1
00:00:00,000 --> 00:00:19,060
33C3 musique de préroulement
2
00:00:19,060 --> 00:00:25,090
Herald: Ok! Venons-en à la discussion...
La suivante est Andrea Jungaberle. Elle
3
00:00:25,090 --> 00:00:35,050
nous parle des drogues et de comment elles
affectent la psychiatrie. Quel mot dur !
4
00:00:35,050 --> 00:00:43,240
Pourquoi tu ne le fais pas? Je sais
maintenant. Et la question est, après la—
5
00:00:43,240 --> 00:00:46,600
comment dit-on "verbot" en français ?
Andrea Jungaberle: Prohibition.
6
00:00:46,600 --> 00:00:50,480
Herald: Après la prohibition dans les
années 70. On n'a pas beaucoup réfléchi
7
00:00:50,480 --> 00:00:58,589
à comment ces drogues fonctionnent et
pourraient améliorer la psychiatrie... Et
8
00:00:58,589 --> 00:01:04,109
maintenant tout le monde se demande,
est-ce le remède miracle? Je ne crois pas.
9
00:01:04,109 --> 00:01:07,803
Mais plus d'informations sur ce sujet avec
Andrea. Un accueil chaleureux, svp.
10
00:01:07,803 --> 00:01:14,110
Applaudissements
11
00:01:14,110 --> 00:01:19,550
Andrea: Bonjour, tout le monde. Je suis
heureuse d'être ici et pouvoir vous parler
12
00:01:19,550 --> 00:01:23,470
d'un sujet qui me tient à cœur et qui est
très important pour beaucoup de personnes,
13
00:01:23,470 --> 00:01:28,660
aujourd'hui et demain. Donc, le sujet est
la médecine psychédélique, le piratage, la
14
00:01:28,660 --> 00:01:33,150
psychiatrie. Et juste pour rappeler la
chute, ce n'est pas un remède miracle et
15
00:01:33,150 --> 00:01:36,910
ça ne le sera jamais. Mais aussi il y a
beaucoup de choses à savoir et à penser
16
00:01:36,910 --> 00:01:40,950
dans ce contexte. J'aimerais vous les
présenter. Mais d'abord, quelques mots
17
00:01:40,950 --> 00:01:46,000
sur moi. Je suis docteur en médecine,
spécialisée dans l'urgence et les soins
18
00:01:46,000 --> 00:01:50,320
intensifs. Je travaille et vis à Berlin.
Je suis aussi l'un des fondateurs de MIND,
19
00:01:50,320 --> 00:01:56,280
la Fondation Européenne pour la Science
Psychédélique, et actuel directeur médical
20
00:01:56,280 --> 00:02:01,590
Juste une phrase de plus. Voici notre
équipe de base. MIND est une association
21
00:02:01,590 --> 00:02:07,560
de membres de Science psychédélique. Nous
avons 450 membres au niveau mondial et une
22
00:02:07,560 --> 00:02:13,250
équipe de 50 personnes. C'est un noyau de
personnel rémunéré, nombreux volontaires
23
00:02:13,250 --> 00:02:17,040
très bons et très dédiés , et de grands
internes de différentes disciplines, comme
24
00:02:17,040 --> 00:02:23,240
les neurosciences, la psychiatrie, la
psycho/pharmacologie, etc Nous travaillons
25
00:02:23,240 --> 00:02:27,630
pour établir la science psychédélique,
comme une méthode, fondée sur des preuves
26
00:02:27,630 --> 00:02:34,489
et informer en Allemagne et autour en
Europe. Ok, plongeons dans le vif du sujet
27
00:02:34,489 --> 00:02:42,230
Les Psychédéliques. Que sont-ils ? Et bien
le terme vient des Grecs, Psychée et Délos
28
00:02:42,230 --> 00:02:46,909
que l'on peut traduire par "manifestation
de l'esprit par la pensée". Tant de gens
29
00:02:46,909 --> 00:02:52,535
parlaient des substances psychoactives
comme ayant une certaine, capacité de
30
00:02:52,535 --> 00:02:57,629
transformer la perception de chacun,
l'introspection,les qualités sensorielles
31
00:02:57,629 --> 00:03:03,009
d'une manière très typique qui est parfois
décrite comme onirique, mais pas toujours.
32
00:03:03,009 --> 00:03:07,260
Les psychédéliques classiques, également
appelés hallucinogènes, terme qui me
33
00:03:07,260 --> 00:03:12,340
déplait car ces drogues ne provoquent pas
d'hallucinations. Ce qu'ils font, c'est
34
00:03:12,340 --> 00:03:17,959
induire de pseudo hallucinations; donc si
on a prend une substance psychédélique,
35
00:03:17,959 --> 00:03:21,369
dans 99% des cas, on est conscient d'avoir
pris une substance et que ce que l'on
36
00:03:21,369 --> 00:03:25,080
ressent est dû à cette substance. C'est
donc non un hallucinogène, mais un pseudo
37
00:03:25,080 --> 00:03:30,938
hallucinogène. Mais ces substances, comme
les classiques- LSD, psilocybine ou DMT -
38
00:03:30,938 --> 00:03:37,340
fonctionnent de manière très spécifique et
agissent toutes sur le système
39
00:03:37,340 --> 00:03:41,510
sérotoninergique. La sérotonine est l'un
des principaux neurotransmetteurs et il y
40
00:03:41,510 --> 00:03:47,029
a un récepteur, le 5-HT2A, qui est le plus
petit dénominateur commun à toutes ces
41
00:03:47,029 --> 00:03:51,390
substances, non qu'elles agissent toutes
uniquement sur celui-ci, elles affectent
42
00:03:51,390 --> 00:03:56,119
toute une pléthore de neuro-transmetteurs
et de récepteurs. Mais c'est la clé où
43
00:03:56,119 --> 00:04:00,780
elles fonctionnent toutes. Il y a d'autres
substances qui sont classées comme
44
00:04:00,780 --> 00:04:04,930
plutôt psychédéliques,comme les
entactogènes -l'ecstasy ou MDMA par ex.-
45
00:04:04,930 --> 00:04:09,840
qui agisent aussi sur le système sérotoni-
nergique. Les dissociatifs -kétamine,...-
46
00:04:09,840 --> 00:04:14,079
agissent plus sur le récepteur NMDA; et
d'autres sont basiquement des produits
47
00:04:14,079 --> 00:04:20,120
chimiques aléatoires, comme l'Amanite
tue-mouche, la Datura ou la Salvia. Bon.
