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36C3 - Psychedelic Medicine - Hacking Psychiatry?!

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    33C3 musique de préroulement
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    Herald: Ok! Venons-en à la discussion...
    La suivante est Andrea Jungaberle. Elle
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    nous parle des drogues et de comment elles
    affectent la psychiatrie. Quel mot dur !
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    Pourquoi tu ne le fais pas? Je sais
    maintenant. Et la question est, après la—
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    comment dit-on "verbot" en français ?
    Andrea Jungaberle: Prohibition.
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    Herald: Après la prohibition dans les
    années 70. On n'a pas beaucoup réfléchi
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    à comment ces drogues fonctionnent et
    pourraient améliorer la psychiatrie... Et
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    maintenant tout le monde se demande,
    est-ce le remède miracle? Je ne crois pas.
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    Mais plus d'informations sur ce sujet avec
    Andrea. Un accueil chaleureux, svp.
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    Applaudissements
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    Andrea: Bonjour, tout le monde. Je suis
    heureuse d'être ici et pouvoir vous parler
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    d'un sujet qui me tient à cœur et qui est
    très important pour beaucoup de personnes,
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    aujourd'hui et demain. Donc, le sujet est
    la médecine psychédélique, le piratage, la
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    psychiatrie. Et juste pour rappeler la
    chute, ce n'est pas un remède miracle et
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    ça ne le sera jamais. Mais aussi il y a
    beaucoup de choses à savoir et à penser
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    dans ce contexte. J'aimerais vous les
    présenter. Mais d'abord, quelques mots
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    sur moi. Je suis docteur en médecine,
    spécialisée dans l'urgence et les soins
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    intensifs. Je travaille et vis à Berlin.
    Je suis aussi l'un des fondateurs de MIND,
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    la Fondation Européenne pour la Science
    Psychédélique, et actuel directeur médical
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    Juste une phrase de plus. Voici notre
    équipe de base. MIND est une association
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    de membres de Science psychédélique. Nous
    avons 450 membres au niveau mondial et une
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    équipe de 50 personnes. C'est un noyau de
    personnel rémunéré, nombreux volontaires
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    très bons et très dédiés , et de grands
    internes de différentes disciplines, comme
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    les neurosciences, la psychiatrie, la
    psycho/pharmacologie, etc Nous travaillons
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    pour établir la science psychédélique,
    comme une méthode, fondée sur des preuves
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    et informer en Allemagne et autour en
    Europe. Ok, plongeons dans le vif du sujet
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    Les Psychédéliques. Que sont-ils ? Et bien
    le terme vient des Grecs, Psychée et Délos
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    que l'on peut traduire par "manifestation
    de l'esprit par la pensée". Tant de gens
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    parlaient des substances psychoactives
    comme ayant une certaine, capacité de
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    transformer la perception de chacun,
    l'introspection,les qualités sensorielles
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    d'une manière très typique qui est parfois
    décrite comme onirique, mais pas toujours.
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    Les psychédéliques classiques, également
    appelés hallucinogènes, terme qui me
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    déplait car ces drogues ne provoquent pas
    d'hallucinations. Ce qu'ils font, c'est
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    induire de pseudo hallucinations; donc si
    on a prend une substance psychédélique,
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    dans 99% des cas, on est conscient d'avoir
    pris une substance et que ce que l'on
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    ressent est dû à cette substance. C'est
    donc non un hallucinogène, mais un pseudo
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    hallucinogène. Mais ces substances, comme
    les classiques- LSD, psilocybine ou DMT -
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    fonctionnent de manière très spécifique et
    agissent toutes sur le système
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    sérotoninergique. La sérotonine est l'un
    des principaux neurotransmetteurs et il y
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    a un récepteur, le 5-HT2A, qui est le plus
    petit dénominateur commun à toutes ces
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    substances, non qu'elles agissent toutes
    uniquement sur celui-ci, elles affectent
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    toute une pléthore de neuro-transmetteurs
    et de récepteurs. Mais c'est la clé où
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    elles fonctionnent toutes. Il y a d'autres
    substances qui sont classées comme
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    plutôt psychédéliques,comme les
    entactogènes -l'ecstasy ou MDMA par ex.-
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    qui agisent aussi sur le système sérotoni-
    nergique. Les dissociatifs -kétamine,...-
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    agissent plus sur le récepteur NMDA; et
    d'autres sont basiquement des produits
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    chimiques aléatoires, comme l'Amanite
    tue-mouche, la Datura ou la Salvia. Bon.
