20 Years of Psilocybin Science A Masterclass with Dr. Matt Johnson

[music] I've been trying to get in touch with Matt Johnson for a while now. If you don't know him, he's been one of the lead researchers on psilocybin therapy. It's the active ingredient in magic mushrooms for 20 years at Johns Hopkins. And the reason that I wanted to get in touch with him is that around me there are so many superstitions around psilocybin and magic mushrooms. I have so many people that I know that say that it's demonic and it's dark energy and you got to be careful and to be honest it's just superstition and I don't know how to get through to them. I keep try to keep looking at the data and having conversations, but the thing about superstition is that I don't know how to break it and we all have it and you can have it individually and you can have it as a culture. You can have a cultural superstition. And so I encounter that a lot when it comes to psilocybin. And so I wanted to sit down with Matt Johnson cuz he's been doing it for 20 years and he has tons and tons of clinical data about how it helps people. It's verified. It's not addictive and people see life-changing results after one session. And it helps in so many ways. Like he's coming out with the study he just finished that helps people quit smoking, quits nicotine. It's one of the hardest drugs to get off of. It helps people quit alcohol in one session. It helps people with PTSD. It works better than SSRIs, benzo, anti-anxilytics. For some reason, I feel like our culture is just open to doing all this other stuff. And then when it comes to this one thing that can actually unstuck you from all of those things, they get push back. And I'm not saying there's no downsides. Like if you have a history of bipolar in your family, like you really got to be screened for that stuff. But it's such a small minority of the population, like singledigit percentage points. And so I think it's just overblown. And you know, all those other things aren't without their own risks as well. And I would argue better, more greater risks. So we got to go to Matt Johnson up in Baltimore and uh sit down with him cuz I really wanted to hear his experience. He sat with hundreds and hundreds and hundreds of people and watched them make their lives better through one or two sessions with this. And I think that's one of the things that's hard about superstition and just getting older is that our brains get stuck. Our brains get into habits. We're habit people. Our brains are habit forming machines. And that's good. That's like a survival mechanism. It lets us know where the good is and the bad is and the danger is. But you know, I've seen people that won't forgive. And you know, somebody does something to you or a family member and for years you harbor that unforgiveness. And you know, the Bible says forgiveness is for yourself, not for the other people. And I don't think anybody would argue that they don't want to forgive people. But everybody has reasons and everybody's stuck. So, you know, if you're dealing with unforgiveness, if you're dealing with depression, if you're dealing with addiction, if you're dealing with anxiety, if you're dealing with nicotine, zins, and and and cigarettes, this psilocybin therapy has application for everybody. And we just have this superstition that came out. And the superstition came out because of the 70s and people were going on acid trips and doing mushrooms. But guess what else that did? It made them not want to fight people. It makes you love people. It helps you love people. And so what happened? People didn't want to go to war. So the government made it schedule one, which means there's no medicinal benefit, but it meant they could start throwing everybody in jail because they had a war to fight in Vietnam and in Korea. So, and then we get DARE, drug abuse, resistance, education, of which I got when I was in elementary school. And this whole narrative came out when we were seeing these benefits in the 40s and 50s from psilocybin. And it got it got smashed underground for 50 years. So, it's finally coming back out because I think as a culture, we need it. And I think like it's going to it's helpful. It's net positive. And if you're willing to take SSRI or drink alcohol to cool down at night, I don't know why you wouldn't be open to a literal mushroom that grows in the ground that has so many beneficial effects. So, anyways, I'm really glad we got to talk to him. It's one of my favorite conversations. So, if you're if you're skeptical about mushrooms and psilocybin, I would encourage you to listen. And if you know how they work, I think you're going to love this because you probably already know Matt Johnson and he's the man. So, please subscribe if you haven't. It really helps. Welcome to the Austin and Matt podcast. I was actually at Burning Man in like 2004 when Katrina happened was 2004 2005 and like that's back now everyone has cell coverage but like no one had cell so all these people were finding out and maybe probably a few trickled like whatever they'd gone to town or whatever but like no one knew this like major hurricane like a whole US city got wiped out you know like oh that was back like even that's gone now it's like everyone's connected to Burning Man that was before everyone knew about Burning Man you were burner before burning was a burning. But that's that's the thing even then like they're like oh it's already jumped the shark like no matter when you go they always say it was always a few years ago. So even then people were saying it was but of course like yeah I think it's like double yeah like now but even then they were saying oh yeah these are you should have been back in the good old days but well I think being there without cell phone coverage is probably one of the things that most people will never know is going somewhere and being totally that is a real marker. I mean, you cannot rep It's hard to replicate that right now, right? Because everyone's gonna have You better You better hope they never find out what that's like, cuz that means we're in tough times. Yeah, that's [laughter] right. By force. Yeah, right. They don't work. So, that means you were into psychedelics before you became a researcher. I actually No. So, I was a researcher then. So, I got into psychedelic research in 2004. And I actually went to Burning Man with the intention and I I did it. So it was more than an intention but to volunteer in the bad trip tent which was called sanctuary. Then it became like Zeno but like back then it was sanctuary and to help as kind of like training to help a bunch of people having bad trips. Whoa. Yeah. Which I did. I actually have very good friend of mine. We're still buddies. Uh and like I I met him because he came in on a bad trip. And you guys are friends now. Oh yeah. We've been friends like for like Yeah. decades since I was at his wedding. Like Yeah. Like how experienced were you with bad trips before going there? And like how much was it? What was it like to just kind of see people having bad trips? Somewhat. I'd been around but it definitely wasn't to that degree. Was there a lot of bad like you're the person trying? Yeah. Yeah. Yeah. So it was it was kind of in it was intense. Like there was a Yeah. And the thing is like the police would bring So they had the medics and the police like if the person just tripping their head up, police are like you take them. I mean they're making plenty of money busting people from cannabis which is like obviously like smelly and like just and apparently if like I could have the numbers wrong and maybe it's changed but at least back then it was like someone get busted they get this ticket. If you pay it within like whatever a couple of days it's like 200 bucks and it's off your record. So everyone they'd catch a ride into like the nearest town, hit the ATM, come back and it's all and so the cops were just making a bank on it. So it's like they didn't like they were making plenty of like money off of C. Like they didn't care. Someone's tripping their head out like like you want you want to take this like yeah please go ahead. And so they get kicked out by medical and they're like no they're not oding on an opioid or whatever. Like yeah they just took a bunch of acid and and so then they would hand so it was kind of like really nice. So, it was still kind of like a bit they didn't advertise it because it was still a bit Yeah. Like the the official organization I think of Burning Man didn't want it to be too loud because it could be accused of like you're encouraging it, which is the classic thing, you know, like totally, you know. Um but but yeah, like you know, people would be handed off by like the cops and medical and like yeah, they're just they just had a bunch of mushrooms and they're having a really tough time and are flipping out like wow. So, it was like a really nice crash course and just dealing. Of course, it's not just it's truly people having difficult experiences because like that's the reason they're there. You know, it's not just them. Of course, then it could turn around and then the person is just like giggling and having a great time and you could see that happen and you know in real time. Uh when you say it's people truly having bad experiences because that's why they're there, are you saying that's why they're at Burning Man or that's why they're in No, that's why they're in the bad trip tent. Yeah, like cuz someone knew it's like uh there's a place where they they help with this and they walk across the playa which is the name for the like whatever the desert area. It's like Burning Man lingo. Did you do that for many years? I've only been to Burning Man twice. That was my first time and I went a few years later. Okay. Actually with the same buddy I met in the Bad Trip the first time and another buddy. Did you get asked to come do that at Burning Man or because you were researching it or how did you how did you get involved? I forget how it unfolded. So I was with I stayed that first time with the maps like um camp at Burning Man and they were running or it was this interesting political thing. They were like one of the organizations. I don't think they were officially running Sanctuary, but they were basically running it. Mhm. But again, I think it was one of those arms length things where the organization didn't want MAPS running it, so they basically were, but there was someone else that was part of the rangers there that were running it. Yeah. Anyway, but basically MAPS was basically running it. And what is MAPS? The multi-disciplinary association for psychedelic studies. They're the ones that have developed MDMA for PTSD. they they spun out into uh public benefit corpose. And so now like the drug development arm is LICOS, but they were the ones that got essentially got the rejection for MDMA for PTSD um a year and a half ago by the by the FDA. Um, but like Rick Doblin and I don't know, everyone knows Rick D if they're around the psychedelic like world like that's his organization and um, and yeah, so I guess I think yeah, through knowing the people at MAPS like that's how another posttock at the time uh, you know, we went there for that purpose, you know, I mean to check out Burning Man and have fun and all the rest, but also like yeah, this will be really cool to get kind of a crash course and just dealing with a bunch of people having, you know, bad trips and it was definitely useful. Like, what did you learn? How do you calm somebody down? Um, yeah, you know, it's going to sound cliche and I hate that, but it really it it is more the vibe than what you say. And that's one of the things that I I've certainly come across in, you know, formal like study sessions like you can find yourself explaining like forget about like what's coming out of your mouth. And I've I've likened it where I've dealt with like relatives with dementia where it could like weird people out and the person's