Psychedelic Research and Culture: An Interview with Rick Doblin

Psychedelic Research and Culture: An Interview with Rick Doblin

What follows is a transcript for the podcast: Psychedelic Research From MAPS: The Impact of Psychedelics on Our World

Sub-section topics within the interview include the following:

  1. In-Depth Founding Story of MAPS
  2. Catalyzing a Sense of Global Connectedness: The Mission and Current Work at MAPS
  3. Psychedelic Assisted Therapy: Set & Setting
  4. Categories and Terms for Psychedelics and More
  5. The Cultural Turning Points Around Psychedelics
  6. Psychedelics Becoming Mainstream
  7. The Cost of Mental Illness
  8. Should There Be an Age Limit on Psychedelic Use?
  9. Psychedelics for Therapeutic Use vs. Psychedelics for Optimizing the Mind
  10. Ulterior Motives in Drug Policy
  11. Is Using Psychedelics Cultural Appropriation?
  12. Current Research on Psychedelics

In-Depth Founding Story of MAPS

Heather Sandison, ND: Welcome to Collective Insights, I'm your host today, Dr. Heather Sandison and I have the privilege of being joined by Rick Doblin, the founder of MAPS. Rick, thanks so much for being here today with us.

Rick Doblin, Ph.D.: Well, Heather, thank you so much. I'm really glad to be able to speak with you today, and I really believe that public education is the crucial issue in mainstreaming of psychedelics. So I'm just especially glad to be working with you on that.

Heather Sandison, ND: What inspired you to create MAPS?

Rick Doblin, Ph.D.: Well, that's a long story, but I'll try to make it shorter. What inspired me to join maps. So I started MAPS in '86. The real inspiration came to me in 1972 when I was 18 reals old, and that was that I had been very tuned in through my family who were very progressive politically to a lot of the injustices of the world, and in particular educated a lot about the Holocaust and about how people can be dehumanized by others, the irrational can overwhelm rational thinking and how people are always looking for scapegoats. So it just sensitized me to psychological factors as being really important and trying to understand them.

Then I was a young boy during the Cuban Missile Crisis where it seemed like the reassurances we got in school about just hide under your desk, duck and cover, and a bomb will go by and you could be okay, and know that that wasn't actually reassuring. Kids these days get active shooter drills once school starts again, but this was more not just they're going to come for the school but the whole world. So that also sensitized me, again, to psychological factors that would lead towards potentially annihilating nuclear war.

Then the final step for me was the Vietnam War. So I became a draft resister for the Vietnam war. I wasn't a conscientious objector, but again, that just sensitized me to irrational decision making and the need to really understand how people are motivated by their fears, by their anxieties, and how we define ourselves in these limited ways. Then when I first started taking psychedelics, which I had been dissuaded from through high school because I believed all the anti drug propaganda. But when I first started taking it I was just, these are incredible drugs, and I felt that what we're calling today the ego dissolution, the reduction of activity in the default-mode network, the sense of self, diminishing it to be participating in this larger sense of self, self with a capital S. This idea that we're all together, we're all ... You could say the collective insight, that we're all collective. That we're all part of this bigger thing, and that to me felt like the antidote to dehumanization, to genocide, to war, to trashing the environment. This was around the same time of the environmental movement really ramping up and also the same time as the moon landing, and people looking back from space onto Earth, and seeing how it's all one thing and we're all together.

So it felt to me that psychedelics were the antidote to the struggles of the world. Not so much psychedelic but the experience of this mystical sense of connection, which can come through meditation and other ways, but for thousands of years people have really been working on it through psychedelics as one of the main most reliable approaches. So when I realized that and then I saw that all the research had been shut down and that there was a backlash, and that the psychedelic '60s had been crushed, and then Nixon was ramping up the war on drugs to go after the hippies, and that I felt that there was something, well it was particularly when Nixon said that Timothy Leary was the most dangerous man in America.

So I started thinking, what is Timothy Leary doing right? That he's got Nixon being so negative. That really led me to think about why would Nixon be threatened by people trying to have these experiences. Well, they were motivated to oppose the war on drugs, to oppose I mean, not just the war on drugs, the war in Vietnam and other things as well. So I felt like there's something that seems established in the world that psychedelics can motivate people to be more involved in social justice movements, and challenging the status quo, and the fact that it was suppressed made me think well, this would be an important thing for me to focus my life on. So that was in 1972.

I was not balanced emotionally. My psychedelic trips were very difficult, and that's where I felt like I needed to take time out for integration, for building myself. That basically took 10 years. So I dropped out of college, I did turn on, I did tune in, and I did drop out. But I always knew I was going to come back. So there was these 10 years of working on myself, getting grounded, and then I went back to college as a college freshman at age 28 in 1972, and that's where the very first semester I did at Esalen with the off campus study from New College of Florida, and that's where I learned about MDMA.

So what I learned about MDMA though was that it was both a drug called Adam being used quietly in therapeutic circles. It wasn't illegal, but it was kept quiet for fear that if it was going to be noticed it would become illegal. So it was Adam and around half a million doses had been used from the middle '70s to around the time that I started learning about it in '82, but it had also escaped those circles and had become ecstasy, and was a party drug used in the public setting. So it was clear that this was doomed and that this was Nancy Reagan just saying no. Again, the escalation of the drug war.

So I realized that I understood about MDMA before the backlash. I really woke up to LSD after the backlash, but I understood MDMA before the backlash, and because it was legal there was an opportunity to gather with some of the other therapists, not that I was a therapist, but the therapists I was learning from, to try to prepare to defend the therapeutic use of MDMA once the crackdown came. So we had a year or so of preparation, of introducing various people to MDMA who could be potential witnesses in a legal case, and then in '84 the DEA moved against MDMA. But they did so where you have a 30 day comment period. They published a rule on the Federal Register, there was 30 days to comment to object to criminalizing ecstasy, what they said. So I went to Washington with support of this other group with a nonprofit that I started before MAPS, Earth Metabolic Design Lab, which had been connected to Buckminster Fuller, and so we asked for a hearing. In the end we won the hearing, the administrative law judge only makes recommendations, and so the administrator of the DEA rejected the recommendation and we won a couple times in the appeals court, eventually lost.

Any case, it was very clear that the only way to bring MDMA back, the only way to bring psychedelic research back in a time of such incredible negative propaganda, fear based information, the only way to bring it back was through the FDA, and that the traditional routes of support for that, the National Institute of Mental Health, the National Institute on Drug Abuse, big foundations, the government, none of those were going to, nor were pharmaceutical companies going to pay for it either. I mean, these were drugs that weren't like traditional medications. They were drugs that helped psychotherapy, and pharmaceutical companies know nothing about psychotherapy. They're just about giving you drugs, and it was stigmatized, and they were selling other drugs that they preferred that were money makers for them in different ways.

