Though psychedelics have been used for thousands of years, modern technology is beginning to teach us more – much more – about their effects on our minds and bodies. We caught up with Apollo Neuro co-founder and neuroscientist and board-certified psychiatrist, Dr. David Rabin, to learn more about how people are using wearables to gather new insights about their trips.
Alexa: For anyone who isn’t already aware, can you give us a high-level overview of what wearable tech is for, who might want to use it, and why?
David: I think of wearable technology as a powerful tool in our health toolkits to help combat the stresses of modern life, just like mindful practices like meditation, breathwork, and exercise. The wearable technology that we’ve developed at Apollo is safe for children and adults alike, so it’s really for anyone who feels they could use a tool to help them feel more safe, in control, and calm and experience better sleep, less stress, and a brighter mood. When we feel more secure, we’re able to fall asleep faster and stay asleep longer, focus more effectively, socialize more freely, and sustain energy throughout your daily tasks
Alexa: Can you explain the synergy between technology and psychedelic treatments in achieving better mental health outcomes?
David: Psychedelic-assisted therapy can be scary or intense for people, especially during their first time. Wearables can serve as a somatic anchor for both the patient and the therapist so they can stay in tune with their bodies. It helps the therapist to remain impartial on any difficulties or challenges that the patient may be experiencing, and it helps the patient to have a smoother journey.
To date, we have never had access to modern tools to help us solve these challenges that exist within and around the psychedelic experience. Today, the Apollo wearable is the only patented technology to reduce uncomfortable experiences associated with medicine-assisted therapy. So far the results from Apollo plus psychedelic-assisted therapy in the real world have been tremendous, including reducing anxiety in advance of medicine administration for easier drop in, reduction in ‘bad’ or uncomfortable trips, and improved ease of integration afterward. Apollo represents the very first example of how wearable technology can empower us to make healing with psychedelic and non-psychedelic techniques easier and more accessible for all.
Alexa: Can you share some examples of scientific research or studies that support the effectiveness of wearable tech and its combination with psychedelic therapies?
David: Currently, the Apollo Neuroscience Clinical Research Team is running an IRB-approved clinical trial with the support of the Multidisciplinary Association for Psychedelic Studies (MAPS), a nonprofit sponsoring the most advanced clinical trials of a psychedelic-assisted therapy. The purpose of this study is to understand how the Apollo wearable touch therapy impacts long-term outcomes and improves integration following MDMA-assisted therapy in people with post-traumatic stress disorder (PTSD).
Two large clinical trials evaluating the Apollo wearable in PTSD patients are currently underway and recruiting participants. The first is taking place at the Rocky Mountain VA in Denver, CO and the second, a nationwide trial, is evaluating the Apollo wearable to sustain remission from PTSD following MDMA-assisted therapy, described above. Anyone who has participated in a MAPS trial of MDMA-assisted therapy is eligible to join the MDMA-Apollo study and receive an Apollo wearable for the study.
We’ve seen tremendous results with the Apollo wearable in thousands of traumatized individuals and those who have participated in psychedelic-assisted therapy thus far. Some of the most promising responses were in people receiving ketamine-assisted therapy, particularly those new to psychedelic medicines or who have a lot of anxiety in anticipation of new experiences. We care about the outcomes, and anything we can do to help people stay in remission or feel better for longer periods of time is a big win for our field. We are very much looking forward to seeing how the Apollo wearable will contribute to the integration period following MDMA-assisted therapy.
Alexa: Have there been any clinical trials or user feedback demonstrating the positive impact on mental health?
David: The Apollo Neuro technology has been studied in over 1,700 research subjects in seven complete and 14 ongoing real-world and university clinical trials demonstrating very promising improvements in everything from sleep, pain, and fatigue to mood, anxiety, and focus. Ongoing studies of the Apollo technology include studies of PTSD, ADHD, and TBI, metastatic breast cancer pain, and severe autoimmune disorders.
Alexa: There are tons of wearable devices out there these days, could you share an overview about Apollo and how it’s different?? What specific features or technologies does Apollo employ to support mental health?
David: The Apollo wearable is different from other wearables as most wearables are trackers. They tell you what is going on with your health but leave it up to you to make decisions to improve it. The Apollo, on the other hand, actively improves your health through soothing vibrations that shift you out of “fight or flight” and into “rest and digest,” or a parasympathetic state. You can actively choose how you want to feel on the Apollo Neuro app on your phone – Focus, Social, or Unwind, for example – and the wearable plays vibrations that help to shift you into that state, much like the way certain songs pump you up or chill you out.
Alexa: What mental health benefits can users expect from your wearable technology on its own, and how does your wearable tech complement or enhance the effects of psychedelic therapies?
David: On average, users experience 40% less stress and feelings of anxiety, an 11% increase in heart rate variability (HRV), up to 25% more focus and concentration, and up to 19% more time in deep sleep. In an ongoing real-world sleep study, users get up to 30 more minutes of sleep a night. Less stress and feelings of anxiety is especially helpful in a psychedelic-assisted therapy setting, as well as an increase in HRV, as that is the biggest indicator of how well your body responds to stress.
Alexa: What does the future of this type of therapy look like? Do you collaborate with mental health professionals, therapists, or healthcare providers to integrate your technology into treatment plans?
David: The future of Apollo being used in this type of therapy is that it will be used by clinicians and patients in the office or treatment facility where medicine is administered, beginning in the waiting room or before arrival, to improve short term experiences. It will then be used, as it is today, by patients/clients after their experiences at home to improve clients engagement in treatment and enhance their outcomes from integration practices, which are the most important piece of treatment and often ignored.
Alexa: If a healthcare provider is interested in incorporating wearable tech into their practices, what is the process for going about that?
David: We work with hundreds of healthcare practitioners ranging from holistic health clinicians, centers for ADHD and autism, psychedelic assisted therapy clinics, trauma therapy practitioners, Chiropractors and more. Our goal is always to work hand in hand with them to tailor a program that meets the needs for their clinic and their patients. To learn more about partnership options with Apollo, Practitioners and Clinicians can reach our partnership team directly by filling out this form on our website.
Alexa: How do you see the intersection of technology and mental health evolving in the coming years? Are there plans for further advancements or updates to your technology to enhance its mental health benefits?