talking out of their head and it's like the words just like that's just some weird layer up here. It's just like look him in the eye and be like it's like we're like I don't know there's a layer underneath like you're animals the same way like you could look at a dog and know that dog is friendly and like we're connecting that dog's not going to attack me and then you could also tell that dog's going to attack me. It's like there's no words involved. So it's more at that level like be a calm presence. Just something a little more practical than have good vibes is like yeah just get on the ground like get lower than them. I mean, that's get thinking back to the dog again. That's advice for like a strange dog. Get down. Don't cover over a dog that you're trying to meet. You know, you get down to their level. Stick out your hand. So, it's like, yeah, get they're sitting on this little kind of like cot um and just, you know, put your butt on the on the ground and yeah, how's it going? You know, like what's up? You know, just, you know, let them know. It's like, no, we're not the cops. they know about this and they're cool with it. But no, we're just people that, you know, let them know the context that help people that might have some, you know, trouble if they've had too much psychedelic or something like that. And, you know, um try to be calm. Yeah. Yeah. like and and just let them know it's not that big a like people have had bad like you know it's but again you can get in trouble by saying don't worry plenty you could find yourself it's not if that's not landing then you know forget about the trying to explain it to them I don't know because at a certain point like just knowing that millions of people have had bad trips doesn't oh so millions of people gone through the most intense hell they could possibly imagine like great is that supposed to make me feel better you Right. When you got into researching psychedelics, did you have was there something you hoped to get out of the research? Was there a direction you hoped to steer psychedelics in? Um, yes. I think the thing that was of most interest to me was behavior change and that's still kind of the the the greatest interest. So, I was really interested in the older work with LSD and alcohol addiction, alcoholism. Um, and so this idea that like and and just plenty of stories of people that said what like be it like Steve Jobs or like Carrie Mullis and you know and then obviously if you get into the musicians and other artists the countless stories are like well yeah they did this thing like one or a few times and it just like it just changed the direction of their life you know often in a good direction. Like I'll often say like it's not uncommon for a a drug experience to alter your life trajectory from a single instance. But outside of psychedelics that's typically bad like you know you you got really drunk and you killed someone in a car accident or you had too much of a stimulant and you had a stroke and like you know and even like on the positive side it's like terms of other drugs it's like something like say cannabis. Yeah. lots of you know uh you know stories of you know you know medical and palative effects but like no one's I've never heard of anyone said they smoked pot one time they never touched it again and it's had this positive ongoing influence in their life it's like oh like it it helped your chemotherapy nausea so you kept using it when when you were going through chemotherapy or whatever like like a paliative and so it's like psychedelics seem kind of unique in that like they could make people more malleable And and there's also examples where on the opposite side like they their life's gone in a worse direction, but just the fact that there are those examples where their life has gone in a positive direction like they've overcome an addiction, that was always of interest to me because I was like I had roots in behavioral psychology as an academic interest from early in college. And so that was interesting to me like like I was kind of combining like the like like the hippie elements and the psychedelic like the past with like like hardcore like BF Skinner behaviorism like Yeah. Yeah. Like I was doing research with rats like pressing levers and like you know that's cool man. It's so interesting. I've been trying to figure out how people change their minds and it's so fascinating because I don't really know still like I don't know where it comes from and and it seems like young people children are changing all the time and then you get older and you're changing less and less even you know you should change you should stop eating or drinking or work out more or save your mind like whatever but we've developed these habits and we want to change but we can't right or you know it's not can't I don't be defeist but it's very very hard yeah there's an an inertia a momentum that like Yeah. And somehow you have to just remind yourself all the time and leave sticky notes around to like, you know, do 10 push-ups, do 10 push-ups, or, you know, just to kind of cultivate this thing. But then somehow psychedelics seem to have a capacity to let you change your mind all at once and it to your point it just you turn right. You just you can turn sometimes. Yeah. Now, a lot and I think it can be overstated like like most of the time when people use psychedelics, there is no like life. It's it it's neither like this horrible like bad trip that you know or this lifechanging like whatever. Usually it's like a fun time. Maybe it got a little scary. It's like fine. Five minutes later there's giggling and like whatever and like it was a really interesting experience. Like that's the normative sure thing. So we can't forget that. But like it's surprisingly common. It may not be typical, but it's not uncommon for people to say like these really outlandish things like it just changed the course of their life. Like like things like that's when you know they'll say like that's when I decided that like you know this girl I was dating like she was really the one or like I'd been drinking for years and I finally decided like this is never going to stop. I have to I have to stop. it's become a problem or like I like whatever like there's countless stories like these kind of big decisions that kind of crystallize and I don't think that's unique to psychedelics. In fact, that's kind of why like psychedelics are super interesting because like what they do is not really unique. They're kind of just a magnifying glass of what people do. Like people do have these kind of changes and they become less common as you were saying as they get older. Um but you know what can we do to like when change is needed because change isn't always needed like you don't want to necessarily like one of the concerns like you know I've had spouses like for their like their spouse is in a study and they're like I don't want you know like you know their husband to leave them and go like give away all their possessions and go to India and like meditate in a cave the rest of their life [laughter] you know it's like not everyone should do Has that ever happened? I'm not sure anyone should do that. For the record, did that ever happen? Did anybody ever do that in the 20 years? No. No. No. I've never seen anyone anyone do that. But, you know, but you know, people do have a kind of a fear of change. And I think that is something to be mindful of that like you just don't want wild like change either. Like and I well I'll tell people before a session or or after a session like whatever big insight you have it's like unless it's something like if you went in there to like to stop smoking it's like yeah like go with that and like you know but if it's like if you're secondguessing your relationship like like dude sit on that give it a few days yeah the most important state of mind is your everyday sober state of mind like see how it rests with that and this is also just a wild like some crazy stuff can occur to you that doesn't necessarily point towards ground truth. And this is important in a lot of ways. Not only is like people secondguing like you know do you want to I don't know like invest in some like new like crypto coin that not to say you never should but like you know like and in invest your kids college fund and it's like no dude you're kind of married with three kids and it's like be really thoughtful about this you have responsibilities like you're not a kid you know like that's important too so it just like requires a wisdom and so like Don't you know just kind of contemplate you know if you think you're going to go in a new business direction cool give that a give that three weeks think about it when you're stone cold sober. Yeah. So how does somebody change their mind without psychedelics and what are the things you can do? Um like where does that because I know it's awareness and it's but it feels like a mountain sometimes. feels like we all have things we want to do and we can't do them or you know we try and try and try and you try it and you do it for 3 weeks and like I'm not a morning person and I've tried to be a morning person so many seasons of my life when I'll get up at 5:00 a.m. and go and I'll be three weeks or whatever and then eventually it's like I hit a fatigue moment or something happens and I just start sleeping in again and then uh didn't work, you know, and you just walk away from it. It's like how how do you actually do that? I think one of the one of the most important points and you could stay say this in different ways but it's like think about systems rather than just end points like like it's just like get into habits and and and construct your life in a way where you're going to be nudged like recognize your own limits. It's not like you have this unlimited amount of like perceived agency or free will at any given moment. Like recognize you're just like a weak human like the rest of us. And so like nudge yourself. Don't put yourself into temptation. I mean this gets kind of like there's plenty of religious examples of it like devil get behind me. Like don't put yourself in dumb situations. um put yourself in smart situations where it's going to be more likely that you're going to do the thing and to stay away from the bad thing, you know, like depending like if you want to get, you know, like obviously like keeping that alarm set like even if you sleep through it in a few days at least sticking at that, you know, like yeah, maybe you'll you go through like a whole month of like every single day like cutting your alarm off and but you've given yourself a chance, you know, like by setting that alarm early. And um and then I don't know, just trying to go with that, like you want to get up and exercise, okay? Like lay your clothes out the night before where it's a little bit easier. Like kind of learned these tricks like self-control is easier. Like I've studied a lot of behavioral economics and outside of psychedelics, it's the main thing I've I've studied. And there's something called hyperbolic discounting, which sounds very mathematical and fancy, but basically the most important implication is it's easier to make a self-control decision where that where the consequence of that decision is far away from you. So it's easier to exercise self-control at the at the grocery store than at your refrigerator when like defection on your own pre-commitment that make your decisions later easier. Yeah. like to go to get mythical about like you know Ulisses tied himself to the mast of the ship when he knew the sirens were going to tempt him. That's right. So like put yourself like don't have like the whatever it is for you like the cheesecake in the fridge if you know like like at any moment when it's your in your fridge like in 20 seconds that could be in my mouth. But if it's like, you know, you know, I could get out and go to the store. It's going to be like whatever gonna take me 20 minutes to get there. Gotta