Microdosing, Biohacking Plant Medicines, Psychedelic-Enhanced Psychotherapy & More - How "Field Trip Health" Works For Ketamine, MDMA, DMT, Psilocybin & Beyond!

On this episode of the Ben Greenfield Fitness podcast.

That's what's really cool about psychedelic therapy overall is because we can start changing the conversation around mental health, which has typically been reactive, which is you go see a therapist because you're depressed or you're anxious to something that's proactive, where you're going through this because you just want to have a better life. That's what's so cool about psychedelics is not only can they treat depression and anxiety, they can increase empathy and creativity and awareness and self understanding. And you don't have to be sick to benefit from those kind of things.

Health, performance, nutrition, longevity, ancestral living, biohacking, and much more. My name is Ben Greenfield. Welcome to the show. All right, I told you all about psychedelic assisted psychotherapy in last week's podcast episode with Dr. Matt Johnson. Now we're going to dive a little bit more into ketamine and how a lot of these clinics actually work with my friend Ronan Levy and a scientist who works with his company Field Trip Health named Marshall Tyler. So if you're not sick of psychedelics yet, then sit back and get ready for even more. But I would recommend you go back and listen to that initial episode with Matt Johnson where I also talk about my friend Tim Ferriss initiative to raise a bunch of money for the MAPS foundation and want to be a part of that initiative. Please go to the show notes in that original episode@bengreenfieldfitness.com psychedelics to get in on the $10 million raise that they're doing for the MAPS foundation, which supports initiatives similar to what you're about to hear about. Well, folks, it's time for another episode on psychedelics and psychoactive molecules, something I know a lot of you are interested in. And it's something that that is becoming increasingly common in the news in the research that we see institutions like Johns Hopkins putting out and also in therapy clinics that seem to be becoming increasingly prevalent. What I mean by that is that physicians seem to really have their ears perked up to this idea of using psychedelics for therapy, for addiction, for trauma, et cetera. And I really wanted to do an interview in which I talk to some people who are kind of behind the scenes when it comes to not only the science behind some of these psychoactive molecules, particularly the ones that I think we're going to see with increasing prevalence in Canada, in the US and elsewhere, but I also wanted to explore what actually happens with these type of clinics and what this type of therapy actually involves in both boots on the streets, fashion, but then also from even something like a telemedicine standpoint for people who may not be able to go to a clinic, because it turns out that both of these options are something that exists. Now, my first guest on today's show is actually a friend of mine. His name is Ronan, Ronan Levy. And he has founded something called Field Trips Psychedelics, which he'll explain a little bit more to you as we get going. But I've been taking a look at what they are doing and it's pretty intriguing when it comes to the whole realm of psychedelic therapy and psychedelic therapy clinics, what they are up to. And so Ronan is a lawyer by trade, but is very involved in the psychedelics sector and also the hemp and the cannabis and the biotech industries. And my second guest on today's show is a friend of Ronan's and a scientist who has studied up on a lot of these psychoactive molecules. So he's going to be the geek on today's show. He really looks into the chemistry and the biology, biology and unravels the molecular basis of a lot of these neuropsychiatric disorders. He's worked previously as the leading scientist at one of the largest cannabis edibles manufacturers in California, but has gone on from being involved with, I suppose, gummy bears and chocolates and brownies to a little bit more of the dive into these therapeutic molecules. Not that cannabis isn't therapeutic and not that I'm not joking about what it involves being a scientist at an edibles company. But anyways, between these two guys, I think we're really, really gonna get a wealth of knowledge on how psychedelic therapy actually works and what the scene looks like right now. So, Ronan, Marshall, welcome to the show, fellas.

Thanks, Ben.

Good to be here. Thank you, Ben.

Yeah, yeah. And you gotyou guys both have a pretty deep history in the cannabis industry, and so II gotta ask you if you'reif you're, like, drinking raw hemp juice or if you put some kind of a CBD tinct coffee this morning or what exactly are you guys fueled up on right now? I always like to find out what my guests have had for breakfast when we're recording a morning show.

I fasted this morning, so I didn't eat anything this morning. And unfortunately, in Canada, access to at least legal CBD products is still overly restrictive, so I didn't put anything in my coffee.

That was the voice of Ronan. So Ronan's burning ketones for today's show. And how about you, Marshall?

Similar sort of thing Yeah, I generally don't eat in the mornings and then I drink copious amounts of coffee. So I think I'm on glass number four right now.

Oh geez. So you're definitely based on the fatty acid upregulation of caffeine consumption, possibly burning, burning even more ketones as a throughput than Ronan is. And I'm in the complete opposite boat. I had organic blueberry powder with kefir and ice and stevia and a little bit of bone broth and some colostrum with a few barucca nuts and some spirulina and chlorella all blended up in a giant nutribullet. So I'm going on about 800 Calor right now and feeling pretty good. So hopefully I'm not sparking your guys appetite too much there. But we'll of course I don't have to do as much talking on today's show so I can sit back and digest my kefir while you guys rock and roll.

Awesome.

That being said, let's start here when we're talking about psychedelic therapy and either of you guys can jump in and reply to whichever questions that you want to reply to. Although I would imagine Marshall's going to be speaking more to the science and you Ronan, to kind of the state of the industry. But exactly would you guys define psychedelic therapy?

I'll hop in here, Ben. It's Ronan. You know, I think in its simplest form, psychedelic therapy is using psychedelic molecules like psilocybin, lsd, mdma, which isn't always considered a psychedelic but for these purposes we can consider it that as well as ketamine, which is very rarely considered a psychedelic but in fact has many psychedelic properties, using molecules like that to really catalyze the effects of psychotherapy. So unlike traditional approaches to mental health care, which uses drugs to just kind of act as a cure, here really the drugs are meant to catalyze a therapy process whether it's cognitive behavioral therapy or other ones. It's really about using drugs to make therapy better, not using drugs as an end in themselves.

Now what, what kind of therapeutic psychedelics are we actually talking about as those that seem to be kind of the, the darlings of the industry right now? I mean psilocybin is one that I'm aware of, but what else is there?

