I had the chance to sit down with Dr. Grace Blest-Hopley of Heroic Hearts UK to discuss using psychedelics to help veterans with PTSD.
Heroic Hearts Project offers a proprietary program to veterans interested in pursuing psychedelic treatment options. We primarily work with ayahuasca retreat centers due to the powerful effect it has shown to have on healing PTSD. Our program has been designed to ensure veterans get the most out of this valuable opportunity and are set up for success when they return home. We also provide financial scholarships to veterans who are struggling financially. They have provided more than $200,000 in support to veterans applicants to date.
(edited for publication)
Good afternoon and welcome to another edition of the CannaList Conversations. We are pleased to be joined by Dr. Grace Hopley, who works with heroic hearts. Can you tell us a bit about your work?
Heroic Hearts is a couple of charities now, but originally it was a charity started in America by an ex-Army Ranger who had come back from several tours in the Middle East. Unfortunately, he suffered from a common ailment in these veterans, which was symptoms of PTSD, hypervigilance, and struggled to move back into his old life and tried many different medications, which didn’t work for him somehow ended up in an Ayahuasca retreat in Peru. And it was during that retreat that he found some healing for himself and came back and thought, “this is amazing; I have to make this available to other veterans.” And so he founded Heroic Hearts. The initial focus of Heroic Hearts was to assist other veterans to go out to places like Peru, where have these Ayahuasca retreats. It wasn’t so much about providing the retreats, but just making it possible for people to make that journey because it’s quite a daunting journey to make if you’re doing it alone, and you don’t really know what you’re doing; particularly in the case of a bunch of people like veterans who quite traditionally have stayed away from any sort of illegal activity and drug use. So that’s how Heroic Hearts was founded. We’ve since moved on a little bit. We are still facilitating a lot of those retreats, but we’re now moving forward; looking at running some of our retreats; moving more into the research aspect. My job within the charity is as research director and expanding out of us.
You might be able to tell I’m a Brit, and we now have Heroic Hearts in the UK, which started up at the end of 2019. There are now plans to potentially open up in Canada as well and expand the Heroic Hearts family. So, in a nutshell, we are championing psychedelic drug use a in a therapeutic setting for veterans who suffered as a result of their service.
And are any of the psychedelics available legally?
Ketamine is available legally and has been used in the States and the UK to treat PTSD. But it’s mostly done via a private prescription and not that widely done. It’s used for PTSD and depression. But no other psychedelics are legal. Some clinical trials are going on now, using things like MDMA, and they’re just starting to open up using something like psilocybin, which is the psychedelic compound found in magic mushrooms. And what we’re hoping is that it’s going to change, and we will start to see legal options coming available to using these drugs within the United States and within the UK. Currently, we can only do the work we do from abroad. In countries where use is legal,
How long is a retreat typically? How long do they go away for?
Usually, something like Can would be maybe three or four days, where they go down into the Amazon. But for something like our psilocybin retreats that we’re doing in the house, that’s going to be up to seven days long. So, yes, it is quite a substantial amount of time. But when you look at something like what is considered the gold standard in PTSD treatment at the moment, which is a sort of cognitive-behavioral therapy course, that’s almost a three months long residential procedure. So we can accomplish a lot in a week, which is much more manageable for people.
And do these retreats solve the problem?
That’s an excellent question. Solve the problem? I mean, I guess, but are we ever kind of done as far as mental health is concerned? It’s certainly possible, from what we see. And the testimonials that come out of the people that join us on these retreats notice a substantial change and is often described as one of the most critical moments in those people’s lives, where they turned a corner. And perhaps the healing is not all done during that weekend, or however long it is, but what happens within that time appears to open something up in the brain; to awaken. Perhaps parts of the brain that have suddenly become dormant, dormant as a result of PTSD, for instance, and having done that is then we’re able to go away and work on that and grow from it. So it’s certainly not a situation where you go on a retreat, come back, and you’re entirely healed or anything like that. But it seems to open this doorway that allows people to make that choice to start that journey of healing.
