Professor David Nutt

0:00Hello and welcome to Happy Place with me Fern Cotton. This is the show that's constantly curious about ways to keep ourselves mentally well. Today I'm meeting Professor David Nutt. An addiction is a behaviour where people can't stop thinking about a drug or gambling or something else. So there's a sort of wanting circuit in the brain which is overactive. There's also a stress circuit. So you've got two circuits which are overactive. Psychedelics disrupt those circuits and they allow people to reflect on themselves. Psychedelics allow you to lay down new thinking patterns. It's a process we call neuroplasticity.

0:40David is a professor of neuropsychopharmacology, specialising in the research of alcohol and drugs. Working at Imperial College London, he currently leads a unit with a particular focus on brain sciences. He reckons we're on the cusp of a major revolution in psychiatric medicine and neuroscience. And I have to say, after reading his brilliant book, Psychedelics, I absolutely have to agree. After 50 years of prohibition, criminalisation and fear, science is showing us that psychedelics, when used according to tested, safe and ethical guidelines, could be one of our most powerful treatments for mental health conditions.

1:25They're showing positive benefits for depression, PTSD and OCD, as well as disordered eating, addiction and chronic pain. Sacked from being a government advisor, we'll hear more about that story from David later. He knew he had to keep researching and talking about evidence-based drugs policy. So he set up a charity called Drug Science to act as an impartial and evidence-based expert group, free from any political pressure. I for one am so pleased that David's continuing to do this incredible research and that he's so keen on sharing it with all of us. Right, let's do it. Here's the show.

2:29Professor David Nutt, it's so brilliant to have you here with us on Happy Place today. I am really wanting to get stuck into this subject matter of psychedelics, which I've been intrigued about for some time. And if we could just start really by explaining what a psychedelic is and how it differs to drugs that sit outside of that bracket. Okay, so a psychedelic in conventional conversation is a drug which changes the way your mind works. Other drugs, traditional drugs we use for treating mental illness or neurological illness, they tend to change the way your brain works. So it's a kind of distinction.

3:06And what psychedelic actually means, it comes from the Greek mind manifesting. And it turns out from our research and others' research that psychedelics do have the ability to switch off the brain and allow the mind to sort of become a bit more prominent or dominant in the dialogue. Yes, that was a discovery that you had. You set up one of the, well, the first psychedelic research centre in the world, and that was a discovery that before it was believed that psychedelics might turn a part of the brain on, but actually it turns a part of the brain off. how does that help when you're looking at helping to heal or cure mental health problems?

3:45Yeah I think it's important to say that I started off doing this research interested in what the nature of the psychedelic experience was it's very clearly very different experience to any other experience in people's lives the brain imaging showed us parts of the brain was switched off so in fact we could have came to the rather jokey conclusion that Timothy Leary was wrong These drugs don't turn on the brain, they turn off the brain. But that was unexpected. But then when we looked at the regions which were turned off, we discovered those were the regions that were often overactive in depression.

4:17Right. And we knew actually that other treatments of depression turned those regions off, but more slowly. So we thought, well, if we can turn them off within 20 minutes of giving someone psilocybin, magic mushroom juice, maybe we would lift depression. And that is what we then set out to do. And we tested that theory and it worked. So is this the default mode network that's being switched off? Because you talk about this in the book and I was very keen to learn more about the default mode network. This is certainly a part of the brain that is overactive in people with anxiety, OCD, depression.

4:48So how are psychedelics, so they're just literally switching that part of the brain off entirely? Yes, they are. And that's responsible for the different experiences, like the sort of out of body experience, like the switching off your worries, like the strange, interesting visual hallucinations people get. The default mode network is the network, which is we've only discovered it recently. It's only been brain imaging. We've been able to see it. But it's the network which does the core thinking about yourself. Now, there's lots of other networks in the brain. Obviously, there's a network which has got to do with language and speech.

5:23which I'm using now. And there's a visual network, which we're both using now. And there's an auditory network. And while we're doing all these things, talking to each other, we're not thinking about ourselves. Most of us aren't, but depressed people might be. Depressed people might simultaneously be having negative ruminations about their failure or about their inadequacies. Anxious people too, anxious. An anxious person might be sitting here thinking, oh God, am I making a fool of myself talking to her because I'm talking too much, I'm talking too fast, etc. But normally the default mode network is switched off until you sit down, shut up, stop looking and think about yourself.

5:54But in depression and anxiety and other disorders like addiction, it becomes overactive and it gets in the way. And psychedelics, by switching off that network, allows people to escape from those problems, really. So in this brilliant book that I've got in front of me here, Psychedelics, that you've released, and as I was saying, I adore the front cover. I think it's absolutely brilliant. And the content is even more important and amazing. You talk about how psychedelics are the future or could very well be the future when we're looking at mental health issues that, as we know, are on the rise and a huge problem for millions and millions of people out there.

