Are you ready for the psychedelic revolution?

Anne Strainchamps (00:00):

It's To The Best Of Our Knowledge. I'm Anne Strainchamps. The psychedelic revolution in mental health treatment is on the way. FDA approval is likely in just a few years, which means that before long, the treatment of choice for depression and addiction could be a hallucinogen like psilocybin.

Alex Sherwood (00:28):

[inaudible 00:00:28]. These are fractions. So each individual has to...

Anne Strainchamps (00:30):

In the upper Midwestern Heartland of America, a nonprofit drug manufacturer is gearing up to synthesize enough medical grade hallucinogenic molecules to supply the world.

Steve Paulson (00:42):

You have a lot of cool stuff in here.

Alex Sherwood (00:43):

Oh yeah.

Steve Paulson (00:44):

Just saying, I mean, this is my image of a chemistry lab.

Alex Sherwood (00:46):

Yeah. It's about as close to a chemistry lab as you can get it. It's great.

Anne Strainchamps (00:51):

Steve Paulson went to see where the magic's made.

Steve Paulson (00:55):

So there are a whole bunch of machines and gadgets here. Tell me what's here.

Alex Sherwood (01:01):

Sure. Closest to us here, this is UPLC mass spectrometer.

Steve Paulson (01:07):

Alex Sherwood is the medicinal chemist at USONA INSTITUTE.

Alex Sherwood (01:11):

This instrument here is called the electro spray ionization source.

Steve Paulson (01:16):

A nonprofit medical research organization in Madison, Wisconsin, and an FDA drug sponsor.

Alex Sherwood (01:23):

This is a flash chromatography apparatus.

Steve Paulson (01:26):

And we're standing in Alex's playground, the R and D lab.

Alex Sherwood (01:35):

Over here, this is an experiment that Elise is running. Elise is manufacturing some novel, some new tryptamine compounds. These are compounds that are structurally related to psilocin and psilocybin, but have never been made before. That is the only source on the planet, maybe in the universe right now, of these two structures.

Steve Paulson (02:00):

IUSONA is investigating new psychedelic compounds and also running clinical trials on the therapeutic effects of these mind-expanding medicines like psilocybin.

Steve Paulson (02:10):

What's the difference between the psilocybin that you are synthesizing in the lab here and what someone would get picking magic mushrooms out in the forest?

Alex Sherwood (02:20):

Synthetic psilocybin is an exact copy of what nature has taught us in mushrooms. I like to say, "Nature is always the best chemist." Sometimes we decide nature did it perfect, we'll just go with that. Other times, we use our chemistry toolkit and say, "Oh, what if we modify this structure a little bit, make it so that it absorbs into the body a little bit better? Or what if the duration of action is too short?"

Steve Paulson (02:46):

You're constantly tweaking if we just focus on psilocybin for a moment. I mean, there's different versions of it then?

Alex Sherwood (02:52):

That's exactly right. Well, what if we put a carbon a over here? Or what if we put a bromine on this part of the ring? Or what if we substitute a nitrogen into this part of the molecule and then you test it?

Steve Paulson (03:08):

Along with the stainless steel machines, the beakers and boiling flasks, there are drawings in magic marker scrolled all over glass doors, diagrams of molecular structures.

Alex Sherwood (03:20):

This is maybe a snapshot into the mind of a chemist.

Steve Paulson (03:26):

When I ask Alex how he actually creates these new compounds, he rattles off a series of chemical steps that I don't understand.

Steve Paulson (03:34):

Can you describe those four steps in the simplest layman terms possible?

Alex Sherwood (03:41):

Without saying oxalyl chloride? I don't... Well it's like Legos, right? You got a bucket of Legos and you want to build something with a shape. So you're going to reach into that bucket and it's like connecting things that want to stick together to make a shape. But what's really happening in that flask to arrive at these transformations to make new compounds, there's a little bit of magic there somewhere for sure.

Steve Paulson (04:22):

Anything else of note in this room here? Should we go over here?

Alex Sherwood (04:24):

Oh, sure. There's the vault, the controlled substances vault. You want to take a peek?

Steve Paulson (04:35):

Sure. Yeah.

Alex Sherwood (04:42):

That bucket contains 2,000 capsules of psilocybin.

Steve Paulson (04:48):

There's also MDMA, mescalin, and LSD.

Alex Sherwood (04:51):

And these represent all of the building blocks that we would use to make new compounds. It's like being in a well-stocked kitchen.

Steve Paulson (05:00):

Alex does all this tinkering with molecules in his R and D lab, but once the compound is perfected, then his job is to manufacture it in a different lab in massive quantities.

Alex Sherwood (05:11):

When you're at the manufacturing stage, we want to do this exactly the same way every time and get the exact same product.

Steve Paulson (05:20):

Can you give me some sense of the scale of what you're working on there? I mean, how much stuff are you producing?

