse liability. Schedule one is for substances with no accepted
medical use but high abuse liability. You then moved to
Schedule two, and this is where things like a lot
of the opioids and methamphetamine and cocaine are at there's
accepted medical use at least in narrow circumstances, but there's

(16:38):
high abuse liability. And then all of the other schedules
as we go down to the Schedule three to Schedule four.
The cat definition to all of those is there's accepted
medical use and there's abuse liability, but less so than
the higher category. So Schedule three has less abuse liability
than the substances, and Schedule two and four less than three, etcetera.

(16:59):
The problem is there is no category for mild or
moderate call it what you will, mild abuse liability, but
no accepted medical value, which is the case right now
because and this was determined through judicial precedent in the
earlier years, not at the beginning of the c s

(17:20):
A the Control sums Is Act, but through the courts afterwards.
Accepted medical value has become to be defined as explicit
f d A approval, So by definition, regardless of the science,
until it reaches has FDA approval for a disorder, it
has no accepted medical use. But right now, again there's
no category for you know, no accepted medical use, but

(17:43):
mild to moderate abuse potential, So it has to remain
right now in Schedule one, which is absolutely absurd. This
also a catch twenty two aspect of this, because they
talked about accepted medical use, which requires that they approval.
But then if you look at something with merril wanted's
medical value forever and ever of the government was throwing
up obstacles right allowing it to be approved in that way,

(18:04):
and even today marijuana persist in Schedule one. And then
you think about things like pharmaceutical heroin, right, which is
now being prescribed to people who have been addicted to
street heroin and half dozen countries in Europe and Canada,
you know, clear evidence from abroad of its medical value.
It's also approved for management of pain in some countries,
but once again still in Schedule one. Right now on

(18:24):
the thing I see, you know, you look at the
drug like fentanyl, which is you know, it's death rate,
it's deadliness in America in recent years and in Canada
has been astronomical, and it's properly not in Schedule one
because it does have legitimate medical value. And so in
a way that almost seems like there's a bias and
maybe in favor. You know, you can have a fentanyl

(18:44):
or cocaine with our little problems associated with them in
Schedule two allowed to be prescribed and limited medical conditions,
but then these drugs in Schedule one that just I mean,
it seems to me they should basically eliminate. Is there
any basis at all? Really are having a category of
schedule one gosh? I mean you really are getting to
the question of, in one sense of should there be

(19:06):
a controlled Substances Act? Well, let me bring you back here.
So the research at Johns Hopkins. I mean, one of
the things is that you're at a research institute which
you know, and both you personally and your colleagues, you know,
have experience in administering all sorts of controlled substances and
illicit what would otherwise be illegal drugs, not just to animals,

(19:28):
non human animals, but to human beings, right, I mean
Johns Hopkins they're giving you know, not just psilocybin now,
but also I think cocaine and amphetamine and even heroin
to to human subjects in very controlled circumstances. Yeah, that's right.
And in fact, I've been principal investigator or lead scientists
on studies administering a number of these substances, methamphetamine, cocaine,

(19:51):
and particularly our group, the Behavioral Pharmacology Research Unit, it's
been an operation for for almost a half century. I mean,
all of the substances you've mentioned, all of those drug
classes um, you know, we're experts at administering them to
human beings under the right conditions, and it's all about
what the appropriate conditions are, you know, for s a

(20:12):
administering cocaine or administering psilocybin, and those conditions are different
across these different drugs given their different risk. But you know,
in the early years, I mean back, this is actually
before you and I even met. But in the late
nineties early two thousand's, I was involved in an effort
to get heroin prescription trials going in the US and
Canada the way that they had been doing in in Europe,

(20:34):
you know, and prescribing pharmaceutical heroin in a clinic setting
to people who had been struggling with addiction to the
street heroin, right, and there were huge health benefits to
their switching from street drugs into legally produced and prescribed
pharmaceutical heroin. And so this group we we eventually called
ourselves NAOMI. WHI stood for the North American Opioid Medication Initiative,

(20:56):
And among the professors who participated group was one of
or colleagues fairly distinguished drug researcher named George Bigelow. And
so I was able to get a little funding and
to do a couple of little pilot studies, one up
in Canada and one of Johns Hopkins, where I think
George was involved in seeing whether or not longtime Heroin
user street Heroin users could tell the difference between pharmaceutical

(21:20):
heroine or delouded hydromorphone right in a control, double blind study, right.
And what he found in this small study was, in fact,
I think that people could not tell the difference. Unfortunately,
think you ever published the damn paper. But what struck
me at that time was that Johns Hopkins, together I think,
with Columbia and Wayne's State, which at that time had

(21:40):
a drug program headed by the former head of the
National Student on Drug Abuse Bob Schuster, were among the
few places in the country which were administering not just
schedule to drugs like amphetamine and cocaine to human subjects,
but also administering Schedule one drugs. Do I have that right? Yeah?
And in fact I do. I suspect those data were

(22:01):
published with hydromorphone because I either that or I have
a really good memory from presentation that George Bigelow has given,
because I could see those graphs in my head In fact,
it's just striking to the pharmacologist nerd in me, you know,
with with the left right adjustment on the dose effect
curve to use my nerdy pharmacology lingo, they're identical, you know,

(22:22):
hydromorphone and heroin. In other words, whether you're administering three
milligrams for it to achieve a certain effect or thirty
milligrams ultimately like trivial, right, like you give what however
much you need to give to achieve that certain effect.
You lay the curves on top of each other, and
it's they're the same drug, which is really getting back
to what we're talking about earlier. Hydromorphone is what scheduled

(22:42):
to you know, but basically, by any any level of science,
these are the same drug. If you're talking about a
pharmaceutically pure um supply all right, well, I mean it's
the basic point that if you were to snap your
fingers and all the people around America getting hydromorphones allowed
it in a hospital setting, we're suddenly getting heroin. Nobody
would have really diff prints. And conversely, if you can
snap your fingers and all the people taking uh heroin

