#21 Do No Harm | Dr. Michael Verbora

April 6, 2021
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2.19 - How Michael started working in psychedelics.


3.44 - Michael’s initial thoughts and trials with cannabis and psychedelic research. 


6.00 - Why Michael went to medical school in the first place. 


7.40 - Michael expands on the culture of medicine and its incongruence with his values. 


9.00 - Ronan discusses the similarities between his and Michael’s story. 


10.03 - The risk of falling outside the norm in medicine. 


12.48 - The challenges within the North American medical system. 


13.32 -  The “patient-centred” medical system. 


15.16 - Why psychedelics are more effective for treating mental health disorders. 


18.24 - What happens when you take psychedelic molecules. 


20.37 - Michael’s take on the materialist vs. dualist debate. 


25.02 - Michael’s experiences on psychedelics. 


30.21 - Michael’s inward experience with ketamine. 


33.35 - What can we do to advance the conversation about psychedelics in a medical context. 


35.50 - What impact Michael has seen psychedelics have on today’s mental health challenge. 


40.30 - How psychedelic medicine is going to change medicine by normalizing an integrative approach.  


Transcripts

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Dr. Verbora: We're really just shutting down the brain and it's like kind of like this soft reset or maybe even a hard reset, depending on how deep you go. And what we're doing is we're just temporarily letting people disconnect from their ordinary thoughts. And what we know is, is that 97 to 98 percent of the thoughts that you have from one day to the next is exactly the same. You're literally just thinking the same thing over and over. So you can imagine how hard it is to change your life or feel motivated or inspired to to help yourself, you know, get out of a depression or an anxiety when, you know, you have this weight of 99 percent of the same thoughts carried with you every day.

Ronan: This is Field Tripping, a podcast dedicated to exploring psychedelic experiences and their ability to affect our lives. I'm your host, Ronan Levy.

Ronan: Today, we have the pleasure of welcoming Dr. Michael Verbora, a global medical expert in the field of cannabinoid therapy who is currently focused on creating space and conducting research on emerging psychedelic therapies, including ketamine, assisted therapy for treatment-resistant depression, major depressive disorder and obsessive-compulsive disorder. He's also the qualified investigator on a study being conducted by MAPS to study MDMA assisted therapies and eating disorders. Mike is also the Canadian medical director of Field Trip, which you should be familiar with now, if you've been listening to this podcast and if you don't know about Field Trip, I clearly do not do a good enough job promoting all the wonderful things we are working on here. No less, I'm thrilled to have you join us today, Mike, and I'm excited to discuss with you some of the latest developments in psychedelic-assisted therapy and how they can address unmet needs in mental health care. Welcome to Field Tripping, Mike.

Dr. Verbora: Thanks for having me Ronan.

Ronan: We're going to talk about a lot of things on this podcast pertaining to psychedelics. But first thing I always want to know, how did you find yourself working in psychedelics? I know I've heard a little bit of the story, but I don't have to hear it again and I'm sure a lot of people would love to hear how a handsome young doctor out of medical school ends up working in cannabis and then ultimately psychedelics.

Dr. Verbora: Yeah, I feel like despite working with you, we never have time to just chat.

Ronan: That's totally true.

Dr. Verbora: So.

Ronan: With the specter of an audience and watching us too.

Dr. Verbora: Exactly so, I just really felt frustrated near nearing the end of my graduation, I was just seeing really, really sick people. I was at Toronto Western Hospital and the patients that were seeing were typically, you know, somewhere between the ages of 40 and 70, had multiple chronic illnesses, both mental health and typically physical health. And they were on like eight to ten different pharmaceutical drugs a day. And none of them were doing well. And I just thought, this is literally insane. Like, why am I just giving higher doses of these medications and changing the medications? I was just shifting things around in medications, hoping that one day they would believe that they were getting better, because I didn't really believe that the changes that I were making were meaningful at all. So it was pure placebo to me. And so I felt frustrated. I'm like, how am I going to do this for the next 70 years? Because doctors never retire. We work you know til the day we die. So, I can't do it. I just can't. And so I started looking for alternatives and I heard news about cannabis becoming legal. And I thought, oh, yeah, I like you know, I've tried cannabis before. I felt relaxed and calm on it. I never had any bad effects with my personal experience. Let me look into this for myself. And and what I learned was, is that, wow, this is actually way safer than almost every single drug that my patients were taking. So I paused there and I thought, isn't the oath of a doctor to do no harm first? Like, how did we get persuaded into doing best scientific evidence sponsored by the manufacturer of the drug who has an incentive to sell it? And so I had that moment, that aha moment where I realized this isn't really congruent with my values. It wasn't the oath I took. And so I went down that rabbit hole into medical cannabis. I met patients, I started hearing their stories and it was remarkable. I was able to get many of these patients off of, you know, going from 20 to 30 tablets or pills a day to two or three, getting them off of opioids, getting them off of other pharmaceutical drugs. And what they had was a huge improvement in their mental health, their physical health, their consciousness, their awareness, their self-confidence and their own ability to be their own healer was enhanced. And then I was doing that for three to five years. And a couple of patients came to me and said, hey, I have these really bad cluster headaches that I'm taking this magic mushroom. And that's the beauty of being an open-minded physician, is patients will actually tell you what they're doing, they'll confide in you and they'll be honest because you won't stigmatize them. And so I said, what do you mean magic mushrooms? Like, I've heard a little bit about that. I also had a little bit of experience back in the day, mind you, great ones. And then I looked into and I realized, holy smokes. Like there's actually a remarkable research here that suggests that these are substantially more potent than anti-depressants. They're substantially safer. And so I started getting involved in the space connected with some of the guys at Field Trip and said, look, this is the next frontier. I want to be a part of it, I want to take everything I've done with cannabis to destigmatize it, to improve access for patients, to educate physicians. And I want to do this in the psychedelic space because I do feel like this is the future.

