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Indigenous peoples have known about the power of psychedelics for eons.

The US Army experimented with LSD and other compounds.

The counterculture used acid as a springboard into a new plane of consciousness.

Today, though, we know more and medicine.

Big pharma and venture capitalists are all taking a hard look at the power of psychedelics.

That's the discussion on this Special Mind Matters edition of Northwest.

Now.

Welcome to This Mind Matters edition of Northwest.

Now, we've got several of these shows planned in the coming months, all focusing on mental health.

We're a long way from Ken Kesey and the Merry Pranksters acid test and Timothy Leary, who told a generation to turn on tune in and drop out.

These days, modern science better understands the brain chemistry and the effects of chemicals like LSD, MDMA and psilocybin, which, by the way, is the chemical found in so-called magic mushrooms.

New research indicates compounds like psilocybin can have major positive effects on PTSD, depression, trauma and even the dread of dying.

A mathematical model captures a normal brain's activity.

In contrast, a brain under the influence of psilocybin reveals a dramatic increase in global communication.

Thousands of new connections form linking brain regions that don't normally talk to each other.

One analogy I've used for how psychedelics work in the brain is a snow globe.

When you pick up a snow globe, you know the snow's settled at the bottom.

It's sort of fixed.

And then you pick it up, shake it and things jiggle around and there's randomness and a kind of chaos.

If you want, in the system.

The user experiences this as an altered and heightened sense of awareness.

But what causes this?

Early in our functional brain imaging studies of psychedelics, scientists were finding that the default mode network was turning down or turning off during these experiences.

And that was a really good place to start.

But we began to then look one layer deeper.

Why was the default mode turning off?

New research led neuroscientist Fred Barrett to investigate a region of the brain called the colostrum.

The classroom is really thin sheet of gray matter in the brain, tucked deep within each of the hemispheres of the brain.

Recent animal models have shown that it is incredibly highly connected to just about every other region of the brain.

Understanding that the receptors targeted by psychedelic drugs are also really densely expressed in the classroom, we began to wonder whether the classroom may be at the center of psychedelic effects.

Fred believes the cluster from central location and Shape suggest regulates communication between the departments.

When it's functioning normally, the classroom is essentially acting like a switchboard.

It's trying to help other brain regions figure out when to turn on and when to turn off.

But when we experience a psychedelic drug, we believe that it's binding to specific receptors in the classroom and somehow disrupting or disorganized in the classroom.

It's almost as if the switchboard walks away.

What happens next is that we seem to observe a radical change in the way that brain regions talk to each other.

And it may be within this context that we're experiencing, learning.

And a possible even rewiring of the circuits that govern our behavior.

And it may be that it's that radical reorganization that allows people to encounter new psychological insights that they hadn't encountered before.

Fred thinks the cluster of sudden abdication of control may help explain why rigid behavior and thought patterns have a shot at resetting.

It's almost like they've seen this like kind of grand menu within their mind that they weren't aware of, that this this greater number of possibilities that they can explore.

It took a while to recover.

I was having headaches and muscle pains, but it was the best headache I'd ever had in my life because it told me that the psilocybin was working.

It was actually physically restructuring my brain, something that I never imagined could happen before.

It's like reprograming the operating system of a computer getting down to very basic code level changes.

Far from energizing a new counterculture, psychedelics have attracted major funding from venture capitalists.

Tom Shoes founder Blake Mycoskie has pledged $100 million toward the effort.

The VA, Johns Hopkins, Berkeley and the UW are just a few of the many institutions diving into this phenomena.

Some people are now involved in acid tourism, taking trips overseas, trying to achieve better state of mental health.

It appears safe to say that this technology in one form or another is coming.

Joining us now, Dr. Darren Smith from the UW Center for Novel Therapeutics.

Dr. Smith, thanks so much for coming to Northwest now, and pleasure to have you here.

This is a funny question to ask you off the topic.

How did you get into psychedelics?

You know, it it it revolving around my research, looking at trying to find answers to racial racial trauma, race based trauma.