(23:04):
illegally or somehow getting uh you know allowed it. Uh,
you know, they also won't know the difference, right, that
one was a drug that's essentially demonized in the broader culture,
the other is the one that's proceeds in a medicalized environment.
But I think the key point here was that Hopkins
seemed to have some experience, together with a few other
research institutions, in allowing or getting permission to do research

(23:27):
with Schedule one drugs on human beings. And I wondered
if that's one of the reasons why Johns Hopkins. I mean,
obviously the fact of Rolling Griffith's being there is being
a sort of pioneering research in this area. But I
wonder if that played a role in Johns Hopkins emerging
as a leader in this area as well, that there
already was a university experience in doing research with Schedule

(23:51):
one drugs, which is notoriously difficult to get permission for
but has always been technically legally possible. Right, Yeah, I
certainly think that was uh most likely and necessary. I mean,
you could have technically done it without it, but practically
a necessary but not sufficient condition. Um So there's not
a whole lot of folks that have had that experience

(24:11):
you mentioned Wayne State, which you know STEP programs you know,
still still running strong, and a few others around the
country that have very strong human behavioral pharmacology lab programs
with a minister these types of drugs, including Schedule one drugs.
But you know, ours was the only group that went ahead,
and in the early days at least, you know, so
you had to have the desire to do this kind

(24:32):
of crazy thing, which you know, twenty years ago it
did sound kind of crazy, like you know it. It
sounded more like like a career killer to be interested
in in psychedelics. You know, good luck getting a grant
in that, good luck rising through the promotion pathway at
a place like Hopkins. That's very demanding. So so listen
as I understand it. You know, you're at University of Remon,

(24:54):
you're doing your graduate work. You know your mentor there
is Warren Bickle, a very prominent drug researcher. You're thinking,
how nice it would be due to psycholics research. You
land up at Johns Hopkins and you find out that,
you know, Roland Griffin is this distinguished drug research or
you know, been working on cocaine, nicotine, a whole range
of other drugs is actually interested in doing something on psychedelics.

(25:16):
So what was that like for you in that moment,
like fifteen years ago. Where it really started was even
before that, my undergraduate advisor had gone to school with
Warren Bickle, who you mentioned was my graduate advisor and
who was a really big deal, not in psychedelics but
in drug research in general and addiction research. And when
I literally talked to him on the phone at a

(25:38):
phone interview for the University of Vermont to be a
greet his graduate student, he said, Matt, if you do
if you come here, if you do well, you go
to Hopkins the Behavior of Pharmacology Research Unit where I
did my post doc in the nineteen nineties, And you
do a post doctor and that's the path, and these
are the conferences you go to and this is the
post ocuteke and blah blah blah. You know, he very

(25:59):
much from the very again like I hadn't even gone
there yet, you know, He's like, if you do grad school, here,
here's what you do your post doc. And so fast
forward several years. Had done well in grad school with him,
and and I had and I had met Roland at
conferences and whatnot. And and so I had sort of
an informal interview, like you know, being a couple of
years out from finishing and but but but this was

(26:19):
sort of the formal interview where I came down and
visited you know, the lab at Hopkins and there for
the total reason that rolling was just known as being
you know, the one of the world's most important caffeine research.
He demonstrated the withdrawal syndrome of caffeine and humans. Lots
of nicotine research, tons of research on sedative hypnotics, played
a strong hand in developing the abuse liability methods that

(26:43):
the FDA uses to evaluate new medications that might have
abuse liability. So just a legend. And the behavioral pharmacology area,
particularly human behavioral pharmacology. So it was that stuff that
was the attraction, you know. And and a strong behavioral
basis to all of the drug stuff, you know, strong
behavioral psychology basis to ana rising drug effects, which is
very consistent with my perspective and the training that I have.

(27:04):
And so but he tells me there, you know, with
his office door closed when I'm interviewing, and um, he's
kind of swears me to secrecy. I don't know, it
might have been my firstborn that he he wanted me
to swear, but it was really it was like really serious,
and Rolling is an intense dude. And I mean like
he's like he's looking at you in his eye across

(27:24):
from crossed from the desk, and and and it swearing
to secrecy. He's you know, he's got this. He has
just started this just study with high doses of psilocybin
looking at spiritual experiences in spiritually interested people. And you know,
I'm just like, get the funk out of here, you know,
like like well I really like really you know, and

(27:47):
he didn't want it in the public, uh, anything in
the public yet because he thought, and I think very wisely,
that if it had gotten out there, that the study
might have been shut down prematurely, that there might have
been sort of sort of this hysteria about it. So
he did he's very quiet and getting it approved and
running the study. So anyway, I promised to keep that

(28:09):
you know, you know secret, and then there was another
you know, a couple of years had to you know,
stay secret until that first study was was published. And well,
you know, one of the things that struck me, I
mean that first study that rollingk with this and William Richard.
Do you mentioned Bill Richards, who has been you know,
key in this field for decades and Bob Jesse, who
has kind of been a quiet behind the scenes force

(28:29):
and fellow. I don't think I know. McCann published that
article in a distinguished journal about psilocybin and mystical experience,
and I remember wondering, like, in fact, I think you're
actually acknowledged as a young colleague who's makes some comments
on this study. And I remember thinking, why did they
start off with his study about psychedelics and mysticism, Like

(28:52):
why wasn't a psychedelics and alcoholism or psychedolics and depression,
or psycholics and PTSD or the things you're seeing talking
about now. But I think what I'm beginning to understand,
and maybe I'm wrong about this, so tell me, is
that it's because that mystical experience and being able to
validate a quote unquote mystical experience through the scientific method

(29:16):
turns out to be crucial in understanding why psychedelics is
so valuable, psycholics are so valuable in all these other
areas in treating depression and PTSD and anxiety. And you
name it. I mean, is that right and where they
think of strategically in that way or am I just
speculating off base here? So you know, I think it

(29:37):
turned out such that that was a very useful consequence,
But I would I have to actually say no with
the caveat behind this that as we we've described, I
showed up once that study had started. So I'm filling
in the blanks to speaking for you know, Roland uh
who certainly was the heavy player in terms of making
this this decision. Um it really is because he was, Um,

