June 25, 2020
[00:01:45] Podcast Sponsors
[00:04:15] Guests Introduction
[00:10:02] What Psychedelic-Assisted Psychotherapy Entails
[00:12:55] The Work Of Field Trip
[00:19:08] The Importance Of Music In Treatment
[00:22:29] A Variant Of Ketamine Field Trip Is Using
[00:29:26] How Field Trip Incorporates Psilocybin Into Their Practice
[00:31:26] Podcast Sponsors
[00:34:29] Other molecules that will be more common in future treatments
[00:40:33] How A Psychedelic-Assisted Psychotherapy Session Is Conducted
[00:45:18] Prepping A Patient On Breathwork Before A Session
[00:49:46] The Patient Experience
[00:54:13] Dream Scenarios In The Emerging Landscape Of Psychedelic-Assisted Psychotherapy
[01:02:36] Microdosing Between The Therapeutic Protocols To Enhance The Therapy
[01:05:30] Closing the Podcast
[01:06:20] End of Podcast
Ben: On this episode of the Ben Greenfield Fitness Podcast.
Marshall: That's what's really cool about psychedelic therapy overall is because we can start changing the conversation around mental health, which is typically been reactive, which is you go see a therapist because you're depressed or you're anxious to something that's proactive where you're going through this because you just want to have a better life. What's so cool about psychedelics is not only can they treat depression and anxiety, they can increase empathy and creativity and awareness, self-understanding, and you don't have to be sick to benefit from those kind of things.
Ben: Health, performance, nutrition, longevity, ancestral living, biohacking, and much more. My name is Ben Greenfield. Welcome to the show.
Alright, I told you all about psychedelic-assisted psychotherapy in last week's podcast episode with Dr. Matt Johnson. Now, we're going to dive a little bit more into ketamine and how a lot of these clinics actually work with my friend, Ronan Levy, and a scientist who works with his company Field Trip Health named Marshall Tyler. So, if you're not sick of psychedelics yet, then sit back and get ready for even more. But I would recommend you go back and listen to the initial episode with Matt Johnson where I also talked about my friend Tim Ferriss‘s initiative to raise a bunch of money for the MAPS Foundation. And if you want to be a part of that initiative, please go to the shownotes in that original episode at BenGreenfieldFitness.com/psychedelics to get in on the $10 million raise that they're doing for the MAPS Foundation, which supports initiative similar to what you're about to hear about.
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Alright, let's go talk to Ronan Levy and Marshall Tyler. And remember, you can also, if you want to be part of the MAPS initiative that Tim Ferriss is promoting, you can go to BenGreenfieldFitness.com/psychedelics to learn more about that.
Well, folks, it's time for another episode on psychedelics and psychoactive molecules. Something I know a lot of you are interested in and it's something that is becoming increasingly common in the news, in the research that we see, institutions like Johns Hopkins putting out. And also, in therapy clinics, that seem to be becoming increasingly prevalent. What I mean by that is that physicians seem to really have their ears perked up to this idea of using psychedelics for therapy, for addiction, for trauma, etcetera. And I really wanted to do an interview in which I talked to some people who are kind of behind the scenes when it comes to not only the science behind some of these psychoactive molecules, particularly the ones that I think we're going to see with increasing prevalence in Canada, in the U.S. and elsewhere, but I also wanted to explore what actually happens with these type of clinics and what this type of therapy actually involves in both boots on the streets fashion, but then also from even something like a telemedicine standpoint for people who may not be able to go to a clinic because it turns out that both of these options are something that exist.
Now, my first guest on today's show is actually a friend of mine. His name is Ronan, the Ronan Levy. And he has founded something called Field Trips Psychedelics, which he'll explain a little bit more to you as we get going. But I've been taking a look at what they are doing and it's pretty intriguing when it comes to the whole realm of psychedelic therapy and psychedelic therapy clinics, what they are up to. And so, Ronan is a lawyer by trade, but is very involved in the psychedelics sector, and also the hemp and the cannabis and the biotech industries.
And my second guest on today's show is a friend of Ronan's and a scientist who have studied up on a lot of these psychoactive molecules. So, he's going to be the geek on today's show. He really looks into the chemistry and the biology and unravels the molecular basis of a lot of these neuropsychiatric disorders. He's worked previously as the leading scientist at one of the largest cannabis edibles manufacturers in California, but has gone on from being involved with, I suppose, gummy bears and chocolates and brownies to a little bit more the dive into these therapeutic molecules, not that cannabis isn't therapeutic, and not that I'm not joking about what it involves being a scientist at an edibles company.
But anyways, between these two guys, I think we're really, really going to get a wealth of knowledge on how psychedelic therapy actually works and what the scene looks like right now. So, Ronan, Marshall, welcome to the show, fellows.
Ronan: Thanks, Ben. Good to be here.
Marshall: Thank you, Ben.
Ben: Yeah, yeah. And you guys both have a pretty deep history in the cannabis industry. And so, I got to ask you if you're like drinking raw hemp juice, or if you put some kind of a CBD tincture into your coffee this morning, or what exactly you guys fueled up on right now? I always like to find out what my guest have had for breakfast when we're recording a morning show.
Ronan: I fasted this morning. So, I didn't eat anything this morning. And unfortunately, in Canada, access to at least legal CBD products is still overly restrictive, so I didn't put anything in my coffee.
Ben: That was the voice of Ronan. So, Ronan's burning ketones for today's show. And how about you, Marshall?
Marshall: Similar sort of thing. Yeah, I generally don't eat in the mornings and then I drink copious amounts of coffee. So, I think I'm on glass number four right now.
Ben: Oh, geez. So, you're definitely based on the fatty acid upregulation of caffeine consumption, possibly burning even more ketones as a throughput than Ronan is. And I'm in a complete opposite boat. I had organic blueberry powder with kefir, and ice, and Stevia, and a little bit of bone broth, and some colostrum with a few Baruka nuts, and some spirulina and chlorella all blended up in a giant NutriBullet. So, I'm going on about 800 calories right now and going pretty good. So, hopefully, I'm not sparking your guys' appetite too much there. Of course, I don't have to do as much talking on today's show, so I can sit back and digest my kefir while you guys rock and roll.
Ben: That being said, let's start here. When we're talking about psychedelic therapy, and either you guys can jump in and reply to whichever questions that you want to reply to, although I would imagine Marshall is going to be speaking more to the science, and you, Ronan, to the state of the industry. But how exactly would you guys define psychedelic therapy?
Ronan: I'll hop in here, Ben. It's Ronan. I think in its simplest form is psychedelic therapy is using psychedelic molecules like psilocybin, LSD, MDMA, which isn't always considered a psychedelic. But for these purposes, we can consider it that. As well as ketamine, which is very rarely considered a psychedelic, but in fact, has many psychedelic properties. Using molecules like that really catalyze the effects of psychotherapy. So, unlike traditional approaches to mental healthcare, which uses drugs to just act as a cure here, really, the drugs are meant to catalyze a therapy process, whether it's cognitive behavioral therapy or other ones. It's really about using drugs to make therapy better, not using drugs as an end in themselves.
