[00:01.430 --> 00:04.930]  Yeah, I like talking about drugs and how they work.
[00:05.830 --> 00:12.530]  I wanted to be a little more ambitious with this talk, though, and so I brought in this, what it means.
[00:14.050 --> 00:22.490]  So, I want to, like, put into context, you know, how these drugs work and what they do for us.
[00:23.690 --> 00:35.270]  I did say in my summary that I do licit and illicit, but I'm going to focus on the illicit because those have been in the media a lot lately.
[00:37.190 --> 00:43.110]  And at the end of my summary, I said, you know, how can we tell which information we're told is true?
[00:43.350 --> 00:45.870]  And that's a spoiler alert.
[00:46.050 --> 00:48.110]  I don't have a real answer.
[00:48.350 --> 00:49.330]  It's more like a journey.
[00:49.330 --> 01:00.410]  I want to promote critical thinking about drug information and give a medical perspective on this.
[01:02.850 --> 01:07.590]  And my slides are kind of low effort, but that's okay.
[01:10.140 --> 01:12.790]  The brain is a network of neurons.
[01:13.330 --> 01:16.050]  Our consciousness has neural correlates.
[01:17.030 --> 01:24.670]  And psychoactive drugs affect consciousness by affecting this network and how the nerve cells communicate.
[01:25.410 --> 01:31.430]  And so how this happens is there's a gap in between the neurons.
[01:31.670 --> 01:38.150]  Well, an electrical signal goes through the neuron, and then there's a gap, and that signal has to get across somehow.
[01:38.150 --> 01:51.350]  And so we have the presynaptic neuron has molecules called neurotransmitters that it has in these vesicles here, stores them.
[01:51.530 --> 01:59.830]  And then when, you know, the signal goes to that neuron, it releases those neurotransmitters into the synapse.
[02:00.650 --> 02:03.710]  And then on the other side, there are receptors.
[02:04.090 --> 02:12.970]  And it's not illustrated here, but the receptors actually go all the way through the cell membrane on the other side.
[02:12.970 --> 02:20.290]  So the neurotransmitters are binding on the outside, and then on the inside of the cell, stuff happens.
[02:23.010 --> 02:26.510]  And then not shown here is on the presynaptic neuron.
[02:26.510 --> 02:32.430]  There's also reuptake pumps that take back the neurotransmitters back into it.
[02:32.550 --> 02:40.150]  So it can be a cycle where, you know, neurotransmitters are released and get back.
[02:43.870 --> 02:51.830]  But these are, like, here's kind of where we see the hacking opportunities with drugs.
[02:52.330 --> 03:01.170]  We can use drugs that bind to the receptors or bind and affect any point of this cycle here.
[03:01.370 --> 03:07.930]  And it'll make changes in how the brain communicates and change our perceptions and consciousness.
[03:11.790 --> 03:16.790]  And an example would be, I'll start with opioids.
[03:18.470 --> 03:22.610]  We have a receptor called the mu opioid receptor.
[03:23.730 --> 03:27.350]  And opioids bind to those, and it modulates pain.
[03:27.630 --> 03:31.010]  It also is sedating.
[03:31.250 --> 03:34.630]  They slow breathing, reduce air hunger.
[03:34.630 --> 03:38.990]  And in overdose, they slow breathing too much.
[03:39.110 --> 03:42.850]  And so you don't get enough oxygen.
[03:43.510 --> 03:47.290]  And you don't really care, because there's no air hunger.
[03:47.730 --> 03:49.570]  People get conked out.
[03:51.410 --> 03:57.190]  And there's an antidote, naloxone, that works by binding to the same receptors.
[03:58.430 --> 04:00.950]  But it doesn't activate them.
[04:01.130 --> 04:06.570]  And it's competitive, so it kicks out other stuff that's binding to those receptors.
[04:07.690 --> 04:11.090]  So if someone's overdosing, you give naloxone.
[04:11.290 --> 04:11.670]  It'll go.
[04:11.850 --> 04:14.710]  It'll kick the other drugs out of that receptor.
[04:14.930 --> 04:17.310]  And they'll wake up.
[04:18.270 --> 04:22.750]  If they don't have any opioids in their system, it won't really do anything.
[04:25.090 --> 04:31.410]  So the fentanyl here, it's used safely in hospitals everywhere.
[04:31.410 --> 04:36.170]  But as I mentioned in the media, there's like a lot of fear surrounding this.
[04:36.890 --> 04:40.730]  Because it is 100 times as potent as morphine.
[04:41.390 --> 04:44.850]  But all that means is that it pretty much has...
[04:44.850 --> 04:48.950]  It'll have the same kind of effects, just at a lower dose.
[04:49.110 --> 04:50.110]  A much lower dose.
[04:52.930 --> 04:58.230]  And so it's not that it's inherently more dangerous at an appropriate dose.
[04:58.230 --> 04:59.470]  But it must be diluted.
[04:59.730 --> 05:03.570]  And it's contributed a lot to a lot more overdoses.
[05:03.570 --> 05:11.610]  Because as, you know, drug dealers, illicit ones, are mixing this into their supply.
[05:11.610 --> 05:19.330]  If they make a small error in how they dilute it, that can lead to a big dosing error.
[05:19.550 --> 05:21.610]  And, you know, people getting too much.
[05:23.610 --> 05:24.830]  More fear.
[05:26.730 --> 05:33.270]  From 2015, the DEA sent out information to law enforcement saying that...
[05:33.270 --> 05:35.730]  You know, talking about how potent it is.
[05:36.290 --> 05:37.530]  And that it...
[05:37.530 --> 05:38.030]  Like...
[05:38.030 --> 05:40.210]  Be careful when doing busts.
[05:40.430 --> 05:43.350]  Because exposure through...
[05:43.350 --> 05:44.670]  Like a little bit in the air.
[05:45.290 --> 05:45.930]  And...
[05:45.930 --> 05:47.270]  Or on your skin.
[05:47.290 --> 05:48.350]  If it's...
[05:48.350 --> 05:50.290]  If you're exposed to it, it can kill you.
[05:51.570 --> 05:57.230]  And after this, there were police body cam videos that were released.
[05:57.230 --> 06:03.170]  And, you know, they would show, like, officers doing a bust.
[06:04.130 --> 06:06.550]  And one of them, like, getting near fentanyl.
[06:06.730 --> 06:09.590]  And then suddenly getting faint and collapsing.
[06:10.090 --> 06:14.110]  And their fellow officers would rush and give them naloxone.
[06:14.110 --> 06:16.230]  And they'd start to get better.
[06:16.850 --> 06:18.950]  So that they would be saved.
[06:19.190 --> 06:23.270]  But they use these videos to promote the fear around it.
[06:24.250 --> 06:29.170]  But there's a problem in that fentanyl doesn't aerosolize.
[06:29.390 --> 06:30.490]  It doesn't...
[06:30.490 --> 06:32.190]  It doesn't get in the air.
[06:32.310 --> 06:35.530]  You can't, like, absorb it through the air.
[06:35.670 --> 06:37.450]  Like, you can't overdose that way.
[06:37.450 --> 06:41.450]  And it doesn't really absorb through the skin without...
[06:42.110 --> 06:43.650]  Like, unless it's in a special form.
[06:44.170 --> 06:49.690]  Like a patch where they've used heroic chemical measures in order to make it absorb through the skin.
[06:51.070 --> 07:01.890]  If, like, what the DEA said here was true, that it was so dangerous, just a little tiny bit in the air could kill you, then the drug dealers themselves would be dying left and right.
[07:02.090 --> 07:02.930]  It's not happening.
[07:06.670 --> 07:10.250]  And the police descriptions are...
[07:10.250 --> 07:13.630]  Yeah, have been things like, I couldn't breathe.
[07:13.970 --> 07:15.310]  I thought I was dying.
[07:15.470 --> 07:16.450]  My body shut down.
[07:16.690 --> 07:18.610]  And really, lots of distress.
[07:19.030 --> 07:26.530]  And that doesn't match the overdose symptoms, where you might nod off and feel like, you don't care if you breathe.
[07:27.390 --> 07:30.150]  You're just breathing more slowly.
[07:30.150 --> 07:34.210]  But it does match symptoms of panic attacks.
[07:38.130 --> 07:46.650]  So, these police may have been victims of false information and fear, just as much as...
[07:47.150 --> 07:49.930]  You know, even while they were perpetuating it themselves.
[07:54.570 --> 08:00.170]  I wanted to talk a little bit about cannabis binds to cannabinoid receptors.
[08:00.450 --> 08:02.610]  So, it's another receptor sort of deal.
[08:03.210 --> 08:05.750]  But it's less understood than the mute opioid.
[08:06.450 --> 08:13.090]  The context here is kind of interesting, because in the U.S., it's an illegal gray area, I guess.
[08:13.090 --> 08:19.090]  Like, in various states have decriminalized or legalized it for various purposes.
[08:19.510 --> 08:22.630]  I mean, medical and or recreational.
[08:23.170 --> 08:25.970]  But federally, it's still schedule one.
[08:26.230 --> 08:29.490]  So, technically, it's illegal everywhere still.
[08:30.690 --> 08:33.270]  And that makes it very...
[08:33.270 --> 08:35.070]  It's just not enforced.
[08:35.710 --> 08:39.990]  But it's still very difficult to do actual research on.
[08:42.650 --> 08:48.870]  And, of course, you might have the impression that actually quite a bit of research has been done on it.
[08:49.090 --> 08:52.570]  And that it helps with, like, all kinds of things.
[08:53.050 --> 08:55.310]  A long list of conditions.
[08:56.570 --> 08:58.230]  It's even claimed...
[08:58.230 --> 09:00.010]  There's even claims for it to...
[09:00.010 --> 09:01.170]  That it helps autism.
[09:02.530 --> 09:05.170]  But, when you actually look at the science...
[09:05.170 --> 09:07.210]  So, this report is from 2017.
[09:08.530 --> 09:14.610]  There's only four conditions here that they found any decent evidence for.
[09:15.230 --> 09:18.370]  There's been some, like, weak studies of some other things.
[09:18.710 --> 09:20.450]  Most of this stuff is hypothetical.
[09:20.870 --> 09:23.310]  And the autism thing just comes from...
[09:24.250 --> 09:25.810]  It's an idea...
[09:25.810 --> 09:26.910]  It doesn't come from research.
[09:26.910 --> 09:31.510]  It comes more from the idea of wanting to sedate your autistic kid.
