In this episode of the Psychedelic Medicine Podcast, Giorgia Caspani, PhD joins to discuss the intersection of psychedelics and the gut microbiome and ramifications for future personalized medicine. Dr. Caspani is a neuroscientist and computational biologist working at the intersection of gut microbiome, psychedelics and personalized medicine.

In this conversation, Dr. Caspani discusses her research published in the article “Mind over matter: the microbial mindscapes of psychedelics and the gut-brain axis.” She shares what we know about how psychedelics impact the gut microbiome from initial studies and what questions remain unanswered. She draws connections between the way the gut microbiome metabolizes SSRI drugs and how serotonin impacts the gut microbiota to hypothesize the potential ways psychedelics interact with this complex living system. In closing, Dr. Caspani discusses the possibility of predicting responses to psychedelic treatments using data from the microbiota, and the research currently happening to make this possible.

In this episode you'll hear:

• How human beings and our gut microbiome co-evolved and the benefits achieved through this symbiotic relationship
• The correlation between the gut microbiome and stress levels
• The effects of psychedelics on immune responses
• Why personalized medicine may be a more effective approach for treating depression
• How personalized medicine could help make psychedelic therapies more accessible and effective

Quotes:

“Without our gut microbes… We wouldn't be able to really perform a lot of the metabolic functions that we rely on as humans.” [4:26]

“The gut microbiome is different in every person—it’s very unique. And so every person carries this unique microbial signature that can potentially map out to all of the treatment options that we already have available; it’s just a matter of understanding and identifying markers that can predict which patient will benefit from a specific drug.” [18:22]

“[We hypothesize that] the gut microbiome shapes individual responses to psychedelic treatment. And so if that [hypothesis] is correct, if that is true, we could potentially target the microbiome, change the composition of the gut microbiome like we wanted to, to be able to maximize the effectiveness of these [psychedelic] drugs.” [25:14]

Links:

Dr. Caspani’s article, “Mind over matter: the microbial mindscapes of psychedelics and the gut-brain axis”

Dr. Caspani on LinkedIn

Dr. Caspani on X

Onaya Science website

Psychedelic Medicine Association

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In this episode of the Psychedelic Medicine Podcast, Star Rose Bond, LCSW joins to discuss the topic of using psychedelic-assisted therapy to address intergenerational trauma. As seen in Huffpost, Vice and Psychology Today, Star Rose is a Renegade Psychotherapist, Social Activist, Clinical Supervisor for PEARL Institute and Co-Founder of Life Camp. With a Bachelor’s degree from NYU and a master’s from Columbia, Star brings 15 years of clinical trauma therapeutic services and experience serving marginalized, under-resourced and at risk populations specializing in harm reduction and PTSD recovery.

In this conversation, Star introduces the topic of intergenerational trauma and explores how psychedelic experiences may be leveraged to address this pernicious condition. She begins by explaining what intergenerational trauma means, how it gets passed down, and how it manifests. Star talks about the importance of psychedelic therapists and facilitators having awareness of trauma-informed modalities in order to better serve these populations. She also discusses the complexities of addressing generational trauma, and how it can often be difficult to process sensitive topics within the family unit. However, in conclusion, Star emphasizes that the capacity to heal is an intrinsic aspect of human existence, and that even in particularly dark moments, it is possible to get in touch with this possibility.

In this episode you'll hear:

• How the conditions of Capitalism produce and exacerbate chronic stress
• The profound impact of neglect and abuse in early childhood
• The unique experience of intergenerational trauma for BIPOC peoples and the recent rekindling of a spirit of connection in these communities due to psychedelic medicines
• How processing intergenerational trauma can transform familial relationships
• Ethical and practical considerations for facilitators and therapists guiding clients through psychedelic experiences aimed at resolving deep-seated trauma
• What to look for in a psychedelic-assisted therapist or facilitator

Quotes:

“Just because you have several students or several clients who’ve experienced the same trauma, don’t make the assumption that they’re all experiencing it the same way. Or maybe you’ll meet a client who has had trauma similar to yours—don’t assume that they have undergone the same emotional impact or psychological impact as you. The truth of the matter is we are complex beings. We have so many different moving variables that go into our psychology and that essentially indicate or play a role in how we respond to things.” [8:43]