Ronan: That's awesome. And obviously, I appreciate all the all the work you've done. I like to take this podcast and talk about the people behind it and understand their stories, like I'm a reformed lawyer. When I went to law school, I was pretty certain from day one that this was not the place I wanted to be and even though I pursued it and became a lawyer and did all that kind of stuff, I knew that was not my journey and that was not the direction I would ultimately end up on. And it sounds your path through medical school, maybe, I'm guessing had similar kind of themes. But like, tell me about that. Like, why medical school in the first place? Like, what was the ambition? And did you feel like, you know, that your path forward was not necessarily going to be down the conventional medical route from early days? Or was it something that you kind of just realized at the end when you realized that you were pursuing the definition of insanity by giving people the same thing and hoping for different outcomes?

Dr. Verbora: Well, that's a great observation. And if I think back to, you know, the first conversations I had about being a doctor, they actually took place on the toilet when I was four years old. There's a video of me from my uncle, unfortunately, who ended up passing away from a drug overdose, sadly. But there's a video of me on the toilet and they asked me, what are you going to be when you grow up? And I said, well, I want to be a doctor. And I don't know if someone planted that seed or if it was my own seed, but it grew. And and for the longest time from four years until this moment, like, I always convinced myself I was going to be a doctor and that was my vision and my path. And I was fortunate enough to excel at the sciences and mathematics. And so I just felt like a natural fit that, you know, to do that to the best level it would be medicine. Wasn't a big fan of the lab bench work. I did some research in university as well, but I realized really quickly that that was not my path, that I needed to interact with humans a little bit more. And so it was really just a self fulfilling prophecy of, you know, I told myself literally a million times from the age of four that I was going to be a doctor. And yet, low and behold, next thing you know, I'm in med school and I'm going through it and I'm seeing patients. And there is a lot of things I really liked about it, but a lot of things I really hated about it. And like the first thing was, is I actually really despise a lot of the culture in medicine and the egos that we have and the fact that we really think we know everything. And I look back at my life experiences and a lot of my life experiences, some of them psychedelic, really taught me that we know nothing. And so it was so incongruent with my personal belief system that I didn't know that because you're shielded from a lot of this in medicine. And there's this thing we call the hidden curriculum. And it's like, you know, the art of medicine that's kind of hidden from you. You're taught to be a scientist. You're taught to be a researcher. You're taught to be a manager and an advocate. But you don't realize a lot of the ugly things that take place behind the scenes, the politics, the financial incentives, the economics of how the model works, really not until you graduate residency that you actually start to realize, well, hey, like no one told me any of this really exists. And now I'm here. I've invested in, you know, hundreds of thousands of dollars of education, a lifelong commitment to learning and retraining. And now you're kind of stuck. And so you have that sunken cost fallacy. But nonetheless, I took that opportunity and trust my instincts and tried to pivot a little bit from it. And that's why I'm in this space now.

Ronan: There's so many synchronicities between what you just said and like my path even going further back, which is amazing. I mean, I felt like I've always had a good connection with you, even though we haven't actually interacted informally that often. And some of the things you touched on kind of suggest maybe why that is. For one, like my path to becoming a lawyer, I can remember that I wasn't sitting on the toilet. I was sitting in front of my Commodore 64, my parents, when I was young, really, really ugly, protracted, disgusting kind of divorce that there's actually a court of appeal cases about and all that kind of stuff. And so when I was young, I remember the day some of my family's lawyers were around the house and one of them sat down and played Commodore 64 video games with me. And I decided at that moment I wanted to be a lawyer and probably much like your family, that was a thought that we weren't allowed to forget being like, oh, you should be a lawyer. That's a great profession, you know, very, very respectable thing to do. And so that was totally like my path forward. What was it like the first time you actually set out to prescribe cannabis? You know, and similarly, I guess a psychedelic or ketamine, but cannabis probably more because it probably felt like maybe a bigger hurdle because you were doing something that fell to outside the norm right?

