Entheon Biomedical’s CEO on DMT, the Nature of Addiction, and the Life Changing Work of Medical Psychedelics
Psychedelics are quickly becoming a crowded marketplace. Recent developments mean that research can proceed, and compassionate access to psilocybin for palliative patients, or those suffering from depression and addiction, is now a reality under Canadian law. In the United States, legalization and decriminalization have gathered an even greater momentum. But what about other substances? In the current rush around psilocybin, are we neglecting the therapeutic potential of other molecules? Timothy Ko, CEO of Entheon Biomedical seems to think so. While far from dismissive of the potential benefits of psilocybin, he seems to be playing a longer game, breaking away from the pack by building a company around the potential for medicalized DMT to treat addiction and substance abuse disorders. I confess myself intrigued, and wanted to know a bit more about his atypical focus.
We started with a bit of background. I asked for whatever personal and professional history he’d like to share, knowing full well from previous press he’d done that some of it was quite painful. “I’m not shy about that,” he tells me, getting things rolling. “It’s my story.”
Disruptive Possibilities and a Personal Stake in Addiction Treatment
“Prior to this, I’d run a bunch of different ventures, from the investment and capital market space, also recently in tech. I’ve always been interested in disruptive possibilities. Previously it was blockchain, now it’s this, where everything has converged in an opportune way. Which is a weird thing to say about the death of my brother.” Ko pauses for a moment, catching his breath.
“I lost my brother to drug addiction in March of 2019. That whole process, though it happened instantaneously, and was shocking and terrible and devastating, was still a narrative that took place over twenty years. During that two decade span, we pursued and tried every facet of the conventional treatment model, with the intention of bringing about sobriety for him. The reality is that even when all of those things intersected—and sometimes they didn’t, sometimes it was piecemeal, whether it was recovery and treatment centres, 12 steps or therapy, or medication assisted therapy—even when all of those came together, it obviously wasn’t effective. There were little bouts of sobriety, but we really saw firsthand the limitations of conventional models. Following his death, I saw the absolute, unshakeable need to address addiction in a fundamentally different way, really inverting the expectations society has around people that suffer from drug addiction.”
“I think all too commonly, when someone does have an addiction issue, people are resigned to the fact that they may die as a result. I think this is due to the limitations of those conditional methods of treatment. They all try to get back to this important place of the psychological and emotional motivations that drive the behaviour. With psychedelics, we know that the nature of these molecules is to produce these profound effects beyond the normal capacity of our consciousness. For us, it’s about making those things dovetail. How do we facilitate this capacity for revolutionary personal change with DMT? How do we medically validate it, make it as scientifically robust as possible?”
Timothy Ko on the Nature of Addiction
It’s a subject that I freely admit to some personal stake in, as I tell Ko. A good friend of mine is a recovering alcoholic. We’ve both known people in our lives that have been able to find some resolution with their substance use issues, and others who were less fortunate. That same friend, now in a program and helping counsel others, raised a point with me when I mentioned the prospect of medicalized DMT. His fear was that addicts given access to another drug, even one without the chemically addictive properties of say, opioids, would likely develop some kind of psychological dependency. My reply was that the difference would be made by psychedelic-assisted therapy rather than drug use. Given Ko’s personal experience, I invited him to weigh in on the topic.
“I definitely see the propensity. In an unguided, unstructured context, these experiences are just experiences. There needs to be a therapeutic and supportive infrastructure in place, like in AA or psychotherapy. You need to contextualize the nature of the problem. Where do the barriers or unuseful attachments exist? What behaviours or habits come from that? In AA, there’s this sort of inventory taking. In a twelve-step model there is this notion of admitting the problem, and going from there to a place of hope and belief. There is this belief in this higher power, something greater than yourself. What takes place after that is a lot like cognitive behavioural therapy, where essentially you take note of resentments, barriers, things that inhibit the normal flow of emotion and set you up for these habituated responses. Having this set of beliefs or experiences can inhibit a neutral reaction to life, and push you towards reacting in anger, or out of fear, and you’ll feel you need substances to cope. On the other side, there are feelings of self-worth, feelings about maybe why you are inherently bad and not deserving of love.”
