AMA on Wed 6/3/20: ICEERS (International Center for Ethnobotanical Education, Research, and Service) Scientific Director

We are excited to announce that Dr. José Carlos Bouso, the Scientific Director for the world-renowned organization ICEERS, will be joining us for an AMA on Wed Jun 2 from 12-1pm PT.

ICEERS is a non-profit organization dedicated to transforming society’s relationship with psychoactive plants. They do this by engaging with some of the fundamental issues resulting from the globalization of ayahuasca, iboga, and other ethnobotanicals.

Dr. José Carlos Bouso, Scientific Director

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José Carlos Bouso is a Clinical Psychologist with a PhD in Pharmacology. He developed his scientific actitives while at the Universidad Autónoma de Madrid, the Instituto de Investigación Biomédica IIB-Sant Pau de Barcelona, and the Instituto Hospital del Mar de Investigaciones Médicas de Barcelona (IMIM). During this time, he developed studies about the therapeutic effects of MDMA (“ecstacy”) and psychopharmacological studies on the acute and neuropsychiatric long-term effects of many substances, both synthetic and plant origin. As the Scientific Director at ICEERS, José Carlos oversees studies on the potential benefits of psychoactive plants, principally cannabis, ayahuasca, and ibogaine, with the goal of improving public health. He is co-author of numerous scientific papers and several book chapters.

Topics Dr. Bouso can speak to:

  1. Plant medicines such as cannabis, ayahuasca, ibogaine
  2. Clinical studies in psychedelics, e.g. on MDMA
  3. Plant medicines vs synthetic psychedelics

Format: please post your questions before and during the event and Dr. Bouso will answer on the forum!

what are your general views on plant medicines vs synthetic psychedelic medicine like MDMA and LSD? does being natural make plant medicines more effective in any way? how do you think about the cultural and historical origins of plant medicines - does this change how we should view them vs synthetic psychedelics?

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Can you please give some information about the scientific evidence about cannabis? Thank you very much for doing this.

  • Is there good evidence that cannabis can help with depression? How about anxiety (I’ve heard conflicting things) or other mental health conditions?
  • I have used cannabis in the past for my depression, but that was more so to hide from my problems rather than deal with them in a healthy way. How should cannabis be used therapeutically? Is it similar to psychedelic-assisted psychotherapy using ketamine, MDMA, psilocybin, etc.? I assume it’s not the cannabis itself but a combination of the experience with certain mental exercises and therapeutic techniques? Would it be more amenable to at-home or self-use similar to how antidepressants are currently used?
  • Say we fast forward 10 years and cannabis, ketamine, MDMA, psilocybin, possibly ayahuasca and ibogaine are all available for therapeutic use. How do they fit together? What conditions would be best fit for what compound in your opinion? How would a clinician evaluate fit between the client and the medication and choose the right one?
  • Why do you think cannabis has made such headway (at least in the US, I can’t speak to other countries) in entering popular culture / becoming more accepted, but other plant medicines have not?
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What makes certain substances so good at treating addiction (like ibogaine)? Is it a primarily psychological effect or other?

Do you think it’s important for someone to have experienced a substance for themselves in order to be a good sober “guide” for those experiences?

Hello, and thanks for conducting this AMA. I am a Neuropsychology grad student and I intend to do my dissertation about either psychedelics microdosing or afterglow effect. I would like to ask two questions:

  1. Regarding microdosing, what are your views on their therapeutical potential vs “macrodosing”? It would seem to me like the ideal compromise with providing the psychological benefits of psychedelics without having the person go through the hallucinogenic experience (and potential “bad trips”), and the best shot at being approved for legal use. What are your thoughts?

  2. Most of the research on psychedelic’s therapeutic pontential seems to be focused upon the treatment of mood disorders, although there also seems to be a positive sub-acute outcome on some cognitive aspects. Do you think psychedelics could possess any therapeutic use for cognitive dysfunction, or do you think that, at least, it warrants some research in that direction?

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Sorry, allow me a third question, this one pertaining more closely to what I’m inteding to research myself:

Studies on “afterglow”, specific on that term, are rather scarce. Supposedly, afterglow refers to the feelings of well-being that linger after the acute phase of the psychedelic has subsided. Could you then consider that the afterglow essentially corresponds to the sub-acute effects of these drugs - and thus studies on these effects pertain to afterglow?

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There are a lot of orgs/companies out there trying to engineer psychedelic compounds to reduce the psychoactive effects. I know a lot of people think psychoactive effects are an integral part of the therapies of psychedelic medicines

Could you describe if any scientific studies have gotten at this question? What have they showed?

Do you think it is possible to create new “traditional” drugs – for example if a psychedelic compound has its psychedelic effects removed without losing its therapeutic benefits, this is just a new class of antidepressant. Do you think this is a scientifically promising approach?

More broadly could you give some thoughts on the plant vs synthetic question?

Thanks so much

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What is the timeline for these plantbased medicines to become legal and FDA approved in the US? How about Europe?

What special training do you think clinicians will need to undergo to use these therapies with their clients and patients?

