On this episode, Mike, Melissa, and Morgan explore how psychedelics are being studied as a treatment for conditions like depression, PTSD, and addiction. They discuss the promise of psychedelic therapy, the importance of medical supervision, and why these treatments should be part of a broader mental health plan. The conversation also highlights the risks of using psychedelics without professional guidance.

Resources & Links:

Website: JAMA Psychiatry (Article: Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder)

Website: Nature Medicine (Article: MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study)

Website: eClinical Medicine (Article: Ketamine for the treatment of major depression: a systematic review and meta-analysis)

Website: Psymposia (Article: How Silicon Valley Used Veterans to Hijack the Psychedelic Industry)

Website: Chacruna (Institute for Psychedelic Plant Medicines)

Search: The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma

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Welcome to A Psycho Delicious Conversation on mental health issues and trends from three local mental health professionals in the greater Lansing area. I'm Michael Stratton, LMSW. And I'm Morgan Bowen, PMHNP. And I'm Melissa Black, PMHNP. And we're here to provide you with a deep dive into the human experience of consciousness and beyond. Our aim is to be educational and entertaining, so just kick back and open your ears and your minds.

Hello, I am Michael Stratton.

I'm Melissa Black.

And I'm Morgan Bowen,

Daedlian Lowry, producer.

And this is part two of our work on psychedelics. And Morgan introduced this topic and. Take it away, Morgan. What are we talking about?

Well, today we are doing part two, so if you have not listened to part one, we suggest you do that. But today let's focus a bit more on the clinical application of psychedelics.

In part one, we kind of explored, sort of introduce psychedelics, what they are, how we have used them in our lives and how one of us did not. Morgan. Well, you can't, you know, can't divulge all your secrets on a podcast, but that's what editing is for. Right.

But so we are all clinicians, so we have, we don't prescribe or we don't use psychedelics in our own practice or disseminate them, but we do, I think probably all of us have patients that have used them clinically for specific clinical purposes. So. Well, let's talk about that. So what kind of experiences or reasons have your patients that you have worked with who have used psychedelics?

What is the reason that they've done them?

One of, I mean, treatment resistant depression for sure. That and ketamine, I know we talked, really isn't a psychedelic, it's a dissociative.

But I have some very interesting stories of what types of agencies are out there that are providing ketamine to people with no oversight or like coordination with me as their other medical provider at all, that's been a concern. But also the alcohol use disorder, addiction, ptsd, that's what I've had more folks go to the psilocybin for.

Interesting. Yeah. And what about you, Mike?

Well, the first time I heard, and again, it was ketamine before any strict psychedelics, but it was somebody who had a really profound reaction to it. They went to Grand Rapids and they got hooked up to an IV and over the course of several weeks did doses of it.

And this person was really depressed, had done a lot of therapy, a lot of therapy where they had A lot of breakthroughs and understood themselves a lot better and were more accepting, but still had a level of depression that was almost debilitating.

And at the end of it, they described this process where they would have these thoughts in the first session, these anxious thoughts, but then they'd have another thought of like, well, but that doesn't matter. But that doesn't matter. And it got to the point when they increased the dose every time they went.

And in the last session they had, they said they lost the ability to think in language. They didn't have words anymore. And it was kind of terrifying.

Like during the episode, During.

During the infusion. Yeah. But after a while, they went, you know, they were able to be driven back home, and they kind of put themselves back together.

And then they said they started to experience something they had not experienced in their adult life, which was joy and no longer had any suicidal ideation. And they had a lot of suicidal ideation before that.

And this person stayed in touch with me, sent me emails over the course of some months, even a couple of years, and said that it had remained.

That way, depression had not come back.

Yeah, yeah. And so, you know, I was, like, open to the idea of it, like, well, if it can have this kind of an effect on somebody.

But again, it was in a clinic where it was very carefully supervised. They were in therapy while it was going on. We could talk about it. And also since then, I've had other clients that are really.

It is what we said in the first session, the wild west approach, where they're doing all of their own research, they're doing their own, figuring out their own dosages, buying their own supplies from places and figuring things out on their own, which is amazing.

It's a good example, because a couple days, people do have profound experiences and remissions of depression with. With ketamine. That's my experience, too, is working with folks who have done ketamine.

One thing that we wonder clinically is does somebody hit remission? Does the depression totally alleviate?

Usually people who are in this category of folks who are considering this have been on a lot of different medications, they've tried a lot of different things, and they're kind of termed treatment resistant. And then another clinical question is, if they do have a positive response, how long does it stay for? Do they have to keep doing it?

Is it a one and done? So those are kind of the questions that are out there for all psychedelics, really, and for any treatment strategy.

But the other piece I was thinking was with ketamine, and this is more informative.

