EVERY SPOKEN WORD
155 min read · 30,746 words- 0:00 – 15:00
(drumbeats) Joe Rogan podcast,…
- RDRick Doblin
(drumbeats) Joe Rogan podcast, check it out. The Joe Rogan Experience.
- NANarrator
Train by day, Joe Rogan podcast by night, all day. (instrumental music plays)
- JRJoe Rogan
Quick talk, what a turn of events.
- RDRick Doblin
This is-
- JRJoe Rogan
So... (laughs)
- RDRick Doblin
... absolutely incredible, Joe. Absolutely. A series of unexpected things have led to this day.
- JRJoe Rogan
So you were supposed to do Duncan's podcast, and then Duncan and I got on the phone and he was saying, you know, trying to move tickets for the psychedelic event.
- RDRick Doblin
Yeah.
- JRJoe Rogan
And then, uh, Duncan said, you know, "Hey man, you can have him on your show."
- RDRick Doblin
(laughs)
- JRJoe Rogan
And I said, "Well, why don't you come on too? It'll be really fun." And then this morning, Duncan has a root canal. Like, uh-
- RDRick Doblin
(laughs)
- JRJoe Rogan
... an unexpected emergency root canal. So-
- RDRick Doblin
Okay.
- JRJoe Rogan
So it was a, just a crazy turn of events and fortunately, you're here.
- RDRick Doblin
Yeah, I just came in from Ukraine, actually.
- JRJoe Rogan
Oh, wow.
- RDRick Doblin
Yeah.
- JRJoe Rogan
Ooh, what were you doing over there?
- RDRick Doblin
Training therapists and psychiatrists.
- JRJoe Rogan
Wow.
- RDRick Doblin
So Ukraine has, um, enormous amounts of trauma, and so what I'm trying to do and, is to go to high-trauma areas and try to talk about MDMA-assisted therapy and how that could be helpful.
- JRJoe Rogan
What is the legality of it over there?
- RDRick Doblin
Well, right now it's illegal. They have these terrible laws left over from when Russia was in control and you cannot even do research with Schedule I drugs.
- JRJoe Rogan
(clicks tongue) Wow.
- RDRick Doblin
Not with psilocybin, not with MDMA. You can't even do research. But over the last couple years, there's been a lot of efforts by their military, by other people to change that, because they're aware that they have so much enormous trauma.
- JRJoe Rogan
Mm.
- RDRick Doblin
So a couple months ago, the Ukrainian government put out draft legislation to change the law. And so the training that we did was for, uh, 55 psychiatrists and therapists from throughout Ukraine. We did it in the western part of Ukraine, Lviv, which is not really a dangerous area. But even while we were there, there were multiple air raid sirens. Um, but then they look at their phone and they see the area that the air raid sirens are supposedly about and they could be, like, 100 miles square, something like that. So nobody seemed to care.
- JRJoe Rogan
Wow.
- RDRick Doblin
Nobody, nobody moved to shelters, and we just ignored these air raid sirens and heard nothing. But it's just, it was so emotionally moving because we went to the cemetery in Lviv, and they have these in cities all over Ukraine, and they have something that I've never seen before, is that they have just enormous numbers of graves. Terrible. They've lost about 250,000 people. But the graves all have flags for Ukraine, but they have the pictures of the person that's dead that's the person that's buried there. And I've never seen that anywhere else, is you just... It has even, even more of an emotional impact-
- 15:00 – 30:00
My fucking phone is…
- RDRick Doblin
out was that, um, that really these kids could recover, that they could do better, um, that it was mostly malnutrition, poverty. It's not like fetal alcohol syndrome, that it was really not this direct connection between the crack cocaine and the problems with these kids. But what he found was that the women that were pregnant and were addicted were driven away from-
- JRJoe Rogan
My fucking phone is dinging again, man. Just put it on do not disturb.
- RDRick Doblin
Yeah, let me just-
- JRJoe Rogan
(laughs)
- RDRick Doblin
... turn, (laughs) turn it off though.
