Ketamine-Assisted Psychotherapy (KAP) uses microdosing (very small amounts) of the ketamine to allow the patient to have disassociative experience. It is during this disassociative experience, also known as microdosing to trip out, that the erasing magic of KAP happens. The medicine is delivered in a clinic setting by a Certified Registered Nurse Anesthetist (CRNA). The CRNA is the assisted part of KAP. They will be your guide and contact during the treatment. They administer the medicine via an IV-drip. The session lasts about 45 minutes with time on either end to prepare and recover. You will need a ride home just like any other medical procedure that uses this type of medicine. Our nationwide reach has shown that 6 session are required by the hundreds of KAP clinics found across the country. Three follow-up treatments happen over the following 1-6 months depending on the individual. You and your CRNA, who is with you all the time, will decide what’s best for you.
OAS advocates for the adoption of KAP at every VA, who needs to accelerate this and other psychedelic drugs to deal with the crisis that is 17 Veteran suicides a day. I have spoken to numerous Veterans with haunting memories from their service of one kind or another. All were at the end of their ropes and all found KAP to turn around and save their lives. The same can be said for their families who had to endure their PTSD, depression and anxiety without a way to help or help protect themselves from getting “infected” by their loved ones’ afflictions.
For Once A Soldier, 17 Veteran suicides a day means 17 families thrown into financial and emotional chaos.
What About The Cost?
Let’s first talk about the cost of ketamine. It is cheap. Super-cheap. It has been off-patent for many years now, and this benefit is not being leveraged by the VA. See below about how cheap it can be. Sadly, for now, it is out of the reach of most Veterans who are suicidal. From speaking to a variety of Vets and family across the country, we’ve seen prices for an individual session range from $120-$360. You won’t find it cheaper, and our experience shows that the middle or upper end of this range is what you can expect. Higher prices tend to be found in places like NYC and LA and the more affluent suburbs and towns across America. So the cost of ketamine is reasonable; what costs are the CRNAs – worth every penny – and the facility. For six sessions plus three follow-ups, you’re looking at anywhere between $1,080 to $3,240. Also, expect to pay for on-going visits just to keep the demons at bay.
As we noted in July of 2019 when SPRAVATO® nasal spray was approved by the FDA for VA use (highly-expensive), we thought that is was more about politics and money-grabbling than real care for our Veterans. The FDA tests were near complete failures and the drug itself if literally only half as good, if at all, because it is literally only half of the ketamine molecule. Since ketamine of off-patent, Johnson & Johnson had to invent a new one to patent. Read more about that here.
Hmm, where can we find a way to cut costs on the facility and the CRNAs?
The Veterans Health Administration is America’s largest integrated health care system, providing care at 1,298 health care facilities, including 171 medical centers and 1,113 outpatient sites of care of varying complexity (VHA outpatient clinics), serving 9 million enrolled Veterans each year. Source
There are over 1,100 Certified Registered Nurse Anesthetists (CRNAs) serve in the Veterans Health Administration. Source
The VA should start a KAP program to fight Veteran suicide today. Sadly, there are lobbyists from all sides of the medical and pharmaceutical industry that don’t’ want that to happen in a manner that is best for our Veterans. This is frustrating for all, and the American Association of Nurse Anesthesiology sums up their position here.
The battleground for attaining the lucrative VA services is a battleground with unexpected combatants. A struggle between the American Nurses Association (ANA) and the American Society of Anesthesiologists (ASA) is ongoing as the two battle over a bill that would limit the ability of CRNAs to practice in VA system hospitals.
Historically, VA hospitals have only allowed physician anesthesiologists to treat patients, but during COVID, with staff limited and patient needs high, restrictions were relaxed. In April 2020 they allowed CRNAs to practice independently in some VA hospitals to alleviate the burden. Now that the pandemic caseloads are lowering, the American Society of Anesthesiologists has introduced a bill to once again restrict the practice authority of CRNAs in VA hospitals. Source
No matter the outcome of these issues in the future, the hear and now doesn’t care. Today, as you read this, 17 Veterans will take their service revolver or Glock, find a place at home or in their cars or at the VA, and blow their brains out. Those same tortured brains are now spread out over the family living room sofa, or the seat of the truck, or a lonely bedroom somewhere that became a fortress against the demons of PTSD, depression, and sadness. Let’s go people.
Ketamine, the veterinary anesthetic turned party drug, is a psychoactive drug that takes the user on a trip to expand their mind. Lighting up dormant parts of the brain, this drug has done wonders to kill the PTSD that the Veterans we talked to were once haunted by. As the VA comes around to endorsing this as a legitimate treatment rather than a rave party drug, many ketamine infusion therapy centers have opened across the USA. It’s time to get some basic understanding of what ketamine is and how it works and feels.
To answer our own question, we say yes, ketamine and other psychoactive drugs are better than the status quo for some Veterans. But the VA needs to gear up to be able to offer it at VA hospitals around the nation. Prices at private practices are out of reach for most. Veteran families are no different. Having the VA launch a new ketamine program is essential before we take another 17/day of Veteran suicides.
Ketamine is a medicine historically used for anesthesia during surgeries and medical procedures. It was synthesized in the 1960s and is FDA-approved for procedural sedation and anesthesia. It is widely used in hospitals and ERs and is on the World Health Organization’s “List of Essential Medicines.” Ketamine is now being used “off-label” to treat depression, as well as anxiety, post-traumatic stress disorder (PTSD), and some chronic pain disorders. This medication has a long track record for its safety when used appropriately.
How Does Ketamine Work?
