The global psychedelic community is taking over Denver, Colorado from June 19-24 for Psychedelic Science 2023, presented by MAPS. Psychedelics Today is an official media partner, and we’ll be on the ground with 10 team members through the duration of the entire event at Booth 834, so be sure to stop by. We’re looking forward to participating in various talks, activations, and events throughout the week. And most importantly, we can’t wait to connect with our community.
Here’s where to find us in the flesh.
Monday, June 19:
5:30 p.m. – 9 p.m.: Calling all ketamine clinicians and practitioners! Join Psychedelics Today, SoundSelf and Being True To You at Lounge CashoM to kick off the conference. This event is specifically curated for ketamine clinicians and practitioners eager to connect with other like-minds, and to learn about new tools, cutting-edge research, and resources to help support their practice.
4 p.m. – 6 p.m.: Join Samantha Sweetwater, Holos and Psychedelics Today at Lounge CashoM for WHOLENESS: Building Capacity for a Real Psychedelic Renaissance. An evocative book reading, panel and networking space.
6:30 p.m. – midnight: You’re invited to an intimate and educational functional mushroom culinary experience with Mount Mushmore and Fungtion, followed by a vibey after party with music by BOSA at Lounge CashoM! Tickets are on sale now, and capacity is limited.
7 a.m. – 7 p.m.: Find Psychedelics Today on the expo floor at Booth 834.
Cost: Free with Conference Pass Registration not required.
Thursday, June 22
7 a.m. – 7 p.m.: Find Psychedelics Today on the expo floor at Booth 834.
Cost: Free with Conference Pass Registration not required.
8 a.m. – 9 a.m.:Your Psychedelic Morning Show. Brought to you by Psychedelics Today Co-Founder Joe Moore and The New Health Club Founder Anne Philippi on the Marketplace Stage. Join us for surprise guests, unexpected questions, and wake-up calls!
Cost: Free with Conference Pass Registration not required.
11 a.m. – 12 p.m.: Pain and Psychedelics Association (PPA) Meetup. Join Joe Moore and Court Wing for a presentation in the PS2023Press Room.
Cost: Free with Conference Pass Registration not required.
4 p.m. – 6 p.m.: Explore ceremonial filmmaking with Entheogenic Roots – Indigenous Origins of Psychedelic Culture for a trailer screening and Q&A with Producer Youchanan Russel, with musical performances and more at Lounge CashoM.
6:30 a.m. – 8 a.m.: Calling all early birds! Join us for theMindful Miles 5k run with Heroic Hearts Project, in an event benefiting veterans and their families to overcome military trauma. (sign up)
7 a.m. – 7 p.m.: Find Psychedelics Today on the expo floor at Booth 834.
Cost: Free with Conference Pass Registration not required.
8 a.m. – 9 a.m.:Your Psychedelic Morning Show. Brought to you by Psychedelics Today Co-Founder Joe Moore and The New Health Club Founder Anne Philippi on the Marketplace Stage. Join us for surprise guests, unexpected questions, and wake-up calls!
Cost: Free with Conference Pass Registration not required.
4 p.m. – 6 p.m.: Vital Student Meet Up at Lounge CashoM
Psychedelics are a fascinating class of compounds that have potent effects on our consciousness. After a multi-decade hiatus, scientific research on psychedelics has now resumed with full force. One field that has rapidly developed in recent years is psychedelic neuroscience, which applies the cutting-edge frameworks and tools of modern neuroscience to understand how psychedelics affect the brain and nervous system to elicit their profound effects. The latest findings from this breakthrough field have increasingly spilled into popular culture and are often profiled in the media – it’s now commonplace to hear terms like ‘default mode network’ and ‘neuroplasticity’ casually thrown around when discussing psychedelics and their effects.
However, much of the research is quite technical, and typical media treatments are often either highly simplistic and watered-down, or plainly inaccurate and sensationalistic. Most people just don’t have the necessary background to properly understand and communicate findings beyond repeatable buzzwords and trickle-down narratives.
It’s easy to wonder: what’s the practical relevance of psychedelic neuroscience for psychotherapy or for individuals navigating their own psychedelic experiences?
Don’t Worry – It’s Only Temporary
Understanding the science of psychedelics can be really helpful for therapists and clinicians preparing their clients for psychedelic experiences, and helping clients conceptualize and understand their experiences afterward. Psychedelic experiences can sometimes be quite overwhelming and hard to make sense of. It can be challenging to experience the profound alterations of consciousness they can elicit, which span from complex dream-like images and vivid memory recall, to ego-dissolving mystical-type effects, to perceptual distortions and synesthesia.
By reminding and reassuring clients that the intense effects they are experiencing are directly related to temporary changes in brain activity, clients may be less concerned that they are “gone without return” or that there is something inherently “wrong” or “bad” about their experience. It can also provide a useful model or framework to ground and interpret what emerges during their journey. They can rest assured that no matter how radical and reality-shattering their psychedelic experience is, it’s being underpinned by temporary changes in how brain regions are communicating and interacting over time.
Predicting the Unpredictable
Research has found that an individual’s psychological traits and brain characteristics can help predict the nature of their psychedelic experience, as well as the likelihood that they might experience long-lasting therapeutic benefits. The principles of ‘set and setting’ are deeply ingrained in psychedelic therapies, and signify the integral role that context plays in determining therapeutic outcomes. ‘Set’ concerns one’s mental and emotional state immediately before the psychedelic experience, encompassing such facets as personality and mood. Meanwhile, ‘setting’ pertains to the physical, social, and cultural milieu in which the psychedelic is taken. Given that traits and moods have been shown to correspond with differences in brain function, it is likely that brain structure and function may prove effective in predicting subjective effects and treatment response. This ‘precision medicine’ approach – using brain markers to forecast how individuals will respond to a given drug – has been applied to antidepressants and ADHD medications, providing a precedent for such a strategy in the realm of psychedelic therapy.
Their findings also appear to suggest that priming subjects to reduce theta power before taking a serotonergic psychedelic may help increase the depth of their mystical experience. For example, an individual could reduce theta with neurofeedback training, in which feedback from an EEG headset would allow them to modulate their brain activity to achieve a desired brain and psychological state. Although further research is required before any definitive conclusions can be drawn, emerging research like this suggests that capturing information about brain states – beyond what can be subjectively reported – may prove to be a valuable tool in predicting an individual’s psychological readiness for a psychedelic experience.
The Nuances of Psychedelically Boosted Neuroplasticity
The proliferation of interest in serotonergic psychedelics, MDMA, and ketamine is in no small part due to their remarkable ability to act as ‘psychoplastogens’ – compounds that enhance neuroplasticity in the brain. Neuroplasticity refers to the ways in which neurons in the brain change their connections with each other or create new ones, which is critical for the brain’s ability to learn, adapt to new experiences, and recover from injury. Psychedelics’ ability to enhance neuroplasticity has frequently been highlighted as central in eliciting therapeutic effects across a range of mood disorders and stress-related conditions such as depression, anxiety, and PTSD, which makes sense because impaired neuroplasticity has been reported for all of these disorders.
Research in rodents has suggested that, generally, for most psychedelics, the period between six and 72 hours post-psychedelic experience is when neuroplasticity is at its highest.
However, changes may last for much longer. For instance, LSD has been shown to promote the expression of neuroplasticity-related genes in rodents even one month after treatment had ceased. More and more research is being conducted on these effects, but there is clear practical relevance for clinicians, therapists, and everyday people. Understanding the nuances of psychedelically boosted neuroplasticity – including how long the effects last and where in the brain they occur for a given substance – is critical for designing optimal integration practices.
An in-depth understanding of psychedelic neuroscience can serve as a valuable tool for therapists and individuals seeking to navigate the intricate and potentially transformative realm of psychedelics. Familiarity with scientific research can empower practitioners to tailor their approach to preparation, the acute experience itself, and integration, thus optimizing therapeutic outcomes.
What’s more, the field of psychedelic neuroscience is profoundly intriguing and sometimes referred to as the “quantum mechanics” of neuroscience – neuroscientists are exploring the frontiers of consciousness with a cutting-edge discipline, and unearthing fascinating gems along the way. For example, did you know that psychedelics can enhance the firing rate of excitatory neurons in rodents’ prefrontal cortex by an astounding 481% over baseline, significantly altering communication throughout brain networks? Did you know that research is uncovering that the brain effects of psychedelics might also be tightly linked to our immune system and microbiome, with relevance to mental health? Or that both MDMA and LSD increase oxytocin levels, which plays a role in social bonding?
These and other fascinating discoveries will be covered in our upcoming eight-week course, “Psychedelic Neuroscience Demystified: How Psychedelics Alter Consciousness and Produce Therapeutic Effects.” This course was designed to be accessible to clinicians, therapists, and curious everyday people, making students well-versed in this emerging field, giving them the ability to understand new findings, put them into practice, and be informed participants in ongoing discussions.
The Multidisciplinary Association for Psychedelic Studies (MAPS) is hosting its fourth Psychedelic Science conference this summer: Monday to Friday, June 19 to 23, at the Colorado Convention Center in Denver.
With over 10,000 expected guests, never before has the global psychedelic community gathered at this scale.
Evolution of the Psychedelic Science Conference
Since 1990, MAPS has organized gatherings to support psychedelic research. These events have strengthened the global psychedelic community, occasioning new research collaborations, business partnerships, and lifelong friendships.
MAPS Founder Rick Doblin, Ph.D., and Alise Agar Wittine, Coordinator at the Omega Foundation San Francisco, initiated the first single-day gathering, “Regulation or Prohibition: Psychedelics in the 1990s,” at the start of that decade. Psychedelic luminaries Ram Dass, Terence McKenna, Ralph Metzner, Timothy Leary, Laura Huxley, and Native American Church President Emerson Jackson all spoke at the initial event.
Over the next 27 years, MAPS organized the 1993 Psychedelic Summit, the 2006 MAPS 20th anniversary celebration at Burning Man, the first Psychedelic Science conference in 2010, followed by Psychedelic Science 2013. Finally, Psychedelic Science 2017 took the conference to new heights, hosting over 3,000 attendees and hundreds of talks, vendors and exhibitors, film screenings, entertainment acts, and community forums.
As an event both responsive to and generative of the rising interest in psychedelics, MAPS’ Psychedelic Science conference has proved to be in a fractal relationship with the field itself – growing and changing as the field grows and changes.
And there has been growth indeed in the five years since PS17. Regulated adult use of psychedelics is no longer just a policy goal: it is underway in Oregon and Colorado. Mainstream audiences are tuning in, and many have been seeking out ketamine clinics to treat mental health conditions. Even once-unbudgeable federal attitudes could be softening.
Psychedelic Science 2023 aims to cover it all.
Psychedelic Science 2023
To provide orientation in the deluge of exciting talks, the conference’s 300-plus speakers have been sorted into multiple tracks: therapy, clinical trials, studies, science, business, veterans, policy, society, and plant medicines. Attendees can pick their own adventure.
The Business track will take a close look at the state of the industry. Executives and entrepreneurs will have a chance to tap into the thriving network of industry wisdom while considering the big question: how can we steward a culture of cooperation and reciprocity in this new field, and even “psychedelicize” our idea of business itself?
The Clinical Trials, Science, and Studies tracks will provide that nourishing chicken soup of psychedelic conferences: updates from the latest clinical research and neuroscience findings, and considerations for future studies and study design.
The Plant Medicine and Society tracks offer an opportunity to explore and celebrate ancient ceremonial traditions and underground communities. How can we match the healing potential of plant allies with ethics, reciprocity, and harm reduction practices?
The Policy track will explore the front edges of drug policy reform, including updates from federal-level reform efforts, and the challenges and opportunities of implementing psychedelic legislation in Colorado and Oregon.
Finally, attendees invested in the intersection of psychedelic treatments with veteran populations, as well as first responders and athletes, will have a chance to hear from Super Bowl champion quarterback Aaron Rodgers and combat veteran Jesse Gould, among others, on the Veteran track.
Community Building
Through over half a century of prohibition, the psychedelic community has kept its fire lit through small and often clandestine meetings and underground networks. But things are changing. With psychedelic conferences happening year-round across North America and Europe, it’s easier than ever to connect.
Psychedelic Science 2023 aims to create something more special still. With thousands expected to descend on Denver in June, the event will bring together folks of all stripes from across the world. A gathering of this scale represents a chance to step out of our digital environments and truly experience the strength and diversity of the growing field. It is a chance to participate in the community it offers, and to have a say in its unfolding culture and values.
To this end, the conference will offer a number of networking spaces, including a dedicated community partner stage for the many local psychedelic societies, non-profit educational and advocacy groups, harm reduction services, and indie media efforts supporting the conference. These are the groups setting a high bar for the field’s values and creativity.
And these are the groups running the conference nightlife, because friends aren’t made by sitting next to strangers in auditoriums! From Psychedelic Drag Bingo, to a 5k run with veterans, to grad student mixers, to cacao ceremonies, to end-of-week dance parties, PS23 will have endless opportunities to connect.
Many come for the talks and panels, but those who know, know. This is where the magic happens.
The Start of A New Era
The legacy members of the psychedelic community have seen this field reach a public recognition that many did not anticipate in their lifetime. Among those who made this possible, few may be as significant as Stanislav Grof, MD, and Roland R. Griffiths, Ph.D. Both will be present at the conference.
Stanislav Grof is best known for his work with LSD extending back to the 1950s, as well as his development of holotropic breathwork. It is hard to overestimate his influence on psychedelic research and integration practices. He will give the conference’s opening address.
Roland Griffiths’ research on psilocybin and consciousness at Johns Hopkins University is often cited as igniting the current renaissance of psychedelic research. Recently, he has reflected publicly about his cancer diagnosis. He will be guiding some of the Science track sessions, and will be present for a three-course dinner in his honor.