- JRJoe Rogan
All you boomers and your-
- RDRick Doblin
Yeah. (laughs)
- JRJoe Rogan
... goddamn gadgets.
- RDRick Doblin
(laughs) What boomers?
- JRJoe Rogan
(laughs)
- RDRick Doblin
(laughs)
- JRJoe Rogan
Yeah.
- RDRick Doblin
Um, but he found that these women were, um, dissuaded from seeking treatment.
- JRJoe Rogan
Why?
- RDRick Doblin
Because they were worried that they would have their babies taken away from them-
- JRJoe Rogan
Oh.
- RDRick Doblin
... because they were worried they were gonna go to jail.
- JRJoe Rogan
Mm.
- RDRick Doblin
So the drug war is counterproductive-
- JRJoe Rogan
Mm.
- RDRick Doblin
... in that the people that need the help the most are driven away from seeking it because of the stigma and shame and criminality.
- JRJoe Rogan
Right. But then they screw up sometimes and do like what Portland did where they just go, "Everybody just do whatever you want." And then unfortunately, you've already set a culture where you've allowed people to do fentanyl on the street and meth and whatever they, else they want, and then, then the laws pass where you decriminalize everything and sort of, it's legal free for all.
- RDRick Doblin
Yeah.
- JRJoe Rogan
And then unfortunately, you have chaos, and then they pulled back the law 'cause it was just too much.
- RDRick Doblin
Yeah.
- JRJoe Rogan
People were going there just so they could get high.
- RDRick Doblin
Oh, oh, well that's the important point, what you just said. People were going there.
- JRJoe Rogan
Yeah.
- RDRick Doblin
So what that means is that, um, and we saw this in Zurich. So there was a place in Zurich, uh, m- multiple decades ago called Needle Park-
- JRJoe Rogan
Yeah.
- 30:00 – 45:00
Yeah. …
- JRJoe Rogan
wing guys.
- RDRick Doblin
Yeah.
- JRJoe Rogan
And, and women.
- RDRick Doblin
Yeah.
- JRJoe Rogan
You know?
- RDRick Doblin
Yeah.
- JRJoe Rogan
They, they serve their country, they ... You know, they're hard nosed, disciplined people.
- RDRick Doblin
Yeah.
- JRJoe Rogan
If they can experience it and they can realize ... You know, I've always said that like, I try to act as a bridge between the meatheads and the potheads.
- RDRick Doblin
(laughs)
- JRJoe Rogan
(laughs) 'Cause I-
- RDRick Doblin
You are a good bridge for them. (laughs)
- JRJoe Rogan
I'm the bridge.
- RDRick Doblin
Here I am. I'm from-
- JRJoe Rogan
Yeah. Because-
- RDRick Doblin
Oh, you know what Timothy Leary said which is phenomenal? And, and tell me if this is true for you.
- JRJoe Rogan
Okay.
- RDRick Doblin
He said, "If you wanna be a bridge, you have to get used to being stepped on."
- JRJoe Rogan
Oh, that's for sure. Yeah, I'm pretty used to being stepped on, yeah. But I mean, not necessarily for those positions because, uh, the, the idea of pot and, uh, a lot of these other things is that it makes you lazy, and you'd have a really hard time convincing anybody that I'm lazy. That's very hard. I'm pretty disciplined. I don't believe that's the case. I don't think it's just ... I, I don't think they're mutually exclusive, like you have to have either discipline or be able to enjoy-... expanding your consciousness. I, I think, in fact, it enhances your perspective, which enhances your- the understanding of the value of discipline and hard work, and of honesty, and of, like, doing things the right way. Like, you do things the right way, you genu- genuinely feel better. And if you ever have trips, like whatever, even in the sensory deprivation tank, like, sober, getting in there, the- they're better when you live the right way. The- you don't have any demons, or as many. You don't have any d- regrets, you don't have th- do the right thing. It's- be a good person. Like, it's, it's not that hard to do. And the fact that it's been conflated with laziness and ne'er-do-wells and all that stuff, like, that's nonsense. Some of the most ambitious people I know smoke weed.
