"Ketamine therapy saves lives!"

testing one to testing yeah we're good okay hey welcome to the Nick Stanley show today we're going to talk about ketamine therapy of course we are not giving any sort of medical advice or recommendations before using any molecules substances or medications you should absolutely talk to a licensed medical provider the conversation today is with Sam Mandel the co-founder and chief executive of of ketamine clinics Los Angeles and before we jump into this conversation I wanted to share a story a conversation that I had with Ty Barber at Belmont Shore Barber Shop an excellent place to get your haircut if you happen to live in the Long Beach area so little shout out to Belmont Shore barber shop he shared a very personal experience with me and I really appreciated it I told him about this episode that was about to come out on Kine therapy and he talked about his own ketamine therapeutic experience he was in a dark room with quiet music very peaceful made sure there would be no interruptions and he said he was transported to this gas station that was in this desert-like landscape a gas station from the 1950s it reminded him of something out of the video game fallout shelter and on the far side of the gas station was this tall old filing cabinet and he knew that inside of that filing cabinet were all of his memories and experiences from his entire life so he went over to the filing cabinet and opened a drawer and pulled out a file and in there he saw a good memory and when he would open the file he would be transported to that memory and the way he described it was that it wasn't just remembering bits and pieces he was really experiencing the entire episode again and after going through a few of those files he decided to pull out the bottom drawer and reach all the way into the back where there were some traumatic bad experiences and he went through those one by one by one and had a positive experience revisiting some very negative experiences from his past and I was fascinated by this because the research shows that for therapy resistant depression and therapy resistant PTSD caused by traumatic events what happens for patients who are undergoing ketamine therapy is that because of the Psychedelic effect of the molecule they are able to experience these traumatic events again and they feel good about them they don't feel threatened they don't feel that they're an imminent danger or harm and this is different from a normal memory because people with PTSD for those who follow the show uh you'll know my grandfather suffered from PTSD from World War I and so it's something that I have uh been interested in my entire life people who suffer from PTSD they actually re-trigger their PTSD when they think about those events and visit those memories in normal life and that's why they work so hard to Tamp those memories down and I shared this with Tai in how his experience lined up so well with the research uh to which he replied do you want me to use a buzzer or or scissors but the conversation continued while he cut my hair and we went really deep with it and I I just appreciated so much him opening up to me in that moment someone who I don't know well and sharing this deeply personal experience and so I wanted to share that with all of you in the hope that it might help someone else and so without further Ado here's my conversation with Sam Mandel you're really going to enjoy it it's a fascinating [Music] conversation let's jump right into it Sam you're the owner of ketamine Clinic Los Angeles KTLA uh been one of the first ketamine clinics in the country as I understand it it's been around for 14 years I want to ask about the Matthew Perry case because that's been a big deal in the news tell me what what really went down with Matthew Perry yeah you know it's uh first and foremost obviously a really sad situation um you know Mr Perry was struggling with mental health challenges with addiction for many years he was very vocal about that he shared a lot in his Memoir he talked in interviews he did work to advocate for people you know who are struggling because of his own journey and so it's obviously really sad what happened with him uh it's important that people understand that it has really virtually nothing to do with the therapeutic use of ketamine though and that's where I get a little bit frustrated and really want to try to help to educate people because of course the media loves to sensationalize things and they don't care much for nuanced reporting and kmian infusion therapy is a truly life-saving treatment it's a transformative treatment when it's used safely therapeutically ethically none of that was occurring in the case of of Mr Perry and you know with him he was taking more than 10 times the amount that we use in the clinic by himself in combination with buprenorphine and opioid and a benzo dipine lorazapam and he took these powerful three separate powerful sedatives in combination which is risky in and of itself alone in a hot tub and he became incapacitated and drowned so it just is such a far departure from how camine is actually used say you know therapeutically that it just there's no correlation whatsoever but despite that he did have a ketamine treatment a few weeks prior in a allegedly legitimate setting though I don't know where he went or if it was or not I don't know anything about that but the media reported that he had had a treatment and so then of course everyone goes and and but they go on to say well you know there's no there's no connection there or the you know the coroner said that that treatment couldn't have contributed to his death but they mention it so then everyone goes well wait a minute what happened and so he was getting treated but then this wasn't you know legitimate use and did the you know his ketamine this bad Dangerous Drug did he get addicted to it because it's this super addictive drug and it just brought on many many questions and concerns from people and I feel that it was really um was damaging frankly you know I mean we had patients who contacted us and said you know this is the only thing that ever helped my husband and I don't know if he should continue with this treatment I have an appointment next week I'm starting with you guys next week should I still come in I mean you know people were very fearful and really wondering I mean we got these kinds of emails which is it's just really sad you know there's a lot of people out there who are suffering they really badly need support this treatment is extremely effective it works 83% of the time in our clinic at at ketamine clinics Los Angeles and it's just a disservice you know it's