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36C3 preroll music
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Herald: OK! Let’s come to the talk. So,[br]next up is Andrea Jungaberle. She is
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talking about drugs and how drugs affect[br]the psychiatry. Oh, that is a hard word.
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Why don't you do it, huh? I know now. [br]And the question is, after the—what
0:00:43.700,0:00:46.600
is “Verbot” in English?[br]Andrea Jungaberle: Prohibition.
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Herald: Prohibition right, after the[br]prohibition in the ’70s, not much thinking
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about how these drugs work and how could[br]they improve psychiatry, has been done, so
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now everybody’s asking, is this the magic[br]bullet cure? I don’t believe so. But more
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about this by Andrea.[br]Well, warm welcome, please.
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applause
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Andrea: So hello, everybody. I'm very[br]happy to be here and able to talk to you
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on a topic that is very important to me[br]and I think very important to many people
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now and in the future. So the topic today[br]is psychedelic medicine, hacking,
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psychiatry. And just to give away the[br]punchline, it's not a magic bullet and
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will never be. But on the other hand,[br]there are lots of things to know and think
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about in this context that I would like[br]to introduce you to. But first, a few
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words about myself. I'm a medical doctor,[br]specialized in emergency medicine /
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intensive care. I work and live in Berlin.[br]And I'm also one of the founders of MIND,
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the European Foundation for Psychedelic[br]Science, and its current medical director.
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One more sentence about us. That's our[br]core team. So MIND is a members-based
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Psychedelic Science Association. We[br]have run 450 members worldwide and a core
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team of about 50 people. That is a nucleus[br]of paid staff, lots of very dedicated,
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very good volunteers and great interns[br]from different disciplines like the
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neurosciences, psychiatry, psychology, and[br]pharmacology, for example. So we work to
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establish psychedelic science as an[br]evidence-based method and also educate
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about it in Germany and Europe around it.[br]Okay, but let's dive in at the deep end.
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Psychedelics. What are psychedelics? Well,[br]the term comes from the Greek Psyche
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Delos, which could be translated as[br]“manifesting the mind of the psyche.” So
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many were talking about psychoactive[br]substances with a certain, well, capability
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of transforming one's perception,[br]introspection, sensory qualities in a very
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typical way that is sometimes described as[br]dreamlike, but not necessarily so. The
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classic psychedelics that are also called[br]hallucinogens, which I don't like as a
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term because they don't induce[br]hallucinations. What they do is induce
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pseudo-hallucinations; so somebody on a[br]psychedelic substance, usually in 99%
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of the time is aware that they have[br]taken a substance and what they're
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experiencing is due to the substance. So[br]it's not a hallucinogen, but a pseudo-
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hallucinogen. But these substances, like[br]the classics—LSD, psilocybin, or DMT—
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function in a very specific way and they all[br]are working on the serotoninergic system.
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So serotonin is one of the key[br]neurotransmitters and there's one receptor
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which is the 5-HT2A receptor, which is,[br]like, the smallest common denominator of
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all those substances, which doesn't say[br]that they all work just on this one, but
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they affect a whole plethora of[br]neurotransmitters and receptors. But this
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is the key where they all work. There are[br]other substances that are classified as
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somehow psychedelic, like the[br]entactogens—ecstasy, MDMA is one of the
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kind—which works also on the serotonin[br]system. Dissociatives, like ketamine,
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work more on the NMDA receptor and some[br]others; they are just basically chemical
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random, like Amanita, which is the Fly[br]Agaric Mushroom, or Datura, or Salvia. OK.
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This is the only slide I'm going to bother[br]you with this dry kind of science. But I
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think it's important to be clear about[br]this because even though psychedelics are
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a pop cultural meme, hardly anybody knows[br]anything about it, to be honest. Most
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people associate them with being drugs of[br]the same danger profile as methamphetamine
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or opioids. Think there is an addiction[br]factor which in fact does not exist with
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classic psychedelics. And basically it has[br]been the dirty corner of perception for
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many people for a very long time. Recently,[br]things have changed a bit. Psychedelics
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have come mainstream. Firstly, because[br]there is a perception shift on drugs in
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general due to the cannabis perception and[br]medication changing. And also because
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people like, for example, Michael Pollan,[br]who's a classic mainstream author writing
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on cooking and nutrition, have turned to[br]writing about psychedelics. And another
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factor that has helped psychedelics in one[br]way and harmed them and another is the
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whole microdosing craze we have seen,[br]especially in the tech and developmental
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scenes, and especially in the Bay Area and[br]Silicon Valley. OK, but where do they come
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from? In this talk, I am not going to[br]speak about psychedelic, psychoactive
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substances in other cultural frameworks.[br]There are cultures like in the Amazonian
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basin or some Aztec people in Mexico[br]who have been using psychoactive
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substances, psychedelics, in a very[br]ritualized sense for millennia, perhaps,
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or at least centuries. But this is not us.[br]So let's talk about what happened here in