48
00:04:20,120 --> 00:04:24,085
C'est la seule diapositive où je vais vous
déranger avec ce genre de science dure. Je
49
00:04:24,085 --> 00:04:29,050
pense qu'il est important d'être clair sur
ce sujet car même si les psychédéliques
50
00:04:29,050 --> 00:04:34,170
sont un mème de la culture pop, personne
ne sait rien à leur sujet, à dire vrai. La
51
00:04:34,170 --> 00:04:41,290
majorité les associe à des drogues ayant
la même dangerosité que la méthamphétamine
52
00:04:41,290 --> 00:04:45,950
ou les opioïdes. Pense qu'il existe une
dépendance avec les drogues psychédéliques
53
00:04:45,950 --> 00:04:51,390
qui, en fait, n'existe pas. Et c'est le pb
fondamental de la perception pour beaucoup
54
00:04:51,390 --> 00:04:57,296
de gens depuis très longtemps. Les choses
ont un peu changé récemment. Les psyché-
55
00:04:57,296 --> 00:05:03,120
déliques sont devenus la norme. D'abord,
à cause d'un changement général de la
56
00:05:03,120 --> 00:05:09,510
perception des drogues, comme avec le
cannabis ou un changement des médications.
57
00:05:09,510 --> 00:05:13,440
Aussi pk des gens, comme Michael Pollan,
qui est un auteur mainstream qui écrit sur
58
00:05:13,440 --> 00:05:19,020
la cuisine et la nutrition, s'est mis à
écrire sur les psychédéliques. Et un autre
59
00:05:19,020 --> 00:05:23,485
facteur qui a aidé les psychédéliques à sa
façon et leur a nuit d'une autre est toute
60
00:05:23,485 --> 00:05:28,870
cette lubie du microdosage que nous voyons
dans la scène tech ou développementale, et
61
00:05:28,870 --> 00:05:36,530
surtout dans la région de la Baie et à la
Silicon Valley. Mais d'où viennent-ils ?
62
00:05:36,530 --> 00:05:43,000
from? In this talk, I am not going to
speak about psychedelic, psychoactive
63
00:05:43,000 --> 00:05:48,160
substances in other cultural frameworks.
There are cultures like in the Amazonian
64
00:05:48,160 --> 00:05:54,260
basin or some Aztec people in Mexico
who have been using psychoactive
65
00:05:54,260 --> 00:06:00,750
substances, psychedelics, in a very
ritualized sense for millennia, perhaps,
66
00:06:00,750 --> 00:06:05,760
or at least centuries. But this is not us.
So let's talk about what happened here in
67
00:06:05,760 --> 00:06:12,510
Europe or in the Western world, including
America. This guy up here, sorry, that's
68
00:06:12,510 --> 00:06:19,390
the wrong one. The pointer isn't strong
enough. We'll work like this. This nice
69
00:06:19,390 --> 00:06:26,820
guy up here is Albert Hofmann. In 1938, he
was developing several substances that
70
00:06:26,820 --> 00:06:32,620
were supposed to work on atonia and in
postpartum women, but also on other
71
00:06:32,620 --> 00:06:36,780
problems like blood pressure and he,
among other things, developed the
72
00:06:36,780 --> 00:06:42,180
thing that later became LSD. But
back then, he didn't see any sense in
73
00:06:42,180 --> 00:06:46,291
pursuing it medically because it didn't
work the way he wanted it to and he
74
00:06:46,291 --> 00:06:51,170
shelved it. And for some reason in ’43, he
took it out the shelf again to retest it
75
00:06:51,170 --> 00:06:59,000
for other purposes, and accidently gave
himself the first noted LSD trip. This
76
00:06:59,000 --> 00:07:03,251
happened not because he was a shitty
chemist, but because the amount that is
77
00:07:03,251 --> 00:07:09,020
needed to induce an effect is so low as it
has never been noted before in any other
78
00:07:09,020 --> 00:07:14,890
substance. So 20 micrograms of LSD can
already produce a notable change in
79
00:07:14,890 --> 00:07:20,360
perception. So when he came out of that
experience, this first one he had, after
80
00:07:20,360 --> 00:07:25,610
accidentally dosing himself, he decided
to go for, well, a trial on himself and
81
00:07:25,610 --> 00:07:29,690
trying to be safe. He used what he thought
was a very low dose of the substance he
82
00:07:29,690 --> 00:07:37,100
discovered, which turned out to be 250
micrograms of LSD, which was his… I hear
83
00:07:37,100 --> 00:07:42,400
the laughter. It’s rather a high dose
trip, especially for somebody who just
84
00:07:42,400 --> 00:07:48,270
didn't know what was expecting him out
there in his own mind. And this is the
85
00:07:48,270 --> 00:07:52,290
famous bicycle day trip where he rode home
on his bike thinking that the world was
86
00:07:52,290 --> 00:07:57,250
collapsing around him, basically. So even
this wasn't a nice trip, the first one. So
87
00:07:57,250 --> 00:08:01,430
what happened next was that he reported to
his superiors at Sandoz Chemical in Basel,
88
00:08:01,430 --> 00:08:06,400
and they had the idea of turning this
into a substance for many doctors,
89
00:08:06,400 --> 00:08:13,000
psychiatrists, psychologists, to experience
what it would be like to be psychotic. So
90
00:08:13,000 --> 00:08:20,110
its first application of LSD was as a
psychotomimetic. And as a psychoto-
91
00:08:20,110 --> 00:08:24,020
mimetic, thousands of dosages were
distributed worldwide from the
92
00:08:24,020 --> 00:08:30,210
Czech Republic to Harvard University to
everywhere. And doctors tried it out. What
93
00:08:30,210 --> 00:08:36,020
happened then was that a small group of
young, ambitious psychologists around
94
00:08:36,020 --> 00:08:40,060
Timothy Leary tried it out too, and
thought this is not just something for
95
00:08:40,060 --> 00:08:45,640
doctors. This is not just a psychoto-
mimetic and brought it out basically into,
96
00:08:45,640 --> 00:08:51,760
yeah, the real world. And people were
experimenting with LSD quite a bit in the
97
00:08:51,760 --> 00:08:57,610
’60s before it was forbidden in ’71. Not
because it turned out to be so dangerous.
