Episode 166: Vyvyane Loh and Ken Ford discuss atherosclerotic heart disease

This episode focuses on the use of ketamine for treating depression and its potential effects on preventing suicide, based on Dr. Jonathan Edwards' experiences and insights.

1. Ketamine has a unique place in medical history, developed as a safer alternative to PCP and widely used due to its efficacy and safety profile.
2. It's effectively used in sub-anesthetic doses to treat depression and prevent suicide, showing remarkable results even after a single dose.
3. The conversation highlights the importance of controlled and supervised medical use of ketamine to mitigate risks associated with its recreational misuse.
4. Dr. Edwards emphasizes the combination of ketamine therapy with psychotherapy to enhance treatment effectiveness, not relying on the drug alone.
5. The episode also discusses the broader context of psychedelic therapy in treating mental health disorders, suggesting a potential shift in traditional treatment paradigms.

1: Introduction

Brief overview of Dr. Jonathan Edwards' background and his medical use of ketamine. Insight into the episode's focus on ketamine's role in treating mental health issues. Jonathan Edwards: "Ketamine's development was revolutionary for both anesthesia and mental health treatment."

2: Ketamine's Medical Journey

Discusses the historical context and medical journey of ketamine from its development to its modern applications in mental health. Jonathan Edwards: "We've used ketamine safely for decades, and it's remarkable in treating certain mental health conditions."

3: Risks and Safety

Covers the safe use of ketamine in controlled environments versus its misuse and abuse in recreational settings. Jonathan Edwards: "While ketamine has potential for abuse, its medical benefits in controlled environments are undeniable."

4: Therapeutic Potentials

Exploration of ketamine's potential to transform mental health treatment, particularly for depression and suicidal thoughts. Jonathan Edwards: "Ketamine can rapidly reduce suicidal thoughts, making it a critical tool in mental health emergencies."

5: Future of Psychedelic Therapies

Considers the future of psychedelic therapies in mainstream medicine, advocating for research and open-mindedness in medical practices. Jonathan Edwards: "The future of mental health treatment could be profoundly influenced by the responsible use of psychedelics like ketamine."

1. Consider the potential of ketamine as part of a comprehensive treatment plan for depression or PTSD, under professional supervision.
2. Stay informed about the latest research and discussions surrounding psychedelic therapies to better understand their role and efficacy.
3. Engage with medical professionals to discuss the potential benefits and risks of ketamine therapy in specific cases.
4. Advocate for continued research and regulatory consideration to expand access to psychedelic therapies for those in need.
5. Educate about the safe and effective use of ketamine to combat the stigma associated with its use in mental health treatment.

Dr. Vyvyane Loh returns to STEM-Talk for her second appearance to talk about atherosclerotic heart disease. Also known as ASCVD, the disease has been reported to affect 26 million people in the U.S., and annually leads two million hospitalizations and more than 400,000 deaths.

Vyvyane is a board-certified physician in obesity and internal medicine. In episode 142 of STEM-Talk, we talked to Vyvyane about her Boston-based preventative-care practice that specializes in weight management and the treatment of chronic metabolic diseases such as diabetes, hypertension and dyslipidemia.

In today’s podcast, Vyvyane and host Dr. Ken Ford talk about ASCVD as well as recent research that has shown substantial individual variability in the response to statin therapy as a way to lower cardiovascular risk. Vyvyane and Ken also discuss how the current knowledge base informing clinical practice in medicine today is far behind advances in the biological sciences, especially in the field of ASCVD.

People

Jonathan Edwards, Ken Ford, Dawn Kernagis

Companies

Leave blank if none.

Books

"Revolutionary Ketamine: The Safe Drug That Effectively Treats Depression and Prevents Suicide" by Jonathan Edwards

Guest Name(s):

Jonathan Edwards

Content Warnings:

None

STEM-Talk

Welcome to Stem Talk. Stem talk. Stem talk. Stem talk. Stem talk.

Welcome to Stemtalk, where we introduce you to fascinating people who passionately inhabit the scientific and technical frontiers of our society. Hi, I'm your host, Don Carnegas. And joining me to introduce today's podcast is man behind the curtain, Doctor Ken Ford, IHMC's director and chairman of the double secret selection committee that selects all the guests who appear on Stemtalk. Hi, Don. Great to be here.

Don Carnegas

So today we have Doctor Jonathan Edwards, who's an anesthesiologist and medical practitioner who specializes in human health and optimization. And he's perhaps best known for treating mental health conditions with ketamine, which is a dissociative anesthetic that is used for general anesthesia, pain relief, depression, and epilepsy. And John also uses ketamine to help adolescents overcome depression and suicidal ideation. So in today's interview, we talked to John about his new book, the Revolutionary Ketamine, the safe drug that effectively treats depression and prevents suicide. More Americans have died from suicide than all the war since Vietnam.

The suicide rate among ten to 24 year olds in this country increased 62% from 2007 through 2021. Before we get to our interview with John, we have some housekeeping to take care of first. We really appreciate all of you who have subscribed to StemTalk, and we are especially appreciative of all the wonderful five star reviews. As always, the double Secret selection committee has been continually and carefully reviewing iTunes, Google, Stitcher, and other podcast apps for the wittiest and most lavishly praised filled reviews to read on Stemtalk. If you hear your view read on stem, just contact us at stemTalkhmc us to claim your official stemtalk t shirt.

Ken Ford

Today, our weaning review was posted by someone who goes by the moniker GW. The review reads, with each new episode of Stemtalk, I broaden my knowledge and understanding of relevant topics, some hitting home and giving me pause for reflection. Ken and Don consistently bring engaging speakers to Stemtalk's platform, offering a vast array of perspectives that not only inform, but also ignite curiosity. Learn more about each topic. Keep the content coming.

Don Carnegas

Well, thank you so much, GW, and thanks to all of our other Stemtalk listeners who helped Stem talk become such a great success. Okay, and now on to today's interview with Doctor Jonathan Edwards. Stem talk. Stem talk. Stem talk.

Stem talk hi, welcome to stem talk. I'm your host Don Carnegas, and joining us today is Jonathan Edwards. Jonathan, welcome to the podcast. Thank you for having me, Don. This is really great and also joining.

Us is Ken Ford. Hello, Don. And hello, John. Glad to be here. Thank you.

So, Jon, in our introduction for your interview today, we mentioned that more americans have died from suicide than all the wars since Vietnam. And we also mentioned that police officers as well as firefighters in this country are more likely to die from suicide than in the line of duty. So I believe these statistics will surprise many of our listeners, just by the way. So today, John, we would really like to have an in depth conversation about this, and also your book, the Revolutionary the safe drug that effectively treats depression and prevents suicide. For listeners who aren't that familiar with ketamine, can you set the stage, John, for today's interview by giving us a short overview of ketamine and its ability to help people suffering from depression and suicidal thoughts, as well as other mental disorders?

