All language subtitles for NOVA S49E14 Can Psychedelics Cure 1080p WEB h264-BAE (1)_track3_[eng]

♪ ♪

♪ ♪

ADRIAN PRIMEAUX:
To me, peyote is a
very intimate

medicinal herb.

ALBERT GARCIA-ROMEU:
Psychedelic-assisted treatments

allow us to reinvent ourselves.

YASMIN HURD:
They're allowing the brain

to see itself.

NARRATOR:
In the 1960s,
psychedelic drugs were famous

for their mind-bending
recreational effects,

but today, they might offer hope
for treating

devastating conditions

from addiction, to PTSD,
to depression.

LEN CAMPBELL:
I didn't take psilocybin

to go find Martians.

I needed to work with
scientists

to be able to stop
smoking cigarettes.

And it worked.

EVAN CRAIG:
I was on antidepressants for
about four years prior.

And I haven't been on any since.

(laughs)

I haven't felt sadness.

NARRATOR:
How is this possible?

Scientists are searching for
answers within the brain,

where psychedelics
alter consciousness

and can open the mind
to positive change.

It's like reprogramming the
operating system of a computer.

You're getting down to
very basic, code-level changes.

FRED BARRETT:
We observe a radical change

in the way that brain regions
talk to each other.

BILL RICHARDS:
It's not only that these
states of consciousness

are beautiful and inspiring.

They seem to have
therapeutic power.

KATHLEEN KRAL:
The psilocybin

shifted my perception
from negativity to positivity.

NARRATOR:
The research is cutting-edge,

but early results
from clinical trials offer hope.

SCOTT OSTROM:
You don't forget

the breakthrough moments
that you had,

and you don't forget
what you learned.

They stay a part of you.

JON KOSTAS:
I haven't drank since

my very first session.

It worked almost like
an antibiotic,

where I did this treatment

and then I was done.

NARRATOR:
"Can Psychedelics Cure?"

Right now, on "NOVA."

♪ ♪

NARRATOR:
Psychedelics:
LSD, magic mushrooms, peyote.

These powerful,
mind-expanding substances

fueled the '60s counter-culture.

For some, they're powerfully
transformative-- even spiritual.

CAMPBELL:
It was a spiritual experience

that I'd never had in my life.

It has probably changed me
forever.

NARRATOR:
But for others,
terrifying and dangerous.

MARCELA OT'ALORA G.:
They felt that I was having
a psychotic episode.

I was hospitalized.

NARRATOR:
And ultimately,
they were criminalized.

RICHARD NIXON:
We must wage total war against

public enemy number one,

the problem of dangerous drugs.

♪ ♪

NARRATOR:
But today, a growing number
of clinicians

argue that there's another side
to psychedelics.

MANISH AGRAWAL:
The psilocybin therapy

has been the most powerful tool
I've seen.

I said, "Wow.

"I feel like I've been treating
trauma with stone tools,

and there's the
state-of-the-art treatment."

NARRATOR:
That they have the potential

to heal the mind as a treatment

for addiction,
depression, and PTSD.

ROBIN CARHART-HARRIS:
They have this big effect,

opening the mind and the brain
up

for change.

The good that can come out of

the responsible use
of these substances

is quite amazing, really.

♪ ♪

NARRATOR:
It's an about-face
that few saw coming.

RACHEL YEHUDA:
How do you shift
from a position of,

"These drugs are illegal,

these drugs are bad for you,"

to, "These drugs are
therapeutic,

"this is the way that you heal

from mental illness"?

NARRATOR:
What are these drugs doing
to patients' minds

to give some doctors such hope
for their potential?

♪ ♪

♪ ♪

KOSTAS:
I grew up in New York City.

It was fairly easy to,
to get access to alcohol,

through friends,
we'd go to a corner deli.

And that all started probably
around 12, 13 years old.

It would take a couple
of drinks to feel anything

or feel good.

But then, a couple of years
later,

those two drinks wouldn't
cut it,

or three drinks wouldn't cut it,

and I'd need more to get to
where I was before,

when I first started drinking.

I wouldn't drink every night.

I was more of a binge drinker,
so I'd pick my battles.

But during one of those nights,

it would be about 23 drinks
in a night.

NARRATOR:
Over the years,
Jon Kostas struggled to quit.

KOSTAS:
I went to my first
AA meeting at 16.

I tried AA for years.

I tried rehab.

I tried different
pharmaceutical drugs.

I've been practicing psychiatry
for 21 years,

focusing on addiction.

And Jon came to me
in his early 20s,

and he probably was the worst
case of alcohol use disorder

I'd ever seen
for someone his age.

He'd go on these terrible
benders that he was starting

to experience alcohol
withdrawal,

which is very rare for somebody
in their early 20s,

and I was very scared that
he was going to have

a premature death because of
how much he was drinking.

NARRATOR:
Worried that Jon was at risk
of death,

psychiatrist Stephen Ross helped
him enroll in a clinical trial

at N.Y.U. with his colleague

psychiatrist
Michael Bogenschutz,

who was testing a controversial
experimental treatment

for alcohol use disorder

using psychedelics.

