This episode is sponsored by TeamBuildr, yet
another company that's doing great things for
the first responder community. As a strength
and conditioning coach myself who also trains
tactical athletes, dissemination of wellness
information is one of the biggest challenges.
Now TeamBuildr is the premier strength and conditioning
software for tactical athletes and there are
several features that really impress me. Firstly,
there is a full exercise library. So you, the
personal trainer, does not have to create that
within your own department. Secondly, you can
send out programming, but also individualize,
which I love. So you blanket program for everyone.
Now you can tweak based on someone's injury,
someone's need to maybe drop some body composition,
rather than having to write a program for every
single person on their own. TeamBuildr also
allows you to build custom questionnaires to
collate health and wellness data. It integrates
with wearables. And I think one of the most important
things is obviously it tracks. To me, it's imperative
that we as a profession start tracking our people
from day one and then over the full span of their
career, therefore catching potential wellness
issues and injuries before they happen. Now,
if you want to try TeamBuildr, they are offering
you, the audience of the Behind the Shield podcast,
a free 14 -day trial to experience all of the
features. And if you want to take a deeper dive
into TeamBuildr, listen to episode 1032 with
Melissa Mercado or go to teambuilder .com. And
I'll spell that to you because it's not as you
think, T -E -A -M -B -U -I -L -D -R .com. Welcome
to the Behind the Shield podcast. As always,
my name is James Gearing, and this week it is
my absolute honor to welcome back onto the show
CRNA and the CEO of Revitalist, Catherine Walker,
and this time she's joined by clinical pharmacist
Nick Nowak and British military veteran David
Norris. Now, in this conversation, we have three
unique perspectives when it comes to the world
of ketamine and mental health. So from Catherine's
experience from the medical side, Nick's experience
from the pharmacy side, and David's experience
as a recipient, this is a very powerful, multifaceted
perspective on this entire discussion. Now, before
we get to this incredible conversation, as I
say every week, please just take a moment. Go
to whichever app you listen to this on. subscribe
to the show, leave feedback and leave a rating.
Every single five -star rating truly does elevate
this podcast, therefore making it easier for
others to find. And this is a free library of
well over 1 ,000 episodes now. So all I ask in
return is that you help share these incredible
men and women's stories so I can get them to
every single person on planet Earth who needs
to hear them. So with that being said, I introduce
to you Catherine Walker, Nick Nowak, and David
Norris. Enjoy. Katie, David and Nick, I want
to start by saying thank you so much for taking
the time and coming on the Behind the Shield
podcast today. Thank you. Glad we're here. James,
it's a real pleasure. Yeah, thank you so much,
James. Excited to kick off the conversation.
Alright, so I know that we've got a shorter time
frame. For people listening, Katie was on episode
559 and then back on with Nick Murray on episode
678. So we took deep, deep dives into the world
of ketamine and Katie's your own life story.
So why don't we just do a brief overview of everyone's
background and then we'll dive into the problems
that we're seeing and then some of the solutions
that you guys are going to be bringing today.
So David, let's start with you. Tell me a little
bit about your kind of background, some of the
uniforms that you've worn, and how you find yourself
having this conversation today. James, thank
you. Very embarrassing. I can't tell you that
much. I served for 33 years in the British Army.
Saw too much. Did quite a lot. And I ended up
suffering from PTSD. And I found that the traditional
approach... doesn't help i needed something different
something new something that actually worked
so i ended up on ending up having psychedelic
assisted therapy and it gave me my life back
so that's where i come from um i also back in
the uk and lately internationally was heavily
involved in using sport to help wounded injured
and sick service men and women recover That ended
up with us having a relationship with the Warrior
Games in Colorado Springs and ultimately led
to the birth of the Invictus Games. And the one
thing that annoyed me through that journey was
it was really, really simple to deal with people
with visible wounds. Next to impossible to help
servicemen and women with invisible wounds. So
that's been a passion of mine is how do we help
people with these invisible wounds? And how do,
importantly, how do we move the needle from cure,
our traditional approach, which doesn't really
work, the individuals already hurt, their family,
their friends, their work, their community, to
prevent? How can we get ahead of the problem
and actually help people before they've got a
problem? So that's why I'm here. We've had a
lot of conversations with American veterans on
the show, but... Obviously, our cultures are
slightly different. What is it through a British
lens that you've seen that has created this stigma
around the mental health when, for example, people
like Mark Holmrod, who's an incredible man, I've
had on him a couple of times now, like you said,
they look at him like, wow, triple amputee, we
need to take care of this guy. He needs prosthetics
and all the things. Why is there disconnect in
the British military when it comes to the mental
health side? I think you can put it under a couple
of things. One is we're all meant to be alpha
males as soldiers. So we don't talk about our
weaknesses or we don't like showing weakness.
And certainly if I think of the first time that
I ended up saying to people, I need help, it
was still taboo. I had other people considering
me weak for saying that I had a problem. And
the only good news I had was I had a... He became
a dear, dear friend who sadly died recently,
who said, David, for speaking out is stronger
than the rest of you. But I think we still have
that. I think we still don't like talking about
something that we don't necessarily understand.
Very easy to understand an amputee. Not so easy
to understand what's going on upstairs. One of
the things I think that I've... that I think
can help us connect with some of the naysayers,
some of the still believe that kind of faux machismo
version is performance. When you have a busy
mind, you're not going to be able to get into
the flow state. You're not going to be able to
perform at the highest level. I'm making an assumption
now that you worked in some high level areas
of the British military. What is your perspective
now? on performance with you know as you as you
started struggling how that affected your performance
because i think it's a different lens that gets
you the same result yeah i think it is i think
um if i if i look at our experience in the british
military we you know we went on operations you
came back you literally try to parachute you
straight back home it doesn't work you're still
on a high from being on operations and when you
get back in your home environment they're not
An operational tour for me would feel like days,
not months. For my family, it would feel like
years, not months. So somehow you've got to get
people back down to the same level, come down
off that operational high you were on, and grasp
reality again. On an operational tour, you were
ultra -focused on the mission at hand, and everything
else was excluded. I think that's how you coped,
but that didn't help you when you got home. Absolutely.
All right. Well, Nick, let's move to you. I know
you've got a very different background. You weren't
SQL scrolling around the British Isles. So talk
to me about your journey and what's brought you
to this conversation. Yeah. Thanks so much, James.
Yeah, interesting mix of people we have on the
call. So I'm excited to see how this all goes.
Yeah, my name is Nick Nowak. I'm a board certified
clinical pharmacist. Most of my career has been
on the clinical side. So I've worked in emergency
medicine, cardiovascular ICU, including was at
David Grant Medical Center, which is on Travis
Airport space for about five years. And then
my other portion of the clinical background is
more like integrative preventative medicine.
And how do we really focus on the whole health
and the whole human in order to take a more proactive
approach to care? And yeah, the way I guess I'm
on this call is ultimately just like frustrated
with the current system. So a recent founder
of a company called Miko Health. Miko, we built
a nationwide inclinant ketamine provider network.
So we created rigorous standards for all those
clinics, and we're focused on the employer benefit
channel, including frontline workers, where often
various mental health conditions may be more
prevalent than the general population. I stepped
away from that role, but still very active in
the overall integrative mental health space from
a political standpoint and from a support and
consulting standpoint. I ask this to a lot of
the physicians. It'd be interesting to get your
perspective. When I ask our doctors, how much
education did you get on prevention, on sleep,
exercise, nutrition, time in daylight, all these
things? It's very little. And they normally chuckle
right before they give their answer. And you
learn that a lot of these medical programs are
actually funded by pharmaceutical companies.
