[Transcript] Episode 2: Alex Dominguez - Psilocybin for PTSD

Dan Riley [00:00:00]:
Savvall, I want to thank you for letting me into your office. I know this is a busy time of the year for you and your staff, so I appreciate the time and the interest in having a conversation. It's great to have you on. Welcome to the show.

Alex Dominguez [00:00:31]:
Oh, thanks for having us. There's never a bad time to be discussing good legislation. Let people know how important they are.

Dan Riley [00:00:36]:
Agreed. We were talking a little bit offline just before we started recording about, I think, what probably was leading to the genesis of your interest in the bill we're going to talk about today. 18 two. You were speaking about your brother. I think the setting was probably late 80s, early 90s. Maybe we can just kick it off from there and you can articulate who he was, what you saw, what his involvement was in the military.

Alex Dominguez [00:01:00]:
I sure think so. My oldest brother, I have nine brothers and sisters. My oldest brother joins the military right out of high school within about two months. And he certainly was my favorite brother, so I idolized him. Certainly look forward to any wisdom he could impart on me. And he joins the air force and almost immediately goes overseas, and he's stationed in Manila. That was the first time I actually knew anybody that was in the military, though I want to say maybe about a month or so after that. Two of my cousins that live in Progresso, which is right on the border, they lived on my grandmother's little ranch, which was backed up from military highway 281 down to the Rio Grande river.

Alex Dominguez [00:01:38]:
They both joined, I think it was the navy. So that was the first time I knew people. And certainly growing up in a household where I had cable tv and I watched CNN, and I could always aware of world conflicts. And growing up in the Cold War, you always knew war was always a possibility. And I took great pride in the american superpower, had all the best machines, the best planes, the best naval vessels. We had a good, strong standing army. And I always felt a source of pride, maybe an entirely foolish, testosterone filled view of what America should be and maybe reading too many G. I.

Alex Dominguez [00:02:12]:
Joe comics, that we could impose power, or certainly, if nothing else, have a sphere of influence wherever we wanted to at any time. And to me, I thought that was the best way that we could ensure safety for the free world as opposed to those that were influenced by the Soviet Union at the time. A few years later, when I'm about to graduate from high school, I take the AsfAb score very well. I'm thinking about joining the military. My brother says, no, no, if you're going to join the military, you need to go in as an officer. Do not do what I did at that point. He was already in college. He'd gotten out.

Alex Dominguez [00:02:44]:
He said, you need to go in as an officer because you'll have a lot more freedom, a lot more options. You could go career. Growing up in the era of top gun, I certainly looked at that as an option. Unfortunately, I didn't pass the physical when it came to an eye exam, and you had to have perfect 2020 vision back then. You could not have corrected vision either with glasses, contacts, or LaSik at the time. So I didn't join after all. But about six months later, two of my friends joined the army, and this was about six months before the first Persian Gulf war. So since then, I've always had a keen eye on what happened to our friends and family when they came back from a military theater.

Alex Dominguez [00:03:23]:
And it was not always an easy transition to get back into civilian life. One of my friends who was a radio operator, which seems like innocuous duty except in military theater. The person that has the radio will likely be the first target for any assault. Take out the radio, you take out communications, and you can't radio in for help. You sort of can't radio in for overhead forces to provide cover for you. And he came back both with physical injuries and also trauma. He had PTSD. His family for a number of years had a very hard time being able to relate to him, to communicate with him.

Alex Dominguez [00:04:00]:
It just wasn't the same. And he ended up moving away from South Texas and moved to Boston. And that was really the first time that I noticed what war really was.

Dan Riley [00:04:10]:
If you can speak about him and the symptoms that you noticed, his family noticed what was different in him when he came back from theater.

Alex Dominguez [00:04:18]:
So the most prominent notice, change in disposition. He was always a very fun loving, very funny, outgoing character, an incredible tennis player, very athletic. Life of the party. When he came back, he was disconnected, didn't want to engage in communication often. He was certainly happy to see old friends, but very quickly subsided from conversation. And it reminded me when I was maybe about nine or ten, when I was in the Royal ambassadors of a local church and we went on a large statewide camping trip on the Baylor college campus, I think in their athletic field and being told, do not talk to this boy's father because he served in Vietnam. They didn't say what he had. They didn't know what the diagnosis was, but they certainly knew that he had a disposition, and I'm glad he was there.

Alex Dominguez [00:05:16]:
He was certainly doing his best to engage. That was the first time I saw somebody who just wasn't engaging. So when I reconnected with my friend when he came back from the first Persian Gulf War, I saw some of the same things in my mind. I didn't really have a name yet as to what it was, but certainly over the years we've been able to read up on literature and learn that PTSD is not uncommon for many people that are in the military theater, and they are either themselves subject to any kind of violent impact, an explosion, or they see very traumatic events, whether they are the cause of the event or they witness an event. It could be the death of a colleague, it could be the death of a small child, incidental to the action that's taking place in the streets of a military theater.

Dan Riley [00:06:01]:
Do you know what specifically triggered the PTSD in your friend? Was it witnessing something? Was it some other experience?

Alex Dominguez [00:06:08]:
The only thing I've been able to get from him is he suffered anxiety for quite a bit of time, and I suspect that was largely from the pressure of the type of job that he had. He was a radio operator, which meant he was the communications liaison for his team. And while he was certainly armed, his job was not to necessarily fire the weapon. It was to report what they're seeing, what they're experiencing, who they're engaging with, from what direction. And it's his job to make sure to call for help when they needed it. And that's a lot of pressure to put on a young soldier, and I think having the weight of the lives of your companions. He never said if any of his friends got hurt or killed, but that experience weighed heavily on him for a number of years. And from there he ended up joining law enforcement in Boston.