98
00:08:57,610 --> 00:09:02,800
They were not so many accidents. Not so
many people had dire side effects. But
99
00:09:02,800 --> 00:09:07,710
because the political will to cope with
the substance and its implications wasn't
100
00:09:07,710 --> 00:09:16,130
existent in the Nixon era. So. ’71,
underground goes into subculture. But the
101
00:09:16,130 --> 00:09:20,740
genie was out of the bottle and it was not
going to go back in. And psychedelics, not
102
00:09:20,740 --> 00:09:28,390
only LSD, but also Psilocybin, later on
MDMA. And these days, more than 500 new
103
00:09:28,390 --> 00:09:32,570
psychoactive substances that have been
brought up on the black market are around
104
00:09:32,570 --> 00:09:38,600
us. And people use them. It's a societal
reality that our juridical system doesn't
105
00:09:38,600 --> 00:09:43,890
keep up with, to be fair. So it's been in
many subcultural setting from people just
106
00:09:43,890 --> 00:09:49,240
going dancing and having a good time to
self-exploration to pseudo-chamanic or
107
00:09:49,240 --> 00:09:55,410
chamanic settings. And I think most people
will at least know somebody who have
108
00:09:55,410 --> 00:10:01,640
experienced psychedelics at least once.
And then something else changed. A few
109
00:10:01,640 --> 00:10:08,270
years ago, let’s say, 10-ish, 10 years ago,
psychedelics started coming back. There
110
00:10:08,270 --> 00:10:13,950
had been research, for example, at the
University of Zürich around psychedelics
111
00:10:13,950 --> 00:10:20,580
before that already. There had been trials
before. But the big comeback of substances
112
00:10:20,580 --> 00:10:29,230
like psilocybin, LSD, and MDMA as tools to
augment psychotherapy was within the last
113
00:10:29,230 --> 00:10:35,460
10 or 15 years. So these people up here
are some of the people worldwide working
114
00:10:35,460 --> 00:10:41,740
with these substances, trying to develop
them into medications. So … not
115
00:10:41,740 --> 00:10:46,380
over-the-counter, but prescription
medications to be applied within the
116
00:10:46,380 --> 00:10:50,510
setting of psychotherapy. So the idea is
never that somebody can walk into a
117
00:10:50,510 --> 00:10:54,790
pharmacy saying, oh, I'm depressed, I want
to buy psilocybin to treat myself, but to
118
00:10:54,790 --> 00:10:59,710
have a structured therapeutical session in
which the effects can be contained and the
119
00:10:59,710 --> 00:11:06,060
benefits enhanced. So the ones that are
most promising these days are psilocybin
120
00:11:06,060 --> 00:11:11,050
for depression, which is already heading
for the third stage, third and final stage
121
00:11:11,050 --> 00:11:17,388
of approvement as medication within the USA
and consecutively hopefully in Europe. And
122
00:11:17,388 --> 00:11:23,279
MDMA, so what is used? What people want to
find if they buy ecstasy, not that they
123
00:11:23,279 --> 00:11:27,220
always get it, but MDMA is the substance
they're trying to get, for post-traumatic
124
00:11:27,220 --> 00:11:31,920
stress disorder (PTSD). In the U.S., even
the Veterans Association has jumped on the
125
00:11:31,920 --> 00:11:37,800
bandwagon and has sponsored this research,
which is interesting at least. But isn't
126
00:11:37,800 --> 00:11:45,930
that harmful? Aren't these substances
very dangerous? Well, not in the way you
127
00:11:45,930 --> 00:11:51,480
think and not as much as you might think.
This graphic up here is something that was
128
00:11:51,480 --> 00:11:56,950
put together by a group of 40 experts who
discussed what substances have what harm
129
00:11:56,950 --> 00:12:03,610
on the user and what harm on the people
around the users. So, for example, alcohol
130
00:12:03,610 --> 00:12:09,100
is harmful for the person, giving them a
liver disorder, making them addicted and
131
00:12:09,100 --> 00:12:14,220
so on, so on. But also because people get
aggressive when they use it or drive
132
00:12:14,220 --> 00:12:18,530
dangerously, for example, when they're
intoxicated, it's dangerous to others. If
133
00:12:18,530 --> 00:12:24,250
you check out. I have to walk over here
now. Sorry to the camera people. The
134
00:12:24,250 --> 00:12:27,800
substances we're talking about for
treatment are not up there with the very
135
00:12:27,800 --> 00:12:32,010
dangerous ones. We have the shrooms down
here, the LSD is there, ecstasy is there.
136
00:12:32,010 --> 00:12:39,250
So very low danger to the user and almost
no danger to other people. If you compare
137
00:12:39,250 --> 00:12:47,880
that to alcohol, heroin, tobacco, it's all
up there. And, to be quite fair, we’re all
138
00:12:47,880 --> 00:12:53,980
part of a giant field study anyway. Because
these substances are being used. This is
139
00:12:53,980 --> 00:12:58,790
data from the 2017 Global Drug Survey,
which is a self-reporting study where
140
00:12:58,790 --> 00:13:04,630
people talk about their own drug use
and fill in forms online. This is not a
141
00:13:04,630 --> 00:13:09,490
statistically sound sample of the general
population because to fill out that trial,
142
00:13:09,490 --> 00:13:13,600
you have to have a certain interest. But
the people that have filled this out—
143
00:13:13,600 --> 00:13:20,880
we're talking about a number of
over 115.000 worldwide—say that
144
00:13:20,880 --> 00:13:29,020
they have, in their lifetime, partially
used LSD. … were the numbers …? MDMA,
145
00:13:29,020 --> 00:13:37,051
mushrooms and LSD, so MDMA 35%,
mushrooms almost 25%, LSD over 22%.
146
00:13:37,051 --> 00:13:41,130
And if you look around you, of
how many people do you know who
147
00:13:41,130 --> 00:13:45,660
ended up in an emergency department
or in a psychiatric ward due to _only_ using
148
00:13:45,660 --> 00:13:51,190
those substances? Actually, looking at
this giant field study that the illegal
149
00:13:51,190 --> 00:13:56,430
market has provided us with, it seems to
be rather safe because these people
150
00:13:56,430 --> 00:14:02,180
are not using clear dosages of a clean
substance and still there's hardly
151
00:14:02,180 --> 00:14:18,089
anything happening. OK. But what about
microdosing? Well. We don't know much
152
00:14:18,089 --> 00:14:25,330
about microdosing, in fact. There are no
scientifically randomized controlled
153
00:14:25,330 --> 00:14:31,620
studies, as to yet; the first ones are just
starting. There are self-reporting studies
154
00:14:31,620 --> 00:14:37,780
where people have filled out online forms.
