Imagine it: Your doctor tells you, “Take a magic mushroom and call me in the morning.”
Imagine it: Your doctor tells you, “Take a magic mushroom and call me in the morning.”
It’s...probably not all that realistic. But the promise of psychedelic-assisted psychotherapy? Definitely realistic. And definitely an intriguing business prospect.
That’s why this week on Business Casual, we’re talking to the preeminent expert in the controlled use of psychedelic drugs: Dr. Rick Doblin, founder and executive director of the Multidisciplinary Association for Psychedelic Studies (aka MAPS).
Rick has spent nearly four decades at MAPS championing the uses of psychedelics and marijuana in clinical settings. The treatment possibilities, as he sees them, range from post-traumatic stress disorder to depression to addiction.
Sounds promising—but there’s always a but. The larger pharmaceuticals, biotech, and insurance industries aren’t quite ready to wholly buy into psychedelic-assisted psychotherapy. Or psychotherapy of any kind, for that matter.
Along with earning a spot in the regulatory good graces of U.S. officials, educating business decision makers presents a challenge for Rick and his peers in the psychedelics space. But if the trend of microdosing (ahem, Silicon Valley) is any indication, interest is growing from both venture capital and consumer POVs.
Listen now to expand your mind.
Rick generously offered to answer other business-related questions. Get in touch with him at email@example.com.
Kinsey Grant, Morning Brew business editor and podcast host [00:00:06] Hey, everybody, and welcome to Business Casual, the podcast from Morning Brew, answering your biggest questions in business. I'm your host and Brew business editor, Kinsey Grant. And now, let's get into it. [sound of a ding]
Kinsey [00:00:17] Today, what exactly we're getting into is a little unorthodox, maybe a little sexy, definitely a little controversial. But all that said, something that I have wanted to talk about on this podcast for a very long time, and that is the beneficial uses of psychedelic drugs in controlled settings. That's right. The time has finally come to answer the microdosing question here on Business Casual. But I want to point out and make it really obvious from the start that psychedelic drugs like, say, MDMA or the magic in magic mushrooms aren't just for the Silicon Valley elite when they get bored of subsisting on nothing but quinoa and Soylent.
Kinsey [00:00:53] These drugs may just be able to help treat and manage mental conditions like post-traumatic stress disorder, depression, addiction. And I'm not the first to tell you that where cutting-edge treatments and Joe Rogan lead, investor money typically follows, especially in the pharma business. But resetting your brain, which is a claim that so many pioneering the control abuse of psychedelics make, doesn't come easily. If depression or PTSD or addiction were easy to cure, someone probably would have done it already. So today, I want to have an open, honest, genuine conversation about the trials and tribulations of psychedelic treatments. We're going to talk about why so many are convinced that this is the next big thing, why regulators are playing an enormously important role, and how the business community is reacting to all of it.
Kinsey [00:01:38] And we're doing it with Dr. Rick Doblin, the founder and executive director of MAPS, the Multidisciplinary Association for Psychedelic Studies. And I just want to say here from the get-go that whatever [indistinct] cut above A-list celebrity in the world of next-gen sciences, Rick, you are above that. [Rick laughs] So you are a pretty big deal [laughs] in this community. I'm really excited to welcome you to Business Casual.
Dr. Rick Doblin, founder and executive director of MAPS [00:02:01] Thank you. It is a very opportune time —
Kinsey [00:02:04] Yes.
Rick [00:02:05] To be talking about this. There's all sorts of investors moving into this area that are interested. There's still a few of us trying to do it through donations, through nonprofits. But it's a very transformative time. So I'm really glad to be here with you, Kinsey, to talk about it.
Kinsey [00:02:20] Well, thank you. And I appreciate you taking the time. You've already pointed out a big part of this conversation that we're going to have today. The differences at play here when we talk about the business perspective of this new frontier in science and for everybody out there listening. I think it's worth pointing out as well that you have just celebrated the 34th anniversary at MAPS, which is a lot of years in any business venture, but especially something in the science community. Congratulations. That's quite the accomplishment.
Rick [00:02:47] Yeah. Thank you. And we've raised over $80 million in donations during that period of time. And we've got a $30 million-fundraising campaign right now. So, yeah, it's amazing how much charitable money has been allocated in this area and also how we've cleared out a lot of the regulatory problems, the social stigma problem, so that now over the last year and a half, two years or so, investors are starting to get interested as well.
Kinsey [00:03:16] Eighty million dollars is a fever dream for so many of the startups we talk about on Business Casual. But, Rick, to start here, I want to establish something of a framework so that people listening to this can understand exactly what we're talking about when we talk about the work you're doing, the work that MAPS is doing. So can you define what you would consider to be these beneficial uses of psychedelics?
Rick [00:03:36] Well, maybe we should start one step back and just discuss what's a psychedelic.
Kinsey [00:03:41] Yes, perfect.