Alex Dominguez [00:06:55]:
And he's still, I believe, in that profession now.

Dan Riley [00:06:59]:
I think in terms of timing, that's probably something like 30 years ago, right?

Alex Dominguez [00:07:03]:
It was. That would have been probably 1990 or so and maybe 91 when the first Persian Gulf under the first President Bush. And that was the first wave of our more recent veterans to come back with these conditions. And certainly we were engaged, but we used a lot of air power at the time that was able to rest a quick, decisive, I guess, victory, if you want to call it that, for what happened before, there was some peacetime, but that didn't stop us from continuing to build up military forces. And fast forward to 911, which is 2001. I'm in law school at the time. We're the victims of a terrible attack on our shores. And immediately there, strong sense of patriotism, maybe even some nationalism to make things right and protect our lands, protect our fellow Americans.

Alex Dominguez [00:07:59]:
So everybody was on board with that, and our forces went abroad. And I can say I was certainly one of those folks that felt strongly that America should stand up for itself. I don't necessarily agree with the way the battle was designed or conducted. More importantly, did we have a plan for when our soldiers were going to come home? And that was an extended battle, which essentially we have been in nonstop for about 20 years. The Biden administration has announced that we will be pulling back forces and really trying to bring everybody home by August of this year. But we should really think about how many veterans we have now and how many soldiers we still have out in the field. And that's really what makes me think about this being a much broader problem than we might think. So when people are coming back from battle, they're going to suffer both physical and emotional and psychological trauma.

Alex Dominguez [00:09:00]:
And we haven't really found a good solution for that. I'm an avid reader, so about four or five years now, I've been kind of studying different types of old treatments to see if there's a way to bring them back. I've always found that we may overlook something in exchange for looking at something that's newer and shinier or perhaps something that the pharmaceutical industry would prefer us to look at. So the two major treatments that we use now to treat veterans with PTSD are Zolof and Prozac. And that regimen hasn't changed much in probably 1520 years. I want to say right around five years ago, I started reading a little bit more about psychedelics. I have never used a narcotic in my life. The strongest I ever had, I think, with a bad toothache.

Alex Dominguez [00:09:47]:
I think I had a crown. I was given tylenol with codeine. Didn't like it, didn't really seem to do much for me. I just kind of stuck to Advil after that. I'm an attorney. I used to be a felony prosecutor. I don't smoke. I rarely drink, certainly don't do any drugs.

Alex Dominguez [00:10:06]:
But I was intrigued as to why. We had developed a number of drugs back in the. They became very popular, and clearly they were misused or used off label for entertainment purposes and very quickly scheduled, classified as schedule one controlled substances so that we could get them off the street so that people wouldn't abuse them and hurt themselves. But it made you think, well, why did we develop them in the first place? And more recently, we're finding out that, well, the military certainly had an interest in some of these, in particular LSD, for a number of reasons, but we haven't really been looking at what possibly it was that we missed out on generations of scientific study that has gone unresearched. And I think the fresh look that different parts of our planet. In particular, I'm talking about studies in Ireland, in the UK, Israel, and in Australia as to the appropriate types of uses of psychedelics. I know Australia is very good on, very big on studying microdosing LSD for productivity. They're even finding that there's got potential uses for people that have ADHD in the United Kingdom.

Alex Dominguez [00:11:17]:
In Israel, they're looking at both psychedelics, such as MDMA, psilocybin, for different applications. And I don't want to say that Israel is out there. They're a very conservative country, and if they're studying this, why aren't we studying it? Since then, a few research universities in this country have begun researching MDMA. That's certainly one possible psychedelic that could be used for treatment. Recently we have legalized for treatment ketamine, which is known as a tranquilizer. So that's a different application than it was normally intended to be used for. When I was a prosecutor, my county developed a veterans court, a diversion court, first of its kind, for the area, because we saw a need, and the need was we had a lot of veterans that returned home and were having a very hard time adjusting to life in the Rio Grande Valley. They were self medicating, typically with either controlled substances or alcohol, abusing both to drown out the demons that they were living with.

Alex Dominguez [00:12:25]:
And in divert court, the types of cases that we saw were either DWIs, where they were abusing alcohol possessions, which is you have cocaine or some other drug, sometimes harder than cocaine, with them, and also abusive offenses where they're being charged with either assaults or assaults, family violence, where they're fighting with their family members, many times when their family members were trying to restrain them or keep them from going out and abusing themselves because their family members cared. They didn't want them to get drunk, to hurt themselves, to cause harm. And what that shows is, despite the help they got in the divert court, we can certainly try to modify behavior. But are we really finding a cure or a treatment? Everything we've done since 911 with our veterans has really been trying to maybe correct symptoms, cover those up. What are we doing to actually treat the problem? And I think that's where psychedelics have a real chance of letting somebody confront their demons and with a therapist, work through them face them and try to get past them.