Dr. Verbora: Like a lot of anxiety, medicine is structured in such a way that there's these institutions and organizations from, you know, your own lawyers that try to protect you against complaints. And then you have, you know, colleges that regulate you and the college is like this big, bad bully that you're fearful of. You just want to stay away from it because you just don't want to be in the crosshairs because you never know who they want to make an example of right? And you just want to avoid it, especially when you're young in your career. There's this, like, huge risk averseness. And so what you do is you just keep doing what everybody else does. You just follow the rules, you follow the guidelines, you don't think for yourself, you know, if the guidelines says you try this drug first, you just do it because you don't want to create that aura around you that you're you know, you're stepping outside the mainstream medicine because then you have a potential target on your back. And so the first time I wrote my cannabis prescription, it was for a child, which is like extra anxiety-provoking because there's rules that say, hey, you know, under twenty five, like you're going to ruin people's brains if you give them cannabis right? Which I strongly disagree with. And it was a child with epilepsy and I gave CBD and I had to prescribe really high doses. And I actually had to call the doctors in Colorado at the time because we didn't have any doctors in Canada treating children really with epilepsy. And I had to speak to some of the doctors in Colorado and just say, hey, look, how do I dose this? What do I give like? And I understand that there's not a lot of science there, but I had that massive anxiety. But two weeks later, when I called the patient and the family, when they had a 50 percent reduction, I had this huge feeling of relief that like irrespective of what happens or my fear of being judged from my own community or the college, I know in my heart that what I did was the right thing. And I have the clinical outcome to validate that. And so that was that moment when I said, OK, I have to trust my instincts as well. Like, I can't just be this robotic doctor that just follows all the rules. Like I have to trust my instincts because they are showing, you know, at least in this instance, that it can be very effective for patients.

Ronan: Absolutely. I mean, I think that's awesome. I think that's brave. One of the big challenges, especially in professions, is like we have these colleges, generally speaking, I believe that the people who work within the colleges are well-intentioned, but they're they're built into a system that they're incentivized to defend right? They work from within and so when young upstarts like you or me show up and try to challenge the status quo or question some of the dogmas or ideals, it is not well received and it's one of the big challenges that we have in society. You know, it's not just limited to professions, it's just particularly heightened in professions.

Dr. Verbora: They serve a really important role like they are there to protect the public from a whole host of things that could go wrong in a relationship where there's someone with a better power structure or a higher power that has authority right? So they're there to try to protect the public, but sometimes in their in their intention to protect the public, they actually unintentionally harm them because they don't give people access to novel treatments that might actually be life saving or very helpful. And I don't think it's mal-intentioned. I just think it's the consequences of being protective and a little bit slower to move.

Ronan: Most modern Western allopathic medicine is the doctor says, here's your prescription, take the pill, hopefully, it makes you better. But cannabis and psychedelics really require active participation from the person receiving treatment as much as the person providing the treatment and that's one of the things that's so exciting about it to me. But I'd love to hear your thoughts on that, too.

Dr. Verbora: You're absolutely spot on. And that was part of the new culture and the new training that we were having as resident physicians. And it was like, oh, we need to develop a patient-centered health care system where the patient is at the center. But it was all talk and that's the truth is like the patients at the center. But then when I give them three or four options to manage their pain, I'm supposed to be forceful or paternalistic and saying, you have to try this one first before you can try this one. It's like, well, I don't get it. You're telling me on one hand the patient's supposed to have autonomy and we're supposed to respect their values. And I should work with them to prescribe what I think is right for them and they think is right for them. But at the same time, you create these guidelines and these guidelines are made outside of colleges right? Usually like they're just expert panels, but then you're going to be held to that standard. So you're you're in this conundrum where you're just like, I don't know if I go left or I go right. Like, I want to help the patient. I want to respect their values. But if I don't follow these guidelines, what happens to me if I, you know, operate outside these guidelines and something wrong happens, like, am I going to get in trouble? So do I try to help the patient or do I try to protect myself and the longevity of my career? And you get stuck in that feeling and most doctors will just say, I can't like I have to protect my my lifetime investment in medicine as a physician. And that's where patients get trapped in the system.

Ronan: We've had a lot of wonderful people on and a lot of people have shared their personal experiences on psychedelics and how it's affected their lives. But I've never really got into the science and the evidence around psychedelic therapies, whether it's ketamine or psilocybin or MDMA. And I think it'd be great for people who listen if you could share what the evidence around psychedelic therapies are and what is the understanding, what is the mechanism of action? Why are these seemingly so much more effective than the current treatments?

