EP 163: Psychedelics: Microdosing and Beyond | James Fadiman PhD

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Welcome Dr. Fadiman.

A great pleasure to be here.

Well, I'm really excited to have this conversation. This probably no greater authority on microdosing and the research around micros. Microdosing. And that's an important part of our discussion for these first two days of the summit, which are focused on psychedelics and on psychedelic assisted therapy. So I'm going to share your bio to familiarize our audience with you for those who don't know about you or your work, and then we'll jump into the conversation. Sound good?

Sounds good to me. Let's.

All right, so James Fadiman, PhD earned his BA from Harvard and his PhD from Stanford and has held a variety of teaching, consulting training, counseling and editorial positions. He has served on for profit and nonprofit boards and taught in psychology departments and design engineering. He has published textbooks, professional books, a self help book, a novel, and a series of videos like Drugs the Children Are Choosing for national public Television. He has been involved in psychedelic research for more than 60 years, the last decade uncovering and reporting on microdosing. He is currently writing a book about microdosing to clarify and consolidate the new uses and methods emerging worldwide. Okay, well, to start off with, could you just explain what microdosing is? I imagine there's a bit of a spectrum that could occur under that title, but could you tell us a little bit about what microdosing actually is or what it means?

Well, microdosing in the psychedelic space is taking a very, very, very small amount of psychedelics, predominantly LSD and psilocybin containing mushrooms. And it has a totally different set of effects than high doses. That's the basic definition and the word very small.

There's a number of. Your audience is very familiar with micrograms and that LSD is one of the most powerful substances ever discovered at these tiny doses. Well, a, an LSD session is usually a couple of hundred micrograms. Microdosing is between say 7 and 12 micrograms. So it's a very small amount of. A very small amount.

And is this something that.

And I guess this could probably vary. But does it nonetheless have.

Some kind of effect that someone experiences immediately or during that time? Or is it more like it's, it's doing things like increasing neuroplasticity or doing other things that are helpful to Us, but we don't really feel it.

The rule of thumb is if you feel it, that's a little too high a dose. So it is sub hallucinogenic or sub psychedelic. It has none of the classical psychedelic effects. And one of, one of the, the major questions that I get asked is or implied is is it kind of like a little bitty psychedelic experience? And the answer is no, it is its own set of experiences. And that in the in lab studies, basically it's very hard for people to be blinded, meaning to not know whether they're taking even a microdose or a placebo. It's not as, it's not as screamingly obvious as high doses, but the blind is repeatedly broken in the studies that try to do that. So people are aware that something is going within their system, but it's not vivid, it's not exciting, it doesn't have amazing properties. The sky does not open even a little bit. Flowers don't turn and smile at you. They may turn just a little, but not that you would notice.

Okay, so.

So let, let's put this in a context of, of psychedelic research and your career path altogether. So you've been doing psychedelic research for more than six years in the last decade focused on microdosing. So what led you into that, that pursuit to begin with? And maybe you could just give us a little briefly a little arc of that career and your interest and how it evolved into microdosing?

Well, it was entirely a mistake, like many things in science. And I couldn't have been less interested in microdoses for at least until I became interested. I was very interested in very high doses, high doses that are more than, quote, therapeutic, but are transcendental. So my interest was in the fact that classical mystical experience, as recorded in all the major traditions, looks exactly like reports of people having a high dose in a safe therapeutic setting of a major psychedelic. That's where my interest was. I dipped down once as low as 100 micrograms for a study on creativity in senior scientists. This is where the question was, if psychedelics opened up the mind to these great mystical vistas, would people be interested in opening up their mind to their own scientific problems, the ones they had been painfully unable to solve?

And much really to my surprise, I was not the lead on this. I was skeptical after the first group of scientists left our location at the end of the first day, and we said, you know, thank you, it was very good. We just all danced around with excitement because it actually had worked. And these senior scientists had focused for three or four hours on problems that they had been stalled on for up to three months.

The end result of that study was 48 problems and 44 solutions. So that was as far as I got into dropping from high doses. There was a lull that the US government helped support by very hard to do research. Even illegal research was hard to do.

And then I had lunch with a friend who told me that Albert Hoffman took very small doses at least the last decade of his life, and he would use them for thinking and walking in the woods. I became interested and the next 15 years unfolded from that.

That study you referenced with the leading scientists trying to address problems they had not yet been able to solve. Was that at Stanford.

This was an off campus research institute, a non profit institute. The scientists were predominantly both, some academics, but mainly people who were making a living in research companies like Hewlett Packard.

We had two architects, for example, who were designing different kinds of buildings. And the clients basically didn't like anything they'd done and they were angry and frustrated. And in both cases, when they went to their clients with what they came up with in the psychedelic session, the client said, great, we're for it. That's what we call a solution. There were also patents, there were products, and there were publications.

