In this episode of the Psychedelic Medicine Podcast, Nigel Denning, MA, MPsych, joins to discuss the reasons profound psychedelic experiences don't always lead to lasting change. Nigel is a Counselling Psychologist and Director of Integrative Psychology & Medicine, with nearly 40 years of experience working with psychedelic and non-ordinary states. He has trained with MAPS, and served as co-lead therapist on three psychedelic clinical trials.

In this conversation, Nigel emphasizes the importance of preparation, integration, and creating the conditions for new experiences to become part of everyday life for effective psychedelic therapy. He explains that psychedelic sessions can open a period of neuroplasticity, but that without adequate reinforcement, people may naturally return to familiar patterns and ways of understanding themselves. Nigel discusses his three-phase approach to integration, which begins with simply becoming familiar with the experience, moves into narrating and embodying it, and ultimately arrives at meaning-making. He also highlights the importance of somatic awareness, curiosity, breathwork, and stabilization in helping people integrate experiences without prematurely imposing intellectual interpretations. Throughout the conversation, Nigel cautions against rushing back into ordinary routines or repeatedly pursuing psychedelic states in search of a lasting transformation, instead encouraging people to give new experiences time and space to become woven into their everyday life.

In this episode, you'll hear:

• The importance of preparation and setting realistic expectations before a psychedelic experience
• Why curiosity is more useful than trying to control or rush to interpret what happens during a session
• How somatic awareness and breathwork can help integrate psychedelic experiences
• Why integration requires stabilization and creating space after an experience
• Why it's never too late to begin integrating a psychedelic experience from the past
• The risks of "state change chasing" and repeatedly pursuing psychedelic experiences instead of integrating them

Quotes:

"[Psychedelic therapy] is a very different way of intervening psychologically. You're really preparing someone to be curious about anything that arises so that they're not going in with expectations that this is going to be this incredibly wonderful experience that's just going to change their life—it might be a really awful experience—but that as long as you can make meaning of it as you're coming out of it, that's where the transformation comes." [5:28]

"We can't predict, we can't shape and control what happens in the session. Therefore, let's just get really curious. Let's learn how to breathe and slow down and relax ourselves into meeting anything that emerges." [6:11]

"The real meaning, the real return to subjectivity, is part of the integration process" [7:21]

"[Integration] is all about familiarizing the unfamiliar without racing into a top-down reduction of it into a thing that meant this." [21:45]

"It's amazing how stabilizing the breath can be. If you're in the depths of a psychedelic hell-world and you've got no perspective on anything, what you can still do is breathe. … that quality of centering in the breath creates then that capacity to at least remember you have a body." [27:21]

Links:

Nigel on LinkedIn

Integrative Psychology & Medicine website

Integrative Psychology & Medicine on Instagram

Psychedelic Medicine Association

Porangui

In this episode of the Psychedelic Medicine Podcast, Fernando Rivas, MD, joins to unpack the safety and screening considerations for ibogaine therapy. Dr. Rivas is an emergency physician with over 15 years of clinical experience. As Chief Medical Officer of Transcend Clinic, he has led the development of innovative treatment protocols in addiction medicine and the clinical application of ibogaine.

In this conversation, Dr. Rivas discusses who may be a good candidate for ibogaine therapy and the clinical considerations involved in determining its safety. He explains that ibogaine has the strongest current support for interrupting substance use disorders and addressing TBI and PTSD, while potential applications in other areas remain emerging and require further research. Throughout the conversation, Dr. Rivas emphasizes the importance of distinguishing absolute from relative contraindications and of carefully screening patients for psychiatric risks, cardiac conditions, and medication interactions. He also discusses medically supported detox protocols, the importance of evaluating treatment through an individualized risk-benefit framework, and how lower-dose or non-psychedelic approaches may eventually broaden access to ibogaine's potential neuroplastic effects.

