Legal Psilocybin Therapy with Hadas Alterman
Alisa Nappa
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How does one get accredited to become a psilocybin facilitator? What are the rules and regulations currently in place in Oregon? What does the legal future look like for psilocybin assisted therapy? We chat with Hadas Alterman, JD from Berkley Law, and Director of government affairs at APPA (American Psychedelic Practitioners Association) to answer all these questions and more.
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TRANSCRIPT
Alex 0:11 Welcome, welcome, you are listening to the mushroom revival podcast. I'm your host, Alex Dora. And we are absolutely obsessed with the wonderful, mysterious, wacky, interesting world of mushrooms and fungi, we bring on beautiful guests and experts from all around the globe to geek out with us and go down a rabbit hole of anything from surface level topics to going extremely deep into this world of mushrooms and fungi. So today we're we're going to talk about psychedelic practitioners and, and the Up Up and Coming psychedelic therapy space. So is it hottest dogs had us how're you doing today? Unknown Speaker 0:55 Good. How are you? Alex 0:56 Good. I'm sorry to hear about your concussion that that's a bummer. But for people who don't know about you and your work, what are you up to? Speaker 2 1:08 Well, I am the director of government affairs for an organization called the American psychedelic practitioners Association or APA, as the acronym we use. And we are a trade organization for practitioners in the psychedelic space. So everyone really from Academy ketamine assisted therapist, anesthesiologist, iOS Guerreros, people doing research on MDMA assisted therapy trials, people who are interested in eventually doing this work, people, you know, doing clinical trials for psilocybin, really, anyone and everyone who is a practitioner, who is going to be an author, or currently is part of this, what we consider to be a real paradigm shift in, in mental health and spiritual health and well being. So we're a member organization, we also are building out the infrastructure for this field that's coming online, at least legally, right? So psychedelic assisted therapy, the use of psychedelics, in communities, for religious purposes, and recreationally, all of it's been going on for a really, really long time. Like, it's not actually new. But it's coming into, you know, the current consciousness of the public in this day and age and a whole, a whole way right now, which I'm sure you're aware, and we can talk more about that culturally. And then of course, it's also becoming decriminalized legal legalized medicalized, we can also get into those distinctions as well. And one of Apple's big roles is to make sure that it happens, at least in the medical in the medical framework, that integration happens in a safe way, in an effective way, and in a way that allows good care to be accessible by all of the people who can safely benefit from these innovative medicines. Alex 3:10 And what is your background? How did you get into psychedelics and specifically mushrooms. Speaker 2 3:15 So, um, when I was in my last year of college, I went to a protest in Oakland. This was during the Occupy times. And it was a there had been like a series of Occupy Oakland protests for months and months and months. And this particular protest was in reaction to eviction foreclosures. So all of these black seniors in West Oakland, which is the historically black neighborhood, were getting evicted from their homes. And as you may or may not know, real estate and real property is the number one way that intergenerational wealth is passed down. So these evictions, and these work home foreclosures, we're not only putting senior citizens who are in, you know, in many cases, the backbones and the pillars of this community, in West Oakland onto the street, but it was also diverting this wealth that would have gone into the next generation of the black community in West Oakland, just into the hands of banks. So 2122 year old me was obviously really outraged and a bunch of my friends and I went to this protest. And long story short, we ended up getting arrested and taken to Santa Rita, which is a prison like 30 minutes outside of Oakland, and we were there for six days and we were in holding cells at first and then got moved into general population. And in general population, I was like, talking to a bunch of the the other were women there. And all of them without fail were in there for nonviolent drug offenses. And at the time, I had already read The New Jim Crow, by Michelle Alexander, which is a work about the war on drugs. And specifically, like the racialization, of the racialized origins and the racist origins of the war on drugs. And I think seeing it and talking to these women were, you know, unlike me, like I knew I was going to get out because I didn't do anything wrong, and then never have to go back in hopefully. But they were like, in and out of the system. And they were really concerned that, you know, their public housing would take get taken away their benefits, that there would be custody issues, that there would be immigration issues, all as a result of the nonviolent drug offense. And that's the first time it all came together and clicked in my head, that the war on drugs and specifically the the DEA is Controlled Substances Act has implications that are so far reaching, and people's lives literally can get destroyed, families lives and communities lives can just get picked apart and do in a very racially targeted way. Black and brown people primarily because of drug use, and everyone uses drugs, not literally everyone, but people of all shapes, sizes, colors, background, people use drugs, that's always been a part of you know, what humans do. And we can get in more into detail on the many, many ways that cultures throughout history have engaged in mind altering substances, including when you know, the foundations of Western civilization. And so I thought it was ridiculous. It made me really mad, I ended up going to law school ended up out of law school, working in cannabis, and then drug policy or form around psychedelics. And it was at that point, a couple years out of law school that I realized, oh my God, these policy initiatives trying to legalize psychedelics, and FDA clinical trials, all of this stuff is eventually going to like this stuff is gonna pass like this paradigm is happening. And there are no lawyers out there. There are only a few, but there are really no law firms that are focusing on what's going to happen. When these laws do change. And businesses are going to need legal counsel specific to psychedelic specific work. So I ended up founding a law firm called plant medicine Law Group. And our client base was, you know, psilocybin retreats in Jamaica, ketamine assisted therapy, clinics, MDMA, clinical trial, research sites, cannabis companies, things like that. And then a few