Skip to content
PivotPivot

Elon Musk Drug Use Concerns Business Leaders | Pivot

Kara Swisher and Scott Galloway discuss Elon Musk's drug use and the repercussions for his businesses, then get some medical insights on ketamine from Kara's brother, Dr. Jeffrey Swisher. #elonmusk #pivot #podcast Subscribe to Pivot on Apple Podcasts: https://podcasts.apple.com/us/podcast/pivot/id1073226719 Subscribe to Pivot on Spotify: https://open.spotify.com/show/4MU3RFGELZxPT9XHVwTNPR Follow us on Instagram and Threads at: https://www.instagram.com/pivotpodcastofficial Follow us on TikTok: https://www.tiktok.com/@PIVOTPODCAST Send us your questions by calling us at 855-51-PIVOT, or at https://podcasts.voxmedia.com/show/pivot

Kara SwisherhostScott GallowayhostDr. Jeffrey Swisherguest
Jan 9, 202426mWatch on YouTube ↗

EVERY SPOKEN WORD

  1. 0:00 – 1:08

    WSJ report raises alarms about Musk’s alleged ongoing drug use

    1. KS

      ... our first big story, and we've gotta get to it, uh, is a, uh, a Wall Street Journal piece. It's a new piece that came out last night. Um, Elon Musk has used illegal drugs, worrying leaders at Tesla and SpaceX. The article cites people close to Musk who say his drug use is ongoing and includes board members, it feels like, and, uh, and one, uh, one name specifically, but it looks like they were all talking. Particularly the ketamine, and there are concerns it could cause a health crisis or damage the business. Uh, Musk has a lot of business, um, with, uh, with the government and he's already... I don't know if he was sanctioned, but he had to do drug tests after he smoked weed on Joe Rogan. This is seemingly more serious and it's interesting that, um, you know, this has been around. We've talked about it, uh, Ronan Farrow wrote about it. Like, lots of people have cited this issue, not so much in Walter Isaacson's book, uh, which it should've, uh, had more about it. Um, but i- it's, uh, it's sort of an open secret a- about this and, y- the Wall Street Journal obviously has lawyered up to, to be able to say this. Um, in a minute we're gonna bring on, uh, my brother, Jeff Swisher, to help us talk through this one. Uh, just first reactions, Scott? And then I'll bring on Jeff.

  2. 1:08 – 2:30

    Scott’s reaction: ‘no free lunch’ and ketamine’s normalization in elite tech circles

    1. SG

      First reactions. Uh, look, uh, we talk a lot about substances. Uh, the majority of people, I believe, who use substances, manage them. And I'm not an anti-substance person, but, um, along those same lines, there's just no free lunch. And when I saw, um, when I saw Elon Musk in that interview at the Times Deal Book, I'm like, "He, he's fucked up."

    2. KS

      Yeah.

    3. SG

      And, and there, th- th- it all comes back to one saying. What I tell young people around their use of substances is, "There's just no free lunch." There-

    4. KS

      Yeah.

    5. SG

      And what I have... and I'll s- stop here, but the thing that really struck me was when I was in Aspen this summer. Um, I was alone and I was bored and a friend said, "I have a bunch of friends there," and we all went to dinner. Like, 12 of us, bunch of-

    6. KS

      Hm.

    7. SG

      ... total players in technology and private equity. And we went to this lounge and I said, "What can I get everyone? I'm headed to the bar." And they said, and w- this guy goes, they all kind of nodded or laughed and said, "We're all on ketamine."

    8. KS

      Yeah.

    9. SG

      And I thought-

    10. KS

      Yeah.

    11. SG

      ... "Oh my God. Everybody?" This is like six men-

    12. KS

      Right.

    13. SG

      ... six women, and the tech, the tech community likes to believe-

    14. KS

      Yeah.

    15. SG

      ... they have found a free lunch.

    16. KS

      Mm-hmm.

    17. SG

      And, uh, uh, uh, and we said this before.

    18. KS

      So no repercussions like with-

    19. SG

      No such thing.

    20. KS

      ... cocaine or...

    21. SG

      There's no such thing.