David: The future of mental health involves the convergence of technology, psychedelic techniques, and our current practices. As Apollo learns from people over time, it will personalize vibes for each individual user based on their needs at any given time today. This is already happening with Smartvibes for sleep, which is the first wearable technology AI collaboration to give us 30-60 minutes more sleep each night that is concentrated in deep and REM sleep, just by understanding our sleep signature and acting on it predictively to prevent unwanted middle-of-the-night wakeups. This will only get better over time!
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In this episode, Joe interviews Dana Lerman, MD: a decade-long infectious disease consultant who has since been trained in psychedelic-assisted therapy, ecotherapy, and Internal Family Systems, and is the Co-Founder of Skylight Psychedelics, where she prescribes IM ketamine and trains therapists who work with it.
Lerman tells her story: how working with kids with cancer made her want to learn medicine, what it was like working as an infectious disease expert during COVID, and how fascinating it has been to start with modern medicine and then fully embrace the traditional frameworks of ayahuasca ceremonies. She has realized that part of her role is to bring that intention, ceremony, and inner healing intelligence to modern medicine – that that will greatly benefit patients as well as clinicians who naturally want to be healers but are burnt out by the bureaucracy and distractions of the faulty container they find themselves in. Skylight Psychedelics is working on opening a clinical research division, researching psychedelics for Long COVID, and bringing in-person psychedelic peer support services to emergency rooms.
She also discusses intergenerational trauma and how psychedelics have affected her parenting; the impossibility of informed consent in psychedelics and why there should be disclaimers as well as instructions; accessibility, the need for insurance to cover psychedelic-assisted therapy, and why the price of these expensive treatments actually makes sense; why we should be sharing stories of mistakes and things going wrong during ceremonies; and why one of the biggest things we can do to further the cause is to educate our children and parents about psychedelics.
Notable Quotes
“What’s come to me recently in ayahuasca ceremony is that part of my role in this space is really to bring intention and to bring ceremony and the inner healing intelligence and that concept to the modern medicine space. I mean, there’s so many places for improvement in modern medicine, like even: We have a few minutes for a timeout so you can check to make sure that’s the right patient [and] it’s the right limb you’re going to amputate, but we don’t have a moment to talk about who this person is and the intention of this surgery and what we want for this person. We just have this disconnect, and this disconnect; obviously, it’s not just in medicine. It’s in everywhere. It’s our food. It’s our community. All systems.”
“I have three small children. A lot of why I went to ayahuasca was because I knew [beside wanting] to heal myself of all the stuff that I’ve been carrying around, I wanted to shift my parenting and to be a better parent, and I felt that if I carried my anxiety, my control, all the stuff: It just keeps getting passed down because the kids are just learning from us. But if you can address that, if you can address where does that come from, what is the work that has to be done around it, and do that work, your kids see it. My daughter: When I came home from ayahuasca (she was probably seven); she looked to me and she said, ‘Why didn’t you go there sooner?’”
“Anytime people are using these medicines, I think: There’s a huge disclaimer that should be coming with these medicines, like: ‘Your life will be changed forever. You will never look at anything the same way again, and there’s a possibility that you enter into a space where you are experiencing the vastness of the universe, and that may be very overwhelming for you when the journey is over. You need someone to talk about it with.’ The whole concept of integration is so important.”
Amidst the fervent cries of psychedelic-centric victory heard around Colorado since the passing of the Natural Medicine Health Act (NMHA), it is important to remember those less publicized, less well-funded, and less white, human beings who continue to suffer and die from various manifestations of the War on Drugs – the same political ill that prevented access to “natural medicines” in the first place.
A malignant disease afflicting the collective body of culture, the War on Drugs is among the most horrific, anti-human disasters in the history of American policy. Lack of access to psychedelics is one symptom of this disease, but there are many others; including the opioid overdose epidemic, mass incarceration, the creation of Mexico’s narco-state, the militarization of police, the erosion of personal rights, and continued institutionalized racism. Like a very expensive band-aid triumphantly placed on the skinned knee cap of a dying person by self-congratulatory doctors, the NMHA does absolutely nothing to alleviate these most malignant symptoms of the disease that is the War on Drugs. In this way, the NMHA and other psychedelic-centric drug policies paradoxically represent the continuation of oppression more than its end.
Passed on November 8th, 2022 by Colorado voters through a ballot initiative, the NMHA brought immediate statewide decriminalization and pending legalization of certain “natural medicines” including psilocybin, DMT, mescaline, and iboga. Those unfamiliar with the details of the NMHA can read about them extensively here. As far as psychedelic policy goes, the NMHA is a reasonably cutting-edge development, merging both legalization and decriminalization models. But there is no such thing as a “psychedelic policy,” only drug policy.
Dr. Carl Hart, Columbia University’s Department of Psychology Chair, defines the problem succinctly as “psychedelic exceptionalism,” “the perspective that psychedelics are somehow better and more useful than other classes of drugs like opioids or stimulants.” This rampant false belief that psychedelics can be meaningfully separated from the larger drug policy conversation enables the generally privileged and up-power “psychedelic community” to ignore prohibition itself as the core societal disease while profiting from the treatment of a single symptom. Rather ironic, really.
Gazing through the glamor and capitalist speculation currently surrounding the psychedelic phenomenon reveals a more essential truth: Psychedelics are morally-neutral substances just like any other. Our inability to see this is our responsibility, but, in part, not our fault. America has a long-standing tradition of simplistic moralistic judgments around substances which began with the Women’s Christian Temperance Movement in the 1800s and continued through programs like D.A.R.E. Our cultural soil is deeply seeded with the idea of “good drugs” used by “good people” and “bad drugs” used by “bad people.”
After decades of wrestling with this tired old narrative, we’re finally managing to change it, but only along those same dualistic lines of thinking. By highlighting the positive effects of psychedelics, we have begun to politically pry some useful substances from the realm of “bad” drugs. The DEA is now considering releasing MDMA from its unscientific schedule I clutches while states legalize and decriminalize some psychedelics. This is the entire basis of the psychedelic renaissance. What has unfortunately not been considered is the problem with assigning a moralistic value to substances in the first place.In a compensatory over-swing of the flawed rhetorical pendulum, “psychedelic people” and their “medicines” are now coming to be seen as “good.” Such thinking leads predictably to unjust policy outcomes. This is, after all, the same fallacious logic that sparked the War on Drugs in the first place.