get real blah blah blah blah. You're less likely to kind of make that split second. So just kind of set up the environment. I kind I try to think of like as a behavioral psychologist kind of the first layer is how can you orchestrate the environment to just nudge yourself in the desired direction? how to plan that ahead of time, you know, so that you minimize the defection, you know, the temptation. And I say defection because it's like like a group that has to cooperate, you can get a defector, someone that like the cheater. If you think of yourself as like a series of intertemporal selves, like you think of yourself as the same person, but your motivations shift. And like if you say, "Oh, I got I'm gonna quit cigarettes, cigarette smoking, and I promise." Like, it's only worth not smoking today if you trust the you of tomorrow to follow suit because it's like one day of not smoking isn't going to make any difference. You might as well smoke, right? Yep. It's only if you can trust the you of tomorrow and the day after that and the day after that. So, you know, think of yourselves as like yourself, your future selves as like kind of like different like related but somewhat different people that you know, you want to build that trust relationship with them. And so, set up the environment in a way to like nudge your yourself in the right your future self in the right direction. I've definitely done that where I thank past Matt for setting stuff up for me where something happens I'm like, "Oh, man. Past Matt just hooked it up. Thanks, man." Like, and it's But you studied quitting smoking, nicotine addiction specifically around psyched not buy the cigarettes and not be around people who smoke and not do a lot of these things, but then also what happens when someone goes in with an intention on psychedelics to quit smoking or or walk me through sort of what that looks like and does it seem more efficacious? Does it seem like it sticks a little bit more? Yeah. And why? In fact, we we finished our our second study. It'll be published uh uh soon. Uh but a big randomized study comparing it to nicotine patch treatment. So, this is one session with psilocybin um the active agent in mushrooms for those who may not be aware. Um but it plays out in different ways. Um, for some people it seems to like solidify their like kind of magnify their intentions and and it kind of frames things in a much bigger from a much bigger perspective like metacognition. I think it goes beyond what's typically meant in cognitive psychology by metacognition. It it sort of like it kind of gets more in the realm of like that's typically talked about in more um mystical. Yeah. mystical or humanistic psychology or yeah, religion, you know, it's like what's the meaning of your of your life? And like like there's tethers to this there's more of a road between this kind of amorphous goal of quitting smoking. like it it can kind of hit someone like very very strongly that like like wow like I I I do all these things in my life where like I want to kind of embrace health and life like I don't want to die like trying to teach my kid to do the right thing and I do exercise and it's like it just it kind of can like it metaphorically like pulls someone back where they see the big picture and like whoa this is crazy like whoa like like how dumb of me to do that. Like I don't want to do that. It's whereas in everyday life and this isn't unique to smoking or anything else. It's like all these decisions all of us go through. It's like you're just you got tunnel vision like you're dealing with the next thing that comes up and it's the immediate and you're dealing with the thing that that you're dealing with and you're not kind of panning out all the way and like how is this like how is this little thing nested into this much bigger picture of my life and kind of like when you put it in a I see like it has the ability to kind of put put people mentally in that kind of space where they can kind of see the connection between like of course I want to quit smoking because I want to be a good parent like how would I and and but this stuff happens outside of psychedelics and I don't think I've ever seen anything with a psychedelic that can't that doesn't happen right outside which is in part what makes them very interesting. I think of an example in this book by the psychologist uh Bill Miller who's done a lot of work on alcoholism alcohol use disorder. Bill Miller wrote a book called Quantum Change about how people outside of psychedelics, how they changed their lives and kind of like discreet ways, not just gradual change, but they just took a 180 on something. And he described a case where a guy quit cigarettes cuz he was like picking up his daughter from daycare and he showed up and it was raining and he was a little bit early and he thought that uh he he reached for a cigarette to realize, "Oh, I'm out." and like, "Oh, I could go to the convenience store up the road and I'll I'll be back in time for her." He started to drive away and just as he started to drive away, he saw her in her his rearview mirror and real. And for a split second, like, you know, he he just he kind of told himself, I I did see that. I'll be back in a minute. It just like, you know, it was kind of inconvenient. I saw her in my room. And then he like caught himself and was like, whoa. [laughter] Like I just like almost left my daughter in the pouring rain for these cigarettes and like he was done like it kind of like that it's it's that's like a psychedelic experience, you know? That's like something that like this kind of asteroid that hit the earth for him, you know? It was like that just like magnified like, oh, that's what this is about. In that context, it's like easy. Yeah. Like of course I'm going to quit smoking. It seems like eventually the decision becomes easy. Yeah. Yeah. Yeah. Yeah. So if you frame things and that I find that most interesting addiction is such a mystery but everything like heroin addiction, cocaine, there are stories where often times people when they finally quit successfully, even if they tried a million times before, there's this clarity that happens where it's I don't want to say it's easy, but it it's relatively speaking it's Yeah, it's easier. It's like they know they're done. It's like something very deep. I think of tectonic plates under the earth. Like something has shifted very deeply where there and another metaphor is like you know the old cartoons where you had the devil and the angel on the shoulder like come on it's just this one time live a little bit. Oh no you should you know like um I wonder if that's fallen out of fashion with the modern cartoons. I love those those old kind of tropes. Yeah. Right. But it's like that's kind of like where you've got the cigarette in your hand or the crackpipe or whatever and it's like if you're if you're having the angel and devil like are you out? It's probably too late. Right. [laughter] That's right. So I think of people with addiction getting to a place where like you're past that. There's no devil on your shoulder and it doesn't require the angel to argue the devil. Like you're you're because you invite that you get close enough to it like you're you're going to lose. Yeah. You're entertaining it, right? And so it's already done. So if the shift is like big picture enough where you just and that's the thing. I mean I'd love I'm so fascinated by like addiction like what is that? Well, it seems like sometimes it's mostly unfortunately my perspective is it's always bad things that happen. Somebody gets in a car accident, somebody dies, somebody gets cancer, somebody gets it's some lifealtering event, a negative lifealtering event that then brings people to that moment of like, oh, I have to stop this either because I literally have to because of my health or something or look at the huge ramifications, the negative ramifications of what just happened and it stinks to think that this low road, right? It's like it takes something negative like that for that perspective shift to happen. Yeah. There's one positive I can think of, but it's also kind of the threat of something negative happening. It's pregnancy is one of the most powerful predictors of not everyone obviously, but it a lot of women quit smoking when they're pregnant and obviously but it has the negative there. It's like the fear of like you know hurting your baby. Um and so but yeah the same thing as strong literature all the like heart attacks and like yeah can't like there's a lot of people that quit when after they get these negative but it's just so interesting that psychedelics can give you that experience sometimes in not a negative way. It just somehow gives you that 30,000 foot perspective before the car accident, before the cancer, before and you go, "Oh, I get it." And you can make the shift before you you're forced to. Interestingly, originally the first people that studied LSD for alcoholism, these researchers in Saskatchewan, Canada, um Humphrey Osmond and um Abram Hoffer and Duncan Buitt and others, they were trying to model something negative with this is back when they were called psychotimedics and you know, Sandos was sending it out from Switzerland to any basically anyone who asked for it. Anyone who asked for it and you could just say you're Dr. So and so and they just stick it in an envelope and like you know just try it on your patients cuz they were like tell us what you think this is good for because it seems to be really interesting and powerful. We don't know what to do with it though as a company to as a pharmaceutical company. And so like but what they were what they figured is ah they were treating alcoholism like a lot of people sober up like we were just talking about who get the DTS who are such bad alcoholics they go into the delirium tremens which is like when you're really physically dependent and you have seizures like you could die from it. Um, you can also die from benzodazipene withdrawal, which are both of these are way more dangerous than heroin or other opioid withdrawal because you could die from it. Your brain just kind of goes crazy with its excitatory neurotransmitters and you can have seizures and and and die. But, you know, the idea is like a lot of people when they go through bad DTS like they sober up because of it. They've been scared straight. So, it's like how can we model the DTS? Like have people think they're kind of going crazy with something that's actually pretty physiologically safe and like LSD fits the bill for that. Whoa. But what happened was, and I think it's because these are just like really cool people. If you see these old videos of like Humphrey Osman, he's just this delightful British guy who' moved to Canada. Like he just This would be a cool guy, you know, like in the bad trip tent, [laughter] you know? Yeah. right? Um like they just started getting these more mystical experiences. Even though they were they were shooting for these kind of hellish experiences to kind of scare people straight, people have started having these transcendental experiences. So incredible. Yeah, it is interesting. It gets what you were saying like it's not even though they were explicitly trying to it's not like the negative, you know, traumatic event. It ended up being more of these positive transcendental perspective shifting like uh experiences that seem to be more helpful. How much do you attribute what's happening to physiological responses of like psilocybin going into the brain or whatever versus somehow it connects to the reality beyond this reality or mystical sort of like what what's actually going on there from you seeing this for 20 years? I think the the first thing is that there really is no dividing line between like the psychological and the biological. M now a caveat is that like yes it's possible and these are being developed like a psychedelic that has similar as characteristics that can in in they can