Why Your Antidepressants Aren't Working (How to Address The Root Cause), with Dr. Will Van Derveer

Foreign. Hello, and welcome to the Feel Freaking Amazing podcast. I'm Wendy Trubo, and we have a celebrity sighting today in Ed Levitan. And we have Dr. Van der Veer. I'm hoping I said that right. He is the founder of the Integrative Psychiatry Institute and co host of the Higher Practice podcast. His institute trains doctors and therapists in how to address the root causes and not just the symptoms of mental illness using integrative medicine and psychedelic therapy. So, Will, welcome. We're so excited you're here.

Great to be here. Thanks for having me.

So we've known each other for a little bit. I'm super excited to get into the weeds.

And is that literal or figurative? Just asking for.

We're not talking about weed. We're talking about even bother stuff than weed.

So I love that your podcast is called Higher Higher Practice.

Yeah, I think that might have been the purpose.

We are here in Colorado, so the weeds outside my window are pretty high and pretty dry right now, so I guess it's fitting.

So how'd you get into this work?

Well, really, it came from, frankly, despair that I felt as a psychiatrist pretty early in my career. I came out of my training, I thought I would have most answers for most people with their suffering, their depression, their anxiety, their bipolar, their schizophrenia. And within a couple of years, it started to dawn on me as I had more and more people falling into this category of treatment resistance that we talk about, that the tools that I had were way inadequate for way too many people. And it was incredibly discouraging. Um, and so that led to. That was a little bit over 20 years ago that that occurred. And that led to a conversation with a former patient who had. When he had gone and been tested for celiac disease, in the context of me treating him for generalized anxiety disorder, I had him on an ssri. I had him in cbt. I worked with him for a year. I got basically no results for him. And when he went and saw a naturopath and came back positive for celiac and stopped eating wheat, his anxiety melted away over about. About six weeks. And then he tapered off his medication and still had no anxiety. And to this day, he remains free of anxiety. So that was back in 2004, where this huge act of generosity from this person woke me up to a different perspective about medicine and mental health in particular. Nobody had ever talked to me about the gut brain connection at that time. I had one hour of nutrition in med school, not a whole course.

Usually it's about half an hour. So that's not bad.

So that was sort of the beginning of. Okay, something else is going on here.

You know, it's funny because to take a little detour into gluten. A tremendous number of people with anxiety, depression, ocd, schizophrenia, bipolar disorder are actually self medicating and just have either gluten intolerance or celiac or somewhere in the spectrum. So. And it's. I think you see kids, I don't see kids as particularly pronounced with kids who, you know, the ones who you just can't get a handle on that getting them off gluten makes a huge difference because of the tight junction issue and the zonulin issue and all of that. So.

And that's not to say everybody that with anxiety, depression, bipolar has a gluten issue, but there is a percentage of people.

No, but you know, it's a, it's a pretty easy way to be like, hey, is there something I could fix that's cheap and free?

Absolutely, yeah. And I agree. And it's. So that was the beginning of a journey of, of looking at gut brain connection. And then that led into inflammation and autoimmune conditions and you know, what are the levers I can pull to reduce inflammation if inflammation plays a role in treatment resistance, which of course we know it often with mood disorders and PTSD and so on. But I still wasn't getting the results I wanted to get. And it was around 2012 that I got a phone call from a physician friend of mine in the community who said, would you be willing to consider joining a clinical trial of MDMA therapy for ptsd? There's a phase two trial getting started in Boulder. They need a psychiatrist. And I said, isn't that the stuff that causes holes in the brain and is no good for anybody and you know, people abuse it and go rave and then, you know, get sick and die from it. So on I had this huge brainwashing really honestly, from, from my training. And it turns out that this story about holes in the brain in MDMA actually came from a trial by George Riccarte where it later had to be retracted from the journal where it was published because he had switch. Switched the labels between amphetamine and mdma. And the animals, the monkeys who ended up with holes in their brain got very high dose amphetamine, not mdma. But the impact of that study before it was retracted was huge. And obviously I was one of the people who was impacted by that. So I went through that clinical trial as the study physician. I got trained in MDMA therapy And I watched people get well in a five month protocol with three exposures to MDMA that were, you know, on average, our folks who came through that study started with 29 years of PTSD symptoms on arrival into the study, and three quarters of them didn't meet criteria anymore at the end of the study. So it was just mind blowing to see such a huge reversal for people who had been getting after it and trying to get well for decades.