    22. KS

      Yeah.

    23. SG

      I haven't found it yet.

    24. KS

      Yeah.

    25. SG

      Maybe caffeine. Caffeine's supposedly the f- the f- closest thing to a free lunch, but I haven't found it, I'm sure.

    26. KS

      Yeah.

    27. SG

      I'm curious what Dr. Swisher thinks.

  3. 2:30 – 3:43

    Kara’s context: long-running rumors, prior reporting, and why it matters for leadership

    1. KS

      Yeah. We'll bring him on. It was interesting because, uh, you know, this was the holiday season this came out, um, where he has some time off. Um, I had heard rumors. There was rumors running around Silicon Valley that they m- had him in Hawaii last year, same thing. Um, and obviously he's talked about it, let's be clear. He's talked about his use of ketamine, he's talked about his mental health issues, um, obviously smoked weed on Joe Rogan. And nothing wrong with that, excepting his government contracts, which is, is a big problem. And I think away from his own health, which makes you worry, um, 'cause there's been history of a lot of tech people like this getting into real trouble, like Tony Hsieh. Um, and, uh, you know, I think it's been an ongoing discussion among and between people in Silicon Valley. And this one example in the piece was him being incomprehensible during, uh, a SpaceX meeting, um, and I think you're right. That interview, I, I looked at it and I thought, "What? He's on something." I mean, I, I don't have any reported knowledge of it, but it really was such a bizarre, um, interview. It seemed either mental health or something else was happening. Anyway, we're not experts, so we're bringing on my brother, Dr. Jeffrey Swisher, to help us talk through this one.

  4. 3:43 – 4:29

    Dr. Jeffrey Swisher joins and sets the stage for a medical explanation

    1. JS

      Hey, Kara. How you doing?

    2. KS

      Good.

    3. SG

      In the house.

    4. JS

      Yeah, what the...

    5. SG

      By the way, whose idea-

    6. JS

      How are you?

    7. KS

      Jay Swish-

    8. SG

      Whose idea was it to-

    9. KS

      Jay Swish.

    10. SG

      ... bring on the good doctor? Whose idea was it?

    11. JS

      (laughs)

    12. KS

      You. You.

    13. SG

      That's right.

    14. KS

      It was not my idea. It was your idea.

    15. SG

      Mine.

    16. KS

      But it's a good idea.

    17. JS

      Well, thank you, Scott, and it's good to see you when it's not scot-free August. And, uh-

    18. KS

      Yeah.

    19. JS

      ... it's fantastic. You look great.

    20. SG

      Thanks, man.

    21. JS

      Um, I do... Kara, I do have, unfortunately, one Scott joke for you.

    22. KS

      (laughs) Oh God.

    23. JS

      So Scott, a Scotsman goes to the doctor's office, right?

    24. SG

      Okay.

    25. JS

      And he goes into the doctor and he lifts up his, uh, kilt and he says, "Doctor, I don't know. I think I'm going crazy." And the doctor says, "I don't know about crazy, but I can sure see you're nuts."

    26. KS

      (laughs)

    27. SG

      (laughs)

    28. JS

      (laughs)

    29. KS

      Oh my God.

    30. SG

      O is like, O is like Swisher.

  5. 4:29 – 5:55

    Ketamine 101: what it is, why clinicians use it, and core effects

    1. JS

      I do use ketamine.

    2. KS

      ... in your job.

    3. JS

      Uh, let me talk to you-

    4. KS

      A lot.

    5. JS

      ... a little bit about ketamine. So-

    6. KS

      Okay.

    7. JS

      ... ketamine is what's known as a dissociative anesthetic and that's really important to understand, you know, what it does. It, it dissociates you from, essentially, reality. Um, it was first, uh, synthesized in 1962, the year you were born, Kara.

    8. KS

      Hm.

    9. JS

      And, um, it, um, was FDA approved in, around 1970 for use in anesthesia.

    10. SG

      Hm.

