The following is a conversation with Matthew Johnson, a professor of psychiatry and behavioral

science at Johns Hopkins, and is one of the top scientists in the world conducting seminal

research on psychedelics.

This was one of the most eye opening and fascinating conversations I've ever had on this podcast.

I'm sure I'll talk with Matt many more times.

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As a side note, let me say that psychedelics is an area of study that is fascinating to

me, in that it gives hints that much of the magic of our experience arises from just a

few chemical interactions in the brain, and that the nature of that experience can be

expanded through the tools of biology, chemistry, physics, neuroscience, and artificial intelligence.

The fact that a world class scientist and researcher like Matt can apply rigor to our

study of this mysterious and fascinating topic is exciting to me beyond words.

As is the case with any of my colleagues who dare to venture out into the darkness of all

that is unknown about the human mind, with both an openness of first principle thinking

and the rigor of the scientific method.

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And now, here's my conversation with Matthew Johnson.

Can you give an introduction to psychedelics, like a whirlwind overview?

Maybe what are psychedelics and what are the kinds of psychedelics out there and in whatever

way you find meaningful to categorize.

Yeah, you can categorize them by their chemical structure.

So phenethylamines, tryptamines, ergalines, that is less of a meaningful way to classify

them.

I think that their pharmacological activity, their receptor activity is the best way.

Well, let me start even broader than that because there I'm talking about the classic

psychedelics.

Broadly speaking, when we say psychedelic, that refers to, for most people, a broad number

of compounds that work in different pharmacological ways.

So it includes the so called classic psychedelics.

That includes psilocybin and solosin, which are in mushrooms, LSD, dimethyl tryptamine

or DMT, it's an ayahuasca, people can smoke it too, mescaline, which is in peyote and

sanpatero cactus.

And those all work by hitting a certain subtype of serotonin receptor, the serotonin 2A receptor.

They act as agonists at that receptor.

Other compounds like PCP, ketamine, MDMA, ibogaine, they all are more broadly speaking called

psychedelics, but they work by very different ways pharmacologically.

And they have some different effects, including subjective effects, even though there's enough

of an overlap in the subjective effects that people informally refer to them as psychedelic.

And I think what that overlap is, compared to say caffeine and cocaine and Ambien, etc.,

other psychoactive drugs, is that they have strong effects in altering one's sense of

reality and including the sense of self.

And I should throw in there that cannabis, more historically like in the 70s, has been

called a minor psychedelic.

And I think with that latter definition, it does fit that definition, particularly if

one doesn't have a tolerance.

So you mentioned serotonin, so most of the effect comes from something around the chemistry

around neurotransmitters and so on.

So it's chemical interactions in the brain, or is there other kinds of interactions that

have this kind of perception and self awareness altering effects?

Well, as far as we know, all of the psychedelics of all the different classes we've talked

about, their major activity is caused by receptor level events.

So either acting at the post receptor side of the synapse, in other words, neurotransmission

operates by one neuron releasing neurotransmitter into a synapse, a gap between the two neurons.

And then the other neuron receives, it has receptors that receives, and then there can

be an activation caused by that.

So it's like a pitcher and a catcher.

So all of the major psychedelics work by either mimicking a pitcher or a catcher.

So for example, the classic psychedelics, they fit into the same catcher's mitt on

the post synaptic receptor side as serotonin itself.

But they do a slightly different thing to the cell, to the neuron than serotonin does.

There's a different signaling pathway after that initial activation.

Something like MDMA works at the presynaptic side, the pitcher side, and basically it floods

the synapse or the gap between the cells with a bunch of serotonin, the natural neurotransmitter.

So it's like the pitcher in a baseball game all of a sudden just starts throwing balls

like every second.

Everything we're talking about is it often more natural, meaning found in the natural

world?

You mentioned cacti, cactus, or is it chemically manufactured artificially in the lab?

So the classic psychedelics, there's...

What are the classics?

Using terminology that's not chemical terminology, not like the terminology you see in titles

of papers, academic papers, but more common parlance.

It would be good to define their effects, like how they're different.

And so it includes LSD, psilocybin, which is in mushrooms, mescaline, DMT.

Which one is mescaline?

One is in the different cacti, so the one most people will know is peyote, but it also

shows up in San Pedro or Peruvian torch.

And all of these classic psychedelics, at the right dose, and typically, they have very

strong effects on one sense of reality and one sense of self.

What some of the things that make them different than other, more broadly speaking psychedelics

like MDMA and others, is that there, at least the major examples, there are some exotic

ones that differ, but the ones I've talked about are extremely safe at the physiological

level.

Like LSD and psilocybin, there's no known lethal overdose.

Unless you have really severe heart disease, because it modestly raises your blood pressure,

so the same person might be hurt, troubling snow or going up the stairs, that could have

a cardiac event, because they've taken one of these drugs.

But for most people, someone could take 1,000 times what the effect of dose is, and it's

not going to cause any organ damage, affect the brainstem, make them stop breathing.

So in that sense, they're freakishly safe at the physio...

I would never call any compounds safe, because there's always a risk.

They're freakishly safe at the physiological level.

I mean, you can hardly find anything over the counter like that.

I mean, aspirin's not like that, caffeine is not like that.

Most drugs, you take 5, 10, 20, maybe it takes 100, but you get to some times the effect

of dose, and it's going to kill you or cause some serious damage.

And so that's something that's a remark about most of these classic psychedelics.

That's incredible, by the way, that you can go on a hell of a journey in the mind, like

probably transformative, potentially in a deeply transformative way, and yet there's

no dose that in most people would have a lethal effect.

That's kind of fascinating.

There's this duality between the mind and the body.

It's like...

Okay, sorry if I bring him up way too much, but David Goggins is like, you know, the kind

of things you go on a long run, like the hell you might go through in your mind.

Your mind can take a lot, and you can go through a lot with the mind, and the body will just

be its own thing.

You can go through hell, but after a good night's sleep, be back to normal, and the body is always

there.

So bringing it back to Goggins, it's like you can do that without even destroying your

knee or whatever.

Right, yes.

Or coming close and riding that line.

That's true.

So the unfortunate thing about the running, which he uses running to test the mind, so

the aspect of running that is negative, in order to test the mind, you really have to

push the body, like take the body through a journey.

I wish there was another way of doing that in the physical exercise space.

I think there are exercises that are easier on the body than others, but running sure

is a hell of an effective way to do it.

And one of the ways that where it differs is that you're unlike exercise, you're essentially...

This exercise, to really get to those intense levels, you really need to be persistent about

it.

I mean, it'll be intense if you're really out of shape, just jogging for five minutes.

But to really get to those intense levels, you need to have the dedication.

And so some of the other ways of altering subjective effects or states of consciousness

take that type of dedication, psychedelics though, I mean, someone takes the right dose.

They're strapped into the roller coaster, and something interesting is going to happen.

And I really like what you said about that distinction between the mind or the contrast

between the mind effects and the body effects, because I think of this, I do research with

all the drugs, caffeine, alcohol, methamphetamine, cocaine, alcohol, legal, illegal.

Most of these drugs, thinking about, say, cocaine and methamphetamine, you can't give

to a regular user, you can't safely give a dose where the regular cocaine user is going

to say, oh man, that's the strongest coke I've ever had, because you get it past the

ethics committee and you need approval, and I wouldn't want to give someone something

that's dangerous.

To go to those levels where they would say that, you would have to give something that's

physiologically riskier.

psilocybin or LSD, you can give a dose at the physiological level that is a very good

chance it's going to be the most intense psychological experience of that person's life and have

zero chance for most people if you screen them of killing them.

The big risk is behavioral toxicity, which is a fancy way of saying doing something stupid.

I mean, you're really intoxicated, like if you wander into traffic or you fall from

a height, just like plenty of people do on high doses of alcohol, and the other kind

of unique thing about classic psychedelics is that they're not addictive, which is pretty

much unheard of when it comes to so called drugs of abuse or drugs that people, at least

at some frequency, choose to take most of what we think of as drugs, caffeine, alcohol,

cocaine, cannabis.

Most of these you can get into alcohol, you can get into a daily use pattern, and that's

just so unheard of with psychedelics.

Most people have taken these things on a daily basis, it's more like they're building up

the courage to do it, and then they build up a tolerance, they're in college and they

do it on a day, or can you take acid seven days in a row, and that type of thing, rather

than a self control issue, where you have and say, oh God, I got to stop taking this,

I got to stop drinking every night, I got to cut down on the coke, whatever.

So that's the classic psychedelics.

What are the, what's the good term, modern psychedelics, or more maybe psychedelics that

are created in the lab?

What else is there?

Right, so MDMA is the big one, and I should say that with the classic psychedelics that

LSD is sort of, you can call it a semi synthetic, because there's natural from both ergot and

in certain seeds, morning glory seeds as one example, there are some very close chemical

relatives of LSD, so LSD is close to what occurs in nature, but not quite it.

But then when we get into the other non classic psychedelics, probably the most prominent

one is MDMA, people call it ecstasy, people call it molly, and it is, it differs from

classic psychedelics in a number of ways.

It can be addictive, but not so, it's like, you can have cocaine on this end of the continuum

and classic psychedelics here.

Continuum of addiction.

So it's certainly no cocaine, it's pretty rare for people to get into daily use patterns,

but it's possible, and they can get into more like, using once a week pattern, where they

can find it hard to stop, but it's somewhere in between mostly towards the classic psychedelic

side in terms of relatively little addiction potential.

But it's also more physiologically dangerous.

I think that the, certainly the therapeutic use, it's showing really promising effects

for treating PTSD and the models that are used, I think those are extremely acceptable

when it comes to the risk benefit ratio that you see all throughout medicine.

But nonetheless, we do know that at a certain dose and a certain frequency that MDMA can

cause long term damage to the serotonin system in the brain, so it doesn't have that level

of kind of freakish bodily safety that the classic psychedelics do.

And it has more of a heart load, a cardiovascular, I don't mean kind of emotion, I mean, in

this sense, although it is very emotional and that's something unique about its subjective

effects, but it's more of a presser.

And the terminology used instead of like a freakish capacity, allowing you from a researcher

perspective, but a personal perspective too of taking a journey with some of these psychedelics

that is the heroic dose as they say.

