Betty Aldworth: MAPS, MDMA, and the Battle Over Psychedelic Medicine

In this episode of Divergent States, 3L1T3 sits down with Betty Aldworth, the new co-president of MAPS, as she steps into shared leadership with Ismail Ali following Rick Doblin’s four-decade run.

Betty brings decades of experience in drug policy reform, from Colorado’s 2012 cannabis legalization campaign to leading Students for Sensible Drug Policy, and now helps guide MAPS through one of the movement’s most pivotal moments: the FDA’s rejection of Lycos Therapeutics’ MDMA-assisted therapy application.

We unpack the tension between science and advocacy, urgency and rigor, and explore what real access means for people living with PTSD. Betty offers a candid, emotionally grounded look at the FDA’s critique, the role of stigma, and how MAPS plans to keep pushing forward through education, policy, and global research initiatives.

Later, the conversation turns to the larger movement: political support from both sides of the aisle, state-level reform models, and MAPS’ upcoming 40th anniversary in 2026.

Key Points

• Betty’s path from SSDP to co-president of MAPS
• The FDA’s rejection of MDMA-assisted therapy: what it really means
• How “positive adverse events” became a sticking point in the FDA review
• Durability of treatment effects and the debate over long-term data
• Balancing activism, science, and education under MAPS’ new leadership model
• The growing divide between regulatory caution and patient urgency
• Grassroots and state-level psychedelic reform gaining ground
• The stigma that still shadows MDMA despite decades of data
• Harm-reduction advice for those seeking underground healing
• What’s ahead for MAPS’ 40th anniversary and new research directions

⏱ Chapter Markers

00:00 – Intro — Bryan’s stage play, today’s guest: Betty Aldworth
02:00 – MAPS’ new leadership and legacy after Rick Doblin
05:00 – Betty on stepping into the role and the three MAPS pillars
08:00 – From activism to leadership — lessons from SSDP
11:45 – Balancing research, advocacy, and education
14:00 – FDA rejection letter — what really happened
16:00 – “Positive adverse events” and the question of abuse potential
22:30 – Durability of treatment and COVID-era data gaps
26:30 – Prior MDMA experience and bias — myth or factor?
29:20 – Politics, science, and the credibility dilemma
32:30 – RFK Jr., AOC, and politicization of psychedelics
35:00 – Echoes of the 1980s scheduling fight
36:20 – What comes next — Phase III, audits, and resilience
38:30 – MAPS’ evolving research priorities & global work
41:00 – Normalization, decriminalization, and stigma
43:45 – Science vs activism — carrying both forward
48:00 – State-level reform and slow federal process
50:30 – Cannabis rescheduling and broader reform
52:00 – A message to people living with PTSD
55:00 – MAPS’ 40th anniversary — what’s ahead
57:00 – Closing reflections — stay weird, keep exploring

Thanks to Dyl👽Alien for the music!

Follow and subscribe!