“We can’t always express or understand why things happen the way they do. But, we can start to make meaning through a spiritual understanding which in turn lends itself to a sense of ease and comfort.” [22:20]

“When you are going into these experiences as a facilitator—whatever your background is—it is of the utmost importance that you are hyper cognizant and hyper aware of the harms that can be caused by not being aware of the ways in which you can navigate someone else’s trauma as it shows up.” [25:02]

Links:

Star’s website

Star on Instagram

Previous episode: Can Your Genes Predict Response to MDMA Therapy? with Dr. Dave Rabin MD, PhD

Previous episode: Warning Signs When Selecting a Psychedelic Facilitator with Juliana Mulligan

Previous episode: How to Choose a Psychedelic Facilitator or Retreat Center with Joël Brierre

My Grandmother's Hands: Racialized Trauma and the Pathway to Mending Our Hearts and Bodies by Resmaa Menakem

SHINE Support website

Psychedelic Medicine Association

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In this episode of the Psychedelic Medicine Podcast, L.J. Lumpkin III, MA LMFT joins to discuss the potential of psychedelic medicine in the context of sports psychology. L.J. is a therapist, adjunct professor at Pepperdine University, a coach, author, speaker, and the CEO of Nomad Healing Practices.

In this conversation, L.J. shares his personal experience as an athlete and discusses the difficult transition to a new life once an athlete’s career has concluded. He compares the need to reinvent oneself in this context to ego death and explains how psychedelic-assisted therapy may be helpful for navigating this transition. L.J. also discusses the intense pressure athletes are under to perform, mentioning that the drive to win can often overpower the more basic mode of play at the heart of athleticism. This is an area where he finds ketamine to be a particularly powerful medicine, as its dissociate quality can help athletes tune out the high pressure expectations. L.J. also discusses leveraging the critical learning period provided by psychedelic therapies to institute new healthy habits, something which could benefit athletes both on and off the field.

In this episode you'll hear:

• How ketamine-assisted therapy may be able to help athletes with their unique psychological challenges
• Integrating mindfulness to prepare for psychedelic therapies
• Leveraging the somatic component of psychedelic therapies to address pain
• The importance of integration practices and support systems
• The differences between working with psilocybin versus ketamine
• Drowning out critics and sports commentary and getting back to basics with the help of psychedelic therapy

Quotes:

“If you’ve been paid millions of dollars to hit and be aggressive for so long and that’s how you’ve dealt with your emotions—and it wasn’t a problem because you were being rewarded for it—what do you do when you’re not getting rewarded for that anymore? When you have to actually change how you process emotion—there’s not a playbook for that.” [7:46]

“Just talking about [mental health] and normalizing it—all of a sudden you’re allowed to get help, you’re allowed to heal, you’re allowed to go to practices that have been practiced throughout human civilization. We’re bringing [psychedelics] back and I think that athletes are the ones who are really going to be the ship of normalization.” [22:38]

“Especially if you’re off season, those other medicines [besides ketamine] I think they’re going to be even more helpful because that might encourage the rest, it might encourage being able to connect with family systems. I think for some of the more acute stuff, the ketamine does serve a great purpose in that.” [28:16]

Links:

L.J. on Instagram

L.J. on LinkedIn

Nomad Healing Practices website

Psychedelic Medicine Association

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In this episode of the Psychedelic Medicine Podcast, podcast host Dr. Lynn Marie Morski comes on the mic to provide a five-year update on the podcast and share the changes in the legal landscape of psychedelics in the past half-decade. Lynn Marie Morski, MD, JD is the president of the Psychedelic Medicine Association and host of the Psychedelic Medicine Podcast. She sits on the advisory boards of Psychedelics Today, Cybin, VETS, Inc (Veterans Exploring Treatment Solutions), the Oxenberg Foundation, and the Ketamine Task Force. Dr. Morski is a Mayo Clinic-trained physician in family medicine and sports medicine, as well as an attorney and former adjunct law professor.