Dr. Verbora: I would look at it from a historical perspective first and recognize that, you know, in the 1950s and 60s when you had the summer of love like that didn't just happen because people were experimenting with drugs. There was actually a lot of research that took place before the drugs left the lab right? So LSD was being studied as a potential cure for drug abuse or substance addiction and depression and trauma. And there were thousands and thousands of patients enrolled in studies and the results back in that time were demonstrating that overall it was really, really safe and that they had really remarkable outcomes. But before that could be medicalized formally, you know, it left the lab. Culture started changing rapidly, threatened a lot of things and the next thing you know, the war on drugs kind of came and shut that whole process down. And then once you label a drug as a schedule one, you make it really, really hard for researchers, scientists, clinicians to access the drug, to do the right research. And then you get into weird conflicts of interest where the people who hold those drugs actually have an incentive to keep them illegal because they're paying agencies to protect prohibition. So they don't want any research that's going to look at positive outcomes. So then if you do fund research, what you find is just outcomes like outcomes that are going to be negative. And then you can say, oh, look how harmful this drug is. But that's not necessarily reality, because all you've looked at is you peaked in one corner, but you're not looking in the other corner and pretending that that's reality. And then probably the last 20 or so years, what we started to discover, at least with ketamine, was that it had antidepressant properties. And so there was a number of studies that came out as long as 20 years ago demonstrating that a dose of ketamine had antisuicidal effects and antidepressive effects. And then you have organizations like MAPS which have been in existence now for a number of decades, and they started raising a whole host of money, thankfully, to do a lot of this research, a renaissance essentially in psychedelic research. And what they've been able to do is get access to not just like LSD or ketamine, but other drugs such as MDMA or psilocybin. And so the research right now, I would say there's good evidence today for ketamine, for predominantly treatment-resistant depression, early evidence in trauma and anxiety disorders, and that's in IV forms as well as oral forms. And then there's a lot of emerging and really good evidence for psilocybin. And I would say is the next drug that's really, again, for mood and probably anxiety disorders, but a whole host of other issues, such as addiction potentially. Then the next one, I would say, is probably MDMA for post-traumatic stress disorder. And so what I think is going to happen is if you have ketamine today, I anticipate the next two drugs that will eventually become medicalized will be psilocybin and MDMA, probably MDMA before psilocybin, I'm not 100 percent sure on that. And what's interesting is simultaneously you have like a movement, right, happening across the US and states to legalize or decriminalize and or medicalize without all the evidence that's required that a pharma drug would. But then I think after all of those drugs, you're going to get LSD and maybe other molecules like DMT or novel molecules as well. But you asked also about like what's happening when you take these molecules. They all really modulate a whole host of neurotransmitters, you know be it your serotonin, the happy molecule, your dopamine, the rewarding molecule, or even glutamate in ketamine's instant, which is like a supermolecule that modulates all of them. But at the end of the day, to oversimplify it is we're really just shutting down the brain and it's like kind of like this soft reset or maybe even a hard reset, depending on how deep you go. And what we're doing is we're just temporarily letting people disconnect from their ordinary thoughts. And what we know is, is that ninety seven to ninety eight percent of the thoughts that you have from one day to the next is exactly the same. You're literally just thinking the same thing over and over so you can imagine how hard it is to change your life or feel motivated or inspired to to help yourself get out of a depression, anxiety when you know you have this weight of ninety nine percent of the same thoughts carried with you every day. So you take the psychedelic drug and you get this change in what we call the default mode network. It allows you to change that default mode network so that the next day when you wake up after your psychedelic trip, you're about to have that same thought. But you kind of your brain will pause, it'll say maybe I can take a different path to a different area of the brain and look at everything from a different perspective. And that's probably the best way to summarize a lot of the experiences we see in the clinic with ketamine is that most patients well, they have a lot of themes to them, whether it's like the sensation of being reborn or reliving an old memory or a trauma through a different lens. But but the theme is really this third-person perspective view and kind of looking at their own life from a different lens and saying, you know what, maybe I can actually look at that situation a problem or that stressor from a different perspective and give it equal weighting, because maybe the fact that I'm too invested in this is giving me a biased perception of my own thoughts. And and that's really what's so remarkable about psychedelics, is that third-person perspective. It reminds me of astronauts, right? When they go up to space, they get this view of the world and they're never the same. And what they realize is like there's no countries, there's no races or anything. We're just one person. And they have that huge sense of connectivity. And it's because we're getting a different perspective. It's the same thing with psychedelics.

Ronan: And personally, like, what's your perspective? On it, you know, there's there's the debate to some degree that touches on this of being a materialist versus a dualist because there's so much emphasis on on the integration work, like taking these ideas and putting them into action, sort of training your brain. But then you have these people who, you know, have experiences where they experience God or they feel love or empathy or all of these emotions. And and even though there is definitely a tie between the neurochemistry of what's happening in the brain and all these receptors, there is definitely something that seems to happen on an energetic level. Now, maybe that's just human consciousness being experienced through the lens of brain activity, receptors, chemicals, neurotransmitters, all that kind of stuff. But, you know, a lot of people, especially people within a psychedelic community, would be it's about energy. It's about healing. It's about much softer concepts that don't fit into conventional medical Western perspectives on it. So just curious to know your thoughts and perspectives on it.