6:29But we'll get more into why and how. But before that, let's talk about the stigma, because the stigma has been there a very long time. And actually reading your book, you can see how throughout history there have been certain religious groups that have tried to infiltrate people using psychedelics. And then I guess more recently, famously and impactfully, President Nixon did a whole sweep of propaganda against psychedelics in the 60s. And as you explain in the book, that was much more about politics than it was about the damage that these psychedelics could do. Well, I think it's fair to say almost all the drug laws have been politically driven rather than health driven.

7:08And of course, that's exemplified by the fact that probably the most harmful drug in the whole community is alcohol, and that's legal. So there's no logic to the drug. There's no scientific logic. There's no health logic. They're politically driven. But the psychedelics were particularly attacked in the 1960s because they were being used by people who were also protesting the Vietnam War. And the American government couldn't ban protests. I mean, it tried to stop them, but it couldn't ban them. But it could ban drugs. So it decided to ban psychedelics. Well, it actually decided to ban LSD because that was the drug that was widely used.

7:48But because of the pharmacological similarity, they banned other drugs like psilocybin, magic mushroom juice and ayahuasca, etc. And then because America essentially controlled the United Nations and the WHO, those bans rolled out to pretty much every country in the world. And it was an extremely cruel thing to do because they didn't just ban them for recreational use by protesters. They banned them for medical use in the face of massive evidence, 15 years of data, a thousand clinical papers showing clinical value. So it was a malicious attempt, I think, to eliminate knowledge of these drugs, because they were changing the way young Americans and also young Westerners generally were viewing war.

8:34And they didn't want that. They wanted to carry on fighting the wars as they actually have carried on fighting ever since. We've got Afghanistan, we've got Iraq, haven't we? And of course, that also led to a 50 year halt in research, which seems to be the most sort of pertinent point here, that that research stopped. 15 years were just instantly halted, and that's delayed a hell of a lot of progression, it seems. Yes, it's the worst censorship of research in the history of the world. It's denied life-saving treatments, potentially, to millions of people. I've just done a sort of back-of-the-envelope calculation in the book.

9:08People don't realise, most people who have got alcohol problems go to AA, but most people at AA do not realise that the founder of AA, Bill Wilson, escaped from his alcohol dependence through a psychedelic trip. And he encouraged, and there were some really powerful studies done using LSD in the 1950s and 60s to treat alcoholism. And those results tell us that is the most powerful treatment for alcoholism there's ever been. It's three times more powerful than any modern treatment. Wow. But the ban, essentially, has denied access to psychedelics for addiction for 50 years. Now, I reckon at least 100 million people in the world have died prematurely from alcohol dependence in that time.

9:55And let's suppose psychedelics helped 10%. Well, that's 10 million lives saved. How many lives have been saved by the ban? Well, probably none because the ban doesn't stop recreational use. But let's say it did deter a few people. Say it was 100 or 1 ,000. Even if it was a million, it doesn't matter because the equation is so stacked in favour of therapy that you can see the ban is, as I say, it's the worst censorship of research and clinical practice in the history of certainly the modern world, probably ever. I mean, let's look at this addiction model because I found that very, very interesting and actually surprising, probably very much due to, you know, this censorship that's in place.

10:36Addiction is a huge problem, as we know, costing us about, I think you said,£19 billion, which is more than for treating cancer at the moment. And although many would assume, and I was certainly in this camp, that giving addicts drugs is a terrible idea, you've got, again, data and proof to show that it works. And can you explain a bit more how? How does taking psychedelics stop someone from having that compulsion to drink or take drugs excessively? So we cannot say categorically how they work because the imaging studies and addictions have not yet been done. We're starting them. But we can infer from the depression studies where we have done the imaging work that psychedelics disrupt over-learned processes.

11:25So let's just say, what is an addiction? An addiction is a behavior where people can't stop thinking about a drug or gambling or something else and can't stop using. when they get near to it, they get a great impulsive desire to use. So there's a sort of wanting circuit in the brain which is overactive. And for some people also, particularly for alcohol, because a lot of people use it to deaden pain and deaden anxiety, there's also a stress circuit. So you've got two circuits which are overactive. Psychedelics disrupt those circuits, and they allow people, often for the first time in decades, to reflect on themselves, rather than be continually thinking, where am I going to get the money for the next hit?

