Interview with Dr. Lynn Marie Morski
In today's podcast, Dr. Lynn Marie Morski describes the current use of psychedelics in clinical medicine.
Lynn Marie is a Mayo Clinic-trained physician, attorney, and former adjunct law professor. Dr. Morski spent nine years as a physician at the Veterans Administration.
She is the President of the Psychedelic Medicine Association. The PSA is a society of physicians, therapists, and health care professionals looking to advance their education in the therapeutic uses of psychedelic medicines. Dor Morski is also the founder of PlantMedicine.org, host of the Psychedelic Medicine Podcast, and medical director for Way of Leaf.com and Nue.Life.
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Today's Conversation
During our conversation, Dr. Morski covered a variety of topics:
- Psychedelics that have previously been shown to be effective in mental health disorders;
- New indications where approval for use is expected soon;
- The best situations for physicians and other clinicians to get involved;
- How Lynn Marie started the PMA.
Psychedelics in Clinical Medicine
Lynn Marie explains that her mission is to spread the word about psychedelic medicines to clinicians. She believes that it is more effective than trying to educate patients.
Clinicians need to know that it no longer makes sense to prescribe antidepressants and anxiolytics chronically when there are newer, more effective options. Very few medical schools or residencies include training in the use of psychedelics. Hence, Lynn Marie made it her mission to fill that gap.
Annual Psychedelic Medicine Association Conference
The Psychedelic Medicine Association will hold its second annual conference in October as part of the annual Sana Symposium. It will be virtual this year, but Dr. Morski plans to hold an in-person meeting in future years.
The goal is to provide next-level information about psychedelics. There will be presentations pertaining to current clinical applications that will enable physicians and other mental health professionals to treat their patients. CME credit will be available.
Summary
You can find Dr. Morski's website at psychedelicmedicineassociation.org. Once there, you can join the Association and access 12 free webinars covering the current science applicable to psychedelics and how to set up a psychedelic medicine practice.
NOTE: Look below for a transcript of today's episode.
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Links for Today's Episode:
- Psychedelic Medicine Association Website
- Psychedelic Medicine Podcast
- Way of Leaf Website
- Nue Life Website
- How to Improve Your Life Using Strategic Quitting with Dr. Lynn Marie Morski – 086
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Transcription PNC Podcast Episode 247
How Do I Prepare for the Use of Psychedelics in Clinical Medicine?
John: Dr. Lynn Marie Morski is a Mayo Clinic trained physician, attorney and former adjunct law professor. Dr. Morski spent nine years as a physician at the VA. She is the president of the Psychedelic Medicine Association, the founder of the plantmedicine.org website, host of the Psychedelic Medicine podcast and medical director for wayofleaf.com and Maya Health.
The Psychedelic Medicine Association is a society of physicians, therapists, and healthcare professionals looking to advance their education on the therapeutic uses of psychedelic medicines. The Psychedelic Medicine Association or PMA is a public benefit corporation of healthcare providers aimed at bridging the gap between advances taking place in the psychedelic research world and medical practitioners. So, thanks for being here as we learn how to prepare for the use of psychedelics in clinical medicine.
I have a good friend who works in the mental health field who's been almost obsessed with the potential to use psychedelics to treat certain severe mental illnesses. So, he's been waiting for years for more and more studies to be done and there's been so much activity in this area recently, and he's been thrilled to see that. So that is what led me to really want to get today's guest on the show because she's been involved in all of this recently. And she started an association to address this. And so, with that, I would like to welcome Dr. Lynn Marie Morski.
Dr. Lynn Marie Morski: Thank you for having me. I'm really excited to be here.
John: I should have mentioned too, that you've been on the podcast before. It was years ago. It was long before the Psychedelic Medicine Association existed. But it's been really interesting to follow you along and what you've been up to. And so, this is going to be fun.
Dr. Lynn Marie Morski: Yes. It's been a wild ride since our last episode.
John: We'll get into some details, maybe not every detail, but okay, let's just start with this. At one point in your life, you were in family medicine, sports medicine, and now you're into something totally different. You're a leading voice in psychedelics and you're running a professional association. So, tell us the short version of how that all happened.
Dr. Lynn Marie Morski: Very short version. I have like you said, family medicine, sports medicine, that was my training. Then I went to law school. And so, at some point in time now I've my law degree and I'm working at the VA. I worked at the VA in compensation and pension, which is kind of like the benefits side of things for nine years. And I grew up in a very conservative family. I don't think I touched alcohol to like 26. I hadn't touched cannabis, no psychedelics, nothing. And then somewhere during my time at the VA, I had a psychedelic experience of my own, and I found it very therapeutic and I did not actually know that psychedelic therapeutics were a thing or psychedelic science was a field. And I had to keep it to myself because I was a department of defense employee. And I couldn't tell anybody I had tried these and I definitely couldn't share it with patients.
But first off, a few years later, I found out psychedelic science was a field of research. And the fact that I was having therapeutic realizations once or twice a year, I would try psychedelic. I was like, "Oh, it's not just me. This is common. And this is being researched." And I found that out. And then I did something called "Ayahuasca", which is a type of psychedelic and it was so beneficial. And here I am in my day job, going to the VA, seeing a veteran after veteran who very often have PTSD or traumatic brain injury, depression, whatever. Things that I know psychedelics are being studied to address and that psychedelics are showing to address effectively and I cannot tell them about it, right?
As physicians first do no harm, I'm sitting there thinking I'm doing harm by omission because I know something that probably is more effective than what they're doing, but I can't say anything about it. And so, in May, 2019, I made a decision to leave clinical medicine. I had no backup whatsoever. No savings, no separate job. I just thought this is totally out of alignment.
All I had was a mission. And my mission was to spread the word about psychedelic fair pieces to clinicians. Because you could spread it to patients all day long, but think about it, if your spread is one clinician who sees a hundred patients a week, it's just so much more effective. And that's who so many people go to for their care. Clinicians are going to keep handing out antidepressants and not know that there are these other things that work better until somebody comes along and educates them. We weren't taught about psychedelics in medical school or residency or fellowship. And so, I made it my mission to find a way to enact that.
I quit medicine. I wasn't quite sure how I was going to enact this mission. So, what I started with is I already had a podcast on quitting, which is the other thing that I used to talk about. And so, I thought I knew how to podcast. I'll just interview all the experts in the field who will be willing to come on my podcast. I'll learn from them and I'll be sharing the information while I learn, and clinicians will learn that way.
By the way, this was working, I was getting lots of listeners, but not necessarily clinicians. And it occurred to me that clinicians don't sit down for 45 minutes to listen to a podcast to hear about a clinical topic. They might like a side gig topic or a lifestyle topic. But if you want to find out the latest way to treat treatment resistant depression, you're probably going to check your email for a journal article or something you can look up between patients.
And so, after the podcast had been out about six months, I realized I'm reaching listeners, but not clinicians. Then, it occurred to me, I need to find a way to get into doctor's inboxes and in a way that I can get them information that's really easily digestible. And so, that's when the idea of an association came up because I had been in something like a society of physician entrepreneurs, or whatever, that I'd signed up for and paid dues and they sent me things that educated me.
And so, I literally just based it on that. I was like, this is kind of the protocol. I called it an association, not really knowing what associations are. So, it's not necessarily like the most accurate name, but that's our mission. It's to get clinicians into the association so that we can educate them through sending them. What we do is we send them a newsletter once a month that has the five or six latest articles in psychedelic science. And then we have a webinar every month where we do a deep dive on a topic and the clinicians can interact directly with the experts.