During a series of carefully
designed therapy sessions

over 12 weeks, Jon received two
doses of a hallucinogenic drug.

His addiction to
a recreational drug

would be treated with
what most people think of

as another recreational drug,
psilocybin,

which is classified
as a schedule one narcotic,

right alongside heroin.

♪ ♪

Psilocybin is the mind-altering

molecule found
in magic mushrooms.

They were introduced
to American popular culture

in 1957 by a Wall Street banker
named R. Gordon Wasson,

who wrote about them in an
article for "Life" magazine.

These fungi have been used
by Indigenous peoples

in the Americas
for thousands of years.

Psilocybin is just one of
a family of substances

often called psychedelics.

They include mescaline,

found in the North American
cactus peyote,

as well as synthetic chemicals
like LSD and MDMA.

Users report that these drugs
bring about

an altered state of
consciousness,

sometimes accompanied by
hallucinations

or heightened sensitivity
to colors, sounds, and patterns.

BARRETT:
The entire range of possible

visual experiences can be
encountered.

Walls breathing,
illusory movement--

seeing movement in a carpet

when the carpet's not really
moving.

NARRATOR:
Many also report a loss of ego
accompanied by

profound feelings of empathy
and connection to others,

even the entire universe.

And what's perhaps most unusual
about these drugs

is that after the experience of
the so-called trip,

users often feel changed
in positive ways.

Though there are
clear differences

between psychedelics, they all,
with the exception of MDMA,

act in a similar way
in the brain.

Each of the active molecules
fits like a key into a lock

by binding to a specific protein
in the nerve cells

of the human brain called the
serotonin 2a receptor,

and this can alter perceptions
and even consciousness itself.

And that's central
for producing

their subjective states,

including mystical states
of consciousness

and these unusual states
of mind.

NARRATOR:
The drugs are very powerful.

And for some people,

the experience of going
on a consciousness-altering trip

that they can't control or stop

can be very challenging
or frightening.

KOSTAS:
I was afraid of psychedelics.

I never experimented with them
growing up

because I was too afraid.

I heard all the bad stories
of having a bad trip,

or I thought I could go
permanently crazy.

Or if you stare at the sun,
you'll go blind.

And so,
when I raised those concerns

with the doctors at N.Y.U.,

they said, "Listen, that's
totally normal going into it,

"but this is incredibly safe
to do.

"We've already
properly screened you,

"and you're mentally
and physically fit

to go through this."

NARRATOR:
Patients with a personal

or family history of psychiatric
disorders like schizophrenia,

bipolar, or psychotic disorders
are deemed to be too at risk

for the treatment.

BOGENSCHUTZ:
There's a possibility that

classic psychedelics
could precipitate

a psychotic episode
or a psychotic disorder

in someone who was predisposed.

And that hasn't happened
in any of the trials to date,

but it, uh, you know, it remains
a concern.

Would you like to state
your intention for...

NARRATOR:
In trials like this one,

the drug is part of a larger
plan to help participants

address specific issues,

and each psychedelic trip
is facilitated by a therapist.

When Jon took his first
psilocybin trip in an effort

to curb his cravings

for alcohol,
the experience was powerful.

KOSTAS:
There were a few
monumental experiences

that I saw during this.

(bird calling in distance)

There was a glass bottle,

a liquor bottle,
in the middle of the desert,

and all of a sudden, the glass
disintegrated into the sand,

back into the desert,
and just vanished.

And I thought that was
pretty powerful symbolism

that my addiction
was leaving me.

And pretty much after that, I
had felt this is going to work.

♪ ♪

NARRATOR:
Jon stopped drinking after
his first dosing session.

KOSTAS:
It worked almost like
an antibiotic,

where I was sick,
I had a disease,

I went in, saw the doctors,

did this treatment,

and then I was done.

I don't have to see doctors.

I'm not on any, uh,
prescriptions.

I don't go to any
support groups.

I live without the addiction,

which I never thought
would be possible.

♪ ♪

NARRATOR:
The N.Y.U. study recruited
93 patients who were

randomly assigned psilocybin
or a placebo.

All the participants received
psychotherapy

over the 12-week
treatment period.

Jon's case is
particularly dramatic.

But the results overall
have been encouraging.

ROSS:
The psilocybin plus

psychotherapy group had a
50% reduction in drinking

compared to just the group
that got psychotherapy alone.

BOGENSCHUTZ:
It's a large difference,

it's a clinically meaningful
difference,

and if these effects sizes
hold up,

it's a much larger effect

than we've seen in
any of the medications

that are currently approved
for alcohol use disorder.

NARRATOR:
Doctors are trying
to understand

why psychedelic-assisted
therapy might be more effective

than currently available
treatments.

They think that the
key difference may be

in the way that psychedelics
can allow the brain to change,

rather than simply suppressing
symptoms such as craving.

♪ ♪

Our brains are composed of
billions of nerve cells

that branch out like trees.

They carry messages between
each other

and connect different regions,
which are like departments

with different functions.

Such as the amygdala,
the department where

the emotions associated
with memories are stored.

The striatum, the office of
reward and habitual behavior.

And at the highest level,
the prefrontal cortex,

like a front office overseeing
them all and making decisions.