And it seems to be that what people are on
155
00:14:37,780 --> 00:14:43,730
one hand trying to achieve is, yes,
enhancing creativity, getting better work
156
00:14:43,730 --> 00:14:52,300
performance. But a lot of them are trying
to treat, cure, enhance that latent or
157
00:14:52,300 --> 00:15:01,750
apparent depression, and the other thing
is: microdosing—which is defined mostly as
158
00:15:01,750 --> 00:15:09,120
using a very low, almost subliminal dose
of a psychoactive substance such as LSD—is
159
00:15:09,120 --> 00:15:13,740
being done by people with all sorts. There
are people microdosing MDMA and ibogaine,
160
00:15:13,740 --> 00:15:17,720
which is, if you look at the receptor
profiles, just insane basically and
161
00:15:17,720 --> 00:15:24,770
frankly can't do what they hope it does.
And when we took a look at people who
162
00:15:24,770 --> 00:15:31,070
microdose, we can't say how much of
the effect they’re feeling is really from
163
00:15:31,070 --> 00:15:37,450
microdosing that substance or if we have a
top-notch, first-grade placebo effect going
164
00:15:37,450 --> 00:15:43,160
on where people feel much better because
they have taken this and believe in it.
165
00:15:43,160 --> 00:15:49,959
Let's not turn down placebo. Placebo is
extremely valuable medically. It’s
166
00:15:49,959 --> 00:15:54,940
actually shown that placebo effect, for
example, enhance the endogenous opioid
167
00:15:54,940 --> 00:16:00,290
production. So your body revs up towards
healing, towards feeling better with the
168
00:16:00,290 --> 00:16:05,740
placebo effect. But this could also be
done with a sugar pill. And there's one
169
00:16:05,740 --> 00:16:09,450
thing I just want to leave with you in
this group. If anybody of you is
170
00:16:09,450 --> 00:16:16,620
microdosing and has preexisting heart
condition: don't! Simply because some of
171
00:16:16,620 --> 00:16:20,560
the subreceptors, especially with LSD that
are being activated in prolonged micro
172
00:16:20,560 --> 00:16:28,180
dosing for a long time can be cardiotoxic
and possibly harm your heart. Just again,
173
00:16:28,180 --> 00:16:32,140
there's not clear data about this yet.
Just to leave it with you, if you suffer
174
00:16:32,140 --> 00:16:37,700
from a heart condition: don’t!
Depression. That keyword I had with the
175
00:16:37,700 --> 00:16:42,430
microdosing as well. But let's go
deeper into this, because if we want to
176
00:16:42,430 --> 00:16:49,160
talk about how psychedelic medicine can
really make a difference in psychiatry,
177
00:16:49,160 --> 00:16:56,839
depression is like, yeah, the first-line
thing to think and talk about and why is
178
00:16:56,839 --> 00:17:04,100
that? Depression is a very serious
psychiatric disorder. People who are
179
00:17:04,100 --> 00:17:09,049
severely depressed—and that's many people;
statistically, in Germany, every 8th
180
00:17:09,049 --> 00:17:13,789
woman is likely to suffer from a severe
depressive episode. At one point in their
181
00:17:13,789 --> 00:17:20,180
life or the other. People who are
depressed lose social functioning. They
182
00:17:20,180 --> 00:17:24,899
have very decreased life expectancy
partially through suicide, partially
183
00:17:24,899 --> 00:17:28,790
because they don't manage to care for
themselves. These people lose themselves
184
00:17:28,790 --> 00:17:35,990
and are being lost for others, too. And
there is treatment for depression, yes,
185
00:17:35,990 --> 00:17:42,380
but in many cases it only has a limited
capacity. And even though depression is a
186
00:17:42,380 --> 00:17:49,180
worldwide epidemic—with rates from
3% of the population in China to
187
00:17:49,180 --> 00:17:54,210
22% of the population in Afghanistan
suffering from it—there have not really
188
00:17:54,210 --> 00:17:59,809
been new forms of treatment for two, two
and a half decades‽ So the stuff we're
189
00:17:59,809 --> 00:18:05,160
working with is partially working, partly
not: about one third of patients don't
190
00:18:05,160 --> 00:18:10,750
react to the medication at all, even
though there's different types. And those
191
00:18:10,750 --> 00:18:16,670
who do usually have very low rates of
acceptance because of the side effects.
192
00:18:16,670 --> 00:18:21,130
Because many people use antidepressants,
and the best combination is cognitive
193
00:18:21,130 --> 00:18:24,910
behavior therapy—so what is called in
German “Verhaltenstherapie,” cognitive
194
00:18:24,910 --> 00:18:32,860
behavioral therapy—in conjunction with
antidepressants. That might work, but for
195
00:18:32,860 --> 00:18:38,135
some it doesn't. And those who take the
medication don't feel well. It's not that
196
00:18:38,135 --> 00:18:42,170
they're back to normal. They're just less
depressed. But usually they're like dimmed
197
00:18:42,170 --> 00:18:46,249
in on all sides. So they are still not
getting happy. The libido is decreased.
198
00:18:46,249 --> 00:18:49,910
Their activity levels are decreased.
People are suffering quite a bit from the
199
00:18:49,910 --> 00:19:00,910
side effects and it's really not nice. So.