For these two luminaries, PS23 may mark their last major public appearances. Indeed, with so many other prominent psychedelic figures present – including Dennis McKenna, Ph.D., Amanda Feilding, Paul Stamets, Rick Doblin, James Fadiman, and William Richards, Ph.D. – the event may be the last time this particular generation of psychedelic elders find themselves under one roof.
This is a chance for attendees to mark the end of an era, and to celebrate the start of a new one.
Register Today
Registration for Psychedelic Science 2023 is still open. Visit the website for a detailed event agenda, speaker lineup, and to register. Use code PT15 for 15% off tickets on checkout.
This post is part of a 2023 media sponsorship between Psychedelic Science 2023 and Psychedelics Today.
Have you attended a psychedelic industry conference over the past few years? Gone are the days of few-and-far-between events, and the lone, massive annual psychedelic happening that one simply must attend if they want to keep up on new research and development. It’s 2023, and the psychedelic conference circuit has become a bonafide industry in and of itself.
With dozens of new psychedelic-focused events springing up ’round the globe in recent years – from Oakland to Reykjavik to Tel Aviv – one can tap into this global network of entrepreneurs, activists, and psychonauts, and really choose their own adventure for the first time in psychedelic history. Interested in learning about the commercializing of psychedelics? Perhaps applying insights to your own life or business ventures? Or how about simply keeping up on what’s happening at the vanguard of the psychedelic industry that’s rapidly evolving (for better or worse)? Chances are, there’s a psychedelic conference for that.
My Psychedelic Conference History
I first became aware of the mainstream psychedelic industry conference circuit when I attended the Horizons: Perspectives on Psychedelics conference in New York City in 2022. For those unaware, Horizons is the longest-running psychedelic conference in the world (15 years and counting!), and for a long time, was unmatched in its size and scope.
The day before Horizons’ official programming started, I was invited to a pre-party hosted by journalists Josh Hardman and Shayla Love at Shayla’s apartment in New York City. I counted my lucky stars for my extroverted personality, as I found myself awkwardly wedging into established circles and cliques of prolific psychedelic journalists, academics, and entrepreneurs who all seemed to know each other already. Curious about how they all became friends, I asked how everyone seemed to know each other so well. Without skipping a beat, three people simultaneously answered: “Conferences!”
The psychedelic conference circuit has become the place to connect with, learn alongside, and build a meaningful sense of global psychedelic community that is arguably impossible to establish or replicate quite as intimately in a digital environment.
Admittedly, when I launched the Mycopreneur Podcast in January 2021, I had never heard of any of these conferences. Despite being a deeply committed psychonaut and media producer since 2006, I was unaware of the existence of psychedelic conferences until I was invited to Meet Delic in November 2021.
Since then, I’ve been invited to a number of major conferences as press, moderator, and a panelist, and am set to present at and report on considerably more major international conferences throughout the rest of 2023.
I’ve been to eight major psychedelic industry conferences to date, and another dozen or so well-attended underground conferences and festivals across three countries over the last two years. Here are my top tips for maximizing ROI at psychedelic conferences.
1. Clearly define your goals ahead of time
My first psychedelic conference experience felt like a piñata swinging contest, whereby I blindly maneuvered around in search of my bearings and an actionable game plan. The whole time, I felt like I was a step behind everyone and was unsure of the optimal protocol and conference flow. Luckily, Liana Gillooly of MAPS took me under her wing to help me navigate the numerous conference-adjacent events happening in that week, and to help me infiltrate an exclusive afterparty for the Palo Santo fund where I loaded up on prosciutto and camembert cheese while masquerading as the heir to a Connecticut hedge fund fortune.
I left Horizons feeling like I had one foot in the door of the ‘psychedelic industry in-crowd’ (which, yes, is a thing) and recognized the value of investing in attending conferences at all.
When the opportunity surfaced to join the press corps at Wonderland in Miami one month later, I jumped on every connection I had in the area to make it happen. This time, I was ready.
I clearly defined my goal for the event: meet as many people as possible, and get contact info for the ones that resonated with me. I take a shotgun approach to networking, which is more of a benign tactical strategy than a hostage situation, but I whittle down the ‘call to action’ group for following up after the conference with people that I really see myself building and collaborating with.
I managed to connect with at least 100 people at Wonderland in face-to-face conversations and afterparties, and I followed up with a few dozen of them after the event. Some of these meetings and connections have prospered into ongoing friendships and business relationships that have returned great value to my life and platform.
What are your goals? Expanding your network? Finding sales leads? Or simply to make more sense of psychedelics and learn? Write them down. Look at your goal statement periodically throughout the event – does the way that you’re tackling the conference, the presentations and panels you’re taking in, and the people you’re spending time with align with your goals? If not, adjust. Rinse, and repeat.
Dive deep into our brand new live 8-week course that explores the seemingly elusive intersection of psychedelics and neuroscience, led by Melanie Pincus Ph.D. and Manesh Girn. Classes begin May 17. Sign up before April 12 for $100 off.
2. Get real about your budget and resources
Conferences can be extremely expensive. If you can’t afford to make the trip and you don’t have an employer backing you, they’re 100% hackable – if you’re resourceful.
I’ve rented Airbnbs one hour away from a conference and commuted on public transport because it was all I could justify affording. Sleep on people’s couches and air mattresses if you have to. I’ve eaten bread and hummus from the grocery store on many occasions, skipped meals, and even better, loaded up on deli meat and cheese from platters at afterparties. Like anything, you get out of these events what you put into them – so eschew any sense of expectation or entitlement, and focus on defining why you’re there in the first place and executing on your game plan while leaving some room open for spontaneity and the magic of psychedelic community.
Prior to Wonderland, I reached out to Miami psychedelic community stalwart Ray Oracca of Moksha Arts Collective, who had extended an open invite to me to do stand-up comedy at their art gallery earlier in the year. Once I made a deal to stay at the Moksha studio for a week in exchange for a stand up performance, I used credit card points to book the cheapest, most inconvenient flight I could find to Miami. I think I had seven layovers en route, and three of them were in Las Vegas. I didn’t even have a ticket when I showed up, banking on finagling my way in by insisting that I was related to Bob Parsons. The day before the conference kicked off, an unexpected VIP pass showed up with my name on it thanks to Ray and the Moksha community. This type of magic happens more than you can plan for on the conference circuit, and plenty of people arrive at a conference without a ticket and capitalize on the networking and afterparties that surround the event. Almost every event has room for volunteers, media, and programming support, so offer yourself up.
Do you have the finances to afford attending the event? If not, will your employer support your trip? If all else fails, ask yourself: “who do I know, and what can I offer that could help fund my event experience?”
3. Find the others
This is probably the most important angle of the conference circuit. At SXSW in Austin earlier this year (which was jam-packed with psychedelic programming), I was so overwhelmed and baffled by the first half of day one that I considered going back to my friend’s house and spending the day with his dog instead. It took everything in me to come to terms with the madhouse frenetic environment of the convention center and downtown Austin; I spent two hours sitting cross-legged on the floor trying to ground myself by chanting the mantra “psychedelic renaissance” over and over until it became a meaningless verbal Rorschach test.
This all changed when I connected with my friend Peter Vitale, who is an excellent steward of community and psychedelic lawyer (which is actually a more sober and jurisprudential vocation than Hunter S. Thompson’s attorney in Fear & Loathing in Las Vegas would have you believe – though there are certainly some overlapping elements).
Peter got me dialed in to the wider and more connected community of psychedelic industry folks who were at SXSW, as opposed to the more scatterbrained approach I was taking wherein I just kept attaching myself to the fringes of Paul Stamets’ entourage. Connecting with a critical mass of aligned people is key to a successful conference experience. Finding likeminded people enables you to move with the ebb and flow of the group, and to break off into satellite groups with one or two people at a time for side quests as you see fit.
This is a big one for many people hoping to build and scale their networks and businesses. I learned this one the hard way in my early days navigating the music and entertainment industry, when I shot my shot far too often without any sense of connection or community framework to the people I was pitching myself to. Quentin Tarantino doesn’t care that your new script has a scene where he gets anally probed by proboscis monkeys with AI capabilities when he’s just trying to have a nice dinner out with his family in Tribeca, and the same principle rings true among the psychedelic conference circuit movers and shakers.
I’ve seen the same thing happen time and again as this industry continues to ascend, but this time, I’m the one who receives the unsolicited pitches and million-dollar ideas that sound far better on ketamine than on paper. It’s best to build rapport with people and communities first before trying to sell them on your project – people buy into you as much (if not more) than what you’re working on, so establishing trust and relationships is key. Be patient. As you continue to hone your network, you may find yourself invited into projects and opportunities that serve to strengthen and add value to your own work.
5. Pace your partying
I learned this one the hard way after Wonderland. I actually quit drinking largely because of my experience at the Wonderland afterparties. Open bars and a taste for mezcal are awesome for stags and the Gathering of the Juggalos, but not always great for professional networking. This, of course, depends on your intention that you’ve clearly stated as your reason for being at a conference (see tip #1). Considering my standard goal is to effectively and meaningfully network and add value to other people’s organizations while elevating my own platform (and also to pick up new satire material, because I can’t switch that part of my brain off anymore and industry types are often unintentionally hilarious), blacking out and rambling about boofing Hape on camera for a professional film crew at an exclusive afterparty sponsored by a high-profile company is, arguably, detrimental to the cause. I’ve seen this kind of thing happen a lot, and while some may not hold it against you, it’s probably not the look you’re going for. Don’t be the person from the afterparty everyone talks about the next day.
In parallel, it’s essential to stay hydrated, on point, and ready to pivot at any moment. Opportunities arise on the fly, and you need to be positioned to jump on them. During events, I’ve received many unpredictable invites to meetings or opportunities that require precise timing and preparedness, so I’ve learned that my phone must always have a charged battery, and that I’m ready to jump in an Uber or navigate to a second location at a moment’s notice. You can’t do that when you’re busy staring in disbelief at galactic swirls in your fingerprints all night.
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At each subsequent conference I’ve attended, I’ve refined my approach to include eliminating alcohol and substance consumption from afterparties to stay sharp and on the ball. I’m usually a solo macrodose tripper, and conferences give me all the social fulfillment I need without surrendering my consciousness to a trustafarian shaman with a Hape applicator and really good MDMA.
As Salvador Dali said: “I don’t do drugs. I am drugs.” Okay, fine. I’ll try some of your mushroom chocolate if you twist my arm.
6. Find the WhatsApp and Signal Groups
There’s virtually always some kind of group chat thread where invitations to the afterparties and unique events that are not officially announced anywhere are posted. If you see someone who works with an established psychedelic company, flag them down and naively inquire about the existence of such a group. Use blackmail if you have to. It’s great to have an overview of the conference atmosphere and what people are doing, and you can take and leave the invitations to panels, parties, and events as you see fit. You don’t have to go to everything, but if you don’t know, you can’t go.
7. Carve out time for 1 x 1 meetings and collaborations
Going to lunch with people, building personal relationships, and dreaming up plans and projects together is what it’s all about for me. The best way to bypass the digital age of impersonal queries and project proposals is to meet people IRL. I’ve sowed the seeds of projects during five-minute conversations with people at conferences that have taken over a year to manifest. If you can steal a few minutes away to eat meatball sundaes with Kyle Buller while the Psychedelics Team shops for rugs at IKEA before Cannadelic Miami, do it.
Get people’s phone numbers and keep in touch with them. Don’t just hit people up when you need something from them or want to sell them on something. If you have a chat about pygmy elephants with someone at a conference, and you click, then text them the next time pygmy elephants come up in your life (this happens surprisingly often in my world). Text or call people on their birthdays, show an interest in what they’re doing, and look to add value to their lives and be a resource rather than trying to extract value from them.
I can’t over-emphasize the importance of showing up wherever you can. Take a leap of faith and put yourself out there.
Hit the Ground Running
Are you looking for an upcoming psychedelic happening to attend or support in 2023? Psychedelics Today wants to see YOU at these great upcoming events:
DiscoveryCon 2023: Taking place on April 18 – 19 in the Bay Area, this gathering of the psychedelic community includes an impressive lineup of speakers including Robin Carhart-Harris, Hamilton Morris, and Bia Labate. DiscoveryCon will be held on Bicycle Day, the anniversary of the first intentional LSD trip taken by Dr. Albert Hofmann (use code PSYCTODAY for 30% off tickets).
Breaking Convention: Europe’s largest psychedelic consciousness conference is happening April 20 – 22 in Exeter, U.K. Breaking Convention offers groundbreaking research and insights across disciplines such as human and social sciences, law, politics, art, history, and philosophy (use code PSYCHTODAYBC10 for 10% off tickets).
Trailblazers NYC: Happening April 24 – 25 in New York City, Trailblazers brings together entrepreneurs, investors, and other leaders in the psychedelic industry.
PsyCon: Scheduled to take place in Portland, OR from May 19 – 20, this event will focus on the emerging psilocybin market in Oregon, featuring speakers including Lamar Odom, Yolanda Clarke, and Del Potter. A second PsyCon event is being held in the fall (from Sept. 29 – 30 in Denver, CO.)
Psychedelic Science 2023: Organized by the Multidisciplinary Association for Psychedelic Studies (MAPS), Psychedelic Science is set to be one of the longest-ever psychedelic conferences. Held from June 19 – 23 in Denver, CO the event features research on psychedelics, therapeutic uses of psychedelics, and the impact of psychedelics on society (use code PT15 for 15% off tickets).