The exact mechanism of how ketamine works in depression, anxiety, and chronic pain is not fully known. (Honestly, we don’t care how it works, just that it does work. Besides, we’re only using, what 4% of our brains, we can’t possibly figure it out yet.) However, scientists do know that ketamine works on the NMDA receptor to block the glutamate neurotransmitter. And scientific study is showing ketamine improves the health of the neurons (brain cells) by increasing the connection between the neurons and improving the brain’s ability to adapt (aka neuroplasticity).
A recent study performed at the University of Illinois at Chicago (UIC) finally detailed the mechanism of how ketamine dampens the symptoms of depression and keeps it at bay. It turns out, it works in a remarkably similar fashion to SSRIs, the most commonly prescribed class of antidepressants. Read their paper: NMDAR-independent, cAMP-dependent antidepressant actions of ketamine.
Ketamine also changes the way the central nervous system processes pain, so it’s like hitting the reset button on your computer, to restore normal pain processing. Research is also showing in animal models, the potential for ketamine to increase resilience and recovery from stressful traumatic events which can trigger or cause depression and anxiety disorders.
Furthermore, ketamine decreases activity in the Default Mode Network (DMN) of the brain, which is more active in those with depression, anxiety, and chronic pain.
What Does a Ketamine Infusion or IV-drip Therapy Feel Like?
For some people they can experience positive effects within an hour of finishing the infusion. For others, they will not notice an effect until after their fourth or fifth infusion. Commonly the effect is gradual and subtle, noticing thoughts of sadness and hopelessness to begin to lift and go away. Occasionally some people may have a dramatic effect. Function (going out, doing things you enjoy, work) improve before mood does. With improved function you are able to more fully participate and engage in your treatment plan, thus improving your success rate.
Other Psychelics That Help With PTSD
Psychedelics, also known as psychedelic drugs, hallucinogens, or hallucinogenic drugs are chemical substances that induce hallucinations and other sensory disturbances.
Psychedelic – relating to or denoting drugs that produce hallucinations and apparent expansion of consciousness. Psychedelics were originally called ‘Psychotomimetics’ by the scientific community (mimicking the effect of a psychotic state). In 1956, Humphry Osmond coined the term Psychedelic (‘Mind Manifesting’ in Greek) in a letter to writer Aldous Huxley.
Entheogen – a psychoactive substance that induces alterations in perception, mood, consciousness, cognition, or behaviofor the purposes of engendering spiritual development in sacred contexts.
Psilocybin – a naturally occurring psychedelic prodrug compound produced by more than 200 species of mushrooms, collectively known as psilocybin mushrooms.
DMT (N,N-Dimethyltryptamine) – a chemical substance that occurs in many plants and animals and which is both a derivative and a structural analog of tryptamine. It can be consumed as a psychedelic drug and has historically been prepared by various cultures for ritual purposes as an entheogen. DMT has a rapid onset, intense effects, and a relatively short duration of action.
LSD (Lysergic acid diethylamide) – also known colloquially as acid, is a hallucinogenic drug.Effects typically include altered thoughts, feelings, and awareness of one’s surroundings.
About Once a Soldier
Once a Soldier’s mission is to help the families after a soldier suicide. Most soldier suicides are performed by veterans who have lost touch with the VA and their families won’t be getting any financial help from the government at this critical time. Even when they do, the support is limited. We aspire to fill or close that gap especially when it comes to the heartbreak of paying funeral costs. But this post aspires to be a place where someone in need RIGHT NOW can get some help for themselves or for a loved one who’s thinking about suicide.
FOR IMMEDIATE RELEASE May 25, 2021 – Ponte Vedra, Florida
Once A Soldier Endorses a Warp Speed Option for Psilocybin Research To Save Veteran Lives
Psilocybin drugs are the rising starts when it comes to killing PTSD in post-9/11 Veterans
In recent days, we have modified our website to include the three major psilocybin treatment options researched today. MDMA, ketamine and magic mushrooms have separated themselves as superior to big-pharma anti-depressant medications. They have shown the unique ability to rewire the brain and destroy a Veteran’s PTSD. Marijuana to a lesser extend provides mental relief from PTSD, but psilocybin has that extra break-though into the subconscious. That’s where the real healing, and magic, takes place. For examples of what it’s like to meet your demons and win during a trip, check this out.
“There is a mounting body of evidence to support our view. And this research is coming from highly-reputable institutions in the US, such as the psilocybin research coming from Johns Hopkins. We are losing the war on PTSD. PTSD is what kills our Veterans. All forms of micro-dosing these mind-altering drugs shows greater promise than the current schedule of anti-depressants offered by the Veterans’ Administration. We fast-tracked a vaccine for COVID-19, and rightly so. It’s time for that sense of urgency to motivate more help for Veterans with PTSD.” says Dave Barbush, CEO of Once A Soldier.
The best scenario for a successful psilocybin treatment plan includes a clinical setting, a trained staff, and a low cost. The best part of the data to date has been that the relief comes fast and is near permanent. Veterans themselves have weighed in on their feelings about it. They like the outcome. Their PTSD is gone. They may not like the process, but they don’t like being dulled by their anti-depressants either.
Mr. Barbush continued. “Our motivation for fast-tracking research and a parallel training of staff to be “trip buddies” comes from hearing the suicide stories from Veterans families. The horror inflicted upon the Veteran during war is passed down to the family in the years before the suicide. The suicide itself also enables the disorder to continue to grow.
Furthermore, our position includes a robust go-to market strategy that educates all levels of soldiers and family about PTSD treatments, screenings and practical advice on life insurance and post-suicide options.”
“Let’s face it, we are losing the war on Veteran suicide at this time. The more effort we’ve put into it to date, the less we’ve seen it working. In fact, the numbers are rising. And those numbers – the branded 22 a day, were probably low to begin with.”
