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A brief chat with Dr. Karl Jansen

as seen in Trip #6

TRIP: So what are you up to right now?

KJ: Iím actually writing up research that I did in London, on people who are
ketamine-dependent, who take it most days of the week for several years. I have a control group of people that smoke cannabis every day, because a lot of the people that take a lot of ketamine also smoke cannabis every day. Some of the research on memory and drugs, like memory and Ecstasy, is very badly controlled, because the people doing that research donít allow for the fact that these people tend to smoke cannabis every day. I think that research on memory and cognition and drugs is really not particularly worthwhile if they donít present urine test results. A good piece of research will present urine results to show that their subjects do not have metabolites of other drugs on board.

TRIP: You talked about the neuroprotective functions of ketamine. Itís our understanding that an epileptic seizure causes a rush of glutamate in the brain.

KJ: Yeah, it does. Itís very damaging.

TRIP: So has there been any thought to using ketamine to help address that?

KJ: Ketamine is both pro-seizure and anti-seizure. It depends very much on the kind of brain itís going into. Ketamine has actually, and there are papers on this in the literature, been given to people in statis epilepticus, to end a seizure. I think if you put ketamine into an over-excited brain, it will calm it down. If you put ketamine into a calm brain, it will over-excite it. Itís probably pro-convulsant in a normal brain, and anti-convulsant in an epileptic brain. Itís a very complicated drug. I think it can be quite a challenge to end statis epilepticus Ė thatís when youíve been constantly fitting for half an hour, and youíre really into the brain damage then. I think ketamine is a very good choice. Valium, phenytoin, and then ketamine, I just throw it all in. Often you canít end up with Valium, and people die of statis epilepticus. They get pumped full of Valium and phenytoin and they still canít crack it. If you really canít crack it, then ketamine is a very good drug for ending a serious fit. If you are not epileptic, then you can have fits from ketamine Ė I know people who have definitely had little fits from ketamine. As with alcohol, youíre more likely to fit on ketamine if youíve been doing it for years. Thatís why people stop doing things like cocaine and ketamine: they start having fits, and then they get really scared. Thatís real end stage ketamine dependence.

TRIP: Are you following up on your research into ketamine addiction with any specific treatments?

KJ: People have asked me if I put some of the ideas I gave for treating ketamine addiction to the test. I would say no, not in randomized trials. These are just ideas you can use for any kind of dependence. Iím actually writing a book to treat any kind of compulsive behavior, for a much wider audience, called Feel the Craving and Donít Do It Anyway, which is dedicated to anyone who ever woke up in the morning saying ďNever againĒ and had done it again by the time they went to bed. Itís a pretty broad spectrum. The advice I give in my book about ketamine dependence you can use for anything you want to get past. Itís about creative visualization, meditation, I mean, these things have been said before about overcoming dependence, but I wanted to bring together this particular take, especially on the creative visualization, and make it relevant to an addictive psychedelic. The idea is you meditate, you go inside yourself, in the archetypal sense of self, and that sort of thing has relevance to people who have become addicted to a psychedelic experience. But they also use these techniques in alcoholism. Itís not tremendously new. In terms of my own work, Iím not sure Iíll be doing a heck of a lot more work on ketamine as such in the future, other than collaborations with people in various countries, and helping them with discussion and interpretation of what theyíre doing. Iím thinking of getting back in research terms to some core psychiatry, some core neuroscience Ė there are a number of things Iím interested in that donít have much to do with ketamine at all, that other people arenít really looking at. One of the interesting things in ketamine is using it as a model of psychosis; theyíre several people doing very good work on that. I donít feel that Iím needed to do that.

TRIP: One of the things that struck me in the book was your discussion of Timothy Learyís work. Timothy Leary has kind of fallen out of favor in the psychedelic scene. Itís not as fashionable right now to go back to the 8-circuit model and say itís useful as a reference point. I found it really interesting to see that brought back into play.

KJ: Iím not really a fashionable person. Iíve really read an awful lot of what Timothy Leary had to say. Iíve seen a significant part of what he predicted coming true. He was into the internet at a very early stage (he had a company called Knowhere), and he said that itís the new LSD, by which he meant itís the new way of connecting with everything. A lot of his stuff has come true. I think he was an extremely intelligent man. A lot of people donít realize that he was essentially the father of transactional analysis. They associate the name Eric Berne and Games People Play, but thatís why Leary was invited to Harvard, because his Ph.D. thesis at Barclay was called ďThe Interpersonal Diagnosis of Personality,Ē which was essentially setting out the basics of transactional analysis, of how you are defined by your interpersonal interactions, almost an existentialist idea if you like. He was a very original thinker about a lot of things with a lot of very good ideas, and I think that the anti-Leary feeling, which is of quite long standing, is that Learyís behavior somehow spoiled things for other people that wanted to do psychedelic research. I think thatís a very naïve view.

I think the view that conservative established forces would not have moved against psychedelics and psychedelic research, that everything would have progressed very nicely if not for Leary, is very naïve and very unlikely. If that were really the case, then that research would have continued but under more controlled circumstances. I mean, we have people doing heroin research and cocaine research, and some of those doctors go off the rails and inject themselves with heroin or misuse their licenses or whatever. You know, in England, weíve got Harold Shipman who killed 150 people with his heroin license, injecting them with heroin Ė well, they call it diamorphine there so it doesnít inflame public opinion. Thereís not going to be an end to the use of diamorphine in people with cancer and so on because of this, and indeed, why should there be.

Psychedelics frighten people who are very much into control. People who become politicians and policemen are people that really need to control other people. They have a real need. The question is why do they have that need? I think that one of the reasons is that they are people with serious unresolved birth trauma issues, and they know at some level even though they may never have taken LSD, for example, that these drugs bring them face to face in a confrontation with their birth trauma. Theyíre absolutely terrified of that. The idea of psychedelics triggers this very core memory in them of the situation where they were not in control at all. One minute theyíre floating in the womb and the next this great pressure is on them and thereís toxic chemicals, and theyíre dying. I mean, some people think the near death experience is a memory of being born, and that weíre already in the afterlife, because itís like a second life Ė the baby thinks itís dying, it thinks this is the end, and suddenly it emerges into light and there are these godlike beings. So youíre already in the afterlife. I think that people who are very involved in control, a lot of politicians become politicians because they want to tell other people what to do. Why bother going into government, or becoming any kind of senior administrator, if you donít want to boss other people around? Thatís the whole point of it: passing laws, telling people what to do. I mean, somebody needs to organize society, Iím not saying itís a bad thing. But you will find that those people have a great deal of difficulty with situations where theyíre not in control, and I think they have a very real fear of psychedelics in particular. I mean, they know that LSD is not neurotoxic. You can read that in psychiatric textbooks. No one even claims that. Itís possible that if MDMA didnít have these unpleasant effects on serotonergic nerve terminals, there might even be some ongoing place for it somewhere, not well-regarded, but a place for it. But thereís no place for LSD at all. And this is one of the reasons for it.

So letís not put too much on Timothy Learyís shoulders in terms of what happened with LSD. He was just the fall guy.

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