Psychedelics, once heavily restricted for research, are now being rigorously tested through clinical trials to explore their potential therapeutic benefits. But how are women represented in the search to uncover the efficacy of psychedelic medicines?
While the inclusion of women in psychedelic clinical trials is clearly important – both to understand the effects of these medicines on all genders as well as to develop effective treatments for conditions that primarily affect women – women have historically been underrepresented in clinical trials.
Why has this become the norm? Is it because women aren’t as available as men to participate in studies? Or perhaps women don’t suffer from the illnesses being studied as often as men?
Spoiler: it’s neither.
The Clinical Trial Process – An Overview
The clinical trial process is, largely, a series of research studies that evaluate the safety and effectiveness of new drugs, treatments, or medical devices on human subjects. To fit into a pharmaceutical model, a.k.a. develop a drug or treatment protocol that clinicians can prescribe and health insurance will cover, psychedelic medicines must follow the same clinical trial process that all new drugs and treatments undergo.
If it seems like there’s a new clinical trial announced each week – from psilocybin for depression to MDMA for PTSD to LSD for cluster headaches – it’s because these trials are crucial (and non-negotiable) for biotech companies seeking to bring their compounds and modalities to market. These trials aim to prove the effectiveness of a particular compound or method of use, and ultimately secure the holy grail of U.S. Food and Drug Administration (FDA) approval.
Clinical trials are conducted in several phases, each with specific goals:
Phase 1: A small number of healthy volunteers receive the drug or treatment to evaluate its safety and determine the appropriate dosage.
Phase 2: A larger group of volunteers with the condition that the drug or treatment is designed to treat receive the treatment to assess its effectiveness and side effects.
Phase 3: An even larger group of volunteers with the condition receive the treatment in a randomized and controlled study to confirm its effectiveness and monitor side effects.
Phase 4: The drug or treatment is approved and marketed for public use, and ongoing studies continue to monitor its long-term safety and effectiveness.
Throughout the clinical trial process, participants are closely monitored and data is collected to evaluate the drug or treatment’s safety, efficacy, and potential side effects.
The objective was to avoid unforeseen birth defects in babies born to women in clinical trials. The result, however, is that most currently prescribed medications were approved by the FDA before 1993 – which means they’re prescribed to women and men at the same dose and were unlikely to have adequate representation of women in their clinical trials.
Francesca Minale, President of Vici Health Sciences and an expert at working with the FDA to bring new medications through clinical trials to approval, says the lack of gender differentiation in dosing persists despite known differences in disease states by gender.
“There is a lack of incorporation of gender data and generic specific dosing and administration on FDA-approved prescription labels,” said Minale. “This gender bias in the research needs to be addressed, especially as it is well documented that many diseases, such as mental health or heart disease, are recognized to have gender differences.”
Excluding women from early-stage clinical trials led to a vast shortage of data around how today’s drugs affect women – a knowledge gap that scientists are still trying to fill. Even though the NIH now requires women to be included in all clinical research funded by the government agency, there are still many criteria that make it difficult for women to participate in clinical trials.
Women in Psychedelic Clinical Trials
The results of clinical trials play a critical role in informing regulatory decisions about whether to approve new medicines for widespread use. However, in the past, clinical trials often failed to accurately reflect the populations they intended to serve – especially women.
As psychedelic clinical trials seek to determine the safety and efficacy of new psychedelic treatments, it’s imperative we learn from past mistakes. A recent study identified 86 medications approved by the FDA that are more likely to cause complications for women than men.
But yet it’s common practice to prescribe equal doses of medications to men and women – contributing to the overmedication of women and female-biased adverse drug reactions.
In fact, because women were excluded from many pivotal clinical trials, many drugs have been withdrawn from the market or have had their labels changed to include warnings about increased risks for women after they were already approved by the FDA and widely used.
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Modern Barriers to Women’s Participation in Clinical Trials
Amy Reichelt, Ph.D.,Director of Neuropharmacology at Cybin explained, “In early-stage clinical trials (i.e., Phase 1) where drugs are tested in healthy volunteers, key inclusion/exclusion criteria can bias genders tested.”
Typical protocol wording includes: “Women of childbearing potential (WOCBP) must be non-lactating and have a negative pregnancy test. Females who are not WOCBP must be either surgically sterile or post-menopausal.” Reichelt said. “This immediately excludes a number of women, particularly when age ranges of trials can have cut-offs of 55-60 years.”
Moreover, it is often written into the trial protocol that a woman of childbearing potential must agree to practice an effective means of birth control/contraception during their participation in the clinical trial, and following the trial for several months. This could impact individuals who are trying to start a family for many months, again discouraging women from participating.
Reichelt pointed out, “Later stage trials (i.e., Phase 2b, Phase 3) can be less restrictive as they are testing in patient populations and initial safety tests are fulfilled in the healthy volunteers in early stage trials, but still there are often requirements for contraceptive use that fall upon the women’s responsibility.”
In addition, body weight restrictions may also prevent women from participating if they are below the protocol threshold i.e., less than 60 kg/132 pounds.
Biological Gender Differences and Why They Matter
The differences between the sexes in circulating levels of sex hormones, such as testosterone and estradiol, can affect pharmacokinetic or pharmacodynamic parameters – which help determine how the drug is absorbed, distributed and metabolized in the body, and how the drug affects the body, Reichelt explained.
Body composition can impact how a drug is processed and eliminated from the body, too. “Women typically have a lower body weight than men, so when the same dose of a drug results in a higher level of drug circulating by body weight. As women generally have a greater body fat content than men, some drugs can be distributed through the body differently,” said Reichelt.
The impact of sex can differ across life stages, too. After menopause, the reduction of estrogen can alter aspects of brain plasticity. Preclinical studies have shown that at the neuronal level, estrogen can increase the density of dendritic spines.
This brain phenomena may subtly affect mood and cognition during a woman’s estrous cycle, and could affect clinical outcomes. More studies are needed to fully understand these impacts, especially when it comes to psychedelic medicines which are closely tied to brain plasticity and dendritic spines.
“We don’t yet have a clear understanding of how different biological factors, such as hormonal fluctuations, including menstrual cycle and menopause, may impact the psychedelic experience. However, it does seem that psychedelics may have an impact on menstrual function,” she said.
Gukasyan co-authored a recent study published in the Journal of Psychoactive Drugs on the impact of psychedelics on menstrual function. While the study looked at only three women ranging from 27 to 34 years of age, the results were significant enough to warrant more research.
“Although phenomena related to menstrual and reproductive function have been largely overlooked in the psychedelic literature to date, these effects may have therapeutic utility and warrant further study,” the study concluded.
Where To Go From Here
In the field of psychedelic medicine, where compounds are being extensively studied scientifically for the first time, the underrepresentation of women in clinical trials could have serious consequences for the safety and efficacy of these treatments. Without data on the experiences of women, it is impossible to accurately assess the potential benefits and risks of these new medicines before bringing them to the masses.
By working to increase the representation of women in clinical trials for psychedelics, we can help to ensure that these treatments are developed in a way that is safe, effective, and equitable for all.
Thankfully, many psychedelic clinical trials are moving forward with this ethos. For example, two-thirds of the participants in the MAPS’ Phase 2 and 3 clinical trials of MDMA therapy for the treatment of PTSD were women.
Rick Doblin, the founder of MAPS, said, “When it comes to PTSD, we talk a lot about the veterans, but it’s mostly women who are sexually abused or have childhood traumas that have PTSD. I think that the media attention on veterans sort of distracts people from the understanding that it’s mostly women that we are treating. Two-thirds of the people in the [MAPS] study are women.”
Other groups conducting clinical trials actively seeking women participants include Psycheceutical Bioscience, which has partnered with clinical research organization (CRO) iNGENū in Australia to conduct its Phase 1 and Phase 2 trials of a topical ketamine cream to treat PTSD.
“iNGENū takes gender balance in clinical trials very seriously and the diversity of participants is one of the key metrics we strive to achieve. We naturally want our clinical trials to recruit participants who closely match the intended population who will benefit from the drug when it is eventually approved,” said iNGENū CEO Dr. Sud Agarwal.
Women-Only Trials
While the inclusion of women in psychedelic clinical trials is critical to the success of this new paradigm in medicine, there’s also a whole realm of largely untapped research on the benefits of psychedelics for health conditions experienced only by women.
Felicity Pharma is a psychedelic biotech company focused on women’s health that’s secured a proprietary psilocybin-based drug for premenstrual dysphoric disorder (PMDD), a very severe form of premenstrual syndrome that affects up to 10 percent of women globally as well as postpartum depression.
Olivia Mannix, Felicity Pharma co-founder and CEO, said “We are passionate about transforming women’s healthcare. Women have been traditionally excluded from clinical trials because of hormonal fluctuations and general biological makeup. We are making a stand to develop female-focused therapeutics, where women will be the only patients used in trials.”
As the psychedelic movement expands, with surmounting research serving to change the tide of public opinion, more people are seeking out psychedelics as modalities for healing and self-exploration. Whether in the context of psychedelic-assisted therapy, plant medicine ceremonies, or recreational use, the modern Western psychedelic discourse has long been interwoven with the concept of “set and setting.”
But in contemporary psychedelic culture, the term is no longer sufficient as a harm reduction mantra. How can it be updated to better serve today’s journeyers?
A Brief History of Set and Setting
“Set and setting” refer to many factors which extend beyond the psychoactive effects of a given substance, playing a vital role in shaping psychedelic experiences. Typically, “set” refers to the mindset of a psychedelic explorer and “setting” refers to the context in which a substance is taken.
However, there has been little development of which variables fall under the umbrella of set and setting since its conception in the 1960s. There are significant factors that shape a psychedelic experience – both acutely and in the long term – which aren’t fully captured by set and setting alone.
The concept of set and setting has become something of a harm reduction mantra interwoven with the emergent field of psychedelic-assisted therapy and psychedelic research at large, used to describe the ways in which factors that extend beyond the substance itself can impact and shape its effects. Accordingly, it’s been an impactful linguistic tool that therapists, researchers and explorers have looked to for guidance on curating a container for an experience with medicine.
“Set” commonly refers to an individual’s mindset, including both immediate and long-range states of mind. A person’s immediate set is related to their state of mind before a psychedelic session, including everything from intentions, fears, hopes, and expectations about the session. However, their long-range set might include enduring personality traits, personal history and formative life experiences, social identities, and mental health history.
“Setting” commonly refers to the container of the experience, which includes the physical and social environment within which a substance is ingested, factoring into account when and where it will take place. Thus, setting may include aspects such as music, whether it takes place outdoors or indoors, the decor/props in the session room, as well as the relationships between others present.
The concept of set and setting does not exist independently of culture, with the sociocultural context of set including, but not limited to, race, economic status, strength of relationships with others, and the individual’s access to and relationship with nature.
Timothy Leary, 1960s counterculture icon and ex-Harvard lecturer in clinical psychology, is generally given credit for popularizing the concept of set and setting through his emphasis on the importance of both in shaping psychedelic experiences.
In the cult classic, The Psychedelic Experience, Leary together with his colleagues Ralph Metzner and Richard Alpert reflected, “Of course, the drug dose does not produce the transcendent experience. It merely acts as a chemical key – it opens the mind, frees the nervous system of its ordinary patterns and structures. The nature of the experience depends almost entirely on set and setting.”
To a large extent, the notion of set and setting within Western culture has been shaped and inspired by the ways in which Indigenous cultures around the world ingest psychoactive plant medicines in contexts bound by ritual, ceremonial objects, music, relationship with the land, and cosmological interpretive frameworks.
Compared with Indigenous cultures, Western culture has a bias against the use of psychoactive substances, and despite evidence that the peoples of Europe once used psychoactive plants ritualistically, such traditions have been long forgotten. Cultural frameworks determine the lens through which psychedelic experience is interpreted, and the lack of a cultural context, beyond that of prohibition, within which to make sense of psychedelics in the global North has produced a need for the ongoing formulation of set and setting.
More recently, Ido Hartogsohn, assistant professor at the program for Science, Technology & Society at Bar-llan University, has been conducting research on set and setting, exploring the ways in which psychedelic experiences are shaped by society and culture. In 2017, Hartogsohn published a paper outlining the history of set and setting, pointing out that although the term is often credited to Leary, its roots extend further back.
He explains how members of the Club des Hashischins, translated as “Club of the Hashish Eaters,” a Parisian group dedicated to exploring psychoactive-induced experiences in the 1840s, gave emphasis to what he calls factors beyond the substance itself. When Timothy Leary began his research with psilocybin in 1960, he exchanged letters with English author Aldous Huxley, who shared an excerpt written by one of the club’s members, Théophile Gautier, in which Gautier explores the necessity of preparation and going into a hashish experience with a “tranquil frame of mind and body.”
In addition, Hartogsohn suggests that having a better understanding of set and setting could serve as a form of harm reduction as well as benefit enhancement, highlighting that “the discourse on set and setting had remained largely underdeveloped over the years.”
An Expanded Vision: Set, Setting, and Support
Considering the growing mainstream emergence of psychedelics, set and setting alone is no longer sufficient as a harm reduction mantra, nor is it sufficient as a guidepost for the benefit maximization of psychedelic therapy and research. We argue that as a matter of public health, this mantra must evolve into “set, setting and support.”
No doubt that the proliferation of positive results from clinical studies being conducted on psychedelics, alongside countless mainstream articles detailing their healing benefits with promising headlines like “The Psychedelic Revolution Is Coming. Psychiatry May Never Be the Same,” are driving increasing numbers of people experimenting with psychedelic substances.
Despite the undeniable healing benefits of psychedelics, media discourse around them is sometimes dressed in sensationalist language, serving to construct psychedelics as miracle cures for all mental health problems. This premise is misleading and does not highlight the innumerable challenges that present themselves around the psychedelic experience.