So any case, the pharmaceutical companies, the big foundations, the government, there was no way to get money. So it felt like the only way forward was to start a new group that would be a nonprofit pharmaceutical company, so that was the origins of MAPS in '86, with the goal to really try to do nonprofit psychedelic drug development through the FDA as a point of leverage, even though at that time psychedelic research was still squashed all over the world. But it felt like there was no other strategy that I could think of, and because it felt to me like I just had the ... Well, I had dreams of Holocaust survivors telling me to do this, that this was the antidote. We need to understand that we're all in it together.

Catalyzing a Sense of Global Connectedness: The Mission and Current Work at MAPS

Rick Doblin, Ph.D.: So let's flash forward right now to the coronavirus, that we're doing this in quarantine. I just did a presentation last week, a PowerPoint presentation over Zoom, and I had one slide, I had multiple slides, but one of the slides was catalyst of a sense of global connectedness. On one side of the slide was the coronavirus, on the other side was a melting iceberg with a polar bear trying to find a place to land, global warming, and in the middle was the LSD molecule. So there's an upside you could say about these environmental crises and the virus, that they help us all understand we are all woven together. We can't have this fortress of America that's defended against everything else in the world, it's not going to work. There is no island utopia.

So one of my favorite authors is Aldous Huxley, and the book that he wrote right before he died, the last book of his life was called Island, and it was about an island utopia where they had integrated psychedelics into their fabric of life into the training of young people. You would have these psychedelic experiences as you were growing up. You would have these vision quests, what you wanted to do with your life. It was this beautiful idyllic society on this island that had fully incorporated psychedelics, but while he was writing this he ended up changing his mind about the novel, so the novel ends with this utopian society being destroyed by the oil companies coming in to mine the island. So it's very much like the movie Avatar, where you've got this beautiful society and they get destroyed by mining companies basically.

So the idea from Island is that there is no island utopia, that the change has to happen from the inside out, from the heart of the beast. What that meant to me, again, is this FDA approved approach. That we need to go to the heart of the systems and change things from inside out, but also that psychedelics can catalyze without the sort of fear of dying from the virus, or of the fear from global warming of what it's going to mean with a billion climate refugees potentially, and mass extinctions and all of that, that if we can do this ego dissolution more voluntarily, more protective, more safe psychologically, then we will be better able to cope with the challenges that humanity is facing right now. So all of that has really led to the interest in me in working with MAPS.

So even though it's been so hard, now it's 34 years of MAPS, but we're at this transition point. I mean, we're in the middle of phase three studies, the final level of studies. We've raised over $80 million of donations over these 34 years, and we have a bunch more money to raise of course to achieve our goal of mainstreaming nonprofit psychedelic medicine. Although again, it's a little complicated in that we're constantly asking donors for money, and we want to demonstrate not just a new first in class psychedelic assisted psychotherapy approval through the FDA, but we also want to demonstrate a new way to market drugs. So we are planning to make money on the sale of MDMA, but the money would all the used for the mission of the nonprofit.

We have no investors, but we have a for-profit public benefit corporation, the MAPS Public Benefit Corporation that is our pharmaceutical arm and it is a 100% owned by the nonprofit. It's got about 55 people working there, and we are a drug development company focusing primarily on MDMA but also we've done other work with marihuana, with LSD, with ayahuasca, with ibogaine, and then we have roughly 25 people in the nonprofit. So we've got about 80 people and we want to show that once we market MDMA, assuming we get approval from FDA, that we can market a drug in a way that maximizes public benefit, not profit, and then we hope that that will become a model for psychedelic medicine as it goes forward. Even though with all these for-profit companies we hope that they will tamper the rapaciousness that comes from profit maximization and the ignoring external costs and really prioritizing public health.

I think many people have said that the American public health system is so warped out of all wisdom by the profit motive that we have more per capita expenses than any other country in the world but our outcomes are down 40 or 50 among the countries. It's because this vast amount of profit that's going to insurance companies and all sorts of people that are not connected to the direct healthcare. We have for-profit pharma companies that are just increasing the cost of their drugs to what the market were bear, and not about really maximizing public benefits. So any case, we're trying to demonstrate yes, we can make psychedelic psychotherapy into a medicine but also there are a new way to market these drugs with public benefit. Now, that's a problem in the sense that it makes it more difficult for us to raise capital. There is a bunch of for-profit companies, they tell these stories, investors are throwing money at them. So it's harder for us to raise the money, but we get it without strings and without having to return it. We'd be doing more research more quickly if we did have more money, but at the same time I really am glad the way that we're trying to do it.

Heather Sandison, ND: Right, it's the long-term gains.

Rick Doblin, Ph.D.: Yes.

Psychedelic Assisted Therapy: Set & Setting

Heather Sandison, ND: Yeah, so it sounds like MAPS has four primary goals around drug development and then sales, getting that out to people, FDA approval of those drugs, and then training. You have a physician training program, right, if I understand correctly, and then education, public education. Is that right? Are there other goals of MAPS?

Rick Doblin, Ph.D.: Yeah, so the first thing to say is that the training is not just physicians, it's therapists, and the way that we're negotiating with the FDA, they have, and also the DEA, the FDA has programs called REMS, which stands for Risk Evaluation and Mitigation Strategies, and that permits to come up with policies that are tailored to the risks of each particular drug. So in this case the REMS that we have proposed preliminary with the FDA is that the only people that can treat patients, and the only people that can prescribe MDMA are people that have been through our training program, because the treatment is not here's the drug, the treatment is therapy enhanced by, assisted by the drug. So people need to understand the therapy in order to interact with the patients.

Heather Sandison, ND: And this is the concept around set and setting.

Rick Doblin, Ph.D.: Very much so, yes.

Heather Sandison, ND: Yeah, can you describe that?

Rick Doblin, Ph.D.: Well, that the ... Stan Grof, so is at this point he's almost 89, he's still 88. He's kind of the leading figure in psychedelic research, he helped start transpersonal psychology. He's been my mentor, he's developed Holotropic Breathwork, which is a way to use hyperventilation to bring out experiences similar to LSD. Any case, he has said that LSD is a nonspecific amplifier of the unconscious. All right, and he's also said something else, which is that psychedelics are for the study of the mind, what the microscope is for biology and the telescope is for astronomy. But what he's saying is that these are just tools and they are tools that bring to the surface non specifically what is emerging, that there is this sort of hypothesis of this inner healer, this inner wisdom, the psyche wanting to heal will bring things to the surface to try to integrate them with overall consciousness.

So what that means is that the set and the setting, the mindset that people go into this with, and where they do it and who is there with them determines what happens during the experience more than just here's the drug and the drug will produce this. So it's fundamentally different than a tranquilizer, let's say. No matter where you take a tranquilizer, or a sleeping pill or a [crosstalk 00:18:26].

Heather Sandison, ND: Or an antidepressant or an anxiolytic, a benzo.