In this episode, you'll hear:

• What conditions ibogaine has been most studied for and where its potential applications may be expanding
• The psychiatric and physical conditions that may make someone an unsuitable candidate for ibogaine treatment
• How patients with active opioid or alcohol use may be medically supported and stabilized before treatment
• Why relative contraindications should be evaluated through an individualized risk-benefit analysis
• How ibogaine's typical psychedelic experience may be shorter than its reputation suggests
• Why the immediate improvements some patients experience should be understood within the broader context of neuroplasticity and long-term integration

Quotes:

"Ibogaine is the most robust of the [psycho]plastogens in terms of the window of time that it is able to open [for increased neuroplasticity]—at least as per preclinical research. So the potential is tremendous." [3:22]

"Cardiovascular health is the most important [safety consideration for ibogaine therapy]. If you have a big hypertrophic heart and a large dilated heart, the risks are greater. If you have rhythm disturbances, the risks are greater and sometimes unacceptable." [11:08]

"The chances [of an adverse cardiac event] are mitigated by properly screening and vetting patients, as well as by the addition of magnesium to ibogaine treatment. Magnesium is an essential component, as it is cardioprotective. … It simply raises the threshold for an irregular heartbeat or to occur." [17:38]

"A first degree relative with schizophrenia, for example, would be a relative contraindication. However, we must think of this in terms of risk and benefit. If this person is injecting fentanyl every day, they are at risk of overdose and death every single day. … so that relative contraindication should always be ascertained in terms of risk-benefit, particularly risk to life when it is present." [29:31]

"The science currently supports that sufficient exposure over a short enough period of time can yield pretty much the same results in terms of [neuro]plasticity without incurring a psychedelic experience. And we have tailored some specific treatments for patients that did not wish to incur a psychedelic experience, yet wanted to obtain the benefits of the plastic component of ibogaine treatment." [32:15]

Links:

Dr. Rivas on Instagram

Transcend Clinic website

Previous episode: Psychedelics and Psychosis with Alexander Lebedev, MD, PhD

Psychedelic Medicine Association

Porangui

This encore episode of the Psychdelic Medicine Podcast features a conversation with Kyle Buller on psychedelics and breathwork. Kyle is co-founder and host of the Psychedelics Today podcast and he has studied breathwork since October 2010 with Lenny and Elizabeth Gibson of Dreamshadow Transpersonal Breathwork. Kyle earned his BA in transpersonal psychology from Burlington College where he focused on the healing potential of non-ordinary states of consciousness, exploring topics such as shamanism, reiki, plant medicine, and holotropic breathwork. He has also earned an MS in clinical mental health counseling with emphasis in somatic psychology and has since worked with at-risk teens in crisis and individuals experiencing an early episode of psychosis.

Kyle opens this discussion by providing a basic definition of breathwork and sharing his own journey with this modality. He discusses how breathwork can refer to a wide variety of practices, but what unites these disparate techniques is utilizing the breath to induce specific physiological states and experiences. The holotropic style of breathwork has roots in transpersonal psychology and the work of Stanislav Grof and it is this modality which is often compared to psychedelic experiences.

Kyle discusses how holotropic breathwork can be an incredibly powerful practice for trauma-healing and inducing visceral experiences—similar to the classical psychedelics. He recounts his own experiences with this practice, describing how he was able to relive the experience of being born in the state conditioned by the method of breathing. Due to the synergy with the psychedelic experience, Kyle mentions that there is a lot of potential for breathwork to help individuals integrate or prepare for psychedelic experiences, as well as being a powerful tool for clinicians involved in psychedelic-psychotherapy to better understand the non-ordinary states of consciousness their patients will be experiencing.

Because of the wide variety of breathwork techniques, Kyle discusses the possibilities of tailoring practices to the specific experiences of a client. Everyone has a unique "window of tolerance" depending on their background and constitution, and some people will benefit more from techniques which downregulate the nervous system and allow for peace and relaxation, while others may find more value in techniques which are highly stimulating and provide deeper, emotionally complex experiences that allow for self-exploration.