“AA undertakes a process where you unburden these things, these reactions to the world that cause you to make bad decisions. Psychedelics can help facilitate these changes. The deeply traumatized or highly habituated person, try as they might, may not be able to honestly access that stuff. Even with AA there is a phrase, ‘those who are constitutionally incapable of being honest with themselves or others.’ That incapacity isn’t necessarily one of willpower or moral standing, but it accounts for the traumatic reality some people face, where they can’t adequately or honestly access parts of their own narrative with the necessary objectivity. We understand that with psychedelics, you can have these shifts. Psychedelics have the capacity, through properly contextualized psychotherapeutic preparation, to address certain longstanding, previously permanent features of your attachment model, your belief system, your memory, things that become cemented over decades.”
Entheon and a DMT Treatment Market
It was a considered answer, with the benefit of hindsight underlying it. Having spent a fair bit of time on the more abstract nature of addiction, I wanted to hear about what Ko and Entheon proposed as a solution; DMT. I’ll confess, again, to some bias in my inquiry. Much of Truffle Report’s coverage of the psychedelic renaissance has been related to developments around psilocybin, and I’m admittedly intrigued by those who go against the grain. I was particularly interested in DMT’s prospects in an emerging treatment market that psilocybin-based therapies already seem poised to dominate.
“There’s definitely some nuance required in the observation of these various decriminalization, exemptions, and legalization initiatives. I’m all for it. With regards to a class of drug that we believe is much less harmful than, say, alcohol, I believe everyone should have access to those things. Realistically though, we’re not targeting a recreational market or wellness space. We’re interested in a highly medicalized set of conditions related directly to mortality and mental health.”
“What we’re developing is, we believe, not only a good alternative to a medical psilocybin model, but potentially a better option. Aside from some crowding in the psilocybin market, of which there is a lot, we believe DMT has the potential to be the ideal psychedelic therapy model, due to its intensity and duration. This is not to speak ill of psilocybin at all, it has a ton of potential as a therapeutic tool, but there are also limitations. It is a long-acting experience. Potentially up to eight hours of very perceptible effects. Some would argue that that timeframe is necessary to wrestle with the things that come out during these sessions. When this gets out into a consumer base numbering in the thousands, or even millions, then you’ve got the multiplied potential for adverse or negative reactions for which there aren’t many therapeutic tools. With DMT, we can tailor the rate at which the experience comes on, and control the rate of immersion based on administration. In that timeframe, if the person should have a negative or adverse reaction, we can stop the flow of DMT, and that person should return to a safe baseline in about fifteen minutes. It’s an added layer of benefit in terms of safety and scalability.”
DMT, Addiction, and Therapeutic Accessibility
It was a point that led naturally to my next question. An ongoing topic of discussion here at Truffle Report has been accessibility of psychedelic therapy. In our coverage of ICPR 2020, we touched on the viability of 5-MeO-DMT as the ideal compassionate access substance, not just for addiction, but for marginalized communities in general. It’s high potency and short duration imply, at least to me, a quicker clinical turnaround and simplified logistics. I asked Ko for his take, and how Entheon might contribute.
“Accessibility will be one of the massive driving forces,” he tells me. “For any of these molecules. For us, the populations we’re creating these products for are often, though not always, people of reduced means. This may be, in part, due to a substance abuse problem. We don’t want to create something that is more expensive or arduous to become engaged in than existing treatment models. Sometimes, the time of engagement for conventionally available models, something like an abstinence-based recovery house, is in the tens of thousands of dollars and takes something like 28 or 30 days, never mind the associated therapies. We’re confident we can come in far under that, and in a way that’s scalable with the already existing networks of psychotherapists, and can prepare a person from that standpoint.”
“It’s a good starting point, and we believe the actual drug experience itself will not be prohibitively expensive. Comparable to some of the existing treatment models out there. We’re looking to create something medically validated, prescribable, and to ensure that people who have insurance have access to it. The real difficulty is going to be creating something more broadly available. Call it a sub-one thousand dollar threshold. That’s tough. It’s a difficulty across the whole medical space. People that need it always need it regardless of the cost. We are looking that way, possibly through partnerships with nonprofits here in Canada. In Vancouver especially, there are people who we’d love to work with. It would just be premature to try and do it right now.”
