Ep. 125 Peter Schorr Podcast Transcript

Steve Martorano
The Behavioral Corner is produced in partnership with Retreat Behavioral Health -- where healing happens

The Behavioral Corner
Hi, and welcome. I'm Steve Martorano, and this is the Behavioral Corner; you're invited to hang with us as we've discussed the ways we live today, the choices we make, the things we do, and how they affect our health and well-being. So you're on the corner, the Behavioral Corner. Please hang around for a while.

Steve Martorano
Hello, everybody. Welcome to the Behavioral Corner. I'm Steve Martorano. I'm your host and guide. If you're watching this as well, I'm the fellow on your right, the pasty-looking one from the northeast. And the fellow on the left -- looking hale and hardy and tan as most Floridians are is our guest today. Peter Schorr. Peter is, of course, the CEO and founder of Retreat Behavioral Health. They, of course, are underwriting partners, and we welcome Peter to the show. Hello, Peter.

Peter Schorr
Hi, Steve.

Steve Martorano
A pleasure to have you. For those that you just maybe just stumbling upon the Behavioral Corner, what we do is dedicate this program to everything because that's what affects behavioral health. So we're gonna take a look today at something fascinating. When I started to hear about psychedelic therapy -- well, first of all, I heard about psychedelics, when I was a former hippie in another life, where they were everywhere, then. And I didn't think I'd live long enough to see it become a therapeutic model. But it apparently, would may be real soon. So we brought in an expert, not in psychedelics, but in treatment. And that's Peter to talk about this growing sense of psychedelics as therapy. It's fascinating stuff little later on Peter is going to touch upon with us this another growing movement in this country. Mercifully, something has to do with harm reduction, we'll tell you about that ahead. So let me see if I got it right. Technically speaking, and we're talking about something that isn't really fully established yet. Psychedelic therapy refers, to the use of any psychedelic plant, or drug as a treatment modality is that pretty much how you understand?

Peter Schorr
That's what it is? Yeah.

Steve Martorano
Okay. So let's tell people who might not know what kind of drugs are we talking about that might ultimately become, you know, therapeutic medicine.

Peter Schorr
We're talking about, that's Esketamine MDMA, which is ecstasy. (We're) talking about...

Steve Martorano
Psilocybin.

Peter Schorr
...which is the "magic mushrooms" when I was a kid.

Steve Martorano
Right.

Peter Schorr
And all these to be used and micro-dosing is how they say right now. But again, you know, you know, we have to look at our limbic system. And people who don't know what the limbic system is, it's a portion of our brain that controls emotions, it controls memory. And then there's all these pathways. And you know, when you're younger, when you're growing up, the brain is not really officially, you know, mature until 21, to 25. So if you take these hallucinogens, as a young kid, you know, these pathways what happened, and this has happened now, too, it kind of mixes them up, and kind of like...like, like a restart kind of fresh, psychedelic drugs, take all those pathways and kind of confuse them. So your memories and emotions and your addiction and things like that, you know, kind of get confused, and maybe you can jumpstart things. In theory, sounds pretty good, right? Sounds pretty good. Now, in our country, we have rules and regulations on how drugs are administered. They have to go through a process through the FDA and it takes years and years and years. Now, ketamine has been used as anesthesia for years, forever. Now, someone came up with this, you know, this idea that we can use these drugs for mental health patients. The MDMA is being used for PTSD patients and things like that. So, ketamine, look at your hands like this, ketamine is on one side, on your right side, right ketamine, your left side, is esketamine. Why is it esketamine, since they're in Latin means left side. That's what it is. So, the right side of ketamine has been shown to cause lesions in rats. Okay? The left side, which we call a ketamine light, has been approved to be used in a nasal spray.

Steve Martorano
As an anesthetic for children, right?

Peter Schorr
No, it's been approved to be used as a nasal spray for what we're talking about in therapy.

Steve Martorano
Yeah, off-label.

Peter Schorr
Off-label, but it's approved. Everything else is not approved for that use. All experimental. And we don't have enough information yet. I mean, because we're saying the right side causes lesions in rats. together, you know, it was used as anesthesia, which is used once, not a daily basis. So we don't know what the ramifications are going to be on long-term use. So whether or not it's good or not, let's figure out what's the long-term effects of these drugs that we're going to use to make people feel better today, and we have a history of doing that.