have a similar neuroplastic profile has the effects on neurons that make them more adaptable but that does not induce a trip and experience now that's an interesting exper empirical question I don't think you're going to get the type of efficacy that we're seeing I think there might be it would be a different treatment model maybe akin to micro doing where people are taking it more regularly which we still don't know whether there's any real efficacy to micro doing it's still very much an active area of research and much less research has been done on that compared to like the high dose research um but when there is an experience you know a regular psychedelic you know there. It's It's not There's a biology and a psychology to it. You can't separate the two. Yeah. You know, they're just two sides of the same coin. Presumably, and this is a presumption, but I think it's a pretty decent one. There's a biological correlate to any thought. Like, we're not at the level right now where we could think, uh, I thought of my grandmother. Like, there's something happening. Like, we're not able to figure that part out yet. We know there's no, you know, grandma cell, you know, but like presumably there's some kind of signature of network activity that goes right along with me having the thought of whatever like yep, my grandmother. Um, it doesn't mean, because you get philosophical with this, it doesn't mean that you have to be a materialist and assume that all subjective experience is caused by material, but it's at least a correlate. We know there's a strong correlation between the two between subjective experience and what's going on in the in the brain. So the you know like clearly psychedelics are very real biological agents. We know what they do. They act as agonist on the serotonin 2A receptor, a subtype of serotonin. And that has downstream effects on glutamate. And that ends up changing the brain network dynamics, like the overall traffic and the communication patterns in the in the brain, which seems to kind of be well related to like the subjective experience. So, it's not one or the you know, it's not one or the other. Um and like if you have a successful course of psychotherapy with no drugs and that just you know and this you know these things do work. They don't always work and sometimes we focus on that, but like you name it. Like there's like phobias are one of the most addressable thing and just anxiety in general is one of the most addressable things through um various extinction therapies like systematic desensitization. Um exposure therapy, exposure therapy. You're afraid of bridges. Okay, first we're going to start in our office looking at photos of bridges, watching videos, and then we'll take a field trip to just get the edge of the bridge. And then eventually you're going to go across it. Your heart rate's going to go up, but you'll get used to it. And then like you just do that that just almost always works if if you if you do it right. So there's that's probably the most extreme example, but there are tons of successful psychotherapies. Presumably the brain changes. Mhm. You know, now we don't think about it that way because it's not a a medication, but like everything you do is presumably changing your brain. So I think about the psychedelics in the in the same way. I do think there's my guess is and we need more work on this but there's a causal role of the experience. Now that experience though has biological coralates but I think that matrix of psychology and biology that subjective experience and all of its biological underpinnings. do think that is a necessary part of at least the current treatment models where you know people have these big picture perspective taking um experiences that are memorable where they kind of reframe things in in their life and they feel like they've kind of you know all the analogies like they rebooted their system their you know like they defragged def we don't do that anymore do we defrag like saying, "Yeah, you defrag your hard drive. Now it's running a little cleaner." You know, you've spoken about the guru effect as well, and I think this sort of correlates or like cuz it's the set and setting, right? It's like you are impressionable and so it can't just be purely biological. But we have to be careful as well because you're whoever's speaking to you in that moment does have influence because it is you're I don't know. It's like you're perceiving reality and they're giving you a perception of reality and so you're just more open to that kind of thing. H how does that like how do you balance that? Is this I guess the person should just know the person they're they're going to go into it with and if they want it to be their pastor then it could be their pastor I guess or like or is there is there a neutral is there like a no influence at all from a s from a sitter? That's an interesting philosophical question. I mean I don't think there's ever no influence. I mean this gets very like Heisenberg uncertainty principle. It's kind of baked into the very like nature of the universe like you you you can't interact without having an influence. Exactly. Um that would be my presumption but like you know that's a spectrum though like yeah you can have a you know kind of again I I don't want to forget about the normative case. The normative case might be like it's not a therapist. just like a buddy who ate mushrooms too or maybe who didn't you know but like you know and um someone that you trust I mean I think that's the most important thing and know the goals and to trust them and that is a difficult thing with professionals you know um whereas like you've you got to tr you know it's the same dynamic with like any doctor any psychotherapist like you know you're putting a lot of trust in these people you know people mess up all the time and now you figure out you just ask chat GPT it's like why didn't my doctor say that like they like because we're you know I mean that's a trust in terms of their knowledge but just even in terms of their intention we know that there's like really astonishingly high rates of all kinds of abuses uh you know like some uh non-trivial percentage of psychotherapists that said that they've had a sexual relationship with a client over the course of their career. Um, there's, you know, everything. There was some thing at Hopkins years ago where some like uh gynecologist was like filming all the women and taking it home and I think he ended up committing suicide. Like, you know, there's crazy stuff out there. Um, and so I don't know, there's no secret like as a as a as a patient, uh, you know, all the kind of normal like try to be with credible people with all the credentials and just have the right vibe for lack of a better term. If the person creeps you out, you don't want to be having a psychedelic around them. Um, trust your gut. If your friend was ex was was educated on it or felt comfortable, they would almost be the best person to do it with. You know, if you trusted them in that capacity, you know, if they knew what they were doing and blah blah blah blah blah. It that trust is one of the heaviest weighted things, right? which I know some people will now like and I could hear kind of the criticisms out there like yeah they may and you started yourself with the caveats they may not have the professional wherewithal and like what if your blood pressure goes up which I'm not a physician so I have a physician colleague that can come and address the blood pressure and but but yeah that it's been argued before and it's an interesting point like when some of these state level initiatives come up that like hey man where people say forget about the Oregon or the Colorado model what about just allowing people to do it with their friends who they actually trust instead of creating this whole industry. And like there's an argument to be made there. There's at least sure one I think one should appreciate even if they don't agree with it like yeah cuz like people know their friends that they could trust that they're not paying thousands of dollars to for this experience and and maybe they're very credible but like also maybe they're not but they if they're talking about their high school buddy that they've done everything with and it's like they can at least trust that their friend isn't going to like whatever sexually assault them. They have their best interest. Yeah. Yeah. Yeah. So there that is true you know um I'm not giving to be clear recommendations I'm just kind of exploring like there is a reality to that to you know you you might trust your friend like more than you know this doctor that you've had you know four hours of preparation visits with [laughter] you know so you've done a lot of cohorts over the years uh studying this and I was curious what are some of your favorite ones or some of the ones that you did where you just for whatever reason you enjoyed those cohorts it's for the way you studied it or the maybe the people or for whatever reason. Yeah, I like I really like the smokers which is kind of my main thing now. Um and it's a line of research going back 15 years or so. Why do you like the smokers? Because I don't know part of the context is I've done a couple of studies with meditation, both people adopting a meditation and then another one with it'll probably never be published uh but long-term uh meditators. The caveat, you get the full spectrum of humanity in every group and you know like yeah sure you give group averages but you can get a lot of narcissism [laughter] and a lot of like sort of like oh I'm you know I've meditated so many thousand hours in my life and like almost like just I'm a guru like the ego is can can be there's exceptions again I I feel the constant need to put the caveats out There's some people, but yeah, you get some people that are like, and you hear stories about famous like meditation researchers like behind the scenes from their grad students and whatnot that are like, yeah, there's something there to like the people that are attracted. There's exceptions, but to get heavily in the meditation world, it's like there's some degree of self-medication. like there's some degree of ego inflation much like psychedelics, you know, but like so in that context, you know, the smokers are really kind of uh cool because they're kind of wearing their thing on the on the outside, you know, it's like overt. Yeah. It's like, guess what? I'm a hu I'm I'm not perfect and neither are you. Yeah. You know, like let's not pretend we're not all a bunch of smelly animals, you know? Like I kind of get that sense like there's a like a realness to someone that's saying like, "Yeah, I'm here because I've been smoking since high school and I can't seem to quit. Like I've tried. It really stinks. I've tried. I feel stupid because of it." And it's like whether you admit it or not, there's may not be smoking, but there's things that we all have that fit into that category. And so it's not like you appreciate how open they are and just how obvious it is for them. Yeah. because you get a lot of people interested in psychedelics that are just I don't know very attracted and when I say these things I feel like I need to put all the caveats in. There's plenty of exceptions but people that are like steeped into the new age movement and spirituality like you can get so thick with ego and and baloney that it's like can you just be a regular person? I don't know. I just you feel like it there's a fakeness to it where it's like yeah like where they're just everything's namaste and like yeah can't you say goodbye or like what I don't know just like you just feel like there's like this superficiality to it and and that can kind of go along in the psychedelic world and and then there's just kind of like more of like I don't know kind of like regular folks that have been around the psychedelic scene who kind of have a wisdom and they're like, "Yeah, they went through the