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Europe or in the Western world, including[br]America. This guy up here, sorry, that's
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the wrong one. The pointer isn't strong[br]enough. We'll work like this. This nice
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guy up here is Albert Hofmann. In 1938, he[br]was developing several substances that
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were supposed to work on atonia and in[br]postpartum women, but also on other
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problems like blood pressure and he, [br]among other things, developed the
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thing that later became LSD. But[br]back then, he didn't see any sense in
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pursuing it medically because it didn't[br]work the way he wanted it to and he
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shelved it. And for some reason in ’43, he[br]took it out the shelf again to retest it
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for other purposes, and accidently gave[br]himself the first noted LSD trip. This
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happened not because he was a shitty[br]chemist, but because the amount that is
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needed to induce an effect is so low as it[br]has never been noted before in any other
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substance. So 20 micrograms of LSD can[br]already produce a notable change in
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perception. So when he came out of that[br]experience, this first one he had, after
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accidentally dosing himself, he decided[br]to go for, well, a trial on himself and
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trying to be safe. He used what he thought[br]was a very low dose of the substance he
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discovered, which turned out to be 250[br]micrograms of LSD, which was his… I hear
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the laughter. It’s rather a high dose[br]trip, especially for somebody who just
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didn't know what was expecting him out[br]there in his own mind. And this is the
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famous bicycle day trip where he rode home[br]on his bike thinking that the world was
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collapsing around him, basically. So even[br]this wasn't a nice trip, the first one. So
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what happened next was that he reported to[br]his superiors at Sandoz Chemical in Basel,
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and they had the idea of turning this[br]into a substance for many doctors,
0:08:06.400,0:08:13.000
psychiatrists, psychologists, to experience[br]what it would be like to be psychotic. So
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its first application of LSD was as a[br]psychotomimetic. And as a psychoto-
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mimetic, thousands of dosages were[br]distributed worldwide from the
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Czech Republic to Harvard University to[br]everywhere. And doctors tried it out. What
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happened then was that a small group of[br]young, ambitious psychologists around
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Timothy Leary tried it out too, and[br]thought this is not just something for
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doctors. This is not just a psychoto-[br]mimetic and brought it out basically into,
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yeah, the real world. And people were[br]experimenting with LSD quite a bit in the
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’60s before it was forbidden in ’71. Not[br]because it turned out to be so dangerous.
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They were not so many accidents. Not so[br]many people had dire side effects. But
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because the political will to cope with[br]the substance and its implications wasn't
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existent in the Nixon era. So. ’71,[br]underground goes into subculture. But the
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genie was out of the bottle and it was not[br]going to go back in. And psychedelics, not
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only LSD, but also Psilocybin, later on[br]MDMA. And these days, more than 500 new
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psychoactive substances that have been[br]brought up on the black market are around
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us. And people use them. It's a societal[br]reality that our juridical system doesn't
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keep up with, to be fair. So it's been in[br]many subcultural setting from people just
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going dancing and having a good time to[br]self-exploration to pseudo-chamanic or
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chamanic settings. And I think most people[br]will at least know somebody who have
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experienced psychedelics at least once.[br]And then something else changed. A few
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years ago, let’s say, 10-ish, 10 years ago,[br]psychedelics started coming back. There
0:10:08.270,0:10:13.950
had been research, for example, at the[br]University of Zürich around psychedelics
0:10:13.950,0:10:20.580
before that already. There had been trials[br]before. But the big comeback of substances
0:10:20.580,0:10:29.230
like psilocybin, LSD, and MDMA as tools to[br]augment psychotherapy was within the last
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10 or 15 years. So these people up here[br]are some of the people worldwide working
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with these substances, trying to develop[br]them into medications. So … not
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over-the-counter, but prescription[br]medications to be applied within the
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setting of psychotherapy. So the idea is[br]never that somebody can walk into a
0:10:50.510,0:10:54.790
pharmacy saying, oh, I'm depressed, I want[br]to buy psilocybin to treat myself, but to
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have a structured therapeutical session in[br]which the effects can be contained and the
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benefits enhanced. So the ones that are[br]most promising these days are psilocybin
0:11:06.060,0:11:11.050
for depression, which is already heading[br]for the third stage, third and final stage
0:11:11.050,0:11:17.388
of approvement as medication within the USA[br]and consecutively hopefully in Europe. And
0:11:17.388,0:11:23.279
MDMA, so what is used? What people want to[br]find if they buy ecstasy, not that they
0:11:23.279,0:11:27.220
always get it, but MDMA is the substance[br]they're trying to get, for post-traumatic
0:11:27.220,0:11:31.920
stress disorder (PTSD). In the U.S., even[br]the Veterans Association has jumped on the
0:11:31.920,0:11:37.800
bandwagon and has sponsored this research,[br]which is interesting at least. But isn't
0:11:37.800,0:11:45.930
that harmful? Aren't these substances[br]very dangerous? Well, not in the way you
0:11:45.930,0:11:51.480
think and not as much as you might think.[br]This graphic up here is something that was
0:11:51.480,0:11:56.950
put together by a group of 40 experts who[br]discussed what substances have what harm
0:11:56.950,0:12:03.610
on the user and what harm on the people[br]around the users. So, for example, alcohol
0:12:03.610,0:12:09.100
is harmful for the person, giving them a[br]liver disorder, making them addicted and
0:12:09.100,0:12:14.220
so on, so on. But also because people get[br]aggressive when they use it or drive
0:12:14.220,0:12:18.530
dangerously, for example, when they're[br]intoxicated, it's dangerous to others. If
0:12:18.530,0:12:24.250
you check out. I have to walk over here[br]now. Sorry to the camera people. The
0:12:24.250,0:12:27.800
substances we're talking about for[br]treatment are not up there with the very
0:12:27.800,0:12:32.010
dangerous ones. We have the shrooms down[br]here, the LSD is there, ecstasy is there.