Rick [00:03:43] The original meaning of the word psychedelic was mind manifesting. So I've interpreted that to be very broad. So that it's about a whole range of the classic psychedelics that people know of, like LSD or psilocybin or mescaline or ayahuasca or ibogaine. But it also includes MDMA. It can include cannabis. It can include dreams. It can include hollow trumpets, [indistinct], any kind of breathwork approaches that brings things to the surface. So I have a very broad definition of the word psychedelic, but most people think about it as the classic ego-dissolving substances that have been used for thousands of years or have been more recently developed in the laboratory.
Rick [00:04:26] And when we talk about what all the potential uses of it are, the range of them is pretty broad because again, what we're talking about is psychedelic assistance, psychotherapy. And so for anything that psychotherapy is for, the psychedelics can enhance that. So there's a range from depression to anxiety to social anxiety to obsessive compulsive disorder to addiction to PTSD—all just a wide, broad range.
Rick [00:04:56] And what the psychedelics do is they make the therapy more effective by bringing things to the surface or by also reducing fear or by connecting people to spiritual feelings that are a source of strength. So, there's just an enormously wide range of uses and it shouldn't be that surprising to people because these drugs have been used for thousands of years for these kind of purposes.
Kinsey [00:05:21] What exactly is the end goal for MAPS? Do you have one specific project in mind? If you could have one thing tomorrow? What would it be?
Rick [00:05:29] Well, let me go back to why I started MAPS. So, the reason I started MAPS is out of a sense of terror and fear about humanity and about our individual psyches and the way that we're motivated by irrational factors a lot. And that as humans, we have been inordinately cruel to the environment, to animals, to people that are the, quote, the other.
Rick [00:06:02] So the goal for MAPS, for me, for focusing on psychedelics and for starting MAPS, the end goal is to have what we call mass mental health, which would mean millions and billions of people having a spiritual experience where they understand that we're really all connected and that the differences are minor, you know, skin color or, you know, that we share so much genetic material with people that we might say are the other. Also the same as with some of the great apes where 98% of the DNA, same with them.
Rick [00:06:39] So the end goal is beyond medicine. It's where we've gone beyond prohibition. And that there are opportunities for people to have psychedelic experiences, for personal growth, for rites of passage for at all different stages of the life span, where you don't necessarily have to go to religion, like for religious freedom to argue, or you don't have to necessarily go to medicine. At the same time, there would be a lot of religious use of this in different contexts or there'd be large amounts of medical use. But the end goal, and I'm glad you asked that question about what's the end goal, is to really ground the human species in a spiritual sense of that word.
Rick [00:07:27] We're in it together. And this is what the astronauts have said when they look at the Earth from space. So lot cheaper to give somebody LSD than to shoot [laughs] them up in space.
Kinsey [00:07:37] Ain't that the truth.
Rick [00:07:38] And so the end goal for me is really looking at the fact that humanity is on a course towards destruction right now. I mean, we have enormous amounts of species going extinct. The environment is under stress. There's going to be, depending on who you listen to, hundreds of millions, if not more, climate refugees coming up. There are weapons of destruction are so great. So that really, I think, the end goal is to try to bring a bit more sanity and spirituality into the human species.
Kinsey [00:08:17] Right. I just have to wonder, Rick, if it's possible that psychedelics can solve these problems, that you bring up a lot of big issues that are more than just taking a different substance. You know, social media, nuclear weapons, any number of things that are detracting from our mental health as a species right now. Do you really think it's realistic to say that if we have more access to these psychedelics, that we could achieve mass mental health?
Rick [00:08:44] I do think that. Yeah. Well, I think personally, I'm a lot mentally healthier because of my psychedelic use than I would be otherwise. So, you know, a lot of times we extrapolate from our individual case to the larger case and often that sets us wrong. You could overgeneralize, but I think I want to raise one point again, whereas before I said it's psychedelic assistance, psychotherapy. It's not like we just have everybody take psychedelics and the world will be a better place. It's the right context and how they take it and what happens and what support they have. And then even more importantly, how do they integrate it into their daily life?
Kinsey [00:09:25] OK.
Rick [00:09:25] But I do believe that. And when I talk about psychedelics, I'm really talking about in this kind of mass mental health idea, a proxy for spiritual experience. So my hope is that having technologies to help people in support of context to have these kind of spiritual experiences, which oftentimes you have to work through a lot of psychodynamic problems, you have to work through trauma. You have to work through anxiety, depression to have these experiences. But it's possible to do sometimes within a six- to eight-hour experience.
Kinsey [00:10:02] Yeah. And I think today we so easily fall into the trap of just pushing those things under the rug instead of actually working through them.
Rick [00:10:09] Yeah. There's another thing, Kinsey, that just the fact that you and I are having this conversation. So there was a period of time where I was really worried that this idea that psychedelics had this potential was kind of a baby boomer, hippie idea and that it would be seen by younger generations as naive and, you know, just foolish, a delusion of the era.