12:05Where am I going to get money for the next drink? You know, where is that bottle I hid? In the trip, they've actually escaped from those thought processes. And that has two real functions. The first function is that they realize they can escape because until that point, they've actually not been sure or even been able to think differently. And then having thought differently, psychedelics allow you to lay down new thinking patterns. It's a process we call neuroplasticity. And so if you come up with new ideas, hey, I shouldn't be drinking to deal with my depression. I should be actually getting it treated in another way.

12:40You can then go out and seek help to develop new behavioural patterns and thought patterns and lay them down more efficiently because of the neuroplasticity. OK, so then let's look at the depression studies, which you do have very clear data for. As we know, if you're on antidepressants, there are millions of people out there who are. This is obviously something that you have to take very regularly, daily, and potentially for very long periods of time, if not for life. Whereas you state in the book, you've got proof of people having one psilocybin trip and not needing medication for six months or longer.

13:16So this is clearly a much more effective and short term cure for depression. Yes, I mean, what we see so far is that there are some people who do seem to be cured. I mean, it is the concept of a cure for depression is quite an interesting one. We, up till now, have been rather sceptical about it. But psychedelics do seem in some people to put the brain into a state where they are not depressed and they stay not depressed. For the majority of people who we treated, and the majority of these people have got what we call treatment-resistant depression, serious depression. that's actually failed to respond to other treatments.

13:54We still get, for the majority, a very significant benefit over weeks or months. But eventually the depression seems to come back a bit. And I think that's understandable because for many people, depression starts in childhood. It starts with being traumatised and being neglected. And children grow up with a poor sense of worth. They feel they're bad people. They feel that they're in the way of their parents. They're not loved. And so that becomes almost a sort of default state in their brain. You know, I'm a bad person. So even though we can help those with psychedelics, that underlying negative thinking sort of forces its way back.

14:29It's like a weed that grows back and we might have to knock it down repeatedly. So one of the things we're thinking about in the future is whether we should be having maybe two episodes of treatments a year to try to help people stay well. But that's still a research area at present. So again, when we're looking at depression specifically, the psychedelics are creating neuroplasticity that is potentially long lasting. Well, yes. I mean, there's some aspects of psychedelics that last forever. I mean, we've got doctors who are in their late 70s, early 80s now who were given psychedelics when they were training in medicine to help them understand the nature of auto consciousness.

15:11and you can talk to them and they can remember their trip. They'll talk to you for 90 minutes about their trip. So for some, the memory is very, very long lasting. And that's why I think some people with depression can be cured. But for others, the depressive process keeps coming. It's a bit like cancer. Very often you knock a cancer on its head and it goes away for a few years. It comes back. You might have to do the same for people who've got chronic resistant depression. But putting it all together, a single psilocybin trip in our hands is the most powerful treatment for depression, particularly treatment-resistant depression, there has ever been.

15:50I mean, you get outcomes after a single dose the next day, which are equivalent to having something like ECT for four weeks. You know, it's what we call a paradigm shift in the ability to treat depression. But there is still, you know, over here, you can't use it legally. We are seeing changes because there has been an attitudinal shift more recently. You know, even in Australia, as of February this year, they revised the Therapeutic Goods Act. So psilocybin and MDMA are now recognised as medicine. But over here, it seems we've perhaps still got a long way to go. We're really backward here. And it's particularly galling to me.

16:32My team has done the pioneering work to show that psilocybin treats depression, funded by the Medical Research Council 10 years ago. Since that time, we've not got any money from the government. All our funding comes from charities or from philanthropists. Other countries are jumping ahead, like Australia, like America. States like Oregon have made magic mushrooms. The Netherlands. The Netherlands, they've been fine for years. That's exactly right. But we're backward, and we're backward for the point I made earlier, that in this country, drugs are seen as a political weapon. The control of drugs, even drugs like psilocybin, which are medicines, is vested in the Home Office.

17:12As we all know, the Home Office is about saying no. The Home Office is about police, it's about prosecution, it's about criminalisation, it's not about health. One of the things we really should do is move drug policy out of the Home Office and give it to the Health Department so that they can really optimise the use. I mean, you know this better than anyone because obviously you were working for the UK government as part of the Advisory Council on the misuse of drugs and were later sacked in 2009 because you were becoming not only concerned but also outspoken about how these drugs were being classified.

17:45So can you tell me about what you were seeing around this time and what led you to actually think, I need to speak out, I can't stay silent on this anymore? Yes, well, I had work. I was brought in as a sort of chief scientist advising on drug policy in about 2000. When I took on the job, I said, I will only take it on if we develop a systematic and transparent way of assessing the harms of drugs. And I developed a scale, a nine point scale, which we worked through over a number of years. The Home Office and all the experts on the Advisory Council worked through that process. and it came to the conclusion that the Misuse of Drugs Act didn't bear any relationship whatsoever to the harms of drugs.