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    C'est la seule diapositive où je vais vous
    déranger avec ce genre de science dure. Je
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    pense qu'il est important d'être clair sur
    ce sujet car même si les psychédéliques
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    sont un mème de la culture pop, personne
    ne sait rien à leur sujet, à dire vrai. La
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    majorité les associe à des drogues ayant
    la même dangerosité que la méthamphétamine
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    ou les opioïdes. Pense qu'il existe une
    dépendance avec les drogues psychédéliques
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    qui, en fait, n'existe pas. Et c'est le pb
    fondamental de la perception pour beaucoup
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    de gens depuis très longtemps. Les choses
    ont un peu changé récemment. Les psyché-
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    déliques sont devenus la norme. D'abord,
    à cause d'un changement général de la
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    perception des drogues, comme avec le
    cannabis ou un changement des médications.
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    Aussi pk des gens, comme Michael Pollan,
    qui est un auteur mainstream qui écrit sur
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    la cuisine et la nutrition, s'est mis à
    écrire sur les psychédéliques. Et un autre
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    facteur qui a aidé les psychédéliques à sa
    façon et leur a nuit d'une autre est toute
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    cette lubie du microdosage que nous voyons
    dans la scène tech ou développementale, et
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    surtout dans la région de la Baie et à la
    Silicon Valley. Mais d'où viennent-ils ?
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    from? In this talk, I am not going to
    speak about psychedelic, psychoactive
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    substances in other cultural frameworks.
    There are cultures like in the Amazonian
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    basin or some Aztec people in Mexico
    who have been using psychoactive
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    substances, psychedelics, in a very
    ritualized sense for millennia, perhaps,
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    or at least centuries. But this is not us.
    So let's talk about what happened here in
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    Europe or in the Western world, including
    America. This guy up here, sorry, that's
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    the wrong one. The pointer isn't strong
    enough. We'll work like this. This nice
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    guy up here is Albert Hofmann. In 1938, he
    was developing several substances that
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    were supposed to work on atonia and in
    postpartum women, but also on other
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    problems like blood pressure and he,
    among other things, developed the
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    thing that later became LSD. But
    back then, he didn't see any sense in
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    pursuing it medically because it didn't
    work the way he wanted it to and he
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    shelved it. And for some reason in ’43, he
    took it out the shelf again to retest it
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    for other purposes, and accidently gave
    himself the first noted LSD trip. This
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    happened not because he was a shitty
    chemist, but because the amount that is
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    needed to induce an effect is so low as it
    has never been noted before in any other
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    substance. So 20 micrograms of LSD can
    already produce a notable change in
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    perception. So when he came out of that
    experience, this first one he had, after
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    accidentally dosing himself, he decided
    to go for, well, a trial on himself and
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    trying to be safe. He used what he thought
    was a very low dose of the substance he
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    discovered, which turned out to be 250
    micrograms of LSD, which was his… I hear
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    the laughter. It’s rather a high dose
    trip, especially for somebody who just
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    didn't know what was expecting him out
    there in his own mind. And this is the
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    famous bicycle day trip where he rode home
    on his bike thinking that the world was
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    collapsing around him, basically. So even
    this wasn't a nice trip, the first one. So
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    what happened next was that he reported to
    his superiors at Sandoz Chemical in Basel,
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    and they had the idea of turning this
    into a substance for many doctors,
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    psychiatrists, psychologists, to experience
    what it would be like to be psychotic. So
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    its first application of LSD was as a
    psychotomimetic. And as a psychoto-
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    mimetic, thousands of dosages were
    distributed worldwide from the
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    Czech Republic to Harvard University to
    everywhere. And doctors tried it out. What
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    happened then was that a small group of
    young, ambitious psychologists around
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    Timothy Leary tried it out too, and
    thought this is not just something for
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    doctors. This is not just a psychoto-
    mimetic and brought it out basically into,
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    yeah, the real world. And people were
    experimenting with LSD quite a bit in the
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    ’60s before it was forbidden in ’71. Not
    because it turned out to be so dangerous.
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    They were not so many accidents. Not so
    many people had dire side effects. But
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    because the political will to cope with
    the substance and its implications wasn't
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    existent in the Nixon era. So. ’71,
    underground goes into subculture. But the
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    genie was out of the bottle and it was not
    going to go back in. And psychedelics, not
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    only LSD, but also Psilocybin, later on
    MDMA. And these days, more than 500 new
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    psychoactive substances that have been
    brought up on the black market are around
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    us. And people use them. It's a societal
    reality that our juridical system doesn't
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    keep up with, to be fair. So it's been in
    many subcultural setting from people just
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    going dancing and having a good time to
    self-exploration to pseudo-chamanic or
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    chamanic settings. And I think most people
    will at least know somebody who have
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    experienced psychedelics at least once.