Ben: Now, what kind of therapeutic psychedelics are we actually talking about as those that seem to be kind of the darlings of the industry right now? I mean, psilocybin is one that I'm aware of, but what else is there?
Ronan: Marshall can probably touch on the more robust research, but certainly, the ones leading the charge are MDMA. Actually, there's a Phase 3 trial happening right now by a nonprofit organization in the states called MAPS, looking at MDMA for the treatment of PTSD, and psilocybin, but then there are other folks looking at DMT in a commercial clinical context. And Marshall, you would know what else is going on from a research perspective.
Marshall: Yeah. There's definitely a lot of different psychedelics that people are interested in right now. As Ronan mentioned, DMT, and another one is 5-MeO-DMT. Those are both very short-acting psychedelics. And one of the keys with the clinical application of psychedelics is the fact that you want something that can fit within a reasonable window. So, LSD for that reason is pretty clinically cumbersome because LSD trips tend to last from 8 to 12 hours. And so, having a psychotherapist with a patient for an 8 to 12-hour experience is very cumbersome and costly to the patient. So, there's a lot of work being done on some of the shorter-acting ones, but yeah, there's a whole host of psychedelics. I mean, there's hundreds of molecules and we still don't know what the best ones are. We're just beginning to understand.
Ben: Yeah, 8 to 12 hours is a lot of cups of coffee for whoever is facilitating as well. So, that's a long day. Now, in terms of these psychedelics that are used in therapy, in particular, for example, I know that you guys at Field Trip, Ronan, and I'd love for you to explain exactly what you guys are doing at Field Trip, I think that right now, you're exploring something that is relatively legal from my understanding in many locations, and I know you're looking into rolling out locations in Toronto and L.A. and in New York, for example, and that's ketamine. So, explain to me exactly what you guys are doing with Field Trip. And then, I'd love to dive in with that kind of low-hanging fruit of something like ketamine, which I think is largely available/legal in many locations now.
Ronan: You mentioned that I'm a lawyer by training and I am, but I've stopped doing that, so I'm feeling much better now, but yeah. So, with Field Trip, what we're doing is really trying to build the infrastructure that's going to be needed to support psychedelics as they become a mainstream industry for — since the '70s, psychedelics have been scheduled drugs and they really got pushed this side. But over the last 10 or 15 years, there's been a lot of research put back into psychedelics. And the results of the studies and their therapeutic applications is just mind-blowing, orders of magnitude better than our current treatments for conditions like depression, anxiety, PTSD, and even eating disorders.
But in order for this really emerging industry to become something that could create a lot of impact and help a lot of people, it really needs a new set of infrastructure, existing medical clinics, existing family doctor's offices, existing psychiatrist's office. They're not really equipped to provide psychedelic therapies both in terms of providing an appropriate set and setting, which are really important in psychedelic therapies. And set and setting meaning, the set, meaning the mindset of like what are you hoping to get out of your psychedelic trip, and the setting being the physical location where you are. Both of those are really instrumental in leading to good therapeutic outcomes.
And that kind of clinical existence just doesn't exist right now. So, with Field Trip, our first priority is building that clinical infrastructure. We're starting with clinics in Toronto, New York, and L.A., as you mentioned. Hopefully, it'd be up to 60 to 75 clinics over the next couple of years, and they're just really purpose-built facilities to provide psychedelic therapies staffed with experienced psychiatrists, psychotherapists, doctors, and all of the medical professionals you'd need to provide this kind of care around very effective, and thoughtful, and safe way.
And then, the other piece of what we're doing is really exploring the opportunities with different psychedelic molecules. So, we recently announced the Field Trip Discovery Drug Development Division, which is in preclinical work on a molecule we're calling FT104 because I'm not sure in the details about it yet, but it's a really cool psychedelic molecule that we think will have a great application across potentially a number of mental health indications, as well as the work that Marshall is leading for us, which is really in the cultivation and understanding of psilocybin producing mushrooms, which — there's 200 species or so of psilocybin producing mushrooms across the world and very few of them have been studied to any degree of rigor or scientific pursuits. And then, we hypothesize that there's a lot of really cool molecules in there that will have therapeutic application, whether it's like the entourage effect in Canada, sorry, cannabis, or whether we just find new molecules that have therapeutic application. There's a ton of opportunity to do some really cool research around here.
Ben: Okay. I've got a lot of questions based on what you just filled me in on regarding not only the different varieties of these mushrooms and how they're actually identified in terms of therapeutic effect. But I also want to ask you about that FT104, and also this variant of ketamine called N-ketamine, which is what I understand you guys are using in your clinic. But first, I noticed — I went to your website — and I'll link to everything, by the way, if you're listening in, just go to BenGreenfieldFitness.com/fieldtrip. BenGreenfieldFitness.com/fieldtrip is where I'll have all the shownotes and everything for all that we discuss on today's show.
But Ronan, you guys say that you're like a spa for psychotherapy on your website. And I'm curious what that actually looks like, like when someone arrives at a Field Trip clinic for treatment, what's the actual experience look like? Are we talking about like a pedicure/manicure that goes along with your psilocybin experience, or what do you mean when you say a spa?
Ronan: Yeah. No, definitely not a pedicure/manicure. We don't quite go that far, but we really focused on building our centers in a very beautiful, approachable way. As mentioned, set and setting are instrumental to therapeutic outcome. So, people need to feel comfortable, need to feel at home where they're having the therapy, and we really designed it to be kind of like what we expect most people would want their house to look like if they're going through any sort of therapeutic setting, which is we've designed lots of green space within the clinic as much as possible. The chairs that people sit in when going through their ketamine session are in zero-gravity chairs that are super cool.
It's just everything. We pamper you to the greatest degree possible within the context of what is really clinical therapy. We provide access to juice bars and coffee and all that kind of stuff. I don't know about your doctors, Ben, but my doctor, it's pretty transactional. You're in your outs, and hopefully, they provide good care. But here, it's more about feeling welcome, feeling safe, feeling comfortable, enjoying your time there even though you're there for a therapeutic procedure. It's really about feeling awesome and feeling comfortable and safe.
Ben: Okay. Got it. And when we're talking about ketamine, I'd like to stick with that momentarily. That's something I've used as a microdose, as like a nasal space spray or a trochee. It can have a mood, uplifting mild antidepressant effect. And I've even used it just — it comes or is commonly used in anesthesia, for example. So, I've even used it in smaller doses for things like massages to relax my body and allow the massage therapist to dig into some of the more painful areas a little bit more easily. And I've also done intravenous ketamine as more like a 45 to 90-ish minute therapy with the eye-blocking mask and the headphones. And what I've found is some pretty supreme access to past memories, reliving periods from childhood, and an overall real nice mood uplifting effect.
And when it comes to what you guys are doing over there, from what I understand, you're using a variant of ketamine called N-ketamine. Am I correct? Sorry, S-ketamine.