Alex Sherwood (05:28):

The most recent batch of GMP psilocybin was about 1.8, five kilograms of pure synthetic psilocybin. And my math is correct on that, that translates to about 74,025 milligram doses.

Steve Paulson (05:46):

Wow. You're talking major production here.

Alex Sherwood (05:50):

Yep.

Steve Paulson (05:52):

Now, you said that was the latest batch. How many batches do you manufacture, I don't know, in a six months or a year or whatever?

Alex Sherwood (06:00):

Well, the goal is just to move beyond that two kilogram scale and go up to, say, a 10-kilogram scale. Obviously we're still in clinical trials, but the goal is to match the amount of psilocybin that's really needed to support eventual commercialization.

Steve Paulson (06:20):

What you're really saying is potentially USONA so I mean, what you were doing in these facilities could supply most of the world's therapeutic needs of psilocybin.

Alex Sherwood (06:31):

That's correct. If this goes in that direction, I think USONA is poised to be a world supplier of psilocybin.

Steve Paulson (06:40):

Wow.

Steve Paulson (06:50):

That's Alex Sherwood's vision. He's the medicinal chemist at USONA Institute. And now the man behind USONA is Bill Linton, a chemist by training who started a biotech company some 40 years ago. Today, Promega has branches around the world with revenue last year of more than $750 million, which has given him the resources and scientific knowhow to start his own psychedelic Institute.

Steve Paulson (07:21):

I've known Bill for more than a decade. We're both fascinated by questions about the nature of consciousness, what it is and where it comes from. His name rarely comes up in news stories about psychedelic research, but he's funded and facilitated a lot of the studies. And it's his USONA Institute that's helping shepherd psilocybin through the FDA approval process. If psychedelic therapy takes off in the US, it'll partly be because of Bill Linton.

Steve Paulson (07:49):

Let's go back to the sixties when Bill was in college at Berkeley, where everything seemed possible.

speaker 5 (08:00):

This is a beautiful day.

Bill Linton (08:02):

I got there in the spring of 1967.

speaker 5 (08:05):

I wish today that all of America could be here.

Bill Linton (08:11):

What an amazing place that was. But that was where there was really an awakening to the power of psychedelics amongst other things, the free speech movement had preceded that, summer of love, and I just thought something is going on here.

Bill Linton (08:34):

One day, it was in October, some people I had met just said, "Hey Bill, do you want to try LSD?" It dawned on me at that point that probably about half the population of Berkeley had tried LSD. And why was that? Well, a couple reasons, first of all, at that time it was still legal or it was just on the verge of becoming illegal. But as you probably know, the CIA had produced and distributed about 3 million doses of LSD, so it was all over the place.

Steve Paulson (09:05):

I did not know that actually.

Bill Linton (09:07):

They had a program. They were really curious as to the impact on society, so it was around. That October, I was given some by these friends and I was walking down Telegraph Avenue and it was about 6 or 7 in the evening. So it was just getting dark and the lights were coming up.

Bill Linton (09:29):

There was a Harley Davidson chopper, this absolutely beautiful, immaculate all-chrome chopper. And I just stood there and I watched it and it just started to move then shape-shift and it just came alive. And this woman said to her boyfriend, "I think we needed to get him home."

Bill Linton (09:56):

We walked a couple blocks into my apartment and they stayed with me there for the evening, but I spent most of the time just by myself in my bedroom. It was just one of the most remarkable experiences of my life. Following that, I felt that something had changed, something fundamental had changed in how I perceived the world.

Steve Paulson (10:19):

I'm guessing you wanted to do more of that after that experience.

Bill Linton (10:22):

Yeah. And I did maybe another over the next three years, maybe up to a dozen times, and then at some point I thought that was nothing that I needed to do further. There just wasn't necessarily a reason for it, but if it came back to me that this was something important to pursue, that I could come back to it later and it was three decades before that happened.

Steve Paulson (10:53):

Bill was busy during those decades building up Promega into a global business. It went from one building on the outskirts of Madison to an entire campus and manufacturing in sales branches in 16 countries.

Steve Paulson (11:06):

And then one of Bill's neighbors was diagnosed with terminal cancer and fell into a deep depression. Bill found out about a research program at Johns Hopkins University where the psycho pharmacologist Roland Griffiths was using psychedelics to treat end-of-life anxiety and getting remarkable results. Bill told his friend, Betty, and she flew to Baltimore for the treatment.

Bill Linton (11:27):

When she came back, I could see and her family could see and her friends could see that something fundamental had changed. And what had changed was that this sense of impending doom and sadness had lifted and instead there was this joy in embracing every day with a sense of gratitude.

Steve Paulson (11:47):

And this was psilocybin?

Bill Linton (11:48):

Yes.

Steve Paulson (11:49):

A single experience with psilocybin did this.