(30:00):
I think he would he would endorse this is correct
as as just absolutely obsessed with understanding transcendental experiences in
the human being from his own meditation practice and from
other interests. Just this idea that people report on certain
drugs that they're describing these states that are purported to

(30:21):
be indistinguishable to some of these states that people only
achieve after years of developing a meditation practice and sometimes
never achieving those states despite really trying to develop those
practices or in these sort of once in a lifetime
life changing experiences that are our Our world's history and
religion and literature is is filled with whether it's you

(30:44):
know Ebenez or Scrooge or uh Saw on the Road
to Damascus, these kind of extraordinary experiences that kind of
transform people's lives. The whole idea that you could like
increase the chances of that having by by throwing in
something into someone's stream that's going to have effect on
a subtype of serotonin receptor. I mean, that's really it,

(31:06):
you know, like not that the research is going to
be able to validate the ontological validity or nature of
those experiences, but but what's going on there, like what
like these these states that people have been writing about
from different traditions for thousands of years, these extraordinary experiences,

(31:29):
and to be clear, I'm talking about outside of drug use,
both including but the large majority outside of drug use.
But the idea that psychedelics are a way to kind
of turn the NAB up on the likelihood of those
types of experiences and then we can study them and
do all kinds of things with them. We'll be talking

(31:50):
more after we hear this ad. When you start doing studies,
I guess you and folks on YU and other institutions
looking at the value of psychedelics in helping people deal

(32:11):
with the anxiety and depression involving struggling with cancer or
even terminal illness. I mean, for these things to work
in helping people through such fundamentally transformative and maybe life ending,
you know, passages in their life, they're just has to
be something. There has to be something almost mystical or

(32:32):
something maybe not, but I mean mystical at the core.
It's part of it explaining why psychedelics are working as
effectively as they are. Very often that yes, yes, and
there are exceptions. It's not a perfect correlation, but yeah,
when it really works, chances are you have one of
these full monty mystical experiences where they're describing this complete

(32:53):
sense of oneness with the universe and the timelessness and
spacelessness and the noetic quality. You know, the person just
gribing it. And sometimes when like you just you just
start checking off the categories in your head and they're
putting it into their own words and whatnot. But god,
they just like check check check, you know, like you
just when you see the real deal, it's just it's

(33:13):
I don't know, it's always such a great reminder about
why we're doing this, But there's this this sense that like, yeah,
that that is a and I get scientifically, I don't
want to say it's necessary or critical, because we do
see people with lower There's also we've played with this.
It may be that an insightful experience is a complementary
but but distinct type of experience, where you can have

(33:35):
an insightful experience that that's not, let's say, with lots
of personal realizations that aren't necessarily of the mystical variety.
So there's other things going on, but certainly for for
the biggest psychological factor that seems to be uh involved
and and probably causing, playing a role in that causal

(33:55):
chain of these really transformative experiences seems to be these
mystical states. Yeah. So the reason that you're saying that
people obviously do derive benefits even when they don't get
into that full blowing mystical state, but that there is
some correlation between the intensity and maybe I don't know
whether the beauty is the right word of the mystical
state occasioned by the psychelic use and being able to

(34:18):
treat the condition right, Yeah, it's in the way I
look at it. It's it's amazing enough that the subjective
experience that we we measure like about six hours after.
So so I'm basically when it wears often before they
go home. The nature of the subjective experience there is
it's amazing that there's any correlation, any relationship between you know,

(34:41):
the reductions in their cigarette smoking six months later, or
reductions in their cancer cancer related depression and anxiety six
months later. But those aren't perfect correlations. Um. So, yeah,
you do see people with you in somebody. You know,
you don't get every aspect. Sometimes you don't the oneness,
but you get some of the ineffability, and you get

(35:03):
a little bit you know, you get shades of you know, timelessness,
let's say, for example, and it's and I should say
this is not I totally consider us in our infancy
and even understanding this construct of mystical experience. I mean,
it's it's it's something to work with and and we
have ways to measure it. But like other subjective experiences,

(35:24):
you know, we're ultimately measuring just that what people are
reporting about their experience. You know, in Michael Pollan's book,
he quotes, I don't know if you regret this or
not or not that, but he says, yeah, imagine have
talked about if there's about psych psycholics. It's almost like
the dope slap effect, right right. I mean there I
could thank Michael for that highly scientific sounding, um theoretical concept.

(35:48):
But yeah, like you know, and I think it it
came and we talked several times during the course of
those years when he was working on the book. But
I think I mentioned this in UM in London. Uh,
We're both there for a psychedelics meeting, and and we
had dinner and after a few glasses of wine, he
keeps pushing that's I've learned. That's a good technique that
you're a journalist wanted, you know. But he's like, how

(36:11):
does this really work, Matt, how does this you know?
And and and it's just like people are dope slap
out of their story. It's like and and that's the commentity,
like whether that story is like you're stuck in depression
and I'm a failure and I'm just wired the wrong
way and God's punishing me and all of this these
you know, or it's oh, I'm just a smoker. I've

(36:31):
tried a million times. I quit. I'm not gonna be
able to quit. I started so young, it's just my
brains just used to it. Blah blah blah blah blah.
Story story, story, you know, yeah, good luck keep telling
yourself that and expecting to step out of that, you
know pattern. But people are stuck in these suboptimal patterns.
And I think of it all his addiction, whether it's
a nominal substance use disorder addiction, or it's addiction to

(36:53):
a certain way of thinking, and but whether it's depression
or it's uh, substituted disorders. It's like there's both behavioral
and you know, emotional cognitive manifestations. It's it's primarily behaviorally
defined and an addiction by behavior, you know, like you're
taking the substance, but obviously with the cognitive and emotional

(37:14):
um uh you know, whole you know um syndrome that
surrounds it. And and just the opposite with the depression.
So I see these as sort of like very much
more related disorders than than modern psychiatry would would would admit.
And I think one of the cool derivative benefits of

(37:36):
psychedelic research is they may because they seem to be
working for these different disorders and and and dope slapping
people out of their story, they're perhaps helping us to
understand the nature of these disorders. What are those transagnostic
commonalities between the supposedly separate disorders. You know, there was
something about that quote that reminded me of the story
about Bill Wilson, right. You know that one of the