FiresideProject.org

Download the app or text/call 62-FIRESIDE

Transcript

0:16

Hey, everyone. Welcome back to Divergent States. I'm 3L1T3, your host with Bryan. How's it going, man? Hey, what's up, man? Glad to be back. Yeah. You working on your working on your play and been hard at work at that. That's right. Yeah, it's it goes on stage in about a week and a half. yeah. That'll be awesome. I can't wait to see it myself. So pretty excited. Right. It sounds like a lot of fun. So today we're sitting down with Betty Altworth. She's the co-president of MAPS now. You know, the organization that's been shaping psychedelic research and advocacy for nearly four decades now. Yeah, I mean, the same one that like invited us to their whole conference and everything. Yeah, I remember that. Yeah, so yeah, way back in, yeah. And their old president, Rick Doblin, was back on, what was that, March. So yeah, we were deeply intimate and are familiar with, I say intimate, but familiar with MAPS. We're best friends now. Yeah, besties. So Betty's been working on drug policy reform for a long time. She previously led the Students for Sensible Drug Policy. She helped drive Colorado's 2012 cannabis legalization effort and now shares leadership at MAPS with Ismael Ali, while Rick Doblin's still involved. So she's deeply familiar with both the political side of the work and on the ground community it affects at the same time. So yeah, there's a lot happening right now. The FDA recently released its rejection letter to Lycos Therapeutics raising concerns about MDMA-assisted therapy, from their trial design to therapist trading materials and long-term durability. And depending on who you ask, it's either necessarily scientific caution or the regulatory goalposts shifting mid-game. And we'll dig into that, where MAPS fits into the picture and what comes next. We'll also talk about the tension inside the movement, science versus advocacy, urgency versus rigor, and real access, what real access might look like for people living with PTSD. So with all that in play, we're going to get to the interview with Betty. you Hey, quick note before we start though, over the last year, I've somehow ended up with like real access into this world that most of us, you know, we never really get. Chemists, clinicians, researchers, underground practitioners, like the whole constellation. But I don't want that access to just stop with us. If you join the Patreon, you can submit questions directly for upcoming guests. You'll also get extended segments, part of the interview that doesn't make the public feed because it's a little too personal, a little weird, whatever, just left behind the curtain. And honestly, Patreon is where keeps this show independent. No corporate filter, no marketing agenda. And if you want to be part of that community, the link's in the show notes. So let's get into the interview now. Betty, congratulations on stepping into this role. MAPS has been Rick Doblin's project for nearly four decades. What's it like to step into those shoes at such critical moment? Well, first, let me say, Lee, thanks so much for having me here today to talk about maps and the work that we're doing. And I really uh appreciate it. I'm excited to be here. Yeah. It's an exciting position. It's what a great position to step into really. It's huge. Yeah. You know, it's been truly exceptional um to be able to do this work alongside Izzy, my co-executive director Ismail Ali, who I'm sure many of your listeners are familiar with as well. um And with Rick, of course, ah the legend himself. We've been know, MAPS is such an incredible and dynamic organization that has done so many extraordinary things over the years, too many of which are sort of invisible to most people's understanding of who we are as an organization. So I'm really excited to start bringing more of that to the forefront of the conversation about MAPS. You know, there's uh of course the thing that we're best known for, which is all of our research on MDMA. and MDMA-assisted therapy for PTSD. But there's so much more to MAPS and that's really what we're moving into, what we've been moving into more of a focus on for a long time. So I can talk more about the research and whatnot a little bit later. But to your question of what it's like to step into um this work alongside Izzy and with Rick. um It's a little bit daunting. feel like I'm appropriately terrified. uh But that's not the biggest part of it, right? Like you should always have a little bit of that when you're stepping into a role like this. uh It's also really exciting to get incredible feedback from the community, from other colleagues at other organizations, to hear from our donors, our members, our stakeholders and our partners who are excited to see what Izzy and I are going to bring forward at MAPS. uh Our team is just incredible. It's a wonderful group of humans who are totally committed to our cause and our mission and really excited to see, you know, to work together to co-create the future. Yeah, you've been in this movement for a long time, SSDP, DPA, and now MAPS. How does that history shape your approach to leadership with this? Yeah. Great question. I have been, like you said, in the movement for a long time, since 2009. uh My first job outside of medical cannabis work was in 2012 when I worked with MPP and the Colorado uh advocates. I had lived in Colorado for a long time to legalize marijuana for adult use in Colorado. um I was the field director and spokesperson there. And then I spent a little more time working in cannabis before I went to SSDP at the beginning of 2014. And before I did any of that, I've been an advocate and an activist my whole life. It's just something that it's the way that it's always been. I don't remember my first protest because my dad dragged me along to something when I was a kid. You know, and I was, I think, like 14 or 16 the first time I ever wait for it. Asked for permission to get arrested at a demonstration. I mean, yeah. What happens when you're a good kid, but you still got that rebellious streak? uh really want to do some civil disobedience. Right. U.S. Commission. So, um I've been doing, I've been engaged in community-based work for such a long time. And that is what really uh brought me to SSDP and made me. a good fit for that organization because I've led giant teams of volunteers. I've activated people around causes. I've been a precinct leader in elections. I've worked on ballot reform initiatives and I've, you know, been in plenty of demonstrations myself over the years. And at SSDP, I had the opportunity to work with