Ronan: S-ketamine is the one that was approved by — actually, I'll let Marshall speak to that. He knows this stuff way better than I do. But just before Marshall hops in, exactly what you described in your 45 to 90-minute session with the eye mask, that's exactly what people will experience in our clinics. They'll come into our setting, put on music. We've got specifically tailored music that's been thoughtfully constructed to enhance trips, comfortable chairs, weighted blankets, like it supposed to be a really enjoyable experience. But what you described is pretty much what people can — what you described that you did, it's pretty much what people can expect when they walk into our clinics. But when it comes to the drug itself, I'll hand it over to Marshall.
Ben: Okay. Before you hand it over to Marshall, when you say music, are you guys — because I've wondered this before. It seems like the music spans the gamut as far as different tracks you can find — I mean, you could find 10 different ketamine playlists on Spotify, for example, and some go into like the old school classical methods, Bach, Mozart, Vivaldi, et cetera, and others are kind of more psychedelic or even Amazonian. Your guys' clinic like Field Trip, do you guys actually have a composer? Are you researching the type of tracks that are used, or how are you selecting the music?
Ronan: Yeah. We've been in conversations with groups like Wavepaths and Mendel Kaelen, who has done a lot of the research through Imperial College on the musical impact of the therapy and psychedelics. I don't remember exactly where we landed on which composers and which music that we use in our clinics, but we're always going to be exploring, involving, and working with different partners. And as we start to roll out some of our other digital tools, we'll be working with a group out of Toronto called LUCID, which has developed a machine-learning algorithm that can help track and respond to people's feedback as they go through a trip. So, it's something that we want to be on the cutting edge of. Even if we're not doing the work itself, we want to be working with the partners that are leading really the use of music in therapy and leveraging technology to make it as impactful as possible.
Ben: Are we talking about like brainwaves and HRV as far as the real time tracking that something like LUCID would be doing?
Ronan: LUCID I think right now relies primarily on direct feedback from the user based on their experience. They'll do it before and after, and they've I think clinically validated their music therapy, but certainly, expanding into HRV and other metrics because when you're in our clinic, we've got oximeter on, you were tracking HRV, doing all sorts of things to make sure people are safe and healthy. And so, it's going to evolve into that for sure. I'm not sure it's there quite yet, but it's certainly on the roadmap.
Ben: Yeah. I think tying quantified technology into some of these therapies is something that — from what I've seen, nobody's really scratched the surface on in a really thorough way. I mean, I would imagine that customizing and tweaking protocols based on what's actually occurring in terms of electroencephalogram, or brainwave measurements, or heart rate variability measurements, or heart rate measurements, or skin temperature readings. I mean, there's so many things that could be monitored that I would imagine would give really good feedback in terms of dosing, music setting, et cetera. That's something that I think should be explored a lot more.
Ronan: Yeah, absolutely. And I know we're going to be very proactive in collecting data around it. I know researchers like Adam Gazzaley at the University of California, San Francisco is very proactive in that. So, it's one of the really exciting areas of exploration and psychedelics. The whole sphere is super exciting. I mean, there's pretty good knowledge of the psychedelic molecules because they were studied pretty in-depth, at least the well-known classic ones in the '50s and '60s. But there's so much because of the interplay of the drug with the setting that can be explored in terms of how to tweak and optimize the delivery of these services. It's an area of focus that's really important for us.
Ben: Interesting. Okay. So, Marshall, let's start with that S-ketamine we were talking about. Is that the form of ketamine that you guys are using? And if so, what exactly is that and how does it work?
Marshall: So, we're actually using racemic ketamine. Ketamine is a very complex molecule and that it exists as a sort of mirror image. So, if you imagine like a pair of gloves where you have both of those within ketamine, so they're virtually identical, yet not interchangeable. And so, you have these two mirror images within what's known as racemic ketamine, and that's what we're delivering right now. There have been some studies done with each individual, enantiomer. So, with the S-enantiomer, which is one form of the molecule, and the R-enantiomer, which is its mirror image.
There has been some research done with those two, but currently, mostly evidence points towards the fact that the racemic mixture is likely the most valuable. And it also, when consumed or injected, it converts into a variety of different metabolites. So, there are over 20 different things, 20 different molecules that your body will break down ketamine into, and some of these do have psychoactive properties. So, some of those are contributing to the overall experience. So, by maintaining both the R and the S-enantiomer in that parent mixture, we're able to get all of those effects from the, not only ketamine, but from all the metabolites it breaks down into as well.
Ben: Okay. So, when S-ketamine is used, what we're referring to is what in chemistry being called an enantiomer and it's an S-enantiomer of ketamine. So, it's considered to be more potent from an antidepressant effect than something like the R-configuration?
Marshall: Yeah. So, the jury is still out on that one. The theory was that the S would be more potent, but that hasn't really played out so far in clinical research. The R-enantiomer is actually quite potent as well, and the racemic mixture is potent. So, they might be equally potent, but have some sort of nuance of differences in these sort of experiential components that they're inducing that seem important, but it's still poorly understood.
Ben: Okay. Got it. Now, when it comes to the delivery mechanism, like I mentioned, my experience with the higher doses has been intravenous. In particular, I've had that overseen by a physician anesthesiologist in a ketamine treatment scenario at a doctor's office. And then for my own home use, I microdose with the intranasal variant. But what are you guys using at a clinic like Field Trip?
Marshall: We're using intramuscular right now. And so, that really induces like a pretty powerful psychedelic experience that hits you all at once. And so, that rapid delivery mechanism is able to get people into this transformational space where they're able to, like you said, confront past memories. Maybe it's a trauma that they experienced in childhood or whatnot. And then they could bring that back with them after the experience. And that's where the psychotherapy really comes into play, so as Ronan said. Unlike a lot of other ketamine clinics, we use ketamine-assisted psychotherapy. So, ketamine is just a tool, but the psychotherapy is really what's needed after the ketamine experience to really make all the learnings that come from the experience into actual behavioral changes that have long-term benefit for the patients.
Ben: Okay. Got it. So, when we're talking about S-ketamine, it'd be an intramuscular delivery, and you think that that's the form of delivery that's going to give me somebody the best experience with something like ketamine journey?
Marshall: So, probably racemic ketamine. So, both S and R ketamine as an intramuscular delivery, yeah.
Ben: Alright, got it. So, in terms of some of these other things that Ronan brought up, one that really perked my ears was this FT104. I've not heard of that before. What exactly is that?
Marshall: It's actually a proprietary molecule. We can't delve too much into this structure right now.
Ben: Nobody's listening except us three, Marshall.
Marshall: But the idea is we are taking the core components of psychedelic molecule and we're narrowing down the features that we think are essential to these positive outcomes and taking away anything that might not be conducive to the outcome. So, the duration of the experience might be changed and we have a hunch that the outcome will be dramatically changed based on some early evidence.
Ben: Okay. Got it. Is it something that acts like ketamine? Is it more like psilocybin? Is this something that you just can't reveal details on right now?