Rick Doblin, Ph.D.: Yeah, they don't focus on set and setting, they sort of overwhelm all those things and they have this kind of more or less reliable effect, but psychedelics are not like that. So just to contrast use of psychedelics for parties, recreational use you could say versus therapeutic. In general, you could say that people who use drugs in a party setting are wanting to just have a good experience. They're wanting to have a good time, they want to select out the happy moments or the playful moments, and if something difficult comes up, memories of trauma, memories of mistakes that they've made, memories of broken relationships, broken heart, any of these things that come to the surface that are difficult in a recreational setting, that the set for people is they don't want to deal with that, and then they suppress those emotions or those thoughts and memories and they end up worse off.

So the set of somebody going to therapy is that whatever comes up I will deal with it, that's the instructions, that's the preparation. We don't know what's going to come up, we don't know the order that it's going to come up, but we do know that it's better to address it and acknowledge it than run away from it or to try to suppress it. Just as a quick, so that's about the set.

As a quick comment about for profit pharma, there is a new company called Mind Medicine that's traded on the Toronto Stock Exchange, and they've just come out with something that I think betrays their ignorance as far as psychedelic psychotherapy, but you could say also betrays their wisdom about how to make money on the stock market by telling a story. So they've bought some LSD data from a fellow Matthias Liechti at the University of Basel and it's an intellectual property, and they're claiming now that they're going to try to get a patent on a drug called ketanserin, which blocks an LSD trip. So they just put out their big press release, this is a for-profit company who is saying the whole field has been held back because people are worried about bad trips, and so now we have this way to abort a psychedelic trip, and that's what the whole field has been waiting for. Now people don't have to worry about the bad trip. Well first off, they didn't invent the idea of ketanserin blocking LSD, it's invented by other researchers years ago, so I don't know what they're talking about their patents, but the other important point is that the set of people going into therapy is I will learn from these difficult experiences. Difficult is not the same as bad.

That's part of our other work we do, harm reduction work with people at festivals in some of the cities now that have decriminalized mushrooms. We do work to educate the police, educate the hospitals to try to prepare them to handle people that have difficult trips, they have the wrong set, that are doing it just for fun. So I think that this idea that this for profit company is selling this story that oh, if something gets bad in a psychedelic trip let's just abort it, that's what. But therapists don't do that, we don't tranquilize people. We support them through the difficult, they learn so much from that, and even if they can't get through it, they learn that they can endure it rather than run away from it. So it's a fundamentally misguided idea, but it will attract certain investors, naïve investors, and they'll throw their money at them for oh, you've got a patent on how to abort a trip. Any case, that's the comment about set.

Setting has to do with where you do it and who you do it with. So you can actually make a therapeutic setting out of anywhere. People just need to feel safe, they need to be supported, they need a bit of privacy, they need to be able to express themselves. Sometimes they need to scream, or yell, or cry, or shake. You need a therapist that understands the way things manifest. Also there is a fellow named Dr. Bessel van der Kolk who is an expert on PTSD. He is the principal investigator here of our Boston site, and he's written this incredible New York Times best-selling book about PTSD called The Body Keeps the Score.

So a lot of times when we're not ready for a thought consciously it comes to us in our body, and we know all about psychosomatic illnesses, and psychedelics really open up this mind body connection. So a lot of things come up into the body first as pains, as sort of symbols of something deeper that they're helping people to get ready to address. So the setting must be conducive ideally for people to express what's happening in their body, even if it doesn't make rational sense, to let out noises, to shake, to be safe. It would look kind of frightening for a lot of people to see what goes on during an LSD experience where people are letting out these emotions that they've suppressed for a long time. But anyway, that's the setting.

So we have taken people that have, through our Zendo project, the psychedelic harm reduction project, people that have taken psychedelics at Burning Man and at other festivals and we have a special setting where we bring people. They come and then we have one-on-one support, peer support to help them process. So that's another sort of comment on this idea that we need a drug to bring people down. We've taken people from incredibly frightened moments because their set and their setting was wrong, and they got overwhelmed, but then we can take them and help them, and many of these people really benefit an enormous amount from these things. So that's the set and setting discussion.

Heather Sandison, ND: Yeah, so it sounds like there is this invitation, you could say, to sort of face your fears or go towards something asking the question of what does this have to teach me, how can I learn and grow from this versus avoiding something that might feel uncomfortable or what they're saying is bad, and this medication takes a lot of the power and potential benefit away from the experience. If you can just quash it when it's uncomfortable then you never get through it, you never get the benefit of getting to the other side.

Rick Doblin, Ph.D.: Yeah, very much so. But I think that the first words that you said are something we need to expand on, which was you said it's an invitation. So we don't use the word guide, we're not the guides. We don't know where people needs to go, and we invite them. You might want to do this, you might want to do that. We're not like you do this, because the fundamental thing of our treatment manual, our treatment approach, and the treatment manual is on the MAPS website, if you go to the menu bar, research, MDMA, and then it's at the bottom of that page. It describes the therapeutic approach. The fundamental point of it is that we are helping people heal themselves. So it's a power dynamic that's often different in traditional psychiatry where the doctor heals you and you are this passive patient, and the psychiatrist gives you the interpretation that you can't figure out yourself.

That's kind of the Freudian thing, that they're the all knowing experts, and you don't know who you are but they will explain yourself to you, and also they're the ones [inaudible 00:26:10] heal you. It's like that sometimes in shamanism, where there's also that power dynamic. The shaman is the powerful one. So we're reversing that. It's more like a midwife. We're helping people give birth. We are not the ones doing the work. They're doing the work, we're helping them do the work, we're helping them heal themselves. So the invitation is the way we do that. As a literal example of that, the start of the session the therapists never actually hand the drug to the person, even though the therapists are the ones that get the prescription. The therapists put the drug in a chalice, or a cup, or a bowl or something, and then from the very beginning the person has to themselves take the capsule and ingest it so that they're choosing to do it. It's not like here, let me put it in your hand, or let me put it in your mouth. You've got to do that little step so that it's always this invitation is the essence of our therapeutic approach and support, and the invitation and an offer of support.

Categories and Terms for Psychedelics and More

Heather Sandison, ND: So you've mentioned marijuana, MDMA, you said tranquilizers, so I want to touch on ketamine, because I want you to describe, we think of this as a horse tranquilizer, right? But it's also used therapeutically as a psychedelic. You've mentioned ayahuasca and LSD. So I'm wondering how you categorize these. Are they all in one category because they're non addictive or are they all in one category because they all are actually psychedelics, or are the herbs and plant medicines, or maybe even animal medicines like you also mentioned ibogaine, and then the LSDs, and ketamines, and the I guess what we might call drugs or medicines, things that are made in a lab, are they in a different category? How do you make sense of these and what do you use when, and who uses what? And some of it, you've already alluded to this, that you really cannot untie it from the legal and political context. So is that another way that they get classified, is just what we have access to legally? How do you make sense of all of this?