hundreds of chapters all over the world. I think we were in nearly 40 countries. as well as the US, of course, uh at our largest during my tenure. And there I got a real sense or a real connection to what are the important issues for young people um as they're looking at drug policy overall and seeing its failures. Obviously, many of them were interested in psychedelics, but we saw a tremendous focus on opioid overdose prevention, on drug education, so that their peers were well-educated in harm reduction, drug checking, and the risks and benefits of substances, and could make educated choices. And it was hands-on work in community with people. to do leadership development, uh grassroots activation, advocacy work, movement building, all the things that I get to bring now to my work at NAPS. And when I was executive director at SSTP, uh Izzy was a student member, then elected to our board. and then elected as board chair. So Izzy and I have been working together for a decade, even though I've only been at MAPS for five years. So those are the things that I'm really bringing, right? That experience with grassroots movement building, leadership development, building out advocacy work, public education, and those values and the important aspects of... uh really putting power in the hands of the people through both action and knowledge. That's the thing I'm most excited about. Yeah, mean, because MAPS has always been that kind of mix of science and activism. And education, right. Do you see yourself carrying that balance forward or do you envision a different emphasis in your leadership? Well, it's neat or synchronous, although it wasn't planned or even stated as a desire, right? When we were going through the ED search process. uh But as it turns out, between Rick, Izzy, and I, we each hold sort of... have held one of the pillars at MAPS for the past five years, Izzy Policy, me, Education and Communications, and Rick Research. And so between the three of us and in our work together, we have an opportunity to um not just balance those three as priorities for MAPS, uh as it is appropriate for the moment, right? uh Sometimes research is what needs to lead, sometimes education needs to lead and sometimes advocacy needs to lead. And that's okay. And we can work with that as a group. But we also get to work together very closely on having each of those pillars serve each other, right? How does the research contribute to what we are? uh what we're providing through public education. How does it add to the body of knowledge that the public should be aware of? Or regulators or first responders or therapists or whomever? So public education and professional education are the two focal points there. um How does educating people lead to policy reform? What's the education that they need to reform these policies? And then how do those policy reforms feed the research, right? And that's just one example of that virtuous cycle that we have. But there are so many, and I think that that will be um one of the coolest things about the next iteration of MAPS is that we have individuals who are all really strongly oriented. toward our areas of expertise and get to hold those in a sense and turn our attention to each of those areas. Yeah, I really like that. You know, as you're talking, you've got Izzy, you know, doing his, his pillar and Rick with his, but then kind of have a nice broad spectrum to kind of, know, with your activism and education and research. So yeah, it's a, it's a great kind of synchronicity, as you said. Um, so yeah, kind of moving on, um, the FDA's letter came out recently. Um, the FDA said maps trading material excluded positive effects. Well, I'm going to start this one over again. That's segue was awkward. Um, yeah, I see that. Um, so we're moving on to FDA's response letter. the FDA has said that maps training materials excluded the positive effects like euphoria, um, from adverse effects. Personally, I've done hundreds of psychedelic sessions and I know that those states can sometimes destabilize as much as they can heal. Do you see this as a fair critique or is it a misunderstanding of how psychedelic therapy works? Well, so the, think it's important to note that it was the training materials for therapists who were uh providing the treatment in the clinical trial, right? In the, and that was Legos, which is a separate organization. um So let me say from the top here that MAPS and LIGOs, now resilient pharmaceuticals, are separate organizations. MAPS is a shareholder, but we don't speak on their behalf. So I'm providing my assessment based on my deep knowledge of the research program and the other work that we do. Yeah, that's fair. Yeah, I mentioned a few minutes ago, professional education. So MAPS is continuing a therapist training program with a focus outside of the US. In just a handful of weeks, we'll be conducting uh a therapist training in Poland, where we'll have attendees from uh Poland, the Ukraine, and Palestine attending. uh The Ukrainians and Palestinians are coming uh on sponsored attendance. So we're very fortunate to have grant funders who are able to support that work for people who are in conflict zones. But to your question, I know I went off on a tangent there. Totally, get it. mean, those people, mean, if people need healing from this more than anyone right now, that would be that that would be the groups. Yeah, absolutely. So um in the training materials for the therapists who conducted the treatment in the trials, um I have not seen those training materials. um That was a very specific training that was provided to those folks. I believe the FDA's assessment there is probably correct because I am aware that, you know, that data wasn't collected. And I want to go back to something that you had said in your question, which is that psychedelic experiences can be healing, they can be destabilizing, and they can be both, right? And the shortest way that I can explain that is that many people have referred to psychedelic assisted therapy sessions as getting eight years of therapy in eight hours. Right? And you can say that with a very optimistic tone, but like, you also have to remember that you're getting eight hours of therapy in eight hours or eight years of therapy in eight hours. Right? Like that's tough. That is tough. And oftentimes you're going to have destabilizing or very difficult experiences. And that is very normal. Now that that positive adverse events, which is such a funny phrase, isn't it? Yeah, that's a weird way to kind of put that out there. But that's actually specifically for em information about