Did you have any crisis of faith? Like I've been, you've had all this training at that point and you do all this work and then was there any part of you that thought, what have I been doing all this for when there's this other thing here? Like, have you been. Did you feel like you had been spinning your wheels for a long time?

Well, absolutely. And you're reading my mind. The thing that started to dawn on me toward the end of that clinical trial was, oh, like I can't go back to working with people in a con. In conv. In ordinary consciousness because I'm, they're paying me to do something that is probably going to be a lot longer and more expensive, potentially more painful, less effective than what I just saw happen in a study. But obviously I can't go out. I'm not, you know, going to go out and risk my license and work with MDMA underground or something like that. So that's when ketamine came into the picture.

So I just wanna, I always, I haven't really talked about this on the podcast, but I've gotten, I, I started working with ketamine two years ago and we're looking to bring it to the practice. But, and I've also gone deep into plant medicine in terms of the research and talking to people. And the thing that I really want to set the stage for people is you, let's say mushrooms, you go out and you party and that's okay, but that's party and that's more of a drug, same dose of mushrooms, you take, you go have a blindfold, face mask, music, a facilitator and an intention, intention setting ceremony. That's, that's healing, that's medicine. So I really want people don't go out and just take some MDMA and think you're going to get cured after three sessions without any facilitation, without any.

Help like functional medicine. You, you can do a certain amount on your own, but to really get the healing benefit, you want to have a guide, you want to have someone facilitating and you, and this is not a Lone ranger type thing in any way?

Yeah, I mean.

Disclaimer.

Disclaimer. Yeah. I mean, under the best circumstances with recreational use, you might have some insights that occur. Right. Or, or you might have a good time with your friends. But I want to also name that I have a number of friends who have had way scarier experiences with recreational use. Because what these tools, what's so beautiful and powerful about these tools is that they can bring forward things from the past from our unconscious mind that need to be healed, that can produce really scary thoughts, like thinking that you should take that gun that you have in your tent like a friend of mine did, camping by himself. I should just kill myself right now. I mean, there are scary things that happen when you don't have someone who's trained to help you work with traumatic memories to help you work with the information that can be healing information or it can also be really destabilizing information if you don't have the right help.

And it's from a destabilization point of view. To be clear, this is not for everybody as amazing. It's what we're going to talk about is not everybody's a good candidate. And that's why you have a professional make sure that it's the right candidate, the right medicine, the right dosing, etc, right follow up may be more important than anything else.

Yeah, absolutely.

All right, disclaimer. Set aside. Let's dive in, guys.

It's a board.

It's very important.

It's important.

Now let's dive in.

All right. You were telling us about ketamine.

Yeah. So this was end of 2016, beginning of 2017. We were wrapping up our study and once again, I'm so grateful to my patients. I had a patient who asked me, would you prescribe ketamine to me for my tremor resistant depression? And I said, what? It was like deja vu, like what? I'm going to prescribe a controlled substance that is an anesthetic for you to take at home. He wanted the nasal spray. And this is before Spravato, this is before all the things that have happened the last few years with ketamine. And so I reached out to a friend of mine, a mentor here in Colorado who did a fellowship at nimh. And he's always up to date on everything coming down the pipe. So he's like, oh yeah, I've been using that for a few years and here's what I know about it. So I, I took notes and I ended up prescribing intranasal ketamine to this person take home. And it. I mean, this is a person I'd worked with for 10 years, once a week. He was very stuck. And it did have a huge impact on his depression very quickly. Um, in his case, we ended up discontinuing the treatment because there were these interesting, almost like flashbacks or like effects that he was experiencing with his consciousness that were not close enough to the dosing that he was doing to be accounted for by, okay, this is an acute effect of ketamine. In other words, something was going on with dissociation that was becoming a problem. So we stopped it. But it did lead me down into the rabbit hole of research and what's out there. And that led me to get trained and start offering in office ketamine treatments. And I stopped doing any intranasal at that point. So it's been a huge boon for folks with depression and ptsd, anxiety. So we could talk about that, whatever you guys want to do with that.