Yeah, I don't know, maybe something similar. Maybe it's just an urban legend, but it sometimes said that there was some studies like that or informal research or formal research that played a role in some of the folks who developed some of the early stages of the digital age as we know it in the computer age.

The answer is that psychedelics were rampant in Silicon Valley. And at one point there was a discussion of should we start outing the presidents of major corporations in Silicon Valley for their LSD use? I was one of the people that said, no, that's just not the way you do things in this world. That's just sensationalism. But it is well understood that psychedelics have been used in Silicon Valley throughout the entire period of their illegality. Mm.

So coming back then, circling back to microdosing, just to be clear now. So the doses, they're very small, but it's not like homeopathics. It's not like that small. Right, It's.

Yeah, actually it's my. One of my favorite numbers. 1 microgram, 1 millionth of a gram contains how many molecules? Okay. Now my own guesses were so impossibly wrong that I, I wrote a. A chemist who, who is allowed to make drugs for research for the government. And he said, it's 1.54 quadrillion molecules. Oh my goodness. In a millionth of a gram. So there's plenty of molecules for every cell of the body. Wow.

Wow.

So yes, we just, you know, it's, it's kind of like when you talk to astronomers and they say, well, it happened just recently. What was recently? Well, 100 million years ago.

Yeah, exactly.

We live on different timescales.

So. So for the last decade you, you've really collected a vast amount of first person reports engaging around microdosing, engaging in this approach. I don't know whether you coined the term or others have, but a citizen science approach. And I want you could tell us about that approach to research and how it differs from traditional research and, and, and its impact and what you're finding.

Well, citizen science is traditional research.

Aha. Yeah, good. Yeah, I like that.

Contemporary science is only about 200 years old, but citizen science means you people tell you what they found or they go out and look for things, or they go out and have. And it's like if you say, well, what is the science of climbing Everest? And the answer is there isn't any quote science, but there's an awful lot of citizen science from the people who have done it and reported and changed equipment and developed new methods, all of which coming out of experience. So fundamentally, even if you're quote a scientist, you're still asking, particularly with human beings, mainly you're asking them about their experience. It turns out that that is an regular science is self limiting.

For some good reasons and some not. When you're working with human beings, eventually you end up asking when you say, if you take a pharmaceutical for depression.

How, how is it? How do you know? How does your physician know it's effective? There's only one way he says, how's it going? Now he may say, on a scale of 1 to 10, how's it going?

So if someone writes in to me or my group, I've been using this psychedelic and for the first time in 20 years I'm not depressed, that to me those are equivalent amounts of data. Citizen science is, is basically paying attention to what people have actually experienced in real life, which is after all what we're after with any say, medical or therapeutic intervention. I mean, it doesn't matter if it works in the lab and if it doesn't work when on the street. So the. Remember what pharmaceutical companies do after they've spent their hundred million dollars, they give it to your physician and your physician says, you know, this might help you. And with psychedelics, since particularly many of them grow, they go in nature and someone says, you know, I think I'll try this. Oh, it seemed to help me. You know, my brother seems to have the same condition. Maybe he'd like to try it too. So citizen science is what you might call normal human behavior.

And how many of these first person reports have you now collected?

Well, personally, a couple thousand from 51 countries. I'm also working with microdose me, a little more formal research group where people sign up to either be the microdosing group or the non microdosing group and then take all kinds of measurements and questionnaires over a period of months and that's another 20,000. And then I make use of as a database, a sub edit on Reddit, which I did, had nothing to do with, but it's called microdosing. And as of right now, it has over 200,000 people who share experiences and advice and all kinds of amazing stories. So it's a rather large database, particularly since most of the published research on higher dose work is with 10, 12 or 20 people.

So I know. Well, I mean, as you said, even in medical research or certainly around any mental health issues, at some point you have to ask the person how you're feeling. Right.

Let me just take one of my other concerns. With conventional research in real life, there aren't double blinds. Imagine you go to your physician and he says, you know, you've had this problem and we've tried some things, but this just came in, it's new and the research is very good and I'm giving it to you and you say, wow, that's terrific. And he says, oh, by the way, half of my patients, I'm actually giving them a dummy pill.

And you might be the one.

It doesn't work that way.

Right. Well, I want to, I want to circle back to that in just a minute. So.

You know, in the social sciences, you know, a lot of what is collected is, is first person report surveys and then they may codify it as a whole science of test validity of scales that are used over time with large enough samples of people. And there's all that and then there's just qualitative data that's collected, interviews and so forth. But even that can be coded and analyzed. So I'm wondering if the microdosing first report data, if anyone, is actually sort of coding that for how certain words and phrases show up and how common, you know, identifying patterns within that data.

Yeah, there are recent research out of, I think Maastricht University. They looked at.

I think five or six thousand reports and this was the same people doing all those scales. But they also were asked just to make some comments and they looked at what were the like 10 most used words and one was joy, one was anxiety.

So the question, you know, when you look at that you say, how does that apply to me? And the answer is you don't know.