years later, I ended up joining APA. This is like a year ago as the director of government affairs, and that's what I'm doing now. Alex 7:50 And how did APO start, Speaker 2 7:53 APA was founded by a group of practitioners in this space who realized that there was going to be, you know, as I think at the time, it was first envisioned MDMA and psilocybin had just been given granted a breakthrough therapy designation by the FDA and brief breakthrough therapy designation is basically the FDA saying, Wow, this is a new drug or treatment that has the potential to help help people help patients who are dealing with issues, indications, diseases, that for their, you know, often life threatening for which there is nothing else that really works. So we're going to fast track the process to approve them. So they still have to prove that they're safe and still have to prove that they're effective as all new drugs do. But we're recognizing like, this stuff really works. And let's all you know, get on board with making it happen. So once that happened, it was like, you know that it was the same realization I had when I decided to start a law firm, it was like game on, people had been fighting for decades to legalize access to MDMA and psilocybin into other psychedelics. And I think for a lot of people that moment, the breakthrough therapy designation period of time was like, Okay, now it's on and, and the FDA regulates the reg regulates medicine, right. So they kind of decide what isn't isn't legal. And what is what you can prescribe for certain indications on label, which is like a whole other conversation we can have, but they don't regulate the practice of medicine practice of medicine is usually regulated by the states and licensing boards. And so there's really no national organization, not in the government, not privately. That was that existed to represent practitioner interests and all of this, because, you know, when people think about psychedelic assisted therapy The likes. There's like psychedelic hyphen assisted therapy. And what comes after the hyphen is really important, right? Like, it's not just about the drug, it's also about the therapy. And in many ways, the therapy is the mechanism of action for the drug itself. So legalizing the drug is super great. Getting the approval for the drug is great. But without the therapy, does it work as medicine? Personally, I don't think so. I haven't had enough, you know, I don't have evidence to show that and I think, you know, it's therapy, it's facilitation, it's ceremony, but it's some sort of set and setting that is focused on healing. And so APA came to be as a result of people who were like, We really need to make sure that the hyphen assisted therapy piece is not lost in the sauce and not left up, you know, to just be regulated by default by the federal government or whatever. Alex 10:55 And there are certain guidelines that have been created. Can you talk about these guidelines? What are they, you know, how were they created? And, you know, why? Why do you think they're important? Speaker 2 11:09 Yeah, so we just yesterday published professional practice guidelines for psychedelic assisted therapy. So these guidelines are the first ever consensus based set of best practices for the field. And they're pretty amazing, not only because of what the final product is, which I think is going to, it's going to be very useful for people in trying to discern, you know, what's like, what is this new thing? Psychedelic assisted therapy? How do we understand it, but also, because of the process. Like I said, psychedelic assisted therapy has existed for a long time, we're not inventing anything, but didn't invent these guidelines, we instead facilitated a process, where we brought together a bunch of different experts who really know their stuff when it comes to the practice and the research and the training aspect of this work. And we said, okay, what are like the 12 main things that practitioners need to know about what psychedelic therapy is? And how to do it, generally. And then they had a lot of dialogue and a lot of debate and eventually reached consensus on what are those things? And how do we explain them? And what's the proper evidence to cite to justify that these are, in fact, the best practices. And I think that, you know, the process took longer, because we asked a lot of people. But what the results of that is, is, you know, it's, we feel that it's really credible, and there's buy in from the field, because people read these guidelines, and they see their ways of practicing represented in them, because we really put a lot of effort into ensuring that this isn't just one lens, this isn't just one voice. This is really the consensus of all different people with a diversity of experiences coming in to say, hey, this field is self regulating. It's not a free for all. Yes, there's a lot left to be discovered. But this is sort of the first step in showing to the rest of the world and the rest of the field of medicine, that there's something very legitimate going on here. Alex 13:26 And it is the intention to be a national kind of certifying body. Speaker 2 13:37 That's a great question. So APA is a national organization where the national we're the National Association for practitioners. So we have, you know, membership services and all what that entails. And then we also have the accreditation piece. So this parts a bit technical, and I'll try to make it really simple because it's not like terribly interesting for everyone. But basically, APA accredits training programs. Graduates of those training programs are eligible to sit for a certification exam. And if they pass it, then those individual practitioners are certified. So training programs get accredited by APA, and practitioners get certified and they're eligible to do so if they graduate from an APA accredited program. Alex 14:32 Got it. And for someone who wanted to become a psychedelic practitioner, I know first for so long. I haven't fully kept up to date with it. It seems to be such a rapidly changing space. But I remember just a year ago, I was talking to a friend who is you know, she's a certified psychiatrist and she has patients And, you know, I'm probably not using the right lingo, but she is, you know, she's a certified professional, and this is what she does. But she said she would lose her license if she, you know, ever. You know, there are certain regulations about a talking about psychedelics, you know, and she could, you know, use very strict wording, if someone came to her post a trip and said, you know, this was my experience helped me integrate, she could only have very strict guidelines of what she could say in that conversation. But she couldn't like recommend, you know, micro dosing or, you know, these things. And she wanted to get into psychedelic assisted therapy. But but she claimed, and this is a year ago, it's probably Chait change over the course of the year, but there wasn't any certifying