Welcome to the Resolve to Solve with Miles O'Brien Podcast, where we g behind the scenes of the Arizona PBS documentary series Resolve to Solve with Miles O'Brien.

We're discussing the challenges, the discoveries, and the things you might not get from watching the TV series alone.

I'm your host, Elise Hu, and joining me is the veteran science journalist himself, Miles O'Brien.

On this episode, we look at the brain's capacity to hea with the power of psychedelics.

Miles, thanks for joining me.

It's a pleasure, Elise.

Tell us first, let's set up the problem tha we're exploring in this episode.

Yeah, well, this is the problem right here for me, I have I'm missing an arm.

As it turns out, amputees like me deal with something called phantom pain.

And it's a particularly enigmatic, stubborn kind of pain.

And really, over the years no one's really come up with any sort of solution.

There's no FDA dru that is designed to address it.

It comes from the idea that even though my arm is missing, if you imagine like a mirror image of my remaining arm, and for those of you listening, I'll try to walk through with some word pictures, but it's kind of crouched up.

It's in concrete feels like it's burning a lot.

And sometimes I get these pain, which is like a huge electrical jolt just really knocked down pain.

So this is a problem a lot of amputees have and it doesn't go away.

A National Geographic Explorer, engineer and scientist by the name of Albert Lin happened to lose part of his leg in an off road accident, and he had similar experience with his missing limb, and he, being a curious scientist and engineer, did a deep dive into the scientific literature and became very interested in some work being done on the use of psychedelics as a way to address pain in an entirely different way, not like an opioi Band-Aid approach, but something a little more addressing the neural roots of pain.

And so there were some studie at Johns Hopkins, early studies which were with people who were dealing with terminal illnesses, and it helped them deal with their mortality.

And he got into that and he realized occurred to him that emotional pain and physical pai and this ethereal pain we call phantom pain might all be one big ball of wax in the brain.

And so he got some magic mushroom and he went out into the desert.

He, based in San Diego went to the Joshua Tree Desert and had a bit of a vision quest, and it cured him.

A phantom pain with one trip, one experience.

So he came back to UCSD, which is his academic home, and connected with a researcher who was focused at that time more on meditation as a way to address pain.

Fadel Zeidan is his name.

And he posed the question to Zeidan.

Do you think that psychedelics might address pain with the same mechanisms that meditation does?

And Zeidan paused and looked in the room to make sure there weren't any cops there, and said, yes, I think so.

And that actually was the origin of a study, many years in length now, of amputees, phantom pain and the us of psilocybin, a big dose of it to see if it can address this really difficult pain.

So it's a really interesting story of turning a tragedy into something that raised some questions, which led to some interesting answers and now an official study.

And so of course, as I approach this one, I thought, well, I probably should volunteer if I ca and see what comes out of this.

And that's what I did.

Yeah.

Let's back up really quick.

What is the current recommended protocol for treating phantom pain?

Well, it's not good.

Some people are prescribed opioids.

We all know that opioids and chronic pain are not a good combination.

I think we can all agree on that one.

Some people use ketamine again, some, you know, habit forming addictive properties to contend with.

And then there's another drug called gabapentin, which actually was its off label.

It was created originally to help people with seizures, epileptic seizures.

And there's some reason to believe that it might address phantom pain.

I tried it, it didn't do anything for me, and there were some unwelcome side effects.

I felt I was always like searching for words.

And, you know, in my business, that's bad thing.

I want to have those words right there.

And so so I decided to cut it out.

And so what I, what I do and it's now legal.

So I guess we can say this if I'm having a particularly bad bout, I will take a puff or two of cannabis and that will help reset things for me.

But ultimately it's still there.

It's with me all the time, sometimes low grade, sometimes medium grade, and sometimes finger in the socket grade.

And so the fact that there is no FDA approved analgesic to make this all go away is a sad statement.

But, you know, I don't think the medical community does a great job addressing pain writ large.

And that's that's a subject we could go into, too.

