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A New Meet Delic Podcast Panel: Peace, Love & Ketamine

September 15, 2020
Listen Time: 
1h 35min
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Tune in to an informative Meet Delic Podcast panel discussion with Dr. Cook, other doctors experts in the field, as they explore different types of ketamine and their therapeutic applications.

 Combine that with ketamine. And then while we're doing that design protocols where people at a, a social, emotional, family and spiritual level start to recreate and retell their version of, of their own heroes journey and how they have a chance to overcome. You're listening to a Bio Reset medical podcast with Dr.

Cook. If you have questions, we'll wanna talk more about your symptoms and issues. You can always reach us at 650 888 7950. The following is a discussion with Jackie Stan from the Delic Radio podcast. All righty. All righty. Let's get into it, guys. Um, We're going to do our panel with our All-Star lineup.

Uh, we're going to, uh, ask you guys for questions at the end and give the panelists a chance to speak with you guys. We're also going to do some firsthand accounts, one-on-one accounts, uh, about ketamine and how it's helped people, um, on the live here today. Um, first and foremost, we have, uh, Dr. Matthew Cook and Barbara Brenneman.

They're the founders of Biore Reset Medical. You've heard Doc and I speak, um, on Delic Radio several times, and you'll hear it in the future. Go check out, uh, delic Radio, of course, and we have Dr. David Ffel, who is the founder of Edema Neuropsychiatry Institute. You have also heard Dr. Ffel on Delic Radio.

We have the lovely Angela Ward, who was an RN and founder of Guardian at the Gateway. And last but not least, for this round of discussion, we have Julie and Kevin Nicholson, founders of Ketamine Wellness Centers. Thank you to all the panelists for being here today. We're super stoked. Um, all right, so let's talk about quickly the history of ketamine.

Uh, ketamine is a dissociative anesthetic with strong cognitive and psychedelic effects, though popular as a recreational drug. Calvin Steven, um, first developed Ketamine while searching for an alternative to P C P. Which produced undesirable effects, uh, with its discovery. In 1962, ketamine went through a series of preclinical trials before the F D A approved it.

In 1970, it became the surgical aesthetic administered to soldiers in Vietnam, due to its relative levels of safety in comparison to other anesthetics. Additionally, ketamine has been used on patients with respiratory and circulatory issues and even made its way onto the World Health Organization's list of essential medicines.

Recently, the applications of ketamine have extended to treat depression, even suicidal thoughts because it takes, um, effect much quicker than other antidepressants and produces what we think are more long lasting results. People are stu studying that, um, as we speak, and it just, it turns out that today is World Suicide Prevention Day.

Uh, ladies and gentlemen, every 40 seconds somebody prevents, or. I would hope prevents, but actually somebody commits suicide around the world. This is a very sobering and true, um, statistic, and I would imagine that it's possibly gone up, um, since I first heard that statistic. It's very real. Uh, the different forms of ketamine that we know are iv, um, intravenous, uh, IM or intramuscular tro, which are these little guys right here, uh, nasal of course nasal spray, and, uh, powder form that you would see recreationally.

So let's get into it. Let's talk about the nuts and bolts. Why does it work? Um, Dr. Ffel, I, you have been studying ketamine in your clinic, um, for many, many years. I would love to hear you talk about, Why Ketamine works or why you have seen it work and how it works.

Thank you, Jackie. It's a pleasure to be here. Um, you know, it is funny cuz I, I, I, uh, ha had this conversation with some colleagues on a chat group, uh, uh, uh, ketamine providers and some of them were, were, um, invoking this, uh, concept of neurogenesis, which I'm sure a lot of the, uh, viewers have, uh, have heard.

Neurogenesis is the, uh, is, is creation of new brain cells. Um, which at one time, not too long ago, we thought was not possible. We thought that the brain, uh, did not actually generate new brain cells after birth. But then, uh, uh, neuroscience discovered that in certain areas it did. And ketamine is known to rapidly produce this neurogenesis.

And so it's been a very kind of, um, uh, seductive, uh, Story to describe to, to, to explain Ketamine's, uh, profound, uh, you know, uh, effects, therapeutic effects with this neurogenesis. And I pointed out to the group that unfortunately, you know, the evidence is really not that, you know, it's, it's a nice story, but, but the evidence is very mixed about whether neurogenesis has any role in it.

And I think, uh, what my point for them was really that, um, there's a lot of theories. We know, we, we know that ketamine does a lot of things in the brain, but the truth is, if we, if we're gonna be, uh, intellectually honest, uh, we don't know, uh, what, uh, you know, what the mechanism of action, uh, for, for, for ketamine is we do know, we do know, for example, some characteristics like it binds to a certain receptor called the N M D A receptor, that it blocks this receptor again, that it has these changes, both, both, uh, physiological and obviously psychological and perceptual.

Um, but, but we're still trying to figure out what is the key component, um, to ketamine and why the experience that people have with ketamine is very similar. Uh, and this has been shown in, in, in, in, uh, controlled studies, very similar subjectively to other psychedelics, but yet it has a different pharmacological, um, uh, mechanism at least initially to, you know, where, where, what it, where it binds in the brain.

Um, so, uh, honestly, uh, I could, I could, uh, I could cite several interesting, uh, provocative, uh, you know, possibilities. But the truth is, we, we just don't know. And it's a great, it's a great area if you want to be a researcher. Yes. I thank you for that answer. So honest, so true. And, um, I think healthy, it's okay that we don't know.

Um, and we do need more researchers, uh, and chemists to study, uh, ketamine and other psychedelics. Um, let's, let's take it from an anesthesiologist perspective. Dr. Matt Cook, who of course you've heard also on, we've talked about this on Delic Radio. My brother. Hello Matt Cook. Um, tell us about ketamine, why, or how, what, what your experiences with it has been.

Um, from an anesthesiologist perspective.

You guys are on mute.

Sorry about that. Can you hear me now? Yes, doc and Barb. Hello, Verizon commercial. Um, thank you. Uh, it's great to be here with everybody. Uh, the, so ketamine is actually a drug that we used as part of our algorithm in terms of taking care of patients in the operating room. And we've used it a lot for sedation.

And then we've also used it a lot as a component of anesthesia. And the reason for doing that is, is because it tends to be a pretty good pain reliever. And it's the, the one thing that is a pain reliever in all of medicine that instead of lowering the rate at which you breathe, it slightly increases it.

So it tends to have a fairly high safety profile. And, and, and anesthesiologists for years and years have been taking advantage of that. And so I've been, uh, using, uh, ketamine as part of our anesthetics in the operating room since, um, since 1988, uh, which is quite a long, a long time ago. May, that makes me kind of old.

Um, But, um, the p anesthesiologist started to notice, man, when we give people ketamine, they seem to be a lot less depressed. And so then clinics started popping up all over the country and all over the world that, uh, started to do protocols where, and these were generally anesthesia driven clinics where we would do ketamine, um, uh, uh, once a week for six weeks.

And so the out the concept was to do, uh, a treatment. And, and ke ketamine seems to clinically decrease someone's depression for about a week or two. And, and the, the effects of the, the, the psychologic and sort of the mental status changes that you get with ketamine go away in an hour, maybe an hour and a half, but then for, for a couple of weeks, people will have a, uh, antidepressant effect.

And I have a lot of patients who would come in and we would give them a treatment and they would say, I felt actually pretty darn good for a week or two. Uh, we started, uh, giving people, uh, uh, combinations of protocols where I would use, uh, a, a substance called N A D, which is a vitamin that helps stimulate your mitochondria.

Yeah, n a d. And, and the idea is that if I'm stimulating the mitochondria in every area of the brain before I give ketamine, A lot of times what will happen is the ketamine seems to work better. People have less side effects in terms of nausea or headaches or other symptoms that you can sometimes get with ketamine and, and then the antidepressant effects will last longer.

And it really clued me in a couple of years ago, I traded somebody and um, I traded them twice with ketamine and n a d in a week, and then they called me a little disappointed that it wore off. And it was like eight months, seven, it was seven or eight months later. And I was like, wow, that is like a case where with that we need to publish that because it's, it gave me an indication.

And what we're doing sort of in parallel to all of that is using that time when the depression is off to help retell a new story to that is a, uh, tells a story like, oh, and people kind of will tell me, oh, I actually see that there's a way for me to get through this. I see the light at the end of the tunnel.

And so returning the lights on in the tunnel while they're, while they're still in that kind of, uh, fragile moment and then trying to kind of reset, reset their physiology and then get them out of it. And so I think that my, my vision of the future is, is that we will do combinations of protocols that use different vitamins and minerals and strategies.

Combine that with ketamine, do that in a staged approach. And then while we're doing that design protocols where people at a, a social, emotional, family and spiritual level start to recreate and retell their version of, of their own heroes journey and how they have a chance to overcome. And, and the combination of all of that is sort of where we're working with.