abuse potential, right? So there is this construct of abuse potential that is embedded in the Controlled Substances Act that the DEA uses, that the FDA uses. We don't necessarily have to go into the validity of that construct, em though we could, that schedules drugs based on their abuse potential, their perceived abuse potential. um and is used when the DEA uh is considering what schedule to put a drug on. It's also used by the FDA in the labeling materials and the prescriber information, right? So that people who are prescribing the drug and uh people who are taking the drug have an understanding of this idea of abuse potential. um And that's, you know, In that context, think important information that said, this isn't a brand new drug coming out of nowhere. This is a drug that millions of people have used and that there is an enormous amount of data on in not just clinical settings, know, where several hundred people have taken MDMA in a clinical setting, 600 or maybe even a thousand. um But millions outside of clinic and thousands of them or hundreds of thousands of them have replied have responded to questionnaires about it. We have all sorts of data from various monitoring programs that the FDA uses that other regulatory agencies use. And that information was all provided as part of the package to the FDA. um That information has been available on MAPS's website for many years. It's called the Investigators Brochure um for an investigational new drug. And uh that document is 75 or 90 pages that outlines all of that risk based on an enormous amount of clinical and non-clinical data. So we know. We have the answers to that. so I believe that it wasn't reported on. I also believe that it wasn't probably necessary. Right, think I remember hearing Rick say something about how they kind of bait and switched um them on that. But hold on to their issue, it won't really get too much into that if you don't want. um I don't know that, I mean, Rick has said that they have moved that they moved the goalposts. And I think that in some cases, um the advice that was received by prior personnel in the FDA um was not the approach taken by the personnel who considered the application in 2024. um I don't know if that's because something changed in the FDA's practices. ah It is unfortunate because that information is so readily available, I um don't ah know about, um I think it's nuanced and complex set of circumstances. And in some cases, like, I think that the FDA really made the wrong call or the wrong assessments. I have critiques um for sure about the way that that assessment was done. Yeah, I agree. m Like durability was another major issue they brought up. The FDA says the trials don't prove benefits past 18 weeks. PTSD is a chronic condition. ah So what would be the answer for that? Well, the durability question is an important and interesting question. Typically in PTSD studies, what you see is follow-ups, you know, 12 to 18 to 24 weeks later. That's pretty typical and not a lot beyond that. I think one of the challenges is that the treatments that people were receiving or not receiving after the study concluded. you know, did they remain in therapy? Did they remain in therapy with the same folks? Did they go back to their old therapist? What was that treatment? People were, you know, many people were receiving treatment after the therapy or receiving therapy after the treatment or, you know, and many people weren't. And so there was some variability in how, in what happened in that period afterward with, uh you know, with reporting on it, but not monitoring. not active monitoring. And so the FDA wanted to see more active monitoring during that period. em And that being said, we do have long-term durability data from a longer-term follow-up. I believe it's been published, em but, you know, up to five years of follow-up. where the treatment has been found to be durable. And in fact, some people continue to improve afterward. Now, not everyone, right? It doesn't work for everyone. That's the first thing that we all have to say when it comes to psychedelic assisted therapies, no matter what kind. It does not work for everyone. And it doesn't work for everyone forever. um But I think that the, um you know, that durability information is... um It is my perception, not as a researcher or as a scientist or a statistician, but as someone who speaks with people who are, that that is a pretty darn high standard ah there. And if it were just that or, you know, just that and one or two other things, then it probably wouldn't have been an issue that would have caused uh the failure of the application and its first try. Here's the other thing. um The long-term follow-up for map one was scheduled to happen in spring, summer, and fall of 2020. That was a tough time, Yeah, that's, uh, it's gonna say that you have a hard time to get anything going for any kind of. That's right. So, uh because there was a delay in collecting the follow-up data due to COVID uh for MAP1, the first of the two phase three trials, uh the FDA advised that it should be balanced. My understanding is, and I haven't seen this documentation, but my understanding is that the FDA advised that the long-term follow-up data should be balanced for for the first study, which was longer than anticipated, could be balanced out with a shorter than called for period uh for follow-up for the second study. So, sure, it was a variable amount of time, but my understanding is that it was because the FDA actually advised that, or approved, or... didn't object to that particular structure. Yeah, I was going to say, I think that was another kind of one of those examples of moving the goalposts. So nearly 40 % of trial participants had prior MDMA experience. So another kind of issue they brought up. The FDA said that risks bias and unbinding. Was that a flaw in design or simply inevitable given MDMA's cultural history? Well, that's a great question. Now, I understand how the FDA might think that that predisposes people to uh have a more positive experience, right? Like, at first glance, that logic makes a lot of sense. But let me ask you this. If 40 % of those people had used MDMA in the past and then had similar results as people who hadn't, by the way. um Why hadn't their PTSD already healed? That's a good question. Right? mean, listen, a lot of so many people, so many people start their healing journey on the dance floor. Right? Not everybody finishes it there. In fact, probably no one does. Yeah, exactly. I was going to say that most of us come into the psychedelic scene or through the, you know, the area