Are you familiar with the Netflix program Nine Perfect Strangers?
I’m not. No.
You should check it out. It stars Nicole Kidman and a cast of others. Her character in the show suffers a trauma earlier in her life, which has motivated her to bring groups of people together and give them psychedelics as a form of treatment. It’s a short series. I want to say it’s eight episodes. And in the storyline, she doesn’t inform them what they’re getting. So, the lingering question is whether her approach is a good thing or a bad thing? Some of them have good reactions; some of them have bad reactions. I won’t give too much away, but the characters enter a new phase of where they are in their lives due to their life experiences. I think you should check the show out because I think you’ll find it interesting. And I’m sure you’ll find lots of things wrong with it, but I think you might find it interesting.
How long is this program?
This program has been going on for two years.
So far, I’ve helped dozens of people go through the program. But, unfortunately, we also have hundreds of people on a waiting list who want to get involved in the treatment and everything we do. And then, in the UK, I have been involved just for the last year a little bit. But as you can imagine, those are more than a year in bedside. And we’ve unfortunately had a major pause in all of our proceedings. As I’ve explained, most of the work we do is based on the idea of people engaging in psychedelic therapy, which involves carrying it out in Heroic Hearts as group therapy. We like to get groups together to participate in this, so COVID has put a nail in that. Also, for us to perform the therapy in a legal framework, we need to take veterans out to countries where we can so. So, unfortunately, the last 18 months have seen us be pretty unable to do our work. Luckily, however, from summer this year, we were able to start taking people out again from the US to various retreats in South America, which is brilliant. And, fingers crossed, 2022 will see us fully reopen and get on with our slightly more focused projects, such as our psilocybin project, which will take place in the Netherlands and Jamaica.
And how do psychedelics, as opposed to other forms of treatment or medications, impact PTSD?
If we look at what PTSD is, and mainly what it is within the veterans’ community, it has a lot of this hypersensitivity, where people just can’t switch off. They become particularly vigilant and triggered by what would otherwise not be important things in their life. And when we look at the treatments available for that, because of the complex nature, what often happens is you get people put on antidepressants and anti-anxiety drugs. And unfortunately, particularly in the PTSD community, the response to that is usually not very good. The amount of “getting better” that occurs by taking drugs like that is pretty negligible. And it becomes a case where people just get medicated to a manageable state that they can just exist in. They’re not permanently feeling the adverse effects of PTSD. So, when we look at what psychedelics can do, that’s different. The biology of PTSD is somewhat similar to that of depression and anxiety. Still, you get impaired brain connectivity, and within those sorts of alterations in memory and how memory is formed. It is also the way that the brain is conditioned to experience fear. So you get an enhancement of those traumatic memories, and then they are triggers to that fear response. This comes about in a way where the brain almost becomes slightly less malleable in how the connections are formed. You get this rigid formation of circuitry within the brain. And so, to treat that, to alter the brain that’s slightly stuck in this loop of thinking, you give somebody something like a psychedelic. And I don’t know if any of your listeners have ever looked it up, but I hugely encourage them to research the work done at Imperial College, London, a number of years ago. They managed to put people on LSD and psilocybin inside an MRI machine and look at the brain during a psychedelic trip and what it does for them.