But, but specifically on the one front of ketamine, my, my sense is, is that it, it helps people in very difficult situations, uh, get a handle, uh, or feel a little bit better. And often that is just the, the, uh, helps them overcome the inertia of feeling that they're in total overwhelm and, and helps them transition to a better place.

Right. So it occurs to me that we actually have four different sets of, of backgrounds here, um, all coming and utilizing Ketamine to help people in this way. Um, so I think it's useful to get Julie and Kevin and then Angela's perspective on how you guys, how you guys see Ketamine in your practice, how you present it, since we've already established that we don't exactly know why it works.

Um, but obviously it's working for you guys. Um, so I'd love Julie and Kevin. Hello, welcome. And, uh, let us know a little bit about your practice and how you seek Ketamine. Hi. Sure. I'll, uh, I'll start and then Julia will fill, fill in where I screw up. But we've been treating out in Arizona since around 2011.

Um, and then officially Ketamine Wellness Centers in 2015. Um, I'm a registered nurse by background, so I started being the clinician in the room and doing, we purely do all IV infusions. We don't do the intranasal or any of the oral. Um, that's purely a decision based on our medical directors and our ownerships, you know, um, thoughts on it.

But, uh, you know, we, we feel the same way in regards to it's unique, how it's so different for every patient. And we, we take an approach by looking at the patient prior to the treatment. We have a clinical psychologist, Dr. Ellen Diamond, who's our, one of our owners. And, uh, we do a psychological interview to look at not only depression, but all the other comorbid mental health factors that may be playing into their wellness, as well as look at their medical and their physical attributes and what may be, um, part of their journey that we have to work through.

And then we develop our program based around that. Um, I love the fact that more and more clinicians are getting into this because there is more research, there's more information coming out that will allow us to. Kind of bridge those gaps in between patients, um, treatments and see if we can get longer and longer benefits.

But one of the things that we hear a lot in the psychedelic community is set and setting is really important in making sure that the environment and the, the physical space, when somebody is going through their treatment and getting into that psychedelic realm, that they feel safe, that they feel comforter, comf, comfortable with the person that they're, that they're with.

And so they can go calmly through that experience and make sure that they don't have to feel so tethered. So I don't know if Julie has any, any other thoughts, but Well, set and setting I gotta tell you is, uh, It's so important. Yes, we talk about it a lot in the psychedelic space, but it's very useful in other avenues of people's lives.

It's really about being mindful present, right? Um, and setting intentions for yourself and keeping yourself safe because as we say, a deic safety is cool. Um, right. And that's really what I wanna talk about next is safety. Um, quick personal anecdote for me in ketamine, I am, I use ketamine as a patient, uh, with an anxiety disorder and depression.

I. The first time I used ketamine was recreationally. I think I might have been 16 back in the late nineties rave culture in Austin, Texas. And I was young and did not know what I was consuming and just said yes, which is not safe. Um, and it was one of the more challenging experiences of my life. I thought I was dying.

Um, I didn't have supportive people around me. I obviously took a dose that was not suitable for me at the time, uh, was, you know, sat in the back of somebody's car alone while it, uh, while it wore off. And so I had avoided ketamine in a therapeutic setting for the next, uh, 15 years or so. And it wasn't until maybe a year ago, um, that I started to consider it in the, and, and, uh, allowed.

The fear had dissipated a little bit. And so it was, it was a beautiful thing to be able to come back to it again, um, in a way that was therapeutic and with people I trust. I've gone up to Biore Reset Medical, um, with Doc and Barb, um, to do it. And, uh, and it's helped me tremendously. Uh, and it's done more for me in a year than 20 years of psychotherapy and SSRIs did not.

Um, so let's talk about safety, because I bet there's a lot of patients who come in freaked out, not, you know, not understanding what they're going to experience. So how, um, Julie, do you guys, do you guys handle the safety aspect and then we'll go to Angela? Sure. Well, it is if their first experience with ketamine is YouTubing videos of people on ketamine, they're terrified when they come in.

So we do a lot of pre-education and tell them what they can expect. Even though it is different for everyone. We give 'em a lot of scenarios. We spend a lot of time prior to them coming into the clinic, um, talking to 'em, answering all their questions so they feel safer when they get here. Um, the, the rooms, and one of the reasons that we prefer the IV method is that you can.

Regulated. If it is getting too strong, you can pull it back, uh, slow it down, those kind of things. I'm not a clinical person, so I don't have clinical terms, so I can let Kevin speak more of the, um, the clinical part. But I, I think making sure they're in a space when they get here tremendously helps on the, how they're gonna react to the treatment.

And then having, we have one-on-one care, so if anybody does start to go a little too far and you know, just between talking them back down and slowing the infusion rate can bring it back down because it is, you know, if they said it's very safe, if it's done in the right environment, um, and done, um, therapeutically.

Right. Yeah. Dr. You know, Dr. Fel and I actually, I appreciate the timing cause we've actually collaborated on a couple of patients in the past and he's. I believe, I hope I don't mis, uh, represent, but I believe he was giving intramuscular injections for ketamine to a patient. And we dialogued about how to bridge that gap when we were converting from intramuscular to intravenous because it is a different experience and, and the bioavailability and those kind of things.

We feel because our, our doctor is an anesthesiologist, we do require our patients to be on a monitor. We do put 'em on a pulse oximeter. We do watch their blood pressure because it does cause elevation in, in, in blood pressure. And we have a chronic hypertension issue in this country. We find ourselves sometimes diagnosing unknown.

We can help make sure that we're managing that. So nice. But you still, you still want to keep it somewhat. Of a, of a relaxed setting. You don't want it so clinical that they feel like they're having it done, you know, in a, in an emergency room. Yeah. It's definitely a fine balance that people across the country are, are working on figuring out.

And because patients are so variable, uh, what the right setting is, you know, again, we're still figuring that out. We don't know. Um, but it's nice to be in an office with, uh, medical professionals who can help if something bad goes wrong. Angela, you have you practice up in the Pacific Northwest. Um, tell, talk to us about how you see ketamine and, and how you deal with, you know, while fear is not necessarily a sustainable motivator, it's still, we experience it, especially when it comes to, to very strong substances like ketamine.

Absolutely. First of all, thanks for having me here and it's so exciting to hear how everyone is working with this medicine. It's really fantastic. Um, from my perspective as a registered nurse, I'm very much in alignment with the helping the patients find their own healing path. And, uh, we have to understand that depression is not caused or not healed by drugs.

It's healed in relationship and connection. So I love what everyone said about prep and integration and providing support and care for people as they move through this process. Um, It's concerning to me, however, that ketamine is the litmus test for psychedelic medicine as it moves forward into the future.

And I'm much more interested in a psychedelic model of medicine rather than a medical model of psychedelics. I appreciate that for some people, it's appropriate for them to be in a more high, uh, high care environment. Maybe they have higher risk factors and need to be more in a clinical setting. Yet many people are, have a lot of trauma that they've experienced in a medical setting and need to have opportunities to experience this medicine in a more, um, either natural environment or home environment or more like a therapist office.

So that's how I tend to work with people. I work in conjunction with the clinic where we do Im, uh, which I think is really nice because for certain people having an IV attached to their arms and, and having a heart monitor and all that can be really anxiety producing. And it sometimes can be really nice for people to be medically cleared.

Uh, have medical professionals available if we need to intervene. But for the most part, as everyone said, it's quite a safe medicine. And then I work with my, my clients with lozenges or trophies, and that is a really lovely way to work. Yes, those are fantastic because

I am concerned that as psychedelics become more, uh, available to the public, that people are going to becoming, I self-identifying that they need to use a particular drug to heal. It's important to remember that psychedelics are tools for transformation and healing, but they are not responsible for the transformation itself.

Um, it's really important that people have a supportive environment and maybe. You know, hopefully when we have M D M A and psilocybin and some of these other things that the providers can identify what might be the appropriate treatment. But it's not just that, which is absolutely why, um, uh, was it, uh, Dell, or I can't remember who was saying Dr.

Cook maybe that people were having great antidepressive effects at the beginning of treatment, but then it wears off so quickly and it's absolutely true that people do need to rewrite their story, but they need a lot of support in that process. And so what I do as a nurse is I work with people on building in basic life skills of how to rewire these patterns into action in their everyday life.

It's a key component of integration work for any psychedelic therapy. So, uh, I've had great success with people in that way. I also wanna speak to some concerns. I have room access. To this medicine, I find that there's a lot of people charging a very high dollar amount for therapies and treatments, which is leaving out a number of people that just don't, cannot afford this medicine and can't afford this therapy.

The great thing about ketamine is it's very inexpensive and, um, yet people are paying thousands of dollars to, to have these treatments. Um, I do love that Ketamine Wellness Center does seem to offer you guys offer a sliding scale or first responder, uh, discount, which is great. Yet, um, it's still quite expensive and I'm also concerned that there's not a lot of people of color or marginalized people that are offering these services to care for those, uh, people that need that kind of support.