from the underground from, know, and just finding it and enjoying it on the dance floor and then discovering, oh, wow, there's a real healing potential here, you know? So, it's, it's. Yeah, I, I, it's a good question. I, and, you know, just to bring that up, you know, you're talking about why, why weren't they healed with their PTSD? Why were they there? Exactly. So I mean, yeah, having the therapy there to go with it. Obviously hell. Yeah, and I just think, I mean, listen, if we think back to our first psychedelic experiences, it was probably a little frightening for most of us at the beginning, right? I get that. So like, perhaps there was a bit of like, not having additional fear going in, I don't know, you know, who knows? ah But at the end of the day, the data between the people who had prior experience, and the people who didn't was basically the same. Statistically insignificant differences in the data for those two groups. uh And that's a good point. mean, that's what really you should be looking at is the results of the data, not, you know, trying to pick it apart. I agree. So recently under the Trump administration, both the HHS and FDA have publicly said they're going to be more open to psychedelic therapies. Do you see that openness reflected in how they're handling the MDMA or does it feel like lip service when the actual decisions come down? Yeah, I can't even answer that. I don't know. We aren't in direct communication with the FDA. Yeah. Resilience handling that and they're, you know, tight-lipped about it. uh Can I, but I do have a item I'd like to, or a thing that I'd like to mention about it, which is that uh PTSD is a very serious, a life-threatening condition. that 13 million Americans are grappling with every day. This is an urgent problem for a life-threatening condition, or a potentially life-threatening condition. People living with PTSD need treatment as soon as possible. And so there is urgency to this work, right? There's urgency to FDA approval. And so when I say what I'm about to say, I'm not ignoring that. I know that. I know that as well as anyone living with PTSD, because I've done it. I've lived with it. That being said, if psychedelics are perceived as being rushed through the FDA, if there is a perception that science has gone out the door in favor of politics, that ah the scientific standards that are necessary aren't upheld, then that is actually, I believe, going to cause more harm than good. Because it is going to... uh cost an enormous amount of credibility with the scientific community, the mental health community, the treatment community, and the community of people living with PTSD and their loved ones. We should absolutely, for this treatment, have to stand up to the same kinds of tests that any medication does through the FDA and to scientific rigor. So while I hope every day for a speedy approval. I also hope that it's done with the full brunt of scientific rigor. Yeah, we've reflected in a episode on that a couple months back where it was um talking about not getting politics too involved um with psychedelics and let the science and the healing stand on its own. That's kind of, to me, what I traced the problems back to the 60s with, is it became... too synonymous with the counterculture, synonymous with personalities like Timothy Leary and his calls to tune out or drop out, tune out with something. That made better headlines than any Harvard study or anything ever could. They labeling Timothy Leary the most dangerous man in America did worse things than anything. So kind of along those same lines RFK jr. Has been vocal about psychedelics and alternative therapies Do you see his voice helping normalize the conversation or does it risk politicizing it further? Yes. Both, right? Yeah. I mean, the... um I think that there are... mean, listen, everything is so politicized. Everything, right? And without spinning out into that conversation right now about the breakdown of... dialogue in America and the way that everything is so politicized. ah I think that among some people it will raise a sense of credibility and I hope that those folks are then learning more and getting acquainted with the science um and continuing beyond that first spark of curiosity or openness because there's a lot to learn as we all know who have been doing this for a long time. um And I think that for some folks, people who are concerned about vaccine availability or food safety or any of the other many issues that are coming up right now, it's going to harm the credibility of these treatments. And I hope that for those people, they will also continue to learn more because you know, no matter who it is that's talking about it. The science is the science. Right, don't throw the baby out with the bath water. That's right. mean, plenty of people would have the precise same reaction to Alexandria Ocasio-Cortez, who's been very supportive, as one of many examples of Democrats who have been highly supportive. Yeah, Kirsten Sinema, we did an interview with her this last summer. She came out and she was talking about her support for Ibogaine treatment. Jared Polis in Colorado, who spoke on our stage at Psychedelic Science both this year and in 2023. The governor has been an incredible supporter. Yeah. And Rick Perry came out and saying he did Ibogaine himself. know, it's just a... Yeah, that's great. And that's what really the focus should be on is the healing and what people can heal with this. Do you see at this moment, do you kind of see any echoes of like the 1980s when MDMA was scheduled despite a judge recommending otherwise? Do you see the history repeating itself, politics overruling science or... I mean, we're seeing that now with other substances, DOI and DOC, for example. I'm not an expert on that. I'm aware of what's happening there, but these very important uh research substances are likely to experience the same fate, unfortunately, we think, as MDMA, although we're still hopeful for a science-based outcome there. uh I don't think it's quite the same. I'm not saying that stigma isn't a part of what's happening, of this phase of the process, right? ah But I don't think it's quite the same as the 80s with MDMA. And we have much more clinical research to back up our arguments now than we did then. Yeah, that's a good point. New data will always help, you'd hope. So moving forward, the FDA seems to be asking for another phase three trial, stricter controls, a long-term blinded follow-up. Is that feasible or is it essentially moving the goalposts that we discussed before? I mean, think that it's, uh is it feasible? Yes. All