Bill Linton (11:52):

Exactly, yeah. And she only lived about another three or four months. And while the impact on her was enormous, I would say the impact on her family and friends was even greater, this ripple effect of being in each day in a state of grace. And that reawakened in me at that time, this sense that maybe this is now the time to reengage and study and to see what's going on, and so I got to know the researchers in the field and then that just progressed over time.

Steve Paulson (12:18):

So how do you explain what happened to this friend? Why would this single experience with psilocybin be so transformative?

Bill Linton (12:26):

My opinion is that it opens a level of awareness that we don't normally perceive. That these molecules that are very similar to serotonin, in some way, unlock perception that enable us to not only see, but to actually perceive in different ways. And often, a different perspective on life and death itself, which I find to be remarkable. The fact that a molecule one time can change a person's view of life and death itself.

Steve Paulson (12:58):

That's astonishing. How is that possible?

Bill Linton (13:02):

I don't think people know. And that's one of the mysteries, I think, of the work that's still going on.

Steve Paulson (13:08):

Well, it sounds like you're saying that for all the science that has been, done all the research on psychedelics, especially over the last decade, there's something about this experience it's just ineffable. Science runs up against a wall as to what it can explain here.

Bill Linton (13:22):

Yeah, at least at this point it does. But in an analogy it would be if we live in a world where, like dogs, we can only see in black and white and shades of gray. And one day someone gave you a capsule and for four or five or six hours you could see color. And then you went back to baseline and your friends gathered around you and they said, "Steve, tell us what you experienced." How could you describe what a color is to people who had never seen a color? And this is one of the challenges in people trying to describe their experiences. They really don't have the words to describe exactly what they were able to experience during that time.

Steve Paulson (14:10):

After seeing how that psychedelic trip changed Betty's experience of dying, Bill Linton plunged back into the world of psychedelics. He got to know the scientists who were studying psilocybin, funded some of their research. And then in 2014, co-founded his own psychedelic center USONA Institute. His mission? To get FDA approval for psychedelic therapy.

Bill Linton (14:37):

Well, it's a very difficult path to follow, to try and get that through, the number of studies that have to be done that show safety are remarkable. The whole manufacturing method we've spent years in perfecting to make sure that every time it's produced, you get the same molecule and it's got the same level of purity. And even putting it in a capsule is a whole process by itself.

Bill Linton (15:00):

FDA is intrigued by the possibilities of what this can mean in the treatment of certain disease states.

Steve Paulson (15:08):

The FDA is notoriously conservative about approving new medications, new drugs. And certainly this is got to be on the top of the list of a substance they would be suspicious of.

Bill Linton (15:20):

Their number-one concern is safety because once a drug is approved in the market, they can't just go in and withdraw it from the market, it is now approved and people are able to prescribe it and they're able to use it. Before it gets there, they're going to ensure that it has gone through every step and every box is checked. I think the efficacy question is going to be easier to answer in the sense that the studies that have been done, whether it's on depression, anxiety, addiction show a pretty good and strong signal of improvement.

Steve Paulson (15:55):

And for depression far more effective than the SSRIs, the traditional antidepressants that we're very familiar with, right?

Bill Linton (16:03):

They are, yeah, because the SSRIs tend to dull us and they tend to numb a person to perhaps whatever's causing the depression. SSRIs are like a neutralizing effect, but it doesn't really get at the underlying reason for depression. It's just papering over the problem.

Steve Paulson (16:22):

But why would so has psilocybin be able to treat the underlying cause? I mean, I get it that it might be opening up the mind in some ways, getting certain parts of the brain to fire is that treating the underlying depression?

Bill Linton (16:35):

I think the experience is, and this is what is such an unusual approach to medicalizing a treatment like this because we always want to know, well, what has actually changed physiologically? And many of the research scientists and psychiatrists and people... At first years ago, many of them thought, "Well, there still has to be a few of those molecules dancing around inter person's brain months after." And it turns out no, it's pretty much all gone out of the system within about 10 to 12 hours. So it's gone. But something has changed and I think what has changed, it's not this massive rewiring of the brain, it's the experience itself, which stays with a person for a lifetime. Just like I remember this experience I had back in 1967. I recall elements of that experience today as though it had just happened. It's that remarkable. It makes such an imprint in a person's memory.

Steve Paulson (17:27):

But not everyone wants a mind-blowing psychedelic trip, which raises a fascinating question. Could you get the same therapeutic benefits from taking psilocybin without actually going through the experience itself?

Bill Linton (17:41):

There are studies that people are doing during a sleep state to give someone psilocybin. And what they're interested in knowing is, can a person with no conscious memory of the experience still have a positive outcome?

Steve Paulson (17:56):

Wow. That's fascinating to think about.

Bill Linton (18:01):

The people who are doing this at the University of Wisconsin, there's a group that's giving individuals midazolam, which erases memory. And the problem they've had so far is that people still remember the psychedelic experience.

Steve Paulson (18:12):

Even though you've taken this drug to try to wipe out the memory.