So, in the normal brain,
you can say especially

in, in adults,
the prefrontal cortex

has this top-down control.

We control our emotions,
we control, you know,

our, our habits,
through very strong

prefrontal cortical activity.

NARRATOR:
Yasmin Hurd is a neuroscientist

who studies the effects of drugs
on the brain.

She's found that alcohol
can erode the nerve cells

that connect departments.

HURD:
With alcohol,
these branches retract.

They shrink.

And that then diminishes
communication

between the brain regions.

So, the amygdala is much more
hypersensitive

to context associated with
the, the drug, such as alcohol.

It's, like, acting on its own.

NARRATOR:
If the amygdala goes rogue,

the result can be irresistible
cravings leading to decisions

that put alcohol ahead of
everything else,

even ignoring pleas from
the front office to stop.

Habitual behavior takes over.

They stop thinking about
what may be the bad outcome.

So their executive control
is diminished.

NARRATOR:
But when Jon took psilocybin,

he seemed to get control
over his cravings.

Somehow, the front office
re-established its authority.

The research is still early,
but scientists do know

that psychedelics activate
specific serotonin receptors

in the brain involved in mood

and unusual states
of consciousness.

One idea is that activating
these receptors may also lead

to new nerve cell connections--
even growth.

Perhaps that is the key.

HURD:
It's hypothesized that
psychedelics will restore

the branches in these trees

that we know are impacted by
alcohol use disorder.

So, by restoring and allowing
the branches to grow again,

that improves communication
once again in the brain.

NARRATOR:
But stimulating
serotonin receptors

or expanding nerve cell
connections

can't be the full explanation.

After all, the drug cocaine
also increases

nerve cell connections.

But there may be
a critical difference.

HURD:
Cocaine will also increase
the projections, these branches,

but it's too many.

One thing about
how psychedelics are used

as compared to cocaine, is that
cocaine, it's habitual behavior.

They're using it chronically.

It can produce perhaps
too much growth.

So, with psychedelics, it seems
that the growth may be,

you know, it's not too much,
it's not too little--

it's just right.

Like the Goldilocks effect,
in a way.

NARRATOR:
One factor that Jon attributes
his sobriety to

is the mystical experience
he went through,

which is often a hallmark
of a psychedelic journey.

KOSTAS:
Something definitely happened,

because my relationship
with alcohol changed.

And I don't think about it

and have the same emotions
I used to have towards alcohol.

ROLAND GRIFFITHS:
People ended up

having experiences that
they rated as among

the most personally meaningful

and spiritually significant
experiences

of their entire lifetimes.

And I think that's a really
important element

that kind of stamps in
the enduring attributions

made to these experiences.

Because they're profound
experiences

felt to be precious,
felt to be absolutely true.

And that accounts for
why, months, years later,

people are often reflecting back
on that experience

and can tap in and draw from it.

♪ ♪

NARRATOR:
The idea that one or two doses
of a mind-altering drug

could create such a profound
impact

with potentially beneficial
results is not new.

Western medical research
into psychedelics

began in the 1940s, not long
after

the accidental discovery
of lysergic acid diethylamide,

or LSD.

In 1943, Swiss chemist Albert
Hofmann was working with ergot,

a potentially poisonous fungus
sometimes found on wheat, oats,

and rye, which had been used
for medicinal purposes

for centuries.

Ergot poisoning was known
to constrict blood vessels.

Hofmann was hoping to isolate
a chemical compound

that would reduce the risk of
fatal bleeding in childbirth.

In the process,
he accidentally absorbed

a miniscule amount of LSD,

possibly through his fingertips,

ultimately launching him
on what some would call

the world's first acid trip.

"Kaleidoscopic, fantastic
images surged in on me,

"alternating, variegated,
opening

"and then closing themselves
in circles and spirals,

"exploding in colored fountains,
rearranging and hybridizing

themselves in a constant flux."

Word got out about
this mind-expanding substance,

and the lab began synthesizing
and shipping samples

to research centers
around the world.

Initially, scientists thought
psychedelics like LSD

could be used to explore
schizophrenia,

since a person's tripping
experience mimicked

some aspects of psychosis.

But then they observed
that some patients,

including those with
alcohol use disorder,

reported feelings
of transcendence

or spiritual epiphanies that
helped them to quit drinking.

I was so curious that the most
studied indication

was the use of LSD
to treat alcoholism.

It turns out there was this
huge body of research

from the 1940s to the 1970s.

And it was a big part
of psychiatry.

There were 40,000 participants
treated.

It was hailed as a wonder drug.

NARRATOR:
But as scientific research
continued,

some efforts took a dark turn.

The C.I.A. attempted to
weaponize LSD

with top secret projects
like MKUltra,

in which they experimented
on volunteers

and unsuspecting government
employees to see if minds

could be controlled, memories
erased, people programmed.

And then LSD escaped the lab.

♪ ♪

Ken Kesey, the author of "One
Flew Over the Cuckoo's Nest,"

was one of the C.I.A.
research volunteers.

RICK DOBLIN:
Ken Kesey first got exposed
to LSD in a C.I.A. experiment.

And then later,
he became one of the leaders

of the hippies.

