EPISODE 21 - Dr. Jeremy Tannanbaum
“The next phase of research into psychedelics will be looking into the factors we can use to optimise these experiences”
Dr. Jeremey Tannenbaum
In today’s podcast, I spoke with Dr. Jeremy Tannenbaum. Jeremy has a longstanding interest in psychedelia, and as you will hear from our discussion, he had a childhood and upbringing that was steeped in a deep, nuanced and intellectual exploration of these substances - as well as many other contemplative practices and non-ordinary states of consciousness like hypnosis and meditation. Jeremy took these sensibilities into his study of medicine and now seeks to amplify and optimise the therapeutic benefits of psychedelics as tools in the treatment of chronic pain.
In today’s podcast We Discuss;
Jeremy’s background in psychedelia, and his early interest in the work of Carlos Castenada,
His formative experiences with Stahls essential psychopharmacology text book,
Jeremy’s exposure to the early psychedelic research at Imperial College London - including the seminal pilot study, ‘Neural correlates of the psychedelic state as determined by fMRI studies with psilocybin’
Jeremy’s early introduction to meditative practice,
His belief that we need to manage expectations around the utility of psychedelics in the holistic treatment of patients with complex presentations,
Jeremy’s mentorship by Professor Sean Hood, and his serendipitous elective at Imperial College with Professors David Nutt and Robin Carhart-Harris ,
Adam Gazzalley’s neuroscape clinic, and the explosion of interest at top tier Universities into the study of psychedelics,
Hypnosis as a possible treatment adjunct to amplify and optimize the therapeutic use of psychedelics
The predominance of anaesthetists as pain specialists and Jeremy’s interest in the treatment of chronic pain from a psychiatric perspective,
The importance of the bio-psycho-social multidisciplinary model as a paradigm for the treatment and understanding of pain and co-morbid psychiatric conditions,
The catch-all concept of ‘Medically Unexplained Symptoms’
The structuring of primary care within medical systems creating a ‘siloing of specialties’,
The primary limiting factor of lack of capitol in the field of ketamine research,
The difference between Ketamine and Esketamine in terms of pharmacology and the method of delivery,
The importance of ritual and the building of clinical care models around ketamine treatment,
The IASP’s definition of pain as, ‘An unpleasant sensory and emotional experience associated with, or resembling that associated with actual or potential tissue damage’.
Types of pain,
Significant risk factors increasing the risk of transition from acute to chronic pain,
Catastrophisation (rumination, magnification, and sense of helplessness) as one of the strongest prognostic factors for heightened sensibility to pain,
The significant perceptive overlap of psychological and physical trauma at the level of the Central Nervous System,
The increased suicidality rates in those who suffer with Chronic Pain,
Psilocybin in the treatment of fibromyalgia and other pain conditions ,
Emmanuelle Schindler’s work looking at the treatment of headache disorders with psychedelics,
The relative paucity of pain education in medical school,
Why Jeremy doesn’t prescribe typical opioids anymore - and why he instead prescribes atypical opioids to avoid opioid-induced hyperalgesia and immune suppression
NMDA receptors and their role in the long term potentiation of pain,
Ketamine as a ‘non-competitive NMDA receptor antagonist’ and how it can also be used as a substance to treat, opioid and alcohol withdrawal,
The importance of ‘collateral history taking’ in assessing improvements in pain histories, and how this might map onto markers for improvement in psychedelic studies,
The importance of bolstering the Australian Medical Model in anticipation of future de-scheduling of psychedelic substances like MDMA and Psilocybin,
The Patient pathway for Ketamine infusions,
Ketamine Assisted Psychotherapy, and the potential phenomenological overlap with the concept of ‘self’ in Internal Family Systems Therapy'
Jeremy’s recent appointment to work alongside the team at Emyria
The importance of individualized maintenance therapy protocols post-ketamine infusions,
The important difference between sub-anaesthetic and dissociative doses of ketamine,
The challenge of prolonging the positive response to ketamine,
The use of Ketamine as a potential treatment for eating disorders,
The potential ‘protective effects’ of psychedelics at a societal level,
The Gold standard of early intervention and what this might mean for the treatment of mental health issues in psychedelics,
Chris Letheby’s book, The Philosophy of Psychedelics,
John Vervaeke’s series, Awakening from the meaning crisis,
Dr. Jeremy Tannenbaum
Psychiatrist
Dr. Jeremey Tannenbaum is a Psychiatrist and Specialist Pain Medicine Physician trainee working in the public and private systems in Perth, Western Australia.
His professional interests include the holistic management of persistent pain, interventional psychiatric treatments such as stellate ganglion blocks for PTSD, rTMS and ketamine infusions as well as the emerging therapeutic role of psychedelics.
He is completing pain medicine training at Fiona Stanley and Hollywood Hospitals and The Anodyne Centre.
Prior to pain medicine, Jeremy completed his psychiatry fellowship in general adult psychiatry, with diverse experience in adult and child/youth mental health services, ranging from emergency psychiatry, inpatient units, private psychiatric and general hospital settings, mental health Hospital in the Home services and community adult clinics. Jeremy has also recently started working alongside the team at Emyria in a clinical advisory capacity.
Before undertaking a post-graduate Bachelor of Medicine/Bachelor of Surgery (with Honours) at The University of Western Australia, he completed a Bachelor of Science (Human Biology Preclinical) degree at Curtin University.
As a medical student, he spent an elective with Professors David Nutt and Robin Carhart-Harris at Imperial College London, which encouraged his interest in the potential for psychedelics to help with managing difficult to treat mental health and other conditions.