Rick [00:10:34] And that now was all suppressed. And so that was really something that I worried about for quite a long time, until 2001 [laughs], when I had just gotten to finish my orals. I was going to get my Ph.D. And I went back to the college that I went to and I taught a class for what's called the Independent Study Projects, a month-long class on drugs and drug policy. And I saw that the students were very interested in psychedelics. And so it no longer makes me think that it's this hippie blip that, you know, now. But also what it means too, is that it's a multigenerational project.
Rick [00:11:18] And we're not going to be able—baby boomers, all of us—we're not going to be able to achieve what this end goal that I want. It's going to be left to younger generations like yourself and others. And so I think there's some of this passing the torch that's happening and inspiring. And so I do feel hopeful. The other part is, what else will work? You know, when you kind of [laughs] think about the state that we're in, what are some of the other solutions? There was an incredible quote from Carl Jung, who was, you know, helped start transpersonal psychology, Jungian psychology.
Rick [00:11:55] And what he talked about was how, and this was 1959, shortly before he died. But what he said was that humans, because of our brains, have basically been able to address all the challenges in terms of food and shelter and protecting us from wild animals and all this stuff. But he said that the humans are the source of all coming evil, that we don't know enough about ourselves. We don't know enough about our psyches. We've addressed all these other challenges, but we ourselves are the source of all coming evil.
Kinsey [00:12:31] Right. It's intriguing. Like the call is coming from inside the house. [laughs] The evil is within us, creepily enough. So, Rick, we've talked a lot here about the possibilities that the psychedelics and psychedelic-assisted psychotherapies can bring to the fore here. I'm curious what the downsides are. Are these the kind of drugs that people can get addicted to?
Rick [00:12:55] Well, the one drug that's the—of all the psychedelics, the drug that's the most addictive is ketamine. And so Janssen, which is a division of Johnson & Johnson, has just made an isomer of ketamine, called esketamine, into a medicine for depression. And it's made as a medicine without any psychotherapy whatsoever. It's just seen as a pharmacological treatment, which I think limits its effectiveness, but it makes it so you keep needing to go back and buy more as ketamine.
Rick [00:13:29] So it's a good example, I think, of profit maximization rather than maximizing patient outcomes. But ketamine, because it's kind of a reliable escape—it's a dissociative anesthetic—it is something that does have an addictive potential. So I would say that all of these drugs have some addictive potential.
Rick [00:13:50] The classic psychedelics, like LSD and psilocybin, mescaline, ibogaine, they don't really have an addictive, significant addictive potential because by virtue of the fact that they're mind manifesting, they bring things to the surface. They're not a reliable escape. And people have difficult experiences. They oscillate. It's kind of a wave, sometimes beautiful experiences, then hard experiences.
Rick [00:14:18] So people in our studies said—many of them said—I don't know why they call this ecstasy, because when you use it in therapy, you're bringing up painful things and you're working through them. But there are cases of people that have used ecstasy every week for a year or two, something like that. But what happens is that in the traditional kind of drugs that you would get addicted to, once you start getting a tolerance, then you just use higher and higher amounts of the drugs. When you do that with MDMA, you end up getting more of the speedy properties. You don't get back the heart opening.
Rick [00:14:58] And so it's kind of self-limiting. So I'd say that of the psychedelic drugs, ketamine has got the most addictive potential. Then I would say MDMA, but it's short-lived. And then the other psychedelics, I would say, really don't have much of an addictive potential because they're very challenging to use and they can be beautiful, but they're satisfying in a certain way.
Rick [00:15:21] I mean, a good contrast between MDMA and cocaine is that MDMA, these feelings that you get are deep and they feel like you need to take time to integrate them, to think about them, that you don't want to immediately do MDMA the next day or so. But then on the other side, what I would say is that these drugs have incredible potential to treat addiction. And that was what we saw during the '50s and '60s—LSD was used for alcoholics. Bill W, who was the founder, co-founder of Alcoholics Anonymous, first got over his addiction with a psychedelic drug called Datura. Belladonna.
Rick [00:16:09] Which brought, again, a bunch of stuff to the surface and it caused him to be sober. And then later he did LSD after he was already sober and thought that LSD had incredible potential for the treatment of addiction, because not only, you know, part of the 12 steps as you're taught, you make amends for the things you've done wrong. You acknowledge them. And so that's kind of bringing stuff up that people have tried not to see. But then the other part of it is you surrender to a higher power. This whole kind of spiritual aspect of it. So the LSD in the alcoholics, it gives you this chance to look at what you've been suppressing, but also you draw strength from the sense of connection.
Kinsey [00:16:49] Right. It's an interesting risk analysis that you have to undertake here to understand how this all helps and how it can also hurt. That the important part here that I feel like I'm getting out of this is the psychotherapy is just as important in this term as the psychedelic-assisted part of what we're talking about here. And I want to get your perspective on why we associate psychedelics the way that we do in pop culture and just general existence today.