Jonathan Edwards

Sure. As you guys know. Yeah. I'm a board certified anesthesiologist. I've been using ketamine for almost 25 years now in my practice, both in the operating room and then in the last five to six years of my practice in the clinic in sub anesthetic doses to give a little background on ketamine.

You know, it was developed in the 1960s, actually, from angel dust or PHN, cycladine, PCP. And they needed another drug that would do better in postoperative delirium because the PCP caused just severe postoperative delirium. So ketamine was the answer to that. It was developed in a place called Wayne State University, and it was more of a timing thing. Why ketamine caught on so well right away.

You know, the first experiments were done on prisoners, of course, and they saw that it didn't decrease respiration rate and it didn't decrease the blood pressure. Yet it produced a dissociative anesthesia. So there's different types of anesthesia, in a sense. And dissociative means that you're dissociated from your, you're conscious, yet you're still thinking within your brain where other, deeper anesthetics. We don't think that happens.

And EEG studies, the long and short of it help us to know that a little bit. But ketamine came around the time of Vietnam war, so it became a buddy drug. What does that mean? Well, since ketamine is safe, it can produce sedation and anesthesia and pain control without risk to the respiratory or cardiovascular system. A fellow soldier could give an injured soldier the drug, get them to safety, all without the need of monitors or things like that.

And then ketamine is obviously used in mass units, even today, which we'll get back to. That's kind of how it was discovered as a mental illness or psychiatric medication. So you go through the eighties and nineties and it's still a very safe drug. It's on the who essential list of medication because it's the most used anesthetic in the world, actually, you know, where this western medicine model we have is the exception, not the rule. Most countries use ketamine, actually, and why?

Like I said, you don't need oxygen, you don't really don't need monitors. So it wasn't until the nineties that if you remember, like the bulimia and the anorexia, so they used ketamine at low doses on that and found it had a huge effect. And then in the early, late nineties and two thousands, doctors like John Crystal and Doctor Berman and some others decided to test the hypothesis that ketamine sub anesthetic doses of ketamine could be used for treatment resistant depression. And that's where some of the major breakthroughs came in. And then they went on to show that was beneficial, and then they went on to show it could also stop suicidal ideations, even after a single dose.

And that's where it really took off, you know, and then, and then the other thing to note, you know, it's the first drug we've ever had for suicide, really, in 50 years, as well as depression. So it's a, you know, so that's, is that that's probably, you know, a pretty good overview of what it is and the, you know, differences in the timeline. And then where we're at and then where we're at today is this is a drug that, yeah. Can stop suicide in its tracks. And that was one of the genesis of why revolutionary ketamine with my relationship with Gavin Debecker, which we can get into later if you want.

Don Carnegas

That was a fantastic overview. We really appreciate that. But just so we can touch on this, there's also a dark side to ketamine. And recent studies have reported a worldwide increase in ketamine misuse and overdoses. And just as an example, back in October, doctor Matthew Perry was found not breathing in his hot tub, and the autopsy report noted that high levels of ketamine were found in his blood.

Because this was such a high profile case, I think it's really important that early on in this interview, we acknowledge and also help our listeners understand what the potential adverse effects of ketamine are. Could you do that for us, please? Absolutely. So in the late eighties and nineties, absolutely, ketamine became a drug of abuse, especially at raves. And, you know, I find it kind of ironic why it would be a drug of abuse at a rave, because when you take sufficient amounts of ketamine, you don't move like you don't walk well, that's for sure.

Jonathan Edwards

You know, your vestibular system is affected. So I've never understood it, to be honest. But apparently, uh, so, and the difference, there are two different animals. So you have pharmaceutical grade ketamine and then you have the street ketamine. Street ketamine is like cocaine.

It's usually snorted through your nasal tract or nasal system, and it's usually impure. And today's ketamine is laced with things like fentanyl and other things. And so it's, it's pretty dangerous. And actually have a very good friend in the DEA, and he said that ketamine like to give you, to give you an idea of how much it's increased in the last ten years. They used to see some hundreds of kilograms come in for ketamine, like 50, and nowadays it's about 200.

And he also told me the fentanyl crisis still usurps the ketamine because people are still more addicted to cocaine and fentanyl. But ketamine, you're right, is becoming a drug of abuse. And where it's really a problem is in Asia, the asian countries have a huge problem with illicit ketamine use. And that goes to some of the dangers of it is you can actually get bladder problems, cystitis or inflammation of the urinary tract. And those are found with very large doses of street ketamine that has not been found with clinic given pharmaceutical grade, correctly administered ketamine.

And that's a big difference that people often misconstrue. So I think it's important to highlight that. And then on the topic of Matthew Perry, you know, I really got into this on my substac. I actually wrote about the Matthew Perry case. And that was an interesting case because his, his levels were about 3500 nanograms per deciliter, which is consistent with general anesthesia, you know, the dose we would give, if just anybody knows those kind of things, that that's about equivalent to two to four milligrams per kilogram at once.

But if you read the autopsy report, which I read through in detail, there were no iv marks, there were no needle marks. There was none of that in the police report. There was no ketamine paraphernalia obviously, the ketamine made it into his system. So there's a big mystery of how he got that high a level. Say, just using intranasal ketamine or oral ketamine, you know, or did he take some kind of insulin syringe and, you know, or did the coroner not do a thorough enough examination to.

To see that he had some kind of intramuscular injection? That all being said, you know, he did have other drugs, the suboxone, on board, which was within his limits, actually. And then the other thing that needs to be prefaced is that Perry had been taking ketamine for at least five years earlier in a clinic setting on a consistent basis. So he was no stranger. It wasn't like he was, you know, you know, a naive to the ketamine effect.

So there were really more questions than answers in that whole case. And to say that his death was only due to the effects of ketamine, I think, doesn't give the whole story. And some of the reasons I went into that is Mister Perry must have been. I mean, let's just say he took that big of ketamine dose. You know, you're in a jacuzzi when let's.

You know, and it's true, you get dissociated a little bit. And he fell under the water. Usually the stimulus of hypoxemia is so strong, it will wake you out of any stupor you've put yourself into. And it would have been logical. He would have put his head above water in a swimming pool.

I get it. Maybe you get disoriented. So there's just more questions for me than answers. And then. And then the other thing you can't forget is that he had underlying cardiac disease.

I mean, he had a. He had a left anterior descending artery, which, as you know, is the widowmaker. And that was diagnosed past 70%. And he suffered from sleep apnea. So I think there was a lot more that went into the Perry case, and they wanted to try to blame it all on acute ketamine administration.