Dr. Verbora: My personal belief is that we really know nothing and that we're very primitive still. So I think the fact that medicine is so grounded and rooted in biochemistry is very primitive. I think that, you know, the physics of our universe and energy is so much more complex and that we're just really starting to understand that quantum world and how we can probably manipulate it. And so I do tend to think that, you know, there is definitely something happening here with energetic states or, you know, being able to tune into a different frequency. And that's how you're changing your consciousness. Like there's a lot of belief out there that consciousness is not originating in our brain. It's originating outside of our brain, and that we're merely antennas for tuning into different frequencies. And if you turn into different frequencies, you get a different reality. And so I tend to side with that belief system. But I think it's going to take a long time for science to catch up to understand. But but I'm really excited with the work that we're doing because I think psychedelics is going to be the gateway to really understanding the human brain, the human condition, a lot better than anything else out there.

Ronan: It's been said that humanity has advanced when it has advanced, not because it has been sober, responsible and cautious, but because it has been playful, rebellious and immature. And since working in health care, I've seen firsthand how the field of medicine may need to take a healthy dose of this advice. To be clear, I respect that doctors are dealing with issues that require the highest degree of consideration and professionalism. A person's life is nothing to take chances with. As my first year history professor, Dr. Wesley Wark said, in respect of the most important lesson from the Cuban missile crisis, you don't fuck with nukes. The same is true here. But in the pursuit of do no harm the field of medicine has taken a very paternalistic approach to care, telling people what's best and not leaving much space for a person's intuition or feelings. And as we see more and more attitude, mindset and outlook not only have an impact on our emotions, they have a significant impact on our physical health and expression of our genes. So when a doctor diminishes a patient by not giving them voice or agency, the effects can actually be much deeper than just making a person feel bad. But that paternalistic approach is in many ways impossible in psychedelic medicine. Psychedelic medicine at its core is experiential medicine. How a person feels and how engaged they are is directly correlated and likely even causal to the outcomes a person has from psychedelic therapy. And the results we are seeing are fantastic. And I think that's going to empower and embolden people to take similar approaches to the rest of their health care, demanding a voice, demanding respect, demanding that health care be delivered in a way that befits the gravity for which it exists. And I expect that the outcomes we're going to see for human health and well-being are going to reflect this evolution in a deeply positive way.

Ronan: I've had a number of pretty powerful insights, I wouldn't say transformative insights on psychedelics, but certainly some powerful ones. And it's actually one of the interesting things that I like to talk about now that people expect, you know, a psychedelic experience or a psychedelic therapy to be transformative, like it totally changes your life. But truthfully, for most people, it's just going to be incremental. Slight increases in awareness, slight shifts in perception can make a huge amount of difference. Each time you move two percent, it adds up more and more that you can have really profound transformations without having it be totally revolutionary the first time. But curious to know and you don't have to answer this, but curious to know if you've had any really profound or life-changing awarenesses, ideas, perspectives on psychedelics that you'd be willing to share.

Dr. Verbora: I think this is a space where, you know, practitioners who have experiences is extremely valuable. There's only so much you can read in a book and, you know, so many articles that you can read to try to understand psychedelics. But it's not until you really have the experience, because it's an ineffable experience, you can't really use words to describe it. It's a feeling, it's a sensation. And so experience, I think, is really paramount to the people working in this field. And I'm very proud of my past experiences. And, you know, I grew up in a in a household with blue-collar workers who, you know, told me never to do drugs and make sure I became a doctor. And I remember in grade 11 chemistry, I decided we were going to go on a big trip, my friends and I, to Quebec for New Year's Eve. And, you know, we talked about, hey, we should try MDMA. And I knew nothing about it, I was anxious, I was scared it was going to be my first drug experience. So I ended up taking the chemistry class and and I decided to make my project MDMA because, you know, the the nerd in me, I needed to know everything because I was paranoid and anxious about it. And so I researched how MDMA worked in the body, the dosages, you know, what could go right, what could go wrong. And I presented it, I did a great job, I got really good work on it. But what I realized is, is that like, hey, like, you know, what the TV and in the media tells you about this drug and what my research told me, was very different. I realized that in grade 11. And so my first really psychedelic experience was in like a club dance setting with probably an unclean sample of MDMA, or what I was told was MDMA. And I just felt immense heart-opening. And it was like I felt like a child for the first time, you know, after I had a booboo getting a hug from mom or dad that like immense gratitude and love and care. And so and I felt that for myself and for my close friends that I was with. And I don't really know how to integrate that. Like, you know, I didn't have the experience or anything to integrate it, but I just knew that it was a place that I wanted to visit again in the future. And I think a number of years had passed until an opportunity came up at another music festival. And I have a number of of themes in my life, one of which is, you know, really being into electronic music and being a DJ during medical school. And I went to Ultra Miami, which is like one of the biggest EDM festivals back in the day, and I had my second MDMA experience. And in that moment, listening to some of my favorite DJs just to see thousands and thousands of people with, like smiles on their face with all this positive energy. It was a profound experience and people will say that that was a recreational experience, but it just made me feel so much more connected to other human beings, to the universe, to to music. And I really think those experiences really opened up my mind. It allowed me to pursue the things that I want to pursue today because it made me very open-minded in med school. Tends to make you very closed-minded, I find. So I don't think I would really be here today with some of those early experience with psychedelics. But since then I've had, you know, other experiences. You know, part of the ketamine training that I've done involves the use of ketamine as well, and also very, very more inward experiences. And so up until, you know, my ketamine training, most of my experiences were outward in recreational settings, but then had a transformative internal experience and I realized really the power of these psychedelic drugs. And, you know, it's also reinforced with me to connect with my breath and to connect with other healing modalities. And I think if we can help humans reconnect with themselves and find even nondrug ways to enhance their consciousness, I think we're going to have a lot better world to live in.