a it's a huge disservice to people who are suffering to just get this kind of incomplete view of of what happened and I'll just add one more thing there's a lot of people myself included a lot of people I've spoken with uh you know Physicians and different people in the space who feel very strongly that if Mr Perry was in his bed for example and he still took the same combination of drugs in the same doses he would still be alive and that it's just simply the fact that he he passed out and and around and he was in this jacuzzi by himself um is what really ultimately was his end obviously combining these these medications and the way he did and taking such a high amount of kmine is not safe but even with that um there's there's a good reason to believe that he would still be with us if he wasn't in a Jacuzzi yeah now where was he getting his ketamine before we get into legitimate uses of it just to set the scene more for what was going on exactly with Matthew Perry yeah I mean I don't I don't know for sure other than just what the media has reported which is you know that he was seeing this woman the kmian queen who is you know this big supplier of Hollywood and Wealthy individuals and supplying all kinds of illicit substances including illegal ketamine uh a couple doctors and his assistant who were all involved uh again just based on what the media has reported on and that these people have been charged and some of them convicted in his his death as a a pretty elaborate network of you know obtaining ketamine illegally or funneling it from legitimate channels to illegitimate and bringing it to him for exorbitant prices and it's sad the people who you know were closest to him took advantage of him for their own you know mon monetary gain and uh gave him huge amounts uh many many large doses in a short period of time and it's it's a terrible situation he was obviously in a lot of pain he was suffering and he needed help and the people around him you know just saw it as an opportunity to get paid which is just really sad and um you know I feel badly for him and his friends and family and obviously many many fans all over the world really loved and adored him I think of course it's you know it's hardest for the people who really knew him personally and were really in his life so it's a sad situation I'm glad that at least there's charges and convictions of those who were involved and those people need to be held to account and I'm pass about talking about it and helping to make the distinctions for people between what happened in his situation and you know the safe and therapeutic use of ketamine infusion therapy because Kine is not a bad drug and anything that is used you know unethically or irresponsibly can cause harm no matter how great it is and ketamine's no different and I think it gets a bad rap there's a lot of stigma around it there's a lot of reasons why the media is you know reporting on it the way that they are and um I just want people to know well let's dive into that then on how do you use ketamine in your clinics how helpful is it for your patients in terms of treating their mental illness yeah I mean camine is absolutely life-saving I mean literally liaving for most of our patients we see a lot of moderate to severe treatment resistant depression PTSD complex PTSD anxiety suicidality I would say that suicidal thinking is pretty much prevalent in nearly all of our patients to one degree or another some of them from you know and it's a spectrum some from the end of the spectrum where they would never do it but they would be very happy if they didn't wake up the next day uh just kind of wishing that they weren't around to um those who actually have a a means and a plan and a timeline and they're very serious about actually taking action on it and so the more detailed and the more specific the more concerning in those cases when it comes to suicidal thinking and are obviously you know treated and addressed differently but I would say that nearly all of our patients have some degree of suicidality and ketamine stops that it reverses that within hours to days and a lot of people who are dealing with that even if the symptoms of their Depression start to come back they don't have a return of thoughts of self harm which is extremely valuable there's really no treatment out there there today that is a you know suicidality treatment it doesn't exist best case people take you know ssris to help with the depression or they take sedatives uh to just kind of you know sedate them a little bit but there there's nothing that actually gets the that thinking in the way that ketamine does uh we have an 83% success rate we were established in 2014 we were one of the first clinics in the country we've been providing you know ketamine infusions for mental health for nearly 11 years and in that time we've provided over 30,000 infusions so we have a lot of experience with this we have a lot of data that we've collected over that time uh there's been over 200 clinical studies conducted over 70 of them with results published and available online dozens of them peer reviewed so this is Way Beyond anecdotal this is Way Beyond a possibility this is a truly tried and true proven thing and for a wide variety of Mental Health conditions there really is nothing that works faster better safer than IV infusions of ketamine what is what would that be like if I came into the clinic and I'm having I'm I'm depressed and I'm having suicidal ideation what is that look like for me from the the moment I step in to getting one or multiple treatments yeah so if I could just take one step back and let me just tell people what ketamine is and then I want to get into that's a really great question that you ask what does it look like so before we talk about how we're using it I just want to clarify ketamine is an FDA approved anesthetic it's been around since synthesized in the 60s it was FDA approved in 1970 this is a very old medicine we've had for a long time and using it for mental health is a very new use I wouldn't say very but relative it's been researched for about 25 years it's been in practice for around 11 as long as we've been doing it so it's this anesthetic we're using it in subanesthetic Doses and in doses much lower than it would be used for Sedation for procedure and patients are conscious and awake the entire time it's also used in veterinary medicine so some of our listeners today might know of it is a horse tranquilizer or a cat tranquilizer and it is a drug that people use recreationally or to self-medicate with um or to abuse however you want to look at it and it's known as Special K So Special K ketam mean same