Marshall can probably touch on the more robust research, but certainly the ones leading the charge are mdma. Actually there's a phase three trial happening right now by a nonprofit organization in the States called maps looking at MDMA for the treatment of PTSD and psilocybin. But then there are other folks looking at DMT in a commercial clinical context. And Marshall, you would know what else is going on from a research perspective.

Yeah, there's definitely a lot of different psychedelics that people are interested in right now. As Ronan mentioned, DMT and another one is 5 Meo DMT. Those are both very short acting psychedelics. And one of the keys with the clinical application of psychedelics is the fact that you want something that can fit within a reasonable window. So LSD for that reason is pretty clinically cumbersome because LSD trips tend to last from 8 to 12 hours. And so having a psychotherapist with a patient for an 8 to 12 hour experience is very cumbersome and costly to the patient. So there's a lot of work being done on some of these shorter acting ones. But yeah, there's a whole host of psychedelics. I mean there's hundreds of molecules and we still don't know what the best ones are. We're just kind of beginning to understand.

Yeah, eight to 12 hours is a lot of cups of coffee for whoever's facilitating as well. So that's a long day. Now, in terms of these psychedelics that are used in therapy in particular, for example, I know that you guys at Field Trip, Ronan and I'd love for you to explain exactly what you guys are doing at Field Trip. I think that right now you're exploring something that is relatively legal from my understanding, in many locations. And I know you're looking into rolling out locations in Toronto and LA and New York, for example, and that's ketamine. So explain to me exactly what you guys are doing with Field Trip and then I'd love to dive in with that kind of low hanging fruit of something like ketamine, which I think is largely available slash legal in many locations.

Now you mentioned that I'm a lawyer by training and I am, but I've stopped doing that, so I'm feeling much better now. But yeah, so with Field Trip what we're doing is really trying to build the infrastructure that's going to be needed to support psychedelics as they become a mainstream industry. For, you know, since the 70s psychedelics have been scheduled drugs and really got pushed to the side. But over the last 10 or 15 years there's been a lot of research put back into psychedelics in the the results of the studies and their therapeutic applications is just mind blowing orders of magnitude better than our current treatments for conditions like depression, anxiety, ptsd. And even eating disorders. But in order for this really kind of emerging industry to become something that can create a lot of impact and help a lot of people, it really needs a new set of infrastructure. Existing medical clinics, existing family doctors offices, existing psychiatrist office. They're not really equipped to provide psychedelic therapies, both in terms of providing an appropriate set and setting, which are really important in psychedelic therapies. And set and setting meaning the set, meaning the mindset of what are you hoping to get out of your psychedelic trip and the setting being the physical location where you are. Both of those are really instrumental in leading to good therapeutic outcomes. And that kind of clinical existence just doesn't exist right now. So with Field Trip, our first priority is building that clinical infrastructure. We're starting with clinics in Toronto, New York and LA, as you mentioned, hopefully be up to 60 to 75 clinics over the next couple of years. And they're just really purpose built facilities to provide psychedelic therapies. You know, staffed with experienced psychiatrists, psychotherapists, doctors, and all of the sort of medical professionals you'd need to provide this kind of care in a very effective and thoughtful and safe way. And then the other piece of what we're doing is really exploring the opportunities with different psychedelic molecules. So we recently announced Field Trip Discovery Drug Development Division, which is in preclinical work on a molecule we're calling FT104 because we're not sure in the details about it yet. But it's a really cool psychedelic molecule that we think will have a great application across potentially a number of mental health indications, as well as the work that Marshall is leading for us, which is really in the cultivation and understanding of psilocybin producing mushrooms, which there's 200 species or so of psilocybin producing mushrooms across the world and very few of them have been studied to any degree of rigor or scientific pursuit. And we think there's a lot of, we hypothesize that there's a lot of really cool molecules in there that will have therapeutic application. Whether it's like the Entourage effect in Canada, sorry, in cannabis, or whether we just find new molecules that have therapeutic application. There's a ton of opportunity to do some really cool research around here.

Okay, I've got a lot of questions based on what you just filled me in on regarding not only the different varieties, varieties of these mushrooms and how they're actually identified in terms of their therapeutic effect, but I also want to ask you about that FT104 and also this variant of ketamine called nketamine, which is what I understand you guys are using in your clinic. But first I noticed I went to your website and I'll link to everything. By the way, if you're listening in, just go to BenGreenfieldFitness.com FieldTrip BenGreenfieldFitness.com fieldtrip is where I'll have all the shownotes and everything for all that we discuss on today's show. But Ronan, you guys say that you're like a spa for psychotherapy on your website, and I'm curious what that actually looks like. Like when someone arrives at a field trip clinic for treatment, what's the actual experience look like? Are we talking about like a pedicure manicure that goes along with your psilocybin experience or what do you mean when you say spa?

Yeah, no, definitely not a pedicure manicure. We don't quite go that far, but we've really focused on building a, our centers in a very beautiful, approachable way. You know, as mentioned, set and setting are instrumental to the therapeutic outcome. So people need to feel comfortable, need to feel at home where they're having the therapy. And we've really designed it to be, you know, kind of like what we expect most people would want their house to look like if they're going through any sort of therapeutic setting, which is, you know, we, we've designed it. Lots of green space within the clinic as much as possible. The, the, the chairs that people sit in. Admin session are zero gravity chairs that are super cool. You know, it's just everything. We pamper you to the greatest degree possible within the context of what is, you know, really clinical therapy. We, we provide, you know, access to juice bars and coffee and all that kind of stuff. So it's, it's, you know, I, I don't, I don't know about your doctors, Ben, but like my doctor, it's, it's pretty transactional. You're in, you're out, and, you know, hopefully they provide good care. But here it's more about feeling welcome, feeling safe, feeling comfortable, enjoying your time there. Even though you're there for, you know, a therapeut procedure. It's really about feeling awesome and feeling comfortable and safe.