[09:34.910 --> 09:38.750]  But, you know, since cannabis is all natural, it's okay.
[09:39.050 --> 09:42.690]  It's better than giving them a different sedative, apparently.
[09:45.910 --> 09:53.590]  Generally speaking, if a drug is claimed to do all sorts of great things, it's probably not true.
[09:54.170 --> 09:55.650]  There's no panaceas.
[09:58.110 --> 09:59.910]  I think in our culture...
[10:00.630 --> 10:01.210]  Well, yeah.
[10:02.210 --> 10:07.990]  Medical use is, you know, considered legally and culturally legitimate.
[10:08.990 --> 10:11.830]  But recreational use is kind of...
[10:11.830 --> 10:12.790]  There's a stigma.
[10:13.250 --> 10:16.010]  It's getting better, but there's still stigma.
[10:16.010 --> 10:18.370]  And I think that's really unfortunate.
[10:19.190 --> 10:23.190]  As far as I'm concerned, it should be as legal as alcohol or tobacco.
[10:24.310 --> 10:25.750]  And there shouldn't be a stigma.
[10:32.000 --> 10:34.940]  And the push for legalization is...
[10:34.940 --> 10:36.600]  I think it's a...
[10:36.600 --> 10:43.500]  As a result of this, has focused on the medical and not the recreational.
[10:43.500 --> 10:45.960]  It's kind of avoided the recreational.
[10:46.460 --> 10:54.500]  So, I think a lot of the medical claims involve some motivated reasoning and wishful thinking.
[10:56.380 --> 11:01.280]  And, you know, now with legal changes, marketing is also involved.
[11:01.500 --> 11:03.100]  There's a lot of marketing efforts.
[11:03.160 --> 11:06.600]  There's quite a bit of money to be made on cannabis products.
[11:09.760 --> 11:13.280]  And, I mean, medical use is a more important thing.
[11:13.560 --> 11:17.220]  But it's also higher stakes and requires more evidence.
[11:18.000 --> 11:21.460]  I mean, for recreational use, it's just like, yeah, did you have fun?
[11:21.620 --> 11:22.240]  Well, okay.
[11:23.820 --> 11:26.220]  You know, know whatever risks there are.
[11:26.360 --> 11:27.260]  There are some risks.
[11:30.480 --> 11:38.340]  So, we shouldn't believe medical claims just out of motivated reasoning.
[11:41.140 --> 11:47.180]  And cannabis products is also a bit of a wild west out there with regulation.
[11:47.860 --> 11:54.340]  I mean, given the legal stuff, there's a lot of products.
[11:54.340 --> 12:00.880]  And who is, if they say something is on the package, you know, a certain dose or certain ingredients.
[12:02.460 --> 12:04.020]  Who's verifying it?
[12:04.500 --> 12:11.080]  Just the manufacturer right now, unless something happens after the fact that brings it up.
[12:11.360 --> 12:14.680]  So, no one's verifying.
[12:15.220 --> 12:19.640]  You just have to trust the maker of the specific product right now.
[12:19.640 --> 12:22.580]  And that's also an unfortunate thing.
[12:27.160 --> 12:29.760]  Let's talk about serotonin.
[12:31.110 --> 12:34.280]  It's one of the older neurotransmitters.
[12:34.730 --> 12:36.640]  It has its hand in everything.
[12:36.990 --> 12:38.940]  It's everywhere, like JavaScript.
[12:42.460 --> 12:46.000]  There's 15 types of serotonin receptors.
[12:46.680 --> 12:51.440]  And the psychedelic drugs, the ones that are considered hallucinogens.
[12:52.560 --> 12:56.340]  They have a chemical structure that looks like serotonin.
[12:57.160 --> 13:02.460]  And on this slide, kind of, you know, you can see psilocybin from shrooms and LSD.
[13:03.640 --> 13:08.540]  And because of that structure, they bind to serotonin receptors.
[13:09.240 --> 13:13.860]  And their psychedelic effects seem to have to do with receptor 2A.
[13:15.240 --> 13:21.700]  And they have some pretty dramatic effects on the brain network and sensory processing.
[13:23.480 --> 13:25.440]  And consciousness.
[13:26.740 --> 13:31.520]  The sensory stuff isn't the main reason they get attention.
[13:32.040 --> 13:36.920]  Because people talk about having deeply meaningful experiences.
[13:37.420 --> 13:39.720]  Viewing their lives in a different way.
[13:40.020 --> 13:41.240]  Gaining insight.
[13:41.960 --> 13:43.400]  And having fun.
[13:45.520 --> 13:47.480]  Well, enlightened.
[13:49.640 --> 13:53.860]  So naturally, there's an interest in psychedelics in medicine.
[13:55.140 --> 14:01.340]  And again, I think there's a little bit of like, you know, well, let's try to get it legalized through medical use.
[14:02.680 --> 14:08.420]  But there's a natural interest in them for medicine, for mental conditions like depression.
[14:08.780 --> 14:15.820]  Like, which, you know, still have, there's like an unmet need to be able to treat that better.
[14:15.820 --> 14:19.640]  Our current treatments take a few weeks to work.
[14:20.140 --> 14:21.980]  And don't help everyone.
[14:23.220 --> 14:27.000]  But in medicine, we need consistent outcomes.
[14:27.440 --> 14:29.120]  And I'll share an anecdote.
[14:30.200 --> 14:34.940]  I knew one person who was depressed and took shrooms for fun.
[14:35.680 --> 14:42.380]  And they saw, they had a great experience where they saw the beauty in the world.
[14:42.380 --> 14:46.840]  And they believed life was worth living just for that.
[14:47.080 --> 14:48.300]  And it was wonderful.
[14:48.820 --> 14:51.640]  They weren't depressed anymore for a few weeks.
[14:51.780 --> 14:52.960]  It came back later.
[14:53.660 --> 14:55.680]  There was another person who was depressed.
[14:56.420 --> 14:58.260]  Took shrooms for fun.
[14:58.440 --> 15:01.160]  And it brought down all their mental defenses.
[15:01.760 --> 15:05.980]  And underneath those defenses, they believed they were a bad person.
[15:05.980 --> 15:08.440]  And that's a symptom of depression.
[15:09.140 --> 15:12.240]  And two weeks later, they made a suicide attempt.
[15:13.760 --> 15:20.240]  So in medicine, we really want to know how to get the first outcome and then not the second outcome.
[15:20.960 --> 15:24.300]  We need a consistent risk versus benefit.
[15:26.080 --> 15:38.000]  And it seems that, you know, despite the mind-expanding effects, these drugs don't automatically resolve underlying issues.
[15:38.460 --> 15:39.700]  There has to be more.
[15:40.060 --> 15:46.140]  So the current research is focused on using these in conjunction with psychotherapy.
[15:48.760 --> 15:51.780]  Which is, you know, good.
[15:52.040 --> 15:57.040]  But there are complications to therapy and studying that.
[15:57.180 --> 15:59.180]  And studying that in conjunction with the drugs.
[15:59.720 --> 16:02.180]  And I'll get more into that later.
[16:03.800 --> 16:05.400]  I do want to do...
[16:05.400 --> 16:07.360]  I'll do a quick shout out to ketamine.
[16:07.360 --> 16:12.780]  It's not known for being a serotonergic drug.
[16:13.060 --> 16:14.380]  And we don't really know how it works.
[16:14.580 --> 16:18.580]  But this recently became...
[16:18.580 --> 16:27.020]  I mean, like, you know, in the past decade, became the first new drug shown to help depression in decades.
[16:28.300 --> 16:29.600]  And it works quickly.
[16:29.600 --> 16:31.400]  And this is without therapy.
[16:33.800 --> 16:37.920]  But, you know, it doesn't seem to be through its mental effects that it works.
[16:37.940 --> 16:39.500]  It seems to be some other reason.
[16:39.800 --> 16:45.360]  So that's a really intriguing research, you know, point.
[16:45.580 --> 16:50.380]  It'll be interesting to find out more about how that actually works.
[16:55.000 --> 16:58.420]  And I'm going to actually talk about quite a bit about ecstasy.
[17:00.240 --> 17:01.440]  Because of...
[17:01.440 --> 17:03.620]  Well, I'll say in a minute.
[17:05.400 --> 17:10.520]  But as far as how it works, it floods the synapse with serotonin.
[17:11.400 --> 17:14.600]  And it does this in several different ways.
[17:14.840 --> 17:20.520]  It binds to the transporters on the vesicles that usually package up the serotonin.
[17:21.580 --> 17:25.140]  And so the serotonin doesn't get packaged up.
[17:25.140 --> 17:27.020]  It's just freeing the neuron.
[17:27.300 --> 17:29.880]  And then it reverses the reuptake transporter.
[17:29.880 --> 17:35.500]  So that serotonin gets pumped out of the presynaptic neuron and into the synapse.
[17:36.180 --> 17:42.100]  And then it also inhibits the breakdown of serotonin.
[17:42.180 --> 17:44.380]  So that it stays there.
[17:44.500 --> 17:45.840]  It doesn't get taken back up.
[17:45.900 --> 17:46.900]  It doesn't get broken down.
[17:47.100 --> 17:50.160]  And it even binds to serotonin receptors itself.
[17:51.480 --> 17:56.020]  So it's a pretty powerful serotonergic drug.
[17:56.300 --> 17:59.340]  It has some effects on other neurotransmitters too.
[17:59.580 --> 18:08.580]  But its effects on serotonin are what we think is its main effects.
[18:09.260 --> 18:12.420]  And of course, it's not called ecstasy for nothing.
[18:12.420 --> 18:15.140]  It causes a lot of euphoria.
[18:15.640 --> 18:20.320]  But it's not a narcotic sleepy high like opiates.
[18:20.540 --> 18:22.200]  It's more social.
[18:22.580 --> 18:29.420]  It's known for people feeling more empathic.
[18:29.600 --> 18:31.300]  Having more compassion.
[18:31.740 --> 18:34.580]  Feeling closeness with other people.
[18:35.020 --> 18:36.420]  Feeling trusting.
[18:36.420 --> 18:39.820]  Having a desire to touch and cuddle.
[18:40.360 --> 18:44.880]  It can dramatically ease anxiety and fear.
[18:45.200 --> 18:47.360]  Even making them go away for a while.
[18:48.360 --> 18:51.120]  It increases acceptance of people.
