Expectation, set, setting, dosage, and route of administration provide the context and scaffolding for psychoactive drugs. An IV morphine drip can make unbearable pain completely manageable, while IV heroin, which is immediately converted to morphine once it crosses the blood brain barrier, destroys tens of thousands of lives a year.  A benzodiazepine such as lorazepam, when taken orally at sensible doses, can stop a panic attack in its tracks, yet snorting or injecting benzodiazepines, or mixing them with alcohol, can lead to complete blackout and terrible consequences.  Taking psilocybin mushrooms with friends out in nature vs at night alone in the darkened streets of an unfamiliar city vs with a trained trauma therapist in a healing setting—- the resulting risks, benefits, and experiences are mind-blowingly different.In today’s story we hear Graham’s long and winding road with various drugs and alcohol in the context of childhood trauma and bipolar disorder, with a particular emphasis on his complicated relationship with ketamine. For years, he used and abused massive quantities of ketamine, yet now he has transitioned to using ketamine in a therapeutic context with Dr. H, and the experience of ketamine, the consequences, and the end results are just shockingly different….all because of expectation, set, setting, dosage, and manner of administration. Audio note: Graham's emotional support dog makes some intermittent appearances on his microphoneBFTA on Instagramhttps://www.instagram.com/backfromtheabysspodcast/BFTA/ Dr. Hhttps://www.craigheacockmd.com/podcast-page/