Rick Doblin, Ph.D.: Yeah, there's a lot of questions in there. It's really good. All right, so the first thing I'll say is that there are a bunch of people that have this romantic illogical notion that if it's from nature it's good and if it's from the lab it's bad. So there is that one distinction that people made. Is it a natural plant medicine or is it synthetic? And if it's synthetic it's somehow or other fundamentally different, and somehow or other less trust, more suspicion, and if it's from nature, ignoring the fact that poisonous snakes are from nature, poisonous mushrooms are from nature. There's all sorts of poisonous plants and buds, and things that you can eat and die, but nevertheless.

So first off, I don't make a distinction between if it's natural or if it's synthetic. I think that the molecule is a molecule. I mean, the best example I guess that maybe a lot of people are familiar with is they'll talk about if you cook food with love, somehow or other that that's different than Burger King or whatever. So I think there is a way in which that's true, but I don't think that you're investing the molecules. People might even go to say that, that you're investing the molecules with a certain kind of love energy or such. But I think that there is a certain love in synthetic drugs, in this sense that you are striving for purity, you're striving for this incredibly high level 99.99%, 99.98% of one single molecule. There is a purity and a beauty to science in that you are trying to remove bias, you are trying to see the truth, you're trying to see what's really there. So I think there is a beauty and a holiness to science, as well as to religion, as well as to nature. So anyway, we don't make those distinctions, at least I don't.

The other part of it is that we need to go back to the original meaning of the word psychedelic. So that was in a discussion between Aldous Huxley and Humphry Osmond. Humphry Osmond was an LSD researcher who did a lot of work with LSD with alcoholics and was in a conversation with Huxley, and they were trying to come up with a name for these drugs. They knew that hallucinogens was kind of a negative pejorative name, that there had been a previous name called psychotomimetic, which means mimics psychosis, which has some resemblances to it but it's not the same. So they were trying to find a new name, and so Humphry Osmond actually wrote a poem, they were exchanging poems back and forth, Humphry Osmond and Aldous Huxley, and the poem that Humphry Osmond wrote was, let's see, "To fathom hell or soar angelic, just take a pinch of psychedelic." And psychedelic, delos is to reveal, to manifest, and the psyche is the mind, the soul. So psychedelic means mind manifesting, and that's the reason the word was created.

Now, other people have come along more recently and said, "Oh, that's tainted by the '60s, that's a negative word, and let's come up with the word entheogen." So entheogen is the god within, to reveal the god within. Hallucinogen is it produces unreality, hallucinations, things that aren't really there, it's a delusion. So where I feel on the spectrum of words is that hallucinogen is a negative word, psychotomimetic is a negative word, but entheogen is also propaganda in the positive way because it's not always about revealing the god within. All sorts of psychodynamic things happen, other things happen. So psychedelic, aside from the cultural connotations, is the most descriptive, the most accurate, to reveal the mind. So I'd say it's different in many cases than let's say stimulants, which speed up the mind but they don't bring things to the surface.

Tranquilizers calm the mind, bring you down but they don't bring things up. Ketamine, which you mentioned, is actually called a dissociative anesthetic, and it is used in veterinarians, it is used in horses, but it's also used in children and in humans. It's a very common drug. In fact, the World Health Organization has classified ketamine as one of the world's essential drugs because it can in large doses produce an anesthesia but it doesn't interfere with respiration. So that it can take you out of pain and you can be operated on, and it's very easy to inject, just you inject it into a muscle, you don't even need to get it into a vein or there's other ways, you can snort it, but that it is safe because it doesn't interfere with respiration. But one tenth the anesthetic dose is a psychedelic dose. And as it turns out, the whole idea of ketamine as a horse tranquilizer, as a kind of way to diminish what the drug is, and to make people scared of it.

It's used in animals because again, it doesn't interfere with respiration, but there's something called the emergent phenomena with ketamine, which is that people get a dose that's sufficient for anesthesia, they get operated on, but as the drug wears off, when they finally get through this heavy amount and the body is metabolizing it, you get to one tenth the level where you can start to remember things. You pass through a psychedelic phase, and anesthesiologists don't prepare their patients for that generally. So adults have a harder time dealing as they come down with this psychedelic phase. But children who are more imaginative, unsure exactly what's real, what's not, they can handle that. So ketamine has tended to be used now more in children for operations than in adults because the children can handle this emergent phenomena better than the adults.

So I consider meditation a psychedelic, Holotropic Breathwork is psychedelic. So I use the word in as broad a way as possible. Now, other people will say that there is the classic psychedelics like LSD, like psilocybin, like mescaline, that dissolve the ego in a certain way, that are ego dissolution drugs, and that MDMA is not like that, MDMA is [inaudible 00:35:30], and it's true, MDMA is not like the classic psychedelics, and so some people have said, "Oh, we should call it..." I think it was Dave Nichols who said that it should be an entactogen, to touch within. Ralph Metzner said an empathogen, to bring out empathy. There's different ways, and that was more of a political strategy, also to say it's not psychedelic, therefore we should have a different regulatory system. It shouldn't be just automatically criminalized like other psychedelics. But we can argue about what the word should mean, and people could come up with their own definitions, but I feel like gay and queer and all of that, that I want to take words that had a stigma and change them, and to reclaim them. I'd say that we pretty much have reclaimed the word psychedelic. It doesn't have I'm going to go live on a commune connotations, it's not like I'm going to go protest in the streets. It's not like I'm a counterculture dropout.

So psychedelic is interesting for people, it's visual, it's beautiful, imaginative, so I think we've done a good job of reclaiming it, and also I've tried to, at least for us, for the Multidisciplinary Association for Psychedelic Studies, have just interpreted the word as broadly as possible.

The Cultural Turning Points Around Psychedelics

Heather Sandison, ND: So Michael Pollan wrote the book How to Change Your Mind and that was published a year and a half, two years ago. What influence did that have or MAPS or on kind of this scope of things? Certainly when he wrote Omnivore's Dilemma and when he was writing a lot about the food industry, I feel like he was one of the people that really shifted that conversation into the mainstream, and this idea that he could do that potentially for psychedelics was quite exciting. Did you see a shift? You have your finger on the pulse and have for decades here. Did that make any difference?

Rick Doblin, Ph.D.: Yeah, well, there's two different cultural turning points that I would say looking back. Well, let me say three. So you know MAPS was started in '86. So the first cultural turning point really took place in 1992, and that was when the FDA and their division of psychiatry products, when the FDA had a formal advisory committee and they met to determine whether they would open the door to psychedelic research or not, and they decided that they would. So that was the key turning point, and all of the psychedelic renaissance that is happening now with more research with psychedelics than at any time in the last 50 years, that stems back to that decision by the FDA. So that was a crucial turning point.