thing it's also used as an analgesic as a pain reliever so in place of opioids in certain context so it's a very versatile drug it's ubiquitous it has a lot of different applications and of course different dose ranges different roots of administration uh different environments and settings that it's given in really dramatically change the effects and the impact of it and the experience of getting this this medication so the way that we're using it as a mental health treatment is IV infusions these lower doses people will have a series of six treatments over 2 to 3 weeks usually they'll come in twice a week or three times a week for a few weeks and the visit is about an hourong infusion and another hour with preparation and recovery so it's around a 2hour visit come in do paperwork this is after they're approved so first caller they're going to we're going to talk about what it is how it works answer questions they'll have a medical consultation determine that they're good fit approve them for treatment then they would come in fill out paperwork assessments mood assessments have a brief physical exam and then they brought back to a private room establish the intravenous use hospital grade monitoring equipment to monitor their their Vital Signs so you know pulse oxygen saturation EKG blood pressure and make them comfortable in a recliner uh it's a very comfortable recliner pillows blankets noise cancelling headphones sleep mask unlimited selection of relaxing music we have you know tons of albums that we've selected and then of course we also have Spotify and apple music so people can listen to essentially anything they want we really recommend something that's very calming relaxing without lyrics and they have the infusion which is about an hour and during that time there's two primary mechanisms of action one is the neurochemical effects going on in the brain of what's Happening happing which is vast and it's you know a whole Cascade of processes that are creating you know neurogenesis new neurop Pathways forming in the brain helping to disrupt these ruts of negative thinking and being that all of us are subject to some of us struggle with more than others but it it's kind of like a reset like a fresh slate an opportunity to really rebuild uh a new sense of of self and it feel very cleansing for people and then on the other side is the experiential component so ketamine is a psychedelic and it's got this ability to give people an objective view of themselves of their lives of their of their past and the patterns in their lives so there's a lot of insight there's a lot of learning there's a lot of healing that happens with that where patients especially if they have trauma which most people have some degree of trauma are able to revisit that trauma and process it in ways that can be very therapeutic without having an emotional reaction or emot feeling is triggered by it emotionally so they have this Clarity and you know the past is is set in stone it's never going to change but our stories around it can change and our understanding of what our role in the past was can can change at any time so people are able to gain forgiveness and forgiveness for themselves forgiveness for other people closure Insight understanding and then even for current issues in life today it's not all about the past of course I mean certain people things there's just this ability to to get that kind of clarity which is really really impactful for people and then of course in the days and weeks to follow is when the action comes in and using that healing and that insight and understanding to really Mak some of those meaningful changes in your life engage in talk therapy and optimize Lifestyles so you know healthy diet Fitness good sleep um healthy relationship with others these are things that we encourage people to really focus on to have the long-term benefits uh of the treatment now is there a therapeutic component when they're in your office or does that take place after the treatment yeah definitely I would say the whole thing is got a therapeutic component because ketamine is a really powerful medicine but it's not just about the ketamine it's about the ketamine plus the care so we deliver a very high level of care we don't provide actual like psychotherapy but there is a lot there is definitely a therapeutic component because we have you know many great licensed clinicians here there's a team of 15 in a 5,000 square foot office it's a multi-disciplinary team so we have psychiatrists psychiatric nurse practitioners registered nurses and then admins all working together to deliver a really high level of care and so the usually like the psych NP and the nurses are going to really help patients to prepare for the experience go over any questions concerns help them to relax you know set intention we're utilizing really cool VR technology actually for Preparation so people that's designed for psychedelic experiences so people are able to do things like breathing exercises mindfulness body scans you know setting intention to really get calm and centered and clear before they go into the experience because the mindset that you have prior is is absolutely critical and so there's a lot of nurturing and support and preparing for it during it of course we're monitoring the whole time if people are having any sort of concerns or challenging experience or they just want to feel supported we're there to make sure they're comfortable and and safe the entire time and then afterwards there's a kind of debriefing that happens where the nurses usually will give space for them to share if they want to and of course there's never pressure to what their experience was like how they're feeling if they want to talk about that but I do make the distinction that it's not actual Psychotherapy and that's really better done in the days to follow because people are typically pretty exhausted and pretty out of it still after the treatment and it's not a great time to try to communicate it's can be hard to put things into words so it's a time to journal to rest to heal reflect and then you have some things that you might like to share some insights or to discuss with someone and who better than than a therapist who most of our patients already have a relationship with who knows them who knows their history and then can really help to uh unpack that and that's where the integration step happens on taking these experiences that you had or reframing of past experiences and integrating that into life going forward definitely and I would say our our entire medical team is trained in preparation and integration we do offer integration as a standalone service