I liked this episode a lot, Miles, because I think it's the only one in the serie where you break the fourth wall and you just talk straight to camera.

Tell us a little bit about what motivated that decision.

Well, it's interestin because when you present an idea to a a wonderful network like PBS that I want to do a story, and I would like to engage in a psychedelic trip and tell that story.

They get a little nervous about that.

And so I said, well, you know, wouldn't it be odd for me as an arm amputee to do this story and not in some way break that wall, including, you know, signing up for the study?

And so the standards and practices people spent a lot of time thinking about this one.

My goal was not to go ou and do a Cheech and Chong movie and celebrate the use of illicit drugs.

Right, right.

I just feel like this is, you know, this is medicine that got stigmatized in the 60s for a lot of reasons.

We could go into, and it got put on an off ramp as far as serious scientific and medical research.

But that's changing.

And that has been changing in recent years.

And that's part of the story here, is that there is a new mainstream scientific, rigorous, you know, controlled researc work on this, which is leading to some really interesting potential outcomes for people not just paying deal with things like PTSD or depression, any number of things that might open up, you know, windows in the brai that might make it easier for us to contend wit some of the challenges we face.

If I recall correctly, Dr.

Zeidan got a huge NIH grant to help further his study.

So it is backed by the National Institute of Health.

Well you know, it's it's interesting.

You never know what's going t get federal funding these days.

It's a different world we live in.

And as it happens, this idea exploring psychedelics as a potential therapeutic for a lot of things is actually in favor right no with the current administration.

And his initial research was done through philanthropic support, and he proposed a study, a larger one, to take it to the next level.

And he got the money.

So that means that 60 more amputees will go through it.

So the portion of the study I was involved was the phase one, which is to test its safety.

Phase two is when you get into the mor specific questions of efficacy.

So on efficacy, what is the science here?

Why are psychedelics said to work to treat this kind of chronic pain?

What's happening in our brains?

Yeah, this is a really interesting stuff.

How could this possibly wipe away years of chronic, debilitating pain as what happened with Albert Lin and some of the other people in this study?

We went and spoke to another leading researcher in this realm.

Her name is Gul Dolan, and she's at University of California, Berkeley, and she's been studying how psychedelics work right down to the neural synapses very, very deep in the brain.

But she also has done some interestin observational studies with mice where they were given various psychedelics.

And as it turns out, her theory is that what what the psychedelics do is they reopen what are calle plastic periods in your brain.

So we all have plastic periods when we're able to learn a language more easily, or when we develop vision or when we identify our parents all these things as we mature.

There are these periods where our brain is read to take in all this information.

Yeah.

This is why they say you're supposed to learn a language before your age, seven because your brain is a little bit more plastic up until like second grade.

But after that it's harder to learn languages.

Yeah, I just, I jus I have a brand new granddaughter in Italy.

Her mother is Italian, and her husband is my son.

And I'm I'm like, you've got to speak both languages to them.

Now, if nothing else, I want to be able to talk to her.

Of course.

But this is the time when they just pick it up.

And that's that's what plastic periods are.

So Gul Dolan's theory is that psychedelics like psilocybin kind of reope some of these plastic periods.

And if you take advantage of it, you can relearn some things or lear some things that you never did.

Or perhaps in her theory is that, you know, my brain is convinced there's an arm here, no more arm.

But that idea that there's like this disconnect between my mental image of my body and what's going on here is what probably creates the pain response.

So the theory is tha as you open up a plastic period, you allow yourself to to retrain your brain to remap your body and explain to it.

Hey, there's no arm there.

And those pain responses can go away as a result.

That's that's way simplified version, but that's the best I can d and try to explain it to myself.

For that matter, let's dive into the trial.

What were the feelings that came up for you when you realized the first time?

But then also the second time you tried?

These are double blind studies, so even the scientists didn't know whether you were getting a placebo or the psychedelic.

And both times it sounds like you got the placebo.

I did, you know, it's interesting.