So angels were being shot by police and and the sort of ensuing widespread potential of PTSD is what led me to this and trying to find ways to to help mitigate the suffering of other marginalized communities.

That's what led me eventually into into psychedelics.

So what is your department's role in in researching this and investigating it?

And and I would guess you have other disciplines, maybe even at the University of Washington, that are on a parallel track.

Talk a little bit about what your how that looks at the UW.

So the Department of Psychiatry has really taken taking this on and really pushing the the research efforts that are being made in the state of Washington.

My department, which is Department of Family Medicine, is also a board this train as well, because we recognize that in primary care, the vast majority of people who come in to be seen for mental illnesses, they're coming to their primary care providers.

So trying to buttress up that those services for folks who are suffering is what I'm trying to do in primary care is in terms of making this available for primary care providers to use in clinic.

Yeah, any given day and it makes complete sense because that's where so much of the interface is between folks and their doctors at that primary care level.

And that not to mention time, there's a dearth of psychiatrists out there.

Yeah, dearth of mental health workers to actually prescribe and do the work of of medicine within the behavioral health sciences.

So, yeah, you know, we need to weed all all hands on deck.

Yeah, but if you can get, you know, a good percentage of those patients managed at the primary care level where everything's not referred, that opens up that resource for the psychiatrists and some of those folks who are in short.

That's right.

Which means that we have to teach primary care providers to think differently about mental health.

Right.

Maybe maybe set aside a couple of exam rooms that are not traditional exam rooms, but look more like, you know, your home in in your home comfortable, comfortable seats.

Doesn't look like a clinical setting is in is in that in that particular configuration.

I think that would make the biggest difference if we can get primary care providers to to realize that mental health is a significant part of their practice and retrofit their offices to meet the need of, you know, of doing psilocybin assisted therapy.

We'll talk about that and what that would mean in practice.

So when I ask you how big of a deal it is, I imagine when you go to a conference and it's, you know, a Friday sat at a conference, this used to maybe be the afternoon breakout you would attend in a in a other small room with a few guys.

Is this in the main hall now?

Is this become a big thing?

It is.

This has been definitely the most exciting, you know, aspects of medicine, at least in terms of psychiatry in 30 years, 25% of the population reportedly has mental health issues of one kind or another.

And you gestured at this in terms of the interface with the general practitioner.

There are a lot of pharmaceuticals out there and they have come a long way.

The new molecules have changed a lot of lives, but if you're not on them and they don't work for you, they don't tend to be very sticky.

Are psychedelics and molecules and compounds like psilocybin, possibly showing the potential to be sticky where it's I don't to use the word cure because that's always dangerous.

But it's you're not maybe on a constantly, but you have some revelations.

You have an experience that doesn't require you to be on 20 years of antidepressants.

Right.

Right.

Well, we know from research that taking medications, psilocybin, assisted therapies or, uh, in MDMA, therapies are only as good as the therapists that are working with their clients.

So it's just not taking the pill.

And you have this sudden, you know, mystical, magical experience and you're cured.

But it really needs to be curated properly with with a licensed professional facilitator or therapist who's been who've been trained to do this work, doing journeys on your own.

People do those things.

They've been doing them for for decades and centuries here, really truthfully, but under under the rubric of the medical model.

Most of the studies that have been done that we were looking at, the studies that are showing such incredible, you know, efficacy are done in in a very controlled environment.

So it's a it's a tool as opposed to a it's a tool and a continuum of of tools as opposed to some you magic mushroom with people.

It's not magic.

That's right.

That's right.

It's one more tool that we can deploy to help in the fight against mental illness.

You talked about MDMA just on my little list here, mescaline, MDMA, LSD, psilocybin.

Some of those talked to folks a little bit about the differences in those compounds of the difference between a naturally occurring compound and a synthetic compound.

And are those are those related or do they act on the brain the same?

What's the situation?

Definitely the naturally occurring classic psychedelics.

You mentioned earlier with mescaline.

