“If I can’t change my views based on evidence, then why do science at all?” Nora Volkow on Psychedelics

Nora Volkow has been Director of the U.S. National Institute on Drug Abuse (NIDA) since 2003, making her one of the longest-serving Directors of a National Institute, perhaps second only to Anthony Fauci. During that time, and by her own admission, Volkow’s views on psychedelics have changed substantially, as larger datasets and more rigorous studies have emerged. Today, she is a proponent of further research into the class, and has at times given glowing reports of their potential in substance use disorders as well as mental health conditions.

Volkow’s latest comments on the topic came in the form of a presentation at the American Psychiatric Association’s annual meeting in San Francisco, via a talk titled ‘Psychedelics in Psychiatry’. While the NIDA Director’s standalone talk on the subject was, in itself, a signal of psychiatry’s intrigue around the class and her Institute’s openness, the number of attendees only further drove the point home.

The talk took place in a relatively small room, which was quickly overwhelmed with attendees. Some sat on the floor and in chairs crammed in against the side walls. Volkow asked for the doors to be left open so that attendees in the hallway could listen in, though organisers didn’t oblige. “Even the overflow room is overflowing for this talk”, as one attendee, NIAAA Deputy Clinical Director Nancy Diazgranados, noted.

Below, we share a transcript of Volkow’s presentation and Q&A, as well as her slides and a brief interview with Psychedelic Alpha founder and editor, Josh Hardman.

A Brief Interview

A throng of attendees descended on Volkow at the close of her session, before she headed to an engagement with APA leadership. Our Editor, Josh Hardman, spoke briefly with the research psychiatrist and NIDA Director…

While Volkow’s views on the class of psychedelics, broadly defined, appear to have shifted substantially in the last few years, her perspective on ibogaine in particular seems to have changed most starkly.

Just a couple of years ago, for example, she said the drug is unlikely to ever receive approval for opioid use disorder. Since Volkow made those comments, no substantial clinical data have emerged that might otherwise change one’s view. But last month, almost to the day, Volkow stood alongside the loudest ibogaine advocates in the world as President Trump signed an executive order that explicitly called out its therapeutic potential.

But her research wasn’t all desk-based: the NIDA Director’s ibogaine learning journey included a visit to Transcend Clinic, an ibogaine outfit in Cancún, Mexico. Is that what changed her mind about ibogaine, I wondered?

“I went to Transcend because I was concerned, actually, about pretty severe QT prolongation with ibogaine”, Volkow told me at the APA meeting in San Francisco.

“I wanted to understand how they were doing it, because I was afraid that they’re going to have very serious cardiac arrhythmias”, she went on, highlighting one of the most prominent safety concerns around the use of ibogaine.