(37:57):
founders of alcoholics anonymous and who you know, many people
will know the story that in his later years he
begins to experiment with psycholics may mccameras lst or not
and starts to talk about how this could be useful
at helping people in a achieve the kind of spiritual
self awareness that is an essential part of freeing themselves

(38:18):
of their addiction to alcohol. I mean the Wilson obviously
was persuaded by his colleagues a day to stop talking
about that, but it seemed like it was a fundamental
early insight analogus to the dope slap effect you're talking
about here, right, And I think it's important to remind
people of that history and that the fact that he

(38:38):
advocated for it, so after so many decades of the
existence of a a this thing that he was foundational
and creating, and part of the dogma that built up
is no you know, you know, medication or substance use,
you know, you know, as part of treatment period. But
I mean here he was his experiences were so profound

(39:00):
that I mean he told folks, Yeah, folks that don't
get that, that whole thing about giving up to something
bigger than yourself, like like, here's something for them, right,
Like they can they can at least have a shot
at getting that step if they try this under the
right conditions. I mean, it's just I'm just so impressed

(39:22):
that he even made that attempt, you know, at the time,
and uh, yeah, it's unfortunate, but it's good to remind
folks of well he didn't I guess during an error
in the fifties, when are really interesting people, famous people, right,
we're experimenting with LSD or or mescal and or psilocybin.

(39:42):
I think, right, it was the first psychelic renaissance back
in the late fifties early sixties before it got shut down.
And then right now, see re emerging folks like Carry
Grant were saying they were getting LSD in therapy and
it was amazing, you know, I mean, lots of celebrities.
Then we're talking about early you know, having had this
therapy and that it really benefited them and you know that.

(40:02):
I mean, yeah, folks, forget that history. It's like that
this is before it showed up on the street at all.
You know, there's another quote that you in Michael's book
about where you said that in some of Speaks, doctors
and researchers play the same role as shamans and elders.
And on the one hand, you know, you're warning against
the guru complex that can come into the whole psychedelics

(40:23):
therapy area and and the need for professionals in this
area to stay grounded in scientific integrity and professional therapeutic integrity.
But you do make the analogy to shaman's and elders,
and I wonder if you could just elaborate on that
a bit. I think the commonality is that we have
to place these substances are best used, most optimally used
in in a in a in a rich cultural context,

(40:47):
one in which there's ideally sanctioned use. There are experts
and there's a framework for using them. There's sort of
a lot of commonalities there. You know, the whole idea
that a lot of us may have been ex bosed
in this society. You know, something one does when they're
a teenager led by another clueless teenager. It's the idea
is like, no, no, this is something that you actually

(41:08):
get the society's experts if it's a young person doing
it there with the elders of that society of whatever type,
whether it's in in the modern era, we're talking about,
you know, the professional someone with a you know, someone
who was a psychiatrist or a psychologist, etcetera. UM. In
the clinical context, so there are some commonalities, but I
think there's a whole lot of dangers and over um, like,

(41:30):
we can't pretend that we're we're shaman, right, that's not
our tradition in modern medicine. If psilocybin's approved as a
as a therapeutic, I think there's all kinds of dangers
and sort of adopting frameworks that were not experts in
that we don't you know, have a claim of of
that cultural tradition and there's nothing right like, we have
our own culture, and there's a whole lot of wisdom

(41:53):
in these sort of subcultures that we have, so that
that the ethics that are taught within the practice of
medice and within clinical psychology, within social work, within nursing,
you know, these sort of the professional boundaries and the
framework that is that exists and is being developed for
psychedelic therapy. I mean, you know, this is our sort
of like our our modern day I don't want to

(42:15):
say there's no, no, not perfect terms because I say
modern day, but like indigenous society still exist. And I
don't want to say western because that doesn't you know,
you see what I'm doing at But like whatever we
call modern medicine, you know, we bring psychedelics into modern medicine.
There's gonna be some you know, commonalities with shamanistic practicals,
but not much. And we have to have the right
Goldilocks level of of yes, you know, there are those

(42:38):
some kind of common wisdom lessons, but we also gotta
rely on on the on the strength of our own
cultural traditions, uh that are supervising the use of these substances.
And and we don't want to be insulting to other
cultures by pertaining that we're part of something we're not.
But I mean, you know, I mean, obviously you have

(42:58):
huge optimism here. I saw you voted saying that it
seems fair to characterize psycholic therapy as a paradigm shift
in psychiatric treatment, and that, aside from therapeutic psycholics hold
incredible potentially, you said, as tools for psychological and neuroscientific inquiry.
I mean, so, do you really see this revolutionizing psychiatry
within the next generation. Yeah, And in fact, you know

(43:21):
that that second part you said, Ethan, really you know,
makes it an even larger statement in the sense that
not only I think it's gonna like transform psychiatry, but
even that kind of small potatoes compared to what it's
really what it's poised to really tell us, you know
about like the nature of the mind. I mean, that's
i mean, arguably the most important thing we could possibly

(43:41):
ever know, right, you know, because it underlies everything else.
But yeah, I think it's poised that psychedelics are poised
to be a paradigm shift in psychiatry. Does that mean
that they're gonna work for everyone? Know, you know, doesn't
mean that there that there aren't any risks to their use, no, um,
But I do think so based on the data, there's

(44:02):
a good shot that they're gonna be able to help
a larger portion of people for a number of disorders
who haven't been helped by traditional you know, existing treatments.
Including medications, and the other aspect of them being paradigm
shifting is that the treatment model is one where you're
only a ministering one two or three times and you're
seeing effects that are lasting in many cases, you know,

(44:24):
six months a year, and presumably for a lot of
folks like the rest of their lives. So that's the
paradigm shift, especially because we're getting to the psychological underpinnings
of these disorders. Tobacco addiction is more than just you know,
quelling the response at the nickotine receptor. It's about the
role of this substance is playing in your life, the

(44:45):
priorities in your life, the examples you're setting for your kids,
all these things that run through your mind when you
tell yourself you want to quit smoking, you know, and
and that's just you know, quote unquote just smoking. I mean,
that's not even like you know, heroin addiction or heavy
alcohol addiction, which you know, the tobacco is more deadly
in the long run. You know, these are other addictions
with stronger destruction of quality of life. But I'm curious

(45:07):
in your research, right, it's been almost entirely about psilocybin,
and mostly one sees psilocybin, and then to something said
m d M A quasi psychedelic as the two principal
drugs of investigation and the two that are most likely
to be approved in the next few years for treatment
of PTSD in the case of m d M A

(45:28):
and for treatment of attractable depression in the case of psilocybin.
But I'm curious, and I've heard people say, well, the
problem with l s D is it's a lot like um,
you know, uh, psilocybin. But you know, because the experience
is like, you know, twice as long, if not more.
Just simply connecting research with it, I mean, having to
pay the clinicians and keep people there and the whole thing.