[18:51.380 --> 18:52.520]  Even yourself.
[18:54.080 --> 18:58.460]  So the idea of using it to treat certain mental illness.
[18:58.460 --> 19:02.060]  such as PTSD, post-traumatic stress disorder.
[19:02.540 --> 19:04.480]  Is kind of a no-brainer.
[19:06.280 --> 19:09.240]  PTSD is a response to trauma.
[19:09.800 --> 19:15.740]  And famously, war veterans can have PTSD from being in explosions.
[19:16.280 --> 19:19.000]  Or other dangerous, life-threatening situations.
[19:20.220 --> 19:24.920]  But it can also happen to victims of sexual assault or child abuse.
[19:25.100 --> 19:28.260]  Or even people who have been in a bad car accident.
[19:28.800 --> 19:30.460]  Really any kind of trauma.
[19:31.440 --> 19:38.460]  And it involves a lot of like an overwhelming and disabling amount of fear and anxiety.
[19:39.420 --> 19:45.320]  PTSD patients can mentally relive the traumatic event.
[19:48.840 --> 19:50.960]  And they can be suicidal.
[19:51.400 --> 19:52.540]  Like it can be bad enough.
[19:52.700 --> 19:55.140]  For some people, it's a matter of life and death.
[19:55.400 --> 20:03.940]  And it is another illness or condition where there's an unmet need.
[20:06.460 --> 20:09.640]  And like there are current treatments.
[20:09.900 --> 20:16.640]  Serotonergic SSRIs in conjunction with therapy that can help.
[20:16.660 --> 20:17.780]  But they don't help everyone.
[20:19.620 --> 20:23.140]  And therapy for PTSD can be very difficult.
[20:23.380 --> 20:28.000]  Because if you're trying to talk out and resolve this traumatic event.
[20:28.320 --> 20:30.700]  It's inherently difficult to talk about.
[20:30.700 --> 20:33.760]  And can cause panic attacks.
[20:34.020 --> 20:44.380]  And so the idea, the hypothesis is MDMA can quiet down this fear and stress.
[20:44.960 --> 20:50.180]  And should have a good chance of making the therapeutic process much easier.
[20:53.540 --> 21:07.180]  There's an organization, the Multidisciplinary Association for Psychedelic Studies, MAPS, that has been...
[21:07.720 --> 21:14.000]  They first started investigating MDMA-assisted psychotherapy back in 2001.
[21:15.760 --> 21:20.120]  That's when they put in their investigational drug application.
[21:20.480 --> 21:22.920]  They study other psychedelics too.
[21:24.660 --> 21:29.300]  But for the PTSD, now they...
[21:29.780 --> 21:31.120]  And they have a subsidiary...
[21:31.720 --> 21:34.200]  They later created a subsidiary Lycos Therapeutics.
[21:34.860 --> 21:38.800]  So when I talk about Lycos Therapeutics, that's who they are.
[21:38.800 --> 21:40.200]  They've been researching this.
[21:40.840 --> 21:49.080]  And in 2017, Lycos was working with the FDA to help design Phase III clinical trials.
[21:49.840 --> 21:52.560]  Clinical trials happen in phases.
[21:52.820 --> 21:54.720]  And Phase III is the last one.
[21:54.720 --> 21:58.460]  So it usually happens with pretty promising drugs.
[21:59.780 --> 22:03.760]  And they agreed upon the endpoints they would use.
[22:05.480 --> 22:10.440]  Because, you know, they really want to try to get this drug approved.
[22:12.160 --> 22:17.360]  And they completed those trials, those Phase III trials, and published them.
[22:17.500 --> 22:18.420]  And they were successful.
[22:18.740 --> 22:20.780]  They met their endpoints.
[22:21.640 --> 22:26.620]  And this year, in February, the FDA accepted their new drug application.
[22:27.000 --> 22:28.900]  And gave it priority review.
[22:29.560 --> 22:32.980]  So that a decision would be made by August 11th.
[22:33.740 --> 22:34.760]  This year.
[22:36.180 --> 22:41.020]  To give a little bit more about the trials, their randomized control trials.
[22:41.400 --> 22:42.360]  Double blind.
[22:43.660 --> 22:50.340]  MDMA-assisted psychotherapy versus an inner placebo with therapy.
[22:51.440 --> 22:53.460]  And they both had...
[22:53.460 --> 22:56.940]  The endpoint was on the CAHPS V scale.
[22:57.820 --> 23:04.600]  The response was considered a 10-point reduction in the score.
[23:04.760 --> 23:07.600]  Which the score is based on the PTSD symptoms.
[23:09.300 --> 23:13.180]  And there were a lot of responders even in the placebo group.
[23:13.360 --> 23:17.420]  But the MDMA group did basically twice as well.
[23:18.360 --> 23:21.780]  In both of the Phase III trials.
[23:23.820 --> 23:27.460]  And it was a pretty large effect size.
[23:28.180 --> 23:30.920]  There was also a long-term follow-up.
[23:30.920 --> 23:33.580]  To see if the effect was durable.
[23:34.000 --> 23:35.940]  Like six months to two years later.
[23:36.800 --> 23:38.220]  And it was.
[23:38.620 --> 23:40.040]  It seemed like it.
[23:41.700 --> 23:44.520]  But in June...
[23:44.520 --> 23:46.500]  On June 4th.
[23:46.640 --> 23:48.640]  An FDA advisory committee.
[23:48.780 --> 23:49.860]  This was in the media.
[23:50.820 --> 23:52.960]  Recommended against approving it.
[23:54.040 --> 23:58.220]  And specifically they voted nine to two.
[23:58.600 --> 24:01.120]  That saying it was the current evidence.
[24:01.560 --> 24:03.120]  Does not show that it's effective.
[24:04.000 --> 24:05.300]  And ten to one.
[24:05.540 --> 24:08.180]  That the benefit does not outweigh the risks.
[24:09.620 --> 24:11.620]  This isn't the decision yet.
[24:11.760 --> 24:13.020]  This is just a recommendation.
[24:14.320 --> 24:16.860]  And the FDA doesn't need to follow it.
[24:17.160 --> 24:20.760]  But it's been very frustrating to researchers and other advocates.
[24:20.760 --> 24:22.620]  I mean I admit.
[24:22.800 --> 24:25.480]  When I first heard about this.
[24:26.920 --> 24:27.560]  I...
[24:27.560 --> 24:28.760]  You know it's like they...
[24:28.760 --> 24:30.800]  This was actually a really large effect.
[24:31.080 --> 24:33.000]  Like even if there's like some bias.
[24:33.300 --> 24:34.500]  Or whatever in here.
[24:35.180 --> 24:36.920]  It seems pretty good.
[24:37.160 --> 24:39.940]  And you know PTSD patients.
[24:40.100 --> 24:41.040]  It's life and death.
[24:41.600 --> 24:43.640]  And it is easy to believe.
[24:44.840 --> 24:49.740]  Like a powerful drug can have powerful successes.
[24:49.740 --> 24:54.680]  I thought maybe this panel was biased.
[24:55.420 --> 24:56.640]  Anti-drug.
[24:57.600 --> 24:58.740]  At first.
[25:00.180 --> 25:02.120]  But I looked a little deeper.
[25:02.480 --> 25:04.640]  It's good to always look into things.
[25:05.240 --> 25:06.140]  Like what...
[25:06.140 --> 25:06.400]  Why?
[25:06.480 --> 25:08.480]  Why do they recommend against this.
[25:08.620 --> 25:09.640]  When it seems so good.
[25:10.820 --> 25:14.280]  There's actually quite a bit of transparency.
[25:15.920 --> 25:19.980]  The meeting is available online.
[25:20.220 --> 25:23.360]  All nine hours and 44 minutes of it.
[25:25.500 --> 25:26.180]  I'll...
[25:26.180 --> 25:26.560]  You know...
[25:26.560 --> 25:28.120]  I didn't watch all of it.
[25:28.200 --> 25:29.360]  But I did watch part of it.
[25:30.040 --> 25:32.700]  An FDA advisory committee, by the way.
[25:32.840 --> 25:34.300]  It's not the FDA.
[25:34.620 --> 25:38.460]  It's a panel of outside experts who've been nominated.
[25:38.460 --> 25:40.520]  For this role.
[25:41.180 --> 25:43.500]  It includes a consumer representative.
[25:43.780 --> 25:44.880]  A patient representative.
[25:45.320 --> 25:47.780]  And a non-voting industry representative.
[25:49.160 --> 25:51.420]  It also includes during the meeting.
[25:51.720 --> 25:52.660]  A public hearing.
[25:53.320 --> 25:54.460]  And they accept...
[25:54.460 --> 25:55.180]  Before the meeting.
[25:55.700 --> 25:58.120]  There's a period where they accept public comments.
[25:58.260 --> 25:58.860]  To be submitted.
[25:59.100 --> 25:59.940]  In writing.
[26:01.960 --> 26:02.600]  And...
[26:02.600 --> 26:04.920]  For this one, there was a citizen's petition.
[26:05.320 --> 26:07.360]  For an extended open public hearing.
[26:07.940 --> 26:12.300]  I believe the public hearing part was actually an hour and 45 minutes.
[26:12.520 --> 26:13.880]  Instead of the usual hour.
[26:15.040 --> 26:17.420]  So a lot went on in this...
[26:17.420 --> 26:18.760]  In this meeting.
[26:22.040 --> 26:23.740]  And there were...
[26:23.740 --> 26:25.400]  A lot of issues.
[26:26.460 --> 26:27.260]  With...
[26:27.260 --> 26:27.580]  This...
[26:27.580 --> 26:29.120]  This...
[26:29.960 --> 26:31.500]  First of all...
[26:31.500 --> 26:34.160]  The trial was supposed to be blinded.
[26:35.200 --> 26:36.000]  But...
[26:36.000 --> 26:37.400]  You can imagine that...
[26:37.400 --> 26:38.260]  If you...
[26:38.260 --> 26:39.560]  Involve a powerful drug.
[26:39.840 --> 26:40.500]  Like MDMA.
[26:42.640 --> 26:43.540]  That...
[26:43.540 --> 26:45.720]  It's hard for...
[26:45.720 --> 26:47.200]  It's hard to...
[26:47.200 --> 26:48.200]  You know...
[26:48.200 --> 26:48.800]  Blinded.
[26:49.000 --> 26:49.560]  And...
[26:49.560 --> 26:50.500]  And...