- RDRick Doblin
Mm-hmm.
- JRJoe Rogan
Some of the most hardworking, interesting, creative people I know smoke weed. They enjoy it.
- RDRick Doblin
Well, one of the (clears throat) best examples is Carl Sagan.
- JRJoe Rogan
Yes! One of the best examples. Yes.
- RDRick Doblin
And he, he had to hide that, though-
- JRJoe Rogan
He did.
- RDRick Doblin
... for decades because he was worried he would lose his security clearances.
- JRJoe Rogan
I was trying to tell that to someone who was a scientist once off-air, and they didn't believe me. I'm like, "How do you not know?"
- RDRick Doblin
Well-
- JRJoe Rogan
"How do you not know Carl Sagan is a- was a huge pot smoker?"
- RDRick Doblin
Right. Well, Lester Grinspoon was the doctor at Harvard Medical School, who was one of my mentors. And he was close personal friends with Carl Sagan. And Lester was an expert on medical marijuana. And he had, um, a book about experiences with marijuana. Carl Sagan had to tell his story under a pseudonym.
- 45:00 – 1:00:00
Well, and then in…
- JRJoe Rogan
regular consumption of a glass of wine with dinner. It's normal.
- RDRick Doblin
Well, and then in the US where when kids do experiment, because they're worried about being caught with things-
- JRJoe Rogan
Right.
- RDRick Doblin
... they tend to not use wine, but they tend to use stronger drinks.
- JRJoe Rogan
Right. Right.
- RDRick Doblin
So they, they call that sort of the iron law of prohibition, that when you prohibit something, it moves more and more to more concentrated, more powerful forms of that drug.
- JRJoe Rogan
Hence, fentanyl.
- RDRick Doblin
Yeah.
- JRJoe Rogan
Yeah.
- RDRick Doblin
Yeah, or even cocaine when y-
- JRJoe Rogan
Right.
- RDRick Doblin
... you, you could have coca tea. I mean, Andy Weil is, uh-
- JRJoe Rogan
Mm-hmm.
- RDRick Doblin
... been promoting for decades and decades, this idea of coca tea. If you-
- JRJoe Rogan
Yeah, I had that once.
- RDRick Doblin
W- what was the, what did it feel like?
- JRJoe Rogan
I couldn't shut the fuck up. I couldn't shut up.
- RDRick Doblin
(laughs)
- JRJoe Rogan
I was like, "Oh my God. Thank God I've never done cocaine." (laughs)
- RDRick Doblin
(laughs)
- JRJoe Rogan
I was telling my friend, Doug, I was like, "I don't think I could shut up."
- RDRick Doblin
(laughs)
- JRJoe Rogan
But it wasn't anything crazy. Um, I think that, um, chewing the leaves is supposed to be like, super beneficial and actually even healthier than coffee.
- RDRick Doblin
Yeah. There- there's a lot of, um, nutrition in the leaves. It helps-
- JRJoe Rogan
Doesn't it fuck your teeth up, though?
- RDRick Doblin
Well, if you do anything too much, it can. But it's something that-
- JRJoe Rogan
You sound like an apologist. You sound like... (laughs)
- RDRick Doblin
(laughs) Well, well I think it's this idea that, um, appropriate use, uh, p- well, Paracelsus is the, uh, um, one of the early physicians and he said, "The difference between a medicine and a poison is dose."
- JRJoe Rogan
Mm-hmm. Right. Well, yeah. Salt'll kill you, you know? Eat a pound of salt, see what happens.
- RDRick Doblin
W- water'll kill you.