The other turning point was in 2003, and that was sort of the high-water mark of the frenzy of fear based propaganda about MDMA causing neurotoxicity and brain damage. So this idea was George Ricaurte funded by NIDA, the National Institute on Drug Abuse, was one of the main researchers at Johns Hopkins. They tried to make a case to justify prohibition, that one dose of MDMA would cause such significant neurotoxicity of the serotonin system that it would cause functional consequences and brain damage and that it should never even be studied. We already know that it's so terrible that it should never even be studied.

Then in fact George Ricaurte tried to block people from doing research in MDMA naïve people to see if it really did cause this kind of serotonin changes, and as it turned out, it did not, but George was trying to stop people from doing the research that would disprove his fear based propaganda. So what happened in 2003, I mean, that was from I'd say '85 when the DEA criminalized MDMA at an emergency basis while our hearings were still going on, through the '80s, through the '90s, this fear based propaganda of MDMA was just rampant. But in 2003 what happened was that Peter Jennings, the newscaster from ABC did a special, an hour special, called Ecstasy Rising, and it was the first balanced portrayal of MDMA. It was absolutely incredible. It was so good that the drug czar's office at the White House tried to block ABC from releasing it. They had an advanced copy of it, they had members of Congress, various people tried to contact the president of ABC. We know this now in retrospect because they've released this information, but they tried to block this documentary from coming out.

So they were unsuccessful fortunately, and the documentary shift public attitudes, and at the same time George Ricaurte had made a fundamental mistake in that he had published a paper that claimed that MDMA not just hurts serotonin but now all of a sudden hurt dopamine and to cause Parkinson's. This was published in Science, which is one of the, Science and Nature are the two main journals in science, in the scientific field. So it's one of the most reputable journals. The editor, it was published by the American Association for the Advancement of Science. The president of that was someone who had previously been the head of the National Institute on Drug Abuse and had been funding George Ricaurte's research. So Science published this dubious paper and also there was an editorial that was there. Alan Leshner was the head of AAAS. He wrote an editorial saying, "Taking MDMA is like Russian roulette."

As it turned out, it didn't make sense. We challenged this, the whole research killed a bunch of moneys, didn't make sense. Any case, they had to eventually withdraw the study because they had made a mistake, they had given methamphetamine to these animals instead of MDMA. So it's one of the biggest scandals in science. They killed loads of animals, they spent mega, mega million dollars, they tried to exaggerate their findings, they should've known it wasn't. So it was the combination of the Peter Jennings special and this retraction of this fallacious article, it changed everything. So since then we have not really, we've done work on neurotoxicity but nobody really believes now that one dose of MDMA is going to cause permanent brain damage and it's so terrible. So that was a real cultural turning point.

Okay, the next and third cultural turning point in Michael Pollan's book. It's had an enormous effect on reaching out to people that we would not otherwise be able to reach. Because his books have been about health, and healing, and food, for him to now come out with this new book about psychedelics, it made people question, are these really poisonous treatments that are going to drive people mad, and cause terrible brain damage? So the other big point about Michael's book, which is very significant, but I think most people don't even notice it, but that he began the book as Michael Pollan. He had all these experiences, and he ends the book as Michael Pollan. He doesn't get divorce, he doesn't drop out to live on a commune, he doesn't decide hey, this writing stuff is bullshit, I'm going to go meditate on a mountain top and withdraw, and get divorced, and live, I'm going to India, or I'm going to find my guru. He doesn't do any of that. He's Michael Pollan, he has these experiences that deepen his experience of life, and he's still Michael Pollan.

So that gets us over this whole arc of psychedelics, counterculture, dropout, so I think Michael's book has reached an enormous number of people in the mainstream that we would never had otherwise been able to reach who value what he says, and it's been a cultural watershed.

Psychedelics Becoming Mainstream

Heather Sandison, ND: So what's changed at MAPS because of that? Have you noticed more funding, has there been a shift in your relationship with the FDA? Are there concrete on the ground changes that have happened? I certainly personally, as a clinician I am interested in this, I specialize in mental health and brain, and there was that Esalen event weekend, and I got my name in the hat as fast as possible along with 10,000 other people who were interested. So I know from my perspective as a clinician there has been a lot more interest. I'm just wondering at MAPS if, what the concrete changes you've seen since then have been?

Rick Doblin, Ph.D.: Yeah. Well, first off, there's been more people from more mainstream willing to talk to us about donations. Yeah, so it sort of destigmatized the field a lot. It didn't really change our attitude with FDA because FDA since 1992 has been more science based rather than drug war based or fear based. So the book didn't really change what we're doing with FDA, but it changed the climate.

One of the things that we've been trying to do since 1990, so it's now 30 years, has been to try to do research inside the Veteran's Administration. There is over a million veterans right now receiving disability payments for PTSD. It costs the VA somewhere around the neighborhood of 15 to $20 billion a year in one year, and these are mostly young people, it's going to be the next 40 years or more. So it's an enormous cost, but the VA has been resistant because of social stigma of getting involved with us in ways. It's been very, very difficult to get the VA involved. However, any day now we are waiting on a reply from FDA about a protocol that we have submitted to take place inside the Bronx VA with a researcher, Dr. Rachel Yehuda, and we anticipate likely to get good news.

So I think Michael Pollan's book has created a climate along with our data, and along with the fact that FDA has declared MDMA a breakthrough therapy, that we're getting really good results, all of that has created a climate where now even the [inaudible 00:46:12] look, and I think that that has to do with Michael Pollan's book in some ways. There's more people willing to acknowledge that psychedelics have enormous healing potential, and we've been able to reach out to family foundations, other people that would previously have been running the other way. So just to give you an example of a sad story, the largest foundation in England it's got about $40 billion, and it's called the Wellcome Trust, and it was started by a pharmaceutical company, and it's focused on neuroscience and trying to understand the brain. We went there multiple times over the last 15 years or so, but Wellcome Trust said, "We're not giving you a penny. It's reputational risk." And I said, "It's a reputational opportunity for you to be a pioneer to help bring this field back." So they were not interested. So I think eventually the Wellcome Trust may actually come around, and if so, it will be in part due to the kind of climate change, you can say, that Michael Pollan's book has created attitudes towards psychedelic research.

The Cost of Mental Illness

Heather Sandison, ND: So you mention the cost too, like the VA of having PTSD, but there's also I think this other cost to society, right? It's that these individuals, I've worked with a couple of special forces vets who've had PTSD, not on the psychedelic side, but they've been interested in that, and doing some of that. I work more on the functional medicine side to support them nutritionally and getting toxins out, all the things that I, the pieces that I can add value. But the other big cost I think that we don't always acknowledge is that here are these incredible human beings who are typically young, very effective, right? They're these amazing athletes, academically very strong, psychologically very strong, we send them into combat and they come back "broken". So now you have these people who could be contributing to society in very real ways, creating families, contributing to their communities, and they have PTSD. They are almost completely debilitated in some cases, and if we could harness that value that maybe you can't put a dollar amount on it.

Rick Doblin, Ph.D.: Oh, right, right.