Some of the other compounds have a high affinity for serotonin, a serotonin, a receptor, sites in the brain and the saturation of of of serotonin that's made available from these medications is what's doing the mood altering the the mood changes that we're seeing in individuals who are using these compounds.

Not to mention one of the most exciting aspects of these compounds is in their ability to create new neural circuits or new neural pathways that are generated as a result of taking it and of course being.

And of course the condition is, is created inside the brain and the curated therapies, if you will, the talk sessions that go on with with with patients and clients we're doing this is where the is where the magic happens.

Yeah, I think that some of the old aberrant neural circuits that are causing some of the mood disorders that patients are experiencing, those get sort of pruned away whenever they went under the influence of psychedelic compounds.

So this really has the potential to do some rewiring.

You're not trading one habit for another necessarily, which is, I think, some of the social baggage we have to maybe get away from, but it's actually we you're replacing good thoughts with bad thoughts or that may be too simplistic, but it's certainly a part of your thoughts with bad thoughts and good behaviors with aberrant behaviors.

Yeah.

Yeah.

And that's what and that's so amazing to me that that kind of change is possible because the mental health needle is hard to move.

It is.

Yeah.

People look normal, but what's happening underneath the hood is not it's not the horses aren't running very well.

Right.

And so and the medicines that we have today, they're good medicines, they work pretty good but they don't cure.

Yes.

They're not curative medicines.

So once you've been diagnosed with something like depression or or even recalcitrant depression, that won't go away.

And medicines don't seem to to do much for for patients.

So there is a lot of a lot of unnecessary suffering that's going on in the world.

We haven't had any new major breakthroughs with any antidepressants in 30 years.

Yeah.

And so we need we need more tools and tools here.

Yeah.

And we know more now.

So now it's not an illicit drug.

It's actually something we can investigate, understand the chemistry, and understand the mechanism of efficacy and leverage that.

That's right.

Let's talk about the moral, ethical question, because I'm sure I'm sure people watching this program and we're talking about dropping acid or going on a shroom trip are rolling their eyes and going, okay, yeah, great.

I get I get what they're talking about.

But but we also have no problem at all with with popping synthetic drugs or things that are are synthesized from natural products that are pharmaceuticals with no problem at all.

Eat those like jelly beans.

Now, granted, they go through approval and there's a scientific method behind them, and that's what's being proposed for this as well.

So can we get over that moral barrier, the eye rolling and some of the issues we have with that?

I think so.

I think with some of the groundbreaking studies that have come out recently over the last couple of years, I know that, you know, JAMA did a piece on this.

Looking at this, I think the Journal of Nature, which is, you know, Premier Journal, a scientific journal, both have done really groundbreaking stories on on and studies looking at the potential benefit of these substances.

And so we know they're beneficial, we know they're efficacious.

There's maps of spit and invested, you know, millions of dollars into research efforts to uncover whether or not MDMA is safe and effective.

And we know that it is safe and effective.

And individuals who are suffering from PTSD, what we don't know necessarily is the degree to which people of color experience psychedelics.

Because because most of the studies that have been done, the large participant, you know, volunteers have largely been white folks.

Yeah.

So we don't really have a good, good sense of how this is going to impact communities of color.

I suspect we'll find similar, you know, similar findings.

I mean, there's been some small naturalistic studies have been done by some colleagues of mine that have noticed the same benefits.

Right.

And that's where you start talking about actual science, right?

Actual research methods, study design and those things.

That's why we're not just dropping acid and having a good experience.

You're looking across racial groups, across age groups, across medical histories and some of those things to really try to get a feel for the reality and the efficacy and the safety of some of these comments, correct?

Correct.

And the governor, the governor's office has really been at the forefront as well, pushing this, because, as you know, the governor's office gave us $1.4 million to study the effects of these antigens on first responders and veterans and marginalized communities.

So we've got support from the from the legislators here in state of Washington to talk a little bit.

You know, hopefully people will do a little reading on this.

But the anecdotal stories that people have about life changing experiences, losing the fear of death, dealing with childhood trauma that they no longer are persecuted by and dreaming about and those things.