So like these are tools that allow you to take a serious mental journey, whatever that

is.

That's what you mean.

And with MDMA, there's a little bit, it starts entering this territory where you got to be

careful about the risks to the body potentially.

So yes, that in the sense that you can't kind of push the dose up as high as you safely

as one can, if they're in the right setting, like in our research, as they can with the

classic psychedelics, but probably more importantly, just the nature of the effects with MDMA aren't

the full on psychedelic.

It's not the full journey.

So it's sort of a psychedelic with rose colored glasses on, a psychedelic that's been called

more of a heart trip than a head trip.

The nature of reality doesn't unravel as frequently as it does with classic psychedelics.

But you're able to more directly sense your environment.

So your perception system still works.

It's not completely detached from reality with MDMA.

That's true, relatively speaking.

That said, at most doses of classic psychedelics, you still have a tether to reality.

Changes a little bit when you're talking about smoking DMT or smoking five methoxy DMT,

which are some interesting examples we could talk more about.

But with MDMA, for example, it's very rare to have what's called an ego loss experience

or a sense of transcendental unity, where one really seemingly loses the psychological

construct of the self.

But MDMA, it's very common for people to have this, they still are perceiving themselves

as a self, but it's common for them to have this warmth, this empathy for humanity and

for their friends and loved ones.

So it's more, and you see those effects under the classic psychedelics, but that's a subset

of what the classic psychedelics do.

So I see MDMA in terms of its subjective effects is if you think about Venn diagrams, it's sort

of MDMA is all within the classic psychedelics.

So everything that you see on a particular MDMA session, sometimes a psilocybin session

looks just like that.

But then sometimes it's completely different with psilocybin, it's a little more narrowed

in terms of the variability with MDMA.

Is there something general to say about what the psychedelics do to the human mind?

You mentioned kind of an ego loss experience in the space of Venn diagrams.

If we were to draw a big circle, what can we say about that big circle?

In terms of people's report of subjective experience, probably one of the most general

things we can say is that it expands that range.

So many people come out of these sessions saying that they didn't know it was possible

to have an experience like that.

So there's an emphasis on the subjective experience.

Is there words that people put to it that capture that experience or is it something

that just has to be experienced?

As a researcher, that's an interesting question because you have to kind of measure the effects

of this.

And how do you convert that into numbers?

That's the ultimate challenge.

Is that possible to one, convert it into words and the second, convert the words into

numbers somehow?

So we do a lot of that with questionnaires, some of which are very psychometrically validated.

So lots of numbers have been crunched on them.

And there's always a limitation with questionnaires.

I mean, subjective effects are subjective effects.

Ultimately, it's what the person is reporting.

That doesn't necessarily point towards a ground truth.

So for example, if someone says that they felt like they touched another dimension or

they felt like they sensed the reality of God or if they, I mean, just you name it,

people's ontological views can sometimes shift.

I think that's more about where they're coming from and I don't think it's the quintessential

way in which they work.

There's plenty of people that hold onto a completely naturalistic viewpoint and have

profound and helpful experiences with these compounds.

But the subjective effects can be so broad that for some people, it shifts their philosophical

viewpoint more towards idealism, more towards thinking of that the nature of reality might

be more about consciousness than about material.

That's a domain I'm very interested in.

Right now, we have essentially zero to say about that in terms of validating those types

of claims, but it's even interesting just to see what people say along those lines.

So you're interested in saying, like, can we more rigorously study this process of expansion?

Like, what do we mean by this expansion of your sense of what is possible in the experiences

in this world?

Right.

As much as what we can say about that through naturalistic psychology, especially as much

as we can root it to solid psychological constructs and solid neuroscientific constructs.

And I wonder what the impact is of the language that you bring to the table.

So you mentioned about God or, speaking of God, a lot of people are really into sort

of theoretical physics these days at a very surface level and you can bring the language

of physics.

Right.

You can talk about quantum mechanics.

You can talk about general relativity and curvature of space time and using just that

language without a deep technical understanding of it to somehow start thinking like sort

of visualizing atoms in your head and somehow through that process, because you have the

language using that language to kind of dissolve the ego, like realize that we're just all

little bits of physical objects that behave in mysterious ways.

And so that has to do with the language.

Like if you read a Sean Carroll book or something recently, it seems like as a huge influence

on the way you might experience, might perceive the world and might experience the alteration

that psychedelics brings to the, to the your perception system.

So I wonder like the language you bring to the table, how that affects the journey you

go on with the psychedelics.

I think very much so.

And I think there's, I'm a little concerned, some of the science is going a little too

far in the direction of, around the edges, speaking about it, changing beliefs in this

sense or that sense about particular, in particular domains.

And I think what really what a lot of what's going on is what you just discussed, it's

the priors coming into, into it.

So if you're been reading a lot of, you know, physics, then you might, you know, bring

up, you know, like, you know, space time and interpret the experience in that sense.

I mean, it's not uncommon for people come out talking about visions of the, it's not

the most typical thing, but it's come up in sessions, I've, I've guided the Big Bang

and the, you know, this sort of nature of reality.

I think probably the best way to think about these experiences is that, and the best evidence,

even though we're in our infancy and understanding it, that they really tap into more general

psychological mechanisms.

I think one of the best arguments is they, they, they, they reduce the influence of the,

of our priors of what we bring into the, all of the assumptions that we all that, you know,

were essentially, especially as adults were riding on top of heuristic after heuristic

to get through life.

And you need to do that.

And that's a good thing.

And that's extremely efficient and evolution has shaped that, but that comes at an expense.

And it seems that these experiences will, will allow someone greater mental flexibility

and openness.

And so one can be both less influenced by their, their prior assumptions, but still nonetheless,

the nature of the experience can be influenced by what they've been exposed to in the world.

And sometimes they can get it at a deeper, in a deeper way.

Like maybe they've read, I mean, I had a philosophy professor at one time as a, as a participant

in a high dose psilocybin study.

And he's like, I remember him saying, my God, it's like Hagel's opposites defining each

other.

I get it.

I've taught this thing for, you know, years and years and years, like I get it now.

And so like that, you know, and, and even at the psychological emotional level, like

the cancer patients we worked with, you know, they told themselves a million times over

the people trying to quit smoking.

I need to quit smoking.

Oh, I'm ruining my life with this cancer.

I'm still healthy.

I should be getting out.

I'm letting this thing defeat me.

It's like, yeah, you told yourself that in your head, but sometimes they had these experiences

and they kind of feel it in their heart.

Like they really get it.

So in some sense that you bring some prize to the table, but psychedelics allow you to

acknowledge them and then throw them away.

So like one popular terminology around this in the engineering space is first principles

thinking that Elon Musk, for example, espouses a lot.

Let me ask a fun question before we return to a more serious discussion.

But Elon Musk as an example, but it could be just engineers in general.

Do you think there's a use for psychedelics to take a journey of rigorous first principles

thinking?

So like throwing away, we're not talking about throwing away assumptions about the nature

of reality in terms of like our philosophy of the way we live day to day life, but we're

talking about like how to build a better rocket or how to build a better car or how to build

a better social network or all those kinds of things, engineering questions.

I absolutely think there's huge potential there.

And there was some research in the late 60s, early 70s that was very early and not very

rigorous in terms of methodology, but it was consistent with the, I mean, there's just

countless anecdotes of folks, I mean, people have argued that just Silicon Valley was largely

influenced by psychedelic experience.

I remember the, I think the person that came up with the concept of freeware or shareware,

it's like it kind of was generated out of or influenced by psychedelic experience.

So to this, I think there's incredible potential there and we know really next, there's no

rigorous research on that, but is there anecdotal stuff like with Steve Jobs?

I think there's stories, right?

In your exploration of the, is there something a little bit more than just stories?

Is there like a little bit more of a solid data points?

Even if they're just experiential like anecdotes, is there something that you draw inspiration

from like in your intuition?

Because we'll talk about you're trying to construct studies that are more rigorous around

these questions.

But is there something you draw inspiration from from the past from the 80s and the 90s

and Silicon Valley, that kind of space?

Or is it just like you have a sense based on everything you've learned and these kind

of loose stories that there's something worth digging at?

I am influenced by the, gosh, the just incredible number of anecdotes surrounding these.

I mean, Kerry Mullis, he invented PCR, I mean, absolutely revolutionized biological sciences.

He says he wouldn't have won the Nobel Prize from it, said he wouldn't have come up with

that had he not had psychedelic experiences.

You know, now he's an interesting character.

People should read his autobiography because you could point to other things he was into.

But I think that speaks to the casting your nets wide and this mental flex.

Or these general mechanisms where sometimes if you cast your nets really wide and it's

going to depend on the person and their influences, but sometimes you come up with false positives.

You connect the dots where maybe you shouldn't have connected those dots.

But I think that can be constrained and so much of our, not only a personal psychological

suffering, but our limitations academically and in terms of technology are because of

the self imposed limitations and heuristics, these entrance ways of thinking, like those

examples throughout the history of science where someone has come up with the paradigm

ships.

It's like, here's something completely different.

This doesn't make sense by any of the previous models and we need more of those and then

you need the right balance between that because so many of the novel crazy ideas are just

bunk and that's what science is about separating them from the valid paradigm shifting ideas.

But we need more paradigm shifting ideas in a big way.

And I think you could argue that we've, because of the structure of academia and science in

modern times, it heavily biases against those.

Right.

There's all kinds of mechanisms in our human nature that resist paradigm shift quite sort

of obviously.

And psychedelics, there could be a lot of other tools, but it seems like psychedelics

could be one set of tools that encourage paradigm shifting thinking.

So like the first principle is kind of thinking.

So it's a kind of, you're at the forefront of research here.

There's just kind of anecdotal stories.

There's early studies.

There's a sense that we don't understand very much, but there's a lot of depth here.

How do we get from there to where Elon and I can regularly, like I wake up every morning,

I have deep work sessions where it's well understood, like what dose to take.

Like if I want to explore something where it's all legal, where it's all understood

and safe, all that kind of stuff, how do we get from where we are today to there?

Not speaking in terms of legality in the sense like policymaking, all that like laws

and stuff, meaning like how do we scientifically understand this stuff well enough to get to

a place where I can just take it safely in order to expand my thinking, like this kind

of first principles thinking, which I mean, my personal life currently doing, like how

do I have revolutionized particular several things?