We launched in September, 2020, and we have over 800 clinicians and students as members. And then we have over 80 organizations that are members. The reason we have organizations as well is we want to create this sandbox where until this industry is so big that every company has their own medical affairs department with drug reps or whatever, we wanted to facilitate communication between the clinicians and the companies making the medicines. And so, they sign up and then they're invited to come sit on panels that the clinicians listen to, et cetera. So, that's how we get from sports medicine, family medicine, to running a psychedelic association.
John: First of all, the fact that you're interviewing people until you learn. That's why I started my podcast, so I could learn from other people about nonclinical careers. So, it is an awesome way to network, to have these relationships. That was brilliant right there. And then this whole thing with the association, I love that because as a CME surveyor, I used to go to organizations, I mean hundreds of these I've interviewed. And many of them were small associations and societies. I mean, you could call anything a society or an association, but they were doing CME, they were doing education. And it was like, "Wow, I never knew that you could just start something from scratch. And then 5, 10 years later, it's this massive entity that's educating everybody and maybe a little advocacy and other things." So that's just also very impressive, I think.
Dr. Lynn Marie Morski: Thanks.
John: All right. That was a good story to hear and where you are. So, there's a couple practical things I wanted to learn from you today if I could. I just got a little bit of taste of what's going on with psychedelics. I heard about something with PTSD, but maybe give us an example of the two or three largest areas where there's really some awesome studies going on or they've already completed and shown great benefits, for those that don't really know this field.
Dr. Lynn Marie Morski: Absolutely. I'd love to start with ketamine because ketamine is already legal and it's something most of us are familiar with. But I was only familiar with it as an anesthetic that we used in the ER, but the off-label use of ketamine, and I say mostly off-label because recently in the past year or so, there's now an on-label use thanks to Johnson & Johnson.
But generic ketamine is now in off-label use for treatment resistant depression and acute suicidality. That one very often leads to the other, but it's being found to be extremely efficacious. It tends to be six treatments over about three weeks. So, like two treatments a week. And that seems to have a pretty durable effect and you can do it while you're on an antidepressant. You don't have to get off the antidepressant to do it, but if you've got somebody who's acutely suicidal, what our options now are, "Well, let's get you started on an antidepressant and hope that in the six weeks it takes to ramp up, you don't do something about that acutely suicidal nature."
Ketamine works much more rapidly. It's a 45-minute session generally. And they found it really great at just breaking the patterns that are leading to that acutely suicidal thought process that's going on. And so, treatment resistant depression and acute suicidally ketamine is very effective. It comes in a number of forms. The most investigated are intravenous and intramuscular.
And the other one that's on the horizon is that in the next couple of years, there will likely be FDA approval of something called MDMA assisted psychotherapy for PTSD. MDMA is the active ingredient in what is commonly called ecstasy as like the street party drug, MDMA is the active ingredient. So, you're using pure MDMA, but there are generally, at least in the studies, two therapists in a room with a patient for eight hours. The patient takes the MDMA. They have eye shades on. They have a playlist of calling music. Those therapists are there.
For nondirectional therapy, they're just there in case the patient wants to discuss something and also just to reduce harm. And this is preceded by a number of psychotherapy appointments in preparation, and then a number in integration afterward. But some of the statistics from these phase three trials are showing like 67% of the people who got the MDMA treatment in that treatment arm, no longer qualify for having a diagnosis of PTSD after the treatment. Not like, "Oh, it's better." They no longer meet the criteria for having PTSD, which if you've ever treated PTSD, this is not something that any standard therapy cure.
This is the first time we are talking about something that looks like a cure, right? We get very hesitant to throw that word around, but when you have a diagnosis and you no longer have a diagnosis, that's revolutionary. This isn't like taking a pill for the rest of your life every day and chasing symptoms. This is let's spend eight hours, or it's generally two sessions, getting to the core of what's going on, what's causing your trauma, the core trauma, let's revisit it.
MDMA has the ability to take the amygdala, the fear center, offline in a way that you can then revisit your trauma without making so many fear-based memories about it. Maybe you can reevaluate how your brain sees it, form some new grooves and pathways there. And it's incredible to think that these people don't have to take an antidepressant for the rest of their life. Yes, there's follow up self-care things you should be doing forever. It'd be fantastic if you kept meditating and doing journaling or whatever things keep your mental health at its best. But when you do these psychedelic therapies and address the core problem, it's changing the disease state in a way that we're no longer just chasing symptoms for the rest of their life. This is real life changing therapies.
John: Yeah. My knowledge of PTSD is just this gestalt I have of it. It's that it's really difficult to treat, that you get tiny incremental improvements and it takes forever. It's really debilitating, and these people sometimes commit suicide. And it's very frustrating to treat, I would think.
Dr. Lynn Marie Morski: Yeah. Right. The amount of disability that goes out, because it's really hard for people's severe PTSD to go anywhere that they could be retriggered. And so, it really leads to a lot of loss of just job mobility and quality of life. And so, when they do these cost effectiveness studies, yes, these eight-hour sessions, they cost a lot. There's a therapist too, sitting there for eight hours, but the cost savings and the fact that these patients are able to go back to work and contribute to society. And there isn't an insurance company shelling out money for two different antidepressants and three therapy sessions every week for the rest of their life. It allows patients to recover and to heal in a way that you're absolutely right, current therapies do not.
John: All right. Give us a third example. Maybe I should just leave it open ended, but I just feel like I see people talking about psilocybin and mushrooms or other things. What's going on in that area?
Dr. Lynn Marie Morski: Yeah. I'll give you my few favorite studies. My favorite study probably is psilocybin for tobacco cessation. Psilocybin is the active ingredient in what used to be called magic mushrooms. And they found at Johns Hopkins that two sessions of psilocybin therapy, kind of like described, you got the therapist there, same kind of setup. And then there's cognitive behavioral therapy sessions before and after.
The smoking sensation rate at 16 months was something like 60%. And this is not "Then they have to wear the patch every day, or they have to take Wellbutrin or they're doing Chantix." No, that was it. They had to do the cognitive behavioral therapy and the psilocybin sessions. And then that amount of abstinence at 12 to 16 months is unheard of, for anything else that is that short in duration.
And so, a lot of these psychedelics are anti addictive. And another one that I'll just round off with saying. I think there's maybe phase one trials or maybe pre phase one trials, but there's a psychedelic called Ibogaine from the Iboga plant out of Africa, but it is extremely effective in addressing opioid use disorder.
So, patients do the therapy. It is generally one very, very 24 - 48 hours journey, but this therapy is very intense. But when they come out on the other side, they do not have the withdrawal symptoms. And so, that's obviously something else we don't have. Some other mechanism. And they're not exactly sure why that happens. This is an area a lot of research is going into, but the efficacy of that medicine for opioid and I think cocaine use disorder as well is incredible to come out on the other side without the withdrawal. And a lot of them are abstinent for a year or abstinent for a lot longer than they would've been otherwise. And also, the magic mushrooms are in entering phase three trials for major depression. That's very common.
These are being looked at for eating disorders, alcohol use disorder, cluster headache, stroke. Because some of these actually lead to neurogenesis, which a while ago was not thought possible. So, they're investigating these in stroke patients. So, there's just kind of a very wide range of applications in the next few years to be researched for currently.
John: That's crazy. That's amazing. It wasn't that long ago where it didn't seem like there was really anything going on as far as actually studying these. It was just like, let's just push down on it, prevent anyone from using it. No one's supervising these things and anything goes. It's fantastic to hear that this is happening.