Bill Linton (18:16):

Yeah, for some reason, they still remember. And so they haven't quite gotten to where they want to go on that. I was curious. But it is an area of deep interest. Could you create a molecule or create a scenario where somebody would have the drug, have no psychedelic experience, but still it would end up being effective on the treatment of depression. I'm skeptical that can happen because I don't think it's possible to work through a positive outcome, depression, addiction, or anything else without the experience. But that's my hypothesis.

Steve Paulson (18:51):

And I appreciate what you're saying, because otherwise there's this sense that, "Oh, you can just medicalize this", like we've medicalized so much else. We're going to perfect the pill, we're going to perfect the experience, but we're going to wipe out any of the possible negative impact on or consciousness. And the whole point of this is there's something deeply mysterious about this experience.

Bill Linton (19:10):

Exactly. The premise seems to be that there's something very negative about the psychedelic experience. Well, a psychedelic is something that reveals the mind. I'm not sure what's extraordinarily negative about revealing the mind or opening the mind to experiencing things in a different way. To me, that's a very positive thing, but that's what I've been interested in all my life is to see things from different perspectives.

Steve Paulson (19:39):

And meanwhile, with the FDA on track to approve psilocybin in the next three to four years, Bill Linton is also investigating another molecule.

Bill Linton (19:49):

It's called 5-methoxy-DMT, 5-MeO-DMT. My description of that molecule is that it's not really a psychedelic, it's more of a [transcendelic 00:19:59]. If a psychedelic reveals the mind, this molecule seems to open pure awareness into a state of transcendence or the [Somani 00:20:10] state.

Anne Strainchamps (20:14):

Coming up, the wonders of toad venom, AKA the god molecule, we'll be back with more of Steve's conversation with Bill Linton, the psychedelic CEO, after this.

Anne Strainchamps (20:29):

I'm Anne Strainchamps, it's To The Best Of Our Knowledge, from Wisconsin Public Radio.

speaker 5 (20:34):

I wish today all of America to be here.

Anne Strainchamps (20:45):

And PRX.

Anne Strainchamps (20:45):

Let's pick up Steve's conversation with Bill Linton, the co-founder of USANA Institute and one of the driving forces behind the current movement to get FDA approval for using psychedelics to treat mental illness. They're about to tell us about a new molecule on the scientific horizon, 5-MeO-DMT, AKA the god molecule.

Bill Linton (21:07):

It's been probably in the new world for hundreds, if not thousands of years, but in 1983, there was a person in Texas who discovered that the Sonoran and desert toad had a toxin or a venom and for some reason, decided to smoke that venom, and in doing so, that extreme heat would destroy the toxins, but it would release the 5-MeO-DMT in a vapor form.

Bill Linton (21:46):

I had my experience with that about five and a half years ago in Mexico at a retreat center, we had a number of physicians, medical practitioners, psychiatrists, and that was my first experience with it. We were probably only about a mile away from the ocean. We were on the west coast. And of course that west coast is very steep cliffs, and at least in that part where we were. And on the third day that we were there, there were two individuals that arrived and they had these little kits with them and they had measured out three different doses of the dried toad venom. One was what they called the handshake amount. This is a very small introductory amount just to get a sense of it. Then there was the next level, which was the hug and then there was the full embrace.

Bill Linton (22:46):

I would sit across from one other person and we would hold this pipe and there was a butane lighter and this thing would fire up and it would vaporize, it would really burn this dried venom, which was in these golden crystal forms. And then you would inhale this, you would try to keep it in as long as you can. When I was given the small amount, which is about 30 milligrams of this dried material, well, within about five seconds, I could feel it. And within 15 or 20 seconds, I thought, "I need more." I mean, it was just like this sense that I'm ready for the next amount.

Bill Linton (23:32):

It was just this sense that I was getting close to a cliff or looking over the edge, but I was ready to jump. But an hour later I had the second amount and the second amount, wasn't the medium amount, it was the high amount. That's where I had just this beautiful, profound, and it was like a death and rebirth, but I felt very comfortable in the death and rebirth.

Bill Linton (24:07):

In that state there's no sense of time. There's no sense of, "This is who I am." It's a sense of pure essence. That's really terrifying for some people, the person I was sitting across from thought that she had died and thought that she would never be around to see her daughter grow up. Literally in two or three minutes, she was going through that sense of grief at the end of that, it was a good experience, but again, it was just this sense of terror, "Hey, I'm dying. I'm not going to be around anymore." For me. For some reason, it was like, "Good riddance. I'm happy for that to be gone. And I'm happy to be in this place. That really felt more like home than even this does."

Steve Paulson (24:59):

So, an incredible experience. Did it just dissipate after that or does it stay with you for days, weeks, months?

Bill Linton (25:09):

For well, forever, Steve, it does. It's just always there.