You got to ask yourself, i a study like this, double blind, who can honestly say they wouldn't know the difference between taking niacin, which is what the placebo was or psilocybin.

I mean, it's quite evident to anybody, right?

It's like there's no question you're either tripping or you're not.

Right.

Yeah.

Exactly.

Right.

It's quit you know, there's no question.

But you know they had to do a double blind.

It's a rigorous scientific study etc.. So so I go in and talk about making it hard to make a movie and ruining the budget.

But I go in for the first one.

I get the niacin, you know after an hour I'm like, oh gosh.

So, you know you kind of sit there and then I then I re-upped and went for another round.

And sure enough I got the niacin one more time.

And so at that point, you know, as the production schedule got closer and closer to edit, I was like, oh God, what am I going to do here?

So I did go ou and I did speak to some amputees who'd been through the study to hear their experienc in case I'd never got a chance.

And then eventually Zeidan was able to get me what's called They basically do an open label version for people who go to the whole study, get the placebo, and then at the end they give them the a known dose so that they haven't done any All this for not.

And so I got my I knew I was going to get it on the third round.

The third time was definitely the char and it was quite an experience.

I'll tell you.

I would love for you to describe that experience for us.

You describe it in the show but why don't we take that time to describe it now, especiall now that you've had a little bit more time to sit with i and kind of process your trip?

Yeah, I found myself, you know, the first hour, I just kind of sitting there and then all of a sudden I just descended and I should tell you, they pu headphones on you and eye shades So it's very muc designed to be inwardly focused.

This is not one of those Michael Pollan walks through nature kind of experiences, a little different kind of take on on and this wa a big dose of psilocybin etc.. So you wouldn't want people wandering around in the woods anyway.

Yeah.

Did they play you a playlist or did they just block out sound completely?

It's a specific playlist.

You can't choose the music they actually choose it for you.

It's very it's big, it's operatic, it's symphonic, and it's it's, you know, a little bit like spa music, you know, that kind of thing, maybe a little beyond that.

I did not fully appreciate how much the musi would engage me in the process.

In any case, I descende into this really ornate world.

It was like the 18th century like I was in this ornate palace or cathedral or something like that, and it was beautiful and the music was going.

And by the way, I was never afraid.

It was intense, but I was never afraid.

So before too long, I was presented with all of my deceased relatives and had really interesting interactions.

But what's interesting about it, at least, is there were no words spoken.

It's like I communicated with them like I had this, you know, mind meld, but I don't recall hearing thei voice from me saying anything.

I was just weeping uncontrollably because I miss my sister, I miss my mother, I miss my father.

And I was telling them how much I wanted them back.

And but I also had this profound sense that everything was okay.

They didn't say it out loud, but I had this direct kind of connection to them where it's okay.

And this was this was important for me.

I had a fraught relationshi with my parents and my mother, and at the time of her death, we were estranged.

And so I, I carry that around.

And I was carrying that around.

And it was a lot of emotional baggage that went along with that.

And this seemed to I sort of got like this feeling that it's okay, it's all right.

And then after that, I sort of found myself in front of them all.

And this include other relatives that have gone to wherever and kind of presenting myself with my new body form, almost saying, her I am seeking approval, I guess.

And I got this distinct sense again that this was okay, you're okay.

Everything has been validated here is being fine.

And then I moved on from there into another space.

I was in this room and there was like this kind of, you know, grim Reaper type character.

It was kind of a darkened face, you know, the Ghost of Christmas Future or whatever.

And he pointed to this bo and there was a slit in the box, and he said, this is where it ends.

And and it was like, oh, and a lot of people face kind of these, you know, deat moments in these, these events.

And I said, you know, no, thanks.

I'm not I'm going to keep going.

See ya.

And I moved on to the next thing.

But I remember in advance of it, you know, my guides told me to, you know, you're kind of in charge.

Don't forget that you're the person in charge.

And as things unfold before you, you can direct things to.

And so that was one of those moments.

And then I found myself, you know, in this beautifu sunshiny, you know, talk about go to the light thing.