And after really dissecting the case, as with most things, I think there was way more to it. But, you know, the most. I think the worst thing of it all is that he was such a huge advocate for addiction, and it was open about his own addiction and had a foundation. And for him to go out that way, I just. I really felt a sadness, you know, because it.

Ketamine and its therapeutic potential took a hit. But not only, you know, those addicts out there that Matthew, the Matthew Perry foundation, assuredly supported, I think, also took a hit. And I was even interviewed by the Epoch Times inner journalist, and I think they wrote up. They wrote up something in there based on my substac articles. So I hope that puts a little more information into the peri case.

But also, yes, ketamine is a drug of abuse, and there's two different animals, street ketamine and clinic administered ketamine, and the two are different. And I think if you use it in the right way in a clinic under healthcare supervision, and go with it into the right for the right reasons, ketamine is an extremely safe substance. You just mentioned both the risks of ketamine abuse and its general safety record. A study back in 2022 in the American Journal of Drug and Alcohol Abuse looked at ketamine overdoses and deaths and really found no cases of overdoses or deaths related to the use of ketamine as an antidepressant in a therapeutic setting. So this sort of makes the point you were just discussing.

Ken Ford

Is there anything else you'd like to tell us about the safety issue on ketamine before we move on? Yeah, I think that study is very important. And then there was also a study that looked at 70,000 instances where ketamine appeared in studies or case reports or abstracts, and they found the same thing. It was like a huge, you know, meta analysis, and they showed that ketamine, you know, was extremely safe, you know, when used appropriately in their appropriate setting. And that's what I hope listeners would come away with.

Don Carnegas

Fantastic, John. So before we dive into the history and biology of ketamine, I'd like to take a step back and talk a little bit about your background. So you grew up in the high desert in Apple Valley, California, which is home to the Mojave Desert and the Joshua Tree National park. And so I understand that at seven years old, you climbed onto a motocross bike and immediately became so hooked that you eventually started racing bikes professionally. Is that correct?

Jonathan Edwards

Yes, I did. I was one of those kids that you couldn't stop. You know, it's just something, you know, something grabbed me at that age, and I just. My uncle raced motorcycles in the desert, and I just, you know, just one of those, you see it in a kid, they're that determined at such a young age. And that was me.

And, you know, my. My mom tried to get me, oh, it's too dangerous, this and that. But, you know, it was pretty obvious that that's what I was going to do from a very early age. And that was my only determination from. From ever since I could remember.

And I. I wound up racing motorcycles up to a professional level until I was age 19. And then that's when I hurt myself enough, and it all, I went back to school, you know, but actually, I never quit school. My mom said, you could pay rent or keep going to school. And so I said, ah, okay, so I'll keep going to school.

Ken Ford

You have an interesting story about a chemistry professor in junior college who sparked your interest in science. Can you share that story with us? Yeah, if there's something else, I want to get the listeners to come out of this. You know, it's like, you know, I was definitely not your average student in high school. You know, I think I passed high school.

Jonathan Edwards

I took, you know, classes. I think I missed, like, 40 days a year because of my racing. You know, I should have been homeschooled, really, you know, but that determination I had in my sport transferred over to my studies when I was ready. And I think the story of me at junior college really shows that determination can be transferred to the academic setting. But you got to have the right people who create that spark.

And she was that spark, and I was the oxygen, I suppose. A greek professor, she was a UC Irvine medical school chemistry professor, and she just happened to teach at the community college as well. She was never happy with me because I'd get a, you know, I'd do all right, get a b or an a on one test, and I'd completely fail another because I was traveling so much. And then I. I broke my knee at one of these amateur nationals, a tibial plateau fracture.

So it was going to take about four months to heal, at least, and I'll never forget. I mean, she was always not happy with me, but she looked at me and said, I have you now, you little son of a bitch. You're going to learn to study and get an a in my class because I know you can do it. And, I mean, she, you know, she was a hard woman, so I worked every night with her in class after class, and she taught me how to study. And then when I kind of saw how it all went and I just could see I was good at it once I learned it, I mean, that just sparked my interest for other classes.

And then I found myself in calculus. I got the highest grade in calculus, and then the next thing I found, I was on the dean's list. And then the next thing I found myself, I was applying to major universities, and then I was going to go to UC San Diego. But when I told doctor chemicals this, she yelled at me, I mean really yelled at me and said she'd put too much work into me to go watch me go to the beach and waste my potential away on a surfboard. So she said, you will go to Susie Davis, stick your, stick your nose in a corner, get good grades and you'll get into medical school.

That's what you're going to do. And I was like, yes, ma'am, that's what I'm doing. So that's how it happened. It's always good to have that kind of influence. For sure it is.

Don Carnegas

So, John, then you jumped around from the Eastern Virginia medical School to the University of Reno to the University of Utah. And at this point it seemed as if you were headed for a career in internal medicine. So we're curious what happened. The internal medicine was actually kind of what's called an intern year. So everybody has to do in their intern year, like a internal medicine or surgery year.

Jonathan Edwards

So internal medicine for me was a stepping point to what's called physical medicine and rehabilitation. And that's where my sports medicine training. So that's really what that was about. I was offered a position in the internal medicine department to keep going because I really had a fascination with oncology, which kind of explains my a little bit about how I meant fascinated, you know, with the mental health space and ketamine. So I finished that year in internal medicine at the Las Vegas.

It was actually at Las Vegas associated with the University of Arena. Then I went on to University of Utah for physical medicine and rehab. And that was a hard year because, you know, I'd been putting all my effort, like almost five, really five, six years of studies and, you know, extracurricular activities. I had even published in that field, only to find out that's not what you wanted to do for your next 30 years of your life. So I finished that year in physical medicine and rehab.

And then I, by chance got connected with a french ambassador. And I'd always thought if I had the time, I'd go live one year completely in a foreign country and learn the language. And lo and behold, that happened after the University of Utah. I went to the University of Lyonneck in Lyon, and I did a neurology fellowship there with research. And yeah, I learned the language, lived it, and my life is completely changed, especially as a world citizen, from living one year in France.

And then after France, I returned to the US, ended up at University of South Florida in Tampa and finished out three years of anesthesia residency. And that's. That brings me, you know, to where I am today. Fantastic. And what led you to the University of South Florida specifically?

You know, at that point, I was kind of out of the match and all that, so I just kind of had to find places that had openings, and they had an opening, and they were happy to take me. And it was a good program, you know, and I thought, why not Florida? My parents were back in California still, but I just. It was one of the places that had an opening. And, you know, sometimes in the anesthesia, it's very competitive.

You know, I just. I went wherever they took me. And that University of South Florida happened to, like what I did and all that, and they, you know, what I was about, and. And it was a. It was a great place.