Well, they are a very forward-thinking group at Imperial College. And so what then happens is you get this psychedelic experience here. It works on serotonin receptors and increases brain activity. Still, you start to reach parts of the brain talking to each other, which you would not usually see talking to each other in normal circumstances. So, when we apply that to the idea of PTSD, you’ve got this brain system that’s slightly stuck in this loop. You’ve got parts of the brain, the sort of reptilian brain that deals with fear, completely disconnected from the rational parts of the brain. And it’s just kicking off at times that are not appropriate for your survival, which is the reason that those parts of the brain exist. And so, if you get something like a psychedelic, it seems to reconnect to those parts of the brain. It’s almost like those very rigid control structures of the brain that sit in the limbic system within the more reptilian parts of the brain, instead of them dictating to the rest of the brain what it wants and how it wants to think, you get the rest of the brain. They’re thinking parts of the brain sending stuff back the other way. And that then creates a system. So, the brain works because neurons send signals back and forth. And then whenever that happens, you get an increase in that connection. So by doing that, under a psychedelic environment, after that’s happened, you’ve then got a brain that’s slightly primed to have all these new pathways of thinking. It breaks down the rigidness of this loop system that PTSD represents and allows for other thoughts to come in. That’s very much on a brain functioning level. Other parts of psychedelics, which are incredibly interesting, deal with things like how the brain expresses certain genes, how it deals with which neurons to keep, etc. And there seems to be evidence that these substances after they are used, increase the amount that the brain expresses certain genes; that increase the amount it can grow and make new connections, and be more plastic. So, you’ve got a two-way improvement in psychedelics going into the brain and saying, right, let’s flood the system, get it all running, get it all working. And then after that, you’re in a position where you can lay down new connections, new ways of thinking, and break out of those quite nasty, repetitive looping systems that underlie depression, anxiety, and PTSD.
Does that become a window where you need to do exercises for behavioral change so they don’t revert?
It certainly offers an excellent opportunity to do those sorts of things. It’s often recommended that people don’t go and change their entire lives within three weeks of having a psychedelic experience because they can be very powerful and often confusing. But we monitor those things at heroic hearts. We don’t just send people out from the retreat and then kind of say, well, thank you. Thank you very much. Yeah, leave us a good Trip Advisor review note. You have to go through a process of what’s called integration. And that is incredibly important, which is looking at perhaps things that happened within your trip, or maybe things that you realized about yourself, about the trauma you’ve been through, and integrating those into your life and what that means to you. And that often looks a lot like cognitive behavioral therapy. And when you look at what people are doing in cognitive behavioral therapy. The whole idea is basically to go and create new ways of thinking, new ways of thinking about things, new ways that you decide you’re going to react to stuff. And so there’s that much-increased potential to do that, in the days and weeks and months after a psychedelic experience.
What is the opposition to this? And who’s opposed to this?
Well, the question “who is opposed to this?” Unfortunately, the political norm, and particularly conservative political norms, I don’t think I’m going to shock anyone by revealing that the war on drugs was a kind of major Sham to demonize certain communities. And, unfortunately, it has just become a sound bite from which politicians can rather lazily hang their hat when they have been caught doing something wrong or can’t figure something to say; just pull out the old, tough on drugs mantra. And everyone will say, “Oh, yeah, what a good bloke that guy is or whatever.” So, there’s huge opposition still there in the political classes because they see it as very difficult for them to convince certain parts of their voters that we have evidence now that suggests that these drugs are incredibly useful if used safely and appropriately. But also to admit that they’ve been wrong, and say, “oh. Sorry. For the last however many years, everything that we’ve been saying didn’t have anything to do with risk, it didn’t have anything to do with keeping you safe or anything. It was all about us and about keeping us safe in our jobs.” So that’s where the real official opposition to this lies. But, furthermore, and very rightly so, there is some opposition that like with any drug, and like with any substance, you have to execute it with medical care. You have to treat it with the utmost respect. And so, I think, rightly so, we are moving towards increased use of psychedelics for the benefit of treatment of psychiatric disorders with some caution because of the legality around it.
Scientific research has been limited. Until this moment in time, it is still reasonably limited. It’s taking off at the moment. And I think we’ve very much seen that in cannabis research. And we’re seeing it now with psychedelic research. And within the next five to 10 years, we will have a vast body of knowledge about these substances that need to be listened to and that needs to be followed. If there’s one thing we’ve all learned in the last couple of years, it is that maybe scientists might be dull at parties, but there are people that need to be listened to when it comes to public health. I’m saying that as a scientist.
I won’t say it, but you could say it.