    11. JS

      Um, and I use it, uh, really pretty much on a daily basis. It's a very, very useful anesthetic and, in fact, the World Health Organization lists it as one of the, you know, invaluable drugs, uh, in the world. It's really good because it has a lot of, um, beneficial effects from an anesthetic standpoint. It's not a respiratory depressant, uh, in usual doses. It's not a cardiac depressant. Um, in fact, it slightly increases blood pressure and heart rate. And it doesn't, uh, blunt airway reflexes. So it can be used, uh, in a pre-hospital setting, let's say in the emergency room, to sedate children. Uh, I use it as an adjunct anesthetic. Uh, I use it to, because it helps, uh, decrease the amount of opiates I use in the operating room. Uh, I use it for procedural sedation if I'm going to be doing something painful, uh, let's say a, a regional anesthetic block of the upper extremity. I will give somebody, you know, 30 or 40 milligrams of ketamine and it allows them to actually participate, but essentially not be there, um, uh, in the sense that they don't-

  6. 5:55 – 7:36

    What the ketamine experience feels like: dissociation, ‘K-hole,’ and dreamlike effects

    1. KS

      So they, they feel calmer, right? It, what's-

    2. JS

      Yeah.

    3. KS

      ... what's the effect?

    4. JS

      Actually, they do, they do. Um, you know, depending on the person, they do sort of, you know, leave their, their body in a sense. In fact, some people describe a ketamine experience as similar to a near death experience where they can actually-... see themselves-

    5. SG

      Mm-hmm.

    6. JS

      ... let's say, floating above their body.

    7. SG

      Yeah.

    8. JS

      Um, uh, I, the best description of ketamine from a patient that I ever had was, uh, he told me afterwards, he says, "Imagine that you're driving a car toward a beautiful sunset and the Grateful Dead is playing on the radio and it's a fantastic, wonderful day, uh, with the breeze blowing through the window. Now, for a second, imagine that you're not driving the car but you are the car and you're driving. And all of a sudden, you're not driving the car, you're a passenger in the car." And, uh, and that's really, a really great description of ketamine. People describe a feeling of melting, uh, you know, you've heard the expression K-hole.

    9. SG

      Mm-hmm. Mm-hmm.

    10. JS

      Um, kete- people sort of fall into this kind of warm molasses pit when they're on it, and, and it's a very pleasant experience for most people. Not everybody. Some people do get, you know, uh, you know, frightening dreams, et cetera on it, but for the most part, it's a great anesthetic and it's very short acting.

    11. KS

      Have you had that happen with surgery, where they get dreams or anything?

    12. JS

      Oh, yeah. All the time.

    13. KS

      Yeah.

    14. JS

      I mean, people describe, you know, uh, uh, one of the most common uses for it is, um, when I'm doing, let's say, a, a little old lady, um, with a hip fracture, and it's very painful to put someone on their side, uh, to do a spinal anesthetic. So I'll give them 10 or 20 milligrams of ketamine and they love it. I mean, they wake up afterwards and they say, "That's the best experience I've ever had."

    15. KS

      Mm-hmm.

    16. JS

      Uh, so it's a very euphoric drug and I can understand why people would use it for recreational purposes. Uh, not that it's safe to do so, uh, because, you know-

  7. 7:36 – 9:13

    Recreational use, psychological dependence, and the Matthew Perry cautionary example

    1. SG

      But, but, but Jeff-

    2. JS

      ... of course

    3. SG

      ... talk about- ... supervise. ... talk about it in a recreational context, out- outside of the medical-

    4. JS

      Mm-hmm.

    5. SG

      ... context and that is-

    6. JS

      Sure.

    7. SG

      ... my understanding is in contrast with alcohol or opiates, it's not physically addictive, but it can be psychologically addictive.

    8. JS

      Yep, that's exactly right.

    9. SG

      And what we were saying before is that tech bros or the tech community or just successful people in general like to believe they found a better blueberry or a better solar panel. Like, their tech, their, uh, diet is better. And I have found the same thing is true here, that people feel that ketamine is a safer high. Talk about it in the context of addiction and, you know, recreational use.

