Key Takeaways from the Psychedelic Science 2023 Conference in Denver

Conference attendees included researchers, scientists, businesspeople, and practitioners from all backgrounds, especially licensed therapists, physicians, and nurses. Event organizers also went to great lengths to include representatives from government, law enforcement, community organizations, various religious clergies, and indigenous nations.

Our Takeaways

Even though I attended the conference with Cindy Nelson LMFT who provides ketamine assisted psychotherapy for our patients at Innerbloom Ketamine Therapy, it was going to be impossible for the two of us to experience everything the conference had to offer.

Instead, what follows are a few of our most notable takeaways. Also checkout what our good friends at Reset Ketamine in Palm Springs just posted about the conference too!

1. Ketamine therapy continues to be a safe and effective way to treat mental illness and pain.

When the conference agenda was released, there were at least three sessions which we knew we had to attend. While each session went into lots of detail, our overall takeaway is that our practices at Innerbloom Ketamine Therapy are aligned with the industry practices. Further, the growing body of scientific research continues to demonstrate that ketamine is a safe and effective treatment for depression, anxiety, PTSD, pain, and other neurological conditions.

A two-day workshop called “An Introduction to Ketamine-Assisted Psychotherapy and Ketamine Methodologies” led by leading practitioners like Phil Wolfson, Gita Vaid, and David Dansky.

While the two-day workshop was billed as an introduction to ketamine assisted psychotherapy or KAP, we quickly learned that it was comprehensive and detailed. The session started with the basics including the methodologies then went into detail on the science of how ketamine works, ketamine administration, clinical indications, and ample time for Q&A. Day 2 detailed different therapeutic modalities used in KAP and included case studies and practice development.

A presentation and panel discussion called “Ketamine Treatment: Current Issues and Controversies” led by Raquel Bennet PsyD.

Ketamine treatment is an exploding field. Dr Bennett gave an overview of what is happening in this rapidly evolving space and then discussed current issues and controversies. Some topics discussed included: the importance of incorporating psychotherapy with at least one KAP session per single ketamine infusion; thinking ‘big picture’ and taking a holistic approach; the dark side of ketamine and abuse potential; need for standardized training and accreditation for ketamine providers; and the FDA approval conundrum.

A presentation called “Toward ‘next generation’ ketamine treatment: from new insights into the neurobiology of depression to strategies to optimize ketamine efficacy” by John Krystal MD.

Dr Krystal is considered by many to be a pioneer in ketamine research. Last year, he appeared on a 3-hour episode of the Tim Ferriss Show to discuss ketamine’s history, clinical administration, and future. His presentation at the conference was a summary of his latest research into how ketamine can be used for Treatment Resistant Depression or TRD. While I encourage you to listen to the full episode, here are a few main points.

• TRD is thought to be caused by reduced synaptic efficacy and density known as synaptic deficits. Ketamine has been shown to stimulate rapid growth of synaptic connectivity, especially in people with synaptic deficits and TRD.
• However, over time, newly grown synaptic connections disappear, possibly due to the immune system. This can lead to TRD relapse. The key question currently under investigation by Dr Krystal and Freedom Biosciences is how to maintain the new synaptic connections so that the positive effects of ketamine persist.
• The answer may involve combining ketamine with an immunosuppressant called rapamycin but much more research is needed.

2. MDMA, psilocybin, and other psychedelics such as ibogaine and 5-meo-DMT are showing great promise in treating depression, anxiety, and PTSD.

MAPS, the conference’s sponsor, recently completed its second Phase III trial of MDMA and we were there to hear the results. (Phase III is the final phase before a treatment receives FDA approval.)

• 88% of the 90 trial participants showed a clinically significant reduction in PTSD symptoms two months after their last treatment.
• 67% no longer met the criteria for a PTSD diagnosis.

Further, the researchers reported no serious adverse events in this 12-week, double-blind, randomized controlled study. Like similar FDA trials with psychedelic compounds, participants received psychotherapy to ensure proper preparation and integration.

We also learned about other late-stage clinical trials like the one led by COMPASS Pathways that is looking into whether a psilocybin compound is a safe and effective treatment for depression. (Spoiler: It is!)

There is also other exciting research showing that psychedelics such as ibogaine and 5-meo-DMT, which are less well-known in the US, may be highly effective medicines. While FDA approval for these medicines may be further out, some practitioners are already treating our military veterans with remarkable success south of the border.