rave scene and blah blah blah and they could I don't know just they're more grounded." The Yeah. be more grounded and not just kind of like be kind of consumed with themselves and and so like the smoker is kind of like it's easier to kind of get there if you're coming in to quit smoking or or any other addiction. Um, and another thing is like the cancer patients, people who are dealing with like essentially existential distress, anxiety, and depression with cancer. That was like a really cool group to to work with. Um, in part because like they were just so primed for like things were so deep like but in like this not superficial way like this very real way. Very real way. And I remember just I would interview all the people that like came into that study, all 51 people, and said, "Okay, this could be this is a high dose, and you could be you could literally think you're dying. Like, don't take this lightly." And I I try to, you know, like basically a joke like scare them, you know, but like like tell them the truth. And it may not be like this, but like yeah, you might think you're dying in a challenging experience and you feel like your heart's going to rip out of your chest, even though we know physiologically it's relatively safe. And here are the caveats around that, but like yeah, man, you might feel like and and you might come back and say everything that you described in the preparation, nothing could have come close to preparing me for that. So, I try to like my best to like give them the the the worst case, best case scenario, whatever you want to call it, like how intense this can be. And so often like the cancer folks are like, "Okay, welcome to my life for the last eight years." It's like this is what I feel like in like legitimately like it's like this is what I feel like every time with my appointment knowing I might have like five more tumors on my lymph node and then I've got like another three weeks to live like you know like dang they're like you know already so intense with like this existential level threat [snorts] that they're like bring it on. And those were and those studies were positive right from the cancer patients. It really helped people. that helps people kind of um accept a little bit or or or have a piece about their life. Yeah, it seems to and it's expressed in different ways, but just people were able to kind of reorient towards accepting like like one like realizing what is currently available to them. Like most of our people, there were some exceptions, but most of them, they could get out, they could enjoy the sunshine, they could like play with their grandkids, and it's physically act they were they were not incapacitated physically. Yeah. And it's like there's like this mental rut is what's been like enslaving them. And realizing like, oh man, I don't have to do that. Like every day is a miracle. Yeah. Like I'm still alive. This is cool. You know, kind of like that reorientation. And so that was and and also just uh uh I don't know if there's like any answers but just it seems like playing with this kind of narrative like there's a whole lot of like like these games that we play I say we because it's like these I think it's the human condition. Yeah. It's like you think and and whether you're religious or not, but if you are, you might phrase it as like and you might phrase it this way even if you aren't religious, but like God's doing like is punishing me. This is like I've brought this on myself. Why? in like these games of like how did I like looking for we're looking for a causal agent to blame and like and all these games and and they just it seems like there's this ability to kind of slip out of like you know wow I'm just getting myself into all these knots over this like this is reality like right now like and there's no going back in time there's no there's no body's f it is what it is, you know? I mean, the stuff that sounds cliche, but like it seems like easier to kind of get out from those like mental like these monsters that we can kind of create these like narratives of like self-hatred and self-doubt and self-lame and um Yeah. Like Yeah. It's new perspective. Yeah. Yeah. And getting out of your own way. Yeah. And and even like there's even like some people would even like oh now I can actually appreciate the positive you know which is like a radical level of like wow not everyone gets to know of like get this lesson of like I'm like to appreciate life like I have like like cancer's been a gift and like that's a not everyone but like there's definitely some of that where people are like wow I've gotten a special lens that most people don't get. What a shame if they were like, you know, just hit by a someone dies being hit by a car and they weren't able to see like I'm actually got to like wrestle with some of what it means to be alive because of the cancer. Let me ask you about the uh the smokers as well when they're going through this. Um are you guys asking is it does it get very direct? Is it very like so what do you think about smoking and like they're tripping and are you bringing it back to smoking all the time and kind of getting them to talk about it? Is that to make the intention sort of sit there? Give them that perspective on that. Not during the trip. Not during the trip. Yeah. So in the preparation we do what's called cognitive behavioral therapy. Yeah. For qu So you know we do things like oh list the good things that smoking does for you. List the bad things that smoking does for you. And and just some kind of psycho education about most people kind of get this stuff. Yeah. Smoking is bad. But like you know just kind of getting it on there like you know let's think about like what like when you have quit before like what are the challenges you've had. So all this sort of talk therapy we know that can help um surrounding smoking but all that's really in the preparation and then in the so-called integration the follow-up sessions but not really during the at the high at the session it's just a high dose. And so this could be different if it was like a medium or lower dose, but Leo Zeff figured this out years ago. Other people did too, but he has a great book called The Secret Chief. Um he was an underground therapist for years. Um but um he described his evolution early with like LSD research in the 50s and 60s where he thought at first like he's this gifted psychotherapist and he's going to like be the master of the mind and like as someone's you know tripping he could like work with them and mold. Yes. He's the master sculptor and he realized like he just humbled himself. is like, man, there's something going on here with that person's mind that's beyond anyone's. Like, the best you can do is make them feel safe [clears throat] and be there for like as like the safety net. And that's, you know, and that's like, yeah, dealing with the bad trip if they're having, you know, hold their hand and be like, you know, I'm with you, you know, I and then working through whatever might come up. But for the most part, it just you set it and forget it. You know, that's amazing. And so, you're not really interfering. You want them to kind of introspect and just kind of go off into their own. So, how often are the smoking guys bringing up smoking when they're tripping? Um, pretty often or it's a huge variability. Yeah. Like sometimes people do and sometimes someone will say like they didn't think about it all day and it could be helpful either way. Yeah. It's really weird. We just there's so much to figure out like some people who didn't think about it all day, you know, that really it it becomes and they really think it helped them kind of reset and orient towards the cigarettes differently afterwards. So, it's not even like necessarily having these kind of like concrete visionary, you know, content even though that happens sometimes too. There was a lady, she was like my first or second participant in my pilot study and she had a vision of herself smoking in an like the Andy Warhol tomato coup soup can like where there's like a b dozens of different copies of it and she zoom zoomed back and realized there were like you know 10 h 100red a thousand millions of pictures of her smoking a cigarette and it was interesting because it kind of tied together with the boring old cognitive behavioral therapy part of the talk therapy beforehand of like, well, it's really not a choice between smoking a cigarette or not. It's a choice between being a smoker and not. So, it's not about like this next cigarette. It's about like whether you want the next million cigarettes. And so, she kind of had that as part of her experience. So, sometimes you get that and sometimes people say like, "No, they didn't think about it at all." And then you get quotes from we did a qualitative analysis where we interviewed people in the long term, like how they thought it helped them quit, if it helped them. And people would say things sometimes like just like you know seeing life as this marvelous adventure of existence and somehow smoking just didn't seem that insurmountable anymore. Wow. So some part of it seems to be like this reframing effect like like when you try to quit smoking like before like it becomes subjectively like this big in your tunnel vision like this huge thing that's in your way. And like now it's like after a really nice psychedelic experience now it's like oh yeah there's the smoking thing. It's like this little it's kind of shrunk, you know? It's like this little manageable thing. I've heard it said that when people have their problems that we call it baggage and people think that the way to get out of your baggage is to literally pull that baggage out and open it up and talk about it a whole lot and then get the next one out and open up and talk about it a whole lot. And that's that's completely not the approach. Like that's not how this works. It's a perspective shift of like you're you realize it's not even baggage. It's not even something you're you're making you're defining it as baggage and so you can define it as just what it is and that helps you release it. It's really like perspective changing more than having to investigate the why and the you know some of that. Yeah. It's not like there's a concrete answer, right? Like like oh now I know the secret to why I smoked. It was because of like separation from my father when I was six years old. and now I don't want to anymore. Yeah. Right. That's so fascinating. So, a lot of the different cohorts you've had the the at least the session itself was pretty standard actually. You didn't have questions about smoking for the smokers and then questions, you know, you didn't do that. It's it it's really just seeing the effects, having a sitter there to make them feel comfortable and be there for a bad trip and then doing integration afterwards. Kind of letting the magic happen. Yeah. And then just like an integration really is although I think there's far more that we can do and I want to do systematically to like how can we like improve the the therapy by doing more specific things at specific time intervals in the days following. But right now what's been done is basically just general discussion, reflective listening. Let's talk about your session you know yesterday and like yeah what do you think is it now? What do you think now about your smoke? You know, you quitting smoking in the context. Was there anything in your session? It's just a lot of probing and just just supportive reflective listening. So, it's really no magic which works pretty well, you know? That's incredible. Yeah. It's like, yeah, it's just like that intention bringing that intention in and they have this experience and it can go different ways, but it I don't know. I think well I think that's something interesting for people who maybe have never had a psychedelic experience and you're a smoker you're on Zen patches or something that you think that oh I have to get into this