(45:50):
It just makes it usually more onerous. But I'm curious,
are you looking at do you think you do you
see yourself looking at other psychedelics? And are the reasons
why I don't hear you talking as much about d
MT or ketamine or mescalin. YEA, so absolutely interested in
these other psychedelics. The UM In the short term, uh so, Uh,

(46:14):
we're going to be starting a study of LSD in
the treatment of chronic pain. UM. We're probably within a
couple of months from starting that study. So we're at
that sort of the last steps of hopefully getting that approved.
It's with the f d A you know right now,
but fingers cross as we moved through that process. I
absolutely think you know that well. I would say, you

(46:35):
know the time course, you know, the five or six
our time course for psilocybin is is a big reason
why a lot of the modern research has has usial
cyber rather than LSD. But frankly, the most important reason,
at least at the beginning, was that LSD was more
controversial now pharmacologically, like right there, Other than the time course,
they're basically identical in terms of any practical in any

(46:58):
risk benefit ratio analysis. I've heard you refer to se
these drugs and I think some others. Is the classic psychedelics?
What are the classic psychedelics? And how does that How
is that difference in the non classic psychedelics. Yeah, it
means that they activate a subtype of serotonin receptor in
the brain, the serotonin two A receptor. But people will
recognize when I start to list what these classic psychedelics are,

(47:19):
that they basically feel the same, or if you've heard
or experienced them yourself, so so psilocybin, l S D,
mescalin and and and d m T, which is in ayahuasca.
Those substances more or less they feel similar to each other.
People now smoke d m T is going to be
more intense, But when one takes d MT in the

(47:40):
form of ayahuasca um, which is really active, it's very
much in that category of those others, the L S
d UM, psilocybin, mescalin um, and then so those are
sort of the core, you know, the classic psychedelics, the
ones that aren't classic psychedelics. A couple of big categories there.
One are the n M d A antagonists, so the
ketamine the PCP family, and then another big one. It's

(48:04):
sort of in a class by itself in terms of
what you people actually take out out there in the
real world. But m D m A, so it's a
serotonin releaser, so it's it's it's a serotinergic psychedelic. In
other words, it has effects on serotonin like the classic psychedelic,
but it interfects interacts with the serotonin system in a
different way. Rather than activating and mimicking serotonin as a
subtype of serotonin receptor. It causes serotonin to be released

(48:28):
from a number of of of receptors, and so for you,
do you see yourself doing research in the future on
d MT or kennemine or gin. Yeah. Absolutely. We did
the first blinded research with salvon orna, which is another
you could consider it a non classic psychedelic. It's an
opioid antagonist. UM. That's very very in one sense, very

(48:51):
similar to d M T and five mouth oxy d
M T V smokable triptomine psychedelics. UM. Salvinorin a is
smokable and that's how we minister it will vaporize UM.
So I have a lot of interest in these Yeah, mean, gosh,
who couldn't. Who wouldn't be interested in a compound where
someone like smokes it and then a few minutes later
starts talking about seeing aliens. I mean, if you're interested

(49:12):
in behavior of pharmacology, it's like, what the hell like?
That's yea. So absolutely I'm fascinating not only in terms
of the just understanding those effects, but but also their therapeutics.
But absolutely, I mean the reason the research has largely
been with psilocybin is just one of precedent and one
of I've recently made the argument and the pitch of
the FDA. Hey, look, twenty years with psilocybin has proceeded

(49:36):
safely with the right you know, uh safeguards. Hey, it's
now time to to do research with LSD because in
fact there's more of a safety record still with LSD.
Far more people were given LSD in those earlier years. Opinion.
You know, I've heard people say, and I don't know
if it's true or not, that one thing about I
began is that whereas most of the psychedelics, mostly what

(49:59):
they're doing is they're, as you put, a sort of
sort of resetting the story, breaking an old destructive narrative
right through that mystical inside or other types of inside
or whatever it might be, especially when done in the
therapeutic context. But that I be gain maybe does that,
and it does something else to the human organism, unlike
the other psychedelics, um that may have a more lasting impact.

(50:23):
Is there anything to that or do we just not
know there might be? There might be, and in fact
it maybe not just the human organism. And the thing
that's actually pretty compelling is in is in the rat
that even the the what you see in the rat
is that after I be gained, there's there's a normalization
of the meso limbic dopamine system. I'll translate that. What

(50:44):
that means is that the dopamine is a neurotransmitter that's
involved with reward and it's basically thrown out of whack
with heavy levels of addiction. So instead of having mild
fluctuations that regulate behavior, you see these white, wild fluctuations
of a lot of dovamine and then like nothing, and
you almost no dovamine, and then a lot again. You know,

(51:06):
so these wild fluctuations um which you get more of
these wild fluctuations even when you get a rat addicted
to you know, an opioid. But but after I begin
you see a normalization in other words, of narrowing. Instead
of wildly fluctuating, it's fluctuating within a normal range of
you know, it goes a little bit up and a
little bit down, which it's supposed to do. That might
be basically the rat version of you know, the person

(51:30):
saying that there you know, what do they say with
ibogaine it's an addiction interrupter that they just feel like
their addiction has is gone. You know, they're not at
this crazy low where they're at this low hedonic state
where they're willing to do anything to get themselves out
of it. So now I will say, though I would
like to see more research. We don't know necessarily that