So I would really love a call for more access in different ways that our less expensive. And that also are offered by therapists that have some background in trauma-informed care, that have some cultural sensitivity training and can do this over a period of time. Yeah, definitely. Access is, access is key.

And it's complicated, right? We're at the beginning of, of this journey here. Um, and with more demand, I believe will come greater access to people. And um, but also going back to something you said about definitely how ketamine or psychedelics are not the answer, ultimately the patient is the answer I think, to themselves.

And, um, and it's important also that we have practitioners who can provide other technologies outside of ketamine to help, um, heal somebody's, uh, gut biome, for example, which has a lot to do with. With health and depression, um, pretty much everything to do with it. Um, so it's not just ketamine. And I think that, uh, where more studies, um, will happen, we'll have greater access, but totally heard on the access thing.

Angela, thank you so much, um, before, and we'll come back to that too because I know you wanted to talk about the Esketamine, um, and insurance. But before that, we have a couple of questions I'll, I'll give to the panel from viewers. Um, a lot of people asked about interactions. Uh, what other drugs can ketamine or should ketamine be mixed with or not mixed with?

That's a very complicated question. Um, does anyone on the panel wanna take that? Uh, Dr. Fel, we haven't heard from you in a minute. Do you wanna answer that? Sure. Um, the truth is, um, there's, there's been, um, some evidence that, that, that certain drugs may interfere with the ketamine effect, may, um, uh, may mitigate it.

Um, for example, um, there's, there, there's been, uh, uh, some evidence that, um, a drug called Lamotrigine, which is a, um, also goes by the, uh, brand named Lamictal. Um, which is, uh, which is a mo, a anti epilepsy drug, but also even more commonly used as a, as a mood stabilizer and sometimes, uh, antidepressant, um, um, can, uh, can mitigate.

The effects of, um, uh, of ketamine. Um, and, uh, but that's in clinical experience speaking to a lot of people. I would say in my own experience, um, that's not been borne out, uh, very well, in fact, and one of the strange things that, uh, that a lot of people who cite it was a small, a small, a small paper, uh, uh, uh, reporting on some case reports.

Um, but, uh, it was interesting about that study. Was it, it it actually mitigated the experience of the, you know, the dissociative experience, the psychedelic experience. But actually did not mitigate, in fact, enhance the antidepressant effect, which is very, uh, an interesting, unusual, and part of my interest in, you know, what, to what extent, uh, you know, is the subjective experience, uh, related to the antidepressant effect.

It's, you know, uh, I think we, uh, we think it's important, but we don't know exactly. There's, uh, there's some people who feel that taking a benzodiazepine, that, that would include drugs like, um, you know, Valium and Xanax and Klonopin and Ativan, um, can interfere with, uh, with a ketamine effect. And, um, that's also, you know, for none of these things I should say.

Is there a clear cut, scientific, the jury is out on these, but, um, But for example, in that latter case, um, I have found that a lot of my colleagues, uh, agree that actually it really depends on the situation that, that, that a benzodiazepine can actually enhance the experience and the therapeutic effect in it.

It, when given in the right time, For example, a patient who is a, a, a first treatment, extremely, extremely anxious about it. And, uh, and, and we feel that that anxiety, you know, is not sufficiently, uh, addressed by non-pharmacologic. You know, we, we have a, we have a great team that can really, uh, uh, work with people to, to, to reduce their anxiety.

But sometimes it's just so strong that we feel that it would be counterproductive to do the ketamine in that state. And so, in those, in those states, we found that, um, uh, pre-treating them with a, with a, uh, benzodiazepine actually can turn, uh, the experience into a much better one. So I would say there, uh, in summary, I don't wanna go through all the, you know, the list of things.

I would say that there's no, uh, there's no drug that is absolutely, uh, a no-no to combine with ketamine. Uh, there are some, some things that, uh, might have some, some, uh, interaction effects. But in, in the, but in the right, uh, circumstances with somebody who's very knowledgeable, um, it, it, they could be fine and even, uh, beneficial.

Got it. Wow, that's super interesting. Um, alright, let's talk about dosage for a second. Here's from a viewer. Um, Amee Delic viewer, uh, ketamine infusions gave me my life back after being bedridden from complex regional pain syndrome. I started October, 2016, and the dose that works for me is about 500 milligrams over five hours.

Most treatments are very expensive to Angela's point. Um, although I'm lucky to get mine through Kaiser for just my copay. Amazing. Um, is there any evidence for low dose versus high dose, or does it depend on what's being treated? Barb? Um, I let you have tons of experience with this and you also bring an interesting approach with your, um, history of Qigong.

Um, what are your thoughts on dosage?

You're on, uh, you're on mute.

Just there you are. There we go. Hey, um, Thanks for the question and also thanks for all the speakers and thank you Stacy, for that lovely break to kind of set the, set us into rest and relax here while we have this conversation because I think, uh, that's one of the things that ketamine tends to allow people that space.

Um, and I think in our, our experience in the clinic, you know, there is a standard therapeutic dosage, which is. You know, the body weighting kilos divided by two, um, for, you know, people with no contraindications. And, uh, many times with, with novice people who haven't done ketamine or with people who have lots of anxiety, um, one of the beauties of the IV therapy, uh, is that we can control the drip rate.

So we can start them off very slowly, create an atmosphere where they know they're in the safest place on earth. Um, I find a lot of energy medicine things, meditation, such as we did with Stacy, um, will help people to get into that space. One of the things people with anxiety do is say, I don't know what to do right now.

What should I be doing? And so doing deep breath work, you know, just doing things to get them in their body is super helpful. Um, and just sort of all the things that we've learned from yoga and Qigong about how to be present and be in our bodies. And then the disassociative effect of ketamine allows once you're present and feel safe, you to be able to release some of the, uh, things that are creating that fight or flight, and cr you know, can be based on trauma, et cetera.

So, You know, my general feeling about dosage is that, is that, uh, less is more, particularly when you're beginning. Um, but you know, then you have the other end of the spectrum with someone that has chronic regional pain syndrome and they need a big dose because of what's going on with their nervous system.

Um, but for many people, even this sort of psycholytic dose where you can stay in a very relaxed interactive and let the patient decide how interactive they wanna be in that conversation. So, you know, it can range from, you know, they'll talk a lot at the very beginning and then get into the experience and be cool.

Or some people will wanna talk through the whole conversation or halfway through the, through the, you know, maybe 25 minutes in they'll be like, okay, I just hit something. Could you hold my hand for a second? Just let me know that I'm safe. Could you just ground me? So there's a lot, and this goes to set and setting, but also presence.

And I think, you know, for me, one of the most important things is making sure that the person that is with the patient is staying super present. So, you know, there's no looking at your phone, there's no texting or thinking about other things. And that's a wonderful exercise for the therapist as well, because they get the benefit of that meditation and that healing experience.

So everyone gets healed in that experience. And then the second point I'd like to make about dosage and about effectiveness is that if you can give people homework, I mean, as somebody who taught yoga and Qigong for a long time, I know that. You know, it's hard to establish a pattern of taking care of yourself, but self-care is so important.

Even if it's just two minutes or five minutes a day and it takes it out of, I'm giving you something to fix. You, poof, you're fixed. I just baked your cake. Your cake, right? It doesn't work that way. You have to actually have some accountability and continue on with your therapy in between the sessions and so, you know, whether it's, you know, let's work with a set of affirmations, a set of intentions, and you know, have some accountability back and forth.

The medicine, the effect of the medicine will work. For longer and we'll work more effectively. And, um, so it's not just about come in, do the medicine, feel better, don't feel better. There is like a, because eventually you want, you wanna not have to need the medicine anymore. We get asked that question a lot.

How many sessions do I need to do? And the answer is, we'll figure that out as we go along. Let's do one and see how you do. You know, the studies are on six sessions or on 12 sessions and, but those are on specific conditions and people are so different. So I guess I view this whole ketamine therapy as just another amazing tool in how you could use all of the sort of mind body tools to help yourself.

Live your best life. And then I'll tag on that. That's a very good question. And it's, um, I think relevant on a number of fronts. And it goes back to the dosage question, dosage question. And I well echo that. I agree pretty much with everything David said. I thought that was good. Um, the so complex regional pain syndrome's an interesting situation.

Cause what happens with it is, is that a part of the body gets stuck in fight or flight. Okay. And when a and the typical thing that happens is somebody has, gets damaged to, uh, uh, a limb, either the, a hand or a foot, and they'll often break a hand or a foot, and then they'll go into that part of their body goes into fight or flight, and it basically constricts all the blood vessels so they don't get any blood and they end up with a lot of pain.

Now interestingly, the concept, and this came up. 15, 20 years ago, uh, of doing really high dose. And so 500 milligrams is a super high dose. And then what the people would do is they would do that dose over three to four hours. And that dose is almost like a general anesthesia dose. Um, now interestingly on the other side of the coin, and I figured this out about 15 years ago, a lot of people in their seventies and eighties, I'll give them two to five milligrams and they'll have an amazing experience that is, is intense.