3. Access to psychedelic therapy will be one of the main challenges in health care.

Unlike modern pharmaceuticals, the cost to develop many psychedelics is very low. This is because several psychedelic compounds are either 1) outside their patent or exclusivity term or 2) found in nature. This is true for ketamine, MDMA, psilocybin, ibogaine, 5-meo-DMT, LSD, and cannabis. And while medical-grade formulations will certainly cost more than their homegrown analogs, psychedelic medicines will be relatively inexpensive to manufacture and distribute.

However, as we heard several times by various speakers, any FDA-approved psychedelic therapies will require labor intensive psychotherapy before, during, and after treatment. Even if group therapy and artificial intelligence prove to be safe and effective ways to lower costs, psychotherapy may still add thousands of dollars to the cost of a single treatment.

And until Medicare, Medicaid, and most health insurance companies decide to cover these emerging treatments, patients will have to pay out-of-pocket.

Clearly, this presents a problem. If these psychedelic therapies are safe and effective but not yet covered by insurance, how can everyone, not just the wealthy, afford treatment? While we found some companies which are trying to address this with insurance alternatives like Enthea, community-sponsored clinics, and non-profits which aim to provide financial assistance for psychedelic therapy, we believe access will be a major hurdle to widespread acceptance.

One positive sign: We were encouraged to see lots of attention devoted to the question about access to these emerging treatments. We hope that if people are discussing these issues early on, then the industry will find ways to increase affordability from the outset.

4. With great power, comes great responsibility.

One surprise was the conference finale. While MAPS founder Rick Doblin was giving his farewell address on Friday afternoon, some in the audience interrupted the presentation. However, instead of silencing the protesters, the event organizers invited them on stage to speak.

The unexpected message, as described by the editors at Lucid News towards the end of this article, was clear. While there is lots of excitement about how psychedelics may transform our lives, our communities, our societies, and our relationship with nature, we must move forward with great care.

Here are some reasons why we think caution is warranted:

• Despite the promising research, most psychedelics are illegal with severe punishment in most jurisdictions.
• While attitudes are clearly shifting, most people still misunderstand, mistrust, or mischaracterize psychedelics.
• Any mistakes, intentional or not, by a manufacturer, distributor, provider, or patient could halt (or even reverse) what many believe is a renaissance in psychedelics.
• With such high stakes, regulators, researchers, practitioners, and patient advocacy groups must collaborate to implement standard clinical and ethical guidelines of care.
• The psychedelics industry should create formal training and certification programs for manufacturers, distributors, physicians, nurses, and therapists.
• Some notable psychedelics such as psilocybin, mescaline, peyote, and ayahuasca have been used by indigenous people for centuries. Without thoughtful reflection and good-faith dialog, there is significant risk that indigenous people, their traditions, and their resources may once again be ignored and exploited.

Conclusion

Our mission at Innerbloom Ketamine Therapy is to help people in our community live healthier, more fulfilling lives. And since treating our first patient nearly one year ago, we have committed to safety, quality, hospitality, convenience, and advancing the state of the art.

To these ends, we felt it was our duty to attend this milestone gathering in Denver to learn as much as we could and return with the latest insights to improve our patient outcomes. And despite the numerous concurrent workshops, presentations, panel discussions, and exhibitions, Cindy and I managed to cover a lot of ground literally and figuratively!

It is our hope that our takeaways inform our practice, our patients—past, present, and future; our collaborators; and our communities across the beautiful Central Coast of California.

The sheer size and variety of the Psychedelic Science 2023 conference is a testament to the significant amount of interest and resources that are flowing into psychedelics. (Checkout coverage from other outlets like NPR, Vox, Rolling Stone, and ESPN to highlight this point.) We couldn’t be happier and more enthusiastic to take part in this renaissance in wellness and health care and share it with our community in San Luis Obispo.

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About the Author

Dr. Ray Rivas, a former general and trauma surgeon with over a decade of experience utilizing ketamine, became a ketamine therapy specialist to treat mental health and pain after witnessing its profound impact on his hospital trauma patients and his own mental health. As the founder and medical director of Innerbloom Ketamine Therapy in San Luis Obispo, California, Dr. Rivas applies his extensive medical expertise to provide safe, evidence-based ketamine treatments for mood disorders, including depression, anxiety, PTSD, and chronic pain. His passion lies in helping patients find relief and rediscover hope through personalized, compassionate care.