0:12:32.010,0:12:39.250
So very low danger to the user and almost[br]no danger to other people. If you compare
0:12:39.250,0:12:47.880
that to alcohol, heroin, tobacco, it's all[br]up there. And, to be quite fair, we’re all
0:12:47.880,0:12:53.980
part of a giant field study anyway. Because[br]these substances are being used. This is
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data from the 2017 Global Drug Survey,[br]which is a self-reporting study where
0:12:58.790,0:13:04.630
people talk about their own drug use[br]and fill in forms online. This is not a
0:13:04.630,0:13:09.490
statistically sound sample of the general[br]population because to fill out that trial,
0:13:09.490,0:13:13.600
you have to have a certain interest. But[br]the people that have filled this out—
0:13:13.600,0:13:20.880
we're talking about a number of [br]over 115.000 worldwide—say that
0:13:20.880,0:13:29.020
they have, in their lifetime, partially [br]used LSD. … were the numbers …? MDMA,
0:13:29.020,0:13:37.051
mushrooms and LSD, so MDMA 35%, [br]mushrooms almost 25%, LSD over 22%.
0:13:37.051,0:13:41.130
And if you look around you, of[br]how many people do you know who
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ended up in an emergency department[br]or in a psychiatric ward due to _only_ using
0:13:45.660,0:13:51.190
those substances? Actually, looking at[br]this giant field study that the illegal
0:13:51.190,0:13:56.430
market has provided us with, it seems to[br]be rather safe because these people
0:13:56.430,0:14:02.180
are not using clear dosages of a clean[br]substance and still there's hardly
0:14:02.180,0:14:18.089
anything happening. OK. But what about[br]microdosing? Well. We don't know much
0:14:18.089,0:14:25.330
about microdosing, in fact. There are no[br]scientifically randomized controlled
0:14:25.330,0:14:31.620
studies, as to yet; the first ones are just[br]starting. There are self-reporting studies
0:14:31.620,0:14:37.780
where people have filled out online forms.[br]And it seems to be that what people are on
0:14:37.780,0:14:43.730
one hand trying to achieve is, yes,[br]enhancing creativity, getting better work
0:14:43.730,0:14:52.300
performance. But a lot of them are trying[br]to treat, cure, enhance that latent or
0:14:52.300,0:15:01.750
apparent depression, and the other thing[br]is: microdosing—which is defined mostly as
0:15:01.750,0:15:09.120
using a very low, almost subliminal dose[br]of a psychoactive substance such as LSD—is
0:15:09.120,0:15:13.740
being done by people with all sorts. There[br]are people microdosing MDMA and ibogaine,
0:15:13.740,0:15:17.720
which is, if you look at the receptor[br]profiles, just insane basically and
0:15:17.720,0:15:24.770
frankly can't do what they hope it does.[br]And when we took a look at people who
0:15:24.770,0:15:31.070
microdose, we can't say how much of[br]the effect they’re feeling is really from
0:15:31.070,0:15:37.450
microdosing that substance or if we have a[br]top-notch, first-grade placebo effect going
0:15:37.450,0:15:43.160
on where people feel much better because[br]they have taken this and believe in it.
0:15:43.160,0:15:49.959
Let's not turn down placebo. Placebo is[br]extremely valuable medically. It’s
0:15:49.959,0:15:54.940
actually shown that placebo effect, for[br]example, enhance the endogenous opioid
0:15:54.940,0:16:00.290
production. So your body revs up towards[br]healing, towards feeling better with the
0:16:00.290,0:16:05.740
placebo effect. But this could also be[br]done with a sugar pill. And there's one
0:16:05.740,0:16:09.450
thing I just want to leave with you in[br]this group. If anybody of you is
0:16:09.450,0:16:16.620
microdosing and has preexisting heart[br]condition: don't! Simply because some of
0:16:16.620,0:16:20.560
the subreceptors, especially with LSD that[br]are being activated in prolonged micro
0:16:20.560,0:16:28.180
dosing for a long time can be cardiotoxic[br]and possibly harm your heart. Just again,
0:16:28.180,0:16:32.140
there's not clear data about this yet.[br]Just to leave it with you, if you suffer
0:16:32.140,0:16:37.700
from a heart condition: don’t![br]Depression. That keyword I had with the
0:16:37.700,0:16:42.430
microdosing as well. But let's go[br]deeper into this, because if we want to
0:16:42.430,0:16:49.160
talk about how psychedelic medicine can[br]really make a difference in psychiatry,
0:16:49.160,0:16:56.839
depression is like, yeah, the first-line[br]thing to think and talk about and why is
0:16:56.839,0:17:04.100
that? Depression is a very serious[br]psychiatric disorder. People who are
0:17:04.100,0:17:09.049
severely depressed—and that's many people;[br]statistically, in Germany, every 8th
0:17:09.049,0:17:13.789
woman is likely to suffer from a severe[br]depressive episode. At one point in their
0:17:13.789,0:17:20.180
life or the other. People who are[br]depressed lose social functioning. They
0:17:20.180,0:17:24.899
have very decreased life expectancy[br]partially through suicide, partially
0:17:24.899,0:17:28.790
because they don't manage to care for[br]themselves. These people lose themselves
0:17:28.790,0:17:35.990
and are being lost for others, too. And[br]there is treatment for depression, yes,
0:17:35.990,0:17:42.380
but in many cases it only has a limited[br]capacity. And even though depression is a
0:17:42.380,0:17:49.180
worldwide epidemic—with rates from [br]3% of the population in China to
0:17:49.180,0:17:54.210
22% of the population in Afghanistan[br]suffering from it—there have not really
0:17:54.210,0:17:59.809
been new forms of treatment for two, two[br]and a half decades‽ So the stuff we're
0:17:59.809,0:18:05.160
working with is partially working, partly[br]not: about one third of patients don't
0:18:05.160,0:18:10.750
react to the medication at all, even[br]though there's different types. And those
0:18:10.750,0:18:16.670
who do usually have very low rates of[br]acceptance because of the side effects.