Ronan: Can you share what you experienced when you went inward on the ketamine? Was there anything that stood out in particular? And just a side note, before you answer that, it's funny you talking about that feeling of like a child being hugged by their parents after a booboo, you know, with my eldest, Jasper, you know, he was always pretty, he cried a lot, but he didn't want sympathy, he didn't want attention. With Cohen, who's my youngest, who was two, when he gets a cut or hurts himself, he still wants, like me or Stephanie to kiss his boo better, just like it totally just connected. Like I forgot what that feels like. I think it's super cute, but it never really went into the emotion of it. But you kind of totally hit on it and it resonated with me being like, yeah, there's something super powerful in that experience.

Dr. Verbora: It's a healing energy, right? It's like this sensation of healing and it's like the pain can dissipate in a moment's time if the neurochemistry realigns quickly and that can be transferred from one person to another, which is really remarkable. To get to your question about the inward experience, like the first time I tried ketamine, it was in an IM form and it was, you know, I would say medium, medium high dose. I was like very resistant to it. Like, I've been very conscious about the times that I take psychedelic drugs, like I have to have meaning and purpose, direction, a sense of what I want to achieve out of it. And I don't know if that's just my type-A personality shining through, but I'm really conscious about what I do them. And it's it's very infrequent but I go in with usually clear intention. Sometimes other things manifest completely, which happens. But nonetheless, experiences are experiences and I try to take learning out of all of them. But the first inward experience, it was extremely transformational. And there's a lot of space themes for me and the sensation of being blasted, you know, out of my current reality into, you know, the universe. And it was like, I think a traditional psychedelic, euphoric experience. And I felt just immensely lighter for the next six months. You know, nothing could really get me down. No problems in the universe could stress me out. I felt like I was a better parent. I was a better husband, better doctor. And I realized that, you know, why I didn't go in it with, like a severe diagnosis. I realized that, like, I could imagine how profound it would be for someone who's really, really suffering every day. And it just kind of reaffirmed the data that I was reading, the literature that I was going through, that this really is the direction that we need to go, is to give people these tools to access their own inner healing intelligence. And I think psychedelics really are the best tool that we have today to do that in a safe fashion.

Ronan: What are your thoughts on how we advance the conversation? Because right now the conversation is still rooted in the very still conventional Western approach of psychedelics are for treating PTSD, depression, anxiety, these DSM classic diagnoses. But as you kind of indicated, and as I'm aware and as many people are aware, is that psychedelics can not only help people get back to baseline, but actually exceed baseline. You have moments where they're better, even though they were, quote unquote, fine beforehand. How do you think about that conversation? Because it's it's a conversation that's not really being had right now in the current evolution. Is it just a matter of time? What do you think we should be doing to advance that conversation? Because I think in many ways, that's also one of the most important things that we can be doing right now, because as a society, there's a lot of, I think, systemic challenges that are getting worse, whether it's polarization of views, isolation, all of these challenges and getting people reconnected, even if they don't have a medical diagnosis I think is incredibly important. But it seems not OK to have those conversations at least, and the medical scientific context. And just curious to know your thoughts about what we do to help advance that part of the conversation, because in many ways, I think it's potentially even more important than than treating these mental illnesses, which is certainly important. Don't get me wrong, I'm not trying to diminish that as all. But when I think about the potential of what this renaissance really has to me, the power's in that side of the equation.

Dr. Verbora: I think it's going to happen one way or another. So whether the medical community wants to get involved with enhancing the Kyun condition beyond just the baseline and you know, one of my favorite sayings is you don't have to be sick to want to feel well. So many people don't have a label or a diagnosis, but it doesn't mean that they have a meaningful life or that they're not struggling. They could be really suffering. They just haven't seen a doctor to get a diagnosis. And, you know, it's not accessible to everybody, a doctor.