Hello,
hope you’re doing well. :blush:

I’m interested in psychedelic assisted therapy.
More specifically, MDMA therapy. As it is passing a 3rd phase of clinical trials for PTSD, will it also become available to people struggling with Childhood PTSD or so called CPTSD?

And should a person have only one traumatic experience to be able to do MDMA therapy, or will it be accessible for people dealing with multiple repeated traumas?

Thank you! :pray:

One more question!

What career path would you recommend for someone with a background in Neuropsychology who’s interested in the research of psychedelics? You yourself have a PhD in Pharmacology; similarly, Mr. Robin Carhart-Harris also obtained a doctorate in Psychopharmacology. Would you say that pursuing a degree related to Pharmacology is essential to this aspect?

thank you for doing this :slight_smile:

  1. Do you see big pharma getting interested in this space?
  2. Do you think these medicines should be legal for use by anyone, or should they be limited to medical situations with prescriptions?
  3. If/when we start getting psychedelic medicine to improve mental health, how do we make sure there are enough providers who are trained in this field? If, as some suggest and asked by @Ezra above , providers should have personal experience, how can we actually get enough providers to help all the people who need it?

In light of current events, my thoughts go out to everyone on this forum and in the world. So much suffering and hatred in the world right now, sending love and best wishes to all

Dear Dr. Bouso

I have noticed that a lot of research studying the efficacy of psychedelic medicines use the AAQ-II questionnaire as a their primary metric.

  1. Do you believe this should be a primary endpoint in clinical trials? why or why not?
  2. What other endpoints would you like to see incorporated?
  3. Do you envision psychedelic medicines may one day be approved for the treatment of personality disorders? If so, which ones do you imagine they could be most helpful for?

Thank you!

Hi everyone, excited to be here! Let’s get rolling with some Q&A

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I think that the source of the medicine (natural or synthetic) is not a way to define efficacy. The efficacy depends on how they are used and for what proposes. Natural medicines use to have a cultural history and have their specific role in traditional societies that is quite different than the role that may play in non-original societies. But at the same time we should recognize traditional systems as valuable ones and to respect indigenous systems of knowledge and it would be desirable to generate dialogues between traditional and scientific knowledge.

There are hundred of papers showing the evidence for different diseases, mainly for neuropathic chronic pain and inflammatory diseases. But for me the most important value is to improve the quality of life of patients allowing them to cope better with their diseases, mainly in patients with chronic diseases.

  1. The results are contradictory regarding their use for mood problems, like depression or anxiety. Depression and anxiety are not abstract diseases. When we talk about using psychoactive compounds to people suffering psychological conditions we should explore in depth how the substance is tolerated because the same medicine can be a remedy for one person and a poison for another.

  2. The psychological effects of cannabis can help people with depression to feel better, but to others do the contrary. In this sense, it works like antidepressants but with fewer side effects. So it is necessary to be careful. Psilocybin or MDMA act because they induce powerful psychological experiences, also have different mechanisms of action. In that sense, they don’t work similarly. Ketamine is used weekly and generally is avoided the psychedelic experience because have a mechanistically antidepressant effects because of the effect on brain. Although at high doses also induce a psychological experience that can be useful in psychotherapy.

  3. Cannabis works better for calming anxiety in people with physical chronic diseases. Ketamine for Major Depression but above all for suicidal ideas and MDMA for PTSD. Psilocybin works well for people in the end of their lives, for calming existential distress. But is soon yet to know if psilocybin works well for major depression. MD is a very complex syndrome. The choice must depend on the problem that the person has and on what she/he wants to improve. Also, I don’t like the biomedicine approach where psychedelics are used thinking that they will treat psychiatric conditions. Psychiatric diseases are not diseases of the brain so the biomedical approach is quite limited. It is necessary to improve also the social aspects of the people if we want to have good psychiatric medicines. This is what we can learn from traditional cultures where they put the focus in the community, not in the plant medicine itself. We have a very big problem of public health with loneliness and with the loss of perception of social bonds and to medicalize mental health is not a proper approach. It is necessary to think from a community perspective. At last, we are social animals.

  4. Cannabis prohibition was a political issue, not a scientific one. Now that there is more open freedom for research and less stigma science can work more freely. Also, cannabis toxicity is quite low, at least physically and thus is a very safe alternative to other more toxic medicines. Our endocannabinoid (ECS) system regulates lots of physiological processes, and researchers are knowing with time the ECS and how to modulate it with cannabinoids.

Ibogaine has specific biological mechanisms that combat craving and reduce tolerance and dependence, among all for opiates. Other medicines, like psilocybin or ayahuasca have antidependence properties, but the mechanism of action is more psychological. Ibogaine, although the exact mechanism of action are yet not well known, has a specific brain activity that makes very useful in the treatment of drug dependence, mainly opiates, cocaine and alcohol.

I don’t think so, but obviously to have the experience makes it easier to have empathy with the patients. The abilities of a therapist depends on many factors. But of course I think that if a therapist knows to do his/her job, to have the experience may help a lot.