Dan Riley [00:13:40]:
It's interesting. We're having this conversation in Texas, in Austin specifically, but in Texas generally, I have a separate podcast that is about this city. And recently, in the past few months, I've had a few interviews related to psychedelic work. And you can feel in the zeitgeist to me as an American that there's a shift, sort of a mental shift or an acceptance shift towards these substances just because a lot of people are suffering and a lot of people are in pain. And I think for the description you were just giving about somebody who is in this state and begins to abuse some substance, I think you said to deal with the demons or address their demons. People generally don't act that way unless they're at their wits end. They don't know what else to do, and so they turn to what ends up looking like an egregious way of living to stop their psychological suffering. My understanding is that bill 18 two is, I guess, why don't I back up and just let you go into your position now that you have in state government? The first question I would have for you is, has this been on your mind for a long time, offering something like this, writing legislation that I know is now being discussed in the House, in the Senate, or what kind of made you initially go ahead and actually put your name on something that could begin to help people?

Alex Dominguez [00:15:20]:
It's probably not usual for a younger member of any legislative body to take a giant leap and ask their fellow members that have been there for sometimes decades to take that leap with them. And the leap, in my opinion, isn't so high so much as it's different. For the past few sessions, we've been debating medical cannabis use, compassionate use. We found anecdotally and some studies that medical cannabis, for example, helps children with autism, certain types of autism, and getting that adopted in our body when we have witness after witness saying we think this helps, I've seen it help. I'm giving it to my child or I'm taking it myself. Yes, I know I'm breaking the law, but I am in a dire situation, and I would like you to help me legalize it. We're having that conversation now, and it's taken us decades to get there. I have never been one to be an advocate for legalizing marijuana.

Alex Dominguez [00:16:34]:
Not so much because I'm against it or it smell so much as, which I don't necessarily like, but more so that I don't want people to feel the need to escape the problems of their life. If someone's doing it recreationally because they like how it makes them feel, or they want to put on weight or they want to just relax at the end of a long, hard week, I'm not going to judge. I think that's perfectly acceptable. But I think to answer the question of why would you want to escape your life? Is one that we should be asking daily, not just from our policymakers, but from our spiritual advisors, our priests, our spouses, our friends. What is it about our lives that have gotten so complicated, so hectic, so rushed, that we feel the need to have to escape? I don't propose this legislation to help people escape so much as I want to have people find something to go towards. And the towards is a solution. I'm trying to give people hope. We have a lot of people that have suffered from trauma.

Alex Dominguez [00:17:41]:
We have sexual assault survivors. We have child abuse victims. We have accident survivors where they actually physically were hurt by an accident or they witnessed somebody else be hurt by a traumatizing act. And these are images that are ingrained, burned in people's minds, and they can't get past it. They can't live a normal life. It might be for a short time, it might be for decades, and it's time they're missing with their family and their loved ones, time where they're not able to grow as a human. And I think it's important that we should do what we can to provide medical providers the tools that they need to make someone whole. The reason why 18 two focuses on our veterans that have PTSD is for two very important but independent reasons.

Alex Dominguez [00:18:27]:
One, I strongly believe that our elected officials in this state and in this country genuinely have an affection for our veterans. I really do. We may disagree why they were sent to a particular country to do battle, but they will all agree that they've done so at great personal risk, and we owe them a duty to help them transition back. And in this state, we've passed legislation to help both veterans and the widows of veterans, for example, financial help, in that they can get tax exemptions on their property, for example. As a country, we've done our part to pass bills to help veterans get college credit or even pass on that savings to their grandchildren so that those children can benefit financially by getting a discount on their tuition for college so that they can have a better life. And that's, I think, what shows that elected officials really do care. And if they're going to care about somebody, they should care about veterans for one very important reason, that we're losing about 20 veterans every day to suicide in this country. That's 6000.

Alex Dominguez [00:19:40]:
Every year since 2001, that's 114,000 veterans.

Dan Riley [00:19:45]:
That's incredible.

Alex Dominguez [00:19:47]:
And I remind our members, when we were having our discussions, I said that's almost as large as our legislative districts. It's an astounding number. And for all the billions that we've spent on our endless wars, why aren't we spending a larger fraction of that on treatment for veterans? Look at our homeless population that suffers from PTSD and see how many of them are veterans. And it's sometimes easy to dismiss because we'd rather just not see it. So we don't think about it because we have our own busy lives. Well, what I'm trying to do with 18 two is to address the second part of the important reasons why we should be doing this. We are at crisis level now when we're losing that many veterans every day. We can't afford to wait for the federal government to try to come together to enact good policy.

Alex Dominguez [00:20:46]:
As we see now, the US Congress isn't passing laws on a weekly or monthly basis. Rather, they're filing omnibus legislation where everybody gets a little bit of a say in it for it to pass. And that's an approach to doing public policy. I don't think it's the best approach, especially when it's a problem that people should agree on addressing. So if the US government will not be addressing this problem, Texas would like to step in to help.

Dan Riley [00:21:16]:
Yeah. First of all, I should say, just to be candid, I really admire you for doing this because I know in this state there is an enormous stigma. I grew up in Pennsylvania, and so I'm not a native born texan. There is a reputation of Texas, of being, in certain elements, deeply conservative and resistant to change and newness, new ideas. I think that is a false idea, largely, especially in the changing Texas that we now live in. But I have to think you knew you were going to face a lot of blowback. There is a stigma, no doubt, that exists among a lot of your colleagues related to drugs generally. And now you're talking about psychedelics or empathogens being legally offered to people in the state.

Dan Riley [00:22:13]:
That being said, I have always thought, since I have personally got interested in this subject, that Texas, it seems to me to make a lot of sense to have this state be one of the leaders in these initiatives because of its, as you mentioned, its love and respect for its veterans. When did you decide you were going to put your name on this, and did you expect your credibility to be attacked or questioned when you're implementing or suggesting that these kind of initiatives and new ideas be discussed and potentially brought into law.