You know, he helped the Grateful
Dead, began at the Acid Tests,

the Merry Pranksters.

So, the history of the C.I.A.,
and the mind control,

and the nefarious uses
of psychedelics, are interwoven

into the cultural story
of psychedelics.

Uh, the first experience
I had was with

seven little mushrooms
in Mexico.

NARRATOR:
In 1966, the former Harvard
psychology professor

Timothy Leary

promoted psychedelic drugs
as a means of personal

and cultural transformation,
urging youth to...

Turn on, tune in, drop out.

(crowd cheers and applauds)

ROSS:
Timothy Leary became the
pied piper of psychedelics.

And it so alarmed the
Nixon government at the time,

Nixon declared Timothy Leary the
most dangerous man in America,

declared war on drugs.

America's public enemy
number one is drug abuse.

And enacted the Controlled
Substance Act in 1970,

which kind of erased them
from the history books.

NARRATOR:
The act classified drugs
like heroin, cannabis,

and psychedelics as having

the highest potential
for addiction and abuse.

ROSS:
The whole war on drugs

wasn't really a war against,
like,

stopping people from
using drugs.

If you declare war on drugs,
you should declare war

on alcohol and tobacco,
the most damaging ones.

They were absented from
the Controlled Substance Act.

He went after psychedelics,

which are really not
addictive at all.

NARRATOR:
The latest revelations about
the benefits

aren't surprising to many
Indigenous populations,

who have venerated plant-based
psychedelics

for thousands of years.

In many cultures,
psychedelics have been used

in rites of passage
and to gain wisdom--

usually administered in specific

religious and healing
ceremonies.

In North America,

some Indigenous peoples use
peyote,

a cactus that grows in
Northern Mexico

and a small region
of South Texas.

PRIMEAUX:
I am Adrian Primeaux.

I come from five generations
of peyote people,

myself being the sixth
and then my son

being the seventh generation.

(speaking Native language):

(in English):
To me,

peyote is a very intimate
medicinal herb.

We use it as a guide,
we use it as a means

to synchronize
with the universe.

My grandparents explained to me
at a very young age

that we could acquire any means
of success through medicine

and peyote if we approached it
with the right intent.

NARRATOR:
Peyote use can touch on
many aspects of life.

PRIMEAUX:
How this medicine is able
to heal,

there's a lot of complex facets.

Within Indigenous forms
of thought, we believe that,

like, the spirit exists
somewhere

back there in the subconscious,
it's connected to the universe.

So, this plant medicines
helps you reach those depths

of your ability to manifest
whatever it is

you can picture in your mind.

Maybe you're picturing
pain going away.

Maybe you're picturing
your cancer going away.

Maybe you're picturing
your body being healthy.

Maybe you're picturing
education.

Whatever it is that
you're picturing,

your subconscious brain has that
power to create that for you.

And this medicine is just
a tool to help you

to reach that point.

(chanting in Native language)

HURD:
When we think about how Native
people

have used these substances,

it was a ritual.

So there's something still
really important

about the setting,
the ritualistic aspect.

That you can see this
positive outcome,

you can hear the positivity
around you.

All of that then gets encoded
into the brain

in a manner that, when you're
not

in that hallucinogenic
state,

it still stays with you.

♪ ♪

NARRATOR:
A peyote cactus can take over
ten years to reach maturity.

Since the arrival of Europeans,
Native American tribes

have often been persecuted
for peyote use

and had limited access
to the plant.

Now commercial interests
and poachers are putting

pressure on
peyote's fragile ecosystem.

♪ ♪

Recently, a philanthropist
purchased 605 acres

of peyote land here in
South Texas

to provide access for members of
the Native American Church,

which teaches Native American
traditions,

sometimes elements
of Christianity,

and regards peyote
as a sacrament.

STEVEN BENALLY:
In order to

assure that this medicine
is going to be available,

we have to have some kind of

direct connection
with this land.

And this land, I think,
is an answer to a prayer

from years ago

that there will be medicine
for our children.

♪ ♪

SANDOR IRON ROPE:
This land now means the world
to all of us.

Mother Earth and what she
has provided us.

This represents the future.

It's about what you are
gonna teach your children,

your grandchildren,

and what you're gonna
leave behind.

The essence of, of generational
responsibilities, you know.

Words cannot suffice
what the spirit feels

in connecting with this land.

NARRATOR:
Psychedelic-assisted therapy
is still in its early stages,

but scientists are inspired
by Indigenous practitioners'

careful and non-recreational
use

of these powerful substances.

One concept that the
emerging use in therapy shares

with Indigenous practices
is the importance of taking

these psychoactive substances

only in the right environment
and frame of mind.

YEHUDA:
We know that like any drug,

including aspirin,
that is in our medicine cabinet,

the use of any drug not in the
way it was designed to be used

can be harmful and even
catastrophic.

So when we talk about
psychedelics,

the setting is very important.

Not just the preparation,
not just the integration,

but your safety.

Who you're with,
what your intention is,

what is the physical
environment.

NARRATOR:
The setting plays a crucial role

in a psychedelic-assisted
therapy experience.