Psychedelics, specifically LSD and Magic Mushrooms (Psilocybin), began to impact popular culture in the 1950’s in the United States. LSD was discovered by Albert Hoffman in 1938, but was mainly used as a research chemical. It wasn’t until R. Gordan Wasson published his experience taking magic mushrooms in Mexico in Life magazine in 1957 that news of these compounds reached the general public.
Until the mid-1960’s the mainstream psychiatric community viewed LSD and Psilocybin as miracle drugs. However, once they became more popularized in the public domain they led to the counter culture of the 1960’s which was quite disruptive to the culture of the time. By the end of the decade, the psychiatric and scientific community turned against the compounds. They were legal until that point, but were then outlawed and forced underground. Unfortunately, most of the scientific research of that period died along with the counter-cultural revolution and ensuing prohibition. That research is now being revived and is building upon the studies that were conducted in the 1950’s and 1960’s.
Before 1965 there were more than one thousand scientific papers published on psychedelic therapy. There were over 40,000 research subjects involved in the trials. Before the compounds were made illegal, psychedelics were studied for the treatment of alcoholism, depression, OCD, and end of life anxiety. The studies often showed impressive results. However, few of them were well controlled by modern standards (i.e. they were not double blind and placebo controlled).
Perhaps the most exciting scientific research back then was on what can be described as the “betterment of well people”. The most famous of these experiments was the Good Friday Experiment. 20 subjects received a white powder, half of which contained psilocybin and half which contained a placebo, before a Good Friday church service. Most of the subjects reported that the experience had reshaped their lives and work in profound and enduring ways. This research showed incredible promise, but even then, practitioners recognized that if it were to be taken seriously it would have to be carried out with more objectivity and scientific seriousness.
LSD, before its prohibition, was widely believed to be a miracle cure for alcoholism
The National Institute of Mental Health funded psychedelic therapy at Spring Grove in Maryland. Several hundred patients received psychedelic therapy there throughout the 1960’s and 1970’s. With federal support, researchers studied their effects on alcoholics, addicts, cancer patients with end of life anxiety, and others. In many cases the researchers were getting very good results and publishing them in respected peer reviewed journals.
LSD, before its prohibition, was widely believed to be a miracle cure for alcoholism. In fact, one of the cofounders of Alcoholics Anonymous considered using these drugs to induce a “spiritual awakening” that he considered necessary for sobriety.
Bill Richards who worked at Spring Grove recalled, “We thought this was the most incredible frontier in psychiatry. We would talk about how we were going to train the thousands of therapists that would be needed to do this work.”
The Beginnings of Psychedelic Therapy
Al Hubbard, the Johnny Appleseed of LSD, introduced an estimated 6,000 people to LSD in the 1950’s and 1960’s using his seemingly unending supply of LSD from Sandoz Laboratories. He pioneered the process of Psychedelic Therapy. Psychedelic therapy usually consisted of a single high-dose session in comfortable surroundings, perhaps on a couch or in bed, with a therapist or two who are sober and looking on. The therapists try to say very little and let the journey unfold on its own. Eyeshades are often worn and elevator style music is played. The goal was to create the conditions for a spiritual epiphany.
The goal was to create the conditions for a spiritual epiphany.
Hubbard established two treatment centers in Canada where he would treat patients to LSD psychedelic therapy. He reported impressive rates of success with alcoholics.
Research published in the early 1960’s by the International Foundation for Advanced Study which used Hubbard’s psychedelic therapy method pointed to some impressive results in a healthy adult population. 78% said the experience had increased their ability to love, 71% showed an increase in self-esteem, and 83% said they had glimpsed a “higher power” or “ultimate reality”. One of the researchers reported that his clients emerged with “sustainable changes in belief, attitudes and behavior”; specifically, they became much more open and less judgmental, rigid and defensive.
“In four hours… I learned more about the mind, the brain, and its structures than I did in the preceding fifteen as a diligent psychologist.”
Timothy Leary, a Harvard psychology professor who famously encouraged people to “Turn on, tune in, and drop out” is perhaps the figure most strongly associated with the counter culture of the 1960’s. He is also perhaps most strongly associated with the moral panic surrounding the 1960’s, the backlash towards psychedelics, and the eventual prohibition of this class of drugs.
Leary had his first psychedelic experience using mushrooms in 1960. It was transformative for him. He described his experience as, “In four hours… I learned more about the mind, the brain, and its structures than I did in the preceding fifteen as a diligent psychologist.”
Leary founded the Harvard Psilocybin Project shortly thereafter and his first experiments consisted of administering psilocybin to hundreds of people. To casual observers these experiments looked more like parties, and the researchers themselves reportedly joined in on the fun, taking the substances themselves! … hard to imagine much hard science coming from that environment.
To his credit, Leary is thought to have come up with the idea of “set and setting” being so important to having a good trip.
Leary was convinced that psychedelics had the power to transform society and save humankind. He was determined to bring the experience to everyone. Leary concluded that psychedelics were “too powerful and too controversial” to be researched scientifically and gave up on this entirely. “We are through playing the science game”.
Instead, Leary wanted cultural revolution. “The critical figure for blowing the mind of American society would be four million LSD users and this would happen by 1969.”
To give you a sense of the scale Leary was operating on, it is estimated that 25,000 people attended an event in San Francisco’s Golden Gate Park to trip on free LSD while listening to speakers discuss cultural revolution.
It turns out Leary’s math was pretty close. By 1969 an estimated two million Americans had tried LSD. It had indeed blown America’s mind and the country was in a very different place, culturally, than it was when he started.
Although Timothy Leary is the most well known and notorious figure associated with the counter-culture. Pollan concludes that this would have happened without him as well. Psychedelics were seeping into American culture from many channels.
By the end of 1966 the whole project of science surrounding psychedelics had collapsed. The senate held a hearing about LSD that year. A few months later, almost all of the psychedelic researchers across the United States received a letter from the FDA ordering them to stop their work.