Through a pharmacist lens, what is the education
on the prevention side of pharmacology? Yeah,
very little. The two examples that come, that's
a great question too, I love that. Because it
really highlights some fundamental flaws when
we go from, when we're focused on a sick care
system as opposed to a healthcare system. And
from a sick care mindset, I would say for mental
health, it was all symptom management. Here's
a pill. take the pill, the pill doesn't work,
try the next pill, repeat. And that seems like
silly to take a medicine for a complex human,
try it for six to eight weeks, and then try the
next one, and then try the next one. It's like
an unscientific, unrigorous process. And so what
you were touching on as well, diabetes comes
to mind, right? Diet, exercise, like really putting
in that effort. But clinically, what we see is
you have diabetes, yeah, diet, exercise, eat
some apples, but really here's your medicine.
Let's focus on the medicine, let's educate on
the medicine, and let's do the medicine without
providing tools for just overall support and
betterment of well -being. When I think of the
FDA, let's remove vaccines from this conversation
completely. I think of an organization that approved
OxyContin. which led to the opioid crisis that
we have today. And I think of the organization
that just denied MDMA to be used as a psychedelic
-led therapy. What is your perspective experience
on either the support or the barrier to healing
modalities through that organization? Yeah, oof.
We could talk on that one for... for a little
bit. So I did an internship at the FDA in Rockville,
Maryland, a number of years ago in the Division
of Bioequivalence or the generic drug arm of
the FDA. And I have a really deep respect for
all of the individuals within the FDA and what
they are striving for. I feel like our overall
infrastructure is where barriers are coming in.
I don't know a clear pathway forward, but ultimately...
they've helped us out in like so many facets
where other drugs have been approved in other
countries and then weren't approved in the US
and we find they maybe have like teratogenic
effects for pregnant women or other issues. So
now without flaws, now without issues, we're
seeing a lot of friction now as we touch on the
psychedelic space. You touch on MDMA, which a
synthetic molecule unfortunately was not passed
on August 8th of 2024. It's still like, yeah,
deep respect for the rigor. I kind of danced
around the question because there's a lot of
loaded aspects in there. But yeah, we took vaccines
out of the picture, which also deep respect there.
Well, I think, I mean, it's not a black and white
conversation, but it is. I mean, it obviously
is an oversight for our safety. But when corrupted
by certain individuals, then it becomes a danger
to the very people they're supposed to be protecting.
So I think maybe kind of dissecting them and
fixing the things that are broken will make the
overall system safer. So here would be my MDMA
stance is if there was a world where we can have
approval but have a longitudinal study, so everyone
who is receiving MDMA -assisted therapy and have
a large cohort of individuals and still consider
them as part of the research, I'd be really excited
about that, where we could have rigor, we could
have a process, we could have access, and it's
not fully released into the wild. And we've seen
that on, I think, two drug occasions, if I'm
not mistaken, where it was like a tentative approval.
to allow access. Yeah, that sounds great. All
right, well, then let's move to Katie. Let's
get your kind of origin story, Katie, your world
into anesthesia and beyond. So, yeah, my background,
nursing, worked in the hospital, did anesthesia
for 10 years. James, I don't know, since we've
talked, I went back and got my psychiatry degree
too. Oh, really? Everyone said, you know, with
the anesthesia that I didn't know the brain,
which actually I learned way more about the brain
with anesthesia than I did with psychiatry. And
so the more I learn, the more I know that we
don't know. And there's three things here that,
like, between what David and Nick said, is seeing
the invisible, right, in mental health, is knowing
that it is invisible wounds. But then also what
Nick was saying, you know, with the FDA, they
may not be bad people, but they're fragmented.
And the whole healthcare system is fragmented.
So it's basically, you know, the more money that
you have in this space, the more that you're
paying a fragmented system to view what you want
them to view. And if there's not a lot of money
in the space going towards a certain product,
then that product's not going to be seen in any
light. And that's, you know, with ketamine, there
is no money in ketamine because it's too old
for anybody to own. So that's why, you know,
everybody's trying to come up with these new
different pieces. So honestly, like, I think
that it's a really big gap in knowledge. And
I think that's our biggest flaw. is in health
care we're very very smart and we can't see what
we don't know but we know that we know it right
so you're trying to go up against these smartest
people in the world and tell them well wait a
minute you may not know this piece and we're
like oh no I know something like I know there's
a box I know there's a bubble I know we've got
it all created like we can put it somewhere and
what one thing I've noticed is the terminology
doesn't exist yet So when David says invisible
wounds, yes, they are invisible right now. But
the beautiful thing with the brain and what we're
seeing with psychedelics and ketamine is we can
if we can learn how to define, bring the terminology
to it and actually make it diagnostic, we can
bring that invisible piece to light. So it'd
be the same way, you know, with open heart surgery.
Right. It's like that's a very known thing that
we do. And we have pretty good success with it.
I mean, we saw people's chests open, you know,
and then we stop their heart and we bring their
heart back. We put their chest back together
and then they live, you know, for 20, 30, 40
years afterwards. And this whole brain thing
is just, you know, it's so dumbfounding to everybody
that we just were just like, oh, it's too complex.
It's not too complex. We've just not identified
the specific patterns with all of this. So the
more specifics that we can get with it, especially
psychedelics are showing us there's patterns.
How do we define those patterns? How do we actually
bring those patterns to light through a diagnostic
lens? And when I say that, I'm not saying diagnoses.
We suck at those in the mental health space.
We're like up to 90 % erred in some cases. But
if we can start bringing like... lab reports
or brain scans or heart scans and show people
like oh yeah hey look when you have PTSD you
have this certain electrical abnormality in your
heart that's actually PTSD it's the same place
in the brain you know so we're seeing that there's
these little pieces that we can bring your traditional
knowledge and just kind of twist it a little
bit to where we can make it fit into the psychedelic
sector so that's kind of where I'm at now I mean
yeah I know ketamine back and forth and i treat
people pretty well like from a clinical standpoint
i can assess them but now i'm starting to see
huge gaps and identifying the fragmentation and
how do we integrate all of it and it's going
to be the hardest thing that we do because psychedelics
are in the core it's in the core of cardiology
and neurology and psychiatry and psychology like
they're in the middle and they're changing everything
You know, so it's like, how do we now make this
a new specialty that the traditional system can
hear? And it's going to be hard because there's
so many communication barriers, more than what
we know. It's an interesting path you've taken
into the world of psychiatry. You know, one of
the biggest comments I get from our veterans
here in the U .S. is I went there, they threw
drugs at me and I left. When I asked Nick about
the pharmacology route educationally, when you
went through the psychiatric route, what was
the pharmacological advice that you were given?
Again, was there a prevention -heavy element,
or was it more leaning into the psychiatric meds
rather than even exploring some of the other
options that we're going to be talking about
today? that's all they talk about in psychiatry
is how do you use a physician best reference?
Like how do you use a PR? How do you use that?
The medic, you know, the, the pharmacy, how do
you use this little book to help you to prescribe?
That's it basically is what you're taught, you
know? And then, and then the, the advice is personally,
I think horrible because, you know, it's like
start somebody on a drug. Oh, well they're having
an adverse effect or a side effect. And like
they, it tells you in the PDR, it says like the
next step is to wait. and then the next step
is to wait and the next step is to wait right
so you have to look at like from the anesthesia
standpoint like that I'm coming from literally
like if you didn't change something in the next
10 seconds somebody's dead right and in anesthesia
we're 99 .9 effective we get one bad outcome
one person out of a hundred thousand people and
then in mental health we're 30 effective if that
James, I don't know if you saw the START -E trial.
They're even now saying that the START -E trial,
the numbers could potentially be even lower on
efficacy than what they even thought. So we may
not even be, we can't even see how bad the system
is because the data is so skewed. It's almost
like we should just go back to placebo in mental
health and just start over. And that's kind of
what psychedelics are letting us do. And I was
telling Nick the other day, I made a really good
point when I was at a talk last week. I was talking
about big pharma being a multi -trillion dollar
market, right? It's like the biggest market in
the world. But what's the number one treatment
for depression? The gold standard treatment.