I was in this sunshiny moment and there was my wife Susie, and you know, the wind was blowing and her hair was blowing, and she was so beautiful.

And I just had this sense of overpowering love.

And so this was like four hours.

And during the whole experience, I had this profound, intense pain in my shoulder and stump and but it wasn't it wasn't phantom pain.

It was like a physical pain, like I had, you know, hurt, been bruised or something.

And as I emerged from this, that pain went away almost instantly.

And I can't explain that.

I don't know where that came from.

I haven't felt that kind of pain you know, before or after.

And I went home.

I was just exhausted.

You know, you tal about a mental workout, right?

So since then, you know, I don't want to spoil the episode for you, but we're just talking amongst each other here.

I haven't had, like, that magical erasure of pain that Albert Lin had.

Right.

And I've actually had some, you know, some flare ups where it's really hurt, like, you know like the jolts, the whole thing.

But I can honestly tell you that it doesn't bother me in the same way.

And I can't explain that except to say that I think that experience of kind of tackling the dee neural roots of emotional pain that was in the same part of my brain, I think, and I think, you know, that un-dealt with stuff with my family that I feel better about now, maybe is a foundation for making this pain more manageable.

I'm maybe I'm not saying that very well, but I do think that there's the connection between emotional and physica pain is greater than we imagine, you know?

Right?

Right.

Yeah.

It seems like these psychedelics do so much to just help us be embodied, to like really in our bodies.

And that seems to help maybe unlock or frack some of the material that gets locked in our unconscious and makes it more consciou and in making it more conscious.

It's a kind of reframe, possibly.

Yeah.

So I think I think you're onto it.

So, you know, when I, I was talking to my guides through the whole thing afterwards and I said you know, I'm not particularly a religious person, I' not a religious person at all.

And so I said, so where, where, where are my relatives?

Are they in here, you know, chemicals.

And then I've just accessed them.

Or are they in some quantum space, you know, that I can't imagine or know.

And they said, well, who knows?

And then they said the most important thing was, does it matter?

Does it matter?

You know, i is the matrix in our head right.

Is the is our abilit to transcend our consciousness all in here?

It's really interesting.

And so since since the whol experience, I've been, you know, I dabbled in meditation, I've been doing more, more and more meditatio because I think it is connected.

And do you do any of these things because it's really.

Yes, absolutely.

I think it's helped.

Yeah, absolutely.

I think it's really important, like I said to make some of our unconscious or subconscious material more conscious, you know, and it helps us.

Yeah, yeah.

Not only deal with our own stuff, our own baggage, but be more compassionate to other human beings and other creatures.

A lot of folks who take psychedelics talk about that oneness with nature, for example, like I am also the tree and I am also the stream.

And that is really powerful.

It's really powerfu in remembering and not getting caught, caught up in kind of our daily irritations.

Yeah.

No, it's it's nice to be reminded that we really ar part of something much bigger.

We are part of this universe.

You're right.

I think we get so, you know, you know, we're so micro and thinking about this, you know, some stupid thing, some deadline or whatever that w that we forget all these things.

And yet, as you say, those things that are unconscious as we go through our lives, they are there and they're talking at us one way or another.

And so to address them is so important.

I think I don't want to b in the position of recommending anything illegal, bu I cannot tell you how meaningful that experience was for me.

It really was.

And I said, well, you know, I'll come back next week and do it again.

And they said, no, slow down, slow down, cowboy.

Well, that does bring me to my next question, Miles, because I'm curious what the risks are for this type of treatment.

You mentioned in the episode that psychosis can be a risk.

Addiction can be a risk for other kinds of treatment that are journeys like this, like ketamine, for example, can be addictive.

What are the risks here when it comes to Fadel Zeidans study?

It can be really scary.

I think, you know, and it can lead to psychosis in certain circumstances.

It's rare, but it does happen.

You know, peopl you've heard about the bad trip where people don't come back.

Now, I think at my age my brain is pretty well, you know, baked, so to speak.