Kinsey [00:17:17] Like you said, a party setting is how most people my age would think about MDMA or ecstasy, would think about many drugs, most drugs, I would say. Why is that? You know, you brought up the great example of Bill W. Why was that such a cutting-edge and spiritual experience, whereas today you take Molly or you take ecstasy at a rave or something.
Rick [00:17:40] Well, that's because for a period of several decades, research into the benefits of these drugs was completely suppressed. So many people, I'd say very few people, really [indistinct]. Many people believe something wrong. Very few people know that MDMA was a secret therapy drug from the middle '70s to the early '80s before it became ecstasy, before it became a party drug. And so it was used in these therapeutic settings. And some of the people that had access to them thought, ah, more people should do this. I could make a lot of money.
Rick [00:18:15] They turned it into a party drug. So I think the fact that a lot of people associate these drugs with parties is because of the decades and decades of suppression of this research into the medical benefits. And so once—we hope by the end of 2022 that we'll have FDA approval for MDMA- assisted psychotherapy for PTSD. And then we're going to roll out hundreds, thousands and thousands of therapists and there'll be hundreds and then thousands of psychedelic clinics.
Rick [00:18:47] And these people will be cross-trained with ketamine, with psilocybin, with other things like that. And then there'll be all sorts of examples of people using it in non-recreational settings. So, I blame prohibition for the limited knowledge that a lot of people have about the potential uses of psychedelics.
Kinsey [00:19:06] Right. Prohibition ruins everything. [laughs]
Rick [00:19:09] It does. It does. It does. It's counterproductive. And it's never about actually addressing drug abuse.
Kinsey [00:19:16] Right.
Rick [00:19:16] It's always been about persecuting minorities of some sort or another.
Kinsey [00:19:21] And always a political issue in one way or another. And I want to get into more of the government regulation, and we're gonna do that in a second. But I would be remiss if I didn't ask what your perspective is here on the sort of new reputation that psychedelic drugs have gotten in Silicon Valley. The microdosing phenomenon is one that has become increasingly popular in recent years.
Kinsey [00:19:44] Steve Jobs was said to have partaken in some psychedelics here and there, and called Bill Gates, like, basically a loser [laughs] if you're not doing it. And I think a lot of people have looked to that as this almost beacon of creativity, of innovation, of productivity. Why do you think that is? And do you think that this is a net good or a net bad for the projects that you're working on?
Rick [00:20:06] Well, I think, first off, it's a net good because people are talking about it as a tool, and useful for different things. I just want to correct something in that Steve Jobs did macrodosing, not microdosing [laughter]. And so he had a series of these experiences that were very important to him. Bill Gates has also done LSD, but wasn't as enthusiastic about it. But I think that this microdosing for creativity, for focus, I think there's something to it.
Rick [00:20:41] And I think that it's like taking something that has been very scary to a lot of people—this idea of losing your ego, of taking large doses of LSD, of bringing things to the surface, but also losing your normal sense of orientation. People feel like when you lose your sense of ego, often people confuse that with physical death, like you're actually dying because the sense of self is dying in a way. You end up being reborn to a greater sense of self or a greater proportionality of where you are in the big system.
Rick [00:21:14] It's like the Copernican revolution. It's like at a period of time, people thought the Earth was the center of the universe and everything revolved around the Earth. And then we realized that the Earth was just this tiny little planet revolving around the sun and a big galaxy with enormous universe. So, it's the foreground-background problem. And so I think that's a lot of what we need. People, in the foreground, is their own ego, their own self, their own survival, their own needs.
Rick [00:21:42] And they've lost the sense that they're embedded in this larger system. And once you can have that surrendering of the ego, as the main center of your orientation, then your ego doesn't go away. But we're part of something bigger. And I think that's really where we need to be going with that.
Kinsey [00:22:05] But can it be done legally?
Rick [00:22:08] Well, in ever broadening ways, yes. But I think—OK—so let me ask you, what difference does it make? Women didn't used to be able to vote. It was illegal for women to vote. So, you know, the law is not this—what's legal is not the same as what's moral.
Kinsey [00:22:27] True.
Rick [00:22:28] And we obviously know that. And our goal is to expand the legal contexts. So right now, microdosing is not legal because it's never been studied through the FDA to be made into a medicine for attention deficit disorder, let's just say. So I think that whenever somebody says that they found a context where there's more benefit than risk, that's helpful with psychedelics, whether it's legal or not.
Kinsey [00:23:04] OK. OK. Well, I feel like, Rick, you've just opened this door to have the [Rick laughs] conversation between legality and morality, which is an entire 'nother thesis and podcast entirely [Rick laughs], but one that I hope our listeners will think on. So while they think on that, we're gonna take a short break to hear from our partner. And when we come back, we will get a little deeper into the legal side of the conversation. —
Kinsey [00:23:27] And now back to the conversation with Rick Doblin. So, Rick, we were just talking about basically establishing the landscape for how we should understand psychedelic-assisted psychotherapy today, talking about legality and morality. Now, let's talk some more about the legal side of those things, the experiences that you've had at MAPS in this 34 years of working on it. What has your experience been like with policymakers when trying to convince people that this is a good thing that needs to be more readily available for the everyday people?