Talk a little bit about some of what you've seen and who can be helped by this.

So so again, so there's there's above ground and below ground.

I'm going to stay above ground.

Okay.

In terms of what we know.

So what we do know so far is the studies that have been done so far have looked at MDA, have looked at major depression disorder, PTSD.

There's been some studies have looked at alcohol use disorder.

There's been some studies have looked at even tobacco use, you know, cessation.

So we know that these medicines and compounds work in very specific populations of people in which they've been studied.

Beyond that.

Right.

We don't know.

Yeah, we don't we don't really have a sense of what this would look like if you're working, treating someone that has perhaps, you know, a schizophrenia.

Right.

And the general rule is that if people have are suffering from diseases where they have a lot of mood instability, potential mood instability, where they might have been manic, for instance, this may not be the best choice for them, because sometimes when you take drop acid or take psilocybin, I don't I wouldn't know that.

But from what I've heard, it can induce mania.

You're you're on the record.

I'm on the record.

So you're safe.

But.

Well, I think what you're talking about from back in the day is you can have a bad trip.

That's exactly right.

Yeah.

So you need to find that patient population.

Like I said, this gets us back into the science piece of this lot, back into, you know, turn on, tune in and drop out.

You know, just drop an acid to explore yourself, even though people are doing that.

Yeah, but, but, but the issue being that the medicalized use of this is what we're looking for.

Yeah.

So by the way, I just make one last point, Tom.

The the governor's office has given us a mandate.

I mentioned it earlier, but we're looking primarily for veterans and we're looking for first responders, Folks who are on the front lines, who are experiencing.

Have seen a lot.

A lot, Yeah.

A lot of veterans, much more than what the average American would see.

And having a hard time processing, processing and getting it out of there.

And the big key is the integration piece helping people when they're having these these horrible experiences help them to integrate those experiences into something meaningful and useful.

What do you think the future of this is?

Is will be is is there a regimen for an heroic dose where you're in a couple of times and I hate to use the word cure again, but you your issues are somewhat resolved, let's say that.

Or is this an ongoing dosage?

Do you see both?

What's your gut tell you about how where we're heading with it?

It depends on what you're again, it depends on what study you're reading, what you're looking at.

There's not been a lot of good studies looking at Microdosing.

We don't really know what the optimal dose is.

So some folks are.

We had mentioned earlier what's his name?

Paul Stamets.

Yeah.

Paul Stamets is a is a well-known name in the psychedelic world who has looked at this.

He does a lot of mycology work.

He's coming up with some with some interesting, important microdosing provisions at his lab.

But beyond that, we don't really know.

We don't know if heroic doses or it or not.

Most of the doses that folks are getting is somewhere between, you know, three grams, five grams.

Anything more than five grams is definitely considered five grams of psilocybin.

It's definitely considered a heroic dose.

Right.

I don't know if that's the sweet spot.

The sweet spot is usually between two and three doses, you know, two and three grams.

So anything more than that might be, you know, a little bit untenable.

And then you'll have to do some research about how many times proves to be most efficacious and what kind of counseling interface assists with that, because you've got to be in the right space with the right people around you.

That's right.

From what I hear, trips can really depend on your mindset going in and the sense of security you have of being supported.

So there's there's a little bit of a preflight checklist you've got to go through, too.

That's right.

That's right.

And two things I hope you hopefully, listeners, your viewers will want to stay on set and setting are the two most important components when you're thinking about doing a medicalized journey.

Right?

So just that's why just hold off on doing your own thing is can be dangerous and it can be a negative experience, right, if you're not careful.

The other piece I want to talk about on this, we talk about efficacy is this could turn out, you know, if people have moral issues with it, well, time out.

It could turn out to be a huge money saver.

If you think about the billions of dollars are spent for long term treatment, long term dosage is long term for pharmaceuticals.

I mean, what if it saves money?

Is that possible?

Well, most pharmaceutical companies are not in the business of saving money.

That's money.

Yes.