Like it seems like the only tools I have right now, it's just just, but my mind going, doing

the first principles like, wait, wait, wait, okay.

Why has this been done this way?

Can we do it completely differently?

It seems like I'm still tethered to the priors that I bring to the table and I keep trying

to untether myself.

Maybe there's tools that can systematically help me untether.

Yeah, well, we need experiments and that's tied to the policy level stuff and I should

be clear, I would never encourage anyone to do anything illicitly, but yeah, in the future,

we could see these compounds used for technical and scientific innovation.

What we need are studies that are digging into that right now, most of what the funding,

which is largely from philanthropy, not from the government, largely what it's for is treatment

of mental disorders like addiction and depression, et cetera, but we need studies.

One of the early initial stabs on this question decades ago was they took some architects

and engineers and said, what problems have you been working on?

Very you've been stuck for months like working on this damn thing and you're not getting

anywhere like your head's butting up against the wall.

Come in here, take, and I think it was 100 micrograms of LSD, so not a big session and

a little bit different model where they were actually working, it was a moderate enough

dose where they could work on the problem during the session.

I think probably, I'm an empiricist so I'd like to see all the studies done, but the

first thing I would do is a really high dose session where you're not necessarily in front

of your computer, which you can't really do on a really high dose.

And then the work has been talked about, you take a really high dose, you take a journey

and then the breakthroughs come from when you return from the journey and integrate quote

unquote that experience.

I think that's where all the head, and again, we're babies at this point, but my gut tells

me that it's the so called integration, the aftermath.

We know that there's some different forms of neuroplasticity that are unfolding in the

days following a psychedelics, at least in animals.

Probably going on humans, we don't know if that's related to the therapeutic effects.

My gut tells me it is, although it's only part of the story, but we need big studies

where we compare people, like let's get 100 people like that, scientists that are working

on a problem, and then randomize them too.

And then I think you need a even more credible active controls or active placebo conditions

to kind of tease this out.

And then also in conjunction with that, and you can do this in the same study, you want

to combine that with more rigorous sort of experimental models where we actually get

there are problem solving tasks that we know, for example, that you tend to do better on

after you've gotten a good night's sleep versus not.

And my sense is there's a relationship there.

People go back to first principles, questioning those first principles they're operating under,

and getting away from their priors in terms of creative problem solving.

And so I think you wrap those things, and you could speak a little more rigorously about

those.

Because ultimately, if everyone's bringing their own problem, that's more in the face

of outside, but you can't dig in as much and get as much experimental power and speak to

the mechanisms as you can with having everyone do the same sort of canned problem solving

task.

So we've been speaking about psychedelics generally.

Is there one you find from the scientific perspective or maybe even philosophical perspective

most fascinating to study?

Therapeutically, I'm most interested in psilocybin and LSD, and I think we need to do a lot more

with LSD because it's mainly been psilocybin in the modern era.

I've recently gotten a grant from the Hefter Research Institute to do an LSD study, so

I haven't started it yet, but I'm going through the paperwork and everything.

Therapeutic meaning there's some issue and you're trying to treat that issue.

In terms of just what's the most fascinating, understanding the nature of these experiences,

if you really want to wrap your head around what's going on when someone has a completely

altered sense of reality and sense of self, there I think you're talking about the high

dose, either smoked vaporized or intravenous injection, which all kind of, they're very

similar pharmacologically, of DMT and five methoxy DMT.

This is like when people, this is what, I don't know if you're familiar with Terence

McKinnon, he would talk a lot about smoking DMT, Joe Rogan has talked a lot about that.

People will say that, and there's a close relative called five methoxy DMT.

Most people who know the terrain will say that's an order of magnitude or orders of

magnitude beyond anything one could get from even a high dose of psilocybin or LSD.

I think it's a question about whether, how therapeutic, I think there is a therapeutic

potential there, but it's probably not as sure of a bet because one goes so far out,

it's almost like they're not contemplating their relationship in their direction in life.

They are like, reality is ripping apart at the seams and the very nature of the self

and of the sense of reality.

The amazing thing about these compounds, and same to a less degree with oral psilocybin

and LSD is that unlike some other drugs that really throw you far out there, anesthetics.

Even alcohol, as reality starts to become different at higher and higher doses, there's

this numbing, there's this ability for the sense of being the center, having a conscious

experience that's memorable, that is maintained throughout these classic psychedelic experiences.

One can go as far, so far out while still being aware of the experience and remembering

the experience.

Interesting, so being able to carry something back.

Can you dig in a little deeper?

What is DMT?

How long is the trip usually?

How much do we understand about it?

Is there something interesting to say about the nature of the experience and what we understand

about it?

One of the common methods for people to use it is to smoke it or vaporize it.

This is a pretty good kind of description of what it might feel like on the ground.

The caveat is it's a completely insufficient description and someone's going to be listening.

It's like nothing you could say is going to come close, but it'll take about three big

hits, inhalations, in order to have what people call a breakthrough dose.

There's no great definition of that, but basically meaning moving away from not just having the

typical psilocybin or LSD experience where things are radically different, but you're

still basically a person in this reality to go in somewhere else.

That'll typically take three hits.

This stuff comes on like a freight train.

One takes a hit and around the time of the first exhalation, we're talking about a few

seconds in, or maybe just sometime between the first and the second hit, it'll start

to come on.

They're already up to, say, what they might get from a 30 milligram or 300 microgram LSD

trip, a big trip.

They're already there at the second hit, but they're going, their consciousness is gear.

This is like acceleration, not speed to speak of physics.

Those receptors are getting filled like that and they're going from zero to 60 in like

Tesla time.

At the second hit, again, they're at maybe the strongest psychedelic experience they've

ever had.

If they can take that third hit, even some people can't, they're propelled into this

other reality.

The nature of that other reality will differ depending on who you ask, but folks will often

talk about, and we've done some survey research on this, entities of different types, elves

tend to pop up.

The caveat is, I strongly presume all of this is culturally influenced, but thinking more

about the psychology and the neuroscience, there is probably something fundamental.

For someone that might be colored as elves, others that might be colored as, Terrence McKinnon

called himself dribbling basketballs.

For someone else, it might be little animals or someone else, it might be aliens.

I think that probably is dependent on who they are and what they've been exposed to,

but just the fact that one has this sense that they're surrounded by autonomous entities.

Intelligent autonomous entities.

People come back with stories that are just astonishing.

There's communication between these entities and often they're telling them things that

the person says are self validating, but it seems like it's impossible.

It really seems like, and again, this is what people say oftentimes, that it really is downloading

some intelligence from higher dimension or whatever metaphor you want to use.

These things come up in dreams where it's like someone is exposed to something that

I've had this in a dream, where it seems like what they are being exposed to is physically

impossible, but yet at the same time, self validating, it seems true that they really

are figuring something out.

Of course, the challenge is to say something in concrete terms after the experience where

you could verify that in any way, and I'm not familiar of any examples of that.

There's a sense in which I suppose the experience is like you're a limited cognitive creature

that knows very little about the world, and here's a chance to communicate with much wiser

entities that in a way that you can't possibly understand, are trying to give you hints of

deeper truths, and so there's that kind of sense that you can take something back, but

you can't, where our cognition is not capable to fully grasp the truth, we'll just get a

kind of sense of it, and somehow that process is mind expanding, that there's a greater

truth out there, that seems like what, from the people I've heard talk about, that seems

to be what it is, and that's so fascinating that there's fundamentally to this whole thing

is the communication between an entity that is other than yourself, entities, so it's

not just like a visual experience, like you're like floating through the world, is there's

other beings there, which is kind of, I don't know, I don't know what to sort of, from a

person who likes Freud and Carl Jung, I don't know what to think about that.

That being, of course, from one perspective is just you looking in the mirror, but it

could also be from another perspective, like actually talking to other beings.

Yeah, you mentioned Jung, and I think that's, he's particularly interesting, and it kind

of points to something I was thinking about saying is that I think what might be going

on from a naturalistic perspective, so regardless, whether or not there are, it doesn't depend

on autonomous entities out there, what might be happening is that just the associative

net, the level of learning, the comprehension might be so beyond what someone is used to

that the only way for the nervous system, for the aware sense of self to orient towards

it is all by metaphor.

And so I do think when we get into these realms as a strong empiricist, I think we always

got to be careful and be as grounded as possible, but I'm also willing to speculate and sort

of cast them that's wide with caveat.

But I think of things like archetypes, and it's plausible that there are certain stories,

we've gone through millions of years of evolution, it may be that we have certain characters

and stories that are central nervous system is sort of wired to tend to…

Yeah, those stories, we carry those stories in us, and this unlocks them in a certain

kind of way.

And we think about stories, like our sense of self is basically narrative self is a story.

And we think about the world of stories, this is why metaphors are always more powerful

than sort of laying out all the details all the time, speaking in parables, it's like

if you really get something…

This is why as much as I hate it, if you're presenting to Congress or something and you

have all the best data in the world, it's not as powerful as that one anecdote as the

mom dying of cancer that had the psilocybin session and it transformed her life, that's

a story that's meaningful.

And so when this kind of unimaginable kind of change and experience happens with DMT

ingestion, these stories of entities, they might be that, stories that are constructed

that is the closest, which is not to say the stories aren't real, I mean, I think we're

getting to layers where it doesn't really, right, yeah, yeah, but it's the closest

we can come to making sense out of it because what we do know about these psychedelics,

one of the levels beyond the receptor is that the brain is communicating it with itself

in a massively different way.

There's massive communication with areas that don't normally communicate.

And so I think that comes with both, it's casting the nets wide.

I think that comes with the insights and helpful novel ways of thinking, I do think it comes

with false positives, that could be some of the delusion.

And so when you're so far out there, like with DMT experience, like maybe alien is the

best way that the mind can wrap some arms around that.

So I don't know how much you're familiar with Joe Rogan, but he does bring up DMT quite

a bit.

It's almost a meme.

It is a meme.

Right.

Have you ever, what is it, have you ever tried DMT?

I mean, I think he talks about this experience of having met other entities and they were

mocking him, I think.

If I remember the experience correctly, like laughing at him and saying FU, FU or something

like that.

