What are the key results of MDMA-assisted psychotherapy for PTSD in clinical trials?

In MAPS' Phase 2 trials, 53% of participants with an average of 17 years of treatment-resistant PTSD no longer met diagnostic criteria after three MDMA doses and 12 weeks of psychotherapy. Remarkably, 67% remained symptom-free five years later without further treatment, showing superior long-term results compared to placebo with therapy.

How are psychedelic studies designed to account for the placebo effect?

Psychedelic studies are typically placebo-controlled and randomized. However, blinding is challenging due to the obvious effects of psychedelics. Researchers sometimes use 'active placebos,' like niacin, to create physiological effects (e.g., skin flushing) to maintain blinding.

What is the 'clay' metaphor for psychedelic effects on the mind?

Psychedelics are described as 'heating up the clay' of the mind and psyche, making them more malleable. This allows individuals to reshape unhelpful narratives, stories, and compulsive behaviors that have governed their lives, offering a chance to 'rewire' or 'remold' the self.

Why is diverse funding important for psychedelic research beyond government grants?

Diverse funding, particularly from individual philanthropists, provides essential seed capital due to a historical lack of government funding. This capital destigmatizes the science, paves the way for larger foundations, and can accelerate the development of world-changing treatments, similar to the funding of oral contraceptives.

What are the challenges in scaling psychedelic therapy to a wider population?

Scaling is challenging because effective psychedelic therapy involves intensive, in-person, dual-therapist sessions. A controlled growth model is necessary to adequately train therapists, manage potential adverse events, and prevent backlash. Rushing could lead to disastrous outcomes.

Why is it difficult for licensed professionals like doctors and pilots to seek mental health care?

Physicians, police officers, pilots, and other licensed professionals face severe stigma. A diagnosis of mental illness can jeopardize their licenses and ability to practice, forcing many to seek covert treatment despite facing high rates of burnout and stress.

What ethical concerns exist regarding the commercialization of psychedelics?

A primary ethical concern is the management of intellectual property and patents. Broad patent claims by a few companies could create a non-competitive field, limiting access and innovation, reminiscent of pitfalls seen in 'Big Pharma.'

Are there non-ingestible ways to achieve psychedelic-like states of consciousness?

Yes, techniques like holotropic breathwork can induce non-ordinary states of consciousness that can be used for mental exploration and healing without ingesting compounds. These methods can be adapted for safe, distanced practice.

How should one approach difficult or 'bad' psychedelic experiences?

Difficult experiences are not always 'bad'; they can be challenging but lead to growth with proper support. Journaling about the experience and seeking an integration therapist experienced in psychedelics can help process and metabolize these challenges, as permanent negative changes are rare.

Key Moments

The Psychedelic News Hour - New Breakthroughs, Treatment of Trauma, and More | The Tim Ferriss Show

Tim Ferriss

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Sep 7, 2020|27,251 views|460|54

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Key Moments

TL;DR

Psychedelic research progress: MDMA trials success, trauma treatment potential, and careful scaling.

Key Insights

Successful fundraising ($30 million) for MDMA-assisted psychotherapy Phase 3 trials for PTSD by MAPS is a significant breakthrough.

MDMA-assisted psychotherapy shows remarkable long-term efficacy for treatment-resistant PTSD, with a high percentage of participants no longer meeting diagnostic criteria even years after treatment.

The combination of psychedelic medicine and psychotherapy is crucial for optimal outcomes, emphasizing the 'context and molecule' synergy.

Diverse funding sources, including citizen philanthropy, are vital for advancing psychedelic research, particularly given the lack of traditional funding.

Scaling psychedelic treatments presents challenges, requiring a controlled growth model, therapist training, and preparation for potential media backlash or adverse events.

Ethical considerations, especially regarding intellectual property and broad patent claims, are critical to ensure a competitive and accessible psychedelic medicine market.

While powerful, psychedelics require careful preparation, intention, and integration; they are not a panacea and should be approached with caution and ideally professional guidance.

The stigma surrounding mental illness, particularly for healthcare professionals, remains a significant barrier to seeking and receiving care, highlighting the need for systemic change.