In this episode:

• What breathwork is and how it relates to psychedelics
• The origins of holotropic breathwork and Stanislav Grof's transpersonal framework
• Breathwork vs meditation
• How to use breathwork to integrate and prepare for psychedelic experiences
• The effects of different types of breathing on the nervous system

Quotes:

"[Breathwork] offered a really great tool for training, for understanding how to sit with people in non-ordinary states of consciousness." [8:49]

"Some breathing techniques, like these more deeply cathartic techniques, they're bringing up a lot of emotional memory and people are starting to work through a lot of somatic sensations, they are working through trauma." [13:38]

"We really need to look at somebody's whole picture, where they're at, how they could potentially benefit, look at their nervous system, attune to that, and really think about what they could tolerate, what's going on in somebody's psyche." [30:29]

"The breath is this flexible tool, it's a vehicle—we can help to regulate our nervous system with it and explore it." [39:38]

Links:

Psychedelics Today

Psychedelics Today Education Center

SettingSun Wellness

Dreamshadow Transpersonal Breathwork

Psychedelic Medicine Association

Porangui

In this episode of the Psychedelic Medicine Podcast, Alexander Lebedev, MD, PhD joins to discuss psychedelic medicine and psychosis. Dr. Lebedev is a physician-scientist, medical AI engineer, and entrepreneur working at the frontier of health and technology. His work spans collective societal dynamics, psychedelics, and medical AI; he leads Lebedev Labs and is co-founder of Dreamseer and Once Wellbeing Center.

In this conversation, Dr. Lebedev explores the complex relationship between psychedelics and psychosis, examining what decades of research—and more recent clinical evidence—actually tell us about the risks. He explains why individuals with personal or family histories of psychotic disorders are typically excluded from clinical trials, clarifies the distinction between transient psychotic experiences and chronic psychotic disorders, and discusses why current evidence has not established a causal link between psychedelic use and persistent psychosis in screened populations. Throughout the discussion, Dr. Lebedev emphasizes the importance of careful screening, preparation, integration, and context, arguing that psychedelics should be understood through both scientific and phenomenological lenses rather than simplistic assumptions about safety or danger.

In this episode, you'll hear:

• What inspired Dr. Lebedev to study psychedelics and psychosis
• Why psychedelics became associated with psychosis and how that perception developed historically
• Why case reports of psychotic episodes following psychedelic use are not definitive to establish a causal link between the two
• How the lenses and frameworks we employ can significantly color how we understand psychosis and altered states of consciousness
• The role of set, setting, sleep, substance use, and integration in reducing psychological risks
• How psychedelic experiences overlap with—and differ from—psychotic states from a phenomenological perspective
• The intersection of psychosis and bipolar disorder and the relevance of this overlap to psychedelic medicine
• Why researchers are beginning to reconsider whether certain psychosis-spectrum populations should eventually be studied under carefully controlled conditions

Quotes:

"The first framework within which psychedelics were studied and considered was the psychotomimetic framework, meaning that they were considered as tools that are supposed to mimic psychotic states." [9:22]

"In the pre-prohibition era, psychedelics were tested on very large populations of different patients—including people with psychosis spectrum disorders, including people with schizophrenia spectrum disorders—with some mixed results. But there was already some data indicating that from a populational perspective, from a statistical link, we didn't have clear indication, even back then, that that link [between psychedelics and psychosis] exists." [12:48]

"Interestingly, unlike for cannabis, for tobacco, for some other substances, this link [with psychosis] was not verified in these large studies for psychedelics." [15:54]

"If the only lens that you have is pathology, you can pathologize transformation as well. On the other hand, if the only lens that you have is spirituality, you can spiritualize the compensation that can come with the psychotic experience." [20:21]