The categorical separation of “good” drugs and “bad” drugs is synonymous with the assignment of human beings into those same categories. The prevalence of this bias in the psychedelic space, implicit or explicit, betrays a deep lack of contextual awareness leading to oppressive behavior, which is contrary to the kind of societal-level healing that the movement claims to represent. Despite the political utility of rhetorically distancing psychedelics from other substances, our “natural medicines” are still ultimately “drugs” that must be considered within the larger context of American drug policy.
The Cultural Context of Psychedelics: A Brief Reminder of The War on Drugs
To triage the symptoms of prohibition, addressing each by their lethality, reveals a clear picture of the injustice inherent in a myopic focus on psychedelic-centric policy change. While it’s true that lack of access to psychedelics is preventing untold numbers of people from receiving helpful treatments for things like anxiety, depression, PTSD, addiction, etc., these kinds of maladies are collectively overshadowed by more immediately fatal symptoms of prohibition.
Itemizing the harms of the War on Drugs is something akin to sorting through the rubble of a war-torn metropolis while bombs are still falling – an extensively horrific task far exceeding the scope of this article. Two vignettes that partially describe the scope of destruction can be found in the interwoven phenomena of the opioid epidemic and mass incarceration; two direct symptoms of the War on Drugs.
The number of people who died from opioid overdose in 2022 was the equivalent of a 9/11 attack every 2 weeks, and rising in 2023. After September 11th, 2001, the U.S. reacted swiftly to pass a series of sweeping legislation, initiate new programs, and even go to war in Iraq and Afghanistan. Opioids clearly kill many times more people than terrorism ever has, but no such action is being taken. We won’t even mention the fact that opium production in Afghanistan was higher under U.S. control. The solutions to the opioid problem can be clearly found in harm reduction-based policies such as those implemented in Canada and Portugal. These policies stand on much firmer empirical ground than those arguments that drove our country to war in the Middle East, so where is the commiserate response?
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Throughout alcohol prohibition in the 1920s, simple logistical realities incentivized clandestine distillers to manufacture the strongest possible concentrate of their drug, and moonshine was born. It was both easier to conceal and more profitable per gallon than beer or lesser-proof spirits. Fentanyl is the same story. One pound of Fentanyl is as potent as nearly 50 pounds of heroin, and one pound of carfentanil is as potent as 100 pounds of heroin. Which is more likely to be smuggled across a border? The manufacture and indiscriminate distribution of the most lethal substances is not stopped by the War on Drugs, it is directly caused by it.
An article published in the Journal of Law, Medicine, & Ethics titled “We Can’t Go Cold Turkey: Why Suppressing Drug Markets Endangers Society” names U.S. drug policy itself as a “key accelerant that transformed this wave of addiction into an inferno of death, disease, and personal destruction.” It’s well known that a policy approach centering harm reduction and public health over criminal punishment greatly reduces overdose deaths. Yet, we continue to quietly tolerate more than a hundred thousand American deaths each recent year.
Overdose is only one of many dark manifestations of prohibition untouched by psychedelic-centric policies. The United States, the “land of the free,” only has 4% of the world’s overall population, yet holds 20% of the prison population. Of those people in U.S. prisons, 45% are there for nonviolent drug offenses. This means that nearly 10% of human beings in prison on planet Earth are imprisoned in the United States as non-violent victims of the War on Drugs.
The outcome of American drug policy is so horrifically maligned with the logicalgoals of such policies (public health & safety) that one can’t help but question the intentions of policymakers. Far from the realm of fringe conspiracy, we have seen institutional harm inflicted intentionally on substance users in the past. In the 1920s, the U.S. Government intentionally poisoned alcohol heading for the underground market, resulting in the death of at least 10,000 people. This action was justified using logic that claimed people who use drugs are bad, morally reprehensible humans – that same tired old trick of moral conflation. If the goal of the War on Drugs was to reduce drug use and create a safer society, then it has failed horribly. If the goal is to punish “bad” drug users in some of the most severe ways imaginable, then the War on Drugs has been a resounding success.
Through the lens of trauma-informed care, which invites us to see substance use as a result of trauma, the situation becomes downright sinister. A common American story might be told as such: A traumatized person turns to substances as a momentarily helpful coping mechanism. (Those with 4 or more Adverse Childhood Experiences are 1,350% more likely to abuse opiates than the general population). As a direct result of prohibition itself, the substances they find on the street are concentrated to the highest potency imaginable. There are few, if any, harm reduction or effective mental health services available. Instead, a militarized police force backed by an 80-billion-dollar prison industry is actively seeking to put this person in a cage – that is if they don’t overdose first. It is into this maelstrom that policies like the NMHA interject: “Legalize psychedelics!”
Why Only “Natural Medicines”?
A report from the Colorado Department of Public Safety on substance use trends does not even mention psilocybin or other psychedelics as relevant factors in state public health. The report does, however, describe an increase in fentanyl-related incidents including lethal overdose, explaining that 275,569 doses of fentanyl were seized in 2021. According to the Denver Open Data Crime Catalog, only 14 people were arrested for psychedelics in 2021, and 24 people in 2020. For opioid arrests in those same years, the numbers were much higher: 236 and 348 people respectively. The numbers were even higher for the worst outcomes, with an average of about 1,000 people dying every year in Colorado from an opioid overdose. In this way, psychedelics are not an immediately pressing issue from a law enforcement or public health perspective. So why do they continue to be the sole focus of organized and well-funded political efforts such as that which birthed the NMHA? Why has this particular symptom of prohibition received so much attention, funding, and policy action?
Interest Convergence: Suddenly The Privileged Care About Drug Policy
It’s an unfortunate truth that our beloved Renaissance and all of the psychedelic research and policy are predominantly reflective of white interests. One historian asserts that “psychedelic culture [is] dominated by privileged white men.” Indeed, a recent U.S.-based survey of over 41,000 people found that more than half of the white respondents had used psilocybin or LSD, “whereas less than one-quarter of Black [people] reported lifetime psilocybin use.” A relevant meta-analysis examining 18 studies on psychedelic-assisted therapy that occurred between 1993 and 2013 revealed that “82.3% of the participants were non-Hispanic white.” Psychedelic exceptionalism appears to have firm roots in institutional racism and white privilege.