Theoretically, you're right.

Yes.

And one of the one of the ways I see this being very cost safe cost savings saving would be in doing group sessions where you can defray the cost, you know, across because right now there's there's the federal government is definitely involved in this.

Their hands are in it but they're not completely in it yet because it's not legal.

Right.

There's been some discussions about it.

There's some things happening.

There's currently a experimental CPT code that individuals are using who are doing psychotherapy, who are doing psilocybin based psychotherapy or some other psychotherapy.

They get the permit, right?

They can code that, they can code it if if it's in the right setting.

Now, the reimbursements of what I'm hearing and this is, of course, is this is not anything that's the gospel truth.

But what I'm hearing is that somewhere between $200 a session, up to ten sessions is what they're looking at, reimbursing for services for psilocybin services when it eventually becomes legal, which is great.

Yeah, just great.

A lot cheaper than some of the traditional treatments, hospitalization and all the other things and the social costs that can go along with that as well.

And and mental health is not like cardio, you know, cardiothoracic surgery or it's not like a family practice.

It takes time to get people to change how they're seeing themselves, how they see themselves related to the world, how to change their, you know, how to change their brain for the good, for the poor, for the good.

It just takes time.

Yeah.

You know, it doesn't take one or two, you know, you know, dosing sessions.

You know, most of the time it may take more.

And the dosing sessions are not the most important things to to be concerned about.

It's what happens after the dosing session.

Is it working through the integration piece, what your experience was?

Absolutely what it means.

Right.

Yeah.

I'm going to ask you to get your crystal ball out.

I realize you have no actual answer for this, but what is your gut tell you about what the future is?

I think right now, Oregon and Colorado, there's limited legality, Everything else that's being done as clinical trials in scientific settings.

But do you think we're ten years away from this or 20 years?

Do I mean that?

And what's what's your gut say?

Yeah, rub the crab in my crystal ball.

So I think I think what we're going to end up seeing is more and more states coming on line like Oregon, Colorado, Washington.

I think we'll see other states that are eventually adopting services where you may see some some significant reticence would be probably in the southern states, I would imagine with the lone exception being North Carolina, who is already making provisions, they already have some money grant moneys out there to actually give out to people who want to study this in the state of North Carolina.

So there's I think that now that now that the genie is out of the bag, this is not going away.

Right.

So you see a time that insurance will cover this.

Yes.

There's I mean, there's I mentioned before the CBT code.

Right.

So the folks who put that out or the governing body who create CBT codes.

So it's the genie.

The genie is is is out of the box.

So I don't see this not I see this movement continuing in our last 30 seconds here.

It really sounds like, I think for people who have family members or themselves suffering from serious PTSD, I mean, this this really does there is a nice piece of hope sitting out there for.

Yes.

Thank you for saying a time.

Yes.

For people who are really suffering, have no other options.

Tried everything.

Everything.

Yeah.

This might be that thing that might be helpful in helping them to recover and to integrate in a healthy way.

I would also add that if not this, then certainly ketamine to try ketamine as well.

Ketamine services are also quite effective depending on who you're seeing.

And the most important thing, the therapist or the facilitator training that they have.

Right.

So those are things to consider as well.

And in this emerging fairly broad palette of compounds that may be efficacious.

Dr. Smith, thanks so much.

Interesting conversation.

Thank you.

Thank you for having me, Tom.

One of the reasons environmentalists talk so much about biodiversity is that many of the compounds we rely upon for human health come from the amazing chemistry lab that is nature right here on planet Earth.

So get ready for a respectable form of dropping acid.

It will come in a pill or a patch and some day insurance might even cover it.

But the bottom line is that it's probably coming at the promise it holds for mental health may be truly remarkable.

I hope this program got you thinking and talking.

To watch this program again or to share it with others.

Northwest now can be found on the web at k Betsy dot org.

And be sure to follow us on facebook and twitter at Northwest now.

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That's going to do it for this Mind Matters edition of Northwest now.

Until next time, I'm Tom Layson and thanks for watching.

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