I was just … just to tell you one
200
00:19:00,910 --> 00:19:05,549
little story. I told you I’m an
emergency medicine doctor. And just
201
00:19:05,549 --> 00:19:14,040
to illustrate how bad depression can get:
A few weeks ago, I was being called out to
202
00:19:14,040 --> 00:19:20,380
an attempt of suicide. A woman had jumped
out of her window on the fourth floor. We
203
00:19:20,380 --> 00:19:27,670
found her lying in her yard and she was...
injured, badly injured, but still alive,
204
00:19:27,670 --> 00:19:34,530
and we stabilized her and took her to
hospital, and when the nurse kind of
205
00:19:34,530 --> 00:19:40,270
pulled up her data in the emergency room,
she went like, oh, no, not again, because
206
00:19:40,270 --> 00:19:46,570
this woman had jumped out the same window
just half a year before. That's how bad
207
00:19:46,570 --> 00:19:54,110
this disease can be. So how desperate
people get and how terribly important it
208
00:19:54,110 --> 00:19:59,950
is for us not to look away, but try to
find better new therapies. And this is, in
209
00:19:59,950 --> 00:20:04,070
my opinion, with psychedelic medicine …
Psychedelic therapy can be a real game
210
00:20:04,070 --> 00:20:12,200
changer. The one therapeutic application
we have the best data for is psychedelics
211
00:20:12,200 --> 00:20:17,450
for treatment-resistant depression. There
are several studies going on in the UK, in
212
00:20:17,450 --> 00:20:23,640
the States, and Switzerland, but also in
the Czech Republic and so on, so on. And
213
00:20:23,640 --> 00:20:27,510
what they seem to be finding is that even
though they're still working with small
214
00:20:27,510 --> 00:20:32,830
samples because you have to fan out; if
you try to bring out a medication like
215
00:20:32,830 --> 00:20:37,180
that, you have to show first that it's
safe with healthy people and then you
216
00:20:37,180 --> 00:20:41,016
start with a small sample of sick people
and then you enlarge it from there. And
217
00:20:41,016 --> 00:20:47,980
they’re now in this enlarging process …
that's treating depression with psilocybin
218
00:20:47,980 --> 00:20:53,260
especially does not only decrease
depression in those patients, but also
219
00:20:53,260 --> 00:20:58,790
does one great thing: it decreases
anxiety! Not only talking about state
220
00:20:58,790 --> 00:21:04,500
anxiety, so how anxious people are at this
very moment in living their lives, but
221
00:21:04,500 --> 00:21:09,990
that trait anxiety. So how anxious people
are as a part of their personality, which
222
00:21:09,990 --> 00:21:16,930
is a good thing to gauge how likely people
are to relapse back into depression,
223
00:21:16,930 --> 00:21:20,500
people that are very anxious, very
insecure about life, are far more likely
224
00:21:20,500 --> 00:21:29,270
to relapse. OK, so you see, there's a lot
happening worldwide studying this, but
225
00:21:29,270 --> 00:21:37,580
this is Germany on that. A scientific
desert. We're in the largest country;
226
00:21:37,580 --> 00:21:41,710
It’s also the scientifically perhaps most
important country when it comes to medical
227
00:21:41,710 --> 00:21:45,290
research in Europe. There’s zilch
happening. There hasn't been a study on
228
00:21:45,290 --> 00:21:50,532
psychoactive compounds in this context,
forever, like 30 years, the last one on
229
00:21:50,532 --> 00:21:56,169
entactogens like 20 years ago. But
studying psychedelic here hasn't happened.
230
00:21:56,169 --> 00:22:08,279
And we want to change that. Let’s …
applause
231
00:22:08,279 --> 00:22:14,140
So we as the main foundation had, perhaps,
let's call it groundbreaking, what a
232
00:22:14,140 --> 00:22:19,090
groundbreaking conference this September
in Berlin at the Charité buildings.
233
00:22:19,090 --> 00:22:23,770
We had 600 participants, over 50
speakers from worldwide, everybody
234
00:22:23,770 --> 00:22:29,470
basically, almost everybody who's
important in this dialog scientifically
235
00:22:29,470 --> 00:22:33,990
was around. So from the pharmacology, the
psychiatrist, the psychologist, the
236
00:22:33,990 --> 00:22:41,580
therapist, but also philosophers talking
about a culture of older sets of mind have
237
00:22:41,580 --> 00:22:46,049
been around. And we have been trying to
bring this to the German public and try to
238
00:22:46,049 --> 00:22:55,320
lay groundwork for doing new science in
Germany. And what's to come next is this.
239
00:22:55,320 --> 00:23:01,260
With our P.I., so a principal investigator,
Gerhard Gründer, who is a
240
00:23:01,260 --> 00:23:09,220
new pharmacologist from the University of
Mannheim ZI. We are about to apply for the
241
00:23:09,220 --> 00:23:16,020
1st psilocybin depression study in Germany
this next year. So in 2020, we're
242
00:23:16,020 --> 00:23:20,040
putting in the applications, we've already
put the first paperwork in, and what we
243
00:23:20,040 --> 00:23:26,360
want to do is do a double standard study,
both at the ZI Mannheim and the
244
00:23:26,360 --> 00:23:30,192
Charité Berlin. Those are the two most
renowned psychiatric research facilities
245
00:23:30,192 --> 00:23:35,040
in Germany. And it's a collaboration from
the ZI, Charité, and the MIND Foundation.
246
00:23:35,040 --> 00:23:40,799
Each group contributing their knowledge,
their capabilities, and their strengths.
247
00:23:40,799 --> 00:23:47,210
And what we want to do is this. We
want to do a double blind, randomized
248
00:23:47,210 --> 00:23:54,690
controlled phase IIa study. Big word.