If you've ever gone to a film and 85 million people went before you and most of them said it was terrific and you walked out within 20 minutes.

Yeah, entirely possible.

What my interest is setting up and establishing as much as we know that is safe and efficacious and how people should observe themselves, particularly for instance with the question of dose. One of the problems with pharmaceuticals is obviously they're not made in an infinite number of doses.

But microdosing can be done that way and people basically say, gee, Fadiman says 10 micrograms is probably right.

That feels like too much for me. When I have 7 micrograms it feels so much better.

They're correct. Or someone with autism, for example, says, nothing happens for me. This is very usual. Nothing happens for me until I'm taking about 40 micrograms. Now we don't know quite why, but with high functioning autistic people that's very common. So the self observation and really, really taking responsibility for your own dosing.

Is part of what has happened for microdosing.

Yeah, Recently I don't think I'll be able to pull it out of my brain, but I recently just read something about autism and something about some commonalities of receptors and some kind of interrelatedness of what's going on in the world of psychedelics and psychologist, therapy and, and certain receptors that seem to have some relationship with autism in the brain.

Well, that's probably true. What I know on the citizen science level and the research level is there's a wonderful book called Autism on Acid and it's someone who was a typical high functioning autistic, which means brilliant and with rather inadequate social skills because they're unable to recognize social cues. And he, his story is both beautifully told and he's now doing research with University College in London and working with lots and lots of groups of people who have similar mental skills and similar mental issues.

That may have been where I read that because I was doing research. We're going to be interviewing Chris Timmerman as well and he's at Imperial College and in London.

Thank you.

Yeah, so.

Yeah, so what you said before as well, about, you know, one of the reasons for double blind studies, I mean the first stage of conventional research and FDA approved trials and all that is about safety, if I'm not mistaken. It's about is this safe for human beings? And then you get into effectiveness studies and all the rest of it. So it, even though it is going to be very personal, perhaps getting down to what's the right dosage and what works for somebody, what doesn't work for somebody else, it does seem important to establish the safety. And of course I guess that just the sheer size of the data that's been collected helps establish that.

Yeah. Well, remember, pharmaceuticals are often now totally synthetic molecules and they've never been taken by a human being. If you take a psilocybin mushroom, we have guaranteed about 11,000 years of work so far. 11,000 years people have been taking it. They figured out that it is where it's safe and where it's not safe. Let's take a different substance. For example. Amanita mascaria. That's the Christmas mushroom, the pretty red one with the white spots.

At a microdose level it's about half a gram. It has remarkably healing properties. At a higher level it is toxic, it is dangerous, people have died from it or, or decided they had superpowers and like ran into brick walls.

So citizen science unfortunately gives you a pretty wide range of experiences from the natural world. If you're starting with a synthetic molecule, it's a wonderful system. First you give it to animals, nobody dies. Give it to bigger animals, nobody dies. Give it to bigger animals, you begin to watch for specific effects. And then the first with humans is basically does it hurt them? There's no interest in benefits on that first level. Just does it hurt them? Then you go into the very careful studies until the, the newly synthetic molecule is made available. Psychedelics don't fit the model. And remember before it was made illegal, we had, it was the most research. LSD was the, the most research psychiatric drug on the planet. It isn't that we lack data. There were 40,000 individual cases in research studies and in clinical practices before it was made illegal. So yes, it is vitally important. And we've had drugs that have gone through all of those tests and then when they were released to the public, terrible things happened. So it's a problem.

Yeah.

But start. Natural substances have. One advantage is at least animals and humans have often checked them out before the lab got to them.

Yeah. So another reason for.

Double blind studies in conventional research is trying to isolate the effect and also to rule out the placebo. Now, very interestingly now, at least alternative science, I think maybe even mainstream science, is starting to catch up with the fact that the placebo is actually a good thing. It's an important part of the healing process. What you're identifying is the mind and the body's own internal healing mechanisms and capacities and calling it the placebo effect. So I just wonder, in terms of the world of microdosing and collecting this data and people's use of microdosing for personal growth and therapeutic means, is there a placebo effect at play or does it make any difference? Is that of interest?

Well, it's of interest and if we weren't on separate screens, I would just hug you for that because I am, I am eager to try to get people to understand that the placebo effect should be called the natural healing capacity of the human body. And it's what makes almost everything we take work. And when it is too, when there's too little of it, we, we are ill and, and medications and so forth don't help. So what we know in microdosing, because the effects are small.

That expectation that it will work should help. And the, the problem, as I said with double blind studies is they're not double blind.

The example I give as well, you can't do it. I have, there's one wonderful senior scientist that says I don't believe anything unless there's a double blind. And I think, well, if I have a foam bat and a two by four and I want to find out if people can tell the difference when I hit them over the head.

That'S perfectly, that's a perfectly.