As if by design, historically oppressed groups suffer and die from the War on Drugs at higher rates than white people. Though the recent intensification of overdose deaths allows a more clear view, we have seen these same kinds of disparities for decades with little attention given. Besides MAPS, which is perhaps the first pharmaceutical company in history to explicitly oppose the War on Drugs, there have been few for-profit organizations working to fight prohibition in any way. Now we see psychedelic ticker stocks, psychedelic venture capitalists, and psychedelic certificate programs all vehemently fronting the narrative of “healing” while functionally ignoring the collective disease that is the War on Drugs.
It seems institutional racism, the at-scale death of opioid users, and mass incarceration were not enough to attract the attention of the wealthy and powerful to drug policy. Only the promise of greater wealth has been sufficient to finally stir society’s biggest players into support of limited reform. Suddenly, every venture capitalist is a psychedelic advocate, but where are the drug policy advocates? After all, the only true difference between the heroin dealer and the “psychedelic entrepreneur” is that one is on a side of the culturally created narrative which happens to be favored at this particular moment in history. Tomar Pierson-Brown puts it succinctly in saying: “It’s not irony, it’s interest convergence.”
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Healing Without Harming: Anti-Oppressive Psychedelic Advocacy
Psychedelic modalities are without-argument desperately needed as accessible tools for front-line mental health professionals, but policy efforts focused on them exclusively are oppressive. Ibram Kendi, author of How to be an Antiracist, explains that “there is no such thing as not racist, there are either anti-racists or racists.” In this same way, drug policy is either anti-oppressive or oppressive. There is no in-between. Without applying this attitude, policy and organizational efforts within the psychedelic space are destined to become embodied examples of oppression.
Anti-oppressive approaches “minimize the effects of structural inequalities, social hierarchies, and power differentials.” As we have seen, psychedelic-centric policies like Colorado’s NMHA actually accentuate the power of the dominant groups and do absolutely nothing for the people suffering most from the War on Drugs. Drug policies like the NMHA neglect the most destructive aspects of the War on Drugs in favor of the more profitable, ‘sexy,’ and privilege-aligned substances (like psychedelics). These kinds of policies pander to the dominant culture while ignoring the core problem.
Fervent psychedelic purists (I know because I used to be one) will argue that making psychedelic healing widely available would lead to the amelioration of addiction. While this is true to a degree, it would not happen fast enough to meaningfully stem the tide of overdose deaths and is a backward way to approach the problem; like using nicotine patches to treat lung cancer.
Anti-oppressive psychedelic advocacy must necessarily include and prioritize an end to the War on Drugs as a whole, not just psychedelic legalization or decriminalization. The systemic situation that prevents access to psychedelics is the same that has created the overdose epidemic, mass incarceration, and a slew of other hugely destructive phenomena. It’s the War on Drugs and the disease of prohibition. As beneficiaries of recent drug policy changes, psychedelic institutions of all kinds have a clear responsibility to advocate for an end to the War on Drugs writ large. To ask “How can I make a psychedelic dollar?” without simultaneously asking “What can I do to help end the War on Drugs?” is unjust and tone-deaf. Only by directly addressing the core disease itself, and not just a single symptom, can we begin to truly heal as a culture.
Khan shares his journey into the world of science and policymaking, beginning with science journalism and inspired by David Nutt’s famous ‘Equasy’ paper and subsequent firing for telling the truth. Realizing how strong the disconnect was between political and science worlds, his goal became to represent science when it comes under attack; using campaigning, lobbying, advocacy work, etc., and essentially becoming a translator between science and society – bringing these overly complicated concepts down to a level every day culture can understand. At UC Berkeley, he’s focusing on research, training scientists to be better communicators, educating the public on the benefits of psychedelics, and trying to make research more trustworthy.
He discusses the word “science” and how it’s used to describe lots of things; the hard problem of consciousness; color constancy, perception, and the influence of priors; the risk of abuse in all therapies; trust and why people don’t always “trust the science”; the risks of putting too much faith in experience insights; the word “sacred”; and more. He concludes by discussing the findings of the first UC Berkeley psychedelic survey, which revealed public sentiments and attitudes towards psychedelics, and, while mostly positive, truly proved the need for people like Khan to be out there educating the public.
Notable Quotes
“They fired [David Nutt] from his role as Independent Advisor and Chair of this Advisory Council on Misuse of Drugs. So I’m sitting there as this 20 year-old that all I’m there to do is care about how science works, and how do we protect the voice of scientists in policy-making, and how do we ensure that policy is informed by the evidence rather than going in the face of it, and right in the middle of that, this very high profile scientist basically gets sacked by the government for basically just saying what the science says, which, as far as I can see, was all he was being asked to do.”
“It’s really hard to look at the experience of being human and this amazing, vivid, technicolor experience we have of walking around and doing everything from drinking coffee to walking a dog to looking at a sunrise, and not being totally bemused that that experience can be generated by this two pound lump of mostly water with a bit of fat and protein mixed in in our skulls. That just seems like an insane proposition to me. So I remember when I was learning about that in my undergraduate and kind of trying to figure out the basic principles of neuroscience, it just seemed like this amazing question of: How can this ever be possible? This doesn’t seem like it should compute.”
“Experiences with psychedelics later as well, I think lead you to a similar place in that if you disrupt ordinary waking consciousness, you can almost start to see the way in which your brain changes its production of consciousness. And the idea that that dramatic change can be induced by chemicals that we know the structure of and we can characterize and we can understand how they interact with the brain, again, just feels like an interesting kind of chink in that bigger question of: What is consciousness and who are we, and how do we relate to the rest of the world?”
He tells his personal story and how his first psychedelic experience felt like a homecoming; discusses his Rebel Wisdom media platform, where, through interviews, he tried to make sense of social upheavals and conflicts through a more flexible, psychedelic way of thinking; and digs deep into the Greek concepts of Moloch and Kairos: how Moloch represents the winner-take-all, race to the bottom, sacrifice-your-values-to-appease-the-system game playing we all get stuck in, and Kairos represents the openness that comes from psychedelics – the transitional, seize-the-moment opportunities we need to take advantage of. And he discusses much more: the power of dialectic inquiry; the corporatization of psychedelics and how we’re really in a psychedelic enlightenment; how the medicalization of psychedelics is like a Trojan horse; and the concept of technology (and specifically the internet) mirroring the switching between realms that we think is so rare in psychedelics – aren’t we doing that every time we look at our phones?