And they will tell me if I did anything more than that, it would've been too intense. And so we have a, a dose range. And now then if you think of the, the recreational experience, I'll talk to people all the time that have, have tried it recreationally. I'll say, do you have any idea how much you took? And the answer is always no.

So to be like, if I said, you want a, you want some wine? And then you said yes, and you said, how much are you gonna give me? I go, I don't know, two or three bottles. We'll see. You know? And so that's kind of like the state that we're in. Um, I do think I, I have seen a lot of people who've done super high dose come in and do lower dose and do great.

Generally, uh, at any dose, if you do n a d, you'll do better before. Um, the thing about IVs is you can turn it off. And so if you've had the experience of getting too overwhelmed, you can slow it down. Once through the IV experience, you figure out what the, your optimal dose is, and let's say your optimal dose is 30 or 40 milligrams, then we'll often convert and start doing some injection doses based on the fact that we've already proved that they can do that.

Um, and, and, and so I think we need to have more conversations around dose. Um, the interesting thing is gotta be careful with, uh, sometimes ketamine can potentiate, uh, pain medications and so then sometimes people can have problems with that, but, um, you know, it's an evolving, uh, e experience and the super high dose can be beneficial, but it's generally expensive and a fairly overwhelming thing to go through and people are often less coherent and almost totally out of it and not as participating as much.

And so, while I think it can be good, I think that the, the lower dose algorithms are a better place to start. And, and even, even the home I think are ultimately things that people are gonna be able to do at lower price points, and I think that's gonna be beneficial. Got it. Um, before we, uh, before we switch over, we got a lot of this question, uh, about my, uh, about, uh, ketamine and breast milk.

Uh, what is the effect of ketamine in breast milk or on children who consume it? Any, anybody on the panel wanna take that one? You know, the, one of the, uh, interesting things about, um, ketamine is, um, that, uh, I'd like pointing out to p to patients is that where, whereas if you take, uh, uh, most other drugs for psychiatric, for depression or other psychiatric things, or even medical for medic, for medical issues, um, you know, you're, you're taking that drug every day and, and if it's, if it's, if it's benefiting you, it's benefiting you because it's actually in your, uh, blood system and uh, and in psychiatric drugs, uh, it's in your brain.

What's really interesting about ketamine and sort of a paradigm shift is, um, you know, um, if, if patients get even a week of benefit from, from, uh, ketamine as an antidepressant, During that week, there, there's no measurable ketamine in their, in their blood. And this obviously has implications for, for, uh, breastfeeding, uh, ketamines, uh, effects occur kind of like kidney dialysis, where you go in whatever the, the interval is, let's say it's once a week, uh, and you get hooked up for an hour and your, your, your, your body, your blood gets cleared of toxins and the next day, if you're feeling well, it's not because you're still getting kidney dialysis.

Uh, it's because of what happened while you were at the, an infusion center, uh, the day before. You're still doing well. And eventually the toxins will build up. So ketamine is in, in some ways like that. And that makes it different than. Other drugs vis-a-vis tolerance, for example, cuz tolerance usually occurs when your brain is exposed to the drug, uh, on a continuous basis.

It, it, it has implications for this question for, um, you know, breastfeeding because, uh, uh, a mother can get a treatment for ketamine and, um, you know, um, um, then, you know, uh, waste some of the breast milk depending on the timing. And then new generated milk would be perfectly fine because, um, there's no ketamine in her system to be, uh, uh, sort of absorbed into the breast milk.

So it, it, it's, it's very important to keep in mind the different, different, uh, way Ketamine does produce its therapeutic effects. Lovely. Thank you for that explanation. That's very clear. Alright, a couple more questions then we're gonna go into q and as from the audience. Um, This, this is another, um, note from a viewer.

I'm sorry, I don't know your name. Um, it almost killed me dealing with my insurance company trying to get, um, s bravado approved. I went through a very brief, intense treatment in May, and it worked wonders for me. Why is it so hard to get access to ketamine? I'm a 60 year old leukemia survivor and have a major PTSD and depression.

All I want is something that will help me well to this person. We're here for you. We're working on it. All the people of the panel are working on it for you, but it's true. Um, it's new and so access is is difficult. Um, um, Julie and Kevin, what are your thoughts on how we can, how we can increase access to people?

Well, it's, it's g you know, when we first opened up, you know, back in. 20, 20 11, there was maybe five or six facilities in the United States that were doing this full time. Um, now that you've got a plethora that are popping up everywhere that may or may not be f a hundred percent focused on it and might be kind of a secondary business and those kind of things, and that sometimes yields different, um, Quality of care issues and so forth.

The biggest challenge is the insurance companies, you know, because it is experimental off-label. Uh, we've tried the super bills and getting some patients to be able to recoup some dollars for their treatments to offset future treatments and those kind of things, but it requires a lot of work on their side.

Um, we have been going through the process of getting credentialed with third party payers currently with, uh, with our clinics. We've got the seven clinics in the six different states and, um, we've now become contractor with UnitedHealthcare and Blue Cross Blue Shield. But unfortunately, they're only willing to consider covering patients' chronic pain treatments.

They're not interested in working with us in the mental health world. So we're gonna try to step into that so that we can see if there's some reimbursement opportunities there that would. Decrease like Angelo was speaking, to decrease the patient's responsibilities financially and see whether or not we can get these big, uh, third party payers starting to pay their share.

Yeah. Do you use Jack? I can speak to s bravado specifically if you like, cuz we, we, we, I've been involved in that. Uh, and, uh, we, we, we, uh, are now doing a fair amount of, of that, that particular, uh, drug, um, you know, to, to, to answer to the, uh, to address the, the, the, uh, Viewer's question. You know, uh, um, s bravado is controversial, but one of the things that is really a breakthrough about it, it is d a approved, and that really opens the door to, uh, medical, uh, cover insurance coverage.

And, uh, the, when something gets FDA approved, especially something novel, there usually is a process, a time lag before the insurance companies sort of, uh, you know, evaluate it, put it on their policy, get codes for it. I can tell, I can tell the, the, um, the person who asked the question and other viewers that there's been tremendous movement in the last, uh, eight months, um, with insurance companies.

Writing policies, uh, for Esketamine and intranasal, uh, saying that, you know, it is, we do, we do accept it as a medical necessary thing and, uh, and, and, and covering it. And, uh, I'll tell you where, where the barrier has mainly been. The, the, the problem is that with Esketamine, uh, the s bravado, the f d a has, has mandated that there are certain, um, you know, monitoring requirements so that patients have to stay in a certified clinic to be observed for at least two hours.

Um, and, and patients never get the, uh, medication, you know, to take home. Um, just so pe some people are not aware of that. And, um, while there's now very good coverage of the drug, there has never been a good mechanism for providers to get reimbursed for that two hours of monitoring and having the patient in their office that's starting to change their codes that have been written.

And, uh, in fact, Medicare is one of the leaders, actually, it's in a, in a kind of paradoxical twist. It's usually Medicare rates that, that are not very, uh, effective. Medicare, uh, now has established, you know, uh, good codes and, and and rates. So I would tell everybody that there's optimism. Uh, it's, it's gonna happen.

It's gonna be fully covered by all insurances. It's just a matter of time and we're already seeing great progress. And I think in a year from now, you'll see probably complete and thorough, um, insurance coverage of s bravado. Thank you. Thank you for explaining that. Angela, I hear you have an idea for increasing access.

Tell I'm at the bit. Oh my gosh, yes, please. Right. Thank you guys for keeping that perspective around around access, but of course this is where we're falling into the problem of the medical model of psychedelic therapy rather than the psychedelic therapy of medicine and healing. So all of us can agree that the healthcare system we are in currently is broken and not getting better.

Insurance may or may not cover this, but it is time for bold action from providers that have the ability to prescribe these things. It is relatively safe to use lozenges and do these things, much lower cost. We are looking at creating some type of, uh, model based on like a community acupuncture clinic where we have a healthcare provider that can screen people and then maybe using other resources such as psychedelic doulas that could sit with people and support them through their process, working with people that don't have to bill.

$400 an hour to support someone going through their care. So I think it's really crucial that patients demand low cost, quality access, that providers prescribe lozenges once they've been able to see that patients have been cleared for care, and that the public starts to recognize that these medicines are profound for healing and that people need access to them.

We know that the middleman of the insurance companies are just going to increasingly put, put money in the pockets of the insurance company. It's not really in service of healing. The fact that Esketamine was pushed through the F D A with the blessing of Trump, even that. It costs about $800 per dose out of pocket and is limited by the people that can provide It is really, uh, a challenge when truly ketamine is dollars per dose to administer.