One evident challenge that may emerge, is that of the psychedelic experience itself. Even when set and setting are controlled, there is no guarantee that challenging content and situations will not present themselves.
“Sometimes active journeyers can find themselves in unsound decision-making states. Having the support of a peer, trip sitter, or facilitator, during an experience can help the explorer navigate their inner state and make adjustments to the setting for maximum comfort and safety,” says Hanifa Nayo Washington, co-founder and Chief of Strategy at Fireside Project, a psychedelic peer support line that provides free, live phone support to individuals actively tripping or looking to process past experiences.
As psychedelic researcher and transpersonal psychologist Stanislav Grof says, psychedelics can be “non-specific amplifiers of mental or psychic processes.” That is, they have the ability to amplify content which is latent in the psyche, bringing up thoughts, emotions, and sense impressions that we were previously unconscious of.
Another challenge that may emerge after the experience relates to the fact that healing is often a messy, non-linear process in which things sometimes get worse before they get better. Anecdotally, there appears a common point of contention around individuals’ expectations going into an experience versus the actual outcome. No doubt, having forms of support already integrated into the process can make such moments of difficulty easier.
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Beyond this, the aftermath of a psychedelic experience can also be destabilizing, as the non-ordinary states of consciousness they elicit serve to catapult us beyond the bounds of our everyday perceptions. In part, it is this very disruption in our normative flow of consciousness that enables psychedelics to be so healing, however, it can also be a simultaneously scary process as we find the foundations of our worldviews and belief systems turned on their heads.
“Psychedelic experiences can invite tremendous dysregulation in the body, mind, and spirit system,” Washington says. “Enlisting post-journey support in the immediate days, weeks, and months that follow a psychedelic experience can significantly ease the process of self-regulating to a ‘new normal’.”
What Can You Do To Seek Support?
Seeking avenues of support is a way to enhance psychedelic preparation, journeys, and integration, with support taking many different forms. One type of support, which may seem more self-evident, is that of socially-based, community support at the interpersonal level.
Despite the fact that psychedelics can elicit feelings of connection and oneness, some who use psychedelics may find themselves feeling alienated and misunderstood. For years, prohibitionist, zero-tolerance policies served to demonize psychedelic substances and those who used them, resulting in a lingering stigma and sense of shame associated with their use. This is especially true for individuals from communities of color who have long faced the impact of the discriminatory enforcement of drug laws, with the war on drugs producing profoundly unequal outcomes across racial groups.
Additionally, spiritual and mystical-type experiences have long been ridiculed and pathologized in Western culture, as they often include elements that are not culturally accepted as objectively real, sometimes resulting in those who have profound transpersonal experiences being dismissed or labeled as “crazy.”
Following a deep spiritual or transpersonal experience in which an individual disconnects from their ego, once they begin folding back into themselves there are layers of their identity or their lives that they may leave behind. This letting go of behaviors and parts of the psyche that are no longer of service can be conceived of as a type of “psychedelic shedding.” Omar Thomas, Founder of Jamaica’s Diaspora Psychedelic Society, CEO of Jamaican Organics and Psychedelics Today Advisory Board member, first formulated the notion of “shedding” in the context of psychedelic integration.
This might relate to one’s job, relationship, identification with a certain religion, sexual identity, or even their gender. When one goes through this shedding process without adequate support, there’s the risk that rather than finding relief from their mental and psychospiritual afflictions, they deepen, due to the many associated implications and consequences of the shedding process.
For example, what happens when someone realizes that the reason for their stress is rooted in their work, but they can’t quit because they won’t be able to support their family otherwise? Or what happens when someone sheds a cis-gendered identity but they’re in a marriage that would fall apart, opening a flurry of difficult, albeit potentially necessary effects?
This shedding process isn’t necessarily a bad one, but it certainly can be without having adequate support present to facilitate and ease the process. Like a butterfly going through its metamorphosis, it needs to be held in a safe container while fragile to emerge on the other side as its fullest and most beautiful expression.
Even today, as psychedelics become increasingly accepted in the mainstream, there is still a residue of stigma that remains. Thus, it is important, when looking for someone to support your journey, to find a non-judgemental, trustworthy person to share the experiences with. For some, this person may materialize in the form of a therapist, counselor, coach, or shamanic guide, while for others it may be a trusted friend or family member.
If support in an individual’s immediate circle is scarce, finding community support could come from connection online or in person with a psychedelic community, many of which offer courses and integration circles. One benefit of finding community online is around connecting with people from a particular social identity group that may not be accessible otherwise. For example, there are now integration circles that cater to individuals who identify as BIPOC, neurodivergent, or queer.
“In preparation for a psychedelic journey, support can look like gathering with a trusted friend, psychedelic facilitator, or support circle, to explore intentions, apprehensions, impressions, and beyond,” Washington says. “This support can increase awareness of one’s inner weather or set. With greater awareness comes the possibility for increased understanding of one’s own needs and knowing.”
Other forms of support include tools and techniques that a psychedelic voyager can draw upon as resources for grounding before, during, and after psychedelic experiences.
No matter the quality of the experience, beyond an intention to reduce the risk of harm, certain practices can be adopted as a way of supporting oneself through moments of discomfort or difficulty, to add a deepened sense of meaning and lasting benefit to the experience. For example, a 2019 study that observed the effects of psychedelics on long-term meditators suggested that the effects of a mindfulness practice may help patients sustain treatment outcomes in the long-term.
One might consider adopting a type of embodiment practice, engaging different aspects of the body in creating deeper self-awareness, balance, and connection. Whether it be a practice rooted somatics or mindfulness, or a more dynamic movement-based practice like yoga or dance, finding ways to become embodied helps to cultivate a deeper relationship with oneself and inner support to fortify your whole being.
Exploring the value of somatic practice, Lauren Taus, therapist practicing Ketamine-assisted Psychotherapy and Founder of Inbodied Psychedelic-Assisted Therapy and Integration Training shares, “Every emotion has a somatic counterpart, a felt sense in the body, which means that developing a daily practice of being in your body and listening to somatic wisdom is essential for healing.”
Support can also manifest by tending to your connection with nature. It can be easy to feel isolated after the depth and intensity of a psychedelic experience, however, the earth and the manifold beings that permeate it can serve as a source of community, providing consistent support through the embodied, knowing you were never alone to begin with.
In our vernacular, we tend to say that we are using psychedelics, but it’s certainly possible that psychedelics are actually using us. When one considers the predictable shift in values developed out of their use, expanding them to the global scale, we can see that not only are psychedelics healing us at the individual level, but are collectively helping to change the course of humanity’s place on earth by allowing us to care more about ourselves, one another, and the earth itself.
As this continues, there will be a never-ending need to increase layers of support for the broader community. Where might you be able to add that missing piece in your community, in your work, or in your personal life? What does it mean for you to evolve beyond set and setting?
I had years of experience in cold water training from my Aikido career, but as my depression had increasingly grown worse, I developed a severe cold intolerance. It had become painful to stand under the shower, with my scalp almost spasming in contraction, when I used to be able to stand in late winter melt-water waterfalls and rivers with ease. But post-dosing, my cold tolerance came roaring back; allowing me to stand under a cold shower for minutes at a time with no numbness and no pain – it was almost like it was happening to someone else or there was a micro-force field on the surface of my skin. I found myself having to leave the shower because I just had other things to do. Cold water tolerance is a gold-standard for measuring pain response in clinical trials, and in fact, later that year, the Department of Psychopharmacology at Maastricht University, sponsored by the Beckley Foundation, conducted the first LSD and pain study in nearly 50 years, showing that low-dose LSD significantly increased cold water tolerance without interfering with day-to-day activities.
I had been known for my mobility and flexibility throughout my career and my ability to train others to achieve the same results, but mine had been compromised for a good while at this point. But the day after my session, I was able to resume positions that I hadn’t been able to comfortably acquire in months, if not years. Movement now felt smooth and effortless once again, and I swear there was even improvement in the tissue quality in areas that had become “crunchy.”
There was also a significant change in my inflammatory baseline. Depression is seen as a disorder that also includes fairly significant neurological inflammation and is often bi-directional with chronic pain, but many of the same receptors that psilocybin operates on are also contained within the gastrointestinal tract, and mine had altered sensation for a month afterward. I believe my systemic inflammation significantly improved during that period because within three months of my dosing, I reacquired personal training records that had become elusive, and by summer, I passed those PRs and set new ones. I also felt incredibly less “puffy.” Accidentally banging into something didn’t hurt anymore and persistent joint aches and lack of motor activation disappeared. There were additional improvements in neurological issues that will be described in a future case study, but that was just as immediate and impactful.
Lockdown Leads to the Lowdown on the First Psychedelic Pain Studies
Within the training and recovery world, patients and trainees can loosely be categorized as super, normal, non, and negative responders. I had stopped being responsive to both training and rehabilitation efforts at the peak of my depression, and was entering negative-responder territory, which was severely distressing. Fascinatingly, I now seem to be trending somewhere between a normal and high responder. I began proclaiming to the researchers at NYU that psychedelics were going to completely change chronic pain treatment within five years. And I also had a secret; the day after my dosing session, I had what’s referred to as a huge download: I realized that if you could consider things like depression, PTSD, and severe anxiety to be nociplastic outputs of the Central Nervous System (CNS) that causes iterative rumination (a.k.a. looping maladaptive outputs), that was no different from the looping maladaptive outputs that characterize chronic pain – the neurology of which I had been studying for years at that point. Due to the extreme visual qualities of the psychedelic experience and the rapidity of my own remission, I saw, in a flash, that since psilocybin was an impact booster for neuroplasticity, it would enhance the impact of mirror box therapy for phantom limb pain or likely any other neuromodulation.
“Remapping” is the term describing the tactic of using visual or other sensory receptor inputs to modify and change nociplastic or noxious/painful outputs of the brain. As this is part of the Z-Health process, I had been introduced to the concept of mirror box therapy years earlier as part of my certifications, but I thought I had come up with a whole new approach and kept it to myself, barely hinting at what I believed I had uncovered. But, since NYC was locked down and I was unable to work, I had nothing to do but go online and research what had happened to me.
Within two weeks or so, I found an old photocopied English abstract from a 1962 study in Japan, by Kuromaru, et al., using low-dose LSD to treat phantom-limb pain with 50% of its participants going into instant remission by the end of their session, and the authors pointedly declaring that stacking the LSD with movement had a far stronger impact on resolving both phantom limb pain and phantom limb syndrome. Stacking inputs is a common practice within the neuromodulation world for pain treatment, often coupling a weaker input with a stronger one, and I realized that this was what had clearly happened to me while I was in my post-dosing neuroplastic window. It finally felt like I was getting traction again; that drills and exercises were once again effective, and crucially, maintaining their own momentum. I didn’t have to be hypervigilant anymore in my daily routine for these drills to become “sticky.” I also realized that the Kuromaru study had, in fact, been released earlier than the Kast study from 1964 investigating the analgesic properties of LSD for terminal cancer and other painful conditions, which is frequently and incorrectly cited as the first psychedelic pain study. I became aware of other previous psychedelic pain studies, as well as recent ones like Dr. Charles Nichols’ work on the anti-inflammatory properties of psychedelics, and studies involving Dr. Robin Carhart-Harris’ REBUS model and cortical reorganization, which is what happens when a stimulus results in the creation of a new cortical map (essentially a vertical column in the brain cortex consisting of neurons performing specific processes).
Both of these discoveries are crucial because cortical reorganization (or remapping) and inflammation are key drivers of chronic pain. Conditions like depression and anxiety are characterized by rigid, fixed beliefs or frameworks where the same negative thought loop keeps reoccurring repeatedly, with no amount of incoming contrary information able to alter that belief. It becomes what’s known as a “strong prior” in neurology, becoming a top-down driven process in the CNS, actively suppressing any bottom-up sensory input error correction. The same mechanisms of action occur with chronic pain, where, despite the healing or resolution of an injury; a rigid, fixed pain signal is continually being sent out by the brain as a maladaptive response of the CNS’ protective suite. These are referred to as nociplastic or noxious neurological conditions. The same is true for multiple chronic pain conditions where inflammation causes maladaptive signaling and perceptions, leading to negative structural or nociplastic changes in the peripheral and central nervous system. In psychedelic-assisted psychotherapy, a non-rigid, chaotic state is induced, which allows the cortical landscape to reorganize into a more efficient and positive state.
Landmark Study in Pain and Psychedelics Confirms Insights
I sat speechless for at least five minutes, shaking my head in a feeling of wonder and disbelief, as if the universe itself had just delivered this paper to me. Other than my remission and the pandemic, I had thought of nothing else but the application of how these two approaches could be combined. Of course someone else had invented it well before me; of course they had. I knew that resourceful, capable people had been working on this for a while, and chronic pain is a singular motivator, but it was still astonishing to see my vision so vividly applied and executed.
Check out this podcast with Court and Joe interviewing Dr. Castellanos and Dr. Timothy Furnish of PHRI!
I had learned in 2015 that cluster headaches had been effectively treated with psilocybin for 25 years, and of mirror box therapy a few years before that. I had even blogged about it because people in the rehab and training communities thought that my using visual inputs to treat pain was so weird they called it “voodoo.” But there is a neural hierarchy, and many pain and performance conditions in the body actually have higher-order components within the visual and vestibular systems. That’s often why, no matter how much manual/physio therapy one does, it is often a downstream compensation within the body in order to reconcile perceptual discrepancies between the visual and vestibular system. The visual system lets you assess the surrounding environment and predict any threats that exist within it, and the vestibular system helps you orient within that space, keeping your body in balance so that you might be able to execute any motor actions in response to any perceived threats. If your eyes are telling you the horizon is 5° tilted to the left, but your vestibular system, a.k.a. your inner ear, is telling you that it’s 5° to the right, your body will compensate so that those discrepancies are reconciled and you maintain a stable, level “sight picture” – your viewscreen of the world. Having an unstable sight picture makes for poor predictions; in other words, in an evolutionary survival context, having a “shaky cam” is not so great for avoiding saber-tooth tigers.