Marshall: Yeah. We can't go too much into detail. I will say that it does very much embrace the psychedelic experience. So, one of the key components of our therapy is really getting patients this really profound psychedelic experience, and the Field Trip molecule is absolutely going to do that because we realized that the experience itself is essential. So, it's not as simple as activating receptors and having that lead to a beneficial outcome, you need this experiential component, this really transformative experience to get the positive outcome. And studies have supported this now. A lot of studies have pointed to the fact that the more intense the psychedelic experience is, the better the outcome will be for the patient. And so, our molecule is capitalizing on that by trying to recapitulate the most essential components of the psychedelic experience. But beyond that, unfortunately, we can't go into too much detail.
Ben: How far are you from being able to release details on that one?
Marshall: That's a good question. We've got our freedom to operate in patentability opinions. So, once we got the patent filing, we'll probably be able to talk a little bit more about it. But the exact timeframe for that is unclear at this point.
Ben: Okay. Got it. Now, with the psilocybin, I know that that's something that, from what I understand, is not even legal to grow in the U.S. and Canada, and correct me if I'm wrong there. So, how exactly you guys going about that?
Marshall: Yeah. So, that's a great question. It's not legal to grow in either the U.S. or Canada. And so, we've taken our research down to Jamaica where there aren't regulations surrounding psilocybin. And so, in partnership with the University of West Indies, we're leaving out a botanical research program down there where we're able to actually cultivate these fungi.
Ben: Is that pretty common, a lot of companies now growing in Jamaica?
Marshall: A few companies seem to be starting up, but yeah, we're definitely one of the first movers and I'll say that our operation is unique and that it's in partnership with the university. And so, there's a lot of luxuries that that partnership affords us and it allows us to really push forward on the academic research side. So, it's not just a production lab. We're not just trying to make massive quantities of psilocybin and distribute them. We're actually trying to understand the fungi that produce psilocybin and related molecules and figure out what other chemicals are present in the fungus that might be contributing to the experience because we think that there are almost definitely other molecules within the fungus that are creating very different experiences depending on how they're interacting with psilocybin. And we think those molecules are important to understand.
Ben: How do you actually do that? Like, do you grow it? Is it kind of like growing a garden where you're selecting a certain type of tomato or a certain type of kale, and then growing those variants of mushrooms then testing them to see what the bioactive components are?
Marshall: Essentially. And so, we have a starting point because there is a list of known species which contain psilocybin, but those haven't really been analyzed in depth. And so, they're known to contain psilocybin, but it's unclear what other molecules they might contain. And so, it starts with growing out all the species, and then chemically analyzing them to see what differences there are, and then correlating that with any sort of differences there are in the experiential component.
Ben: Got it. And then once you guys come up with varietals that actually have these bioactive components that you're looking for in Jamaica, then the process is you're actually encapsulating those and then bringing them back to a clinic once this stuff begins to grow in legality and administering. Is it like a capsule administration in the actual clinic when someone comes in for a protocol?
Marshall: Yeah. So, there are a few different avenues we could go with any of our findings down in Jamaica. So, we wouldn't be exporting anything from Jamaica. Everything we do there is going to stay there, but we would use our learnings and our findings down there and translate those to jurisdictions, either where it's legal to produce and sell psilocybin. So, if you've been keeping up with this psychedelic legislature, it's been changing quite rapidly in the United States, and it looks like there will probably be a ballot measure in Oregon this year that would legalize psilocybin-assisted psychotherapy within a couple of years.
And so, in a market like that, we could theoretically translate our findings to that space and that would be able to be administered legally to people within the state of Oregon. Alternatively, we could go the drug development route. So, any sort of new molecules that we find that seem really promising and interesting, they might be lead candidates for drug discovery. And so, we could do all this pre-clinical work that would be required. And if it looks promising in animal models, bring that all the way to humans.
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Are there any other molecules that you guys are looking into or any other — I mean, even things that might be more commonly known? Like you mentioned, DMT and 5-MeO-DMT as options. Are there other things that you think would be kind of like gold standard in the future? Let's say five years from now in a clinic like Field Trip, for example, when someone comes in as far as available therapies or available psychedelics?
Ronan: I'll hop in here. I mean, certainly, in terms of the academic research, Marshall can speak to that better, but the gold standard is still to be determined because it's going to depend on a number of different factors, which is what indication are you going after? How long is the experience? What are any off-target effects? One of the risks around psychedelics is there's something known as the 5-HT2B liability. So, in terms of mechanism of action, and I'm totally speaking out of turn here, so Marshall, come in and correct me at any point, in terms of the mechanism of action, most classic psychedelics target the 5-HT2A serotonin receptor in the brain, which is what triggers the psychedelic experience. But they also hit the 5-HT2B serotonin receptor, which has been known to cause potential heart complications.
And so, when you're looking at any new therapies, you got to look at the risk versus the benefits. And so, DMT is really interesting because it's powerful, it's short, which means it's more scalable. But are there off-target consequences? There's some research that suggests maybe the longer the trip, the more the therapeutic outcomes. So, short experiences may not be as beneficial. So, there's a whole bunch of different considerations you got to triage and think about. But I think the answer is there's going to be no gold standard for any one individual. Everyone's circumstances will be unique and the appropriate therapies will be triaged appropriately.
Ben: Now, with something like DMT, and I think this is even more commonly said about something like MDMA, there's potential for some type of neurotoxicity or neural inflammation that could occur, especially with the higher dosages. For example, I personally have done pretty high dosages in a set and setting with a therapist with some of these compounds and have reached out to several physicians and been given advice to take things like SAM-e to replenish methyl groups and vitamin C for the antioxidant effect, or even something like a cannabis for the neural inflammation along with 5-HTP to replenish some of the 5-HTP.
And so, there's almost like all these damage control type of compounds one consumes after pretty hefty trip. Are you guys planning on working in post-therapy, things like supplements, nutriceuticals, et cetera, to help someone bounce back more quickly from something like a trip?
Ronan: To some degree, I mean, it is limited and this is one of the challenges of trying to navigate a new therapeutic landscape, which is because our audience is twofold, both the patients and as well as the medical community, which tends to be more conservative, we're a little bit cautious about advocating for the use of supplements where the evidence isn't very strong. Certainly, I'm sure there's lots of evidence for the things you talk about, but the standards that we get measured up to when we're dealing with physicians and then a medical community is usually a very high bar. And so, to the extent that we can provide some scope of nutritional advice for how people can recover, we will do so, but we won't step too far just out of being cautious about saying things that may not necessarily be backed up with a great degree of clinical research, even if it may be intuitively and biologically sound.
Ben: Yeah. I think that it would actually be pretty cool to begin to look into, when someone comes in for a therapy, what you can do to actually clean up some of the potential for neural inflammation or for oxidation. After something like that, that's something I think that would be interesting to explore. And the other thing I wanted to ask you guys was what about so-called biohacks that a lot of folks are, I know in their own personal space, combining with some of these therapies to do things like enhance blood flow, something like pulsed electromagnetic field therapy where someone's not just sitting in let's say like a zero gravity chair, like you talk about Ronan, but maybe they're laying on a PEMF mat. Or, for example, a hyperbaric oxygen therapy is another thing that could be administered post-treatment. Are you guys interested in this whole realm of biohacks that could be stacked along with therapy?