Steve Martorano
We have, unfortunately, our history of knowledge about these drugs, unfortunately, comes down to their recreational use. I mean, ketamine was a club drug...

Peter Schorr
No ketamine was anesthesia is not it's not...t was used afterward.

Steve Martorano
Yeah, afterwards, right? And MDMA is ecstasy. That's, that was...that was a club drug for a very long time. And LSD, by the way, we didn't mention LSD as well. The mushrooms are also part of this mix. Oh, plant-based hallucinogenic drugs are ultimately going to be used, I think, or tried anyway. They are now but as Peter points out, in a very well, not so much underground, because it's very public, but it's illegal. It's just illegal in this country to fool with these things. So Peter...

Peter Schorr
It's not illegal because it's...it's...it's legal drugs for different uses. That's how they get around it. If it was illegal, doctors not going to prescribe something that's illegal.

Steve Martorano
Doctors don't prescribe psilocybin, do they?

Peter Schorr
Well, yes, they're using psilocybin now in micro-dosing for depression. I don't know where they get it. But they, you know, yeah. When I was a kid, I had to go find someone who sold it.

Steve Martorano
You didn't have the internet when you were a kid. You can get it on the internet, now. I agree with you completely. There's a lot to know about brain chemistry in general. We learn more every day about how the brain really works. I believe is I think you do as well, obviously, our problems are there and drugs alter that, and alcohol alters that, and mental health, you know, messes with our brain. So the more we know about that, why shouldn't these drugs, who we know have a profound effect on our perception and brain not also wind up being helpful, but I look at what's happening now. And it's something like a land rush. It's something like, "They struck gold in them. There are hills." because if you look at the right places on the internet or your Facebook newsfeed, and you put in psychedelic therapy, you are going to be bombarded with marketing messages. And I'd like your impression on my impression of them is that many of them are wildly inappropriate. They are reckless marketing of this stuff. And the public's not aware of it. How do you feel?

Peter Schorr
Like anything, people jump on the bandwagon, but not even knowing what they're selling. You know, it's something that's hot. Let's go do that. We'll sort it out later. And the same thing happened with oxycontin only twenty-five -six years ago, when...when they said that this is a great drug for pain. It's not addictive this and that. We walk along that fine line, and we said, "Okay, you're right. Let's do it." Now, it's caused a pandemic in our country, of amazing numbers. And but it's not as extreme, but we don't know the full-term effects. What are you doing when you're changing the pathways in your brain? By using medication? What's the long-term effects? We don't know. Because it's hasn't been around a long time. So we just don't know,

Steve Martorano
Compare the process that is employed to you know, okay, these drugs, in this case, what will psilocybin have to go through till it gets to the status of vitriol? Or a drug like that?

Peter Schorr
Right. So the FDA does all these kinds of testings. It's years and years. And you know, people complain about, oh, we don't get drugs out fast enough. That's in our protection to go through that process. And did they always get it right? No. Obviously, we seen that they don't always get it, right. It's not just oxycontin that hasn't gotten right. There are many drugs. But the majority and great majority 99% or 98% are with used through that testing, the long term effects are mitigated and we don't have them. Right now we don't have that we need to go through this process. And again, you're using a drug that one sacrament has caused lesions in the brains of a rat. To me, that's a red flag comes up. What am I doing? I'm doing taking something that caused lesions in a rat, what is it going to do in a human? I don't know.

Steve Martorano
Well, in that context, how do you react when you see, as I have websites that say, you can administer this stuff in the comfort of your own home? And they'll have some guy in a Barker lounger with a sleep mask on and headphones. And I guess he's just sprayed himself with ketamine. I mean, is that responsible?

Peter Schorr
Right? Not only is it irresponsible, I don't...I don't think it's legal. I mean, I think that there has to be some kind of control over that. How can you get a drug that's not legal other than for a different kind of use, and I don't even know if you can buy that?

Steve Martorano
The way I, I spoke to a couple of psychiatrists nearby me who do both TMS and ketamine, and their medical doctors or psychiatrists and they can prescribe it, but they've never said that they would prescribe it to someone and tell them to take it home and use it. I also see not, strictly speaking, a psychedelic therapy, but TMS. I've seen home kits for that online, do this in the comfort of your home. This is crazy.