of these things are possible with uh more investment into the research, right? And that's now happening with Legos Resilience new owners. um It's a uh two, three, six year process. So it is a delay if the FDA, um doesn't accept the arguments presented to them for why there doesn't need to be another phase three trial. And I know that there's been talk of like I was trying to provide the data that's being asked for in different ways. um So we shall see. uh But yes, is it feasible? Yes. Is it possible? Yes. Is it going to happen? Absolutely. uh one way or another, you know, we, I can't imagine that we won't come to a point someday when MDMA for PTSD, MDMA assisted therapy for PTSD is an FDA approved treatment. Yeah, we need to get there. um They also raised the idea of third part at audit for therapy recordings. um Are you guys open to that level of scrutiny? uh So that's, again, that's a resilient thing, I'm sure. you're right. Yeah. So um part of the deal with uh FDA regulated trials is you basically have to be willing to open your doors to the FDA at any moment and they get to audit or inspect anything related to the trials, anything related to the trials. So they kind of have to be. That's part of the deal. Yeah, so if you had to lay it out, what would be the next concrete steps for maps in response to the letter? We'll continue to try to educate people through interviews like this, you know, and make sure that um we're continuing um to tell the story of MDMA-assisted therapy and the people who have healed from it uh in the context that we can. But in terms of our work, our direct work with the FDA on that issue is done, right? Now, that being said, that doesn't mean our support of MDMA research is done, but now we are focused on different priorities. So under Rick's purview, uh we're working on the cutting edge of MDMA-assisted therapy. For example, we're supporting uh studies of MDMA in couples therapy. We're supporting studies of MDMA-assisted therapy for people in conflict zones. ah We are supporting and by providing advice and intellectual support, uh any number of other trials that are looking at how do we broaden the scope of what this treatment might provide relief for, what kinds of conditions or experiences this treatment might provide relief for. How do we make it accessible to people beyond the American context or the Western context and adapt the modality em to be culturally responsive uh in other parts of the world? em How do we em find ways to make it more accessible through things like group therapy? So really exploring the edges that are not necessarily going to be profitable for a drug company to look at, but could in fact provide far more healing for people who might not have a formal PTSD diagnosis, know, for all of the people who might not have a formal PTSD diagnosis or who are living with other conditions that might benefit from MDMA-assisted therapy. Yeah, yeah, that's very true. It kind of reminded me of something Leonard Picard had told, you know, talked to me about, um, at his episode. He was asking, what about the person who's not sick? What about the person who just wants to have a good time and go out in the woods and, you know, enjoy, you know, I think that's part of it too. It's just, you know, the normalization and, and, you know, to get to the decurbalization point so that we can enjoy that. Absolutely. And there are so many reasons for that. you um know, well, people enjoy psychedelics routinely and ought to be able to know that what they are taking is not adulterated, is of a potency that is predictable and known that they are not criminalizing themselves and exposing themselves to uh consequences uh from the criminal justice system or any of the other systems of the war on drugs that might punish them for their psychedelic use. ah And that there is a support framework that can help them if they have a hard time. All of those things need to be there. Yeah, that's, mean, getting it going, but yeah, it just, takes time and you got to build it, right? uh So from my perspective, you know, kind of in the underground world, MDMA still carries the ray of drug stigma. Do you think any of the cultural baggage played a role in the FDA's rejection? I mean, it's hard to say that. um It's hard to argue against it. I have no proof of that, right? But uh I've been doing drug policy reform for 16 years, and you can't tell me that stigma doesn't play a role in everything we do. No, that was, in fact, that was probably one of the most surprising answers I got from Kirsten Sedema was, you know, I asked her flat out, do you see it ever becoming decriminalized on the federal level? And she was just playing no. I was like, really? No chance, huh? You know, and it was kind of, like, well, okay, then we'll move along, you know, it was, but yeah, I am seeing more and more and I see it from both sides of the aisle front in politics where they are becoming more open and accepted through that. And so I hope that that prediction of hers is not coming true. I'll just say that. hope we can. Well, yes, I very much look forward to proving her wrong someday. I hope I live to see it. Exactly. um So MAPS has always straddled both being a scientific organization and an activist one under your new leadership. How do you balance those identities? Yeah, I think we embrace it all, right? You know, uh we have that extraordinary history of embracing it all. And one of the really wonderful ah things about Rick is, I mean, listen, his mind is astonishing, ah you know, which is ah sometimes a bit challenging too. No, have a like when he came on our show uh back, I think we recorded back in December. I think it was March when it came out, but he he he got me off off of my script so quickly. My my outlines that I draw up, he's like, wait a minute, let me ask you about this. And then the whole the whole conversation was derailed for the next probably 30 minutes. So. is always so much fun, yeah. uh Rick has a mycelial mind, right? And he can see the connection between things long before most other people can. I think that that's a... and he's also an encyclopedia. Like his memory is unbelievable. And as a woman of a certain age, I'm like, how do we do that? How do you do that? So... um You know, Rick has always deployed those three pillars of maps in his work, right? The policy work. I mean, he has a degree in political science. That's why he's a doctor, right? Because he understood early on that the political maneuverings were going to be just as important as the science, and nobody else was quite equipped to do the political work. in the way that he