said years old, it's thousands of years old cut to the ground and it's one of many. the timber is shipped from a nearby port to asia to make furniture that will be sold to people in wealthier countries. recent research suggests a quarter of this green forest could disappear by 2050, because of logging. and yet the congo base and stores around 20000000000 tons of carbon. that's around 3 years worth of global greenhouse gas emissions. it is a precious natural barrier to climate change and its trees are of values, not for a few, but for humanity and planet earth itself. nicholas hawk al jazeera, pandey, southern cameroon. ah, reminder, top story is hernandez, era,

a gathering of foreign ministers from the g 20 group of nations in india, as ended without an agreement on how to end the war in ukraine. yes, x, your state, antony, blinking, says russia has shown no interest in engaging on peace in ukraine. if i was the 1st face to face conversation between lincoln and his russian counterpart sale of ha, since the start of the war. because i told the foreign minister what i and so many others said last week at the united nations. and what so many g, 20 foreign minister said today, and this war of aggression engage in meaningful diplomacy. that can produce a just and durable piece presence landscape for $4.00 to $10.00 point plan for adjusting durable piece. the united states stand ready to support ukraine through diplomacy to end the war on the spacious president clinton, however, has demonstrated 0 interests and engaging, saying there's nothing to even talk about unless and until ukraine accepts. and i quote the new turtle realities,

while doubling down on his brutalization of ukraine. ukraine is blaming russia for a strike on a residential block in their southern city was a parisha that killed at least 4 people. several others were injured. the attack destroyed many apartments in the 5 story building. emergency services say they rescued 11 people from the rubble. the station master on duty during tuesdays train crash and greece, the worst of the nation's history has appeared in court facing charges, including negligent homicide. emergency crews are still combing through the wreckage head on collision in northern greece. left at least 57 people dead. i'm serious labor party presidential candidate, peter o. b, a said saturday's election results were fraudulent and that he actually won governing party candidate bowler to nibble was declared the winner with the election commission saying he received 37 percent of the vote over. he says he will take the issue to the courts. chinese government has begun minutes. rising the

country's northern border with bolivia to control the entry of undocumented migrants the military will be deployed for 90 days. the stream is up next, looking at the future of mental health treatment. when is he after that talk, the law will the law when with neither side rowing to negotiate is the ukraine war becoming a forever war? is america's warble leadership increasingly fragile. what will u. s. politics look white as we had to the presidential election of 2024. the quizzical look at us politics. the bottom line. ah, welcome to the stream at sabbath dean. ketamine therapy is quickly gaining popularity and seen as a life saving option for people suffering from treatment resistant mental health disorders like depression. but in the us,

many are raising concerns that increased availability of ketamine is out pacing oversight of the drug. and they say that more research is needed. so today we ask is ketamine therapy, the future of mental health treatment. and of course we want you to join the conversation as always. so be sure to share your thoughts and questions with us on you to ah, johnny us to discuss all this from boston, dr. robert meisner, medical director of the ketamine service and mclean hospital in philadelphia, dr. hannah mclean, a physician, psycho analyst and founder of sound mind center and from los angeles journalist for tessa latifah, who has documented her own experience with ketamine therapy online as well as in her writing. and thank you so much for being with us. such a fascinating topic. i want to start robert by kind of asking you how does ketamine work in this instance and why is it so useful for treating depression or is it

thanks for having me and thank you for your interesting the topic. so we don't know precisely how ketamine works biologically, but we have a, a reasonable working hypothesis. and the key concept in that hypothesis is something called synoptic genesis. so now the genesis describes the brain's ability to essentially create new or novel connections that may not have been there before . so how does this happen? we think it involves something called an n m d a receptor and, and way through which ketamine antagonizes or prevents that receptor from operating as it usually does. that then leads to a cascade or a flow of other messaging molecules which communicate with each other. that leads to more and more what we call quote, down stream effects in the cell. you may have heard things about b, d,

f. for example, a very popular object of study right now is well as interleukin in the immune system. there are many 2nd messenger other molecules down stream of this and m d a receptor that ultimately through glutamate to be think in part. yeah. lead to send out to genesis. so i have to say i, you know, robert of coming from a doctor. that was the most absurd layman explanation in a beautiful way. i was still able to follow you. so just for the audience, maybe people who may be struggling with some of that jargon i want to share derrick story. this is someone who has some experience with kennedy and therapy, echoing a lot of what you say, but just with different words, take a listen. my 1st experience is to mean the for all of your emotional trauma experiences and your ego separating from