and increasingly are doing that on separate days outside of the infusion days for clients um though most of the time we're encouraging them to work through a therapist because those that work can be more in-depth longer term and really better suited for for someone again who has more of established history with with the patient but if they don't have that we can either refer out or we can have those sessions um with with our team okay now to change gears slightly here the DEA recently made a comparison out the a ketamine epidemic and compared it to the opioid epidemic which most people are much more familiar with the massive issues across the country over the last 10 years with opioids um and what was your reaction when you heard that well I had to wonder who's writing this material because it's quite funny it should probably work work for a uh you know on a comedy show or something like that um it's just really mindboggling to try to understand how anyone could possibly draw that parallel um without some sort of an ulterior motive in that it's totally false I mean there's no that statistically doesn't make sense so there's nearly 100,000 deaths every year related to the opioid epidemic opioid is an addictive drug it has uh can create physical dependency for people to feel sick if they don't take it um they often will take it not to just feel good or get high anymore but just to Stave off the withdrawal symptoms so not even enjoying it they're taking it just to prevent themselves from feeling lousy that's a that's a powerful drug That's A Dangerous Drug it's easy to overdose and and to die on it um it can kill you a lot of people are like I said over almost a 100,000 every year in the United States alone ketamine on the other hand does not create a physical dependency it is not physically addictive it has a extremely high therapeutic index it is actually there is no known lethal dose of ketamine if you take it in a bad environment or in an unsafe environment and you're driving a car or something or you're in a Jacuzzi yes you can absolutely have a bad outcome but there's not actually any known lethal dose of camine if people take very high doses and they're in a safe place they will likely go to sleep and wake up later um there have been with through there was a meta analysis of cemine related deaths and there were around 140 total 140 okay and is that in the last year or just ever ever that could be found okay outside of a there was Zero found in a CL IAL setting zero deaths C I mean in a clinical setting among those that were reported outside of clinical settings there's around 140 nearly all of them involve the combination of other powerful drugs almost none of them were just Kine by itself and so here you have like all time what we can find ever is like around 140 deaths and then for ketamine and then for opioids we have nearly 100,000 every single year year after year it doesn't make any sense at all no it doesn't I mean and I know a little bit from talking to our uh mutual friend Brad Burge who's been on the show before talking about psychedelic therapies and that there are some concerns about ketamine now being sold online in a non therapeutic setting and that it's there's a version now that you can inhale instead of having to inject it which makes it a lot easier and there's some growing dependency when people are taking it out again I want to really emphasize outside of a therapeutic setting with doctors administering it um but it is a ridiculous comparison it feels like a very waron drugs comparison when the ketamine issue is compared to the op opioid I don't know why I having trouble with that word the op opioid epidemic uh because just like you said I mean it it almost lessens the real tragedy of what has happened with opioids cuz we are talking 100,000 people a year I mean the numbers are still staggeringly high uh with everyone with everything that's been done to try to saave off that epidemic and ketamine it's a different type of issue and it's not really doing anybody a service to compare the two like they are the same thing absolutely like you said it's I mean you bring up a lot of great points you know it's a disservice to those who are struggling with the opioid epidemic and the impacts of that and it also really creates I think unnecessary fear and concern around ketamine and a uh increased scrutiny of ketamine when it is such a powerful medicine for healing and for good and has a lot of you know advantages and important differences between it and opioids and it's and its ability to help people and as well as the negative impact and I don't mean to say that it's you know that no one's ever had a problem with it I mean obviously we look at what happen with with Matthew Perry and that's a terrible situation people do end up using ketamine you know irresponsibly people end up with uh becoming depending on it in the in the way that they would be dependent on anything that they're using as a means of Escape though that's the distinction that I make and you can become dependent upon chocolate uh or Donuts or sex or video games you know these are things that can be uh Ed to avoid life or to hide out or for pleasure that you can do in extremes and be very healthy with uh but it just does it's not in the same category as something that you're like if I don't take this today I'm going to feel physically ill you know it's just not in the same group uh but yes people do use ketamine to dissociate to kind of you know disappear detach from reality and some people have a problem with it absolutely um but it's nothing even it's not even a tiny you know Splinter of what it is for opioids that's that's for sure and your point about um more looser prescribing or other forms of ketamine is also a great one and I'm glad you brought that up because there are a lot more companies who are selling ketamine online in the mail a lot of trokies or lenes that people take at home and they're really playing fast and loose with it you know they're not really adequately screening people they're sending them ketamine not knowing really much of anything about them for them to take it home unsupervised and it it is a safe medicine when it's used respons responsibly but it's a powerful medicine and it is concerning for so many people who maybe don't recognize it or understand its potential or how to safely use it and especially when they're using it in an unmonitored environment it poses real risks absolutely well I would have no idea what sort of dosage if I were because I did find in doing a little research for this episode it was once I started looking on Instagram started searching ketamine accounts it was