It's so inexpensive. Ke ketamine is not approved as an S F D A treatment for treatment-resistant depression, but that's because it's off patent and off label. Janssen, the organization that, or the, the pharmaceutical company that made SPR bravado did the research initially with ketamine that showed its effect effectiveness for treatment-resistant depression, and yet because it was off label created esketamine so they could charge a ton of money for it.

I mean, already Esketamine has been. Rejected two separate times by the National Health Service in Europe, just including recently yesterday because of the outrageous cost and expectations for, uh, what's needed for the clinical care piece. So, um, that's my soapbox, but I think there are absolutely ways that we can provide these therapies that are much more in service of healing people's trauma and not lining the pockets of insurance companies.

Mm. Preach girlfriend? Um, yes. Okay. So, you know what I love, I love that we're at the beginning of this journey and there are so many different perspectives and practitioners working it out because that is what is required to create some sort of, uh, Um, stand general standard of care that keeps people safe, but also allows access.

Ketamine's not gonna be the first substance that's extremely therapeutic that people can't have access to, um, or don't have access to because of its, its cost. Um, and it won't be the last, but I think, um, it's so useful to everybody listening. You are the way, so the more that we have discussions like this, um, the more you are interested in substances like ketamine for your own therapy or for your loved one's therapy, and you go and you talk about it and you push and you push and you push, um, the, the system will respond.

Um, and so unfortunately, yes, in the meantime, people are subject to have to get things on the black market. Um, which as we talked about earlier, is incredibly dangerous because you don't know what you're doing, and if you don't know what you're doing, you can't be safe. Biore Reset Medical is a medical practice specializing in integrative therapies and advanced wellness protocols.

At Biore Reset Medical, we treat some of the most challenging to diagnose and difficult to live with ailments that people suffer from today, including Lyme disease, chronic pain, P T D, and Mycotoxin illness. Our team has a wealth of experience in advanced integrative strategies to get you to optimum wellness, many of which can be conducted remotely from the comfort of your own home.

Right now, our team's approach is to use the most non-invasive, natural, and integrative ways possible. Find out how we can help you by reaching out to us at 6 5 0 8 8 8 7 9 5 0, or at our website, www bio reset It's going to be amazing, but thank you for that perspective, Angela. Okay, so we have, uh, a lot of amazing questions from our audience and I'd like to open it up so that our panelists can answer some of them.

Please welcome, um, Madison from my team. Madison, what's, say you. How's it going? Hi Jackie. We have had so many great questions during this stream. Thank you all so much for engaging. Uh, one of the first ones I wanna throw at you, and this is to really anybody that wants to answer, there's been a, a bunch of questions about basically how to get involved, whether it's, uh, participating in studies as a researcher or people who just wanna get into the field of psychedelics.

Um, and then someone even mentioned a psychedelic doula. They would like to learn how to get trained on getting involved in these things without having a medical background.

Well, I'm gonna be launching a psychedelic doula training at, uh, in spring next year. So if anyone wants to learn more about that, that's informed by my, uh, years of work at the bedside as a labor and delivery nurse and a doula myself, and looking at, uh, psychedelic work as a transformational experience, much like birth or death or these experiences are.

So feel free to reach out to me and I can share more about that. I think Madison, too, this brings up something I wanted to discuss, and that's about ketamine. You know, do you need to consume a substance in order to administer it or, um, prescribe it or whatever. However you're, um, however you're acting as a doula, whether it's as a doctor or um, as something else.

And I think, um, What do you guys think? Um, do you need to know the substance before you can? Um, prescribe it. Well, I, this is something that I've had a lot of conversations with, um, colleagues who've been, uh, doing ketamine for a long time, like me. Uh, I should, I should clarify also doing, uh, is a, is a ambiguous term, but, um, uh, treating people with ketamine, um, there's a, one of the things I would say.

And, and maybe some people will be upset by this. Um, you know, I, I'm a scientist, uh, and ibel, I, I, one of the reasons I think that, uh, that medicine is, is, is, is, is great. Is that contrary to what people think? It actually has no dogma. There are, there are, there are dogmas at certain points of time, but we've seen so many concepts in medicine overturned and, you know, every, everyone has gone to medical schools, had the, uh, experience of first day, you know, big lecture, and, uh, you know, the professor saying, you know, everything we're teaching you now will, was gonna be probably considered, uh, inaccurate, incorrect, uh, incomplete.

That's part of the amazing, um, process, uh, of, uh, of, um, Medicine and ancient, uh, uh, medical systems don't do that. They're, they're a dogma, you know, they're, this is the way it is and it's because, you know, you have cheerer energy and, you know, they don't, nobody asks the question. Um, so I just would say that, uh, I'm very open-minded and I think it's part of the exciting thing about working with ketamine is that how different it is and how, how it involves the psychological state and set and setting and the patient being a participant.

And I explained that to every one of my patients, but there's also, uh, I know there's a lot of dogma that comes from. The preclinical use of, uh, of psychedelics. There was a one, you know, uh, uh, when we started do seeing these studies come out of N I M H, another place where intravenous infusions of ketamine, uh, with no, uh, you know, therapy were having remarkable effects.

Uh, I, I spoke to many colleagues who were thera therapists and said, it's not possible. They've worked with ketamine. Ketamine is just a lubricant for, for therapy. It doesn't have its own effects. They now, with the overwhelming evidence, acknowledge that that probably isn't true, that. Even by itself, ketamine can have, uh, incredible effects, but you know, still will believe that, you know, therapy plays an important role.

And so what, and so there's a lot of other things. There's, there, there, there was, was beliefs that, you know, uh, ketamine cannot have an you, you cannot do it inside a building and have to be at na in nature. A lot of these things have, have been shown, not necessarily, uh, to be accurate. And so, um, I, and, and one of the dogmas is, uh, is that, you know, you, you know, you have to experience the, these drugs.

And it might be true that that's a positive, uh, uh, that's a positive, uh, you know, experience. But nobody's been able to really give me a good. Explanation for why we have to do that with, with these drugs and not, you know, if you're giving cancer drugs, you have to experience the, the analogy of cancer, uh, drugs or so forth.

And I had one, one person say to me, well, you know, if I was, uh, the analogy was if I, you know, uh, if I was, um, climbing a mountain, uh, I would want the Sherpa to, uh, you know, to have, uh, experienced climbing that mountain. My response is, there is no one mountain. Every mountain is gonna be different. And if your Sherpa has, has been up his mountain, thinks that that's what the mountain is, uh, he, he may actually be a liability because the mountain, you, the mountain you climb with him, uh, may be different.

And he's, and he's assuming that it's, it's, it's his mountain. So psychedelic experiences are, are different from person to person, and they're different from. Uh, within a person from time to time. And I could say that in closing, that I've had, you know, there were times where we've, we've thought about doing support groups, uh, with people who have had like no experiences.

And part of the reason we we stopped doing that is that they had such different experiences. It was frustrating, uh, to, to some of the, uh, the patients is like, why am I not experiencing that? So, uh, I'm not saying, yes, it's important or not important, but. But we need to, uh, put everything to the test. I think all these things need to be evaluated in good experiments, and we're actually, uh, planning an experiment where we are gonna be, uh, you know, uh, uh, having, uh, you know, the type of, um, uh, therapy, for example, that some people insist in tense therapy, whereas more of a, just of a, a set setting approach.

Uh, and, uh, I just encourage us to be open-minded and agnostic going into these things. Now I get off my soapbox now. No, I love it. Thank you. Beautifully said. Um, Matt Cook and Barb, you guys have sort of a teaching practice where there's lots of young medical, uh, and experienced, uh, medical people, um, in your world.

So what, uh, what say you about, how do people get in, get into medicine? Would you advise that these days? I know medicine's changed a lot. Um, And then how, how also to bring in, you know, to take the path towards, um, becoming a psychedelic practitioner.

You're on mute again. I, I think I almost fixed it in time. Um, so thank you. That's a good question. You know, I think fundamentally this is a regulated procedure and so we're gonna need to, to some extent, try to do our best way to follow, follow regulatory guidance and regulatory pathways. Um, uh, that being said, I 100% agree with everything that was said about Esketamine, I think is kind of a catastrophe of people just trying to make money on a product that's no better than something that is okay.

Uh, or something that's, that's generic and great. Uh, we have, I have doctors almost. Every day here and we're teaching them how to do this stuff. So if people want to come and learn, we're delighted to have you and, and educate you and coach you in, in what we're doing. Um, the, and, and you can kind of see how we do it.

We do sometimes the set and setting approach. I've done a moderate amount of, uh, ketamine assisted psychotherapy that I, I personally think is just about the greatest thing because, you know, I'll talk to people all the time. I've been doing, I did, I I have almost a little tiny cottage industry of taking care of psychotherapists that are in their seventies.

Like I see. I, if, if, if you said, who do I see? I see people in entertainment, venture capital and therapists. Um, it's interest. It's interesting cause this idea that let's, let's say there was a conversation that I'm just emotionally can't quite have. But then a lot of times on, on ketamine, someone can have that conversation and they can begin to engage in a therapeutic process that's totally different than what they could do just in a clinical room.