Ken Ford

I understand that you were sort of slated to become a research anesthesiologist and had accepted a position at the University of California, San Diego, the dreaded beach locale that the program director suggested you do. Something else. Can you tell us about that? Yeah, you know, the world of medicine is, you know, ever changing. Some years.

Jonathan Edwards

There are opportunities in medicine that come about from a professional standpoint. And I was. And they just. The money in research, or at least funding research at that time, was so weak. But the money you could make in private practice was far and above.

I mean, you know, five to eight times more than you could ever make at a research position. And the program director just said flat out, I love what you do. I want you. But private practice is too good right now. And I think.

I think you'd be amiss to not go make some money in private practice, pay off your loans, and then come back to research if that's really what you want to do. And, you know, again, I had a deep thought about it. You know, I'd already published five first author papers, enough to have a PhD in residency during my research track. And it was kind of bittersweet, you know, because I've always wanted to come back to research, but I just did what was practical for my career at that point. And so I took the private practice job in Las Vegas, you know, and it was also close to.

Close to my father. I also understand that you moved to Las Vegas to be close to your father because your mother had died unexpectedly, is that right? Yeah. No. 911 was everybody I rate this about in the revolutionary ketamine, you know, as far as, you know, our life challenges and traumas.

And for most people, 911 was about, you know, two planes crashing and thousands of people losing their life. And for me, it was about getting a phone call when I got home, learning my mother was in the emergency room and she had a history of, you know, some heart disease. And I thought, okay, at worst she's going to have a heart attack and she's in a good place, so she'll be taken care of. So, you know, I called, got through to the emergency room physician and then he asked what kind of doctor I was and I told him and, uh, and he said, well, your mother's in a pulseless ventricular tachycardia and we've been working on her for ten minutes and it's not looking good. And I knew at that point we'd lost my mom.

I just told them to get my family in a room that was there. And yeah, that was my 911. Um, and again, it, those kind of traumas which I've seen many of now is something that, you know, therapy and things like ketamine and other psychedelics can help you deal with, I think. Yeah, absolutely. Well, the positive in Las Vegas, you met your future wife and the two of you have a daughter.

Don Carnegas

When she turned five, you all decided to move to France. So what was behind that decision? Again, I'm a big family man and I just couldn't see raising my daughter in Las Vegas. You know, you get all the billboards, there's 8000 press augmentations done there a year. And so that was one reason.

Jonathan Edwards

The other thing, in Las Vegas, I had five physician colleagues whose kids all died by suicide before the age of 18. And that's just physicians imagine there's CEO's and all that kind of thing. So that really stuck with me. And I was like, no, we're not raising Charlotte. That's my daughter's name in Las Vegas.

And I know how much learning French and the french culture did for me. And since we had a house in France, I talked to the mayor and the mayor said, bring her over, we'll put her in school. And so we, I moved my family to France and I continued working in Las Vegas and I would go back and forth while my wife stayed with Charlotte. And she wound up doing three years of maternal off and on. And then she had a completely one year of first grade, which is called a CP or college preparatoire.

So she did completely that. And Charlotte's bilingual. And I know, I, I mean, I'm constantly speaking French to her to keep her, to keep it up, but I hope she thanks me for it one day. But as you know, she's twelve and there's a lot of resistance there. Yeah, don't hold your breath yet.

Right? Yep. So, and then, um. So anyway, and then after that was done, then her cousins live here in south Florida, and that's where we wanted to raise her near family, here in new Smyrna beach in Port Orange. And, you know, we decided to relocate to Florida just before 2020.

And I think, given the pandemic, that worked out pretty well for us. Yeah, good choice. So, John, that's a fascinating and very interesting career and journey, but we're going to transition back to discussing Ketamine's history. So Ketamine's path from anesthetic to antidepressant originated in the late 1990s. So can you talk about the discovery of ketamine as an antidepressant, which has been described as a century's most significant advancement in the treatment of depression and suicide, just by the way.

Yep. And I'll tell you who said that was the former director of the Mental National Institutes of Health, Thomas Ensell. He's a prolific author and ran the NMIH for years. And he said that. He said ketamine was the most significant medication that we have in mental health in 50 years.

And like I said before, you know, they say it was discovered in the two thousands, you know, the fact it could help mental health and treatment resistant depression and suicidality. However, we knew in the 1970s that it could be used as an antidepressant and that if you go back to a paper called taming the ketamine Tiger by doctor Edward Domino, he writes, he used to tend to a ketamine abuse clinic, and one day he had a patient who came in and, you know, she was addicted to ketamine back then, and she was also an antidepressant. And the doctor noted that you're not taking your antidepressants anymore. Why not? And she said, oh, that's easy, doctor.

Ketamine works so much better that I didn't need my antidepressants anymore. It just doesn't last as long, that's all. Yeah. So we, we knew back in the seventies that it had that potential, you know, and so that's really where it started. And I write about that.

Then we went through, you know, how in the Vietnam war it was a really big deal as a buddy drug, you know, and then it became the anesthetic of choice worldwide, you know, through the who being on its list of essential medications, which it's, which it's on today, actually, you know, and then in the eighties and nineties, as you know, you know, it became a drug of abuse, and that topic overshadowed its utility. But I also think it's worth talking about. Well, we can get into that later. Why it wasn't used for mental health is because of the whole psychedelic. How psychedelics were banned in the 1960s.

So that kind of, you know, there was no. Not a big interest to do that kind of research. And I think had there been, we would have been using ketamine a lot earlier for treatment resistant depression and suicidality. So I think to continue on that narrative, I think one of the most impressive advancements in the treatment of suicide was Laurie Calabrese's study in the two thousands. She did that actually, 2018 or 19, something like that, or, no, 2022.

Excuse me. And then she. She took 235 suicidal patients. And over three sessions with therapy, she was able to show in an outpatient setting that she could stop suicidality. And not one of those patients went on to commit suicide.

There were other studies in academic institutions, Yale and Cornell and other places, but that study really, really stuck with me. And I had the pleasure of meeting doctor Calabrese at the recent metabolic health conference, and we had a really good talk, and I thanked her for her work. I'm sure she appreciated that. You write in the book that the benefits of supervised psychedelic therapy can be broken down into four effects. Explain those.

Ken Ford

Like, just touch on each of those. Sure. So the psychedelic experience, you know, is not just the biology, so it's the mind, body, spirit. It really is an experience in your own head. And to preface that, you know, ketamine produces a psychedelic experience.

Jonathan Edwards

It's defined by loss of ego, the oceanic experience, loss of time, higher order reality, novel insights. And what four effects is that? It produces a safe environment through fear extension. So if you have a fear of needles, for example, or a trauma that you're triggered by, you can be inside the psychedelic experience and you can face those thoughts, traumas, whatever triggers you. And it doesn't happen inside of a psychedelic treatment, at least not like it does when you're not on a psychedelic treatment.