So. Well, let's. Because we're bringing that in. Let's talk about kind of what have you seen in terms of results, like from my training of it and my. And having some personal experience with it, Definitely anxiety, depression, ptsd. What I understand OCD is available is possible, but maybe not as useful. What's been your experience?

Same here. I was very excited about the work that came out of Stanford around OCD and ketamine. But in my practice, I haven't seen a lot of benefits. It's been hard to get really clinically meaningful and durable responses with OCD and then with major depression and with anxiety disorders and post traumatic stress disorder. Our protocol where we assign a therapist to work with the person from start to finish. And we do six IV sessions with preparation and integration sessions as well. The IV sessions are two hours long, so there's a lot of. There tends to be a lot of trauma processing going on during the dosing sessions, as well as obviously integration.

So when you say integration, what does that mean?

Well, it's different for each person, and we like to offer a smorgasbord or a big menu of different styles of integration, different approaches to integration. For some people, making use of artwork like markers and paper and crayons, and drawing the symbols of the download or the nugget that the person received that we think helps move them forward in their lives. A big part of it is behavior change and establishing new habits, because obviously wellness is something that isn't given. It's earned every day with the habits that we have in our lives. And people who are very impacted by depression and anxiety disorders often have a lot of targets that we need to address for the way they live. Diet, exercise, relationships, sleep, hygiene and so on.

Do you mean that it becomes a self fulfilling loop? That the depression and anxiety cause you to exhibit certain behaviors and then those behaviors reinforce the depression and anxiety which then makes it worse and so that you get stuck in a vicious circle essentially?

I think that's a great way to put it. Here's an interesting study that came out. I think it's now, gosh, I've been talking about this study for probably more than 10 years. So I think it was like 2007, but came out of the VA and they took the C reactive protein of people who were joining their Marine Corps and then they went to combat and then they measured their C reactive protein when they got back. And the interesting thing was that people who already had higher levels of inflammation were more likely to develop combat PTSD than people who were not as inflamed going into combat. So I'm offering that because there's sort of like a two way street between, let's say you have a terrible diet, maybe you're going to fast food every day and you've got higher levels of inflammation that might make you more prone to developing a mood disorder or ptsd, or you have adverse childhood experiences and you've got a stack of traumas that elevated your chronic inflammatory levels that make you crave crappy food, right? Make make you more prone to wanting to go get that dopamine from fast food. And so it's sort of like this vicious cycle, as you said, or you're.

Not sleeping or you're not ex. Moving your body, all those basic habits. The one thing I do want to highlight that just going back to one point that you made in terms of, for what I heard, statistics wise, part of it is having the experience. They I've heard that 20 of the work is in the experience and 80% is afterwards. To actually bring it to life, bring it into your life. Because if you just have an interesting experience and that's just what it is and don't put it into your life, that's you'll have a memory, but you won't have a change.

Absolutely, yeah. And I mean like, here's another example. I was working with a veteran who had terrible depression and suicidality that was being triggered by a divorce that was happening in the current circumstances. There were things that happened in the past, but the current one was a divorce and we did a ketamine series that took him close to normal with his mood. Not totally normal, but close. So it was a big result for him. When he came in for his initial evaluation, we also tested gluten sensitivity. Here's another gluten case.

They're everywhere, Will.

They're everywhere. So this particular gentleman worked in a bakery, and so he was breathing gluten in addition to eating it. And the results came back after the ketamine series. And he didn't have celiac disease, but he was on that spectrum we talked about earlier. So for him, the benefits of this series of ketamine sessions lasted for a few weeks, and then he crashed. And the behavior change around gluten was not happening yet. Then we did another series, and we started chipping away at these contextual underminers, I would say, of stability. So in cases like this, and I think these cases are really common, where the psychedelic therapy can access and produce a result in the psychology. But there's all of this biology that has to get addressed, too. And I think that's a huge missing piece here for many people.