The gold standard treatment for depression since
1950, right? So 75 years ago, the number one
treatment is ECT, shock therapy. So Big Pharma,
while it's become a multi -trillion dollar market,
it has never been able to top us electrocuting
someone's brain. But fortunately for us, psychedelics
are actually showing that it's changing the electrical
patterns in the brain. So, you know, so maybe
if Big Pharma would have started looking at how
do you auto -regulate, you know, too excited
or not excited enough. electrical patterns in
the brain and made drugs that way instead of
looking at all these chemicals that they thought
it was like then maybe we wouldn't be in as bad
of a situation that we're in but it's there it's
the biggest like we're fighting the biggest i
don't know it's the industry i mean it's not
it's not even industry it's it's it's the biggest
thing in the world that we're trying to fight
right now as we're trying to advocate for people
who are literally dying once every 20 seconds
of suicide right now. So we've got a long ways
to go. Well, I think it's important to hear these
perspectives. It's interesting when you talk
about changing the electrical patterns. There's
a technology out now that used to be a big box
in high -performance rooms, whether it was NASA
or the SEALs called NuCom, and the smartphones
have become so advanced now, that's now an app.
And that is the only one that's got the patent
that it actually down regulates the brain. It's
a phenomenal technology. I use it. My mom uses
it. My son uses it. And it's not, you know, snake
oil. It's so, so good as N -U -C -A -L -M. But
just hearing about the success stories there,
that makes sense. And I've heard over and over
again about the lack of efficacy. And this is
important for us to know, because if you're not
getting any benefits, truly, but you're getting
all these side effects. you know, what are you
taking it for? And it's costing you, you know,
thousands and thousands of dollars. So Nick,
you've got a very unusual lens on this too. What
are you seeing from a pharmacist lens on efficacy
in this world? And what made you start leaning
into the holistic space? Yeah. And holistic might
be a loaded term, but we'll run with it. Yeah,
it was, honestly, in pharmacy school, it was,
as mentioned, symptom management, daily pill,
if not working, go to the next one. And the idea,
when we use the term psychedelic, just to clarify
here, we're focused on ketamine therapy, which
is available nationwide, all 50 states, United
Nations list of essential medicines, MDMA still
being researched, psilocybin outside of the country,
as well as Oregon and Washington within the U
.S. have it legally available, along with multiple
other agents there. So my deep interest, James,
is the idea that someone going to have a medicine.
So if we take ketamine, for example, the half
-life, we'll say about two hours. So it's out
of the body in less than a day. And there's going
to be intermittent doses, usually a session of
six over three weeks. And potentially someone's
not going to have to go back on that medicine
ever again. As opposed to standard pharmacology,
it's in the body. And if it's not in the body,
it's not working. The idea that a medicine could
be given to an individual, to a human, and they
might not have to be on it. The only other things
that do that are antibiotics and some chemos,
some oncology agents. And otherwise, like blood
pressure meds, every other med is just symptom
management. Yeah. Well, I know even with MDMA,
I've had years ago, Dr. Ben Sessa from Bristol
University. And he was talking about it's three
sessions and you're with, you know, you're with
a clinician. You're not taking it out on the
street, which I had fun doing that in Japan years
ago. It was a blast, but that's a whole different
conversation. It was just probably one of the
reasons why I help. I had the mushrooms were
legal in Japan, too. So maybe I self -healed
without realizing it. But joking apart, you know,
you're not it's not a prescription. You're not
walking out. taking these pills, you're sitting
with a, you know, a clinician or therapist, you're
doing the first session. I think it was two weeks
later, you do the second one, four weeks after
that, I think was the third. And then that's
it. And they just saw, you know, improvement,
improvement, improvement. So as you said, it's
very rare that there's an exit strategy to a
prescription. I think this is what's broken in
the healthcare industry. is there's no money
in healthy people. There's no money in dead people.
But if you can keep them on the pills for the
rest of their life, then you've got a customer
forever. And if you look at the way, and it's
not like some evil doctor with a prescription
pad, but the ethos around this, you hear it with
all the men and women that take it. Yeah, I'm
on these and these. Oh, when are you going to
get off? How much weight have you got to lose?
What have you done to change your... change your
eating habits? Are you hydrating? What are you
doing so that six months from now, you're not
taking these pills anymore? That's not even in
the conversation. They are assuming that they're
going to take it till the day they die. And I
think that mentality is completely broken as
well. 100%. I think you nailed on that. With
my time at MECO, a core tenant was really focused
on agency. If we were able to have patients create
a sense of self -agency to help make those decisions
and to drive their, their own life path forward.
Like that was our definition of success and supported
by the clinics, such as Katie's being revitalists
and others nationwide. They're actually doing
the care delivery. So don't let me touch on James
and you may the, the model here is totally different.
So when you're touching on pharmacy and pharmacy
benefit managers and health carriers and this
whole infrastructure, there's medical benefits
and there's pharmacy benefits fundamentally broken
down. This is the merging of both of those, which
is really the first time we're seeing that. If
someone is having a medicine and they're having
a psychotherapist or therapeutic support paired
with the medicine. And this is like first of
its kind from a U .S. standpoint, mostly driven
by an organization called MAPS, Multidisciplinary
Association of Psychedelic Studies. I'm sure
people are familiar. And then like Michael Midhofer
with MDMA Research. And Nick too, not only is
it compared, it's the pharmaceutical and the
medical, it's the behavioral health. So you have
to look at the way healthcare, it's all three
different. When I said it's core earlier, we're
having to merge. And merge means we're having
to break their business model. Like everyone's
going to be on the same level. Yeah. Absolutely.
Well, David, let's pull you back in for a second.
We were talking about, you know, some of the
science a little bit. Walk me through your initial
kind of therapeutics that were offered to you.
And then, you know, how did you find yourself
using ketamine? So most of it was traditional,
90 days. Speak to somebody, pop a pill, you'll
be okay. If you're not okay, pop another pill.
And I suppose it suppressed everything, but it
didn't actually cure at all. And then it was
really my journey with things like the Invictus
Games and meeting Katie and meeting Nick Murray
that took me into there are different things,
approaches that we can do that I haven't tried.
I used some psychedelic -assisted therapy with
Katie and Nick, and it, yeah, brilliant. Also
talking to a lot of US veterans that I know,
and it's the journey that they've been on, not
necessarily in the US, but overseas. And they
will all tell you that it gave them their lives
back. And to me, that's got to be better than
our traditional approach, which numbs you, numbs
the symptoms, numbs the problem, but doesn't
give you a cure. Well, there's this one kind
of perception that, you know, ayahuasca is the
magic pill and you just do it and everything's
fixed and then you you know learn to play the
fiddle and ride a unicycle away into the sunset
obviously there's a lot of people that actually
have been through it that talk about okay this
is opening the door and then you continue to
unpack all the things that you need to address
and there's this this kind of growth curve that
you have what was your experience you know what
what did that initial um exposure to psychedelics
do for you and then what did you do to continue
after that um okay so i'm agnostic as to which
i think they all have a value they all have a
part to play none of them alone are the silver
bullet so i won't say one is better than the
other um did i did i know what to expect not
really i i do remember from my youth the film
yellow submarine and it wasn't that it wasn't
that kaleidoscope at all But there was a clarity
and an ability to look at the things that I was
beating myself up about from a different perspective
and to understand them better and to stop feeling
guilty. And all of it for me was a guilt that
I should have done more, that we should have
done more, that I could have done more. Yeah,
look at it in a different perspective. But to
me, it's not just that treatment. It's a continual
process. So there's a community that I'm part
of that I keep in touch with. There are people
that I can contact when I need to, or they will
check in on me. And, yep, I'm microdose. Fine.
Please, jump in, Katie. Well, so one thing, thinking
about this, and sorry, you all kind of highlighted
on it, and I actually talked about this yesterday.