Alex Dominguez [00:22:50]:
I think the one thing I've learned being in the Texas house is that it didn't come with a handbook necessarily on what we can or can't do, should or shouldn't do. And because nobody told me I shouldn't do it, well, that just gave me a little bit more freedom. There are 150 members of the Texas house, and different people have priorities. We started working on this bill in the late fall, and we filed it fairly early on and all through the summer. And I want to say, even starting last calendar year, when I would run across a very good article, I would forward it to my chief of staff. I said, you got to read this. And I still do it. I still get those articles because I read a lot, or it pops up on my feedboard and like, oh, here's somebody studying this.

Alex Dominguez [00:23:40]:
Let's see how this works. What do they learn? How can we incorporate this so we can become better with our legislation? We knew we were going to do this, and we felt it was urgent. I thought that this session would be one where we could open the discussion. I thought maybe we could get a hearing of significance and really start to work on spreading this message, not just amongst those in my caucus, but those of the other party as well. And the reason why I say that is the Texas House didn't change its numbers, meaning that the conservative base was in the majority, and typically they would also control the chairmanship of a committee that would hear this type of legislation. So there are quite a number of obstacles to get a bill passed into law in the state of Texas. Lots of checks and balances to make sure really only the really important things get done, typically the important things to the majority party. But there is good legislation.

Alex Dominguez [00:24:40]:
We're a very bipartisan state. And I thought that I could win some people over, if nothing else, but because of my personal relationships with them. So I knew that was always something that was going to be at risk. And the reason why I point this out is, early on, when I filed this bill and I started moving it, I first reached out to my delegation in south Texas. We're all Democrats. We're all friends. And I say, I'm pushing this piece of legislation. I would like your support, meaning, I would like you to be a co author on my bill.

Alex Dominguez [00:25:08]:
The more signatures you have, the more credibility you'll have with the chairperson of a committee that the bill will be referred to so that they will set it for a hearing. Just for a hearing. And the first thing that one of my friends sent back was an emoji of a mushroom and followed by another friend who sent a gif of a mushroom. So I thought, okay, this is going to be a much harder battle than I thought, and I have to check myself. Of course, they haven't read what you've read. Okay, how can we summarize into digestible form, either written or in talking points so I can start explaining what this does, and I start doing that on the floor early on. And some folks just kind of give me this blanks. They're like, are you trying to legalize mushrooms? To which I say, I am not.

Alex Dominguez [00:25:59]:
I said, how about I drop off some literature and we touch base again tomorrow? Okay. They're fine. Nobody was a no. But there were a lot of very quizzical looks this session. I am a vice chairman of two committees, which would seem to imply I have a little bit of credibility, at least with somebody. At least I would hope so. And maybe that's what gave me the courage to go forward of, like, well, I filed a number of bills, other bills that are very good pieces of legislation. This one is special to me because I think in my heart of hearts that this bill could save lives.

Alex Dominguez [00:26:39]:
That's not something that very many policymakers can say that they have accomplished, even if this bill were not to be enacted. But began the conversation, that's how I began this session. I thought, let's start this discussion. We've talked about medical cannabis. We've talked about hemp and CBD oil. Can we have the courage to go a little bit deeper? And let me show you that the science is there. And not everybody here is always receptive of science or reason, but they are open to ideas that save lives, because we do have that one shared goal in mind of making people's lives better. And they at least were willing to give me the time to sit down and talk with me.

Alex Dominguez [00:27:26]:
And the more I talked with people, the more on board they became. Soon after a while, people were coming up to me saying, I've heard about this bill of yours. Tell me what it does. I don't know why my staff's talking about it. And soon thereafter, and this is where the bill takes a new turn, I get a text message from a lobbyist who says in a representative, Governor Perry would like to set up a Zoom and talk with you about one of your bills. I thought I was getting pranked because it was from a number that I didn't know. I thought, very funny, which one of my friends got their staffer to text me. So I called.

Alex Dominguez [00:28:05]:
No, sure enough, it was the lobbyist. Turns out it was lobbyists who used to be a communications officer for the governor, worked in staff intimately, and was reaching out as a friend. So we set up a Zoom meeting a couple days later, and I was astounded at the level of knowledge that former governor Rick Perry has on this topic. Absolutely floored. So, as it turns out, Governor Perry, when he was. The governor, ran into a Navy SEAL in California when he was out there conducting some kind of visit. I don't know if it was at the airport or the hotel, exactly where it was, but he was relating that he ran into the soldiers, and turns out that he was from Texas, said, well, if you're ever in the Austin area, as governor Perry is likely to do, stop by the mansion, say hi, and sure. Several, several months later, that Navy SEAL stops by and the governor gets a call from the trooper at the security gate saying, there's a soldier here to see you.

Alex Dominguez [00:29:10]:
And he said, we'll send him in. And he lived with the governor for about six months. And firsthand, the governor learned what it means to come back with PTSD. Since then, the governor has explored that topic, researched it himself, has, I think, staff members that are always keeping an eye on the veterans that he has met and became very close to different organizations, one being the nonprofit called Vets, which was formed by Amber and Marcus Capone. Marcus was a former Navy SeAL, SEAL team six. These are the guys. Top notches are the ones that we count on. And his job was to set up the detonation devices to open up walls and doors.

Alex Dominguez [00:30:04]:
And even though they moved to safety, he certainly has suffered trauma to his brain from those explosions, not to mention the war effort itself. And when he came back, he wasn't all there. His wife was having a very hard time with him, and he knew that. He said his family life was pretty much over, and he reached that crisis point. And the more and more veterans we talk to, they all say they have reached that point where there is no other solution other than taking your own life, because life has just become that painful. You can't escape it anymore because the demons are always there. The pain is always there. And so he took a leap of faith and saved some money and went to Mexico to receive therapy that included psychedelic treatments.