So, those downstream bodily compensations that keep your viewscreen steady are creating distortions and possible maladaptations in the structure of your body, and are now being cemented due to repeated compensatory use. The nervous system will protectively reduce motor output and increase pain perception as a response, to slow you down in order to avoid potential injury and survive another day. Ultimately, the body has evolved towards survival, not performance. And pain is an alarm/action signal designed to keep you alive.
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Mirror Box Therapy and Pain as An Output of Perception From the Brain
When we look at phantom limb pain, what we’re seeing is the phenomenon known as deafferentation: the loss of afferent or ascending inputs from the peripheral nervous system up to the brain. No limb equals no signal, and the loss of signal is very dangerous within an evolutionary context because limb loss due to injury or infection will mean, at the least, loss of sensation and loss of coordination for motor outputs/muscle contraction/movement, meaning a lost ability to gather food or to avoid threats. Or worse, it could mean signaling that you’re going to bleed to death in a matter of minutes.
Multiple pain conditions could be considered sub-clinical deafferentation: peripheral neuropathy from conditions like diabetes or shingles, or different types of phantom limb pain where the limb is still present but the nerves are so injured that they no longer transmit afferent signals – such as we see in cancer, stroke, or crush injuries. That loss of signal gets hardwired into the cortical representations of that limb, and never gets a counterbalancing signal, so the CNS registers it as an ongoing sense of threat. That creates a huge alarm signal in the form of pain perception.
What mirror box therapy does is replace that loss of signal with the image of an intact limb, generating input that dampens down that pain signal. And when you touch the remaining limb (which is generating normal signals) while seeing it reflected in the mirror in place of the missing or injured limb, it can immediately cause the pain signals to cease; so powerful are visual representations within the somatosensory cortex of the brain. Essentially, through seeing a limb appear where it wasn’t before, one tricks their own brain into thinking it’s still there, and the pain signals from the CNS for that lost limb stop being sent.
Mirror box therapy is often not enduring though; only being effective for as long as you do it, and that was the case with Albert Lin. It often takes a lot of repetition for it to become “sticky.” Neuroplasticity requires novelty and intensity, usually in the volume of work. But that can be hard to achieve, thus the issue in pain treatment that I had experienced directly as a practitioner and as a patient; everything works, nothing lasts. When it was suggested to Lin that psilocybin had strong neuroplastic properties that could impact cortical reorganization for chronic pain, he tried it a few times, taking a high dose of psilocybin mushrooms, which gave him approximately 3-12 pain-free hours, depending on the dose. But then the pain came back with a vengeance. Within the cluster headache communities, this is known as a “slapback effect” and can actually be a sign that the nervous system is adjusting and more permanent relief could be imminent.
Then, Lin’s wife suggested combining (stacking) mirror box therapy with psilocybin. He went out to the desert with a closet door mirror, and while under high-dose psilocybin, he would stare at the reflected image of his remaining leg and then at the space where his amputated limb had been, while repeating the phrase “You are safe. You are totally safe,” for approximately 45 minutes. This met all the conditions for driving neuroplasticity: novelty, intensity, and volume of work with deep assurance of emotional and physical security. Amazingly, it worked, immediately putting him into remission for the next 20+ hours, with 50% reduced pain for nearly two weeks. He shared his success with the lab, and experiments with different types of visual neuromodulation while under high-dose psilocybin quickly began.
Lin was dealing with a persistent pain in his phantom foot that felt as if a railroad spike was being driven through, suspected to be a sensory remnant from when the bones in his foot were surgically pinned together as they attempted to save it before ultimately deciding to amputate. An artificial foot and a pen with a telescoping pointer was introduced, and they covered the space between his stump and the plastic foot with a blanket, then “pulled” the telescoping pen out of his foot at the site of pain, mimicking the action of removing pins (or really, removing the pain). He felt instant relief.
Another experiment involved a novelty Halloween-store “flame” (bright light with orange and yellow fabric and a fan underneath that makes it flutter). Lin chuckled when he saw it, but when they brought it near his representational foot, he actually felt heat from the “flame,” which was intensely relieving.
Through these experiments and continued work, Lin went into full remission after five weeks, and has been free of chronic pain ever since. It’s worth noting that he had a top research team working with him that was extremely creative in creating novel inputs, and he is known for being an almost Michelangelo-type character, with a high degree of inventiveness and novelty-seeking, allowing him to discover unique, lateral approaches to solve problems. And, it bears repeating: chronic pain is a singular motivational force.
Additionally, post-dosing, cortical reorganization was happening during a psychedelically-induced “critical period reopening”; when the brain has a metaplastic quality that allows it to reset to an almost-new condition. As described in the work by Dr. Gül Dölen, critical period reopening happens during crucial phases of nervous system development in childhood, such as when toddlers can learn multiple languages without an accent or when adolescents are uniquely sensitive to social cues from peer pressure (and/or support), allowing them to quickly adopt different social customs and frameworks. This reopening is also seen post-stroke, when there is a limited window for rehabilitating from brain injury, so this likely applies very well here with chronic pain. We know that veteran groups like the Heroic Hearts Project, VETS (Veterans Exploring Treatment Solutions), and The Mission Within, who are employing psychedelics for treatment, are having striking results both in recovery from combat-induced PTSD as well as traumatic brain injury – typically seen as treatment-resistant conditions.
If there’s anything I would like you to understand after reading this article, it’s that:
We don’t have to prove that psychedelics are effective for treating chronic pain; we have to establish that this has already been proven.
Psychedelics are not an instant cure for chronic pain, but they are strong impact boosters for neuroplasticity and can make physiotherapy/neuromodulation become “sticky,” creating enduring relief.
We know that many mechanisms that create psychiatric conditions that are responsive to psychedelic-assisted psychotherapy are extremely similar in nature to the same mechanisms that generate chronic pain; it’s just that psychiatric conditions have gotten far more focus in psychedelics, perhaps because the non-ordinary states of consciousness they are known for producing seem more applicable to conditions more traditionally thought to be related to the mind.
But both arise out of the central nervous system and are rigid, fixed states of cognition and perception. With depression, you have negative outlooks and self-perceptions: “Nothing I do makes a difference,” “People are just saying that to make me feel better,” etc. At one point, these thoughts may have helped you to cope with a traumatic incident, environment, or upbringing, but now they’re maladaptive, weigh you down, are out of step with reality, and have actually caused (or are the result of) structural deficits in the neurology of your brain. It’s the same with chronic pain: when there is an acute injury or even the possibility of one, pain is part of the protective suite of responses from our nervous systems to prevent further injury and allow healing to occur – an alarm bell/action signal to change a behavior. But it can be so overprotective that it gets embedded and cemented with movement, emotions, and surrounding environments long after all tissue healing is done – getting triggered by seemingly innocuous events, maladaptively hardwired into your neurology in a negative loop of conditioned responses.
This is exactly what happened to me when I went through NYU’s psilocybin trial; an adverse financial and work environment, repeated (and under-recovered) musculoskeletal stress/injuries, and (likely) sub-clinical post-concussion syndrome and PTSD, all topped off by the sudden death of a close friend releasing long-suppressed grief and leading to a significant nociplastic output in the form of increasingly treatment-resistant depression and moderate chronic pain. Many recovery efforts were attempted using every modality I knew, but there was too much of a deficit to overcome – until psilocybin was introduced to the mix. That life-changing experience allowed for metaplasticity, cortical reorganization, descending inhibition, and anti-inflammatory properties to take root, giving all post-dosing interventions the opportunity to gain traction and for me to flourish once again.
Future articles in this “Pain and Psychedelics” series will focus on old assumptions vs. new science, additional case studies, the suspected mechanisms of action behind the interaction between psychedelics and pain, and best practices and safety concerns for working with psychedelics to alleviate chronic pain.
An NYU psilocybin depression study participant discovers an unforeseen application for psychedelics: the treatment of chronic pain. Part 1 of the series: Psychedelics and Chronic Pain.
Everything Worked, but Nothing Lasted
In the fall of 2020, I was living a pretty successful and happy life – on paper. I had co-founded a very popular, leading-edge CrossFit gym in NYC; one of the first in the world. I held multiple advanced certifications in applied neurophysiology through Z-Health, helping clients with challenging pain and performance issues. As an early adopter of kettlebell training, I became a nationally top-reviewed instructor and trained Team 6 Navy SEALs, astronauts, pro athletes, wounded veterans, and members of the FBI, NYPD, NYFD, and ROTC. I was featured in Men’s Fitness, the NY Times Sunday Routine, and USA Today. I had 30 years in the pain & performance field, training and teaching at a high level, and was becoming widely known for helping people with difficult mobility problems or chronic pain, using unique methods from the leading edge of neurological rehabilitation. On top of all of that, I was 17 years sober.
However, not all that glitters is gold. A now ex-business partner was committing a Ponzi scheme to the tune of millions, and his case followed him like a shadow, turning my life’s passion into an emotionally and financially toxic nightmare that economically devastated my family. My best friend, Kirk MacLeod, who I had completely rehabbed from chemo & cancer surgery, died six months after being declared in remission. My first son had developed undiagnosed GERD and couldn’t sleep more than an hour and half at a time, which meant my wife and I slept even less.
Unsurprisingly, my episodic depression returned after more than a decade and a half, and I was now increasingly treatment-resistant; unresponsive to psychiatric drugs that had previously worked. All my pain neuromodulation interventions that worked on my clients no longer worked for me, and I had developed chronic pain myself.
I share all my background here to demonstrate that I was not under-resourced in either knowledge, networks, or diversity of approaches, practice, or experiences. I poured over all my certification materials looking for anything I had missed, but had fallen into an increasingly deeper recovery hole; everything worked, but nothing lasted. I was hitting a new bottom in my life, deeply sinking into the midst of an increasingly treatment-resistant depression episode that had likely been ongoing for five years.
But then I became aware of ongoing studies on psilocybin for depression happening locally in NYC. I had experienced a few high-dose psychedelic sessions nearly a quarter century ago and had been an avid Terence McKenna fan (even speaking with him directly after a lecture in Seattle), but I had never taken psychedelics therapeutically, and my recreational interest had effectively vanished once I became sober from alcohol. Intrigued, I connected with the local clinical research coordinator, Leila Ghazhal, at the NYU for the clinical trial of Psilocybin for Major Depressive Disorder study (sponsored by the Usona Institute), and took all the online and over-the-phone assessments, passing them easily. The primary investigator (PI) on my study was Dr. Stephen Ross, who had been leading psychedelic research at NYU for more than a decade. Amazingly, I made it into the trial within a month and a half, learning that I’d actually beat out 8500 other applicants for just 100 spots nationwide.
Trying Not to Hope
When I first entered the trial, I was in a state of denial about how severe my depression was, but once I took the MADRS assessment, there was no avoiding that I had moderate to severe depression with suicidal ideation.
I remember a specific moment very well during this process, when I was finally cleared to enter the study and the study coordinator was speaking with me about the results of my assessment and my upcoming participation. I asked what would happen if I didn’t receive psilocybin during my session, and he reassured me that they would not just drop me off in the middle of the ocean to dog paddle – that there were other interventions and studies available and they would be sure to find me something, but there was a good chance I would receive psilocybin and hopefully get some good results. At this point, my mask cracked a little bit and some protective cynicism came out, and I quipped with a bit of a shrug: “Well, we’ll see.” I hadn’t meant it to be dismissive or sarcastic but it came out that way, and the conversational atmosphere rapidly shifted. He looked right at me and suddenly he wasn’t the primary investigator anymore, lost in the myriad details and logistics of a very involved study. Now he was the deeply experienced clinician and therapist, and, having heard something within the tone of my voice, dropped all the way in and asked softly: “What’s going on behind that, Court?” Suddenly, all the masking dropped and there was no more place to hide because I was so, so tired at this point, and had been waiting for this moment. In and out of therapy for years, dozens if not 100 self-help books, so many modalities, so many somatic systems, and here I was with a chance for something new to help me. When I realized why there was cynicism behind my statement, my voice cracked, I started crying, and I answered him: “Trying not to hope.”
The one glimmer of hope I did have was reading a 2018 paper by lead author Calvin Ly describing psychedelics’ neuroplastic activity in the prefrontal cortex. As someone who had studied the neurology of pain for years, this was revelatory. Many pain conditions are, in fact, nociplastic or noxious conditions arising out of the central nervous system (CNS); there’s no more injury or damage if there ever was, but your CNS is still continuing to put out a maladaptive alarm signal that is perceived as pain. So learning that psilocybin was creating actual structural change within my cortex – not “just” psychological change – was completely astonishing.
Applications close on March 26 for this year’s edition of Vital.
My dosing date was on March 5, 2020, and I remember looking down at the capsule sitting in the cup, saying to it: “I really hope that’s you.” I was terrified inwardly that I would receive the placebo, that I wouldn’t respond to the psilocybin, or that it would only work just a little bit, only for its effects to slowly fade. But within half an hour, there was no denying that I had received psilocybin, and I earnestly pursued all the procedures everyone on my care team at NYU had worked with me on for weeks in preparation for this day.