Rick [00:24:00] Well, of course, it's changed over the decades, so I'll give you a sense of how it's changed. So the start of MAPS in 1986, following one year in 1985 when MDMA was criminalized. And actually, I'd started a nonprofit before MAPS in 1984 to try to protect the therapeutic use of MDMA when the DEA, we knew, would inevitably come to crack down because it was being used as ecstasy. So the DEA didn't know about the therapeutic use because it was done in homes and private settings. There weren't problems, but they knew about ecstasy.
Rick [00:24:35] So we were involved in this lawsuit eventually. It's called the DEA Administrative Law Judge lawsuit. The judge agreed with us. MDMA should be Schedule III, meaning illegal for recreational use, but legal for medical use. The DEA rejected the recommendation and then criminalized MDMA. So I realized the only way to bring it back was through science, through medicine, through the FDA. And then what happened in 1990, actually, was that the group of people at the FDA that regulated psychedelics switched from one group to another, and the new group was willing to put science before politics. It had now been over 20 years since the backlash against the '60s.
Rick [00:25:16] And so in 1992, the FDA had a formal advisory committee and they decided they would open the door to psychedelic research. And ever since then, it's really been an open door for psychedelic research at the FDA. However, we've not been able to get a penny from the National Institute of Mental Health, from the Veterans Administration. There's over a million veterans now receiving disability payments for PTSD.
Rick [00:25:42] It costs the VA around $17 billion a year in disability payments. And these are mostly young people that's going to go on for decades. So you would think a promising new breakthrough therapy for PTSD would get support from a group that's paying 17 billion a year in disability payments. But that's not happening yet. So I think we see the federal government tends to change last. So we have an open door to do the science. [indistinct] the national issue of mental health, the traditional foundations—none of them are really supporting what we're doing.
Kinsey [00:26:19] Right. And I think it's a widespread experience for many people working in this field of science that the government is the last one to know [laughs] or the last one to admit that they know or adopt any sort of change or change anything about themselves. And that's why we call it [Rick laughs] bureaucracy.
Rick [00:26:36] Yeah. Although let me make a contrast, though, with ketamine, with esketamine. So it actually, in this case, the National Institute of Mental Health was a pioneer in looking at ketamine for depression. So a bunch of anesthesiologists had noticed that when they gave ketamine to their patients, some of them who had been depressed before, woke up after the operations and weren't depressed.
Rick [00:26:59] And so over 20 years ago, the NIMH started looking at ketamine for depression. And so they really deserve a lot of credit for that. But in our case, ketamine wasn't identified as counterculture or hippie use with LSD or it's not a classic psychedelic, but yeah, like what we see with marijuana. You know, change is happening at the state level only when enough states have changed [indistinct] the federal government change.
Kinsey [00:27:28] Yeah, it's a great point. And I think that there are probably some comparisons that can be drawn between the experience that recreational adult use, legal marijuana has gone through. It's been an absolute minefield for a lot of the businesses trying to make the most out of this. It's hard to get funding. It's hard to work with banks—hard is even a nice way of putting it. It's virtually impossible for many of these small companies to make money because they can't get access to credit. They can't get access to loans that other businesses would be able to get. Obviously, something you feel very passionately [laughs] about.
Kinsey [00:28:02] But [Rick laughs] do you think that the experience will be similar for the projects you're working on? Can you say that they'll be like these cannabis companies?
Rick [00:28:11] No, I don't think so. I think it'll be different. There has been a lot of disillusionment by people working in ArcView about how the idealistic beginnings ended up, where people then just focused on profit and they didn't support the further drug policy reform or things like that. And then the big producers, or it could be driving out a lot of the early pioneers with economies of scale and things like that. So we're hoping to do things differently.
Rick [00:28:39] And that's where I think there's a fair amount of nonprofits and benefit corps where you're not maximizing profit, you're maximizing public benefit. You can still take investors. So just to say MAPS a structure, so we have a nonprofit. But once I realized that even though MDMA is off-patent, there's a way to make money selling MDMA as a medicine. It's a law that Ronald Reagan actually passed in '84 to provide incentives to develop drugs that were off-patent. It's called data exclusivity. It means if you're the first to make a drug into a medicine, even if it's off-patent, nobody can use your data.
Rick [00:29:16] For a period in the U.S. now, it'll end up being practically about six years. They could generate their own data, but they can't use your data. So that's where I realized we could tell a different story to our donors, that we're not going to be constantly asking you for money, that if we can make MDMA into a medicine, we can sell it for a profit. But we can't do that inside the nonprofit. It's taxable. So we created the MAPS Public Benefit Corporation in December 2014, and that's the for-profit arm of MAPS, and that's now got about 55 people. That's our pharmaceutical drug development arm.
