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and neuroscience. Dr. KT wanted readers to know that his colleague Ben Malcolm has a website called
Spirit Pharmacist where he does consultations for folks who would like help navigating an underground
experience.

Great Expectations: How do we know if psychedelics

work?

Studies in animal models support efficacy but clinical trials are confounded by the hype.

In this interview, Dr. Boris Heifets discusses his efforts to understand the neurobiological under-
pinnings of psychedelics, the healing power of suggestion, and how he uses his knowledge to
turn ideas into real-world applications.

How Boris started: Dr. Boris Heifets is an Assistant Professor of anesthesiology, perioperative, and
pain medicine at the Stanford University School of Medicine. He became interested in the potential of
psychedelic medicine in the 1990s while doing field research at Burning Man. He saw firsthand the pow-
er of these compounds, such as LSD and MDMA, to positively change people's lives and thought it was
absurd to lump them together with drugs like cocaine and heroin as they were inthe "just say no" era.
However, as he matured and gained clinical experience, he realized that abuse potential must be reck-
oned with when scaling these treatments to so many folks in need.

Boris studied the neurobiology of drug abuse early in his career in Eric Nestler’s lab, then joined UCSF
in 1999.

“It was the only place in the country at the time that was giving humans MDMA. And that to me was just
fascinating. So back then volunteers would come into a room in the back of the drug dependence re-
search center on the third floor of Langley Porter. And we’d hook 'em up to an IV, give 'em some MDMA,
and watch movies with them. That was the protocol, and we would collect everything their body made
over the next 48 hours.”

After USCF Boris took a position at Stanford and started working with Dr. Rob Malenka on a project to
see if the prosocial effects of MDMA could be separated from its effects on abuse liability in mouse mod-
els.

Boris’ team found that the pro-social effects of MDMA could in fact be reproduced in mice by releasing
serotonin locally into the nucleus accumbens (NAc), a key reward hub in the brain, resulting in activation
of the serotonin 1b (5HT1b) receptor and without triggering abuse liability.

Instead, dopamine release in the NAc led to abuse liability, according to their study published in Science.

Moreover, the same group showed that activation of the 5HT1b receptor also reversed social behavior
deficits in mouse models of autism. Excitingly, Stanford investigators are now running a clinical trial of a
5HT1b receptor agonist for autism under the auspices of MapLight.

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NORTHERN CALIFORNIA PSYCHIATRIC SOCIETY Page 14 January / February 2023