I was genuinely shocked at the sheer volume of psychological material from my childhood and early adulthood that came up. I had profound transpersonal experiences and healing, revisiting instances that were pivotal in my childhood. I had an encounter with the first woman I had ever loved, who had committed suicide three years after we had broken up. Her death had caused a profound grief in me that drove my drinking for a decade after. I thought I had released the majority of my grief around her once I got sober, but clearly, there was so much more to heal that had been deeply suppressed as I tried to move forward with my life.
Reset, Renewed, and Reborn
The biggest shock of all, though, was waiting for me at the end of the day when one of my facilitators casually pitched a seemingly routine question while closely watching me out of the corner of his eye: “So, how do you feel?” Without thinking, I reflexively replied, “Good,” but then, just as reflexively, scanned more deeply inward, and in a sudden rush, realized my depression was completely gone – not just better, but vanquished, exclaiming: “Good! That fast? Are you fucking kidding me, that fast? Is it gone already?”
It felt as if a huge mass had been surgically removed from me or as if an entire continent within my interior was now suddenly revealed. No matter how many times you read the word “remission” and the percentages behind it in scientific studies, very little will prepare you for the shocking reality of it. The contrast between before and after was profound. All of the iterative rumination was gone, and it took no effort for that to happen. And it only seemed to strengthen as the days passed. Miraculously, all suicidal thoughts ceased on that day and never returned.
Shockingly, only ten days after my dosing session, NYC went into a complete pandemic lockdown, my entire industry closed, and my two young boys were now at home with me 24/7, tele-learning. I cannot imagine what 2020 would have been like for me if I had received the placebo. It’s almost unimaginable.
For more on this topic, make sure to check out episode 369, where Court and Joe interview Timothy Furnish, MD & Joel Castellanos, MD of UC San Diego’s Psychedelics and Health Research Initiative (PHRI).
But here is where the story takes an even more profound and impactful turn. During the session, my leg started intensely tremoring/spasming. I had been evaluated for musculoskeletal pain and dysfunction that I had acquired through a host of injuries over the years of my performance career, and in fact, had just been in the doctor’s office a few months earlier trying to determine if I had arthritis or something worse. But right there in the session room, I started having a neurological revision, with my muscles and nerves in my right inner thigh firing in an effort to recalibrate the sensory and motor inputs and outputs in that part of my kinetic chain. It was almost like a self-generated TENS unit (Transdermal Electromagnetic Nerve Stimulation, used to generate muscle contractions and neuromodulate pain signals with micro-electric pulses) getting my leg back online by creating intense motor activity in the muscles of my thigh.
I’ve since spoken with spinal injury survivor Jim Harris and read a case series from UC San Diego’s Psychedelics and Health Research Initiative (PHRI) published in PAIN Journal where the exact same thing occurred to them under the effect of psilocybin with the same positive results, but at the time, the facilitators were concerned enough to ask the primary investigator to come and evaluate me during the session. I had to explain to him, somewhat hilariously as I was going into my peak, that, in fact, the tremors felt intensely good. I’m grateful that he let them continue because it has made all the difference.
While I partially understood what had happened, I was understandably beyond eager to learn more, and to see where else this realization could take me: Why did this work so well? Has our understanding of chronic pain been wrong? And if psychedelics are the answer, what does treating chronic pain with psychedelics actually look like?
This is part 1 of a 2-part piece and part of a larger series on chronic pain and psychedelics. In part 2, I will dive into the research around remapping and mirror box therapy, and why my psychedelic experience seemed to be so effective.
Future articles will focus on:What is pain and what causes chronic pain, old assumptions vs. new science, the suspected mechanisms of action behind the interaction between psychedelics and pain, and best practices and safety concerns for working with psychedelics to alleviate chronic pain.
So, you’re thinking about starting a career in psychedelics. Maybe you’ve experienced your own breakthroughs. Maybe you’ve watched others transform. Or maybe you’ve noticed the massive groundswell of political, industry, and community support around psychedelics in recent years, and just want to be part of something colossal.
Luckily, there is no shortage of options for talented individuals looking to get involved, from roles in psychedelic media to biotech, education, coaching, and integration.
But where should you start?
While there are psychedelic-focused job boards to peruse, building your own professional network and acquiring experience through education could set you apart from the pack of applicants – especially as the demand for trained, career-ready individuals grows.
And the demand is growing – fast. As more states, including Oregon and (with any luck) Colorado, look to develop psychedelic facilitation programs, and with FDA approval looming over MDMA therapy, there could be a real need for over 100,000 psychedelic facilitators in the coming years.
And while the need is there and growing, some say the practitioner bottleneck may be one of the biggest supply chain barriers in delivering treatment to the multitude of people who want to receive it. Wait lists for conventional therapy alone are months long in some parts of the world today, and the growing demand for mental health services and support has resulted in a significant caregiver shortage.
“When you consider all that people have been through over the last few years with the pandemic, and the stigma around mental health thankfully eroding, it’s no wonder many are looking for support. The mental health crisis is real, and it isn’t going away on its own,” said Kyle Buller, Psychedelics Today’s Vice President of Education and Training. “We need compassionate people to answer the call to support their fellow human beings.”
At Psychedelics Today, we’re doing our part to educate people who are curious about taking part in this seismic shift. From regular free webinars, to our 12-month intensive practitioner training program, Vital, to over a dozen courses on various topics in our Psychedelic Education Center, we’ve designed options for all levels of learners to expand their personal and professional psychedelic acumen and build their professional networks.
If you’re taking the first steps in your journey, consider Navigating Psychedelics. This popular, nine-week program combines the history and foundations of psychedelics with essential knowledge required to work with clients, including legal and ethical considerations, harm reduction tips, job opportunities available today, and new avenues to explore.
Not just for clinicians or therapists, the program offers a springboard into a range of career options, including retreat facilitation, ketamine clinic administration, integration coaching, and more – two students even went on to work for Psychedelics Today after graduation!
To learn more about where Navigating Psychedelics has taken students, we recently surveyed past graduates. Here’s what they told us:
50% of students chose the course to increase their knowledge to establish a psychedelic career, while 25% used the lessons to enhance an existing practice.
75% went on to successful careers in psychedelic therapy.
25% of students surveyed indicated they simply took the course to increase their general psychedelic knowledge and did not pursue a career after.
100%would recommend Navigating Psychedelics to someone looking to expand their psychedelic knowledge.
One past student said, “I found this course extremely helpful in preparing for a career in psychedelics. The live (sessions) were extremely practical and thought about how to keep ourselves safe, reputationally, in the work. The experience of the course helped me to plot out a path for myself in the field of psychedelic work and the encouragement of the facilitators was brilliant!”
Eager to learn more? Check out our program page and join us for a free Q&A session to decide if Navigating Psychedelics is right for you. CE credits, financial assistance for students, and discounts for past Psychedelic Education Center students are available. The next live cohort begins Nov. 28, 2022, and space is limited, so don’t delay.
Wherever you are in your psychedelic career path, we are thrilled you are here. The question you may want to ask yourself is: where do you want to go next?
Could a nation defined by inflammation find relief in psychedelics?
It’s a verifiable truth that the United States of America may be considered a global leader, especially when it comes to the prevalence of mental and physical health disorders. In fact, of the nearly 330 million people in the population, millions to hundreds of millions of Americans suffer from chronic conditions like:
These sobering statistics beg the questions: How could a single nation of relatively modest size be home to such a vast selection of chronic diseases?And how could psychedelics be used to combat these conditions affecting so much of the population?
The American diet overall is egregiously devoid of whole grains, beans, fruits, vegetables, and nuts, with the US Department of Agriculture estimating they represent a mere 11% of the populous’ typical daily food intake. Despite this lack of prevalence, these unprocessed natural foods are otherwise rich in medicinal phytochemicals found to support the immune system and strengthen the body’s resistance to infections, as well as fight cancer and diabetes; diseases that are twice as prevalent in the US relative to the global average. Shockingly, the US also leads the world in obesity rates by nearly 400%, and is first in global consumption of sugar, outranking Germany by about 26% yearly.
Although diet quality is proven to significantly impact the likelihood of disease development, what Americans eat is only one contributing factor among many. Poor diet alone doesn’t explain the exceptional amount of chronic health conditions seen in the population. In fact, it’s estimated that over 60% of Americans suffer from at least one chronic health condition, 42% of the population are diagnosed with at least two, and up to 12% of Americans live with five or more chronic diseases.
To put those percentages in perspective, the 2020 election saw the highest voter turnout in 120 years, with the most votes for a single presidential candidate ever recorded in American history. Joe Biden reportedly received over 81 million popular votes, representing less than half of the 198 million Americans suffering from at least one chronic health condition, and only marginallymore than half of the 139 million with at least two.
Despite the fact that they’re by no means a minority in the population, chronic diseases are found to disproportionately affect socioeconomic minorities in the United States of America and beyond. A recent study published in the journal, “Archives of Public Health,” used 20 years (1995-2015) of empirical data from the Organization for Economic Cooperation and Development (OECD) to investigate the impact of education on health across the populations of 26 countries, including the United States, Canada, United Kingdom, France, Germany, and other founding nations that became members when OECD was created in 1960. This data, taken from millions of people in numerous countries across the globe over one fifth of a century, clearly demonstrated that higher educational attainment in adults positively correlates with longer lifespans, better health outcomes, increased Gross Domestic Product (GDP) per capita, and reduced infant mortality rates.
Put simply, the OECD data suggests that highly educated adults with ample finances generally live up to 12% longer (8-10 years), enjoy healthier lives, make more money, and are less likely to die at birth or of cancer, when directly compared to individuals of lower socioeconomic status (SES). Unsurprisingly, adults with higher GDP per capita also spent more money on healthcare and education over their lifetime, with college and university education found to positively influence life expectancy, child vaccination, and enrollment of children in education, as well as negatively impact infant mortality. Taken as a whole, the OECD data demonstrates an essential principle:
If appropriate education and adequate income significantly increase life expectancy, then access to quality schooling, sustainable employment, and equitable socioeconomic mobility are inherent to health care services.
However, even if we factor in education and employment as essential contributors to health, the fact remains that as of 2021, over 85 million Americans older than 25 had attained a Bachelor’s Degree or higher, and US unemployment was a mere 3.7% in August 2022. Since neither education nor employment are able to fully reconcile the disproportionately large number of Americans currently suffering from chronic health conditions, there must be a deeper underlying cause contributing to the pathology of diseases reportedly observed in the country’s citizens and resident aliens.
Compellingly, inflammation has been identified as a central contributor to all aforementioned chronic health conditions and beyond, and is implicated in over 60% of all human deathsaround the globe. Some may already be familiar with acute inflammation in the form of localized pain, redness and swelling, usually in response to an injury or infection. Acute inflammation is typically a normal immune response during which the immune system is activated through the release of specific proteins, essentially called inflammatory markers. These markers then act as beacons to recruit immune cells, which subsequently migrate to the particular body part(s) in need of defense or repair.
In contrast, chronic inflammation is less apparent and far less immediate, but has insidiously dire consequences when left unchecked. Instead of causing localized pain or swelling, chronic inflammation causes systemic issues with immune cell signaling through excess “noise” created by high levels of inflammatory markers. Rather than being recruited to areas of the body most in need of healing, immune cells are drowned in an overwhelming number of biochemical beacons and ultimately disoriented. By disrupting this essential communication between immune cells, chronic inflammation prevents the appropriate direction of immune cells to critical issues needing attention, and may instead direct disproportionate amounts of immune activity to arbitrary areas – thus crippling the body’s capacity to effectively heal itself or prevent systemic disease.
In this self-guided class, we investigate the history, science, and best practices for safe and effective microdosing; with Adam Bramlage, founder of Flow State Micro, Dr. James Fadiman, the “father of modern microdosing,” and a dozen expert guest faculty. Enroll today!
Over the past 20 years, a growing body of research has further investigated the complex relationship between chronic inflammation, various mental and physical diseases, and socioeconomic status (SES). High levels of inflammation measured by markers in the blood of low SES patients were found to prospectively predict whether they would suffer from depression, heart disease, ischemic stroke, and/or mortality.
Furthermore, factors such as poverty, lack of social or educational resources, obesity, and diets rich in refined sugar were all closely associated with increased inflammatory markers, chronic diseases, and mortality rates. Stress derived from socio-political, financial, environmental (chemical, biological, electromagnetic), or psychosocial (relationship experiences, trauma, social conditioning) aspects of a patient’s life also reportedly influenced inflammation, with chronic psychological and emotional stress inducing a significant increase in observed blood inflammatory markers; thus promoting immune dysfunction and ultimately increasing the likelihood of chronic diseases in individuals of low SES.
Psychedelics as Anti-inflammatory Medicine
Despite these undeniable correlations and profound implications, the medical model of inflammation as the root of disease is not a new concept. Whether willow bark or aspirin, both traditional Ayurvedic and modern Western medicine employ preparations of anti-inflammatory drugs to treat a number of maladies, from headaches to heart disease. In fact, many over-the-counter (OTC) medications, commonly prescribed pharmaceuticals, and even psychedelic drugs owe some portion of their medicinal benefits to anti-inflammatory effects exerted in particular tissues of the human body.
For example, recent research has revealed that two of the most commonly prescribed classes of antidepressants, Selective Serotonin Reuptake Inhibitors (SSRIs) and Selective Norepinephrine Reuptake Inhibitors (SNRIs), may instead induce their expected medical effect via anti-inflammatory action within the brain itself, thus alleviating underlying neuroinflammation implicated as a central contributor to malaise, fatigue, brain fog, emotional reactivity, and other psychological symptoms. This revelation casts significant doubt on the broadly accepted model for the pathology of depression that classically purports serotonin deficiency as the primary cause. Today, a new breed of antidepressants specifically intended as anti-inflammatory drugs are undergoing feverish development by major drug corporations.