0:18:16.670,0:18:21.130
Because many people use antidepressants,[br]and the best combination is cognitive
0:18:21.130,0:18:24.910
behavior therapy—so what is called in[br]German “Verhaltenstherapie,” cognitive
0:18:24.910,0:18:32.860
behavioral therapy—in conjunction with[br]antidepressants. That might work, but for
0:18:32.860,0:18:38.135
some it doesn't. And those who take the[br]medication don't feel well. It's not that
0:18:38.135,0:18:42.170
they're back to normal. They're just less[br]depressed. But usually they're like dimmed
0:18:42.170,0:18:46.249
in on all sides. So they are still not[br]getting happy. The libido is decreased.
0:18:46.249,0:18:49.910
Their activity levels are decreased.[br]People are suffering quite a bit from the
0:18:49.910,0:19:00.910
side effects and it's really not nice. So.[br]I was just … just to tell you one
0:19:00.910,0:19:05.549
little story. I told you I’m an[br]emergency medicine doctor. And just
0:19:05.549,0:19:14.040
to illustrate how bad depression can get:[br]A few weeks ago, I was being called out to
0:19:14.040,0:19:20.380
an attempt of suicide. A woman had jumped[br]out of her window on the fourth floor. We
0:19:20.380,0:19:27.670
found her lying in her yard and she was...[br]injured, badly injured, but still alive,
0:19:27.670,0:19:34.530
and we stabilized her and took her to[br]hospital, and when the nurse kind of
0:19:34.530,0:19:40.270
pulled up her data in the emergency room,[br]she went like, oh, no, not again, because
0:19:40.270,0:19:46.570
this woman had jumped out the same window[br]just half a year before. That's how bad
0:19:46.570,0:19:54.110
this disease can be. So how desperate[br]people get and how terribly important it
0:19:54.110,0:19:59.950
is for us not to look away, but try to[br]find better new therapies. And this is, in
0:19:59.950,0:20:04.070
my opinion, with psychedelic medicine …[br]Psychedelic therapy can be a real game
0:20:04.070,0:20:12.200
changer. The one therapeutic application[br]we have the best data for is psychedelics
0:20:12.200,0:20:17.450
for treatment-resistant depression. There[br]are several studies going on in the UK, in
0:20:17.450,0:20:23.640
the States, and Switzerland, but also in[br]the Czech Republic and so on, so on. And
0:20:23.640,0:20:27.510
what they seem to be finding is that even[br]though they're still working with small
0:20:27.510,0:20:32.830
samples because you have to fan out; if[br]you try to bring out a medication like
0:20:32.830,0:20:37.180
that, you have to show first that it's[br]safe with healthy people and then you
0:20:37.180,0:20:41.016
start with a small sample of sick people[br]and then you enlarge it from there. And
0:20:41.016,0:20:47.980
they’re now in this enlarging process …[br]that's treating depression with psilocybin
0:20:47.980,0:20:53.260
especially does not only decrease[br]depression in those patients, but also
0:20:53.260,0:20:58.790
does one great thing: it decreases[br]anxiety! Not only talking about state
0:20:58.790,0:21:04.500
anxiety, so how anxious people are at this[br]very moment in living their lives, but
0:21:04.500,0:21:09.990
that trait anxiety. So how anxious people[br]are as a part of their personality, which
0:21:09.990,0:21:16.930
is a good thing to gauge how likely people[br]are to relapse back into depression,
0:21:16.930,0:21:20.500
people that are very anxious, very[br]insecure about life, are far more likely
0:21:20.500,0:21:29.270
to relapse. OK, so you see, there's a lot[br]happening worldwide studying this, but
0:21:29.270,0:21:37.580
this is Germany on that. A scientific[br]desert. We're in the largest country;
0:21:37.580,0:21:41.710
It’s also the scientifically perhaps most[br]important country when it comes to medical
0:21:41.710,0:21:45.290
research in Europe. There’s zilch[br]happening. There hasn't been a study on
0:21:45.290,0:21:50.532
psychoactive compounds in this context,[br]forever, like 30 years, the last one on
0:21:50.532,0:21:56.169
entactogens like 20 years ago. But[br]studying psychedelic here hasn't happened.