18:29And then I started talking to ministers about that, saying, you know, it is unjust to put people in prison for six years for perhaps having 30 ecstasy tablets, when actually ecstasy is less harmful than tobacco. And they didn't like that. But they kept saying, oh, well, we'll do something, we'll do something. And eventually it became clear they weren't going to do anything. And so then I started thinking, well, we have to broaden the debate. We can't do it behind closed doors. The old British tradition, you know, you go to a club and you chat to someone and something happens. It wasn't working with drugs because drugs were too politically useful to governments.

19:06So then I started speaking out. And, of course, one of the most famous challenges of the government was comparing ecstasy with horse riding. This is an article you wrote that did not go down very well with them. Well, that's right. They couldn't understand why I'd written it. In fact, the Home Secretary at the time, Jackie Smith, was very, very angry because she couldn't understand how I could compare a legal activity, horse riding, with an illegal activity, MDMA. And I was saying, well, hang on a sec, MDMA used to be legal. Then you made it illegal. Why did you make it illegal? Because it's a dangerous drug.

19:36Yeah, but it's not as dangerous as horse riding. And that concept of proportionality or comparison just couldn't get through because drugs are seen as something different. We've got to also talk about how we're using these drugs in a therapeutic setting and you've discovered that it's an incredibly powerful combination to use psychedelics alongside psychotherapy so how would you do that in a therapeutic setting? Well let me just explain what we do when we are treating someone There are three phases so someone who needs this treatment the first thing we do is to make sure that the treatment is going to work so they may be on medicines which will block the treatment So we have to get them off those.

20:16So you can't be on antidepressants if you're going to try psilocybin, I've heard previously. Yeah, we think it will minimise the effect or reduce the effect. So we get people off as much as possible. There are studies going on to actually ask exactly by how much it attenuates the effect. So we don't exactly know. But we want to get people better. So we want to maximise the benefits. So we get them off their antidepressants. We get them off any other medicines that might interfere. And then we talk them through what's going to happen. You know, they're going to go to a very strange place. It could actually be very challenging.

20:44Most important to say most of the trips that the press people have are really challenging because they go back to memories that they've often suppressed for years or decades, places they don't they're not going to in the normal world. But we want them to go there because we want them to deal with them so that we prepare them for that the day before. And we come to an engagement if they if they're frightened, they can talk to us if they if they're scared. And we could ask if they can hold their hands, et cetera, just to reassure them. then the next day the same therapists are present you know they give them the medicine they're sitting there they have usually have a soundtrack playing they usually choose to have eye shades and and we encourage them to to go into the experience and it's very important not to fight it if you fight it you can kind of block it but then you don't get better so so one of the things which are really critical is that people are are encouraged to just go even if it seems frightening to start with because it's quite soon after once they go in then the fear goes away and then they start to actually engage with the with the insights and the and the memories and then the next day we start what's called integration we start talking about the experience we talk because people have profound challenging experiences that they want to talk about and they also want to make sense of and so our therapists can help them understand the meaning and in many cases help them you know reframe um what they've learned so someone for instance might come out and say i I realised it wasn't my fault that my parents were abusing me.

22:09It was their fault. And the therapist can help them sort of say, well, how are you going to deal with your parents now? How are you going to reflect on this? How are you going to change your pattern of behaviour, etc.? And that therapeutic process can go on for quite a few weeks. In fact, a lot of our patients find it really very helpful to carry on talking about it because it is a massive learning experience. And some of them have come together to form a little group so they can support each other in future because obviously we can't keep supporting and we haven't got the resources. So are psychedelics useful in healing trauma or overcoming a mental health problem without the psychotherapy or is it important that combination remains?

22:52Yes, it's a really very critical and interesting question at present. So there are people who say, prove you don't need the psychotherapy. And I say, well, OK, that's actually, you know, That's quite an expensive and complicated thing to do. Someone else can do that. I want to get people health well. And our experience up till now is that the therapy, people really find the therapy very useful and supportive. Can I actually prove you need it? Well, there is a German company that is doing another psychedelic, which is called 5-methoxy DMT, and they're just giving people a little pulse of that, or they're giving them a bigger and bigger pulse until they have a powerful short trip.

23:32and they're saying that might reset the brain just as well as our psilocybin, our four or five-hour psilocybin trips. So they're not doing psychotherapy, but we haven't seen the outcome of their work. So that's the first thing to say, that science so far suggests that the therapy is certainly helpful. Also, our patients really want to talk about it. I think it's kind of a bit weird that you'd give someone a most powerful experience of their life and just leave them. I mean, that just seems, to me, a missed opportunity, but I cannot prove, I cannot prove that it's necessary. There's another reason why it's important to think about this question, which is, can we afford the therapy?