    And then something else changed. A few
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    years ago, let’s say, 10-ish, 10 years ago,
    psychedelics started coming back. There
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    had been research, for example, at the
    University of Zürich around psychedelics
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    before that already. There had been trials
    before. But the big comeback of substances
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    like psilocybin, LSD, and MDMA as tools to
    augment psychotherapy was within the last
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    10 or 15 years. So these people up here
    are some of the people worldwide working
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    with these substances, trying to develop
    them into medications. So … not
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    over-the-counter, but prescription
    medications to be applied within the
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    setting of psychotherapy. So the idea is
    never that somebody can walk into a
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    pharmacy saying, oh, I'm depressed, I want
    to buy psilocybin to treat myself, but to
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    have a structured therapeutical session in
    which the effects can be contained and the
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    benefits enhanced. So the ones that are
    most promising these days are psilocybin
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    for depression, which is already heading
    for the third stage, third and final stage
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    of approvement as medication within the USA
    and consecutively hopefully in Europe. And
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    MDMA, so what is used? What people want to
    find if they buy ecstasy, not that they
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    always get it, but MDMA is the substance
    they're trying to get, for post-traumatic
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    stress disorder (PTSD). In the U.S., even
    the Veterans Association has jumped on the
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    bandwagon and has sponsored this research,
    which is interesting at least. But isn't
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    that harmful? Aren't these substances
    very dangerous? Well, not in the way you
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    think and not as much as you might think.
    This graphic up here is something that was
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    put together by a group of 40 experts who
    discussed what substances have what harm
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    on the user and what harm on the people
    around the users. So, for example, alcohol
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    is harmful for the person, giving them a
    liver disorder, making them addicted and
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    so on, so on. But also because people get
    aggressive when they use it or drive
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    dangerously, for example, when they're
    intoxicated, it's dangerous to others. If
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    you check out. I have to walk over here
    now. Sorry to the camera people. The
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    substances we're talking about for
    treatment are not up there with the very
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    dangerous ones. We have the shrooms down
    here, the LSD is there, ecstasy is there.
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    So very low danger to the user and almost
    no danger to other people. If you compare
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    that to alcohol, heroin, tobacco, it's all
    up there. And, to be quite fair, we’re all
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    part of a giant field study anyway. Because
    these substances are being used. This is
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    data from the 2017 Global Drug Survey,
    which is a self-reporting study where
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    people talk about their own drug use
    and fill in forms online. This is not a
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    statistically sound sample of the general
    population because to fill out that trial,
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    you have to have a certain interest. But
    the people that have filled this out—
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    we're talking about a number of
    over 115.000 worldwide—say that
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    they have, in their lifetime, partially
    used LSD. … were the numbers …? MDMA,
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    mushrooms and LSD, so MDMA 35%,
    mushrooms almost 25%, LSD over 22%.
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    And if you look around you, of
    how many people do you know who
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    ended up in an emergency department
    or in a psychiatric ward due to _only_ using
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    those substances? Actually, looking at
    this giant field study that the illegal
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    market has provided us with, it seems to
    be rather safe because these people
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    are not using clear dosages of a clean
    substance and still there's hardly
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    anything happening. OK. But what about
    microdosing? Well. We don't know much
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    about microdosing, in fact. There are no
    scientifically randomized controlled
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    studies, as to yet; the first ones are just
    starting. There are self-reporting studies
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    where people have filled out online forms.
    And it seems to be that what people are on
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    one hand trying to achieve is, yes,
    enhancing creativity, getting better work
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    performance. But a lot of them are trying
    to treat, cure, enhance that latent or
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    apparent depression, and the other thing
    is: microdosing—which is defined mostly as
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    using a very low, almost subliminal dose
    of a psychoactive substance such as LSD—is
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    being done by people with all sorts. There
    are people microdosing MDMA and ibogaine,
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    which is, if you look at the receptor
    profiles, just insane basically and
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    frankly can't do what they hope it does.
    And when we took a look at people who
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    microdose, we can't say how much of
    the effect they’re feeling is really from
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    microdosing that substance or if we have a
    top-notch, first-grade placebo effect going
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    on where people feel much better because
    they have taken this and believe in it.
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    Let's not turn down placebo. Placebo is
    extremely valuable medically. It’s
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    actually shown that placebo effect, for
    example, enhance the endogenous opioid
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    production. So your body revs up towards
    healing, towards feeling better with the
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    placebo effect. But this could also be
    done with a sugar pill. And there's one
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    thing I just want to leave with you in
    this group. If anybody of you is
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    microdosing and has preexisting heart
    condition: don't! Simply because some of
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    the subreceptors, especially with LSD that
    are being activated in prolonged micro
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    dosing for a long time can be cardiotoxic
    and possibly harm your heart. Just again,
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    there's not clear data about this yet.
    Just to leave it with you, if you suffer
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    from a heart condition: don’t!