0:21:56.169,0:22:08.279
And we want to change that. Let’s …[br]applause
0:22:08.279,0:22:14.140
So we as the main foundation had, perhaps,[br]let's call it groundbreaking, what a
0:22:14.140,0:22:19.090
groundbreaking conference this September[br]in Berlin at the Charité buildings.
0:22:19.090,0:22:23.770
We had 600 participants, over 50[br]speakers from worldwide, everybody
0:22:23.770,0:22:29.470
basically, almost everybody who's[br]important in this dialog scientifically
0:22:29.470,0:22:33.990
was around. So from the pharmacology, the[br]psychiatrist, the psychologist, the
0:22:33.990,0:22:41.580
therapist, but also philosophers talking[br]about a culture of older sets of mind have
0:22:41.580,0:22:46.049
been around. And we have been trying to[br]bring this to the German public and try to
0:22:46.049,0:22:55.320
lay groundwork for doing new science in[br]Germany. And what's to come next is this.
0:22:55.320,0:23:01.260
With our P.I., so a principal investigator,[br]Gerhard Gründer, who is a
0:23:01.260,0:23:09.220
new pharmacologist from the University of[br]Mannheim ZI. We are about to apply for the
0:23:09.220,0:23:16.020
1st psilocybin depression study in Germany[br]this next year. So in 2020, we're
0:23:16.020,0:23:20.040
putting in the applications, we've already[br]put the first paperwork in, and what we
0:23:20.040,0:23:26.360
want to do is do a double standard study,[br]both at the ZI Mannheim and the
0:23:26.360,0:23:30.192
Charité Berlin. Those are the two most[br]renowned psychiatric research facilities
0:23:30.192,0:23:35.040
in Germany. And it's a collaboration from[br]the ZI, Charité, and the MIND Foundation.
0:23:35.040,0:23:40.799
Each group contributing their knowledge,[br]their capabilities, and their strengths.
0:23:40.799,0:23:47.210
And what we want to do is this. We[br]want to do a double blind, randomized
0:23:47.210,0:23:54.690
controlled phase IIa study. Big word.[br]this basically means that … It’s a
0:23:54.690,0:23:59.240
top-notch level, internationally acclaimed[br]study. This is how these studies need to be
0:23:59.240,0:24:03.780
done to have any value. So it's double[br]blind, meaning that neither the patient
0:24:03.780,0:24:09.690
nor the therapist know what this patient[br]is getting. It's randomized. So this gets
0:24:09.690,0:24:14.650
assigned without anybody playing around[br]with it. And phase II means that it's a
0:24:14.650,0:24:20.840
safety and efficacy study, so not yet dose[br]testing and not yet comparing dosages, but
0:24:20.840,0:24:26.730
just trying to make sure it works. And we[br]are going to do that in a 144 participants
0:24:26.730,0:24:32.780
sample in total, in two locations, which[br]is huge. This will be the second or third
0:24:32.780,0:24:37.260
biggest sample worldwide doing this. And[br]the first one in Germany, as we said and
0:24:37.260,0:24:42.390
what we are going to test is 25[br]milligrams of standardised GMP. So
0:24:42.390,0:24:47.049
Medical Grade Psilocybin versus two active[br]placebos. One being a small dose of
0:24:47.049,0:24:52.500
psilocybin, which used to be the standard[br]thing to do. But now talking about
0:24:52.500,0:24:58.400
microdosing, what is if the small doses[br]already does something? And testing it
0:24:58.400,0:25:02.950
against another placebo that isn't[br]psilocybin, which is: there’s some physical
0:25:02.950,0:25:10.620
reaction, but is not psychedelic in this[br]sense. So in this design, every patient
0:25:10.620,0:25:15.690
will receive at least one—some two—high[br]dosages of psilocybin. So everybody who
0:25:15.690,0:25:22.039
gets accepted will have his try. And the[br]study design consists of preparation
0:25:22.039,0:25:27.150
sessions, dosing sessions where people[br]receive either placebo or psilocybin and
0:25:27.150,0:25:32.930
integration sessions. Integration is so[br]important and not only in a scientific
0:25:32.930,0:25:36.830
study on this topic, but if people are[br]working with psychedelics, experimenting
0:25:36.830,0:25:41.850
with psychedelics themselves, integration[br]is the key to do something with the
0:25:41.850,0:25:46.259
experience. Because if you don't work with[br]it actively, the experience is going to
0:25:46.259,0:25:50.770
fade. And you might remember something[br]about what you learned, but it will not
0:25:50.770,0:25:56.880
have the impact on you, your life, and how[br]you—yeah—benefit from what you've seen
0:25:56.880,0:26:02.890
and learned in that way. Right. Just one[br]more sentence. It's mixed funding, its
0:26:02.890,0:26:07.010
funding and progress. So we have some[br]public money coming in, but we're also
0:26:07.010,0:26:12.669
looking for donations and investment just[br]at the side. And this is almost the end of
0:26:12.669,0:26:18.610
my talk. What I want to say is the[br]following: What we try at the moment
0:26:18.610,0:26:25.070
is to establish safe and legal psychedelic[br]therapies in Germany, Europe, and the
0:26:25.070,0:26:30.250
world. This is going to take time. If[br]things go well, we might be there in five
0:26:30.250,0:26:35.340
to ten years—five if things go really[br]well. And I know that it's very tempting
0:26:35.340,0:26:40.490
for many people to say: “Well, I can [br]just go to somebody and have a
0:26:40.490,0:26:44.520
psilocybin session. I can go to somebody,[br]have an ayahuasca session.” And yes, you
0:26:44.520,0:26:49.000
can. But be aware if you do that, because[br]you're really suffering from psychiatric
0:26:49.000,0:26:53.130
disease, if you have a mental illness, if[br]you really are in distress. Be very
0:26:53.130,0:26:57.340
careful with yourself, because the thing[br]is, you need somebody to really support
0:26:57.340,0:27:01.180
you, really help you through somebody who[br]really knows what they're dealing with,
0:27:01.180,0:27:06.210
because otherwise you can do yourself more[br]harm than good. This picture down there
0:27:06.210,0:27:11.921
with the ambulance is a real picture. [br]Right. That's what I wanted to say.