Peter Schorr
We do use DTMS, which is deep tissue. Once I tried it, it gives you such a headache.

Steve Martorano
Does it really?

Peter Schorr
If you don't it right it's not going to be effective. But there's a lot of people who really have gained a lot of help with these things. And that's something that it's been tested and retested for years it came out, but it's not a drug you're ingesting.

Steve Martorano
Peter Shor is our guest, Peter is the CEO and founder of Retreat Behavioral Health. I mean, you're a great guy. First of all, your expertise in this field is valuable. But you're also this is the company you started. And I know you know what your reputation is, you guys are nothing but you know, best practices, guys, and you're trying to do it right. And I see some of this as altering the way treatment facilities like Retreat might have to change the way they do business. So psychedelic drugs in therapy, it's not something you're I would guess, particularly frightened about you've seen medicine used before in drug and alcohol treatment, right?

Peter Schorr
Many different drugs.

Steve Martorano
And so what has to happen here? Doesn't the government have to take some of these drugs, these hallucinogens off the schedule one narcotics list first?

Peter Schorr
They will have to, yes. The other thing is this, though, you know, we do what's called medical assisted treatment. So we, you know, we give medicine to replace something that they take. We're a society that for everything we did, the minute we want, we have we don't feel oh, what do we ask for? "Give me a pill to make me feel better." "Give me something to make me feel better." So we, we've always been that society, we've always done things like that. But if you don't do the therapy that go along with that, what's going to change? Its the same thing when suboxone came out. Buprenorphine came out 20-something years ago, it was never intended for a doctor just to give someone a prescription to go home to do it all by themselves and never have to be part of a treatment program or any therapy or anything like that. Never was it supposed to be like that. And it's still not supposed to be like that. It's supposed to be a therapeutical piece of it when you do that. And if we don't continue that, and this is psychiatrists are going to ruin it for themselves. ...but that's not gonna happen.

Steve Martorano
I had the occasion to tell someone who was talking to me about this, I said, "You know, not only could potentially be a problem for your medical practice, but you don't want to go around being thought of as the guy in the tie-dyed medical jacket.. I mean, you don't want to be doctors, you know, Dr. Psychedelic."

Peter Schorr
Or they'll be in a tie-dye prison outfit if they don't watch what they're doing. That's the problem.

Steve Martorano
Alright, so in terms of what retreat does, and other well-run and honest brokers in treatment facilities, you have faced this before. You have to knock down these notions that there's a magic bullet and you can't do it...just one and done. This is that again, isn't it? I mean, you're not dismissing the potential for some of these things -- psychedelics to be very, very beneficial. But you're just telling people to slow down on this?

Peter Schorr
Yeah, I don't, I don't dismiss any kind of therapies that's going to be better for people. And again, all I want to make sure is that it's safe. I believe that people suffer from depression. People suffer from PTSD. There's many different things that people suffer from, and they deserve to find something that's going to eliminate that. But I believe that we need to do further testing before we just jump on something and say, This is the answer. Because I don't know the long-term effects, especially with young kids...young kids get thrown...I know young kids are throwing on this ketamine, like it's like it's candy, you know, because they're a little depressed, but you know, their brains are not formed yet, not complete. So what kind of damage are we doing by bombarting it with psychedelics?

Steve Martorano
Well, I again, I reached out to you because over the past two weeks, I have just been inundated with PR firms that want to come on the podcast that they're pushing this or that and it's talking about micro-dosing, and this and that, and then the and then this stuff online...the guy in the Barker lounger, doing ketamine at home. I just thought somebody should knock on their door and say, "You can't do this. It's wrong." But anyway, there's a momentum and we could see it. We'll seen it before -- you've seen it before. There is a momentum. And...

Peter Schorr
What you're saying about someone sitting in a chair administering their own psychedelic? Think about that. Who's using that? Someone who's using any kind of psychedelics or any kind of drugs is someone who's...who's in crisis, right. And when you're in crisis, you don't make the best decisions in the world. So if you're taking something and as an unlimited amount, and you can take something that could really do, you know, be detrimental to your health. You know, when you're in that state, you don't know you're not in the right mind, you don't know you're making the right decisions, you can take something that's going to either kill you or affect you medically for long term. It needs to be watched. It needs to be done on a professional manner. And, again, further testing.