So the challenges is that, you know, there's two camps and the majority of people who would have access to, you know, let's call it biohacking tools or techniques to really enhance their mind, body connection or their biochemistry to optimize whatever parameters is meaningful for them. It's not really equitable across, you know, society. And so I think the best thing that we can do is to continue to do the research from the medical perspective in the box that we're kind of stuck in. But I think we should broaden our outcomes. Like I think at some point we're going to recognize that burnout is a real condition. And so why not study psilocybin for burnout? And, you know, the DSM five is going to turn into the DSM six and seven and you're going to go from four thousand mental health diseases to 40000 in the next decade. So I think we're going to eventually realize that, you know, some of these enhancements that we're trying to do, you know, eventually they might just be labeled psychiatric diseases one way or another. So I think if we could do the research to demonstrate that we have those positive outcomes, it will help progress the field forward, and if we don't do the research, it's still going to happen. People are going to realize and learn through, you know, talking to other people, through anecdotes, through stories that it works and they're going to just do it on their own if we don't help them.

Ronan: Your comment about the DSM going from four thousand forty thousand reminded me of that old joke, that life is a sexually transmitted disease with 100 hundred percent mortality rate right? So it's all about perspective. You oversaw the publishing of a white paper from a Field Trip about some of our therapies. And what did you find? I mean, you know, you talked high level about the research that we're seeing in the academic sphere, but we're seeing it firsthand or you're seeing it firsthand in our Field Trip Health center. So, you know, if you could share what we're seeing and the impact of our specific protocols are having that be great.

Dr. Verbora: Yeah, absolutely. So so the white paper really lays out the foundation for, you know, the mental health challenge that we face. And we all know it intuitively. It's just hard to quantify just how big is this mental health challenge. And we looked at the literature and establish that, you know, hundreds of billions of dollars in lost productivity is caused by mental health. It's the fastest growing area of productivity loss and probably the biggest factor causing human suffering. One of, and what's remarkable is there's a bit of a paradigm shift, I think, in the insurance and health care world where we're starting to recognize, you know, if you just give people money through insurance plans to do what they want to do to help themselves heal, they're probably going to do a lot better than being restrictive on saying you can only see this therapist or this person or this chiropractor, this acupuncture. I think we're shifting slowly to this model of recognizing that the individual knows best what's what's good for them. And what I'm hoping for is that people will have more autonomy in their coverage plans to choose things that are more congruent with their values. And if you look at the ketamine model that we have, the challenge with it is, is that people have to recognize, as with all things in life, something that appears to be cheap at the beginning can be very expensive long term, and something that is very expensive up front tends to be a lot cheaper in the long term. Right. It's like, you know, the saying of you can hire the right expert and pay them the right amount at the first time to get it done right. Or you can pay 10 people 10 times the amount and never get it done properly. So we have to shift our ideology and health care and look at what are the long term outcomes, because the reality is, is that the less you're going to invest the resources up front to fix the problem and get to the root cause, you're just putting out fires and you're just going to move from one fire to one fire. And that's what Canadian health care really is, is, you know, family doctors are overburdened. They're just putting out fires. They have no time to help people prevent disease. The number of patients they have to care for the incentives. It's just they can't get to that root cause for a lot of people. And so if you look at the clinical outcomes that we have, fortunately, we now been having the Toronto clinic open for over a year. Our results correspond strongly with the literature that's been published. So patients coming in with moderate to severe depression, as well as moderate to severe anxiety and trauma, all of them, after their first visit, their sixth visit and three months follow up, have all demonstrated a reduction from severe and moderate to mild. And and that's really remarkable. And we're going to continue that data collection so that we can follow up in a year and 18 months. And what we're hoping to continue to demonstrate with that is that you can get long term effects and outcomes, and that's actually going to be far cheaper and a much better model to really help people long term than this Band-Aid solution that we do now. Putting out fires.

Ronan: That's awesome. I mean, the results, obviously, I had seen the white paper and seen the results, but hearing it, someone present it like that for the first time, actually, got me excited, like, you know, it's different. It resonates on a on a different level and it's super powerful. So thank you for that and thank you for overseeing it. You touched on, you know, I think what is going to be my my last kind of topic area. But, you know, one of the things I've been thinking about is how psychedelic medicine is going to start to change, not just how we approach mental health care, but physical health care as well, is that I think it's going to lead a revolution towards more integrative medicine, because I've spoken to my family doctor who have a lot of respect for I think is very good and very thoughtful. But when you talk about integrative medicine or functional medicine, taking steps to prevent illness outside of, you know, get enough exercise, get enough sleep and eat, well, he's like, no, he doesn't go there. He's not going to go there. Because that's not what you learn in medical school right? And I think more and more, we're going to see this shift from where people approach their physical health as the first point of triage to their their mental health as being the first point to, you know, this this integrative medicine notion of mind, body, and soul all being so deeply intertwined that if you start with the mind, everything else actually becomes a lot easier, you know? Making good decisions, controlling your epigenetics, to the extent that there's a connection between attitude and mindset and your genetic expression, which there seems to be, it makes sense for the flow of how we approach health care to actually be converted to mental health first versus physical. But that's my perspective, and I'd love to hear your thoughts. If you see that being an evolution or how you see the current psychedelic renaissance shifting how we approach health care in general.

