Published: Saturday, 20 November 2021 13:55
Experts say that psychedelic drugs, along with psychotherapy, can help treat PTSD as well as depression. People Images/Getty Images
- More veterans are turning to psychedelic drug-assisted therapy as a treatment for post-traumatic stress disorder as well as other mental health conditions such as depression.
- Veterans advocates are urging the Department of Veterans Affairs to consider psychedelic drugs such as MDMA as part of the agency’s treatment programs.
- The advocates say that psychedelics are “misunderstood” and can provide a variety of benefits.
- They add that the drugs along with therapy can also be used by people other than veterans for mental health conditions.
When Army Ranger Jesse Gould came home from Afghanistan in 2014 after his third deployment, he was suffering, both physically and emotionally.
It took the Department of Veterans Affairs (VA) 2 years to process his disability claim and diagnose him with post-traumatic stress disorder (PTSD).
Gould said that the VA’s treatments for PTSD simply weren’t working for him, and he was losing hope.
So, he began a search for something that could help him.
Ultimately, he discovered psychedelics, a class of psychoactive substances that can alter perception and mood and affect numerous cognitive processes.
These include lysergic acid diethylamide (LSD), methylene dioxin methamphetamine (MDMA), dimethyltryptamine (DMT), psilocybin (psychedelic mushrooms), ketamine, and ayahuasca brew.
Gould chose ayahuasca brew, which is made from the leaves of the Psychotria viridis shrub along with the stalks of the Banisteriopsis caapi vine, although other plants and ingredients can be added.
“It saved my life,” said Gould, who in 2017 founded the Heroic Hearts Project, a nonprofit organization pioneering psychedelic therapies for military veterans.
Gould has partnered with the world’s leading ayahuasca treatment centers and sponsored psychiatric applications with the University of Colorado Boulder and the University of Georgia.
He said that he’s now aware of thousands of veterans who’ve been helped by ayahuasca brew.
“In terms of direct connection, we have served over 150, and a clinic we work with has served 450,” Gould told Healthline.
Psychedelics are ‘misunderstood’
Thomas Bandzul, a legislative counsel for Veterans and Military Families for Progress and a longtime veterans advocate, said that what Gould is doing is becoming increasingly more common.
Bandzul explains that the reason so many veterans ultimately land on psychedelics is because they work.
“MDMA, for example, is one of the most misunderstood drugs that have huge potential for doing good,” he told Healthline. “Under controlled circumstances, used under medical professionals’ care, I think this can be, and has been, of great use for the good of people with stress-related injuries.
“Too many of the issues of the past have biased the public against this drug, but I have seen people with PTSD use this as a curative in conjunction with other therapies,” Bandzul added. “I believe it has great potential.”
How the VA sees it
Despite what some see as growing evidence that psychedelics can positively treat people with PTSD and other psychological conditions, VA officials haven’t given them much attention.
Gary J. Kunich, a spokesman for the VA, told Healthline that the use of psychedelic treatments such as MDMA-assisted psychotherapy and psilocybin-assisted psychotherapy are “not part of the standard of care for treatment of mental health conditions at the Veterans Health Administration (VHA) and is not an approved clinical treatment.“
The use of psychedelics as part of a research protocol might be permissible, he added, “but this would require Institutional Review Board and Research and Development Committee approval at the local facility.”
He continued, “The Veterans Health Administration’s Office of Mental Health and Suicide Prevention is closely monitoring the developing scientific literature in this area.”
When considering evolving scientific literature around innovative mental health treatments, Kunich said, the VA looks for outcomes from “rigorous and well-designed clinical trials” as well as things such as Food and Drug Administration (FDA) approval or recommendations in clinical practice guidelines.
“When implementing a new, evidence-based mental health treatment, VHA puts safety of veterans first and foremost,” he said.
New clinical trials beginning
While the VA hasn’t endorsed any psychedelics or funded any trials at the federal level, several individual VA hospitals have begun looking at psychedelics as a possible treatment alternative.