yourself. and afterwards it allowed me to come back later, i kind of you all of my experiences objectively in that objectively. and then level them and level myself from there are like 90 and they're still threatening buffering in my world. and in the world in general, have you been helped me over and get back to a place of connected in loving protests when you hear that? i mean, how does that compared to your personal experience with ketamine therapy? i think it's really interesting because it seems that incredibly in therapy there are kind of 2 things that are happening. there's the neurological changes, which the doctor just explained. and then there's also these kind of like mental realisations that you're coming to and that secondary. but it's very powerful and that's how it was for me. i definitely felt very forgiving when i

was doing how to me. and i felt not only forgiving towards other people, but towards myself. and my own may be mistakes that i had made and it was a sense of peace that was really comforting. and i appreciate you using those terms . i know that other people have used them also from the pre interview. i loved robert that you talked about ketamine being a great catalyzed for humility and hearing for tis i say that and i'm curious, dr. hannah, what is this about? is it about generating empathy? people have described the experience as giving you a new perspective, maybe an objective perspective on some subjective traumas. what can it be used to treat and, and who should be using it? yes, so i think that's a great question. and again, thanks for having me. it's amazing to be here and thanks for the interest in the subject. as robert said, you know,

i think it's important i so i went through neurology, occupational medicine, psychoanalytic training, and i now i teach therapist and facilitators how to facilitate how to become facilitators and ketamine, assistant psychotherapy, as well as working with mbm and phyllis. i've been and when i teach them, i always say here's the brain explanation. and here's the other explanation, which is how i want you to think about it. so the brain is really important and it's important to think about how these like synopsis and the neuro plasticity occurs. but it's also just as important, if not more important in my mind, that these substances, whether it's ketamine, phyllis, simon, m, d, m a 5 m d m t. we have so many things coming down the pike. what they do is they help us get into our difficult, difficult experiences, get into the difficult memories and really process things that we couldn't process . and it's like, it seems so simple and yet it's like, you know,

when they say it's like a 100 therapy sessions in one session. yes. isn't it, isn't it, is it so? and i can talk about my own experience as well that i was i, as i was training to be a psycho analyst. they did 4 times a week for 4 years. psychoanalysis. like so that's, that's how you get trained as you receive. and you also have patients. and for me, i had this idea of what my trauma was. i could tell it from like a 3rd party perspective. and i have one of the best analysts in philadelphia. he's actually 94 years old and he's trained a lot of the therapist and analysts here and it's like we can get to i, but we couldn't get into it and what things are next. maybe are access it or process or? yeah, right, there was like, i couldn't, and i wanted to and i was ready and it wasn't, i wasn't ready to get that and i could, through ketamine, assisted psychotherapy and other, psychedelic assisted therapy is the legal ones because you can go to other countries and do legal versions of the things i was able to actually get into it and feel it and cry and process and it's like and then and then and then your,

your trauma lifts or your difficulty and, you know, there's lots of different types of i'm and i want and i want to unpack all that i see for to seems like you want to jump in as she was speaking, there are some things maybe echoed with you resonated? yeah, well, so my 1st 2 sessions as academy. and i actually went with my mom and she came and sat with me because i was very nervous. i was anxious about how i would feel in the drug. and so she came with me and we have a great relationship. but it really felt like just in those couple hours, we felt like we had gotten through therapy for like 4 years together or like it just things that i didn't even realize that i wanted to tell her or be able to express where suddenly just like there it was really cool and i'm wondering, i mean, we didn't really get to the heart of this question, but who should be considering the therapy, robert?