[26:50.500 --> 26:51.360]  They did a survey.
[26:51.660 --> 26:52.500]  Like...
[26:52.500 --> 26:53.840]  Of the participants afterward.
[26:54.680 --> 26:55.180]  And...
[26:55.180 --> 26:56.060]  In the...
[26:56.060 --> 26:57.100]  MDMA group.
[26:57.580 --> 27:02.060]  Ninety-four percent of them had correctly guessed which group they were in.
[27:06.360 --> 27:08.580]  In the placebo group.
[27:08.580 --> 27:11.880]  Seventy-five percent of them correctly guessed.
[27:14.060 --> 27:16.600]  They didn't survey the therapist.
[27:17.140 --> 27:24.580]  But I'm going to guess that it's pretty likely the therapist could tell which participants...
[27:25.140 --> 27:25.300]  You know...
[27:25.300 --> 27:28.680]  Which of their patients were getting the real doses.
[27:29.620 --> 27:32.380]  So it was functionally unblinded.
[27:33.400 --> 27:36.900]  And this is a problem because it can introduce bias.
[27:36.900 --> 27:40.720]  There was also a selection bias in the participants.
[27:41.520 --> 27:47.140]  Forty percent of them had used MDMA before in their lifetime.
[27:47.720 --> 27:51.000]  Which is much higher than the general population.
[27:52.440 --> 27:59.220]  So basically the people involved in the trial weren't people who were objective going into it.
[28:00.120 --> 28:02.780]  And that creates a risk of bias.
[28:05.080 --> 28:07.300]  As far as the long-term follow-up.
[28:07.600 --> 28:14.140]  There was about twenty-five percent of the participants dropped out who didn't respond to that.
[28:14.420 --> 28:17.400]  So that's another possible selection bias.
[28:17.400 --> 28:20.080]  And the ones who did respond...
[28:20.080 --> 28:21.400]  They had...
[28:22.400 --> 28:22.900]  You know...
[28:22.900 --> 28:23.400]  There was no...
[28:24.140 --> 28:24.520]  Like...
[28:24.520 --> 28:24.880]  You know...
[28:24.880 --> 28:28.560]  Don't use any other interventions in between...
[28:28.560 --> 28:29.040]  You know...
[28:29.040 --> 28:30.400]  Like some of them had...
[28:30.920 --> 28:34.220]  In between the end of the trial and the follow-up.
[28:34.800 --> 28:36.400]  Used other therapies.
[28:36.920 --> 28:37.540]  Or...
[28:37.540 --> 28:39.480]  Even MDMA in some cases.
[28:40.000 --> 28:40.660]  You know...
[28:40.660 --> 28:42.000]  Their own illicit supply.
[28:43.300 --> 28:46.020]  So that makes it hard to say that...
[28:46.020 --> 28:47.860]  That if they were doing well.
[28:48.120 --> 28:50.680]  That it was definitely this treatment.
[28:50.960 --> 28:51.260]  This...
[28:51.260 --> 28:51.800]  The trial.
[28:52.040 --> 28:53.400]  And not something they did later.
[28:55.160 --> 28:57.360]  But I'd say the biggest sticking point.
[28:57.540 --> 28:59.220]  Especially in the commentary.
[28:59.740 --> 29:00.680]  And the issues.
[29:01.200 --> 29:03.240]  Wasn't actually the MDMA itself.
[29:03.680 --> 29:05.400]  But it was the therapy.
[29:07.240 --> 29:07.960]  Therapies...
[29:07.960 --> 29:08.320]  Kind of...
[29:11.710 --> 29:12.890]  Regulate therapy.
[29:14.070 --> 29:15.210]  They would...
[29:15.570 --> 29:16.710]  If approved.
[29:16.850 --> 29:18.130]  They would have a...
[29:18.130 --> 29:19.690]  What's called a REMS.
[29:19.770 --> 29:20.290]  A risk...
[29:20.290 --> 29:23.590]  A risk evaluation and mitigation strategy.
[29:25.010 --> 29:26.150]  For MDMA.
[29:26.950 --> 29:29.370]  Which can put constraints on how it's used.
[29:29.610 --> 29:30.890]  Like it can require that...
[29:31.570 --> 29:34.210]  That during an eight hour dosing session.
[29:34.910 --> 29:35.930]  You know...
[29:35.930 --> 29:36.630]  A certain...
[29:36.630 --> 29:37.050]  Like...
[29:37.050 --> 29:38.890]  Number of providers are available.
[29:39.710 --> 29:40.850]  Things like that.
[29:41.170 --> 29:42.010]  But it can't...
[29:42.010 --> 29:42.390]  Like...
[29:42.390 --> 29:43.090]  It doesn't...
[29:43.090 --> 29:43.670]  You know...
[29:43.670 --> 29:43.950]  Say...
[29:43.950 --> 29:44.450]  This...
[29:44.450 --> 29:45.050]  Kind of therapy.
[29:45.510 --> 29:46.170]  Or...
[29:46.170 --> 29:47.330]  You know...
[29:47.330 --> 29:48.470]  Those types of...
[29:48.470 --> 29:49.230]  Specifics.
[29:49.290 --> 29:51.010]  Not really the purview of the FDA.
[29:52.090 --> 29:52.850]  And...
[29:53.210 --> 29:53.610]  Lycos...
[29:53.610 --> 29:54.890]  Didn't use...
[29:54.890 --> 29:56.370]  A standard...
[29:56.370 --> 29:57.490]  Validated...
[29:57.490 --> 29:57.950]  Therapy.
[29:59.270 --> 30:01.570]  They have their own...
[30:01.570 --> 30:03.010]  And...
[30:03.010 --> 30:04.410]  They have their own...
[30:06.350 --> 30:07.170]  And...
[30:07.170 --> 30:08.530]  They...
[30:08.530 --> 30:09.830]  They...
[30:09.830 --> 30:10.150]  Encourage...
[30:10.150 --> 30:10.390]  And...
[30:10.390 --> 30:11.910]  So there's some issues...
[30:11.910 --> 30:13.590]  That people brought up.
[30:13.790 --> 30:15.030]  One is they...
[30:15.030 --> 30:16.670]  Encourage the use of touch...
[30:16.670 --> 30:17.350]  During therapy.
[30:17.830 --> 30:19.050]  That's very...
[30:19.050 --> 30:19.290]  Not...
[30:19.290 --> 30:20.430]  Not standard.
[30:21.090 --> 30:22.450]  They say...
[30:22.450 --> 30:23.650]  It has to be...
[30:23.650 --> 30:24.350]  Non-sexual.
[30:26.470 --> 30:27.030]  But...
[30:27.030 --> 30:27.390]  On MDMA...
[30:28.310 --> 30:29.770]  You can imagine...
[30:29.770 --> 30:31.350]  That this is a very vulnerable...
[30:32.350 --> 30:32.910]  Situation...
[30:32.910 --> 30:34.010]  That there's a high...
[30:34.010 --> 30:34.570]  Risk...
[30:34.570 --> 30:35.330]  Because...
[30:35.330 --> 30:36.350]  There's a power imbalance...
[30:36.990 --> 30:37.550]  Inherently...
[30:37.550 --> 30:38.610]  Between the therapist...
[30:38.610 --> 30:39.810]  And the patient...
[30:39.810 --> 30:40.930]  In these trials...
[30:40.930 --> 30:42.590]  They had two therapists...
[30:42.590 --> 30:44.310]  For each patient...
[30:44.310 --> 30:45.830]  To try to reduce...
[30:45.830 --> 30:47.390]  Risk of that...
[30:47.390 --> 30:48.650]  But...
[30:48.650 --> 30:49.710]  You can imagine...
[30:49.710 --> 30:50.390]  That there...
[30:51.070 --> 30:51.730]  You know...
[30:51.730 --> 30:52.390]  With someone...
[30:52.390 --> 30:53.670]  Who is...
[30:53.670 --> 30:54.650]  You know...
[30:54.650 --> 30:55.630]  Really...
[30:56.710 --> 30:57.690]  Inebriated...
[30:57.690 --> 30:59.810]  They are...
[30:59.810 --> 31:00.230]  You know...
[31:00.230 --> 31:01.650]  There can be...
[31:01.650 --> 31:02.230]  Issues...
[31:02.230 --> 31:02.930]  Thorny issues...
[31:02.930 --> 31:03.770]  With consent...
[31:03.770 --> 31:04.870]  And boundaries...
[31:04.870 --> 31:06.050]  And possible boundary...
[31:06.050 --> 31:06.830]  Violations...
[31:06.830 --> 31:07.690]  When you're...
[31:07.960 --> 31:08.570]  You know...
[31:08.570 --> 31:10.470]  Using touch...
[31:10.470 --> 31:11.390]  And...
[31:12.110 --> 31:13.830]  The risk of sexual assault...
[31:13.830 --> 31:14.810]  Is not...
[31:14.810 --> 31:15.750]  Theoretical...
[31:15.750 --> 31:16.790]  It...
[31:16.790 --> 31:17.450]  Happened...
[31:17.450 --> 31:18.410]  In an earlier...
[31:18.410 --> 31:18.870]  Phase 2...
[31:18.870 --> 31:19.510]  Trial...
[31:19.510 --> 31:19.870]  In...
[31:21.610 --> 31:22.050]  2014...
[31:22.470 --> 31:22.910]  MAPS...
[31:22.910 --> 31:23.510]  Has...
[31:23.510 --> 31:24.270]  Essentially...
[31:24.270 --> 31:24.990]  Said...
[31:24.990 --> 31:26.110]  Basically...
[31:26.110 --> 31:26.770]  There's a couple...
[31:26.770 --> 31:27.670]  Bad apples...
[31:27.670 --> 31:28.410]  They kicked...
[31:28.410 --> 31:29.290]  Those therapists...
[31:29.290 --> 31:29.890]  Out...
[31:29.890 --> 31:30.270]  Of...
[31:30.270 --> 31:30.890]  The program...
[31:30.890 --> 31:32.050]  And everything...
[31:32.050 --> 31:33.030]  But...
[31:33.030 --> 31:34.570]  The participant...
[31:34.570 --> 31:35.530]  Has said...
[31:35.530 --> 31:35.950]  That...
[31:35.950 --> 31:36.550]  I mean...
[31:36.550 --> 31:37.450]  She's concerned...
[31:37.450 --> 31:37.990]  That nothing...