Non-ingestible methods like breathwork can offer access to non-ordinary states of consciousness for therapeutic exploration, presenting an alternative to compound ingestion.

Difficult psychedelic experiences, while unsettling, can be valuable stepping stones for personal growth with proper integration and support, and are not inherently 'bad' if safe.

LANDMARK FUNDING AND MDMA TRIALS FOR PTSD

The conversation highlights a major milestone: MAPS' successful $30 million fundraising campaign to complete Phase 3 trials for MDMA-assisted psychotherapy for PTSD. This achievement is crucial for validating the treatment's efficacy. The success of these trials, even with a placebo control group receiving sub-therapeutic doses, demonstrates the profound impact of MDMA when combined with intensive psychotherapy. Long-term follow-up data is particularly encouraging, showing sustained remission rates for individuals with treatment-resistant PTSD, suggesting a potential for lasting healing beyond conventional treatments.

THE SYNERGY OF MEDICINE AND PSYCHOTHERAPY

A central theme is the indispensable combination of psychedelic compounds and structured psychotherapy. Speakers emphasize that the molecule alone is insufficient; it's the synergy between the substance and therapeutic support that unlocks profound healing. This 'context and molecule' approach, rooted in ancient healing practices, facilitates a state of heightened plasticity where individuals can deconstruct and reshape maladaptive thought patterns and narratives. The success of MDMA-assisted therapy underscores that true healing often stems from within, rather than merely suppressing symptoms with daily medication.

DIVERSE FUNDING AND THE NEED FOR CAUTION

The critical role of diverse funding sources, especially citizen philanthropy, is discussed in advancing psychedelic research, which often struggles for traditional institutional support. Tim Ferriss stresses his personal commitment to providing seed capital to high-leverage opportunities that can be world-changers. However, this enthusiasm is tempered with strong calls for caution. The complexity of these substances, the variability of street-sourced compounds, and the potential for misuse necessitate thorough preparation, responsible use, and professional guidance, likening the approach to rigorous surgical preparation rather than casual experimentation.

SCALING ACCESS AND MANAGING EXPECTATIONS

The monumental task of scaling psychedelic-assisted therapies to meet the vast demand, particularly post-pandemic, is a significant focus. While acknowledging the urgent need, the discussion emphasizes a controlled, deliberate growth model. This includes rigorous therapist training, anticipating potential media backlash from adverse events, and learning from historical adoption patterns of new technologies. The strategy often involves starting with premium services for early adopters to fund R&D, gradually building towards wider accessibility, akin to how early medical interventions were initially limited.

ETHICAL CONSIDERATIONS AND PATENT LAND GRABS

The burgeoning psychedelic movement faces numerous ethical considerations, with intellectual property management being paramount. There's a concern about broad patent claims that could stifle competition and create a monopolistic landscape, mirroring Big Pharma's playbook. The need for vigilance in opposing overly expansive patents is highlighted to ensure a healthy, accessible ecosystem for psychedelic medicine. Other ethical issues, such as the history of sexual abuse in certain traditional contexts and the importance of informed consent due to potential contraindications, are also implicitly acknowledged.

OVERCOMING STIGMA AND NORMALIZING CARE

The persistent stigma surrounding mental illness, particularly for licensed professionals who risk their careers by seeking treatment, is identified as a major obstacle. The discussion points out the paradox of a healthcare system that punishes those who admit vulnerability. While a direct solution remains elusive, sharing personal stories and advocating for systemic changes, like paid sick leave and policy reforms, is seen as a catalyst. The conversation also touches on the potential application of psychedelics for addressing ingrained societal issues like racism and sexism, though current medical coding systems pose regulatory challenges.

Navigating DIFFICULT EXPERIENCES AND INTEGRATION

Difficult or 'bad' psychedelic experiences are framed not as failures but as opportunities for profound growth when approached safely. The importance of integration—processing the experience afterward—is stressed, with professionals offering support for navigating challenging emotional material. The dialogue differentiates between 'bad' and 'unsafe' trips, encouraging individuals to delve into difficult experiences with the right guidance. It's noted that moderate doses or certain substances like LSD can sometimes lead to particularly challenging introspective states that require patience and support for effective resolution and integration.