I may be misremembering this, but there's a general mockery.

And what he learned from that experience is that he shouldn't take himself too seriously.

So it's the dissolution of the ego and so on.

What do you think about that experience and maybe if you have more general things about

the Joe's infatuation with DMT and if DMT has that important role to play in popular

culture in general?

I'm definitely familiar with it.

I remember telling you offline that when I first, the first time I learned who Joe Rogan

was, it's probably 15 years ago and I came upon a clip and I realized there's another

person in the world who's into both DMT and Brazilian Jiu Jitsu and I think both those

worlds have grown dramatically since and it's probably not such a special club these days.

So he definitely got onto my radar screen quickly.

You weren't to both before was cool.

Right.

I mean, it's all relative because there's people that were before the late 90s and early

2000s who were into it to say, you're a Johnny come lately.

But yeah, compared to where we're at now.

But yet one of the things I always found fascinating by Joe's telling of his experiences I think

is that they resemble very much Terrence McKenna's experiences with DMT and Joe has talked very

much about Terrence McKenna and his experiences.

If I had to guess, I would guess that probably just having heard Terrence McKenna talk about

his experiences that influenced the coloring of Joe's experience.

It's funny how that works because I mean, that's why McKenna has poets and great orders

give us the words to then start to describe our experiences because our words are limited,

our language is limited and it's always nice to get some kind of nice poetry into the mix

to allow us to put words to it.

But I also see some elements that seem to relate to Joe's psychology, just from what

I've seen from hours of watching him on his podcast is that he's a self critical guy.

And I think with always his positive been, I'm always struck being a behavioral pharmacologist

and no one else really says it about cannabis.

I'll get back to the DMT thing about he likes the paranoid side of things.

He's like, that's you radically examining yourself.

It's like that's not just a bad thing, that's you need to look hard at yourself and something's

making you uncomfortable, dig into that and it's sort of along the lines of Goggins with

exercise and it's like, yeah, things, learning experiences aren't supposed to be easy.

Take advantage of these uncomfortable experience.

It's why we call in our research in a safe context, psychedelics, they're not bad trips,

they're challenging experiences.

Yes, so yeah, it's fascinating just that's a tiny tangent.

It's always cool for me to hear him talk about marijuana like weed as the paranoia, the

anxiety or whatever that the experience as actually the fuel for the experience.

Like I think he talks about smoking weed when he's writing.

That's inspiring to me because then you can't possibly have a bad experience.

I'm a huge fan of that, every experience is good.

Right, which is very Goggins.

Yeah, it's very Goggins.

Is it bad?

Okay.

All right.

Great.

Well, see Goggins is one side of that.

He wants it bad.

He wants the experience to be challenging always, but I mean, both are good.

The few times I've taken mushrooms, the experience was like everything was beautiful.

There's zero challenging aspect to it.

It was just like the world is beautiful and it gave me this deep appreciation of the world.

I would say, so like that's amazing, but also ones that challenge you are also amazing,

like all the time to drink vodka, but that's another lesson.

So back to DMT.

Yeah.

Joe's treating cannabis as a psychedelic, which is something that I'd say like a lot

of people treat it more like Xanax or like beer or vodka, but he's really trying to

delve into those, it's been called a minor psychedelic.

So with DMT, as you brought up, it's like the entity's mocking him and it's like you're

not good.

I mean, this reminds me of him describing his writing his or just his entire method

of comedy.

It's like watch the tape of yourself, don't just ignore it.

That's where I screwed up.

That's where I need to do better, this sort of radical self examination, which I think

our society is kind of getting away from because all the children win trophies type

of thing.

And it's like, no, don't go overboard, but recognize when you've messed up.

And so that's a big part of the psychedelic experience.

People come out sometimes saying, my God, I need to say sorry to my mom.

But it's so obvious or whatever interpersonal issue or my God, I'm not pulling enough weight

around the house and helping my wife.

And these things that are just obvious to them, the self criticism that can be a very

positive thing if you act on it.

You've mentioned addiction, maybe we could take a little bit detour into a darker aspect

of things.

Or not even darker, it's just an important aspect of things.

What's the nature of addiction?

You've mentioned some things within the big umbrella of psychedelics, maybe usually not

addictive, but maybe MDMA, I think you said might have some addictive properties.

But the point is stuff outside of the psychedelics umbrella can often be highly addictive.

So you've studied addiction from several angles.

One of which is behavioral economics.

What have you understood about addiction?

What is addiction from the biological, physiological level to the psychological to whatever is the

interesting way to talk about addiction?

Yeah.

And the lenses that I view addiction through very much are behavioral economic.

But I also think they converge on, I think it's beautiful at the other end of the spectrum,

sort of just a completely humanistic psychology perspective.

And it converges on what people come out of 12 step meetings talking about.

Can you say what is behavioral economics and what is humanistic psychology?

What do you mean by that?

And more importantly, behavioral economics lens.

What is that?

Yeah.

So behavioral economics, my definition of it is the application of economic principles,

mostly microeconomic principles.

So understanding the behavior of individual agents surrounding commodities in the marketplace,

applying microeconomic types of analyses to non economic behavior.

So basically at one point, psychologists figured out that there's this whole other discipline

that's been studying behavior.

It just happened to be all focused on monetary behavior, spending and saving money, et cetera.

But it comes with all of these principles that can be wildly and fruitfully applied to

understanding behavior.

So for example, I've studied things like demand curve analysis of drug consumption.

So I look at, for example, the tobacco cigarettes and nicotine products through the lens of

demand curves and in other words, at different prices, if there's different work requirements

for being able to smoke cigarettes, sort of modeling price.

Within that price data, there is some indication of addiction.

How much you, the habits that you form around these particular drugs?

It's one important dimension.

So I think a particularly important one there is elasticity or inelasticity, two ends of

the spectrum.

So that's the price sensitivity.

So for example, you could have something that's pretty price inelastic like gasoline.

So the price of gas at times can keep going up and Americans are just going to pretty

much buy the same amount of gas or maybe the price of gas doubles, but their consumption

only decreases by 10%.

So it's a sub proportional reduction.

So that's an inelastic.

And that changes, like you push the price up high enough, I mean, if it was $100 a gallon,

it would eventually turn, the curve would turn and go downward more drastically and

it would be elastic.

But you can apply that to someone who, a regular cigarette smoker who is working for cigarette

puffs, who has gotten six hours without smoking and you're asking questions like, how many

times are they willing to pull this knob in the lab during this three hour session?

And I do a lot of work like this in order to earn a cigarette.

How does the content of nicotine in that affect it?

How does the availability of nicotine replacement products like nicotine gum or e cigarettes

affect those decisions?

So it's a certain lens of, it's sort of a way to take the classic behavioral psychology

definition of reinforcement, which is just basically reward.

How much is this a good thing?

And it kind of breaks that apart into a multi dimensional space.

So it's not just the idea is reward or reinforcement is not unit dimensional.

So for example, you can unpack that with demand curves.

At a cheap price, you might prefer one good to another.

So the classic example is luxury versus necessity, so diamonds versus toilet paper.

So at those cheap prices, you can look at something called intensity of demand.

If it was basically as cheap as possible or essentially zero, how much would you buy of

this good?

But then you keep jacking up the price and you'll see, so diamonds will look like the

better reward at that low price or of intensity of demand side of things.

But as you keep jacking up the price, you got to have some toilet paper.

Yes.

And again, we can get into the whole like bidet thing, but forget that, you know, like, I

know Joe's been pushing that too, but you're going to hang on and keep buying the toilet

paper to a greater degree than you will the diamonds.

So you'll see a crossing of demand curves.

So what's the better reinforcer?

What's the better reward depends on your price, you know?

And so that's one, that's an example of one way to, in that, of look at addiction.

So specifically drug consumption, which is, isn't all of addiction, but it's like, in

order for something to be addictive, it has to be a reward and it has to compete with

other rewards in your life.

And one of the two main aspects of addiction in my, in my view, and this doesn't map onto

how the, you know, the DSM, the psychiatry Bible defines addiction, which I think is

largely bunk, you know, but there's some value to have some common description.

But it's, you know, how rewarding is it from this multi dimensional lens?

And specifically, how does it, how does that rewarding value compete with other rewards,

other consequences in your life?

So it's, it's not a problem if, if the use of that substance is rewarding, you know,

okay, yeah, you like to have a couple beers every once in a while and it's like not a

problem.

But then you have the alcoholic who is drinking so much that they, it tanks their career,

it ruins their marriage.

It's in competition with these pro social aspects to their life.

It's all about comparing to the other choices you're making, the other activities in your

life.

And if it, you evaluate it as a much higher reward than anything else that becomes an

addiction.

Right.

So it's the rewarding value, but it's the relative rewarding value.

And in the other major aspect, again, from behavioral economics, the thing that makes

addiction is something called delayed discounting.

So in economics, sometimes it's called time preference.

This is the, it's what compound interest rates are based upon.

It's the idea that delaying a good access to a good or reward comes with a certain decrement

to its value.

So we'd all rather have things now than later.

And we can study this at the individual level of, you know, would you rather have $9 today

or $10 tomorrow?

And you get, when you do that, you get huge differences between addicted populations and

non addicted, not just heroin and cocaine, but like just cigarette smokers, like normal,

everyday cigarette smokers.

And even when you look at something like, you know, monetary rewards.

And so you can go into the rabbit hole with, with this delayed discounting model.

So it's not only those huge differences that seem to have a face valid aspect to it, like

the cigarette smoker is choosing this thing that's rewarding today, but I know it comes

with increased risk of having these horrible consequences down the line.

So it's this competition between what's good for me now and what's good for me later.

And the other aspect about delayed discounting is that if you quantitatively map out that,

that discounting curve over time, so you don't just do the, you know, how much, you know,

that $10 tomorrow, how much is it worth to you today?

So you can say, what about nine?

What about eight?

What about $7?

And you can titrate it to find that in difference point.

And so we can say, aha, $6, you know, $10 tomorrow is worth $6 to you today.

So it's by the one day, it's decreased by 40%.

We can do that also at one week and one month and one year and 10 years and map out that

curve, get a shape of that curve.