Steve Martorano
You know, if I've learned nothing in the years that I've worked with you guys, and before you, it's that this whole notion of getting well, whether it's from mental illness, and certainly in substance abuse issues. What I've learned is that it's not one thing, or two things. In fact, it's a process that goes on, and we talk about this all the time. So whatever these drugs, potential winds up being, they still will only be part of a process.

Peter Schorr
Hopefully, I mean, I hope that's what people understand that it is part of a process, you're looking at it like a, it's a puzzle, and each piece is important for the whole, if we look at something that just gonna be, here's your magic pill, everything's gonna go away, we're gonna set ourselves up for a real disappointment.

Steve Martorano
Unfortunately, this moment in time feeds right into a very shortened attention span, and a lot of anxiety, and a lot of sense of, I need something now I need something now. So it's got to be very careful. Just this last note about psychedelic treatment. I saw in Forbes the other day the formation of something called the American Psychedelic Practitioners Association, apparently a group of professionals who are...who advocate effective treatment using this stuff. It's interesting. They're forming a professional organization around substances that aren't even available or ready to use it. At the end of the article, it says that the APPA is right now in the process of recruiting members,

Peter Schorr
Which they'll find, I mean, you know, that you're gonna...

Steve Martorano
Yeah, it's good.

Peter Schorr
...find people who believe...Look, the mission is correct. They're trying to help people who are suffering. But you know, the method has to be proven, that's all. That's all we're saying. We're not saying don't do it, don't use it. Just show us it safe, show us long-term effects, and show us what we do in conjunction with that.

Steve Martorano
Incidentally, it all has to happen before the insurance companies will pay for anything anyway. So we might as well just be very patient. Finally, Peter, I wanted to ask you about harm reduction. I know harm reduction is something that seems self-evident and positive. It seeks to just slow down, if not stop, the toll that drugs take in terms of the deaths, you think, well, harm reduction. What's wrong with that? It runs up against as you know, a lot of resistance because people think it's enabling people to use drugs rather than trying to save their lives. I bring it up to you now because Rhode Island just yesterday, according to The New York Times, became the first state to legalize drug consumption sites in the state. Is that a good idea?

Peter Schorr
In my opinion, no. Harm Reduction, now? Look, years ago, and I've been in this field for 40-something years, you were only a little baby when it came in.

Steve Martorano
Yes, I know, just a child.

Peter Schorr
When it came to, you know, going into this field, your one goal is, I'm going to fix everyone. I'm going to cure everyone. I'm going to do this. I'm going to do that. Over the years, as you grow and mature yourself and have an understanding, especially in this field. We've seen such a change in the drugs that people use it, there's so much more powerful today than they were, you know, 5...10 years ago, let alone 30 or 40 years ago. What we're seeing now is an overdose death of over 100,000 people from using illicit drugs. So what do we do as a society, we have to come up with some kind of formula of how we're going to do harm reduction because people are harming themselves and they're dying. It's no longer they're just getting using drugs, sitting on a doorstep, and falling asleep. Now they're dying. So now what do we do? How do we fix that? So there's many different ways I mean, we try many different kinds of techniques. One is medically assisted treatment is using it for opiate addicts is using, you know, methadone or Suboxone, buprenorphine, whatever we can use for harm reduction so we can get them to that point. So now within conjunction of using these kinds of different assisted treatments is what about the therapy piece of it? What are we going to do on that side? Because we can't just say, here's a pill and the same thing with doing psychedelics, and you're gonna get better, you might feel better right now. But in the long run, and I think we've had this discussion before, Steve, how substance use disorder, you know, eight out of 10 times is a symptom of a mental health disorder. So if you give someone a pill for the addiction piece, what's changed in the mental health piece? Zero, You need to have the therapy part of it also great, they're not going to be using drugs, or they're somebody to take the drug. But that's not going to last because, after a while, the depression or whatever is gonna pop up is like, "Wait, I need something that makes me feel better. And this medically assisted treatment is not the answer for me right now. I need something that's good to anesthetize me, I can't feel this way anymore.