Another part of it is the idea that we are developing drugs and developing drugs that are very different from what we’ve previously known. So we’re going to give you this experience; we’re going to get into your psyche and change the way you think. And I think that gives people a bit of a shock value sometimes. So I guess that’s why we should be active with caution. That’s why at Heroic Hearts, take note of what evidence we have now; what is known as the best practice, the best safe practice. And what we can learn every single time we take people out there, we see that as a learning opportunity, we see that as an opportunity to collect data to go forward and produce research, and then inform the next group, the following charity, or the next clinical body or whoever else that takes up psychedelic therapies, so that we can come up with best practices.
It also speaks to the laziness of the traditional medical community because it’s much easier for them just to say, “There’s no evidence-based research to support this.” So, we don’t have to think about it, right? And they will rely on what they’ve been using all along, which, as demonstrated, is not necessarily effective.
Yes, completely. I think that’s very true. And the medical community is quite lazy to say that there’s no evidence behind this. We’re not very good at looking into different options as a Western medical society if you look into it. If you look into what has been done in indigenous populations, using psychedelics for millennia, it’s very well documented that this stuff has a positive effect. And we are starting to see those initial studies done by the MDMA trial for PTSD that came out last year; showing positive results. And, again, Imperial had some amazing results against depression. And they’re only small pockets of evidence that have been done in a clinical setting, but they’re there. And once you look behind that clinical setting, at the wealth of knowledge that exists within the indigenous community, and within observational studies that have been done over the years, it’s quite difficult to now say, “Oh, there’s nothing there. We should completely disregard it.” I think that we see the same with cannabis use. We’re now getting pretty good evidence around CBD. And when we compare them to the drugs that we’ve got, can we say, “Oh, well, these are far too dangerous. How, how dare we?” I read something just the other week that truly shocked me. Within the veteran community, one thing you see, which I always noticed a lot when people come to us to be part of one of our retreats, is the number of medications that the soldiers get put on because they have such complex traumas. And because of that psychiatric problem to solve, as far as the doctor is concerned, they often end up on three or four different medications. And from that, once you start taking 234 medications, you start taking medications to overcome the side effects of previous medications. And there are now studies that are coming out that suggest that the number of suicides that we see in the veteran population is truly horrific. One of the worst statistics is that the UK and the US have lost far more men to suicide than we ever lost in Iraq and Afghanistan in the last 20 years. I think that’s a shameful indictment of the way that we’ve treated our veteran community. Besides, it has been reported that the deaths could have been accidental overdoses from the drugs that they were taking because they are often taking so many.
The other problem is that if those drugs are not necessarily effective, many people will begin to self-medicate with other forms of relief, right? So they may start to drink and look at other illegal drugs just to get out of the pain they’re in.
Absolutely. Unfortunately, we see a lot of alcohol abuse within both the serving and ex-military communities, which do not mix well with high levels of other medications. But when you look at that, and you have doctors coming forward, saying we don’t have enough evidence about psychedelic use, it could be really dangerous. Well, look at what we’ve got already.
Exactly. And actually, is it any more dangerous than the risk of suicide or accidental overdose that exists within the veteran community right now? For me, as a slightly data-driven human being, it has to be all about the probability of risk. And when you look at the risk of harm from psychedelics, from what we know, very, very, very little evidence to suggest that there is any kind of real potential of overdose using the majority of traditional psychedelics. Within cannabis, I can’t think of a single case anyone has ever overdosed on.
I don’t think anyone has. You just get high. Do you feel that the slowly growing acceptance of cannabis and its medicinal applications is then opening doors to other alternative treatments, such as psychedelics?
Yes. Absolutely. And it’s a help and a hindrance in some way. Because what has happened within the cannabis world in the last ten years has set a precedent for the idea that we can now start to rethink how we think about what were previously illicit substances. States in America have certainly set out the guidelines for moving these substances into use, medicinal and recreational, as has been done. But then it’s also made people nervous because of the cannabis boom, I think, in particular in states that went forward without some of the regulation required. And there are now a lot of situations of black market cannabis for sale in the US, and people are making what are quite unfounded claims; claims about cannabis.