body like there was there was no, it was all kind of programs that people were throwing together, but none of it was I'm not, I don't know what the correct term is. But it has this, how is this change over the course of the year? And if someone wanted to be become a psychedelic assisted therapist, what what's the current track that they can follow? Speaker 2 16:29 So that's a really good question. And I'll just brief disclaimer, this isn't legal advice. But I'll say there are definitely legal constraints when it comes to when it comes to practitioners working with patients and psychedelics right now. Because at this moment, in brief, ketamine is the only legal psychedelic to use in therapy. In Oregon, and in Colorado, psilocybin has been legalized for use in what is called regulated adult use. So it's, it's a system where you can go into a service center, get screened, do preparation, have a psilocybin administration session, and then you go back in for integration afterwards, you've got to be 21 years or older, the service center needs to be licensed, and you receive the services from a facilitator, the facilitator is not necessarily a therapist, and the services are not therapy, like it is explicitly, at least in Oregon, outside of what we call the medical model. So people can access supported services with you in conjunction with with psilocybin that way, but right now, it's only available in Oregon, it's not therapy. And you can, you know, your friend in this case, would just do a a training facilitator training that was licensed by the state of Oregon. And that would be that and then the same thing is going to be available in Colorado soon. But everywhere else, you know, at the national level, psilocybin, MDMA, every single psychedelic except for ketamine is still schedule one controlled substance, meaning that according to DEA, it has no currently accepted medical use. And it's totally restricted prohibited. You can use it for research, but it's really hard to get a research license under schedule one. So long, long story short, it's not legal, right? Like you can't prescribe to your patients, MDMA right now. You can't say, Hey, this is how you microdose you simply can't it's not that your license is going to get automatic, you know, they're not gonna hunt you down and find you and take away your license, but you certainly wouldn't be in compliance and you'd be breaking the law and there is a gray area there, right. Like I think there's there's legal precedent for practitioners to exercise their First Amendment rights to give their patients information. We saw this in cannabis with a case called Conant V. Walters, where the Court said basically DEA was going after doctors who were talking to their patients about cannabis and in some cases giving them recommendations for medical marijuana. And they were taking DEA was taking away their their registrations to prescribe other drugs. And the court said no grit you know, granted there's no system for doctors to prescribe cannabis which is also a schedule a controlled substance. You can I tell doctors what they can and can't say. Right? So again, the FDA doesn't regulate the practice of medicine. DEA doesn't regulate the practice of medicine, the practice of medicine is regulated by what best practices are, what's the standard of care? That's what APA is figuring out, and good clinical judgment. So I think that if you and again, not legal advice, but if you're a practitioner, and you have let's say, You're a therapist, and your patient comes in and says, Hey, I've been thinking a lot about doing an Ayahuasca ceremony. I wouldn't think that it was, I don't think it's good clinical judgment, to not know what Ayahuasca is, and to not know how to talk to your patient about it. And at this point, I think if we're talking about mushrooms, I mean, their use is so incredibly ubiquitous, to hear as a therapist, you know, an adult talking about using mushrooms, and the only place your brain can go is to this war on drugs, colonised mindset of like, Oh, my God, drug abuse, there's simply no precedent for that there's no legal precedent, there's no medical, you know, case to be made that just because something is illegal doesn't mean using it as a sign of drug abuse. So I think, you know, to my mind, even if you're not a psychedelic assisted therapists, best practices as just a clinician, you got to at least be educated on what this stuff is. And I would say, Yeah, for now, there is no official certification for psychedelic assisted therapy. But that's what we're working on creating, and we will have it ready, hopefully, in time for the FDA approvals. And that's the point at which, you know, therapists and psychiatrists will actually be able to provide these therapies to their patients. Alex 21:49 So once the DEA moves it off, you know, schedule, I don't know what schedule it is now. One, so once they move it off any schedule, and they approve it as a drug, then then an official certifying board can be created, right? Speaker 2 22:13 Something like that. So basically, what happens is, let's use psilocybin as an example. So right now, compass pathways is the drug sponsor that is taking their specific compound called comp 360, which is synthetic psilocybin, essentially, through an FDA clinical trial. So FDA clinical trials, for the most part consists of two things, you're proving safety, and then you're proving efficacy. So once you finish proving efficacy, you submit what's called a new drug application, and then the FDA reviews all of the data from your clinical trials, and they either approve the drug, or they don't. If psilocybin is approved by FDA as being as having efficacy, then the DEA has 90 days to review all of the information from FDA and decide, we are moving this down to schedule two or down to schedule three or down to schedule four, because a drug is only allowed to be in schedule one, if it has no accepted medical value. So once FDA says that it does DEA needs to say okay, let's put it somewhere else, and it becomes more accessible. And at that point, it's not that a certifying body can't exist before that because it exists, right? We're sort of all working on laying the groundwork so that once we have FDA approvals, not only can we start certifying people, we actually already have people trained and certified so we can hit the ground running and have a army of trained, well prepared practitioners to start to start using these therapies because we're in a mental health crisis. And we can't afford to wait, you know, we're already behind. We have like, just skyrocketing suicide rates. Depression has never been higher. You know, like, we have such a problem on our hands, opiate addiction. Teen mental health, I think, especially for young women, it's worse than it's ever been. So really what we're trying to do as APA and with our partners in the ecosystem, is like we're not working on drug drug approvals, or we're not working like directly with the FDA to move MDMA through