And I think that, um, on the dose spectrum, interestingly, you can do a lot of amazing things at low dose and at micro dose. And I think that the, a big area for the future is gonna be, Um, a doing that in a clinical setting with psychiatrists, eventually I think that that should be expanded to psychologists who probably have more bandwidth to do this stuff.

And then I think eventually psycho, uh, some, having some form of medical supervision of doulas and stuff like that, I think is a good idea as well, so that there's appropriate medical considerations being taken into consideration. But, but experiencing what can happen at a therapeutic, at a conversational level and at a low dose level.

Um, and we're. Actively engaged in everything from high dose to very low dose and teaching that. And, um, I think it's the future. And, uh, I think there's social justice issues, issues, there's political issues, there's medical issues and there's insurance issues, and, and it's gonna take time to navigate all of those.

But I think when something is really good, it ultimately is gonna bubble to the surface and it's gonna be something that people, it's, it's something that people deserve to have. Hundred percent. Can I, I take in a real quick comment on that, Jackie, please, Barb. Um, as we've seen a, uh, practitioners come through here, MDs, ods, uh, dos, I mean, uh, nurse practitioners, all kinds of different practitioners come through here that wanna, they wanna learn about the practice cuz we do a whole lot of different regenerative things.

Most of the time, ketamine is one of the things they're most interested in, is they're trying to figure out how to get out of the insurance model, um, of whatever their specialty is, and also bring healing to people, um, in a, you know, a cost-effective manner. And they, and I can't think of one who, as they learned about ketamine from us, did not wanna do a ketamine journey and experience it with us so that they could have that experience to take back into their practice.

And have worked with a number of practitioners who went through that and then went back and started it in their practice. And, you know, there were some calls back and forth and why didn't this dose work? And was it because I let them have coffee or many, many kind of conversations that happened around that.

But their knowledge and their enthusiasm about bringing this therapy was somewhat. Born out of their own personal experience because most people in the medical field are carrying, just like most people in the world, especially in 2020, are carrying some trauma or a lot of trauma. And so as they lighten their load, they're able to be better practitioners and also seeing the benefits of the medicine.

So just a personal observation of that. Um, I see amazing transformations of people from all fields, but I think particularly for medicine, uh, for as people are trying to take what was their original intention of becoming a healer, and it's been kind of beat out of them by the system. And to kind of come back to that, oh my goodness, there's so much trauma in medicine.

And, uh, hopefully we can figure that out too, because we need more doctors and practitioners and Western medicine is not bad. It's amazing. Um, and we need smart people to be encouraged to go and study it more. Um, amazing. Okay, so in the interest of time and everybody's day, uh, let's do one more question and, uh, I'd love to start with Julie and Kevin after we get the question.

So, Madison, what's a, you? Uh, it's hard to pick the last question here. I'm gonna kinda combine a couple. The first one, I just wanna see if there's anybody that has feedback on how veterans can get support with ketamine, ketamine treatment. And then the actual question I wanna ask is, how can abuse be prevented?

What is the potential harm or negative effects from short-term or long-term use? All right, Julie and Kevin, what do you guys treat A lot of veterans. We do, um, like Angela alluded to, we do have a heroes program that applies to men and women of the military, uh, but also, uh, first responders that are struggling with, you know, either depression, ptsd, and those kind of things.

Um, it is probably right now about a third of our business, uh, that we see on a monthly basis. On an average per month, we're averaging anywhere between 500 to 600 infusions between the, the seven centers. Um, so we get a good volume. We've actually been partnering up out of, uh, Colorado. What's the name of the company again?

There's a, there's a, there's a 5 0 1 C three that we're doing some research with the, the Ketamine fund. Uh, yeah, it's a little bit different. I, it might be a Ketamine fund, but we're trying to do some research with, uh, with CCAN and some different companies doing hyperbaric oxygen treatment in combination with, with ketamine, and seeing if we can get some, some quantitative studies that we can go back to Tricare and to some of these, you know, these, these evil third parties and see if we can show value and so forth and get the, the military's, um, insurance plans and stuff to cover this for them.

So, but yeah. Yeah, we, we see a lot of them. Beautiful. Yeah. Okay. And one last question for all the panelists. Jackie, can I just, uh, pipe in and say one thing? Go for it. We, uh, we actually have a contract with the va, so, uh, um, that, that for the last, um, five years I've been treating vet's referred to me by the va.

There's been, there's been, uh, uh, a, a change in policy and they're bringing people back to dos bravado, actually. But, uh, I did wanna say that we actually have, um, uh, a, a five, we're working with a 5 0 1 C that will underwrite, uh, ketamine treat treatments for, for veterans. So, um, if there, if there are any veterans locally, uh, and they're worried about funds, we can, we, we, we have a, we have ability to, to, uh, really, really, um, reduce costs because of this, um, because of this, uh, uh, charitable, um, uh, um, organization.

Yeah. Let me, let me just say real quickly, the 5 0 1 C three is Invictus. That's where we're working with Colorado, Colorado. Got it. And Ketamine fund is another one we're friendly with. Great. Um, and we'll, we'll put that up on the post, um, communication of this live. Um, in closing to all the panelists who wanna participate, considering, I think we can all agree that, uh, we can all agree that Ketamine is a wonderful tool in a patient's journey or a person's journey, um, to wellness.

Um, you can call that psychedelic wellness. You can call that just wellness. And we all want each other to be well, we want ourselves to be well. So with that in mind, um, uh, what's a final thought on how we can ride the line between using psychedelics mindfully, and creating a and, and creating a new vice or numbing habit with psychedelics?

What would you want to leave the people with?

I'll take that one. Um, all right. First. Am I unmuted? Amazing. Um, so I think to sort of build on the idea of that ketamine is not a cure and we need to look at all medicine, whether it's plant medicine or traditional medicine, you know, or pharmaceuticals, um, and that it should be used, uh, we need to look at it as part of an overall program.

And so I really encourage people if they don't have a meditation practice, if they don't have a yoga practice, if they don't have a way to move their body and get into their body and do breath work, that all of those things, and they can be reinforced by the person that's the doula or the therapist or whoever's with the patient during that journey and during that treatment.

That, you know, it's just super important to use this as an opportunity to build some, a strong foundation, uh, for psychological health, emotional, mental, physical, and spiritual health. So, you know, for me, my personal experience with Ketamine is that I've had a lot of trauma in my life. It's been super helpful with that.

And now I use it for my own, like psycho-spiritual work. And I think that that, um, everybody can do that, you know, even when they're deep in depression and it may take a lot of trophies and a lot of sessions before they can get to the point where they can start to really cultivate those habits. But that should be the end game.

And the end game shouldn't be, Hey, every two weeks you gotta do ketamine for the rest of your life. And so, you know, because it, because that will build to a habit and there is a danger in that. And they used to say ketamine was not addictive. And we all know now that that was sort of like what the cigarette companies were saying.

Um, and that we all have, all of us high performing people have addictive personalities and all the people that come into the clinic that have psychological issues and emotional issues. There's trauma underneath and there's addiction oftentimes, and we find ketamine really useful as part of our addiction protocols, whether it's, um, for people with chronic pain, so they're on opioids, uh, for people that are alcoholics, long-term alcoholics.

We do a lot of things between trauma, including still a ganglion blocks and other kinds of traditional medical, um, procedures and injections. But ketamine is a super useful part of that. So, so looking at it, you know, as a medicine, but also looking at it holistically is just super important. And I think it's just, it's so exciting that we're at the point now where we can have these conversations with people who have credentials in the medical world and have it listening for that.

So I'm super excited, even in this year of a whole lot of trauma, let's use this as a way to kinda launch into that full healing. Let's do it. Love you, Barb. Thank you. Um, who else wants to go? Angela, what's, say you, what's your final thought? Oh my gosh. I love everything Barbara just said. 100%. I think the way that we have, we have to stay oriented to the idea that if we are coming from a psychedelic perspective, that we understand that people aren't getting addicted to ayahuasca, people aren't getting addicted to psilocybin these things.

Ketamine is in that category, and I think we're walking that fine line right now where if we medicalize it too much, it will turn into this pill that you have to take on a regular basis. So the ways that we avoid that is to really make sure that we come in with set setting sga, bringing in community, having support through the process, and setting intention and integrating in a really deep and embodied way.

I think that is a crucial component, and I completely agree with Barb around this is a holistic approach. We need to look at the whole person, and it's not just the individual, but it's also the community and the environment in which we live. And with that, I think that we have potential to do some great healing on the entire planet.

Beautiful. Thank you Angela. Julie, and Kevin, what's your final thought and what's next for you guys? Well, um, final thoughts? Well, we are probably gonna be opening three more clinics in the next three months. We're gonna be busy, so we're hoping that we'll be, uh, we'll, we'll help with some of that access to, to, to care.