But, you know, when people are younger and their brains are more plastic, things can go awry if there's underlying depression already, for example.

So this is something that people should really think about carefully.

And I highly recommend that if people want to do this for its therapeutic value to find, you know, there are places in the US and in the world where it's legal to do this, and people will guide you through it in a educated, smart way.

You know, in my case, I was in a, you know, double blind, FDA approved, DEA approved study.

I've got two psychologists in the room with me.

There's a doctor down the hall with, you know, some meds that would, you know, make me feel better if I was anxious and was not having a good trip, so to speak.

So I can't imagine a safer way to do it than what I did for people just to run out and stuff some magic mushrooms in their in their mouth, and expect that to have the same effect that I had.

I think that would be a bit of a crapshoot, but I will say the risk is overall it's low.

I mean, this i this is medicine that, you know, humans have been interacting with for thousands of years.

You know, Europeans, we in the Wes have kind of not looked at this, have kind of ignored this, but it's been there.

It's been used for a long, long time.

What's next for this study out of UC San Diego?

Well, they're going to do.

They'll do 60 more.

And this time they will look into, you know, the efficacy and more significant ways.

But, you know, here they did this small study, which I was a part of, which was really about just, yo know, tolerance, safety, etc., and but they got data that just blew them away, you know, like 80, 90% positive pain improvements, you know, in some cases completely wiping it away.

And, you know, I can't say it didn't it didn' erase my pain, as I tell you, I but I do live with it in a different way.

And it's it's changed my you know, our relationship to pain is so important Pain needs an audience.

Right.

And if you if you allow yourself to, to get into that circle, that kind of pain cycle, it can only get worse.

And so I think that there's somethin about what that did to my brain, which made me look at the pain in a more almost objective.

I can sort of stand away from it, which is a weird thing to think about.

Even the two of us talking right now and you telling the story.

And thank you for sharing.

Two of your trip is important.

I recall, you know, an important reminder towards the end of this episode, which is that the efficacy is greatest for this kind of treatmen when paired with talk therapy, when there is somebody where there are guides, or you have a therapist that you can talk to about your journeys, yeah, it's really important.

And, you know, a couple things.

You're going to have more success if you're guided through it and you're prepared for it.

I mean, I literally had a, you know, a trip plan, you know, on what I was going to d because I had several sessions with the psychologist in advance to talk about, you know, what are what are your expectations?

What do you want to do?

What do you expect to see?

What will, you know, literally walking me through?

Yeah.

The intention is so important.

Right.

And so I really had an idea of you know, where I wanted to go and what I wanted to accomplish, obviously.

And I think that was really helpful.

So I would highly recommend that people find, you know, sometimes, you know, set and setting is important.

Find the right place with the right people.

They can give you that kind o guidance because it's, you know, it's such a powerful too if it's guided in the right way.

The other thing that's important that Gould brings out is that, you know, there should be some good follow on as well, because you are, after all, you know, taking your brain, in some cases to a plastic state that would make you like a six year old in some cases.

Right.

And that's something that you just don't want to leave somebody after they're done on the side of the road.

You need to follow up and make sure everything is okay, because there's a responsibility that goes along with that.

Love.

Gul Dolan also just she's just a great character.

I love her whole vibe.

I love her whole energy.

As we say here in LA.

I love your energy.

I'd love to do a whol separate film with her so well.

Thank you so much for all of this, Miles, and your vulnerability and sharing this experience with us.

That's it for this one and we'll talk to you guys next time.

Resolve to Solve with Miles O'Brien is a co-production of Mobias Media and Arizona PBS.

You can watch the show at azpbs.org/resolvetosolve this podcast is a productio of Central Sound at Arizona PBS.

Our video editors are Matthew Anderson and Macie Logan.

We get audio support from Joe Miller and Daniel Bevc.

Our producer is Anna Williams.

Executive producers Alex Kosiorek, Carol Yancho, Sco Woelfel, and Miles O'Brien.

I'm your host Elise Hu.

Thanks for joining us.