Mentioned in This Episode

●Supplements

●Products

●Software & Apps

●Companies

●Organizations

●Books

●Drugs & Medications

●Concepts

●People Referenced

Common Questions

Tim Ferriss has publicly shared his own mental health experiences, destigmatizing trauma and mental illness. He has also committed significant resources and encouraged others to invest in research, development, and commercialization of psychedelic-assisted therapies.

Topics

Neuroscience & the Brain Mental Health & Psychology Psychedelic Therapy Altered States Of Consciousness Drug Safety Ketamine Therapy Medicine & Clinical PTSD Treatment MDMA-assisted Psychotherapy Mental Health Destigmatization Psychedelic Research Funding Scaling Healthcare

Mentioned in this video

People

David Rubenstein

One of the visionary founders of The Carlyle Group and host of 'The David Rubenstein Show'. Author of 'How to Lead'.

Phil Knight

Mentioned as one of the leaders featured in David Rubenstein's book 'How to Lead'.

Claudio Naranjo

Author of 'The Healing Journey', a highly recommended book on psychedelics.

Brian Chesky

Co-founder of Airbnb, interviewed on the Masters of Scale podcast.

Terence McKenna

Ethnobotanist who coined the term 'heroic dose' for psychedelic experiences, specifically referring to 5 grams of psilocybin mushrooms.

Reed Hoffman

Host of the 'Masters of Scale' podcast, which featured an excellent episode on Airbnb's deliberate strategy of doing things that didn't scale initially.

Rick Doblin

Founder and executive director of MAPS, credited with raising significant funds for psychedelic research and for enduring efforts over decades.

Bill Gates

Mentioned as one of the leaders featured in David Rubenstein's book 'How to Lead'.

Tim Ferriss

The host of the podcast, interviewed in this episode, known for deconstructing world-class performers and supporting psychedelic research.

Sam Harris

Creator of the 'Waking Up' app, recommended for meditation.

Warren Buffett

Mentioned as one of the leaders featured in David Rubenstein's book 'How to Lead'.

Matt Johnson

Dr. Matt Johnson at Johns Hopkins, known for his staggering nicotine addiction studies using psychedelics.

Walter Isaacson

Past podcast guest who provided a quote for David Rubenstein's book.

Catherine McCormick

An incredible woman who almost single-handedly developed oral contraception through her philanthropy.

James Cameron

The director, quoted as saying, 'Hope is not a strategy.'

Jeff Bezos

Mentioned as one of the leaders featured in David Rubenstein's book 'How to Lead'.

David Rabin

A board-certified psychiatrist and neuroscientist, executive director of the Board of Medicine, and co-founder of Apollo Neuroscience.

Ruth Bader Ginsburg

Mentioned as one of the leaders featured in David Rubenstein's book 'How to Lead'.

Molly Maloof

A physician, Stanford lecturer, and ketamine-assisted psychotherapist, co-hosting the Psychedelic News Hour.

Annie and Michael Mithoffer

Therapists who helped define and formalize the format for MDMA-assisted psychotherapy used in MAPS trials.

Oprah Winfrey

Mentioned as one of the leaders featured in David Rubenstein's book 'How to Lead'.

Shalini Ramachandran

Author of the Wall Street Journal piece on psychedelic research funding.

Anthony de Mello

Author of 'Awareness', a book recommended for spiritual and self-inquiry practices.

Phil Wolfson

Mentioned for his work in ketamine-assisted therapy, particularly his training program that brings practitioners together to experience psychedelics.

Richard Branson

Mentioned as one of the leaders featured in David Rubenstein's book 'How to Lead'.

Joe Green

Played an important role alongside Tim Ferriss in the MAPS capstone campaign.

Media

Psychedelic News Hour

The show where this interview was originally recorded, soon to be a podcast, focusing on psychedelic news.

Wall Street Journal

A publication that summarized the MAPS capstone campaign success.

Masters of Scale

A podcast by Reed Hoffman, mentioned for its episode on Airbnb's early strategy.

Software & Apps

Clubhouse

An app described as 'a space for casual drop-in audio conversations,' where this episode was recorded.