And psychedelics, they're, you know, they're a compound that produces neuroplasticity. And what does that mean? Newer neuropathways. And that's important because most pathological depressions and suicidality are stuck in what's called a default mode network, meaning you're in a forever loop and you always go back because it's like a deep rut, and you're stuck in that rut of thinking in a certain way and so psychedelics are neuroplastic and create new pathways, and we can get into why that is. But the third is its anti addictive benefit.

So we talked about the ironic addictive potential of ketamine, but yet it has an anti addictive benefit, much for the same reasons of the default mode network. And it's been shown, you know, in alcohol, cocaine, heroin. And many psychedelics used it properly with therapy are showing that it can actually help addiction, you know, and let's remember, you know, we've lost over 110,000 people in 2023 alone to overdoses. It's a big number. So then you got psychedelics.

And this is the one where biology can't really explain. It's. They bring a spiritual connection and a reconnection. It helps people. Everybody who comes out of these treatments feels like they've been experienced to a higher power and that everything is connected.

You know, they're just a small energy in the whole universe. And I think this is the hardest thing, I think, to explain to, like, family physicians or other researchers is, you know, this kind of lack of better words, just, you know, psychedelic spiritual connection, that psychedelic, you know, like ketamine bring. And it's a very important part of those four things that psychedelics produce.

STEM-Talk

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Don Carnegas

This might be a really good time to explain to listeners how ketamine manipulates the function of brain receptors. So the list of brain receptors that ketamine can influence is quite long, and it influences the function of these receptors in two different ways. First, as an agonist. So first, can you talk about the significance of ketamine as an agonist? Yes, it's better to talk about as an antagonist at first because of glutamate, and then for gaba.

Jonathan Edwards

So you got the two large brain cells are release glutamate. Small brain cells mostly release gaba, which is, you know, gamma aminobutyric acid. Glutamate is the excitatory neurotransmitter. And by blocking NMDA receptors, that increases the level of glutamate in your brain. And glutamate is so important that it's the reason we remember how to do things like riding a bike after years of never riding it again.

Glutamate is what facilitates all those things in those areas of hippocampus and the amygdala and the prefrontal cortex and such. And then when you talk about, as an agonist, I would say the best way to talk about that is with the way it upregulates gaba. So gaba is a modulation to glutamate. So when you get an increase in glutamate, you get an increase in gaba. And again, this is all theory that we think we understand.

Right? And I don't want to, you know, I don't want to give anybody the, you know, the idea that we understand this comprehensively. And then the other thing it upregulates is BDNF, which is brain derived neurotrophic factor. And it also upregulates the protein mTOR, which, you know, the mammalian target of rapamycin. And those things are, to just put it in easy terms, those is what creates fertilizer for the brain or the neuroplasticity.

And, you know, that's what I would say as far as it's an antagonist and an agonist. You know, on those receptors, it gets into the weeds, you know, but that's a basic, you know, nuts and bolts of it. On that note, I would like to circle back to our discussion about psychedelics. So some people argue that ketamine is not a classical psychedelic, which refers to hallucinogenic compounds that operate on the stenomeric five HTA, two brain receptors. So these groups include psilocybin, which are found in psychedelic mushrooms, and lysergic acid diethylamide, or lsd for short.

Don Carnegas

So would you agree that ketamine is not in the same class as LSD or psilocybin? Yes, I would agree. You know, and I argue, I actually have a. I read a couple pages about this in the revolutionary ketamine, I think, in chapter two. Yes, from a research standpoint, great.

Jonathan Edwards

Don't call it a psychedelic if you want. When you look at the properties of what a psychedelic is, ketamine meets all those criteria in different aspects. You know, it might produce more loss of ego or that oceanic feeling, you know, which is that feeling that everything's more real than real. That's what oceanic feeling is, you know. So anyway, they create or increase or decrease those more than others.

And there's studies comparing all of them to lsd, to psilocybin, to ayahuasca, to ketamine, to ibogaine. And then where I really got the idea that ketamine is a true psychedelic is when you talk to people who've given it for years. And I have talked to countless psychiatrists and every one of them have said, sorry. Ketamine is a psychedelic in every sense of the form. And it's really, the research is where you see that ketamine is not listed as a psychedelic, rather a dissociative anesthetic, you know, and then MDMA is in the same category.

If you look in the research, MDMA is also paired in with ketamine as a non psychedelic. But, you know, I got so engulfed into this question that I actually did find a study to show that ketamine does light up the five HTA, two receptors. And I actually referenced that the author is malty, you know, and it'd be interesting talking to, seeing what his take would be on this, but it does, in fact, affect those receptors. So for me, it's that kind of sealed the deal. It's a psychedelic both, you know, from a biochemical point of view and a psychedelic point of view, we'll call it.

Ken Ford

A key reason that ketamine is different has to do with the way it acts on the brain's glutamate system. We recently had Mark Mattson on the show to discuss his new book, Sculptor and Tales of Glutamate. Mark is best known, of course, for his work on intermittent fasting. But for quite some time, decades, he's been doing extensive research on glutamate, which he refers to as the brain's most important neurotransmitter. As Mark points out in his book, ketamine's highest affinity interactions are with glutamate.

And this affinity has been shown to help alleviate depression and schizophrenia. Can you talk about the significance of ketamine and its ability to increase glutamate in the brain? Yep, that's all from the NMDA receptor blockade. And that's where, you know, they. They've measured these increased, you know, levels of glutamate in the, you know, mostly neuronal firing patterns and the, you know, in the cerebral metabolism and the use of functional mris.

Jonathan Edwards

And I think they've actually had some actual measurements of extrasynaptic glutamate. And that's where some of the mystery is, right? Ketamine increases this level of glutamate. This helps up regulate other neurotransmitters, other proteins, like I was saying, and affects GABA as well, which is, you know, GABA is the brakes, glutamate is the accelerator, and if you have too much acceleration, you can actually have brain damage, I mean, over stimulation of glutamate. As you may have spoken with Doctor Matson, you know, can actually cause brain damage.

And this is something that is underappreciated, which is the reason we have, you know, an inhibitory neurotransmitter as well, you know. So that's how ketamine works, too. It increases glutamate appropriately, and there's an appropriate response to cover the level of glutamate release and clearance. And if those things aren't, and this is one of the reasons why you don't give ketamine to, say, people who are in active mania, you know, because it's, you know, active schizophrenia and active mania, those people are believed to have basically too much glutamate is this. I think it's an oversimplification, but we can think about it that way, leading to neurotoxicity.