The lack of training that we have as... prescribers
whoever right in the medical space when somebody
presents to you with mental health issues they
look like they're moving so slow that they need
help with learning how to move again and if you
are a person who's struggling with trauma symptoms
or anxiety or whatever else what's going on internally
is moving so fast that all your energy is going
into that. Like it's an overarching system, right?
So as prescriber, we don't know, right? We're
not taught like, oh no, like their brains are
moving so fast. Like they can't stop. They can't
slow it down. Like they can't sleep because the
brain's still moving. So here as providers, what
we're doing is we're trying to teach them like
ADLs, right? Their activities of daily living.
Here's how you should take a shower. Here's how
you need to eat, right? And their brain's moving
so fast. And here we are trying to teach them
something. So what we have to do is to learn
to auto -regulate, slow that brain down, and
then there'll be more energy to do these things.
And I think that's a really big piece. We're
coming in and we're giving you pills. We're giving
you stimulants a lot of times. Like in PTSD,
they get a lot of stimulants. And so we're stimulating
them to actually have more energy, but we're
just feeding this beast that we can't see. psychedelics
ought to regulate that that energy um to a point
so when you're saying people's brains are speeding
all the time people in medicine don't understand
that at all right unless they're struggling with
something and then we don't admit any of that
so if we can teach providers and nurses and whoever
else is dealing with the mental health community
that when you talk to someone who's struggling
to take a shower They're struggling to sleep.
They're struggling to eat. They don't know the
last time that they ate or that they took a shower.
It's not because they're moving so slow. It's
actually because their brain's moving so fast.
There is no energy left to actually do these
tasks. And the only thing that they want is a
moment of peace in their brain to breathe. Just
something. And so from a provider standpoint,
we're probably, it's malpractice all the time,
every day. Every day we're probably prescribing
the wrong thing, giving the wrong interventions,
putting the wrong strategies in place. And it's
because we don't understand what's truly going
on with those people. So if providers can sit
down with somebody and actually have a really
good conversation with someone who's struggling
with anxiety or struggling with PTSD, instead
of just being like, oh, I know what to do here
if you've got this. Then we'll be able to start
learning more about it. But until we do, we're
going to continue to prescribe aired treatment
regimens, which are even putting people at a
higher risk of mortality. Absolutely. Well, we
talked about, you know, some of the psychedelics
and MDMA not being approved yet. And I hope,
you know, we'll have a conversation in a couple
more years and this will be. included in the
toolbox for our veterans and first responders.
But there is a lot of fear as far as, well, I
can't take that, workplace drug tests, all the
things. So talk to me about the unique element
of ketamine, not only the therapeutic part, but
also the legality of it as a mental health drug.
That's a great question. So ketamine under a
prescriber, it's under a prescriber, right? It's
like you can be getting ketamine therapies and
continue to work. And they cannot legally hold
that against you unless they think that you're
going to be altered while you're doing your job.
And what Nick said earlier, it's out of your
system in two days. So I actually had a really
good conversation with a pilot who was with the
FAA, who actually works with mental health. And
he was saying that, you know, Pilots can actually
be diagnosed with depression and they can still
fly. They can be on antidepressants and still
fly. And I didn't know that. I didn't think that
they could at all. But even the FAA is looking
at ketamine now, which is huge, right? So it's
this long -lost intervention that we've never
seen from people. So you can still get treatment.
You can still work. Have we treated DEA agents?
Yes. Have we treated federal agents? Yes. Have
we treated veterans because ketamine is approved
under the VA? Yes. You know, so it's people are
afraid to get treatment because they're afraid
their guns are going to be taken away, their
jobs are going to be taken away, all these different
pieces. And have we treated active duty police
officers? Yes. Treated active duty police officers.
And I have a sheriff and a deputy that are trying
so hard. to get ketamine approved for their guys
under their insurance plan because they said
just treating one officer changed the entire
environment of the whole precinct. So that's
the piece. We've got to get that out there. And
when you take a medicine, and Nick can talk more
about this, every time you take an antidepressant,
It's changing the entire landscape of your brain.
Like it's like it's constantly changing all these
different scenarios. Ketamine doesn't do that.
It's in, turns the light switch on, turns it
off, gets back out. And then your brain just
starts operating on its own. Like it's a neuro
regenerative piece. The brain can organically
fix itself. That's what we need to hear is the
brain can. And somebody said this earlier. I
was speaking to a neuro engineer. which I thought
was a cool degree to even get into. But he was
saying the brain is an organ of learning. And
he's right. It's continual learning. So if we're
medicating it daily, we're teaching it other
things. If we're able to do interventions, do
the therapy, do the integration, whatever else,
teach it peace, teach it calm, it can learn.
Because that's what the brain's intended to do
our entire lifespan is to learn. So how do we
optimize that environment? Well, Nick, I'll throw
it over to you. I just want to put one thing
in before we kind of hear your thoughts on that
as well. So often I've heard of people. you know,
either attempted or even completed suicide. And
they were on psych meds, even sadly, if you look
at a lot of the school shooters, you know, psychiatric
meds are involved. So talk to me about, you know,
Katie just talked about the kind of changing
the chemistry when it comes to being on these
meds. What are the dangers? What are the side
effects of some of these meds that, you know,
we can actually replace with something like ketamine?
That is a loaded question there, James. Where
do I start? Ultimately, I think philosophically
and pragmatically, each of us as human beings
are unique and different with some similar characteristics.
And so to pin someone on antidepressants and
school shooters is like more correlation. What
else was happening for that person? What type
of childhood do they have? I mean, just so many
questions come to mind. We need a better approach.
And we need more rigor around what this looks
like. Is it genetics? Are they a fast metabolizer?
Are they a slow metabolizer? Do they try to stop
their meds? Is it too high of a dose? I'm not
educated enough to have a clear perspective on
a causation. for those aspects. Yeah, and I'm
just saying it's a contributing factor. It's
not by no means, you know, the thing, you know,
this violent video game, sleep deprivation, you
know, trauma, all these other things as well.
But it does seem to be one of the things on the
pie chart almost every single time. And a lot
of people I know that are suicidal have been
on these meds. And you even, I mean, you watch
the TV commercials of these meds can cause suicide
ideation. Wait a second, antidepressant causes
suicide ideation. This may be my red flag. Yeah,
I guess here would be my perspective on that.
When we consider antidepressants, which actually
atypical antipsychotics work better as antidepressants
than what we consider antidepressants. So antipsychotics
are a preferable agent in many cases. We don't
use them often. Yeah, all the side effects. So
if we consider whether it be erectile dysfunction,
sexual habits, sleep disturbances, increased
suicidality, we try to be so reductionist in
our approach in medicine and get down to a root
cause of it, but I think we've missed the mark.
I leveled on that. I danced a little bit. Katie,
what are your thoughts there? I know you have
some big feelings. I do. But yeah. Again, this
is all about we've got to reframe the entire
system with it. So when you talk about like ED
stuff, right, it's like, you know, you get somebody
who's depressed or suicidal and you put them
on an antidepressant. Well, James, depression
is not a direct correlator to suicide. So, you
know, so it's like, why are we putting them on
antidepressants when they're suicidal? Right.
So, again, makes no sense. Like there's you couldn't
you couldn't take somebody to court and try to
rationalize what they're doing because there's
no rationalization to it. But, you know, but
thinking about psychedelics again and thinking
about like erectile dysfunction. Right. Like
that's a huge piece, like having that connection
with someone. You know, especially like if that's
your safety or that's your trust or whatever
else. And now you can't even contribute to that
connection and with that oxytocin release and
all this other stuff. And that's what they're
going to get. It's like, you know, we're adding
to their fire again. I mean, psychedelics allow
you to reconnect with yourself that allow you
to see what you want to be aligned with. And
people who do psychedelics, they're able to put.
everything that they want back into their relationship,
right, which improves all of that too. So, no,
James, I'm a big, I mean, I've read all the,
you know, the inserts on the antidepressants
because I have a really big, I don't know if
Nick wants to talk about this, but I went down
a big rabbit hole one time because, you know,
antidepressants, you're intended to be on them
for 90 days. There's no long -term studies on
antidepressants, but, you know, we've got people
on them for. 10, 20, 40, 50 years. And insurance
is fine to cover that all day long. But also
what happens when people are on these drugs for
a very long period of time, a lot of them get
really atypical liver failures. And they also
get diabetes and all these other different pieces
that no one's telling them about. And if you
look on the... the inserts to the meds, it doesn't
say that it causes, you know, like fatty liver
or whatever else you want to say with liver dysfunction.