Steve Paulson (25:14):

So you said that you are starting to study this you and your team of scientists and presumably with the idea that maybe this would be another substance that would be put forward to the FDA for approval.

Bill Linton (25:26):

Yeah. This 5-methoxy-DMT I think has got just profound implications for awakening the sense of being, this sense of who we are. Some people feel that it can be very helpful in addiction. Our first indication will probably be something related to major depressive disorder because it would include then a lot of other indications underneath that, including PTSD.

Steve Paulson (25:59):

Bill, I want to shift the focus a little bit and ask about how you see your role in all of this. Because you have been a major player in this whole renaissance in psychedelic research, you've funded research, you've started your own psychedelic institute, USONA, so you have facilitated a lot of connections between different scientists, but you've largely kept out of the public eye. We've heard a lot from the wonderful work that scientists like Roland Griffiths and Charlie Grob and Steve Ross have done. We almost never hear your name in the media.

Bill Linton (26:33):

Well, that's a good thing.

Steve Paulson (26:35):

Why? Why have you chosen that? Because I've talked with a lot of these scientists, you're a major player in all of this.

Bill Linton (26:45):

When people ask me, "What is the work that you do?" Or, "What is your job?" I like to refer to myself as a stage hand. I mean, as a job description. And a stage hand gets the set, they maybe build the stage and the backdrop and the lights and the sound and make sure everything works. But then you do that so that other people can really get on the stage and perform. And that's a role I like to play.

Steve Paulson (27:10):

You are the founder and CEO of a major biotech company with branches all over the world. I mean a non psychedelic company. And I'm wondering what you see as the role of someone like you, an entrepreneur, a capitalist, a businessman, when most of what we hear about are from the scientists who study this. I mean, what can you provide? You and other people in the for-profit world? How do they advance this agenda?

Bill Linton (27:39):

Well, first I've never seen my interest in the business world as a means of making money. What is important is that any enterprise, whether it's a for-profit or not for-profit, needs to have positive cash flow, this is something I learned very early. If you're not generating money, then that means you're losing money and ultimately you're have to close things down.

Steve Paulson (28:01):

What do you see as the goal of USONA, your psychedelic Institute?

Bill Linton (28:06):

Well, the ultimate goal is to provide the pathway and the means for an awakening through these drugs.

Steve Paulson (28:16):

So not necessarily treating just mental illness. I mean, I don't mean just, "Just", but you're talking about something bigger than an awakening.

Bill Linton (28:23):

I am, yeah. And while FDA will only approve something that is treating a disease state, I think in the long-term, when you talked about 10 years, I think in the long-term, there will be opportunities for these treatments to be available to more than just people who have been referred by a psychiatrist for some mental illness.

Steve Paulson (28:45):

Legally you think this will happen, this will be available to anyone potentially. Do you worry about this? These are powerful substances.

Bill Linton (28:55):

I'm concerned that people will potentially use them in ways that are not productive. But I also think that there's enough concern about this, that nobody wants to see what happened back in the 1970s when everything was made illegal. But of course, once momentum builds in a particular field and particularly if there's money to be made, then boundaries get crossed and it's not always the best outcome.

Steve Paulson (29:18):

Well, let me ask about the money to be made here, because there is a gold rush right now. There are a lot of startup companies, a lot of venture capital out there wanting to cash in on this new psychedelic revolution. And the fear is that this will become one more tool in the big pharma toolbox. What do you make of this?

Bill Linton (29:39):

I think the fear is monopolization to the extent that a pharma company or for-profit organization will be so intent on trying to control the field, that they'll take the steps to have that control in a way that's not productive.

Steve Paulson (29:54):

And by control, they would have to claim intellectual property rights.

Bill Linton (29:57):

Exactly, yeah. For example, they're companies that have had patents issued that they probably should not have been issued, but it was because patent offices just simply didn't have the information in hand to deny the claims of the patent. I think that's changing because there are an increasing number of groups, Porta Sophia being one of those.

Steve Paulson (30:17):

A group that you have started.

Bill Linton (30:19):

Yes. Together with patent lawyers, patent attorneys, to make sure that information that has been in the field for, many cases, decades, is available to patent examiners. As they look at a claim, they can say, "Well, wait a minute, this has been out there for 10 years, 20 years." And so we're making a lot of information now available primarily to patent examiners, but also to companies so that they're not going to try to pursue patents that in the end are not going to get approved.

Steve Paulson (30:45):

Just so I'm clear about this, so USONA is not trying to patent any of these drugs that you are manufacturing.

Bill Linton (30:50):

The only reason we would patent something would be to ensure that nobody else patented them. And so a strategy could be, for example, to file for a patent and then abandon the patent. But you've already now got the patent on file and then you either donate it to the public good or you abandon the patent and it basically means nobody else could patent it. That's a bit of an odd patent strategy, but it's something we've discussed.