really easy to get onto an account and you can within 30 minutes you can be online with someone and the screening process is not super thorough you can have ketamine shipped to you basically within 24 hours it will be on the way and yeah they give some guidelines but it seems to be a a money grab and really not doing something that's in the best interest of patients when you're just going to go hey go ahead take this and then we'll schedule a zoom call uh whenever you feel like it if and when you feel like it afterwards um it just seemed like a way to get the substance as opposed to really trying to help people and I think what you guys are doing is the the right way where they come into a clinic they're in a supervised environment and you've got all these other pieces around it for people who really do need help um because something that gets lost in the shuffle with a lot of this is the incredible efficacy of ketamine um and for different people it might be uh supervised psilocybin it might be supervised MDMA um but when we muddy the waters with this extreme talk it makes it harder for people that are trying to use these in a legitimate therapeutic way to get access to the to these substances yeah absolutely I mean we have to have Nuance we have to have conversations that are you know informed and u based in fact in science and that are not just emotional you know just because you know somebody who took too much acid in high school and had a total freak out or you think you're you know your buddy was never the same after some crazy trip he had as a kid doesn't mean that psychedelics are these you know demonic substances you know and the reality is there's a tremendous amount of scientific data and literature and a tremendous amount of anecdotal evidence as well that shows that these substances again when they're used responsibly the right mindset and in the right environment can be hugely transformative and healing and therapeutic and like with anything that's powerful they also have the potential to cause harm when they aren't used responsibly sure well I think you hit the nail on the head there when you said we need to have a nuanced dialogue about this topic and it seems to be an issue across Society right now on all kinds of topics I mean it is everything every topic huh is there anything we're talking about in way yeah yeah right right along those lines let's dive just a little bit deeper how's it different in a setting like yours what are the practices in place to make sure that these substances are used in a way that's going to have a net POS POS on the user over the long term yeah you know it's really about not just the ketamine but the ketamine and the care and where you go and how you receive it is hugely important and we have a wonderful team multi-disciplinary team of licensed clinicians who are collaborative and really compassionate and very knowledgeable and experienced with this medicine and really want to help people and that that matters a lot um our facility is accredited by qua a as an ASC it's essentially uh a surgery center in terms of the standards that it that it meets and we are the only cian Clinic that holds that accreditation so what that means is additional training of Staff in their uh safety and understanding of this medicine such as ACLS BLS um moderate sedation training from the American Society of anesthesiologists they're all preparation and integration train and psychedelics so we go way above and beyond in the training of our team and in selecting people who have a deep experience in using this medicine and then the physical office itself is actually built in designed for safety as well so we have the supplies and the equipment to go along with all of that training such as a crash cart oxygen defibrillator we're equipped to handle really any kind of a situation here and you know fortunately knock on wood we've had no bad outcomes that we've needed to deal with but we have all of the supplies and equipment in the training so people are extreme safe in an environment like this and again I want to reiterate ketamine is a very safe medicine when it's used responsibly but we don't leave any you know any vulnerabilities there in terms of our processes and that all goes a very long way I want to also clarify that just because someone's getting camine in an office at a camine clinic such as an IV infusion does not mean that all of that is is a given as a matter of fact I don't know of any other clinics that have the level of rigor in their stand standards that we have so there's an important distinction between unsupervised atome ketamine and ketamine given in an office by clinicians those are two totally different categories but then to go into more Nuance among the IV clinics among clinics that are administering it in person there's also great variability in the quality of care and in the kinds of approaches for example some places are providing IM injections and IM injection muscular is a different experience and process than an IV infusion and has different safety and efficacy considerations IV is the gold standard it is what over 90% of the literature is about it has a lot of nuanced advantages in terms of how to control the experience reproducibility of the experience for safety how to adjust up or down in the rate of infusion so people can go deeper into the experience or have come out of it a little bit and a whole slew of other things we could talk into more detail about if you'd like but I don't want to get you know too into the weeds but my point is just that there's differences among the roots of administration there's differences among out of office and in office and even within in office there are different methods and approaches and and and structures set up and we feel very strongly that a private room accredited facility a multi-disciplinary team and really compassionate people are are some of the core aspects of doing this in what we would consider the right way and you and your father are the co-founders is that correct yes we I I co-founded the practice with my father Dr Steven mandal and uh we are proud to remain family-owned and operated today fantastic can you give me a little bit more detail on your background your father's background because one of the things I have learned in this process is that YouTube is now very sensitive to discussing these topics and it is from talking to some of the representatives at YouTube it's very important to explicitly State the credentials of who is speaking about therapies and drugs that are in some settings illegal and sometimes the algorithm can't quite figure out who's sending who's talking to someone who's