Rick [00:29:53] And that's the group that will eventually sell MDMA by prescription at a reasonable profit, not a outrageous profit. And then the benefit corp is 100% owned by the nonprofit, so there's no private owners, there's no investors. So whatever profit is made, will be back to the mission of MAPS, which will be this more research and education, trying to reach this mass mental health goal. So that's our structure. So I think that there's a—Usona is a nonprofit that's trying to work with psilocybin COMPASS, the for-profit.
Rick [00:30:26] So I think that there's a good chance that the way in which the psychedelic therapy movement grows will be fundamentally different than the way the cannabis has grown in. And one of the most important things to say about the difference is that it's psychedelic-assisted psychotherapy. So these drugs as medicines are only going to be administered under direct supervision in a clinic setting. They're not going to be take-home medicines. There's not this enormous recreational market you could say, initially, until there's drug policy reform, which I think will happen in 2035 [laughs].
Kinsey [00:31:09] No time at all. Rick, do you think—what should be the attitude of these big pharma companies? You seem like, as a smaller nonprofit situation here, to have the right attitude. But I have to imagine that the more traction you make in what you're doing, the more attention you get from the big pharma companies hoping to also make money off of this. What's the interaction like for you?
Rick [00:31:31] Well, it's the opposite, actually. So —
Kinsey [00:31:33] Really.
Rick [00:31:33] Big Pharma doesn't know about psychotherapy. That's why ketamine has been made into a medicine without psychotherapy, because Johnson & Johnson, they don't know anything about psychotherapy. They think that their business model is selling drugs. It's not selling treatments, in a way. So Big Pharma knows exactly what we're doing. They want drugs that are patented. And the classic drugs like LSD, psilocybin, mesclun, [indistinct]—all these drugs are in the public domain. You can patent uses, but we've tried to have an anti-patent strategy to block people from patenting the uses.
Rick [00:32:12] There's patents on the production processing. But I think that Big Pharma has in large part abandoned the field of mental health. Ketamine was the major new development in the last 30 years. And that was really developed, as I said, by the National Institute of Mental Health, and others. And then what Pharma did came in in certain ways. It's a good example. What pharma did is, because they couldn't process ketamine, ketamine is now generic and it costs a dollar. So it's super-cheap.
Rick [00:32:46] But what's happening in the field right now is that a lot of people are saying, why should we spend four or five hundred bucks for this patented compound when we can buy this other one for a dollar? And the insurance companies are not really paying for therapy anyway as part of the drug. So what we're seeing is more and more of the ketamine providers are buying the generic version that's super-cheap, and then they're trying to figure out how to charge the insurance companies for some of the basic therapy sessions.
Rick [00:33:19] So in any case, I think that the Big Pharma has a terrible reputation in the American public mind and in large part, deserved. And at the same time, they do really essential important work. But the profit motive has warped healthcare. I think we have to look at is capitalism really the best for everything? And it's clearly not for healthcare.
Kinsey [00:33:46] Honestly, Rick, it just brings to mind how genius it would be if a company like Merck or J&J or a Novartis just bought one of these therapy or psychotherapy-focused startups like a Headspace or a Calm, and then married the two and ran happily off with all their money. But —
Rick [00:34:01] Yeah.
Kinsey [00:34:01] We've brought up a lot of problems here, you know, the regulation of drugs, who pays for it, the lack of focus on these necessary psychotherapies. Who fixes this? Can it all be fixed? Is it the government's role?
Rick [00:34:17] No. No. Well, it would be nice, particularly if the nonprofits could get some government money. But the way you fix something is you develop a better alternative. That's Buckminster Fuller talked a lot about that, as you can complain about how things are being run, but until you develop a better alternative, people aren't going to gravitate to it.
Kinsey [00:34:38] Right.
Rick [00:34:38] So we fix it, meaning MAPS fix it. Even the for-profit companies and psychedelics—if you are paying attention to how to get the best outcomes, you will combine these things with some sort of therapy. It will be a psychedelic-assisted psychotherapy, and then we create a different model. And then people say, oh my God, I only need to go to three MDMA sessions. I don't have to take MDMA afterwards, you know, two-thirds of the people at the one-year follow-up no longer have PTSD.
Rick [00:35:10] And these are chronic severe treatment-resistant PTSD patients as compared to, oh, take this SSRI. That'll reduce the symptoms, but it won't really solve the problem. It also has a lot of side effects and you're going to take it every day for the next two decades or three decades or the rest of your life. So people are going to gravitate to this because it is profound and profoundly healing and profoundly freeing. And it will also be less expensive. It's more expensive in the short run, but less expensive in the long run. So that's our challenge to persuade insurance companies of that.