    Depression. That keyword I had with the
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    microdosing as well. But let's go
    deeper into this, because if we want to
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    talk about how psychedelic medicine can
    really make a difference in psychiatry,
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    depression is like, yeah, the first-line
    thing to think and talk about and why is
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    that? Depression is a very serious
    psychiatric disorder. People who are
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    severely depressed—and that's many people;
    statistically, in Germany, every 8th
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    woman is likely to suffer from a severe
    depressive episode. At one point in their
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    life or the other. People who are
    depressed lose social functioning. They
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    have very decreased life expectancy
    partially through suicide, partially
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    because they don't manage to care for
    themselves. These people lose themselves
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    and are being lost for others, too. And
    there is treatment for depression, yes,
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    but in many cases it only has a limited
    capacity. And even though depression is a
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    worldwide epidemic—with rates from
    3% of the population in China to
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    22% of the population in Afghanistan
    suffering from it—there have not really
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    been new forms of treatment for two, two
    and a half decades‽ So the stuff we're
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    working with is partially working, partly
    not: about one third of patients don't
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    react to the medication at all, even
    though there's different types. And those
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    who do usually have very low rates of
    acceptance because of the side effects.
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    Because many people use antidepressants,
    and the best combination is cognitive
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    behavior therapy—so what is called in
    German “Verhaltenstherapie,” cognitive
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    behavioral therapy—in conjunction with
    antidepressants. That might work, but for
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    some it doesn't. And those who take the
    medication don't feel well. It's not that
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    they're back to normal. They're just less
    depressed. But usually they're like dimmed
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    in on all sides. So they are still not
    getting happy. The libido is decreased.
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    Their activity levels are decreased.
    People are suffering quite a bit from the
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    side effects and it's really not nice. So.
    I was just … just to tell you one
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    little story. I told you I’m an
    emergency medicine doctor. And just
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    to illustrate how bad depression can get:
    A few weeks ago, I was being called out to
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    an attempt of suicide. A woman had jumped
    out of her window on the fourth floor. We
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    found her lying in her yard and she was...
    injured, badly injured, but still alive,
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    and we stabilized her and took her to
    hospital, and when the nurse kind of
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    pulled up her data in the emergency room,
    she went like, oh, no, not again, because
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    this woman had jumped out the same window
    just half a year before. That's how bad
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    this disease can be. So how desperate
    people get and how terribly important it
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    is for us not to look away, but try to
    find better new therapies. And this is, in
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    my opinion, with psychedelic medicine …
    Psychedelic therapy can be a real game
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    changer. The one therapeutic application
    we have the best data for is psychedelics
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    for treatment-resistant depression. There
    are several studies going on in the UK, in
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    the States, and Switzerland, but also in
    the Czech Republic and so on, so on. And
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    what they seem to be finding is that even
    though they're still working with small
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    samples because you have to fan out; if
    you try to bring out a medication like
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    that, you have to show first that it's
    safe with healthy people and then you
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    start with a small sample of sick people
    and then you enlarge it from there. And
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    they’re now in this enlarging process …
    that's treating depression with psilocybin
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    especially does not only decrease
    depression in those patients, but also
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    does one great thing: it decreases
    anxiety! Not only talking about state
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    anxiety, so how anxious people are at this
    very moment in living their lives, but
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    that trait anxiety. So how anxious people
    are as a part of their personality, which
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    is a good thing to gauge how likely people
    are to relapse back into depression,
  • 21:17 - 21:20
    people that are very anxious, very
    insecure about life, are far more likely
  • 21:20 - 21:29
    to relapse. OK, so you see, there's a lot
    happening worldwide studying this, but
  • 21:29 - 21:38
    this is Germany on that. A scientific
    desert. We're in the largest country;
  • 21:38 - 21:42
    It’s also the scientifically perhaps most
    important country when it comes to medical
  • 21:42 - 21:45
    research in Europe. There’s zilch
    happening. There hasn't been a study on
  • 21:45 - 21:51
    psychoactive compounds in this context,
    forever, like 30 years, the last one on
  • 21:51 - 21:56
    entactogens like 20 years ago. But
    studying psychedelic here hasn't happened.
  • 21:56 - 22:08
    And we want to change that. Let’s …
    applause
  • 22:08 - 22:14
    So we as the main foundation had, perhaps,
    let's call it groundbreaking, what a
  • 22:14 - 22:19
    groundbreaking conference this September
    in Berlin at the Charité buildings.
  • 22:19 - 22:24
    We had 600 participants, over 50
    speakers from worldwide, everybody
  • 22:24 - 22:29
    basically, almost everybody who's
    important in this dialog scientifically
  • 22:29 - 22:34
    was around. So from the pharmacology, the
    psychiatrist, the psychologist, the
  • 22:34 - 22:42
    therapist, but also philosophers talking
    about a culture of older sets of mind have
  • 22:42 - 22:46
    been around. And we have been trying to
    bring this to the German public and try to
  • 22:46 - 22:55
    lay groundwork for doing new science in
    Germany. And what's to come next is this.
