June 18, 2020
My guest on today's show, Dr. Matthew W. Johnson, Ph.D., is a professor of psychiatry and behavioral sciences at Johns Hopkins University. He also happens to be one of the world’s most published scientists on the effects of psychedelic therapy on humans and has conducted seminal research on the behavioral economics of drug use, addiction, and risk behavior.
Dr. Johnson has worked with psychedelics since earning his Ph.D. in experimental psychology at the University of Vermont in 2004 and published safety guidelines in 2008 that helped resurrect research on psychedelic therapy.
As principal investigator, he developed and published the first research on the use of psychedelics for the treatment of tobacco addiction in 2014. Dr. Johnson and colleagues published the largest study of psilocybin in treating cancer distress in 2016. His 2018 psilocybin abuse liability review recommended placement in schedule IV upon potential medical approval. He was also principal investigator on funded studies investigating psilocybin for the treatment of opioid dependence and PTSD.
Beyond psilocybin, in 2011 Dr. Johnson published the first-ever blinded human research showing psychoactive effects of salvinorin A, the active constituent in Salvia divinorum. In 2017, he published the first data indicating that MDMA pill testing services may reduce harm, specifically by reducing drug consumption of unknown or undesired adulterants.
Dr. Johnson is recognized for his research in behavioral economics, behavioral pharmacology, and behavior analysis. He has conducted seminal and widely cited research applying behavioral economic principles such as delay discounting and demand analysis to decision making within addiction, drug consumption, and risk behavior. This includes research determining delay discounting to be a fundamental behavioral process underlying addiction across drug classes, using economic demand analysis to determine the roles of nicotine and nonpharmacological factors in the abuse liability tobacco and other nicotine products, and using delay discounting, probability discounting, and demand analysis to understand sexual risk including condom non-use in casual sex situations. He conducted the first research administering cocaine to humans in determining that cocaine increases sexual desire and affects sexual decision making. He has conducted similar research administering methamphetamine and alcohol, examining effects on sexual decision making. He has published studies on drugs across nearly all psychoactive classes, including studies of cocaine, methamphetamine, tobacco/nicotine, alcohol, opioids, cannabis, benzodiazepines, psilocybin, dextromethorphan, salvinorin A, GHB, caffeine, and cathinone analogs compounds (so-called “bath salts”).
Dr. Johnson was the 2019 president of the Psychopharmacology and Substance Abuse Division of the American Psychological Association and is the current president of the International Society for Research on Psychedelics, an organization he founded with colleagues. He has received continuous NIH funding as principal investigator since 2009. He has reviewed for more than 75 journals and has served as guest editor on two special issues on psychedelics. Dr. Johnson has reviewed grants for NIH, NSF, the US Military, and multiple governments outside of the US. He is a standing member of the Addictions Risks and Mechanisms (ARM) NIH study section.
Dr. Johnson has been interviewed about psychedelics and other drugs by various media outlets, including the New York Times, Washington Post, Wall Street Journal, Globe and Mail, Daily Mail, Chicago Tribune, San Francisco Chronicle, Denver Post, Baltimore Sun, CNN, CBS News, NBC News, the Atlantic, Newsweek, Marie Claire, Vogue, the Washingtonian, Scientific American, Nature, Vice, Inverse, Healthline, Psychology Today, and others. He has appeared for interviews on numerous television and radio shows as well, including 60 Minutes, CNN’s Wolf Blitzer Situation Room, Fox Business News’ Kennedy, the Dr. Oz Show, PBS’ Retro Report, Labyrint (television show in the Netherlands), Spectrum News NY1, the BBC World Service, NPR’s Morning Edition, NPR’s Kojo Nnamdi Show, New Zealand Radio, and Newstalk Radio Ireland.
Dr. Johnson’s panel discussion with Tim Ferriss at the Milken Institute Global Conference was broadcast on the Tim Ferriss Podcast. His research was featured in an episode of Breakthrough on the National Geographic Channel, produced by Ron Howard, and in Michael Pollan's best-selling book, How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence.
MAPS Capstone Challenge
When I introduce this episode, I also talk about the MAPS Capstone Challenge. My friend Tim Ferriss has helped to organize a $10 million challenge pledge for MAPS, the Multidisciplinary Association of Psychedelic Studies.
Why is this important?
Tens of millions of people worldwide suffer from post-traumatic stress disorder (PTSD). Millions more have suffered from emotional and physical abuse but never get diagnosed. On top of that, PTSD is notoriously difficult to treat and cure. Conventional treatments fail all the time. Never before has the treatment of trauma been more relevant. In good news, it appears that one odd candidate—MDMA-assisted psychotherapy—can produce results that practically defy belief. As one actual patient put it in the Trip of Compassion documentary, “I felt like I went through 15 years of psychological therapy in one night.”
Now, let’s look at data instead of anecdote: In MAPS’ completed phase 2 trials with 107 participants, 56% no longer qualified for PTSD after treatment with MDMA-assisted psychotherapy, measured two months following treatment. At the 12-month follow-up, 68% no longer had PTSD. Most subjects received just 2–3 sessions of MDMA-assisted psychotherapy. All participants had chronic, treatment-resistant PTSD and had suffered from PTSD for an average of 17.8 years. On August 16, 2017, the FDA granted Breakthrough Therapy Designation to MDMA for the treatment of PTSD. There is a clear path ahead to make MDMA a legal medicine for millions of people suffering from PTSD. And just as important: If we succeed on this path, MDMA will also set precedent and open the door for dozens of other therapeutic compounds, including psilocybin.