But I think our biggest thing is as the community continues to learn about ketamine and other options for mental health care and improvement, um, they, we need to have the community ask questions. They need to know the questions to ask. And there's a lot of, of different providers that are throwing up their shingle on, you know, in a building and doing this and maybe doing it for the right intentions or maybe doing it because it's, uh, It's just an extra revenue stream and we, we feel, you know, everybody on this panel has been talking about the amazing results that we all see.

You can see the passion in everybody. It would be very detrimental, I think, if too many providers got into this for a cash based reason and so forth. And we started seeing some negative press and negative outcomes. So we gotta set those qualities. We gotta set that standard of care, and we gotta keep communicating with the community to make sure that the community understands what questions to ask of a provider, if there is multiple providers in an area to look for the best option for them, whether or not it's intranasal, intramuscular, intravenous, or trophies or whatever.

Now a hundred percent agree on the wellness component. It's so important that the ketamine is just to get you over that hump. So then you can look at your nutrition, you can exercise. A lot of our patients come to us and if on day one we started saying, you know, you need to eat better, you need to exercise, that wouldn't go anywhere.

So it is, there is a process to get 'em to the point where they can look to that. And I think it's also important to know that, that the ketamine customer base is not, um, your person who's comfortable dabbling in psilocybin. They're, they're from all walks of life. And a lot of them actually, you know, prefer a more, not a clinical setting, you know, not necessarily like a hospital setting, but something that gives them a little more comfort that, you know, this, this is real, this is, you know, there's some legitimacy to this treatment and you know, Everybody's comfort level on any kind of psychedelic drug is different way, different level.

So, you know, it's important to have a level of legitimacy to that, that will take this treatment, you know, to where it needs to be mainstream. Definitely mainstream psychedelics. That's what we're all about. Um, thank you guys for being here. Last but not least, um, Dr. Ffel, what is your final thought and what is next for you in your practice?

Um, Um, well, um, uh, in terms of, uh, in terms of, uh, final thought, well, uh, uh, in terms of practice, we're, we're going in in several di in several different directions. We are also, uh, expanding, uh, edema, um, planning on, uh, uh, opening, uh, additional sites in the next, uh, uh, 18 months. But we're also doing a lot of research.

We're actually, I've got a couple studies now with psilocybin under the F D A in, uh, collaboration with, uh, compass Pathways and, uh, and really trying to learn as much about it while we are treating patients. Uh, and I've been doing this, you know, as you know, since 2008, uh, was I, was, I, I created the first, uh, ketamine clinic, uh, outside of research when I was, uh, on, on faculty at U C S D.

So this has been, uh, you know, year 13 for me doing this. Um, but, uh, there's still so much to so much to learn. And, uh, and, and I, um, and I think that's part of the, the, what really excites me is we're, we're already able to, to help people phenomenally, but, but we're also, I also realize there's so much more, uh, to optimize.

And that's part of a big part of what we do at Edema. Uh, uh, I guess in terms of final thoughts, I would say is, I, I I, I'm gonna take a little bit of a different stand from Barbara. I think there is danger to, to opening up ketamine too much. We just published a study, uh, uh, surveying, uh, a number of, uh, ketamine providers around the country.

Long-term effects, cuz there's no, no, uh, prospective studies. And one of the concerns, as you know, from some of the skeptical people is that, you know, there's gonna be a lot of addiction. Uh, you know, uh, and we found that the, uh, very few cases of adic, uh, of addictive behaviors as defined sort of, you know, formally by the DSM five.

Um, uh, and the only ones that were, that, that were ever reported were, uh, around home use. That was done in conjunction with the, uh, uh, medical visits in, in, in clinic use. Uh, and a lot of the providers, uh, who had done it had backed away cuz patients, you know, when they had access to it, uh, unregulated, uh, tended to, uh, To want to do more and more of it.

Um, uh, I totally agree about sort of, we need to incorporate some of the, some of the, uh, knowledge and wisdom of the psych, uh, uh, of, of what we know with psychedelics. But that can be done into a medical model. And the reason that ketamine is, is, is where it is today, is because of, uh, of studies done, uh, by psychiatrists.

Um, you know, uh, at places like Mount Sinai Hospital and N I M H and things that we published when, uh, at U C S D, um, it, it, it's, it's why Ketamine is where it is now, and Silo Sabin and those things are where they are now, uh, because of studies being done at John Hopkins under very sort of, you know, Uh, under the tradition of medicine, being open to inquiry, but being skeptical and asking the questions.

So I think the, the, the best route for, for, for these medications is, uh, through a sort of a regulated and, uh, well thought out medical umbrella, uh, to provide increasing a, uh, access. And I think that will happen. Um, so I would point out that the very first person who really discovered the mind, uh, qual, mind altering qualities of, of ketamine, John Lilly, um, actually his life got ruined because of, uh, because of, uh, of ketamine in excess use.

He could not con, could not control. So it's, uh, it's not as benign, uh, as, as we like to think when it's, when it's comp, when there's completely unfettered access to it. And, uh, and home use and so forth. All righty. Thank you for that. Thank you to all of our panelists for being here today. I know you're all busy working, making the world a better place.

We really appreciate your time at Delic. Thank you so much. And to the listeners who want to, um, know more about our panelists, we will again communicate that to you, uh, post the live event. Um, and please dig deep and, um, thank you so much. So panelists, you're free to go or you can stay on. Before we close out, ladies and gentlemen, we're going to, um, we're going to bring on some, some other friends of ours.

Uh, he is a, he is a, uh, Hold on real quick. Ian McCall. Yep. There we go. He is an American mixed martial arts world champion, um, and founder of the McCall Method, and she's a psychedelic integration coach. Please welcome Ian McCall and Arena Reyna to talk about their personal experiences with Ketamine, how they've helped, um, how they, how Ketamine has helped them.

We got a lot of questions from you guys wanting to hear firsthand accounts about this substance. It's one thing to hear about how it ha it works in the body, um, or how it's regulated. It's another thing to hear another human really talk about how it's helped them or not help them. So, welcome Ian and, um, arena and uh, we can't wait to hear your story.

Thank you. Thank you so much for having us here. It was, uh, so wonderful to hear everybody. Um, so many components were incredibly relatable to my personal experience and also to the experience of others that, um, I've helped, um, integrate their ketamine and other psychedelic experiences into their lives.

Um, I would like to talk about some of the classic experiences, of course, uh, in having used ketamine to treat my depression and P T S D, but as Dell has, uh, mentioned how interesting it is to actually mention some of the lesser, uh, known or used applications of some of these substances like psilocybin for treating facial texts.

Um, in my, um, instance, uh, the big part, one of the most transformational experiences that I have had, um, involves, uh, using ketamine for treating depression that was caused by sexual trauma. And, uh, experiencing the most profound form of psychosomatic release that I have ever had, which became a turning point in my healing and my ability to manage, uh, certain manifestations that my body was, uh, struggling with.

And as all of you have remarked, ketamine experience can be incredibly different depending on the mode of application, depending on the set and setting and the dosage that's used. Um, in my specific case, coming from a deep history of sexual trauma that was never, uh, truly processed, it has, um, the large dose was, was needed to bring me to that.

Place of actually being able to process certain experiences that have happened to me as a child and being able to, to be in that beautiful space of psycholytic and psychedelic experience at the same time, being able to witness what my body was going through in a very intense psychosomatic form. Uh, for example, my hands have completely curled up, which I have never experienced before, and I have used ayahuasca and psilocybin as well as, uh, psychotherapy and e emdr r for processing, uh, for trauma reprocessing.

However, in this instance, uh, it was the first time that after many years I had the opportunity to actually speak about what has happened in these instances. And following that occurrence, I had a treatment and I. That intense form of, of, uh, psychosomatic experience is something that has allowed me, just like one of the panelists had mentioned, to literally turn on the light in a tunnel and to be able to be there to verbalize what was going on with my body, to actually feel that place of being stuck that has happened to me.

And at the same time, to ask the person who I felt safe with at that time. Can you help me? I have never asked for help. I have never really reprocessed that experience. And to feel that release of actually becoming unstuck and uh, coming out of that place of my body freezing completely was incredibly profound, uh, for that specific experience.

Uh, so that has resulted later on in, uh, being able to implement some of the very new sensations that my body has received during that, uh, specific treatment into my integration practices. I have practiced yoga, breath work and meditation for over a decade. Yet I have stopped dancing. I have only used my body in a structured manner, meaning following yoga routines and following, um, uh, structured practice that my body was engaged in.

But I have stopped dancing completely in my early twenties when I started raising children and got involved in, in r and d and academic career and got really busy, I became a classic model of what Dr. Gaer matte calls an addict that becomes a workaholic, and in which case, sexual trauma becomes a sexual addiction.

I kept my mind busy. I kept my body super busy and super efficient. However, I never reprocessed those traumas that have caused me in my later life, in my later adult life to experience depression and PTs d and severe signs of trauma. So this experience, um, even though I said I've done ayahuasca and psilocybin before, after ketamine, I've actually started two.