this basically means that … It’s a
249
00:23:54,690 --> 00:23:59,240
top-notch level, internationally acclaimed
study. This is how these studies need to be
250
00:23:59,240 --> 00:24:03,780
done to have any value. So it's double
blind, meaning that neither the patient
251
00:24:03,780 --> 00:24:09,690
nor the therapist know what this patient
is getting. It's randomized. So this gets
252
00:24:09,690 --> 00:24:14,650
assigned without anybody playing around
with it. And phase II means that it's a
253
00:24:14,650 --> 00:24:20,840
safety and efficacy study, so not yet dose
testing and not yet comparing dosages, but
254
00:24:20,840 --> 00:24:26,730
just trying to make sure it works. And we
are going to do that in a 144 participants
255
00:24:26,730 --> 00:24:32,780
sample in total, in two locations, which
is huge. This will be the second or third
256
00:24:32,780 --> 00:24:37,260
biggest sample worldwide doing this. And
the first one in Germany, as we said and
257
00:24:37,260 --> 00:24:42,390
what we are going to test is 25
milligrams of standardised GMP. So
258
00:24:42,390 --> 00:24:47,049
Medical Grade Psilocybin versus two active
placebos. One being a small dose of
259
00:24:47,049 --> 00:24:52,500
psilocybin, which used to be the standard
thing to do. But now talking about
260
00:24:52,500 --> 00:24:58,400
microdosing, what is if the small doses
already does something? And testing it
261
00:24:58,400 --> 00:25:02,950
against another placebo that isn't
psilocybin, which is: there’s some physical
262
00:25:02,950 --> 00:25:10,620
reaction, but is not psychedelic in this
sense. So in this design, every patient
263
00:25:10,620 --> 00:25:15,690
will receive at least one—some two—high
dosages of psilocybin. So everybody who
264
00:25:15,690 --> 00:25:22,039
gets accepted will have his try. And the
study design consists of preparation
265
00:25:22,039 --> 00:25:27,150
sessions, dosing sessions where people
receive either placebo or psilocybin and
266
00:25:27,150 --> 00:25:32,930
integration sessions. Integration is so
important and not only in a scientific
267
00:25:32,930 --> 00:25:36,830
study on this topic, but if people are
working with psychedelics, experimenting
268
00:25:36,830 --> 00:25:41,850
with psychedelics themselves, integration
is the key to do something with the
269
00:25:41,850 --> 00:25:46,259
experience. Because if you don't work with
it actively, the experience is going to
270
00:25:46,259 --> 00:25:50,770
fade. And you might remember something
about what you learned, but it will not
271
00:25:50,770 --> 00:25:56,880
have the impact on you, your life, and how
you—yeah—benefit from what you've seen
272
00:25:56,880 --> 00:26:02,890
and learned in that way. Right. Just one
more sentence. It's mixed funding, its
273
00:26:02,890 --> 00:26:07,010
funding and progress. So we have some
public money coming in, but we're also
274
00:26:07,010 --> 00:26:12,669
looking for donations and investment just
at the side. And this is almost the end of
275
00:26:12,669 --> 00:26:18,610
my talk. What I want to say is the
following: What we try at the moment
276
00:26:18,610 --> 00:26:25,070
is to establish safe and legal psychedelic
therapies in Germany, Europe, and the
277
00:26:25,070 --> 00:26:30,250
world. This is going to take time. If
things go well, we might be there in five
278
00:26:30,250 --> 00:26:35,340
to ten years—five if things go really
well. And I know that it's very tempting
279
00:26:35,340 --> 00:26:40,490
for many people to say: “Well, I can
just go to somebody and have a
280
00:26:40,490 --> 00:26:44,520
psilocybin session. I can go to somebody,
have an ayahuasca session.” And yes, you
281
00:26:44,520 --> 00:26:49,000
can. But be aware if you do that, because
you're really suffering from psychiatric
282
00:26:49,000 --> 00:26:53,130
disease, if you have a mental illness, if
you really are in distress. Be very
283
00:26:53,130 --> 00:26:57,340
careful with yourself, because the thing
is, you need somebody to really support
284
00:26:57,340 --> 00:27:01,180
you, really help you through somebody who
really knows what they're dealing with,
285
00:27:01,180 --> 00:27:06,210
because otherwise you can do yourself more
harm than good. This picture down there
286
00:27:06,210 --> 00:27:11,921
with the ambulance is a real picture.
Right. That's what I wanted to say.
287
00:27:11,921 --> 00:27:15,839
Thank you very much for having me. If
you're interested in what we're doing,
288
00:27:15,839 --> 00:27:23,740
check it out!
appplause
289
00:27:23,740 --> 00:27:29,360
Herald: Andrea, thank you very much.
That gives us plenty of time for some
290
00:27:29,360 --> 00:27:34,730
questions. People are lining up on the
microphones already. So we start with
291
00:27:34,730 --> 00:27:39,540
microphone number two, please.
Mic 1: Thank you for this amazing talk.
292
00:27:39,540 --> 00:27:43,510
That's really great. Just one question.
Wouldn't that be a problem for a double
293
00:27:43,510 --> 00:27:48,980
blind study if a person can surely tell if
they're experiencing psychedelic effects?
294
00:27:48,980 --> 00:27:54,980
Andrea: That is a problem. Yes, but this
is the way the authorities request the
295
00:27:54,980 --> 00:27:59,039
study to be done. And interestingly
enough, there have been cases where people
296
00:27:59,039 --> 00:28:07,630
couldn't tell. If people thought they were
either on a small dosage or on a high
297
00:28:07,630 --> 00:28:16,057
dosage, or even if they where on an
inactive placebo. Right. So the self…
298
00:28:16,057 --> 00:28:20,590
Yeah, self-suggestive capabilities of
people should not be underestimated
299
00:28:20,590 --> 00:28:23,759
either.
Herald: Okay, then we're going to jump
300
00:28:23,759 --> 00:28:28,260
over to number six.
Mic 6: Thank you very much for the
301
00:28:28,260 --> 00:28:36,880
talk. I would like to hear your opinion on
the fact that, uh, like in the last 150
302
00:28:36,880 --> 00:28:46,549
years, most drug agents were discovered
in Germany, and meanwhile, we have
303
00:28:46,549 --> 00:28:53,640
the pity of scientifically Germany
lying in Arizona.
304
00:28:53,640 --> 00:29:05,690
laughter
Andrea: Right. Germany has two points that
305
00:29:05,690 --> 00:29:12,650
historically hold us back. One is the
forced human trials during the Nazi era
306
00:29:12,650 --> 00:29:19,349
where substances, techniques, were tested on
concentration camp prisoners. And we have
307
00:29:19,349 --> 00:29:27,460
the Contergan scandal that harmed so many
people and led to, in all of the world,
308
00:29:27,460 --> 00:29:34,690
the stricter rules we have now. That's two
reasons why Germany is so reluctant to
309
00:29:34,690 --> 00:29:41,660
expose itself in this kind of process. But
still, it is a pity. And I think it is
310
00:29:41,660 --> 00:29:46,011
about time that the German not only
government, but also the scientific
311
00:29:46,011 --> 00:29:53,160
establishment gets to understand that they
lose out and they are trading behind a
312
00:29:53,160 --> 00:29:57,950
development that has
started and will continue.
313
00:29:57,950 --> 00:30:01,920
Herald: And now we have a question
from the Internet, I hear.
314
00:30:01,920 --> 00:30:07,120
Signal Angel: Yes! For people
struggling with depression, anxiety, or
315
00:30:07,120 --> 00:30:12,150
mental illnesses: What specific options
are there in Europe with regards to
316
00:30:12,150 --> 00:30:18,240
psychedelic-assisted therapy?