was, ah or few people perhaps were equipped to do it and interested at the time. ah But there were scientists around who could help. So he was, at that time he elected to get his degree in political science because that was the most important part. Education and harm reduction have always been a huge focus for him. And when it comes to sort of what is leading at MAPS in any given moment, em for the past decade or so, 20 years, it's been the science, right? em And the science is still very much there, but I think that there's going to be more room provided, not necessarily even by maps, but provided by the national narrative, the context that we're in, to see education or um advocacy leading. in that strategy at various moments. And I'm super excited for that opportunity. You know, conversation about psychedelic assisted therapy has in large part taken all the air out of the room for many of other conversations for a long time. And of course, you know, we need to be focusing on what's going to help people live healthier lives. know, 100%. I'm down for that. I'm here for that. Absolutely. And um what is very exciting to me now is that we're seeing in states and localities and community and with professionals, mental health professionals, first responders and so many other folks, just such a strong desire to understand these substances more, their potential benefits, their risks, how to support people, you know, as they're having the experiences or if they come out of those experiences having difficulties or as they are going through any life transitions that might result from a psychedelic experience. Like all of that, all of it's there. It's enormous. It's such a huge, huge bunch of work. And I feel like this movement is big enough for us to handle a fair bit of it at this point. So MAPS is gonna be here to help support that. to help in coalition with people and collaborating on exciting educational projects and research projects, advocacy projects, and to bring our megaphone and all of our experience to the table to see how we can make this movement participate in building this movement and making it stronger. Yeah, I kind of want go back a little bit of what you said about the state level. If FDA approval drags on, do you see state level or grassroots initiatives moving faster than the federal process? Yeah, yeah, absolutely. And no matter what, right? Like what we see at the state level, mean, perhaps not for MDMA, we've set up this false construct of plant medicine and not plant medicine. so, know, MDMA is for the moment excluded from that. um But um the state, the possibility for state level reform in... damn near any category of reform, not just psychedelics, not just drug policy, just about anything. know, states are the laboratories of democracy, right? And this is where you can talk straight to the voters, especially in places where there are initiatives in New Mexico, you know, that they were able to talk directly with the legislators in order to get the New Mexico bill passed. And ah you can have, you can move things much more quickly. at smaller levels of government, in fact, right? The first thing that we saw were citywide initiatives for decrim or our lowest law enforcement priority. And then eventually state initiatives for the regulated models in Colorado, Oregon, and New Mexico. And the federal government will be slower and the slowest body of governors, of people who govern that I've ever... uh sat in a room with is at the UN, right? just like speed, the speed is faster, the smaller you get. Yeah, that's very true. And you can kind of already see it coming up grassroots, as you mentioned with Colorado and Oregon, but also, you know, Texas and Arizona recently with their initiatives for Ibogaine. So yeah, it's really exciting, you know, to see it come up and it's kind of the same model how it's come up with cannabis reform too, though, you know, it started out with low priority within cities and then states. And it's grown until, I mean, hopefully where, you know, they were talking about, I think last year, sometime this year talking about rescheduling marijuana cannabis finally so down to like schedule Just a few days ago, there um were noises from the administration about imminent rescheduling. Now, I will say that I still follow cannabis. It's where I started in the movement. I'm the chair of the board for the Marijuana Policy Project, so I'm still very much engaged in that. um Many times over the last six or eight years, we've heard that uh federal rescheduling of cannabis is imminent. And every time we've been disappointed. So I'm not holding my breath. And I'm definitely not holding my breath for uh cannabis being removed from the CSA entirely and treated from a regulatory perspective, like say alcohol, uh you know, on a nationwide basis. We are probably still quite a few years from that. ah But yes, there is certainly some noise being made about rescheduling and ah you know there. I know if this is public yet, so I will stop there. I can always throw it on a Patreon section or something. Yeah. uh So just kind of with that kind of closing out a little bit for people living with PTSD and those feeling crushed by this FDA decision, what message would you want to leave with them? No. that it's such a... It is so tough to wait. I know. I know. um And I don't know why I'm so emotional. We've been living with this decision for almost 14 months, but um it's really hard to wait and I know that. And I have so much empathy uh for being in that position. And I just hope... Please wait, please, please just hold on. And in the meantime, do what you can with other treatments, know, with other effective treatments. And I know that some people are going to try to treat themselves at home or visit, ah you know, community-based practitioners, unregulated practitioners using unregulated substances. ah Please, if you choose that, which I can't encourage, but also know that that's a reality, if you choose that, please make sure that you are taking every step you need to to reduce the risks. Make sure that you know the person. Make sure they're in community with other providers. Make sure that you are testing the substances, whether they provide it or whether you provide it. Please protect yourself. as you're moving forward because the systems, the regulatory systems, the licensing systems aren't there in community-based care to protect you. So you've got to lean on community um and make sure that you have built community with your global psychedelic society because they probably have an integration, you're local. Global Psychedelic Society chapter because they probably have an integration group. Make sure you've saved the number for the fireside project because you might need to call them and their volunteers are wonderful. They're so well-trained in providing peer support. Please protect yourself. 