The MAPS Capstone Challenge will help provide the funds—$30 million total—needed to complete the studies required for FDA approval of MDMA-assisted psychotherapy for PTSD. MAPS has already raised $10 million. If another $10 million are raised by September 10th, this will unlock a $10 million challenge pledge that Tim Ferriss has helped put together, alongside PSFC. Half of the pledge comes from the Steven & Alexandra Cohen Foundation, and the rest is split equally between Tim; James Bailey from Bail Capital; Peter Rahal, the founder of RXBAR; Blake Mycoskie, the founder of TOMS; and an anonymous donor.
This challenge pledge is all or nothing. If MAPS fails to raise $10 million by September 10th, they do not receive the $10 million challenge pledge. There is no partial credit, and there is a real urgency. This $10M challenge pledge was announced in Tim's recent interview with Rick Doblin, the founder of MAPS. Every dollar matters, so if the spirit moves you, please consider giving what you can by clicking here. If you can contribute $100,000 or more over two years, please get in touch with Rick and his team by emailing [email protected].
During this discussion, you'll discover:
-The major announcement made at Johns Hopkins regarding psychedelic therapy and research…14:15
- Academic center for psychedelic research was established (lots of funding for research)
- $17 million donation is the largest in history to psychedelic research
- NIH has not invested in the positive use of psychedelics (they have on the dangers)
-How to explain the efficacy of psychedelics to “healthy normal” people…19:00
- Positive psychology is a substantial part of the research
- Not being diagnosed with a disorder doesn't mean you're living optimally
- Psilocybin leads to lower levels of stress, a more pleasant demeanor
- Jumpstart spiritual practice programs: journaling, meditation, etc.
-The gold standard on microdosing for enhanced productivity…23:05
- Very little research on microdosing thus far
- The few studies done (with LSD) have shown slight impairment, very little benefit
- Evidence suggesting efficacy of psychedelics is mostly anecdotal
- “Relative efficacy” of psychedelics vs. other drugs (amphetamine, Adderall, caffeine, etc.)
- Placebo (expectancy) effect is a possible factor in the anecdotal evidence
- Double-blind conditions are necessary to determine a drug's efficacy
-Matt's response to the suggestion that he's just in it for the drugs…32:40
- It's a very inefficient way to get high
- Using is highly discouraged when researching
- Researchers employ the safest means of taking psychedelics
-How psychedelic therapy can treat addiction to tobacco…38:35
- Small study (15 heavy smokers) were given 2-3 psilocybin doses
- 80% reported they were smoke-free in 6 months
- 2.5 years later, 60% were still smoke-free
- Traditional treatments yield a 5-20% success rate
- 1 session of high dose psilocybin vs. nicotine patch: 57% vs. 27%
- Treatment is preceded by 8 weeks of cognitive behavioral therapy (CBT) for smoking cessation
- Target quit date from the CBT is the day of the psilocybin session
- A double-blind study is forthcoming
-Why the music in a psilocybin treatment is so important…49:35
- Classical music playlist (put together by Bill Richards)
- Start with light, strings
- Progress to more powerful pieces and apex close to the peak activity of the compound
- The music used during sessions is a field of research in its own right
-How to handle participants who experience anxiety during the session…53:07
- Approx. 1/3 of people experience anxiety during a session
- The facilitator is a “safety net”
- Prep the person prior to the session to alert when they feel anxious
- No physical aggression; simply wanting to leave the room
- Simply remain calm and reassuring is often the best option
-The dosage used for a treatment session…56:50
- 30 mg body weight adjusted (5 dried grams of psilocybe cubensis)
- Due to the purity of the compounds as well as the environment
- Book: The Secret Chief Revealed by Myron Stolaroff
-How a person is transitioned from the session back to reality…1:00:15
- It's easy for a person to think it's over before it's really over
- Have a discussion about the experience
- Homework is to write a narrative of the experience (long or short)
- This begins the process of integration, applying it to their life and challenges
- 2 weeks between first and second session; 8 weeks between second and third
-The dark side of MDMA and other psychedelics…1:04:30
- Tucker Max article on MDMA experience
- 40% of MDMA samples from the street contained no MDMA
- Bath salts (cathinone analogues) were also found in the samples
- Psychedelics cannot be found in bath salts you find in Wal-Mart
- Tainted psychedelics on the street is a huge problem
- Phenylethylamine based compounds can be microdosed; previously, only LSD could be microdosed
- The supply of compounds used for research at Johns Hopkins is produced by Dave Nichols
-The psychedelic even the most hardcore users avoid…1:13:50
- People report experiences on par with smoking DMT
- Communication with “entities”
- Very self-limiting: people are often freaked out by the experience
-The future of psilocybin in society…1:16:40
- Currently decriminalized in a few cities; different from legalized
- Conditions for legalization: Must be done in a clinic, with proper supervision
- Not likely to be seen in supplements
- Not likely to be on par with marijuana when it comes to legality
- Very little controversy surrounding psychedelics compared to other drugs like marijuana
-The future of psychedelic therapy…1:21:00
- Field Trip Health
- Will play a role in mental health treatment
- Move toward a preventive approach re: mental health
- Center for Psychedelic and Consciousness Research
-And much more!
Resources from this episode:
– Other resources:
- Johns Hopkins Psychedelic and Consciousness Research website
- Psychedelics as a Performance-Enhancer in Athletics
- 6 Music Playlists For Psilocybin Journeys
- The “bad trip” tent at Burning Man
- What MDMA Therapy Did For Me by Tucker Max
- Synthetic Cathinones (“Bath Salts”)
- Salvia divinorum
- Field Trip Health
- Dr. Johnson’s panel discussion with Tim Ferriss at the Milken Institute Global Conference
- The Tim Ferriss Show
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