So now what about physicians who are interested in this? I want to talk about the association, of course, but before I do that, maybe we'll go with this. Like ketamine, of course. Who usually does ketamine in a clinic? And is that still something that people that are interested can learn to do and start a business or whatever to do that? And then what about the others? Where do we stand in terms of people getting involved?
Dr. Lynn Marie Morski: Absolutely. Ketamine clinics come in a number of varieties. Like I said, there's intravenous clinics, there's intramuscular clinics. There are clinics that you go to and you do lozenges. So, there's a variety of ways that that can be administered. A lot of the intravenous ones are kind of naturally run by anesthesiologists or EM docs, people who had been used to working with ketamine as a medicine. And some are obviously run by psychiatrists. Some are run by a combination thereof, but a lot of who's doing the heavy lifting in these are the therapists.
So, if a psychiatrist wants to get trained in ketamine assisted psychotherapy, which is obviously just the psychotherapy while you're sitting there, while the person is undergoing on a ketamine treatment, probably similarly non-directional to the same thing that was discussed with the MDMA, but they can get that training.
But a lot of times the MDs or DOs are on more of the prescriber side and then they hire a therapist to actually be sitting with the patient. So that's a setup that's pretty common in ketamine clinics. And yes, there is still a need for quality ketamine clinics. And like I said, if the psychiatrist or other doctors themselves want to get trained in the psychotherapy portion, they can. These training programs are not terribly long. And that's one option. So yes, ketamine clinics, as you said, are still a viable option.
And then the others, when MDMA becomes FDA approved, there will still need to be prescribers. The therapists who are sitting with them have to go through a specific MDMA assisted therapy training, but they don't have to have prescribing licenses. So there still will have to be prescribers. Those prescribers will have to have taken the REMS, which is Risk Evaluation Mitigation Strategies. They have to go through this small training program to know how to make that prescription. And then they're allowed to be prescriber. Same thing with the Spravato which is the Johnson & Johnson form of ketamine. You have to go through the REMS to be able to prescribe that version of ketamine.
But there's going to be a need for a lot of prescribers. Something that the association is looking to focus on is that also there will be a need for us to do medical clearance for these. And it's something that isn't talked about enough, but if anybody out there has read Michael Pollan's book called "How to Change Your Mind", which is what got a lot of people into psychedelics. Good old Michael Pollan and his many other books. He writes in there. He tried all of the psychedelics that he could to get information first hand for this book. But when he went to his doctor, his doctor's said, "You cannot do MDMA." And that's the one that I said is going to be likely FDA approved soon. They said you have a specific type of heart arrhythmia that would not be good with MDMA. Okay. That's a very specific type of clearance you have to know.
For Ibogaine, which I mentioned for the opioid use disorder, you cannot have long QT syndrome that can be very dangerous and lead to some arrhythmia. So, there's just a very specific set of criteria for clearances for these that is not well known. One of the things we're going to focus on is working with the people doing these trials, what are the medical clearances you're doing so that we can work on teaching this to doctors so that we end up having a database of doctors that patients can go to if they need clearance for psychedelics. Because I'm not putting on something that I don't know. Like right now, if somebody came to me, I don't practice, but I wouldn't know how to do this. This is an obscure thing. How do you clear these different psychedelic medicines? So, that's something that there will be a need for at some point in the future as more of these become available.
John: Very good. Yeah. Like the friend I mentioned at the beginning here, there's physicians out there that are interested and maybe they've been just doing their usual thing and been thinking, "Well, this is never going to be available." But it looks like things are opening up. And once there's a drug company with an approved drug, well, there's plenty of money to go around to get that out there. There isn't a drug company that doesn't promote the heck out of anything that they're creating or producing.
Dr. Lynn Marie Morski: Interestingly, MAPS, who is the one behind MDMA for PTSD, they're basically a nonprofit. They have to raise. They just did a $30 million fundraising thing last year to get over the hump of the phase three trials. I think they just put out their MDMA creation protocols as open science. We don't want these medicines to go the same way as a lot of the big pharma stuff, because a lot of the big pharmaceuticals are out of reach of people who aren't wealthy.
And who needs mental healing the most? Very often those who have the least. The members of society that have suffered through the trauma of poverty, et cetera. How would we make another thing that they still can't get to? And so, that's why a lot of these companies are trying to be much more conscious and they're doing open science and not patenting their things and working in different methods to get these out. And not quite the super money driven pharma way that we're used to.
John: Yeah. Well, that makes sense. And I've heard of MAPS, that organization, and it obviously does a lot of fundraising to kind of get these things supported so that you can demonstrate it. All right. So that brings me back to the association. Oh, by the way, the website for that is psychedelicmedicineassociation.org.
Dr. Lynn Marie Morski: Yes.
John: Is that correct?
Dr. Lynn Marie Morski: Yes.
John: Okay. We got to make sure we get that in there now.
Dr. Lynn Marie Morski: Thank you.
John: And again, at the end. So, tell me about the clinicians that are in there. Who joins the association and where is it in terms of is it national or international?
Dr. Lynn Marie Morski: Okay. Gotcha. Yeah. It's international. I would say the majority of our clinicians are North American, mostly in America and Canada, the US and Canada. We have clinicians of all types. This is another reason. It's like a slightly different association because it's not just physicians. We want anybody that a patient may go to and say, "I'm struggling with this condition." Anxiety, depression, cluster headaches, whatever. It might be the therapist that they go to. So, we have therapists in there. It might be their PA or their nurse practitioner.
But we know that doctors are writing, and specifically primary care doctors are writing 80% of antidepressant prescriptions. And so, right now we've got ketamine much better generally for treatment resistant depression than a lot of the antidepressants, but most doctors don't know about that. So, they're going to keep writing the antidepressants that they do know about. So that's who the target audience is. We want to get primary care doctors in there.
Now I'm very grateful to be on your podcast because one of the difficulties in marketing and getting people into an association is that it's hard to go looking for an association to join when you don't know a thing exists. If you don't know psychedelic medicine exists, you're not really Googling "How do I learn more about psychedelic medicine?" We have to tell clinicians that exist.
And then we have the extra hurdle of overcoming years of stigma and the "Just say no" in the drug war and all that stuff that we were told for years to be like, "No, I swear these aren't addictive. They're actually going to maybe carry your addiction, but let's completely change your thought process in this."
There's kind of a hurdle to us getting new members in. So that's why I'm very grateful you've had me on your show because the more we can get out to clinicians across the country or the continent or the world to even open eyes that this is something that people should be looking into.
And I'll be very honest. We have a yearly conference and we give you a discount on that conference. And that conference has CME, but short of CME, if you're going to join our association, it's not going to pay off, probably in your bottom line immediately. What it's going to pay off is your patients' outcomes. We're going to tell you ways that instead of giving that antidepressant, maybe that patient's going to do better on ketamine. So, you refer to ketamine. Does that change your bottom line? Maybe even for the worst, to be honest. If they go to ketamine and they don't need to come back for six months, well, that might be six months of medication management appointments you don't get.
And that is why it's hard to necessarily market something that isn't such an obvious thing. But if you want to do what's best for your patients, and also because patients are going to come ask, and they're going to say, "I saw this on 60 Minutes. I saw this in the New York Times." As clinicians, we want to be educated. I remember the worst thing would be when I felt like a deer in the headlights, when somebody would come in, like "I saw a commercial on this new medicine and I was blindsided. I didn't know anything about it." And that puts us also at risk of malpractice. And what we're trying to do is get clinicians comfortable enough so they can have that conversation intelligently when the patient comes in and says, "I've heard about psilocybin for depression. What do you know?" And then they can have that conversation.