In this anniversary episode you’ll hear about the legally-accessible forms of psychedelic therapy which have come to prominence as potential mainstream therapeutics in recent years. Dr. Mroski shares Information on the legal adult use framework for psilocybin in Oregon, including licensing, costs, and exclusion criteria. She also discusses programs in Australia and Canada that will allow certain patients to access psychedelic therapies such as psilocybin- and MDMA-assisted therapy. In addition to classic psychedelic medicines, Dr. Morski also shares information on the medicine which is currently most accessible: ketamine. She discusses the difference between S-ketamine and R-ketamine and on-label and off-label uses of this substance. In closing, Dr. Morski presents some of the finer details of the current landscape of insurance coverage for ketamine.

In this episode you'll hear:

• The difference between decriminalization and legalization
• The FDA decision to deny the Lykos Therapeutics’ new drug application for MDMA-assisted therapy for PTSD
• The upcoming Colorado psilocybin program
• Psychiatric licenses to administer MDMA and LSD to patients in Australia
• The Special Access Program for psychedelic therapies in Canada
• Legal ketamine access in the United States
• How the Psychedelic Medicine Podcast chooses guests

Quotes:

“I wanted to focus mostly on what is legal because we know that’s the way things are going to be the most monitored and therefore safely accessible.” [20:45]

“People are in this industry because they want other people to feel better and they want to help and they’re so generous with their time” [25:31]

Links:

clinicaltrials.gov - the place to find information on upcoming clinical trials for psychedelic medicine for which you may qualify

Insurance Coverage for Psychedelic Therapy by Vincent Joralemon

SPRAVATO withMe Patient Support Program

Enthea insurance

Previous episode: How to Choose A Psychedelic Facilitator or Retreat Center with Joël Brierre

Previous episode: Warning Signs When Selecting a Psychedelic Facilitator with Juliana Mulligan

Previous episode: Ketamine Scientific Research with Dr. Jason Wallach

Psychedelic Medicine Association

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In this episode of the Psychedelic Medicine Podcast, Dr. David Rabin, MD, PhD joins to discuss whether genes can be predictive of one’s response to MDMA Therapy. Dr. Rabin, a board-certified psychiatrist and neuroscientist, is the co-founder & chief medical officer at Apollo Neuroscience. In addition to his clinical psychiatry practice, Dr. Rabin is also the co-founder & executive director of The Board of Medicine, and a psychedelic clinical researcher currently evaluating the mechanism of psychedelic-assisted psychotherapy in treatment-resistant mental illnesses.

In this conversation, Dr. Rabin shares his research into epigenetic responses to MDMA-therapy, exploring topics of trauma, gene expression, and personalized, data-driven medicine. He discusses the seminal discovery that trauma can cause epigenetic changes in the structure and function of the cortical system and his own research findings that uncovered a reversal of these changes associated with MDMA-assisted therapy. Dr. Rabin hopes further research in this area may allow for leveraging epigenetic data to determine which psychedelic medicine a particular patient may be most likely to respond to and track how effective a given treatment has been. In closing, he expresses excitement about bringing objective biological precision to mental health treatment, drawing a parallel to the discovery of antibiotics which allowed for much more tailored treatments of infections which has saved countless lives.

In this episode you'll hear:

• Response rates to psychedelic-assisted therapy for PTSD versus conventional therapies
• The consequences of ineffective treatment for PTSD
• MDMA-assisted therapy as preventative care and the societal cost savings involved
• Genetics, epigenetics, and gene expression
• Using epigenetic data from simple saliva swabs to better gauge response to MDMA-assisted therapy for PTSD

Quotes:

“Most of the treatments we have available today for PTSD—that are the FDA-cleared, considered gold standard treatments—only actually induce remission from illness… in about 30% of people. So of the 100% of the millions of people every year that are getting treated for PTSD, with the best treatments that we have that are currently available, only 30%—at best—are getting better long term. Everyone else has a diagnosis of PTSD for life.” [3:55]

“MDMA-assisted therapy for people with PTSD is having an effect that’s similar to what we saw with the discovery of antibiotics for infection.” [8:07]

“Folks with severe PTSD who went through this trial, when they received MDMA-assisted therapy, [the researchers] saw a statistically significant change—in terms of repair—of the cortisol receptor’s epigenetic code which reflects improved structure and function of that receptor site. But not only that—we saw that the amount that people got better… was directly correlated with… the amount of remodeling and repair at the receptor site.” [18:36]