24:12So some healthcare systems say, well, it's all very well, but you know, therapy is expensive and drugs are cheap. So why don't you just give the drug? And yeah, in the end, it'll come down to an economic analysis. But we've already done preliminary analysis showing that psilocybin therapy with psychotherapy is pretty cost effective. I mean, it's cheaper than having a knee replacement, let's put it that way. And to my mind, getting over depression is rather important. Yeah. And also, as we discussed earlier, if it is perhaps one trip with the therapy backing it up or a couple over the course of a year rather than lifelong medication, I'm sure it will disproportionately work out cheaper in the end.

24:53I think it's likely to. Yeah. I mean, I think not just because of the costs of the administration, but also because the nature of the recovery is different. Let me just tell you a little bit about that. So there are two aspects of depression. There's the depressive thoughts and the loss of positive thoughts, loss of well-being. So there's hostility to yourself, negative thinking, and also just the loss of well-being. Now, psychedelics get rid of the negative thoughts and they massively improve well-being. Whereas antidepressants, they get rid of the negative thoughts a bit less than psychedelics, but they don't give you the same well-being.

25:33So the overall outcome is actually better with psychedelics, considerably better, as I say, after just the one dose. As you said, when some patients go on a trip, they're going to face some pretty challenging times. And I've got friends who have been to the Netherlands to do this and they've experienced that, but it has been incredibly beneficial. But of course, we've also got the stories from perhaps more so the 60s and 70s where people have taken LSD and they've had a very, very bad trip. How would you distinguish what a bad trip is and why might somebody have one? Yeah, it's a really important question.

26:07So two things to say about that. A trip in a patient for therapeutic value is almost always challenging. Now, we don't call that a bad trip. We tell them it's a challenging trip. Yeah. In general, you cannot overcome traumas in your life without confronting the trauma. You can try. I mean, a lot of people suppress the trauma. Some people are quite successful in doing it. Historically, perhaps we were better in the war, in the stiff upper lip. People were severely traumatized. They didn't talk about it. It didn't destroy their lives, but it made them different people. They came back from the war never being the same again, but they didn't have what we would call PTSD in this common way now.

26:51But they weren't well. What we want to do, and we know this from masses of research, is we want people who've been traumatized to re-engage with the trauma and then deal with the emotional aspect, which is what is the disruptive part of PTSD. So in a trip, you do that, and it is really challenging. But that's not a bad trip. That's a therapeutic trip. And in fact, just to give you an example, if we're treating PTSD without a trip, we still do that. PTSD therapy is about getting people to re-engage with the trauma, the trauma memory, and try to live with the emotion long enough for it to exhaust itself.

27:29You can do that with EMDR, for instance. You have to revisit the trauma in that case. Well, that's right. So EMDR, this eye movement desensitization reprogramming, is a way of helping people cope with the reemergence of the emotion so that it doesn't overwhelm them. So, in fact, all therapy for PTSD, whether it's EMDR, whether it's essentially behavior therapy or whether it's the psychedelic therapy, it's all about allowing people to get where it was bad and then stick with it enough so that the emotions become controlled and controllable. So we're just doing the same thing, but we're doing it more powerfully.

28:05In fact, fascinatingly, last night at my book launch, an EMDR therapist was talking to me and saying, they are now beginning to use low doses of mushrooms to facilitate EMDR. And I said, that actually makes perfect sense, because you've got the neuroplasticity of the mushrooms and you've got the neural activity of the EMDR. And I'm really excited that people are beginning to pull those two things together. I mean, the potential is ginormous. It's so exciting. Well, indeed. I mean, you know, we can go beyond medicine or we go beyond psychiatry. We go into neurology. I'll talk about it in a minute.

28:39And we can also go into wellness generally. I mean, we have seen since the Nixon days and other swathes of propaganda that we've observed over the years. More recently, there has been this attitudinal change. Why now? Why are we starting to actually explore these areas? Why are we able to do a podcast today and talk about it without there being such heavy censorship? Why do you think there's been that change? Yes, I think it's a combination of two things, really. I think one is the pressure, the need for change. There's been no real innovation in psychiatric treatments for 50 years. Yeah, and depression's potentially getting worse than ever?

29:18Well, it will become the leading illness, not just mental illness, the leading disability in the Western world within a couple of years. So we've got, and COVID has added the burden enormously. And also, younger people are actually less, life has become more complicated at many levels, not just with social media, but also the uncertainty now with the war, the uncertainty of the economy. So there's a lot of anxiety in young people. So we don't have ways of dealing with that. and they can't trust their leaders. So it's challenging for them. So that's the first thing. And the second is that there has been in the last 20 years a concerted attempt by experts like me to tell the truth.