clinical trials. We're trying to be like, alright, what can we do now? What can we chop up and prepare and saute in the kitchen so when the main course is ready, we can like throw everything on the table and have it be just like we're setting the table I guess is a better example. So when the food is ready We just played it, and people can start eating. But it's not like a mess. And it's not a food fight. It's all very organized. But it can happen efficiently because the world is I mean, for lack of a better term, just starving for some good mental health care. Alex 25:16 And cannabis is still a scheduled one. Right? Right. So it's probably going to take a while for mushrooms and MDMA and the rest. Speaker 2 25:27 Well, so that's a really, really good question. Um, and we could I mean, there's like varying layers of legal stuff that we could get into, but keeping it pretty high level, the main difference between cannabis and MDMA and psilocybin in terms of moving out of that schedule, one restrictive category is that and this gets into issues around patents and profitability. No one has, as of yet taken cannabis. Through FDA clinical, so let me take Alex 26:10 this, yeah, so it's different because with MDMA and psilocybin or compass 360, or whatever, it's gone. They're going through the clinical trials, where cannabis, no one did that. Speaker 2 26:23 Exactly. So people are saying on that for like, like, certain synthetic versions of CBD. You like it's been done, but in ways that are much more fractional. And there's also Yeah, so basically, like, you can change the Controlled Substances Act through an act of Congress. Or you can move something via like the agent, like via FDA. So they can also be done in the courts. But so far, nothing with cannabis has been successful. And no one's felt like it would be profitable enough for patent reasons to do a clinical trial, get it done. Alex 27:01 So question could it's called compass 360. Right? Pump 363 60. Say that goes through the trials gets in, it becomes an approved drug. Could you imagine a scenario where that is approved, but, you know, magic mushrooms as a whole, they're still schedule one. They're still criminalized, and they kind of have a it's kind of a loophole, right? So if you make a synthesized drug version, right with like, you know, genetically modified E. coli and you don't use actual mushrooms, and you know, you make it in a lot. You go through those clinical trials. Is that kind of the loophole. Do you do you imagine that scenario happening? Yes, that is such Speaker 2 27:48 a good question. That is an amazing question. So unfortunately, the way the Controlled Substances Act is written, and the way rescheduling works is that it's something called bifurcated rescheduling. So bifurcating bifurcated rescheduling essentially means that just because just because let's say, map says MDMA gets down scheduled, MDMA generally stays in schedule one, just because they'll comp 360 gets down scheduled, psilocybin generally stays in schedule. Schedule One, there's like a bill called the breakthrough therapies act that if it were passed, it would change this is language that would actually or at least for certain psychedelics, it would, we would change this. But in general, no. The only thing that gets moved down is the specific drug that went through clinical trials, which is redic. I mean, it's nonsense, but it is what it is. Alex 28:57 Yeah. And I'm sure they'd love that. More more money and exclusivity for them. So yeah, there's there's a lot of incentive by people that have a lot of money to keep that in place. Right. Right. And if it if it wasn't, you know, there wouldn't be it's a catch 22 because there wouldn't be incentive for people to spend. I can't even imagine how expensive it is to do the trials. There wouldn't be any incentive to put any money towards the trials, because you're kind of the martyr at that point. Unless, unless it's like, everyone pitches in a little money to do it collectively. But humans are a little greedy. So yeah, that's, that's complicated. That's, that's interesting. And I didn't realize it was the same for MDMA. Is there MDMA, like the chemical is a bit different, you know, because MDMA is just a chemical, right? It's just a compound. Speaker 2 29:58 So all right, so Oh, um, I'm not a patent attorney. And so I'm not great, like my understanding of this is is limited. So I'm kind of speaking at the very extreme of my expertise here. But the way I understand, and this is part of why Maps has hard time raising money and started off as a nonprofit, because they knew like they, you can't patent something that's not that's not novel, or that's based on something that already exists. And it was publicly available. So, PMA was invented by Merck, it was like then sort of revived famously by Alexander Sasha Shogun, for the DEA put it on schedule one. So people, so maps didn't invent MDMA. And in short, that's why they couldn't get good not get a patent on it. But they wanted to take it through this approval process nonetheless, out of altruism, honestly. Because, because why else? And I don't, I think I, I'm not sure the way they did it. But I think that they are going to have something called data exclusivity. I believe they'll have data exclusivity so that what they the data that they got from their trials won't be able to be used for other DMA trials for a certain number of years. And that's how they're going to like, basically get a return on their investment, so to speak. Right? It's a little bit complicated and technical. But no, they didn't cheat me, it's still just MDMA. Alex 31:35 That makes sense. And one thing that you said earlier, which I was curious about, you said that in Oregon, you're not allowed to call it therapy, and they're not therapists. Which is that because it's not an approved drug? Like therapy, is that technically practicing medicine? And if you include a controlled substance, therefore, it it conflicts, so you can't call it therapy? Because that's practicing medicine. Speaker 2 32:10 Yeah, that's so that's a really good question. So long story short, yes. That's, that's mainly the that's mainly the deal here. If so, I think it's easy to to understand it through hypotheticals. If I am a psychologist, and I want to I'm in Oregon, and let's say I could call it therapy. And I do the psilocybin process as contemplated under the Oregon program with a patient, then who's let's see, like, what agency would take action against me. Maybe the licensing board, but that's state regulated, that doesn't necessarily need to align with federal law. Maybe there's some issues with who I can bank with, because I'm doing something that violates federal law, maybe I run into certain tax issues, but none of that really ought to be specific to psychologists. The real problem is if I'm a psychiatrist, like, where do I get the medicine from? Actually, sorry, can we cut this part out? I just made that so much more confusing. Alex 33:24 