state and then I'll really understand why I do this but to even hear while you're doing these sessions they're virtually all kind of the same there's not direction there's not actually let's let's open up that baggage and discover really what's going on here it's just the actual experience itself as long as it's safe and you feel comfortable does the work on it does the work Yeah. Yeah. Which isn't to say that the people aren't important because that's important for allowing you to let go, right? Because if the person wasn't the goal is for that person to completely let go into their experience and absorb into it. And so if if you're in that trusting environment, they're able to do that. But yeah, it's like we don't even know like most of the heavy lifting might be in the days following. We know like in rodent research that there's different forms of neuroplasticity that unfold in the days and weeks following the session. So maybe that's I mean maybe there's like four or five different things like for some people if they have kind of this visionary perspective, you know, shifting kind of like specific like thoughts and images surrounding smoking that can help. But all of them afterwards may be like they're starting a little more with a fresh slate in terms of like when the cravings come up, they're a little more less likely to have an an automatic response and they're more mindful. Um perhaps because of the the nervous system, the mind is in a more malleable kind of state. Yep. We just don't like we're in our infancy and figuring out how it's working. It's probably working by multiple in multiple ways. Have you ever overcome an addiction with the use of psychedelics yourself? No. No. No. Have you ever overcome an addiction? It depends on what you define by addiction. Yeah. How do we define addiction? Well, see, I I would define an addiction kind of beyond, you know, just sub substances. So I I kind of view like really like we're all just swimming in a sea of addiction. Just managing our addictions, right? Yeah. Like it's just like being an animal is like addiction is like the necessary byproduct of autopilot and habit, which is something we need to do. We can't we don't have the computational power to be like you couldn't cross the street unless you put 99% of reality into autopilot. And and so yeah, I'm addicted to crossing the street safely, right? I some and and so addiction becomes clinically more of like what are those things? We all fall into patterns. What are those patterns where the way I look at it in the long term it's a negative but you're attracted to it in the short term. And so like yeah, I mean I think we all I wish I could say I have a great you know like I overcame heroin addiction but thankfully not you know like I could like there's certain certain things you like you you want like yeah you could you learn those lessons from others when they articulate it [laughter] like you don't have to go through it yourself. It's like it's useful to have an older brother because you get to watch him do a bunch of mistakes. Yeah kind of thing. Yeah. Yeah. But you know uh Yeah. Yeah. Yeah. So I I do have that kind of very broad view of what addiction is. And I think like ver people who keep falling into verbal patterns like they have a a relationship with a loved one, a a spouse, a boyfriend, girlfriend, a a son or a daughter where like people fall into the same pattern. They realize, "Oh, why did I say that? I always respond. I was I had a temper or whatever." It's like you're falling into a pattern that you recognized before. And but in the short term it's like it there's an attraction there but then afterwards you say well why did I respond like that's an addiction you know um could you be addicted in a in this sense to the way that you like walk into a room and greet people if it's auto is it sort of just autopilot behavior is addiction I think so and again with that kind of the clinical caveat is like you might say well it has to have that if you want to consider it an addiction it has to have the negative long it has to have the negative effect Like yeah. So in that sense like yeah like you realize oh like if you walk into a place and you don't really try to connect with people and like you're kind of superficial and like I'm horrible like remembering names and so it's like you're like oh man why don't I just take another second to like really try because like they're not just objects they're people you know like so I don't know I could imagine someone being like really bad at at and f find themselves falling into the same pattern of like not introducing or or something like they might like they introduce themselves to the and this is something that annoys me when I see it like like the person in charge but like the like so-called underlings they don't or like you see like the difference how people treat like like weight staff versus someone else and like like I don't know like they're not just those are people they might be on a roll but like you can and I think we all can fall into that pattern but I see some people falling like really badly into that pattern. I can imagine some people seeing that in themselves as an addiction like not really connecting with with people and just kind of seeing them as part of the environment. It's like a default function running in their head. They're not really in control of it. But it is just if they could step back and view themselves, they might see it happening. Right. Right. and being like more mindful about how they're interacting. So yeah, that's a good example. I could that could be an addiction. If the person catches themselves and says, "Oh man, why did I do that? I was kind of like a jerk to like what? I didn't mean to come off like that." Like if they like Yeah, that's kind of like, "Oh man, I did it again. I had said I'd have two drinks and ended up having nine." Like, [laughter] you know? Yeah. Same psychological like, you know, phenomenon. So in some sense it's really not an addiction until you admit it because you're saying if it's not negative [laughter] is it's not an addiction. You know that's and that's a good point and that might be like all metaphors are are weak and like ultimately the reality is beyond any and it's verbal behavior. What we can call an addiction or not is just whatever bunch of you know. So I asked Jenny because I'm struggling with marijuana myself like I don't know how to get in my head. Yeah, I do think so. Again, I think those that propensity to fall into patterns like if you're used to like you know using cannabis every day like yeah you're just not going to automatically not like it's going to be difficult. There's a momentum there. It's habitual. It's habitual. Um, now we get into the clinical question. Is it is it harmful? And now the cannabis is an interesting one because um it's kind of more like kind of caffeine. I don't want to overstate it, but it's not like I had one like uh a friend who's a psychiatrist. He said who's a long time in psychedelic research. She said, "Oh, cannabis can be insidious." Because the sort of thing is like people who would like, you know, they'd wake up and wake and bake where they would never like drink in the morning, you know, or they would never like um, you know, drive drunk or rarely or maybe they did it when they were young, but like they but you know, and so it's interesting because like I know the science like cannabis will you know about double your risk of a of an accident and that's pretty reliable and people will rightfully say it's nowhere as bad as alcohol because alcohol fall at the 0.08 level will about it'll have a 14-fold increase. So not two times but 14 it's like way way way worse. doesn't mean it's great to be, you know, now that does also put it in the category of like being sleepdeprived and having had anti-histamines and you know like Adavan like these things where we say well just be careful when you drive but like we're not going to haul you off in cuffs the way we will with alcohol. So cannabis is in many different ways in this kind of category where it's not as harmful doesn't mean it can't be without harms and so much of that is going to be up to the person like whether they're like how it's interacting with their life and some people say they just like life on a lot of cannabis and the the the the benefits outweigh the the downsides and other people and and some people will go through that for decades and then be like all of a sudden one day like I just don't like it anymore and they're like yeah so cannabis is an I will say like some people say you can't be addict or back to my point about psychology versus biology like well cannabis is a psychological not a physiological BS like there is a ve cannabis withdrawal is very real most people not there is exceptions but most people will have about about a month of really really crappy sleep um and a lot of dreams and wild what I encourage people I put a thread out about a year ago on on X about you know advice for cannabis like invite that as a right of passage like you know you can look at that as like disturbing but say if you're if if you're someone who's attracted to psychedelics you could be like oh wow you get to have several weeks of some really wild crazy dreams that's not necessarily a bad thing but kind of embrace that Um, but yeah, like you're probably going to be like, you know, sleep deprived. It's not going to kill you, but like it's going to be really, really, really tempting at like 3 in the morning like, "Oh, dude, one little hit. I'll just go to sleep so much easier." You're like, "Come on, how bad is it?" You know, and then so yeah, cannabis again talking to you on your phone. You're already entertaining it. But cannabis, I think I it I mean, I've been for like since the early days, you know, the liberalization of can. I'm glad there's regulated markets and everything. And it's crazy to some something that someone would have a criminal record for. It's weird to put people in jail for it. Yeah. Yeah. I mean, that's, you know, but it's like then you'll see some people though like arguing like, yeah, like there's no real cannabis addiction. And there are people that are like it puts them in a weird place where they see that type of even they see it online where they think well like I'm like I'm just a [ __ ] or this is lightweight stuff where they hear stories about someone like addicted to fentanil and and you know heavy drinking and it's like well I don't have a real addiction. It's like screw that. I I hate that. Like, you know, it's like, no, dude. People have because cannabis can be so easy to use and it it can actually in some ways make it more difficult in a way than some of these other things. It is similar to caffeine like you mentioned. I mean, yeah, because you can wake and bake and do pretty good functioning during your day if you're used to it. Caffeine just makes you productive. I mean, that to your point of like it's we're like it's not an addiction because the future is fine. It's not a negative future, right? versus everything else. You get drunk and then you have negative futures for the immediate help. But I mean, caffeine, I know so many people who wake up and have headaches because they haven't had their caffeine yet. And if they miss it for a day, they got headaches and then they quit for a week and they're back on it. And functionally, it it's it is an addiction from physically and you know, but it just doesn't have the negative long-term things. So, it is kind of similar to can there's things with cannabis, you know, relaxation, creativity. Yeah. um [clears throat] sleep. Yeah. Now, I think people like part of the formulation though is like they're kind of access to those states starts to change a little bit more when they're not when it's not in their system every day. Y um but there is an attraction to having something no like having a button to press like boom. No. going like it's a control