- 1:00:00 – 1:15:00
Mm-hmm. …
- RDRick Doblin
having no obligations, no appointments, and the therapists come back and do more integrative therapy the next day. And also, we do the therapy during the day. It starts at 10:00 in the morning. It's an eight-hour session. So often people can get sleep that night. And we don't see more low mood or more tiredness in the people that get MDMA than in the people that got therapy without MDMA. So we were never, um, felt that the need to introduce 5-HTP.
- JRJoe Rogan
Mm-hmm.
- RDRick Doblin
We didn't have evidence of symptoms that required this. But I think it's because we talk about it as a two-day experience. The, the other part is that when people, um, take MDMA at raves or parties and things like that, often they're drinking, they do it at night, they don't get full sleep.
- JRJoe Rogan
Right.
- RDRick Doblin
The next day, they don't just take the day off. Often they go into activities.
- JRJoe Rogan
Right.
- RDRick Doblin
And so-
- JRJoe Rogan
And they're exhausted.
- RDRick Doblin
And they're exhausted.
- JRJoe Rogan
Yeah.
- RDRick Doblin
And so-
- JRJoe Rogan
Makes sense.
- RDRick Doblin
... I think that this concept that we've developed is this really thinking about it as a two-day experience where there is this, um, low energy and there, uh, but it's, can be productive in terms of trying to work on the issues that came up during the MDMA experience or the-
- JRJoe Rogan
Mm-hmm.
- RDRick Doblin
... PTSD or depression or whatever it is-
- JRJoe Rogan
Right.
- RDRick Doblin
... that that... Now, there's a, um, a project at a place called Sunstone, which is a therapy center outside in Rockville, Maryland. And they've worked with cancer patients w- who are anxious about dying, and they have brought in their partners to the therapy, and both of them get MDMA as well. So these are all under, uh, FDA-approved studies. And they found that that was tremendously effective as well, because when your partner's got a life-threatening illness, it doesn't just affect them, it, it affects-
- JRJoe Rogan
Right.
- RDRick Doblin
... you as well.
- JRJoe Rogan
Of course.
- RDRick Doblin
And often the therapy is focused, again, on the designated patient. So this kind of broadening the sense of who it is that is gonna be treated and bringing in people's partners, I think, is gonna be very important. Um, one of the works, uh, um, Marcus and Amber Capone, who've done work with vets, they've brought, um, probably by now about a thousand veterans down to Mexico for ibogaine. And they have also started bringing their partners as well. They realize that y- you need to think about this as a family.... setting and to try to treat the entire family context.
- JRJoe Rogan
Mm.
- RDRick Doblin
Um, this raises another, um, issue which is, uh, to talk about group therapy. So the scale of the trauma ... In America, there's 13 million PTSD patients. This is the estimate by the Veterans Administration. You know, in Ukraine, we've got an entire country. Uh, when I was there, practically every family knows someone or has someone that has been injured or, or, or killed. And so you've got massive population-based trauma, and to think about treating people as individuals is really important, but it's gonna be hard to scale because of the limited number of therapists and psychiatrists and the cost of doing that. So the FDA has wanted all the research with LSD, psilocybin, um, MDMA, 5-MeO-DMT to start on an individual basis. But there's new studies now that are gonna be working on group therapy. So one of the first in America was at the Portland, Oregon VA, and it was four therapists for six veterans. Um, and it started out where each one got an individual session first and then they got a group session. And there's two basic kinds of, um, trauma in the military. One is war-related or accident training-related, and the other is what they call military sexual trauma. There's a lot of sexual abuse by veterans or by military active duty people of other people in the, in the military, and they call that military sexual trauma. And so what they've learned is they have to separate those groups when they do the group therapy, because if you're a military person who's been abused by other people in the military, that, that you might not feel safe if you're in a context, uh, group therapy. So they've done ... Separate the groups, but they've found that the, the groups do terrific with supporting each other afterwards in this integration process.
- JRJoe Rogan
Mm.