I want to add something to that, actually, because I was thinking as you were talking. I have this patient who's. I've known her for 50 years. We have a personal relationship, and for the last 10 years that she's been my patient. I've been encouraging her to adopt a particular way of eating. I've been encouraging her to go keto just because of her blood sugar and her. Her weight and her brain and all these things. And for 10 years, she has not been able to do it. And something shifted for her about 10 months ago, and it was the first time she was able to not only do it, but sustain it. So she's been doing a form of keto. Sometimes she'll flex it, sometimes it'll be keto light. But she is now able to clearly see in a way she couldn't see before, that it's impactful for her. And so there's also this component of whether your frontal cortex is involved and your ability to do something with deferred gratification, or whether you're just plumb not ready. I think there's a component of readiness for people where they can actually see the difference, sustain the difference, and recognize that it's meaningful, which it's not always. You know, it's like quitting smoking. It's not usually the first time that it sticks. You have to keep sort of working your way into the next level of success. And there's so there's something about people just being ready.

I totally agree.

Only they can say when that happens and totally agree.

To add to that, the, the, the physician I trained under the ketamine, he's, he's been using ketamine. He's an anesthesiologist and ER doc. So he's been using ketamine for 30 plus years and was involved also with the studies. And he was saying in general, ketamine practices are only about 30, 40% effective. However, if you do things like look at people's hormones, look at people's magnesium levels, look at carnitine levels, what I would call a functional medicine light. He came to it himself, which was really cool. You can get it up to 70 to 80%. So I, there's a lot of ketamine clinics that are what I call drive by academy clinics. All they do is they want you come in, get your academy and leave. And that has no integration. That's not looking at the lifestyle. That's not really fundamental, doing the fundamentals. So I'm, I'm really happy here that you bring all those components in because it's. Without all of it, it doesn't make sense.

Yeah, you know, it's. I, whenever I'm speaking in public where people who might be considering ketamine therapy might be listening, I, I want to beat that drum that you need to ask the clinic you're going to work with, what's the goal of the treatment? Because most clinics are going to tell you that we think the ketamine is going to work for you and you're probably going to need maintenance ketamine to stay well. And they're treating the ketamine just like they treat Prozac. You're going to come here, you're going to spend your money over and over again. We're going to pump up your tire, but we're not going to patch it. Right. We're not going to change the inner tube in your bike tire. We're going to just put a little air in it and you'll come back in three days or three weeks or however long. What the goal needs to be is, hopefully everyone is in agreement that I want to put psychiatry behind me. I want to get over my mental illness or my symptoms or my root causes. And it's unfortunate that there's a, There's a sense, I think, amongst mental health practitioners because our tools are so weak for so many people, that what I'm going to do with this person isn't. It's sort of like, I'm never going to be able to get this person well, so I might as well tell them that they're never going to be well and they're going to need meds forever. It's just not true. And it's really disturbing to me that people, practitioners and patients are sort of under the spell. Right. Of this isn't going to work all the way for you, but we're going to try to keep you as comfortable as possible for as long as possible. It just doesn't have to be like that. We can hope for more than that.

I really love that message. It's. Yeah, that. That there is hope, that there is other way. And to be fair, there are people that no matter what you do, do need maintenance, do need. But it's a lot less than everybody else thinks.

Totally agree with you. But we can. Even for people who continue to struggle and continue to, to. To need care for decades, we can still hold the view of, hey, there's probably a stone that we haven't turned over. There's probably something in me as a practitioner that I need to look at or learn that could be really impactful for this person. And yeah, I think a couple of decades of working in this model has really taught me that some people have an issue with an environmental toxin like a mycotoxin. Some people have the effects of an infection like Lyme disease or associated infections from that. Some people are dealing with any number of challenges. So we have to look at the whole map. And obviously I'm preaching to the choir here, but there's such a myopia around. Here's the list of symptoms and the checklist. And if you make that checklist, then now you get this medication and it's symptom relief only.