Marshall: Yeah. I mean, certainly. As a founding group, we're are all very interested in this kind of care. The analysis is always going to be those. Is there enough evidence to justify the use of these approaches? Not to suggest that any of them are potentially bad, but we have to be cautious being on the vanguard of new medical modality, not to be seen to be participating in what some may view is kind of quack treatments. And I'm not suggesting any of those are, but there's probably a lot of people who may think so. And so, we're just trying to blend being cautious, but being proactive with also being conscious of costs, which is some of these options have cost an investment associated with them.
And given that psychedelic-assisted psychotherapy is already pretty labor-intensive, we've priced our model to be pretty consistent with conventional therapy, so it works at about $300 a session for ketamine therapy. It's still expensive for a lot of people, and out of reach. So, the more you layer on these other approaches or these other techniques, the more expensive it gets. So, we're trying to balance all of those factors to ensure scalability, ensure that we can reach the greatest number of people, but in the same token, ensure that we're doing it in a way that doctors in the medical community can really get behind without much effort.
Ben: When somebody goes into a clinic like this, is it a physician who is overseeing the protocol or is this like a therapist or some kind of a shaman, for example?
Marshall: Yeah. We have a no shaman policy in Field Trip, again, just targeting our audience, which is the medical community. But getting their support in their buy-in is going to do more for psychedelic therapy than any individual patient or treatment. It's going to require changing a whole set of probably fairly conservative attitudes in the medical community to really make this go mainstream and help the most amount of people. But the protocol we have right now is, it's primarily physician-driven, so patients will get referred to us. Typically, right now, we're only treating people with treatment-resistant mental health condition. So, they have to have tried conventional treatments, and that's just based on guidance from the College of Physicians in Ontario.
But we'll have a psychiatrist doing assessment to determine whether ketamine-assisted psychotherapy is a potential treatment option because there certainly are some contraindications to ketamine treatment that we have to be cautious of. It's not appropriate for everybody. If the psychiatrist is comfortable, we'll have a medical doctor or family doctor do a basic physical to ensure that physically, you're sound for it because it can have implications for blood pressure and other cardiac considerations. If everything is good on that front, then you'll meet your clinical therapist who will take you through the sessions, but the actual drug will be administered either by a medical director or a nurse practitioner.
You go through the session. We've got a respiratory therapist on site again just because of some of the potential complications from ketamine, which is quite safe. We're providing all of these medical professionals out of abundance of caution. But yeah, the nurse practitioner or doctor will administer the ketamine. You'll be present with a therapist who will be with you through the actual trip. Following the trip, you'll do an exploratory light touch therapy session, which is really about identifying some of the things like, Ben, you mentioned, reliving some memories and all that kind of stuff. So, we want to have someone there to ask the right questions and record your experience so we can use that in the actual integration therapy.
So, you'll do two ketamine sessions with two exploratory therapy sessions right after the ketamine experience. And then following that, you'll have an integration session where you take all of the things that came up, and we really use cognitive behavioral therapy techniques, or try and not only integrate this stuff, but lead some meaningful lifestyle and habit change so you don't fall back into depression. At the end of the day, we don't want to have the pharmaceutical business model where we keep people hooked on our services all the time. We want to see them get better and never have to come back. And from a business model perspective, fortunately, there's enough people suffering with enough challenges. Even if you're cured of depression or PTSD or whatever the case may be, it doesn't mean that you're not going to have new experiences in life that could set you back.
So, we don't think from a business perspective, there's any concern that even if we can send people on their way and totally resolve pre-existing mental health conditions, there won't be a need for them to come back in the future. And that's just the nature of life. I mean, that's what's really cool about psychedelic therapy overall. And one of the reasons I'm really excited about it is because we can start changing the conversation around mental health, which is typically been reactive, which is you go see a therapist because you're depressed or you're anxious, you're going through a hard time to something that's proactive where you're going through this and having these experiences because you just want to have a better life, not because you need to, but because there's so much improvement to have even if you have a great life. What's so cool about psychedelics is not only can they treat depression and anxiety, they can increase empathy, and creativity, and awareness, and self-understanding, all of these wonderful things, and you don't have to be sick to benefit from those kinds of things.
Ben: You mentioned a respiratory therapist, right? Is that what you said?
Marshall: That's correct, yeah.
Ben: From my own experience, there are some pretty interesting things that happen with breath in terms of exhales and inhales that are very consciously taken as being able to almost like guide one as they go through a journey. And many people experience a feeling as though they are able to take extremely long inhales and extremely long exhales, even with something like ketamine, and of course more particular with something like a DMT, for example. And I'm curious in terms of the coaching or the lead-up going into a session, is there conversations or any type of training specifically when it comes to talking to a patient about how to use their breath during a session? That's another thing that to me seems like it would be pretty valuable, but I'm curious if you guys have looked into that at all.
Ronan: I mean, through our virtual therapy offerings now, we actually offer breathwork plus integration. So, different breathing techniques like holotropic breathwork or transformational breathwork can actually induce a largely psychedelic state just through breathing, which is incredibly profound. And if you haven't tried it, you certainly should be. It's a very, very cool, meaningful experience, and it's something that we're offering as a standalone service. We're again just somewhat cautious about trying to encourage people to adopt different breathing techniques when under the ketamine experience because the interplay between those breathing techniques and ketamine, it hasn't been well-studied and we don't want to create any additional risk for our patients and focus on protocols that are well-established and well-understood.
Again, part of that is for the safety of our patients. Part of that is again just trying to like be as prudent as we can while we're still being very progressive in a new sphere because we want to get the medical community body into supporting these types of care. So, they refer patients confidently to us and don't see it as some sort of fringe practice. We really want this to be a mainstream, which means we're probably not doing a lot of the things we'd love to because our audience may not be receptive to it just yet.
Ben: Yeah. And I was necessarily talking about like doing holotropic breathwork during a session, but more just being in touch, being aware of breath and obviously doing rigorous breathwork while on something like DMT or psilocybin. It's pretty difficult to do anyways because there's some amount of conscious control that's lacking in that scenario of a high dose, but I think that going into a session like that, very aware of and connected to one's breath, I've personally found that to be incredibly helpful.
You mentioned another thing and that was this idea of the fact that you guys are doing some breathwork coaching, for example, via digital consults and online. And I know that right when the coronavirus pandemic started to hit was when you guys were in the process of rolling out of Toronto and New York and L.A. facility, and you seemed to pivot a little bit and begin to look more into telemedicine or teletherapy. How exactly does something like that work?
Ronan: Yeah, that's exactly right. I mean, teletherapy and virtual care are something that was always on our roadmap, but because the pandemic slowed our ability to physically open clinics, it enabled us to focus on our more digital offerings. And the digital offerings are really just getting off the ground in terms of the psychedelic breathing plus integration. That's like a recorded video of a breathwork session. That's kind of self-guided and then you step right into an integration session with one of our therapists. Some places are rolling out other forms of virtual therapy with mail-ordered ketamine where you take the ketamine at home and then do an integration session with a therapist remotely.