Ko on Psychedelic Practices, Traditions, and Acceptance: “Stewards of the Sacred and Spiritual”
I wasn’t done with the subject. The recent rejection by Canada’s parliament and federal health ministry of a petition intended to decriminalize entheogenic plants for, among other things, traditional medicinal uses, should serve as a reminder that psychedelic healing takes more than one form. Should we favour one model over another? I asked Ko what he thought of the coexistence between the for-profit, non-profit, and traditional use aspects of psychedelics, and how that would play into Entheon’s strategy.
“It’s interesting. I think this has been one of our big conversations since the beginning,” Ko answers. “There are, quite rightfully, people who see themselves as stewards of the sacred and spiritual, and people in the position that consenting adults should have access to whatever they need. Some people think the only reasonable means of access are the traditional shamanic routes, and others go through the traditional medical route. There’s validity to all of it, but to me, as much as there will be different contextual realities that dictate what’s appropriate for a given person, some of the inherent cultural specificity of shamanic practices might not be congruent with judeo-christian beliefs, or with someone who doesn’t have the capacity or the faith to work with a traditional shaman. Maybe this person has a medical need, and gains the confidence to try something like this with legalization. We see a lot of this with cannabis, where maybe your grandma or your aunt or someone didn’t trust something prior to it’s approval, and might benefit from it. It’s not a natural evolution to acceptance, so much as a threshold. There is no wrong answer, all these approaches have some validity, but we’re trying to service a population with a real medical need, and provide solutions for them that can be insurance supported, and medically validated to the point where it’s safe enough for people who wouldn’t otherwise have considered it to give it a try.”
DMT Delivery System and Trials
With all that in mind, I wanted to know more about Entheon’s specific formulas and administration. Where were they with trials? In terms of the delivery system, I was picturing something along the lines of an insulin pump. Knowing Ko would necessarily be keeping tight-lipped about anything proprietary, I asked what he could tell me.
“We’re working out the specific details right now, and we’re pretty focused on making sure the dosing protocols and profile are validated from a pharmacological standpoint. The specific form of the pump technology is still being considered. We’re looking at how best to deliver and house that, and adding additional features that would optimize it. I can’t really go into that other than to say that there exists some opportunities to roll it out technologically. As far as clinical trials go, we have our agreement signed with our contract research organization in the Netherlands, we’re looking to conduct that initial small scale efficacy and safety work, which will be a study in smokers in the second quarter of next year, Covid permitting. The other key tenet of that is that we have a drug supply agreement with Psygen Labs, who are health Canada’s only licenced producer of DMT.”
Ko on Entheon’s Advisory Board, and “Life Changing Work.”
As we began to wrap up, I asked Ko about Entheon’s impressive advisory board, boasting prominent figures in psychedelic research such as Dennis McKenna, Robin Carhart-Harris, and Mathew Johnson. I wanted to know what they’d contributed to Entheon’s work into medicalized DMT, and given that they serve on several corporate advisory boards, whether or not they might have a role as facilitators of future collaborations.
“It became pretty apparent from the early days that we needed to find the best and the brightest in the world of psychedelic research. I think that’s exactly what we did. We came to them and communicated our intention to help this massively underserved population. They’ve all been instrumental in helping to guide our knowledge base. I don’t want to put words in anyone’s mouth, or specify, but there seems to be this aggregate of ideas toward DMT not just being a good candidate, but the ideal molecular candidate for therapeutic use in treating addiction. They’ve been really useful in driving everything from the dosing regimen, how the specifics of administration work, the associated psychotherapy and prep work, right down to things like the gauge of the needles we use. As much as our advisory board has name recognition value, they have been very intimately involved in terms of guiding us.” Ko mentions McKenna, Johnson, Carhart-Harris, and Christopher Timmerman by name, before giving a special mention. “I can’t forget about Kenneth Tupper. I feel like sometimes he gets shifted out of view. He was the linchpin in all of this, our connector, our consigliere. Just by virtue of his commitment and seriousness to psychedelic science, he was the person who opened a lot of doors for us,” he tells me.
Before I signed off, I offered Ko the chance for the final word, and to give any parting thoughts we hadn’t already covered to Truffle Report readers. “Thanks. This work we’re doing is a passion of mine. It occupies that rare instance where there’s an opportunity to generate something profitable, but also make some real societal impact. It’s special when that happens. This isn’t just an app that saves you a few bucks. This has the capacity to change our understanding of addiction, and we think people will see the opportunity. It’s life changing work.”