Pollan concludes that what doomed Psychedelics in the 1960’s was an irrational exuberance surrounding the drugs themselves. They were a disruptive technology. Those that had experiences with these drugs concluded that they contained the power to change the world. The researchers studying these drugs concluded that it was wrong to only use these drugs for research and for healing the sick. They could do so much more for the world!
Leary sparked a political revolution partly because he was willing to say what those within the research community thought was true, but didn’t want to speak or write about publicly. It was one thing to use these drugs to treat the ill. It was another thing entirely to treat the sickness within the culture of society itself.
A New Path Forward
The first wave of psychedelic research was careful and methodical and contained a set of protocols and shamanistic rituals that, in effect, regulated their use and broad effects. Leary unleashed an unguided, do-it-yourself approach to psychedelics. Perhaps this was too laissez-faire.
Other cultures have had long and productive histories with psychedelics that we can learn from. These cultures have sets of rituals, rules, or procedures that govern them. They also typically have someone (a shaman) to guide the experience. For American’s the closest thing to this would have been psychedelic therapy, as pioneered by Al Hubbard.
Pollan thinks that these drugs are too transformative to be unleashed on society without anything to govern or contain them. He concludes that without psychedelics there probably would have been a counterculture around the Vietnam War. It just wouldn’t have been as strong of a backlash.
Research on psychedelics is now being revived and is building upon the studies that were conducted in the 1950’s and 1960’s, but this time with far more rigorous scientific methods.
I think of my life as before and after Psilocybin
Participants in a John Hopkins study on Psilocybin ranked their experience using psychedelic therapy as one of the most meaningful in their lives, ”…comparable to the birth of a first child or death of a parent.”2 A full two-thirds of those in the study ranked the experience among their top five most spiritually significant experiences and one-third ranked it as the most spiritually significant experience of their lives. The participants reported significant increases in “personal well-being, life satisfaction, and positive behavior change.” This study, carried out by Roland Griffiths, was the first rigorously designed, double-blind, placebo-controlled trial to be carried out. On a side note, I actually tried to recreate this study on my own and I must say it was one of the most spiritually significant experiences of my life, profoundly changing my life philosophy and tendency toward altruism.
The John Hopkins team under Roland Griffiths has now been conducting Psychedelic research for 15 years. They have conducted over 300 psilocybin sessions.
Pollan interviewed many of the subjects in the Hopkins study on spiritual experiences. He reports that although most of the subjects had their psilocybin experience 10-15 years earlier, their effects were still deeply felt, for many on a daily basis. One volunteer even relayed, “I think of my life as before and after Psilocybin.”
Research also indicates that psilocybin might be useful in treating addiction. A pilot study achieved an 80% cessation rate, which is unprecedented.
Griffiths also ran a trial using psilocybin to treat anxiety and depression in cancer patients. It reported one of the largest treatment effects ever. The majority of subjects reported that their fear of death had completely disappeared or greatly diminished.
Psychedelics, the Default Mode Network, and the Ego
Researchers discovered, by putting people into MRI machines, that psychedelics affect brain activity by dramatically reducing activity in what has come to be known as the Default Mode Network (DMN).
The Default Mode Network exhibits heightened activity when subjects are doing nothing of substance mentally. This area of the brain is thus called the “Default Mode Network”. This is what is active in our brains when our minds wonder, ruminate, and worry.
Quite a lot is going on when our minds aren’t doing anything in particular.
But quite a lot is going on when our minds aren’t doing “anything in particular”. In fact, the default mode network consumes more energy than other brain states. The default mode is most active when we are doing “metacognitive” tasks such as self-reflection, imagining what it is like to be someone else, moral reasoning, etc.
Electrical signals within some brain areas take precedence over others. The DMN is at the top of the hierarchy, organizing all the other signals. Without the DMN, our brain might not be able to maintain order, causing us to devolve into mental illness.
The default mode network appears to play a key role in mental constructs, the most important of which is our sense of self or ego. Some neuroscientists have even referred to it as the “me network”. Nodes within the default mode network are thought to enable us to tell the story of ourselves, linking our past experiences to our present experience and potential future experiences.
A sense of self is a highlight of human cognitive evolution, however it has its drawbacks. Individual identity creates a sense of separation from others and nature. Most people take their sense of self as an unshakeable given, and Pollan states that he felt this way too until his psychedelic experience made him feel otherwise.
The deactivation of the brain’s default mode network corresponds to the loss of a sense of self. Similar results are achieved by putting experienced meditators into fMRI scanners. The transcendence of self, reported by expert meditators, corresponded to a steep drop off in activity within the default mode network.
It appears that when the activity within the default mode network declines significantly, the ego temporarily vanishes and the usual boundaries we experience between self and other, subject and object, all melt away. This sense of merging into some larger experience is a hallmark of mystical experience.
The mystical experience may be what it feels like when you deactivate the default mode network (ego). This can be achieved through psychedelics and meditation, but also through overwhelming experiences of awe, breath work, sensory deprivation, fasting, etc.
The default mode network doesn’t just exert top-down control over the mind. It also helps regulate what is let into conscious awareness from outside. It operates as what Aldous Huxley would describe as the minds “reducing valve”. Without this regulation of what is let into conscious awareness, our minds might struggle to process the torrent of information being let in – as is the case sometimes during the psychedelic experience.
The brain typically takes in as little sensory information as it needs in order to make educated guesses. We are always cutting to the chase and leaping to conclusions, using prior experience as a guide. Our perception of the world is thus not actually reality but an illusion based on data from our past. Normal consciousness feels transparent, but it is less a window of reality and more a product of our imaginations, a controlled hallucination.
The brain has gotten very good at observing and testing reality and developing reliable predictions that optimize the brain for energy efficiency. Uncertainty is the brains biggest challenge and it has been encoded to solve for this uncertainty with the utmost efficiency.