[31:37.990 --> 31:38.470]  Has...
[31:38.470 --> 31:39.090]  Really changed...
[31:39.090 --> 31:39.970]  Systemically...
[31:39.970 --> 31:40.130]  And...
[31:40.130 --> 31:41.390]  She thinks...
[31:41.650 --> 31:41.990]  Like...
[31:41.990 --> 31:43.030]  Systemic safeguards...
[31:43.030 --> 31:44.310]  Really need to be...
[31:44.310 --> 31:45.670]  In place...
[31:45.670 --> 31:46.570]  Because...
[31:46.570 --> 31:47.670]  It's such a big...
[31:47.670 --> 31:48.490]  Risk...
[31:48.490 --> 31:48.930]  Of...
[31:48.930 --> 31:49.370]  Happening...
[31:49.370 --> 31:49.550]  And...
[31:49.550 --> 31:50.570]  She didn't even...
[31:50.570 --> 31:51.290]  Remember...
[31:51.290 --> 31:52.390]  Much...
[31:52.390 --> 31:52.570]  Of...
[31:52.570 --> 31:53.230]  What had happened...
[31:53.230 --> 31:54.230]  During her dosing...
[31:54.230 --> 31:54.990]  Sessions...
[31:54.990 --> 31:55.810]  Until...
[31:55.810 --> 31:56.210]  She saw...
[31:56.210 --> 31:56.990]  The videos...
[31:56.990 --> 31:57.990]  Later...
[31:57.990 --> 31:58.990]  Um...
[31:59.550 --> 31:59.990]  So...
[31:59.990 --> 32:00.670]  It's a pretty...
[32:00.670 --> 32:01.670]  Disturbing...
[32:01.670 --> 32:02.570]  Case...
[32:02.570 --> 32:03.690]  Um...
[32:03.690 --> 32:04.350]  There were...
[32:04.350 --> 32:05.370]  There were definitely...
[32:05.370 --> 32:06.010]  Public comments...
[32:06.010 --> 32:06.930]  At the committee meeting...
[32:06.930 --> 32:07.530]  There were definitely...
[32:07.530 --> 32:08.570]  Public comments...
[32:08.570 --> 32:09.250]  From...
[32:09.250 --> 32:10.210]  People...
[32:10.210 --> 32:10.690]  Who were...
[32:10.690 --> 32:11.190]  Very much...
[32:11.190 --> 32:11.770]  Helped...
[32:11.770 --> 32:12.730]  By...
[32:12.730 --> 32:13.530]  The treatment...
[32:13.530 --> 32:13.750]  And...
[32:13.750 --> 32:14.510]  And...
[32:14.510 --> 32:14.770]  And...
[32:16.150 --> 32:17.030]  Felt...
[32:17.030 --> 32:17.830]  That it was...
[32:17.830 --> 32:18.430]  You know...
[32:18.430 --> 32:19.810]  A really good thing...
[32:19.810 --> 32:20.790]  For them...
[32:20.790 --> 32:22.050]  Um...
[32:22.050 --> 32:22.430]  But...
[32:22.430 --> 32:23.230]  There were others...
[32:23.230 --> 32:24.490]  Who testified...
[32:24.890 --> 32:25.210]  To...
[32:25.210 --> 32:25.750]  Harm...
[32:26.650 --> 32:27.290]  Um...
[32:27.290 --> 32:27.630]  And...
[32:27.630 --> 32:28.430]  I think...
[32:28.430 --> 32:29.110]  Like...
[32:29.110 --> 32:29.830]  I want to read...
[32:29.830 --> 32:31.210]  Some parts of the comment...
[32:31.210 --> 32:31.970]  From...
[32:31.970 --> 32:33.690]  One participant...
[32:33.690 --> 32:34.430]  Who also...
[32:34.430 --> 32:34.750]  Like...
[32:34.750 --> 32:35.310]  Went into this...
[32:35.310 --> 32:36.370]  She's a licensed...
[32:36.370 --> 32:37.410]  Psychotherapist...
[32:37.410 --> 32:39.130]  And trauma researcher...
[32:39.130 --> 32:40.150]  Um...
[32:40.150 --> 32:40.950]  But also...
[32:40.950 --> 32:42.830]  Has PTSD...
[32:42.830 --> 32:43.610]  Um...
[32:44.650 --> 32:46.190]  While I was in the study...
[32:46.190 --> 32:47.690]  There were many things...
[32:47.690 --> 32:48.450]  In my trial...
[32:48.450 --> 32:49.350]  Therapists did...
[32:50.170 --> 32:50.590]  Uh...
[32:50.590 --> 32:51.830]  Things I would never do...
[32:51.830 --> 32:52.610]  As a therapist...
[32:52.610 --> 32:53.190]  Or researcher...
[32:53.870 --> 32:55.290]  And it includes things like...
[32:55.290 --> 32:56.430]  Encourage me to view...
[32:56.430 --> 32:57.410]  My worsening symptoms...
[32:57.870 --> 32:59.270]  As evidence of healing...
[32:59.270 --> 33:01.130]  And spiritual awakening...
[33:01.130 --> 33:02.310]  Seeding mistrust...
[33:02.310 --> 33:04.190]  In mainstream psychiatry...
[33:04.190 --> 33:05.250]  Talking about...
[33:05.250 --> 33:06.190]  Past life traumas...
[33:07.090 --> 33:07.470]  Encouraging...
[33:07.850 --> 33:08.190]  And...
[33:08.190 --> 33:08.850]  One time...
[33:08.850 --> 33:09.710]  Pressuring me...
[33:09.710 --> 33:11.190]  To cuddle with them...
[33:11.190 --> 33:12.570]  Repeatedly telling me...
[33:12.570 --> 33:13.510]  I was...
[33:13.510 --> 33:14.930]  Helping make history...
[33:14.930 --> 33:16.290]  And then I was...
[33:16.290 --> 33:17.550]  Part of a movement...
[33:17.550 --> 33:18.670]  And letting me know...
[33:18.670 --> 33:19.730]  How my responses...
[33:19.730 --> 33:20.910]  And behaviors...
[33:20.910 --> 33:22.370]  During and after the trial...
[33:22.370 --> 33:24.730]  Could jeopardize legalization...
[33:24.730 --> 33:25.990]  Over a very...
[33:25.990 --> 33:26.490]  Intense...
[33:26.490 --> 33:27.750]  Three months period...
[33:27.750 --> 33:28.710]  While I was being...
[33:28.710 --> 33:29.250]  Given...
[33:29.870 --> 33:30.390]  Suggestibility...
[33:30.390 --> 33:31.810]  Enhancing drugs...
[33:31.810 --> 33:32.910]  My therapist...
[33:32.910 --> 33:33.850]  Systematically...
[33:33.850 --> 33:34.590]  Engaged with me...
[33:34.590 --> 33:35.590]  In ways that...
[33:35.590 --> 33:36.410]  Influenced me...
[33:36.410 --> 33:37.970]  To become a representative...
[33:37.970 --> 33:39.050]  Of the movement...
[33:39.050 --> 33:40.050]  To legalize...
[33:40.050 --> 33:41.310]  MDMA therapy...
[33:41.310 --> 33:43.070]  And shaped my behavior...
[33:43.070 --> 33:44.050]  As a research participant...
[33:44.830 --> 33:45.410]  And therefore...
[33:45.410 --> 33:46.150]  Shaped the data...
[33:46.150 --> 33:46.790]  I provided...
[33:46.790 --> 33:48.530]  Through self-reports...
[33:48.530 --> 33:49.570]  I even changed...
[33:49.570 --> 33:50.280]  My voting behavior...
[33:50.690 --> 33:52.090]  In a federal election...
[33:52.090 --> 33:53.050]  That took place...
[33:53.050 --> 33:54.090]  While I was enrolled...
[33:54.090 --> 33:54.890]  In the trial...
[33:54.890 --> 33:56.410]  I voted for a party...
[33:56.410 --> 33:57.070]  Whose platform...
[33:57.070 --> 33:58.130]  I explicitly...
[33:58.130 --> 33:59.090]  Disagree with...
[33:59.090 --> 34:00.550]  But whose therapist...
[34:00.550 --> 34:01.790]  But who my therapist...
[34:01.790 --> 34:02.410]  Verbalized...
[34:02.410 --> 34:04.270]  Explicit support for...
[34:04.270 --> 34:05.210]  Three months after...
[34:05.210 --> 34:05.930]  I was giving...
[34:05.930 --> 34:07.190]  My first dose...
[34:07.190 --> 34:07.970]  Of MDMA...
[34:07.970 --> 34:08.910]  I was...
[34:08.910 --> 34:10.090]  For a time...
[34:10.090 --> 34:11.190]  One of the staunchest...
[34:11.190 --> 34:11.810]  Advocates...
[34:11.810 --> 34:13.710]  For MDMA therapy...
[34:13.710 --> 34:15.410]  These very sudden changes...
[34:15.410 --> 34:16.390]  In my beliefs...
[34:16.390 --> 34:16.930]  Values...
[34:16.930 --> 34:17.830]  And behaviors...
[34:17.830 --> 34:19.130]  Even in some aspects...
[34:19.130 --> 34:20.350]  Of my personality...
[34:20.350 --> 34:22.270]  Are mystifying to me...
[34:22.270 --> 34:24.370]  Because these kinds of changes...
[34:24.370 --> 34:25.090]  And the direction...
[34:25.090 --> 34:26.490]  Those changes went in...
[34:26.490 --> 34:28.010]  Are wildly out of character...
[34:28.010 --> 34:28.750]  For me...
[34:28.750 --> 34:29.930]  They are even more...
[34:29.930 --> 34:30.570]  Mystifying...
[34:30.570 --> 34:31.810]  Because at the same time...
[34:31.810 --> 34:32.890]  That I was turning into...
[34:32.890 --> 34:33.790]  A firm advocate...
[34:33.790 --> 34:34.710]  Of MDMA...
[34:34.710 --> 34:35.510]  Therapy...
[34:35.510 --> 34:36.350]  I was also...
[34:36.350 --> 34:37.110]  Relentlessly...
[34:37.590 --> 34:38.090]  Suicidal...
[34:38.090 --> 34:38.830]  And was...
[34:38.830 --> 34:39.330]  Clinically...
[34:39.330 --> 34:40.410]  Decompensating...
[34:40.410 --> 34:41.050]  In a...
[34:41.050 --> 34:41.910]  Frankly...