And you would never give something that would increase more glutamate in those situations. You know, you would give. You'd give something that increases GAbA, like a benzodiazepine or. Or other, you know, psychiatric drugs like Haldol or something, or even, I mean, if it was so bad, you would actually put them in a coma. And that's done.

You know, we'll actually put people who are in Frank mania. I mean, we're talking pathological levels of psychosis, and in some cases, we'll actually put those people under general anesthesia for some hours to days until their brain calms down and then go from there. So I hope that sheds a little light on the, you know, on the ketamine glutamate question. Yeah, that was super helpful. And so another question.

Don Carnegas

In addition to ketamine, MDMA is another non classical psychedelic with medicinal applications has been shown to have positive mental benefits, especially in patients with PTSD. Can you talk a little bit about that? Absolutely. MDMA is showing that it is going to be the drug of choice in PTSD. The Johns hopkins group, they're in phase three trials right now with veterans in PTSD.

Jonathan Edwards

And, you know, this is such an important question that I highlight in chapter five when I talk about veterans. We used to think we were losing about 20 veterans a day overall to suicide. And, in fact, recent analyses have shown that's completely wrong. We're probably losing in upwards of 40. So, I mean, that's, you know, that's a lot of human beings.

So this research is so important. But anyway, they're showing MDMA is very effective at relieving the PTSD symptoms itself, where ketamine is better at relieving the depression associated with PTSD. This was highlighted in a podcast I heard with doctor John Kristol and Tim Ferriss. And Doctor Kristol went into his studies and the current studies, that MDMA is just so. Such a powerful thing for PTSD, even more effective than ketamine, in his opinion.

And I really took that to heart, so I studied it more. I don't know what the political landscape, if they. If they will ever allow truly MDMA to become a prescribed medication, because at this, at the current time, it's still a class one, no logical human use kind of thing, you know? And then the other problem with it is what I've heard from the grapevine. It's going to be very expensive to give.

So I don't know what it's. What its accessibility is. So we'll see. It has great potential, and I hope it's the next psychedelic that's legalized under our medical system and not just by, you know, some state mandate in Oregon or Washington that says, oh, you can use it. I hope it's available and legal, just like ketamine is today.

Ken Ford

That's really interesting. And just continuing along those lines, back in episode 101, we had a fascinating discussion with Rachel Yehuda, whose research on cortisol and brain function have revolutionized our understanding of the treatment of PTSD. And we've talked at length with her about the potential of MDMA therapies to help veterans, holocaust survivors, and other victims of trauma suffering from PTSD. At IHMC, we frequently work with military populations who experience not only PTSD, but also traumatic brain injuries. In your book, you emphasize that treating veterans with PTSD is complex, and we historically have not been very good at it.

I remember a quote from Rachel's interview where she said, my career has been enhanced by the fact that nobody believed in PTSD. The reality of PTSD is fairly well studied today. A key problem we faced in the past is that, as you mentioned, politicians just really don't want to be associated with using tax dollars to pay for psychedelics for veterans. And I think we all hope that this stigma is removed. Do you sense that this is changing in light of the numerous studies showing the efficacy of ketamine and other psychedelics to reduce PTSD in military populations as well as in veterans?

Jonathan Edwards

It is changing for sure. I'm still not convinced at the reality of a politician. There's been a couple politicians who've gotten behind it, apart from, like, RFK and some others like that, who are completely for the legalization, the medical legalization of ketamine and MDMA. For these things. There's not a lot of support, but we've been losing veterans.

I mean, at, you know, huge numbers ever since the Vietnam War. And all you have to do is go back to any president and look up their policies on, you know, building committees for suicide. And there's been millions, you know, hundreds of millions of dollars put into this. And, you know, at least we've gotten over the fact there is PTSD, you know, and some of the movies helped us with that, you know, the Deer Hunter, for example, and, you know, and then the. And some others like that.

But we're still not there, even after as much studies as I've done and after writing the books and doing all these, where I still feel like we haven't arrived at a place where we're going to see legislation to support the veterans like they need to be supported. Yeah. There's a distinction to be made here between legality. So ketamine is legal and availability for a lot of folks, though it may be legal, is not available to them. Correct.

And only through studies. You know, ketamine is the only drug we have that's legal and available today in a clinic by a physician. MDMA, psilocybin, all those are technically, you know, in most states, they're only research studies right now, although Australia is changing that. Australia just legalized MDMA in their medical system. I think it will happen here, too, due to the trials that are finishing up now.

Ken Ford

The results are so strong that they are so strong in a medical context. I think it will be legalized for prescription, maybe not in all contexts and probably shouldn't be, but in the medical context, I'm pretty confident that MDMA will be added to ketamine. I'm really hopeful because I think we're desperate to find help, you know, for these veterans who come back, you know, with these trauma exposures, it's desperately needed. And if one thing I learned through writing, it's, we're missing the mark there, and we can do. We can definitely do better.

Jonathan Edwards

And I look forward to that day. Shifting gears just a little bit. Inflammation and suicide are strongly linked. Inflammatory molecules such as cytokines, interleukins, tumor necrosis factor, and the rest of are increased. Typically, the.

Ken Ford

They're seen as increased in suicidal patients. The mechanisms explaining the anti suicidal effect of ketamine, as you mentioned earlier, remains somewhat unclear. There is emerging evidence, however, that ketamine does have anti inflammatory effects, and this would be relevant also to traumatic brain injury, which causes heightened inflammation. Can you talk a little bit about this 100%. So we've always known ketamine has been an anti inflammatory in its regard to the brain.

Jonathan Edwards

You know, there were some controversy way back when in the neuroanasthesiology literature about, you know, does it increase intracranial pressure? Those kinds of things. But it's been known for quite a long time that the inflammatory molecules like cytokines, interleukins, tumor necrosis factor are all increased in suicidal patients and traumatic brain injuries. And giving ketamine is just, you know, one step that you. We actually did it therapeutically in the brain injury units.

We did this. And you might be interested, we also gave them intravenous ketones for traumatic brain injury as well, for obvious reasons, because the brain could use other energy sources and give it a break from its glucose. Also anti inflammatory. And also anti inflammatory. Absolutely.

It goes hand in hand, and now we're seeing that it's also immunomodulatory, meaning it has an effect on modulating the immune system toward anti inflammation. So that's very important. So that means all these molecule effects go on to affect the macrophages, the microglial and the neutrophil activation. And it's one of the studies that really caught my eye was a researcher during COVID He surmised that by giving ketamine infusions while somebody was ventilated because of COVID would actually help their inflammation by decreasing Il six and other tumor necrosis factor. I believe he did some.