  • 22:55 - 23:01
    With our P.I., so a principal investigator,
    Gerhard Gründer, who is a
  • 23:01 - 23:09
    new pharmacologist from the University of
    Mannheim ZI. We are about to apply for the
  • 23:09 - 23:16
    1st psilocybin depression study in Germany
    this next year. So in 2020, we're
  • 23:16 - 23:20
    putting in the applications, we've already
    put the first paperwork in, and what we
  • 23:20 - 23:26
    want to do is do a double standard study,
    both at the ZI Mannheim and the
  • 23:26 - 23:30
    Charité Berlin. Those are the two most
    renowned psychiatric research facilities
  • 23:30 - 23:35
    in Germany. And it's a collaboration from
    the ZI, Charité, and the MIND Foundation.
  • 23:35 - 23:41
    Each group contributing their knowledge,
    their capabilities, and their strengths.
  • 23:41 - 23:47
    And what we want to do is this. We
    want to do a double blind, randomized
  • 23:47 - 23:55
    controlled phase IIa study. Big word.
    this basically means that … It’s a
  • 23:55 - 23:59
    top-notch level, internationally acclaimed
    study. This is how these studies need to be
  • 23:59 - 24:04
    done to have any value. So it's double
    blind, meaning that neither the patient
  • 24:04 - 24:10
    nor the therapist know what this patient
    is getting. It's randomized. So this gets
  • 24:10 - 24:15
    assigned without anybody playing around
    with it. And phase II means that it's a
  • 24:15 - 24:21
    safety and efficacy study, so not yet dose
    testing and not yet comparing dosages, but
  • 24:21 - 24:27
    just trying to make sure it works. And we
    are going to do that in a 144 participants
  • 24:27 - 24:33
    sample in total, in two locations, which
    is huge. This will be the second or third
  • 24:33 - 24:37
    biggest sample worldwide doing this. And
    the first one in Germany, as we said and
  • 24:37 - 24:42
    what we are going to test is 25
    milligrams of standardised GMP. So
  • 24:42 - 24:47
    Medical Grade Psilocybin versus two active
    placebos. One being a small dose of
  • 24:47 - 24:52
    psilocybin, which used to be the standard
    thing to do. But now talking about
  • 24:52 - 24:58
    microdosing, what is if the small doses
    already does something? And testing it
  • 24:58 - 25:03
    against another placebo that isn't
    psilocybin, which is: there’s some physical
  • 25:03 - 25:11
    reaction, but is not psychedelic in this
    sense. So in this design, every patient
  • 25:11 - 25:16
    will receive at least one—some two—high
    dosages of psilocybin. So everybody who
  • 25:16 - 25:22
    gets accepted will have his try. And the
    study design consists of preparation
  • 25:22 - 25:27
    sessions, dosing sessions where people
    receive either placebo or psilocybin and
  • 25:27 - 25:33
    integration sessions. Integration is so
    important and not only in a scientific
  • 25:33 - 25:37
    study on this topic, but if people are
    working with psychedelics, experimenting
  • 25:37 - 25:42
    with psychedelics themselves, integration
    is the key to do something with the
  • 25:42 - 25:46
    experience. Because if you don't work with
    it actively, the experience is going to
  • 25:46 - 25:51
    fade. And you might remember something
    about what you learned, but it will not
  • 25:51 - 25:57
    have the impact on you, your life, and how
    you—yeah—benefit from what you've seen
  • 25:57 - 26:03
    and learned in that way. Right. Just one
    more sentence. It's mixed funding, its
  • 26:03 - 26:07
    funding and progress. So we have some
    public money coming in, but we're also
  • 26:07 - 26:13
    looking for donations and investment just
    at the side. And this is almost the end of
  • 26:13 - 26:19
    my talk. What I want to say is the
    following: What we try at the moment
  • 26:19 - 26:25
    is to establish safe and legal psychedelic
    therapies in Germany, Europe, and the
  • 26:25 - 26:30
    world. This is going to take time. If
    things go well, we might be there in five
  • 26:30 - 26:35
    to ten years—five if things go really
    well. And I know that it's very tempting
  • 26:35 - 26:40
    for many people to say: “Well, I can
    just go to somebody and have a
  • 26:40 - 26:45
    psilocybin session. I can go to somebody,
    have an ayahuasca session.” And yes, you
  • 26:45 - 26:49
    can. But be aware if you do that, because
    you're really suffering from psychiatric
  • 26:49 - 26:53
    disease, if you have a mental illness, if
    you really are in distress. Be very
  • 26:53 - 26:57
    careful with yourself, because the thing
    is, you need somebody to really support
  • 26:57 - 27:01
    you, really help you through somebody who
    really knows what they're dealing with,
  • 27:01 - 27:06
    because otherwise you can do yourself more
    harm than good. This picture down there
  • 27:06 - 27:12
    with the ambulance is a real picture.