Okay, got it. And when we're talking about ketamine, I'd like to stick with that momentarily. That's something I've used as a microdose, as like a nasal spray spray or a troche. It can kind of have a mood uplifting, mild antidepressant effect. And I've even used it just, you know, it comescomes or is commonly used in anesthesia for example. So I've even used it in smaller doses for things like massages to relax my body and allow the massage therapist to dig into some of the more painful areas a little bit more easily. And I've also done intravenous ketamine as more like a 45 to 90ish minute therapy, you know, with the eye blocking mask and the headphones. And kind of what I found is some pretty supreme access to past memories, reliving periods from childhood and an overall real nice mood uplifting effect. And when it comes to what you guys are doing over there, from what I understand you're using a variant of Ketamine called Nketamine, am I correct? Sorry. S Ketamine.

S Ketamine is the one that was approved by. Actually I'll let let Marshall speak to that. He knows this stuff way better than I do. But just before Marshall hops in exactly what you described in your 45 to 90 minute session with the eye mask, that's exactly what people will experience in our clinics. They'll come into our setting, you know, put on music. We've got specifically tailored music that's been thoughtfully constructed to enhance trips, you know, comfortable chairs, weighted blankets, like it's supposed to be really enjoy enjoyable experience. But what you described is pretty much what people connect. What you described that you did is pretty much what people can expect when they walk into our clinics. But when it comes to the drug itself, I'll hand it over to Marshall.

Okay, before you hand it over to Marshall, when you say music, are you guys. Because I've wondered this before, you know, it seems like the music kind of spans the gamut as far as, you know, different tracks you can find. I mean you could find 10 different ketamine playlists on Spotify for example and, and some go into like the old school classical methods, you know, Bach, Mozart, Vivaldi, etc and others are kind of more psychedelic or even Amazonian. At your guys clinic like field trip, do you guys actually have a composer? Are you researching the type of tracks that are used or how are you selecting the music?

Yeah, we've been in conversations with groups like Wave Paths and Mendel Kalin who has done a lot of the research through Imperial College on the musical impact of the therapy in psychedelics. I don't remember exactly where we landed on which composers and which music that we use in our clinics, but we're always going to exploring and Evolving and working with different partners. And as we start to roll out some of our other digital tools, we'll be working with a group out of Toronto called Lucid, which has developed a machine learning algorithm that can help track and respond to people's feedback as they go through a trip. So it's something that we want to be on the cutting edge of, even if we're not doing the work itself. We want to be working with the partners that are leading really the use of music and therapy and leveraging technology to make it as impactful as possible.

Are we talking about like brain waves and HRV as far as the real time tracking that something like Lucid would be doing?

Lucid, I think right now relies primarily on direct feedback from the user. Based on their experience, they'll kind of do it before and after. And they've, I think, clinically validated their music therapy, but certainly expanding into HRV and other metrics because when you're in our clinic, you know we've got a oximeter on you. We're tracking hrv, doing all sorts of things to make sure people are safe and healthy. And so it's going to evolve into that for sure. I'm not sure it's there quite yet, but it's certainly on the roadmap.

Yeah, that's something I think tying quantified technology into some of these therapies is something that, from what I've seen, nobody's really scratched the surface on in a really thorough way. I mean, I would imagine that customizing and tweaking protocols based on what's actually occurring in terms of electroencephalophogram or brainwave measurements, or heart rate variability measurements, or heart rate measurements, or skin temperature readings. I mean, there's so many things that could be monitored that I would imagine would give really good feedback in terms of dosing, music, setting, etc. That, you know, that that's something that, that I think should be explored a lot more.

Yeah, absolutely. And I know that, I know we're going to be very proactive in collecting data around it. I know researchers like Adam Gazelle at the University of California, San Francisco is very proactive in that. So it's one of the really exciting areas of exploration and psychedelics. The whole sphere is super exciting. I mean, there's pretty good knowledge of the psychedelic molecules because they were studied pretty in depth, at least the well known, classic ones in the 50s and 60s. But there's so much because of the interplay of the drug with the setting that can be explored in terms of how to tweak and optimize the delivery of these services. It's an area of focus that's really important for us. Us.

Interesting. Okay, so, Marshall, let's start with that S ketamine we were talking about. Is that the form of ketamine that you guys are using? And if so, you know, what exactly is that, and how does it work?

So we're actually using racemic ketamine. Ketamine is a very complex molecule in that it exists as a sort of mirror image. So if you imagine it, you know, like a pair of gloves, where you have both of those within ketamine, so they're virtually identical, yet not interchangeable. And so you have these two mirror images within what's known as racemic ketamine. And that's what we're delivering right now. There has been some studies done with each individual enantiomer. So with the S enantiomer, which is one form of the molecule, and the R enantiomer, which is its mirror image, there has been some research done with those two, but currently, most the evidence points towards the fact that the racemic mixture is likely the most valuable. And it also. So when consumed or injected, it converts into a variety of different metabolites. So there are over 20 different things, 20 different molecules that your body will break down ketamine into. And some of these do have psychoactive properties, so some of those are contributing to the overall experience. So by maintaining both the R and the S enantiomer in that parent mixture, we're able to get all of those effects from not only ketamine, but from all the metabolites it breaks down into as well.

Okay, so when S ketamine is used, what we're referring to is what in chemistry would be called an enantiomer, and it's an S enantiomer of ketamine. So it's considered to be more potent than, you know, from an antidepressant effect than something like the R configuration.

Yeah, so the jury's still kind of out on that one. That was the theory was that the S would be more potent, but that hasn't really played out so far in clinical research. The R enantiomer is actually quite potent as well, and the racemic mixture is potent. So they might be equally potent, but have some sort of nuance of differences in the sort of experiential components that they're inducing that seem important, but it's still poorly understood.

Okay, got it. Now, when it comes to the delivery mechanism, like I mentioned, my experience with the higher doses has been intravenous. In particular, I've had that overseen by a physician anesthesiologist in a ketamine treatment scenario at a doctor's office. And then for my own home use, I've microdose with the intranasal variant. What are you guys using at a clinic, like, field trip?

We're using intramuscular right now. And so that really induces a pretty powerful psychedelic experience that hits you all at once. And so that sort of rapid delivery mechanism is able to get people into this sort of transformation space where they're able to, like you said, you know, confront past memories. Maybe it's a trauma that they experienced in childhood or whatnot, and then they can bring that back with them after the experience. And that's where the psychotherapy really comes into play. So, as Ronan said, unlike a lot of other ketamine clinics, we use ketamine assisted psychotherapy. So ketamine is just a tool, but the psychotherapy is really what's needed after the ketamine experience to really make all the learning things that come from the experience into actual behavioral changes that have long term benefit for the patients.