Waking Up App

A meditation app by Sam Harris, recommended for an introductory course to help navigate and optimize psychedelic experiences.

Organizations

National Institutes of Health

Government agencies mentioned as traditional sources of research funding, contrasted with the need for diverse funding sources.

Johns Hopkins

A leading research institution where significant psychedelic research (e.g., nicotine addiction studies) has been conducted.

National Institute of Mental Health

Government agencies mentioned as traditional sources of research funding, contrasted with the need for diverse funding sources.

MIT

Where Catherine McCormick had part of her history before her philanthropic work.

FDA

The U.S. Food and Drug Administration, which has given breakthrough therapy designation to both psilocybin and MDMA.

Multidisciplinary Association for Psychedelic Studies

A non-profit organization focused on psychedelic research, particularly MDMA-assisted psychotherapy for PTSD, which recently completed a successful fundraising campaign.

Drugs & Medications

5-MeO-DMT

A potent psychedelic viewed by some as the 'Everest' of psychedelics, but described here as another tool with a narrower application band.

acetaminophen

Common over-the-counter painkiller (Tylenol), mentioned as being more toxic than MDMA or psilocybin, yet causes more emergency room visits.

Ayahuasca

A plant-based psychedelic brew, caution is advised due to particular risks, especially when taken in South America without proper guidance. Also delivered in group settings in indigenous cultures.

psilocybin

A psychedelic compound that has received breakthrough therapy designation by the FDA, with vast data supporting its clinical use and an incredible safety profile.

Subliminal Ketamine

Used as a starting point for low-dose psychedelic experiences in Dr. Maloof's practice, described as safe and controlled.

MDMA

Methylenedioxymethamphetamine, also known as ecstasy, used in phase 3 clinical trials for psychotherapy-assisted treatment of PTSD, showing significant efficacy and low toxicity.

Ketamine

A dissociative anesthetic used in assisted psychotherapy, with its own protocol (KET-AP). Discussed as a 'gateway drug' for psychedelic experiences.

LSD

A classic psychedelic that can have a particularly tricky and long-lasting effect, especially at higher doses, making it challenging to navigate.

Books

Awareness

A book by Anthony De Mello, recommended to be read concurrently with the Waking Up app for deeper integration of psychedelic experiences.

The Secret Chief

A book published by MAPS, discussing different modalities of facilitation for psychedelic experiences.

How to Lead

A book by David Rubenstein featuring leadership principles from world-greatest CEOs, founders, and game-changers.

The Healing Journey

An exceptional book by Claudio Naranjo, highly recommended for those contemplating psychedelics.

Products

Leaf Therapeutic Device

An HRV monitor recommended by Dr. Molly Maloof in her clinical practice for continuous monitoring and visualization of stress responses throughout the day.

Oura Ring

A wearable device used by Tim Ferriss for monitoring resting state morning measurements (HRV).

Whoop band

A wearable device mentioned for monitoring physiological responses like Heart Rate Variability (HRV) and correlating with stress and burnout levels.

Supplements

Niacin

Mentioned as an 'active placebo' that can create a physiological effect (skin flushing or niacin flush) in psychedelic studies to maintain blinding.

DMT

A potent psychedelic, mentioned as a compound that requires significant preparation and responsible use, especially for a first experience.

Companies

The Carlyle Group

A global investment firm, co-founded by David Rubenstein.

Airbnb

A company mentioned for its early strategy of doing things that didn't scale to prototype and refine its offering.

Apollo Neuroscience

A company co-founded by Dr. David Rabin; mentioned as creating a device to modulate HRV and reduce stress.

Janssen Pharmaceutica

The company behind S-ketamine, often criticized for not combining it with therapy.

Uber

A company that used initial premium pricing for a small subset of people to pay for R&D and subsidize cheaper, wider deployment.

Concepts

Holotropic Breathwork

A breathwork technique that can induce non-ordinary states of consciousness without ingesting compounds, suggested as an alternative for isolated individuals.

Internal Family Systems

A therapeutic approach mentioned as a tool from traditional therapy that can be enhanced by psychedelics.

Locations

Oregon

Mentioned in the context of statewide decriminalization movements and initiatives related to psychedelics.