By Brian Broom-Peltz
(Editor’s Note: Brian Broom-Peltz is a psychedelic harm reduction educator, developing and delivering professional training materials both for emergency first responders and the general public.)
Truckee resident Nathan Pohl believes psychedelic treatments saved his life.
Starting in 2001, Pohl served the U.S. military as a private contractor and as a soldier with the 75th Ranger Regiment, the U.S. Army’s elite and lethal division that is one of the most extensively used units in the country’s armed forces. Throughout his tours in Iraq and Afghanistan and on over 2,000 combat days, he witnessed firsthand approximately 30,000 mortar detonations. At one point, he was nearby when an IED (improvised explosive device) exploded. It gave him a percussion experience he likened to “getting hit by a truck.”
The years of accumulated concussive trauma took their toll on Pohl. Upon his return to the United States in 2008 — the outdoor enthusiast was also a father of twins — life wasn’t completely delightful: He struggled with disorienting symptoms; he experienced double vision and difficulties processing sounds in loud environments. This indicated he had an auditory processing disorder. Pohl sought help in the VA but believed the staff lacked the training to properly diagnose his condition or the clinical freedom to explore options to address his symptoms.
Pohl’s ailments worsened over time. He experienced anxiety, depression, and concentration and memory problems.
“In 2017, I strung up an electrical cord and I was going to hang myself,” he said. “I looked at what I had done, and I immediately checked myself in a psych ward in Palo Alto. The VA recommended I go to a PTSD [Post-Traumatic Stress Disorder] program. I went to an inpatient PTSD program for five months.”
That didn’t help, he said, and his despair deepened.
Later that year, though, a conversation with a fellow Ranger changed everything.
The friend, who suffered from similar injuries, told Pohl about a weeklong psychedelic retreat in Costa Rica called Soltera where guides served ayahuasca, a plant-based brew that contains the natural hallucinogen known as dimethyltryptamine, or DMT. His friend said the program helped to alleviate his symptoms. Pohl researched and learned about other people who’d been having psychological trauma who were now having lasting benefits from the program. He was interested in the neuroregenerative aspects of DMT.
Psychedelic, which means “mind-manifesting,” refers to a class of psychoactive substances that affect perceptions, emotions, and thinking. While commonly associated with trippy recreational experiences, the reputation of psychedelics has been shifting in recent years as researchers have been testing and publishing their therapeutic benefits.
In the past decade, and made worse by the pandemic, mental health across the country and region has deteriorated. For example, the Centers for Disease Control estimates that between 2015 and 2018, 13.2% of adults used antidepressants. In a 2021 study of depression in the U.S., of the 8.9 million adults being treated for major depressive disorder, 2.8 million (30.9%) are treatment resistant. The annual burden of medication-treated major depression among the country’s population is estimated to be $92.7 billion, with $43.8 billion (47.2%) attributable to treatment-resistant depression. Researchers, therapists, and even Tahoe/Truckee locals are beginning to look outside the traditional set of approaches to ask if psychedelics may be a novel solution to this growing problem.
Pohl had gone through many western treatments and had run out of options as far as treatments that the VA offered, he said. He wanted to give something else a try and decided to check out the retreat. Pohl flew to the retreat center and attended a week of guided ayahuasca ceremonies. In the evenings, he would join a small group in a ceremonial space and drink cups of the psychedelic brew. While a guide played music and chanted, Pohl purged into a prepared bucket and laid back on a mattress experiencing a psychedelic state. The next day he rested and reflected on his experience. This pattern repeated for a total of three sessions over the week.
After the ceremonies, Pohl noticed a rapid shift to a “feeling of being like my old self” and improved clarity of thought. The effects lasted for months and for the first time in years Pohl felt grateful to be alive.
Now, at times, some of Pohl’s symptoms return, but he said they are greatly reduced and that he can remedy them with subsequent psychedelic treatments and so he heads back to South America or Costa Rica for a follow-up retreat. Having found effective tools to deal with his condition, he shares his experience with the nonprofit group Heroic Hearts Project, which connects military veterans struggling with trauma to psychedelic therapy options.
Is it Legal?
Pohl is excited for the future of psychedelic medicines and believes, as he said, “It should be available not just for brain injury but for substance use problems.”
Right now, Americans seeking these psychedelic therapies must travel to Latin America for them because the U.S. Drug Enforcement Administration has restrictions on Schedule 1 psychedelics, their categorization. However, soon (or presently, as is the case with the drug ketamine), Pohl and all Californians may be able to legally experience these treatments in their hometowns.