I don't know the results of the study, but it was actually an NIH funded study on the web. I know you could go look it up in the studies, and I don't think the study was ever completed, but it was a fascinating case use for ketamine that I saw during the pandemic. And it made a lot of sense to me when I saw it. Absolutely. We've been talking about suicide for much of the show today.

Ken Ford

You write in your book that humans are the only animals that commit suicide. But what about whales? Is that thought to be suicidal behavior? Or is it a function of, like, a damage to the brain and not really suicide as we think of suicide? What's your take on that?

Jonathan Edwards

Yep. No, definitely humans. I wrestled with this one for quite a bit. Definitely humans are the ones only ones who can premeditate their own death. You know, you got le.

They used to think lemurs. Lemurs might do it. You know, whales beach themselves, and those aren't suicide in the way we think of suicide. Suicide for us is really a hijacking of our brains, and we premeditate it. It's like an engineering problem.

So suicide for humans is, by definition, isolation, sense of being an extreme burden, hopelessness, all in a very vulnerable situation with access to lethal means. And so that's, I would say, if you think about it in those terms, that's, you know, how we differ from animals, you know, who, who may kill themselves versus a human who, you know, commits suicide. You know, in a sense, we have it pre planned and worked out like an engineering problem. You know, I think a good example of that is the Golden Gate Bridge. So, you know, to date, about 1700 people have jumped off the Golden Gate bridge.

You know, they climbed about 75 miles an hour, hit the water, and either die on impact or of hypothermia. Not just any bridge will do. It has to be the Golden Gate bridge. You could go, you may want to commit suicide, but for some reason, it's that bridge that you have worked it in your mind that this is going to work. And Malcolm Gladwell in outliers, he writes about these kinds of things, and I got a lot of information from that.

And then there's some other, you know, philosophers who've, who've written about animal suicide, and, and hands down, once you get into the, you know, the nuts and bolts of it, humans, that's it. Humans are the only ones who commit suicide in the way we think about suicide anyway. So ketamine is just one step in treating mental health disorders. In your practice, you emphasize that psychotherapy is also a critical component. And, in fact, you've pointed out that there is research that makes it clear that medications and psychedelics alone are not as effective if they're combined with some type of psychotherapy.

Don Carnegas

Is that correct? Yeah, absolutely. Great question. People listening to this should also come away with, you know, ketamine is not by itself the answer. It's just a part of the solution.

Jonathan Edwards

It's not a panacea at all. And I try to make that point. You know, I did a, what's called a speak talk. It's a break off of TED talks. And I did that in New York, and I made that point.

It's important to highlight that, you know, I get patients all the time. I just want ketamine, and I just look at them and go, nope. You know, we're, we're plugging you in with the therapist. It's the only way we're going to do this. And if you don't do the therapy with the ketamine, you know, and therapy can mean many things.

I mean, therapy in many instances can just mean, you know, sitting with your family and talking things through. You know, it's. There's traditional therapists were your family, you know, for the most part, we didn't start doing therapy until Freud and Doctor Beck and, you know, all these people who came through, you know, psychotherapy really wasn't a thing. So it's important these studies have all been done. Like, you know, we sing the praises of psychedelics and ketamine.

But one thing I think is critical to point out, all of these studies involve very high levels of good therapy done, you know, from a psychiatrist or psychologist or at least directed as such. So you're going to get a good result from the, from that therapy alone, you know, and ketamine just adds to it. Now let's transfer that to the real world. Most therapy in a real world, as you know, is you're with a psychiatrist on a telemedicine for ten minutes and you end it with a prescription. You know, the end was the goal all along.

Right? So what we really should highlight here is that we need better therapy and more people who are dedicated to providing therapy, helping people talk through their problems and their traumas and their triggers. While ketamine acts as that fertilizer on the brain, you know, helping the default get you out of that default mode network through the neuroplastic mechanisms it affords us. And I hope people come away from this realizing that that is so important, really is. You talked earlier about how a sense of social isolation and hopelessness raises the risk of suicide.

Ken Ford

What about drug overdoses? You know, the correlation between isolation and drug overdoses became particularly apparent during the COVID-19 lockdowns. In 2018, two years before COVID-19 70,000 Americans died from overdoses. However, in 2021, while lockdowns in many states were still strongly in effect, nearly 108,000 Americans died from drug overdoses, a massive increase. Can you talk about this?

And how many emergency rooms in the country saw 1000% increases in overdose cases during the COVID lockdowns? Yes. You know, so if you look on my website, I actually wrote a book that's a little darker than the revolutionary ketamine, but it's what sparked the revolutionary ketamine. It's called suicide. COVID-19 and ketamine, how a little known drug saves lives as well.

Jonathan Edwards

So that was the preface, really, to the book. And in that, and in both cases, I wrote about how people in addiction centers would say, one guy from a Johns Hopkins addiction center quoted that we are seeing people go straight to the morgue because of overdoses. We don't even have a chance to intervene or provide support or therapy, you know, and then, so, I mean, the overdose deaths, that's one reason. Number two reason is now, you know, with China making the fentanyl and shipping it easily to South America and Mexico, to the cartels who are all too happy to distribute it into the United States and are tainting every drug known, including MDMA. There's, you know, illicit MDMA and everything, and ketamine, and they're attaching fentanyl to everything that's killing.

That's what's leading to these, you know, this 110,003rd. The pandemics caused, I mean, for lack of a better word, a rift in the usual person you would get your drugs from. So then you have a lot of people who are addicted to drugs now would try other dealers, and that usually ended bad as well. So that was another reason. And I think a good, I have a story in the book about a gentleman from West Virginia, and he had been addicted earlier to pain medications from a soldier surgery.

And just, just five days of isolation during the lockdowns caused him to go back to that addiction, which he had to fight for several weeks. And when he was finally called back to work, the addiction was gone. He gave it up. So, you know, and that, that happened, you know, certainly thousands of times during the lockdown. So, you know, so when you say what killed more people worldwide?

The lockdowns. The lockdowns certainly were among the most deadly force that killed people than just an infection. I'm sure that's right. Earlier, we were talking about ketamine and its risks and rewards in certain contexts. And you mentioned that some people really should probably not use ketamine.

Ken Ford

You mentioned those suffering from manic episodes, some degree of mania. Are there other groups that, where ketamine is ill advised? You know, that's a, that's a good question. Besides open mania, you know, I think there's some other, the only other examples I've seen, I've treated. You know, it's like the cutters, people who cut themselves, those kids who do that, and even some adults, they're not looking to kill themselves.