Beiner was recently part of Imperial College London’s initial trials on intravenous, extended-state DMT, testing correct dosages and speeds for the pump. He describes the details of the study, how he thought they were messing with him at first, and what he saw in his experiences: an outer space-like world of gigantic planet-like entities, and how a massive Spider Queen entity taught him about intimacy and how our metaphysical and personal worlds aren’t separate at all.
Notable Quotes
“There’s a particularly psychedelic way of thinking in my view. …I would define it as a flexibility in how we think and a looseness and a creativity and a playfulness with how we approach the world that psychedelics can open up in us. And I think that’s so deeply needed right now. So my hope is to kind of combine that ethos together with a lot of very practically important, interesting, sociological, psychological, scientific, and metaphysical insights, and use all of that to write a book that hopefully gives people new lenses in which to make sense of the world and psychedelics.”
“The process of speaking to the truth of your lived experience in the moment is deeply transformative. And it’s also, in my experience and I think the experience of many people, it’s what psychedelics encourage us to do: They encourage us to be with the truth of our experience and go into what we’ve been hiding from and avoiding, and feel it – feel the truth of what’s actually going on. And that is so, so powerful culturally because so many of our cultural shadows and our polarization and our ‘at each other’s throats’ and our ideological fixations come from these unsaid things. So there’s so many practices, psychedelics included, that can open us up into the truth of what’s going on. And I think that is just the most transformative practice or approach that there is that I’m aware of.”
Bogdan* is a 43-year-old asylee who lives in New York City. He has a Master’s degree from the University of Sussex. He used to live in student accommodation on the King’s Road near my old house in Brighton on the south coast of the UK, but he is currently homeless and living in what he calls a “ghetto.”
A series of highly traumatic ayahuascatrips with a famous ‘shaman’ led Bogdan to become seriously ill. It wasn’t helped by later trips with LSD and san pedro, either. Blighted by a debilitating mixture of chronic pain, anxiety, depression, and brain fog, he says he “feel[s] like a 100-year-old Alzheimer’s patient.” Bogdan suggests that successive traumas have left his central nervous system “fried.” He has no medical insurance, and so cannot pursue the Somatic Experiencing therapy people have encouraged him to try.
Bogdan did five sessions with ICEERS’ free integration service, but he doesn’t think “just talking with someone on Zoom will help” him. A cash handout from the local Eastern European community was helpful, yet it only lasted so long. One wonders how much processing his ‘stored trauma’ would alleviate living in a homeless shelter.
Or take Kristen*, a 39-year-old who participated in a Canadian clinical trial for psilocybin. In between each dose of psilocybin, Kristen developed debilitating spikes in anxiety that eventually manifested as a visual complaint, which in turn flowered into full-blown HPPD after two ‘therapeutic’ trips once the trial ended. What was driving Kristen spikes in anxiety? It wasn’t only the likely dysregulating effects of psilocybin’s serotonin dump. It was also significant financial stress. That didn’t just go away.
For those with severe HPPD, the visual presentation is so intense as to impair one’s ability to work. Reliance on scant welfare and disability benefits is not unheard of; I remember a phone call with one long standing HPPDer who was on the continual brink of homelessness for the destabilizing and disabling effects of his condition.
Possibly as many as 60% of homeless people have schizophrenia, and over half may have serious mental health problems. If we take seriously how dangerous psychedelics can be, these will be the outcomes. There will be many more people like Bogdan, Kristen, or those whose lives are destroyed by HPPD, increased anxiety, depression, or brain fog brought on from a challenging experience with no support, or simply the financial and life stress that continue on after even the greatest experience. Suicide is a tragic and occasional fact one cannot escape in HPPD communities – something that has been openly acknowledged by the late, great Roland Griffiths.
So what is the answer? As is hopefully becoming clear, ‘harm reduction’ is not just a matter of appropriate drug testing or set and setting and integration. It is a matter of having enough money to muffle a mental health crisis’ worst outcomes – to pay for help, stay housed, and stay healthy amid the stress and chaos that can follow a trip. Simply put, if we want to help those most affected by the challenges of psychedelic exploration, there may be a case for direct monetary transfers: giving people money to safeguard their material container.
A Cost of Living Crisis
There is a curious gap, a kind of Uncanny Valley, between our dreams of healing the ‘Mental Health Crisis’ with psychedelic mystical trips, while an arguably more primary Cost of Living Crisis is tearing apart people’s wallets. The association between anxiety, depression, addiction, and poverty is well known, and requires no elucidation. Even those who are not on the streets or actively facing homelessness in the future need money.
Have you looked at how expensive therapy is lately? $75-$150 a session is not viable for someone on a low income, so what could be a necessity becomes necessarily optional. It’s the same for gym memberships, exercise equipment, or good food and nutritional check-ups: all vital ingredients for good mental health and recovering from a psychedelic shockwave. The costs of therapy especially can add up while one shops around to find a suitable practitioner, or at least one who isn’t a weirdo – a genuine concern in psychedelic circles.
After an extremely destabilising LSD experience in September 2021 – whose sequelae included a deep depression, cannabis dependency, and suicidal ideation – I first tried a ‘psychedelic integration’ specialist based in Brighton. He wasn’t good. A couple of friends and I were wondering whether to do mescaline together, and I thought that might be a terrible idea. My ‘therapist’ urged me to wonder whether the second thoughts were perhaps the internalized voice of the “free market.” I burned through about £600 with this guy. I then burned through another £350 on another, thankfully more helpful therapist who gave me a discounted rate. It still amounted to £50 a session, or $60 USD.
Most people cannot afford to do this. And if they cannot afford to seek help while suicidal, they may die. We ought to consider the history lessons of psychiatric research. The ‘Decade of the Brain’ set in motion by President Bush in 1989 envisioned a future of revolutionary psychiatric treatments furnished by data from brain imaging and genetic research. This has not happened. Psychiatric outcomes have deteriorated. SSRI medications are of uncertain value relative to placebo and involve a staggering list of side-effects. Neurobiological markers have so far proved too wide and confounded to guide treatments – not least when our brains must exist in a world that’s crumbling.