Heather Sandison, ND: But there is this other big cost of PTSD of anxiety, of depression, that it inhibits people from reaching their full potential of what they have to give, and that psychedelics are this incredible opportunity to sort of reclaim that, to get that back. You've talked about of course coronavirus right now, and climate change for this generation, the next that we all collectively have to face, and who are these people that could come up with potential solutions who are hiding under these debilitation conditions.

Rick Doblin, Ph.D.: Yeah. Well, the other thing is their families. So it doesn't just affect them, it affects their families, their communities. So one of the most important studies that we've done, and actually the first one that we were able to do with VA affiliated researchers, was an approach to treating PTSD that's called cognitive behavioral conjoint therapy. Conjoint meaning dyads or couples. It's where you bring the person with PTSD and their significant other or a relative, somebody that they are in a close relationship with in, and then they both go through the treatment together. So that's cognitive behavioral conjoint therapy. So we did a project blending MDMA with cognitive behavioral conjoint therapy, where both members of this dyad, the PTSD patient and their close person that they're close with, they both get MDMA, and it was tremendously helpful in that regard.

So I think that it's very true that these people are incredible potential, these people that are coming back, a lot of them are not just suffering from seeing death and destruction so close, but it's also moral injury. I think that's the part that's being talked about now more in the military, which is that when you don't believe in the mission, when the mission is politically engineered by President Bush to invade Iraq for reasons that don't really make sense other than selfishly for him, and it's not helping the country. We win territory, we give it back, the Taliban are still around, Afghanistan, they're still suppressing. What have we accomplished in Iraq and Afghanistan other than sowing an enormous amount of chaos, disrupting the world. It's been a negative disaster for the United States, and I think the veterans when they're there, they realize that. I mean, that was similar what happened in Vietnam, is that what is this war really for and why are we there?

So I think there is this dual kind of aspect to the treatment, which is a lot of these people have lost trust in their leadership, in the values of the country and why they volunteered for the military in the first place. A lot of these people really had idealistic patriotic thoughts in mind, that they were going to protect us, it's a dangerous world, we need a military, and at the same time then they do things that they see are mostly destructive or for certain companies to make money, and it's just a terrible thing. So in any case, I think that the therapy that we can offer to people with PTSD, whether it's war related or not. Now, I think the veterans get way more attention, but the VA just put out a statement saying that there's eight million PTSD patients in the United States at any one time. We've got a million vets on disability for PTSD, so most of the sufferers are women who've been sexually abused, who've been domestic violence, there's a whole bunch of people that are from accidents, there's PTSD from medical procedures, cancer patients some of them have PTSD, but the veterans get most of the attention because they are a national tragedy. We've got now the latest estimate is 17 a day committing suicide, a lot of them from PTSD.

So I think that the treatment can restore them to life and not just save money from disability payments, but take people who had an incredible amount of potential and restore their ability to be engaged in the world. So that's what we're saying is very possible and we've seen it happen a lot of times, and that's what we have to prove in phase three, and that's what we're in the midst of.

Should There Be an Age Limit on Psychedelic Use?

Heather Sandison, ND: I'm curious about the age. So from my perspective as a clinician I would worry about introducing psychedelics to a developing brain. Part of me wants to say hold on, let's wait until this human is 25, 26, and then they can experience some of these psychedelic trips or therapeutics, but while they are 17, 18, or like you mentioned ketamine for kids when they're undergoing anesthesia. I just, my concern is that something, we might interfere with something that's happening naturally and there could be unintended consequences. Can you speak to that? Can I rest easy?

Rick Doblin, Ph.D.: I would say that yes, you can rest easy, and I would also say that you have been the victim of propaganda designed to sustain the war on drugs, and that this idea that we have to stay away from developing brain. So first off, there's multiple different ways I can address this, but first off let me say that those cultures that have successfully integrated psychedelics, the Native American Church, there's half a million members of the Native American Church that use peyote here in America. There is the ayahuasca churches throughout South America. There is the Huichol Indians that use peyote, there's the groups that have used mushrooms in Mexico, that all of the cultures that have successfully integrated psychedelics do not have an age limit, and in fact a lot of the women give birth while they're on the psychedelics, they're nursing while they're on the psychedelics. I went to a Native American peyote ceremony, Native American Church ceremony, and one of the Navajo Indians brought his nine year old son who took a half a dose of peyote or so, less than we did, but stayed up all night.

So the idea that this developing brain, let me flip that around, to say that if you could layer in connections to spirituality, connections to love at an early age, isn't that a good thing? The other thing to say is that the FDA knows that a lot of drugs are tested in adults but are never tested in children and are then prescribed in children without enough evidence. So the FDA is now encouraging sponsors to do research in adolescents if the research works out in adults. So that's happening to us as well. So the FDA has required us, if we succeed in adults, we have to work with 12 to 17-year-olds who are traumatized. So the other part of this discussion is to say that if you are a traumatized child, your brain is warped, you are already not [inaudible 00:56:13] normally the way a normal brain would grow until you're 25. The trauma that you've experienced has changed your brain. We have evidence of that from brain scans from trauma patients, hyperactive amygdala, reduced activity in the prefrontal cortex, reduced connectivity between the hippocampus where memories are put into long-term storage in the amygdala.

So people's brains are warped already if they're traumatized, children. So actually this idea that somehow or other there is this natural process of aging that we need to stay away from, tell that to all the doctors, all the psychiatrists who are prescribing Adderall and methamphetamine stimulant drugs to kids for ADHD. Are they saying, "Oh my god, these kids, we can't medicate them till they're 25"? No. We have a massive amount of psychiatrists medicating, overmedicating kids, a lot of them who don't even have ADHD, they're just hyperactive or whatever.

Heather Sandison, ND: And I think that's where my sort of caution comes from, is that as a clinician seeing so many kids and then young adults who have been prescribed Adderall or antidepressants, or these amphetamines. I thought it was interesting you were talking about that science paper and that they were actually instead of using MDMA they were using methamphetamine and they were saying how toxic it was, but here we are when amphetamines are prescribed like candy. People are on Adderall, and Vyvanse, and I see people coming all day long on amphetamines not realizing this is an amphetamine because it's got some other fancy drug name.

Rick Doblin, Ph.D.: Yeah.

Heather Sandison, ND: And here it's been proven how dangerous that is, but psychedelics are sidelined, right?

Rick Doblin, Ph.D.: Yeah, yeah. In that case I would say yes, I mean, a lot of kids are way overmedicated. That can inhibit, but the difference here is that the drugs we've just been talking about that kids are getting, Adderall, they get them on a daily basis for years and years. We're talking about a few uses of psychedelics to enhance psychotherapy with the goal making people independent of the psychedelics. So it's a fundamental difference between for-profit pharma in general that wants people on drugs for a long period of time and nonprofit, but also it's a fundamental difference between psychedelic psychotherapy and standard psychopharmacology, which is this theory that we're trying to correct a biochemical deficit and therefore you need a chemical on a daily basis for the next decade or whatever, longer. Many times people are on antidepressants for 30, 40 years. So it's a fundamentally different approach, and so I do have those yeah, concerns that we overmedicate, but I don't believe that when you work with traumatized children, for example. If we succeed with 12 to 17-year-olds, we are being required to work with seven to 11-year-olds who are traumatized.