That's something that we're watching, but we don't think it's terribly prudent at this point to be given people ketamine at home when they don't have the necessary support and oversight, particularly given some of the, like I said, low but not insignificant risks that can be associated with ketamine. But we're exploring the space in terms of actually at-home delivery of psychedelic therapy, but it's not something that we're active in right now, just given some of the health considerations and what we think to be best medical practice at this point.
Ben: Got it. So, walk me through this. Like if somebody goes to the website — and again, I'll put all the links at BenGreenfieldFitness.com/fieldtrip. And although from what I understand just again because of COVID, the clinics are not currently operational as many clinics are not. What's the actual experience? Like, let's say someone calls you on the phone or they go to the website, they want to come into the clinic, what happens next?
Ronan: Yeah. So, I'll just note that we have been closed in our Toronto clinic since mid-March, but we're actually opening our doors again tomorrow and starting to dose patients again tomorrow. So, that's great. And we're on track. It seems for both New York and L.A. to open in July. So, that's really great news and it doesn't set us back too much. In terms of the experience, what would happen is a patient would reach out, given this as a novel therapy area and not appropriate for everyone, one of our care coordinators gets on a call with you to walk you through the process, help you understand exactly what's going to happen and what needs to be done before we can treat you in Toronto. Because of the guidance from the College of Physicians, it's only available for treatment-resistant patients.
So, if you haven't tried conventional therapy techniques or conventional antidepressants as good or bad as they may be, you've got to go through that before we can provide care to you. So, walk people through that and make sure that they're a qualified patient. If everything looks good, we'll book a consult with our psychiatrist. You'll meet with a psychiatrist who will do an assessment, make sure that ketamine therapy is appropriate for you as well. If everything looks good, we'll book an appointment at your first dosing session where you'll come in. You'll meet with the medical doctor, as well as the therapist. We'll be taking you through the experiences. The doctor will do a quick physical, make sure everything is good, and then we'll do the treatments, the dosing session on ketamine, which as you mentioned is about a 45 minutes to an hour experience.
Therapist is with you the entire time. Afterwards, the therapist will take you through sort of a light conversation just trying to understand your experience. There will be coffee and juice and a cool place to relax after you go through it because even though the intense experience on ketamine is about 45 minutes to an hour, it can have lingering psychoactive effects, and people don't necessarily feel altogether with it before they go home.
Ben: Oh, yeah. You're pretty wobbly for a few hours afterwards.
Ronan: Yeah, exactly. So, we want to make sure people have all the time they need to get back into their head and get back into their body. And so, there'll be a juice bar and tea and all that kind of stuff, and people will relax. I mean, like I said, this is designed to be — it's like a lounge. You can see images of our clinic on our website. It's not what you'd expect from most medical clinics. So, that's kind of the experience, and then depending on the patient schedule, the whole course of treatment, which is supposed to be six dosing sessions and three integration sessions should take about three weeks, but that's usually a big commitment. So, for people taking time off work, if you are fortunate enough to be working these days, and then that's it, but we could schedule it for as long as the shortest as you need be. I think that's pretty much the experience overall.
Ben: When you guys are screening someone to come in — because I know this is another thing that's really interesting, like there are certain genetic pathways that influence whether you clear dopamine more slowly or more quickly, or how your methylation status is, or even things like blood work, micronutrient status, et cetera. Are you guys interested at all in beginning to run labs on people to take a look at how protocols, very similar to something like you might be doing with LUCID and collecting self-quantification data, are you looking into customizing protocols based on lab work as well? That's another area that I think would be super interesting, but I'm curious if you guys have actually looked into that at all.
Ronan: It's something that we thought about, but it's not something that we're actively doing right now. We're focused on just delivering the best ketamine therapy within the context of assessing patients based on their psychiatric and basic biological considerations and medical considerations. But all that kind of stuff, which is super cool, and stuff that we certainly plan to get into in the future is on the roadmap, but not available just yet.
Ben: Yeah. Well, hopefully, I'm giving you guys plenty of ideas for —
Ronan: Tons of ideas, Ben. Thank you.
Ben: Because this is the kind of stuff I lay awake at night and think about is how we can make the world better by combining some of this ancestral wisdom with modern science. Now, Marshall, what else are you excited about when it comes to the type of therapies that you think could be implemented in a clinic like this? Unique molecules, delivery mechanisms like dream scenarios for you as far as what you as a scientist would really like to see in terms of the emerging landscape of psychedelic therapy.
Marshall: Yes. I mean, I think there's a lot there. There's definitely a lot that excites me about this space. One of the things I'm most excited about is probably looking at different molecules and diving into the nuances, not only of the psychedelic experience, but the nuances of these disease states like depression, addiction, anxiety, OCD, PTSD, because we know those are just blanket statements that cover a wide spectrum of different kind of cases. It's so individual, those disorders. And understanding what predicts someone's response to a drug is going to be so essential going forward.
So, back to your point on testing before they actually undergo the drug therapy and doing these sorts of panels, those are some things that I'm really interested in because then you could really delve on individual patients and predict whether or not they'll respond to a certain drug. And maybe a higher dose of ketamine might be recommended for that patient, or maybe instead of ketamine, it should be psilocybin or DMT or 5-MeO-DMT for whatever reason. And so, that's some of the stuff I'm most excited about. I mean, psychedelics are remarkable in their ability to rapidly relieve depression.
So, with SSRIs, it takes two to three weeks generally before you see any sort of effects. And oftentimes in that first two to three-week period, symptoms get worse. And so, for someone who comes into a clinic with suicidal ideations and is told to start on this drug where their symptoms might get worse. They're already on the verge of suicide, and the psychedelic might lift them out of that state almost instantaneously, or generally within 24 hours. So, finding psychedelics that can do that most effectively and diving into what aspects of the chemical structure are allowing these molecules to do it and what receptors are essential because we know, like Ronan said, there's this one subset of serotonin receptors or 5-HT2A receptors that seem to be responsible for a large part of the psychedelic effects. But there's a host of other receptors that these molecules activate, and many of those are important in the psychedelic experience. They're just not well-understood right now. So, really delving into that research and understanding how all these receptors are playing.
And then finally, I'll add. So, that's on the drug side. Then there's also the setting component. And so, everything we've done in the clinic, as Ronan says, they're not arbitrary decisions, these are all evidence-based decisions. Even a decision like incorporating greenery into the clinic is based on research that says there's a huge increase in nature relatedness that comes from these psychedelic experiences and people find this connection to nature very meaningful and actually helps to relieve depression in a lot of people. And so, getting into how we can use things like music, visual stimuli, auditory stimuli, tactile stimuli, whatever kind of inputs might guide the patient to a better outcome, those are things that I'm really excited about.
Ben: Okay. Got it. Now, in terms of competitors, do you guys anticipate this being a thing, like they're being a target of psychedelic therapy? And a Walmart and a McDonald's, I mean, like, is this something that pretty few companies are doing right now? What do you think the landscape is going to look like regarding that?