Well, I was. I'm not normal. Okay, Just to acknowledge, like, I've not ever been depressed and I'm really not anxious. I'm very high strung. I'm like, very intense, but I'm not anxious. And two summers ago, I started to be extremely fatigued. And we belong to something called Freedom Boat Club. So they go out, we go out on the boat, we go fishing. It's so much fun. And I started to find that I was getting seasick. I've grown up on boats. I've never been seasick in my life. I didn't even puke when I had all these children. So I was like, what's going on here? And one day I'm sitting on my couch and they were on the boat and I didn't feel well enough to go on the boat. And I found myself thinking this thought that said, maybe it would be better if I weren't here anymore. And that got my attention because I've never had a thought like that in my life. I have never contemplated hurting myself. Nothing. And it got my attention because it was not me. And I was like, what's, what's thinking me? That is not my thought. What is thinking me? And I ultimately got down to a tick borne illness diagnosis and treated it. But I think for a lot of people who have a history, especially we're in the New England area, that, especially for people in the New England area who might have a history of anxiety or depression when they get a tick borne illness, they might not have the distinction in their brain to understand that something is thinking them. But because I didn't have the history and it was such a weird thought, I was very clear, like, this is not me. Something has happened to me, something's wrong, I need to figure it out. And that was the thing that got me the diagnosis because then I started to think critically about it, like, what could be causing something to think me like that? Because I knew it wasn't me. But the challenge is that a lot of patients, I think, don't recognize that they have an infection on top of a predisposition. And so we get people who like, they can't even function. So I love that we're really looking at untangling all the different causes because it's, you know, you went to med school, right? Like it looks like it's a lug.

That'S not connected to the heart. That's not connected to the heart.

Well, if you have one issue, you got one issue. And all your issues come down to this one one thing. But it really could be that you have 10 issues and we gotta fix every issue, not just the one issue that you're presenting with, but, you know, the depression, anxiety, the food sensitivities, the infection, the toxic exposure. Don't forget the plastics that we're all kind of harboring. So it is this massive workup to make sure that we get everything, not just the presenting issue. So that was my plug for don't take it at face value.

Thank you for sharing that experience, Wendy. That's a really powerful example. And to have the contrast because you didn't have a predisposing condition to be able to recognize, wait, this doesn't feel like me, like something's thanking me. Very beautiful.

But you might not have that if you're used to being, like, a little hopeless or a little. You might not be able to recognize it's not you. There's something else going on here.

Yeah. And, you know, it's. It's interesting, you know, when we think about, let's say, metabolic syndrome or, you know, kind of like the commonplace constellation and let's say an American population, right? Obesity, insulin resistance, higher cholesterol, hypertension, coronary artery disease, that whole syndrome. Why don't we think about psychiatry the same way where it starts out? You could say maybe mostly in the metac. Alcoholic syndrome with the standard American diet, and maybe not enough activity, physical activity and sleep disruption. But it snowballs then. Now you're in what we call a sickness syndrome, where your inflammatory signals inside your body are elevated even though you're not in an acute infection. Fighting off an infection, we have higher levels of inflammation. But what goes on in these chronic diseases is the inflammation doesn't come down. It doesn't come back to normal levels. And so there's this snowball effect, and we kind of accept that and we treat that in primary care, all of these different aspects, maybe the GLP1 or the metformin or whatever, to try to deal with these things, the cholesterol drug and so on. But in psychiatry, we don't do the multimodal approach that you're talking about, Wendy, where we don't say, okay, well, maybe this started with an adverse childhood experience, but then this person had a certain way of thinking about themselves that they took into the school that they were enrolled in, and then they got picked on there. And then they sat by themselves in the lunchroom, and they began to use food as an emotional regulation tool. And then they went home and ate terrible food, snacking and watching TV or going on social media, and they're set. And now you're sort of seeing the roots develop of all of these different aspects. But we're still using an old model where we. I was taught in medical school. I'm sure, Ed, you probably heard about Occam's razor, right? The multitude of different types of symptoms should be looked at as coming back down to one root cause. Well, what if. What if there's five or 10 root causes?

Well, everybody that comes to us has five or 10 tax.

Man, you're sitting on 10 tax.