“[W]hile we studied the risk factors for suicide, the death rate had climbed 33 percent. While we identified the neuroanatomy of addiction, overdose deaths had increased threefold,” Dr. Thomas Insel, the former Director of the National Institute of Mental Health, reflected in his 2021 book, Healing. “While we mapped the genes for schizophrenia, people with this disease were still chronically unemployed and dying twenty years early.”
In many ways, we already know what works: people need social support, housing, good therapeutic rapport, and food on the table. What will spell the difference for many people is the possession of resources that will enable them to reach for such low hanging fruit.
What Would a Harm Reduction Fund Look Like?
It is already well-known that the psychedelic movement is overwhelmingly middle- and upper-middle class and white, and has a particular representation among the aristocracy. The psychedelic movement is mainstreaming, though, and more people of color and low income are joining ranks of users. This means more people are at unnecessary risk, for lack of social and economic resources, of the worst outcomes of psychedelic drugs.
The psychedelic movement needs to own this risk, because the public sector and existing infrastructure probably won’t. As discussed above, welfare support is measly and the most vulnerable will be without medical insurance – if such packages would even cover the debilitations of drugs illegal in many parts of the United States. The Zendo Project, DanceSafe, and Fireside Project are laudable, but their applications for those struggling after their trips are limited.
It is often accepted that some proportion – usually dismissed as a merely ‘rare’ occurrence – of people will be greatly damaged by psychedelic drugs, and end up homeless, dead, or struggling with severe mental illness. What if we stopped accepting these as inevitable?
If we are really interested in harm reduction, one option may be a fund for those harmed by the effects of psychedelic drugs.
Suppose there was a fund of $500,000 – similar to the resources required in a study – which was focused on those facing suicide, homelessness, or mental health crisis after a trip. The details can be discussed and fleshed out by anyone who wants to take my proposal seriously, but it would simply provide bursaries, cash transfers, and much needed subsidies to people struggling in the wake of psychedelic journeys to seek help. Perhaps the effects of the help they seek can be recorded to collect data. Perhaps it could fund legal action against therapists and ‘Shamans’ that leave their clients in tatters, much as Bogdan is facing now. Such projects would likely mean saving or seriously changing dozens of lives. I welcome feedback on my loose suggestion.
Of course, there would be a risk of people ‘gaming’ the system, but I imagine its wastage would be comparable to a study, which has large opportunity costs in terms of the direct help such a fund could provide. Search costs would be invested to ensure the person is who they say they are: interviews, conversations with family members and friends, possible documentation. Different priorities would be made. Do we invest 80% of our budget for search costs on that 20% at the greatest risk of peril? Or ought we to prioritize creating free support in other ways, like expanding free therapies along the lines of ICEERS?Alternatively, as I suggest in a new article for Ecstatic Integration, immediate support could occur through peer support groups organized through Reddit, whose potential is, in many ways, untapped.
Certain challenges would no doubt arise through using private money, as well as exporting what should likely be a government task, such as through a Universal Basic Income – there’s a risk that some measure (number of people helped vs. number of dollars invested) would become a core indicator rather than real value provided. There’s likewise a risk that the kinds of interventions and support deemed worth subsidizing will fit with donors’ own biases, or that the pool of therapists deemed acceptable will be narrow and normative.
I would not be surprised if the data were relatively unsurprising. Income support and housing for those most debilitated would be a clear game changer. Free CBT, EMDR, Somatic Experiencing, Acceptance and Commitment Therapy, membership to a local gym that has a sauna and a pool, or full blood work to scan people’s nutritional deficiencies and inform a better diet would all likely help. These are relatively inexpensive interventions, but the marginal gains are probably enormous, and could be, at the very least, comparable to the hundreds of thousands raised to fund studies – which will not necessarily translate into interventions and treatments, nor with any particular immediacy.
The Psychedelic Movement and Owning the Risk
One may wonder if a post-psychedelic fund is arbitrary. All mental health problems, including but not limited to psychedelics, vary with poverty and access to resources. Why have a post-psychedelic fund and not one concerned with mental health in general? How can we ever separate the two? I suppose similar questions can be raised about the psychedelic sector on the positive end as well. Why the interest in psychedelics, when similar experiences can be engendered by other means like meditation – including with similar risks? To focus on post-psychedelic risk is likewise only repeating the same distinction already explicit in psychedelic risk management: that psychedelic trips can meaningfully create adverse outcomes even while connected to broader life concerns.
Even if this proposal doesn’t make sense to you, something needs to be done to address post-psychedelic harm. I believe we know more than enough to do something right away – and something specifically targeted towards those worst affected, for whom every dollar of subsidy and support reaps massive gains in social benefit – and saves lives.
These are new ideas, but let’s start the dialogue.
*Names have been changed to protect the identity of sources profiled in this writing.
In this episode, Alexa interviews Dom Farnan: Founder of DotConnect; author of the best seller, “Now Here: A Journey from Toxic Boss to Conscious Connector”; and Founder and Chief Consciousness Connector of DoseConnect™, a first-of-its-kind company blending organizational strategy, systems thinking, and talent acquisition in the psychedelic space.
Farnan shares her personal journey with psychedelics, discussing her experiences with psilocybin, ayahuasca, and 5-MeO-DMT, and how the last few years of her life have been focused on slowing down and integrating those experiences. She discusses the current state of the psychedelic industry, including downsizing and company closures, but also opportunities from networking, community engagement, and volunteering. She believes that while options may not be clear now, they will be there in the future, and may be jobs we never anticipated. So get to know companies now, and pay close attention with good discernment – not everything is as it appears.
She discusses her experiences with mentors and coaches; how psychedelic journeys and integration build onto each other; the importance of journaling; the need for patience as the industry grows; her book and the concept of conscious leadership over toxic leadership; and the beauty of embracing the openness we experience after a psychedelic experience: Can we use what we’ve learned to reprogram what we’re taught about life, invest in ourselves, let go of dissenting and limiting voices, and truly redefine what success (and happiness) means to us?
