From Houston Public Media:
Earlier this year, Gov. Greg Abbott signed into law a bill that might come as a surprise in a conservative state like Texas. House Bill 1802 will allow research on a novel treatment gaining traction in the mental health world: psychedelic therapy.
The Health and Human Services Commission, Baylor College of Medicine and the Michael E. Debakey VA Hospital in Houston will conduct a first-of-its-kind study of psilocybin, the psychoactive compound in “magic mushrooms,” as a treatment for veterans struggling with post-traumatic stress disorder. A second study on MDMA treatment is also being considered.
"I think many people are at the point of ‘I will try anything,' whether they're conservative, anti-drug, whatever it is," said Lynette Averill, a clinical research psychologist at Baylor College of Medicine who is working on the study.
A demand for mental health services has only gotten more severe over the past six months. In response to the heightened need, the Houston VA hospital is adding 20 new therapists and VA outpatient centers have increased staffing for specialty and primary mental health care.
Kaki York, the hospital system's deputy mental health executive, said that the pandemic and the withdrawal from Afghanistan have made it more difficult for veterans to manage depression and anxiety disorders, including PTSD.
"I think that people have had issues for a long time, but they’ve managed to cope in spite of the issues," York said. "Stress levels have just gotten so high that it’s just not enough to overcome the degree of distress that people are feeling."
The full mental health impact of the recent withdrawal is not yet known. Discharged veterans are still acclimating back to civilian life, a period when they face the highest risk of suicide, York said. Veterans might be more occupied with finding a job or housing, rather than seeking treatment.
"It’s the one choice that people make that you can’t unmake, so we do our best to try to make sure that veterans know that we’re here, that they’re eligible for care and that we are going to help them through this transition so that they don’t have to do it alone," York said.
A small group of Texas veterans have already found success with psychedelic therapy in treating this disorder, which is notoriously difficult to manage. However, they have had to cross the border into Mexico in order to access it.
"I can say unequivocally that psychedelic assisted therapy changed my life forever," said Former U.S. Navy Seal Marcus Capone.
He and his wife testified in support of the bill in April. They created a non-profit called VETS to help veterans access psychedelic treatments in other countries.
"We had spent five years exhausting every avenue of healing offered by military medicine, the VA and Western health care," said Amber Capone. "I attribute this lifeline to saving Marcus’s life, our marriage and our family."
Only two medications are approved by the U.S. Food and Drug Administration to treat PTSD. Both belong to a category of drugs called selective serotonin reuptake inhibitors, or SSRIs. Psychologist Lynette Averill said these drugs often have significant side effects and require patients to wait weeks before seeing any benefit.
"You might gain or lose 20-30 pounds or not be able to perform sexually," Averill said. "They might not actually work at all or might make some of your symptoms worse. No one would sign up for that, but that is the reality of those interventions."
By contrast, psychedelics have few side effects and the treatment is fast-acting. Averill, who previously studied ketamine therapy at the National Center for PTSD at Yale University, said best practice is to administer the drug in a controlled setting, hold prep sessions beforehand and follow up with talk therapy.
She hopes that this research can also help PTSD survivors outside the veteran community too.
"We have a suicide epidemic," Averill said. "We have an opioid epidemic. And those were all the reality before we’ve had an incredible heightening of social, civil, political unrest across the last five years or so. I think there is not a corner of the US, nor the world, that is not significantly impacted right now by chronic stress and trauma."
At the moment, ketamine is the only psychedelic approved by the FDA. Within recent years, a handful of boutique clinics have opened up across Texas, offering ketamine treatment to treat mental health disorders. This therapy is not covered by insurance, so access has been limited to those who can afford to pay the out-of-pocket costs.
Other psychedelics are on track for approval. MDMA and psilocybin are labeled as breakthrough therapies. MDMA could be approved as early as 2023.
"These interventions absolutely are also not the golden bullet," Averill said. "Some people will have not as profound an experience. And yes, of course, some people will have a negative experience. I do think, though, they are an incredible thing to be adding to a toolbox."
The veteran crisis hotline is 1-800-273-8255, which can connect veterans, family and friends with mental health staff.