30:03Even experts over the last 50 years have been largely misled by the past. They've tended to believe that these drugs must be harmful. Otherwise, they would not be controlled like this, would they? I mean, how could any rational government actually do that? But in fact, the answer is the governments did it for political reasons. It was all about getting Nixon elected. It was all about deflecting attention from the Vietnam War to drugs so that he could basically, his Vietnam War, he was supporting the Vietnam War. He didn't want to talk about that because it was going badly. He started a war on drugs, a war on black people, a war on hippies, and he got elected.

30:38And we followed suit and other countries followed suit. No one's had the real courage to stand up to that falsehood. except in the last 10 years. And now we've got my own data. We've got data from the European Department of Justice doing the same thing. We've got data from Australian experts just last week, New Zealand experts. They all used the same sophisticated analysis of drug harms, which all showed that psychedelics and MDMA, even when used recreationally, are amongst the least harmful of drugs. And when you use them medically, just once or twice, you know, the harms are vanishingly small.

31:15I mean, again, my generation grew up with the whole ecstasy kind of, you know, bad press on ecstasy and kids dying in clubs, etc. What do you have to say about that? How would you counter argue that? I mean, ecstasy was banned because governments, actually not even governments, because some newspapers didn't like kids having fun in raves. The police didn't want ecstasy banned. The police loved raves. A rave was the first time in a policeman's life that he went somewhere and people hugged him. The police thought the thief wanted to get rid of alcohol and replace it by ecstasy. The drinks industry didn't want to get rid of alcohol and replace it by ecstasy.

31:59And the right-wing media very much didn't want to see kids having fun. The banning of ecstasy was basically an attack on young people doing something that the old people didn't want them to do for no good reason other than it was really different. And also young people, well, you know, they don't deserve to have fun. You know, we didn't have fun when we were young, so why should they have fun? And also, of course, young people don't vote. So, you know, you can abuse them and put them in prison, knowing that most of them won't vote to change, particularly as both the major parties were anti the drugs anyway.

32:29So were a lot of the deaths reported at the time exaggerated or focused on more than perhaps alcohol deaths at the time? Yes, there's a remarkable paper that was published by a student from the Institute of MRC Health Research Centre in Glasgow. He looked at every death, every coroner's death in Scotland in the 1990s, and there were thousands. And he looked then at every newspaper, national and local newspapers, what proportion of each death were reported. And he discovered that one in 200 paracetamol deaths were reported. He discovered that something like one in five amphetamine deaths were reported.

33:12About one in four heroin deaths were reported. About one in 100 alcohol deaths were reported. But every ecstasy death was reported. There was a systematic attack by the media on people using ecstasy. And it's because the media is run by old people who don't like young people and who didn't know what ecstasy was about and really were very, I think, kind of aggrieved, maybe that they'd missed out. Why are these young people suddenly got this super drug and all we had was tobacco and alcohol? I don't know what the reasons were. They may not even know, but it was just an easy attack. And that distortion of harms by the media was actually the justification for the government doing what it wanted to do, which was banning.

33:54Yeah, and like we touched on at the start, the biggest shame of this is that the medical research stopped because of that. And you are seeing again how a drug like MDMA can be extremely useful when treating depression. Yes, it's really important. The history of MDMA in the recent times is that it was rediscovered by a man called Chulgin, who made and tested a whole range of different drugs. And he realised that MDMA was special. And he said, this is peculiar. It's not like other amphetamines, because it gives me a sense of warmth and empathy and also clarity of thought, which makes it unique. And then he gave it to his wife, who was a therapist.

34:36His wife said, how, this is amazing. This actually could be very useful in helping couples who've sort of begun to grate with each other. You know, they've begun to sort of fall out of love, come back in love. And it was widely used. He made it available. And it's estimated that maybe up to 100 ,000 patients or therapy sessions were conducted with MDMA back in the 70s and 80s when it was legal. Everything, no problem at all. And then a Texas club owner thought, hang on a second, you know, hear it about this. This is a legal amphetamine. We can start selling it. We can use it in clubs. It's a bit amphetamine-like.

35:13It helps people dance a bit longer and they have fun. You know, you get the empathy as well. It was called empathy, by the way. When it got into clubs, its name was changed to ecstasy. And that then began to goad the media and politicians because, as I said, old people don't like young people having ecstasy. I'd love to know more about the spiritual element of this, because in your book, you've got case studies. And again, lots of people talking about a spiritual experience they have, whether it's a psilocybin trip, MDMA. I think it's probably more specifically psilocybin. It's probably more commonly known that magic mushrooms will give you that experience.