And if it's legal in your area and appropriate, because psilocybin will be legal for medical use in Oregon, January 2023. So less than a year from now, if you're an Oregon doctor, this is coming right to your door and patients are going to show up, like, "I've heard about the psilocybin thing. What do you know?" We want doctors to not be caught off guard, and we want you to feel comfortable having a conversation and saying, "This is what psilocybin can do. These are the indications, the contraindications." That kind of thing.
Our target is really primary care doctors, psychiatrists, a lot of people on the front lines. And like I said therapists, et cetera. And who we currently have, let's be honest, like a lot of the people who were already interested in and rare to go on psychedelics. But what we want is to reach out past. We don't want to preach to the choir. We want to reach past that. We want to reach the people who don't know the choir exists. Right. We're like a year and a half or so in. And so, we're kind of into phase two. It's like, "How do we get this mass awareness that this is something clinicians really need to know about?"
John: Just to comment on the issue about if your bread and butters prescribing antidepressants, as a family physician, of course, I didn't necessarily have the sickest of the sick as a psychiatrist do, but to me treating someone that's getting marginally better with an antidepressant for month after month, year after year, I would much rather have a treatment in a short time you're curing it, like you would cure pneumonia or something. So, I'd feel so much more fulfilled as a family doctor if I could do that than this chronic management, which is a pain in the ass.
Dr. Lynn Marie Morski: And I hope that most doctors feel that way. I literally am just playing a kind of devil's advocate because when I look from a marketing standpoint, what are we offering? I'm offering something that may make a patient come back to you less, but most of us, and I no longer practice, but most people practicing are in it for the right reasons. And they do want their patients to get better. So hopefully, that's not what everybody thinks of it when they think of psychedelics.
John: There's some truth to that. There's some of the resistance, I think, to adopting new things, besides just ignorance is like, "Hey, I'm groove here. I just do what I do." And you just keep doing it, even though there's much better treatments. Come on, get on the bandwagon. Okay. Let's see. The association is really focused primarily on education at this point. Now, you say you're planning an annual meeting, or you do an annual meeting. When is that?
Dr. Lynn Marie Morski: Yes. Psych Congress, if anybody out there has heard of them, they put on addiction and mental health conferences for years. Right after we launched the association, we were very grateful because they just came knocking and they said, "We want to have a conference just on psychedelics. We want you to be our official partner." And so, in September of last year, we held the first ever Sana Symposium which was the name of the conference they started. And we had over a thousand clinicians for our three-day virtual event, which was amazing to get to talk directly to clinicians. It was great to see the question. They were asking such detailed questions. "I've got this person and they are bipolar and they're on these medications. Can I send them ketamine?" It was great.
We're doing the second annual Sana Symposium in October of this year. And it'll be virtual again. Hopefully at some point we can start having these things in person again. I'm sure it probably will be. This year maybe it will just be a little too volatile, but yeah, it'll be incredible to finally get to meet people in person and have these conversations face to face. But it's three days of just the most kind of detailed, next level information about psychedelics and how it will be clinically applicable to physicians and other mental health therapists or mental health professionals. And it comes with CME.
John: Yeah. You have a CME partner, or something, so you can grant that. That helps a little bit, I think, to get physicians in particular involved. We can't get into great detail on how you started this whole thing, but what is it like to start an association? Did you have partners? How did you do this thing? And just the short version of that. What's the first couple of steps?
Dr. Lynn Marie Morski: Yeah. Very fair. For the clinicians out there, who are interested in doing anything outside of medicine, I can't stress enough to just get on LinkedIn. It's the number one advice I would give for absolutely anybody because what I left out in my journey is that after I quit the VA and had no job, like starting the podcast didn't suddenly make me money. Somebody found me on LinkedIn and said, "How much would you charge to edit articles about cannabis?" I knew nothing about cannabis, but I'm a good writer. And so, I told them, and then I started editing articles, like a kind of freelance. And then they found out I had a law degree and then they made me their medical director. And I did that for almost two years. So that was keeping my bills paid.
But I had this podcast and then one day out of nowhere, I get a LinkedIn message from somebody in England. And they wanted me to work with their group to make psychedelic CME. And so, that's how they came to me. And when we were in discussions, I happened to say, "Well, when we get the CME made, I want to start this association. And then that'll be a way we can promote the CME." And they literally just stopped dead. They're like, "Well, we want to just start an association too. Forget this CME. We're going to help you start the association." And lo and behold, these were like VC funder people in Europe.
John: Oh really?
Dr. Lynn Marie Morski: Yeah. They had a fund and they had a million connections. And so, they said, we'll be your business advisors. And they gave me a CTO, somebody who'd been working like a tech guy for them. They said, here's your CTO. You two make this happen and we'll be your business advisors and we'll just give you our Rolodex.
And if I wasn't given a tech person, it would've never happened. That's generally like the barrier to anybody creating anything. Like "Oh my gosh, I got to go to Fiverr or Upwork or figure out Squarespace. All of a sudden, I had a tech guru, because setting up an association takes like a website that makes subscriptions. It was not a small hall and he and I worked from June to September. And also, because I had the podcast, I had the connections to reach out and say to some very influential people "Will you be our first organizational member? Will you be at our launch party?" kind of thing.
And so, between the Rolodex of our advisors and mine from having the podcast, that's how we got kind of our initial push. And also, the people with the Rolodex, our business advisors, they said here's a PR person with a list of a hundred PR outlets or something. So, I just sent an email and all of a sudden there's like press releases in Italy about our association. It's just these few little steps that got us. I don't know how we would've been there otherwise. And then I also just did some reaching out to publications in psychedelics and cannabis. And yeah, it was a lot of luck, but a lot of hard work and just some of the perfect connections that went into making it happen.
John: Yeah. I think in something like this, oftentimes there are people out there that are just already interested, but they don't know where to go, how to help, what to do. And a lot of them will just volunteer their time and expertise to get something going, as long as you're not going to make them work 40 hours a week doing it. Take advantage of them too much. That's really interesting and in the right place, at the right time, but I'm sure you've been putting a lot of effort and time to coordinate all this and keep all the pieces together. So, it sounds really exciting.
Dr. Lynn Marie Morski: It's a good time to be in the field because it's about to explode. It was perfect timing when I in 2019 decided, "No, this is where I'm going to put my focus because it positioned me quite well." And it's not too late. We just have ketamine. There are still so many things that are going to be coming. So, for those who are interested, there will be a number of roles for clinicians in this field for sure.
John: Excellent. That's very encouraging. And not only for those that are interested in doing that, but for all the patients out there that are going to benefit from this. All right. Well, Lynn Marie, I think I better let you get back to the rest of your life here. We've learned a lot. We just can't take anymore. There's so much to learn. So, they should just come and go check out the Psychedelic Medicine Association. There's already lots of educational stuff right there. There are lectures and recorded courses and things like that.
Dr. Lynn Marie Morski: Yes. If you go to our website, there's a list already under our course tab. You don't have to be a member to see our course tab. And there's a list of courses. Some have CME, some don't. And then we have a resource page that has a number of written resources. And then it links to my podcast, which is the Psychedelic Medicine podcast, which is technically separate from the association. But they let me host it there where you can learn. There are 106 episodes there, and they're very easily cataloged. If you're looking for ketamine for depression, there's one on that. If you're looking for psilocybin for eating disorders. They are very specifically titled so that you can check it out.