And one of the fascinating things about this is that whether you're talking about pigeons,

making these types of choices between a little bit of food now or a little bit of food a

minute from now or rats or every, like dozens of species of animals tested, including humans,

the tendency is pretty consistently that we discount hyperbolically rather than exponentially.

What exponentially means is that every unit of time is associated with the same proportional

reduction, every unit of delay is associated with the same causes, the same proportional

reduction in value.

And that's the way the compound interest rate, you know, works, you know, that there's, you

know, compound every day, you know, you get this sort of out of whatever values in there

at the beginning of that day, you get this, you know, we'll give you this amount of extra

money to compensate you for that delay.

But then the way that all animals tend to function is of this very different way where

the reductions, the initial, that initial delay, so like one day's worth of delay, you

see a much stronger discounting rate or reduction in value than you do over those.

So you see the super proportional, then it changes to these lesser rates.

And so the implication of that, I know I've gone like really into the weeds quantitatively,

but what that means is that there's these preference reversals when you have curves

of that nature, the decay that's hyperbolic, it maps onto this phenomenon we see both in

terms of how people deal with future rewards, but also how perception works.

When two things are far away, whether it's physical distance or whether in terms of perception

or whether it's in terms of time, when you're really far away, the value, the subjective

value for that further, that delayed reward is larger.

So for example, let's say we're talking about 360 days from now, you can get $9 or 365 days

a year, now you get $10 and you're like, dude, it's a year, no difference, I'll take, why

not get one more dollar?

You bring that same exact set of choices close or nothing's changed other than the time to

both rewards and it's like, would you rather have $9 today or $10 tomorrow and plenty of

people would say, about the size, go ahead and take it today.

So you see this preference reversal and so that is, that's a model of addiction in the

sense that consistently with true addiction, I would argue, you see this competition between

molar and molecular utility.

It's like intrapersonal, like within the person competing agents, someone sometimes has control

of the bus that wants to do what's good for you in the short term and someone at other

times is in control of driving the bus and they want to do what's good for you in the

long term.

So you tell the, you're trying to quit and you see a doctor, you see your 12 step therapist

and say, God, I know this stuff is killing me, I'm really, I'm on the path, I'm done.

And that's when you're kind of in their office or wherever you're not, it's not around you.

And then later on that day, your buddy says that, hey, man, I just scored, I've got it

right here.

Do you want it?

And that reward is right in front of you.

That's like bringing those two choices right in front of you and it's like, hell yeah,

I want to use.

Yes.

And then you can go through that cycle for like years of the person telling themselves,

I want to quit, but then other times that same person is saying, I don't want to, you

know, functionally they're saying I don't want to because they're saying, yeah, like,

yeah, give me some.

So in the moment, it's very difficult to quit.

And this isn't just something, this is something that has, has huge clinical ramifications with

addiction, but it's like all humans do it.

Anyone who's had hit the snooze alarm in the morning, like the night before they realize,

oh, I got to get up extra early tomorrow.

That's what's ultimately better for me.

So I'm going to set the alarm for, you know, five AM and they, they, it goes off at five

AM, you know, and then it's, so now those two consequences have come sooner and it's

like, what the hell?

And they hit the snooze alarm and some is not just once, but then five minutes later

and five minutes later, you know, and so, and it's why it's easier to exert exercise

self control at the grocery store compared to in your fridge.

Like if that snack is like 30 seconds away in your fridge, you're going to more likely

yield to temptation than if it is further away.

So then to take a step back to something you brought up earlier, the inelasticity of pricing.

Is it from a perspective of the dealers, whether we're talking about cigarettes or maybe venturing

slightly into the illegal realm, you know, of people who sell drugs illegally, they also

have an economics to them that they said prices and all of those kinds of things.

Does addiction allow you to mess with the nature of pricing?

Like, so I kind of assume that you meant that there's a correlation between things you're

addicted to and the inelasticity of the price so you can jack up the price.

Right.

Is there something interesting to be said both for legal drugs and illegal drugs about

the kind of price games you can play because the consumers of the product are addicted?

Right.

I mean, I think you just described it, yeah, you can jack up the price and, you know, some

people are going to drop off, but the people, you know, and it's not dichotomous because

you could just consume less, but some people are going to consume less and the people that

are most addicted are going to keep, you know, I mean, you see this, they're going to keep

purchasing.

So you see this with cigarettes and so it's interesting when you interface this with policy,

like in one respect, heavily taxing cigarettes is a good thing.

We know it keeps, you know, adolescents particularly price sensitive, so you definitely, people

smoke less and especially kids smoke less when you keep cigarette prices high and you

tax the hell out of them.

But one of the downsides, you've got to balance and keep in mind is that you disproportionately

have working class, poor people, and then you get into a point where someone's spending,

you know, quarter of their paycheck on cigarettes.

So they're going to smoke no matter what and basically because they're addicted, they're

going to smoke no matter what and usually, yeah, you're taxing their existence.

Right.

So you're making it worse for, if they don't, if they are completely inelastic, you're

actually making that person's life worse because we know that by interfering with the amount

of money they have, you're interfering with the other pro social, the potential competitors

to smoking, you know, and we know that when someone's in more impoverished environments

and they have less sort of non drug alternatives, you know, the more likely they're going to

stay addicted.

So, you know.

Is there data, this is interesting from a scientific perspective of those same kind

of games in illegal drugs, sort of, because that's where most drug, I was, I mean, I don't

know, maybe you can correct me, but it seems like most drugs are currently illegal.

And so, but they're still in economics to them, obviously, as the drug war and so on.

Is there data on the setting of prices or like, how good are the business people running

the selling of drugs that are illegal?

Are they all the same kind of rules apply from a behavioral economics perspective?

I think so.

I mean, they're basically, whether they're crunching the numbers or not, they're basically

sensitive to that demand curve and they're doing the same thing that businesses do in

a legal market and, you know, you want to sell as much of a product to get as much money.

You're looking more at the total income, so if you jack the price a little bit, you're

going to get some reduction in consumption, but it may be that the total amount of money

that you rake in is going to be more than, it's going to overcompensate for that.

So you're willing to take, okay, I'm going to lose 10% of my customers, but I'm getting

more than enough to compensate from that, from the extra money from the people who still

are buying.

I think they're more, you know, and especially when we get to the lower, I wouldn't be surprised

if people are crunching those numbers and looking at demand curves, maybe at the really

high levels of the, you know, up the chain with the cartels and whatnot.

I don't know.

That wouldn't surprise me at all, but I think it's probably more implicit at the lower levels

where something he brought up, drug policy, I will say that for years now, it's been this

kind of unquestioned goal by, for example, the drug czar's office in the U.S. to make

the price of illegal drugs as high as possible without this kind of nuanced approach that,

yeah, if you make, you know, for some people, if you make the price so high, you're actually

making things worse.

I mean, I'm all about reducing the problems associated with drugs and drug addictions,

and part of that is that are more direct consequences of those drugs themselves, but a whole lot

is what you get from indirectly, and, you know, sort of the, both for the individual

and for society, so like making it a poor person who doesn't have enough money for their

kids, making them even poorer, so now you've made their children's future worse because

they're growing up in deeper poverty because you've essentially levied a tax onto this

person who's heavily addicted, but then at the societal level, you know, so everything

we know about the drug war in terms of the heavy criminalization and filling up prisons

and reducing employment and educational opportunities, which in the big picture, we know are the

things that in a free market compete against some of the worst problems of addiction is

actually having educational and employment opportunities, but when you give someone a

felony, for example, you're pretty much guaranteeing they're never going to go very high on the

economic ladder, and so you're making drugs a better reward for that person's future.

So this is a quick step into the policy realm, and I think for both you and I, I'm not sure

you can correct me, but I'm more comfortable into studying the effects of drugs on the

human behavior and human psychology versus like policies, seems like a whole giant mess,

but you know, there's some libertarian candidates for president and just libertarian thinkers

that had a nice thought experiment of possibly legalizing, I've spoken about possibly legalizing

basically all drugs in your intuition, do you think a world where all drugs are legal

is a safer world or a less safe world for the users of those drugs?

It really depends on what we mean by legalization.

So this is one of my beefs with this, you know, how these things are talked about.

I mean, we have very few completely laissez faire, you know, legal drugs.

So even caffeine is one of the few examples.

So for example, caffeine and tea and coffee is in that realm.

Like there's no limits, no one's testing, there's no laws, regulation at any level

of how much caffeine you're allowed to buy or how much in a product.

But even like with this Starbucks like Nitro, there are rules with soda and with canned products,

you can only put so much in there.

Yeah.

So this is FDA regulated and it's kind of weird because there's a limit to sodas that's

not there for energy drinks and other things.

But you know, so even caffeine, it depends on what product we're talking about.

If you're like no dose and other caffeine products over the counter, like you can't

just put 800 milligrams in there.

The pills are like one or 200 milligrams.

And so it's FDA regulated as an overcounter drug.

Some of the most dangerous drugs in society, I would say arguably one of the most dangerous

classes of drugs is the volatile anesthetics, huffing, people huffing gasoline and, you

know, airplane glue, toluene, whatnot, um, severely damaging to the nervous system.

Pretty much legal.

But there's some regulation in the sense that there's a warning label, like it's illegal

to do it for, not that it nested people, they're busting people for this, but you know, it's

against federal law to use this in a way other than intended type of the basics, like, yeah,

don't huff this, you know, um, your paint thinner, whatnot, at least keeps people from

selling it for that, like no, because they're going to, they're going to go after that person.

They're not going to be able to find the 12 year old who's huffing.

So anyway, just as some extreme examples at the end.

And then, you know, even the, the so called illegal, like schedule one drug, psilocybin,

we do plenty in, in, um, in terms of schedule two, which is ironically less restricted than

psilocybin, but methamphetamine and cocaine, I've done human research with my research

has been legal.

So they're scheduled compounds, but they're not completely illegal.

Like you can do research with them with the appropriate licensees and, um, uh, approval.

So there really is no such thing in like alcohol.

Well, it's illegal if you're 12 years old or 18 years old or 20 years old.

And for anyone, it's illegal to, to be drinking it while you're driving.

So there's always a nuance.

There's rules, right?

It's not dichotomy.

And I actually should admit, it's been on my to do list for a while to buy in Massachusetts

some like edible or buy weed legally.