0:27:11.921,0:27:15.839
Thank you very much for having me. If [br]you're interested in what we're doing,
0:27:15.839,0:27:23.740
check it out![br]appplause
0:27:23.740,0:27:29.360
Herald: Andrea, thank you very much.[br]That gives us plenty of time for some
0:27:29.360,0:27:34.730
questions. People are lining up on the[br]microphones already. So we start with
0:27:34.730,0:27:39.540
microphone number two, please.[br]Mic 1: Thank you for this amazing talk.
0:27:39.540,0:27:43.510
That's really great. Just one question.[br]Wouldn't that be a problem for a double
0:27:43.510,0:27:48.980
blind study if a person can surely tell if[br]they're experiencing psychedelic effects?
0:27:48.980,0:27:54.980
Andrea: That is a problem. Yes, but this[br]is the way the authorities request the
0:27:54.980,0:27:59.039
study to be done. And interestingly[br]enough, there have been cases where people
0:27:59.039,0:28:07.630
couldn't tell. If people thought they were[br]either on a small dosage or on a high
0:28:07.630,0:28:16.057
dosage, or even if they where on an[br]inactive placebo. Right. So the self…
0:28:16.057,0:28:20.590
Yeah, self-suggestive capabilities of[br]people should not be underestimated
0:28:20.590,0:28:23.759
either.[br]Herald: Okay, then we're going to jump
0:28:23.759,0:28:28.260
over to number six.[br]Mic 6: Thank you very much for the
0:28:28.260,0:28:36.880
talk. I would like to hear your opinion on[br]the fact that, uh, like in the last 150
0:28:36.880,0:28:46.549
years, most drug agents were discovered[br]in Germany, and meanwhile, we have
0:28:46.549,0:28:53.640
the pity of scientifically Germany[br]lying in Arizona.
0:28:53.640,0:29:05.690
laughter[br]Andrea: Right. Germany has two points that
0:29:05.690,0:29:12.650
historically hold us back. One is the[br]forced human trials during the Nazi era
0:29:12.650,0:29:19.349
where substances, techniques, were tested on[br]concentration camp prisoners. And we have
0:29:19.349,0:29:27.460
the Contergan scandal that harmed so many[br]people and led to, in all of the world,
0:29:27.460,0:29:34.690
the stricter rules we have now. That's two[br]reasons why Germany is so reluctant to
0:29:34.690,0:29:41.660
expose itself in this kind of process. But[br]still, it is a pity. And I think it is
0:29:41.660,0:29:46.011
about time that the German not only[br]government, but also the scientific
0:29:46.011,0:29:53.160
establishment gets to understand that they[br]lose out and they are trading behind a
0:29:53.160,0:29:57.950
development that has[br]started and will continue.
0:29:57.950,0:30:01.920
Herald: And now we have a question[br]from the Internet, I hear.
0:30:01.920,0:30:07.120
Signal Angel: Yes! For people[br]struggling with depression, anxiety, or
0:30:07.120,0:30:12.150
mental illnesses: What specific options[br]are there in Europe with regards to
0:30:12.150,0:30:18.240
psychedelic-assisted therapy?[br]Andrea: Well, one is that you can try to
0:30:18.240,0:30:22.820
participate in the existing trial. So, for[br]example, in London, there's Kings College
0:30:22.820,0:30:28.350
and Imperial College, there's a group in[br]Bristol working, there's also therapy
0:30:28.350,0:30:34.530
happening in Switzerland and so on. And[br]there's also, if you happen to be lucky
0:30:34.530,0:30:38.260
enough to live in Switzerland, there's the[br]so-called compassionate use where
0:30:38.260,0:30:44.020
psychiatrists with special permits are[br]allowed to use LSD and MDMA as therapeutic
0:30:44.020,0:30:49.127
agents on a case-to-case basis that they[br]have to discuss with the authorities.
0:30:49.127,0:30:54.079
So that's all we can say for now:[br]study participation or compassionate use.
0:30:54.079,0:30:57.420
We just really hope that[br]things will rev up and we'll be able
0:30:57.420,0:31:02.050
to offer more in the future.[br]Herald: And microphone number 4, please.