Andrea: Well, one is that you can try to
317
00:30:18,240 --> 00:30:22,820
participate in the existing trial. So, for
example, in London, there's Kings College
318
00:30:22,820 --> 00:30:28,350
and Imperial College, there's a group in
Bristol working, there's also therapy
319
00:30:28,350 --> 00:30:34,530
happening in Switzerland and so on. And
there's also, if you happen to be lucky
320
00:30:34,530 --> 00:30:38,260
enough to live in Switzerland, there's the
so-called compassionate use where
321
00:30:38,260 --> 00:30:44,020
psychiatrists with special permits are
allowed to use LSD and MDMA as therapeutic
322
00:30:44,020 --> 00:30:49,127
agents on a case-to-case basis that they
have to discuss with the authorities.
323
00:30:49,127 --> 00:30:54,079
So that's all we can say for now:
study participation or compassionate use.
324
00:30:54,079 --> 00:30:57,420
We just really hope that
things will rev up and we'll be able
325
00:30:57,420 --> 00:31:02,050
to offer more in the future.
Herald: And microphone number 4, please.
326
00:31:02,050 --> 00:31:05,071
Mic 4: Yeah. Hello. Thank you
very much for your talk.
327
00:31:05,071 --> 00:31:10,110
My question is more related to
the history of the uses of psychedelics
328
00:31:10,110 --> 00:31:17,890
in the US and to the MAPS Association
founded by Rick Doblin, but I was curious,
329
00:31:17,890 --> 00:31:25,510
how would you explain that MAPS is so
actively criticizing the experiments led
330
00:31:25,510 --> 00:31:35,509
in the 1950s and ’60s by the CIA, and yet
they accept donations of several million
331
00:31:35,509 --> 00:31:42,010
dollars coming from the Mercer family, who
are among the largest shareholders of
332
00:31:42,010 --> 00:31:47,720
Cambridge Analytica, Breitbart News, and
they also accept, they accepted recently
333
00:31:47,720 --> 00:31:54,300
about three millions from members of Tea
Party. Isn't it a bit of an irony here?
334
00:31:54,300 --> 00:32:03,429
applause
Andrea: That is a very good question. The
335
00:32:03,429 --> 00:32:11,200
way I know Rick Doblin and many people
from MAPS personally, I know that they're
336
00:32:11,200 --> 00:32:16,860
pursuing an honest goal. What they’re
trying to do is bring this into the world
337
00:32:16,860 --> 00:32:22,929
and they have been doing that since 1986.
So they've been on this for almost 35
338
00:32:22,929 --> 00:32:27,830
years. He's dedicated his life to doing
that. I don't fully understand his
339
00:32:27,830 --> 00:32:32,740
motives. I don't have to, to be honest,
because I'm not speaking for him. I think
340
00:32:32,740 --> 00:32:39,980
there is a huge necessity for integrity
because if we don't—as people working
341
00:32:39,980 --> 00:32:46,440
with it scientifically—if we don't move
along with the necessary integrity, we're
342
00:32:46,440 --> 00:32:52,070
opening the doors for other people to
don't care at all. But on the other hand,
343
00:32:52,070 --> 00:32:57,150
finding the money, getting this done and a
lot … he was … Rick was criticized a lot,
344
00:32:57,150 --> 00:33:03,699
for example, for accepting veterans;
snipers from Iraq into his therapy
345
00:33:03,699 --> 00:33:08,079
program. Like, okay, are you not getting
people fit again to go out back to the
346
00:33:08,079 --> 00:33:15,581
battlefield? And I find this all very
difficult because there is a thing that is
347
00:33:15,581 --> 00:33:20,690
called perpetrated PTSD. There is a thing
of people only realizing afterwards what
348
00:33:20,690 --> 00:33:26,809
they have done. And I would not … I
would be very careful in judging people in
349
00:33:26,809 --> 00:33:32,780
distress. But you're very right. It's a
very delicate topic. And I think we all
350
00:33:32,780 --> 00:33:36,900
have to be very aware that there are thin
paths we are threading in what we're
351
00:33:36,900 --> 00:33:41,230
doing there. When we accept money that
comes from sources that don't follow
352
00:33:41,230 --> 00:33:45,240
ethical standards.
Herald: Then we're going to switch over to
353
00:33:45,240 --> 00:33:49,730
microphone number five.
Mic 5: Hello, I guess you have a really
354
00:33:49,730 --> 00:33:55,730
nice answer to the following statement. So
I hope you will share your answer:
355
00:33:55,730 --> 00:34:01,950
Little Greta twittered today that the
house is on fire and just that. So
356
00:34:01,950 --> 00:34:07,781
actually that means an adequate reaction
would be to jump out of the window. So you
357
00:34:07,781 --> 00:34:12,210
could argue that actually we should rescue
all the people that are really down, like
358
00:34:12,210 --> 00:34:16,970
down and out, because they cannot help us
anymore. But actually, we should get the
359
00:34:16,970 --> 00:34:22,210
people that are still happy to be a little
depressed instead of all getting them
360
00:34:22,210 --> 00:34:30,570
happy. What do you say?
Andrea: There's always two ways of dealing
361
00:34:30,570 --> 00:34:40,429
with a system: You can step out of it,
and you can try to change it from within.
362
00:34:40,429 --> 00:34:47,020
It is always very difficult to go from
caring for the individual to things that
363
00:34:47,020 --> 00:34:53,889
are right for all. And me being a doctor,
for example, I have simply decided to put
364
00:34:53,889 --> 00:34:59,170
the individual in the center of my
concern, and I think others need to put
365
00:34:59,170 --> 00:35:03,790
the greater good in the center of their
concern. I think it's inconsolable. We
366
00:35:03,790 --> 00:35:08,030
can't do both at the same time. So it's
good to make your decision and do this
367
00:35:08,030 --> 00:35:12,099
what you do with all your heart.
Herald: Then we're going to switch over to
368
00:35:12,099 --> 00:35:15,730
the Internet again.
Signal Angel: Yes. And do you know of any
369
00:35:15,730 --> 00:35:21,290
studies or evidence corroborating the
other side, like triggering mental
370
00:35:21,290 --> 00:35:26,760
illnesses by using psychedelics, for
example, if you have a family history of …?
371
00:35:26,760 --> 00:35:31,880
Andrea: Well, doing a randomized,
controlled study with that would be
372
00:35:31,880 --> 00:35:38,330
unethical. So what we have is the
epidemiological and the anecdotal
373
00:35:38,330 --> 00:35:44,020
evidence that is found. So, yes,
if you have a predisposition for
374
00:35:44,020 --> 00:35:49,890
psychosis, for schizophrenia, for mental
instability, there is a large chance of
375
00:35:49,890 --> 00:35:54,570
triggering that if you use psychedelics.