But if you're one of those clinicians that would much rather get the information sent to your inbox than please join us at the Psychedelic Medicine Association, because that's what we'll do and we have this newsletter every month. And then, like I said, every month we have a deep dive webinar with the experts in the field. MAPS, we mentioned. MAPS wrote to me and said, "Can we do a May or June webinar for all MAPS people? We want to tell every single last thing about MDMA for PTSD." I'm like, yes, please. So, that is what's coming out. Who wouldn't want to hear from the people making this drug a reality, how trials have been going on, what it looks like and what the therapy should be like and what kind of REMS there might be? This is the kind of access you get to what's going on if you join. So, it's my humble ploy that if you're interested, please join us.
John: All right. I will put links to each of those things in there so they have easy access and check it out. It doesn't cost anything, at least check it out and then join.
Dr. Lynn Marie Morski: And by the way, medical students are free and residents are cheaper.
John: Okay. Good. That's always helpful. Get them started young.
Dr. Lynn Marie Morski: Yes. That's the plan.
John: All right. Well, thank you very much. I appreciate the time you spent and just explaining all of this. With the way this field is going, I'll probably have to have you come back in a year just to tell us how things have morphed in that relatively short time. Again, thanks for being here. It's been really fun.
Dr. Lynn Marie Morski: Thanks for having me, John.
John: Okay. Bye-bye.
Dr. Lynn Marie Morski: Bye.
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Transcription PNC Podcast Episode 247
How Do I Prepare for the Use of Psychedelics in Clinical Medicine?
John: Dr. Lynn Marie Morski is a Mayo Clinic trained physician, attorney and former adjunct law professor. Dr. Morski spent nine years as a physician at the VA. She is the president of the Psychedelic Medicine Association, the founder of the plantmedicine.org website, host of the Psychedelic Medicine podcast and medical director for wayofleaf.com and Maya Health.
The Psychedelic Medicine Association is a society of physicians, therapists, and healthcare professionals looking to advance their education on the therapeutic uses of psychedelic medicines. The Psychedelic Medicine Association or PMA is a public benefit corporation of healthcare providers aimed at bridging the gap between advances taking place in the psychedelic research world and medical practitioners. So, thanks for being here as we learn how to prepare for the use of psychedelics in clinical medicine.
I have a good friend who works in the mental health field who's been almost obsessed with the potential to use psychedelics to treat certain severe mental illnesses. So, he's been waiting for years for more and more studies to be done and there's been so much activity in this area recently, and he's been thrilled to see that. So that is what led me to really want to get today's guest on the show because she's been involved in all of this recently. And she started an association to address this. And so, with that, I would like to welcome Dr. Lynn Marie Morski.
Dr. Lynn Marie Morski: Thank you for having me. I'm really excited to be here.
John: I should have mentioned too, that you've been on the podcast before. It was years ago. It was long before the Psychedelic Medicine Association existed. But it's been really interesting to follow you along and what you've been up to. And so, this is going to be fun.
Dr. Lynn Marie Morski: Yes. It's been a wild ride since our last episode.
John: We'll get into some details, maybe not every detail, but okay, let's just start with this. At one point in your life, you were in family medicine, sports medicine, and now you're into something totally different. You're a leading voice in psychedelics and you're running a professional association. So, tell us the short version of how that all happened.
Dr. Lynn Marie Morski: Very short version. I have like you said, family medicine, sports medicine, that was my training. Then I went to law school. And so, at some point in time now I've my law degree and I'm working at the VA. I worked at the VA in compensation and pension, which is kind of like the benefits side of things for nine years. And I grew up in a very conservative family. I don't think I touched alcohol to like 26. I hadn't touched cannabis, no psychedelics, nothing. And then somewhere during my time at the VA, I had a psychedelic experience of my own, and I found it very therapeutic and I did not actually know that psychedelic therapeutics were a thing or psychedelic science was a field. And I had to keep it to myself because I was a department of defense employee. And I couldn't tell anybody I had tried these and I definitely couldn't share it with patients.
But first off, a few years later, I found out psychedelic science was a field of research. And the fact that I was having therapeutic realizations once or twice a year, I would try psychedelic. I was like, "Oh, it's not just me. This is common. And this is being researched." And I found that out. And then I did something called "Ayahuasca", which is a type of psychedelic and it was so beneficial. And here I am in my day job, going to the VA, seeing a veteran after veteran who very often have PTSD or traumatic brain injury, depression, whatever. Things that I know psychedelics are being studied to address and that psychedelics are showing to address effectively and I cannot tell them about it, right?
As physicians first do no harm, I'm sitting there thinking I'm doing harm by omission because I know something that probably is more effective than what they're doing, but I can't say anything about it. And so, in May, 2019, I made a decision to leave clinical medicine. I had no backup whatsoever. No savings, no separate job. I just thought this is totally out of alignment.
All I had was a mission. And my mission was to spread the word about psychedelic fair pieces to clinicians. Because you could spread it to patients all day long, but think about it, if your spread is one clinician who sees a hundred patients a week, it's just so much more effective. And that's who so many people go to for their care. Clinicians are going to keep handing out antidepressants and not know that there are these other things that work better until somebody comes along and educates them. We weren't taught about psychedelics in medical school or residency or fellowship. And so, I made it my mission to find a way to enact that.
I quit medicine. I wasn't quite sure how I was going to enact this mission. So, what I started with is I already had a podcast on quitting, which is the other thing that I used to talk about. And so, I thought I knew how to podcast. I'll just interview all the experts in the field who will be willing to come on my podcast. I'll learn from them and I'll be sharing the information while I learn, and clinicians will learn that way.
By the way, this was working, I was getting lots of listeners, but not necessarily clinicians. And it occurred to me that clinicians don't sit down for 45 minutes to listen to a podcast to hear about a clinical topic. They might like a side gig topic or a lifestyle topic. But if you want to find out the latest way to treat treatment resistant depression, you're probably going to check your email for a journal article or something you can look up between patients.
And so, after the podcast had been out about six months, I realized I'm reaching listeners, but not clinicians. Then, it occurred to me, I need to find a way to get into doctor's inboxes and in a way that I can get them information that's really easily digestible. And so, that's when the idea of an association came up because I had been in something like a society of physician entrepreneurs, or whatever, that I'd signed up for and paid dues and they sent me things that educated me.
And so, I literally just based it on that. I was like, this is kind of the protocol. I called it an association, not really knowing what associations are. So, it's not necessarily like the most accurate name, but that's our mission. It's to get clinicians into the association so that we can educate them through sending them. What we do is we send them a newsletter once a month that has the five or six latest articles in psychedelic science. And then we have a webinar every month where we do a deep dive on a topic and the clinicians can interact directly with the experts.
We launched in September, 2020, and we have over 800 clinicians and students as members. And then we have over 80 organizations that are members. The reason we have organizations as well is we want to create this sandbox where until this industry is so big that every company has their own medical affairs department with drug reps or whatever, we wanted to facilitate communication between the clinicians and the companies making the medicines. And so, they sign up and then they're invited to come sit on panels that the clinicians listen to, et cetera. So, that's how we get from sports medicine, family medicine, to running a psychedelic association.
John: First of all, the fact that you're interviewing people until you learn. That's why I started my podcast, so I could learn from other people about nonclinical careers. So, it is an awesome way to network, to have these relationships. That was brilliant right there. And then this whole thing with the association, I love that because as a CME surveyor, I used to go to organizations, I mean hundreds of these I've interviewed. And many of them were small associations and societies. I mean, you could call anything a society or an association, but they were doing CME, they were doing education. And it was like, "Wow, I never knew that you could just start something from scratch. And then 5, 10 years later, it's this massive entity that's educating everybody and maybe a little advocacy and other things." So that's just also very impressive, I think.
Dr. Lynn Marie Morski: Thanks.