Moving from the science of the default mode network to the theories of the researchers themselves. One of the leading researchers on the DMN, Robin Carhart-Harris, contends that brain disorders such as depression, obsessive compulsion, addiction, and others are not due to disorder within the brain, but too much order. This is when a hyperactive default mode network triggers a repetitive and destructive loop of rumination. He believes that these compounds can break these patterns of thought by deactivating the default mode networks and restoring the correct amount of order within the brain, providing relief from depression, addiction, etc.
The Ego and Spirituality
Pollan describes his own psychedelic journeys and their relationship to the ego. These journeys helped him understand that there is much more to consciousness than the ego. The dissolution of the ego is a prerequisite to spiritual progress, to transcendence.
The ego is what Huxley referred to when he described the minds “reducing valve” which eliminates much of reality. The ego is a security guard that only lets in a narrow band of reality, “a measly trickle of the kind of consciousness that will help us stay alive.” The ego is really good at the things natural selection values, “getting ahead, being liked or loved, getting fed and getting laid. It keeps everything else at bay from our minds eye.”
A spiritual experience is just what happens when the ego is diminished.
Pollan says that it was only when his ego was quieted by psilocybin that he was able to sense the spirits of the plants in his garden. He knew intellectually that every species around him was alive and interacting with other species, but it wasn’t until his trip that this became “more deeply infused”. This is what he calls a spiritual experience.
Pollan theorizes that a spiritual experience is just what happens when the ego is diminished. Wonders or terrors it normally defends from our awareness manifest themselves. The difference between self and other, which the ego normally keeps up, is diminished when it is not on patrol. This allows us to feel more connected to something greater than ourselves. Whether we call this nature, God or something else hardly matters.
Death and Ego Death
Psychedelics seem to have a unique therapeutic ability to help people deal with their own deaths. Both NYU and John Hopkins researchers gave psychedelics to cancer patients with terminal diagnosis. About 80% of them showed clinically significant reductions in anxiety and depression. Few, if any, psychiatric interventions of any kind have achieved such results.
Both research experiments found a high correlation between the intensity of the mystical experience and the degree that their depression and anxiety was relieved. As we have seen above, psychedelics deactivate the brain’s default mode network which causes a loss of self or ego. The more the default mode is deactivated, the more intense the mystical experience.
Many people report something called “ego death” when taking a high dose psychedelic. “A high dose psychedelic experience is death practice,” says Katherine MacLean, the former Hopkins psychologist. “You’re losing everything you know to be real, letting go of your ego and your body, and that process can feel like dying.” Pollan continues, “And yet the experience brings the comforting news that there is something on the other side of that death—whether it is the “great plane of consciousness” or one’s ashes underground being taken up by the roots of trees—and some abiding, disembodied intelligence to somehow know it.”
Psilocybin, by temporarily diminishing the ego via the default mode network, seems to open up new realms of psychological possibility. Many experience death and rebirth on their journeys. At first, losing yourself feels scary, but if one can surrender to the experience (as patients are advised to do) positive emotions typically flow through. What seems to come out of the experience for many people is love. Love for specific people, but also love for everyone and everything. Love as the purpose and meaning of life; the ultimate truth. Or, as The Beatles sang, “Love is all you need”.
The true gift of psychedelics is their ability to turn everything in one’s experience into something meaningful.
The true gift of psychedelics, Pollan hypothesizes, is their ability to turn everything in one’s experience into something meaningful. Even for avowed atheists like Pollan and myself, psychedelics can change a world from something like cold chance, to something with incredible meaning and consequence.
To imbue life with a sense of meaning, whether of oneness with nature or universal love or something else, can make one’s own death far easier to contemplate. Religion has typically provided a sense of meaning to people, but why should we rely on religion alone for this sense of meaning?
Cigarettes are very addictive, some say it is even harder to quit than heroin. A Hopkins study 3 found that six months after their psychedelic sessions, 80% of the subjects were confirmed via testing to be abstinent. At the one-year mark, 67% had remained abstinent. These types of numbers are nothing short of astonishing. Interestingly, the number one predictor of an individual’s ability to quit smoking was whether or not they had a mystical experience.
Strangely, the insights people bring back from psychedelic journeys are surprisingly boring or plainly obvious. People who trip often experience different dimensions, infinite timeframes, meet strange god-like beings, and have many other out of this world experiences. Yet their epiphanies when they come back to a normal mind state are often mundane, “Love is the purpose of life”, “Eat right and exercise”, or simply “Stop smoking”.
We often, smokers included, know things about ourselves. Smokers know that their habit is unhealthy. Yet, psychedelics seem to help them to know this in a deeper way that carries more weight.
One of the researchers from the study says that addiction is a story that people get stuck in. A story that gets reinforced every time they try to quit and fail. The thoughts ruminate and they get stuck in a rut. “I’m a smoker and I’m powerless to quit” they tell themselves.
Psychedelics seem to help break this thought pattern. Again, by diminishing the ego and the default mode network. It seems to enable smokers and other addicts to take a step back and see their addiction (and the story they have been telling themselves about it), in the larger context of their lives.
The therapist plays a role similar to a traditional shaman
Pollan notes that psychedelics might not work on their own. Numerous people have taken psyschedelics and continued to smoke cigarettes. If a breaking of the addiction is to happen, it is because it is the express purpose of the session, reinforced by the therapist in preparatory sessions and integration sessions afterward. The therapist plays a role similar to a traditional shaman in this regard, setting the stage for a successful trip. It is important to understand that this is psychedelic-assisted psychotherapy, rather than being as simple as taking psychedelics without much forethought or follow-up work.