over I mean we're as humans like we use tools we want like yeah we could like grow a bunch of fur but like no I'm going to have a coat I could put on when it's cold and take it off when I don't want it if I want this state of mind I'm going to go there and you know I could choose to be on it or not on it so there's an attraction to say like I want to be in a creative whatever you know kind of a looser free association space cannabis is going to nudge you more in that direction And so it's like, you know, yeah, like and you could probably I mean, if we're being honest, you can say that about any drug. There are those things that you could, you know, I mean, cocaine, if you don't overdo it. A lot of the same things with caffeine. Cocaine's going to do for you. It's going to give you motivation. It's going to like give you focus, you know. Um, it's obviously going to give you a good mood, you know? [laughter] Yeah. Yeah, there in lies the problem. It's a little too much of that stuff. But um but yeah, so I don't know. Addiction again is like a cra it's a it's a such a fascinating thing and it kind of depends on the person like what my thing is like I I I get I'm attracted to doing things that like empower people to to to achieve their own goals. Like if someone's fine smoking tobaca, I mean there are people that say like no like tobacco helps them be a better writer. It like it's like they like the way it makes their digestive system feel. Blah blah blah kind of thinks makes more reliable. It's like you have a cigarette and you take a bowel movement. It's like kind of like that's right, you know, like again like things become like more tied to like that substance and its effects and they like it and it's like you know Oh yeah, man. I I took a Zen, one of the six milligrams for the first time. We were hanging out with a friend who did Zens. I used to do Zens. I just quit like four four months ago and I [ __ ] a brick. Oh yeah. I mean, it was unbelievable. People don't talk enough about stimulants and like bowel movements. It's like [laughter] so real. It's like like I I studied like sex and like stimulant drugs. I had NIH funding to study sexual risk. So it's like I'm into the all the nitty-gritty that the drugs do. It's like, you know, aderall to cocaine like to Zen, like it's going to like, yeah, especially if you don't if you're not tolerant to it, it's going to put you on the toilet. I haven't heard you mentioned yet. I'm curious if you've heard this study. When I was first trying to quit marijuana, I talked to my uncle because he had been in Vietnam and he had been on just everything. I mean, heroin, everything. Yeah. And I asked him, "How did you quit?" Because he quit everything. And he said, "You just changed locations." He's like, "As soon as I came back, I was in a different place. That's when you quit." Yeah. But you have to be intentional about it, I guess. Yeah. So that like one of my uh yeah best friends back in college like he had actually um he had went to I think a week or two of high school before he dropped out and basically lived with friends like cooking up like helping with their meth lab in Northern California in the woods and was basically a methhead for [laughter] a decade before he like went back to school and like they just moved to Oregon and like whatever he just I didn't even really try out of it just got away from those friends and wasn't helping friends cook up meth in their cabin anymore and just now he's a school counselor has he got his GED went on to college we went to college together now he helps you know kids hopefully not drop out of school and become methads you [laughter] know but like yeah like that changing but that kind of ties to those nudges I was saying before about changing behavior like that's kind of the opposite like that's one way like moving from Vietnam back to the states and that's kind of a classic example where a lot of like vets quit things like heroin because like it's just this radical change of context and if you don't get used to doing it back home it's relatively easy to I mean even if you're physically dependent like it has an effect on phys it physical dependence isn't independent from that psychological effect of of of context or set and setting and so like shifting that environment it just you know, you're divorced from all those cues and those situations that that prompt you to do it. Now you're kind of back, you're getting all the old reminders before you did heroin, you know. Well, how much can you talk about the study that you just finished up um around nicotine and cigarettes? Yeah. Yeah. So, we we um can you talk about the results? Yeah. Yeah. So at 6 months uh it was um 52% abstinent um in the psilocybin group versus 27% abstinent in the um patch group. Yeah. So wow substantially more. This is from one psilocybin session. Um, and this is using, you know, nicotine patch with um the same type of cognitive behavioral therapy with CBT in both groups. And so kind of um and and our results with nicotine patch were on on kind of the upper side, they're very good for what you typically get in the scientific literature for nicotine replacement with counseling is good. Yeah. Wow. Yeah. Yeah. Yeah. Yeah. So that's the the thing with smoking like the odds are I think before our results were our pilot study was published the highest quit rate ever was there was a uh Sharon Walsh did an intervention at she had not one but two medications um and ongoing cognitive behavioral therapy for a year where they were still it's it weaned out over the end. So, they weren't going every week, but every few weeks, but it was like constantly for over a year. And I think she got something like I think it was like 52% a year in. So, it's like okay, that's like you know, you still that's half the people that didn't work even with this constant like two medications and constant counseling over an entire year. So, and you guys did one session and CBT afterwards? Yeah. Yeah, about, you know, so like sort of a 10-week program where they there were like so it wasn't just that, you know, there were like several like four preparation sessions and then several weeks afterwards checking in once a week, meeting for an hour. But what was the feedback like uh from I'd love to know more about the 52% who didn't have one and some of the 48% that did go back. What was their kind of feedback on the session and how it affected them both from the the success and the failure? Yeah. or not failure, but you know, they didn't they didn't quit for along the lines I was describing before of like you people would say different things about like they would have um sometimes there's visionary content surrounding smoking and sometimes there's there's not. Um there's a lot of like you know folks kind of having this kind of big experience that seems to like reframe smoking as kind of a smaller obstacle for them. Uh sometimes people get through the the sessions and if it's a difficult session which we try for it not to be difficult but if it is we try to you know encourage them like wow if you can get through that you can certainly get through some smoking withdrawal. So you know that's a part of it too. Now some people don't have difficult sessions even if it's intense but you know um so sometimes that's a part of it like wow you know like they went through this experience where they felt their soul was being shredded limb from limb and every microsecond was an eternity and it's like oh my god now I just have to go through like three minutes of jonesing a cigarette big whoop you know wow um so there's a reframing in that aspect um on the like the negative side how many so do you have this data around how many times you've given doses and then how many bad trips happen in your set and setting like is it it's about onethird onethird can have a bad a bad trip. So and that's very dose dependent and so that's at a high dose of around 30 milligrams which is kind of a so-called heroic dose. Yeah. Um and the person classifies it as a bad trip. Yes. Well, there or we've done it in different ways, but yeah, essentially they'll say like this was um now we have a scale over the last several years that we developed to assess it, but we've also kind of done it by just saying was there any point in the session where you had substantial fear, anxiety, panic, a sense of feeling trapped. Basically, yeah, they're saying like yeah, they had a bad trip. But um but that's all it's about a third and we've done that in multiple studies where it seems pretty reliable that even with the best preparation that if you get a high enough dose like you know and it doesn't mean the whole session sometimes it is the whole session. That's what I was going to ask cuz if they if they define as a high moment of fear but then there's a breakthrough moment and it turns into a wonderful thing. Often times there is that that still goes in the bad trip bucket, right? Okay. Do you how many do you think get to the very end and go that was awful? Like they get all the way to the end and they go I you know can we remove that out of the data or just think of an exact number an exact I'll like that tells me about 10%. Okay, maybe 5%. Sure 5%. But to it's a real minority. But here's the crazy thing. even that doesn't necess some some of those people will say it was still helpful like the whole session itself sucked but they still think it helped them quit smoking so about one or helped them with their cancer whatever one in 10 one in 20 will actually go that was awful but even some of those will go but I don't regret it almost because it help it was helpful right now some will say that sucked and I wish I hadn't have done it and it wasn't helpful you know that's a reality too I think That's less than I mean that's probably like and get these aren't I'm not exact but I think that's a few percent that maybe like 1 2 3% something around there. Yeah. Yeah. Yeah. Okay. So when we're talking about a bad trip that's a subjective like okay that's something that the person says and later on it could be could become a good trip if they view it as such later on. Right. And so which is part of this what we're dancing around is like why when we came up with the scale I mentioned we called it the challenging experience scale and we've gotten critiques from some people that say oh you're trying to whitewash it and like it's a euphemism and like the point was to just say like this good and bad that depends on so much. You could have a hellish experience and say, "Oh, I learned from it and it still helped me with this." And it's like, "Okay, but we still want to capture like, okay, you had a hellish experience." Yeah. Like, so that's why we call it challenging. The point isn't to like isn't to to whitewash it. Challenging takes away the good and bad out of it. It just means it was hard. It was hard. The same way you could say like doing a triathlon was challenging. Yeah. You say, "Oh, that aren't you sorry you did it." It's like, "What do you mean? and I trained forever for that and it was the most grueling thing I've ever done, but it's the thing I'm most proud of and and like I've never experienced anything like it. It's like, you know what I mean? Or like a woman giving birth. It's like, yeah, that sucked, but it was also like the whole thing was part of like one of the most meaningful things you've ever done. Like like yeah, like [laughter] you know, so it's like just we're just trying not to. And so some people have like I don't know whether it's bad faith or just misunderstanding but saying oh like they've critiqued like the use of the term challenging experience and and saying well you don't want to count that as an adverse effect with FDA like regulations. It's like no this like scale actually has nothing. you still count those like the FDA is weird and it's like whatever it is what it is but like any anything where you're off normal if the person says I feel a little strange like