I, um, yeah, haven't done that in Massachusetts, put it this way, and I, I wonder what that

experience is like, cause I get, I think it's fully legal in Massachusetts.

And so I wonder what legal drugs look like to me, you know, I grew up with even weed

being like, you know, not, it's like this forbidden thing, you know, not, not forbidden,

but it's illegal.

You know, most people, of course I never partook, but, uh, most people I knew would, uh, attain

it illegally.

And so that big switch that's been happening across the country, there's like federal stuff

going on to make a marijuana legal federal, I'm, I'm half paying attention.

There's some movement there.

I mean, the house passed a bill that's not going to be passed by the, by the Senate.

But yeah, it's, it's a progress.

There's, there's clearly a change in, right.

It's moving in a trend.

So that's the example of a drug that used to be illegal and is now becoming more and

more and more legal.

Um, so I wonder what like, uh, cocaine being legal looks like, right?

What a society with cocaine being legal looks like.

The rules around it, the, uh, you know, the processes in which you can consume it in a

safer way and be more educated about its consequences, be able to control dose and like purity much

better, be able to get help for overdose, I don't know, all those kinds of things.

I, it does in a utopian sense feel like legalizing drugs at least should be talked about and

considered versus, uh, keeping them in the dark.

I agree.

But yeah, so that in your sense, it's possible that in 50 years, uh, we legalize all drugs

and, uh, it makes for a better world.

The way I like to talk about it is that I would say that we, it's possible and it would

probably be a good thing if we regulate all drugs.

How would you regulate, uh, like cocaine, for example?

Is there, is there ideas there?

So yeah, and you were already, you know, goings, you know, where I was going with that kind

of first I described how there's always a new ones and even like the cannabis in Massachusetts,

federally illegal.

So for example, if I was like, and I, you know, colleagues that do cannabis research

where they get people high in the lab, like you're a federal funded researcher within

NIH funds, you can't get that, that stuff from the dispensary because it's, you're breaking

a federal law, even though the feds don't have the resources to go after, they don't

want the controversy at this point to go after the individual users or even the, the sellers

in those legal states.

So there's always this nuance, but it's, it's about right, the right regulation.

So I think we already know enough that, for example, like I think safe injection sites

for hard drugs, um, makes a lot of sense.

Like I wouldn't want, um, heroin and cocaine at the convenience stores.

And I don't think, maybe there's some extreme libertarians that want that.

I think even the folks that identify as libertarians, probably most of them don't, well, I don't

know, like not all of them want that, you know, um, I think, you know, that as a form

of regulation, like, look, if you're using these hard drugs on a, on a regular basis,

you're putting yourself at risk for lethal overdose, you're putting yourself at risk

for catching, um, HIV and, and hepatitis, um, if you're going to do it, if you're doing

it anyway, come to this place where at least you're not like, you know, you're like pulling

the, the, the water out of like, you know, the puddle on the side of the street.

Yeah.

So it's done by professionals and those professionals are able to educate you also.

So like a 711 clerk may not be both capable of helping you to, uh, to inject the drug

properly, but also it won't be equipped to educate you at, but the negative consequences

on those kinds of things.

That's a huge part of it, the education, but then I think with the opioids, like the big

part of it is just like with naloxone, which is an antagonist, it goes into the, um, the

receptor.

It's called Narcan.

That's the trade name, but it's what they revive people on an opioid overdose.

That's almost completely effective.

Like if there's a medical professional there and someone's ODing on an opioid, they're

virtually guaranteed to live.

Like that's remarkable that if a hundred percent at the opioid crisis, you know, if all of

those people right now that are dying, we're doing that in the presence of a medical professional,

like even just like a nurse with Narcan, there'd be basic almost no deaths.

There's always some exceptions, but you know, almost no deaths.

Like that's staggering to me.

So the idea that people are doing this, you know, that we could have that level of positive

effect without encouraging the drug.

And this is where like you get into this like terrain of like sending the wrong message

and it's like, no, you can do that.

You can say like, we're not encouraging this.

In fact, probably one of the greatest advertisements for not getting hooked on heroin is like visiting

a methadone clinic, visiting a safe injection site.

Like, like this is not like an advertisement for getting hooked on this drug, but knowing

that we can save people.

Now you have a landscape here because a lot of times it's just like supervised injection,

but you bring your own stuff, you know, you bring your own heroin, which could still be

you know, dirty and filled with fentanyl and fentanyl derivatives, which because of the

incredible potency and the more difficulty measuring it, and some differences at the

receptor, like you may be more likely, you are more likely on average to lethally overdose

on it.

You know, so you could the level that's been more explored in Switzerland is in some places

is you actually provide the drug itself and you supervise the injection.

So I don't see...

Do you like that idea?

Yeah.

The public health data are completely on the side of there's really no credible evidence

to this.

If we allow that, we're sending the wrong message and everyone's going to be, I mean, I'm not

showing up like, you know, and it's different by drug like, yeah, you, you legalize, you

set up cannabis shops and some people are going to say, so you come and go there.

I don't think a whole lot of people are going to go to one of these places and say, I'm

going to shoot up heroin for the first time because, and even if like, you know, it's

a country of 300 million people, like even if someone does that, you have to compare

this to the everyday people are dying from opioid overdoses, like people's kids, people's

uncles, people's like, these are real lives that are being shattered.

So you just look at that.

And then the other thing, and I know this from having done residential, even like non

treatment research where we just have a cocaine user or something, stay on our inpatient word

for a month and you really get to know them and sometimes you see, like oftentimes that's

the first time this person has had a discussion with a medical professional, any type of professional

in their entire life around their drug use, even if they're not looking to quit.

And it's like, I, you know, you could imagine that in the safe injection settings where

it's like, it might be a year into treatment and they're like, you know, doc, I know you're

not the cops.

Like you really care for me.

Like, I think I'm ready to try that methadone thing.

I think I'm really, I think I want to be done.

I want to be done.

Yeah, they get to trust the people and, and realize that they're, they're there because

they truly like, they have a compassion, a love for, for, for this community, like as

human beings and they don't want people to die.

And you get real human connections and that, and again, like those are the conditions where

people are going to ultimately seek treatment.

And not everyone always will, but you're, you're going to get that.

And then you're, you know, you're going to get people like looking into treatment options.

You know, maybe it's years into, to the treatment.

So it's like, they're just all of these indirect benefits that I think at that level, I don't

know if you'd call that legalizing, you know, I think again, right, at least well regulated.

Right.

Whatever that word is.

Yeah.

Well regulated, but out in the open.

Right.

Minimizing as many harms as we can, while not encouraging.

I mean, we don't encourage people to drink all the, I mean, people die every year from

caffeine overdose.

Like, you know, and there's different ways to like, you know, like, you know, like,

just by allowing something doesn't mean we're sending the message that, you know, by saying

we're not going to give you a felony, which is actually often the, the, the, the, the

penalty for, for psychedelics.

I just actually testified for the judiciary committee, the, the Senate, the assembly in,

in New Jersey.

And just to move psilocybin from a felony to misdemeanor, they use different language

in New Jersey.

It's weird, but like the equivalent of felony and misdemeanor, and that was like two people

didn't vote for that on the, on this committee, because it was might, one of them said it

might be sending the wrong message and it's like a felony.

I mean, there's real harms.

Like that's the scarlet letter the rest of your life.

You're stuck at the lower ends of the employment ladder.

You're not going to get, you know, loans for education, all of this, maybe because of a

stupid mistake you made once as a 19 year old.

Doing something that like, you know, a presidential candidate could have done and admitted to

and had no problem.

You know, yeah, what drug is the most addictive, the most dangerous in your view?

Not maybe like, not technically like specifically which drug, but more like in our society today.

What is a highly problematic drug?

We talked about psychedelics not being that addictive on the other flip side of that.

You mentioned cocaine.

Is that, is that the top one?

Is there something else that's a concern to you?

It depends.

And you've already alluded to this nuance.

It depends on how you define it.

If we're talking about on the ground today in, you know, modern society, I'd say nicotine

tobacco.

Oh, interesting.

I mean, in terms of mortality, it kills, it kills far more than any other drug known

to humankind four times more than alcohol, like a half million deaths in the US every

year and about five to six million worldwide due to tobacco.

That's four times more in the US than alcohol.

And if you graph all of the drugs, legal and illegal, like, you know, put all of the illegal

drugs in like one category on that figure and you put alcohol and tobacco on that figure,

all the illegal drugs combined, barely, they're a barely visible blip to this incredible, like

it's, there's no, even all of the opioid epidemic rolled up along with cocaine and everything

else in the meth barely shows up compared to tobacco.

That's one of those uncomfortable truths that I don't know what to do with.

It's like, where everybody's freaking out about coronavirus, right?

And nobody's.

The relative.

It's, it's all relative.

If you look at the relative thing, it's like, well, why aren't we freaking out about now

cigarettes, which, which we are increasingly so over the historically speaking, right?

Right.

It's like terrorism versus swimming pools.

I remember that being back in the, after the war on terrorists started, it's like, yeah,

there's not even comparison.

Okay.

So, you know, that's a little sobering truth there.

Cause I was thinking like cocaine, I was thinking about all of these hard drugs, but the reality

is relatively nicotine is the, is the big one.

When you didn't ask about mortality or deaths, you asked about addiction, but that's, that

really is hard to, hard to evaluate.

It gets into those nuances I spoke of before about there's not a unit dimensional way to

measure reinforcement.

It kind of depends on the situation and, and what measure we're looking at.

But, you know, more people have access to tobacco and I'm not, I'm not advocating that we make

it an illegal drug.

I think that would, it was a hard, would be a horrible mistake, although there is a very

credible push to, to mandate the reduction of nicotine in cigarettes, which I have most

scientists that study it are for it.

I think there's some real dangers there because I see that in the broader history of drug

use.

It's like, when has drug prohibition worked broadly speaking?

And, and it's, it's, to me, that would, that, that path would only make sense in very good

conjunction with eCigarettes, which once they're fully regulated can be a safer, not safe, but

much safer alternative.

And if we don't, if we tax the hell out of eCigarettes and ban every attractive feature

like, like flavors and everything, then that's going to push people to a black market if

they can't get the real thing from real cigarettes.