Yeah, okay. Yeah. Speaker 2 33:25 Um, so I'll just say, Yeah, long story short, you get into more critical legal issues, if you call it therapy, because it then touches the practice of medicine. And there's a whole system that you would need to be in alignment with. That is not yet up to speed with Oregon State law, right. Like, it's, there's too many implications because of the Controlled Substances Act to really make that a workable system. I think that's part of why it's not therapy. I think the other reason is, I think there was an assumption that licensed practitioners wouldn't want to participate in that system because either they could get penalised by their licensing boards, or if they have DEA registrations, DEA could revoke those registrations, things like that. The other thing, which, you know, I don't know whether or not this this may be intentional, maybe it was not intentional. But I think that there was there is resistance to making therapy and making the like Western allopathic healthcare system, the only avenue by which people can access legal services, and I don't think that's necessarily wrong. We know psilocybin is an incredibly safe. I do I think people need to be screened. Yes. Do I think certain people, you know, it's less safe for those people? Absolutely. Will there be harms as a result of this This program, yes, there's no such thing as zero risk. And this, you know, there will be things that go wrong. But I don't think that psychedelics need to exist in like a tightly controlled system. They're not fentanyl, right, like, they're actually very safe. It's not like, you know, it's not chemo medication. So I think that, you know, setting the precedent that this should only be something that exists within a medical model, I don't actually agree with that people, indigenous people have been using mushrooms safely for you know, longer than the FDA or the DEA has been in existence. And we know that it's safe. Like we have more longitudinal data, even though it's anecdotal on the safety of mushrooms than we do of SSRIs, because they've just been used for longer. So I think that there's a lot of power and validity in breaking out of the medical model, it does just cause problems, because you can't make things covered by insurance. And then you have like a health equity and access issue, because this stuff in Oregon is super expensive. It's like $500 for a microdose. Literally. Alex 36:10 Yeah, it's It's nuts. Yeah. And even if even if they tried to keep it, you know, super airtight, it's so cheap and easy to grow. Yeah, like, anyway, and they're making just stupid, easy grow tech, like grow kits. Now, like, back when I like 10 years ago, when I first started into got into mushrooms, it was so hard to grow them, like, you had to look up, you know, Reddit forums, and there's all these complicated texts out there of people like throwing together weird stuff that you got at the store. Now, it's like you buy an all in one kit, and you don't have to do anything. And they just like, you have pounds like and you didn't even lift a finger. And so it's just stupidly easy for people to grow it. So cheap. So even even if, you know, people tried to make it super regulated, like, Yeah, you can't put a lid on it. For sure. Yeah, Speaker 2 37:11 totally. And like, nor should we. And I think that, you know, like I said, I think that there are certain people, certain patients specifically, that are really vulnerable. And they have complicated underlying conditions and comorbidities. And any new input that you introduce into their treatment plan is going to have is going to carry that much more risk. And so accessing these therapies, through a highly regulated medical framework, it makes perfect sense. And I think that that is like a public health. It is a public health thing, rightfully so. But for the vast majority of people, like they can just grow their own mushrooms and do mushrooms the way they want to, because like I said, they're not actually dangerous. And so I think, you know, the medical model, obviously, I'm in favor of it. And I think we should just decriminalize use of mushrooms, in the same way Colorado has in the same way Oregon has, and allow people to just use them as they want to because I don't think it's a public health risk. You know, I think it's insane that we would regulate these things any more than we would regulate alcohol or even like acupuncture. You know, it's just not that risky. And I think that the risk is more of like, leftover moral panic, and war on drugs thinking than anything based in any science I've ever seen. Alex 38:44 You know, this is so fascinating. To talk about all these regulations, I'm sure there's a ton of people listening that are like, yawning and they're like, oh, I don't care. But I think it's, you're blowing my mind right now. Because, you know, I have a functional mushroom company, and we're regulated by the FDA. And, you know, we used to say all these things about and we used to cite, you know, peer reviewed articles about the different mushrooms that we use and all these things, I'm talking about their benefits, and then you know, we kind of got a slap on the wrist from the FDA of like, you can't do that like you can't link scientific articles and like, I was like why? What do you mean like and at first you know, I was I was a little like taken aback but now it makes sense, the more I understand it, and about the Sharia compliance and you know the rules by the FDA, but and it is funny is about 910 years ago. I went to a college they had free therapy at the college was just cool. It was like, I don't know how many free sessions a month or something like that and And so I went into one, it was my first time and I microdose for it. And I told the guy, I was like, Yeah, I'm like, microdosing right now, and he got pissed. And he kicked me out. And he was like, and he was really angry. And like, I for you. It wasn't until, like, a minute ago that I like, for years, I was like, oh, man, what a dick. Like, he didn't, you know, and but now talking to you, it makes sense, because he probably could have lost his license. If anyone found out that like, he, you know, because, you know, whatever the rule was that he broke of, it would be like him. You know, being a therapist, like giving out mushrooms or whatever the role would be, but it makes me curious about, say, an Oregon, I don't know if you have this answer. But are they also restricted about the terminology that they can use? Like they can't, they can't bring in? Like, I don't even know if they can use the word client or, you know, patient, probably not patient. But, you know, someone comes in, can they say like, oh, let's let's talk about your depression today. Like, like, do they have to be very strict on on the verbiage that they use? Like they? Can they say treat? I'm guessing no, or like, they can't use medicine. They can't use all these buzzwords that maybe a traditional therapist could could use? Right? Speaker 