    Right. That's what I wanted to say.
  • 27:12 - 27:16
    Thank you very much for having me. If
    you're interested in what we're doing,
  • 27:16 - 27:24
    check it out!
    appplause
  • 27:24 - 27:29
    Herald: Andrea, thank you very much.
    That gives us plenty of time for some
  • 27:29 - 27:35
    questions. People are lining up on the
    microphones already. So we start with
  • 27:35 - 27:40
    microphone number two, please.
    Mic 1: Thank you for this amazing talk.
  • 27:40 - 27:44
    That's really great. Just one question.
    Wouldn't that be a problem for a double
  • 27:44 - 27:49
    blind study if a person can surely tell if
    they're experiencing psychedelic effects?
  • 27:49 - 27:55
    Andrea: That is a problem. Yes, but this
    is the way the authorities request the
  • 27:55 - 27:59
    study to be done. And interestingly
    enough, there have been cases where people
  • 27:59 - 28:08
    couldn't tell. If people thought they were
    either on a small dosage or on a high
  • 28:08 - 28:16
    dosage, or even if they where on an
    inactive placebo. Right. So the self…
  • 28:16 - 28:21
    Yeah, self-suggestive capabilities of
    people should not be underestimated
  • 28:21 - 28:24
    either.
    Herald: Okay, then we're going to jump
  • 28:24 - 28:28
    over to number six.
    Mic 6: Thank you very much for the
  • 28:28 - 28:37
    talk. I would like to hear your opinion on
    the fact that, uh, like in the last 150
  • 28:37 - 28:47
    years, most drug agents were discovered
    in Germany, and meanwhile, we have
  • 28:47 - 28:54
    the pity of scientifically Germany
    lying in Arizona.
  • 28:54 - 29:06
    laughter
    Andrea: Right. Germany has two points that
  • 29:06 - 29:13
    historically hold us back. One is the
    forced human trials during the Nazi era
  • 29:13 - 29:19
    where substances, techniques, were tested on
    concentration camp prisoners. And we have
  • 29:19 - 29:27
    the Contergan scandal that harmed so many
    people and led to, in all of the world,
  • 29:27 - 29:35
    the stricter rules we have now. That's two
    reasons why Germany is so reluctant to
  • 29:35 - 29:42
    expose itself in this kind of process. But
    still, it is a pity. And I think it is
  • 29:42 - 29:46
    about time that the German not only
    government, but also the scientific
  • 29:46 - 29:53
    establishment gets to understand that they
    lose out and they are trading behind a
  • 29:53 - 29:58
    development that has
    started and will continue.
  • 29:58 - 30:02
    Herald: And now we have a question
    from the Internet, I hear.
  • 30:02 - 30:07
    Signal Angel: Yes! For people
    struggling with depression, anxiety, or
  • 30:07 - 30:12
    mental illnesses: What specific options
    are there in Europe with regards to
  • 30:12 - 30:18
    psychedelic-assisted therapy?
    Andrea: Well, one is that you can try to
  • 30:18 - 30:23
    participate in the existing trial. So, for
    example, in London, there's Kings College
  • 30:23 - 30:28
    and Imperial College, there's a group in
    Bristol working, there's also therapy
  • 30:28 - 30:35
    happening in Switzerland and so on. And
    there's also, if you happen to be lucky
  • 30:35 - 30:38
    enough to live in Switzerland, there's the
    so-called compassionate use where
  • 30:38 - 30:44
    psychiatrists with special permits are
    allowed to use LSD and MDMA as therapeutic
  • 30:44 - 30:49
    agents on a case-to-case basis that they
    have to discuss with the authorities.
  • 30:49 - 30:54
    So that's all we can say for now:
    study participation or compassionate use.
  • 30:54 - 30:57
    We just really hope that
    things will rev up and we'll be able
  • 30:57 - 31:02
    to offer more in the future.
    Herald: And microphone number 4, please.
  • 31:02 - 31:05
    Mic 4: Yeah. Hello. Thank you
    very much for your talk.
  • 31:05 - 31:10
    My question is more related to
    the history of the uses of psychedelics
  • 31:10 - 31:18
    in the US and to the MAPS Association
    founded by Rick Doblin, but I was curious,
  • 31:18 - 31:26
    how would you explain that MAPS is so
    actively criticizing the experiments led
  • 31:26 - 31:36
    in the 1950s and ’60s by the CIA, and yet
    they accept donations of several million
  • 31:36 - 31:42
    dollars coming from the Mercer family, who
    are among the largest shareholders of
  • 31:42 - 31:48
    Cambridge Analytica, Breitbart News, and
    they also accept, they accepted recently
  • 31:48 - 31:54
    about three millions from members of Tea
    Party. Isn't it a bit of an irony here?