Ronan: Yeah. I mean, certainly, psychedelics are having a moment from a capital market's perspective. I don't know if you've been following, Ben, but a company called MindMed went public. They're looking at [00:56:59] _____ to treat opioid addiction, and now are doing something with LSD. Another company called [00:57:06] _____ basically took a lot of our business model and used it for themselves and they're publicly traded as well.
Ben: Those dirty bastards. They stole your stuff?
Ronan: You know how many decks I've seen that have taken pages right out of our deck? Like, they really copied word for word format and everything.
Ben: You're a lawyer. Can't you do something about that?
Ronan: I mean, most of that just stuff is just academic information that we found elsewhere. And I don't think there's any big problems associated with it. You know what do they say? Imitation is the sincerest form of flattery. So, we'll take it as a compliment. But there are a lot of companies emerging. What's unique though is that, and really the thesis of our business model is that you need a whole new clinical infrastructure. You need something that's very, very thoughtfully constructed, both in terms of the physical space, the therapeutic protocols, as well as the drugs you're putting into potentially the therapeutic application.
And that's not something that's going to be happening at Walmart or anything along those lines soon. Certainly, there's going to be a number of other ketamine clinics that are open and will be opening across the U.S. and Canada trying to replicate our model. But I think what makes us unique is that, A, we have an integrated model where we're focused on the end-to-end experience from drug all the way to therapy. And B, we got a team that's done it before. We brought some of the best people in the world together to build Field Trip, and I think that really sets us apart.
Ben: And how long do you think it'll be before something like psilocybin is offered in these type of clinics?
Ronan: It depends on how we get there. So, in Oregon this year, it looks like there's going to be a ballot in the 2020 election looking to create a legal market for psilocybin, which will include psilocybin producing mushrooms. And if you look at the rules that has a two-year rulemaking period, so by 2022 if that ballot passes, which according to polling right now it will, psilocybin will be available in Oregon in 2022 and will certainly be there to participate in that. More broadly, you're probably looking at 2024 because there'll be other states looking to create similar markets to Oregon, or 2025, which is [00:59:17] _____ expect to get its approval from the FDA for their synthetic form of psilocybin.
So, it's still years away before you're going to see access to psilocybin. Maybe in Canada, it comes a little bit sooner because in Canada, cannabis came about through constitutional challenge and the same people who fought that constitutional challenge for cannabis are going to fight it for psychedelics. We know that to be true. So, maybe the courts bring it a little bit faster in Canada, but we still got a few years before it happens, but I think that's a lot faster than the average person would think before psychedelics are going to be legal in Canada and the U.S.
Ben: Interesting. So, Marshall and Ronan, anything else that you guys think that folks should know about psychedelics, either from your own personal experience, things that you guys are rolling out at Field Health, or Field Trip, things that you plan on rolling out, anything else you want to share with people, particularly when it comes to psychedelic-assisted psychotherapy?
Ronan: I guess the most important thing is that I think a lot of people, with all the news and media attention given to psychedelics recently, are going to be inclined to go out and self-medicate and try it on your own. First, I would say that we're building tools that we're going to make publicly available over the course of the summer to really support people if they're going to be doing it on their own, so they're not taking risks that they don't need to take and doing it in the best way possible. So, if they're looking for a therapeutic outcome, they're going to maximize the potential of doing it. Even if they're not doing it with doctor supervision or a therapist in hand, we want to really make sure that people are empowered to get the most out of this and avoid risks.
But really, I think the most important thing that I think about is like, be thoughtful, be careful. The one thing that could ruin all the momentum around psychedelics is one person doing something really, really stupid that the media or politicians who may be regressive around this take ahold of and point to as a reason not to promote and pursue psychedelic research. And so, be thoughtful. Anyone who's doing this, make sure you're doing it with the proper support if you're going to do it and make sure not to fuck it up for the rest of us, I guess.
Ben: Yeah. Interesting. How about you, Ronan?
Marshall: That was Ronan.
Ben: Sorry, Marshall.
Marshall: Yeah. No worries.
Ben: It's so hard to keep track with all these people on my show.
Marshall: Yeah. So, one thing I'll add to that is the fact that these molecules aren't panaceas, so they're not cure-alls. And for some people, they're not effective and they really require a level of active participation. That sort of goes against the traditional medical model of, “Just take this drug every day and hope you feel better.” It's, “Take this drug and then really integrate those findings into your day-to-day life,” because we're talking about a transformational experience. And if you just have that transformational experience, but then fall back into the same kind of behavioral patterns that led you to a negative state before the experience, you're just going to fall back into that negative state.
And so, I think it's important for people to realize that there does need to be active participation on the patient's part. And even if you're just trying to use these molecules to enhance your creativity or general cognition or whatever it might be, there has to be an active effort after the fact to actually put this all into practice, because they induce a period of neuroplasticity after the drugs are used. But that neuroplasticity, it's only valuable if you capitalize on it.
Ben: Okay. Got it. Now, one last thing I want to ask you guys about, and that's this idea of microdosing that I know a lot of people are doing now, and I know even some therapists or shamans are recommending certain microdosing protocols in between the therapeutic protocols. Have you guys messed around at all with that, whether it'd be LSD, or psilocybin, or LSA, or MDMA, or any other form of microdosing as a way to enhance the effects of this therapy?
Marshall: Yes. So, we've definitely looked into microdosing and it's been a big conversation. Unfortunately, the evidence for microdosing really isn't there. It's been shown that microdoses do enhance some aspects of your cognition on the day that the microdose is taken, but those usually aren't sustained effects. So, the next day, if you don't take another microdose, you're likely to not have any sort of benefit from the previous microdose. And as I said earlier, more and more studies are pointing to the fact that the intensity of the experience really is correlated with the positive outcomes.
So, one way we see microdosing potentially is coming into play is after having taken a large dose and having had a transformational experience to sort of sustain the findings from that experience, someone could take microdoses to reintroduce a little bit of those feelings and emotions that they had during the original experience and help them to reactivate those sorts of neural pathways. But microdosing on its own is something that we're definitely keeping an eye on the research, but doesn't seem to have nearly the same promise as these larger doses.
Ben: Yeah. I personally have been doing quarterly plant medicine therapy treatments along with my wife, but then I've also been using microdosing in between those therapies to kind of like stay in almost like a miniature version of that space. And I have actually found it to be pretty incredible as far as maintaining a lot of the work that I did during the therapy sessions compared to not microdosing in between. And it's actually a really interesting concept again. I think something that could and should be explored more as far as what occurs in between these therapy sessions to kind of keep someone connected to that space that they may have been in the therapy.
But returning back to the type of journaling, and the downloads, and the notes that I take during or after therapy, and then combining that with smaller microdoses afterwards on specific days, I've personally found that to be something that is incredible as far as enhancing the experience. So, yet another area in addition to self-quantification and biohacks and supplements to look into when it comes to bringing this to the next level really. I think there's just so many areas that could be explored. So, lots of fodder for thought.