    10. JS

      Sure. So, you know, ketamine, A, it's widely available. It's very inexpensive to make and therefore y- you can get it fairly easily, uh, on the street. Um, it is a, you know, relatively safe drug in, in the sense that, you know, as opposed to methamphetamine, which can be really dangerous if you have, you know, you know, cardiac issues, et cetera, or cocaine. Um, the, the problem is that like any recreational drug, uh, people tend to binge it. Uh, they like the feeling of it and then they need to start upping their doses, um, of ketamine. And, I mean, you know, the really unfortunate situation that happened recently is Matthew Perry, um, and Matthew Perry was legitimately getting therapy with ketamine for depression and we can talk about that if you want at some point. But, but the, uh, the problem is he, he also was using it recreationally and, and he also had other se- substances in his body on the coroner's report.

  8. 9:13 – 11:28

    Drug testing realities: detectability windows and many routes of administration

    1. KS

      Yeah. So the piece quotes, uh, an attorney, uh, for Musk saying that he is quote, "Regularly and randomly drug tested at SpaceX and has never failed a test." But we don't know... Can you talk about... And the attorney said there were other false facts in the Wall Street Journal column but didn't have any details. So, um, this is Alex Spiro who, who's sort of Musk's lawyer front man. But, um, w- what do you... H- how do you think about drug testing on this, o- on this kind of thing?

    2. JS

      Well, you can... There are c- uh, ways of testing for ketamine. The, the metabolite... It's metabolized by the liver and there are several metabolites of ketamine which are detectable. Uh, it's cleared, uh, by the liver but it's excreted in urine and feces. So you can certainly test for it. Uh, the problem is it's a fairly short-acting medication and, um, uh, it depends when you use it and what the levels are. Clearly with Matthew Perry for instance they had it immediately because, you know, he wasn't metabolizing anymore after he died. But, uh, but, uh, for people who are using it, you have to catch it fairly soon after they use it to detect it, uh, which is one of the reasons, Scott, uh, you mentioned that I think a lot of these, uh, tech bros and stuff were using it. Um, but, you know, great caution because dosing is very important. The other thing about ketamine I wanna mention is that it can be given via a r- a variety of routes. Uh, so you can inject it intravenously, you can subcutaneously inject it, you can intramuscularly inject it. You can snort it, you can swallow it, you can put it up your behind if you want. Uh, there's a lot of ways of taking ketamine and so it's very, um, bioavailable, let's put it that way. You know?

    3. KS

      Bioavailable?

    4. JS

      Intravenously... Yeah, bioavailable. 100% intravenously.

    5. KS

      Yeah.

    6. JS

      Down to about 50% if you take it orally or, or-

    7. KS

      Right.

    8. JS

      ... snort it, it's about 50% to 70%.

    9. KS

      How do most people... When you, you give it, you do it intravenously 'cause you're in an operating-

    10. JS

      I do it both.

    11. KS

      How do most people recreationally use it?

    12. JS

      B- when I give it, I give it-

    13. KS

      Or, or therapy?

    14. JS

      ... intravenously and intramuscularly.

    15. KS

      Okay.

    16. JS

      Uh, it's a very useful drug. Let's say if you have a person with, uh, um, you know, severe mental disorder who is combative, uh, prior to anesthesia-

    17. KS

      Mm-hmm.

    18. JS

      ... and I wanna start an IV, uh, I can give people intramuscular ketamine in that situation. Uh, and it takes a little bit, but then they'll sort of fall asleep. But usually I give it intravenously, but I think most people who are using it recreationally are probably snorting it.

    19. KS

      Snorting it, okay.

    20. JS

      Um, yeah.

  9. 11:28 – 13:14

    Ketamine therapy landscape: off-label use, FDA-approved esketamine, and ‘clinic’ boom

    1. KS

      So, um, let's talk about... Uh, w- the Matthew Perry you were referencing, he... The, the coroner said he died from the acute effects of ketamine. Um, uh, he was on ketamine infusion therapy as you noted. Um, talk a little bit about these therapies because, you know, I- I'm about to interview Jill Green tomorrow. There's a lot of people trying very hard to replace opiates and other things with ketamine and other psychedelics. Um, i- is it... uh, is that problematic or is just the abuse problematic?