that's an adverse event fine like and the rules are you got to record all of that which is which doesn't mean that the drug wouldn't get approved eventually or anything like that just means you want to cast your nets wide in terms of data collection including things that might be bad you know so people have like said well you're calling it a challenging experience erience means you're trying to say it's not an adverse effect. Like no, it just has nothing to do with that. It can also be an adverse effect, but like just scientifically we wanted like a scale that could measure the so-called bad trip even for people that said, "Yeah, but it wasn't really bad because I learned a lot from it." Like, okay, like whatever you want to call it. Yeah. And I think that's why it's helpful to chat about because there's both like the clinical method of of registering challenging moments, but then also that's why I was I wanted to ask the subjective of like how many people get to the ending just go that was bad. I didn't want to do it. And it's really interesting that it's like 1 2 3%. It's like and you've been doing it for 20 years and very infrequently you not not zero but very infrequently somebody gets to the very end and goes I regret that completely and that was terrible. Right. Right. Right. I mean, a couple of people out of hundreds like saying, "I don't want to come back even for the follow-up visits." And you try to learn as much as you can from that. And like, did you have that heart-to-heart like good enough? Did you connect enough with them to really kind of warn them like like one woman I remember like there was a lot of like reliving of earlier trauma. And that's another thing you warn people about. It's not like, "Oh, this is to quit smoking and I'm only going to have thoughts and feelings around smoking." It's like yeah, anything in your p like it could kind of come to the surface and um you know you might relive. Now there's a whole interesting discussion about like um so-called repressed memories which have a good amount of skepticism surround and I think there's a real danger of thinking oh I had a vision of my father touching me when I was a kid and you never had a memory of that before. Don't go accusing your father of being a pedophile like because that could just been a wild thought too like you have bad dreams. I'm very skeptical. Yeah. like you know your brain is just operating and stretching in really weird wild ways and it doesn't mean that everything you experience is ground uh truth but in terms of people like again not repressed memories but things you remembered but like whatever like were traumatic events in your life yeah like you that stuff could just come to the surface and you're not going to be able to say no just make it about quitting smoking. So, I remember like one woman was just really like she didn't want to go. She didn't like the fact that some stuff had come up from her past. She didn't want to deal with it. Didn't want to like and there's an uncontrolled nature to this where like you try to warn people if you're not ready for like this like radical psychotherapy maybe about the thing you didn't want it to be about then this isn't the treatment for you because it could just like go wherever it wants to go in terms of like it's your mind ultimately. It's not I don't know in my view it's like it's not the drug. It's the mind. Your mind might take it in certain directions that you don't have control over. And like you said, you're not even directing the session. Like you're not even like, let's talk about smoking. Like that's actually not even happening during it. So it is going to do whatever it wants to do, right? And you can't be like, well, don't think about the, you know, don't think about the Bayer in the room, you know, like whatever. Like it's just not going to work, you know. And and the typical advice for all of this is in and through. Like if that's what you're like, experience it, absorb into it, don't retreat psychologically. Say like bring it on. Okay, here we're going to we're going to do it. And if if you end up like crying like a baby and like that's exactly what you should be doing, you know, like radical acet if you can't. It's easier said than done, but the more you can kind of radically accept this is the experience and there's no like, oh, should I have done this or try to get away from that like there's just this is 100% reality right now and this is what's before me and what am I going to learn from this? How am I going to let's go through this? Like if there's metaphorically I I thought I had an older like colleague that did work in the 60s that said use this example and I always thought it was kind of like a metaphor until like it actually came up with one of my patients. He said if there's a monster like you know like look it in the eye and say what are you here to teach me you know like and so like I had a person that said like you know that like no it's like in my v like it was a monster like it was about to devour me and I did that and it became my puppy dog like it turned it wanted its belly rubbed you know like [laughter] you know so you know that's the orientate it may not always be as like metaphorical like black and white like a vision of a monster it might be the amorphous monster of just kind of like this uncomfortableness of of of reality. I don't know, you know, but just okay, then the goal is to sit with that and to experience that. It's kind of confronting fear in some capacity. It's it's saying I chose this. I investigate it. You can't run. Running from it is the wrong decision in that moment or the harder decision in that moment. Facing it and going forward actually is the way through, right? And so many people have come out and this is yet yet another way like this is probably working like a hundred different ways like like how does this help people like the another way is like people will say oh my gosh this is like a microcosm for life like yeah that's good trip instructions but that's like pretty much everything [laughter] like the thing you're afraid of like that's what you need to deal with like escape is never helpful. What do you mean by that? This is a microcosm of life. Yeah. Like like when they say like people will say, "Oh my god, when I was trying to say don't don't like make it like this," it just became work like worse. Like physically like it became darker. It became more hellish. Like it became But the more I like went into it and said, "Okay, bring it on." Yeah. When they're tripping. And then it's like, "Oh, then the water's still, you know," and they were like, "Wow." And so it's like immediate BOF feedback. Like the more I accept it, the more it's actually going to be okay, you know? So it's like I don't know like how to deal with an argument with a loved one or you just get the news you have some tumor. It's like okay, you know, like you got those two choices. You can catastrophize and it shouldn't have been like this. Why I have, you know, a partner like this? Why? Like, why has God done this to me? Like, but or you can be like, "Okay, here we are right now. What am I going to learn from this? What am I going to do?" And I mean, and don't like, you know, not it's not like I'm good at that. I'm just reporting what people say. Like, I kind of I get it. It doesn't mean that I'm I'm just like anyone else. But, you know, it is one of these things where people say like, well, yeah, that's like a lesson that's like pretty much everything in life is this lesson of like acceptance and, you know, going through the thing. The present moment just is. Yeah. Like all the horrible things like life just sucks. You know, if it doesn't like you haven't lived long enough. I don't you know, like there's going to be horrible horrible things. Yeah. Yeah, I've heard it said that, you know, what we're very terrible at or what we try and practice is being right here because what we like to do, what we will do by default is think about either the past and I should have done this or why did this happen or we think about the future and we're planning on when I do when I get here this or let me whatever and we're very it's very challenging to be right in the present moment. And so I think maybe in those moments of fear or when you're going through those trips, it makes you fully present and you really want to escape and you really want to not do not face it right now, but it m you know the healthier thing is to actually face it in that moment and it you see it's nothing cuz it just is right. And it's sort of like a magnifying glass on top of that because it's like when someone is kind of like settling into the present moment, it's like they can have an experience of time where like every microscond seems like has the weight of the universe on it. And so it's like if they just settle into that like they kind of comes with this lesson of like, you know, well, they just want the comfort. They just want they just want this to end because they're they're at the precipice. They're at this like it shouldn't be like this. There's this uncom this raw naked reality that is just too much to bear. And it's sort of like guess what? That's everything. Like even even when you're not on a drug and like any kind of illusion of any sense of comfort is an illusion anyway or it's temporary. We're not in control. Yeah. like you're not in control like and you're going to die and you're going to experience pain and you're going to have people that you love that die like you know a lot of bad stuff you know so it's like so like appreciate if it happens to be going good right now you know but like um yeah like it's like a bof feedback where they if they if they say where they just breathe into that moment and experience it it's okay but They also realize that like psychologically it's like they could just go an inch this way or that way and fall into the abyss, but it's like no, right here it's okay. That's incredible. Like if they're in the present moment, it's going to be okay. That's a great message to wrap with. I think I'll accept that you have to go and [laughter] I'll realize it's going to be okay. It's really really a pleasure to chat with you, man. Oh, it's been fun. Yeah. Thank you. Thanks for being willing to sit down with us. This was incredible. you are like a pioneer in this psychedelic psilocybin research and so thank you so much for chatting with us. I've been lucky like it's so it's it's been fun. Yeah. What is one message you want think everybody should think about regarding psilocybin to leave them with? Like you've been with it for 20 years. There's a lot of stigma. There's a lot of goods, bads, everything. Like what what's your message sort of that you want people to know about it about psilocybin and psychedelics, therapy, the therapy and the whole thing? Um, and this sounds weird for someone that's like spent like decades like focusing on [laughter] psychedelics, but like it's not the psychedelic. Like the psychedelics are don't become too focused on the like it's all about it's all human stuff, you know. It it's it's everything that psilocybin can provide. it's also available to you. It's just kind of a magnifying glass and and sometimes you don't even need that. And so you get the same spectrum of humanity in people and beware of people that are I don't know like it's like I've never met an enlightened person. You know, I've met people that are better role models and this and that, but like I don't know. Just beware of a lot of the of the baloney that goes along in psychedelic circles. It's all the same old human story. It gets complicated and and messy. But just um it's okay to be interested in psychedelics obviously, but also recognize it's ultimately not about the psychedelic. It's more about like being a person. like that. That's way more important is being [laughter] a Sounds obvious but sounds stupid like you know like Thanks Matt. You're welcome. That's awesome. Cool.