6-2 fireside if anybody out there needs it ever 6-2 fireside. Well, thank you, Betty. I appreciate your candor and coming up and talking with me today. It's been a great conversation. I'm excited. I throw? Yeah, sorry. I throw in? Thanks. Maps was founded in 1986. We are about to turn 40 next year. So I'm incredibly excited about some of the things that are coming up around that some of the great ideas that we have and some of the ways that regardless of our 40th, right? uh But in that context, too, we get to look back and see. you know, what has MAPS been to people? What can MAPS be for people? And I hope that folks will keep an eye on, uh you know, our work through our website and our list and social media and all of the rest of it, because I think you're going to see some very exciting things coming out of MAPS over the next couple of years here as we uh celebrate our 40th next year and then uh get ready for a big 2027. Is there anything you could share with us? Like coming up or something, kind of tease? um Well, we're still in the little bit of a brainstorming phase about what we're going to do for our 40th. But uh one thing I can say for sure is that we're going to invite folks to celebrate with us in all sorts of different ways, right? Whether that's, um well, I'll stop there. But I think that there are going to be many ways that people can help us celebrate. And we'll be doing uh some look backs at the last 40 years that are going to be fun for people who've been following maps a long time. It sounds amazing. I can't wait to see what you guys come up with. It's always a good time. ah Betty, yeah, thank you for coming and talking with me. It's been a real enlightening conversation. guess maps.org is where they find out information, the maps. Yep, and can access every almost every session from psychedelic science 2027 on the virtual trip. So virtual trip dot maps dot org. I can't believe I almost forgot to plug that. We're almost done uploading those videos. And if you missed psychedelic science or you missed a session that you wanted to check out, please go visit. It's free to the public and offering to the community. And yes, maps dot org and virtual trip dot maps dot org. That's amazing. Well, Betty, thank you again for joining me tonight. It's been an enlightening conversation. It's been a lot of fun too. And I appreciate it. And I can't wait to see what you guys do in the future. Thanks so much, Lee, it was a blast. All right, folks, so that wraps up our conversation with Betty Altworth, co-president of MAPS. uh Stepping into shared leadership role with Ismael Ali while Rick Doblin stays involved, Betty described MAPS as operating across these three pillars of research, education, and policy advocacy, each taking the lead as it's needed. It's a shift, but one that seems intentional and collaborative. And we spent a good chunk of the time unpacking the FDA's rejection letter to Lycos Therapeutic. Betty was careful to draw the line between MAPS and Lycos. MAPS is no longer the sponsor of MDMA application, but she still provided the context. She acknowledged that some of the FDA concerns, like how, quote, positive effects were captured in training materials, were probably fair. At the same time, she questioned how much weight those critiques should carry. Given the decades of data surrounding MDMA usage, both clinical and real. on durability, bias, and the moving the goalpost debate. Betty's take was thoughtful and measured. Long-term follow-up data suggests benefits can persist for years in many people, though it's not universal. She was very clear about that. No single therapy works for everyone. Right. And we've talked about that several times ourselves. Of course, Yeah, not everything. And I mean, we're not medical professionals, so. I am. Yeah, I just got, it was on Phoenix. University. I'm just kidding. Yeah, got a University of Phoenix doctorate. Yeah. Anyway. Yeah. Anyway. Yeah, don't take our word for it. You guys know how to be safe. That's part of this whole thing. Right. One thing she really emphasized strongly is there's real urgency for people living with PTSD in their day to day life. Yeah, 100%. Right. She argued that psychedelic therapy has to be able to withstand that same scientific standards as anything else. If that process is rushed or politicized, like we talked about, it lists losing credibility with clinicians or with researchers, general public, politicians, everyone. Right. Yeah. Yeah. That just sets everyone back. I'd rather see that happen on the other side than... Right. than on our team. You know, it's like when you look back at like some of the cannabis research and stuff and they're oh, it's so bad. And then they look into it. It's like none of that was legit. Right. Yeah. I mean, they did that with MDMA back in the day when they. I think they gave uh gave, I think it was monkey's methamphetamine and they claimed it was MDMA. They found these like holes in their brain and like they gave them like absurd amounts. So yeah, just they, you know, they, they. They have a there's a bad track record there. So to kind of bring the that legitimacy into focus uh for folks considering. Oh, wait. While federal approval may take some time, MAPS is continuing to support the research around the edges still. Group therapy models, couples therapy, culturally adapted approaches, and work in conflict zones. And she expects that state level efforts will keep moving forward, even if the federal process starts slowing down a little. For folks considering the non-clinical path in the meantime, she offered the most practical advice of the day. If you're going to consider underground healing, please do it as safely as possible. Yeah, know your provider, test your substances, stay in the community and keep resources like Fireside Project, 6-2 Fireside. We've had them on. had their, there used to be their executive director, Josh White, uh stepped on and I think he's our very first interview in fact. So that's right. Yeah. You know, finally she hinted that MAPS is gearing up for its 40th anniversary with new opportunities for public. uh engage, reflect, and participate in the next phase of their mission. So Betty, if you're listening, thanks again for joining us. Everyone else, stay weird, keep exploring. Yeah, thanks for joining us and what you said. Stay weird. you