    2. JS

      Um, I, I think it's the abuse that's a problematic. I mean, ketamine, um-... for, for depression is an off-label use. I mean, and not that off-label uses are wrong. In fact, we, we, every day doctors use medications in an off-label manner. It just means it's not FDA approved for that indication. Um, they actually did make, uh, what's called an en- an enantiomer of ketamine, uh, called esketamine, which is a nasal spray, which was, uh, approved by the FDA, I think, in 2019. Uh, it's, it's called Spravato and that's, that, that was the indication for that is depression. And it's an, and as I said, it's a mirror isomer of ketamine. It's the same drug, but the mirror isomer of it. Um, but ketamine clinics have popped up like kudzu, you know, all over the place and, uh, it's very, very expensive. I mean, thousands of dollars for, uh, a couple sessions of injecting. Now keep in mind that the injection of ketamine in these clinics is a very small dose. It's typically a half a milligram per kilogram, so usually 30 to 40 milligrams infused over about a 40-minute period. That's not a lot. That's not a lot to get you super high. Um, a little dissociative, but not super high. When you're using it recreationally, you know, who knows how much people are using. They, you know, you can't really regulate your dosage.

    3. KS

      Right.

    4. JS

      Um...

  10. 13:14 – 14:49

    Reacting to Musk’s claims about SSRIs vs ketamine: evidence, limits, and ‘third-line’ framing

    1. KS

      Now, now one thing Elon tweeted about ketamine last June, "Depression is overdiagnosed in the US, um, but for some people, it is really brain chemistry issue." He went on to say, "Zombifying people with SSRI for sure happens way too much from what I've seen with friends. Ketamine, yeah, my best, some of my best friends use ketamine. Ketamine taken occasionally is a better option." Um, how do you, when you hear him say that, I mean, a lot of people have problems with SSRS.

    2. JS

      SSRIs, yeah.

    3. KS

      SSRIs, sorry.

    4. JS

      Uh, seroto- yeah, selective serotonin reuptake inhibitors, um, is what that stands for. So ketamine is in the class of drugs that are called NMDA antagonists and there's a lot of, uh, of, um, very useful, uh, work that's being done understanding NMDA antagonists in general for depression. And the research on it is it's a, I wouldn't say it's definitive, but it's definitely statistically significant that ketamine definitely improves symptoms of both unipolar and bipolar depression, um, in the short term.

    5. KS

      Mm-hmm.

    6. JS

      The question is, is it a lasting effect? Uh, that's hard to know and I think that's ongoing research. And, uh, personally, I think, you know, uh, Mr. Musk is correct in that sense. I mean, SSRIs are very different, uh, and, um, um, than ketamine. Still though, ketamine is not a firstline therapy for depression. It's probably like a third line therapy.

    7. KS

      Right.

    8. JS

      But a lot of people-

    9. KS

      And they're trying to get it to be one for people with post-traumatic stress, et cetera.

    10. JS

      Sure, yeah. PTSD is a good indication for it, um, and, you know, I personally know people who've had ketamine therapy who swear by it, who say that it's really improved them.

    11. KS

      Mm-hmm.

  11. 14:49 – 17:29

    Nuance vs demonization: separating a drug’s medical value from misuse

    1. JS

      Um, and, uh, so I do think that, you know, shutting down any kind of research on this, that's why I don't really like that Matthew Perry article or even this Wall Street Journal article, 'cause it demonizes, uh, a very useful drug, uh, and ketamine is a very useful drug. Uh, I mean, similar, what happened with Michael Jackson and propofol. I mean, ev-, uh, every day people tell me, "You're not gonna give me that propofol drug." It's like, yeah, basically it's the most common anesthetic in the world. Yes, I'm gonna give it to you.

    2. SG

      And by the way, it's amazing.

    3. JS

      But, you know, when-

    4. KS

      (laughs)

    5. JS

      Oh, it's amazing. (laughs)

    6. SG

      It is, it's amazing.

    7. JS

      Yeah, it is.

    8. SG

      Whenever I've had a colonoscopy, I take that thing-

    9. JS

      Yeah.