- RDRick Doblin
And so, uh, what they've done is they've realized though that the design they had initially was an individual session and then a group session, and after they did two cohorts of the six, they realized that the, the people felt they needed a third MDMA session, and they wanted that also as a group, not as an individual.
- JRJoe Rogan
Mm.
- RDRick Doblin
Um, there's a project, um, in Australia that's gonna be climate-related PTSD from floods that they've had, uh, related to climate, and so they're gonna be doing group therapy there. And there's an incredible project that's developing in Israel that's, um, for people traumatized on October 7th, and there's gonna be, um, groups of seven with, uh, two therapists, two assistants, but the Ministry of Health has taken a while to, um, review this application. It's funded by, um, charitable donations, uh, um, the MDMA is coming from Canada. But what the Ministry of Health in Israel has wanted is ... and this is the first study ever where it's gonna be direct comparison of individual therapy versus group therapy. So everybody is ready to have one or the other. You get randomized to either individual or group, and it will be a, a direct comparison.
- JRJoe Rogan
Mm.
- RDRick Doblin
And so I, I think, like, when we think about AA and we think about peer support, um, I think you can go deeper when it's individual therapy because you have more focus, you're not thinking about other people, you can go deeper. But when you're in a group setting, you can kind of bond with the other people, you can kind of, um, hear their other stories, but then you can support each other in this integration process. So I think at the end of it, it could be that the groups do just as well as the individuals, and then that will dramatically reduce the cost of the treatment and help it scale.
- JRJoe Rogan
Mm.
- 1:15:00 – 1:22:34
Mm. …
- RDRick Doblin
- JRJoe Rogan
Mm.
- RDRick Doblin
What was problematic for us was, the people at the FDA that we negotiated this with in 2017 then left the FDA, and then new, more conservative people came in at the Division of Psychiatry, and they made... Uh, they were more concerned about this, what they called functional unblinding. And that became an issue at the FDA advisory committee meeting and at the, uh, FDA when they reviewed what, what, whether to approve MDMA-assisted therapy or not. And so the, the pharma company, Lycos, um, did not really proactively explain to the advisor committee how this design was developed, why FDA chose this design. And so the people in the advisory committee are often more academics, and they're more focused on this, uh, double-blind issue, but they're, they're not practical in a sense. So that the FDA realizes that the double-blind fails in practice a lot. It's, it's a theory of how you wanna do things. It's something to strive for, but it doesn't work a lot of the times. Even with SSRIs, you think that, uh, Prozac or various, um, drugs that you take that are not psychedelic, that those are easy to double-blind.
- JRJoe Rogan
Mm-hmm.
- RDRick Doblin
But they're not because when people have sexual side effects, they have other side effects, and they report to their therapist what's going on, then they can tell from the side effect profile. So the double-blind fails in practice a lot.
- JRJoe Rogan
Mm-hmm.
- RDRick Doblin
But the FDA is, is saying, "We can't just only approve drugs where the double-blind is perfect." There's, we have to weigh these different things. So that was one of the big issues that the FDA advisory committee objected to, was this functional unblinding. So when, when you asked about the timeframe, there was other issues, but where we're at right now is that there's going to be negotiations between, um, Lycos and the FDA, with the new FDA, with the new people at HHS. And they're, the, there's two, uh, the proverbial fork in the road. There's either the FDA will say, "We, um, believe your data enough that you're not gonna need to do another phase three study." They might require what's called a phase four study, which is after approval, you gather information about safety, about durability, different things. And if that's the case, it's possible that within six months, the FDA could say yes to approving MDMA-assisted therapy for PTSD. If the FDA says, "We want another phase three study," um, that could delay approval for another three and a half years or so. So th- and that's just on an individual basis.
- JRJoe Rogan
Wow.
- RDRick Doblin
So then, so talk about frustration.
- JRJoe Rogan
Yeah.