Some people will just quit straight out, but I think with the regulators and what a lot

of scientists that study tobacco like myself, it's a big part still of what I study, they're

not used to thinking about the, like tobacco really as a, as a drug, largely speaking in

terms of, you know, for example, the history of prohibition.

And I think of like, we already know there's an illicit market, a black market for tobacco

to get around, you know, taxes, I mean, and for selling even loose cigarettes.

That's what initially caused in Staten Island, the police to approach, was it Eric Garland

who is selling loose cigarettes and he got choked out.

I mean, the thing that caused that police contact was he was selling, well, I think

reported to sell individual cigarettes for like, you know, you could sell them for quarter,

happens in Baltimore.

And it's like, that's technically illegal.

But you know, are you not going to have massive boats of, you know, supplies coming over from

China and elsewhere of real deal cigarettes if you ban, you know, the sale of nicotine?

Like it's obviously going to happen and you have to weigh that against, you know, you're

going to create a black market to one size or another.

And your intuition that really hasn't worked throughout the history when we've tried it.

Right.

But I see a potential path forward, but only if it's well, if it's not in conjunction with

eCigarettes.

If there's a clear alternative that's a positive alternative that it kind of stares the population

that, right, towards an alternative.

Yeah.

The unique thing that could be taken advantage of here is nicotine is by and large not what

causes the harm.

It's the aromatic hydrocarbons, it's the carcinogens and tobacco, it's burning tobacco smoke.

It's not the nicotine.

So that it's not like alcohol prohibition where like, you know, you couldn't create

the adules, the near beer is not going to have the alcohol.

And so people like, here you do have the possibility of giving another medium, the ability to

deliver the drug, which still aren't, to a lot of people, isn't preferred to the tobacco,

but nonetheless, again, if you over regulate those and make them less attractive, like if

you aren't thoughtful about the nicotine limits and thoughtful about whether you're

allowing flavors and everything, and if you over tax them, you're actually decreasing

the ability to compete with the more dangerous product.

So I feel that like there is a potential path forward, but I don't have a lot of confidence

that that's going to be done in a thoughtful, analytical way.

And I'm afraid that it could decrease the increase of black market calls all of the

harms.

Like every other drug we're moving away from the heavy, from the prohibition models slowly,

but the big barge ship is like making a very slow turn and like, okay, we really had a

step back and question if we want to with nicotine tobacco, are we moving into that

direction?

Yeah.

Like big picture.

It doesn't quite make sense.

You've done a study on cocaine and sexual decision making, can you explain the findings?

I mean, in a broad sense, how do you do a study that involves cocaine and the other,

how do you do a study involving this sexual decision making?

And then how do you do a study that combines both?

Yeah.

Sex and drugs too.

I'm just missing the rock and roll.

The rock and roll.

The two controversial.

Rock and roll isn't very controversial anymore, but yeah, so the cocaine, you know, lots of

hoops to drum through.

You got to have a lot of medical support.

You got to be at a basically an institution, a research unit like I'm at that has a long

history and the ability to do that and get ethics approval, get FDA approval, but it's

possible.

And whenever you're dealing with something like cocaine, you would never want to give

that to someone who hasn't already used cocaine and you want to make sure you're not giving

it to someone who is an active user who wants to quit.

So the idea is like, okay, if you're using this type of drug anyway and you're really

sure you're not looking to quit, hey, use a couple of times in the lab with us so we

can at least learn something.

And part of what we learn is maybe to help people not use and reduce the harms of cocaine.

So there's hoops to jump through.

With the sexual decision making, I looked at the main thing I looked at was this model

of I applied delayed discounting to what we talked about earlier than now versus later

that kind of decision making that goes along with addiction.

I applied that to condom use decisions and I've done probably published about 20 or so

papers with this and different drugs and...

So the primary metric is whether you do or don't use a condom?

Right.

All hypothetical...

And so this is using hypothetical decision making, but I've published some studies looking

at showing a tight correspondence to self reported in correlational studies to self reported

behavior.

So this is like, how do you do a questionnaire kind of thing?

Right.

So it's not quite a questionnaire, but it's a behavioral task requiring them to respond

to see...

You show pictures of a bunch of individuals and it's kind of like one of these fun behavioral

like a lot of them you get like numbers are born, but it's like, okay, hot or not, like

which of these 60 people would you have a one night stand with?

Men, women to pick whatever you like, a little bit of this, a little bit of that, whatever

you're into, it's all variety there.

Out of that group, you pick some subsets of people.

Who do you think is the one you most want to have sex with the least?

He thinks most likely to have an STI or at least likely a sexually transmitted disease

by STI.

And then you could do certain decision making questions of what I've done is ask, say this

person, he'd read a vignette, this person wants to have sex with you, now you've met

them, you get a long casual sex scenario, like a one night stand, with a condoms available,

just rate your likelihood from one to 100 on this kind of scale.

Would you use it?

Would you use a condom?

But then you can change your scenario to say, okay, now imagine you have to wait five minutes

to use a condom.

So the choice is now instead of using condom versus not in terms of your likelihood scale,

it now it ranges from have sex now without a condom versus on the other end of the scale

is wait five minutes to have sex with the condom.

So you rate your likelihood of where your behavior would be along that continuum.

And then you could say, okay, well, what about an hour?

What about three hours?

What about, you know, what about 24 hours?

It's a misunderstanding.

Now without a condom or five minutes later with a condom is in the, so what's supposed

to be the preference for the person like is like, there's a lot of factors coming into

play, right?

Right.

Like there's like pleasure, personal preference, and then there's also the safety.

Those are two like, are those competing objectives?

Right.

And so we do get at that through some individual measures.

And this task is more of a face valid task where there's a lot underneath the hood.

So for most people, sex with the condom is the better reward.

But underneath the hood of that is just at the purely physical level, they'd rather have

sex with without the condom.

It's going to feel better.

What do you mean by reward?

Like when they calculate their trajectory through life and try to optimize it, then sex with

the condom is a good idea?

Well, it's really based on, I mean, yeah, yeah, presumably that's the case that there's,

but it's measured by like what would really that first question where there is no delay.

Most people say they would be at the higher net scale.

A lot of times a hundred percent, they would say they would definitely use a condom.

Not everybody.

And we know that's the case.

See, it's like that some people don't like, some people say, yeah, I want to use a condom,

but quarter of the time ended up not because I just get lost in the passion of the moment.

So for the people, I mean, the only reason that people, so behaviorally speaking, at

least for a large number of people in many circumstances, condom use as a reinforcer,

just because people do it, like, you know, why are they doing it?

They're not because it makes the sex feel better, but because it makes that it allows

for at least the same general reward, even if actually, even if it feels a little bit

not as good, you know, with the condom, nonetheless, they get most of the benefit without the concurrent,

oh my gosh, there's this risk of either unwanted pregnancy or getting HIV or way more likely

than HIV, you know, herpes, you know, in general, the words, et cetera, all the lovely ones.

And we've actually done research saying, like, where we gauge the probability of these individual

different STIs, and it's like, what's the heavy hitter in terms of what people are

using to judge, you know, to evaluate whether they're going to use a condom.

So that's why the condom use is the delayed thing.

The minutes are more, and then, yeah, because that's the preferred.

Which would normally be the larger, later reward, like the $10 versus the nine.

It's like the $10, which is counterintuitive if you just think about the physical pleasure.

So that's a good thing to measure.

So condom use is a really good, concrete, quantitative, quantifiable thing that you

can use in a study, and then you can add a lot of different elements, like the presence

of cocaine and so on.

Yeah, you can get people loaded on, like, any number of drugs, like cocaine, alcohol,

and methamphetamine are the three that I've done and published on.

And it's interesting that...

These are fun studies, man.

Right.

I love to get people loaded in a safe context, and like, but to really...

It started like there was some early research in alcohol.

Fascinating.

I mean, the psychedelics are the most interesting, but it's like all of these drugs are fascinating.

The fact that all of these are keys that unlock a certain, like, psychological experience

in the head.

And so there was this work with alcohol that showed that it didn't affect those monetary

delay discounting decisions, you know, $9 now versus $10 later, and then like getting

people drunk.

And I thought to myself, are you telling me that, you know, getting someone that people

being drunk does not cause people, at least sometimes to make, to choose what's good for

them in the short term at the expense of what's good for them in the long term?

It's like, you know, bullshit, you know, like, we see it, like...

But in what context does that happen?

So that's something that inspired me to go in this direction of like, aha, risky sexual

decisions is something they do when they're drunk.

They don't necessarily go home and even though some people have gambling problems and alcohol

interacts with that, the most typical thing is not for people to go home, you know, log

on and change their allocation and their retirement account or something like that, you know, like...

But they're more likely, risky sexual decisions, they're more likely to not wait the five minutes

for the condom and instead go no condom now.

Right.

So we see an effect and we see that and interestingly, we do not see with those different drugs,

we don't see an effect if we just look at that zero delay condition.

In other words, the condom's right there waiting to be used, would you...

How likely are to use it?

You don't see it.

I mean, people are by and large going to use the condom.

So and that's the way most of this research outside of behavioral economics that's just

looked at condom use decisions, very little of which has ever actually administered the

drugs, which is another unique aspect.

But they usually just look at like assuming the condom is there, but this is more using

behavioral economics to delve in and model something that and I've done survey research

on this, modeling what actually happens.

Like you meet someone at a laundry mat, like you weren't planning on like, you know, one

thing leads to another, they live around the corner, you know.

These things, you know, and like we did one survey with men who have sex with men and

found that 25% of them, 24%, about a quarter reported in the last six months that they

had unprotected anal intercourse, which is the most risky in terms of sexually transmitted

infection.

In the last six months, in a situation where they would have used a condom, but they simply

didn't use one just because they didn't have one on them.

So this to me, it's like, if unless we delve into this and understand this, these suboptimal

conditions, we're not going to fully address the problem.

There's plenty of people that say, yep, condom use is good.

I use it a lot of the time.

You know, it's like, where is that failing?

And it's under these suboptimal conditions, which in Frank, if you think about it, it's

like most of the case.

Action is unfolding, things are getting hot and heavy.

Someone's like, do you got a condom?

No.