2 41:33 Yeah. So I just, that's a good question. I just want to go back to something you said earlier about your experience in college, I would actually say your initial instinct was right, and your therapist was being sort of a dick. Alex 41:46 No, no, I mean, I, you know, I, I was being very entitled to do that. Like, you know, I shouldn't I shouldn't have put him in that position to be like, Yo, I'm doing some illegal stuff. Like, we're all cool. You know, like, yeah, it's kind of I was also being a bit on my part. So but Speaker 2 42:03 yeah, I mean, we were all Dixon College, let's be honest. But I do think that, you know, in some ways, it's like, I know, this isn't a one to one comparison. But let's say it's the, the 80s, or the 70s, or something where, like, being gay is still pathologized. And you go to your therapist, and you like, talk to them about, you know, some experience you had kissing someone of the same gender. And they're like, like, that's bad. Like, what are you doing? That's bad, instead of being like, oh, okay, interesting. Why are you doing that? Tell me more. You know, like, I think, this idea that this idea that practice should follow science only, and like research only as opposed to, like, the practice itself should inform what best practices are like, I think if you have people that are coming to you and your session saying, I want to talk about psychedelics, I want to talk about micro dosing, I do think that it's on you to at least educate yourself on it and not have like a fear response. Yeah. But yeah, back to your question. Yeah, there are, so they can't call it. There is like limitations about terminology, which I think is good. I think from a consumer protection standpoint, that makes sense. Like people need to know that, what they're getting, and have a really clear and deep understanding of the difference between services and therapy. So what they think they're getting and what they're actually getting a line. So I think that's part of the informed consent process, because you can't consent to something you don't know or understand. And, and at the same time, like if you're a therapist, and you're also a facilitator in Oregon, and you're told to not do therapy, I'm doing air quotes right now, you're still gonna do therapy? You're like, what are ya, you know? Alex 44:06 No, I'm just curious, like, like, who's gonna find out? You know, I don't, I don't think that the recessions are recorded. So, you know, the FDA is not watching every single thing and be like, Oh, you use medicine? Minute 22nd 30. You know, but I like, would you say that, that in Oregon that technically that their verbiage is regulated? Like what they can say and what they can't? Speaker 2 44:37 Um, yeah, so they can't, that's not something so the practice of medicine isn't it's not wouldn't be an FDA issue or really, or DEA issue. It's more of like the it's more like licensing boards that are giving the state at the state level Exactly. Alex 44:58 Weird that there's not an issue On a federal thing, medical practice. That's so strange. Yeah. Speaker 2 45:05 Um, yeah, it is strange. I don't know, actually, I'm curious what the history of that would be. There's also, I think that you could run into problems with your with, with boards, not so much like, I don't think the issue would be a therapist, like a licensed a licensed practitioner getting in trouble from their licensing authority, because of what they're what they're holding themselves out as I think the bigger problem would be like, someone who is not a therapist saying they are a therapist, because, like, in large part, these licenses exist as a gatekeeping mechanism to make sure consumers are getting what they think they're getting, and also to protect the investment, like, the time and the money, that people who did go to school and get the training in a particular area of expertise to protect that. Because, you know, if I go to law school, and I'm a lawyer, and then all of a sudden, anyone can practice law, even if they didn't go to law school, and they didn't take the bar exam, etc, etc, etc, then every my, the value of my title is diluted. So I think it's also some of that. Alex 46:29 Yeah. And that's only state laws. That's not a federal thing, like practicing law without a license, or in this case, practicing medicine without a license is that's only state regulation. That's why Speaker 2 46:43 I think so. I don't I don't know that there isn't any federal law that would you know, like, if you were doing that, and somebody wanted to file a lawsuit, I don't I don't exactly know that you could say it's strictly state. But in terms of the the agencies that are overseeing that the boards things like that, like those are state agency. Alex 47:13 Right, right. Right. That's complicated. Yeah. I mean, if it wasn't complicated enough, being scheduled one. That's yeah, it's a lot. It seems like a big gray area that, you know, I'm impressed by pioneers and people like you. And, you know, pretty much anyone in this field, trudging through this massive gray area. That it seems like a lot of people are against, and a lot of people are, you know, throwing tacks on the ground, making it very hard to travel forward. What would you say are kind of the main hurdles for this space progressing? Speaker 2 47:53 So I think there's two things, I think one, the whole issue of the only way you can get a drug Out Of Schedule One is by doing, at least in terms of like, getting it out of schedule one via FDA, is by researching it. But getting a schedule on research license is really hard and takes a ton of time and is super expensive. That's like this crazy Hall of Mirrors. Sort of, like death spiral, a situation where like, you want to get out of schedule one, so you need to research it, but because it's schedule one, it's nearly impossible to research. Like, that's insane to me. Alex 48:42 Do they make it hard for you? Yeah, totally. Why? Speaker 2 48:49 Because they're mean, no, because, you know, honestly, I think that like if we really broke it down as to why it's the Controlled Substances Act, Alex 49:00 it's not to uphold systems of oppression, is it? A way? Speaker 2 49:04 No, of course not. I think part of it is I think the Controlled Substances Act was created to hold systems of oppression. I think that the DEA and the FDA don't communicate with each other. And I think the breakthrough therapies designation was something that was created way after the schedule. One, that was the schedules were created, like the Controlled Substances Act has never been amended. So as FDA has moved forward, and we've learned more about, you know, we've created things like breakthrough therapies designation, the Controlled Substances Act has stayed the same. So like, even if you want to get even if a drug has a lot, you know, we know it's got potential, we want to move it out of schedule one, there effectively is nothing that's ever been changed to make that easier. So it's just it's just