But on the other hand, many people try to
376
00:35:54,570 --> 00:35:58,920
self-medicate with substances, be it
psychedelics or cannabis, because they're
377
00:35:58,920 --> 00:36:04,470
feeling they're already on the edge of
some instability. But the current paradigm
378
00:36:04,470 --> 00:36:09,470
for the studies is to exclude people
whose direct family is affected by
379
00:36:09,470 --> 00:36:13,280
psychosis.
Herald: Number two just disappeared, so
380
00:36:13,280 --> 00:36:18,720
we're gonna go straight over to four.
Mic 4: I would like to ask you whether you
381
00:36:18,720 --> 00:36:23,460
changed your mind about anything related
to psychedelics in last few years or if
382
00:36:23,460 --> 00:36:33,010
you have seen something in the
research that really surprised you?
383
00:36:33,010 --> 00:36:43,839
Andrea: Let’s … Well, I am worried. In a
few respects. Like, for example, the whole
384
00:36:43,839 --> 00:36:52,170
development around the 5-MeO scene, people
using bufo alvarius toxins for very, very strong
385
00:36:52,170 --> 00:36:56,020
psychedelic experiences, sometimes risking
their live doing it. This whole scene
386
00:36:56,020 --> 00:37:01,301
kind of lifting from the ground and going
in a very strange direction, in my
387
00:37:01,301 --> 00:37:05,030
opinion. This is kind of worrying me
because I think people are not taking the
388
00:37:05,030 --> 00:37:11,550
care they should be taking of themselves
in what they are doing. But otherwise, I
389
00:37:11,550 --> 00:37:16,260
think scientific results we're seeing are
rather consistent. It's very important to
390
00:37:16,260 --> 00:37:21,007
know that these are not magic bullets and
not expect too much. You can’t expect
391
00:37:21,007 --> 00:37:25,930
something to cure everything. And
psychedelics seem to be a good idea
392
00:37:25,930 --> 00:37:31,178
for people who are rigid, transfixed, not
able to transcend something. But people
393
00:37:31,178 --> 00:37:35,005
who are already like in a chaotic state
are very unlikely to benefit. And I think
394
00:37:35,005 --> 00:37:38,350
that's a very good basic rule. And
this is something I see proven
395
00:37:38,350 --> 00:37:41,740
time and time again.
Herald: Number five, please.
396
00:37:41,740 --> 00:37:46,940
Mic 5: Hi, thanks. Regarding certain
setting and how it can have such a huge
397
00:37:46,940 --> 00:37:52,940
influence on one's experience, can you
comment on the setting of the new
398
00:37:52,940 --> 00:37:58,140
psilocybin study in the upcoming year?
Andrea: Like all the studies that are
399
00:37:58,140 --> 00:38:03,030
being ta… being done, certain settings
are being taken into consideration. These
400
00:38:03,030 --> 00:38:09,650
people don't trip in a sterile white
hospital bed. They get to have their
401
00:38:09,650 --> 00:38:14,480
psychedelic experience in a warm,
comfortable, organic, welcoming
402
00:38:14,480 --> 00:38:22,030
environment. For example, on a couch with
a nice cushion, nice dim light, flowers,
403
00:38:22,030 --> 00:38:27,340
music is extremely important. There have
been released scientific works around what
404
00:38:27,340 --> 00:38:31,146
kind of music is beneficial for those.
Mendel Kaelen, for example, at Imperial
405
00:38:31,146 --> 00:38:36,160
College is a specialist in this kind of
music and is being taken very seriously.
406
00:38:36,160 --> 00:38:43,008
Also, those questions of how much physical
contact is beneficial, is allowed. What
407
00:38:43,008 --> 00:38:48,020
could harm the patient is discussed very
precisely in all those groups I know,
408
00:38:48,020 --> 00:38:52,330
because this is so much more than just a
pill. This is really about making sure
409
00:38:52,330 --> 00:38:58,700
that people have a safe experience where
they can, yeah, come to healing inside
410
00:38:58,700 --> 00:39:01,060
themselves
Mic 5: Thank you.
411
00:39:01,060 --> 00:39:05,800
Herald: So we have time for one more
question. Number one, please.
412
00:39:05,800 --> 00:39:09,770
Mic 1: I don't know if I want to hear the
answer, but do you think it would help
413
00:39:09,770 --> 00:39:16,750
your cause if you would stop
take these drugs for fun?
414
00:39:16,750 --> 00:39:25,690
Andrea: My answer to this is the
following: Imagine there was a food
415
00:39:25,690 --> 00:39:33,020
thing, something that tasted nice; let’s
say chocolate and there were people
416
00:39:33,020 --> 00:39:37,850
who could only survive if they got
chocolate. But because everybody else was
417
00:39:37,850 --> 00:39:41,690
doing it too, and it was somehow
not okay, it would be forbidden for
418
00:39:41,690 --> 00:39:47,940
everybody. Then I would say, well if you
replace chocolate with LSD, I think there
419
00:39:47,940 --> 00:39:53,260
are people there who really need it. And
we have to be careful that recreational
420
00:39:53,260 --> 00:39:59,260
use and playing around with drugs doesn't
spoil their chance to something lifesaving
421
00:39:59,260 --> 00:40:03,710
because they need the chocolate. You might
get along without, but it's something we
422
00:40:03,710 --> 00:40:08,890
have to take into consideration. This
doesn't mean it's wrong to have psychedelic
423
00:40:08,890 --> 00:40:13,330
experience for your own benefit, for your
own betterment, for your own fun. But just
424
00:40:13,330 --> 00:40:17,070
keep in mind, if you're hindering with
your wanting to have a good time that
425
00:40:17,070 --> 00:40:22,790
somebody gets a life-saving therapy,
perhaps, then this is an ethical problem
426
00:40:22,790 --> 00:40:28,520
we are facing.
Herald: Andrea, thank you so much.
427
00:40:28,520 --> 00:40:32,454
That's your applause.
applause
428
00:40:32,454 --> 00:40:38,410
36c3 rollout music
429
00:40:38,410 --> 00:40:58,884
subtitles created by c3subtitles.de
in the year 2020. Join, and help us!