"From a phenomenological perspective, there are, of course, clear similarities [between psychedelic experiences and psychosis] . But of course, the background, the emotional content is very different. … If you read sometimes descriptions of people's mystical experiences or bad trips, sometimes they can actually on the surface look remarkably similar. What is different is the affective balance of it. And that's true for psychedelic experiences and also for psychotic experiences." [40:37]

Links:

Dr. Lebedev on LinkedIn

Dr. Lebedev on Instagram

Dr. Lebedev on Threads

Once Wellbeing Center website

Once Wellbeing Center on Instagram

Once Wellbeing Center on LinkedIn

Psychedelic Medicine Association

Porangui

In this episode of the Psychedelic Medicine Podcast, Arsalan Azam, MD joins to unpack the intersection between psychedelics and GLP-1s. Dr. Azam, founder of Daydream MD, completed his residency in Emergency Medicine at the Metropolitan/Harlem Emergency Medicine Residency program in New York before practicing emergency medicine nationwide. Drawing on that experience, he developed a comprehensive ketamine-assisted therapy practice and now blends functional medicine with personalized GLP-1 services to help patients achieve sustainable, biologically tailored health outcomes.

In this conversation, Dr. Azam explores the emerging intersection of GLP-1 medications and psychedelic therapies, arguing that both create temporary windows for behavioral change that can be leveraged to improve long-term mental and metabolic health. He explains how GLP-1 medications act primarily on the brain's reward and craving circuits, reducing "food noise" while creating opportunities to reshape habits and addictive behaviors. The discussion also covers how GLP-1s may complement psychedelic-assisted therapies for conditions such as addiction and PTSD, potential interactions with ketamine and classic psychedelics, and important clinical considerations, including nausea, delayed gastric emptying, medication dosing, and the importance of individualized treatment strategies.

In this episode, you'll hear:

• How GLP-1 medications influence the brain's reward, craving, and motivation circuits
• Why Dr. Azam views GLP-1s and psychedelics as complementary therapies that each create windows for lasting behavioral change
• The potential role of GLP-1 medications in treating addiction alongside psychedelic-assisted psychotherapy
• What patients and clinicians should know about combining GLP-1 medications with ketamine and classic psychedelics
• How delayed gastric emptying may alter the timing, intensity, and safety of orally administered psychedelic experiences
• Why careful dosing of GLP-1 medications is important to avoid emotional blunting while preserving their therapeutic benefits
• The importance of using both psychedelic and metabolic therapies as opportunities to build healthier long-term habits rather than relying on medication alone

Quotes:

"Not all behavioral health symptoms are driven purely by things going on in the brain and the nervous system and mood and whatnot. Sometimes it's well outside that. And so that's where, naturally, GLP-1s caught our gaze. Here's a medicine that treats probably one of the biggest of the two health crises I think right now facing America: one is—I do think—mental health, but the other is metabolic health." [4:52]

"Just like psychedelics create a window [of transformation], GLP-1s create a window. It's this pharmacologic scaffolding that you can use to start to really reexamine your relationship with food, with craving, how you've been eating, why you've been eating. And you can essentially use GLP-1s to hit the pause button on that noise, and that makes it easier to eat less. But it also makes it easier to start to ask the questions of why? Why was I eating the way I was eating?" [9:59]

"In general, GLP-1s seem to play pretty nicely [with ketamine]. I'd say the bigger thing that I've observed that doesn't get named all that much is that craving and reward are important. They're part of how we see salience in the world and also derive pleasure from it, and if you go too high on a GLP-1, people experience a flattening. They feel kind of blah, and it's not in their head. It's because you've over-damped the salience and reward circuitry. And so it's about finding the sweet spot where there's enough to motivate you in life without being noisy." [20:13]

Links:

Daydream MD website

Daydream MD on Instagram

Daydream MD on Facebook

Dr. Azam on LinkedIn

Psychedelic Medicine Association webinar: GLP-1s and Psychedelics: Clinical Considerations, Interactions, and Emerging Questions

Psychedelic Medicine Association

Porangui

In this episode of the Psychedelic Medicine Podcast, Dori Lewis, MA, MEd, LPC-S returns to discuss the differences between psilocybin and ketamine. Dori is the Clinical Director of Elemental Psychedelics and Owner/Operator of Reflective Healing in Fort Collins Colorado. As a clinician, she blends transpersonal psychology, depth work, and psychedelic-assisted therapy within a model that centers the therapeutic relationship. To date, she has stewarded over 100 ketamine therapy sessions, more than 200 mushroom sessions, and numerous group ceremonies.