But it does say that it like can change, you
know, the plasma or whatever levels that may
contribute to liver dysfunction. So there's just,
there's a lot of things here. I mean, I know
people feel like crap when they're struggling
and they just want something easy, something
light, you know, which is just a pill. Just take
this one pill. That's all you have to do. They
don't see how much damage that's potentially
getting ready to be done in their situation.
And then they'll look back and be like, oh, my
gosh, what if I would have done something else
20 years ago, like another intervention, right?
But now they feel so far down the track that
they're lost. It's like, you know, it's us. Again,
James, you talk about the opioid epidemic. This
is us as prescribers in the health care field
creating this crisis again. It's us. We want
to help. We do. But just because we have good
intentions sometimes doesn't always mean that's
what should be done. We're creating a really,
really bad system and it's going to get worse
for a while until we can learn to create these
new business models. Well, you mentioned about
the insurance companies having no problem continuing
to cover the psych meds. You've got this law
enforcement agency fighting to get ketamine approved
by their insurance. What is the barrier to entry
to this therapy that's seeming to be so effective?
You're all day long there, Miko. Yeah, I know,
I know. Yeah, so the company that I was recently
part of and founder, Miko, was trying to crack
that nut. And effectively... It's an old drug
that's off -label. So there's a brand name drug
called Spravato, which is one portion of ketamine
that's sprayed in the nose. It costs anywhere
from $30 ,000 to $50 ,000 per year. But it went
through the formal FDA approval pathway. Ketamine,
whether it be infusion or intramuscular or trochies
or other method, is... approved in 1970s. Really,
it wasn't until the year 2000 when Yale published
a study on depression that we really realized
that there was a compelling mental health use
case for ketamine. Otherwise, there's been this
old drug that I've used in pediatrics in the
emergency department. Katie's used it a ton in
anesthesia. So like just a common old drug. And
I think the pathway just comes down to it's not
FDA approved. I've had like... very high up decision
maker conversations. And it just came down to
the fact of it's not FDA approved for that indication.
So we're not doing it. And that was it. I was
like, here's real world evidence. Here's studies
with 10 ,000 people. Here's compelling literature.
I do feel, James, if you gave me a crystal ball,
within two years, maybe three, I think ketamine
will be FDA approved through the FDA as the first
drug to go from generic to a new on -label indication.
And the pathway is built for that now. And I
really think that will happen and we'll get there.
And you can explain this more to James and David
and maybe to me, but off -label prescribing is
so common. And it's almost like 100 % of the
drugs in the mental health field are off -label
prescribing. And insurance will cover... off
-label prescribing of these meds. And, but people
like prescribers, you know, they're not, they,
they are off -label prescribing all the time,
all the time. And they just don't know it. They
don't know that, you know, if you, if you're
giving a secondary agent for depression or PTSD
or anxiety, more than likely that's an off -label
approach, you know, but even greater than mental
health that's off -label is oncology. So if a
chemotherapeutic agent, if they're given a secondary
agent, which most of them do, those are all off
-label prescribing and insurance covers it all
the time. But there's just some type of barrier
with ketamine. Oh, nope, it's off -label, not
going to cover it. But they do it all the time,
James. And that's the piece when I tell you there's
so much education here because these people at
the FDA, their world is their box so you're trying
to tell 10 boxes that they're all part of a bigger
box and they can't hear it and they can't see
it and they've got a good paying job and they
don't want to see it because it's easy now they've
got a good business model but you know but what
we're trying to advocate for is all this new
to where it's like please just try to think outside
your box just a little bit because you're doing
exactly what we want you to do just for ketamine.
Like you're prescribing off -label drugs all
the time. But they really don't understand that.
So it's almost like it's like a court system.
You've got to like make the conclusion for them
and then let them have that like, oh, wait a
minute. Every time I prescribe Trazodone. Wait,
I prescribe trazodone all the time. That's one
of the most commonly used drugs in an off -label
capacity that insurance continues to cover. So
any prescriber who's ever prescribed trazodone,
you just broke the law, basically, in their head
with ketamine if they were to prescribe ketamine
in an off -label capacity. So, James, it's almost
like we're dealing with people that are developmentally
delayed. They can only see their path, and they
can't see that anybody else exists in this world
except their world. And that's where we're at
right now, and it sucks because people are dying
because of our ignorance. Well, that mirrors
the fire service. I mean, I'm trying to make
the point for... a shorter work week so we can
give our first responders time for rest and recovery
the average firefighter works 56 hours a week
you have a recruitment crisis now because of
the devolution of working environments and now
people don't want to do this job anymore so now
one mandatory overtime one you know 7 a .m phone
call you can't go home after all now it's an
80 hour work week And again, all the evidence
is there. Like I've said, even forget evidence.
If the way we did it worked, then we would have
healthy firefighters and no recruitment crisis.
But, you know, they're so indoctrinated by the
way they think that even the firefighters themselves
push against it. And it's crazy. And again, like
you said, you want to break down the walls of
the box and say, look, look around you, you know,
and, you know, comprehend these deaths that are
happening at the same, you know, these men and
women in the same uniform as you. So I see the
same resistance even in my own profession in
a different way, but the same issue is just the
inability to critically think. But I think, again,
that comes from this kind of divisive, highly
stressed society that we're in now as people
lack the ability to just stand back and take
it in for a moment and go, does this make sense?
And I think a big piece with that, right, is
and that's the beautiful thing with psychedelics
is it's allowing all these specialists to come
in. So, like, I don't know veterans. I don't
know firemen. I don't know pharmacy. But you
all understand those languages. So it's almost
like when we go to the FDA or we go to the DEA
or whomever else, we have to sit down and be
like, OK, tell me how your system works. And
if we can understand how their system works,
then we build what we need to put into that system.
And then they'll be able to empathize with it
and connect with it. So, you know, it's like
if I walked in, I was like, oh, I'm an anesthesia
provider. I can do all this stuff. It's like
people are like, oh, whatever. You put people
to sleep like like you don't know anything, you
know, or if I came in and instead said, you know,
like if I was, I don't know, a pediatric conference
and I was like, hey, this is, you know, when
I work with. children who have brain tumors this
is something that we see well right there i've
connected with them because they're like oh she
knows about kids brain tumors and we're at a
pediatric conference now all of a sudden i have
broken down that communication barrier to where
it's starting to be more open and people's tail
feathers aren't getting stuck up kind of thing.
And physicians are one of the worst. I asked
my ex -husband, I asked him, I said, what is
this? Like, you know, because you can't go in
and say that you're going to educate a physician.
And he's like, well, actually I was going to
go say that. And he said, if you go in and say,
you're going to educate a physician, he said,
they will slam the door in your face and tell
you to get out because they are the highest educated
professionals in the world. If you change your
terminology and say, I have new information for
you to help treat your patients better. then
they're going to be, oh, wow, you're going to
get me better outcomes. I'm like, that's it.
I'm getting you better outcomes. Right. So we're
feeding their egos. So an issue that we have
to realize is like, we've got to put our egos
down a little bit so we can at least try to get
into the door so we can feed their egos. Right.