Steve Paulson (31:15):

And we think another problem with trying to cash in on psychedelics is if it's true that you might only need a single experience or just a few experiences. I mean, that's a very different business model than giving people a Prozac pill every day. The cost benefit of psychedelics is not quite so clear to me.

Bill Linton (31:37):

It's not clear to me either. If you're a typical pharmaceutical company, you want to create something that is unique that you can patent and that is taken every day and then you charge quite a bit for it. This doesn't fit any of those models. So these molecules, the ones that are known what we call the heritage molecules, psilocybin or LSD or DMT or 5-methoxy-DMT or midazolam, they've been around a long time, they are generics by definition. And the fact that a single experience with one of them, or maybe a couple in a person's lifetime can have that kind of effect is not a good business model for pharmaceutical companies. And that's why you haven't seen any major companies coming into the field.

Steve Paulson (32:24):

I want to come back to this question again and ask you to look into the crystal ball. And I realize all of this could go in a lot of different ways, but 10 years from now, how do you think our whole system, let's just talk about in the US of treating mental illness, might change?

Bill Linton (32:42):

I think these molecules open up just a whole new way of thinking about mental illness. Again, if you look at the underlying cause of addiction or mental illness or obsessive compulsive disorders or eating disorders, a lot of it comes from... Again, my view or my interpretation comes from a sense of disconnection, psychiatrists sometimes call it a spiritual break. Often a person who has lost their sense of meaning and purpose and when an experience can reestablish that sense of connection, that sense of relationship, then these symptoms can begin to resolve themselves in a remarkable way. And it's going to change how people think about how do we treat these, how psychiatrists treat these. There's an estimate of a billion people in the world that suffer from some form of addiction, depression, anxiety, things that have profoundly affected their ability to live a normal life.

Steve Paulson (33:42):

You're talking about a potentially revolutionary change in how we treat various mental Illnesses.

Bill Linton (33:47):

Yes.

Anne Strainchamps (33:56):

That's Bill Linton, the co-founder and executive director USONA of Institute, a nonprofit medical research organization based in Madison, Wisconsin. And he was talking with Steve Paulson.

Anne Strainchamps (34:14):

Coming up, a palliative medicine physician is disenchanted with the way we handle end-of-life care and wonders if psychedelics could help.

Lou Lukas (34:22):

The feeling that I got regarding all serious illness is that we sent some really smart people to the Louvre and they came back with a plumbing diagram and didn't notice the art.

Anne Strainchamps (34:34):

Meaning we mostly treat the dying body rather than the whole person?

Lou Lukas (34:41):

Well, even if you're sick, even if you're dying, when we go to a doctor, we tend to get very technical and very specific. And this is a time when people don't have time and they don't have energy. What would it be like to offer them the opportunity to have this sense, that experience of vastness in a very natural and organic way?

Anne Strainchamps (35:00):

Using psychedelics to ease fear and anxiety at the end of life. It's To The Best Of Our Knowledge at Wisconsin Public Radio, NPRX.

Anne Strainchamps (35:22):

A decade ago, Lou Lukas was working as the medical director of a hospice in the Baltimore area when she took part in one of the very first trials of psilocybin-assisted therapy. This was with two of the pioneering researchers at Johns Hopkins, Roland Griffiths, and Bill Richards. So there was an initial screening, several sessions of preparation and finally, a glass of water and a capsule.

Lou Lukas (35:54):

I just noticed my peripheral vision changing a little bit as if things were just a little bit glittery. And I said, "I think it's happening now, Bill." And he said, "Alrighty, it's time to put on your eye shades." And I put on my headphones and I laid back on this couch and everything changed. I felt like I was moving on a conveyor belt into a jungle. And what it was leading to was a huge wasp.

Anne Strainchamps (36:39):

A wasp?

Lou Lukas (36:40):

A wasp. And I'm like, "Oh, I'm going into a wasp." And then things changed again.

Lou Lukas (36:53):

One of the pieces of guidance that Roland in particular gave me, he said, "This is a medicine that when you take it's going to change the way you can perceive the world. All of the ways that you have perceived the world, this medicine takes that apart. As that happens, your mind's going to try to tell you a story. It's going to conjure up something terrifying." If you read the ancient literature, that's like people would see demons or dragons. He said, "Modern people don't see demons and dragons, modern people tend to think either you're going to die or you're going to go crazy. And what I'll tell you is just let it happen. If you fight it, you will lose. And if you run, it will chase you."

Anne Strainchamps (37:47):

It sounded more and more like one of my worst nightmares.

Lou Lukas (37:53):

Well, it has that characteristic about it. Everything that you've understood about you is dissolving.

Lou Lukas (38:02):

Every once in a while, there would be a window, and through the window, I could see scenes of my life that were horribly boring and mundane and pedestrian just being crushed with boredom of like, "Your life is nothing. Your life is just this maze and you can't get out of it." I'm like, "No, I can get out of here. I can get out of here." And a voice is just laughing, "You can't get out of here." It's like, "No, I can get out of here. I'm going to study at Johns Hopkins." And this voice's sick, this is just evil, demonic left, "You are not going to study in Johns Hopkins. This is your life. This is all there is and there will never be anything." "No, no, there has to be more than this. I'll lose my mind."