really difficult and really, really expensive. But I think actually, so I think that's I think that's like a really big problem. I think that the other thing, honestly, is that there's a lot of people working in this space who allegedly all want the same type of thing to happen, which is expanded access to these drugs, and medicines, who have such, like, tunnel vision on legalization and decriminalization happened in the way they think it ought to happen. And they are certain that they're right, which is the concept I've sort of just given up on, right, like, I don't know, the way this all supposed to unfold. I know, like what my principles are, and I know what feels like patently wrong to me, and I know how to, you know, show up as my best self or certainly try to. But I think that there are people who want to exert a high degree of control over outcome, and that causes a lot of conflict. And conflict is really resource intensive. And when you're in an ecosystem that is not yet revenue generating, it's just you're totally reliant on philanthropic dollars and investment. wasting resources is like such a deathwish. So, um, you know, it's just kind of like a lot of nonprofit industrial complex, bullshit, for lack of a better word, that's really I think, going to help kind of hold the field back. Unless people I don't know, do more mushrooms and become better at being humans. Alex 51:36 Yeah, yeah, it's hard. And I usually ask this for pretty much every guest that comes on. And it's like, what, what's the hardest part of their work? For you? Seems like everything is like this very hard. And all in all ways, it like dealing with the government is just, I mean, that sounds like pulling teeth, but then also just like, in in the community, you know, it is a it is kind of a stressful environment. Have everyone tried to make it under all these strict guidelines? And, you know, not It's not revenue generating yet. So it's, it's just, it's tough. But what what would you say is like, the hardest thing for you? And like, has there been a moment where you've wanted to give up? Or maybe it's something that's just like, not expected? That is the hardest part for you? If you had to pick, Speaker 2 52:33 yeah, so I think that people, this is kind of what I was talking about just a second ago. But, you know, I think that, like medicine work of all kinds. Part of why it's so effective is that it brings out this shadow, right? Like if you're doing if even just a recreational mushroom trip, right? Like, this is what people call quote, unquote, a bad trip sometimes like if it's not what you're anticipating or desiring if you resist against it, like dark stuff, hard stuff comes up. And if you go with that, and work through that, you can get a lot of insight and a lot of growth. And again, I don't think that that's a bad thing. I think it's a good thing. And then what I see at like, the organizational level is sort of there's, it's like a macrocosm of that same phenomenon, where the shadow really comes up and out, like people's things around power, and prestige, and money. Like it all feels like it's really being brought up and really amplified. And I've seen it, and it's a really, it's a really interesting thing. And it is hard, but I think it's also good because it's humbling. One of the commitments I made to myself a long time ago when I started doing this work, like, in the professional sense of the word was that, like, the number one client is the medicine, you know, whether it's psilocybin, or San Pedro or Iosco, like we are in service of these medicines I do at my core believes that they have some type of consciousness. I think Michael Pollan does a really good job illustrating what that is in Botany of Desire, where it's like, are we as humans exerting our will on these plants? Are there these plants exerting their will on us? And I think ultimately, it's a little bit of both. Like I think that there's just obviously there's so much intelligence in mushrooms, for example. And so, for me, I think the hardest part is like really surrendering into all of the muck that gets stirred up by doing this work and trusting the process and trusting the medicine and not getting ahead of the medicine and just remembering like, we're human beings. We're doing some thing no one's ever done before. And, and just to stay open and to stay very humble about all of that, because otherwise it is it's like too hard. Alex 55:13 Honestly, I'm picturing like, mushrooms having a conversation with the aliens in their in their UFO just like looking down at Planet Earth. And the mushrooms are like yeah, we we tried to make it really easy for them we just like popped up on the where we grew right out of the ground for them and like I don't like they made all these authoritarian systems of, of government and all these laws and everyone's fighting each other. Like there's just like, just pick pick us and Ito's like, you know, I just I feel like the aliens and the mushrooms are just having a field day like we're the trashiest reality TV show for them. Like we're really Speaker 2 55:53 Jersey Shore. Yeah, like where like real world planet Earth? No, you're 100 I think that's like exactly right. Um, we have overcomplicated things. That is our gift and curse as human beings it is. But it's like, yeah, it's the like, I remember, I don't remember where I was, but I think it was a conference. And like, there was there was like the exhibition hall of some psychedelic conference. And there was a booth with these. These like, really shiny bins for growing mushrooms in. And they just looked very space age and future free. And like I was like, this is cool. But like, you know, this grows in cash it right, like, right. Alex 56:43 Right. Exactly. Yeah, definitely. For sure. Yeah, I'm switching gears a little bit. What What would you say is the most rewarding part of part of this, this work that you do this space? Working with these medicines? Like what would what would you say? Keeps getting you out of bed and you know, yeah, keeps you feeling motivated and inspired and feeling like you're doing what you need to be doing. Speaker 2 57:17 Um, it's knowing that people are already and will continue to have better chances of living, meaningful, purposeful, fulfilling lives as a result of these these therapies and medicines and drugs. I think that, you know, Western allopathic medicine, in many circumstances is a miracle. And I think SSRIs work for a lot of people. And, you know, cognitive behavioral therapy works for a lot of people. But often, I think people who struggle with mental health are being like, it's almost like emotional, psycho spiritual life support, where you are just okay enough not to want to kill yourself, but you don't love life. And I, you know, I've been there and it's so sad. And it's so hard. And I think like, I don't know, I think sometimes I'm sitting on the subway and I look at people just like random people. And we're such, just, like, vulnerable, like, creatures, you