In this conversation, Dori explores how clinicians and facilitators can thoughtfully decide when ketamine or psilocybin may be the more appropriate therapeutic option, emphasizing that the two medicines are complementary rather than competing approaches. She explains how factors such as current medications, trauma history, substance use, prior experience with altered states, therapeutic readiness, and available social support all shape this decision. Throughout the discussion, Dori argues that ketamine often serves as an accessible and effective introduction to psychedelic-assisted therapy, while psilocybin may be especially valuable for addressing grief, attachment and religious trauma, and deeper existential questions when paired with sufficient preparation, integration, and a strong therapeutic relationship.

In this episode, you'll hear:

• Why ketamine is often recommended before psilocybin for people new to psychedelic therapy
• How SSRIs and other medications influence the choice between ketamine and psilocybin
• What personal history, symptoms, and therapeutic readiness clinicians should evaluate before recommending either medicine
• Which conditions and life experiences may be particularly well-suited for psilocybin-assisted therapy, including grief, attachment trauma, and existential distress
• How cannabis use, substance use disorders, and suicidal ideation can affect treatment planning
• Why community support, integration resources, and a trusting relationship with a facilitator are critical for successful psychedelic experiences
• The importance of cultivating self-awareness before engaging in psychedelic-assisted therapy

Quotes:

"How do we help somebody who is on these [SSRI] medications, has been on them for a really long time and is actually doing well with them? The answer is not to get someone to stop taking their meds just to have a psilocybin experience. That's actually really reckless, in my opinion. What I would say is, why don't we start with ketamine and see how that affects you." [7:59]

"There's another important piece here: What [does the patient] want? If this person says, 'Dori, I really don't want to do ketamine. I want to work with a plant medicine. That's what I'm feeling really called to.' I might say, 'okay, then let's explore that.' But if they're open [to either], I might say, 'why don't we start with [ketamine]?'" [15:50]

"There are very few cases that I would say, 'don't start with ketamine' unless somebody says 'I've already done ketamine' … or they say 'I don't want to do ketamine' but in most cases I'm going to recommend just start with ketamine" [23:05]

Links:

Dori on LinkedIn

Elemental Psychedelics website

Elemental Psychedelics on LinkedIn

Reflective Healing website

Reflective Healing on LinkedIn

Reflective Healing on Instagram

Fireside Project website

Previous episode: Common Psilocybin Myths & Misconceptions with Dori Lewis, LPC

Previous episode: How Psychedelics & Pharmaceuticals Can Both Aid Healing with Erica Zelfand, ND

Psychedelic Medicine Association

Porangui

In this episode of the Psychedelic Medicine Podcast, Katie Fassbinder, MD joins to explore how to choose the right ketamine clinic. Dr. Fassbinder is the Faculty Medical Lead for ketamine-assisted psychotherapy training at Elemental Psychedelics and a practicing psychiatrist based in Wisconsin with over 20 years of experience. She also directs mental health and KAP programming at Promega and has worked extensively in public-sector mental health systems.