There is an FDA approved usage of a intranasal ketamine, because one of the things with ketamine is in its form that was used in the way your patient did, you can't take it orally. I mean, you can't really take any ketamine orally because it's not digested or it's not absorbed through the oral tract.

So it has to be IV or more recently. And it's been like 10 years maybe since.

There's an intranasal form that came out by a drug company that, you know, put the money into funding the development of it. And it's called Spravato, and it went through the clinical trials that are required for FDA approval.

And it did get the approval and is able to be prescribed and used under very specific circumstances and also reimbursed through most insurances at this point. So it's, it's kind of. It's been incorporated into sort of, you know, quote unquote, legitimate, you know, western healthcare medicine. It's approved.

Melissa and I worked in at St. Lawrence. And ketamine had been used intravenously. Intravenously for a long time.

I mean, like ECT plus ketamine.

Yes, but usually it was done in the electroconvulsive therapy. Yes. Yeah, usually it was done in the or. Because you need an iv, you have to be supervised while it's being done.

So patients who get electroconsvulsive therapy, ect, have an iv, they're in the or. So a lot of times I just sort of loaded up the ketamine too. So it's more unusual for people to go to a clinic.

Well, at least it's less easy to find a place. And I've had patients ask, is there a place around here where I can do IV Ketamine? There is some. There's research that shows the IV form.

It's a different mixture of the different metabolites. Yeah, Racemic mixture versus like a certain. A mixture that only has a certain form of the compound is more effective than the other.

As we talk about it, I'm thinking about a couple friends that I know even who have done ketamine treatments for their depression and have had good success with it.

So if somebody's doing ketamine treatment at home, that's not the Spravato, because Spravato has to be done in a clinic. You have to be supervised by somebody for two hours. So that is, you know, and so when we're talking about the Wild West.

And I have no judgment against, you know, people that do things in different ways.

But for us to, you know, legally and responsibly, you know, prescribe or refer somebody, I mean it really has to be through the channels that have the evidence base.

I had a former patient, you know, and I think that some of the folks who bring it up to me, there are a lot of things that are really difficult in their lives and like maybe I'm not. I think it's maybe more of a therapy issue and they see it more as, as symptoms are not adequately managed. And in this case, yeah, basically.

So in this case, this person found a service online where they delivered tablets of ketamine to their home.

And the rationale which again and again very much non judgmental, but like, well, I've done ketamine recreationally and I remember I felt really good. So I think it would be helpful for my depression.

There's lots of mind jumps there.

Yes.

For the person which has a certain logical. And this happens with my clients I work with all the time. And so we kind of have to slow down and.

Because it's sort of, it's an awkward place for a clinician to be and maybe that's a totally different podcast. But I did want to talk about these online services because that is very much a cultural change that has happened.

The availability of telehealth and then the availability of telehealth services through really venture capitalists. Yes, they're clinics, quote unquote clinics, but they're really profit making businesses. Mind bloom comes to mind.

There was one called cerebral that was ADHD. Get diagnosed with ADHD in 2.5 seconds and we'll send a script to you.

But I think this is a very important component of where we're at culturally because people are engaging with these things on TikTok, on, you know, all of the socials, they're heavily marketed, they're involved in the algorithm because these are Silicon Valley associated and promoted and funded organizations, particularly Mind Bloom. And it's very much about money making for them.

But our patients are coming to us with this sort of veneer of information, this kind of sense of I sort of understand how these things work and they make these mental jumps, like I have depression. A friend of mine does this microdosing. I heard about it on TikTok. I want to, you know, I want to do this.

And so there's a lot of sort of pulling that apart, you know, like in a, like that's not what I, you know, that's That's. We gotta, we gotta talk about this. You have a few pieces of information, but not the whole picture here.

We touched on this in the first segment. But the idea of someone having. Wanting relief, you know, that they're, they're in distress, they're in pain.

And you know, with a client that I talked about a little while ago, I think from a like a literate kind of perspective, what happened is that she detached from her narrative and the ability to like, separate yourself from the thoughts you're having that are. That are reinforcing a lot of pain is the desired thing. How do I get out of this? And it's one thing that's interesting.

In this symposium I attended about a month or so ago, they were very much into the internal family systems stuff and that the idea of it is that all parts are adaptive and protective. So the idea of like, I have pain. Well, that's a part. That's a part that's adaptive and protective. Let's explore that.

Let's talk about what the pain protects you of or what the fear. Fear of the pain. That's yet another part of that. What's that part like, do you think it's going to get worse? How much worse would it get?

What would happen with that?

There's ways of exploring it through therapy that might, you know, a person might still decide to go ahead and try psychedelics or try a different kind of medication or something, but they're really looking for some kind of relief versus yeah, absolutely. How do I befriend this?