We saw that particularly with CBD, where it was touted as the cure-all for almost everything. We believe that the plan has many benefits, but it hinders our progress when people make outrageous claims without any evidence to suggest that. And then, on top of that, to take advantage of the green rush, everybody was throwing CBD out there for anything, right? And then without standardization, without pop, labeling, we didn’t know what you were getting. So, even if the CBD were potentially applicable to whatever claim they were making, we didn’t even know if CBD was in the product because the labeling was unclear. Those efforts to cash in harmed the overall credibility of the cannabis industry.
Yes. Absolutely. I think that’s something that hopefully we will have learned from, as we move forward with psychedelics, is the idea that we need to be clear about standards of products, standards of treatments and protocols around therapy, etc. And yes, I find it quite amusing. During the whole CBD thing, I was working much more in a cannabis science world at the time, and people would come to me and say, “I’ve taken the CBD, and it does do the deed.” I say that’s interesting because we know it potentially works on at least three receptors. There are another four we’re not even sure about. So, how do we even know what it does? If we’re not even sure exactly which receptors there are. We’re not even sure which binding site it might be joining. And I just find it incredible how sure the likes of your high street wellness shop was telling you, “oh, yes, this is going to sell out. And give it to your dog. Give it to your mom, give it to your plants.” And you accept it.
As a health care professional, do you also know that there is a placebo effect?
If we don’t know what we’re giving them, we’re not sure it was CBD, but there could have just been a placebo effect that they believed would benefit them. So it did.
Absolutely. I completely agree with you. And the placebo effect is not something to be sneered at. Psychedelics allow you to go into a state where you’re almost able to access your own story and your narrative, and what you think and know about yourself and how you’ve written that story. A placebo kind of does the same thing, but without you knowing it, you’ve taken something that you then alter your narrative to say, “Well, I’ve taken this. Therefore, I’ll get better.” Psychedelics almost give you the ability to access that placebo effect somehow, but with your eyes wide open. You get to go into your narrative and say: “I’m going to choose to not be affected by this anymore.” Whereas a placebo tricks you into not being affected by it anymore because the power of the mind is such that it can have huge effects on what we wrongly have misunderstood as purely physical illness. And so, with CBD and/or any cannabis product that is going around, people probably get the placebo effect. And what if it makes you better? Great. As long as it’s not financially ruining you, or you’re turning down other medicines, that would be much better at helping you; then I see no problem in that.
And do you think, when you look at the PTSD community, do you think we are doing a better job at addressing this and working with veterans?
Yes, we are. You can come out here and say, “Oh, this is bad, we should be helping them and all the rest of it. The general story is an uptick. We are a hell of a lot more aware of PTSD, of what it is, as a society. There’s certainly a great improvement within the armed forces and the community around destigmatizing and saying, “Actually, I’m not alright. I am having problems with this. I’m not sleeping; I can’t walk into a room without checking all the exits. And people are talking about it, which, unfortunately, was very much not done before. And that was a hangover from the World Wars, where people just didn’t want to come out and talk about what happened, which doesn’t seem to be the case anymore. With veterans today, it used to take around ten years for somebody to come forward and say, “Actually, I’m having a problem.” We’ve seen that drop to about two or three years. There might be something in that that says, “Well, maybe it took longer for those traumas to become fully aware.” We’re doing better and, as far as research is concerned for PTSD, it’s improving massively. Some huge grants have been given out in the last couple of years. I’m afraid I can’t run off the states, off the top of my head, which has given a lot of money towards cannabis for the treatment of PTSD, but it has happened. I think when we look at that, that polypharmacy idea that I was talking about earlier; that there’s a great application for cannabis in getting people off all the pain meds and anti-anxiety medications and all the rest of it.
So is that where you’re looking for different treatment? Is that where cannabis is? To become a preferred approach where you’re trying to wean them off of opiates or something like that.
For me, that’s what I would say. Yes. Just on my theory, I think cannabis holds a place for getting people off meds. There are huge amounts of medication so that they can start to look at what they want to do next. I don’t particularly agree with the idea that people should be on a never-ending cannabis prescription. It is an addiction.
Tom would disagree. Sorry. “Cheech and Chong.” That’s an old reference. So maybe the dog would disagree; how’s that?