Steve Martorano
So it was a form of triage, stop the bleeding, and then...

Peter Schorr
I use that word a lot, we kind of triage our patients, especially when patients who are constant relapses and things like that, you know, especially in Florida, what I what I've seen is a lot of patients, when they come into treatment, the reason they're coming into treatment, don't have any more money to buy drugs on the outside. And they still have insurance under their parents. They don't have a place to eat, they don't have a place to sit there on anything, you know, let me go in, they'll give me Suboxone, or whatever, I won't feel bad. And I'll stay there for a week, you know, get myself feeling better, I'll go back out and nine out of 10 times, using again. Those aren't the people who are coming into treatment to get better.

Steve Martorano
It's a small window you guys have to examine...

Peter Schorr
And we have to pounce on that and make sure that we can try to convince them in that short period of time that there's a better way.

Steve Martorano
Yeah, yeah, it's not we're not...we're not a...we're not a Motel Six for you know, rest up and get stronger...

Peter Schorr
Parents come and they go, you know, the fix my child, you know, I'd love to say, I'm going to fix your child, but I'm going to help fix your child, I'm going to do that. But there's a there's a process that goes along with it.

Steve Martorano
Peter, to put a finer point on this harm reduction thing. So I understand your position. You obviously support harm reduction in the context of what you guys do. Do you provide fentanyl strips to people? Is that...is that so that they can test the drug...at least the drugs are using isn't full of fentanyl? Do you advocate...not for you guys, but you advocate a clean needle exchange programs and stuff like that? Does that all make sense to you?

Peter Schorr
It makes sense to me on the basis of not spreading disease and things like that. But how about a safe shooting site? How about having suboxone there or something else or a doctor there, "Hey, you don't have to shoot up. Let's get you on this. Let's do this. Let's try to do that." I mean, but it's not giving someone a room and go here, go shoot up in there.

Steve Martorano
Can you ever envision a time in the future when Retreat would, in addition to every other modality they offer in terms of long-term treatment, provide a place where people could still use drugs while they get treatment?

Peter Schorr
No, never, ever, ever, ever, ever, ever.

Steve Martorano
Well, that couldn't be any clearer. There's sort of a knot in what you guys do, right?

Peter Schorr
No. The opposite. Our job is, and again, you know, we talked about harm reduction. It's hard to tell an 18-year-old kid you know who's going to start college in the fall that you can drink with your buddies and this and that you know it you can't. It's hard. So you cannot what's harm reduction on that side? You got to show them how to do it responsibly. You can you drink responsibly? As much as they can, but you have to show them the downside. So what we do is when we have young patients, you'll have an older patient say, you know, you don't want to be doing this when you're my age, or you know, just seeing what is but their brain remembers an 18-year-old kid is using drugs. And if they started when they were 12, they're 12. So you know you're trying to get someone who's an adult body that to do something when you're really talking to a 12-year-old.

Steve Martorano
There's no stop sign in a teenager...in a teenager's mind. Peter Shorr Founder and CEO of Retreat Behavior Health, is our great partner. We appreciate your support very much. Thanks for adding a lot of clarity to psychedelic therapy and your position on harm reduction. And that leaves me with just one favor to ask. I know your answer is going to be moved to Florida, but I got I look like a ghost. I mean, it's ridiculous. Look at you.

Peter Schorr
You know your problem was Steve, you chose to have a career in radio.

Steve Martorano
Right, it kept me inside.

Peter Schorr
If you worked in TV, you'd know how to put makeup on. Didn't someone once tell you have the perfect face for radio?

Steve Martorano
Oh, come on. There's no makeup that's going to help me. Peter Schorr...

Peter Schorr
You can come to visit us, too. You know that.

Steve Martorano
Yes, I can. And I should. Well, soon as the weather...as soon as you guys get a handle on the weather down there. And good for you guys for dodging that bullet. Anyway, thanks, Peter. We appreciate your time. And thank you all as well. Don't forget to Follow us on Facebook and like us on an Apple...and by the way, push the subscribe button. That's a big deal for...I'm learning this as I go along. It's wonderful that you like us and you follow us, and you share with us, but we need you to push the subscription button. Then you'll get it every week. That's it for us here on the Behavioral Corner. Catch you next time.

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