John: All right. That was a good story to hear and where you are. So, there's a couple practical things I wanted to learn from you today if I could. I just got a little bit of taste of what's going on with psychedelics. I heard about something with PTSD, but maybe give us an example of the two or three largest areas where there's really some awesome studies going on or they've already completed and shown great benefits, for those that don't really know this field.
Dr. Lynn Marie Morski: Absolutely. I'd love to start with ketamine because ketamine is already legal and it's something most of us are familiar with. But I was only familiar with it as an anesthetic that we used in the ER, but the off-label use of ketamine, and I say mostly off-label because recently in the past year or so, there's now an on-label use thanks to Johnson & Johnson.
But generic ketamine is now in off-label use for treatment resistant depression and acute suicidality. That one very often leads to the other, but it's being found to be extremely efficacious. It tends to be six treatments over about three weeks. So, like two treatments a week. And that seems to have a pretty durable effect and you can do it while you're on an antidepressant. You don't have to get off the antidepressant to do it, but if you've got somebody who's acutely suicidal, what our options now are, "Well, let's get you started on an antidepressant and hope that in the six weeks it takes to ramp up, you don't do something about that acutely suicidal nature."
Ketamine works much more rapidly. It's a 45-minute session generally. And they found it really great at just breaking the patterns that are leading to that acutely suicidal thought process that's going on. And so, treatment resistant depression and acute suicidally ketamine is very effective. It comes in a number of forms. The most investigated are intravenous and intramuscular.
And the other one that's on the horizon is that in the next couple of years, there will likely be FDA approval of something called MDMA assisted psychotherapy for PTSD. MDMA is the active ingredient in what is commonly called ecstasy as like the street party drug, MDMA is the active ingredient. So, you're using pure MDMA, but there are generally, at least in the studies, two therapists in a room with a patient for eight hours. The patient takes the MDMA. They have eye shades on. They have a playlist of calling music. Those therapists are there.
For nondirectional therapy, they're just there in case the patient wants to discuss something and also just to reduce harm. And this is preceded by a number of psychotherapy appointments in preparation, and then a number in integration afterward. But some of the statistics from these phase three trials are showing like 67% of the people who got the MDMA treatment in that treatment arm, no longer qualify for having a diagnosis of PTSD after the treatment. Not like, "Oh, it's better." They no longer meet the criteria for having PTSD, which if you've ever treated PTSD, this is not something that any standard therapy cure.
This is the first time we are talking about something that looks like a cure, right? We get very hesitant to throw that word around, but when you have a diagnosis and you no longer have a diagnosis, that's revolutionary. This isn't like taking a pill for the rest of your life every day and chasing symptoms. This is let's spend eight hours, or it's generally two sessions, getting to the core of what's going on, what's causing your trauma, the core trauma, let's revisit it.
MDMA has the ability to take the amygdala, the fear center, offline in a way that you can then revisit your trauma without making so many fear-based memories about it. Maybe you can reevaluate how your brain sees it, form some new grooves and pathways there. And it's incredible to think that these people don't have to take an antidepressant for the rest of their life. Yes, there's follow up self-care things you should be doing forever. It'd be fantastic if you kept meditating and doing journaling or whatever things keep your mental health at its best. But when you do these psychedelic therapies and address the core problem, it's changing the disease state in a way that we're no longer just chasing symptoms for the rest of their life. This is real life changing therapies.
John: Yeah. My knowledge of PTSD is just this gestalt I have of it. It's that it's really difficult to treat, that you get tiny incremental improvements and it takes forever. It's really debilitating, and these people sometimes commit suicide. And it's very frustrating to treat, I would think.
Dr. Lynn Marie Morski: Yeah. Right. The amount of disability that goes out, because it's really hard for people's severe PTSD to go anywhere that they could be retriggered. And so, it really leads to a lot of loss of just job mobility and quality of life. And so, when they do these cost effectiveness studies, yes, these eight-hour sessions, they cost a lot. There's a therapist too, sitting there for eight hours, but the cost savings and the fact that these patients are able to go back to work and contribute to society. And there isn't an insurance company shelling out money for two different antidepressants and three therapy sessions every week for the rest of their life. It allows patients to recover and to heal in a way that you're absolutely right, current therapies do not.
John: All right. Give us a third example. Maybe I should just leave it open ended, but I just feel like I see people talking about psilocybin and mushrooms or other things. What's going on in that area?
Dr. Lynn Marie Morski: Yeah. I'll give you my few favorite studies. My favorite study probably is psilocybin for tobacco cessation. Psilocybin is the active ingredient in what used to be called magic mushrooms. And they found at Johns Hopkins that two sessions of psilocybin therapy, kind of like described, you got the therapist there, same kind of setup. And then there's cognitive behavioral therapy sessions before and after.
The smoking sensation rate at 16 months was something like 60%. And this is not "Then they have to wear the patch every day, or they have to take Wellbutrin or they're doing Chantix." No, that was it. They had to do the cognitive behavioral therapy and the psilocybin sessions. And then that amount of abstinence at 12 to 16 months is unheard of, for anything else that is that short in duration.
And so, a lot of these psychedelics are anti addictive. And another one that I'll just round off with saying. I think there's maybe phase one trials or maybe pre phase one trials, but there's a psychedelic called Ibogaine from the Iboga plant out of Africa, but it is extremely effective in addressing opioid use disorder.
So, patients do the therapy. It is generally one very, very 24 - 48 hours journey, but this therapy is very intense. But when they come out on the other side, they do not have the withdrawal symptoms. And so, that's obviously something else we don't have. Some other mechanism. And they're not exactly sure why that happens. This is an area a lot of research is going into, but the efficacy of that medicine for opioid and I think cocaine use disorder as well is incredible to come out on the other side without the withdrawal. And a lot of them are abstinent for a year or abstinent for a lot longer than they would've been otherwise. And also, the magic mushrooms are in entering phase three trials for major depression. That's very common.
These are being looked at for eating disorders, alcohol use disorder, cluster headache, stroke. Because some of these actually lead to neurogenesis, which a while ago was not thought possible. So, they're investigating these in stroke patients. So, there's just kind of a very wide range of applications in the next few years to be researched for currently.
John: That's crazy. That's amazing. It wasn't that long ago where it didn't seem like there was really anything going on as far as actually studying these. It was just like, let's just push down on it, prevent anyone from using it. No one's supervising these things and anything goes. It's fantastic to hear that this is happening.
So now what about physicians who are interested in this? I want to talk about the association, of course, but before I do that, maybe we'll go with this. Like ketamine, of course. Who usually does ketamine in a clinic? And is that still something that people that are interested can learn to do and start a business or whatever to do that? And then what about the others? Where do we stand in terms of people getting involved?
Dr. Lynn Marie Morski: Absolutely. Ketamine clinics come in a number of varieties. Like I said, there's intravenous clinics, there's intramuscular clinics. There are clinics that you go to and you do lozenges. So, there's a variety of ways that that can be administered. A lot of the intravenous ones are kind of naturally run by anesthesiologists or EM docs, people who had been used to working with ketamine as a medicine. And some are obviously run by psychiatrists. Some are run by a combination thereof, but a lot of who's doing the heavy lifting in these are the therapists.
So, if a psychiatrist wants to get trained in ketamine assisted psychotherapy, which is obviously just the psychotherapy while you're sitting there, while the person is undergoing on a ketamine treatment, probably similarly non-directional to the same thing that was discussed with the MDMA, but they can get that training.