Reasonable, except for the, the obviously stupidity of it set up for a double blind study, but the blind would be broken, so to speak, quite quickly as well as the, the, the deliberately lowering the effectiveness of the effective substance through a double blind study. Double blind studies were designed and they're ideal, they're fantastic. If you have a antidepressant and your company is making $2 billion a year, and my company says we can make a different antidepressant and if it's better than yours, we will make $3 billion a year. So we need to have a double blind study between your antidepressant and my antidepressant. So whatever placebo effects are built into both groups, that's an ideal study. I mean a simple study is can people tell Coke from Pepsi, there's no seltzer water in there.

As a double blind. Right. So it has a very Clear use in science, but it doesn't mean it's particularly not useful for psychedelic studies. It happens to be a necessity because of the federal regulations, but it's not very useful.

So I'm curious about what you feel are some of the most promising therapeutic applications for microdosing. I had the opportunity to interview Paul Stamets for another summit. We're also going to have him in this summit and I know he's been doing some kind of citizens approach research, I believe. And the idea, possibly there will be supplements that will be a mixture of like psilocybin, lion's mane, maybe some other herbal supplements and psilocybin will be present as a, once it's legal as a, you know, at a microdose level and that these supplements, people will just take them to enhance mood and performance and cognitive ability and so forth. I'm curious about what you think of some of the more promising therapeutic applications or just human, you know, benefit applications of microdosing.

Those are two groups. Let's look at the therapeutic benefits and again, looking at the, the volume of male, high percentage of people who were interested in the first couple of years of our data collection were people who had not been able to alleviate depression with therapies or medication.

There's a terrible word called treatment resistant. As if it's their fault. Okay, but it's not.

They were finding that microdosing.

Alleviated depression in approximately 80% of the cases. Now these were all hard cases. That is similar to the high dose work done say by the people at John Hopkins and now at other places.

Now why what people reported is.

Not that they felt less depressed. They said, oh, I'm back.

As if a veil had been taken away. As if, you know, kind of glasses that are the wrong prescription were taken away. And people would often report on the first or second dose, again, very small doses, that this feeling of, oh, amazing.

I'm, I'm enjoying my children. I haven't. And I, I have to admit, as parents sometimes do that I haven't liked them the last few months and they haven't changed. So depression is major.

The other set of the other areas, and there are other, a lot of other areas, some of them we're just exploring. But difficult menstrual periods is one that seems to be quite commonly used successfully with microdosing.

Migraine headaches. Now when people take microdosing for migraines, they're not cured of anything. What they report is the number of migraines and the intensity of the migraine. Both decline significantly like 80, 90%. Those are a couple of the large ones. If we look at the other group which is might be called enhanced wellness or just self improvement, we have an awful lot of students who say, you know, I was getting Bs and now I'm getting A's. And we have an awful lot of students that say I've been on Adderall. If you look at what students take that they're not allowed to marijuana is the. Is the most.

Adderall and the equivalent. What are they called? Cognitive enhancers.

One professor of psychopharmacology says they're called speed.

Are the most used substance by students. What students have said and again, again we have lots of reports is my goodness.

Microdosing seems to give me the benefits of Adderall without the crash or the addiction.

So that's a therapeutic. But for among healthy people.

There are a number of athletes who have simply said my performance is improved. And the simplest way is someone in the martial arts said, I used to get silver medals. Since I've been microdosing, I get gold.

So we're looking at why such a wide range. What does that make sense? What it makes sense is if the whole body is functioning better, then whatever is wrong is also functioning better. So that you know, what you're told in every health article you've ever read is get a good night's sleep, eat a good diet and exercise. Now what they're saying is if you do that, the system will function maximally well and whatever is specifically wrong will be more likely to heal. So microdosing is more a better image is of a vitamin rather than a pharmaceutical. No one ever says to you, what condition is vitamin C for? The answer is vitamin C is for every condition because it makes your body work better. That's the way it seems, that's the way the data is coming out.

These could be considered a kind of nutraceutical at some point. That term is sometimes used. Yeah. And.

So I don't imagine much neurobiological research has been done that's always done in a conventional setting with neuroimaging and all the rest of it. And. And so I don't know how they would even begin that with these substance have not been approved. I guess they could get, you know, if they're doing FDA studies on psilocybin, they could do some. But I'm just curious if you have any data or if you speculate that one of the reasons for these improvements that you see, these positive effects that you see is like an increase in neuroplasticity of some kind. And I'm thinking of what a colleague, Dr. Dan Siegel, talks about.

The healthy function, optimally functioning brain is highly differentiated to solve more and more complex problems, but it's also highly connected and highly integrated.

The parts are all talking to each other very efficiently. So you have differentiation, you have connection, you have integration, and you get a high functioning brain. And that all requires a certain level of neuroplasticity. We know exercise also improves that. So I'm curious about your thoughts around that.