[34:41.910 --> 34:42.770]  Spectacular...
[34:42.770 --> 34:43.150]  Way...
[34:44.710 --> 34:46.450]  And to be...
[34:46.450 --> 34:46.890]  Clear...
[34:46.890 --> 34:47.510]  She was...
[34:47.510 --> 34:47.870]  In the...
[34:47.870 --> 34:48.330]  Success...
[34:48.330 --> 34:48.830]  Group...
[34:51.370 --> 34:52.370]  And she's...
[34:52.370 --> 34:53.290]  Not the only...
[34:53.290 --> 34:54.050]  Participant...
[34:54.050 --> 34:54.550]  Who had...
[34:54.550 --> 34:55.250]  Experiences...
[34:55.250 --> 34:55.570]  Like...
[34:55.570 --> 34:56.270]  This...
[34:56.270 --> 34:59.330]  It seems...
[34:59.330 --> 35:00.030]  That...
[35:00.610 --> 35:01.430]  I mean...
[35:01.430 --> 35:02.010]  And there were...
[35:02.010 --> 35:03.110]  It was interesting...
[35:03.110 --> 35:04.230]  A lot of these comments...
[35:04.230 --> 35:04.350]  Were...
[35:04.350 --> 35:06.210]  Were people who still believe...
[35:06.210 --> 35:07.510]  In the potential of...
[35:07.510 --> 35:08.510]  MDMA...
[35:08.510 --> 35:09.350]  Therapy...
[35:09.350 --> 35:09.810]  You know...
[35:09.810 --> 35:10.690]  Assisted...
[35:10.690 --> 35:11.450]  Therapy...
[35:11.450 --> 35:11.870]  For...
[35:11.870 --> 35:12.890]  PTSD...
[35:12.890 --> 35:13.430]  And are...
[35:13.430 --> 35:13.850]  Pro...
[35:13.850 --> 35:14.290]  But...
[35:14.290 --> 35:15.530]  Were at the same time...
[35:15.530 --> 35:15.870]  Saying...
[35:15.870 --> 35:16.170]  Yay...
[35:16.170 --> 35:17.290]  This can have...
[35:17.290 --> 35:17.870]  Can...
[35:17.870 --> 35:19.210]  Cause harm...
[35:19.210 --> 35:20.170]  There was...
[35:20.170 --> 35:20.590]  There was...
[35:20.590 --> 35:20.750]  A...
[35:20.750 --> 35:20.910]  A...
[35:20.910 --> 35:21.170]  Man...
[35:21.170 --> 35:22.110]  Who...
[35:22.110 --> 35:22.490]  Actually had...
[35:22.490 --> 35:23.910]  Informal...
[35:23.910 --> 35:24.270]  Not...
[35:24.270 --> 35:24.650]  Not...
[35:24.650 --> 35:25.390]  Part of the trial...
[35:25.390 --> 35:25.870]  MDMA...
[35:25.870 --> 35:26.610]  Experience...
[35:26.610 --> 35:27.070]  In...
[35:27.070 --> 35:28.030]  2022...
[35:28.030 --> 35:28.690]  That he said...
[35:28.690 --> 35:29.130]  Was...
[35:29.130 --> 35:29.970]  You know...
[35:29.970 --> 35:30.690]  So good...
[35:30.690 --> 35:30.970]  For his...
[35:30.970 --> 35:31.670]  PTSD...
[35:31.670 --> 35:32.450]  And then he...
[35:32.450 --> 35:33.670]  Participated in the trial...
[35:34.250 --> 35:34.690]  Later...
[35:34.690 --> 35:35.470]  And said...
[35:35.470 --> 35:36.350]  He became...
[35:36.350 --> 35:36.430]  Non...
[35:36.430 --> 35:36.950]  Non...
[35:36.950 --> 35:38.090]  Functional...
[35:38.090 --> 35:39.150]  You know...
[35:39.150 --> 35:39.790]  And...
[35:39.790 --> 35:40.050]  And...
[35:40.050 --> 35:41.110]  This can really...
[35:41.110 --> 35:42.230]  Cause harm...
[35:42.230 --> 35:43.270]  And that he really...
[35:43.270 --> 35:43.930]  Is...
[35:43.930 --> 35:44.750]  Pro...
[35:44.750 --> 35:45.630]  But...
[35:46.810 --> 35:47.690]  In...
[35:47.690 --> 35:49.010]  In any case...
[35:49.010 --> 35:50.250]  Even with a large...
[35:50.250 --> 35:51.650]  Effect size...
[35:51.650 --> 35:53.630]  There's a lot of...
[35:53.630 --> 35:53.990]  Concerns...
[35:54.330 --> 35:55.050]  That...
[35:55.050 --> 35:55.890]  Really call the results...
[35:56.270 --> 35:57.090]  Into...
[35:57.090 --> 35:58.030]  Question...
[35:58.030 --> 35:58.670]  Um...
[35:58.670 --> 35:59.570]  And I can see...
[35:59.570 --> 36:00.510]  Why the committee...
[36:00.510 --> 36:01.030]  Thought...
[36:01.030 --> 36:01.550]  The curve...
[36:02.590 --> 36:02.950]  Evidence...
[36:02.950 --> 36:03.850]  Doesn't show...
[36:03.850 --> 36:04.370]  That it's...
[36:04.370 --> 36:05.530]  Effective...
[36:05.530 --> 36:06.390]  It doesn't mean...
[36:06.390 --> 36:06.910]  That it's...
[36:06.910 --> 36:07.870]  Not effective...
[36:07.870 --> 36:08.650]  We can't say...
[36:08.650 --> 36:09.550]  That...
[36:09.550 --> 36:10.270]  That...
[36:10.270 --> 36:11.690]  We just don't know...
[36:11.690 --> 36:12.270]  There's...
[36:14.490 --> 36:14.850]  Complications...
[36:14.850 --> 36:15.990]  In this evidence...
[36:15.990 --> 36:16.570]  So...
[36:16.570 --> 36:17.490]  We really don't have...
[36:17.490 --> 36:18.110]  Good evidence...
[36:18.110 --> 36:18.650]  To say...
[36:18.650 --> 36:19.010]  Yeah...
[36:19.010 --> 36:19.810]  It's definitely...
[36:20.650 --> 36:21.190]  Effective...
[36:21.190 --> 36:22.430]  Um...
[36:22.430 --> 36:23.150]  And this...
[36:23.150 --> 36:24.110]  These trials...
[36:24.290 --> 36:24.730]  Are...
[36:24.730 --> 36:25.290]  Pretty much...
[36:25.290 --> 36:25.810]  As controlled...
[36:25.810 --> 36:26.570]  As it gets...
[36:26.570 --> 36:27.290]  So...
[36:27.290 --> 36:28.190]  Um...
[36:28.190 --> 36:28.630]  So...
[36:28.630 --> 36:29.010]  With some...
[36:29.010 --> 36:29.810]  Of these...
[36:29.810 --> 36:30.830]  Issues...
[36:30.830 --> 36:31.790]  Um...
[36:31.790 --> 36:32.690]  I can see...
[36:32.690 --> 36:33.650]  Why the committee...
[36:33.650 --> 36:34.310]  Was worried...
[36:34.310 --> 36:35.170]  About risks...
[36:35.170 --> 36:35.830]  If it's...
[36:35.830 --> 36:36.530]  Approved...
[36:36.530 --> 36:36.930]  And...
[36:36.930 --> 36:37.770]  Released...
[36:37.770 --> 36:38.030]  Um...
[36:40.110 --> 36:40.990]  We...
[36:47.090 --> 36:47.970]  Um...
[36:47.970 --> 36:48.630]  Um...
[36:50.430 --> 36:51.030]  Um...
[36:51.030 --> 36:51.670]  It's clearly...
[36:52.330 --> 36:52.830]  Yeah...
[36:52.830 --> 36:53.450]  MDMA...
[36:53.450 --> 36:54.370]  And other...
[36:54.370 --> 36:55.530]  Drugs like it...
[36:55.530 --> 36:56.810]  Some of the drugs I've talked about...
[36:56.810 --> 36:58.670]  Are clearly powerful tools...
[36:58.670 --> 36:59.630]  That can hack the mind...
[37:00.610 --> 37:00.910]  Um...
[37:01.210 --> 37:01.750]  But...
[37:01.750 --> 37:03.130]  We're still figuring out...
[37:03.130 --> 37:04.410]  Especially in medicine...
[37:04.410 --> 37:05.710]  Where we need consistent...
[37:05.710 --> 37:06.730]  Good consistent results...
[37:07.250 --> 37:08.590]  To judge risk and benefit...
[37:08.590 --> 37:10.630]  To actually recommend it to patients...
[37:10.630 --> 37:11.190]  It's a...
[37:11.190 --> 37:13.010]  A higher standard in a way...
[37:13.010 --> 37:13.710]  Than...
[37:13.710 --> 37:14.470]  Than like...
[37:14.470 --> 37:14.910]  You know...
[37:14.910 --> 37:16.150]  Letting someone...
[37:16.150 --> 37:17.630]  Just take it for fun...
[37:18.330 --> 37:18.770]  Um...
[37:18.770 --> 37:19.790]  Which I don't think there's...
[37:20.150 --> 37:21.830]  Anything inherently wrong with that...
[37:22.730 --> 37:23.370]  Um...
[37:23.370 --> 37:23.870]  But...
[37:23.870 --> 37:24.190]  For...
[37:24.190 --> 37:25.910]  For medical use...
[37:25.910 --> 37:26.530]  Um...
[37:26.530 --> 37:27.710]  It's not there yet...
[37:28.910 --> 37:29.550]  Um...
[37:29.550 --> 37:30.130]  It's...
[37:30.130 --> 37:30.310]  It's...
[37:30.310 --> 37:32.190]  The FDA might still approve it...
[37:32.190 --> 37:33.230]  Or they might not...
[37:33.230 --> 37:34.010]  And if they don't...
[37:34.010 --> 37:34.190]  It's...
[37:34.190 --> 37:35.290]  It's a setback...
[37:35.290 --> 37:35.630]  But...
[37:35.630 --> 37:36.510]  The research will...
[37:36.510 --> 37:38.130]  We'll keep moving forward...
[37:38.130 --> 37:40.330]  And I really do hope they...
[37:40.330 --> 37:42.450]  Resolve some of these issues...
[37:42.450 --> 37:44.970]  We want to hack the mind...