No detail is overlooked in this
physical space,

and the mindset, or intention,

a person brings to the session
is of paramount importance,

just as it is when Indigenous
people

prepare for the use of peyote.

CRAIG:
My intentions were just to

go in with an open mind.

Whether it be a good trip or a
bad trip, just experience it.

My intention
was self-exploration,

self-understanding,
and openness.

KRAL:
My intention was

to see the face of God.

ERIC GOSS:
My intention was to take

my experience of having cancer
at age 11

and transform it into something
neutral,

or even something positive.

My intention was
to have no intentions.

I wanted to be open to
accepting

whatever the experience would
give to me.

NARRATOR:
What draws these
patients together

is a common enemy: cancer.

AGRAWAL:
I've had the privilege of being

with you guys all this last
year.

NARRATOR:
Here in Rockville, Maryland,

oncologist Manish Agrawal is
the first doctor

in the country to run a
psychedelic-assisted

clinical trial treating
depression

and other mental health impacts
of cancer

with group therapy.

CRAIG:
I was having really bad

monthly depressive episodes
where I would just cry all day.

NARRATOR:
As many as a third of patients
with a cancer diagnosis

will experience major depressive
disorder.

But perhaps because it exists in
the shadow

of a cancer diagnosis,

the condition is
rarely acknowledged.

AGRAWAL:
I've been an oncologist for
almost 20 years.

And I've been taking care of
patients

and there's an aspect of that
care that was really missing.

You know, we take care of the
physical aspects,

but then I close the door, and I
know so many, um,

important issues are really
unaddressed.

WOMAN:
I wanted to start with something
to help us center.

Just like to invite you
to close your eyes.

AGRAWAL:
I think healing is
bringing the body, the mind,

the emotion,
the spirit back home,

to where you feel comfortable
with it again.

And so,

you can't just fix the physical
pain,

and then people are healed.

It doesn't work that way.

NARRATOR:
Building on pioneering
clinical trials

at N.Y.U., U.C.L.A., and Johns
Hopkins,

Manish saw that it was important
to treat the depression

as part of treating the cancer.

AGRAWAL:
That sort of whole-person care.

And that in order to take care
of someone,

in order for them to feel good,

it's not just killing the
cancer.

♪ ♪

NARRATOR:
Manish was surprised
by the results.

AGRAWAL:
To be honest with you,
the numbers were so good

that I wouldn't believe it
if I wasn't with every session.

I saw every person
go through here.

We treated 30 people.

And 82% had more than a 50%
reduction

in their depression symptoms.

When we measured quality of
life,

we measured anxiety,
all of those were improved.

CRAIG:
The experience just kind of
made me more aware of myself,

and the space that I take up in
the world,

and the energy that I put out
into the world,

and how that affects people,
too.

GOSS:
Prior to the dosing,

I had this tendency to get
caught up

in distressing thoughts related
to the cancer.

I noticed a subtle shift, in
that,

while distressing
thoughts would still come up,

I was able to let them go for
the first time ever.

I don't feel the need to follow
them.

NARRATOR:
While Eric's endless
distressing thoughts

and Jon Kostas's alcohol use
disorder

may seem to have nothing in
common,

some see a possible similarity
at work in the brain.

MATTHEW JOHNSON:
These different disorders,

I've really thought of them all
as forms of addiction.

So whether we're talking about
depression

or what we normally
think of as addiction,

these are all just forms

of being stuck in
a suboptimal pattern.

It's being stuck in a narrowed
mental repertoire,

a narrowed pattern of behaviors.

NARRATOR:
In patients with depression,

scientists have noticed an
abnormal increase in activity

in a network of different
regions in the brain

called the default mode network.

JOHNSON:
The default mode network refers
to this pattern of activity

across a number of brain areas

that is strongly associated

with thinking about oneself,
um, thinking about one's past,

um, projecting oneself
mentally into the future.

NARRATOR:
The default mode network
activates

when a person is introspective,

and, under normal circumstances,
becomes less active

when a person shifts their
attention to the outside world.

But brain studies show

that under the influence of a
psychedelic,

the default mode network is
quieted,

while other regions of the brain

increase communication with
each other.

A mathematical model captures
a normal brain's activity.

In contrast, a brain under the
influence of psilocybin

reveals a dramatic increase in
global communication.

Thousands of new connections
form,

linking brain regions that don't
normally talk to each other.

CARHART-HARRIS:
One analogy I've used
for how psychedelics work

in the brain is the snow globe.

When you pick up a snow globe,
you know,

the snow's settled at
the bottom, it's sort of fixed,

and then you pick it up, shake
it, and things jiggle around

and there's randomness and a
kind of chaos,

if you want, in the system.

NARRATOR:
The user experiences this

as an altered and heightened
sense of awareness.

But what causes this?

BARRETT:
Early in our functional brain
imaging studies of psychedelics,

scientists were finding that the
default mode network

was turning down or turning off
during these experiences.

And that was a really
good place to start.

But we began to then look
one layer deeper.

Why was the default mode
network turning off?

NARRATOR:
New research led
neuroscientist Fred Barrett

to investigate a region of the
brain called the claustrum.

