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Dr. Alison Draisin discusses her work at the forefront of cannabis assisted psychotherapy and psychedelic assisted psychotherapy.
We have witnessed a surge of cannabis normalization and information sharing over the past decade. Together we have advanced cannabis science and removed much of the undue stigma placed on cannabis. But over the past few years we have also seen a great rise in interest in several other psychedelics. In this installment of “Cannabis Crossroads,” I have the great pleasure of interviewing Dr. Alison Draisin, an inspiring individual and exceptional psychotherapist working on the forefront of cannabis assisted psychotherapy and psychedelic assisted psychotherapy. She sheds light on these topics, shares her unique approach to therapies, discusses her experiences as founder and CEO of Ettalew’s Edibles, and comments on the evolution of laboratory testing.
Can you please explain to our readers how cannabis is being used as a treatment for psychological issues at the AIMS institute in Seattle?
At the AIMS Institute in Seattle, we offer cannabis assisted psychotherapy, cannabis education, and support patients with choosing the correct cultivar and dosing for their particular needs. In addition, our doctors write medical marijuana authorizations for patients who qualify under Washington state law.
Some folks may assume the concept of cannabis-assisted psychotherapy is an extension of the understanding that sitting on one’s couch and smoking weed makes them feel good, but my approach and interest lie elsewhere.
In a therapy situation, I want the client to become anxious. I want clients to have a shift, so then I can explore what’s really going on behind that anxiety. Some people will say they can’t use cannabis because it makes them paranoid or anxious, but I actually like to put clients in that state of anxiety, so that we can explore what’s causing it and what’s coming up for them.
As part of the process, I stress that focusing on specific cannabis cultivars (or strains) is, in my belief, of vital importance. If you’re going to do cannabis-assisted psychotherapy, you should also be talking to your client about cannabis. I firmly believe that looking at different cultivars with a client—why some work, why some didn’t—should be part of that process.
I still cannot directly recommend a cultivar. I can make suggestions. I must do this in order to protect my state licensure. On the topic of cannabis and mental health, there is a lot of talk of promise and a healthy dose of frustration over the fact that everything must still be cloaked in caveats until more research is allowed and completed.
You also use ketamine doses for psychedelic assisted psychotherapy. Can you please explain some of the benefits of using psychedelics for these therapies? What are some of the downsides?
Psychedelics are an amazing tool for mental and physical health and wellness. Having been a psychotherapist and psychologist for nearly 30 years, it is the best tool in my toolbox. At AIMS we offer ketamine assisted psychotherapy as well as integration for not just ketamine, but also other psychedelics that clients may procure on their own. The benefits of using psychedelics include, but are by no means limited to, helping an individual to connect with their unconscious mind to get in touch with the wounds or traumas that may be impacting their ability to have healthy relationships, be effective in their jobs, be more present with their children, find joy or meaning in their lives as well as come to terms with their own mortality at the end of one’s life. In my experience, clients with addiction, depression, anxiety disorders, and end-of-life psychological distress have had great shifts in their wellbeing.
The biggest downside is the paucity of research on the extent of the benefits, as well as contra-indicators. In our office we do not use psychedelics with those who are actively psychotic or who have a current thought disorder diagnosis. There is not enough research or information and we cannot run the risk of putting an individual in a potentially harmful situation.
Can you tell us more about psychedelic therapies? What is the route of administration for ketamine therapy? Is it “microdosed” and what is the typical dosage? What other psychedelics are emerging (aside from ketamine and psilocybin)?
In our clinic we use two methods of delivery for the ketamine: troches or lozenges and intramuscular injections. We use low dose as well as high doses depending on what the client wishes to accomplish. We have individual as well as group sessions. A typical dose for an intramuscular injection is 1.5 milligrams/kilogram. We increase the dosage based on metabolism of medicine (anesthesia), past psychedelic experience, and tolerance.
We have clients who are using LSD, psilocybin, DMT, MDMA, and ayahuasca. The AIMS Institute is currently a plaintiff suing the US Drug Enforcement Agency (DEA) for access to psilocybin under state and federal right-to-try laws, which allow patients with terminal conditions to try investigational medications that have not been approved for general use.
AIMS also has a pre-trial application into the US federal government to study the use of Ayahuasca with late-stage oncology patients. Dr. Leanna Standish, co-director at AIMS, is currently in the “seeking funding” phase of this project.
Just recently (January 6th) in Washington state a couple of lawmakers introduced legislation that would legalize what the bill calls “supported psilocybin experiences” by adults 21 and older. If enacted, the Psilocybin Wellness and Opportunity Act would allow individuals to consume products containing psilocybin and psilocin, the two main active ingredients in psychedelic mushrooms, under the support of a trained and state-licensed psilocybin service administrator.
In Oregon, they passed an initiative in 2020 that would legalize supported psilocybin treatment for mental health. It is currently in its development phase. Our team at AIMS is currently partnering with colleagues in Oregon to expand our current provider training program.
How did you first get involved with providing assisted psychotherapy to patients?
Dr. Sunil Aggerwall, one of the directors at AIMS, approached me at Seattle Hempfest in 2018. He heard I was a psychologist, in addition to founding a cannabis edible company. He asked if I would consider working at AIMS when they opened in October 2018 doing cannabis assisted psychotherapy and psychedelic assisted psychotherapy. I was in limbo at the time because I did not move my brand into the recreational market. Joining AIMS gave me the opportunity to remain in the medical cannabis arena and use my education to support patients in a different manner. I have been at AIMS since we opened the doors and the experiences I have had have been amazing. Helping patients find health and wellness, as well as teaching providers this amazing new modality has become my passion.