Notable Quotes
“It’s not always about the substance or the plant medicine. It is underlying about the healing and being more conscious as a leader and as a human being and as a contributor to the community that we live in. And so, for me, that’s what all of this is really grounded in. As much as I’m an advocate, I’m also very much aware that not everyone can leverage these medicines, and a lot of people are still scared and don’t quite know and maybe they can’t handle it and all of that. And that’s totally fine. …I just look at life as being psychedelic, and there’s so many things that you can do in your daily life that create this beautiful experience that don’t require any other things to contribute to that.”
“When you do this exercise, the invitation is to give yourself full permission to let go of everything that you’ve ever heard from anybody else. So, like, get out of the shoulds or your parents say this or your partner thinks that, or your best friends think this or your boss says that. Let all that shit go and just drop into truly your own heart space. Like, what does success look and feel like to me? If money were not an option, what would I be doing? How would I be spending my days? And the energy that I want to feel and be in – less so even, like, the tasks and the doing stuff, but it’s like, how do you want to feel? Because that helps you to then think through opportunities that will be in alignment of you achieving that feeling every day.”
“Understand the energetics, because if you’re going to be leading from a place of fear in your life, it’s only going to attract more of that stuff. If you’re really leading from a place of faith and looking at this as an opening for something new in your life, then that is when something new will show up. You have to be in that energetic vibe.”
This episode – the last of the many recorded at Psychedelic Science 2023 – may ruffle some feathers, as Wheal is very outspoken and opinionated, focusing on what he spoke about at the conference: the pitfalls of the psychedelic movement. While his outlook is negative, he speaks with humor, and these shadow aspects are issues we need to be talking about: how the nature of capitalism and returning profits to shareholders affects the concept of set and setting; how easy it is to prescribe ketamine and the puppy mill clinics popping up everywhere; how innovators are racing to the bottom to get ahead; the designer drug epidemic likely leading us to a Prozac Nation 2.0; digital narcissism, Instagram “Shamans,” and the dangers of cults; chemists trying to take the experience out of the drug; the overuse of psychedelics creating super egos; and much more.
While he believes the hype and excitement of the psychedelic renaissance is leading us towards a trough of dissolution and that people aren’t turning their amazing experiences into net positives anywhere near enough, he believes that fewer people using psychedelics less often and more intensely – with initiatory practices, intentions, integration, and honest self-reflection – will help us all climb out of our egos and move towards a healthier society. There is hope, but we need to honestly look at all the shadow aspects in order to move towards it.
Notable Quotes
“I think that ironically, the Prozac Nation 2.0 model, the medicalization of the psychedelic experience: on the one hand, it will absolutely wring most of the magic out of the experience that has been the whole point and premise from the Eleusinian mysteries, from ancient shamanistic traditions – the whole point was the magic. Prozac Nation 2.0 will defang that, will denature that, but on the other hand, it will protect it from some of its worst excesses and abuses. I think the bottom of the trough will be resolved for psychedelic cults. …It feels like there is a rush to fill the void of fundamentally fuckwit Instagram ‘Shamans’ thinking that they have some unique and profound message, and that their insights, their metaphysics, their cosmology, their practices are somehow worthy of instantiation and followers.”
“These days, the worst people are doing the best drugs. We have a bunch of entitled, upper middle class to ultra high net worth, bougie white folks wearing big dumb hats, tripping balls on the best, most sacred substances ever available to humans, and not changing their orientations or their attitudes one bit. And they’ve just become party favors. …It’s all the beautiful people, and I haven’t yet seen one empty their bank accounts, put on sackcloth, take up a begging bowl, rework their lives, dedicate them to charity. I’ve seen lots of: ‘We’re going to set up a VC fund,’ or ‘Where’s the next amazing party that we’re jetting or boating off to?’”
“After 5-MeO-DMT, we are out of bullets. If this isn’t enough to cause us to drop to our knees and weep with gratitude for the precious burden and blessing of our incarnated humanity, and then get the fuck back up and help the least of our brothers and sisters to figure this out without further distraction or delay, we don’t have anything else. We have used up all the silver bullets, because we’ve just been praying and spraying.”
In this episode, Joe interviews Federico Seragnoli: coordinator of the ALPS Foundation, psychologist who works with patients undergoing compassionate use treatments with psychedelics, and Founder of the ALPS Conference.
This year, the ALPS Conference (which stands for Awareness Lectures on Psychedelic Science) takes place Oct. 27 – 29 at the Bâtiment des Forces Motrices in Geneva – a prime location for a conference due to Switzerland’s legality around psychedelics, where any citizen can apply for psilocybin or LSD therapy if they fall into the category of ‘treatment-resistant.’ Seragnoli discusses how the conference was originally inspired by an article on the MAPS blog about how to be a psychedelic researcher; and talks about its humble beginnings, its new location, and why it’s moved across the country each year. The conference features names like Rick Doblin and Michael Mithoefer, but he’s most excited about the smaller size of the event and the panel discussions, which gives attendees a chance to ask questions and hear some real conversations.
He discusses the vibrant field of psychedelic therapy and research in Switzerland; the importance of compassionate use and the criteria physicians need to be able to use it; the impact of students creating psychedelic associations at their universities; and Seragnoli’s new research: seeing if there is a link between cognitive science and a conceptualization of science – if you can model consciousness off neuroscience, can you model it off how you feel?
Notable Quotes
“When we deal with psychedelic therapy, with people coming as patients, we have to find ways to let them know what they are going to do and to let them integrate what happened in their own mind. So one thing that you actually do every time when you prepare people for that is to just straightaway try to understand how they perceive themselves as cognitive agents. In other terms, it would be like how do they feel about being a conscious human being? What is their narrative, what is the story that they tell themselves around what is their own consciousness, like their own naive definition of consciousness? And then basically, you try to get their own worldview on this, then you try to inform that worldview with more [pragmatic] and useful ways of seeing it so they can better use it to better regulate themselves.”
In this episode, Joe interviews Louie Schwartzberg: renowned filmmaker known for the award-winning documentary, “Fantastic Fungi”; and now, director of the new film, “Gratitude Revealed.”