0:31:02.050,0:31:05.071
Mic 4: Yeah. Hello. Thank you[br]very much for your talk.
0:31:05.071,0:31:10.110
My question is more related to[br]the history of the uses of psychedelics
0:31:10.110,0:31:17.890
in the US and to the MAPS Association[br]founded by Rick Doblin, but I was curious,
0:31:17.890,0:31:25.510
how would you explain that MAPS is so[br]actively criticizing the experiments led
0:31:25.510,0:31:35.509
in the 1950s and ’60s by the CIA, and yet[br]they accept donations of several million
0:31:35.509,0:31:42.010
dollars coming from the Mercer family, who[br]are among the largest shareholders of
0:31:42.010,0:31:47.720
Cambridge Analytica, Breitbart News, and[br]they also accept, they accepted recently
0:31:47.720,0:31:54.300
about three millions from members of Tea[br]Party. Isn't it a bit of an irony here?
0:31:54.300,0:32:03.429
applause[br]Andrea: That is a very good question. The
0:32:03.429,0:32:11.200
way I know Rick Doblin and many people[br]from MAPS personally, I know that they're
0:32:11.200,0:32:16.860
pursuing an honest goal. What they’re[br]trying to do is bring this into the world
0:32:16.860,0:32:22.929
and they have been doing that since 1986.[br]So they've been on this for almost 35
0:32:22.929,0:32:27.830
years. He's dedicated his life to doing[br]that. I don't fully understand his
0:32:27.830,0:32:32.740
motives. I don't have to, to be honest,[br]because I'm not speaking for him. I think
0:32:32.740,0:32:39.980
there is a huge necessity for integrity[br]because if we don't—as people working
0:32:39.980,0:32:46.440
with it scientifically—if we don't move[br]along with the necessary integrity, we're
0:32:46.440,0:32:52.070
opening the doors for other people to[br]don't care at all. But on the other hand,
0:32:52.070,0:32:57.150
finding the money, getting this done and a[br]lot … he was … Rick was criticized a lot,
0:32:57.150,0:33:03.699
for example, for accepting veterans;[br]snipers from Iraq into his therapy
0:33:03.699,0:33:08.079
program. Like, okay, are you not getting[br]people fit again to go out back to the
0:33:08.079,0:33:15.581
battlefield? And I find this all very[br]difficult because there is a thing that is
0:33:15.581,0:33:20.690
called perpetrated PTSD. There is a thing[br]of people only realizing afterwards what
0:33:20.690,0:33:26.809
they have done. And I would not … I[br]would be very careful in judging people in
0:33:26.809,0:33:32.780
distress. But you're very right. It's a[br]very delicate topic. And I think we all
0:33:32.780,0:33:36.900
have to be very aware that there are thin[br]paths we are threading in what we're
0:33:36.900,0:33:41.230
doing there. When we accept money that[br]comes from sources that don't follow
0:33:41.230,0:33:45.240
ethical standards.[br]Herald: Then we're going to switch over to
0:33:45.240,0:33:49.730
microphone number five.[br]Mic 5: Hello, I guess you have a really
0:33:49.730,0:33:55.730
nice answer to the following statement. So[br]I hope you will share your answer:
0:33:55.730,0:34:01.950
Little Greta twittered today that the[br]house is on fire and just that. So
0:34:01.950,0:34:07.781
actually that means an adequate reaction[br]would be to jump out of the window. So you
0:34:07.781,0:34:12.210
could argue that actually we should rescue[br]all the people that are really down, like
0:34:12.210,0:34:16.970
down and out, because they cannot help us[br]anymore. But actually, we should get the
0:34:16.970,0:34:22.210
people that are still happy to be a little[br]depressed instead of all getting them
0:34:22.210,0:34:30.570
happy. What do you say?[br]Andrea: There's always two ways of dealing
0:34:30.570,0:34:40.429
with a system: You can step out of it,[br]and you can try to change it from within.
0:34:40.429,0:34:47.020
It is always very difficult to go from[br]caring for the individual to things that
0:34:47.020,0:34:53.889
are right for all. And me being a doctor,[br]for example, I have simply decided to put
0:34:53.889,0:34:59.170
the individual in the center of my[br]concern, and I think others need to put
0:34:59.170,0:35:03.790
the greater good in the center of their[br]concern. I think it's inconsolable. We
0:35:03.790,0:35:08.030
can't do both at the same time. So it's[br]good to make your decision and do this
0:35:08.030,0:35:12.099
what you do with all your heart.[br]Herald: Then we're going to switch over to
0:35:12.099,0:35:15.730
the Internet again.[br]Signal Angel: Yes. And do you know of any
0:35:15.730,0:35:21.290
studies or evidence corroborating the[br]other side, like triggering mental
0:35:21.290,0:35:26.760
illnesses by using psychedelics, for[br]example, if you have a family history of …?