But before we herald these pharmaceutical innovations as the ultimate solution to tame the treachery of chronic neuroinflammatory disease, we must address the unjust marginalization and criminal victimization of disaffected Americans self-medicating via naturopathic means. Notwithstanding their evolutionary, anthropological, and social significance, the potent anti-inflammatory effects of cannabis, psilocybin mushrooms, and other psychedelic derivatives are now well-supported by an ever-growing body of recent scientific research. Although prohibitionist laws previously precluded a thorough investigation of their potential, the US has slowly and begrudgingly allowed the pursuit of psychedelic pharmacological power. As the barriers of outdated, impermissible, and fallacious legislative paradigms fall, clinicians are finally gaining critical insights that have enabled the development of novel pharmaceutical psychedelic derivatives with extreme precision; such that specific medical characteristics like an anti-inflammatory effect or psychedelic effect may be intentionally targeted and enhanced or diminished.
However new this scientific perspective may seem, medicinal preparations of psychedelics have reportedly been used for centuries, and even pharmaceuticals investigated and approved for clinical use decades ago were arguably directly modeled after psychedelics like LSD and psilocybin. Most notable of these compounds, Methergine (methylergometrine), is an LSD derivative used to induce contractions during childbirth since 1582, and is currently included on the World Health Organization’s (WHO) List of Essential Medicines. A similarly indispensable class of pharmaceutical psychedelic derivatives, the triptans, were first developed and patented in 1991 to treat migraines and cluster headaches, conditions which are both implicated to be caused byneuroinflammation. Interestingly, early triptans display remarkable structural similarities to tryptamine psychedelics like DMT and psilocybin.
Further progress spearheaded by brave and dutiful psychonauts in professional practice, underground social circles, and beyond has steadily illuminated the psychological and pharmacological nuances of many psychedelic drugs, revealing that they’re in fact highly safe and effective treatments for Post-Traumatic Stress Disorder (PTSD), suicidality, depression, anxiety, addiction, Fibromyalgia, various chronic inflammatory diseases, and more. Tireless efforts across decades of clinical trials using psychedelics such as cannabinoids, MDMA, ketamine, and psilocybin have paved the way to their current or imminent approval by the US Food and Drug Administration (FDA).
It finally seems quite possible that psychedelic medicines previously incorrectly admonished as “psychomimetic drugs” that imitated psychosis, damaged DNA, and were toxic to the human body may soon be available as legitimate pharmaceutical compounds aiming to alleviate the suffering of millions. With the current medical and legal trajectories, it’s highly likely that sometime in the not-so-distant future, inflamed Americans in need of psychedelic therapies will be able to access them without the unnecessarily harmful (but now still-looming) threat of social, criminal, and civil persecution. As much as one author celebrates this opportunity for a modicum of much needed progress in the United States, a single question remains:
Do a handful of state-level decriminalization initiatives for some select drugs, as well as the monetization and regulation of a limited number of pharmaceutical psychedelics at the federal level truly represent a sufficiently compassionate and broad solution to remedy the innumerable and egregious offenses against American life, liberty, and the pursuit of happiness committed by the war on drugs?
Horizons: Perspectives on Psychedelics, the annual psychedelic conference in New York City, is celebrating its fifteenth anniversary year.
Horizons has been a landmark on the psychedelic conference circuit long before there was ever such a thing. Once a small, single-day gathering at Judson Memorial Church, the conference has grown into a five-day event. In the past, its stage has welcomed speakers such as Steven Benally, Rick Doblin, Amanda Feilding, Roland R. Griffiths, Ph.D., Bia Labate, Ph.D., Nick Powers, Ph.D., Alexander Shulgin, Ph.D. and Ann Shlugin.
From the beginning, the goal has been to create a forum with the credence and respectability that the topic of psychedelics deserves. The conference has, accordingly, sought out historic venues to host its programming: The New York Academy of Medicine, founded in 1847, and The Great Hall at Cooper Union, where; when it was new, Abraham Lincoln spoke. More recently, in September, Horizons debuted the Horizons Northwest conference at the Portland Art Museum, one of the oldest art museums in the country.
After all, why should this subject, which many traditional cultures have held sacred for thousands of years, not be discussed in esteemed cultural institutions?
A panel from last year’s Horizons NYC
What’s Special About This Year?
In previous years, the focus at Horizons has been on advocacy and awareness. But things are changing. Now that we are seeing the fruits of this work – with, for example, the Natural Medicine Health Act in Denver, Colorado, and most prominently with the Psilocybin Services Act in Oregon – the focus is moving quickly toward implementation.
What are the hard problems of making psychedelics accessible to a large group of people? How do we meet this historic opportunity safely, responsibly, and with wisdom?
The Program and Speakers
Classes and workshops for care professionals will be offered on Wednesday and Thursday, October 12 and 13, at The New York Academy of Medicine. Attendees will have a chance to learn from experienced researchers and guides William A. Richards, Ph.D., Brian D. Richards, Psy.D, Matthew W. Johnson, Ph.D., Marcela Ot’alora G., LPC, and Bruce D. Poulter, RN, MPH on Wednesday. Those who have taken classes before can enroll in intermediate workshops on Thursday: “Guiding Psilocybin Therapy Sessions,” with Mary Cosimano, LMSW of Johns Hopkins, and “Intermediate Topics for MDMA Therapy Clinicians,” with Marcela Ot’alora G., LPC and Bruce D. Poulter, RN, MPH.
After a challenging year in the industry, The Psychedelic Business Forum at The New York Academy of Medicine will begin with an overview of the state of the industry on Thursday, October 13. We will hear from companies operating in this space on impact- and values-driven models, as well as from those raising capital for psychedelic endeavors. Mike Mullete, who oversaw the commercialization of Moderna’s COVID-19 vaccine and who is now COO of MAPS PBC, will give a briefing on how MAPS PBC is preparing to bring MDMA-assisted therapy to market.
Sutton King, MPH speaks at last year’s Horizons NYC
Saturday, October 15, is focused on the medical and legal implementation of psychedelic treatments. What are the current successful and ongoing efforts to develop regulated access to psychedelic experiences? What work has yet to be done? Assembly member Patrick B. Burke, who introduced a bill to regulate the medical use of psilocybin in New York State, will kick off the day. Rachel Yehuda, Ph.D. will appear along with retired Lieutenant General Martin R. Steele and Marcus and Amber Capone of VETS to speak about the remarkable confluence of veterans and psychedelic therapy. Brett Waters, Esq. will also give a briefing on federal-level policy reform.
Sunday, October 15, is all about the way people are actually using psychedelics in the world – not in medical or clinical environments, but “in the wild.” Saleena Subaiya, MD, MSc and Kate O’Malley, MA will present two of the larger surveys that have been done on the impact of ayahuasca use on behavioral health and mental illness among users and facilitators – the first time preliminary conclusions have been presented on this subject. Bia Labate, Ph.D. and Joseph Mays, MSc will speak about decolonizing psychedelics, and Sandor Iron Rope, president of the Native American Church of South Dakota, will tell his story and offer an Indigenous perspective on the rise of psychedelics in popular culture.
Looking Forward to Community
The purpose of Horizons is to be in service to the public availability of quality knowledge on psychedelics, as well as to strengthen the networks and communities involved in this work. The decisive ingredient in both? People.
Indeed, because this subject has been prohibited and criminalized for decades, this can be a powerful experience. For many who are on the fence about committing to advocacy or entering this field in some way, this environment can tip the scales, empowering people to become community participants and leaders.
Registration for Horizons New York is still open. Visit Horizons PBC’s website for a detailed event agenda, speaker lineup, and to register.
And when registering, make sure to use code PSYCHEDELICSTODAY-NY-17 at checkout to receive 17% off!
Photos by Andres Bohorquez Marin
This post is part of a 2022 media sponsorship between Horizons PBC and Psychedelics Today.
The history of kratom’s long path to (mostly) legality shows us that if done right, fighting against prohibition can actually lead to wins. But to truly fight these battles, we can’t fall into the trap of psychedelic elitism.
Ever since Westerners first encountered psychedelics, they have been prohibited, demonized, and considered unfit for civilized folk. Beginning with Columbus’s first encounter with psychedelic-snuff-using natives in Hispaniola, this class of psychoactives has always been relegated to the underground. (Ott, 11) While the recent emergence of psychedelic commercialization and medicalization marks our first flirtation with aboveboard operations in nearly 50 years, psychedelic advocates are all too familiar with prohibition after 500 years of psychedelic distrust and drug war assaults.
The road to our blossoming revival of psychedelic culture has been filled with tragedy and struggle. Even with the decriminalization of some psychedelics in select cities, most Americans cannot trip without the fear of losing their freedom. We are criminalized for possessing a portal to an unordinary state of consciousness. Undoubtedly, psychedelic prohibition has brought with it the tragic ruination of thousands of lives. Passionate advocates, then, have a chip on their shoulder – an urge to close the chapter on the long history of the Western demonization of psychedelics.
For many, this is a noble and moral goal. Yet in shedding the chains of prohibition, we must ensure that we thoroughly scrub ourselves clean of it. In our desperation to leave our struggle behind, we must not fall into the trap of a prohibitionist mindset.
Psychedelics are not becoming legal and mainstream because they are “good drugs” in contrast with the rightfully-prohibited “bad drugs.” There is no such distinction, and it was prohibition which constructed the illogical demarcation between “good” and “bad” drugs in the first place. As the Swiss alchemist Paracelsus mused many centuries ago, the difference between a medicine and a poison is the dose – not whether or not it occasions a psychedelic experience.
What is Psychedelic Elitism and Why is it Bad for the Anti-Prohibitionist Movement?
Despite emerging from the same struggle against prohibition that most other “drugs” face, the narrative around psychedelic legalization has often included an attitude which can be termed “psychedelic elitism.” Psychedelic elitism is the belief that psychedelic drugs (psilocybin, LSD, etc.) are harmless and beneficial, and used by responsible, upstanding citizens; whereas other drugs (such as PCP, methamphetamine, or heroin) are bad, inherently dangerous, and only used by the lowest characters in society. As such, psychedelics are seen as wrongfully prohibited, while other drugs are rightfully prohibited.
Dr. Carl Hart’s 2019 presentation at the Horizon’s Conference in NYC directly touched upon this issue. He warned that any internalization of the prohibitionist mindset would be counterproductive to our overarching goals of creating a more just and equitable society. All drugs, removed from their social context, have potential for both good and bad reactions. For example, in mainstream narratives, psilocybin is used by affluent professionals and underlies the business model for publicly-traded companies, whereas methamphetamine is only used by impoverished individuals without social status. So psilocybin is associated with success and health, while meth is associated with ruin and sickness. This narrative holds sway despite the fact that methamphetamine is legally prescribed under the name Desoxyn, which has helped countless patients live a better life – very much confusing the moralizing mindset which demonizes some drugs but not others.
We were honored to have Dr. Carl Hart on the show last year. Check it out here!
Psychedelic experiences can be freeing, euphoric, problem-solving, pain-reducing, easy going, recreational, creative, therapeutic, medicinal, spiritual, ad infinitum. While these qualities drive our passion for psychedelic advocacy, we should keep in mind that the broader category of psychoactive substances, including non-psychedelic drugs (a category which is largely arbitrary and subjective), can also bear these same positive traits. Therefore, they should be included in our struggle against prohibition.
Any drug, psychedelic or non-psychedelic, can also be indicted in unpleasant experiences as well. It seems, rather clearly, that psychedelic elitism comes from a positive drug experience with what happened to be a psychedelic. With this experience, part of the propagandist veil which obfuscates our understanding of how drugs affect us individually and on a societal level falls away. We become acutely aware that a drug – in this case a psychedelic – can have a positive effect; a profoundly different narrative than the one peddled by prohibitionists. Yet this newfound knowledge of the contradiction is internalized as simply: “Psychedelics are good.” There is rarely any further research to see if the prohibitionists were lying about all drugs or just psychedelics.
Psychedelics are worth advocating for, but this should never be done at the expense of other substances and their consumers. Removing the risk of imprisonment for psychedelic users but retaining it for other illicit drug users is hypocrisy at its finest. Allowing individuals and organizations to make exorbitant profits with psychedelics while forcing illicit drug merchants into the unregulated underground perpetuates unnecessary user risk while furthering the divide between the wealthy and the poor.
Prohibition didn’t originate to prevent the so-called “menace of drugs on society.” Rather, it was enacted to broaden the range of authority held by law enforcement. From its origin in the Harrison Act of 1914, prohibition has been about power and control – usually with a racial slant. The Harrison Act was passed to regulate and tax opium and coca imports in the US. This effectively made it impossible for Chinese immigrants to procure opium legally, thus making opium users liable for arrest. Cocaine was described in the press as giving superhuman strength to black men while simultaneously making them belligerent and violent. From the get-go, prohibition has never been about protecting people, but rather about protecting the status of the dominant class.
Selectively opposing psychedelic prohibition may be easier than challenging the entire status quo. Focusing on psychedelics means you don’t have to learn about other drugs and why people choose to take them. And speaking out in favor of psychedelics has become increasingly in vogue. In many places you will be positively received when opening up about your psychedelic drug use. But by including all drugs in the fight against drug prohibition, we can selflessly aid others and reduce overall ignorance of pharmacology while raising awareness of sociocultural inequity.
We should step back and remember why we oppose the prohibition of psychedelics in the first place. If we are committed to fighting for freedom of choice, the reduction of non-violent prison sentences, and the liberty to alter one’s consciousness as one pleases, then complete anti-prohibitionism is necessary. What I hope to convey is that being a psychedelic advocate should be no different than being an anti-prohibitionist. Both fight for freedom, the right to dictate one’s own consciousness, and the end to unnecessary violence instigated by the war on drugs.