(51:52):
drugs like psilocybin don't do this to at least a degree,
I'd like to see more of these drugs in a
head to head comparison. I have seen Kate some cases
where and it's not the norm, but but where folks
will say even the physical withdrawal from smoking that they've
gotten basically no withdrawal. I mean when we're thinking, say,
let's talk focus about addiction, addiction to different substances, and

(52:13):
there's anything substances. Obviously addiction could be two behaviors in
ways of thinking that are destructive as well, but some
form of dependence that's self destructive. Let's summarize addiction in
that way. Do you do, you do your gut sense
or Some of the research suggests that certain types of
substances are gonna be better or worse for certain types

(52:33):
of addictions, so that ones that you know have a
kind of withdrawal, you know, whether it's nicotine or or
or opioids, or for some people alcohol if you don't
do it every day. UM that maybe some psycholic substances
will better for those addictions, whereas substances like cocaine or
others where there's a kind of you know, radical up

(52:54):
and down and maybe less the daily need uh for
the drugs, that other psycholic substances would be better for
dealing with stimulants. What do you think I would not
make that prediction now, I my speculation is that that
at least within the classic psychedelics, that yes, there's there

(53:16):
are certainly variations and how there's a coloring of different
effects across these different substances. But I my working hypothesis
is that therapeutically, there's that they all have the same
thing in common. Now, again this is speculation. I could
be wrong about that, um, but but there that there's

(53:38):
nothing as specific such as, oh, well, psilocybin is going
to be better help people quit smoking, but you know,
mescaline is going to be better to help people quit cocaine.
The mechanisms by which they're ultimately working, I think the
meaningful uh level of analysis are these the these sort
of profound psychological transformations related to the subjective experience and

(54:02):
I think that's you know, potentially there with all of
these substances, So I don't I think there's probably more
of a future entailing way different ways to use these substances,
you know, So not just you know, differences between molecules,
but different ways of using There might be more of
a potential difference between let's say, using you know, psilocybin.

(54:22):
I don't know, uh oh gosh. At one extreme we
haven't even explored in the modern era. Let's see how
it looks as a psychedelic therapy versus a psycholitic in
other words, meaning a high dose, were overwhelming dose where
the person is quiet and then we talked about it afterwards,
which is most of the modern research with psychedelics, or
one where we give a lower dose and facilitate talk therapy.

(54:43):
I mean, we could go back to the older research,
and I mean that was the predominant model in Europe.
We don't know that that doesn't work better, So we
can do that even within the you know, so called
psychedelic or high dose research. You know, like like with
the treatment of addiction with smoking, we've used cognitive behavioral therapy.
Michael Bogan shoots treating alcohol use disorder has used motivational

(55:04):
enhancement therapy. Is what is one better than the other?
You know, I see that as maybe perhaps just as important,
perhaps even more important than differences between compounds. The one
caveat I would throw into it, though, I do think
if there's a difference, uh, it might some addictions might
require more a stronger dose, but it wouldn't really depend

(55:28):
on what compound. But some might require just a longer experience.
So I do think in some sense there's a chance
for LSD to be more therapeutically impactful simply because the
experience is longer, and there's a greater opportunity that any
given twenty minutes during that entire experiences is going to
be a profoundly meaningful experience. Let's take a break here

(55:52):
and go to an ad M. Well, let me ask
you this shift shift gears a little bit right here,
which is that I mean, you were just in the
news recently because you headed up this study on it

(56:14):
using psilocybin for smoking cessation, just got a significant grant
from the National Student on Drug Abuse. And you know,
as I understand it, you were initially turned down and
then they came back and said, oh, it turns out
we have some money to fund this, and it's just
happened recently, and it's the first grant I think to
fund psychedelics research apart from Kennemy, which is a legal
psychedelic but it's the first one to do it with

(56:36):
psilocybin or any other sort of drug. And so I
have a bunch of questions about that. I mean, first
of all, with respect to the National Student Drug Abuse
why has it taken them so forever long to do
this and why do you think they did it finally recently? Well,
I think, you know, kind of going back to an
earlier part of our conversation, you know, perhaps strategic starting

(57:00):
off with the focus on mystical experiences with the psilosiban
research might have may have not have been the most
strategic in terms of moving it in a medical pathway
for NIH funding. I don't know, I'm just being I'm
speculating there, but you know, perhaps if there was something

(57:21):
you know, more boring that you know, where the research
crept up, and maybe they would have been more likely
to fund the clinical research earlier if but but at
the same time, a lot of the world wouldn't have
been interested this you know, maybe Michael Pollen wouldn't have
written his book that's you know, drastically increased interested in
this area had you know, we and others not focused
on mystical experience. So you know, it's a little hard

(57:43):
to you know, kind of you know, yeah, yeah, to
critique that history. But but yeah, perhaps that's some of it.
And and and might kind of the mystical aspect might
highlight the idea that oh this somehow a new a
g thing, and it's kind of about you know, hippies
talking about astral planes and whatnot. I didn't, come on, men,

(58:05):
We're talking here about a scientific agency that has every
ability to look at the vast research in the fifties
and sixties and a little bit of research that since then,
knowing that there was real promise there. I mean, there's
no reason. I mean, yes, that's the cultural compact text
and hippie dippiness. But when you look at the amount
of you know, the all the interesting stuff that came
out about psycholics and and alcoholism and a whole range

(58:26):
of other conditions back in the day, um, you know,
it's I mean, I thought, I really quite frankly think
that when people reflect back on the role of NAIDA
National stud and Drug Abuse in dealing with drug addiction.
They're gonna see this closed mindedness with respect to psychedelics
until just the last few months really as really a
major lost opportunity, and that probably one of the reasons

(58:49):
why people have continued to suffer so long from drug addiction,
when there were things that could have been really helpful
out there, but they just weren't doing um. But obviously
Nora Volca, the head of NIDA, seems to at it now.
I mean, I'm curious where there are a lot of
other efforts to get funding from night of beforehand they
just kept getting shot down, or to researchers like yourself
and roll In others that of the universities just think