It's like, do they break the action and take 10 minutes to go to the convenience store

or whatever?

Maybe everything's closed.

Maybe they got to wait till tomorrow.

And though there's something to be studied there on the, that just seems like an unfortunate

set of circumstances.

Like what's the solution to that is, I mean, what's the psychology that needs to be like

taken apart there?

Because it just seems like that's the way of life.

We don't expect the things that to happen.

Are we supposed to expect them better to be like, be self aware enough about our calculations?

Or you see the 10 minute detour to a convenience store as a kind of thing that we need to understand

how we humans evaluate the cost of that.

I think in terms of like how we use this to help people, it's mostly on the environment

side rather than on the, on the, on the, on the, on the, on the, on the, on the, on the

those, those interact.

So it's like, you know, in one sense, if you're especially, if you're going to be drinking

or using another substance that, that is associated with, you know, a stimulant, alcohol and

stimulants go along with risky sex, you know, good to be aware that you might make decisions

just to tell yourself, you might make a decision that, that is going to, that you wouldn't

made in your sober state.

And so, hey, throwing a condom in the, in the purse and the, in the pocket, you know,

might be, you know, a good idea.

I think at the environmental level, just more condom, I mean, it highlights what we know

about just making condoms widely available.

Something that I'd like to do is like, you know, reinforcing condom use, you know, so,

you know, just getting people used to carrying a condom everywhere they go, because it's

such a once it's in someone's habit, if they are, say, like a young single person and,

you know, it's, you know, they occasionally have unprotected sex, like training those

people, like, what if you got a text message, you know, once every few days saying, ah,

if you show me a, send back a photo of a condom within a minute, you get a reward of $5.

You could shape that up, like that it's a process called contingency management.

It's basically just straight up operant reinforcement.

You could shape that up with no problem.

And, and I mean, those procedures of contingency management, giving people systematic rewards

is like, for example, the most powerful way to, to, to reduce cocaine use and addicted

people.

And, but by saying, if you show me a negative urine for cocaine, I'm going to give you a

monetary reward.

And like that has huge effects in terms of decreasing cocaine use.

If that can be that powerful for something like stopping cocaine use, how powerful for

that?

Could that be for shaping up just carrying a condom?

Because the primary, unlike cocaine use here, we're not saying you can't have the main reward.

Like you could still have sex and you can even have sex in the way that you tell yourself

you'd rather do it, you know, if the condom is available, you know, so, you know, like,

you're not, you know, it's relatively speaking, it's way easier than like not using cocaine.

If you like using cocaine, it's just basically getting in the habit of carrying a condom.

So that's just one idea of like, what?

There could be also the capitalistic solutions of like, there could be a business opportunity

for like a door dash for condoms, like, like delivery, I thought about this within five

minute delivery of a condom at any location, like Uber for condoms.

I've thought about it, not with condoms, but a very similar line of thinking, a line that

you're going into in terms of Uber and people getting drunk when they, they into the bar

playing to have one or two, they ended up having five or six and it's like, okay, yeah,

you could take the cab home, the Uber home, but you've left your car there, it might get

towed, you might like, there's also the hassle of just, you know, you want to wake up tomorrow

with your hangover and forget about it and move on.

Like, and I think a lot of people in their situation and they're like, screw it, I'm

going to take the risk, just get it, you know, what if you had an Uber service where two,

you know, you have a two, some, a car come out with two drivers and one of them, two sober

drivers obviously, and they, and the person they, the one driver drops off the other that

then drives you home in their car, in your car, so that you can, I mean, I think a lot

of people would pay 50 bucks, it's going to be more than a regular Uber, but it's like,

it's going to be done.

I got the money, I already spent 60 bucks at the bar tonight, like, just get the damn

thing done, tomorrow I'm done with it, my car, I wake up, my car's in front of my house.

I think that would be, I think someone could, I'm not going to open that business, so like,

if anyone hears this and wants to take off with that, like, I think it could help a lot

of people.

Yeah, definitely.

An Uber itself, I would say, helped a huge amount of people, just making it easy to make

the decision of going home while not driving yourself.

I read about in Austin where they, I don't know where it's at now, where they outlawed

Uber for a while, you know, because of the whole taxi cab union type thing and how just,

yeah, there were like hordes of drunk people that were used to Uber that now didn't have

a cheap alternative.

So just, we didn't exactly mention, you've done a lot of studies in sexual decision making

with different drugs.

Is there some interesting insights or findings on the difference between the different drugs?

So I think you said meth as well, so cocaine, is there some interesting characteristics

about decision making that these drugs alter versus like alcohol, all those kinds of things?

I think, and there's much more to study with this, but I think the biggie there is that

the stimulants, they create risky sex by really increasing the rewarding value of sex.

Like if you talk to people that are really, especially that are hooked on stimulants,

one of the biggies is like sex on coke or meth is like so much better than sex without.

And that's a big part of why they have trouble quitting, because it's so tied to their sex

life.

I think your decision making is broken, it's just that you, well, you allocate.

It's a different aspect of their decision, yeah, on the reward side.

I think on the alcohol, it works more through disinhibition.

It's like alcohol is really good at reducing the ability of a delayed punisher to have

an effect on current behavior.

In other words, there's this bad thing that's going to happen tomorrow or a week from now

or 20 years from now.

Being drunk is a really good way, and you see this in like rats making decisions.

A high dose of alcohol makes someone less sensitive to those consequences.

So I think that's the lever that's being hit with alcohol, and it's more just increasing

the rewarding value of sex by the psychostimulants on that side.

We actually found that it, and it was amazing, because hundreds of millions of dollars have

been spent by NIH to study the connection between cocaine and HIV.

We ran the first study on my grant that actually just gave people cocaine under double blind

conditions and showed that when people are on coke, their ratings of sexual desire, even

though they're not in a sexual situation, yeah, you showed them some pictures, but they're

just saying they're horny.

You get subjective ratings of how much sexual desire you're feeling right now.

People get horny when they're on stimulants, and a lot of people say duh if they really

know these drugs.

But that's a rigorous study that's in the lab that shows like, there's a plot, the dose

effects of that, the time course of that, yeah, it's not just.

Can you please tell me there's a paper with a plot that shows dose versus evaluation of

like horniness?

Yeah, we didn't say horniness, we said sexual arousal.

Sex.

Yeah, basically, yeah.

There's a plot, I'm going to find this plot.

Right, I'll send it to you.

There was one headline from some publicity on the work that said, horny cocaine users

don't use condoms or something like that.

You got to love journalism.

I wouldn't have put it that way, but yeah, that's right on.

I guess that's what it finds.

So you've published a bunch of studies on psychedelics.

Is there some especially favorite insightful findings from some of these that you could

talk about, maybe favorite studies or just something that pops to mind in terms of both

the goals and the major insights gained and maybe the side little curiosities that you

discovered along the way?

Yeah, I think of the work with using psilocybin to help people quit smoking and we've talked

about smoking being such a serious addiction and so that what inspired me to get into that

was just having behavioral psychology as my primary lens, this sort of radical empirical

basis of, I'm really interested in the mystical experience and all of these reports.

Very interested, but at the same time, I'm like, okay, let's get down to some behavior

change and something that we can record, like quantitatively verify biologically.

To find all kinds of negative behaviors that people practice and see if we can turn those

into positive.

Right, like really change it, not just people saying, which again is interesting, I'm not

dismissing it, but folks that say my life has turned around, I feel this has completely

changed me.

It's like, yep, that's good.

All right, let's see if we can harness that and test that into something that's real

behavior change.

You know what I mean?

It's quantifiable.

It's like, okay, you've been smoking for 30 years.

That's a real thing and you've tried a dozen times seriously to quit and you haven't been

able to long term, okay, and if you quit, we'll ask you and I'll believe you but I don't trust

everyone reading the paper to believe you.

So we're going to have you pee in a cup and we'll test that and we'll have you blow into

this little machine that measures carbon monoxide and we'll test that.

So multiple levels of biological verification.

Now we're getting, to me, that's where the rubber meets the road in terms of therapeutics.

It's like, can we really shift behavior and so much as we talked about my other scientific

work outside of psychedelics is about understanding addiction and drug use.

So it's like looking at addiction, it's a no brainer and smoking is just a great example.

And so back to your question, we've had really high success rates.

It rivals anything that's been published in the scientific literature.

The caveat is that, you know, that's based on our initial trial of only 15 people but

extremely high long term success rates, 80% at six months per foot, smoke free.

So can we discuss the details and so first of all, which psychedelic we're talking about

and maybe can you talk about the 15 people and how the study ran and what you found?

Yeah, yeah.

So the drug we're using is psilocybin and we're using moderately high and high doses

of psilocybin.

And I should say this about most of our work.

These are not kind of museum level doses.

In other words, nothing, even big fans of psychedelics want to take and go to a concert

or go to the museum.

If someone's a burning man on this type of dose, like they're probably going to want

to find their way back to their tent and zip up and hunker down for, you know, not be around

strangers.

By the way, the delivery method, psilocybin is mushrooms, I guess.

What's the usual?

Is it edible?

Is there some other way, like how is people supposed to think about the correct dosing

of these things?

Because I've heard that it's hard to dose correctly.

That's right.

So in our studies, we use the pure compound psilocybin.

So it's a single molecule, you know, a bunch of molecules.

And we give them a capsule with that in it.

And so it's just, you know, a little capsule, they swallow.

What people, when psilocybin is used outside of research, it's always in the context of

mushrooms because they're so easy to grow.

There's no market for synthetic psilocybin.

There's no reason for that to pop up.

The high dose that we use in research is 30 milligrams body weight adjusted.

So if you're a heavier person, it might be like 40 or even 50 milligrams.

We have some data that, based on that data, we're actually moving into like getting away

from the body weight adjusting of the dose and just giving an absolute dose.

It seems like there's no justification for the body weight based dosing, but I digress.

Generally 30, 40 milligrams, it's a high dose.

And based on average, even though, as you alluded to, there's variability, which gets

people into some trouble in terms of mushrooms like psilocybe cubensis, which is the most

common for species in the illicit market in the US.

This is about equivalent to five dried grams, which is right at about where, right where

McKenna and others, they call it a heroic dose.

You know, this is not hanging out with your friends, going to the concert again.