so there are a number of different people who can benefit and there are some folks who were not quite sure if there is an evidence base or that there shortly will be an evidence base for them to benefit. right now the most robust evidence is for folks who struck who suffer from treatment resistant, major depressive disorder, and possibly major depressive disorder. there is also quite a bit of evidence for patients who are specifically suffering from suicidal ideation in the context of treatment resistant, major depressive disorder. and i really want to emphasize that one of the reasons why and by the way, i think of ketamine as the 1st of of my of much to con, really kind of a gate keeper to, to things that are coming down the road. and the reason there's so much interest in this medication and part is because we're in a public health crisis. if you look at the 1st 2 decades of this century,

suicide rates globally, or excuse me, in the united states have gone up in the past, approximate to decades by 35 percent. 035 percent. right. and we know that the world health organization has reiterated depression is the leading cause of is the leading cause of ah, let's call it disability morbidity in the world globally. so we're in a public health crisis and we have drugs that tend not to work very quickly and tend to be permutations of each other to have something new that's opening up a gate wave for other drugs as well as cat m e n. a psychedelic pipeline. is exciting and robert, when you talk about it being a cadillac or for humility, i had a personal experience taking another psychedelic, i'll just be transparent. i was in a legal environment. it was a, it was, i was sca actually and it was very hard for me after that experience. i know they're very different, but it's these same difficulties and trying to find words to encapsulate this

feeling of connecting to trauma as being able to process things feeling, you know, feeling very sort of humble about your own struggles if you will. i mean that's a very general way of putting it, but i'm curious before we get into some of the risks and challenges. robert, why is this humidity catalyze? are so important for 2 reasons. not a day goes by where my team and i think are not. and still, but a sense of respect and humility for this emerging mechanism that, that can mean seems to leverage. and that is to say, we're often surprised about what's coming out and what's evolving as we better understand it. and it tells us just how much we don't know about this very exciting thing. i think from a subjective perspective, there's a sense of humility. one might feel can be due to any number of things,

but in some cases probably has something to do with what we heard a little bit earlier before about the combined effects of snap to jana says in an environment where a patient is allowed to explore. new cognitive or psychologic stances and starting point and see things with a new lab. well, i really appreciate you framing it that way because we have a video that we want to share with someone does just that. the people echoing what you say throughout this. so dr. before we get to that video, i just want to share with you what, what people are saying, and youtube, for example, big grad thing or sorry, past the thing, my wife wants to try it for her migraines. nothing else has helped and i'm hoping ketamine treatment will be a miracle. maybe nothing is a miracle, but there have also asking about the side effects. so we'll get to all that. but before we do this is dr. michael, they're born from toronto explaining sort of some of the,

the rapid this association that can happen. take a listen when people are under the influence of ketamine. they get this rapid association of their, you know, constant thoughts that they normally have. and over the period of an hour, they get a chance to kind of have an opportunity to say fresh, new perspectives on, you know, a lot of their personal beliefs or routines or whatever it may be. and for people suffering with mental illness that can be very therapeutic to have a fresh perspective on, on their life there. so many people suffering from depression or anxiety who want to try ketamine therapy or just psychedelic therapy. and they, and they want help, right? they don't want to go do this in their back yard or underground, where they don't have a medical team in the therapy teams to help them. so hannah, about fresh perspective that we have heard from time and time again when talking about coming in therapy. i mean, you've said that the results you've seen have been astounding. and even people who

were previously suicidal have felt like, you know, their entire traumas or depression has been lifted. could you just talk us through? what's astounding, you yeah, i like. i like to tell people that i did 15 years of training and in western medicine, and i didn't feel like i had any tools to actually heal people, which is it seems ridiculous and crazy, but the, the, the healing that we're that i'm seeing and that my team is seeing in the clinic and, and i think it's really important to note that we're doing ketamine assisted psychotherapy. it's not like if it's sent to your home, or if it's done as an infusion and not together a psychotherapy, it essentially works as a long acting antidepressant. well, we're doing is we're really doing therapy we do for our sessions. so this, you're seeing one of our patients who as a marine who had severe trauma, saw his best friend die in front of him when they switched places and he was leading the squad was able to go back and cry and miss and apologize and really

feel the feelings of missing his best friend, he lost, but then he also underneath that was able to uncover all these other traumas and difficult feelings. and what we're working on now in therapy is his grief over his loss of his mother. and just like that, he never got degree for, he was in the military, he went home and then had to go back into the field to rock rock like 2 days later . so it's like all these things to get bottled up and you never feel them. and you think you're pushing away and you think you're fine, but actually you don't realize what you could, the life you could be living if you weren't squeezing all the memories back and not processing them. and i think a really, really amazing example of someone who came in to us and had treatment resistant, depression and treatment resistance, suicidal ideation for her whole life had been adopted. and her 1st cut in session. she actually had a memory of being taken away from her mom, son and build record and had this her 1st 3 years of life. or actually she didn't remember them, but she was remembering,