Right. Although I. I do want to. So I want to actually reverse the conversation a little bit, because we're. Because on one hand, you. Let's say they come to us or they come to Will or they come to another Provider that really looks at those five or ten things and addresses five or ten things. Most people are still in a pattern of thinking poorly about themselves or pattern of childhood trauma or whatever else. So that's where the ketamine comes in or the psychedelic medicine comes in.

Bringing their wiring up to code.

Right, Exactly.

That's a great way to put it.

We're in the midst of a construction project. So I was, they were like, it's not to code. I'm like bring it up to code. But yeah, let's bring the humans wiring up code.

So we have to also like. So yes, we have to address all those 5, 10, 20 causes.

So that.

And we have to address. Make sure. Like interesting about ketamine is that it's actually hits a lot more receptors than a lot of the other psychedelic medicines and really releases the bdnf, the fertilizer of the brain. So it actually is a very exercise.

Right. So it's like it all comes. Sorry, it all comes together.

Yeah, so. So making the rewiring faster is, is a huge plus with psychedelic medicine.

Absolutely. And that's why they work well, so well together, functional medicine and psychedelics. Because, you know, if someone shows up at my office with 10 years of treatment resistant depression, they're sedentary, they're isolated and so on. I'm not going to get anywhere by talking about changing their diet or changing their activity levels. I mean it is completely and totally tone deaf to start with that with someone who's that debilitated. But I take that person and I offer them a catamine session and they go deep into their own inner world and they have the ability, as people often say with ketamine sessions, to see the forest for the trees. They get up above the forest and they can see, oh, I eat crap because I think I'm crap or I don't love myself. And this is just another way for me to express my self hatred that comes from my trauma that the thing happened. So if we can start with that and we can help people see a little bit of why they're doing what they're doing, give them a little boost of BDNF, cut their PHQ9 from 20s to under 10 and help them then face these big challenges that felt insurmountable before the ketamine, then we can get somewhere, then we can start doing the things that need to happen in integration.

So it's the jump start.

Exactly.

But also, as you were saying, I could, I could imagine somebody from the audience saying, well, I know that why I'm doing what I'm doing because of my trauma and blah. Like, I've already analyzed myself to death and I know, and I, I can. Like I. In my former self, I would be that. And the response would be, you may know everything and you might be 100% right, but actually feeling it in your body and getting it as a kinesthetic and in the body effect versus in the brain is a completely different venture. It doesn't. It's not even close.

Yeah. And another way to say that is, and I find myself saying this to patients a lot, is you've got to find a reason to live. You know, it's developing an intellectual understanding of why you do the things you do is not enough of a. That's not a reason to live. It's like an. It's an academic experience, so people have to. It's like Viktor Frankl's work was, you know, was so critical around meaning making, you know, do. Do I care about my kids enough to change my diet, to see my kid graduate from college, for example? Is that the meaning? Is that the reason to live? Do I love spending time with my grandchild enough to want to do what's necessary to have another 10 or 15 years with that person, so on? I think that's also important in integration. And something that is overlooked is this issue around reexamining what makes our lives meaningful. Now. There's plenty of reasons in our external world to feel despair or fear, right? There's. There's a lot of chaos. There's climate change, there's political instability, Markets are crazy. You know, it's, It's. It's a scary world to be in. So I think we have to dig deeper. All of us, you know, whether we're. We're in healthcare like we're receiving healthcare or providing it, or we're anybody, it's just. There's a higher level of need for us to really dig deep and look at what's important.

Yeah, agreed. I have a question. We talked about the people who are appropriate for ketamine and what to expect. Are there any downsides for ketamine or things that are unrealistic expectations of the ketamine dosing or the experience?

Well, first of all, people who. And I've had a few misadventures in ketamine with patients who are more prone toward dissociation or who have a tendency in that direction, people who don't have any social support. In other words, they don't have even one person that they can talk to about their experience or who can show up for them and be with them after, pick them up from their sessions and so on.

It.

I will say that you might think because ketamine's an antidepressant that it can never be used in bipolar disorder, but I don't see it that way at all. And we have studies now to support the use of ketamine for bipolar depression. So. So that's an important thing to say. I think, I think in terms of dosing, it's interesting that many of the people that we see in Boulder, Colorado, and I don't know, this might be something that happens outside the Boulder bubble, but I don't often get outside the.