Okay, got it. So when we're talking about S Ketamine, it'd be an intramuscular delivery. And you think that. That that's the form of delivery that's gonna give somebody the best experience with something like ketamine journey.

So probably racemic ketamine. So both S and R ketamine as an intramuscular delivery. Yeah.

All right, got it. So in terms of some of these other things that Ronan brought up, one that really my ears was this. FT104. I've not heard of that before. What exactly is that?

It's actually a proprietary molecule. We can't delve too much into the structure right now.

Nobody's listening except us three, Marshall.

But the idea is we are taking the core components of a psychedelic molecule and we're kind of narrowing down the features that we think are essential to these positive outcomes and taking away anything that might not be conducive to the outcome. So the duration of the experience might be changed. And we have a hunch that the outcome will be dramatically changed based on some early evidence.

Okay, got it. Is it something that acts like ketamine? Is it more like psilocybin or. I mean, is this something that you just can't reveal details on right now?

Yeah, we can't go too much into detail. I will say that it does very much embrace the psychedelic experience. So one of the key components of our therapy is really getting patients this really profound psychedelic experience. And the field trip molecule is absolutely going to do that because we realize that the experience itself is essential. So it's not as simple as activating receptors and having that lead to a beneficial outcome. You need this experiential component, this really transformative experience, to get the positive outcome. And studies have supported this. Now, a lot of studies have pointed to the fact that the more intense the psychedelic experience is, is the better the outcome will be for the patient. And so our molecule is capitalizing on that by trying to recapitulate the most essential components of the psychedelic experience. But beyond that, unfortunately, we can't go into too much detail.

How far out are you from being able to release details on that one?

That's a good question. We've got our freedom to operate and patentability opinions. So once we have the patent filing, we'll probably be able to talk a little bit more about it. But the exact timeframe for that is unclear at this point.

Okay, got it. Now, with the psilocybin, you know, I know that that's something that, from what I understand, is not even legal to grow in the US And Canada, and correct me if I'm wrong there. So how exactly are you guys going about that?

Yeah, so that's a great question. It is not legal to grow in either the US Or Canada. And so we've taken our research down to Jamaica, where there aren't regulations surrounding psilocybin. And so, in partnership with the University of West Indies, we're leaving out a botanical research program down there where we're able to actually cultivate these fungi.

Is that. Is that pretty common? Are a lot of companies now growing in Jamaica?

A few companies seem to be starting up, but, yeah, we're definitely one of the first movers. And I'll say that our operation is unique in that it's in partnership with the university. And so there's a lot of sort of luxuries that that partnership affords us, and it allows us to really push forward on the academic research side. So it's not just a production lab. We're not just trying to make massive quantities of psilocybin and distribute them. We're actually trying to understand the fungi that produce psilocybin and related molecules and figure out what other chemicals are present in the fungus that might be contributing to the experience, because we think that there are almost definitely other molecules within the fungus that are creating Very different experiences depending on how they're interacting with psilocybin. And we think those molecules are important to understand.

Hmm. How do you actually do that? Like, do you grow, you know, is it kind of like growing a garden where you're selecting a certain type of tomato or a certain type of kale and then growing those variants of mushrooms, then testing them to see what the bioactive components are, essentially.

And so we're going to be. We have a starting point because there is a list of known species which contain psilocybin, but those haven't really been analyzed in depth. And so they're known to contain psilocybin, but it's unclear what other molecules they might contain. And so it starts with growing out all the species and then chemically analyzing them to see what differences there are and then correlating that with any sort of differences there are in the experiential component.

Got it. And then once you guys come up with varietals that actually have these bioactive components that you're looking for in Jamaica, then the process is you're actually encapsulating those and then bringing them back to a clinic. Once this stuff begins to grow in legality and administering. Is it like a. Like a capsular administration in the actual clinic when someone comes in for a protocol?

Yeah. So there are a few different avenues. We could sort of go with any of our findings down in Jamaica. So we wouldn't be exporting anything from Jamaica. Everything we do there is going to stay there. But we would use our learnings and our findings down there and translate those to jurisdictions either where it's legal to produce and sell psilocybin. So if you've been keeping up with the sort of psychedelic legislature, it's been changing quite rapidly in the United States. And it looks like there will probably be a ballot measure in Oregon this year that would legalize psilocybin assisted psychotherapy within a couple of years. And so in a market like that, we could theoretically translate our findings to that sort of space and that that would be able to be administered legally to people within the state of Oregon. Alternatively, we could go the drug development route. So any sort of new molecules that we find that seem really promising and interesting, they might be lead candidates for drug discovery. And so we could do all this sort of preclinical work that would be required, and if it looks promising in animal models, bring that all the way to humans.

Are there any other molecules that you guys are looking into or any other. I mean, even. Even things that might be more commonly known. Like you mentioned DMT and 5 Meo DMT as options. Are there other things that you think would be kind of like gold standard in the future? Let's say five years from now in a clinic like field trip, for example, when someone comes in as far as available therapies or available psychedelics, I'll hop in here.

I mean, certainly in terms of the academic research, Marshall can speak to that better. But the gold standard is still to be determined because it's going to depend on a number of different factors, which is what indication are you going after, how long is the experience, what are any off target effects? You know, one of the risks around psychedelics is there's something known as the 5ht 2b liability. So you know, in terms of mechanism of action, and I'm totally speaking out of turn here, so Marshall, come in and correct me at any point in terms of the mechanism of action. Most classic psychedelics target the 5HT2A serotonin receptor in the brain, which is what triggers the psychedelic experience. But they also hit the 5ht2b serotonin receptor which has been known to cause potential heart complications. And so when you're looking at any new therapies, you got to look at the risk versus the benefits. And so DMT is really interesting because it's powerful, it's short, which means it's more scalable. But are there off target consequences? There's some research that suggests maybe the longer the trip, the more the therapeutic outcome. So short experiences may not be as beneficial. So there's a whole bunch of different considerations you got to kind of triage and think about. But I think the answer is there's going to be no gold standard for any one individual. You know, everyone's, everyone's circumstances will be unique and the appropriate therapies will be triaged appropriately.

