Newswise — Psychedelic-based therapies are poised to change the treatments that psychiatrists can offer patients.
"Psychedelic treatments are frequently discussed by Jennifer Jones, M.D., a psychiatrist from the Medical University of South Carolina. She conducts research on these treatments, considering them transformative forces for both individuals and the psychiatric realm."
The long-awaited endorsement of MDMA, commonly known as "ecstasy," as a remedy for post-traumatic stress disorder, would mark a pioneering milestone for psychedelic substances, bringing about significant transformations in patients, mental health practitioners, and society at large. The Food and Drug Administration is anticipated to render a verdict on the utilization of MDMA-assisted therapy for PTSD in the beginning of 2024.
Jones noted that the successful integration of this groundbreaking research into practical applications would hinge on the willingness of patients to engage in psychedelic-based treatments and their access to such therapies. In her recent study, published in Frontiers in Psychiatry, Jones investigates the potential obstacles faced by a specific demographic that could greatly benefit from psychedelic therapies for PTSD: individuals who engage in substance use.
Changing treatments and outcomes
Sanctioning psychedelic therapies may aid individuals with mental disorders, specifically those with numerous or unresponsive conditions. PTSD is a frequently intense psychological ailment that may manifest subsequent to exposure to a traumatic incident. Present interventions, though they ameliorate symptoms for certain patients, render countless individuals devoid of any advantageous outcome.
In relation to individuals afflicted with PTSD who habitually resort to alcohol or other substances, the rates of unresponsiveness to treatment are further elevated. Jones deems this state of affairs as intolerable, prompting her to initiate research endeavors aimed at discovering novel methodologies to address patients contending with both PTSD and a substance use disorder.
An encouraging "emerging" treatment alternative for individuals grappling with both PTSD and SUD could potentially arise from a "time-honored" category of medications known as psychedelics. Psychedelics encompass both naturally occurring substances (such as psilocybin, mescaline, and DMT) and synthetic compounds (such as LSD and MDMA). Natural psychedelics have been employed for medicinal and spiritual purposes in traditional societies for countless centuries. Nevertheless, their scientific characterization primarily took place during the 1950s and 1960s.
"Remarkably, in these preliminary investigations exploring psychedelic therapy for a specific condition such as PTSD," Jones commented, "noteworthy advancements in symptoms related to another mental health disorder, such as depression or SUD, were observed."
Clinicaltrials.gov reports that since 2009, roughly 80 clinical trials centered around MDMA have been concluded or are presently underway. These trials focus on exploring the utilization of MDMA in a broad spectrum of disorders, encompassing anxiety, depression, obsessive-compulsive disorder, SUD, and PTSD. The breadth of these diverse studies underscores the potential impact of MDMA in addressing multiple disorders, addressing a gap that previous treatments have failed to fill.
"This holds tremendous significance," emphasized Jones. "It is exceedingly common for individuals to experience coexisting mental health disorders. Therefore, the availability of a treatment like MDMA that has the potential to simultaneously ameliorate symptoms of both PTSD and SUD is genuinely thrilling for the field."
Presently, medications employed in the treatment of PTSD may be administered either independently or in conjunction with a complementary form of therapy commonly known as "talk therapy." However, in the context of MDMA-assisted therapy, the inclusion of talk therapy constitutes an integral and essential component of the treatment approach.
"In the realm of MDMA-assisted therapy for PTSD," Jones explained, "MDMA is believed to attenuate the fear response associated with the traumatic memory, enabling the participant to actively participate with the therapy team in processing this memory, which may occur for the first time in their lives. Rather than evading it, they can effectively confront and process the traumatic memory, ultimately progressing beyond its grip."
This processing may also apply to other mental functions, perhaps accounting for MDMA’s ability to improve symptoms for other disorders, like SUD.
Jones remarked, "Participants involved in psychedelic clinical trials experience enduring benefits stemming from transformations in their behaviors, thought processes, and interpersonal interactions. Frequently, participants attribute these changes as the pivotal factors that have made a significant difference in their symptoms."
While the immediate effects of MDMA during therapy raise some concerns, Jones frequently encounters inquiries regarding the potential induction of "ecstasy" sensations. She clarifies that "ecstasy" is a term commonly associated with the recreational use of MDMA, so much so that it became a colloquial name for the drug. However, in the therapeutic context, where the focus lies on a challenging process of self-healing, MDMA typically does not elicit feelings of ecstasy, according to Jones. This common concern highlights some of the potential obstacles that Jones aimed to evaluate in her recent publication.
Changing minds
For certain individuals, hesitance towards undergoing MDMA-assisted therapy is linked to negative perceptions of psychedelics and their recreational utilization. In the 1970s, all psychedelics were categorized as Schedule I substances, characterized as drugs with a high potential for abuse and lacking clinical benefits. This classification contributed to the tarnishing of political and public opinions regarding these drugs. The persistent stigma surrounding psychedelics stems from their recreational usage and portrayal in the media, further reinforcing these negative perceptions.
According to the Multidisciplinary Association for Psychedelic Studies, adverse attitudes towards psychedelics and heightened regulatory restrictions significantly impeded early, promising research on psychedelics in Western medicine during the 1970s. It was not until the 1990s that authorized psychedelic research recommenced on a limited scale, with significant acceleration occurring in the 2010s. The introduction of new government policies facilitated the resumption of psychedelic clinical research. However, the ultimate success of these drugs as treatments will heavily rely on public perceptions of psychedelics, which will play a crucial role in shaping their acceptance and integration into mainstream medicine.
According to Jones' study, around 70% of the survey participants expressed their support for MDMA-based research and held the belief that MDMA could be beneficial in the treatment of mental health disorders. A slightly smaller group, approximately 59%, indicated their willingness to undergo an MDMA-based treatment if it were recommended by a mental health professional. These survey findings suggest that the majority of individuals who use substances exhibit an openness towards MDMA research and would be receptive to the idea of trying an MDMA-based therapy.
In Jones' research, an investigation into the impact of race and ethnicity on attitudes towards MDMA-assisted therapy was conducted. Despite the underrepresentation of these groups in psychedelic clinical trials, the study revealed that racial and ethnic populations exhibited similar levels of support for MDMA research. However, there were slight yet potentially significant disparities in the willingness to try an MDMA-based therapy. Jones speculated that these differences, although largely theoretical, may be associated with prior usage patterns or cultural beliefs.
Although this investigation raises further inquiries for Jones and her associates, she maintains that these findings can aid researchers and mental health practitioners in comprehending how to equitably devise and execute treatments for diverse patient and ethnic groups.
By discussing these issues prior to the FDA decision, Jones hopes steps can be taken to address patient concerns.
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