    10. SG

      ... and 30 minutes later, I'm, I'm, I- I mean-

    11. KS

      Yeah.

    12. SG

      ... it's amazing.

    13. KS

      Yeah.

    14. JS

      Yeah. No, it's, it's, it's literally probably the greatest invention in anesthesia I- in its history. Um, but, but ketamine is-

    15. KS

      But not for daily nightly use.

    16. SG

      Yeah.

    17. JS

      No. So that's the problem is that you, you know, using propofol in your living room by someone who did not admit, you know. So they, they, it's not the drug that's the problem, it's the person giving it-

    18. SG

      Mm-hmm.

    19. JS

      ... or the person taking it.

    20. SG

      My sense is, more generally as it relates to drugs in our society, and I don't know if it's the far right or an attempt to use drugs as a tool to keep people of color down through incarceration and drug bill, whatever it might be, but we have a tendency to go very black and white. Uh, marijuana helps people sleep, helps people with anxiety, helps kids with glaucoma, but we just decided, oh, it was all bad. And it, it strikes me that no one wants to have a nuanced conversation around what is an appropriate use of a drug. And the fact that something like 85% of people who use alcohol and drugs are functioning. (laughs) And it's not impacting them in a terribly negative way. Having said that, alcohol is a menace and terrible for tens of millions of homes in America, but nobody wants to have really what I would describe as a thoughtful conversation. They want to assign something is only used in a medical context, but when it's used outside of a medical context, it's immediately, it must be all negative and all bad. And we demonize it, criminalize it, and in my view, just make, make things, you know, much, much worse. Anyways, it wasn't a question, it was a TED Talk.

    21. KS

      Yeah, um-

    22. JS

      No, I mean, it's, it's, you're right, the most commonly abused drug, uh, by far and away is alcohol.

    23. SG

      Alcohol, yeah.

    24. JS

      And, you know, more people drown because they, uh, are, you know, drunk and, you know, doing stupid things in boats than, than have ever been, you know, drowned by ketamine.

    25. KS

      Yeah.

    26. JS

      I mean, it was not even close.

    27. KS

      Right, right. But this creates a situation where they're trying to bring ketamine and other psychedelics into really good medical uses and then it gets, you know, either glamorized and demonized, both glamorized and demonized by people like, uh, Musk and others. Um, which is, you know, before, it's the cart before the horse 'cause I think they will be using these, um, it's an intriguing drug. Correct? Um, Scott-

    28. JS

      Yes.

  12. 17:29 – 20:16

    Corporate governance and ‘guardrails’: boards, power, and the lack of accountability

    1. KS

      ... what's, what's the responsibility of a board member in this situation? It looks like several board members talked or someone's worried, this is why I can't imagine the Journal would move forward this, uh, you know, Rupert Murdoch and the Murdoch family would move without some level of assurance that they... And I have to tell you, discovery would be fascinating because I don't think, you know, the stories of Elon's wild party life are really quite out there all the time and they just are, they just are.

    2. SG

      It, the governance question here is complicated because supposedly, there was a director who resigned over concerns-

    3. KS

      Yes.

    4. SG

      ... of, of Musk-

    5. KS

      Mm-hmm.... because they weren't doing anything about it.

    6. SG

      But I would argue he doesn't... And this goes to a broader issue here.

    7. KS

      She.

    8. SG

      I, I would argue that he doesn't have any governance, that it's-

    9. KS

      Mm-hmm.

    10. SG

      ... family members and people who have made so much money because of his genius and his bold innovations, that effectively, they have no power. They're there to have dinner once every three months and collect a big check, because his behavior would not be tolerated across anything resembling what you would call a real board of governors who are supposed to represent fiduciaries. They just, they just wouldn't allow it. So, he doesn't have, uh, the- the- the duties, the- the- the duty and care that is levied on fiduciaries in the form of boards of directors does not and has not applied to Elon Musk for a long, long time. The fact that he's still on Twitter, that would never be allowed-

    11. KS

      Mm-hmm.

    12. SG

      ... of a CEO who had done what he has done. A CEO, uh, uh, incorrectly accuses former employees of being pedophiles-

    13. KS

      Mm-hmm.