Kinsey [00:35:47] So this is a perfect segue. I mean, this creating this freeing experience, it's also a better alternative that people will naturally gravitate toward. Takes a lot of money. We talked a little bit about how MAPS is making money, but can you explain more in context what the investor interest is like in the space right now? It seems like I said at the top, [indistinct] like a sexy place for investors to put their money. And it might be a little dangerous for some of these bigger, more institutional names. But what's the interest been like in your experience?
Rick [00:36:14] Well, I'm not so sure all these for-profit companies are going to succeed. I mean, there's a lot of them, and a lot of them are hype, you know? And again, the question is, succeed for who? If you are one of the founders, you can make a lot of money on your stock before it turns out that your story didn't pan out.
Kinsey [00:36:33] Right.
Rick [00:36:33] And so I am concerned for a lot of the investors who are just throwing money because they think it's the next big thing after cannabis. So I think that there are companies that are being started up to produce psychedelics. There's companies that are being started up to run clinics. There is companies that are being set up to develop new psychedelics that then could be patented.
Rick [00:37:02] And then what they'll do is—the same way that we see in biotech a lot of times—is you do your phase one, your phase two studies, and then you sell out to a bigger company to do the large scale phase three studies. So I think there can be investment opportunities that could work out well for people. But I think in some cases, I think it'll work out well for the founders, but not so much for the investors. But that remains to be seen.
Kinsey [00:37:32] Right.
Rick [00:37:32] And then the other part is, you know, these drugs, when they work, they only need to be given a few times. So pharma does have drugs like that, but they charge enormous amounts of money for it. I don't think that that's gonna be likely to happen here, but still the need is so great that I think that's the main point—there is, you know, 300 million people with treatment-resistant depression in the world.
Rick [00:37:57] After COVID, there's gonna be a lot more. So if you can help people with just one or two sessions, there's going to be more and more people coming to your door for that, there's an unending supply. So I think that people will be able to make money off of drugs that are combined with therapy that are effective in only a few sessions. So I think there is financial opportunities here for people.
Rick [00:38:22] I think trying to develop a new drug—that's going to be very difficult. Because what you see when you develop a new drug, even though you can patent it, is that because it doesn't have a history of use, the amount of money you have to spend on the safety studies is really large. And the amount of money then you have to spend on trying to sort out in phase one studies—what's the dose? How does it work? Who's it for?
Rick [00:38:49] So I think that's going to be less likely that people—and then to make a new drug is expensive. Again, you'll probably have people develop new drugs and sell them out to some bigger companies. But, how are these new drugs gonna be fundamentally different than the classic psychedelics? Well, MDMA is fundamentally different than the classic psychedelics, and it's got unique therapeutic properties. So maybe people will develop new drugs. And if so, I'd like to try them. [laughter]
Kinsey [00:39:19] And we just have to hope there's no Martin Shkreli of psychedelic-assisted psychotherapy.
Rick [00:39:24] Well, there will be people like that. [Kinsey laughs] And the thing that keeps them in check is going to be the benefit corps, the nonprofits.
Kinsey [00:39:31] Right. OK. Well, Rick, we've talked a lot here about the state of affairs in the work that you're doing in psychedelics in general. I want to spend just a couple of minutes here talking about what comes next. So if you had to say, in as brief terms as possible, what the next, I don't know, say year, five years, 10 years holds for psychedelic-assisted psychotherapy, how would you say it?
Rick [00:39:57] Crossing the threshold of becoming legal as prescription medicines. So, we will, we think, start up research in the next couple of months. We think that there'll be enough tests for the virus, enough people willing to start up, therapists and patients willing to go through treatment. So we think by the end of 2021, we'll have finished gathering all the data for the FDA, and by the end of 2022, we believe we'll have approval to market in the U.S. And then what will follow is Israel and Canada.
Rick [00:40:29] And then depending on our fundraising, 2023, 2024, we'll get approval in Europe and then we'll globalize. I think that psilocybin is about a year or two behind MDMA, but we will see psilocybin becoming a medicine, I believe, for major depressive disorder, for treatment, resistant depression, for alcoholism.
Rick [00:40:49] We're pioneering all the ways that you need to do mass production. We've got millions and millions of dollars of revenue to spend on toxicity studies that are required by the FDA. But once you've made a medicine out of a drug, for one thing, it's only a fraction of the cost to make it into a medicine for a new indication. So we will make MDMA into a medicine for PTSD. Then we'll move into all sorts of other indications, social anxiety.
Rick [00:41:19] We're starting a study with eating disorders, with MDMA for eating disorders. And then the other thing that will be happening over the just the very short run is going to be establishing the psychedelic clinics. So there's already over 100 ketamine clinics in America that are offering ketamine for depression, but they're also prescribing what's called off-label, which means that the drug is approved for one thing, but you can give it for other things.