Boulder.

People think that higher doses are better. You know, bigger is better.

Oh, it's not.

Obviously ketamine at higher doses is an anesthetic and it does cause amnesia. So, you know, going into a so called K hole where you're sort of fully dissociated, I don't, I don't think it's necessary or, or more beneficial than dosing that allows people to be present and witness their experience and process it afterwards. But I also think that there's a lot of misinformation out there about ketamine protocols and there isn't a ton of evidence to go on for us to know what the right route of administration is, this right cadence of sessions, how many sessions total. So it's difficult as a practitioner to know what the right approach is. And of course personalizing it is important as well.

Yeah. So this might be a part two. So my Wendy will tell me if this is a part two. But I'm actually. Because I'm very interested in psychedelic medicine in general. So I'd love to get a sense of what's happening in Boulder and in general Colorado with psychedelic medicine.

And we can spend five minutes on that.

Are you, are you able. Sure. To speak to doctors because.

Sure. Happy to.

It's a brand new field. I do think like cannabis, it's going to eventually pop. I'm not sure when, but I'm. I'm sure it will be happening throughout the country. And Boulder and Oregon is the. Are the two major betting grounds.

Bellwethers, Leaders.

Yes. So can you speak to a little bit about what's happening? Well, can you give a background to our listeners?

Sure.

The laws that have been passed and what's been happening.

Absolutely. So in a nutshell, Oregon passed a psilocybin measure to make it fully legal and above board to receive psilocybin. Healing sessions about four and a half years ago. So it was the November of 2021. It took a couple years for that to get up and running. And there are I think 300 licensed psilocybin practitioners in Oregon at the moment. Maybe 3, 50. We, we have a, a center there in Oregon where we run our practicum trainings for licensed mental health practitioners who are inside of a bigger training that we run year long training. So we've, we've seen several hundred people go through that experience and there's actually people up there doing that as we speak today. But it's, it's really beautiful to see folks like you and me who are, many of them are completely naive to any psychedelic experience and they're choosing to undergo that experience to better understand what their clients are going to go through so they can be more effective guides and space holders. Two years after Oregon passed their measure, Colorado followed suit. It's a different structure in Colorado which is interesting and I think it sort of matches the political differences between Oregon and Colorado. But what I mean by that is Oregon calls the psilocybin work psilocybin services. It's completely outside of the medical system, completely outside of the psychotherapy system. And if you're 18 years old and you have a GED and you take 150 hour training, you can become a facilitator of psilocybin in Oregon. So rather bold I would say, from my risk averse standpoint. Colorado located psilocybin services inside of the Colorado regulatory umbrella for medical practitioners and therapists. So Colorado decided to issue psilocybin facilitator licenses under, under that umbrella. So if you're a doctor or a therapist in Colorado, you can take a training like the one we offer or another one, and then you can, and then you can go and you can work under your license with this special psilocybin certificate that comes after your training. So the service centers in Colorado just started opening in June and July and they're, they're starting to, to get started. People have been dosed with regulated psilocybin in Colorado and I think that will continue to grow. The other interesting change in Colorado, it was called the Natural Medicines act which includes psilocybin, but it's not limited to psilocybin. So the next medicine that's going to be rolled out is ibogaine.

And really, yes, reading about ibogaine today.

In the New York Times, actually ibogaine's.

Pretty, that's a, can be dangerous.

Well, yes, it can be dangerous, but it's a long acting medicine.

Long acting medicine. Way more challenging physiologically, psychologically and logistically for a clinic to manage that.

So not MDMA or. I became like, I'm just sort of.

Surprised that I just want to go back. Psilocybin, for the people who are listeners, is mushrooms. Psychedelic mushrooms.

Right.

Very interesting.

Just to be clear. Magic mushrooms or whatever you want to call it. I just want to be clear. Yeah. So I really. So I. They're rolling out on phases. It's not okay.