Now with something like dmt, and I think this is even more common, commonly said about something like mdma, there's potential for some type of neurotoxicity or neural inflammation that could occur, especially with the higher dosages. And for example, I personally have done pretty high dosages in a set and setting with a therapist with some of these compounds and have reached out to several physicians and been given a few advice to take things like same to replenish methyl groups and vitamin C for the antioxidant effect or even something like cannabis for the neural inflammation along with 5 HTP to replenish some of the 5 HTP. And so there's almost like all these kind of damage control type of compounds one consumes after a pretty hefty trip. Are you guys planning on working in, in post therapy, things like supplements, nutraceuticals, et cetera, to kind of help someone bounce back more quickly from something like a trip?

To some degree, I mean, it is limited. And this is one of the challenges of trying to navigate a new therapeutic landscape, which is because our audience is twofold, both the patients as well as the medical community, which tends to be more conservative, who are a little bit cautious about advocating for the use of supplements where the evidence is, is very strong. Certainly. I'm sure there's lots of evidence for the things you talk about, but the standards that we get measured up to when we're dealing with physicians and a medical community is usually a very high bar. And so to the extent that we can provide some scope of nutritional advice for how people can recover, we will do so. But we won't step too far just out of being cautious about saying things that may not necessarily be backed up with a great degree of clinical research, even if it may be intuitively and biologically sound.

Yeah, I think that it would actually be pretty cool to begin to look into when someone comes in for therapy. What you can do to actually clean up some of the potential for neural inflammation or for oxidation after something like that. That's something I think that would be interesting to explore. And the other thing I wanted to ask you guys was what about so called biohacks that a lot of folks are, I know, in the, in their own personal space, combining with some of these therapies to do things like enhance blood flow, you know, something like pulsed electromagnetic field therapy where someone's not just sitting in, let's say like a zero gravity chair like you talk about Ronan, but maybe they're laying on a PEMF mat or for example, hyperbaric oxygen therapy is another thing that could be administered post treatment. Are you guys interested at all in this whole realm of bio hacks that could be stacked along with therapy?

Yeah, I mean, certainly as a founding group, we're all very interested in this kind of care. The analysis is always going to be though, is there enough evidence to justify the use of these approaches? Not to suggest that any of them are potentially bad, but we have to be cautious being on the vanguard of a new medical modality, not to be seen to be participating in what some may view as kind of quack treatments. And, and I'm not suggesting any of those are, but there's probably a Lot of people who may think so. And so we're just trying to blend being cautious but being proactive with also being conscious of cost, which is, you know, some of these options have cost and investment associated with them. And given that psychedelic assisted psychotherapy is already pretty labor intensive and, you know, we've priced our model to be pretty consistent with conventional therapy. So it works out to about $300 a session for ketamine therapy therapy. It's still expensive for a lot of people and out of reach. So the more you kind of layer on these other approaches or these other techniques, the more expensive it gets. And then so we're trying to balance all of those factors to ensure scalability, ensure that we can reach the greatest number of people, but in the same token, ensure that we're doing it in a way that doctors in the medical community can really get behind without much effort.

When somebody goes into a clinic like this, is it a physician who is overseeing the protocol or is this like, like a therapist or, you know, some kind of a shaman, for example?

Yeah, we kind of have a no shaman policy and field trip. Again, just targeting our audience, which is, you know, the medical community, but getting their support and their buy in is going to do more for psychedelic therapy than, you know, any individual patient or treatment. Right. It's going to require changing a whole set of probably fairly conservative attitudes in the medical community to really make this go mainstream and help the most amount of people. But the protocol we have right now is it's primarily physician driven, so patients will get referred to us. Typically right now we're only treating people with treatment resistant mental health conditions, so they have to have tried conventional treatments. And that's just based on guidance from the College of Physicians in Ontario. But we'll have a psychiatrist do an assessment to determine whether ketamine assisted psychotherapy as a potential treatment option. Because there certainly are some contrast contraindications to ketamine treatment that we have to be cautious of. It's not appropriate for everybody. If the psychiatrist is comfortable, we'll have a medical doctor, a family doctor, do a basic physical to ensure that physically you're sound for it, because it can have implications for blood pressure and other cardiac considerations. If everything's good on that front, then you'll meet your clinical therapist who will take you through the sessions. But the actual drug will be administered either by our medical director or a nurse practitioner. You go through the session, we've got a respiratory therapist on site. Again, just because of some of the potential complications from ketamine which is quite safe. You know, we're providing all of these medical professionals out of abundance of caution. But yeah, the nurse practitioner or doctor will administer the ketamine. You'll be present with a therapist who will be with you through the actual trip. Following the trip, you'll do an exploratory light touch therapy session, which is really about kind of identifying some of the things like Ben, you mentioned and reliving some memories and all that kind of stuff. So we want to have someone there to ask the right questions and record your experience so we can use that in the actual integration therapy. So you'll do two ketamine sessions with two exploratory therapy sessions right after the ketamine experience. And then following that you'll have an integration session where you take all of the things that came up. And we really use cognitive behavioral therapy techniques to try and not only, you know, integrate this stuff, but lead to meaningful lifestyle and habit change so you don't fall back into depression. At the end of the day, we don't want to have the pharmaceutical business model where we keep people hooked on our services all the time. We want to see them get better and never have to come back. And you know, from a business model perspective, fortunately there's enough people suffering with enough challenges. Even if you're cured of depression or PTSD or whatever the case may be, it doesn't mean that you're not going to have new experiences in life that could set you back. So we don't think from a business perspective there's any concern that even if we can send people on their way and totally resolve pre existing mental health conditions, there won't be a need for them to come back in the future. And that's just the nature of life. I mean, that's what's really cool about psychedelic therapy overall. And one of the reasons I'm really excited about it is because we can start changing the conversation around mental health, which has typically been reactive, which is you go see a therapist because you're depressed or you're anxious, anxious, or you're going through a hard time to something that's proactive, where you're going through this and having these experiences because you just want to have a better life. Not because you need to, but because there's so much improvement to have, even if you have a great life. That's so. That's what's so cool about psychedelics is not only can they treat depression and anxiety, they can increase empathy and creativity and awareness and self understanding. All of these wonderful things. And you don't have to be sick to benefit from those kinds of things.