BARRETT:
The claustrum is a really thin

sheet of gray matter in the
brain,

tucked deep within each of the
hemispheres of the brain.

Recent animal models have shown

that it is incredibly highly
connected

to just about every other region
of the brain.

Understanding that the
receptors targeted

by psychedelic drugs are also
really densely expressed

in the claustrum,
we began to wonder

whether the claustrum may be at
the center

of psychedelic effects.

NARRATOR:
Fred believes the claustrum's
central location and shape

suggest it regulates
communication

between the departments.

BARRETT:
When it's functioning normally,

the claustrum is essentially
acting like a switchboard.

It's trying to help other brain
regions figure out

when to turn on
and when to turn off.

But when we experience a
psychedelic drug,

we believe that it's binding to
specific receptors

in the claustrum

and somehow disrupting or
disorganizing the claustrum.

It's almost as if the
switchboard walks away.

What happens next is that we
seem to observe

a radical change in the way

that brain regions talk to each
other.

And it may be within this
context

that we're experiencing
learning

and a possible even
rewiring of the circuits

that govern our behavior.

And it may be that it's
that radical reorganization

that allows people to encounter
new psychological insights

that they hadn't encountered
before.

NARRATOR:
Fred thinks the claustrum's
sudden abdication of control

may help explain why rigid
behavior

and thought patterns have a shot
at resetting.

JOHNSON:
It's almost like they've seen

this, like, kind of
grand menu within their mind

that they weren't aware of.

That this, this greater number
of possibilities

that they can explore.

GOSS:
It took a while to recover.

I was having headaches
and muscle pains.

But it was the best headache
I'd ever had in my life.

Because it told me that the
psilocybin was working.

It was actually physically
restructuring my brain,

something that I never imagined
could happen before.

It's like, uh, reprogramming

the operating system of a
computer.

You're getting down to very
basic, code-level changes

that can enduringly change
someone going forward.

NARRATOR:
As of 2022, there were more than
a dozen clinical trials

underway involving psilocybin
and MDMA.

♪ ♪

Early efforts to revive this
research

began with individuals like
Rick Doblin,

who founded the
Multidisciplinary Association

for Psychedelic Studies, or
MAPS, in 1986,

to facilitate research
into the therapeutic benefits

of psychedelics with a focus

on MDMA, or ecstasy, for
post-traumatic stress disorder.

One of the reasons that
MDMA is so successful in therapy

is the way in which it builds a
certain

self-confidence,
a self-acceptance.

MDMA can increase the hormone
oxytocin,

and that oxytocin is
really important for bonding.

That may be why that
therapeutic bond,

the setting that they have,

all induce these positive
emotional mood states.

DOBLIN:
People under the influence of
MDMA

are able to feel more
connected, both to themselves,

to their inner world,

and also to the people that
they're with.

NARRATOR:
But these feelings of
connectedness and love,

paired with an altered mental
state,

can make participants
uniquely vulnerable.

There is concern among
researchers

about how to ensure patient
safety.

And there are not yet universal
guidelines or a code of ethics

for administering this kind of
therapy.

In addition, unlike LSD and
psilocybin,

MDMA has stimulant properties

that can lead to toxic side
effects.

MDMA, because it impacts on
dopamine or adrenaline,

it has a stimulant properties
to it, it can induce

chills,

it can induce nausea,
it can increase heart rate,

people even thinking that
they're having heart attacks.

NARRATOR:
Since 2000,
more than 200 PTSD patients,

including survivors
of interpersonal violence,

disasters,

and combat, have received
MDMA-assisted therapy

in MAPS clinical trials.

One of those patients
is Scott Ostrom.

In 2006, he was deployed to
Fallujah, Iraq,

where he engaged
in multiple combat missions.

OSTROM:
Real war is scary.

You play for keeps and
everything's unexpected.

You know,
you go there highly trained

and as physically fit as you
can be,

but a lot of it's, you know,
luck.

NARRATOR:
On the front lines,
Scott was under constant threat,

and would go on to develop PTSD.

ROSS:
We know that at its core,

PTSD involves the amygdala and
overactivation of the amygdala.

The amygdala's the fear
center of the brain,

and it keeps us alive; it keeps
us away from being killed.

But it's the main pathological
construct in PTSD.

You have an overactive amygdala.

People respond to neutral
stimuli.

Like, a door slamming

can remind them of being in
combat.

So, innocuous stimuli trigger
this exaggerated fear response.

HURD:
MDMA seems to calm the
amygdala.

By having people not be so
hypersensitive

to negative emotional state,

the prefrontal cortex now can
dampen the amygdala,

reduce its, its hypersensitivity

to distress,

to old memories that would cause

the amygdala to be overactive.

ROSS:
Your prefrontal cortex is
really important.

It's the most evolved part of
our brain,

and it helps you say,

"You know what?
The trauma's in the past.

It's not happening now."

And it allows you to rationally
think through something

and make executive decisions.

People with PTSD,

they're just stuck in this,
like,

fight-or-flight reactive thing.

NARRATOR:
Scott qualified for a
clinical trial

with MDMA-assisted therapy,

which helped him to
confront traumatic memories.