Part of my concern. Absolutely. And my concern is that there are, you know, there are reasons to use psychedelics.

There are, there's, you know, clinical evidence about the usage of these things in a therapeutic process. But it's part of a therapeutic process. But the marketing.

And this is something that has been a huge criticism of companies such as Mind Bloom and others that there's.

We're going to get sued by the.

Well, they did sue the Wall Street Journal for. They have a large money base, but they present information with very little evidence as well as. So it's. It's marketing tactics. It's, it's.

It's clinical and this is a wider issue, but it's clinical. Again, a veneer of clinical knowledge, but hooking somebody in for the purpose of profiteering, which is very much in vain.

In the same vein, in the same line as supplements the Maha movement, these types of practices that have.

What's the Maha movement?

Make America healthy again.

Make America healthy again. I didn't know about this.

Oh, this is a part of the Maga.

Yes. Like the granola crunchy crossover with the Maga.

I see.

So Robert Kennedy, you know, RFK Jr. As our help.

So the intersection of new research, new frontiers, Internet, social media presence, influencers and products that if you buy them are really gonna help you. They're really gonna solve the problems that you have. So somebody's. What I like to say is somebody's making money. This is working for somebody.

And that's a whole level of very much what's happening in the moment. Post Covid telehealth, lots of information.

I love that thinking outside of the box with how to get resources to people. I like that aspect of it. Like having to diversify in our diverse and strange world.

But what I don't like is there's very much that this is a vulnerable population.

Very vulnerable.

And we're basically saying that we're gonna cure you and that this is the answer when I just don't think there's ever one.

No. And ethically as all of clinically, I would never say this is 100% gonna you and I think you mentioned Melissa in the first episode.

People are frustrated, at least clinically with antidepressants. They're, you know, 50, 60%, you know, success rate. Some people are on them. Maybe it's helped a little bit.

It hasn't taken away, you know, I think I've talked extensively.

There's, you know, really desperate, just people in a lot of distress that want help and they, you know, so it sets up a dynamic for people to look for those things that seem like they may be helpful. But going back to. I have clients like I could think of one in particular.

Lots of trauma has done trauma therapy has done parts work, responded very well. Very meditation Forward meditates regularly, 30 to 60 minutes. Very disciplined, very introspective, educated, wants to use psychedelics to go.

When he's doing meditation, there's a piece that he can't get past. There's a pain or a space internally that he can't access for some reason.

And I think this happens in parts work frequently, that very inner child type of thing. So he felt that.

And I think that there's some good evidence that psychedelics can help with breaking down maybe internal barriers, consciousness barriers to move through something very difficult. And that's where I've really read about and really believe in the use of psychedelics to do that. Yeah, go ahead.

You know, reflecting back to how I shared in the first episode about like being A teenager and there was a recreational experience. But I also, I think my mind jumped. Like, I also didn't know at the time, have ptsd.

And like now I'm just curious, like, did I have a positive experience at that time? Because, I mean, I wasn't on medication. Anyways, sorry, I'm. I'm getting us off track.

No, but it's, it's. Yeah. In the same realm of that. Like. Yeah, that. Well, when you guys were talking about your extensive use of psychedelics, I don't.

Know if it was extensive.

Well, I went galaxy a little bit. There's a shift in perspective. And when somebody goes through trauma, they can get locked into the space that they're in.

They're terrorized by the flashbacks, by the experiences, triggers. They don't understand what's going on. They have pieces of the puzzle, but they're not. They don't have the whole thing. It's. It's life ruining.

I mean, it can just be fear. Can't leave the house, can't hold a job, cannot take care of themselves. These are extreme examples.

But as somebody progresses into defragmentation, trying to put the pieces back together, the idea that psychedelics can somehow sort of shake things up, like shake up the story, get out of where the trapped feeling is, move away from that, the rigidity. Yeah, yeah, that just rings really true. And you know, I've read a lot of case reports and things of folks doing that, but do you guys.

Have you seen that or heard that from people?

Well, I often talk to clients about what, what fires together, wires together, that and trauma. Fires together a lot.

And then a consortium of different links that go with negative beliefs and any body sensations that get linked to that and EMDR addresses those things. And I've thought about it like, the most profound therapy that I've received myself has been emdr. And it's. And it's kind of the.

For me, the kind of therapy I do, it's kind of the gold standard. It's the best thing I think I do therapy wise. I do the therapeutic conversation quite a bit. And that's really helpful for people.

But when they really isolate, like, here's this thing that really wrecked me and I want to get to the point where I can think, think about it differently. And it doesn't have the same kind of hold on me.

People may be able to get to that with psychedelics, but I think there's other ways to get to that as well. And the other thought I have, which is not, we haven't really talked about it.