But a lot of times the MDs or DOs are on more of the prescriber side and then they hire a therapist to actually be sitting with the patient. So that's a setup that's pretty common in ketamine clinics. And yes, there is still a need for quality ketamine clinics. And like I said, if the psychiatrist or other doctors themselves want to get trained in the psychotherapy portion, they can. These training programs are not terribly long. And that's one option. So yes, ketamine clinics, as you said, are still a viable option.
And then the others, when MDMA becomes FDA approved, there will still need to be prescribers. The therapists who are sitting with them have to go through a specific MDMA assisted therapy training, but they don't have to have prescribing licenses. So there still will have to be prescribers. Those prescribers will have to have taken the REMS, which is Risk Evaluation Mitigation Strategies. They have to go through this small training program to know how to make that prescription. And then they're allowed to be prescriber. Same thing with the Spravato which is the Johnson & Johnson form of ketamine. You have to go through the REMS to be able to prescribe that version of ketamine.
But there's going to be a need for a lot of prescribers. Something that the association is looking to focus on is that also there will be a need for us to do medical clearance for these. And it's something that isn't talked about enough, but if anybody out there has read Michael Pollan's book called "How to Change Your Mind", which is what got a lot of people into psychedelics. Good old Michael Pollan and his many other books. He writes in there. He tried all of the psychedelics that he could to get information first hand for this book. But when he went to his doctor, his doctor's said, "You cannot do MDMA." And that's the one that I said is going to be likely FDA approved soon. They said you have a specific type of heart arrhythmia that would not be good with MDMA. Okay. That's a very specific type of clearance you have to know.
For Ibogaine, which I mentioned for the opioid use disorder, you cannot have long QT syndrome that can be very dangerous and lead to some arrhythmia. So, there's just a very specific set of criteria for clearances for these that is not well known. One of the things we're going to focus on is working with the people doing these trials, what are the medical clearances you're doing so that we can work on teaching this to doctors so that we end up having a database of doctors that patients can go to if they need clearance for psychedelics. Because I'm not putting on something that I don't know. Like right now, if somebody came to me, I don't practice, but I wouldn't know how to do this. This is an obscure thing. How do you clear these different psychedelic medicines? So, that's something that there will be a need for at some point in the future as more of these become available.
John: Very good. Yeah. Like the friend I mentioned at the beginning here, there's physicians out there that are interested and maybe they've been just doing their usual thing and been thinking, "Well, this is never going to be available." But it looks like things are opening up. And once there's a drug company with an approved drug, well, there's plenty of money to go around to get that out there. There isn't a drug company that doesn't promote the heck out of anything that they're creating or producing.
Dr. Lynn Marie Morski: Interestingly, MAPS, who is the one behind MDMA for PTSD, they're basically a nonprofit. They have to raise. They just did a $30 million fundraising thing last year to get over the hump of the phase three trials. I think they just put out their MDMA creation protocols as open science. We don't want these medicines to go the same way as a lot of the big pharma stuff, because a lot of the big pharmaceuticals are out of reach of people who aren't wealthy.
And who needs mental healing the most? Very often those who have the least. The members of society that have suffered through the trauma of poverty, et cetera. How would we make another thing that they still can't get to? And so, that's why a lot of these companies are trying to be much more conscious and they're doing open science and not patenting their things and working in different methods to get these out. And not quite the super money driven pharma way that we're used to.
John: Yeah. Well, that makes sense. And I've heard of MAPS, that organization, and it obviously does a lot of fundraising to kind of get these things supported so that you can demonstrate it. All right. So that brings me back to the association. Oh, by the way, the website for that is psychedelicmedicineassociation.org.
Dr. Lynn Marie Morski: Yes.
John: Is that correct?
Dr. Lynn Marie Morski: Yes.
John: Okay. We got to make sure we get that in there now.
Dr. Lynn Marie Morski: Thank you.
John: And again, at the end. So, tell me about the clinicians that are in there. Who joins the association and where is it in terms of is it national or international?
Dr. Lynn Marie Morski: Okay. Gotcha. Yeah. It's international. I would say the majority of our clinicians are North American, mostly in America and Canada, the US and Canada. We have clinicians of all types. This is another reason. It's like a slightly different association because it's not just physicians. We want anybody that a patient may go to and say, "I'm struggling with this condition." Anxiety, depression, cluster headaches, whatever. It might be the therapist that they go to. So, we have therapists in there. It might be their PA or their nurse practitioner.
But we know that doctors are writing, and specifically primary care doctors are writing 80% of antidepressant prescriptions. And so, right now we've got ketamine much better generally for treatment resistant depression than a lot of the antidepressants, but most doctors don't know about that. So, they're going to keep writing the antidepressants that they do know about. So that's who the target audience is. We want to get primary care doctors in there.
Now I'm very grateful to be on your podcast because one of the difficulties in marketing and getting people into an association is that it's hard to go looking for an association to join when you don't know a thing exists. If you don't know psychedelic medicine exists, you're not really Googling "How do I learn more about psychedelic medicine?" We have to tell clinicians that exist.
And then we have the extra hurdle of overcoming years of stigma and the "Just say no" in the drug war and all that stuff that we were told for years to be like, "No, I swear these aren't addictive. They're actually going to maybe carry your addiction, but let's completely change your thought process in this."
There's kind of a hurdle to us getting new members in. So that's why I'm very grateful you've had me on your show because the more we can get out to clinicians across the country or the continent or the world to even open eyes that this is something that people should be looking into.
And I'll be very honest. We have a yearly conference and we give you a discount on that conference. And that conference has CME, but short of CME, if you're going to join our association, it's not going to pay off, probably in your bottom line immediately. What it's going to pay off is your patients' outcomes. We're going to tell you ways that instead of giving that antidepressant, maybe that patient's going to do better on ketamine. So, you refer to ketamine. Does that change your bottom line? Maybe even for the worst, to be honest. If they go to ketamine and they don't need to come back for six months, well, that might be six months of medication management appointments you don't get.
And that is why it's hard to necessarily market something that isn't such an obvious thing. But if you want to do what's best for your patients, and also because patients are going to come ask, and they're going to say, "I saw this on 60 Minutes. I saw this in the New York Times." As clinicians, we want to be educated. I remember the worst thing would be when I felt like a deer in the headlights, when somebody would come in, like "I saw a commercial on this new medicine and I was blindsided. I didn't know anything about it." And that puts us also at risk of malpractice. And what we're trying to do is get clinicians comfortable enough so they can have that conversation intelligently when the patient comes in and says, "I've heard about psilocybin for depression. What do you know?" And then they can have that conversation.
And if it's legal in your area and appropriate, because psilocybin will be legal for medical use in Oregon, January 2023. So less than a year from now, if you're an Oregon doctor, this is coming right to your door and patients are going to show up, like, "I've heard about the psilocybin thing. What do you know?" We want doctors to not be caught off guard, and we want you to feel comfortable having a conversation and saying, "This is what psilocybin can do. These are the indications, the contraindications." That kind of thing.
Our target is really primary care doctors, psychiatrists, a lot of people on the front lines. And like I said therapists, et cetera. And who we currently have, let's be honest, like a lot of the people who were already interested in and rare to go on psychedelics. But what we want is to reach out past. We don't want to preach to the choir. We want to reach past that. We want to reach the people who don't know the choir exists. Right. We're like a year and a half or so in. And so, we're kind of into phase two. It's like, "How do we get this mass awareness that this is something clinicians really need to know about?"
John: Just to comment on the issue about if your bread and butters prescribing antidepressants, as a family physician, of course, I didn't necessarily have the sickest of the sick as a psychiatrist do, but to me treating someone that's getting marginally better with an antidepressant for month after month, year after year, I would much rather have a treatment in a short time you're curing it, like you would cure pneumonia or something. So, I'd feel so much more fulfilled as a family doctor if I could do that than this chronic management, which is a pain in the ass.