just making this up and selling ketamine illegally out of their garage and who is a physician and doing it in the proper way so if you could just speak to your background a littleit bit just to make sure the algorithm doesn't censor this conversation that would be fantastic yeah absolutely yeah so my my father is a um board certified anesthesiologist and he also has a master's degree in Psychology he actually did everything towards his uh PhD in Clinical Psychology except for his dissertation when he decided to go to medical school and become an anesthesiologist so he kind of a unique dual background there having a Master's in psychology and then being an anesthesia physiologist so he maintained a personal and a professional interest in mental health and worked in a wide variety of uh anesthesia departments outpatient clinics hospitals he did mobile anesthesia Dental Suites you name it and with that it you know is an expert using ketamine has been using ketamine for 40 years and so when it was discovered with the early research in the early 2000s that this old anesthetic that he could use use very comfortably confidently was found to be effective for depression and PTSD and other mental health conditions it was like the perfect marriage of his two worlds and it was very exciting and we decided to start the practice together when he shared this information with me and we started looking at the early research and it was very positive and some of our early patients had just nothing short of miraculous results and we just went for it we said this is too special not to share and make available to people as far as for me I'm I'm the CEO I'm more on the business side I'm not a clinician um my background in terms of speaking about this is just pioneering this work for almost 11 years and really dedicating my life to it for the last 11 years and building the practice from scratch you know when we started there was no blueprint to follow there was no one really doing this that we could look to to see how it goes so we just had to figure it out on our own there was some good data in terms of early clinical research to look at of how we would establish clinical protocol and then my father really continued to Pioneer that and expand upon it with his own background but as far as how to create a um a service that we could make available to people with this it was like we just really had to kind of figure it out and so that's what what I did and um it's been quite a journey I mean when I was 12 years old I volunteered for teen line which is still around today it's a teen to teen suicide prevention line and I took calls from kids in crisis a few days a week after school so that was my early training I guess and uh in mental health and it had an impact on me and as I grew up I had different experiences um primarily challenges and uh loss of loved ones of friends of family that I lost to Suicide I lost to addiction um and my own struggles and so mental health and even today I have you know people I love very much who are really struggling greatly so it just is a personal issue for me it's something I'm passionate about it's something I've been around and I've had to deal with since I was really young so uh that's really driven me to want to make a difference to be able to offer a solution that is effective that works and to create an environment where people can get that with genuine care and concern for them that I've just found shockingly frankly yeah well this issue is important to me any of these alternative treatments to depression and suicide because my grandfather suffered from PTSD as a result of World War II and was not able ever to find an effective treatment during his lifetime tried to solve it with alcohol throughout his years and that was absolutely not uh an effective treatment and I think if things like this had been available he was an open-minded individual who would have explored it and I would have I would like to think uh it would have been very beneficial to someone like him and often times in the culture wars of using substances that either used to be illegal or they are restrained in society to one level or another it starts come down to well are you are you pro- drugs are you anti-drugs and I think what gets lost is we have a lot of people who are suffering out there in to various degrees of mental health challenges but when somebody's feeling suicidal we're dealing with a very someone in need of some serious treatment and I think anything that can help these people is something that at the very least we need to explore and support places that are doing it in the right way like your organization I was just wondering if you could speak to a minute uh for a minute here on what you think the future of some of these treatments looks like where might the FDA and the DEA go with some of this stuff what does the climate look like now um yeah what do things look like moving forward yeah thank you for sharing that by the way I'm sorry to hear that about your grandfather and it's uh it's too common that people are not getting solutions that work for them even today um you know mental health has not progressed mental health care I should say has not progressed in the way that some other areas of medicine have and uh it's finally starting to get some momentum behind it in terms of because the need is so great and it's been increasing you know for so long that at a necessity there's finally some Innovation that's happening where where do I think we're going I mean you know with FDA unfortunately rejected the approval of MDMA assisted Psychotherapy um a few months ago in August I think on August 11th or 12th or something like that and that was surprising and disappointing I think I was really expecting it would be approved I know a lot of people were Rick doblin and Maps you know Rick's been working on this his entire life literally 38 years uh very promising results from their studies their second phase three trial I think there were a lot of issues with with the way that they did things but I also think that it was not a very reasonable assessment on the part of the panel advisory panel in the FDA and that their infrastructure is not really established to approve a medicine like this especially in the way that it was submitted without getting into too much detail though about that situation to answer the question you asked which is what what do I think is to come well I think that MDMA will be approved it's not a matter of if but when and that will be a breakthrough therapy for PTSD it's going to be hard with how long MDMA lasts and with the level of required Psychotherapy to see that scale and it's going