Because that's how you're going to get things
passed is. How can what I'm doing help you from
a political standpoint? How is it going to make
you advocate for your people better? How is it
going to decrease costs in the system? Like,
what are they looking for? And if we can see
what they're looking for, then we can learn how
to negotiate better. And maybe David knows that
in the veteran space. It's all about negotiation
and mediation. That's what it's all about. Well,
David, we talked about your healing journey.
I want to get to, you know, the therapies that
are offered and what you collectively are trying
to do as far as, you know, moving forward and
even prevention. What was it that brought you
into this group to now be part of the solution
for your fellow veterans? It's pretty simple.
Our veterans, our first responders deserve better.
We know the problems. And we know what causes
the problems. If I look at Helena, if I look
at deployments in Iraq, if I look at deployments
in Afghanistan, if I just look at the fires in
California, we know that they're going to cause
problems. What we can't afford to do any longer
is wait until that problem is there in front
of us. We've got to get ahead of it. Curing doesn't
work, but preventing will help that individual,
will help their families, will help their communities.
will help their businesses that's that's that's
what gets me into the space is if i look at my
journey it was painful hurt me and it hurt my
family that's that's what drives me um and i
think if i look at how do we get there one we
have now got this ability with with this bot
to identify your risk of having a mental health
episode. That gets us ahead. I'm no longer waiting
for you to have the episode. We've got an idea
that you are at risk of having an episode. We
can now give you help. We can give you support.
We can give you treatment. And if I move into
using psychedelic -assisted therapies, there's
a real solution because we already are gathering
the evidence that they work, that they give you
your life back. So talk to me about the bot.
Yeah, please. Let's open that up. Katie, go on.
So James, oh, actually here, James, this is all
from you, buddy. This is all from our first conversation
was when I was describing ketamine and how there
was a. A police officer, and I wish we could
find who he was, but he was a police officer,
reached out to me after our podcast because I
was describing to you how ketamine works. And
you said, so it kind of unfucks the brain. And
I said, yeah, unfucks it. And that was when a
police officer reached out and said, I listened
to your podcast on James' show. And I went and
got treatment. You saved my life. Thank you.
If you ever made a shirt that said, unfuck it,
I would buy it. So I went down this, like, category.
You know, that's how I created the unit initiative
and all this other stuff. But I created a scale.
And my scale is five questions, and the five
questions actually has been validated with over
12 ,000 people, and it cross -correlates depression,
anxiety, PTSD, insomnia, suicidality. And the
five questions are kind because I just know when
people struggle, literally that breath of wind
might be the last thing that pushes them over
the edge just because everything is just so hypersensitive.
So I created this scale, and I called it the
Federal Unit. conservative or the the federal
unit conservative kinesiologic investigational
task force scale which actually stands for fuck
it um but we're just allowed to call it federal
unit scale but just so you know it's its name
was birthed through your podcast um but uh but
anyway because you know there's something about
controlling your own narrative um from that standpoint
but We got the scale validated. That draft manuscript
should be published, actually, in the Journal
of Psychiatric Research soon. And then we were
able to work with our science team. They made
an AI bot. It's an avatar. It can actually talk
to you with these five questions and go back
and forth. And it gives you a number, zero bad,
100 good, and whatever in between. So it's not
saying, oh, James, you're bad. It's saying, oh,
you're 30. Well, let's try to work to a 50 or
whatever you want to work to, right? So it's
all about recontexting the way that we look at
mental health, realizing all of us have a score,
everybody. And it might be good, it might be
bad, but you can always improve it. So the bot
is geared to deploy across the world to where
we can start measuring people preventatively
through risk mitigation because we're all at
risk because we don't know what causes all this
stuff yet. Thank you, James. It's not just what
you say. It's how you say it. It's your facial
expressions. It's how do you speak, what you
do. It looks at it. It's brilliant. Absolutely
brilliant. Yeah, it measures your – so believe
it or not, James, we have 22 emotions in every
conversation that we have. All of us right now
are having 22 emotions. And she measures your,
like, yeah, your facial expressions, your tone,
to where after the review or after you talk to
her, she gives you a summary of your conversation.
And then she also shows you on a bar graph where
you are with these 22 emotions. Because you may
say, we may be like, hey, James, I think you've
got some anger issues. And you're like, I don't
have any anger issues. Like, if anything, like,
I don't have anger. I suppress anger. You know,
whatever. But if you're able to go and look at
this review and it shows that your tiredness,
is off the scale like we could be like oh yeah
i'm just tired all the time if it's showing that
then maybe we need to take steps in order to
lower that bar graph down or to improve the joy
i mean because it does like joy distress all
these different pieces but it just it just gives
you an analysis so if we're able to get this
spot and this is something that david and nick
and i are actually working on is getting the
bot in the psychedelic space So it can be the
one piece that analyzes everybody. It's like,
I don't care if you're in the jungle, if you're
in Europe, if you're in Asia, it doesn't matter.
I don't care what psychedelics are doing. It's
an agnostic scale and bod that's been made to
advocate for you. It's not advocating for a product
like the other scales are out there with medications.
You are the product. So whatever you do, whether
that be diet change, yoga, meditation, antidepressants,
psychedelics, you are doing and that's what we
missed in mental health there is nothing that's
advocating for you so simple but nobody's done
it right so that's the cool piece with the bot
um and it is it's fascinating um so hopefully
we can get that eventually approved to be an
fda device nick jump in he loves it it's the
best thing he's ever seen Yeah, ultimately, like
high level, like where I have a deep appreciation
for the bot is when I think about mental health
and the way we have care delivery currently,
a lot of patients are going to meet and potentially
appointments are only six minutes. So there's
a snapshot in time and a busy schedule. They
walk right out the door. And the idea to have
longitudinal information that's able to assess
voice, able to assess, facial features, able
to have just like a more of a video reel as opposed
to just a six -minute snapshot brings a tremendous
value. If someone, a therapist or psychiatrist
or other mental health care provider is able
to have data points before walking into a room
for a patient, they're just better equipped.
And like some of the technology coming out for
the space is just like fascinating and really,
really high value. This being one, I imagine
a world as well where there's like, there's some
really neat technology coming out for like with
vibrations and sound. I imagine before going
into appointments, there's almost like reset,
no medicine involved before going into an appointment.
To break that space of getting out of a car after
a rushed visit during your lunch hour to like
go to a therapist to talk. I'm just having like
resets and continuity. It will be so vital in
the upcoming years. And it could, and what we
just talked about, it can make, it can address
that gap of our stupidity or ignorance in the
field, you know? And it would give us something
like, oh, wow, look, this color's higher than
this color. We should look on that one, you know?
So it actually puts some tangible aspects so
we can become better providers. Because again,
we are not good. you know you know it'd be a
really interesting and i'm curious james question
back to you here um because of the individuals
that you're working with in the level that you
work with are you seeing anything on like the
presumptive law side for for departments um so
job related injury for firefighters or frontline
workers what i'm seeing and it's very sad is
that there are some states that have some presumptive
laws um for example i know some states let's
say you have a presumptive law for cancer, but
if women are over a certain age, then breast
cancer isn't covered. You know, even though they've
worked for 20 years as a firefighter, there's
some presumptive laws on the mental health side
as well, PTSD. But what I've heard from many,
many people is just because you have a presumptive
law doesn't mean they're going to pay out. And
these insurance companies will fight tooth and
nail to the point where some have reported literally
hearing them say, well, we'll just fight them
and they'll die. They'll die before they ever
get a penny. So this is kind of the landscape
that we're dealing with. I'm sure there's some
that are great and they just take care of their
people. That's not the stories I'm hearing more
often than not. Okay. David. Thanks for context
on that. Yeah, I know like Maine, Florida, I
think Colorado, some other states have some,
but I wasn't sure about actual outcomes on implementation.