[37:44.970 --> 37:45.750]  Um...
[37:45.750 --> 37:46.150]  You know...
[37:46.150 --> 37:46.770]  In this case...
[37:46.770 --> 37:48.270]  We want to hack the mind...
[37:48.270 --> 37:48.810]  Of...
[37:48.810 --> 37:50.430]  PTSD patients...
[37:50.430 --> 37:50.570]  To...
[37:51.570 --> 37:52.170]  To...
[37:52.170 --> 37:53.370]  Resolve this...
[37:53.370 --> 37:53.990]  You know...
[37:54.590 --> 37:55.190]  Terrible...
[37:55.190 --> 37:56.070]  Uh...
[37:56.070 --> 37:56.630]  You know...
[37:56.630 --> 37:58.510]  Condition that's disabling them...
[37:59.070 --> 37:59.450]  Um...
[37:59.450 --> 38:01.290]  But we don't want to hack the mind...
[38:01.290 --> 38:02.550]  In the wrong way...
[38:02.550 --> 38:02.910]  Where...
[38:02.910 --> 38:04.570]  Where people are...
[38:04.570 --> 38:05.110]  Uh...
[38:05.110 --> 38:05.630]  You know...
[38:05.630 --> 38:07.290]  In these trials...
[38:07.290 --> 38:07.830]  And...
[38:07.830 --> 38:07.990]  And...
[38:07.990 --> 38:09.670]  Develop this blind trust...
[38:09.670 --> 38:09.970]  And...
[38:09.970 --> 38:10.490]  This...
[38:10.490 --> 38:11.630]  This closeness...
[38:11.630 --> 38:12.730]  To their therapist...
[38:12.730 --> 38:13.510]  That maybe...
[38:13.510 --> 38:13.910]  Uh...
[38:13.910 --> 38:15.350]  Actually go against their...
[38:15.350 --> 38:17.470]  Their previous values...
[38:18.990 --> 38:19.590]  Um...
[38:19.590 --> 38:20.110]  So...
[38:20.750 --> 38:21.350]  And...
[38:21.350 --> 38:21.990]  Um...
[38:21.990 --> 38:23.430]  To wrap up that...
[38:23.430 --> 38:23.690]  Uh...
[38:23.690 --> 38:24.230]  And say...
[38:24.230 --> 38:25.570]  Be careful...
[38:25.570 --> 38:26.330]  Like I said...
[38:26.330 --> 38:27.570]  When I first...
[38:27.570 --> 38:29.130]  Ran into this issue...
[38:29.130 --> 38:29.950]  Um...
[38:29.950 --> 38:30.290]  I...
[38:30.290 --> 38:31.210]  I thought like...
[38:31.210 --> 38:31.910]  Why...
[38:31.910 --> 38:33.270]  Why did they vote that way?
[38:33.270 --> 38:33.610]  But...
[38:33.610 --> 38:34.490]  But now I...
[38:34.490 --> 38:34.990]  I...
[38:34.990 --> 38:35.430]  Kind of get it.
[38:36.890 --> 38:37.350]  Um...
[38:38.550 --> 38:39.010]  And...
[38:39.010 --> 38:40.990]  I was worried about time...
[38:40.990 --> 38:41.230]  But...
[38:41.230 --> 38:42.730]  There's still a little bit left...
[38:42.730 --> 38:43.230]  Uh...
[38:43.230 --> 38:45.170]  That's all I have for you...
[38:45.170 --> 38:45.400]  Um...
[38:45.850 --> 38:47.090]  I wanted to say...
[38:47.090 --> 38:47.190]  Uh...
[38:47.190 --> 38:47.450]  You know...
[38:47.450 --> 38:49.010]  So thank you for coming...
[39:02.790 --> 39:03.250]  Um...
[39:05.610 --> 39:06.130]  Um...
[39:06.990 --> 39:07.510]  And...
[39:07.510 --> 39:08.030]  Um...
[39:11.310 --> 39:13.030]  I ended up digging in...
[39:13.030 --> 39:14.290]  So much...
[39:14.290 --> 39:16.110]  And learned a lot about it...
[39:16.110 --> 39:16.550]  Um...
[39:16.550 --> 39:18.710]  So that will be my first video...
[39:18.710 --> 39:18.990]  Uh...
[39:18.990 --> 39:20.410]  In a couple of weeks...
[39:20.970 --> 39:21.490]  Um...
[39:21.490 --> 39:22.170]  And...
[39:22.170 --> 39:22.470]  Uh...
[39:22.470 --> 39:22.830]  Yeah...
[39:22.830 --> 39:24.510]  So I guess there will be some...
[39:24.510 --> 39:26.750]  Time for questions...
[39:37.140 --> 39:37.640]  Hello...
[39:38.160 --> 39:38.820]  Thank you for that...
[39:39.380 --> 39:45.340]  Could you perhaps tell us a little bit more about what the trials were?
[39:45.560 --> 39:49.640]  Because a lot of people, drugs on TV, it's like, here, take this magic pill, you're done.
[39:50.500 --> 39:57.740]  These studies that are before the FDA include the dosage, as well as the therapies that go along with it.
[39:58.460 --> 40:03.080]  And that's what they're looking at saying, you haven't got that right for helping people.
[40:03.280 --> 40:10.720]  So could you tell us a little bit more about whether it's a party dose or a higher level of dose, and what kind of therapies?
[40:11.080 --> 40:12.660]  You sort of described some of that.
[40:12.880 --> 40:18.940]  Yeah, I mean, they took a, like a pretty standard dose, but they did a split dosing.
[40:19.700 --> 40:27.920]  I think it was something like 80 milligrams and then 80 milligrams a couple hours later, if the patient was feeling okay.
[40:29.000 --> 40:37.920]  There were three dosing sessions, there were three prep sessions where they'd like, you know, kind of like interview the patient.
[40:38.560 --> 40:46.340]  And then there were three sets of dosing sessions where they had an eight hour dosing session with two therapists.
[40:48.500 --> 40:51.920]  And then three integration sessions after that.
[40:52.060 --> 40:53.600]  And they did the split dosing.
[40:53.860 --> 40:57.880]  If there was a problem after the first dose, they didn't give the second dose.
[40:59.220 --> 40:59.820]  Okay.
[41:00.260 --> 41:00.980]  Thank you.
[41:03.380 --> 41:04.920]  Thanks so much for giving the talk.
[41:06.140 --> 41:07.580]  If you're talking about...
[41:07.580 --> 41:17.360]  So can you speak a little bit about the chemical differences and like long term effects of like performance enhancing drugs versus like street methamphetamines?
[41:18.400 --> 41:19.040]  Yeah.
[41:19.100 --> 41:20.820]  Which kind of performance?
[41:21.340 --> 41:24.080]  Like Adderall, Vyvanse, Concerto, like that kind of stuff?
[41:24.260 --> 41:24.380]  Yeah.
[41:24.720 --> 41:24.880]  Yeah.
[41:25.240 --> 41:29.140]  Well, those are stimulants chemically.
[41:30.160 --> 41:34.060]  And long term, they can be not good for the body.
[41:34.720 --> 41:43.660]  And in the use of, you know, the prescription drugs, they've made sure they're lower risk.
[41:44.700 --> 41:54.120]  This actually like for the risk of MDMA, they compared it to the risk of meth and Adderall and Ritalin.
[41:54.240 --> 42:03.460]  And it had a lower risk than meth as far as like complications, hospitalizations, but higher risk than Ritalin and Adderall.
[42:03.680 --> 42:10.320]  Because those drugs do have some risk, but the risk has been minimized by the way they're used medically.
[42:11.080 --> 42:15.220]  I mean, aren't they just, they're essentially speed though, right?
[42:15.340 --> 42:19.960]  I mean, they're not really that different from meth you can buy on the street, or is that not true?
[42:20.780 --> 42:21.320]  Yeah.
[42:21.560 --> 42:24.040]  I mean, they are, yeah, Adderall.
[42:24.240 --> 42:25.300]  It's an amphetamine.
[42:25.580 --> 42:31.220]  It's a little less potent because it doesn't have a little extra methyl group, that methamphetamine.
[42:33.560 --> 42:39.520]  The, you know, half-life is probably a bit different.
[42:40.480 --> 42:49.200]  But what keeps the risk under control is the constraints on usage when it's done in, you know, the medical context.
[42:49.940 --> 42:50.580]  Thank you.
[42:52.360 --> 42:53.080]  Hi.
[42:53.880 --> 42:55.000]  Two questions.
[42:55.320 --> 42:59.500]  One, specifically for ecstasy, like what is a safe frequency of use?
[42:59.500 --> 43:09.360]  And then two, for sources both of information and safe, clean versions of ecstasy and these newer, like 2CB, blah, blah, blah.
[43:09.540 --> 43:15.920]  I don't want to read Arrowhead for hours, like how can I safely find information and source novel things?
[43:16.800 --> 43:19.120]  Yeah, yeah, it's tricky.
[43:19.120 --> 43:29.000]  So, the first part of the question, safe frequency, it's a tricky one.
[43:30.200 --> 43:32.940]  It's not really outlined yet.
[43:33.380 --> 43:44.740]  I mean, in this study, it didn't have supposedly, I mean, except where there were some allegations of them encouraging people to use their own supplies after the trial.
[43:45.600 --> 43:55.560]  But it's just, you know, the three doses that they did with the spacing of, I don't know, three weeks, was it, apart?
[43:58.800 --> 44:07.000]  They, it's not like frequent enough, you know, or like just three doses that that could be safe probably.
[44:08.480 --> 44:17.840]  But, but the parameters of how, like, I can't really, I don't have an answer for, like, well, could you use it once every two weeks for a year?
[44:18.100 --> 44:21.300]  Or, I don't know, that seems like it would be probably pretty heavy usage.
[44:22.520 --> 44:24.360]  Yeah, could you use it once a year?
[44:25.360 --> 44:25.800]  Probably.
[44:25.800 --> 44:26.060]  Probably.
[44:26.700 --> 44:27.360]  Probably.
[44:27.360 --> 44:41.300]  But there's not really, like, most of the information we have is just on, and there was some unknowns with cardiac risk coming up in the trials, too.
[44:43.440 --> 44:49.100]  So, as far as finding information, there are harm reduction organizations.
[44:50.260 --> 44:53.480]  There's also arrowid.org.
[44:53.640 --> 44:55.340]  I don't know if you've heard of them.