Dr. Verbora: Yeah, no, I agree completely. You're seeing finally studies being done for mindfulness, for example, demonstrating improvements in pain outcomes, mental health outcomes. And now we have evidence-based mindfulness programs that patients can be prescribed and partake in. Mind you, sometimes there's still some barriers right? And, you know, the thing that drives me crazy about Western medicine is that we have no problem funding pharmaceutical drugs for all of these problems, but we really struggle with funding the actual therapies that really help people. And, you know, one of the analogies I use, I'm a student health doctor as well in one of the hats I wear and and I and I always tell patients like you go to the gym to take care of your body, you got to check in with a therapist once in a while or a third party who can help you look at your thoughts and get you different perspectives for your mind. It's just like going to the gym for your mind. And it's just got to be ingrained in our culture that, you know, that's not a stigma. That's actually performance-enhancing, that you're taking your mental health seriously. You're checking in with someone regularly so that you you know, you don't unground yourself too much. And so I'm hoping that this paradigm shift takes place. And I agree. The more mindful we are, the more conscientious we are, the more that we raise our consciousness, the disease burden I anticipate it's going to go down dramatically and there's good science to support that in a whole host of conditions. And that approach, I think, is going to provide way better dollar value and economic value than than the current model today.

Ronan: A hundred percent. We came into this podcast, I came it to this podcast, A) having a lot of gratitude and appreciation for who you are and having always felt a very good resonance with you and throughout this podcast, it seems only that that intuition has been validated. It seems like we see the world in very similar ways. And so accept my gratitude for joining me on the podcast and all the other podcast we've done together for being part of this field journey. And it's great to have you along and see for doing what you do. It takes a lot of bravery to to buck convention and challenge very established institutions to do novel things and really with the right intentions to help people in the most positive of ways, not only physically but emotionally and from an autonomy and agency perspective. And you're doing all of those. So that's amazing.

Ronan: Well, thanks Ronan. Those words are far too kind, and I'm extremely ecstatic for this journey that we're both on together to, you know, massively, you know, help transform the world in a positive way.

Ronan: My conversation with Mike showed some incredible insight into how psychedelic medicine will not only change mental health, but physical health, too. Here are three key takeaways. While the medical profession continues to evolve in a progressive way, led by people like Mike, we need to recognize that we are our own best advocates. As Tom Robbins says, if you lack the iron and the fuzz to take control of your own life, if you insist on leaving your fate to the gods than the gods will repay your weakness by having a grin or two at your expense. While, I'm sure no doctor will ever have a grin or two at your expense. The point remains valid. Second, Mike indicated that 97 to 98 percent of the thoughts we have from day to day are exactly the same. A fact that initially shocked me, but then I realized was totally on point. We are creatures of habit and inertia, and if there is one thing that psychedelics do for us is that they remind us that our lives are not as limited as we think they are, that all things are possible if we just had the guts to shrink our egos and quit taking ourselves so damn seriously. Life is too serious to take that seriously. Finally, Mike mentioned that he believes that the focus in medicine on biochemistry shows our collective lack of knowledge and that physics and energies of our universe are much more complex than we can imagine. Part of our mission at Field Trip is to show people these possibilities. We are in this life to enlarge the soul, liberate the spirit, and light up the brain. And at Field Trip, we are trying to help not only individuals see this, but the medical profession too.

Ronan: Thank you for listening to Field Tripping, a podcast dedicated to exploring psychedelic experiences and their ability to affect our lives. I'm your host, Ronan Levy. Until next time, stay curious, breathe properly, and remember, every day is a field trip if you let it be. Field Tripping is created by Ronan Levy and produced by Conrad Page. Our researcher is Sharon Bella. Special thanks to Quill. And of course, many thanks to Dr. Michael Verbora for joining me today. To learn more about Mike's work, you can find him on LinkedIn or the field trip website. Finally, subscribe to our podcast and sign up for our newsletter at fieldtripping.fm.

About Ronan

An entrepreneur and a visionary, Ronan is one the founders of Field Trip – with a mission to bring the world to life through psychedelics and psychedelic-enhanced psychotherapy. Concurrent with his work at Field Trip, he is a partner at Grassfed Ventures, a venture capital and advisory firm focused on the cannabis and biotech industries and is Chief Strategy Officer and Member of the Board of Directors for Trait Biosciences Inc., a leading biotech company in the hemp and cannabis industries. Prior to his current roles, Ronan co-founded Canadian Cannabis Clinics and CanvasRx Inc., the latter of which was acquired by Aurora Cannabis Inc. (NYSE: ACB) in 2016, after which he served as Senior Vice President, Business and Corporate Affairs for Aurora. A lawyer by training, Ronan started his career as a corporate lawyer at Blake, Cassels Graydon LLP and Legal Counsel at CTVglobemedia Inc. (now Bell Media Inc.) He holds a Juris Doctor and a Bachelor of Commerce degree, both from the University of Toronto.