But is there a rule out at all with substance abuse population that to what extent is it okay and to what extent are they looking for a way to get high?

That's a hot topic.

Yes, it is.

It is, it is.

It is. It's an important topic though too. Have an answer to it? No, I don't think. Well, I don't for sure.

But does anybody, I mean, having a substance use disorder in your past, does that kind of negate or sort of like take away the possibility of if somebody has an active substance use disorder, then I would say for sure it's not a great idea. But more because if somebody's active in substance use, they're likely not going to be able to progress very far.

Maybe that's not totally true either, but it's difficult.

It's super difficult. Mike mentioned in the first episode harm reduction. So I mean, I do take a harm reduction approach to my patients with substance use issues.

And I don't ever purport to be like any sort of specialist or expert or have any kind of like special knowledge, but I know that's like a polarizing topic in recovery.

Like I think I have some patients who, you don't go to groups because like they, they do, you know, the, the group they're going to like the AA group or NA is very like, you know, anti all medication or whatever.

Like they just feel like even if they're taking a prescribed medication or a, you know, a recommended, you know, if someone, not me is, is recommending like micro dosing that like then it's not really friendly in that group. So anyways, I'm getting way off track.

But that's, it's no but it dips into like.

Because these things are very, again, I think they're on the forefront because our approaches to substance use, as I want to say an industry, not the right word as a profession, is different than it was maybe 10, 15, 20 years ago towards harm reduction as a legitimate strategy versus just abstinence, abstinence only. And there's many paths to the end, you know, for whether it be recovery or whether it be healing from trauma.

Because there's such a huge crossover between substance use and trauma.

And I think that, I think where my brain thought that I was going and now I'm remembering where it was going was like, I think underneath most substance use disorders there is profound pain and trauma and that, but that I like, if someone were to bring that up to me, I would be like, hey, yeah, like you need to like get into recovery and not be abusing substances before you were. I mean, yeah, that comes up a lot even with alcohol.

Like yes, I can give you this medication but like if you're still drinking it's never going to make you feel that much better.

I will say so. I work in a substance use residential clinic in Ypsilanti. It's not a clinic, it's a residential facility.

But I have worked with folks who young usually alcohol use looking there's co occurring depression. They had also been treated with ketamine, not through spravato, not through like a clinic.

They were kind of doing the wild west thing and that was part of for them at least they felt like that was going to be part of the answer. It did not because they ended up in treatment. It did not go well. And it led to some really problematic.

One of them extreme psychosis leading to self violence and a break, really a psychotic break that ended in the hospital and jail and lots of different things very damaging to him.

And then another person as well who had not that extreme but had a really negative experience but also very much wanted to maintain the usage of ketamine as a treatment for them. In their mind that wasn't the problem. That wasn't the problem.

And I guess my piece of the puzzle wasn't what happened before but from their experience it just sounded common, sensically that it probably wasn't a good idea to do that again. But that sort of part of their brain that is addicted is, you know, seem to keep coming back to that as something they wanted to continue doing.

So you know, that's just anecdotal evidence but it's complicated to tear them.

But people get this, you know, they hear a little bit of this and a little bit of that about what could be helpful for this and they come up with their own treatment plans. So wrapping up, what do you guys want to leave the listener with as far as key takeaways from this conversation?

Conversation, I would say one, always be safe and talk to your provider and talk to your trusted folks no matter what you do for treatment with mental health, whether that includes psychedelics or anything else. But just making sure that you safety first.

What about you, Mike?

I would say it's a brave new world and that we're discovering new avenues and possibilities but that it is kind of the wild west. And I would echo what Melissa just said that check in with your provider.

But also I think for us as providers the key is to get more training and there are ways for us to get trained by it and I'll distribute links to all of us. Maybe we can all take a class together, learn more about it.

Are you gonna pay for it?

No.

I think it's been a great conversation. I agree with both of those things.

I think it's such a an interesting cultural moment that has an intersection between mental health, healthcare as a industry in America, as well as where our population is right now with wanting more relief, wanting some more answers to help them with mental health.

A Psycho Delicious Conversation is meant for educational and entertainment purposes only. It is no substitute for therapy and should not be treated as such. If you feel a need for real therapy, you should consult your local provider, Google “therapy” or “therapists” in your area. Check with community mental health or a suicide hotline if you are feeling suicidal. Mike, Morgan and Melissa welcome your questions, feedback or dilemmas. Feel free to send your emails to [email protected] that's P S Y C H dot D E E L I S H at Gmail dot com. The views expressed on this podcast are solely the opinions of Mike Stratton, Morgan Bowen and Melissa Black and do not reflect the views or opinions of any site broadcasting this podcast. Replication of this podcast without written permission is strictly prohibited.