[44:56.840 --> 45:08.920]  But they have, you know, more, you know, it's not like the DEA website that's all, like, ecstasy causes euphoria and depression.
[45:09.620 --> 45:16.800]  And they make it sound like it feels terrible, and obviously people wouldn't use it if it were like that.
[45:19.400 --> 45:22.640]  So, I don't know, did that answer your question?
[45:22.960 --> 45:23.620]  Kind of, or?
[45:24.380 --> 45:34.180]  So, just like the first person accounts on arrowid is kind of the best there is for information and, oh, and sourcing on including novel things like 2CB.
[45:34.320 --> 45:40.220]  Like, I hear about this, haven't tried it, no idea how to evaluate if it's safe or where to find clean versions of things.
[45:40.220 --> 45:41.080]  Right, right.
[45:41.280 --> 45:47.860]  I mean, it is difficult because we do, they are illegal and so, like, information is a difficult thing.
[45:48.980 --> 45:52.420]  And it comes a lot from, you know, users.
[45:53.040 --> 45:56.380]  And some of it is simply not known.
[45:56.720 --> 46:02.600]  Like, if a lot of, like a lot of, there's a history of use of MDMA that goes back a long time.
[46:02.600 --> 46:03.760]  2CB as well.
[46:04.000 --> 46:12.100]  Like, so you can surmise that, you know, it's probably, you know, relatively safe.
[46:12.160 --> 46:15.400]  You can look at the number of deaths and what they were from.
[46:15.520 --> 46:16.660]  There are risks.
[46:16.860 --> 46:19.360]  But it's still a little bit in the dark.
[46:20.960 --> 46:23.980]  And sourcing no, no useful advice.
[46:25.060 --> 46:26.080]  Too controversial.
[46:26.080 --> 46:27.320]  Yeah, yeah.
[46:27.960 --> 46:30.460]  I mean, what was that?
[46:30.900 --> 46:32.580]  Let other people ask things.
[46:32.840 --> 46:33.600]  Yeah, yeah.
[46:35.460 --> 46:57.140]  I was just wondering, you know, you touched on one of the concerns with the advisory group of the FDA seemed to really focus on the issues with the trials on MDMA revolving around psychotherapy in conjunction with the use of the medication and the fact that the FDA doesn't really have anything to say about psychotherapy.
[46:58.620 --> 47:06.660]  So they were questioning, you know, whether or not there was useful data that didn't involve that.
[47:06.680 --> 47:09.560]  Because if it depends on the psychotherapy, how can they have input on it?
[47:09.580 --> 47:17.200]  I was just wondering, a lot of these psychedelic trials seem to connect that component.
[47:17.200 --> 47:24.240]  Like, you use the medication in a controlled environment or with assisted psychotherapy.
[47:26.840 --> 47:38.180]  And do you have any commentary on going forward with the idea of, do we have to develop new frameworks for how to evaluate medications that are going to be used in such a controlled environment?
[47:40.280 --> 47:44.440]  Yeah, I think there's some work to be done on that.
[47:46.380 --> 47:56.860]  The, you know, drugs haven't just automatically, well, the ketamine sort of has been found to work well in like a single dose without therapy.
[47:57.960 --> 48:00.600]  But that's not true of, say, LSD.
[48:02.020 --> 48:06.360]  But, like, the therapy component is also has its issues.
[48:08.640 --> 48:13.840]  And, yeah, I think that we need to do some work on that.
[48:14.020 --> 48:25.780]  The fact that the drugs are powerful and do it, which is what gives them so much potential, right, is kind of also part of what makes it really difficult.
[48:28.800 --> 48:30.780]  Okay, you're going to be glad you stayed.
[48:31.560 --> 48:36.220]  I've been introduced to the topic now five decades of psychedelic research.
[48:36.480 --> 48:43.020]  Pretty hardcore from, you know, Oaxaca to Peru to shamans to have a solid background in organic chemistry.
[48:43.660 --> 48:45.500]  If you go to Washington, D.C.
[48:45.700 --> 48:51.080]  today, three blocks from the White House, you can buy the world's strongest medicines in the world.
[48:51.620 --> 48:53.100]  It's three blocks from the White House.
[48:53.260 --> 48:55.060]  They've totally legalized everything in D.C.
[48:55.720 --> 49:02.000]  So the mushrooms, 12 kinds of mushrooms, 22, 23, 24 kinds of cannabis.
[49:02.360 --> 49:12.240]  And they have, this is just a warning to people, they have a new breed of mycelium mushrooms that make look like ayahuasca in Peru, like going to the five and dime.
[49:12.940 --> 49:13.700]  It's so powerful.
[49:13.800 --> 49:15.880]  These things are so strong, you can't believe them.
[49:15.880 --> 49:17.560]  But that's right from Washington.
[49:17.800 --> 49:25.500]  The second part I had to ask is, are all this research is being financed by extreme hard right-wingers?
[49:26.120 --> 49:27.800]  Do you know the maps?
[49:28.080 --> 49:30.740]  They got a million dollars from the group.
[49:30.920 --> 49:32.540]  Who are they that gave them the money?
[49:32.780 --> 49:33.540]  Bannon's people.
[49:34.320 --> 49:36.240]  I forget off the top of my head.
[49:36.420 --> 49:36.780]  The Mercers.
[49:37.620 --> 49:44.580]  Yeah, the Mercers are the most conservative people in America, and they are financing the MDMA research.
[49:44.580 --> 49:46.000]  So the question is why?
[49:46.740 --> 49:55.940]  The second question is, every single dose of psilocybin used in a clinical trial in America today is through Peter Thiel's pharmaceutical company.
[49:56.400 --> 49:58.600]  And as you know, Peter Thiel is extremely right-wing.
[49:58.780 --> 50:00.780]  So why are they financing these projects?
[50:01.640 --> 50:04.140]  Well, there's a lot of money to be made in it.
[50:04.280 --> 50:05.120]  They see an opportunity.
[50:05.760 --> 50:07.240]  They don't need any more money.
[50:07.240 --> 50:07.720]  Oh.
[50:08.260 --> 50:08.740]  Believe me.
[50:08.740 --> 50:10.420]  Nobody needs any more money.
[50:10.560 --> 50:10.680]  Believe me.
[50:10.680 --> 50:10.720]  Believe me.
[50:10.900 --> 50:11.060]  Believe me.
[50:11.060 --> 50:13.840]  The Mercers do not need any more money.
[50:13.960 --> 50:15.640]  They're multiple, multiple billionaires.
[50:15.820 --> 50:18.280]  They don't need any more money, but they want it.
[50:18.400 --> 50:19.360]  What's your opinion?
[50:19.360 --> 50:22.420]  Why would they finance the MDMA trials?
[50:24.280 --> 50:30.320]  I mean, I think it's, there's interest because I think there is a financial interest.
[50:30.660 --> 50:31.660]  They're like 80 years old.
[50:31.820 --> 50:32.520]  They don't need any money.
[50:33.500 --> 50:36.040]  Did you have an opinion on why?
[50:36.560 --> 50:37.320]  I'm asking.
[50:37.460 --> 50:37.840]  No one knows.
[50:37.960 --> 50:38.700]  No one has an opinion.
[50:38.900 --> 50:39.980]  Even MAPS doesn't know why.
[50:40.100 --> 50:45.180]  The second question is, why is Peter Thiel, you know, everyone knows, I'm assuming, who Peter Thiel is.
[50:45.180 --> 50:52.540]  Why is he in charge of every single psilocybin dose used in a clinical trial in the United States through his pharmaceutical company, Compass?
[50:53.260 --> 50:55.180]  I mean, that's probably partly.
[50:55.180 --> 50:56.840]  He does not need any more money either.
[50:57.460 --> 50:58.400]  I'm just curious.
[50:58.600 --> 50:59.200]  I'm asking this.
[50:59.340 --> 51:00.140]  For the source.
[51:01.440 --> 51:02.580]  They got away with it.
[51:02.780 --> 51:03.340]  They do whatever they want.
[51:03.340 --> 51:04.820]  Yeah, they were killing people.
[51:05.200 --> 51:05.380]  Yeah.
[51:05.800 --> 51:08.300]  The MDA is not going out to kill people.
[51:08.400 --> 51:09.260]  Anyway, I'll leave you with that.
[51:09.880 --> 51:10.340]  All right.
[51:10.460 --> 51:12.640]  Well, that's all the time we have.
[51:12.640 --> 51:15.160]  I think the easy answer is control, right?
[51:15.160 --> 51:16.220]  It's control.
[51:16.780 --> 51:17.020]  But...
[51:18.500 --> 51:19.600]  Sorry, Dr. Jen.
[51:19.700 --> 51:20.940]  I just have one question.
[51:20.940 --> 51:21.800]  I promise.
[51:21.940 --> 51:23.080]  This is a softball one.
[51:23.420 --> 51:24.020]  So...
[51:24.020 --> 51:31.940]  For the clinical trials where MDMA was, like, obvious to the, you know, blinded versus...
[51:31.940 --> 51:35.000]  I should say, you know, what group you were in, right?
[51:35.960 --> 51:38.100]  For placebos, what were they giving them?
[51:38.920 --> 51:40.420]  It's an inert placebo.
[51:40.780 --> 51:41.380]  So...
[51:41.380 --> 51:42.980]  Which kind of begs the question.
[51:42.980 --> 51:50.460]  Why wouldn't you give something that had also some psychoactive to mask the obviousness of it?
[51:50.460 --> 51:50.820]  Is that...
[51:50.820 --> 51:52.200]  That's just something that occurred to me, right?
[51:52.340 --> 51:57.480]  They tried in some of their earlier phases, but it increased anxiety.
[51:57.860 --> 52:00.340]  It had some, like, negative effects.
[52:00.760 --> 52:01.160]  Yeah.
[52:01.320 --> 52:06.020]  Like something that they know that, you know, would be reasonably tolerated, but still, hey, could this be...
[52:06.020 --> 52:07.820]  They didn't find a good solution, so...
[52:07.820 --> 52:07.840]  Yeah.
[52:07.860 --> 52:08.040]  Yeah.
[52:08.180 --> 52:08.500]  Interesting.
[52:08.500 --> 52:08.940]  Okay.
[52:09.000 --> 52:09.460]  Thank you.
[52:09.520 --> 52:09.880]  All right.
[52:09.980 --> 52:10.200]  Thank you.