Lou Lukas (38:53):

And with that, I remember Roland saying, "If you feel like you're going crazy, go crazy." And I went, "Oh, I'm going crazy." And the next second, I was back stroking through this beautiful bioluminescent subterranean cave. I was in a lagoon in his subterranean cave and I was back stroking through this beautiful landscape and that's when the real deal happened. That's when I crossed over. And from then on, it was seen after scene of illumination, I was in the fullness of the universe, the Buddhist talk about the boundless of abodes. On the outside, it was about a six-hour trip, on the inside, it could have been forever. And in fact at times felt like forever.

Anne Strainchamps (40:06):

Today, 10 years later, Lou Lukas is a palliative medicine physician and an advocate for psychedelic-assisted therapy, especially for patients like hers, people who aren't near the end of life and scared.

Anne Strainchamps (40:21):

Walk me through how this works. I mean, normally when somebody is referred to you, some other doctor has said, "There's nothing more we can do for you."

Lou Lukas (40:31):

I get involved a little bit before the, "Nothing more we can do for you." And often another doctor has said, "This person has an illness that's going to take their life." And we don't know exactly how long it's going to be, but how the rest of that life goes is going to depend upon the decisions they make.

Lou Lukas (40:49):

I sit with people and help them understand what their body's doing and why this illness is causing issues. How that illness is going to impact their ability to meet their hopes and dreams and to live into their lives, and then to help them sort through what kinds of choices in terms of treatment are available. And there are sometimes when there are treatments that will be helpful and they are congruent with this person's goals. And there are times when the treatments either won't be helpful or the life it leaves them with won't allow them to achieve those goals and they might not want those treatments.

Anne Strainchamps (41:25):

Is there an example that comes to-

Lou Lukas (41:27):

Yeah, I'm trying to think of a good one. I had a patient recently when I asked him what was important in his life. He told me that his wife had died 10 years ago and that he'd been longing for her for all of that 10 years. And we talked about this illness, he said, "Thank God. God has finally called me home, and I don't want to treat this, I want to go be with my wife." There are lots of people who don't have the calmness and clarity to deal with that, but it might be the same desire. They just get stuck on the merry-go-round of medical treatment.

Anne Strainchamps (42:03):

And probably no idea... I mean, so many questions, what's it like what's going to happen? Is anything, is it just like a match blows out? That's it?

Lou Lukas (42:14):

Well, what's interesting. And is that you talk about that and you have the natural curiosity of a journalist. What happens to most people is that they're so frightened, they can't even be curious and then they start to shut down. They become depressed, they become anxious and we start scheduling them for medical treatment. Whatever time they do have they're in-treatment that may or may not work, but we haven't questioned whether we can stop treatment because they're too terrified to think about the possibility. So we're in this cycle of, we lose a sense of meaning. We get trapped into clinging onto this life, no matter what it means, even if it means I'm spending three days a week going through treatment and not spending time with my family.

Lou Lukas (43:00):

And in the end, nobody gets out of here alive, right? We've got a deadline in life and what do I need to do? What gifts do I need to leave to my family? How do I think about passing on some of my wisdom? How do I think about really going out with some joy and some curiosity and really being full of life. There are even people who talk about an ecstatic grief of this life that we're living is so precious and so sacred. But it's only in that time when you realize that it's short, that there's not that much of it, that you feel the beauty and the magnificence of it. And if you can help to convey that to people, "Wow. Look at this gift we're sharing. Look at the intimacy we're able to have now, just because I realize time is short and I don't have that much more time to hold your hand."

Anne Strainchamps (43:49):

You must be a very unusual palliative care physician because honestly, I don't think that most palliative care physicians go into such depth. I think it's more focused on, "Maybe we add some more morphine."

Lou Lukas (44:03):

Given the opportunity most palliative doctors would go into similar territory, I think. And I teach residents and fellows. And there's a sense of, "Well, what am I here to do?" If you don't talk to people about this, who is? Because even if they have a trusted spiritual advisor, their trusted spiritual advisor doesn't know what's going on with their body. Their pastor doesn't have any idea how sick they are. If you don't broach this with them, it's like, we're keeping you patched together now, but this might not last. If you don't initiate those conversations of how are we making meaning out of your life, they're never going to connect with their pastor in a different way.

Lou Lukas (44:40):

Our ability to reclaim some of that, the shamanic origins of medicine of how do we help people bridge this gap and not every doctor needs to do this, some people should be quite technical. You want your surgeon to have precise technical skills, but we need more doctors and more healthcare providers who can bridge that gap. Physicians who are called to this edge-walking that I think about, well, you've got one foot in the medical world and one foot in the psychospiritual world.