Clinicians are learning more about cannabis, especially over the past decade. Are they learning about the uses of psychedelics as well? I imagine that combination therapies with both cannabis and psychedelics must be especially challenging. Can you share with us where we are today and what needs to happen in the future to advance these treatments?
You would be surprised how many clinicians seem to reject psychedelic psychotherapy as a new modality. I do not know if it is lack of education, training, or personal bias with the use of what was or still is considered “drugs.” I have spoken with several higher education universities to offer psychotherapy graduate students the opportunity to learn more about psychedelic and cannabis assisted psychotherapies, but have been met with mixed responses. While the students are reaching out to me and wanting to observe or complete their practicums and internships in our clinic, the universities often state that they have no professors on staff who want to supervise the students. I am finding this is often due to the rejection of psychedelic psychotherapy as a modality and just general lack of information. We saw this in the early days of cannabis, people are afraid of what they do not know.
I recently supported a group of graduate level students, from one of these universities in question, to use their voices with their school administrators to change their access to psychedelic psychotherapy knowledge. I learned from my activism days that the best tool we have is our voice. One of their professors has since signed up for our ketamine assisted psychotherapy provider program to gain more knowledge so she can offer support to the students who are interested in this field. In the same way it took quite a while for clinicians to gain knowledge and feel more comfortable with cannabis as a medicine, it will take time for psychedelics to do so.
You are the Founder and CEO of Ettalew’s Edibles, and you were involved in this industry long before many of our readers. How has cannabis science and testing evolved since you started? What advice can you share with others that are interested in building their own edibles brands?
I am so out of the loop at this point with regard to direct-to-consumer cannabis products. I have been dismayed by the regulated path of legalization and how there does not seem to be a love for the plant. It seems it is more about maximizing profits. When I started Ettalew’s, I was focused on creating products that would heal people. We used US Food and Drug Administration (FDA) labeling and packaging requirements before it became standard for products on the regulated market, as well as the high performance liquid chromatography (HPLC) testing standards that were available. It was adequate for the needs a decade ago. However, testing is still not regulated and therefore remains inconsistent. I find that even though we have made improvements in cannabis science, products might taste better, less weedy. However, there are brands that continue to market their edible products as “sativa” or “indica,” which are just not possible once the cannabis has been decarboxylated, unless it is a tincture or original terpenes are added back into the product after heating. I have clients who complain about consistency in dosing of edibles. The trend to use distillate in edibles, while cheaper and allows for more consistency, is disappointing for medical patients.
What is positive is seeing more tinctures with ratios that include cannabidiol (CBD) and cannabigerol (CBG). It is great to see the beginning trend of less focus on tetrahydrocannabinol (THC) and more attention to other cannabinoids and terpenes.
Advice to those seeking to build their own edibles brand, do not let the VC Chads take over your brand! Hold tight and stick to your vision. Find capital from those who do not seek to change you but to work with you to support your mission. Make certain you have a great attorney to protect your brand and intellectual property. Consider full spectrum over distillate and do not mislabel your edibles with sativa or indica for marketing purposes. Lastly, include skus/products for medical cannabis patients/consumers that might include gluten free, sugar free, soy free, dairy free, and free from artificial colors and dyes.
I look forward to your presentation at the 2022 Cannabis Science Conference West in May. What take away points will attendees get from your presentation?
Attendees will learn more about cannabis assisted and psychedelic assisted psychotherapies, including the competencies we use in our training and development program for providers. We will explore some of the basic principles of what makes a good psychedelic “guide.”
I’d like to thank Dr. Draisin for sharing her insights and experiences with us. You can see her presentation at the 2022 CSC West in Long Beach, CA on May 18th to 20th. Dr. Draisin inspires so many others within our industry and continues to blaze new trails in rapidly emerging fields, including psychedelic assisted therapy.
About the Interviewee
Alison Draisin is the founder and CEO of Ettalew’s Edibles (established in 2009), past President of the Board of Directors for the Center for Cannabis and Social Policy (CASP) and an original member of Women of Weed. As an active member of the Washington state cannabis community, she speaks publicly on cannabis education locally and nationally. Alison seeks to support women by connecting them to cannabis community and to empower women to rise within the cannabis industry.Alison’s entrepreneurship built Ettalew’s Edibles from the ground upon a foundation of helping fellow patients in Washington state. Her dedication to quality, consistency, and labeling of products was recognized at the High Times Cannabis Cup Seattle in 2012 and 2013, as well as being named one of the Best Edible Companies of 2013 by High Times Magazine. Prior to running a successful cannabis-infused company, Alison attained a Master’s Degree in Art Psychotherapy and a Doctorate of Clinical Psychology. She has worked in the mental health field for 28 years. Alison joined the AIMS Institute in 2018 where she has been able to employ her knowledge of cannabis and psychedelics as a tool in her psychotherapy practice to support patients finding peace and resolution. As the Lead Clinician in the program, she has begun training other providers about the power of psychedelic and cannabis assisted psychotherapy.
Josh Crossney is the columnist and editor of “Cannabis Crossroads” and a contributing editor to Cannabis Science and Technology magazine. Crossney is also the president and CEO of CSC Events.
Direct correspondence to: Josh@JoshCrossney.com.
J. Crossney, Cannabis Science and Technology 5(1), 30-31 (2022).