A proposed California law, introduced last year by state Sen. Scott Wiener — a San Francisco Democrat — aims to legalize certain psychedelics for personal use and social sharing. The substances effected by the bill include psilocybin (found in magic mushrooms), dimethyltryptamine (DMT, a psychedelic molecule in ayahuasca), ibogaine, mescaline, lysergic acid diethylamide (LSD), and MDMA (commonly known as ecstasy).
Sen. Wiener has stated that he decided to propose this bill to help address the untreated mental health and addiction problems in California, and he sees the bill as a “part of the larger movement to end the racist War on Drugs and its failed and destructive policies,” according to a press release.
Riding a wave of similar decriminalization legislation being proposed nationwide, the California Senate Bill 519 would make California the second state after Oregon to legalize the access and use of certain psychedelics. SB519 passed through the Senate (Ayes 21, Noes 16, NVR 3) but did not gain enough support to pass through the Assembly in the 2021 session. State Sen. Brian Dahle in District 1 (which includes North Lake Tahoe) voted against the bill, and District 1 Assemblywoman Megan Dahle has not yet responded to inquiries about how she may vote on the bill. At the end of 2021, Wiener put a pause on the bill, but he has continued to build support for it. Wiener told the online publication Marijuana Moment he feels there is a 50/50 chance the bill will reach the governor’s desk.
Opponents to the bill are concerned SB519 will encourage substance use and increase the number of drug overdoses. “Where people are dying on the streets of California from drug overdoses at massive rates, one has to ask Sen. Wiener, is this really a good idea?” said Sacramento County District Attorney Anne Marie Schubert, according to a report from KESQ News Channel 3 in Southern California.
Requests for comments from Sen. Brian Dahle’s office were not answered.
Pohl said SB519 would make these therapeutics more accessible for people who need them. “It costs $3,000 every time I need to go [to Peru or Costa Rica] to do one of these treatments,” he said. “It is expensive. Many don’t have those resources available. They aren’t going to experience the healing potential of these compounds.”
Psychedelics in Tahoe
After decades of dormancy, psychedelic research is flourishing and showing promising results in U.S. Food and Drug Administration clinical trials for the treatment of PTSD, treatment-resistant depression, mild traumatic brain injury, cluster headaches, general and end-of-life anxiety, as well as alcohol and substance use disorder. Based on initial clinical studies, the FDA has prioritized and accelerated clinical trials by granting the “Breakthrough Therapy” designation to MDMA (ecstasy) for the treatment of PTSD, and to psilocybin for the treatment of depression.
The promise of new and effective therapies is a heady hope for a nation rocked with mental health issues during the Covid pandemic. Some Tahoe/Truckee locals aren’t waiting for the legal pathway for psychedelic therapy that SB519 promises. Instead, they are seeking respite now. One long-time Truckee resident — we’ll call her Heather — began experimenting with microdosing psilocybin after a slow recovery from a sports-related concussion. After months of “almost imperceptible … snail-like improvements” from physical and occupational therapy, Heather was still having trouble with everyday tasks like driving, making plans, and doing the sustained high-level thinking required for her job.
“At first I was skeptical because I don’t consider myself a drug user, and that’s what this seemed like to me — drugs,” she wrote in an email interview. “But I found a whole new world by just doing a little bit of research. There is serious science in progress for this medical intervention.”
Heather read that psilocybin is generally understood to be safe, barring some pre-existing mental health conditions. “Knowing its safety, I was willing to give it a try, having exhausted all of the allopathic treatments available to me,” she wrote.
A few times a week, Heather would take 0.1 grams of dried psilocybin mushrooms measured out in a capsule, which is a very small amount compared to a normal recreational or therapeutic dose of 1 to 3 grams. She would combine the psilocybin mushroom with another therapeutic mushroom, Lion’s Mane, which supports brain health but does not produce psychedelic effects.
“I didn’t notice any ‘trippy’ effect, which was probably my biggest concern,” she wrote. “Instead, it was quite the opposite. I felt more alert, energized, and ready to focus. After three weeks, I felt like I was nearly back to my baseline. I could drive, pay bills, organize plans with friends, and importantly, perform better at my job. It just seemed incredible to me that all of this happened in just a few weeks.”