Dr. Lynn Marie Morski: And I hope that most doctors feel that way. I literally am just playing a kind of devil's advocate because when I look from a marketing standpoint, what are we offering? I'm offering something that may make a patient come back to you less, but most of us, and I no longer practice, but most people practicing are in it for the right reasons. And they do want their patients to get better. So hopefully, that's not what everybody thinks of it when they think of psychedelics.
John: There's some truth to that. There's some of the resistance, I think, to adopting new things, besides just ignorance is like, "Hey, I'm groove here. I just do what I do." And you just keep doing it, even though there's much better treatments. Come on, get on the bandwagon. Okay. Let's see. The association is really focused primarily on education at this point. Now, you say you're planning an annual meeting, or you do an annual meeting. When is that?
Dr. Lynn Marie Morski: Yes. Psych Congress, if anybody out there has heard of them, they put on addiction and mental health conferences for years. Right after we launched the association, we were very grateful because they just came knocking and they said, "We want to have a conference just on psychedelics. We want you to be our official partner." And so, in September of last year, we held the first ever Sana Symposium which was the name of the conference they started. And we had over a thousand clinicians for our three-day virtual event, which was amazing to get to talk directly to clinicians. It was great to see the question. They were asking such detailed questions. "I've got this person and they are bipolar and they're on these medications. Can I send them ketamine?" It was great.
We're doing the second annual Sana Symposium in October of this year. And it'll be virtual again. Hopefully at some point we can start having these things in person again. I'm sure it probably will be. This year maybe it will just be a little too volatile, but yeah, it'll be incredible to finally get to meet people in person and have these conversations face to face. But it's three days of just the most kind of detailed, next level information about psychedelics and how it will be clinically applicable to physicians and other mental health therapists or mental health professionals. And it comes with CME.
John: Yeah. You have a CME partner, or something, so you can grant that. That helps a little bit, I think, to get physicians in particular involved. We can't get into great detail on how you started this whole thing, but what is it like to start an association? Did you have partners? How did you do this thing? And just the short version of that. What's the first couple of steps?
Dr. Lynn Marie Morski: Yeah. Very fair. For the clinicians out there, who are interested in doing anything outside of medicine, I can't stress enough to just get on LinkedIn. It's the number one advice I would give for absolutely anybody because what I left out in my journey is that after I quit the VA and had no job, like starting the podcast didn't suddenly make me money. Somebody found me on LinkedIn and said, "How much would you charge to edit articles about cannabis?" I knew nothing about cannabis, but I'm a good writer. And so, I told them, and then I started editing articles, like a kind of freelance. And then they found out I had a law degree and then they made me their medical director. And I did that for almost two years. So that was keeping my bills paid.
But I had this podcast and then one day out of nowhere, I get a LinkedIn message from somebody in England. And they wanted me to work with their group to make psychedelic CME. And so, that's how they came to me. And when we were in discussions, I happened to say, "Well, when we get the CME made, I want to start this association. And then that'll be a way we can promote the CME." And they literally just stopped dead. They're like, "Well, we want to just start an association too. Forget this CME. We're going to help you start the association." And lo and behold, these were like VC funder people in Europe.
John: Oh really?
Dr. Lynn Marie Morski: Yeah. They had a fund and they had a million connections. And so, they said, we'll be your business advisors. And they gave me a CTO, somebody who'd been working like a tech guy for them. They said, here's your CTO. You two make this happen and we'll be your business advisors and we'll just give you our Rolodex.
And if I wasn't given a tech person, it would've never happened. That's generally like the barrier to anybody creating anything. Like "Oh my gosh, I got to go to Fiverr or Upwork or figure out Squarespace. All of a sudden, I had a tech guru, because setting up an association takes like a website that makes subscriptions. It was not a small hall and he and I worked from June to September. And also, because I had the podcast, I had the connections to reach out and say to some very influential people "Will you be our first organizational member? Will you be at our launch party?" kind of thing.
And so, between the Rolodex of our advisors and mine from having the podcast, that's how we got kind of our initial push. And also, the people with the Rolodex, our business advisors, they said here's a PR person with a list of a hundred PR outlets or something. So, I just sent an email and all of a sudden there's like press releases in Italy about our association. It's just these few little steps that got us. I don't know how we would've been there otherwise. And then I also just did some reaching out to publications in psychedelics and cannabis. And yeah, it was a lot of luck, but a lot of hard work and just some of the perfect connections that went into making it happen.
John: Yeah. I think in something like this, oftentimes there are people out there that are just already interested, but they don't know where to go, how to help, what to do. And a lot of them will just volunteer their time and expertise to get something going, as long as you're not going to make them work 40 hours a week doing it. Take advantage of them too much. That's really interesting and in the right place, at the right time, but I'm sure you've been putting a lot of effort and time to coordinate all this and keep all the pieces together. So, it sounds really exciting.
Dr. Lynn Marie Morski: It's a good time to be in the field because it's about to explode. It was perfect timing when I in 2019 decided, "No, this is where I'm going to put my focus because it positioned me quite well." And it's not too late. We just have ketamine. There are still so many things that are going to be coming. So, for those who are interested, there will be a number of roles for clinicians in this field for sure.
John: Excellent. That's very encouraging. And not only for those that are interested in doing that, but for all the patients out there that are going to benefit from this. All right. Well, Lynn Marie, I think I better let you get back to the rest of your life here. We've learned a lot. We just can't take anymore. There's so much to learn. So, they should just come and go check out the Psychedelic Medicine Association. There's already lots of educational stuff right there. There are lectures and recorded courses and things like that.
Dr. Lynn Marie Morski: Yes. If you go to our website, there's a list already under our course tab. You don't have to be a member to see our course tab. And there's a list of courses. Some have CME, some don't. And then we have a resource page that has a number of written resources. And then it links to my podcast, which is the Psychedelic Medicine podcast, which is technically separate from the association. But they let me host it there where you can learn. There are 106 episodes there, and they're very easily cataloged. If you're looking for ketamine for depression, there's one on that. If you're looking for psilocybin for eating disorders. They are very specifically titled so that you can check it out.
But if you're one of those clinicians that would much rather get the information sent to your inbox than please join us at the Psychedelic Medicine Association, because that's what we'll do and we have this newsletter every month. And then, like I said, every month we have a deep dive webinar with the experts in the field. MAPS, we mentioned. MAPS wrote to me and said, "Can we do a May or June webinar for all MAPS people? We want to tell every single last thing about MDMA for PTSD." I'm like, yes, please. So, that is what's coming out. Who wouldn't want to hear from the people making this drug a reality, how trials have been going on, what it looks like and what the therapy should be like and what kind of REMS there might be? This is the kind of access you get to what's going on if you join. So, it's my humble ploy that if you're interested, please join us.
John: All right. I will put links to each of those things in there so they have easy access and check it out. It doesn't cost anything, at least check it out and then join.
Dr. Lynn Marie Morski: And by the way, medical students are free and residents are cheaper.
John: Okay. Good. That's always helpful. Get them started young.
Dr. Lynn Marie Morski: Yes. That's the plan.
John: All right. Well, thank you very much. I appreciate the time you spent and just explaining all of this. With the way this field is going, I'll probably have to have you come back in a year just to tell us how things have morphed in that relatively short time. Again, thanks for being here. It's been really fun.
Dr. Lynn Marie Morski: Thanks for having me, John.
John: Okay. Bye-bye.
Dr. Lynn Marie Morski: Bye.
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