Using psychedelics to treat addiction is nothing new. Native Americans traditionally used peyote to treat alcoholism and other addictions, and it has been a better treatment for them than anything Westernized medicine has come up with thus far.
given the evidence… it is puzzling why this treatment has been largely overlooked
The initial evidence has in fact been pretty clear, even before prohibition. In 2012, a meta-analysis reviewed the six best, randomized controlled studies from the 1960’s and 1970’s, over 500 patients in total, and found that a single dose of LSD created a clinically “significant beneficial effect on alcohol misuse” for up to six months. The authors of the study conclude, “given the evidence… it is puzzling why this treatment has been largely overlooked.”
Those who work with Alcoholics understand it as a spiritual disorder. Over time they lose their connection to everything but Alcohol. Life loses its meaning and at the end, nothing is more important than the bottle, not even their spouses or their children. Eventually, the worst alcoholics sacrifice everything to their disease. If alcoholism is a dramatic narrowing of perspective, psychedelics, by their very nature, offer a compelling antidote. A way to dramatically open up a person’s perspective of themselves, and their relationship with others and the natural world.
In the same way, psychedelics show promise in helping treat depression. Interviews with depressed patients show some common themes. Depression is often described as a state of disconnection, either from other people, a past self, their own feelings, their own spiritual values or core beliefs, or from nature itself. Depressed people also often describe being in a “mental prison” that they cannot escape, a place where they are stuck in endless circles of rumination. Psychedelics offer an opportunity to reorder a depressed patients mental state, to reconnect them, if only temporarily, to that which they feel disconnected from.
The Ego and Buddhism
Pollan, when summarizing his journey writing the book and taking psychedelics, comes back to the dissolution of the ego as the most important and most therapeutic effect of psychedelics. Although Pollan found little overlap in the metaphors or vocabulary of all the researchers or practitioners he interviewed. Whether they viewed psychedelics though a spiritual, psychoanalytic, or neurological lens, it seems to be the loss of ego or self that is the key driver of the psychedelic experience. The loss of ego is what provides for all of the different experiences people describe: the mystical experience, a mental reboot, a sense of psychic death, the experience of awe, and the re-formation of meaning.
Pollan quotes what numerous guides have told him, “the psychedelic journey may not give you what you want, but it will give you what you need.” He notes that this is true for his journey. He expected a religious experience, and although that wasn’t what he experienced at all, he does describe the journey as a spiritual experience. I can also say that this is true for me. I was hoping for a religious experience, but did not get what I expected. However, it has made me feel a deep connection with all beings, what could be more spiritual than that!
The discovery that the brains of experienced meditators and those on psilocybin look remarkably similar through MRI scans is of interest. Buddhists believe that attachment is at the root of all suffering and that by detaching from our own thoughts, feelings and desires we can escape our own human suffering. Buddhists often describe this process as become detached from our own ego. Both psychedelics and meditation appear to enable us to be with our thoughts and desires without getting caught up in them.
It is incredibly easy to dismiss the psychedelic journey as simply a drug experience, and wave our hands and dismiss it as something that doesn’t matter. But it is important to remember that the experience, the narratives, the images and the insights don’t come from out of nowhere. They come from our own minds, and at the very least they have something to tell us about that.
This is the value of exploring different conscious states. The ability to reflect back on how that compares to the normal state of consciousness, which might no longer look so normal. Normal consciousness, by its nature, must only be a subset of the possible states of consciousness, optimized by evolution for our own survival but not much else.
Pollan states that he can sometimes access the state of psychedelic consciousness through meditation and I have found this to be true as well. Other people have noted this too, Sam Harris and Steve Jobs come to mind. Just because an experience takes place while on a drug doesn’t mean that the experience isn’t real. The experience itself is real and can be one of the most profound a human can have.
The history of psychedelics, both in other cultures and pre-prohibition western culture, indicates the enormous potential they hold for benefiting people who suffer from all kinds of mental disorders including addiction, depression, and anxiety. They also indicate enormous potential for people with no known disorders, by fostering a spiritual experience and deep connection to nature and other people.
These benefits are thought to be due to the temporary diminishment of the default mode network or ego that is experienced by people on these drugs. Interestingly, experienced meditators show the same mind state as those on psychedelics, indicating that the Buddhists were on to something with their teachings.
Psychedelic research is clearly still in its infancy, but the evidence we do have points in a clear direction. These drugs show enormous potential and we should be massively funding further research on these chemicals.
Pollan thinks that these drugs should be carefully regulated, with access limited to carefully planned psychedelic therapy sessions with a trained shaman or guide. This seems reasonable, but I’m also uncertain that Leary’s approach is completely incorrect. With the right education, set and setting, and intention, people should be able to have similar experiences in their own homes. After all, the psychedelic guide’s purpose is to let the journey unfold on its own and to provide reassurance during difficult moments.
Step Inside a Veteran-Run Ketamine IV Drip PTSD Therapy Clinic
The future for PTSD treatment looks bright – so let’s get right to it. Our focus will be on the drug ketamine and how micro-dosing with certified and trained professionals is a promising PTSD-killer.
Ketamine is an anesthetic used in every OR in the world. Low doses given via IV are showing fast-acting and lasting results for suicidal and depressed veterans.
Other non-pharmaceutical drugs like marijuana and magic mushrooms are also showing great promise, but until there are some big changes in the stigmas and Schedule 1 classifications defining them, ketamine will probably be the first game-changer to hit the mass market. In fact, thanks to the Food and Drug Administration (FDA) approving it as a prescription treatment for depression in May 2019, it’s already out there.
Check this blog post for a timeline of the latest treatments.