Dance. I've actually started to, uh, express my body. A static dance has horrified me. Even as a devout yoga and Redford practitioner. Just a few years ago, being in the circle of everybody dancing, ecstatically absolutely horrifying me. My body was stuck. It was frozen. It was impossible for me to do that. So anyhow, I started to dance again.

One, a couple of, um, couple of memories that came up. During, uh, this, uh, specific, um, encounter were also very profound. I have never remember that in my early childhood as a five year old ballerina, I've danced for a dictator, uh, in the country where I was born, Yugoslavia. I was five years old and I was one of the ballerinas that had to dance for celebration of his birthday.

I had some vague memories of my body form and sha being scrutinized by this group of gray looking people, but I never quite tapped into that memory what that was. And then later on when I was 15, my first modeling gig again in Eastern Europe was in front front of a sea of Eastern European diplomats.

And again, here is the body that got frozen because of the form being scrutinized and so many other interesting things that have popped up in that profound moment. But anyhow, I'll leave you with that. Um, I think this was something that, um, I wanted to share as a very unique way of liberating my body and, uh, also lessening signs of depression long term.

I got chills. I got chills. I, I I love that you're dancing again. I, I've, I talked about this on Deic radio a few times with a, an actual, uh, I say an actual dancer, but I'd like to think that we're all dancers, um, as much as we can move our bodies as we should. And there is a connection between consuming psychedelics and, like you said, relieving your body or allowing your body to, to come back to life again.

Thank you so much for sharing. Yeah. What's say you All right. So, uh, I've got to deal with a lot of different things. Pain. One of them. Uh, depression. Another one, addiction was, I would say my biggest because, you know, for my entire career I was addicted to painkillers from 14 to 34. My, my sporting career, the greatness of becoming a world champion, trying to go, you know, college Olympics, whatever.

Um, my body's broken. Uh, I don't hear any doctors talking about inflammation. Um, the anti-inflammatory effects, and sure, this is all theoretical, I guess because I'm just reading it off of books, but, um, the anti-inflammatory effects, when those receptors do get turned on, that, that's, everything in the body that's bad is tied back to inflammation.

And we all know that. Um, I, I'm not telling you anything new, but this is what I see is with the pain, with the depression, with those things, having those neural pathways less inflamed, having the body less inflamed, getting that stress response down, you know, uh, dealing with, with that sort of stuff is what worked with me.

Uh, I got past my addiction to opiates a, a while ago. Um, and was that in that, are we talking about your ketamine therapy or just general therapy using other substances? Ke ketamine therapy therapy specifically? Yeah. Uh, other psychedelics as, as again I've read, whether it's L S D I, uh, um, psilocybin, ketamine, they all have this anti-inflammatory effect on your body.

I believe it's true. Um, and, and to, to knock that down, not just through, you know, diet and exercise, but, but through these forms, uh, high dose C B D, you know, is how I, how I, uh, I fixed my daughter with juvenile rheumatoid arthritis. Um, but, but with, with, with me back to the addiction part was the biggest, most profound thing with ketamine, where a, a sure was with a very large dose.

Um, but I was able to pull out and look at these issues that I thought, oh, I've got these. That was no big deal. I'm good. I'm fine. I'll be great. You know, I was in the hospital recently, and I, and I have a stress disorder, which causes immense pain in my body. That's just my stress response. H pylori in my stomach.

Gall bladder. What? What have you. Um, I, I, I took morphine in the hospital and I'm like, yeah, yeah, give it to me. It's fine. I'll, I'll deal, I'll deal with it. It made me feel so gross, but then I was able to come home and I don't want the morphine or any sort of opiate, but it was, it was a door that opened into my addiction that I, I realized I hadn't, I hadn't dealt with yet.

I was able to pull out and look and go, stop. Number one, stop calling yourself an addict. Like, that's, that's not it. You're, you're, you're maybe a psycho, not sure, but it's responsible. There's safety behind it. There's, there's, there's real integration behind this isn't, this isn't, you know, me trying to be a party boy anymore, uh, you know, douche bag.

Basically it's me fixing myself and helping fix the clients that I have, whether they're an Olympian or they're this or that or the other thing. You know, becoming an integration coach and really learning about these sort of things, learning about the feminine. I mean, I was like, again, I was a douche bag.

I was fighting my whole life, beating people up, climbing into a cage in my underwear and, and, and hurting people for a living, for blood money, for everyone else's viewing pleasure that they don't understand that there's ptsd. Not enjoy MMA at all. No, no, no. I have so much fun, but I, I was tortured, you know, I was, again, I, I get obsessed with things and I, there was three things I wanted to be, and that was a scientist.

That was a comedian and that was a fighter. So I got the fighter thing down. I got into comedy and realized I don't wanna be that person anymore. It brings out some gross things in me that I, it's not comedy's fault, it's my fault. But, uh, and again, I'll never be a scientist, but now I'm a scientific researcher and I get this obsession with things.

I mean, things said, I have a good teacher in my life. Uh, but just to really understand these things and, and, and to be able to pull back ketamine has, has let me really, I mean, look at myself where I was always just in the bubble of a psychedelic journey. No, this is so cool. Okay, great. Like there's no work done to be done after, you know, I'll be fine.

Mm. And that's not how it's, it's it's, it's about doing the work. Just like, um, you know, repetition is the mother of skill. Yeah. That's how you can rid at anything. And for me, this, this is, I had to do it more than once. Yeah. So, Wow. Thank you for sharing. There's so much there. I wanna go back to the, um, to the inflammatory com, uh, anti-inflammatory comments you made about psychedelics.

To my knowledge though, we can't actually confirm that there are psilocybin, for example, when taken, when consumed that the actual mushroom, um, mushroom plant matter can cause an inflammatory response in people who have a gut biome that's not healthy to begin with. So I think in my experience, there are some inflammatory responses, but I like to think about it and maybe you agree that it's having sort of a spiritual and anti-inflammatory effect on your spirituality.

Um, which is amazing because if you're not inflamed, then you can flow in flow state and experience life and wellness. Yeah, I, I would, um, that, that dropping of the fear response right there is the anti-inflammatory effect. Getting that cortisol down, stress hormones down. That's a huge part of it. You know, you go test someone's blood who's, who is constantly depressed, their inflammatory markers are through the roof, you know?

Um, and that right there is just you, you're, I forgot who was talking about earlier, but you're able to give and receive the information, whether it's with a loved one or some random person walking down the street. Um, you're able to deal with those issues and just kind of, you know, pull 'em out. Whether it's, whether you're putting it on, on top of some other psychedelic, or you're just doing it on its own, you're able to pull out and look at these issues and just go like, all right, like, I can deal with these.

It's just emotion, you know? We are, we are emotional beings, and we need to learn to compartmentalize our emotions and deal with them, uh, individually without, without letting them give us this emotional response in our body, because that's, as we've seen and have, have, we've been, we've been programmed.

That doesn't work. It doesn't work for anybody. It doesn't work for, for you or the people that you live with, or the people that you love, you know?

Yep. Um, well, I would, I'd say that go easy on yourself, Ian. You've been, you've been through a lot and your body has been through a lot, your brain has been through a lot, is the, doing the kind of sport that you, that you've done for so many years, and I'm so glad that psychedelics have, uh, you found, um, a newfound wellness with them, both of you.

Um, and that's what we can hope for, right? That's what, you know, we're not here to tell people what to do or how to do it. I think the more we all talk about our experiences real time and come out of the psychedelic closet, the more other people will feel more comfortable doing that themselves and so on and so forth.

And then it will become mainstream and, and people in general will have the opportunity to be more well using substances like psychedelics.

Well, thank you guys so much. Um, where can people find out more? But I know you're in the psychedelic field working, so where, where can people find out more about what you're doing? Um, there's my website. It's called the McCall Method. Uh, I feel silly saying the McCall method because it's half hers anyways, or there's other people in my life that helped me do this.

I just happened to be the guy with the soapbox, with the blue check mark. So I want everyone to know that I have the best professionals around me helping me with this, because this isn't just about me, you know, this just has my name on it for some silly reason. Um, but well, you gotta call it something. I think that's exactly, it's just a name, but the, the or the McCall

Uh, check out her Instagram at Michael Stoic. Beautiful. Well, we love you guys. Thank you guys for taking time and telling your story. Thank you. Um, thank you again to the panelists. Um, and everybody share time with us today. Thank you to the Meet Delic team. The to the viewers. You guys are, You guys are it.

You are the future. You are the now. Thank you so much. Be kind to yourself one. Love, all love.

You can find this Bio Reset podcast and others on iTunes, Spotify, and all other top podcast directories as well as on bio reset Make sure to subscribe and thanks for listening.

Tune in to an informative Meet Delic Podcast panel discussion with Dr. Cook, other doctors experts in the field, as they explore different types of ketamine and their therapeutic applications.

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