But in the meantime, you guys have done a great job putting together this series of clinics and I honestly can't wait. I haven't been to one yet, but I'm really looking forward, potentially on my next L.A. or New York trip or up to Toronto to actually try out what you guys are doing and kind of experience the space for myself. So, I'm excited about what Field Trip is doing.
Ronan: Thanks, Ben. We'd love to have you anytime you're in the hood. Come on by. We'd love to show you around.
Ben: Yeah. I absolutely will. And in the meantime, if you want access to the shownotes and everything that we talked about, as well as an exploration of Field Trip Health and their website, just go to BenGreenfieldFitness.com/fieldtrip and I will have it all there for you. In the meantime, Ronan, Marshall, thanks for coming on the show, guys.
Ronan: Thanks, Ben.
Marshall: Thanks, Ben.
Ben: Alright, folks. Well, I'm Ben Greenfield along with Ronan Levy and Marshall Tyler signing out from BenGreenfieldFitness.com. Have an amazing week.
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Field Trip Health, Inc., the world's first mental wellness company focused on psychedelics and psychedelic-assisted psychotherapy, is opening the first medical centers—first in Toronto, then in New York and LA—dedicated exclusively to the administration of psychedelics, in a “spa-like” setting.
So what exactly happens at one of these types of psychedelic therapy clinics? You're going to find out in today's podcast and also discover what kind of biohacks, self-quantification tools, supplements, and more could potentially be combined with plant medicine for enhanced efficacy.
My first guest on today's show is entrepreneur and visionary Ronan Levy. Ronan is a co-founder and the executive chairman of Field Trip Health, Inc.; partner at Grassfed Ventures, a venture capital and advisory firm focused on the cannabis and biotech industries; and a member of the board of directors for Trait Biosciences Inc., a leading biotech company in the hemp and cannabis industries. Prior to his current roles, Ronan co-founded Canadian Cannabis Clinics and CanvasRx Inc., the latter of which was acquired by Aurora Cannabis Inc. (NYSE: ACB) in 2016, after which he served as senior vice president of business and corporate affairs for Aurora. A lawyer by training, Ronan started his career as a corporate lawyer at Blake, Cassels & Graydon LLP and legal counsel at CTVglobemedia Inc. (now Bell Media Inc.) He holds Juris Doctor and bachelor of commerce degrees, both from the University of Toronto.
My second guest on today's show, Marshall Tyler, is a scientist with a deep interest in psychoactive molecules. He spent his academic career at Cornell and Harvard, exploring the intersection of chemistry and biology in an attempt to unravel the molecular basis of neuropsychiatric disorders. He subsequently worked as a leading scientist at PLUS, one of the largest cannabis edibles manufacturers in California. Marshall's passion lies in guiding research to arrive at a deeper understanding of consciousness with the ultimate goal of enhancing wellbeing.
MAPS Capstone Challenge
In the recent podcast episode, “What Happens During A Psychedelic Journey: Dr. Matthew Johnson On Psychedelic Treatment Rooms, The State Of Psychedelic Research & The Future of Psychedelic Therapy.,” I 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:
-What psychedelic-assisted psychotherapy entails…10:00
- Using psychedelic molecules to catalyze the effects of psychotherapy
- The most popular psychedelics currently:
- MDMA for treatment of PTSD
- You want a small window of time in which the psychedelics act for maximum treatment efficacy
-The work of Field Trip…13:00
- Build a new infrastructure to support psychedelics as they become more mainstream
- The current infrastructure (psychiatry, hospitals, doctors, etc.) are not ideal for psychedelic treatments
- Set and setting are critical: Proper mindset, and proper setting for the treatment
- Explore different psychedelic molecules for future treatment
- The “spa” experience at Field Trip:
- Beautiful and approachable setting
- Greenspace, zero-gravity chairs, juice, and coffee, etc.
- Not a “transactional” experience like a doctor's visit
-The importance of music in treatment…19:20
- Music specifically tailored to enhance the trip
-A variant of ketamine Field Trip is using…22:30
- Racemic ketamine
- The body will break down ketamine into 20 different molecules
- Intramuscular delivery mechanism
-How Field Trip incorporates psilocybin into their practice…29:06
- Currently illegal to grow in the U.S. and Canada
- Researched in Jamaica (Univ. of West Indies)
- Learn about different strains within psilocybin
- What grows in Jamaica stays in Jamaica
- Oregon is soon to vote on a bill that would legalize psilocybin-assisted therapy
-Other molecules that will be more common in future treatments…35:30
- The “gold standard” treatment is yet to be determined
- Each individual has differing needs, conditions, etc.
- Exercise caution when recommending supplements to offset the effects of a psychedelic trip
-How a psychedelic-assisted psychotherapy session is conducted…39:45
- Biohacks are not common: “Is there enough evidence to justify their use?”
- “No shaman” policy at Field Trip
- Protocol is mainly physician-driven currently
- Nurse administers the psychedelic; abundance of caution employed
- The goal is to treat the patient and send them on their way
-Prepping a patient on breathwork before a session…45:30
- Holotropic breathwork can mimic a psychedelic session
- Breathwork during a session may not be in the patient's best interest
- Restraint in trying new things so that the patients will be open to what they do offer
-The patient experience from booking the appointment, to the treatment, and beyond…50:00
- Care coordinator walks through the process to determine if the treatment is appropriate
- Must have tried conventional treatment before going to Field Trip
- Psychiatrist assessment
- First dosing session: meet doc, therapist, physical. Around 45 minutes in length
- Adequate time to recuperate after the session
-Dream scenarios in the emerging landscape of psychedelic-assisted psychotherapy…54:15
- Nuances of both psychedelics as well as the disease states
- “Depression” is a blanket statement that can cover a wide array of disorders
- Discover the most efficacious chemical combinations
- Research on the set and setting for the experience
- New and similar companies are emerging (they deeply admire Field Trip's business model)
- Psilocybin is on the horizon; however, we don't know when exactly
- At-home ketamine therapy (be very cautious)
- They are no “cure-alls” i.e. it may not have any effect on a person
-Microdosing between the therapeutic protocols to enhance the therapy…1:03:30
-And much more…
Resources from this episode:
- BGF podcast on MDMA for the treatment of PTSD
- BGF podcast on holotropic breathwork
- BGF podcast on HRV with Dr. Jay T. Wiles
– Other resources:
–Kion Colostrum: Nature’s “first food” that supports immunity, GI function, athletic recovery, and more. BGF listeners, receive a 10% discount off your entire order at Kion when you use discount code BEN10.
–Joovv: After using the Joovv for close to 2 years, it's the only light therapy device I'd ever recommend. Give it a try: you won't be disappointed. Order using my link and receive my brand new book, Boundless absolutely free!
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–Thrive Market: Organic brands you love, for less. Your favorite organic food and products. Fast and free shipping to your doorstep. Receive a gift card up to $20 when you begin a new membership using my link.
Do you have questions, thoughts, or feedback for Ronan, Marshall, or me? Leave your comments below and one of us will reply!