He talks about his path to photography and filmmaking and how psychedelics were a huge inspiration – how his techniques of slowing down, speeding up, and zooming in were ways to capture the invisible aspects of reality – that which is “too slow, too fast, too small, and too vast for the human eye,” but is always there. He discusses the premiere of “Fantastic Fungi” and the waves it spread through the psychedelic space; The Louie Channel, his new streaming channel that will feature all his work in 4k and the work of other curated artists and friends; and the clinical trial he’s involved in to see if participants have better results in the treatment of their alcohol use disorder by watching his imagery set to music on an 80-inch screen while on psilocybin – research that hopefully leads to the concept of being able to prescribe images and music to people based on specific criteria.
He discusses his new film, “Gratitude Revealed,” which explores the power of gratitude: making it a daily practice (and especially a post-psychedelic integration practice), how resilience is one of the best benefits from practicing gratitude, and how easy it is to stop a rumination spiral by simply finding something to be grateful for. He also talks about the blessing of being a photographer and always thinking of beauty; how psychedelics make people more environmentally conscious; tripping with parents; how a shared love of nature could be the bridge between opposing sides; and how the best way to deal with the climate crisis is to start in your own yard.
Notable Quotes
“We’re talking about psychedelics on your podcast, but the truth is, I think the imagery I want to create for your community, this community, is exactly the same as I would do for a four-year-old or a five-year-old. How beautiful is that? It’s about wonder and awe. It’s about being open-minded.” “The politicians, they understand how to press that fear button. They go right to the cultural differences and press the abortion button or the gun thing or whatever it might be, and all the lies and all that. I don’t want to even spend another second talking about that, other than [to say] we have to be conscious that pressing the fear button is easy to do because that’s survival, and you get an immediate reaction. The films I’m trying to make and what we’re discussing here is making people laugh, making people cry, making people fall in love. That takes a little more talent than pointing a gun at you. …Beauty and love and gratitude is the emotional energy we can employ to overcome fear.”
“It’s a great tool. It’s not like we have to practice meditation, become a Yogi for like ten years or 20 years of practice. It’s something you can do immediately. It’s not like a meditation thing that you have to become an expert in. It’s like, how easy is it just to ask yourself in the moment: what can I be grateful for? Pretty easy.”
They explore the relationship between Judaism and psychedelics, with Margolin sharing her experiences growing up in a Hindu-Jewish family; her personal journey with her Jewish identity; and how her use of psychedelics has deepened her life. She talks about the significance of Jewish holidays and how holiday traditions connect them to nature and themselves in a very psychedelic way; the importance of intentionality; the beauty in dancing through an uncomfortable ayahuasca experience; the Jewish Psychedelic Summit; whether or not ancestors were using substances (and does that matter?), and why being in Israel feels so different – and psychedelic.
Margolin is an instructor in our new course, “Navigating Psychedelics: Jewish Informed Perspectives,” where she will be leading discussions on setting sacred time and space, particularly focusing on the significance of Shabbat and the energetic frequencies that are at play during certain holidays. The 9-week course begins next week – October 10 – so sign up now!
Notable Quotes
“I don’t think set and setting has to only apply to doing a psychedelic trip. I think it really applies to life in general: like, what are you bringing to a situation and what’s the situation bringing to you?”
“The term, ‘Yisrael’ means to wrestle with God, and I think so much of the Jewish experience is this kind of complicated relationship with the creator. …I think that’s what it is to be Jewish, is to really be seeking out this relationship. …Psychedelics offer us this opportunity to really dig into ourselves and be seekers in this way, and I find that there’s a lot of spiritual journeying and impulse in the Jewish community.”
In this episode, Joe interviews Ethan Nadelmann: author, speaker, Founder and former Executive Director of Drug Policy Alliance, host of the PSYCHOACTIVE podcast, and one of the leading voices in drug policy reform and harm reduction.
Nadelmann shares his journey from Princeton University to founding Drug Policy Alliance, to working with George Soros, encouraging Gary Johnson to push cannabis legalization, and interacting with prominent figures like Milton Friedman and Grover Norquist. He explores the motivations behind the drug war, the massive growth of incarcerations it led to, why the US spread its war on drugs abroad even when it went against our best interests, and, thankfully, the progress made in fighting the drug war – particularly with cannabis and psychedelics.
And he discusses much more: the banning of drug testing kits; the damages of our slow learning curve against the idea of a safe supply; the risks of under-prescribing opioids for people who actually need them; how libertarians, the right, and left are all starting to become against the drug war for the same reasons; why cigarette smokers should all switch to vaping; the concept of needing to pass a test at the pharmacy to prove you understand (and won’t abuse) medication; and some strong arguments for decriminalization as an incremental step. And he asks some pretty important questions that we can all simmer on for a bit: how do we find a balance between helping people and not opening the rest of society up to harm? How do we challenge abuse in a way that doesn’t hurt future harm reduction efforts? And how do we incentivize people into acting in their own best interests?
Notable Quotes
“The drug war resulted in the unnecessary arrests of tens of millions of Americans, the unnecessary incarceration of millions of Americans (oftentimes for very long periods of time), hundreds of thousands of people dying in this country with HIV/AIDS unnecessarily, tens of thousands dying of overdose unnecessarily. That was the drug war.”
“If I could snap my fingers and all of the 30, 35 million American cigarette smokers in the country today, or all of the 1.1 billion smokers around the world were to suddenly stop smoking cigarettes, and all of them were to take up vaping (the e cigarettes); …it would represent one of the greatest advances in public health in U.S. and global history, because the risks of smoking are so dramatically, dramatically greater than the risks of consuming nicotine in non-combustible forms.”
“You look at people pursuing that type of legal course of action where they claim it’s about helping bring attention, but in fact it’s having exactly the opposite results. Yes, it’s important to fix these things, but the methods and ways you go about it are incredibly important. It’s just like the same thing when you had that case involving the therapist in the MAPS training program who did stuff that was sexually inappropriate, etc. And on the one hand, you definitely need people to bring attention to that, and more credit to them for bringing attention to those abuses. On the other hand, one has to have the basic realization that that happens in all areas of psychotherapy. You can’t eliminate this stuff. It’s human nature, it’s humankind. You can minimize the incidence of it, you can bring attentions to the abuses, but make sure that what you’re advocating as the fix is not leading to doing more harm.”