Rick [00:41:46] Insurance won't cover it necessarily. You've got more concerns about malpractice, but there's a lot of off-label prescriptions. And so that's already happening with ketamine for personal growth, not just for depression. In fact, Field Trip and others, the for-profit companies, are thinking that their business model will be creating networks of these clinics. And so I think that's what we're gonna be seeing in the next couple of years as well.
Kinsey [00:42:11] All right. Well, Rick, predicting the future is fun, but it's a little taxing. [Rick laughs] So we're going to take a quick break to hear from our sponsor. And when we come back, we're gonna get some rapid-fire in. — All right. We are back with Rick Doblin, who is explained to me all of the ins and outs of these benefits, beneficial uses, if I can get the words out, of psychedelic-assisted psychotherapy. And now we are going to have some fun and do some rapid-fire questions. So I bringing out our Business Casual wheel. And we are again doing this remotely. So I will take our wheel app for a spin for you, Rick.
Rick [00:42:49] Oh, marvelous.
Kinsey [00:42:50] But now, let me just turn up the volume because that's the best part, right?
Rick [00:42:53] I like this. This is cool.
Kinsey [00:42:55] All right. [sound of wheel spinning] [Kinsey laughs] [sound of a ding] OK. So I'm glad that you got this one. It's Call Me Crazy. So what is a hot take that you have that you feel like you might be in the minority in believing? It could be an opinion that you are either right or wrong about in the past, one that you have today that you think you are the hottest take out there. No one else is with you on it.
Rick [00:43:18] Well, there's two ones. One is that —
Kinsey [00:43:21] OK.
Rick [00:43:21] We're working with Israelis and Palestinians who are doing ayahuasca and MDMA together. And so this idea that psychedelics can be part of reconciliation and solving political conflicts, I think a lot of people are dubious about it. But we see that in small, tiny groups this is already happening. And we're trying to study that and make that larger.
Kinsey [00:43:45] All right. We're going to take one last spin [sound of wheel spinning] around the wheel. [sound of a ding] All right. Landed on The One Thing. So what is the one thing—it could be a book, a quote, an album, a class you took—the one thing that you feel has had the biggest impact on your life and your career?
Rick [00:44:03] Stanislav Grof.
Kinsey [00:44:04] OK.
Rick [00:44:04] So it's a person. I consider him my mentor. So it was 1972, when I was just 18 years old, and I had done a lot of LSD and mescaline in college. This is after the '60s had crashed and burned, after the Controlled Substance Act of 1970. I was thinking that I might go to jail because I was a draft resister in Vietnam. I was starting to experiment with psychedelics. I felt the world was crazy, as we said before. But I ended up—I wasn't emotionally mature enough to really handle the things that came up. And so I would get scared and I would get frozen, and I wouldn't be able to kind of let go and see what happens.
Rick [00:44:50] So, I kind of got frozen up. And so I went to the guidance counselor and I said, I need help with my LSD trips. And instead of, like, reporting me to the police or kicking me out of school, the guy said, this is legitimate. This is important. I understand what you're doing. And there's a book that you should read. And the book was "Realms of the Human Unconscious Observations from LSD Research" by Stanislav Graff, who was at Johns Hopkins at the time. He's the world's foremost LSD researcher. He's about to be 89. And reading this book is what changed everything for me.
Rick [00:45:27] That was the fundamental transformation of my life because he talked about LSD research in a way that was legitimizing of it. But he also talked about realms of the human unconscious. So he talked about these spiritual experiences that people had. But he came at it from a scientific framework rather than a religious dogma. You know, who can trust it, you know, but this was kind of scientific. And then it had a reality check —
Kinsey [00:45:53] Right.
Rick [00:45:53] At the end, which was therapy. Can we use these experiences to actually help people? So he was basically a psychiatrist-psychotherapist, but a brilliant man who was able to synthesize so many different areas of knowledge.
Kinsey [00:46:06] Wow. What a fantastic thing it is to be able to point to that exact moment and know that your life was forever changed. I love it. That was a wonderful answer. Well, Rick, thank you so much for coming on Business Casual. This has been an enlightening and particularly interesting conversation. I'm grateful that you took the time.
Rick [00:46:24] Yeah. No, I appreciate it. I think public education is the most important thing right now to prepare people, to prepare society. And I'll just say that if people do have business-related questions or something, I'd be happy to work with you to think about them or respond in the future.
Kinsey [00:46:41] Well, fantastic. We'll get your information in our show notes.
Rick [00:46:44] OK.
Kinsey [00:46:45] Thank you.
Rick [00:46:45] OK. Terrific.
Kinsey [00:46:47] Thank you so much for listening to this episode of Business Casual. Rick and I talked a lot about microdosing and its impacts on creativity and focus and a whole lot more. So what are your thoughts on microdosing? Would you do it, or dare I say, have you done it already? I want to hear what you think. So tweet at me and let's start the conversation. I'm on Twitter @KinseyGrant. That's @ k i n s e y g r a n t, and I will see you next time. [sound of a ding]