Alex Dominguez [00:31:00]:
And he will never use the word cure, but he will tell you that his life is enriched. He's finishing his MBA now from USC. He and his wife are having a great life together. They're happy, they have purpose, they're engaged with other veterans that have gone through this and many who want to go through it. And what that tells me is that there's a need, not just for treatment, but more importantly, there's a need for hope, because if they know there's a possibility for a treatment, a solution in the future, maybe they can hold on a little bit longer.

Dan Riley [00:31:40]:
Yeah. It's funny in talking about this, how this brings together so many currents, and it's like a confluence of events in the US that are working against this momentum of implementing solutions like this one, I think, which is prevalent in the culture generally. It definitely is prevalent in Texas. The idea that of believing in personal responsibility and believing that we are the agents of our own psychological state, and that if you have a problem, it's up to you to resolve it. I think, though anecdotally, and you just gave a couple of examples, if you do have personal experience interacting with people with severe mental illness, you do realize, you come to realize that it is not a moral shortcoming or a moral failing. It's something that they simply just have had some effect that has led them to that point in their life and they don't know what to do with it. I'm curious for you specifically, when you've mentioned a couple of times what an avid reader you are, what convinced you that these options, and maybe you want to go through what psychedelics are. Which of the psychedelics or pathogens you think might be effective in helping veterans or people who experience trauma? What was the trigger in your mind? What did you read? What kind of statistics or anecdotes did you come about in the literature that made you think like, man, there's really some potential options here for helping people.

Alex Dominguez [00:33:07]:
I may come from a slightly unique background. When I was an attorney, having left the DA's office, I was asked by the court to essentially be an attorney at Lidham for patients at the local state hospital. So when someone is having a mental episode, a family member can call the police department and they will intervene for a mental health intervention. And police officers have a special unit dedicated to that, both in my county, anyway, it was the sheriff's officers, certain police officers for each major city knew how to talk with these possible patients because they are not arresting them, but they are depriving them of liberty while they take them into a hospital to be evaluated as a potential danger to themselves or to others. I grew up knowing somebody like that. He was the older brother of my best friend when I was in middle school, and one of his friends dropped some acid into his whiskey, which he drank and essentially fried his brain. And I knew him for years. I knew him before he suffered from that.

Alex Dominguez [00:34:23]:
And I saw what he was like afterwards. I would see him shake his head, thinking there was a demon in him, people being called in from the state hospital to put him in a straitjacket and watching his mother cry because she loved him and she couldn't help him. So I grew up seeing that all the time, saying, definitely say no to drugs, especially with your friends, who you don't know what they're going to be doing to your drinks. One of the reasons why I've never used drugs. But the hospital where he was taken to when I was the attorney at litem appointed to these cases is where I worked. So for a couple of hours every week, I'd go down. We'd have these small hearings with a county judge, and they rotated. One of the prosecutors would be there and myself representing the best interest.

Alex Dominguez [00:35:15]:
And I would interview the patients all the time before our hearings. And my questions became a little bit more like a doctor would ask. Certainly I'm not a doctor at all or any kind of clinical psychotherapist, but I would ask questions, well, do you know who you are? Do you know why I'm here? Do you know what this event is going to be? We're going to have a hearing. Do you know what's at stake? And to varying degrees, I would get answers that would really help me prepare a defense for them. And at the end of it, my choices were either to fight for their immediate release or to concur with the assessment of the doctor and the request of the district attorney, which is, no, they need to stay here for two weeks or 90 days, depending on what the petition was. So I became very close to the doctor that was ahead of there. His name was Dr. David Moron, a Yale trained.

Alex Dominguez [00:36:05]:
Sorry, Harvard trained doctor who made it his life's work to work with patients of mental illness and just got a chance to see him, talk to him often. And I got to learn the medicine that they were treating people with. And it wasn't intentional. I was doing it mostly to pay the bills. I was a young attorney in private practice, but it stuck with me, and I worked there for about three years. So I got very good at the job, and pretty soon I could kind of guess what the medication was that any particular patient was on and make the appropriate recommendation to the judge. And sometimes my patients went home, and sometimes they came back. Sometimes they were there multiple times.

Alex Dominguez [00:36:43]:
But many times I would see those same patients in criminal courts. And I remember one time having to intervene with another attorney who was representing a lady who I knew to be one of my former patients, and tell her, do you know that this patient suffers from the following mental illness? And she kind of like, no, I didn't know that. And I'm thinking, how could you not know that? Look at her. She's chewing her fingers. And at the time, that lawyer had struck a deal to just have her plead a time served so she can go home, which is all the patient wanted. And I said, this patient does not have the mental capacity to agree to anything, much less to commit a crime. She just doesn't know any better. Afterwards, the judge asked me and she saw me talking to.

Alex Dominguez [00:37:38]:
And turns out it was a judge who knew this patient. The patient had changed her look a little bit over the years. She says, oh, yeah, I remember her. What can we do? Well, there are other options other than incarcerating or freeing somebody. They could actually get mental health treatment. And sometimes you offer the mental health treatment in lieu of any criminal charges. So as long as you're going to go see your doctor, your therapist, you're on your medication, you're staying on track, the charges can be dropped. So it's an incentive.