  • 31:54 - 32:03
    applause
    Andrea: That is a very good question. The
  • 32:03 - 32:11
    way I know Rick Doblin and many people
    from MAPS personally, I know that they're
  • 32:11 - 32:17
    pursuing an honest goal. What they’re
    trying to do is bring this into the world
  • 32:17 - 32:23
    and they have been doing that since 1986.
    So they've been on this for almost 35
  • 32:23 - 32:28
    years. He's dedicated his life to doing
    that. I don't fully understand his
  • 32:28 - 32:33
    motives. I don't have to, to be honest,
    because I'm not speaking for him. I think
  • 32:33 - 32:40
    there is a huge necessity for integrity
    because if we don't—as people working
  • 32:40 - 32:46
    with it scientifically—if we don't move
    along with the necessary integrity, we're
  • 32:46 - 32:52
    opening the doors for other people to
    don't care at all. But on the other hand,
  • 32:52 - 32:57
    finding the money, getting this done and a
    lot … he was … Rick was criticized a lot,
  • 32:57 - 33:04
    for example, for accepting veterans;
    snipers from Iraq into his therapy
  • 33:04 - 33:08
    program. Like, okay, are you not getting
    people fit again to go out back to the
  • 33:08 - 33:16
    battlefield? And I find this all very
    difficult because there is a thing that is
  • 33:16 - 33:21
    called perpetrated PTSD. There is a thing
    of people only realizing afterwards what
  • 33:21 - 33:27
    they have done. And I would not … I
    would be very careful in judging people in
  • 33:27 - 33:33
    distress. But you're very right. It's a
    very delicate topic. And I think we all
  • 33:33 - 33:37
    have to be very aware that there are thin
    paths we are threading in what we're
  • 33:37 - 33:41
    doing there. When we accept money that
    comes from sources that don't follow
  • 33:41 - 33:45
    ethical standards.
    Herald: Then we're going to switch over to
  • 33:45 - 33:50
    microphone number five.
    Mic 5: Hello, I guess you have a really
  • 33:50 - 33:56
    nice answer to the following statement. So
    I hope you will share your answer:
  • 33:56 - 34:02
    Little Greta twittered today that the
    house is on fire and just that. So
  • 34:02 - 34:08
    actually that means an adequate reaction
    would be to jump out of the window. So you
  • 34:08 - 34:12
    could argue that actually we should rescue
    all the people that are really down, like
  • 34:12 - 34:17
    down and out, because they cannot help us
    anymore. But actually, we should get the
  • 34:17 - 34:22
    people that are still happy to be a little
    depressed instead of all getting them
  • 34:22 - 34:31
    happy. What do you say?
    Andrea: There's always two ways of dealing
  • 34:31 - 34:40
    with a system: You can step out of it,
    and you can try to change it from within.
  • 34:40 - 34:47
    It is always very difficult to go from
    caring for the individual to things that
  • 34:47 - 34:54
    are right for all. And me being a doctor,
    for example, I have simply decided to put
  • 34:54 - 34:59
    the individual in the center of my
    concern, and I think others need to put
  • 34:59 - 35:04
    the greater good in the center of their
    concern. I think it's inconsolable. We
  • 35:04 - 35:08
    can't do both at the same time. So it's
    good to make your decision and do this
  • 35:08 - 35:12
    what you do with all your heart.
    Herald: Then we're going to switch over to
  • 35:12 - 35:16
    the Internet again.
    Signal Angel: Yes. And do you know of any
  • 35:16 - 35:21
    studies or evidence corroborating the
    other side, like triggering mental
  • 35:21 - 35:27
    illnesses by using psychedelics, for
    example, if you have a family history of …?
  • 35:27 - 35:32
    Andrea: Well, doing a randomized,
    controlled study with that would be
  • 35:32 - 35:38
    unethical. So what we have is the
    epidemiological and the anecdotal
  • 35:38 - 35:44
    evidence that is found. So, yes,
    if you have a predisposition for
  • 35:44 - 35:50
    psychosis, for schizophrenia, for mental
    instability, there is a large chance of
  • 35:50 - 35:55
    triggering that if you use psychedelics.
    But on the other hand, many people try to
  • 35:55 - 35:59
    self-medicate with substances, be it
    psychedelics or cannabis, because they're
  • 35:59 - 36:04
    feeling they're already on the edge of
    some instability. But the current paradigm
  • 36:04 - 36:09
    for the studies is to exclude people
    whose direct family is affected by
  • 36:09 - 36:13
    psychosis.
    Herald: Number two just disappeared, so
  • 36:13 - 36:19
    we're gonna go straight over to four.