know, like, we're all just still babies on the inside. On some level, even when we're adults, we all have that innocence and preciousness somewhere. And I think that, like when I stop and think about it, I just really hate that people have to suffer. And I am certain that these you know, psychedelics aren't a silver bullet. But I'm also certain that they are going to alleviate suffering for many people. And that's what makes all of this worth it to me. Alex 59:01 And if you had unlimited resources, unlimited money, unlimited team, unlimited time, what would you do? And why? Speaker 2 59:13 I'm, I would, gosh, a lot of things. The first thing that comes to mind, at least like APA specific, is have just a massive scholarship funds to get people really well trained in psychedelic assisted therapy. I would fund research and support services for effective harm reduction. And figure out a way actually, I would figure out a way to get every single person in this country housing and health care, because I think that as much As I believe in this medicine, and I really do, the idea that it's going to help you, if you don't have a home, and you don't have a way to deal with, like, your physical health is insane, and it's not going to work. And I think that, you know, everything's inter locking systems and like people who want to solve problems understand, like, we've all got to take our slice. But that's like a really big one that I think is is probably upstream of this work. And I think, I think that's where I'd start, and then I would get like a legion of amazing therapists trained. And then I would actually also this is a bit niche, but I would find a way to strip the FDA of their ability to require clinical trials, to force people to prove efficacy, for medicines, because I don't think FDA should do it, I think they should just deal with safety. And efficacy can be determined by doctors, because they're the ones that actually know what they're talking about. I don't know how we would do that maybe litigation. Alex 1:01:09 Interesting. Yeah, I, I really liked the point that you bring up of focusing beyond just psychedelics and, and into more holistic thinking. And even beyond therapy, which is, you know, it's a systems approach, if you don't have, you know, proper housing or whatever, I mean, we see this with addiction all the time, it's like, you can go through a whole program, you can go into, you know, a private retreat, where you're isolated from everything, and you can get sober and then the second year split back into your old, you know, neighborhood and, or your old place with your old friends or whatever, then you're right back into it. Right. And, yeah, and so it's, it's, you know, it could be the same as, with this, it's like, yeah, you can, you can have an amazing experience with with psilocybin, you could have the best therapy, but if your environment, that's what created the problem in the first place, and so you can, you can fix it as many times as you want. But if you're still in the, in the place in which created that problem in the first place, is just going to come right back. Totally, for most things, you know, and, and so I think that's, that's really important for people, it's a lot easier to look at this as like a magic bullet, and just, you know, pop a pill, let's talk for an hour then, like, it'll all go away. But, you know, fortunately, and unfortunately, it's a little more complex and not as, as with everything, yeah, which is important to have every, every single part of of this this system, you know, to work on all aspects and two major parts of that are access to the psychedelic for, for a lot of people, some some, for some people, the psychedelics are not for them. But then also really good therapy, and something that I was just talking with someone about is also, I don't know if this will happen, but most traumas for people happen in their youth in their childhood. And so addressing them as as fast as possible, I think is also incredibly important. You know, I don't I don't know where psychedelics fit into that. But I think it's also important, you know, as soon as possible, but this is all amazing work. Where can people follow you your work APA? If they want to get involved in any way? Speaker 2 1:03:52 Yeah, so um, I mean, any practitioner is welcome and encouraged to become a member. Our website is www dot a PPA dash us.org. And there's a membership signup link on there, of course. And, yeah, I mean, if people want to get in touch and ask questions, or talk about policy or anything, really, you can email me and we can chat. My email address is just my first name. Das ha da s at APA dash us.org. Alex 1:04:34 Amazing. And is there anything that we didn't talk about that you're like, for we, for we put a lid on it? Is there anything that you want to shout out talk about before we wrap it up? Speaker 2 1:04:46 I guess I would just say like, I think culture is poking just upstream of legal change. And I think legal change will always inherently be a bit more conservative than the cultural change. From which it stems. So I just I really appreciate you and all of your listeners for being a part of generating, like, tons of enthusiasm and hype and curiosity about mushrooms because I think that all of this stuff is what gives us the the encouragement, and the sort of like data to know Yeah, people care about this and it's worth dedicating your entire career to making it accessible to people. So I guess like, just keep going and keep being very curious. And thank you. Alex 1:05:39 You heard it here. Thank you everyone for for tuning in and trimming it wherever you're listening to, from from around the world. And you know, if you learn something in this episode or another one, or you're just generally hyped about this evolving space, tell a friend tell your tell your family tell a random person that you meet. Because the more that we're talking about it we can create a cultural revolution and and really a cultural revival into connecting deeper with nature plants, and really helping helping ourselves so so we can be better organisms on this planet and, and maybe the aliens will will reach out and say you pass the test. But yeah, again, thank you everyone. If you want to check out our site, if you want to support the show, go to mushroom revival.com. We have a whole line of functional mushroom products from gummies, tinctures, capsules, powders, we have free ebooks on there, a bunch of blogs, recipes, you name it, we have a giveaway going on the link is in the bio. So if you want to win some free goodies, and if you want to get anything, we have a VIP coupon code just for listeners of this show. It's called pod treat is the it's the code. And it's for surprise amount and we change it all the time so you can get lucky there and it just grateful for everyone tuning in for another episode. Looking forward to the next one. Much love and may the spores be with you Transcribed by https://otter.ai