Alex Dominguez [00:38:06]:
Anyway, that's where my professional dabbling into mental illness took place. I know that's a long answer to your question, but if you've ever worked with people who suffer from mental illness, you know they cannot pull themselves up from their bootstraps, which is itself a very hard thing to do physically. If you've ever tried to pull yourself up from your bootstraps, they don't know all the options that they have sometimes because their mind won't let them formulate those thoughts or those solutions, or the people they are with don't offer solutions, because it's much easier for some people to move away from somebody who has mental illness, to walk on the other side of the sidewalk, metaphorically of their lives, than to help them get the help that they need. And some people want to protect them and don't want them to relive trauma. You better just to move on or to cover it up or move past it. You don't think about it when sometimes what they might need to do is actually face their problems. But that comes at a cost. Any person who has suffered severe trauma, in particular PTSD, when they try to face the trauma, to face the demons, to face what is troubling them, what's always gnawing at them that they can't quite escape, not even with sleep.

Alex Dominguez [00:39:38]:
It's a very scary place. And that's why I think psychedelics offer a possible avenue for treatment. Psychedelics differ from psychotropics. Psychedelics allow a patient to, in a way, separate themselves from the experience, where they can observe the experience, they can describe the experience, they can see it, they can smell it, they can talk about it, and while they will still be emotionally affected, they can continue to do so without shutting down. And the research I found shows that for some patients, some types of psychedelics help the brain to reset. And that might be what some of these patients need, a second chance, so to speak.

Dan Riley [00:40:28]:
No, you don't strike me as a hippie, and I have an aunt who was, I think, involved in that community, and I think that the more people, the problem to me in getting this more widespread, getting these ideas more widespread and accepted in the culture, is one largely of education. And you went through a little bit of speaking about, talking about Bill 18 two, how people seem to be interested in it. And the more you were able to educate people about the specifics of it, the more it sounds like amenable people were to at least having a conversation about what you might like to do with it. Let's talk about the bill specifically. Maybe I'll start with a simple question. What are you proposing at the root that this bill offer to the citizens of Texas?

Alex Dominguez [00:41:25]:
Information. So, 18 two has two components. I'll describe the easier one. There has been research done on ketamine because it's legal. And I've certainly met a couple of doctors who use ketamine in their therapy to address PTSD. And they work with patients, typically veterans, and they see them often. They're able to use as ketamine as a tranquilizer. It's used by anesthesiologists.

Alex Dominguez [00:41:56]:
There has been more recent research, more wealth of it worldwide on MDMA, and recently it's been undergoing clinical trials to see how effective it can be towards PTSD in general. I believe it's at the phase three level, and with luck, if it keeps going on track, in a couple of years it will likely achieve FDA clearance as a breakthrough medication. So it won't be legalized, but it will be given essentially an exemption so that doctors can use it in a clinical setting and in a hospital setting to treat people who have PTSD. Assuming that trials keep going the way they have been going, it would be fantastic for HHSE, the state, and the FDA to put together the research necessary to compare the different types of treatment. So, again, information. The first part of the bill is the bigger portion, the part that will likely get the attention. It will propose a clinical study with the Baylor College of Medicine in collaboration with a veterans hospital, most likely the one in Houston, to study the effects of psilocybin on veterans who have PTSD. And I'll tell you why for two reasons.

Alex Dominguez [00:43:21]:
The first is veterans that we've spoken with, and some of the literature we've seen on anecdotal use of psilocybin show that it can be a very effective psychedelic in treating a number of things. It is currently being studied to treat depression, which is a mental illness, and I think has that designation right now by the FDA to be used as a treatment for it. So those studies are underway, but it has never been used to study its effect on patients that have PTSD. Well, as it turns out, veterans like the idea, the concept of using psilocybin, as opposed to a lab created psychedelic such as MDMA. And the reason why is in two parts. One, it's natural. It grows. You derive it from a natural plant, and they feel that that's maybe a more acceptable use.

Alex Dominguez [00:44:21]:
The veterans that I've spoken with on this topic are all very conservative, very politically conservative, and they have not used drugs. They don't use drugs. They're not interested in taking medical cannabis to address their problem, but they are open to the idea of psilocybin because they believe, because it's natural, that it will also not be an addictive narcotic. So this study would be the first of its kind for this purpose on the planet. And that's an example of looking at a problem and finding a clever solution. And what I mean by clever is addressing something that we haven't done for decades, that we could have been doing. And it just involves giving a little bit of consideration to a wild idea. And the wild idea is this, we're in Texas.

Alex Dominguez [00:45:28]:
This hasn't passed in any other state, far more progressive states than this one. But why are we getting the look? Why are we getting the consideration? It's certainly not because I built enough credibility. I'm not a chairperson in the state. I'm a young freshman from South Texas. But we've gotten the attention of some very important people, some very important operatives, heroes among the people we've spoken with here in this office about this issue, who are willing to put themselves out there to address the problem and possible solution are people who are not naturally extroverts. These Navy seals, they don't like attention. They shy away from interviews. We even had a congressional medal of Honor winner come here and say, this is the research we need.

Alex Dominguez [00:46:18]:
And it's very hard to ignore a winner of the Congressional Medal of Honor, the type of person that admirals and generals salute first. So people have gravitated towards us while we've been doing the research. People sought us out, was saying, I'm from another state, but I heard about your bill. How can we help? Share your information with us. What are we missing? How do we need to better address this and showing them the language, talking about approaches. And thankfully, it mostly has aligned with what our initial vision was, a very conservative, narrowly tailored bill to address really one thing on a very select group of patients. And it certainly doesn't hurt to have Governor Perry willing to call a few people and shake a few hands to say, I really need this, and you need to support this.

