Chief Medical Officer, Novamind Ventures. Co-Founder & Medical Director of Cedar Psychiatry, acquired by Novamind Ventures on July 30, 2020. Founding Board Member at the Utah-based non-profit Psychedelic Institute. Coordinating Investigator of the MAPS MDMA-Assisted Psychotherapy study of Eating Disorders. Extensive experience with Ketamine in both research and clinical settings, conducting his first research study in 2011.
When and why did you create Cedar Psychiatry and Cedar Clinical Research? What problems were the companies built to solve?
Well, the short answer is that I’m a psychiatrist focused on the therapeutic use of psychedelic medicines (and the therapy that goes with it), and there’s a large need for new and improved treatment modalities. Mainstream treatments fall short for too many people, and we need new options. I started working with ketamine back in 2011, and to be honest, I had never seen any other medicine like it in terms of its ability to catalyze the healing process, that is until I started working with other psychedelic medicines. We’re experiencing a psychedelic renaissance in mental health (and in society as a whole) that I feel is just in its infancy but is poised to transform the way we practice psychiatry. My goal is to bring psychedelic medicine to the people, in the best way I know how.
From the very beginning, I’ve tried to dedicate my career to helping individuals suffering from mental health conditions, especially when traditional treatments have failed, by finding new treatments, then researching them, and helping people access them safely and effectively. We’re at an important time in the evolution of mental health and wellness, where the suffering of humanity is profound, chaos runs rampant, and yet these healing tools are re-emerging that have the potential to be game-changing for how we approach mental health. I wanted to use my unique background in neuropsychiatry, clinical research, and entrepreneurship to bring psychedelic medicine to the forefront of mental healthcare.
I co-founded Cedar Psychiatry with a dual purpose; i) to provide compassionate, innovative, and individualized mental health care, ii) to engage our local community in an evidence-based conversation about psychedelic medicine. Cedar Clinical Research, Cedar Psychiatry’s sister organization, was founded to provide our patients with extended access to innovative research-stage treatments and to conduct clinical research on psychedelics outside of traditional academic settings. I truly believe that together with Novamind, both Cedar Psychiatry and Cedar Clinical Research will play an important role in the next chapter of mental healthcare. By the early to mid-2020’s psychedelics, including MDMA and psilocybin, are anticipated to be approved by the FDA. Cedar is excited to be in a patient-facing role, as we have an incredible opportunity to facilitate transformative healing and to responsibly shape the future of psychedelic medicine.
What inspired you to begin researching ketamine treatments? What are some of the most powerful conclusions you have drawn from your experience applying ketamine treatments in a clinical setting?
When I started studying and working with ketamine in 2011, I was intrigued by its ability to catalyze change in individuals afflicted with even the most treatment-resistant conditions. Notably, ketamine is available to prescribers, unlike classic psychedelics such as psilocybin, ayahuasca, or LSD. While ketamine has only been approved by the FDA as an aesthetic, licensed physicians can prescribe it “off-label”, at their professional discretion for a wide array of conditions. The first report of ketamine’s potential as a psychiatric medication dates back to 1973. Ketamine, while not a classic psychedelic, it arguably it acts like one. I can attest to this, having facilitated thousands of ketamine therapy sessions over the past decade. Given at the right dose in a therapeutic setting, ketamine creates a non-ordinary state of consciousness, helping facilitate profound experiences that can help resolve even deep-seated emotional traumas.
What have you learned in your research trials about how people respond to these types of treatments, particularly people who have dealt with mental health challenges for a long time?
I’ve witnessed this time and time again, ketamine gives hope. When all else has failed, when traditional treatment methods just don’t cut it, I am so grateful to have ketamine in a tool in the quest to alleviate suffering. It’s encouraging, and keeps me forging ahead, to see people who came in with very little hope leave our clinic with a clearly delineated path toward health and wholeness -- even and especially people who have been stuck in the same patterns for decades.
What do you think are some current misconceptions about ketamine treatments in the medical community?
My answer would have been different a year or two ago in the sense that awareness is increasing in such a positive way. I’ve been encouraged by how the medical community has been extremely welcoming about the use of ketamine in psychiatry. Referrals come from everywhere, and fruitful collaborations keep popping up. The world is ready for new healing tools, and ketamine is opening the door to this new era of psychedelic medicine.
Sure, there are still misconceptions about how ketamine is given and what conditions it can be used to treat. Dosage matters, as well as delivery. There is still some confusion out there about the various ways ketamine is used therapeutically, such as intramuscularly (IM), intravenously (IV), intranasally (IN), and sublingually (SL). We work with all these administration methods but in different ways. For example, IM injections are typically given for an in-office “transformation” session, whereas a lozenge or nasal spray is more commonly given before a therapy session to facilitate openness to the therapeutic process.
The importance of therapy in treatment plans is another large misconception. Sure, ketamine by itself can be a rapid antidepressant medication, but the effects are often temporary. What ketamine does do, however, is open up a window of opportunity for deep therapeutic work.
Outside of the treatments currently offered at Cedar Psychiatry and Cedar Clinical Research, what are you most excited about within the world of psychedelics?
There’s a very positive energy within the world of psychedelics stemming from the exciting results of late-stage clinical trials sponsored by MAPS, Compass Pathways, and the Usona Institute. While chaos ensues in the world, healing tools are emerging like nothing I’ve ever seen before. The energy, embrace and enthusiasm in the world of psychedelics is palpable. And it’s reaching the mainstream—my mother even sent me an ayahuasca neuroscience article the other night. Psychedelic science has arrived and this time it’s here to stay. For me, the work doesn’t get any more beautiful than that—helping people move from their heads to their hearts.
Additionally, I am looking forward to continuing my work as a Coordinating Investigator for the latest MAPS study of MDMA-assisted psychotherapy as a treatment for eating disorders. Now that MAPS has entered phase III studies for PTSD, other conditions are coming into the research pipeline, like this one that has been a large focus of mine for quite a while. It took many decades of research, lobbying and passion to get here, but we are here now, and I feel honored to be involved with the psychedelic renaissance that is taking place in whatever way I can.
Does Cedar plan on offering other psychedelic treatments in addition to ketamine? What would that model look like?
Yes, we’re already doing it in fact. When Spravato (esketamine) was approved by the FDA in 2019 for treatment-resistant depression, we made the conscious decision at Cedar to dedicate resources to helping our clients access this new treatment option. Even though it took a monumental effort at first (including nearly a full-time person just to manage insurance prior-authorizations), it has paid off for our patients as we’ve been able to give nearly a thousand doses in our clinics that have all been covered by insurance. As new psychedelic medicines get approved, we’ll already have the infrastructure in place (including trained therapists and prescribers) to offer these tools to those who need it.