to be also hard to see how insurance companies are going to pay a rate that enables people to get it and those are concerns I have about access and scalability but I think you know MDMA will become available as psilocybin will get approved there will be psilocybin therapy I think the two issues two or three issues I just mentioned will be the same for that it's a longer lasting uh experience you know the trip if you will can be 4 hours with a taper off of like recovery I mean that can be a six plus hour ordeal easily so having Li you know licensed therapists and the amount of time space that's required training and then is insurance going to cover it and if so are they going to pay a rate that can allow for a decent clinician and a decent environment for people so these are some of the issues but uh I do think we're going to see a lot more psychedelics getting approved and psychedelic therapies starting with MDMA probably then psilocybin I think the others to follow suit there's many psychedelics out there I think virtually all of them have the potential to get approved for at least some clinical use you know LSD or acid um ioan or iboga there's you know some pretty amazing stuff being done with that in addiction uh in a variety of conditions as well in you know Mexico and other places in the world and uh there's just so so many others and then there's these newer class of you know synthetic psychedelics that are being engineered by big pharmaceutical companies who are racing to come out with the the latest and greatest novel compound and it'll be interesting to see what happens with those I hope some of them will help people I'm a little cynical I think that a lot of them are also approaching this work in a pretty weird way um you know their idea of trying to solve for some of my concerns about how long the Psychedelic trips are is to get rid of the trip part and to say okay well we're going to make a drug that acts on the brain in a similar way but it doesn't create a psychedelic effect well that psychedelic effect is in my opinion an absolutely essential part of the therapeutic component and so while you could create a drug that affects the brain similarly and probably get some good results there's no question in my mind that you can't get that the the Psychedelic experience is not some sort of negative side effect to get rid of it's an essential part of the therapeutic results that you're getting and so it'll be interesting to see uh what happens you know and of course there's concerns about the commercialization of psychedelics how these companies are going to be exploitive in the way that they go about it and you know I think we've already seen with maps I mean I believe that if it was a different um you know company who put up the NDA you know the the the new drug application other than Maps like if it was uh you know fizer for example I think it would have been approved so you know I think we're going to see some favoritism here among who's got the connections the power the money to go ahead and get their drug paid for and approved when uh the newer you know independent guys who are you know trying to make a meaningful difference are getting brushed to the side so those a lot of politics that play here unfortunately you know Healthcare in the United States is not about health or care it's about money and control and I think people are waking up to that you know and I can just hope that with through that there'll be people who are able to navigate that system and still get progress made to help people but it's definitely a hugely uphill battle Yeah and for anyone for anyone who's listening uh maps that we have referenced several times is the multi uh what is the acronym multi it's the multidisiplinary associ ation for psychedelic studies there we go there we go and a lot of people over there are trying that have really good intentions trying to do good work yeah in this space yeah and by the way now it's m I was just going to clarify sorry that the maps is you know create is a nonprofit organization advocating for psychedelics they created the maps PB um PBC or was like a public benefit Corporation to lead This research which was recently turned into lyos Therapeutics so it's actually now lyos l y KO s okay who is pushing to try to get MDMA which for those who don't know also is like the active ingredient in ecstasy you know AKA Molly I mean that's what it is and that again just like with ketamine you can use it and go party and have a great time or party and have a bad time or you can use it with Psychotherapy in a specific measured way and have huge breakthroughs so set setting mindset and setting that you use it but lyos Therapeutics is a company that's in charge now of really trying to push that through the FDA for approval yeah and it it is concerning to on your other point with the insurance companies if it had been fizer that put forth the new drug application they probably would have been approved and there's little incentive for them to do something like that because these substances that have been around for a very very long time they can't easily monetize them and so the incentives are a bit perverse to come up with a new engineered substance that is very similar but it's one that they can patent and then make money off of for a long time to come and just like you said that's not putting the Patient First and the people who need these substances first yeah and I mean these big pharmaceutical companies are actively opposing the addition of other molecules because they eat into their bottom line they take away from their profits they want you to take the your your cakil and your paxel and your Welbutrin and take it every single day and never get healed and never die just take it every day forever that's the that's the golden model for them and these psychedelics actually have the ability to cause lasting you know remission really meaningful transformation to really heal people the results are absolutely incredible I mean people who have had lifelong struggles with a wide variety of conditions can have one or just two experiences and be totally healed of their issues I mean that is like it's it's incredible and you know again unfortunately the bigger pharmaceutical companies out there they they don't like that and unless they're going to own something that is going to you know be similar and they're going to get paid on it then they want to tell the FDA and the DEA and all friends these are not good things and don't don't do that well yeah and as I have come to learn I I started it all started for me with the watching the series dopesick on Hulu which was a great show on the opioid