Cannabis is a really good place to start getting people through the day-to-day stuff. And then psychedelics are a way for them to step through the door, as it were, into a new life, whereas the psychedelics open the door for change.
Yes. And have that profound effect where people are saying, “change this narrative about themselves. Allow their brains the opportunity to rethink, and then they can move forward.” And perhaps the reasons they were taking the cannabis will no longer be necessary, and they won’t need it anymore. Right? Surely, we want people not to have to take a different route.
And unless it’s for recreational reasons with your friends on the weekend, we’re not opposed to them, but you have to take it because there’s an underlying problem. So we want to address the underlying problem.
So tell us, how do we support your work? What can we do to help?
Heroic Hearts is a charity, as I’ve probably mentioned quite a few times now. We always need more support. As I alluded to, we’ve got hundreds of veterans on our waiting list who want to come through our programs. We exist, both in the UK and the US. It’s quite a lovely partnership because we played such an important role in supporting each other out in the theater of war. And so, I think it’s important that we play this role in supporting each other. You can visit our website if you just Google Heroic Hearts. And, yes, Jesse Gould, he’s spoken quite a number of times. Many podcasts are available if you want to hear straight from the horse’s mouth. He went through what he found when he went out there and did Ayahuasca in Peru and got the word out there.
Also, obviously, we’re always looking for sponsorships so that we can help more people. But what we’re also looking for is to start a conversation; not only with the people that are already here, that have already bought into the fact that these substances can be incredible medicines, but to start these conversations with other people. I think the veterans are an ideal community to do that. To come forward and say, “We need changes to legislation.” “We need to relook at how we classify these substances so that we can have income back and forth for this country so that we can all live the safer libertarian life that we all want to.” They can then start living their lives again; having gone through for what a lot of them is an unbearable amount of suffering post-war.
And are you also partnering with other organizations to change the laws?
In the UK, we are partnering up with a number of different organizations. There are different lobbying groups within the UK Parliament. In the US, I know that Jessie speaks on many platforms. And it’s definitely our aim to make this argument in a very safe, very sensible, and pragmatic manner to the legislators. We’re not trying to say, “Let’s pretend it’s 1966, put on our bellbottoms, and head to Woodstock.”
You’re looking to help people that need it.
Yes, what we’re saying is we have a situation similar to what has happened in Canada. There has been a very, very small amount of illegal use of psilocybin within Canada. It was a compassionate use case for anxiety at the end of life care. People can go through a psilocybin protocol, which is a therapy to help with anxiety. We want a similar thing for veterans. Amazingly, we can help the veterans we are helping so far, but it’s very expensive. We have to fly them out to Peru, Jamaica, and the Netherlands, wherever we can conduct this work. And then it makes it a lot more difficult for us to research it. But if we could do that within the US, if we could get permission to hold retreats on US soil, these veterans don’t have to pack their bags and get on a flight for however many hours to go somewhere unfamiliar. That would be amazing. And ideally, that’s where we want to head to, and then the research will be a lot easier from there. It will be of a lot higher quality. Then we can come up with more evidence as to exactly the potential of these medications, exactly how they can be used, exactly what the protocol should look like. Is it better in a group? Is it better if we have two therapists or three therapists? Held over one week, two days, etc.? All of that kind of stuff can then be fully explored in a safe and meaningful manner. And then, at the end of the day, we all end up with protocols for therapy that will not only benefit the veterans’ community, but all the people who have PTSD as a result of childhood abuse, or people who have treatment-resistant depression, who have been on antidepressants for ten years, and so on. So by moving forward with these protocols, we benefit everybody.
Well, we very much appreciate your time today. We look forward to when those protocols are available to anyone who needs them. We hope you keep doing the good work that you’re doing. And we look forward to great things with Heroic Hearts. We’ll put a link below so that people can see what’s going on and find ways to support that. We appreciate your time. And thank you for joining us today. https://www.heroicheartsuk.com/
Thank you so much for having me. It’s great to talk about the work we do. Thank you