    14. SG

      ... would never be allowed to be a CEO. He plays by a different set of standards, and whether you think he should be allowed to or not, but it goes to a much broader issue. And I think the key issue here, and what I would describe as the learning or the takeaway for young people, and that is the most important thing you can have in your life is people who love you and serve as guardrails. And to have people idolize you is different than having people who love you, and I think the guy has a lot of the former and not a lot of the latter. And as someone who's participated in interventions, they don't invite powerful, important people to those interventions. They invite people who love you, and th- uh, this is turning into a cautionary tale along the lines of Tony Hsieh, because you have a guy who, as far as I can tell, is living alone, doesn't have a close relationship with a romantic partner or his children, and is, quite frankly, just fucking off the rails. And if- if at the age of 52, you don't have people in your life who can sit you down and you listen to, 'cause you know that it's not that they got rich because of you. It's not because they think you're just so fucking awesome and can land rockets on two surfboards. It's because they just full-stop care about you. If you don't have that, especially men, you- you literally can lose it all.

  13. 20:16 – 21:17

    Long-term heavy ketamine use: organ risks, impaired functioning, and dependence

    1. KS

      What happens with extended use of ketamine? If you use it a lot and there's no guardrails, as Scott says there should be, and I agree, um, what happens over time to your mental state? Or do we not know this? I guess we probably do, right?

    2. JS

      Well, yeah, I mean, there's some research on l- chronic long-term use of ketamine, uh, effects on the liver and on the kidney. I mean, there are, there are, you know, physiologic effects of it-

    3. KS

      Mm-hmm.

    4. JS

      ... which, you know, large, large-scale use of it can be toxic to your liver and kidney. More importantly, I think, though, is that-

    5. KS

      Then what happens then? And-

    6. JS

      Well, you could get... I mean, anything can damage your liver. I mean-

    7. KS

      Mm-hmm.

    8. JS

      ... there's- there's so many, like... Well, alcohol, number one, is the biggest. (laughs)

    9. KS

      Yeah, yeah.

    10. JS

      But, uh, so the- the big problem, I think, with ketamine is, uh, the psychological, as Scott mentioned before, the sk- the psychological dependence on it. And it is a dissociative anesthetic, so you're not gonna behave normally if you're doing high doses of ketamine. It just will make you not functional as a, you know, human being. Uh, you'll be, you know, high and-

  14. 21:17 – 22:51

    Government contracts and security clearance: why the stakes are higher for SpaceX

    1. KS

      And then Scott, uh, Elon also has a lot of government contracts, which was mentioned in the journal article. As CEO and founder of SpaceX, and he's also the key man there, Musk has a security clearance that gives him access to classified information. I think the journal was trying to pin a, like, here's why we're writing this thing. Um, and obviously the government has already, uh, objected when he was doing the weed on Rogan. This is a quantum level of problem, I would think.

    2. SG

      Yeah, but again, he's- he's an exceptional person that people and organizations make exceptions for. So for example, he can put a breakthrough heavy rocket, he can launch it, and it can blow up, and he just puts another one up in a few weeks. NASA could never do that. NASA could never send projectiles into space that blow up. He is willing to take risks and has access to capital such that he can put together communications, um, low orbit communications networks that the government, at least in this current infrastructure or current regulatory environment, isn't able to do. So, he plays a really valuable role, and I- I don't wanna be an apologist for the guy. But to think that he's going to be subject to anything resembling the same standards as other contractors, you might find it unfair, and it is. He- there- there are... (laughs) There are so many things he would have lost all security clearances for, that the government has made exceptions around. He just plays by a different set of rules and- and it- I don't- I- I'm not saying that's right or wrong, but you could never see the head of the Forestry Service or the CIA going on podcasts smoking a joint.

    3. KS

      Yeah.

    4. SG

      That person wouldn't be allowed-

    5. KS

      Or having opinions.

    6. SG

      ... in the government- a government building again.