Let's take that apart and talk about healthy kids. Even healthy kids, the evidence is that traditional cultures sometimes have situations where kids as they're growing up have these experiences. Now, I'll just say that one of the turning points in my life looking back in retrospect, was my bar mitzvah when I turned 13, and it was a failure. It failed to turn me into a man. It failed to connect me to god. It failed, and a lot of us have these traditional rites of passage that when we're 12, or when we're 13, or when we're 15, that that's a big thing. In religions and culture there's these rites of passage for adolescents, but they don't have the same power that they used to. So I felt when I was 13 I wanted a spiritual connection. I think if I would've given at my bar mitzvah, if the party would've involved everybody doing MDMA, it would've been way better and more spiritual. So I just think that you look at these rites of passage that are set up for adolescents and they don't work anymore, but the core idea is that we need this rites of passage, and psychedelics can do that for adolescents.

Just to reduce a certain amount of controversy from some of the people that may be listening to this now, is to say that I believe that psychedelics should be legal for adults but illegal for children, unless you have your parent's permission. There should be a parental override to laws against minors, and what most people are not aware of is that in the United States 23 states have parental override for laws against the use of alcohol by minors. [inaudible 01:01:13] States parents give alcohol to their kids, at [inaudible 01:01:15] out in public, at home, anywhere because the family has been given this authority by these laws to override the rules against minors. So I think that's the way it should be with psychedelics. There should be a parental ... And in this way we are the party of family values. We are saying who should make this decision about what children are exposed to as they are growing up when it comes to psychedelics. Should it be the government that tells everybody no, or should it be the family that decides how they want to educate their kids? So we are pro family, and I just wish that the various parents groups and families groups that are antidrug would join with us on endorsing this family friendly policy of a parental override to drug laws against use by minors.

Psychedelics for Therapeutic Use vs. Psychedelics for Optimizing the Mind

Heather Sandison, ND: I want to talk a little bit about the distinction between using psychedelics therapeutically versus using them for optimization. Can you speak to that?

Rick Doblin, Ph.D.: Yeah, I think that we need mass mental health. In general we have a mental health crisis all over the world, and I think you can see that in America. That under stress, under economic stress, or stress of a way or invasion, or stress of coronavirus, or background stress of global warming to the extent that people are empathic at all, that people shut down rationality and are motivated more and more by kind of irrational factors. So we need mass mental health, and not all these people that are subject to this stress and have a diagnosis of PTSD, or necessarily a diagnosis of depression or anxiety, but we all have sort of low level aspects of that, and some of us have higher levels. So there still is that part about still bringing people back to normal, but I think taking healthy people and making them healthier or optimization, I think that that's essential. I think that what we need is drug policy reform so that while we have a strategy of medicalization for clinical illnesses, for personal growth we're not going to be able to get the FDA to approve MDMA for personal growth. MDMA is phenomenal for couple's therapy, but we're not going to be able to get FDA to approve MDMA for couple's therapy because it's not a disease.

So I think that this optimization is what people have used psychedelics for also for thousands of years, that I think that ... But it will require drug policy reform. We're not going to medicalize for optimization because it's just a different context.

Ulterior Motives in Drug Policy

Heather Sandison, ND: So does that happen with the DEA say versus the FDA?

Rick Doblin, Ph.D.: Well, no. The DEA just does what it's told. That has to do with Congress, with initiatives, with various expressions of public support. The DEA is not going to say, "Oh yeah, let's get rid of the DEA, we don't need it." They're too invested in what they're doing, but I think that we will need overall drug policy reform, and what we really need to do is take drug policy out of the criminal justice system and put it into the mental health system. Drug abuse is not a crime, it's an illness that we need to help people through humane support rather than ... And the drug war has never been about reducing drug abuse, it's never once been about reducing drug abuse, it's about suppression of minorities, it's about financial interests for people. Why does marijuana become illegal shortly after the alcohol prohibition ends? We had enormous amounts of prohibition agents looking for something new to do. We had people, Harry Anslinger trying to build a political fiefdom, and he became quite powerful through the laws against marijuana and against other drugs. So it's always been about ulterior motives. It's never been about drug abuse.

Heather Sandison, ND: Certainly in my practice clinic whenever I see that there is a familial history of substance abuse, my again, invitation is to view that as someone who is looking to self-medicate, somebody who is uncomfortable, who is looking to feel more comfortable versus somebody with some moral issue or some legal issue, right? It's not that they are broken or that they have something wrong with them, they're just looking for that relief.

Rick Doblin, Ph.D.: Yeah.

Heather Sandison, ND: So if we could do this in a way that it's more empowering, how amazing.

Rick Doblin, Ph.D.: Yeah, I think so, and I think that Bob Jesse has called this the betterment of well people. Yeah, and I think it's completely [inaudible 01:06:14] we need to create a context for that and it won't be through FDA, and I also think it shouldn't be through religion. I mean, we do have religious freedom for the Native American Church, we have religious freedom for several ayahuasca churches to do their practices in the United States, but individuals should not have to be part of a religious group to legally have access, nor should they have to have a medical disease.

Is Using Psychedelics Cultural Appropriation?

Heather Sandison, ND: And what about the cultural appropriation around this, right? There is people who have argued that if you want to do ayahuasca you should go to Peru and do it with a shaman in Peru, where it's culturally appropriate, and if you want to do ibogaine you should go to where that is locally endemic, and if ... What are your thoughts?

Rick Doblin, Ph.D.: Let me just say this, okay? So some or other, you go down to Brazil or Peru, let's say, and you want to go to a shaman. Chances are that shaman has a telephone, a smartphone. Let's say you go to ibogaine and you want to go working with the Bwities who developed the Bwiti religion using iboga. Those people also have phones, right? They have taken technology from the West and they have adapted it to their own uses. So similarly I believe it's you can have respect without having to slavishly copy something from one tradition into another and use it in the same way. So I don't believe that it's cultural appropriation to take a substance and use it in a different context.

So let me say that as a Reform Jew that the way that I was trained is that it's the obligation of Reform Jews to look at the tradition and reinterpret it for modern times. So for example, it's not quite Reform, but there's another group called Reconstructionist. That in the 1920s said all of a sudden girls can get bat mitzvahed. So for roughly 5,000 years of Jewish history girls could not have a bat mitzvah, it was only men. Somehow or other that changed, and now do we think it's weird or do we say, "Hey, that's inappropriate"? Well yeah, the Orthodox say no, you can't have girls have bat mitzvahs, but it's our obligation to adapt things for our own unique context, not just to slavishly transmit from one generation to the other the same thing.