In this conversation, Dr. Fassbinder explores how patients can make informed decisions when choosing a ketamine clinic, emphasizing that safety, therapeutic support, and personal fit should guide the process. She discusses the differences between medical ketamine treatment and ketamine-assisted psychotherapy, highlighting how factors such as trauma history, treatment goals, medical complexity, and access to integration support can influence the most appropriate model of care. The conversation also examines the strengths and limitations of various routes of administration, including IV, intramuscular, sublingual, and at-home ketamine programs. Throughout, Dr. Fassbinder stresses the importance of preparation, integration, set and setting, and finding a treatment environment that feels safe and supportive, noting that ketamine's benefits are often maximized when paired with meaningful therapeutic relationships and ongoing psychological support.

In this episode, you'll hear:

• Key factors to consider when evaluating the safety of a ketamine clinic
• How medical and psychological needs influence the type of ketamine treatment that may be most appropriate
• The differences between ketamine-assisted psychotherapy and more medically oriented ketamine treatment models
• How IV, intramuscular, sublingual, and at-home ketamine approaches compare
• Why set, setting, preparation, and integration are critical components of successful treatment
• Who may be a good candidate for at-home ketamine programs and what risks to consider
• The distinction between psycholytic and psychedelic ketamine dosing and how each supports different therapeutic goals
• Resources and community-based options for psychedelic integration when ongoing therapy is not available

Quotes:

"[Ketamine] is one of those medicines that's very much a shape shifting medicine and it can meet people for different types of concerns or goals at different levels and different routes. So it's so good we have such a breadth of options—and very complicated if you're a patient trying to figure out where to begin." [7:55]

"Those challenging psychedelic experiences, when well integrated, typically provide even more benefit for the person than the sort of bliss journeys that we all hope everybody gets to have, you know? So having a challenging journey, if well supported and integrated, is also a gift that's very potent for somebody that's really ready to do that work." [21:52]

"Ego dissolution or that sort of loss of concept of self can be extremely liberating for some people. For others, coming back from that can be very discombobulating and even traumatic. So this really comes down to patient selection and helping people make a safe choice for what they're looking to do in their recovery and also what they're bringing in as risk factors for helping choose that safe dose range." [31:15]

"While we don't have clarity about cognitive impacts of ketamine in the long run, it seems like when done therapeutically in pulses it's pro-cognitive. … But when done daily, what we've seen in recreational ketamine use—or misuse—is that it does have some cognitive impairment that's perhaps difficult to reverse." [42:58]

"The dose of ketamine has so much to do with the preparation of your system more than the number of milligrams. … If you've done the at home course and you're not getting the sustained benefit or you're not journeying, it might be that that's a cue that you need more support for your actual sessions." [45:01]

"Psychedelics and ketamine included, create a nonspecific amplification of everything. Everything feels bigger. And part of meeting with the ketamine provider is for them to really assess: Is this a good time in your life? Do you have the outside support, the inner resourcing to do this work safely?" [47:09]

Links:

Elemental Psychedelics website

Elemental Psychedelics on LinkedIn

Promega website

Healing Maps website

Fireside Project website

ACER Integration website

Journey Clinical website

Usona Institute website

"Psilocybin vs. Ketamine Training: Which is Right For Your Practice?" blog by Shannon Hughes and Dori Lewis

Previous episode: Fireside Project: The World's First Psychedelic Hotline with Joshua White and Hanifa Nayo Washington

Psychedelic Medicine Association

Porangui

In the 200th episode of the Psychedelic Medicine Podcast, Ismail Lourido Ali, JD joins to discuss the future of psychedelic medicine. Ismail serves as MAPS Co-Executive Director and has been actively participating in the drug policy reform movement for over a decade, informed by half a lifetime of diverse personal experience with psychedelics and other substances.

In this conversation, Ismail explores the rapidly evolving landscape of psychedelic medicine, reflecting on the field's major milestones, challenges, and future possibilities. He discusses how public perception has shifted over the past decade, the role of state-level psychedelic reforms, and the tensions created by commercialization, overhype, and competing regulatory models. Much of the discussion focuses on the recent federal executive order related to psychedelic research and drug development, including what it may mean for FDA approval timelines, right-to-try access, rescheduling, and public health standards. Throughout, Ismail emphasizes that psychedelics are not a "silver bullet," but tools that require strong systems of care, thoughtful policy, and community support to be integrated responsibly into healthcare and society.