Well, a year ago, I would have said, I don't know, but fortunately I have friends who are doing the research. And now it has been demonstrated in a couple of different studies that microdosing increases neuroplasticity, meaning it increases the development of healthier neurons with more dendrites, meaning more capacity to message. And this is cellular research. So that's one that we now know. One of the things that you've all seen the pictures of the brain without psychedelic and the brain with a psychedelic, and what we know is that high doses of psychedelics give you lots more colored lines. We don't quite know what it means, but that's the diagram. Everyone knows the diagram. Well, it turns out the question is, do microdoses have any effect at all? Particularly the people who say, no, it's all placebo. Well, there's a study out of UCLA, Connor Murray, who was studying the effects of 13 micrograms.

And what he found, he had higher and lower doses. But 13 was the sweet spot that his. His subjects didn't know whether they were on placebo or on psychedelic. So it was very low. Their brains, however, knew very well because the change in brainwave patterns was identical to higher doses at lower amplitude.

So that's about.

As clear as we can get it. And we now, and this is recent research that everyone is very excited about. One of the questions has been, well, all of the research says it's serotonin inhibitors, a particular neuron named 5 2a. And it's just exactly the same neuron that all the antidepressants work on. And I'm thinking to myself, but it doesn't work like an antidepressant. What's wrong with this model? And my theory had been it affects other neurons as well, which, of course it does. But the 5:2a people have actually looked at what happens when an LSD molecule and a neuron meet.

And what happens is the LSD molecule goes inside the neuron. Imagine the neuron like a little cup the serotonin approaches the molecule and basically gives it a slap across the bottom.

It actually reacts differently. We've just now seen one of the reasons for the neuroplasticity is it affects the molecule very differently. It affects the neuron, sorry, the neuron very differently. I am thrilled to be able to be asked that question when we just have these two pieces of, of striking research.

The one particularly that says, why does it, why does it not act like an antidepressant? And the answer is, because it doesn't affect the neuron the same way, you know, someone shaking your hand or going to bed with you, they're both making physical contact, but it's really very different.

And although the serotonin inhibitors have certainly helped some people, they're, they're not the most wonderful class of drugs. They, that, you know, they're not super effective and they have a lot of downsides with them.

Yeah.

So I'm curious about your thoughts about the future of psychedelic research in general, as well as microdosing research. As you mentioned, there was a lot of data back in the 1950s and 60s before LSD was made of Schedule 2 drug. And in fact, back then they were saying, this is the future of psychiatry. And then it all got suppressed. And from my understanding, even the data was made a little difficult to get to. And, and then here we are again and we have FDA trials going on with psilocybin and mdma. You know, it's hard to, you know, the social. There seems to be almost still a strong social stigma around lsd, whether they'll do trial. So I'm just curious, where do you think all this is going and what are your hopes and concerns?

Well.

It'S getting harder and harder for people in regulatory or political positions to stand up and say, I want people to continue to suffer, I want them to continue to die, rather than look at this substance which has thousands of years of successful work. It's just getting harder, particularly when we look at veterans.

What's happening in state after state and in Congress. There's now a psychedelic caucus, which in my world is just as amazing as, you know, as anything I could think of. Because the idea that people should suffer and that people should die before they could, when they don't have to, makes no sense. It's, aside from it being immoral and so forth, if these were dangerous substances, you know, nobody's pressing to have it, have radioactive, you know, vitamins in your pharmacy because we're all pretty clear that radioactivity is generally not a Good idea. Psychedelics are among the most, oddly enough, physiologically the safest drugs we've ever seen. There's a fascinating paper out of Canada of several people who took 50 times the amount you should take for a high dose of LSD 100 times. And someone else took several thousand times what you should take. What happened to those three people is they, they did not walk out and go home. They were hospitalized and they were observed and they were in a coma like state for a certain amount of time. The recovery however, was without damage of any sort and at least two out of the three cases, long term medical illness was gone.

So we're in new territory now. I'm not recommending people take thousands of times an overdose. It's still an overdose, but they're safe. That's that first part we were talking about with what do you do with the medication.

The future. Well, first of all, capitalism is at the trough. And there were Last year about 400 companies worldwide all saying they were doing the breakthrough in psychedelics.

The people, the investors and the stockholders thought they were doing very well. All of these stocks are down between 50 and 80% this year. So maybe there's some sobriety in seeing that. It takes a long time to make a drug legal and it isn't clear. See with, with depression, for example, the high dose studies, people take two or three sessions.

Period.

That's not a good business model for a pharmaceutical company.

Antidepressants, you take them for the rest of your life.

It's a magnificent capitalistic model. So people actually haven't figured out how to make money, but they're working on it and I think they'll be successful. Microdosing is more like.

More like a vitamin. And, and the problem for capitalism is it's incredibly inexpensive.

