VA Studying Psychedelics As Mental Health Treatment For Veterans
The U.S. Department of Veterans Affairs has launched clinical trials to study the effectiveness of psychedelic drugs including MDMA and psilocybin as a treatment for military veterans with post-traumatic stress disorder, addiction and other serious mental health issues. Building on previous research that has shown the potential for psychedelics to treat serious mental health conditions, the VA is now conducting at least five studies to gain more insight into the promising drugs, according to a report in The New York Times.
“This is a watershed moment,” said Dr. Rachel Yehuda, the director of mental health at the James J. Peters Veterans Affairs Medical Center in the Bronx, who is leading one of the studies. “This is a time for a lot of hope.”
Psychedelics As Mental Health Therapy
Research into psychedelics including psilocybin, MDMA and ketamine has shown that the drugs have potential therapeutic benefits, particularly for serious mental health conditions such as depression, addiction and anxiety. A study published in the peer-reviewed journal JAMA Psychiatry in 2020 found that psilocybin-assisted psychotherapy was an effective and quick-acting treatment for a group of 24 participants with major depressive disorder. Separate research published in 2016 determined that psilocybin treatment produced substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer.
In 2017, the U.S. Food and Drug Administration designated MDMA as a breakthrough therapy for PTSD, a move which streamlined clinical trials to test the effectiveness of the drug. A year later, the FDA granted the same status to psilocybin as a breakthrough therapy for treatment-resistant depression. The new willingness to allow research has led to a push to study psychedelics as medicines for the nation’s military veterans, whose challenges with mental illness have led to a suicide rate among vets that is higher than that of civilians.
In New York, researchers are testing MDMA-assisted psychotherapy for a group of veterans in a trial that began in January. Three additional trials of MDMA and synthetic psilocybin, the active compound in psychedelic mushrooms, are scheduled to begin later this year at clinics in Portland and San Diego. Dr. Leslie Morland, a clinical psychologist at the Veterans Affairs Healthcare System in San Diego, is researching the potential for MDMA to enhance couples therapy in relationships challenged by PTSD.
“The VA is in some ways the best place for this type of research to happen,” said Dr. Leslie Morland, a clinical psychologist at the Veterans Affairs Healthcare System in San Diego, who is studying the possibility that MDMA can enhance couples therapy in marriages strained by PTSD. “The VA is going to make sure that we have good data that supports the safety and efficacy before they offer it to veterans, as I think is appropriate.”
Last month, The New York Times reported that hundreds of veterans have traveled to psychedelic retreat centers, which can be found in Mexico, Jamaica and other foreign countries. With vets seeking these often-unregulated options, Dr. Shannon T. Remick, a psychiatrist at the Veterans Affairs Healthcare System in Loma Linda, California, said that those charged with caring for vets have a responsibility to research into the drugs.
“There’s a risk of doing nothing as veterans are seeking care elsewhere,” said Remick, who is leading a study of MDMA as a treatment for PTSD among a group of 10 combat vets. “It’s our priority to make sure veterans are safe and getting the best care.”
Psychedelic Therapy Not An Easy Path To Mental Health
While the research into psychedelics shows a strong potential to help people struggling with mental illness, they are not miracle drugs. Although the effects have been shown to be quick and long-lasting, therapy with the drugs often entails intense, frightening sessions as patients deal with the trauma from their past. Yehuda said that the treatments can be exceedingly painful, likening the experience to giving birth.
“The most common misconception about MDMA with psychotherapy is that you’re taking this magic pill that will take away your symptoms,” she said. “What’s happening is you are getting in a state that is conducive to doing difficult work in a manner in which you are in the right window of tolerance where you can emotionally engage, where you can process the memory but not get so distressed by the memory that you become emotionally numb.”
But the experience seems to be tremendously helpful. Standard treatments for PTSD at VA clinics, which can include prolonged exposure therapy and cognitive processing therapy, can help relieve patients’ distress. Early results of her research, however, show a much more profound effect.
“Many people are showing what seems to look like remission,” said Yehuda.
Researchers are optimistic about the potential for psychedelics to foster a new age of care for mental illnesses. But they are tempering their enthusiasm with the reality of the impact the substances can have on patients.
“We’re taking vulnerable people, particularly people with severe mental illness, PTSD, substance abuse disorders, and we’re putting them in a vulnerable state of mind, a very suggestible state of mind,” said Dr. Christopher Stauffer, a psychiatrist at the Veterans Affairs Healthcare System in Portland, who is leading two psychedelic studies. “We have to be super careful about bias in all directions, from the researchers to the participants.”
Kevin Nicholson, COO of psychedelics therapies firm Delic and CEO of Ketamine Wellness Centers, says that his company is already providing ketamine psychedelic therapy for veterans seeking mental health treatment. Last month, the company announced a new partnership with the VA in Arizona.
“Veterans suffering from treatment-resistant depression, PTSD and anxiety will now have access to ketamine therapy at the KWC Arizona clinics in Phoenix, Tucson and Mesa-Gilbert at no out-of-pocket cost with prior authorization from the VA,” Nicholson writes in an email, adding that more treatments will be available for vets and other patients in the future. “We will continue to expand access to ketamine treatments through KWC, and as future medicines move towards legality, such as MDMA and psilocybin, we are prepared to support emerging markets and cater to those suffering from a growing range of conditions.”
Yehuda is certain that psychedelics will become a successful therapy for many patients with mental illness. But she warns that the drugs aren’t for everybody.
“I think it’s going to be a breakthrough for a bunch of people,” she said. “But we just have to figure out who they are, and more importantly, who they aren’t.”