So my understanding is that it's going to be January of 2027 when ibogaine rolls out. So we have a year and a half to figure out how to effectively do that here in Colorado. But as you mentioned, there are some significant risks with ibogaine that are very different from other psychedelics. But it also holds tremendous potential for especially opiate use disorder and traumatic brain injury. There was a study that was published in January out of Stanford that this researcher there, Nolan Williams, took 30 special operators veterans to Mexico who had TBI and PTSD and their measures really improved, especially the cognitive measures after ibogaine. People are pretty excited about it.

Yeah. With veterans it's been.

That's one hell of a black box warning. If you live through this, you can notice significant improvement in your TBI and your ptsd as long as you don't have cardiac arrest. Cardiac arrest.

But unlike psilocybin, which is a five or four or six hour of journey journeying, it's like 18 hours or something. Is that correct?

12 people. I know I've got two friends, one's a physician, one's not, but they've both done ibogaine sessions as clients and they both told me it was a 72 hour experience.

Ouch.

So you monitor for 72 hours, like cardiac monitoring.

How do you do that? Yeah, great question.

It's like a halter monitor.

I mean, a Holter monitor. It could even be a rhythm strip that you're having a.

You know, But I mean, expensive of that.

Very expensive.

Like on the other hand, all these treatments that people are getting for their PTSD, depression, anxiety, TBI, that is way more expensive than a three day, essentially inpatient stay. But my gosh, that's like 72 hours. Insane.

That's.

That was the experience they had. I also hear people say 24. So I, I think it probably varies.

Wow.

But anyway, that, yeah, wow. The opiate epidemic is a huge problem. Obviously deaths and suicides in that arena are very common. And so it's Hopeful to have the possibility of something that could definitively change that for people. And obviously we need more research, too. And you probably heard that Texas approved a $50 million research allocation to study ibogaine. So hopefully that will produce a lot more information for us to go on.

Wasn't that Rick Perry who was advocating that?

Right.

Yeah. Yeah, I was just reading, literally today I was just reading about that.

What's rolling out after ibogaine? Is there clarity or no question?

One thing that is definitively not rolling out is peyote, because the state of Colorado said, look, this is an endangered medicine. The Native American folks use this in their rituals. It would not be okay for us to contribute to that problem.

Good. I'm glad about that.

Yeah. So that's not happening. I, I don't know if I can't remember if mescaline from other sources because there are other cacti that have mescaline, if that's going to be a part, maybe. Right, Exactly. San Pedro. So I have to go look at that. But it's some years in the future.

Interesting, Interesting.

All right. Are you good?

Like, I can do the hours for a while, but like, I, I, I, I'm like, this is, we can come.

Back and visit it again.

Okay.

Okay.

So the question would be where can people find out more about you? And we'll put all your information in.

The show notes so that we haven't really talked about your institute. And I'll put a plug in because we had one of our providers go through and she, she was raving about the quality of the presentations and the quality of the teaching. So I'll put plug. If anybody is interested in this work, IPI is a beautiful place to start or finish.

Thanks, Ed. Appreciate that. We, we're really excited about the future of mental health care. We think that with these new tools that are coming online and, you know, really integrating functional medicine with psychedelic medicine as we're talking about today, we can, we can save lives and we can really shift the conversation. The best place to find me is our website, which is just simply psychiatryinstitute.com and that's where you can reach out to me or you can find out about our programs and our offerings.

Beautiful.

Great.

Thank you.

We'll put that in the show notes.

Thank you.

And is there anything else you want to tell the listeners before we close up the show?

Well, this is way too early to mention, but I'll just mention it anyway. We do have a book coming out in March, so it won't be even available for pre sale on Amazon until December. But it's called Psychedelic Therapy, and it is meant to be a guide for people who are suffering, who are not excited about having a psychedelic experience, but one of the many people we know and love who are not getting the result that they need to get from conventional care. And so it's a way to support them, to walk through the experience. So stay tuned for that.

Well, we'd love to have you back. And when it's ready, and we'll have you back and tell us all about it.

Perfect.

Awesome.

Thank you.

All right.

So on that note, Will, thank you for joining us for this episode of the Feel Freaking Amazing podcast. It's been awesome having you on, and thanks to the listeners.

Thank you so much for having me.

Our pleasure. Sam.