Dan Riley [00:47:20]:
The bill, is it unique to psilocybin in the study, or is MDMA involved.

Alex Dominguez [00:47:26]:
In any way in the study itself? It will only be psilocybin. And the reason why is we were originally going to include MDMA. We found a number of articles from other countries that are currently studying it. Plus there will be a future study that has not been published that is underway currently, and we didn't want to duplicate that. And because we know money is a component of any study, to do it right, we didn't want it to derive funds from psilocybin if we didn't have to. So since MDMA, for example, is already being studied, why not instead use that money to increase the pool of participants in the psilocybin study?

Dan Riley [00:48:06]:
Yeah. Makes sense for people who maybe are listening to this and have never heard about any of this before, when they think about psychedelics, they think about Woodstock. In the anecdotal stories you're familiar with, for veterans who are experiencing or have experienced severe trauma, PTSD, and I know there's a lot of mystery around what is happening in the brain when this is effectively healing their trauma or at least really helping the people who are taking it. What seems to be going on? What about this substance is potentially so revolutionary, might be too strong of a word, but so unique in its ability to really help.

Alex Dominguez [00:48:52]:
I've never experienced any kind of tripping that we heard about taking place during Woodstock, and certainly there will not be any music being played during therapy sessions. What we understand at this point happens is your brain is very focused. In other words, you're not hallucinating about what's happening, but rather your memories are being drawn to the fore and you're able to see them and pull out the detail. And anytime I imagine when somebody sees a picture of a loved one or an event, they will remember that event. Now, when I see a picture of a deceased friend, I'm both happy and sad. Happy because I have the memory, sad because I realize that's all I have. But it might trigger other things as well. For patients who are undergoing this treatment, when they are receiving the effects of the psychedelic, it's more than just the memory.

Alex Dominguez [00:49:58]:
It's almost like reliving the moment or moments that you need to address. And oftentimes for these patients, these veterans in particular, it's not just one moment. It could be one very large one, but it could be many moments. And some veterans have been able to deal with that. And I don't want to discount those veterans who've gone through treatment either with the use of psychotropics or other substances or without substances, and just they were able to face their demons and still have them as part of their life. But being able to be functional and moving on, this is not necessarily for them. Though if they would like to one day be a part of this, I'm not going to discourage them. Rather, this is for those veterans who are at the end of the rope.

Alex Dominguez [00:50:44]:
I heard this quote when I was a kid, and I didn't quite understand that a drowning person will reach even for a sword to hold on to. We don't need those swords. We need something else, a different lifeline to pull them up and let them know that there is light at the end of the tunnel. And that's why this bill is important. And I think that as more people learn about it, it becomes self evident that this is a good thing. And then soon after that, the anger comes of, why aren't we doing this already? And that actually speaks largely to the types of policy that this office advocates, finding problems that exist in this state, asking, why doesn't this already have a solution? And putting forth a solution. So it's not just this. I had a younger brother who was disabled, so I would typically get very upset when you see a vehicle parked in a disabled parking spot that clearly does not belong to a disabled person.

Alex Dominguez [00:51:43]:
I shared a picture with my staff here of a giant green monster truck taking up two disabled parking spaces, to which my legislative director, Logan Davidson, said, oh, yeah, I knew somebody in college that would do that because they would need a flatbed tow truck to come and get it. And typically those are not around. So someone is parking without any possible action taken against them. But what happens when somebody who is truly disabled needs a parking spot and this vehicle has taken up two? A vehicle that's easily lifted and maybe about 3ft off the ground to get into the door? That's not, in my experience, what a disabled person would drive. So we certainly addressed that with some legislation that was accepted and has moved forward already to the other chamber. So I think part of my role, and maybe that's a reputation I developed at the house, is I'm here to try to solve problems. I'm not here to make a name for myself. I'm here to improve both the lives of my constituents, but those are lives of people I don't know in a way that I think will be beneficial to them.

Dan Riley [00:52:57]:
Yeah, I think you hit on this earlier. I think you were mentioning there was a congressional medal of Honor winner who hasn't spoken about or is familiar with this piece of legislation specifically. And I think those anecdotes tend to be what have the capacity to potentially change people's minds once you really can empathize with what this person who has sacrificed so much is dealing with on a day to day basis, what hell they're living in and how they might be able to help them. Did that individual have experiences with psychedelics that helped him specifically? Or is he just more familiar with the literature and thinks it would be a good thing.

Alex Dominguez [00:53:42]:
Not to put him at risk of any professional criticism? Let's just say he's very grateful for this area of study. Yeah, and the reason why I say that is because of timing. He was unable to testify at the committee hearing, but I believe his testimony would have been at least as moving as that of the other special operators. And what I mean by special operators. Navy SeaLs, Green berets who did testify. One Green Beret who testified in particular had a few members shed a tear in recounting what he lived through when he came back. Being able to list every type of medication he was prescribed and knowing that none of them worked. And he finally got so frustrated with them.

Alex Dominguez [00:54:32]:
And that's not an unusual feeling, this feeling of frustration and hopelessness that he stopped taking them, had the other thoughts of an alternative way out, but realized that's not what he wanted to do if there was a chance for something else. And thankfully he had friends who pointed him in the direction of the psychedelic treatment. And he is grateful for it. He is living an incredibly productive life. He is a motivational speaker. He's the type of person that we would invite to any event to make us all feel good about ourselves. If it takes a bill like this to make 150 members of the house feel good about themselves and we can keep moving forward, by all means, let's spread our message to all 50 states and see if we can make everybody feel a little bit better.