So you mentioned a respiratory therapist, right? Is that what you said?

That's correct, yeah.

From my own experience, there are some pretty interesting things that happen with breath in terms of exhales and inhales that are very consciously taken as being able to almost like guide one as they go through a journey. And many people experience a feeling as though they're able to take extremely long inhales and extremely long exhales, even with something like ketamine and of course, more particularly something like dmt, for example. And I'm curious, in terms of the coaching or the lead up going into a session, is there conversations or any type of training? Specifically when it comes to talking to a patient about how to use their breath during a session, that's another thing that to me seems like it would be pretty valuable. But I'm curious if you guys have looked into that at all.

I mean, we do offer, through our virtual therapy offerings now, we actually offer breath work plus integration. So different breathing techniques like holotropic breath work or transformational breathwork can actually induce a largely psychedelic state just through breathing, which is incredibly profound. And if you haven't tried it, you certainly should because it's a very, very cool, meaningful experience. And it's something that we're offering as a standalone service. We're again, again, just somewhat cautious about trying to encourage people to adopt different breathing techniques when under the ketamine experience because the interplay between those breathing techniques and ketamine hasn't been well studied and we don't want to create any additional risk for our patients and focus on protocols that are well established and well understood. Again, part of that is for the safety of our patients. Part of that is again, just trying to be as prudent as we can while we're still being very progressive in a new sphere, because we, we want to get the medical community bought into supporting these types of care so they refer patients confidently to us and don't see it as some sort of fringe practice. We really want this to be mainstream, which means we're probably not doing a lot of the things we'd love to because our audience may not be receptive to it just yet.

Yeah, and I wasn't necessarily talking about doing holotropic breathwork during a session, but more just being in touch, being aware of breath and, and obviously doing rigorous breathwork while on something like DMT or psilocybin is pretty difficult to do. Anyways, because there's some amount of conscious control that's lacking in that scenario of a high dose. But I think that going into a session like that, very aware of and connected to one's breath, I've personally found that to be incredibly helpful. You mentioned another thing and that was this idea of the fact that you guys are doing some breathwork coaching, for example, via digital consults and online. And I know that right when the coronavirus pandemic started to hit was when you guys were in the process of rolling out a Toronto, a New York and an LA facility and you kind of seem to pivot a little bit and begin to look more into telemedicine or teletherapy. How exactly does something like that work?

Yeah, that's exactly right. I mean, teletherapy and virtual care was something that was always on our roadmap. But because the pandemic slowed our ability, ability to physically open clinics, it enabled us to focus on our more digital offerings. And the digital offerings are really just getting off the ground in terms of the psychedelic breathing plus integration. That's like a recorded video of a breathwork session that's kind of self guided. And then you step right into an integration session with one of our therapists. Some places are rolling out other forms of virtual therapy with mail order ketamine, where you take the ketamine at home and then do an integration session with a therapist remotely. You know, that's something that we're watching, but we don't think it's terribly prudent at this point to be giving people ketamine at home when they don't have the necessary support and oversight, particularly given some of the, like I said, low but not insignificant risks that can be associated with ketamine. But we're exploring the space in terms of actually at home delivery of psychedelic therapy. But it's not something that we're active in right now, just given some of the health considerations and what we think to be best medical practice at this point.

Got it. So walk me through this. Like if somebody goes to the website and again, I'll put all the links@BenGreenfieldFitness.com fieldtrip and although from what I understand, just again, because of COVID the clinics are not currently operational, as many clinics are not. What's the actual experience like? Let's say someone calls you on the phone or they go to the website, they want to come into the clinic. Clinic. What happens next?

Yeah, so I'll just note that we have been closed in our Toronto Clinic since mid March, but we're actually opening our doors again tomorrow and starting to dose patients again tomorrow. So that's great. And we're on track, it seems, for both New York and LA to open in July. So that's really great news and doesn't set us back too much in terms of the experience. What would happen is a patient would reach out. Given this is a novel therapy area and not appropriate for everyone. One of our care coordinators gets on a call with you to walk you through the process, help you understand exactly what's going to happen and what needs to be done before we can treat you. In Toronto, because of the guidance from the College of Physicians, it's only available for treatment resistant patients. So if you haven't tried conventional therapy techniques or conventional antidepressants, as good or bad as they may be, you've gotta go through that before we can provide care to you. So walk people through that, make sure that they're qualified, qualified patient. If everything looks good, we'll book a consult with our psychiatrist. You'll meet with a psychiatrist who will do an assessment. Make sure that ketamine therapy is appropriate for you as well. If everything looks good, we'll book an appointment. Your first dosing session, where you'll come in, you'll meet with the medical doctor as well as the therapist who will be taking you through the experiences. The doctor will do a quick physical, make sure everything is good, and then we'll do the treatment. The dosing session on ketamine, Ketamine, which as you mentioned is about a 45 minute to an hour experience, therapist is with you the entire time. Afterwards. The therapist will take you through sort of a light conversation just trying to understand your experience. There'll be coffee and juice and a cool place to sort of relax after you go through it. Because even though the intense experience on ketamine is about 45 minutes to an hour, it can have lingering kind of psychoactive effects and people don't necessarily feel, feel altogether with it before they go home.

Oh yeah, you're pretty wobbly for a few hours afterwards.

Yeah, exactly. So, you know, we want to make sure people have all the time they need to kind of get back into their head and get back into their body. And so there'll be a juice bar and tea and all that kind of stuff and people will relax. I mean, like I said, this is designed to be. It's like a lounge. You can see images of our clinic on our website. It's not what you'd expect from Most medical clinics, so, so that's kind of the experience. And then depending on the patient's schedule, the whole course of treatment, which is supposed to be six dosing sessions and three integration sessions, should take about three weeks. But that's usually a big commitment. So for people taking time off work, if you are fortunate enough to be working these days, and then that's it. But we could schedule it for as long or short as you need be. And I think that's pretty much the.