Yeah, I know it's a fight. David, you mentioned
about needing to close out in an hour. Did you
need to, if there's anything you want to leave
us with before you step out? I think, well, James,
yeah, I'm very sorry that I've got to go because
I think it's a great conversation. The bit for
me is we've got to do better. The joy is we can
do better. Absolutely. All right. Well, I wanted
to get, just kind of circle around. To the comments
that you guys made, when I think about being
a paramedic, one of the most important concepts
to me was trending. You might have someone in
cardiac arrest or whatever it is, but it's over
the journey in the ambulance or whatever it is,
or even it's my family's health. How are they
doing today, tomorrow, five days? Okay, it's
looking good. We're trending upwards. That's
beautiful. It seems like this AI bot that you've
got. will give someone the ability to see how
they are trending because it's not something
you can normally annotate. So if you do have
someone with depression or anxiety or, you know,
God forbid, even suicide ideation, you know,
is there an ability then to be, oh, well, I was
a, you know, I was a 16 yesterday and now I'm
a 24. I could see that would almost give them
hope. And, you know, they're doing cold plunges
or ketamine or whatever it is. And like, oh,
this, this is working. This is working. Yes.
And here's the really cool thing, James, is with
this, like antidepressants have been covered,
you know, 90 days. Well, here's what's happening
in the psychedelic space right now. You're getting
veterans, great job vets for coming out and saying,
you saved my life. The FDA can't hear it. We've
got to put it in the language that they can hear.
And the language that they can hear is seeing
data change. So if we're able to get somebody
to use this bot for a year and just do psychedelics,
go do ayahuasca, go do Ibogaine, go do whatever
you want to do, and then do the bot once a month,
and then we can have that longitudinal data to
where maybe we can prove that people are in remission.
And then we can give more insight. And the more
insight you can give, the more that we're able
to decrease that fear factor. Because people
are afraid. They're afraid of all these things.
But a lot of times, unfortunately, we have to
hit rock bottom before we get help. And that's
what we need to prevent, is to say, like, maybe
the scale, if you do hit into the 30s, then you
need to get help, even if you don't feel like
you need to get help. You know, so it's just
something. It's like your red blood cells. If
your red blood cells are off, do you feel like
a bad person because of it? No. You know, so
if we're able to put a number there instead of
being like, oh, just tell me why you feel so
bad. I mean, we're using people who can't even
eat or drink as the primary indicator on if they
need to get help. And it's like asking a computer
that's malfunctioning to fix itself or to identify
why there's an issue. It can't. So we're starting
off on the wrong foot with all this. So if the
bot, yes, if the bot can just show these numbers
over time. When are you optimally functioning?
Oh, when I'm like a 65, I'm optimally functioning.
Okay, great. Stay at 65. You know, but yeah,
no, absolutely. I think it's going to be life
changing. I really, really, really, really do.
But I'll send you the draft manuscript. It's
fascinating. And we got a lot of really cool
people that are behind it. And they're all big
Ivy League scientists. And they're doing it because
they know there is better out there. They're
not doing it to make a dollar. They're doing
it because they see that they need to contribute
to history. And this is going to be very contributing
to history. I want to put something to both of
you just quickly. There's a phrase I love. Don't
wait for science to prove what you already know
is true. And I'll give you a perfect example.
Again, this resistance to changing the work week.
People will tell me, oh, we need to see studies.
And what they're asking is, can you show me in
a laboratory study that a 42 hour work week will
be healthier than a 56 hour work week? And there's
a certain point where you've got to draw a line
in the sand and go, we don't need a study for
this. I don't need a study to know that if I
stand in front of a moving bus that I'm going
to get flattened. You know, where is that point
of common sense? So, you know, why is it in some
of these things that we're all seeing are very,
very. And arguably, if we're talking about the
plant medicine, really, we've got hundreds of
years of studies, you know, as far as history
and indigenous cultures. Why is this roadblock
of studies so high in some of these areas? Nick,
you want to take that one on? So many pieces
there. I mean, ultimately, it comes down to DEA
scheduling. If we really were to get to like
a first principles aspect of regulation. So the
idea that many of these medicines are in phase
two or phase three clinical trials with rigorous
scientific research, and there's still DEA schedule
one, meaning they're restricted and there's no
medical value. Marijuana being an additional
component there, despite being legalized, I don't
know, 30 or 40 states, I have no idea how many,
is still a schedule one federal substance. And
the idea that for these agents, what was the
quote he said? Don't wait for science to prove
what you already know. And the idea that if we
took the collective voice of all of these individuals,
and I only advocate for legal access, just to
be clear on that. But all these individuals who
maybe they're going out to the jungle and they're
risking it in like some hut with some shaman
or all these individuals going down to Mexico
or outside of the country, even if they fought
for our own country. And the collective voice
is saying, this helped leaps and bounds more
than what conventional insurance covered care
provided for me within the US. And I took it
on my own accord to leave the country to go for
this. We need to listen to those people. Despite
whatever our political perspective is, whatever
our viewpoint is, it's proven if we listen to
the voice to an extent. Where my interest and
intrigue lies from a scientific lens is like,
who is this working for? What type of people?
Is there harm? What kind of harm? If we look
at the MDMA research, 71 % are no longer diagnosable,
88 % had benefit. But there's a 12 % that, if
we're real, 12 % didn't have that benefit. So
who are those 12 %? How do we really siphon those
people out initially? we could focus on the 88%,
which is massive, massive, considering that we
currently have 60 % treatment resistance or drug
discontinuation with our current mental health
care model. Yeah, that's the direction we need
to go. And I think states like Oregon and Colorado
are really, really interesting case studies with...
Legal access to psilocybin -assisted therapy
for wellness or for mental health care. And the
leading indicator that will have some really
interesting data within the U .S. that we can
bring to regulators. Kate, anything to add? No,
I think you summed it up really, really well.
But, yeah, I think we're going to look back.
And what you just said, our veterans are going
to other countries to get help that they need.
That's an instrumental statement. And it's very,
very sad. It's very sad that we, being in the
United States, cannot provide that care for them.
But yet, what isn't scheduled, and I mentioned
this the other day with Nick, alcohol. Alcohol
is a mind -altering drug. It can also be utilized
as a non -regenerative psychedelic, per se. But
it's not scheduled, and it's everywhere, right?
I mean, if anything needs to be scheduled, one,
it needs to be alcohol. But we need to de -schedule
or take them out of the Schedule 1 classification
with psychedelics and put them more than likely
on a Schedule 3 to where we can give people access.
It's like, what are we doing? And hopefully the
new administration that just came in is going
to help with some of this stuff because so much
of this as to what we talked about today, none
of it makes sense. It just doesn't make sense
anymore. And we just need to change our view
and build a new system. And also not making sense
in the way that the app works on your phone,
that your TV channel changer doesn't work properly.
That doesn't make sense. That's fine. No one's
dying there. But in what we're talking about
today, what doesn't make sense is costing lives.
And this is why it's such an important conversation.
And not only is it costing lives. It's costing
lives for generations to come. So when you lose
your mom, when you lose your dad, when you lose
your child, it has such catastrophic impact on
our society that it decreases, you know, like
how much people are actually able to work, how
much income they're able to bring in. Like, you
know, on so many different economic levels, this
is having, like again, it's an impact we don't
even know how bad it is. Absolutely. Well, let's
just talk about solutions then. Talk to me about
anyone listening now where they can access ketamine,
whether it's through your own company or whether
it's in other areas around the country. And then
what else should we be looking for? You mentioned
the AI bot. What is the next step to try and
bring this solution to more people? Oh, that's
a good loading question right there, Jane. So,
of course, they can go to Revitalist. There's
about 5 ,000, you may know, 5 ,000 -ish ketamine
clinics across the United States, maybe more.
Good, bad, or ugly, right? They're all different.
They all have different modalities of. But one
thing that we're doing, James, is, yes, we've
got the AI bot, but the other piece is we're
opening a lab in February to where we're drawing
blood, doing brain scans, doing heart scans.