(59:09):
it wasn't even worth trying. We had a few efforts here,
and we've had you know, and there have been a
few others of close colleagues in the psychedelic field, you know,
outside of Hopkins, and there have been several efforts and
they've all and some of them have done really well scientifically.
And for those not familiar, it's it's it's typically a
two stage process where you have scientific reviewers who were

(59:30):
independent of like. So, for example, I've served as a
reviewer for ni H. I don't work for ni H,
but i H gets scientists out there, and back before
the pandemic, they would all fly them together to d
C or whatever. These days it's on zoom but um,
and you evaluate the grants and then you get a score.
That's only the first step then, regardless of whether you
get a great score or a horrible score. Then the

(59:51):
institution looks at it, and it could get a great
score and they could decide not to fund it if
if it's on in their priority mission you know, if
it they don't want to do it basically, or it
can have a marginal score like yeah, not great but
maybe kind of good enough, and they can fund it
if it's something they really want to do. So there
had been multiple of those grants into either like really

(01:00:13):
good or nearly perfect category that didn't get funded. Um
you know, involved because they involved presumably because they involved psychedelics.
Although I wouldn't argue with your I would agree with
your history, with your characterization, Ethan, and that yeah, looking
at the history, you know, like, yeah, why why didn't
an i H jump in sooner? Although I do want

(01:00:35):
to throw in. Though. The flip side to that is
the room for redemption. How thankful I that you it
is now funded, Like, hey, this is like it's fabulous,
and to some degree I can understand. It's like, even
if I disagree, I can understand politically, the National Institute
on Drug Abuse is gonna be you know, their their

(01:00:56):
main thing is looking at at the bad aspects of drugs,
and they they're you still thinking about psychedelics as drugs
of abuse, and so yes, there was an uphill hurdle.
But man, you're in a way, you're in a cash
twenty two situation because you guys are submitting grants and
getting near perfect scores from the scientific review process, and
then they're getting shot down because of what they call
priority reasons, but which are essentially political reasons and go

(01:01:18):
to the profound politicization of drug abuse research funding in
this country right, which has been a real tragedy and
something that I think far too few drug researchers have
really been fully conscious of. But at the same time,
you and others aren't really in a position to openly
criticize the politicization of that process because if you do so,
it may reduce the likelihood of getting future grants or

(01:01:39):
being asked to serve on grant review committees. So I
think it's a you know, it's a way in which
I could go on on this, and I obviously when
I had Nora vocal on, I gave her a very
hard time about this politicized process, which I think is not,
you know, not what good science deserves in this country.
But now having broken through, Matt, do you think we're

(01:02:00):
going to see many more grants being approved for research
by IDA for research on using psychelics for treating drug addiction? Oh? Absolutely,
I mean, if I can do it, I mean I've
been at it. I'm persistent people that, but you know, like, hey,
I'm just me, Like, if I can do it, I
think others can do it. I mean the what I'm

(01:02:21):
hopeful for is that I don't know. I think of
myself like you know, fifteen years ago, seventeen years ago,
early in this field, you know, I did have folks
telling me like mentors are very such, are you sure
you want to do this? There may not be a future.
You have such a great pedigree, such a great future
ahead of you in terms of your your career potential

(01:02:43):
and and you know, now, I did take the gamble
of doing the psychedelic research. But I could have gone
the other way and said, no, I don't want to
take that gamble. You know, who knows maybe if I
had had more student loan debt that type of thing,
and I thought, hot, I want to take that gamble.
And I don't have a freaking job because you know,
I made this decision and of this risky research. What

(01:03:03):
I'm hopeful for now is the young graduate students in
the post docs that are going into they're interested in
this area. They see a path forward. They see the
fact that you know, not only the NIH grant, they
see that, you know, John's our Center a couple of
years ago got a seventeen million dollar grant, the biggest
philanthropic gift and Johns Hopkins psychiatry department history. They see

(01:03:26):
you know, like this, you know, NIH funding to look
at psilocybin as a treatment for addiction. And they see
a path forward. This isn't They see companies with like
literally billions of dollars of investment in this area that
are looking to fund research. So these are all these
new developments that I'm I think the real change is
going to come from these young people that are just

(01:03:46):
getting in now, who are seeing this path forward, and
you're just gonna get us such a larger percentage of
those folks who move into the field and stay into it.
So I have no doubt, Like, how could it be.
Are we going to write the history and it the
years and say, Matt Johnson, was that only lucky sucker
that got that one, you know, psychedelics treatment grant and
then it all disappeared. That's not going to be the case, right,

(01:04:09):
So I'm very hopeful. And Matt, well, I don't want
that distinction in history. But you broke through and that
was a key the key thing you did. And my god,
if it turns out that you know, psychedelics, philocybern and
psychedelics is incredibly effective in smoking cessation, um, I mean,
that's gonna be saved. Just monumental numbers of lives, you know,
speaking of which you know. What I also like is

(01:04:31):
the fact that in your research on Nikki, there's not
that many people interested in both psychedelics and nicotine, and
obviously you and Roland are among the couple of researchers.
And it's something that I've been very you know, engaged
in recent years and stepping down from DPA the issues
around tobacco harm reduction. And there's a very good journalist
out there, Mark Gunther, who's writing both about psychedelics and

(01:04:52):
about tobacco harm reduction. What's going on there. But you've
recently sent me a very interesting paper looking at as
more and more people in the tobacco control field are
recommending that there'll be a prohibition on selling cigarettes with
the nicotine yields they have today, and that only low
cigarettes with very low nicotine yields be allowed to be sold.

(01:05:17):
You know, many people are predicting that a substantial black
market could emerge, and other people are pointing out, well,
at least the government should be promoting the cigarettes as
an alternative. But could you just explain that paper you
did and why you did it and what your find
things were. Yeah, so we wanted the big picture. I'm
just you know, I just think it's crazy that we're

(01:05:39):
that we're considering a nicotine reduction hypothesis without fully considering
the potential for an increased black market. I mean, it
just flies in the in the face of all other Essentially,
what this means is functionally eliminating nicotine from cigarettes can
eliminate at to zero level, but it could be at
a functional zero near zero level. And so when have

(01:06:03):
has society ever outlawed you know, a drug? And essentially
that's what that would be, um, I mean, it would
be like you know, only being able to buy you know,
near beer o' duels, you know, alcohols made illegal. You know,
when have we ever made a substance I legal and
not seen a drastic increase in black market? We already
have a black market for tobacco. So that's the backdrop.