Jonathan Edwards

They're actually looking to stimulate their dopamine systems. The act of cutting is actually not, you know, they might be depressed, and ketamine could help that, but, you know, therapy can also help that. And so what I'm trying to say is, like, I've had a couple of these cases where these, you know, these adolescents cut themselves and they get, you know, a set of ketamine treatments, and it didn't do anything for them, really. You know, it helped a little bit in the short term, but it seemed like they always went back to cutting. And some of the reasons for that are you can read in well known addiction physician doctor Gabor mate, in the myth of normal, the act of cutting yourself goes back to a maternal trauma, you know, of some sort when you were a child or whatever.

And it was true in each of these cases I dealt with, it was the adolescents anger trauma directed towards the mom. So anyway, you know, the ketamine didn't help. And I suspect that, you know, therapy directed towards these angers and traumas would have been more effective. And so I would, I would hesitate to go to ketamine right away and somebody like that. But outside of that, no, there's not a lot of contraindications.

There might be others, but I can't think of anything offhand. Has ketamine been successfully applied in the context of chronic pain, like people that have chronic hip pain or chronic shoulder pain or back pain? Yes, it has, and I've used it in my practice. Ketamine affects many types of receptors. They're including opioid receptors, dopamine, you know, all that.

And I've had a couple cases. So the protocol for giving ketamine and those instances of chronic neuropathic pain, and I write about some of these in my book, you know, trigeminal neuralgia or shingles and things like that, you can give an extended infusion of very low dose ketamine over hours, and these people respond. And then one nurse practitioner I wrote about in my book, this person had been trying for years, and, I mean, took everything. You know, they, they did therapy, they did, you know, the Neurontins, you know, all that stuff that just is supposed to numb, you know, kind of numb the nerves and the blocks and all that kind of stuff. The only thing that helped this gentleman was the ketamine treatments.

And it helped so profoundly, he was able to deal with this pain and go back to work in a meaningful way. And I've actually seen this myself in some patients. And it's a particularly rewarding thing to see, because when you work with people, there is no answers for people with neuropathic pain, as you may know. I mean, it's one of those things that medicine has no good answers to. So to see it work in that context is particularly rewarding as a physician.

Ken Ford

Hmm. I can imagine. Well, John, thanks for sitting down with us today. And I believe our listeners will really find this interview quite enlightening. So one last question we have for you.

Don Carnegas

I understand that you spent a number of years traveling the world for the Dakar rally, an off road endurance event, and you found the rally so exciting that I understand your next book is going to be called the real Stories of the Dakar rally. Is that right? Yes. That is one of my next books I'm actually into right now. And, yeah, one of my writers just won the Dakar rally, Ricky Brabic.

Jonathan Edwards

I help him, not a lot, mainly with medical stuff. I've helped him with his neck in the past and where he kind of has me on speed dial when needed. But, yeah, I did the Dakar rally. It was an interesting. It's an interesting story, and I'll try to be brief about it.

But when I was in my anesthesia practice in Las Vegas, I got called by the head of KTM, who was setting up the Dakar rally team by Scott Hardin. And he's a famous Baja 1000 racer. And he knew I spoke French. He knew I was a, you know, also a physiotherapist, you know, along with being a doctor and that I had, you know, experience in professional motocross racing. And he kept trying to say, like, oh, you have to go with this.

You know, we're setting off a us team. And I kept telling him, like, I just can't take three weeks off and go to Africa and be your doctor. And then he just kept. He kept going, asking me. And then finally I asked my group, and one of the guys looked at me and he goes, Jonathan, you're going to have all your life to make money in anesthesia.

You're not going to have all your life to do these kinds of experiences. You should go. And the group supported me on it, so I went and I went one year, and then I wound up going five years. And at that time, the Dakar rally. Dakar is the capital of Senegal.

So we start in Europe, and we start from France, Portugal or Spain. And then you go across the Gibraltar strait on a ferry to Tangiers, Morocco. And then you go all through Morocco in different ways into Mauritania, and then you cross into the polis aerial front where the Torregs, you know, that struggle exists and you have to go through landmines. And, I mean, we went through parts of Mali, Africa, Guinea, Basso. We went through Burkina, FSo, and then.

And then finally you make it to Dakar. And, yeah, I went through places in Africa that are less traveled, most tourists never get to see. And even I went through some places that are now under islamic jihadist control that you'll never be able to go through again, at least for many years. So that, that's where the Dakar rally story comes from. And it's close to my heart, and I love supporting those guys and gals and, yeah, I hope to go back someday.

You know, it's no longer in Africa. It's actually in Saudi Arabia right now. Well, that's really fascinating, and we really look forward to reading it. And if you could, you could send us an advance copy of the book, that would be fantastic. I'll send you.

I will send you what I have. Yes. Yep. And I write, actually, I write about some of these Dakar rally stories on my substack. So some of it exists there.

If you want to sneak peek into some of the adventures that I write about. Your substack's quite good. I signed up for it, and Substack has become the place. You know, I think it's, it's really taken off. Yeah, I've enjoyed it so far.

It's just, it was just kind of a thing I did off the, off the cuff. And so far, it's, it's kind of built up into something fun. And I just, I enjoy posting it and, yeah, anybody who, anybody who wants to get on it, let me know. Very cool. Well, John, thank you so much for joining us today, and please do keep us posted on your work on ketamine as you move forward.

Don Carnegas

We would really love to have updates as we move along. Absolutely. Oh, man. Thank you. This was such a great opportunity, and I can't thank you enough for affording me this opportunity and to share everything I've done.

Jonathan Edwards

And you guys are great. I love everything you do, and I can't say enough. Well, thank you, John. It was a great interview. Thanks.

Don Carnegas

Thank you. Stem talk. Stem. Stem talk. Stem talk.

Jonathan Edwards

Stem talk. Well, John certainly makes the case that suicide is a public health crisis, and I wasn't really aware what a surge in suicides there's been in the past decade among adolescents and children. After listening to this interview and hearing about the potential of ketamine to prevent suicide, I really hope that people check out John's book. And just overall, I love the research that he's doing. It's a shame that we have research demonstrating that not only ketamine but also MDMA can be effective treatments and therapies for depression, suicide, and some other mental disorders.

Ken Ford

Unfortunately, there remains a reluctance to accept these therapies because they're considered psychedelics. But as John said, suicide is not going away, which is why it's so important more people become aware of the positive potential of psychedelics to treat people and to save lives. Absolutely. If you enjoyed this interview as much as Ken and I did, we invite you to visit the Stemtalk webpage, where you can find the show notes for this and other episodes. At Stemtalk us.

Don Carnegas

This is Dawn Carnegie signing off for now. And this is Ken Ford saying goodbye until we meet again on Stemtog.

STEM-Talk

Thank you for listening to Stemtalk. We want this podcast to be discovered by others, so please take a minute to go to itunes to rate the podcast and perhaps even write a review. More information about this and other episodes can be found at our website, stemtalk us. There you can also find more information about the guests we interview.