Experience overall when you guys are screening someone to come in. Because I know this is another thing that's really interesting, like there are certain genetic pathways that influence, you know, whether you're a, you, you, you clear dopamine more slowly or more quickly or you know, how your methylation status is, or even things like, you know, blood work, micronutrient status, et cetera. Are you guys interested at all in beginning to, to run labs on people to kind of take a look at how, how protocols very similar to something like you might be doing with lucid and collecting self quantification data. Are you looking into customizing protocols based on lab work as well? That's another area that I think would be super interesting, but I'm curious if you guys have actually looked into that at all.

It's something that we've thought about, but it's not something that we're actively doing right now. We're focused on just delivering the best ketamine therapy within the context of, you know, assessing patients based on their psychiatric and basic biological considerations and medical considerations. But all that kind of stuff, which is super cool and stuff that, you know, we certainly plan to get into in the future, is on the roadmap, but. But not available just yet.

Yeah, well, hopefully I'm giving you guys plenty of ideas for.

Tons of ideas, man. Thank you.

Things you can do, because this is the kind of stuff I lay awake at night and think about is how we can make the world better by combining some of his ancestral wisdom with modern science. Now Marshall, what else are you excited about when it comes to the type of therapies that you think could be implemented in a clinic like this? Unique molecules delivery mechanisms like dream scenarios for you as far as what you as a scientist would really like to see in terms of the emerging landscape of psychedelic therapy?

Yeah, so, I mean, I think there's a lot there, there's definitely a lot that excites me about this space. One of the things I'm most excited about is probably looking at different molecules and diving into the Nuances, not only of the psychedelic experience, but the nuances of these disease states, like the, like depression, addiction, anxiety, ocd, ptsd. Because we know those are just blanket statements that cover a wide spectrum of different kind of cases. You know, it's so individual, those disorders. And understanding what predicts someone's response to a drug is going to be so essential going forward. So back to your point on testing, you know, before they actually undergo the drug therapy and doing these sorts of panels, those are some things that I'm really interested in because then you could really delve on individual patients and predict whether or not they'll respond to a certain drug. And maybe a higher dose of ketamine might be recommended for that patient. Or maybe instead of ketamine it should be Psilocybin or DMT or 5 Meo DMT for whatever reason. And so that's some of the stuff I'm most excited about. I mean, psychedelics are remarkable in their ability to rapidly relieve depression. So with SSRIs, it takes two to three weeks generally before you see any sort of effects. And oftentimes in that first two to three week period, symptoms get worse. And so for someone who comes into a clinic with suicidal ideation and is told to start on this drug where their symptoms might get worse, you know, they're already on the verge of suicide and a psychedelic might lift them out of that state almost instantaneously, you know, generally within 24 hours. So finding psychedelics that can do that most effectively and diving into what aspects of the chemical, chemical structure, allowing these molecules to do it, and what receptors are essential. Because we know, like Ronan said, there's this one subset of serotonin receptors, the five HT2a receptors that seem to be responsible for a large part of the psychedelic effects. But there's a host of other receptors that these molecules activate, and many of those are important in the psychedelic experience. They're just not well understood right now. So really delving into that research and understanding how all these receptors are, are playing, and then finally I'll add, so that's on the drug side. Then there's also the setting component. And so everything we've done in the clinic, as Ronan says, they're not arbitrary decisions, right? These are all evidence based decisions. Even a decision like incorporating greenery into the clinic is based on research that says there's a huge increase in nature relatedness that comes from these psychedelic experiences. And people find this connection to nature very meaningful. And I actually helps to relieve depression in a lot of people. And so getting into how we can use things like music, visual stimuli, auditory stimuli, tactile stimuli, whatever kind of inputs might guide a patient to a better outcome, those are things that I'm really excited about.

Okay, got it. Now, in terms of like competitors, do you guys anticipate this being a thing? Like they're being a target of, of psychedelic therapy and a Walmart and a McDonald's or. I mean, like, is this something that pretty few companies are doing right now? What do you think the landscape's going to look like regarding that?

Yeah, I mean, certainly psychedelics are having a moment from a capital markets perspective. I don't know if you've been following Ben, but a company called Mindmed went public. They're looking at ibogaine, a form of ibogaine to treat opioid addiction, and now are doing something with lsd. Another company called Champagneol Brands basically took a lot of our business model and used it for themselves. And they're publicly traded as well.

Those dirty storage. They stole your stuff.

You know how many decks I've seen that have taken pages right out of her deck? Like really copied word for word format and everything?

You're a lawyer, can't you do something about that?

I mean, most of that just stuff is just, you know, academic information that we found elsewhere. So I don't think there's any big problems associated with, with it. You know, what did I say? Imitation is the sincerest form of flattery, so we'll take it as a compliment. But there are a lot of companies kind of emerging. What's unique though is that, and really the thesis of our business model is that you need a whole new clinical infrastructure. You need something that's very, very thoughtfully constructed both in terms of the physical space, the therapeutic protocols as well as the drugs you're, you're putting into to potentially the therapeutic application. And that's not something that's going to be happening at Walmart or anything along those lines soon. Certainly there's going to be a number of other ketamine clinics that are open and will be opening across the US and Canada trying to replicate our model. But I think what makes us unique is that A, we have an integrated model where we're focused on the end to end experience from drug all the way to therapy. And B, we've got a team that's done it before. We've brought some of the best people in the world together to build Field Trip. And I think that really sets us apart.

And how long do you think it'll be before something like psilocybin is offered in these type of clinics.

It depends on how we get there. So in Oregon this year, it looks like there's going to be a ballot in the 2020 election looking to create a legal market for psilocybin, which will include psilocybin, psilocybin producing mushrooms. And if you look at the rules, that has a two year rulemaking period. So by 2022, if that ballot passes, which according to polling right now it will, psilocybin will be available in Oregon in 2022 and will certainly be there to participate in that. More broadly, you're probably looking at 2024 because there'll be other states looking to create similar markets to Oregon or 2025, which is when Compass Pathways expects to get its approval from the FDA for their synthetic form of psilocybin. So it's still years away before you're going to see access to psilocybin. Maybe in Canada it comes a little bit sooner because in Canada, cannabis came about through constitutional challenge. And the same people who fought that constitutional challenge for cannabis are going to fight it for psychedelics. We know that to be true. So maybe the courts bring it a little bit faster in Canada, but we still got a few years before it happens. But I think that's a lot faster than the average person would think before psychedelics are gonna be legal in Canada and the U.S. interesting.