YEHUDA:
If you think of your
mind as kind of a hallway

where there are a lot of doors,

and you try very hard to walk
down the hallway

and not
be triggered by bad stuff

that you know
is behind those doors.

One of the things that happens
with MDMA is, you say,

"I wonder what would happen if I
opened that door.

Maybe it's not so terrible."

OSTROM:
I started seeing this, like,
spinning, black, oily ball,

and it started off in the
distance,

and then it would grow,

and get closer to me
and closer to me.

And then when it would get
close enough

for me to kind of realize that
it was this spinning black ball,

I would say, like, "What are
you, what are you doing here?"

And it would retreat away.

Instead of asking it what it
was,

as soon as I surrendered to it,

and I surrendered to the
feeling that it gave me

on the inside and I let that
anxiety grow,

it started to open up in
different layers like an onion.

And when I got to the center,

I relived a memory of a phone
call that I had with my dad

when I was overseas in Iraq.

What I had said to him was,
"Dad, I'm really scared.

They said some of us
aren't coming home."

And my dad had said to me,
"Don't worry, Scott.

"You're highly trained.

"You're with the best guys the
Marine Corps has to offer,

and don't worry, your training
is going to take over."

All of a sudden, I realized

that's where this shift
happened.

I had become this other person
that I needed to become,

that I had to become, to survive
those combat deployments.

The only thing I could think to
name that person was the Bully.

NARRATOR:
Taking his father's words
to heart,

Scott let his training
take over to become the Bully.

But the Bully could not shield
him from the pain of loss.

One thing that was really tough

was not being able to save
someone that I felt close to.

The vehicle that he was riding
in, um,

ran over an anti-tank mine.

(explosion roars)

I had ran up to the vehicle
shortly after that explosion,

and the vehicle had caught fire.

My friend was trying to get out
of the passenger seat,

and he couldn't, and I couldn't
get to the passenger door.

My body wouldn't let me get any
closer,

because the fire was too hot,
and he burned alive.

There was nothing I could do.

NARRATOR:
Nightmares of the war
followed Scott home,

along with painful regret.

OSTROM:
I felt a lot of guilt for

not being able to save him.

And for a long time,
I punished myself for that.

My interpersonal relationships
were completely down the tubes.

I had high-risk behaviors like
getting into fights,

self-medicating with drugs,
alcohol,

being just aggressive
and martial in general.

And after, like,
three-and-a-half years

of having
nightmares every night,

I really started to kind of
fall apart.

NARRATOR:
Scott wasn't alone
in his desperation.

Every day, almost 20 military
veterans die by suicide.

Current treatments for PTSD
are of limited benefit.

After identifying the Bully
within him,

after the first MDMA
dosing session,

Scott had another breakthrough
in a subsequent session

with his therapist, Marcela
Ot'alora,

and Scott's dog, Tim.

OSTROM:
Marcela was sitting in her chair

and I was spooning Tim
on the rug.

And Marcela had just told me,
"Well, would it be okay

"if you asked the Bully

if Scott can take over for a
little while?"

And being in the state that I
was in, I was, like,

"Hm, I don't know,
I guess I'll give it a shot."

So, I had an unconscious
conversation with the Bully,

where I was able to ask if it
was okay

if I took over for a little
while, Scott took over.

OT'ALORA:
Right, and it was more, like,

can he step out,
to the side for a moment

to see who else was there,

to see what other parts of Scott
are there?

And it was just this beautiful
time of being able to connect.

And I think after that, you
didn't call him a bully anymore.

NARRATOR:
The MDMA helped Scott
to reframe the guilt he felt

over not being able to save his
friend's life.

OSTROM:
You don't forget the
breakthrough moments

that you had, and you don't
forget what you learned.

They stay a part of you.

So no, MDMA is not something
you microdose,

it's not something you have to
take all the time.

Um, it's, it's just the key

that fits
into the psychotherapy lock.

The psychedelic-induced
experience

can help a person get unstuck

in a way that's
not just, just being told it,

but really experiencing it
firsthand,

and I think that's where there's
a lot of power

in these experiences.

NARRATOR:
Remarkably,

nearly 70% of participants
in phase three

of the MAPS
MDMA-assisted therapy trials

no longer qualify

for a PTSD diagnosis.

DOBLIN:
We learned that
MDMA-assisted therapy

works in combat-related PTSD.

It works in the hardest cases.

And it works regardless
of the cause of PTSD.

So our phase three studies are
PTSD from any cause,

and if we manage to get FDA
approval,

it will be for PTSD
from any cause.

NARRATOR:
Rick Doblin thinks
that the treatment

could be beneficial to many more
people,

including some who struggle
with stressful experiences

that aren't easily associated
with PTSD,

like bullying
and systemic racism.

But introducing psychedelic
therapies

to communities of color brings
a special set of challenges.

MONNICA WILLIAMS:
Because this is a new treatment,

because it's connected to
research,

and because it's connected to a
substance

that's been stigmatized due to
being illegal,

a lot of people of color
are very wary.

The African-American community
has suffered a great deal

from the war on drugs

and having their communities
targeted due to drugs.

Just growing up, I was always
taught, stay away from drugs.

This is a trap.