Lawmakers and PTSD Therapy – An Unlikely Meeting Place
On Capitol Hill, the plight of veterans suffering from PTSD who are killing themselves is getting more attention than ever. Trying to solve the puzzle of PTSD and veteran suicide enjoys bi-partisan support from legislators as diverse as Rep. Alexandria Ocasio-Cortez (D-NY) and Rep. John Rutherford (R-FL) who served a decade at the head of the as the Jacksonville Sheriff’s Office. Common ground is akin to Holy ground these days in Congress, so this is real progress.
Short History of PTSD Therapy
Before we move forward, let’s take a step back with some historical context:
Ketamine came off patent in 1960, meaning that just like how music and movies enter into the public domain, anyone can make their version of and make money from it.
In March 2019, after many clinical trials like this one from 2014 by the Mayo Clinic, the FDA approved a ketamine nasal spray for those who are classified with treatment-resistant depression. This spray is marketed under the name of Spravato and made by Johnson & Johnson. Both promising and falling short on that promise, the drug hasn’t outperformed the placebo.
As you’ll see, the reason is because the spray only uses half the molecule. PTSD micro-dosing via IV beats the spray in results and it is our position that lawmakers need to revise the old laws that are out of touch with today’s medical advancements.
Brian Hogan, Director at Sunbelt Wellness Clinic
Brian Hogan, Director at Sunbelt Wellness Institute, is on the front lines of ketamine-infused PTSD therapy. As a Navy veteran himself, Mr. Hogan’s heart and mind are in the right place for this big challenge.
OAS: What is it about the spray, Spravato, that could be better? Brian Hogan: It’s a great start and we’re happy to see the FDA’s approval of it. It really is going to open up a lot of doors for people suffering with PTSD and those veterans killing themselves over it.
On the downside, like you said, it’s just as effective as the placebo, so that could be better. One of the reasons it that Spravato is the ketamine molecule chopped in half. While this will reduce side effects, it also limits effectiveness. Ketamine is the whole molecule. This increase hasn’t impacted the side effects. We haven’t seen the anxiety during a treatment that was predicted.
Second, the price is approximately $7,500 for initial treatments. That’s just for the medication, not including monitoring and in time in a facility. We’re about half that cost.
OAS: Okay, tell me about the treatments.
Brian Hogan: First off, the micro-dosing has shown to be non-addictive, unlike opioids. And there’s only 6 treatments required for most patients to test low and stay low on the PCL5 scale of “how depressed are you?”
We administer the drip in a regular IV bag. The ketamine is mixed with saline, it’s delivered through a pump, and the infusion lasts about 40 minutes. The experience for the patient is that they’re sitting in a reclining easy chair listening to music on headphones with a registered and certified nurse, in our case all Navy-trained veterans, by their side.
These micro-doses also don’t sedate patient. They’re easily aroused from whatever state of mind they’re back to the here and now.
OAS: Can you describe the patient’s state of mind during the session and how it actually helps them deal with their PTSD? Brian Hogan: This is the interesting part and why there’s so much attention on the results. To start with, the medication plays with their mind in terms of the passage of time. To them, their forty-minute sessions seems to have passed in just five minutes.
How they deal with their PTSD has been described as a three-part meeting between them, their memory of the experiences, and a distance between the two that gives them the new perspective they’ve needed. This feeling of being out of their body enables them to feel safe as they deal with the problems.
For some, PTSD is described as a negative thought that comes in and just sits there. Then poof, it’s turned into a cloud and is gone. Pretty mind blowing.
Ketamine Drips are Fast-Acting and Lasting Relief
OAS: I read about fast-acting results, but what have you seen in your clinic working with the veterans? Brian Hogan: The clinical term for these kinds of drugs is Rapidly Acting Antidepressants, or RADS. Ketamine falls into this category. In our practice, they have tested out with same-day results that we’re overjoyed with. As are our veterans.
If the patient comes in with suicidality, they get an immediate ketamine infusion and it works. Most patients report a 70% lift two hours after their treatment.
OAS: Can you provide us with some of the data behind that? Brian Hogan: The way that depression is measured is via something called a DCM5 checklist. It has 20 itemized questions that ask about feelings of depression and suicide. They are then transformed into a number scale from the National Center for PTSD to give us a guide, called the PCL5 scale that lets us know how severe their depression is.
PTSD-infused has shown a 33.3 reduction on scales using PCL5 scale. That’s a significant reduction.
In anecdotal terms, our patients have reported that after the very first treatment, 70% of our patients feel better, after the second treatment feel 85% feel better, and after the third treatment, they level off or rise up a small amount.
OAS: How long are they one this drug and how long is each session? Brian Hogan: Our initial consultation lasts about 30 minutes. Treatments last 40 minutes. During that time, patients are accompanied by one of our certified registered nurse aestheticians who administer the IV and monitor the session.
OAS: Micro-dosing is a new term in the vocabulary of PTSD treatments. What does that mean for ketamine? Brian Hogan: Most of the staff here are veterans and work in our community’s medical centers in surgery centers and ORs. Micro-dosing for us translates into using 1,000 less of a dose than you would get for anesthesia for surgery. To be more precise, our vets receive a range of .5 -.7mg over a 40 minute session. That’s a micro-dose.
OAS: People know some of the more popular depression drugs like Zoloft, Prozac and Paxil. How is ketamine different from them? Brian Hogan: If you’re clinically depressed, you get put on a class of medications called Serotonergic anti-depressions (SSRI). For most of the patients, two-thirds of them, one of those you listed, or the other five or so you didn’t list, will give them meaningful results.
If you don’t respond to those drugs, you are what we call “depression drug resistant.” Now it’s time to try the pMDMA receptors
Keta plays on the glutamate pathway. It’s a different neural pathway taken but for some people, it’s the one that gives them relief.
Next time we’ll speak with some of the patients of Sunbelt Wellness Clinic and hear from them their results and what it’s like to micro-dose and confront your worst fears.