That I'm sure can be remedied if people could get control of it and patent it and you know, do what they did for insulin. But it looks like between, see with the problem that the culture has is it's a new category and it's very hard for regulatory agencies to handle a new category. For instance, high dose psychedelics should not be taken unless you're with a professional. So it's really not buying a substance. It's buying a substance and professional time. We really, that's two different agencies and that drives the regulatory people, you know, into very crazy places. They will solve that because the countries that are legalizing are finding one, no problems and two, a lot of clinics are springing up and people are benefiting. So the model is a different medical model. But remember, before antibiotics there was a different medical model. Before antidepressants and antipsychotics and anti anxieties, there was a different medical model. We're perfectly capable of developing the new medical model. And when I talk to medical students, one is most of them have psychedelic experience. Two is they're very interested in new models. When I talk to tenured professors, it's a lot slower.

But I'm optimistic because the, the desire to be healed.

Is one of, you know, is one of the things that not only drives ourselves, but it's drives our, our feeling for our children and our relatives and our village.

So in terms of, you know, the research that's going on with MDMA and psilocybin, the FDA trials, not everybody realizes they're not, those are not typical drug studies. They're actually testing the therapy supported by the medicine, the drug. And the test is on the whole thing. And actually, if this rolls out, one of the big challenges is going to be how to train enough psychotherapists to deliver this at scale and how to make it economically accessible to people and not have it just be something that's, that's available to the elite. Microdosing seems, you know, much more potentially accessible. Although, you know, some of the nutraceuticals at least marketed as the high end or, you know, the, they're pretty expensive. I don't know what makes them expensive where it's all marketing and, but, but ideally.

And I have related one question. For example, if you had a supplement, let's say that had some, some psilocybin mushroom in it according to the current law, right. Would the amount of psilocybin in that supplement have to arise to a certain level for it to be illegal? Or would it be if they could detect any at all?

Basically, it's a practical question because if, and they can detect it if they want to. But I remember listening to an FDA official being asked, why are, you know, are you interested in psychedelics? And he said, this is a Drug Enforcement Administration. They said, no, not really. They said, well, why not? They said, no money in it. And what they meant is it doesn't attract crime. See, the problem is, is if I had here a little tube of mushroom of kind of growing mushrooms, I can grow enough psilocybin mushrooms in a couple of weeks to last in if I were microdosing, often months.

And if I look at the price on the illegal market, we look at the high dose, plus therapist, plus support, plus integration, plus facilities, and it's a 10 to $12,000 for successful ending of depression, about 80, 85%. I look at a microdosing for a month. That would be about 10 doses. Costs about $10.

And if it isn't working? Well, the first two levels. One is people get anxious, people have some. Some nausea.

The first, the first rule is first cut your dose in half. That handles about 80% of the people. And the other people should stop.

You know, if, if you eat a food that's very popular but not in your culture and you're not used to that food and you don't like it, you don't have it. Again.

Yeah, my, my wife is allergic to avocados. I feel so terrible for. Because I think avocados are the most amazing food on the planet. But.

So we're dealing with a safe substance to start. And if it doesn't agree with you or you don't like it.

High dose has, has a different. It's a different universe and it has different regulations and well, it should. One of the problems that Oregon has is psych. Basically. Mushrooms are, are not quite legal. They're decriminalized and you can take them in a legal setting. And it isn't a trained psychotherap or psychiatrists. It's someone who has been trained in how to be with people using mushrooms.

Then the problem for. Or. And you have to stay there like four hours. The problem with, with microdosing is how do you handle it? And, and I testified for them and they didn't like my testimony at all because they were worried about medical issues. And so the new law and organ says you can go down to the same place and get a microdose, but you have to stay 30 minutes.

Now, that's not a solution.

But it, but it is an attempt to deal with the reality that not much happens with microdosing and therefore the whole regulatory apparatus may not be necessary. That's why we have over the counter drugs, almost all of which started as prescription.

Mm, absolutely. So, yeah, part of the economics of that, you know, obviously, if you know, that's why our whole medical system is so focused on curative medicine and not on preventive medicine, because, you know, the money is in the curative medicine. So.

So other than the fact that in terms of microdosing, other than the fact that for a given individual, whether it's microdosing with psilocybin or LSD or another plant medicine, it might not just agree with their constitution and therefore they should probably not use it, but other than that, you don't see any real safety issues.

There haven't been safety issues so far. Again, we've only got, you know, 15,000 that I can count on and 200,000 that I, you know, that I listen to. We would probably know. We do know. Things happen to people. Early on someone wrote and said, I have headaches and vomiting and something. And I said, yeah, what should I do? And I wrote back his email. I don't know where he is. I said, stop. He wrote back, he says, you can't make me. Wait a moment, wait a moment. So I said, no, I can't make you, but I have to tell you, I'm a researcher and you should stop. Silence. Three days later, a letter said, I cut the dose in half and all my symptoms went away. That's how we, that's how citizen science works. So the problems. And now there's a whole new class of what are called microdosing coaches. And those are people who will basically add a therapeutic element, but not very often and not very hard, but they were. Remember a coach, if you say, I have a running coach, he doesn't run with you, but as you come around the track, he said, you know, down that last lap, I noticed your left heel was a little out. See if you can move it in. That's coaching.

