Ketamine in context-- From substance abuse to psychedelic therapy

Back from the Abyss: Psychiatry in Stories

Craig Heacock MD

Psychiatry, Bipolar, Suicide, Depression, Ketamine, Psychotherapy, Science, Psychedelics, Health & Fitness, Addiction, Medicine, Psychology, Mental Health

4.8 • 452 Ratings

🗓️ 31 December 2021

⏱️ 72 minutes

🔗️ Recording | iTunes | RSS

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Summary

Expectation, set, setting, dosage, and route of administration provide the context and scaffolding for psychoactive drugs. An IV morphine drip can make unbearable pain completely manageable, while IV heroin, which is immediately converted to morphine once it crosses the blood brain barrier, destroys tens of thousands of lives a year. A benzodiazepine such as lorazepam, when taken orally at sensible doses, can stop a panic attack in its tracks, yet snorting or injecting benzodiazepines, ...

Transcript

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0:00.0	Welcome to Back from the Abyss. I'm Dr. Craig Hickok.
0:16.8	Before we get to today's story, I wanted to read an email that I just got a few days ago,
0:21.4	which I think brought up a lot of interesting points about this secret sauce episode with Elizabeth in her MDMA work.
0:30.9	Here we go.
0:32.6	Hi, Craig.
0:33.7	I recently heard your podcast about the MDMA session with Elizabeth and the surprise, almost
0:38.9	disbelief that she had received the placebo, especially with all the progress she clearly made
0:43.9	after the three medicine sessions and subsequent integration sessions. My placebo experience has
0:50.4	been just the opposite. I finished my phase three study in May 2021, and I'm 99.9
0:58.0	sure that I received the placebo. It was and continues to be one of the hardest things I've ever
1:03.7	gone through. The grief, disappointment, sadness, and frustration at not receiving the medicine
1:10.4	after the rigorous screening
1:11.6	process was incredibly overwhelming. And then to do the extremely hard work of trying to work
1:17.0	through the traumas without the benefit of MDMA, it was like surgery without anesthesia.
1:23.0	It was excruciating. Suicidal ideation was super activated and now I hear that even after the unblinding,
1:29.5	which won't happen until at least October, it could be another year after that before I can do
1:35.0	the crossover with actual MDMA because of therapist trainings. I want to share with you a quote
1:42.2	that I heard Rick Doblin say on a podcast.
1:44.5	Quote, so the big risks for us are in the placebo group where people realize they're getting the
1:50.2	placebo.
1:51.5	We had one person try to kill herself when she realized she had the placebo and she'd given up.
1:55.9	She was like, I have terrible PTSD.
	...

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