- RDRick Doblin
I mean, w- we had incredible outcomes. So the two phase three studies that were done, the first one was severe PTSD, and what we showed is that, um, two-thirds of the people that had severe PTSD no longer had PTSD after the treatment, which was 42 hours of therapy, three MDMA sessions one month apart, 12, 90-minute non-drug psychotherapy sessions. Um, two-thirds no longer had PTSD that got therapy plus MDMA. And those people that got therapy without MDMA, with the inactive placebo, roughly one-third no longer had PTSD. And then another, um, 20 roughly, um, 20% had what's called, um, clinically significant reductions of PTSD symptoms, means that their life has changed, their symptoms are not as burdensome, but they still have PTSD. So they're called responders. So we had 88% responders, only 12% non-responders.
- JRJoe Rogan
Wow.
- RDRick Doblin
It wa- it was a- it's, it's the best treatment.
- JRJoe Rogan
That's pretty extraordinary.
- RDRick Doblin
In the second phase three study, we, we purposely moved it to moderate to severe PTSD because we didn't want the FDA to say it's only for severe PTSD. Three-quarters of the people did have severe PTSD. Um, o- and, um, one-quarter had, uh, moderate PTSD, and it was 72.6% no longer had PTSD. Almost three-quarters no longer had PTSD at this two-month follow-up. And what was even more remarkable, and this relates, I think, to the concerns that was expressed about bias and functional unblinding, is that, uh, 46% of the people that had therapy with no MDMA also went below the threshold of having a PTSD diagnosis.
- JRJoe Rogan
Mm-hmm.
- RDRick Doblin
That's better than any of the other therapies for PTSD. And so what that demonstrated is that the therapist, even though most of them could tell the difference between whether somebody had MDMA or not, that they tried just as hard as they could to help people whether they got the MDMA or not, and we got extraordinary results in the control group.
- JRJoe Rogan
Mm-hmm.
- RDRick Doblin
And I, I think one of the things that is the explanation is that when you have an eight-hour therapy session with music, with headphones, with more or less half the time people are inside having these different, um, feelings, and the other half they're talking to the therapist in no particular order, you're not forced to f- focus on the, the therapy the way with prolonged exposure or cognitive processing therapy that... That's what I said was re-traumatizing in the studies that the VA did. Rough- roughly half the people dropped out. We had very low dropout rates because people are encouraged to just... We support whatever's emerging. That's the essence of the therapeutic approach that has been developed to support people when they're going through MDMA therapy, and it's very similar to what can be done with psilocybin or LSD or even ibogaine, that, that you just support whatever's emerging. You have this sense that there's a wisdom of the unconscious. We all know that our body has a certain wisdom.... in that it, it moves towards wholeness. We get cuts, it heals. It's below our level of awareness. So there's some kind of wisdom to what's emerging. Y- you can think about it as this, um, barrier, this permeable barrier, semi-permeable barrier between the conscious and the unconscious. And it all happens, we all know in dreams, that, that material rises to our awareness at dreams. And it's like that with psychedelics. And so we just support whatever's emerging, and people can go to some happy memories or to layers of trauma, whatever. They're not forced to just focus on the trauma, so we have very low dropout rates. But the people that got the therapy without MDMA were able to make incredible progress. We also have what are called fidelity ratings, which is we videotape all the sessions, um, and then we have raters, who are called adherence raters, and they look at, are people adhering to the therapeutic method? And then that's called fidelity. We had an over 90% fidelity, meaning that, uh, the therapists really were doing the same whether it was a placebo or not. So the results were outstanding in that way, and the side effects were very, um, low. We, we had nobody commit suicide that received MDMA. That was one of the concerns. We had, uh, one woman tried to kill herself twice, but she was in the placebo group. And we had another woman, such severe suicidal ideation, she checked herself into hospital not to kill herself. She was also in the placebo group. Because when you help people with terrible trauma, it's difficult for them, and, you know, they're, they're not able to, to really process. That's why they had long-term PTSD. So w- we demonstrated remarkable results, and yet the FDA said, "We need more data. We need more data."
Episode duration: 2:14:11
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