epidemic and then that led to reading and Research into this the FDA often as I understand it now employs a lot of people that either are former or future Executives Within These pharmaceutical companies and often functions as an enforcement arm for these huge pharmaceutical companies so when they want if there's a new substance coming along a new molecule or an old molecule that might disrupt their business model which as you uh pointed towards any sort of a SSRI or or some of those drugs that that you mentioned where there is no end point with it it's like hey if you take this pill and pay us monthly for the rest of your life they're going to shut that down anything that is disruptive to that model and I think it what we need are conversations like this to raise awareness of what's actually going on we can't change any sort of situation until we see it for what it is first and then to get people to speak out as a group uh especially those who who are in need of treatments and therapies like this or have family members that are in need of treatments and therapies like this um to push these agencies to do the right thing and not necessarily give the benefit of the doubt to these pharmaceutical companies that may not have patients best interest at heart yeah you know it's you hit the nail on the head I mean we got have these conversations people have to be aware I think people are starting to wake up there is a revolving door between these Federal Regulatory Agencies like the DEA and the FDA and the pharmaceutical companies and they're constantly having people just go around and around I mean somebody who's you know high up in the FDA big Pharma says o we want that one that person's got the knowledge and experience and connections relationships the inner workings of the FDA they're perfect to afford our agenda we're going to give them you know double their salary and and bring them on great benefits package stock you name it right bring them in great that person's happy to jump and then they'll work there for 2 3 4 5 seven years however long and FDA is like oh cool this is you know this is a good person to have an our organization because they know what's going on really at fizer and they can help us make some great Headway you know and so and again I don't have anything personally against fizer as a company I think all these pharmaceutical companies have are are open open themselves up to quite a bit of scrutiny I'm just using them as an example but there I don't think any of them have uh have clean hands to say the least uh but uh yeah and then so these people just go back and forth you know or even even a big Pharma company says we want this person now to go back to that organization we want to try to help them get H there because then we got someone on the inside there a lot of games being played here um so I just yeah uh people got to know that that's the reality of what we're dealing with well and we learned in no uncertain terms in 20072 2008 with the banking financial crisis what happens when when the regulatory agencies are captured by the industries that they're supposed to be regulating it's not good for the average citizen it's not good for anybody right I mean at a certain point it's the average citizen pays the most in the short term but everybody pays in the long term the whole country and the whole world CU you have full-on collapses of massive systems it affects everybody I mean you said it very articulately yeah where where can people go if they've they're interested in these issues they want to help support these movements towards uh real health care that's about health and care of patients with people like you uh with organizations like lyos um where where are some spots that they can go to just help these movements learn more about it and all that good stuff yeah I mean I think definitely to listen to shows like yours to share this episode with someone they care for to engage more in learning in Reading watching you know documentaries uh Maps is a great organization uh very active I would say they are the leading organization in this uh area so you can just go to their website I have no direct affiliation with them just a fan you you can learn more about them what they're up to I'm sure there's opportunities to get involved there um my company is is a great place to just learn more about ketamine and other innovative solutions to mental health if there's somebody who's suffering camine is the only legally available psychedelic today so if this is an area of interest and people want to get treatment through a legitimate means for themsel or someone they care for camine clinics.com is a great place to go um they can call us we offer free consultations happy to talk with anyone any time and and just uh help to you know educate and inform and there are a lot of other nonprofits that are doing advocacy work in a variety of areas whether it's the decriminalization of the war on drugs and trying to you know put an end to the War on Drugs to moving forward with psychedelic science and research um all kinds of stuff really um but I would say definitely just learning and engaging in the conversation and you know when next time somebody around you wants to just make some blanket statement demonizing all drugs as as you know tools of the devil you know maybe you can tell them a little bit about why that's not actually actually the whole story yes absolutely uh and ketamine clinics.com that's your website yes yeah k t m i n c l i n i CS ketamine clinics.com uh lots of great information on there um about uh not only cemine but also trans cranial magnetic stimulation or TMS General psychiatry evals Med management um variety of of services that we offer for uh a variety of mental health conditions as well excellent well Sam thank you so much for your time today this was uh thought-provoking and fascinating and I really appreciate your time I appreciate yours Nick and you having this show and creating a platform for people to have you know engaging conversation and just to inform your listeners on on the latest topics that's uh I commend you for that it's really important that people are just aware and have the opportunity to know what's going on yes I mean mental health and wellness it's a topic that I'm very passionate about so I'm sure it's one it's an issue that we're going to keep coming back to uh every so often throughout the show and and bringing on people like you to help educate us around these issues yeah thank you again Sam and um we'll we'll talk again soon sounds good thanks Nick okay everybody until next time ask questions don't accept the status quo and be curious [Music] [Music]