So it's a four -minute EEG. It's a four -minute
EKG. We're seeing the real -time electrical patterns,
and we're seeing how those cross -correlate with
blood based on the inflammatory cascade. So we're
seeing that stress on the system causes inflammation.
Inflammation causes dysfunction. And that's what
we want to do is to like reverse engineer treatment
so we can get up here and we can start figuring
out like how do we change, how do we minimize
that stress on the inflammatory cascade? And
then how do we also help people to have more
data to prove that their diagnoses are real?
Because you shouldn't walk around with 38 diagnoses.
You know what that means? You've had 38 wrong
practitioners more than likely. You know, and
they all have their own different lens and view
and whatever else. It's like, you know, we just
need to have, the brain is one. What's the brain
doing wrong? And what symptoms is it giving you?
And how can we reset the brain? So yeah, so then
once the lab comes out, James, it's a reference
lab. Anybody across the world can send us blood.
Anybody can partner with us across the country
and the world. So our goal is that we can have
somebody come in once a year, right? Once a year
you come in, you get your brain scan, your heart
scan, your blood. I don't care if you feel good
or bad or whatever. Just come in. We don't have
to talk about childhood trauma. We don't have
to talk about, you know, the trauma, whatever,
right? Whatever's been in your life. We don't
have to talk about that. Just come in. Let's
just look at the data and let's do interventions
that can treat the data because psychedelics
and ketamine, they're huge anti -inflammatories
and not anti -inflammatories that they're like,
you know, blocking the inflammatory system. They're
auto -regulating. the inflammatory system to
where it's actually starting to function better.
So we're trying, but I tell you, it's not an
easy path at all. Well, that would affect cancer
and heart disease and other areas too. And this
is the thing, even with new calm, when he's down
regulating with that technology, you know, he's
talking about cancer. He's talking about aging.
I mean, when you're carrying that trauma, as
they say, the body keeps the score, it's going
to affect everything. Yep. Yep. And that's a
piece, right? So I've actually, when I told you,
you know, we've got to give people conclusions.
That's the way I set up the lab is I have actually
on the, on the forms, it just has the diagnosis
there. So if you have, if you're obese, if you
have diabetes, if you have fibromyalgia, if you
have TBIs, CTEs, depression, anxiety, insomnia,
you just circle what you're feeling at that moment.
And we've actually made protocols behind that.
Well, that will draw all the labs behind that
protocol. So that's the piece, right, is we're
trying to make it, gosh, we're just trying to
make it to have just a very small level of statistical
error. That's the goal. Because right now, like
I said, it's all error. That's all we know in
the mental health system. And burnout with providers
is 50 % or greater. How do we stop that? How
do we give them more tools, right? And here's
my analogy that I tell people. Because, again,
it's like new language skills. If you break your
leg and you go to the emergency room, if you
think your leg's broken and you go to the emergency
room, you don't go and see the orthopedic surgeon
first who's looking at you like, oh, is James
grimacing enough? Does his leg look swollen enough?
You know, well, I guess I'm going to have to
go in blindly and just cut him open and see what's
in there. No, you do an x -ray. So that's where
the bot will come in, that's where the lab will
come in, is we can give these people data markers
that they can look at, then they can look at
your diagnosis. Because people are getting diagnosed
in like five minutes, seven minutes, and absolutely
not. It's negligence, it's malpractice, it's
all the negative legal jargon we want to throw
in there. But again, it's just ignorance. The
system's not where it needs to be. Just reminded
me, and I don't know anything about the background
of this particular video, but someone was in
the street and they were interviewing, I think
it was psychiatrists, and they were said, how
many patients have you cured? And over and over
again, each of these different people were saying
none. And so when you talk about the burnout
being compassionate and empathetic for the provider,
whether it's, you know, an ER physician or nurse,
it's just seeing all these obese patients coming
in and obviously us, the paramedics that are
literally intubating them and defibrillating
them and they die over and over and over again.
That inability to improve or inability to save
is incredibly. you know, detrimental to someone
who wanted to serve someone who wanted to alleviate
pain. So this shift, I hope helps the practitioners
too. That's the goal of it, you know, and they're
all in the mental health space again, because
I hear things I'm like, Oh, you don't work like
that. It's so different, James, they're just
trained differently in the mental health space.
As therapists don't have to have peer reviewed
journals, they don't have them. They don't exist.
In medicine, that's all we have is peer -reviewed
journals. You've got to present your case, hope
it gets eaten, then you draft it, then it gets
eaten again, you draft it again. But therapists
don't have that right now. So they're looking
for a bot. They're like, oh, does your bot diagnose?
No, it doesn't diagnose. Why are you calling
it diagnostic marker? It's like because it's
giving you data to help you diagnose because
you all suck right now. And that's the piece.
They're looking for a bot to diagnose. Guys,
we don't even have the language on how to effectively
diagnose. How are we going to make a bot that
diagnoses it? Like, we don't have the large language
model. We don't see it yet. And AI, in order
to build AI, you have to give it a large language
model. And the large language model doesn't exist.
So, yeah, I'm hoping it's going to help out providers,
health care, communities, schools. Here's another
thing, James. I think we've talked about this
before. In the school system, I asked one of
the teachers. When do your kids kill themselves
the most? What's the highest? What's the highest?
When's the highest rate of occurrence? Oh, we
don't know. It's random. No, it's not random.
There's a pattern somewhere. How have you looked
at the pattern? Oh, we don't know how to look
at that. So if we can get the bot into schools.
It can show when these children are decreasing,
when we need to put more support around them.
And that's how we prevent. We've got to get out
there. We've got to start surveying the landscape
from an agnostic viewpoint. Right now, we're
only surveying the landscape when people are
rock bottom or they feel stressed to ask for
help or they're scared and they ask for help.
So all the data that we see is very skewed. Yeah,
I had a personal experience. I'm sorry, say again.
I said, but I'm very hopeful for the future.
Well, I think this is a good thing. A crisis
is the perfect time to turn the ship around.
But yeah, with the school thing, I had an issue
with my son and he was, I mean, just basically
malpractice of what happened to him and it traumatized
him for years and years and years after that.
So, you know, you're preaching to the choir there.
Well, Nick, anything to add on this last kind
of close out element? Great conversation, James.
This was a blast. I appreciate you. Appreciate
you having us all. And I think ultimately the
pathway, which I feel like we're all in alignment,
is first it's finding balance in life. If we
go through a lab pathway, it's like, how do we
balance our hormones? How do we balance our electrolytes?
How do we balance our nutrition? And then there's
these deeper tools available. Ketamine, we know,
is effectively a therapy accelerant, available
nationwide. Clinicaltrials .gov is a really,
really great resource for... Individuals seeking
legal access, legal regulated access for various
modalities within the US. And yeah, I'm optimistic
about the future. And I feel like this post -COVID
trauma era has really been rough on society as
a whole. So all we can do is build forward. Absolutely.
Well, I want to thank you both. This has been
a great conversation. We were kind of joking
at the beginning. We didn't know where it was
going to go as far as... the dynamic because
i mean you've got these amazing concepts and
we're kind of unpacking now what hopefully the
future looks like but uh you know between david
who's left us now so we won't be able to say
goodbye to him um and uk and nick i just i want
to thank you for such an amazing conversation
and being part of the solution you know when
we question the things that are broken that we
we see do not work anymore and we're able to
bring solutions into the conversation i've been
calling calling out cowardice a lot recently.
At what point do we stop burying our people and
actually have the courage to stand up and say
this needs to change? And I think this, you know,
what we've discussed today, whether it's ketamine,
the AI bot, or even psychedelics that we need
to bring into the country, not our veterans and
first responders have to leave the very soil
they're protecting to get the healing that they
need. I think it's extremely exciting. So I want
to thank you both so much for being so generous
with your time and coming on the Behind the Shield
podcast today. Well, and thank you for all of
your advocacy, too. You've saved a lot of lives.
Absolutely.