In this episode, you'll hear:

• How public attitudes toward psychedelics have shifted over the past decade
• Major milestones that expanded psychedelic policy reform beyond federal drug approval
• The promises and pitfalls of increased visibility, commercialization, and hype in the psychedelic field
• What the recent federal executive order on psychedelics actually does and does not do
• An explanation of right-to-try laws, FDA approval pathways, and the complexities of rescheduling psychedelic medicines
• Why maintaining rigorous evidentiary standards is essential for the long-term credibility of psychedelic medicine
• MAPS' vision for the future of psychedelic access, including regulated adult use, professional education, and community safety infrastructure
• How psychedelic policy reform could evolve to include broader systems of mental health care, crisis response, and social healing

Quotes:

"[Federal funding for psychedelic research] will only be so effective unless there is a massive reinvestment in mental health, harm reduction, and social services that actually ground—and one could say integrate—this medicine into like the continuum of care and the fabric of community that people are actually in." [25:07]

"Even though those of us in the psychedelic advocacy field do want to see drugs like MDMA and others be approved by the FDA for medical use in these controlled clinical settings… At the same time, we don't want medical access to be accelerated so much that it's at the expense of public health or consumer protection or an evidentiary standard that other drugs are being held to." [37:59]

"Medical professionals are not just prescribing things because they're approved. Many of them want to look at the evidence themselves. They want to look at the clinical trials. They want to understand 'is this the right choice for my patient?' But you can only know if [psychedelics] are being held to a comparable standard." [39:31]

"What's MAPS' vision for ten years from now or 40 years from now for that matter? I like to think of it as lots of on ramps and lots of off ramps. It's that people who are seeking access to psychedelics for any beneficial purpose—for their own treatment or healing, for their own spiritual growth, for their personal development, for their for improving of their relationships with their loved ones or with nature or with spirituality, whatever that cosmology is that they hold—that they have safe, responsible methods of doing so." [44:47]

Links:

Ismail on Instagram

Psychedelic Medicine Association

Porangui

In the 200th episode of the Psychedelic Medicine Podcast, Ismail Lourido Ali, JD joins to discuss the future of psychedelic medicine. Ismail serves as MAPS Co-Executive Director and has been actively participating in the drug policy reform movement for over a decade, informed by half a lifetime of diverse personal experience with psychedelics and other substances.

In this conversation, Ismail explores the rapidly evolving landscape of psychedelic medicine, reflecting on the field's major milestones, challenges, and future possibilities. He discusses how public perception has shifted over the past decade, the role of state-level psychedelic reforms, and the tensions created by commercialization, overhype, and competing regulatory models. Much of the discussion focuses on the recent federal executive order related to psychedelic research and drug development, including what it may mean for FDA approval timelines, right-to-try access, rescheduling, and public health standards. Throughout, Ismail emphasizes that psychedelics are not a "silver bullet," but tools that require strong systems of care, thoughtful policy, and community support to be integrated responsibly into healthcare and society.

In this episode, you'll hear:

• How public attitudes toward psychedelics have shifted over the past decade
• Major milestones that expanded psychedelic policy reform beyond federal drug approval
• The promises and pitfalls of increased visibility, commercialization, and hype in the psychedelic field
• What the recent federal executive order on psychedelics actually does and does not do
• An explanation of right-to-try laws, FDA approval pathways, and the complexities of rescheduling psychedelic medicines
• Why maintaining rigorous evidentiary standards is essential for the long-term credibility of psychedelic medicine
• MAPS' vision for the future of psychedelic access, including regulated adult use, professional education, and community safety infrastructure
• How psychedelic policy reform could evolve to include broader systems of mental health care, crisis response, and social healing

Quotes:

"[Federal funding for psychedelic research] will only be so effective unless there is a massive reinvestment in mental health, harm reduction, and social services that actually ground—and one could say integrate—this medicine into like the continuum of care and the fabric of community that people are actually in." [25:07]

"Even though those of us in the psychedelic advocacy field do want to see drugs like MDMA and others be approved by the FDA for medical use in these controlled clinical settings… At the same time, we don't want medical access to be accelerated so much that it's at the expense of public health or consumer protection or an evidentiary standard that other drugs are being held to." [37:59]

"Medical professionals are not just prescribing things because they're approved. Many of them want to look at the evidence themselves. They want to look at the clinical trials. They want to understand 'is this the right choice for my patient?' But you can only know if [psychedelics] are being held to a comparable standard." [39:31]

"What's MAPS' vision for ten years from now or 40 years from now for that matter? I like to think of it as lots of on ramps and lots of off ramps. It's that people who are seeking access to psychedelics for any beneficial purpose—for their own treatment or healing, for their own spiritual growth, for their personal development, for their for improving of their relationships with their loved ones or with nature or with spirituality, whatever that cosmology is that they hold—that they have safe, responsible methods of doing so." [44:47]

Links:

Ismail on Instagram

Psychedelic Medicine Association

Porangui

In this episode, Dr. WaiFung Tsang, DClinPsy joins to discuss the intersection of psychedelics and neurodiversity. Dr. Tsang is a clinical research psychologist from Hong Kong, musician, and student of Shipibo curanderismo. He is the co-founder of Onaya, an organisation dedicated to bridging Indigenous tradition and Western science, and research advisor for psychedelic veteran charity Heroic Hearts Project.

In this conversation, Dr. Tsang explores the emerging intersection of psychedelics and neurodiversity, reframing neurodivergence as a context-dependent spectrum shaped by biology, culture, and lived experience. Drawing on clinical work with autistic individuals, veterans, and athletes, he discusses how psychedelic states may temporarily induce experiences similar to neurodivergence—heightening sensory processing, altering cognition, and expanding perception—and how these states manifest differently for neurodivergent individuals. The conversation highlights early anecdotal evidence and preliminary research suggesting potential benefits for social connection, attentional regulation, and emotional processing, while emphasizing the need for more rigorous studies. Dr. Tsang also underscores the importance of thoughtful accommodations in psychedelic settings, noting that many best practices for supporting neurodivergent participants—clear structure, sensory tools, and intentional environments—ultimately improve outcomes for all participants.

In this episode, you'll hear:

• How neurodiversity and neurodivergence are defined across cultural and clinical contexts
• The overlap between autistic sensory processing and psychedelic perceptual states
• Why psychedelics may shift autistic experiences toward more cognitive or structured processing
• Early findings on psychedelics and ADHD, including impacts on attention, impulsivity, and mental "chatter"
• The role of MDMA and other psychedelics in enhancing social connection and reducing social anxiety
• How group settings and shared ceremonies may uniquely benefit neurodivergent individuals
• Practical considerations for making psychedelic experiences more accessible and sensory-informed
• Why many "neurodivergent accommodations" are simply good practice for all participants

Quotes:

"Every autistic individual is so different and every autistic individual can be so vast and varied in their presentation." [8:57]

"For the autistic participants that come and join in our studies, we have a tendency to see a lot of more cognitive experiences or cognitive-based experiences." [15:57]

"One thing we have been finding is especially people who are autistic can benefit more from the community aspect within psychedelic experiences." [20:05]

"[In Shipibo ceremonies] there's no touching, no talking—it's very autistic friendly. You get to be in your own space. You get to be together but not be together." [35:16]

Links:

Dr. Tsang on Instagram

Dr. Tsang on LinkedIn

Onaya website

Onaya Science website

Onaya on Instagram

Onaya on LinkedIn

United Freedom Collective on Instagram

United Freedom Collective on Spotify

Heroic Hearts Project website

Psychedelic Medicine Association

Porangui