“The VA is lagging way behind with regard to psychedelics,” said Rick Doblin, PhD, the founder and executive director of the Multidisciplinary Association for Psychedelic Studies (MAPS).
“Most veterans believe that the VA should be the active voice for veterans. If there is some treatment that can help the veteran, they should be first to study it,” Doblin told Healthline. “But that is not the case. The vast majority of the funding has been from private donors.”
Doblin, who received his doctorate in public policy from Harvard’s Kennedy School of Government, wrote his dissertation on the regulation of psychedelics and cannabis for medical use.
His professional goal is to change the public’s perception of psychedelics. He supports the development of psychedelics as prescription medications but also for personal growth for otherwise healthy people.
Not just for veterans
Doblin believes that there are many applications and uses for psychedelics that extend beyond the VA — especially for depression and other psychological issues.
By 2025, Doblin said, we’ll see a ramping up of psychedelic clinics for PTSD, psilocybin clinics for addiction, and more that will go beyond veterans.
“Psychedelics will also play a major role in community-wide addiction treatment, he said. “It will be combined with psychotherapy, as well as for couples, obsessive-compulsive disorder (OCD), phobias, and depression.”
By 2035, he said, “many people will be telling stories about having been to a psychedelic clinic. They will have legal access to these psychedelics.”
First priority is veterans
The VA Loma Linda Health Care System in California has initiated a single-site, phase 2 clinical trial designed to test the feasibility of administering MDMA alongside psychotherapy for combat-related treatment-resistant PTSD.
MDMA will be given in conjunction with structured psychotherapy in three single-dose psychotherapy sessions in a hospital setting over the course of 12 weeks.
The overall objective of the study is to evaluate the risks, benefits, and feasibility of MDMA used in conjunction with manualized psychotherapy, on reduction of symptoms, or remission of PTSD, as evaluated by standard clinical measures, in a VA healthcare system.
“So far, only one veteran has been enrolled and treated at the Loma Linda VA,” Doblin said. “The study is for eight vets. No other psychedelic trials at VAs have been conducted.”
Doblin said that the first veteran has been screened for a trial at the VA facility in the Bronx in New York City but hasn’t yet been treated.
“We just submitted a protocol to the FDA for a group therapy study at the Portland VA, which we anticipate starting about March 2022. There will be psilocybin PTSD trials at multiple VAs, but they haven’t started,” he said.
PTSD expert changes her mind
Rachel Yehuda, PhD, a PTSD expert and a professor of psychiatry and neuroscience, is director of the Center for Psychedelic Psychotherapy and Trauma Research and director of the Traumatic Stress Studies Division at the Icahn School of Medicine at Mount Sinai in New York.
Yehuda told CBS News last week that she was previously skeptical about psychedelics being of any benefit to patients.
“When I first heard about this, I thought to myself, ‘How could this possibly be a good idea?’” she said. “Psychedelics were illegal and designated by our government as being of potential harm and no medical benefit.”
However, in 2016, the FDA authorized phase 3 trials of MDMA, and Yehuda has since changed her view.
Yehuda told CBS that the results from MAPS’ first phase 3 trial “were just astounding.”
“Two-thirds of the people that were treated with a course of MDMA no longer have PTSD,” she noted.
The FDA now recognizes MDMA-assisted psychotherapy as a breakthrough approach, which could help lead it to full approval.
How safe are psychedelic trials?
Are psychedelics clinical trials safe? Doblin gives an emphatic yes.
“We have medical screening to keep people safe from physical complications,” he said.
“We have lots of preparation and integration sessions, and we administer a suicide severity rating scale at every meeting with a patient to try to keep people safe from psychological complications.”
Doblin said that therapists have a code of ethics and two-person therapy teams. They videotape all therapy sessions, whether they involve medications or not.
“We have monitoring and oversight from our clinical research team to keep the data safe from mistakes,” he explained.
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