So I believe that ayahuasca is something that we need to appreciate where it came from, ideally give some rewards back to the people that developed it, but that it's part of the world's history, it's part of the nature's gift to everybody. It's not owned by them, and the same way if we look at all the research that's going on now with psilocybin, it's all synthetic psilocybin, and it's being given without the Mazatec ceremonies.

There was a study in Brazil of ayahuasca for depression that was very effective but they gave the ayahuasca without any religious ceremony. So even in Brazil they're taking ayahuasca out of the traditional setting and using it in a Western medical setting. So are those Brazilians now, let's say we're appropriating it from those Brazilians rather than the indigenous, and it's not indigenous anymore in Brazil or Peru that are using ayahuasca either. It's made it to the mainstream, to the west, to the cities. So I fundamentally am in disagreement with those people that say that these substances should only be used in the other context.

Now, let me just add this, that the churches in Brazil and in ayahuasca are called syncretic churches, the ones that use ayahuasca, meaning that they were dominated and suppressed by the Catholic Church. So they've had to make accommodations to the Catholic Church. So these are not like these pristine things come out of nature and this is the way they are. They're homophobic, patriarchal, hierarchical, they are not the kind of examples that we would say are part of sort of Western progressive culture. So we should adopt them the way they are where only men can be shamans? I mean, there are women shamans too sometimes, but these religious contexts are not these pure beautiful from nature, and we got to keep them exactly the way they are.

Current Research on Psychedelics

Heather Sandison, ND: Thank you for speaking to that. Can you speak a little to the state of the research? So certainly depression is a big one and end of life care. There's a bunch of places where psychedelics have performed unbelievably well, especially when compared to the standard of care for treating things like depression. Can you speak to kind of where that is right now?

Rick Doblin, Ph.D.: Yeah, yeah. So I'll speak about two things. So there is the MDMA for post-traumatic stress disorder and that's been declared a breakthrough therapy by the FDA, and then there is psilocybin for treatment-resistant depression, it has been declared a breakthrough therapy by FDA for a for-profit company called COMPASS, and then there is a nonprofit company called Usona that's trying to develop psilocybin for major depressive disorder. That has also gotten breakthrough therapy status from the FDA. So MAPS is in phase three studies.

Heather Sandison, ND: Can you describe what a breakthrough therapy means?

Rick Doblin, Ph.D.: Yeah, yeah. So the most important designation you can get from the FDA is breakthrough therapy. It's for the most promising drugs, and what that means is that roughly two thirds, big pharma wants all of their drugs to be considered a breakthrough, but two thirds of the applications to FDA for breakthrough therapy designation are rejected because they are not real breakthroughs. So these are drugs that show promise to either bring a whole new population that didn't have a medicine available for them, or there was a medicine but there were a lot of people that failed on obtaining relief, and that this new drug based on the early data is considered a potential breakthrough. So you get breakthrough therapy designation, and what that means practically is that you have more meetings with the FDA, shorter timeframes. They prioritize the development of these breakthrough drugs, and there's even regulatory competition between the European Medicines Agency and FDA, who can approve the most new breakthrough drugs.

So MAPS was able to open the door to MDMA becoming a breakthrough drug for PTSD, and that eased the way for psilocybin to become a breakthrough therapy, but because from the very beginning my strategic analysis was that we need to medicalize these drugs. A lot of the early work began with psilocybin by people that were more academic researchers and they wanted to understand how does it work, and they didn't understand that there is a fundamental difference between drug development research and academic research. There's different ways to design the studies, different ways to monitor the data, different negotiations you have with FDA. If you just want to find out stuff or if you want to make a drug into a medicine. So MAPS is ahead of the game, we're the leading edge, and we are now we think by the end of 2021 we think we will have gathered all the phase three data that we need, if we get the money that we need to raise, and we think that psilocybin is probably one year or two years behind us. So the psilocybin groups are still in phase two, and we are now maybe one third of the way, well maybe 40% of the way through phase three.

Heather Sandison, ND: Fantastic.

Rick Doblin, Ph.D.: Yeah.

Heather Sandison, ND: So in the context of COVID-19, do you see psychedelics having a role to play in our collective recovery from this trauma?

Rick Doblin, Ph.D.: Yeah, very much so. Although it's going to be very difficult, because again, we have to make this distinction between what's happening in research and what's happening in the culture, some of which may be illegal. So I think that we're in order to demonstrate that MDMA is a medicine we are working with the hardest cases. So we're working with chronic severe PTSD, most of whom are treatment resistant. A lot of the people that are now getting traumatized from the COVID are healthcare workers, first responders, but a large number of them will recover and not develop classic PTSD. There will be a fraction that do, and often they've had series of traumas and this one was just the one that pushes them over the edge. So we will try to be reaching out to first responders in all different ways, they can already join our studies.

I think that as preventative medicine that's unfortunately for now going to have to be, people have to do that on their own illegally, but if it were something that let's say Congress in their ... If they were wise, let's say they put in a billion dollars towards treating healthcare workers who've sacrificed so much, who've seen their associates die from the virus, who are worried about getting the virus themselves. If they were to give everybody an MDMA experience for preventative medicine, pay for it, we would have a vastly reduced problem of PTSD and also people would be able to get back into life more, they would overcome a lot of these traumas that are below the level of the actual PTSD.

So the other part of it is that this idea that we're all interconnected. People are realizing that more, and I think you can see that through psychedelics, it's a very effective way to go beyond your individual self and feel that global connectivity. So I think psychedelics can inspire people, can help them. I think they could play a major role, but it's really we're too far behind sort of in this medicalization, legalization struggle to make it widespread, tragically, but I think that for those people that seek it out, if they have the right set and setting, if they have drugs that are really pure, I think psychedelics can do a lot of good.

Heather Sandison, ND: So just one more quick question briefly.

Rick Doblin, Ph.D.: Yeah.

Heather Sandison, ND: The next milestone, so if it's a decade out or so, or five, 10 years, what do you see that being?

Rick Doblin, Ph.D.: Oh, the next big milestone. Well, it'll be the approval, which we think will be 2022 is the next big milestone.

Heather Sandison, ND: Fantastic.

Rick Doblin, Ph.D.: Then will be thousands of psychedelic clinics.

Heather Sandison, ND: So it could really have an impact.

Rick Doblin, Ph.D.: Yeah, yeah, setting up thousands, and these will be ketamine, and MDMA, and psilocybin eventually, and eventually ayahuasca and other things too.

Heather Sandison, ND: Thank you so much, Rick. It's just been an absolute pleasure to have you on today, and thank you for sharing your insights and this cultural perspective, this historical perspective. It's been a pleasure.

Rick Doblin, Ph.D.: Oh, Heather, I've really enjoyed it.

Heather Sandison, ND: Thank you so much.

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