Jacksonville Clinic Sees Encouraging Results Now and Promise for the Future
Treatment-Resistant Mood Disorders Have New Hope in Ketamine PTSD Therapy
If the name Ketamine sounds vaguely familiar to you, you might be thinking about the street drug Special K. Yes, they’re the same thing, but in multiple trials this drug has found a new life in the most amazingly helpful way.
Sunbelt Wellness can be reached at (904) 328-6749
Not Just for Veterans
One-third depressed people don’t benefit from traditional treatments. Luckily, with the relaxation and reclassifications of some drugs, new therapies are showing great results and greater promise. We are happy to feature a local Jacksonville treatment center, veteran run, that is living proof of the benefits for PTSD victims.
Sunbelt Wellness Institute offers a customized cost-effective treatment regimen of Ketamine Infusion therapy, for clients suffering from treatment resistant depression, bipolar depression, post-traumatic stress disorder (PTSD), suicidal ideations and other resistant mood disorders. This therapy has also been effective in chronic pain conditions including complex regional pain syndrome, fibromyalgia, migraines and cluster headaches.
Interview with Dr. Kalynych and Dr. Hogan
HOW DOES IT WORK ?
Most medications prescribed for treatment-resistant mood disorders and chronic pain work by changing the amount of specific neurotransmitters, chemical messengers, in the brain. The side effects of these medications can be debilitating.
Ketamine works in a different way. IVKT triggers a cascade of events in the brain, temporarily blocking the activation of certain chemical receptors in the brain and signaling other pathways. Ketamine works on NMDA receptors, producing a protein that causes rapid growth of new neural connections, or “rewiring” of the brain. This rewiring effect leads to the antidepressant and anti-inflammatory benefits of IVKT.
Intravenous infusion is the Gold Standard for Ketamine therapy and is widely supported in published clinical studies.
POST TRAUMATIC STRESS DISORDER (PTSD) PTSD is a disorder that develops in some people who have experienced a shocking, scary, or dangerous event.
It is natural to feel afraid during and after a traumatic situation. Fear triggers many split-second changes in the body to help defend against danger or to avoid it. This “fight-or-flight” response is a typical reaction meant to protect a person from harm. Nearly everyone will experience a range of reactions after trauma, yet most people recover from initial symptoms naturally. Those who continue to experience problems may be diagnosed with PTSD. People who have PTSD may feel stressed or frightened even when they are not in danger.
Symptoms include flashbacks, bad dreams, recurring thoughts, avoidance behaviors, hyperarousal, agitation, cognitive difficulties, and mood disorders. PTSD is often accompanied by depression, substance abuse, or one or more of the other anxiety disorders.
Not every traumatized person develops ongoing (chronic) or even short-term (acute) PTSD. Not everyone with PTSD has been through a dangerous event. Some experiences, like the sudden, unexpected death of a loved one, can also cause PTSD. Symptoms usually begin early, within 3 months of the traumatic incident, but sometimes they begin years afterward. The course of the illness varies. Some people recover within 6 months, while others have symptoms that last much longer. In some people, the condition becomes chronic.
DEPRESSION Depression (major depressive disorder or clinical depression) is a common but serious mood disorder. It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working. To be diagnosed with depression, the symptoms must be present for at least two weeks.
Some forms of depression are slightly different, or they may develop under unique circumstances, such as: Persistent depressive disorder, Postpartum depression, Psychotic depression, Seasonal affective disorder (SAD), and Bipolar disorder.
ANXIETY Anxiety is a general term for several disorders that cause nervousness, fear, apprehension, and worrying. These disorders affect how we feel and behave and can cause physical symptoms.
The term “anxiety disorder” refers to specific psychiatric disorders that involve extreme fear or worry, and includes generalized anxiety disorder (GAD), panic disorder and panic attacks, agoraphobia, social anxiety disorder, selective mutism, separation anxiety, and specific phobias. Anxiety disorders are real, serious medical conditions – just as real and serious as physical disorders such as heart disease or diabetes. Anxiety disorders are the most common and pervasive mental disorders in the United States.
SUICIDAL IDEATION Suicidal thoughts, or suicidal ideation, means thinking about or planning suicide.Thoughts can range from a detailed plan to a fleeting consideration. It does not include the final act of suicide.
Suicidal thoughts are common, and many people experience them when they are undergoing stress or experiencing depression. In most cases, these are temporary and can be treated, but in some cases, they place the individual at risk for attempting or completing suicide.
Most people who experience suicidal ideation do not carry it through, although some may make suicide attempts. Causes of suicidal thoughts can include depression, anxiety, eating disorders such as anorexia, and substance abuse. People with a family history of mental illness are more likely to have suicidal thoughts.
A person who is experiencing or could experience suicidal thoughts may show the following signs or symptoms:
feeling or appearing to feel trapped or hopeless; feeling intolerable emotional pain; having mood swings, either happy or sad; being agitated, or in a heightened state of anxiety; experiencing changes in personality, routine, or sleeping patterns; consuming drugs or more alcohol than usual, or starting drinking when they had not previously done so; engaging in risky behavior, such as driving carelessly or taking drugs; experiencing depression, panic attacks, impaired concentration, and more.
CHRONIC PAIN Chronic pain is often defined as any pain lasting more than 12 weeks. Whereas acute pain is a normal sensation that alerts us to possible injury, chronic pain is very different. Chronic pain persists—often for months or even longer. Chronic pain may arise from an initial injury, such as a back sprain, or there may be an ongoing cause, such as illness. However, there may also be no clear cause. Other health problems, such as fatigue, sleep disturbance, decreased appetite, and mood changes, often accompany chronic pain. Chronic pain may limit a person’s movements, which can reduce flexibility, strength, and stamina. This difficulty in carrying out important and enjoyable activities can lead to disability and despair.