Original subtitles

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.

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, 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.

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, 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.

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.

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.

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.

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, 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.

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,

"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,

"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.

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, 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, 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,

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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