The capabilities of psychedelics to address a wide range of clinical indications is believed to be related to similarities in the underlying causes of many of these conditions. Depression, anxiety, and addiction are often attributed to rigid mental states and thought patterns. Findings from clinical trials indicate that psychedelics have the capacity to temporarily loosen up rigid thought patterns as well as promote the formation of new brain connections through a process known as neurogenesis. When combined with a supportive mindset and environment (also known as set and setting), psychedelic-assisted therapies are helping people with treatment-resistant conditions and accelerate healing and growth where traditional therapy modalities were ineffective. Scientist Robin Carhart-Harris, a psychedelic researcher at Imperial College London, told WIRED magazine that he thinks psychedelics could be used to deliver a turbo-charged form of therapy, one that does everything that psychoanalysis does but in a more cost-effective manner.
For locals interested in exploring psychedelic therapies legally now, Kensho Well-being, a board-certified emergency medicine physician’s office, medicine IV infusion clinic, and wellness collective, began offering ketamine-assisted therapy in Truckee just before the start of the pandemic. Ketamine is an FDA-approved anesthetic that is available for off-label prescription by a licensed clinician. It has been used in recent years with psychedelic therapies with increasing popularity as a rapid treatment for depression. Although initially part of the list of substances to be decriminalized by SB519, ketamine was removed from the list due to concerns about its potential for abuse, and because it can already be prescribed by a doctor.
“Intentions grow and expand,” said Cody Sims, an emergency medicine physician’s assistant and co-founder at Kensho. “It may start with ‘I just want to feel better’ or ‘I just don’t want to kill myself.’ Then after a few sessions, people notice that they are feeling better and able to explore other areas of their life more deeply.”
Over the course of an hour-long ketamine infusion session, Kensho clients lie back with eye shades and headphones as they enter into a psychedelic space and are monitored and supported. After the session, clients debrief the experience with a therapist to begin integrating insights from the experience.
Barbara Chandler, a licensed marriage and family therapist and life coach, works with clients at Kensho for some time before they sit for their first infusion. “It starts before you even get in the door,” Chandler explained. “We will meet with you on the phone to review intentions and what you can expect.” When exploring objectives, clients are asked about their goals and blocks in their life as well as their existing coping skills. Clients are then given education about the fundamentals of non-ordinary states and the roles of setting and mindsets. They are also given support for preparing spiritually and physically, including mindfulness practices.
If other psychedelics become legal for treatment, Kensho staff said they would consider adding them to their offered services.
Roles of Therapy
Much research in recent years has focused on psychedelic-assisted psychotherapy. In contrast to mental health medicines such as antidepressants that are prescribed to be taken daily and often into perpetuity, psychedelic-assisted psychotherapy aims to treat the root causes of mental illnesses like depression in a few sessions of deep therapeutic work. A 2020 randomized clinical trial with psilocybin found that two-sessions of psilocybin-assisted therapy was effective at producing large, rapid, and sustained antidepressant effects in patients with major depressive disorder.
In psychedelic-assisted therapy, patients work with a mental health practitioner to prepare for their guided psychedelic experience. They work with the guide during their journey, and then integrate (or put into practice) insights learned from the experience over a period of weeks or months. Instead of being a direct cure for any mental health challenges, psychedelics enable providers and patients to work together to overcome blocks, face traumatic memories, explore new possibilities, and resolve internal conflicts.
Sharon (name changed for anonymity) is a Tahoe-area resident and underground psychedelic-assisted therapist. After working as a nurse for a decade, Sharon became disillusioned with her profession and decided to exchange careers and begin guiding others on psychedelic journeys.
“I have a background in science and it was hard for me to get into some of this stuff,” she said. “But after spending 15 years in western medicine, I found western medicine more of a bandage than a cure.”
Sharon meets new clients through referrals and works with them to identify what they would like to accomplish through their sessions. Many of the people she works with are suffering from depression or substance abuse problems and have tried multiple other “traditional” treatments. “They’ve tried antidepressants and anti-anxiety medication, and nothing is helping them,” she said. “I’ve worked with people who are desperate and ready to exit the planet.”
She found psychedelics more useful. In guided sessions, Sharon said, they are “able to pinpoint and release the trauma that caused the disease in the body and mind. Rather than putting on a bandage, we’re getting to the root of the problem — generational trauma and trauma from this lifetime.”
Immediately or soon after the session, Sharon notes remarkable changes, she said: “I see complete shifts of consciousness.”
Sharon explained how she just had a client with a 30-year addiction to cocaine do a five-gram psilocybin journey. “He hasn’t used for seven months and has no desire to use again,” she said.
That’s a meaningful result.