being in the orphanage not really knowing who to turn to write and just cried and cried. and had no idea was even part of she'd been in therapy or her life had no idea that it was even part of something she should process. and then the suicidal ideation lifted. so i think it's all really important when in the last clip we watched someone talk about dissociation, and we've heard that word and i think it's really important to know that it's technically categorized as a dissociative. but most people actually report that they, you know, they'll travel into different realms during their journey, but they actually end up feeling more connected with her body, which no one can really explain why that right through. but it may be part of like you travel when you come back and like, well i have a body, well my body needs rest, you know? so it really isn't like, i think we need to, to really just think about that term and not just categorize it as just as one thing, but it actually does many things for people therapeutically, most certainly, and i see robert nodding there, robert, i want to come to you, but before i do, i kinda want to share with the audience. of course,

there's another aspect all of this. there's a startup culture aspect, if you will, a lot of online prescription. and there's concerns, as we said at the top, about safety, oversight and accountability. i mean, roberts, if you look at my screen here, this is, i think one of the wellness center is that are popping up online, you know, discover the power of psychedelic therapy. here's another one, talking about how their program centered in science, and it helps you see transformative results yet another one here, encouraging you to unlock your ability to heal and, and, you know, i think this is great. it encourages people to ask questions to reach out. but what are the maybe concerns about the different ways in which this could be abused and the ease with which there is access? now? yes, it's a, it's an extremely important question. so for all the optimal, the cautious optimism and enthusiasm that, at that basic science clinical science and translational clinical research and

research levels that there is many of us are quite concerned that there is apt, an absence of adequate oversight, a, i, as ketamine and other molecules and medicines circulate, so my phone rings, you know, several times a month with a disaster story about a situation that evolves somewhere in the country or the world. and a patient suffers catastrophic consequences or may possibly death as a result of either inappropriate procedures, lack of oversight, lack of monitoring, inappropriate dosing or giving the medicine to someone who has contraindications and it's critical to realize that and translational pharmacotherapies, this field of translational science and clinical signs, it's very hard without a strong group of collaborators nationally and internationally to establish

a precise standard of care. so one of our goals is to always say, what's the evidence base asked, what's the evidence base? show me the data. and then let's create together a reasonable statement of standard of care that is reflective of the evidence and the data, and let's not be fooled or coerced into using it outside of those bounds. because that's when dangerous. that's when the danger and amount to match when bad things happen. well, i appreciate that. i also want to share that there are other people in our youtube chat, jamie and in real time saying for example, line junior academy in a great solution for physical and mental issues, but really dangerous when it becomes an addiction. my co reagan. yes, saying ketamine is an interesting concept alongside various other psychedelic substances. all very good in theory, but in practice faces resistance from the medical establishment. i'm curious. i see you're, you're nodding, robert a doctor, hannah,

you talked about sort of the disconnect between western medicine and how that inability you felt to actually treat people. but what do you make of this comment? this resistance that we see it's or a robert 1st and then we'll come to you dr. ana. but i'm curious specifically, you know, we saw this, you know, or again, i think in the u. s. context is now able legally to treat a silo. psy been, of course, which is magic mushrooms, but with all the psychedelic, we've seen this pushback. what can you share with us, robert, about that pushback, and is it good? i mean is that, is that gonna help us maybe control potential abuse? yes, the pushback is actually, it's not just important. it's critical. the pushback and my experience, it 1st doesn't follow in east west binary. i would suggest we really deconstruct using that language because it just doesn't follow along those lines anymore. fair enough that the pushback really, i think, is about ensuring that there is an evidence base for the protocols that are being