35:53How would you define a spiritual experience with psychedelics? And also, why does it perhaps lead to having one? So a spiritual experience is having an experience which is out with your normal consciousness. And typically with psychedelics, it's seeing that there's more to you than your body or your brain. It's potentially going outside of your body, going somewhere else. Very often people talk about going to heaven or going to somewhere else, which is kind of bright and wonderful. So there's that sort of sense of alteration of where you are in the universe. So that's one aspect of it. And, of course, if you believe in God, quite a few people do actually go to heaven-like places.

36:41And I remember vividly one of our subjects said, you know, he went to heaven and he bowed at the foot of God during his trip with us. So there's that side of it. But then there's sort of the more, I suppose you might, sort of philosophical aspect. When you come back, because they all do come back, we never lose any. they don't stay there they don't stay there, they come back but they don't forget and then it's that sense that there is more to you than what you thought there was and that's actually why that's the wonderful thing about Aldous Huxley's book The Doors of Perception because here was a man who wrote about lots of other drugs, he wrote about Soma controlling society, he was very knowledgeable about drugs and very cynical really and then he took mescaline and it opened his mind and he wrote this you know the book the doors of perception and he realized that up till then the doors of his perception had been closed and they were opened by masculine which is why he called it the doors of perception and his descriptions of of seeing things differently is extremely compelling and that's actually the beginning of the of what you might call the modern psychedelic period because people realize that psychedelics could tell you a lot about the mind and the spirit as well as about the brain and what psychedelics do and he he discussed he thought this and we've shown it he thought psychedelics basically take away the ability of the brain through the default mode network to control the mind and then your mind can be free and it can do things it it's not been able to do really ever or certainly since you're a child so that liberating of the mind is also quite spiritual because people suddenly realize they can think differently they can see things differently things seems brighter sound seems clearer and they can often feel much more in tune with other people.

38:22They feel more in tune with nature and they also feel more in tune with their own self and their own emotions. Yeah, there's that kind of dissolving of the ego that allows you to have that different perception, I guess. Exactly. I'd love to have you explain a little bit about hallucinations because it's probably one of the first things we think of when we imagine having a psychedelic trip. Can you just tell us about what a hallucination is? What's happening between the eye and the brain at that point. Oh, I'd love to do that because actually one of the most thrilling discoveries I think we've made about psychedelics is that we actually not only understand visual hallucinations now, but the fact that you have them under psychedelics explains how the brain works.

39:05So let me talk you through it. So over the past 60, 70 years, and there have been a few Nobel Prizes on the way, people have worked out how we see we don't see by our brain's not a camera because if it was we it would we filled up our memory banks before we were born you know before we were one years old so what our brain does our brain takes um electrical impulses which are generated in the retina in your eye from light so light goes into your eye electrical impulses go into your brain different parts of the visual scene the colors and and the dent the brightness and the movement they go to different parts of the brain and a large chunk of your brain about it's about a quarter of your brain is involved in putting all that together to create an estimate of what what you actually think you're seeing and then and then you test it you know i think oh here's a cup oh it is a cup because i can pick it up and drink from it so then you and that's and then you're pretty confident that what you've seen is what you thought was actually there so we know how that happens with that process of building up and building up and building up of these primary inputs to a big complicated visual scene we know that's how the brain works at least but we've never shown it in humans because obviously you can't stick electrodes in human brains in the way you measure these different changes but under psychedelics what we know is that the the coordinating neurons that pull that process together they're the ones which are targeted by psychedelics so we disrupt the ability of the visual cortex to pull together all the information and create the final image of me seeing you what you act when you have these what we saw christmas tree type hallucinations these bright lights and these curly waves and squiggles and things we know from physiology physiological measurements of of other species that that that's the primary that's the beginnings of the recreation of vision so so when you see hallucinations uh under psychedelics you're actually seeing the primary workings of your brain and you you haven't seen those before except since you were a baby.

41:08That's how I think in childhood, a lot of, you know, the world is a very buzzy, strange, exciting place, because you haven't learned how to put it all together to get the prediction, oh, here I am sitting in front of a table. So it puts the brain back to where it was as a child and you can actually, I think, from my perspective, to be able to see these primary workings of the brain that have been predicted by a lot of scientists over the years is very exciting. It's so exciting. I think it's exciting that we assume that everything we're seeing and experiencing now, whether it's audibly or what we're seeing or what we're touching, is it, this is everything.