An extremely relevant case study in fighting prohibition (and winning) can be found in the story of the Southeast Asian tree leaf, kratom.
What is Kratom?
Kratom, or Mitragyna speciosa, is the leaf of an evergreen tree that grows from the base of the Himalayas to the Pacific Islands of Southeast Asia. In Thailand, there is written historical evidence of kratom’s use since the mid-17th century, but many believe it has an undocumented history of use dating back thousands of years.
A photo by Soren Shade of kratom trees from Top Tree Herbs’ greenhouse
Kratom also has a therapeutic folklore associated with it. A 350-year-old Buddhist temple in Thailand has a message etched in stone recommending kratom for diarrhea. In the “Hamilton’s Pharmacopeia” episode on kratom, a farmer mentions that he reaches for kratom leaves to help with coughing.
Thailand has the richest history of kratom use among the Southeast Asian countries where kratom trees grow and traditional use centers around the common laborer. Regardless of what kind of manual work they are performing; the scorching heat, unremitant sun, and long days wear on Thai workers. They chewed kratom long before coffee was introduced to the peninsula, with kratom leaves or tea serving the same purpose of energizing them and pushing them through the physical discomfort of hard work.
Kratom use originated as simple plucking and chewing of the tree’s leaves. People pick a leaf from the tree, tear the stem from the leaf, roll it into a quid, insert the quid into their mouth and lightly chew on it. They express the juices from the leaf for a little less than a minute, letting the juices come into contact with the mucus membrane, before the leaf is spat out and discarded. This chewing and spitting act can be repeated multiple times throughout the day as desired.
Another popular way to consume kratom is as a tea. Usually, teas are brewed for social settings or to be sold in the bazaar. Leaves are taken from the tree and added to a pot of water, which is left to simmer over a fire for around three hours. In the marketplace, kratom tea is frequently sold in plastic bags to customers who seek it with the same intent as an American Starbucks patron – for the boost. There are also groups of friends who gather in the evenings to drink a shared cauldron of tea that they make over a fire. At this time of day, the tea isn’t meant to give an energizing kick, but rather to be drunk socially while taking it easy and relaxing. Consuming a larger portion actually provides an effect opposite to the one desired when laboring.
Kratom has a unique response curve depending upon how much is consumed. One or two tea bags or anything under five or six chewed leaves may have an energizing effect, while stronger tea (or tea consumed in larger quantities) may have an unwinding and sociable effect while comforting the whole body.
For more about kratom, check out Joe’s interview with Clinical Professor at the University of Florida, College of Pharmacy: Oliver Grundmann, Ph.D.
Kratom and Prohibition
Despite the abundance of native ethnopharmacological options, many Thai citizens were regular opium users in the early 20th century. The opium trade was blessed by the Thai government, and a 20% tax was passed onto the consumer. By 1940, it was estimated that between 8%-20% of all tax revenue in Thailand came from opium.
In 1942, however, Thailand declared war on Allied forces and entered World War II. With war came economic hardship, and in 1943, the Thai government noticed that their opium tax revenue had plummeted. Usually, opium taxes were a fairly constant source of revenue for the government, as consumers maintained their use continually to avoid withdrawal symptoms.
Following an investigation in 1943, the Thai government realized that their former opium taxpayers had switched from state controlled opium to locally-growing kratom after someone had discovered that chewing on kratom or drinking kratom tea allowed them to stop using opium without unpleasant side effects. The word got out and spread like wildfire.
In a special meeting on January 7th, 1943, Police Major General Pin Amornwisaisoradej, a member of the House of Representatives from Lampang, stated “Taxes for opium are high while kratom is currently not being taxed. With the increase of those taxes, people are starting to use kratom instead and this has had a visible impact on our government’s income.” Later that year, kratom was made illegal, marking its first encounter with prohibition. In the 1970s, the war on kratom escalated, and the law changed to require that all kratom trees in Thailand be chopped down. Thousands of people were imprisoned and had their lives ruined, while many more were negatively impacted in other ways.
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Terence McKenna and Kratom
In 1987, Terence McKenna was approached by a magazine called Trip to write a column called “Our Man in Nirvana.” McKenna was to be sent to remote locations around the world to relax and report back on the local culture. The magazine closed its doors shortly after he started writing for the column, but he had been sent to Thailand on the magazine’s dime, and had produced a brief article from his journey.
Ever the curious adventurer, he sought out kratom while in Thailand, which he had read about in Richard Evans Schultes’ book, The Botany and Chemistry of Hallucinogens. Impressed with the leniency of Thai culture and permittance of drug manufacture and use – especially heroin – Terence was intrigued as to why the kratom tree was illegal.
According to Terence, “We put out the word, and lo and behold, we got samples of this plant – rootstock. And it was very hush-hush. Everyone was either giggling or looking at us with thin, hard expressions as we scored this plant.” He took the rootstock back to Hawaii and made it “available for certified phytochemists and biochemical researchers to determine what this thing is.” Remarkably, this makes McKenna perhaps one of the earliest kratom vendors in the United States.
Still intrigued by the mystery of kratom prohibition, McKenna continued to look into the issue. Finally he heard a theory that registered with him. “What we learned as we made our way towards it was why it’s illegal. It’s illegal because it inhibits and interferes with heroin addiction.” Referencing how Thailand exported up to “one third of the world’s heroin,” he hypothesized that perhaps the reason it was illegal was due to its threats on their legal opioid industry. “So, who knows, you know, if this is true. But say it were true. So that means, you know, that this is, ethnobotanically, one of the great coups of the decade. And it explains, then, why the Thais are of such an ambivalent state of mind about it, because it’s poised like a dagger at the heart of their economic life if it’s real.”
Americans were first introduced to kratom in the aftermath of the Vietnam war, when GIs returning from Southeast Asia brought leaves back with them. While small circles of interest developed, only hardcore nerds like Terence McKenna were speaking publicly about kratom in the 1980s.
Despite McKenna making it available to “phytochemists and biochemical researchers,” public interest in kratom grew slowly. By 2005, kratom was beginning to develop niche appeal on online bodybuilding forums, and by 2016, the ranks of American kratom consumers were swelling. More and more, people were drawn to kratom by the idea that it may give them energy, help them with an opioid use pattern that they wanted to leave behind, or act as a natural painkiller. The DEA, however, challenged these beliefs when it was announced that they would be scheduling kratom as a controlled substance in August of 2016.
Instantly, passionate kratom consumers jumped into action. Petitions were circulated that drew more than 100,000 signatures. The DEA’s bulletin, the Federal Register, was bombarded with tens of thousands of passionate stories from people recounting how kratom made their lives better. Kratom business leaders joined together to form a lobbying group called the American Kratom Association (AKA). In a short time, dozens of members of Congress, including Bernie Sanders, had written to the DEA expressing their concern that a kratom ban would cause more harm than good.
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Amidst the public outcry, the DEA backtracked on their plan to schedule kratom. This marked the first instance that anything listed by the DEA to be added to the Controlled Substance Act was overturned: a monumental achievement that cannot be overlooked by those studying the history of prohibition.
The parent agency of the DEA and FDA, the US Department of Health and Human Services (HHS), reviewed the claims put forth by the DEA and concluded that there wasn’t sufficient evidence to make kratom illegal. However, following their receipt of the HHS letter, the FDA maintained for years that their official policy was that kratom was a threat to public health. It took a congressional investigation in 2020 to reveal that the executive branch’s official position on kratom was that it presented no substantiated risks, and that making it illegal would likely cause widespread social harm.
In the years that the FDA knew they were directed to not pursue kratom, they still solicited a number of local municipalities and state governments to prohibit kratom anyway. They ultimately convinced six states to make kratom illegal – Alabama, Arkansas, Indiana, Tennessee, Vermont, Wisconsin – driven by an internal, prohibitionist conviction. The AKA responded, and lobbied five states – Nevada, Arizona, Utah, Oklahoma, and Georgia – to pass protections for kratom consumers with a standardized regulatory framework to ensure the quality and safety of the sales. These legal regulations were filling the void that would normally be filled by the FDA, who, instead of focusing on protecting consumers through regulations, chose to pursue total prohibition.
The anti-prohibition trend has caught wind overseas as well. After over 75 years of prohibiting an ancient, traditional, and naturally occurring tree leaf, Thailand announced they would re-legalize kratom in 2020. Since 2021, 12,000 prisoners have been freed from their sentences related to possession or sale of kratom, and the price of a kratom leaf has dropped by 80-90%. In 2021, kratom was estimated to be a $1.3 billion dollar industry, and with an overwhelming majority of the world’s kratom being exported from Indonesia, the Thai government recognized how much money their prohibition was leaving on the table. After such positive change in global kratom acceptance, Thailand’s legalization news, however, was quickly overshadowed.
World Court
In July of 2021, kratom once again narrowly escaped prohibition. After failing to convince enough state governments to ban kratom, the FDA announced that they would be sending an official letter of recommendation to the United Nations, advising them to add kratom to the international list of controlled substances. When it was announced in the Federal Register, the kratom community was once again quick to respond.
Initially, the AKA sent out a mass newsletter to inform kratom consumers that the UN and World Health Organization (WHO) were in the process of making kratom illegal on behalf of the FDA. They concluded that the FDA was likely frustrated with the slow progress of attempts to push kratom prohibition through individual states, so they changed their strategy and decided to take their prohibitionist mission to the international level. Having failed at the federal level in 2016 and having lost the blessing of the HHS, it was no longer feasible to make kratom federally illegal.
The United States is constitutionally bound to UN declarations that it signs. Since the US signed onto the Convention on Psychotropic Substances of 1971, Congress is required to make any substance illegal that finds its way onto the UN’s list of controlled substances. This would allow the FDA and the DEA to effectively skirt the need to supply the evidence required to ban a substance in the United States, and render the failure to prohibit kratom domestically null and void.
Kratom advocates submitted over 70,000 comments against the prohibition to the FDA via the Federal Register. The AKA organized dozens of scientists and researchers to present their work on kratom to the WHO. By the time the hearing date came around, kratom advocates were ready for a fight. The strategy at the WHO meeting was to present as much evidence regarding the safety of kratom as possible, and science was on the side of kratom. Point by point, kratom advocates and scientists refuted each false claim made against kratom, proving they were unsubstantiated. On November 18th, 2021, the WHO’s Expert Panel of Drug Dependence concluded that “there is insufficient evidence to recommend a critical review of kratom.”
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The KCPA has a distinct focus on health and safety regulations. It recognizes that contamination and adulteration are real and dangerous, and any adverse effects resulting from contamination would be spun by the media and prohibitionists to further harm kratom’s reputation. The strategy, then, is to lean into the robust safety profile of kratom to ensure its longevity. The largest kratom businesses have also banded together to enact quality control measures and perform audits on themselves to prove that they are adhering to food grade cGMP (commercial Good Manufacturing Practice) standards. This is not a cheap or easy process, but the effort is undertaken to show in good faith that the industry is mature and responsible.
Finally, the role of normalizing the use of a substance plays a significant role in the fight against prohibitionists. Generally, getting a majority to oppose prohibition (as 91% of Americans feel towards cannabis) is the goal of all grassroots anti-prohibitionists. As such, there have been a few attempts to personalize kratom, oftentimes through pathos-driven commercials detailing the story of people who can enjoy life again because of kratom. Today, kratom is increasingly being seen as a household object, as products such as kratom tea bags grow in popularity and broaden the consumer demographic.
Another kratom shot from Top Tree Herbs’ greenhouse
What to Learn About Prohibition From Kratom
Kratom has successfully defeated every federal prohibition attempt made against it in the United States. Six states have made it illegal, but even those states are now considering replacing their bans with the regulatory framework laid out in the KCPA. Thailand, the country with the richest history of kratom use, recently re-legalized it, likely due to the undeniable economic benefit kratom exportation would bring to their country. The WHO and UN, normally aligned on drug policy with the US, couldn’t ignore the overwhelming outpour of grassroots support and unanimous scientific consensus on the safety profile of kratom.
Still, the most impressive feat performed by the kratom community yet was defeating the DEA in 2016. Normally, the DEA has unilateral decision-making power when it comes to prohibiting substances in the United States. That kratom was able to slip their grip suggests that prohibition at large is defeatable. The methods used to defeat kratom prohibition – hiring lobbyists, mobilizing hundreds of thousands of supporters, and convincing Ph.D.s and MDs to testify – should be taken to heart by anyone who finds themselves standing up against prohibition of any sort.
At this very moment, the DEA is attempting to schedule more than half a dozen psychedelic compounds, including DOI and DOC. Together, they have been utilized in over 2,000 peer reviewed scientific publications and have been indispensable to psychedelic research. 4-OH-DiPT, 5-MeO-AMT, 5-MeO-MiPT, 5-MeO-DET, and DiPT are also slated to be scheduled soon, which would prevent further study of their effects. (DiPT, for example, causes novel auditory distortions which have the potential to elucidate the mysteries of auditory neural-processing.) Some journalists and advocates have stepped up to the plate to fight the DEA for their continuation of prohibition. However, a united psychedelic front hasn’t emerged, which kratom advocates have argued as being essential to stopping these bans.
Like psychedelics, kratom has a storied history of use. Both have been devastated by prohibition, but the true test of their merit is shown in their phoenix-like ability to continually inspire consumers to fight for their legality. Use of a substance – any substance – is not justification to imprison someone. Prohibition exponentially raises the possibility of harm that comes with consuming any substance by preventing education, quality control, and normalization. We must expand our scope to include more than psychedelics in our advocacy. Prohibition needs to end, and the clues to victory may just be found in the story of a tropical tea leaf.
A graphic Top Tree Herbs made when fighting the UN
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