used in the community to make sure that patients are 6 that's pushed back that you want to exist, right? you want data driven evidence based care and that data driven evidence based care is it can occur and the research that's needed is happening. what we don't want to have happen is for the unregulated, broader community in which market incentives. yeah. are extraordinarily powerful, right? to dictate care plan. i'm unfortunate money driving care. no, i appreciate you saying that i do wanna just take us to another topic because we have this woman who posted about her experience with ketamine therapy on tick tock for tess. i'm going to come to you after this have a look at this. of course, she's using all those hashtags like ketamine therapy and mental health, but take a look at this. okay, let's talk about ivy ketamine therapy. this treatment as ideal for people with severe anxiety, depression, p, t s d, a dickson. i have treatment resistant anxiety and depression,

which means that i've tried literally every single medication and not have worked. so my doctor recommended t. m. s, and i think had a mean that benefits are supposed to be long term or permanent. so i'm really excited to see how those stick around long term. but i have noticed amazing changes since i've started these infusions. i highly recommend this treatment to anyone who has been struggling. it is a game changer and it literally saved my life. your reaction to that for tessa? yeah, i just wanted to comment really quickly. what you are saying about the companies that are sending it out and kind of making it easier to get. and i do think there is a conversation to be had about the accessibility of mental health treatment, especially in the united states. but as someone who did kind of mean in a clinical setting, and i could not imagine doing it outside of a clinical setting and not having a doctor there and not having a technician taking my blood pressure. i mean, seriously, like we talk,

i was the doctors how heavily there nodding right now, they're both. i guess you, well, i mean, i think you, you maybe it's, i'm calling me to say, but sometimes it like hits me really hard and i get very, very anxious. and i literally feel like i am not in a good place. i need that professional there. and so sorry, i just wanted to say really quickly, but i think it's really important that the accessibility is widening, but i would never tell someone, even though ketamine has done great things for my mental health. i would say if you can't do it in a clinical setting, it might not be the right time to do it. i don't agree with these companies and how they're doing. and i'm wondering the video video that we shared with you. i mean, it also addresses sort of breaking some of the stigma around not just mental health, but this whole issue. i mean how important is that in dr. hannah, in terms of moving forward? i know for example, and i don't want to just makes too many things here but, but a lot of moving pieces here, for example, a proposal by biden in the new york times here that would ban online prescribing of

certain drugs. i would imagine including that ketamine. how important is it that we break the stigma but also keep access available? yeah, i think it's more about like how do we keep safety and keep keep accessibility in mind but not throw safety out the window. i don't think sending cutting me home to people is safe in most circumstances. once in a while we'll do it. 95 percent of our patients are all in office. we do like extended in person treatments, but i think it's really important for for ketamine. there's 4 categories, really i say they're saying there's home laws, hinges, there is in office i, v and fusions that are usually not with therapy, and then there's therapy. and then you can have like at home, you can have someone sitting with you so there can be alone. someone sitting with you and fusion and therapy. yeah. and i think it's really important that we're keeping the separate right. and i also think it's really important to keep in mind

that i think the facilitators and well trained facilitators are really what's going to make or break this ecosystem. our, our program is actually one in 7 in the whole country. ok, that is well that using that license to train and oregon and i think we really just need to keep an eye on who is sitting with who and how safety is. and then we also need to keep an eye on people like you and other developments of this very fascinating topic, which we will do. i want to thank you. in the meantime, robert hannon for for being with us. stay tuned. the next time. ah, ah ah ah, a passion for supporting local communities and pioneering,

innovative african science and technology projects. how. how beautiful. how doris? ah, all of us on this planet look just africa al jazeera. what as a leading by chemist determined to use his scientific knowledge to serve africa. women make science from the lab to the field are now to sierra a journey of discovery and one albini in man's exploration of his religious heritage. how has the big katasha faith survived for 700 years, despite of all the time history of oppression? i'll just the real world tells the story of a religion that has over 7000000 followers. in the footsteps of my big tachi ancestors on ology 0. on a recent february day in central park in new york city,

you never have guessed it was right smack in the middle of winter. look around, people are dressed like it's spring or summer. wait, hold on. where is the snow ever seeing new york in february like this? never a new reality, perhaps with new yorkers, 1st enjoying the warm weather, but now beginning to ask themselves, will it ever snow this year? because this isn't normal, they probably don't even need to be wearing this jacket right now, because it's mid february and it's supposed to be cold. but it's not. ah, i know, and lauren taylor in under the top stories on al jazeera, a gathering of foreign ministers from the g 20 group of nations. and india has ended without an agreement on how to end the war and ukraine.