This is a way that people are
gonna get you

and put you behind bars.

NARRATOR:
Aware of abuses in the past,

MAPS teamed up with therapists
from communities of color

to offer them training

in the use
of MDMA-assisted therapy.

One of the participants,
Sara Reed,

chose to experience
an MDMA dosing session

as part of her training

to become a psychedelic-assisted
therapist.

REED:
One of my therapists
made a comment about,

"There's a part of you that
doesn't want to be understood."

As a Black woman,

there is nothing more that
I want than to be understood.

I felt that

so deeply in that moment.

Particularly with problems
like racism,

I mean, one of the ways
that it hurts people so much

is that you're experiencing it
all the time,

but other people don't see it.

And even when you point it out,
they're, like,

"Oh, are you sure
that's what happened?"

Or, "That didn't really happen,"

or, "Maybe you're being too
sensitive,"

so your whole experience is one
of being invalidated.

And of being not seen
and not heard.

NARRATOR:
Learning from this experience,

Sara went on to provide one of
the first

MDMA-assisted therapy sessions
for a participant of color

experiencing racism and
post-traumatic stress disorder,

or PTSD.

(music playing, singing along)

♪ I'm dropping new weights ♪

♪ Bugs Bunny, feelin' so sunny ♪

NARRATOR:
From a young age, Kanu Caplash

had been the target
of racist remarks

and bullying.

WILLIAMS:
With racism, often
it's not necessarily

one big problem.

It's not necessarily, like,
oh, the Ku Klux Klan came,

and burned a cross on your lawn.

And now you have trauma.

It's usually a lifetime of
smaller things that may have

some big things here and there,
but at some point,

the stress becomes overwhelming,

and it tips into PTSD.

We call that racial trauma.

♪ ♪

NARRATOR:
Kanu was already experiencing
racism when, as a swimmer,

he was sexually assaulted
in the locker room,

tipping him into PTSD.

CAPLASH:
So the nightmares
and the symptoms

really started to take effect
after the sexual assaults,

which happened when I was 13.

I was sexually assaulted,
uh, four times.

If it wasn't for the study,

I don't know if I'd be,
you know, alive today.

'Cause, like, there was times
kind of right before the study,

where I was really, really
struggling,

where I really wanted
to kill myself.

REED:
Our site was focused on
providing participants

with a culturally informed
experience with MDMA therapy.

And as one of his therapists
who is attuned to his

racial background,
his religious background,

his childhood upbringing,
I wanted to incorporate chants.

During one of his dosing
sessions

where one of those chants
played,

I just remember it seemed like
something

really resonated with
him in that moment.

♪ ♪

He was actually able to go
back to a childhood memory.

CAPLASH:
I'd be transported to,
like, a different galaxy.

Look down, and I see this long
set of piano keys

going on to infinity.

And it's crazy, 'cause
as I'm going down the keys,

I can see different parts
of my life.

I find that sexual assault,

'cause I'm, like,
that's the big one.

That's the one that I had
trouble remembering,

and kind of
trouble processing.

And I remember, I jumped in and
I woke up on another world.

I sat there and I meditated on
that planet

for, like, a thousand years.

And I was able to go through
my memory,

and walk through it like
a museum.

And, like, walk through each of
the incidents

and remember vividly everything
that happened.

I was, like, flexing my arms
really, really hard

and just getting out all of the,
effectively, like, pain.

You know, that was just kind of

stuck in my arms, stuck in my
body.

The one thing I learned through
the study

is, like, there's no
other way but through.

The only way to handle the
beast is to confront it.

To recognize it is what it is,
it's a part of you, um,

but it doesn't necessarily have
to define you.

And when you do that,
eventually, you know,

you will accept more of
yourself.

But also, you will
accept, like, the larger world

in a more kind of
positive light.

NARRATOR:
As of 2022,

MDMA-assisted
therapy for PTSD

is in the final stages of the
FDA approval process.

Psilocybin-assisted therapies
for major depression

and other conditions are also in
the FDA pipeline.

While hope runs high for
psychedelic medicine,

scientists are quick to point
out the inherent risks.

WILLIAMS:
People think about psychedelic
drugs and they think, oh,

you know, you're gonna kind of
zone off into

a world with clouds
and unicorns.

But I see them more as
medicines, as tools for healing.

And, um, and they are
powerful tools.

And so, I think, as such, they
require a lot of respect,

because I think something that
has that kind of power to heal

could also cause harm.

You gotta use it safely.

NARRATOR:
Scientists are cautiously moving
forward.

AGRAWAL:
The psilocybin therapy has been
most powerful tool I've seen.

It's not for everybody,

it's not to be, it's not a magic
bullet,

but it does change things
meaningfully for many patients.

GRIFFITHS:
It's so different than any other
intervention

we have within psychiatry,

because it's changing the very
narrative structure

about how people

tell their own story,

what they believe going forward.

YEHUDA:
We're not going to have this
whole jigsaw puzzle

completed for a while.

And I think that we want to
stay a little humble about that.

The less we kind of interpret,
and the more we just

state what
our observations are,

I think the better off we're
going to be.

♪ ♪

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♪ ♪

♪ ♪