0:35:26.760,0:35:31.880
Andrea: Well, doing a randomized,[br]controlled study with that would be
0:35:31.880,0:35:38.330
unethical. So what we have is the[br]epidemiological and the anecdotal
0:35:38.330,0:35:44.020
evidence that is found. So, yes,[br]if you have a predisposition for
0:35:44.020,0:35:49.890
psychosis, for schizophrenia, for mental[br]instability, there is a large chance of
0:35:49.890,0:35:54.570
triggering that if you use psychedelics.[br]But on the other hand, many people try to
0:35:54.570,0:35:58.920
self-medicate with substances, be it[br]psychedelics or cannabis, because they're
0:35:58.920,0:36:04.470
feeling they're already on the edge of[br]some instability. But the current paradigm
0:36:04.470,0:36:09.470
for the studies is to exclude people[br]whose direct family is affected by
0:36:09.470,0:36:13.280
psychosis.[br]Herald: Number two just disappeared, so
0:36:13.280,0:36:18.720
we're gonna go straight over to four.[br]Mic 4: I would like to ask you whether you
0:36:18.720,0:36:23.460
changed your mind about anything related[br]to psychedelics in last few years or if
0:36:23.460,0:36:33.010
you have seen something in the[br]research that really surprised you?
0:36:33.010,0:36:43.839
Andrea: Let’s … Well, I am worried. In a[br]few respects. Like, for example, the whole
0:36:43.839,0:36:52.170
development around the 5-MeO scene, people[br]using bufo alvarius toxins for very, very strong
0:36:52.170,0:36:56.020
psychedelic experiences, sometimes risking[br]their live doing it. This whole scene
0:36:56.020,0:37:01.301
kind of lifting from the ground and going[br]in a very strange direction, in my
0:37:01.301,0:37:05.030
opinion. This is kind of worrying me[br]because I think people are not taking the
0:37:05.030,0:37:11.550
care they should be taking of themselves[br]in what they are doing. But otherwise, I
0:37:11.550,0:37:16.260
think scientific results we're seeing are[br]rather consistent. It's very important to
0:37:16.260,0:37:21.007
know that these are not magic bullets and[br]not expect too much. You can’t expect
0:37:21.007,0:37:25.930
something to cure everything. And[br]psychedelics seem to be a good idea
0:37:25.930,0:37:31.178
for people who are rigid, transfixed, not[br]able to transcend something. But people
0:37:31.178,0:37:35.005
who are already like in a chaotic state[br]are very unlikely to benefit. And I think
0:37:35.005,0:37:38.350
that's a very good basic rule. And[br]this is something I see proven
0:37:38.350,0:37:41.740
time and time again.[br]Herald: Number five, please.
0:37:41.740,0:37:46.940
Mic 5: Hi, thanks. Regarding certain[br]setting and how it can have such a huge
0:37:46.940,0:37:52.940
influence on one's experience, can you[br]comment on the setting of the new
0:37:52.940,0:37:58.140
psilocybin study in the upcoming year?[br]Andrea: Like all the studies that are
0:37:58.140,0:38:03.030
being ta… being done, certain settings[br]are being taken into consideration. These
0:38:03.030,0:38:09.650
people don't trip in a sterile white[br]hospital bed. They get to have their
0:38:09.650,0:38:14.480
psychedelic experience in a warm,[br]comfortable, organic, welcoming
0:38:14.480,0:38:22.030
environment. For example, on a couch with[br]a nice cushion, nice dim light, flowers,
0:38:22.030,0:38:27.340
music is extremely important. There have[br]been released scientific works around what
0:38:27.340,0:38:31.146
kind of music is beneficial for those.[br]Mendel Kaelen, for example, at Imperial
0:38:31.146,0:38:36.160
College is a specialist in this kind of[br]music and is being taken very seriously.
0:38:36.160,0:38:43.008
Also, those questions of how much physical[br]contact is beneficial, is allowed. What
0:38:43.008,0:38:48.020
could harm the patient is discussed very[br]precisely in all those groups I know,
0:38:48.020,0:38:52.330
because this is so much more than just a[br]pill. This is really about making sure
0:38:52.330,0:38:58.700
that people have a safe experience where[br]they can, yeah, come to healing inside
0:38:58.700,0:39:01.060
themselves[br]Mic 5: Thank you.
0:39:01.060,0:39:05.800
Herald: So we have time for one more[br]question. Number one, please.
0:39:05.800,0:39:09.770
Mic 1: I don't know if I want to hear the[br]answer, but do you think it would help
0:39:09.770,0:39:16.750
your cause if you would stop[br]take these drugs for fun?
0:39:16.750,0:39:25.690
Andrea: My answer to this is the[br]following: Imagine there was a food
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thing, something that tasted nice; let’s[br]say chocolate and there were people
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who could only survive if they got[br]chocolate. But because everybody else was
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doing it too, and it was somehow[br]not okay, it would be forbidden for
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everybody. Then I would say, well if you[br]replace chocolate with LSD, I think there
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are people there who really need it. And[br]we have to be careful that recreational
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use and playing around with drugs doesn't[br]spoil their chance to something lifesaving
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because they need the chocolate. You might[br]get along without, but it's something we
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have to take into consideration. This[br]doesn't mean it's wrong to have psychedelic
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experience for your own benefit, for your[br]own betterment, for your own fun. But just
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keep in mind, if you're hindering with[br]your wanting to have a good time that
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somebody gets a life-saving therapy,[br]perhaps, then this is an ethical problem
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we are facing.[br]Herald: Andrea, thank you so much.
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That's your applause.[br]applause
0:40:32.454,0:40:38.410
36c3 rollout music
0:40:38.410,0:40:58.884
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