41:44But actually, psychedelics, again, are showing us we're probably only using a tiny fraction of our brain and the potential of what it can do. Well, certainly, our brain is very, very good at these predictions. I mean, it's almost certain that if I go back there, there'll be a door I can go out on. I hope so. Yeah, but I think you're right in the sense that the human brain is the most efficient computer that we know. It's 10 times more energy efficient than any computer humans have created. But its efficiency comes at a cost. It comes at the cost of just focusing on what it thinks is important.

42:20And what my brain and your brain might think is important might not really be what is important. And that's the trouble. So that efficiency, and that's, the brain spends a lot of its time over decades developing programs very efficiently. But if you develop a program that's wrong, you know, if you get a wrong thought, suppose you're someone with OCD and you suddenly think, oh, I wonder if that cup was contaminated, I better wash my hands. Well, I'm not sure I've washed them enough. Once you get into a thought loop like that, they can become really rapidly entrenched and they're very difficult to break.

42:54and psychedelics can break them. And that's the unique property of them, really. It's incredible. So what do you think the future of psychedelics is? You know, there's still stigma in this country, as we know. You're still having to use charitable funds to carry out your research work. What's the future? When are we going to see psychedelics used alongside psychotherapy to really help beat this, you know, it's an overused term, but mental health crisis that we're in? Well, I mean, it can't come soon enough. We need to change the law. Everyone knows this except the government. I think even most newspapers know this, certainly most doctors, most therapists, most lobbyists.

43:34It makes no sense whatsoever to have psilocybin, which you can go and pick the mushrooms pretty much anywhere in Britain, controlled to a point where medical people can't use it. And you ask the government, why is it? Why won't you loosen the regulations on these drugs? and they say our priority is monkey dust. And you say, well, hang on a sec. Monkey dust is a powerful cathodrome. That's just, there's almost no one dies from monkey dust. It's not a therapy. We could save hundreds, millions of lives over time if we had access to psychedelic therapy in this country. Why are you focusing on banning something?

44:12You know, monkey dust is already legal, by the way. They just want to move it from class B to class A because it's got a gesture politics. We cannot move forward in this country until we reschedule these drugs. In the same way as we rescheduled medical cannabis from Schedule 1 to Schedule 2. At that point, there will be an explosion of research. There's only about two universities in Britain that work with these drugs clinically. That's Imperial College, my group, and King's College. Every university in Britain has a mental health department. Most of them would like to work with these drugs, but they just can't afford or don't understand how to get these licenses.

44:47So we should just get rid of that ridiculous control that says that psilocybin is more dangerous than fentanyl. I mean, how absurd is that? Yeah, it seems like a huge problem that still needs massively tackling. And I'm very glad that you've decided to do it, even if it is almost single-handedly in this country at the moment. And I've so enjoyed learning more about psychedelics, reading your brilliant book and chatting to you today. I know we've only scratched the surface in this chat today and there's so much more, so I urge people to go and read your brilliant book and listen to you talk, etc.

45:20But Professor David Nutt, thank you so much for being on Happy Place. Well, thank you, Fern. And what I would say is invite me back in a couple of years and I will tell you how the research has gone in anorexia, in OCD, in pain syndromes and addiction. Two years' time, I think we'll have real progress in those four different disorders. Let's hope so, let's hope so. Thank you so much. Well, I don't know about you, but my mind, is well and truly blown. I mean, we all know there's huge stigma around a lot of these drugs. And I think looking through not only David's book, but also just history, we can see all of the attempts to really shut down any further research or conversation on these matters.

46:04So again, I'm massively grateful that David has been able to write this book, but also talk to us today. I think it's really important when we know how much of a mental health crisis we are in currently with so many people feeling much, much less than well that we look for alternative options. We need new solutions. So I'm extremely curious and will be certainly keeping my ear to the ground as to what David's got to say on the matter. Thank you so much for your time, David. David's new book, Psychedelics, is available now as a hardback ebook and audiobook. Also, do you know what? It's so tricky when I'm doing these chats because I have so many questions I want to ask and time whizzes by terrifyingly quickly.

46:49I really wanted to talk a little bit about microdosing with Professor David Nutt and I just simply ran out of time. But it's something I'm equally as curious about. So if you like this topic and you're intrigued, I would definitely go and have a look into that and do your own research online as well. I cannot wait to hear what thoughts are swirling around your head after hearing that episode. I would love to hear your thoughts. Please come and tell us over on Instagram at happyplaceofficial. I'm back next week, of course, but in the meantime, click that lovely little follow button wherever you're listening to this now so that new episodes find their way to your device as soon as they're available.

47:31You never need miss an episode. A massive thanks again to David, the producer, Anushka Tate at Rethink Audio, and to you. Thank you so much for listening and for always being so open-minded.

48:05Thank you.