(01:06:25):
So I use and I've done a lot of work
over the years with both in lab and also hypothetical
simulation methods, where in the behavioral economics framework, you you
ask people, under certain conditions, how many folks would be
willing and we we found that about a third of
the folks would be willing to engage in black market
behavior purchase at least some of their cigarettes for the
black market. And the other question is, as you increase

(01:06:47):
the price of the legal cigarettes, the ones that have
no nicotine in them, do black market cigarettes have the
ability to serve as substitutes? In other words, as the
legal cigarettes become more expensive. Will people pick up black
market cigarettes as a subst dude, and the data suggests
they would, So there basically is a signal and it's
hypothetical methods, So there's limitations. But before moving into a

(01:07:08):
policy that's going to affect millions of people, Yeah, we
need to look more, you know, more at this, at
this potential for you know, drastically expanding a black market. Yeah. So,
Matt Lack, last question is you know, most research in
American around the world on drugs that are primarily illicit
is funded by the government. With psychedelics, what's different is
that most of it, at least until you've got this grant,

(01:07:31):
has been funded by you know, some of it philanthropically,
but a lot of it by for profits. You know,
people are looking to make money. You know, you look
at Compass other big investment players, who are you know,
putting money into universities as well. I'm curious what way
does that affect the research um or anything around the
research that you do on psychedelics as opposed to if

(01:07:54):
all this work was being funded by the government as
opposed to philanthropists or for profit players, it raises additional contingencies.
Of course, now I mean, to be clear, I think
it's a good I mean, hey, I welcome you know,
the companies that are jumping in that that have credible
plans to to to develop psychedelics through the FDA and
international equivalent pathways. But you know, obviously, when you move

(01:08:16):
into straight up into the for profit realm, like yeah,
you know that questions about you know, are the company,
is the company going to be doing things safe? You know,
are they going to maximize profit even at the expense
of safety, which I've tried to emphasize for the field,
like is actually one and the say it's gonna be
you know, if people aren't kept safe, like, that's gonna

(01:08:37):
hurt your bottom dollar. Like if something someone's on the
front page of the New York Times, like jumping out
of a window because you know they were in a
psychedelic trial that what was was not handed without the
appropriate safeguard and someone did something and that got themselves
hurt or something like, that's not good for your bottom line.
It's certainly not good for the patient. So it raises
questions like that, questions that are already there. But obviously

(01:08:58):
the financial incent of UM just creates more of a
concern but but you know, this is all addressable and
to be clear again, I welcome. I mean, I'm going
to be doing so the company of midusin Innovations Group
is really motivated to move forward with picking up on
our smoking cessation research and and and and getting it
to people. So this is sort of this is sort

(01:09:20):
of uh independently can deal along with the sort of
the night of funding. So we're gonna be doing actually
multiple trials um uh going forward examining smoke pilcybin for
smoking cessations. So so I'm I'm very hopeful that they
get this. You know, that this research is successful. We're
going to be helping them lead this trial um and

(01:09:40):
then you know that it ends up helping patients. But
you know, in general, again for the you know, the
various companies, it's a different landscape. It's in some ways
very exciting, but yeah, it's just you know, clearly there
are some companies that have come into the space where
you meet some folks, so you read about them and
you're like, what the heck is going on here? Man? Yeah,
they just view this as as cannabis two point oh

(01:10:01):
in terms of the money where cannabis was wherever it
was ten fifteen years ago in terms of the big
money making opportunities and thinking this is the same thing,
and it's not the same thing unless you really know
this area. FDA approval is a different beast. But listen,
it's been great, great reconnecting with you. It's been great
hearing you speak of these conferences. I think what you're
doing is absolutely going to be changing the world. And

(01:10:23):
I think your partnership with Rowland and now you're assuming
the leadership of the Center Johns Hopkins, I mean, you know,
more power to you. I love the frankness and the
easy that you discuss all these subjects. So you know,
I look forward to crossing paths many, many times in
the future, and I hope that many of your studies
turn out truly transforming the fields of psychiatry and even

(01:10:44):
more broad broadly, our understandings of consciousness and neuroscience. Thank you,
it's been great. You're welcome. It's been great reconnecting with
you recently Ethan and and thank you for your leadership
and drug policy and now more recently and including tobacco
Alyss Lisa, thank you so much. Thanks. We love to

(01:11:05):
hear from our listeners. If you'd like to share your
own stories, comments and ideas, then leave us a message
at one eight three three seven seven nine sixty that's
eight three three psycho zero, or you can email us
at Psychoactive at protozoa dot com, or find me on
Twitter at Ethan Naedalman. You can also find contact information

(01:11:28):
in our show notes. Psychoactive is a production of I
Heart Radio and Protozoa Pictures. It's hosted by me Ethan Nadelman.
It's produced by noa'm osband and Josh Stain. The executive
producers are Dylan Golden, Ari Handel, Elizabeth Geesus and Darren
Aronovsky from Protozoa Pictures, Alex Williams and Matt Frederick from
My Heart Radio and me Ethan Nadelman. Our music is

(01:11:52):
by Ari Blucien and a special thanks to Avi Brio,
s F Bianca Grimshaw, and Robert B. B m. Next
week I'll be talking with Kat Packer, Executive director of
the Department of Cannabis Regulation for the City of Los Angeles.

(01:12:15):
As I was doing advocacy in the City of Los
Angeles and really trying to hold the city accountable to
what I felt were principles and values that we have
to lead with when we're talking about cannabis policy reform.
I was tapped by the mayor to take on the
challenge of advising the city and administering its commercial cannabis

(01:12:37):
program in August. Subscribe to Cycleactive now see it, don't
miss it.