  15. 22:51 – 26:38

    Predicted fallout and a doctor’s advice: transparency, moderation, and avoiding backlash against treatment

    1. KS

      I think it's... I think it'll be interesting to see how he reacts. So last question for each of you. Scott, how do you think a Musk is gonna react? I haven't seen anything yet.

    2. SG

      I have no ability to predict his actions, Kara. I just don't- I don't understand-

    3. KS

      He'll probably sue them.

    4. SG

      ... um...

    5. KS

      He'll threaten to sue them.

    6. SG

      Yeah, but I- I don't-

    7. KS

      That's his go-to.

    8. SG

      ... I- a- and I think all his fans will come to his- come to his-

    9. KS

      Oh, they have.

    10. SG

      ... defense and say that he's being persecuted and it's bad reporting, but I don't... I, you know... A- actually, uh, when I read that, I felt bad 'cause I- I- I have had some people in my life who have an addiction, and I find they slowly but surely, when you know you've lost them, is when they choose... I remember one of the interventions I was in, uh, one of the most rattling moments I've ever had. Everyone went around, kid was addicted, um, to heroin. Everyone around said their piece, said, "Love you all. Your heart's in the right place. I know this is gonna kill me. I choose heroin." I mean, uh, no one knew what to say. So, uh, if he in fact is... I think he plays an important role. I don't like the man. I think he abuses his power. But as it relates to the government innovation, he does play an important role, and you just gotta hope a guy with 11 or 12 kids like that...... gets help, and you also hope that, uh, uh, the- the right way to react is if, in fact, he is struggling, that he's open about his struggles and people can learn from it. 'Cause I do think a lot of people are fighting these demons in quiet, and- and a guy like that-

    11. KS

      Mm-hmm.

    12. SG

      ... who is literally the idol of- of billions of people, you know, optimistically, you'd like to think he could play a key role in education about it. How he's-

    13. KS

      Yeah.

    14. SG

      ... what he's gonna- actually gonna do, I have no idea. You know him better than I do, Kara.

    15. KS

      Uh, I-

    16. SG

      I'll put it back to you.

    17. KS

      ... I think his tweets have become, uh, I think this article means a lot of people close to him are worried again, as they were last Christmas time, um, uh, when there's a little downtime, and I think that's what it looked like to me when I was- I was like, "Oh, I know who that- who said that." You know what I mean? Like, I could guess. Um, so I think a lot of people are worried, um, and they're worried for a bad outcome in lots of ways, um, not just economically. And maybe this was their way of talking to him? Um, his tweets recently have been pretty unhinged, I- or- or juvenile recently. They're not- they've not been, "I'm spending some time thinking," or anything like that. And so Jeff, that's my last question. If you were e- uh, I know some of his doctors. Um, if you were his doctor, what would you say to him if he were to listen?

    18. JS

      Well, I would say that, you know, any kind of polysubstance abuse, uh, is not necessarily in your best health interests, and, uh, you know, clearly, you don't go around, uh, doing fairly powerful, um, psychoactive medications and drive a car, uh, or fly a plane or buy multi-billion dollar, uh, social media companies. Um, and I think that, um, that's what I would tell him is just, like, you know, like, the old adage, everything in moderation. I mean, uh, th- one thing I just wanna be clear that, you know, your listeners understand that ketamine is not a dangerous drug in the right hands. Uh, but like any drug, it can be misused, and it's a very useful drug, and I would hate to see a drug like ketamine, which is so useful, being demonized, and there'll be government reaction against it, et cetera, et cetera. That would be the worst possible thing that could happen, uh, because it is a very useful medication. But I would just tell him, you know, like, alcoh- I mean, it- the same thing that would- if somebody came in and they were showing signs of alcoholism. I would say, "This is really bad for you, uh, and this is why." You just give them information. He clearly is a very smart man, and, um, you know, you try to appeal to people's reason.

Episode duration: 26:38

Install uListen for AI-powered chat & search across the full episode — Get Full Transcript

Transcript of episode iAk83y0pG2M

Get more out of YouTube videos.

High quality summaries for YouTube videos. Accurate transcripts to search & find moments. Powered by ChatGPT & Claude AI.

iOSAndroidClaudeChrome