Anne Strainchamps (45:07):

The FDA has not approved psilocybin for medical use, so you cannot now say to a patient, "I think you would be a great candidate for psychedelic therapy", but you do have some studies, right? That you're thinking about.

Lou Lukas (45:23):

Exactly. And I'm doing a trial of a psilocybin protocol for people who have distress-related to pancreas cancer. And as you probably know, pancreas cancer is one of the most lethal of the solid organ cancers.

Anne Strainchamps (45:38):

They're really terrifying one, or one of them.

Lou Lukas (45:40):

It is. And most people who are diagnosed or diagnosed very far along and we can give people a couple months usually, but not a whole lot longer than that. Some people might live a year, a year and a half. You can imagine being told this. People who are at our cancer center being treated for their pancreas cancer will be offered admission into this study, will take them through this period of about six to eight hours of preparatory counseling, a-day-long dosing session, and then several sessions of integration afterwards.

Anne Strainchamps (46:12):

I guess what I'm wondering is what is the experience like for somebody who does have a terminal illness to take psilocybin? What changes? The day after how do they feel? And the day after that, and the day after that what's different?

Lou Lukas (46:28):

It's phenomenal. People say a few different things. First, somewhere between 60 to 80% of people have profound experiences that dramatically changed their life and their perception of their illness, which is remarkable because nothing else works like this. And it isn't even the next day in.

Lou Lukas (46:45):

When they're finished with this, when they come back into consensus reality, and they're talking to you, they just look at you and like, "That was amazing." It's as if you've built your reality on this house of cards of all the stories that you have about yourself, "Oh, life is hard and then you die and I've got this cancer and I'm really worried and I can't get myself out of it and I'm scared and every time I feel a bump, I think the cancer's going on." If that's what you came in with, and then you go through this experience and that whole house of cards of stories just gets washed away. I witnessed one patient just say, "All that anxiety I felt it's just stories. I can get a different story. I don't need that story." And then have that sense of, "Oh, that worry. I don't have to be that worried. Yeah, I've got cancer, but I don't need to be that worried about it."

Anne Strainchamps (47:36):

Are they less afraid of dying?

Lou Lukas (47:39):

There's a wonderful story. Anderson Cooper captured it on 60 Minutes and this woman who was in the study three years earlier and who just before the interview, she was diagnosed with brain met. So she was actively getting worse. And she looked at him and said, "I don't say I'm happy. I say I'm comfortable. I said my whole life being anxious and uncomfortable. I'm not afraid to live. I'm not afraid to die. I'm just comfortable." And she giggles. And this is three years after her psilocybin experience.

Lou Lukas (48:14):

Underneath it all, what people report is love. And just a sense of like, "I've been in the presence of love." And maybe if we were dropping the stories that we need... To get through our world, we need a certain level of defense, right? It's a hard world and we put defenses up to keep ourselves physically safe and emotionally safe. If we were able to let some of those defenses down, maybe we would have more access to love. If we have that, then you can really accept a lot of things.

Anne Strainchamps (48:45):

Wow. This does raise the question, why do people have to wait until they're dying? I imagine some of the terminally ill patients must say, "Darn, if I'd only had this revelation 30, 40 years ago, I might have lived differently."

Lou Lukas (49:04):

Well, exactly. And for most people you would use it like a sacrament. And in indigenous cultures, we see that this is often a Rite of passage that when you come into adulthood it's the first time you would use this. And then perhaps when you got married or perhaps before a child, or perhaps every decade or whatever the right interval is, you just touch back down and recognize sometimes I'm individual within my community, but I remember that I'm connected to everything. And it's almost like a ritual bath, like a Mikva and Judaism, perhaps there's this time when I take a psychedelic bath and I remember like, "Oh, I'm going to wash myself in the universe. I'm going to immerse myself in the unconscious mind. I'm going to feel that expansive consciousness and realize that I'm part of everything. And then I'm going to come back and do the laundry and change the diapers." If you could just wake up a little bit more frequently and remember, "Oh, there's more than just this little life that I'm leading. My life is lovely and there's more."

Anne Strainchamps (50:09):

Lou Lukas is a professor of palliative medicine at the University of Nebraska Medical Center. You can learn more about her clinical practice at paleodelic.org.

Anne Strainchamps (50:25):

And that's it for this hour. No matter what stage of life you are in, I hope every day feels like a gift. Take a minute and be grateful for this time we share.

Anne Strainchamps (50:37):

To The Best Of Our Knowledge is produced in Madison, Wisconsin. Steve, Paulson put this hour together with help from Shannon Henry Kleiber, Charles Monroe-Kane, Mark Riechers, Angelo Bautista, and our sound designer and technical director, Joe Hardtke. I'm Anne Strainchamps. Thanks for listening.

Speaker 8 (50:55):

PRX.