Dan Riley [00:55:19]:
Frankly, I think if it does fully pass, this coming out of this state as well, I think would reverberate around the country because I think it would take other states that maybe look to Texas as a standard bearer for mimicking potentially in other states, who knows? Last question I want to ask you is about what you maybe two last questions. The first one would be, if this does pass, what will be available to people who are suffering like this that isn't available now? Is it unique to veterans or who will be eligible for these kind of to this study?

Alex Dominguez [00:56:01]:
So currently what we think will likely happen is after this bill passes, and assuming that the appropriate funding also is included in the appropriations budget, the Baylor College of Medicine will be working with a veterans hospital in Houston. I am not the decider of who the participants will be in the study. That will likely be a collaboration between both the hospital and the Baylor College of Medicine researcher. I'm guessing they will want to have both a control population who will be given a placebo, and then the actual study participants who will receive the real dose. The patients won't know, which I imagine at some point when they advertise for this study within their patient group. The Houston Veterans Hospital is enormous. It is the largest one in the state, and Texas has probably the largest veteran population in this country. But it won't be for everyone.

Alex Dominguez [00:57:03]:
We just financially can't do that. And two, we're trying to get this information out. I can't tell you how many patients it will be, depending on the money amount at the end, but we know that the veterans community will be watching this study, and certainly those participants will be sharing what they learn. And I think the important part here globally is at the end of the study, we will have information that we can put together with that study of the ketamine and MDMA to see which treatment is the best. When speaking to one of our local anesthesiologists who currently uses ketamine to treat PTSD in veterans, he says, yes, this treatment does work, but my patients and I think that the psychedelics will be even better than this, and this is a medical professional who uses this treatment daily. Once we have that information. And because I do think Texas can be the leader in this, I think if not other states, I think that the US Congress could likely take this on at a larger scale and certainly put the resources that are available. You know, Texas, we have a balanced budget every cycle.

Alex Dominguez [00:58:23]:
We will use every dime, and when in doubt, we will save our dollars. Our rainy day fund is extensive, even though it's been raining for a number of years. We're very grateful for what's being considered now to do this. This is a topic I'm sure was not on the governor's predicted list of high priority bills to come out, and it's one that has gotten the attention of the governor. A number of senators who are very excited by this, who didn't know anything about it, are very curious, but more importantly, they're excited that the veterans community has come out so strongly for it. We had no opponents during our hearing, and it just goes to show that we have worked this bill very hard, not just without our own caucus, but with the other side as well, and remind people this is a veterans. And some of our strongest advocates on the House for whipping votes have been my republican colleagues, especially those that have a military background, saying, we absolutely need this. And I don't know why we haven't done this before, which is a very common call to action.

Dan Riley [00:59:37]:
It strikes me in talking to you that, I mean, you're a freshman here, and I worked in the startup world for a long time, and there's a common idea in Silicon Valley that I think in business in general, that if something is not being addressed, it often takes something brand new or a brand new person with new ideas to show up and innovate and bring conversations to the fore simply out of newness that just were not acceptable, that were not happening prior. And I used this word before, but I really admire the work that you're doing. And I don't know if it's naivete, but just the audacity to follow what I'm sure is both your head and your heart in trying to do this. And I have no doubt that if this passes and gets implemented, it will begin to save lives. In closing, I would like to ask you just to speak on anything about this that you think are misconceptions, are stigmas that need to be addressed, are just points of just educational ignorance in the public that are necessary or important for people to know about, to be open minded about this, to try to begin to help some people that might be involved in this study.

Alex Dominguez [01:00:55]:
You know, I think you. You alluded to something earlier, which I think encapsulates why there's a natural opposition to this type of topic. Psychedelics have a stigma, and perhaps even now, we see an era in american history, a culture of people who just said, just be happy. Stop worrying about things. And that's in direct conflict with our capitalist ideals of no. If you want to be happy, you have to work very, very hard every day, save your money, invest properly, buy a house, raise a family, and then repeat over and over again. As opposed to the counterculture, which was live day by day, love each other, and I would like to find a world here where we can combine those two, if possible. We burned the candle at both ends trying to provide for our families, working hard for just a couple of hours of relaxation, only to wake up the next day and repeat the cycle.

Alex Dominguez [01:02:06]:
Because of that criticism of the counterculture, we have criminalized substances that were created with benign intention, and we abandoned that for decades. Imagine how many lives we could have saved had we at least maintained the research, just kept studying and looking back. Now, I'm not looking backwards for a solution, but rather, I think big problems require bold solutions. And maybe it's because, I guess I'm a newish member from South Texas whose dad only finished the 6th grade. I just don't know any better.

Dan Riley [01:02:50]:
Yeah, well, it takes people who have maintained that kind of sensibility. I can tell how much this means to you to lead with that. And I think I speak on behalf of a lot of people in the public who you will never meet that I really appreciate you putting voice to this, and I really hope that this state leads the way in this kind of research. And I'm very optimistic that if we do, a lot of people that you probably will never meet in the future will benefit from this and will have hope in a hopeless place in their life. So I really appreciate the time, and I really appreciate more than that, just your focus on this and your audacity and courage in moving this forward, and I wish you all the best of luck. It was really great to meet you.

Alex Dominguez [01:03:42]:
I appreciate that. Thank you so much.

Dan Riley [01:03:43]:
Thank you.

Alex Dominguez [01:03:43]:
Man, you.