It isn't. When was the first time when you were running that you recognized that your left heel was out? And can we talk about your childhood? That's, that's not necessary. So there's a whole occupational. There's actually an international microdosing association of professionals who will help you with the kinds of questions you're asking.

What about longitudinal research? I realized, you know, the microdosing movement, well, it's ancient. You could say it's been going on for thousands of years. And on the other hand, in terms of the collected data, it may be fairly young. So do we know about any possible long term effects or if someone is, you know, regularly microdosing and it's benefiting them and then for whatever reason they would stop using or it would become unavailable to them or something, could that lead to a downward slope and maybe being worse than they were originally, or do we have any longitudinal data?

Well, we have a different model. The model in microdosing is called start low, go slow and take time off. That means start with a low dose, don't raise the dose very much if you think you need to, and take serious time off. So all the group independently. And these are people in Peru and in, in Europe and here have all come to the same conclusion, which was not part of my research, is that it seems right to take time off, meaning microdose for a month every third day, that's not that often, and then take two to three weeks off. So people have evolved what they consider a very, again, a different model than most medication because it's, it's not a medication.

So.

But we're still learning and the coaches are a new, a new breed. And they're also busy connecting with each other. We're also dealing with unusual conditions. Let me give you an unusual condition, Mississippi.

I only have one case, but this was someone who said I microdosed, had Ms. Since I was 20. She's now like 40. And she says I can walk around with a walker on level ground.

Which for those of you who know ms, that's, that's where she is. She said, and I've also had crippling headaches for all of those 20 years. I have microdosed and I no longer have the headaches. And then her letter, she said, I'm hoping that my myelin sheets will start regrowing and I'll let you know.

So we're, we're, that's, that's called discovery. Okay, now if you say to researchers, hey, why don't you give microdoses to people with ms? They'll say, my, my internal review board would, would never let me do that.

Citizen science says it's my body.

And if it's safe, let's see what happens. And we have a couple of those extraordinary cases with strokes.

And actually a lot of cases now, traumatic brain injury.

So we're really, we're really at the second level of going beyond what is what high dose psychedelics are good for. Nobody says you should take high dose psychedelics for Ms. Or anything chronic because you're only taking it once or maybe twice. But microdosing.

Allows the neuroplasticity to continue. And we have no idea. So we, we have, you know, the only long term we have again are indigenous, which is lifetimes, and nobody's complaining. But that's not very good data.

The people I know the longest are maybe 20 years. I did, I did meet a sculptor who said he's been taking it for 60 years and at age 80 he was still sculpting and dancing and teaching people. So who knows?

Micro. Albert Hoffman was giving lectures at 100.

And we know he took small doses to walk in the woods. So we don't really have long data. But let me give you a scary place where we also don't have long data. It's very, very hard to find any research on long term use of SSRIs and antidepressants. And I say long term, I mean like a year.

Now. And, and if you want to be really disturbed, there were. Because the, the companies have no benefit, they see no benefit in long term.

Right.

The government, however, now and then says, you know, we've got a lot of money, we've got a lot of time. And there were two long term studies of people on SSRIs with a matched control group, whatever that meant. What they found after 20 years is the group not taking antidepressants had better mental health.

Now.

So there's some interesting studies yet to be done. My guess is what happens with microdosing in general. People say take it for a month with one of these protocols and then they take it less often. The coaches I've talked to say my goal with my clients is first of all to start lowering their dose and eventually to get them off. It was just a different model.

So in the indigenous world of plant medicine and shamanism and so forth, many of these natural substances that human beings have been taking for millennia.

Are considered, you know, they have a spirit, an associated spiritual entity that sometimes people reference as beings or spirits or guides or so for. And the reason I bring this up is whether.

You feel there will be any difference or whether there's been any research on, for example, people microdosing with, let's say, synthesized psilocybin versus natural mushroom, organically derived psilocybin.

I'm actually involved in a piece of research doing exactly that. We're not using humans because we really want to measure.

Kind of life, life extension or life pleasure, and we're using much lower animals. There were two, I didn't know there were any. But there are two studies, both I believe, in Japan, natural and synthetic. And in both cases natural was more effective. Now, natural meaning in embodied in a mushroom not extracted.

Right.

And that includes a number of other alkaloids that we have not studied at all. Not too many. Marijuana has like 400 alkaloids. Psilocybin mushrooms have like 6. But it, but that is, you know, that's, that is to me a fascinating study, both as a scientist, as a person, because almost all of the data I've talked to you about has been with natural mushrooms. And of course there's a lot of economic.

There'S a lot of economic money on the table that has never considered the possibility that the psilocybin containing mushroom Might be different than the single molecule in a lab.

Well, it's interesting you brought up marijuana. So there's an example, I would think, of citizens research that really led to the legalization of medical marijuana and then the proliferation of CBD products. I mean that was also driven, driven by, by capitalism as well. But, but certainly the, the general public said this is safe, it's helping me. We want access to that, that, that's kind of what the trajectory was.