    Mic 4: I would like to ask you whether you
  • 36:19 - 36:23
    changed your mind about anything related
    to psychedelics in last few years or if
  • 36:23 - 36:33
    you have seen something in the
    research that really surprised you?
  • 36:33 - 36:44
    Andrea: Let’s … Well, I am worried. In a
    few respects. Like, for example, the whole
  • 36:44 - 36:52
    development around the 5-MeO scene, people
    using bufo alvarius toxins for very, very strong
  • 36:52 - 36:56
    psychedelic experiences, sometimes risking
    their live doing it. This whole scene
  • 36:56 - 37:01
    kind of lifting from the ground and going
    in a very strange direction, in my
  • 37:01 - 37:05
    opinion. This is kind of worrying me
    because I think people are not taking the
  • 37:05 - 37:12
    care they should be taking of themselves
    in what they are doing. But otherwise, I
  • 37:12 - 37:16
    think scientific results we're seeing are
    rather consistent. It's very important to
  • 37:16 - 37:21
    know that these are not magic bullets and
    not expect too much. You can’t expect
  • 37:21 - 37:26
    something to cure everything. And
    psychedelics seem to be a good idea
  • 37:26 - 37:31
    for people who are rigid, transfixed, not
    able to transcend something. But people
  • 37:31 - 37:35
    who are already like in a chaotic state
    are very unlikely to benefit. And I think
  • 37:35 - 37:38
    that's a very good basic rule. And
    this is something I see proven
  • 37:38 - 37:42
    time and time again.
    Herald: Number five, please.
  • 37:42 - 37:47
    Mic 5: Hi, thanks. Regarding certain
    setting and how it can have such a huge
  • 37:47 - 37:53
    influence on one's experience, can you
    comment on the setting of the new
  • 37:53 - 37:58
    psilocybin study in the upcoming year?
    Andrea: Like all the studies that are
  • 37:58 - 38:03
    being ta… being done, certain settings
    are being taken into consideration. These
  • 38:03 - 38:10
    people don't trip in a sterile white
    hospital bed. They get to have their
  • 38:10 - 38:14
    psychedelic experience in a warm,
    comfortable, organic, welcoming
  • 38:14 - 38:22
    environment. For example, on a couch with
    a nice cushion, nice dim light, flowers,
  • 38:22 - 38:27
    music is extremely important. There have
    been released scientific works around what
  • 38:27 - 38:31
    kind of music is beneficial for those.
    Mendel Kaelen, for example, at Imperial
  • 38:31 - 38:36
    College is a specialist in this kind of
    music and is being taken very seriously.
  • 38:36 - 38:43
    Also, those questions of how much physical
    contact is beneficial, is allowed. What
  • 38:43 - 38:48
    could harm the patient is discussed very
    precisely in all those groups I know,
  • 38:48 - 38:52
    because this is so much more than just a
    pill. This is really about making sure
  • 38:52 - 38:59
    that people have a safe experience where
    they can, yeah, come to healing inside
  • 38:59 - 39:01
    themselves
    Mic 5: Thank you.
  • 39:01 - 39:06
    Herald: So we have time for one more
    question. Number one, please.
  • 39:06 - 39:10
    Mic 1: I don't know if I want to hear the
    answer, but do you think it would help
  • 39:10 - 39:17
    your cause if you would stop
    take these drugs for fun?
  • 39:17 - 39:26
    Andrea: My answer to this is the
    following: Imagine there was a food
  • 39:26 - 39:33
    thing, something that tasted nice; let’s
    say chocolate and there were people
  • 39:33 - 39:38
    who could only survive if they got
    chocolate. But because everybody else was
  • 39:38 - 39:42
    doing it too, and it was somehow
    not okay, it would be forbidden for
  • 39:42 - 39:48
    everybody. Then I would say, well if you
    replace chocolate with LSD, I think there
  • 39:48 - 39:53
    are people there who really need it. And
    we have to be careful that recreational
  • 39:53 - 39:59
    use and playing around with drugs doesn't
    spoil their chance to something lifesaving
  • 39:59 - 40:04
    because they need the chocolate. You might
    get along without, but it's something we
  • 40:04 - 40:09
    have to take into consideration. This
    doesn't mean it's wrong to have psychedelic
  • 40:09 - 40:13
    experience for your own benefit, for your
    own betterment, for your own fun. But just
  • 40:13 - 40:17
    keep in mind, if you're hindering with
    your wanting to have a good time that
  • 40:17 - 40:23
    somebody gets a life-saving therapy,
    perhaps, then this is an ethical problem
  • 40:23 - 40:29
    we are facing.
    Herald: Andrea, thank you so much.
  • 40:29 - 40:32
    That's your applause.
    applause
  • 40:32 - 40:38
    36c3 rollout music
  • 40:38 - 40:59
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Title:
36C3 - Psychedelic Medicine - Hacking Psychiatry?!
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