“Epigenetic code is actually something that can be modified by experiences in our environment. And trauma—or PTSD diagnoses, a series of significant traumas over time—can in fact change epigenetic code of the cortisol receptor gene. And that changes how the cortisol receptor gene gets made, and it changes its function.” [29:52]

“PTSD is a disorder of learned fear. How do we treat PTSD? In animals and humans, we provide the same stimulation that they were getting that they are now afraid of in the context of safety. That’s how exposure therapy works, that’s how MDMA therapy works to some extent—all of these tools and techniques work to treat PTSD effectively… in the same way. It’s called safety conditioning.” [36:48]

Links:

Dr. Rabin’s article: Pilot study suggests DNA methylation of the glucocorticoid receptor gene (NR3C1) is associated with MDMA-assisted therapy treatment response for severe PTSD

Dr. Rabin’s website

Dr. Rabin on LinkedIn

Dr. Rabin on Instagram

Dr. Rabin on Twitter

Apollo Neuroscience website

Psychedelic Medicine Association

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In this episode of the Psychedelic Medicine Podcast, Mark Braunstein, DO joins to discuss the promise and the peril of ketamine. Dr. Braunstein graduated medical school in 1997 then completed a General Psychiatry Residency at the University of New Mexico and then a fellowship in Child and Adolescent psychiatry at Maine Medical Center in 2002. Upon graduation from his fellowship and becoming board certified in general psychiatry he established a private practice in Durango, Colorado where plant medicine became part of his everyday integrative psychiatric practice.

In this conversation, Dr. Braunstein shares some of the developments in the world of ketamine in the past three years since his previous episode, drawing on his own experience providing ketamine-assisted therapies. He stresses issues of grandiosity that can arise both when working with ketamine and when taking the medicine—issues which in the worst case and fuel ketamine use disorders. Dr. Braunstein stresses the importance of clinicians providing ketamine treatments being realistic and upfront about the potential harms of ketamine when advising prospective patients. In closing, he warns against the dangers of being in an echo chamber which reinforces potentially pathological substance use, especially for clinicians in the ketamine space.

In this episode you'll hear:

• Why ketamine has an addictive potential and how ketamine addiction presents
• Ways to treat ketamine use disorder
• The importance of informed consent
• What patients should look for when seeking a ketamine provider
• The importance of ketamine providers working with multiple modalities and having multiple tools in the toolbox besides ketamine

Quotes:

“Here’s what’s scary to me about ketamine: these people that I’ve seen having problems [with ketamine use] are largely lifetime recreational psychedelic/drug users without problems. And these are people who have made it to age fifty, smoking [cannabis], tripping a little bit, their whole life without having a problem—then at fifty years old, find themselves hooked on something for the first time.” [12:30]

“[Ketamine] is not a microdosing medication… There is no such thing as ketamine microdosing. You think of microdosing as sub-perceptual. Everyone that I’ve met that’s abusing ketamine, it was not a sub-perceptual effect—they were very much abusing it to have that perceived effect. Maybe not a psychedelic effect—usually an intoxicated wonky effect is what they’re going for. And people refer to that as microdosing. It’s not microdosing. It’s abusing small doses.” [17:11]

“What do I see that makes me concerned with someone I’m talking to—a clinician or a client? That grandiosity. So that gets me concerned right away when I hear about these ‘downloads’ because that’s where … other psychedelics can have dependency too. You see people … they go for aya ceremonies every week after week after week. So there can be an addiction to the download or to the release.” [34:35]

“The people I know that have been successful in this line of work (from a patient standpoint), whether they’re a clinician or not, have been the ones that have embraced the work. And just knowing that this is going to be a process and I’m in it to win it, for life. I’m working on myself.” [35:40]

Links:

Dr. Braunstein on LinkedIn

Ketamine Research Foundation website

NeuPath Mind Wellness website

Ketamine Training Center website

Previous episode: Ketamine for Alcohol Use Disorder with Steven Mandel, MD

Previous episode: Avoiding the Traps of Psychedelic Self-Absorption with Adam Aronovich, PhD(c)

Previous episode: Navigating Psychedelic Narcissism with Adam Aronovich

Previous episode: Psychedelic Therapy: Slow Down to Heal Faster with Sunny Strasburg, LMFT

Psychedelic Medicine Association

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