So, Marshall and Ronan, anything else that you guys think that folks should know about psychedelics, either from your own personal experience, things that you guys are rolling out at field health or field trip, you know, things that you plan on rolling out, anything else you want to share with people, particularly when it comes to psychedelic assisted psychotherapy, I guess the.

Most important thing is that I think a lot of people with all the news and media attention given to psychedelics recently, are going to be inclined to go out and self medicate and try it on your own first? I would say that we're building tools that we're going to make publicly available over the course of the summer to really support people if they're going to be doing it on their own, so they're not taking risks that they don't need to take and doing it in the best way possible. So if they're looking for a therapeutic outcome, they're going to maximize, maximize the potential of doing it, even if they're not doing it with doctor supervision or a therapist in hand. We want to really make sure that people are empowered to get the most out of this and avoid risks. But really, I think the most important thing that I think about is like, be thoughtful, be careful. You know, the one thing that could ruin all the momentum around psychedelics is one person doing something really, really stupid that the media or politicians who may be regular aggressive around this, take a hold of and point to as a reason not to promote and pursue psychedelic research. And so be thoughtful. Anyone who's doing this, make sure you're doing it with the proper support if you're going to do it. And, and make sure not to it up for the rest of us, I guess.

Yeah. Interesting. How about you? Ronan?

That was Ronan.

Sorry, Sorry, Marshall.

Yeah, no worries.

So hard to keep track with all these people on my.

So one thing I'll add to that is the fact that these molecules aren't panaceas. So they're not cure alls. And for some people they're not effective. And they really require a level of active participation that sort of goes against the traditional medical model of just take this drug every day and hope you feel better. It's take this drug and then really integrate those findings into your day to day life. Because we're talking about a transformational experience. And if you just have that transformational experience, but then fall back into the same kind of behavioral patterns that led you to a negative state before the experience, you're just going to fall back into that negative state. And so I think it's important for people to realize that there does need to be active participation on the patient's part. And even if you're just trying to use these molecules to enhance your creativity or general cognition or whatever it might be, there has to be an active effort after the fact to actually put this all into practice. Because they induce a period of neuroplasticity after the drugs are used. But that neuroplasticity, it's only valuable if you capitalize on it.

Okay, got it. Now, one last thing I want to ask you guys about, and that's this idea of microdosing that I know a lot of people are doing now. And I know even some therapists or shamans are recommending, recommending certain microdosing protocols in between the therapeutic protocols. Have you guys messed around at all with that? Whether it be, you know, LSD or psilocybin or LSA or MDMA or any other form of microdosing as a way to enhance the effects of this therapy.

Yeah. So we've definitely looked into microdosing and it's been a big conversation. Unfortunately, the evidence for microdosing really isn't there. It's been shown that microdose microdoses do enhance some aspects of your cognition on the day that the microdose is taken, but those usually aren't sustained effects. So the next day, if you don't take another microdose, you're likely to not have any sort of benefit from the previous microdose. And as I said earlier, more and more studies are pointing to the fact that the intensity of the experience really is correlated with the positive outcome. So one way we see microdosing potentially is coming into play. Play is after having taken a large dose and having had a transformational experience to sort of sustain the findings from that experience. Someone could take microdoses to reintroduce a little bit of those feelings and emotions that they had during the original experience and help them to reactivate those sorts of neural pathways. But microdosing on its own is something that we're definitely keeping an eye on the research, but doesn't seem to have nearly the same promise as these larger doses.

Doses, yeah. I personally have been doing quarterly plant medicine therapy treatments along with my wife, but then I've also been using microdosing in between those therapies to kind of like stay in almost like a miniature version of that space. And I have actually found it to be pretty incredible as far as maintaining a lot of the work that I did did during the therapy sessions compared to not microdosing in between. And it's actually a really interesting concept, again, I think something that could and should be explored more as far as what occurs in between these therapy sessions to kind of keep someone connected to that space that they may have been in the therapy. But returning back to the type of journaling and the downloads and the notes that I take during or after therapy, and then combining that with smaller microdoses afterwards on specific days, I've personally found that to be something that is incredible as far as enhancing the experience. So yet another area in addition to self quantification and biohacks and supplements to look into when it comes to bringing this to the next level, really, I think there's just so many areas that could be explored. So lots of, lots of fodder for thought. But in the meantime, you guys have done a great job putting together this series of clinics. And, you know, I honestly can't wait. I haven't, I haven't been to one yet, but I'm really looking forward, you know, potentially on my next LA or New York trip or up to Toronto to actually try out what you guys are doing and kind of experience the space for myself. So I'm, I'm excited about what Field Trip is doing.

Thanks, Ben. We'd love to have you anytime you're, you're in the hood. Come on, buddy, we'd love to show you around.

I absolutely will. And in the meantime, if you want access to the show notes and everything that we talked about, as well as kind of an exploration of Field Trip health and their website, just go to BenGreenfieldFitness.com Fieldtrip and I will have it all there for you. In the meantime, Ronan, Marshall, thanks for coming on the show, guys.

Thanks, Ben.

Alright, folks, I'm Ben Greenfield along with Ronan Levy and Marshall Tyler signing out from BenGreenfieldFitness.com have an amazing week. Well, thanks for listening to today's show. You can grab all the show notes, the resources, pretty much everything that I mentioned over@BenGreenfieldFitness.com along with plenty of other goodies from me, including the highly helpful Ben recommends page, which is a list of pretty much everything that I've ever recommended for hormones, sleep digestion, fat loss, performance, and plenty more. Please also know that all the links, all the promo codes that I mentioned during this and every episode help to make this podcast happen and to generate income that enables me to keep bringing you this content every single week. So when you listen in, be sure to use the links in the show notes, use the promo codes that I generate rate, because that helps to float this thing and keep it coming to you each and every week.