So the, just as the legislation that banned it was not based on citizen science, the legislation is now being pushed by citizen science to kind of grow up and notice the reality. The idea, the whole idea of making something illegal, most of whose attributes are for healing.

Is counterintuitive to being a human being.

So you mentioned before that in speaking with medical students.

They tend to have had some experience with psychedelics, as with a lot of college age kids, young people, but also they're very open to new medical models.

Right.

And so I'm just curious, maybe, you know, we're kind of coming to the end of our time here, but if you can kind of envision some level of transformation within mental health, how we're, how we're relating with mental health. I mean, one of the advances is, you know, rather than seeing. It used to be that, you know, when we were struggling with the mental emotional.

Challenges, it might be labeled a moral issue or a character defect. And then it became all about the brain chemistry. Back in the, in the 70s, we'll just come up with some drugs and readjust your brain chemistry. And nobody was looking at the underlying. And now, you know, with everything we've learned about trauma, we realize that underlying a lot of these issues there are traumas. And, and I guess we're understanding from psycho, consistent psychotherapy that there can be in part the therapy can help heal some of those traumas, but also the increased neuroplasticity from the medicines and the combination thereof may be part of the healing mechanism with these traumas. So the landscape of mental health can be changing. And I'm curious about just what you envision maybe as a future of both mental health and medical. Maybe it's the de. Medicalization or something or what it is.

But remember that it used to be that the artist and the shaman and the tribal leader were the same guy or the same woman. We then made them into specializations. And then, you know, once you start specialization, it's, it's. I don't want to say it's like a cancer that's inappropriate, but you get.

The idea, right, yes, yes.

The idea that psychology allows you to study what happens in this part of the body, but you're not allowed to talk about this part.

There's a silliness that, that the academics do to, you know, and I've been a professor and I have a textbook, so I've done, I, I know those, you know, some of my best friends are professors.

But I don't recommend it as an occupation for certain reasons. What we're, what we may return to is a more nature based medicine.

The problem with many medications, it used to be 70% of the medications were derived from sin. From natural subs. They may have been then synthesized, but they were still from natural substances. With computers we now generate molecule shapes and, and, and go for, go that way. It's not going to work out as well. We could have, for instance, we, we know for instance, that if you eat an orange or a lemon and you're on a ship, you won't get scurvy.

Okay? There isn't a, there isn't a medical specialization called lemons.

There is a natural substance which when used correctly, you can also get mouth ulcers, you know, from lemons. Okay? So we're seeing as a parallel to the current model, and this is the way things really do work, is a new model. And if you look at the history of science and the old model holds on as long as it can and the new model keeps accumulating data and then at some point, usually according to Max Planck, your theory advances each time one of your colleagues dies.

So we have this incredible. We also have people who've used lsd. Different number. Since LSD was illegal in the United States.

40 million people in the United States have had LSD. Now, I'm not talking about psilocybin. If I go to marijuana, it's like 114 million. We are not unaware of that. Psychedelics have been part of the culture since the 60s and they're now surfacing because a lot of people already are. No, I mean, someone did a study and found that people who were psychedelic coaches and doing integration and doing research had personal experience. And I thought, wow.

And I bet that sex workers have had personal experience.

So science sometimes kind of just gets silly.

Sometimes you read about these latest studies and you kind of go, duh. They're really spending all that money doing something that we all know is common sense, right?

So the common sense is actually worth study, you know, worth noticing. Okay? And we use it all the time. We don't. No one, no one Says, you know, someone says, you know, I saw this, this thing on Netflix. I think you'll like it. You don't say, well, how many people have seen it and how many people liked it at a 5? And what were the rotten tomatoes?

And was it a double blind study?

Right. Or people are looking at something else.

So, yeah, I think I'm very optimistic because the medical model, it's hard to kind of really generalize because the United States medical model is built around profit. The world medical model is built around we want to help people, and we'd like to do it inexpensively. Well, microdosing looks like a really good answer for that second group.

And I think the United States will come along once they have found a way to monetize it.

Well, this has been a fascinating conversation. Dr. Patterman, thank you so much. Thank you for all the work you've been doing all these decades and the work you're doing around microdosing now. There just seems to be such potential benefit for humanity, not only in the individual benefit that humans may experience with microdosing, but just the possible transformation of some systems in our culture which tend to lose their way and not be so people centric or human centric anymore. So thank you so much for your work and for being part of our summit.

Well, I'm so glad I could be part of the summit, and I'm so glad I could be with someone who. Who is way ahead of what I'm talking about in so many areas, which just adds to my optimism.

Well, thank you. Doing my best here. All right, well, again, thank you so much. And.

I think this is just really important conversation that we're having on all these conversations that we're having on this summit. And, and this is. We're just in the first couple days here, so I think this is setting the stage for a really rich journey. So thank you so much.

Thanks a lot.

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