Wednesday, January 10, 2024

By Courtney Wise

Happy Hump Day, MindSite News Readers! In today’s Daily: For the first time since the 1960s, the Department of Veterans Affairs is ready to fund research into the use of psychedelics for PTSD and depression. “Safe bathrooms” emerge as a harm-reduction measure for overdoses in Boston. A warning about the risks of companies selling subscriptions to pharmaceuticals. And a psychologist encourages a “Dry January.”

VA says it will fund studies of psychedelics for treating PTSD and depression in veterans

The Department of Veterans Affairs announced that it will fund research to test the benefit of psychedelics for treating veterans with depression and post traumatic stress disorder (PTSD) – something it hasn’t done in 60 years. The V.A. – trying to address veteran suicide rates that are double that of the general population – is requesting proposals to study the effectiveness of MDMA and psilocybin, in conjunction with psychotherapy, to treat veterans with PTSD and depression. 

“Veterans and V.A. researchers have told us about the potential promise of psychedelics to treat mental health conditions for some time,” said Dr. Shereef Elnahal, the V.A. undersecretary for health, said in a statement. “Now is our chance to study this potential method of treating veterans with PTSD and major depression across the country.”

The V.A. has used “non-V.A. funds” for limited, small studies at V.A. facilities for psychedelic- assisted therapies in the past, but this will be the first time the agency provides direct funding for large-scale trials on the safety and effectiveness and safety of the compounds as mental-health treatment. The Drug Enforcement Agency and the Food and Drug Administration have issued regulatory approvals to facilitate the research. The FDA granted “breakthrough” status in 2018 to speed up studies of MDMA for PTSD and, in 2019, for testing psilocybin for depression.

Juliana Mercer, a retired Marine Corps sergeant who served in Iraq and Afghanistan, told Stars and Stripes, a news outlet covering the military, that she welcomed the VA’s announcement as a “historic event for those, like me, who have experienced these compounds’ life-saving potential.”

Mercer served in the Marine Corps from 2001 to 2016 and now directs veteran advocacy and public policy at Healing Breakthrough, a California nonprofit that supports MDMA-assisted treatment for veterans. The V.A.’s decision, she said, “is the culmination of tireless efforts of veteran advocates, bipartisan legislators, V.A. clinicians and researchers, and philanthropists who are determined to end the veteran suicide epidemic.”

“Safe bathrooms” prevent opioid overdose deaths in public restrooms in Boston

First installed in a clinic that serves Boston’s unhoused population, it alerts staff when people in bathrooms stop moving, allowing them to administer life-saving naloxone before it’s too late. “It gives you an early warning so the providers on site can bring everyone back,” King explained to STAT. “It’s like going back in time — like I invented a time machine.”

Flashing lights and a high-pitched siren alert staff to a problem when movement in a restroom is no longer detected after 2 minutes and 45 seconds. At a time when overdoses are claiming more than 110,000 lives a year, the technology has helped save lives at a growing number of public locations throughout Boston, as well as public libraries, coffee shops, health clinics, and schools across the country. 

“We were drowning in overdoses,” said Jessie Gaeta, until recently chief medical officer of the Boston Health Care for the Homeless Program. Although illegal drug use is not permitted at the clinic, staff members know that some people will use anyway. She says the bathroom technology makes a potent argument for supervised consumption sites – clean places where drug users can safely inject or ingest and receive immediate life-saving care from on-site medical professionals if they overdose. 

Supervised consumption is still illegal under federal law but two sites are up and running in New York City and another is slated to open in Rhode Island next year. No deaths have occurred at the two NYC sites. Proponents say supervised consumption sites offer a double benefit – they prevent overdoses and help connect people to treatment when they’re ready.

The Biden Administration has maintained Trump-era policies against supervised consumption and California Gov. Gavin Newsom recently vetoed legislation to open several in the state. Such opposition is a symptom of the nation’s failed efforts to prevent drug deaths and leads to the creation of “workarounds in our bathrooms, like motion detectors and safety protocols,” Gaeta said. Supervised consumption is “what we need,” Gaeta said. “But we can’t do that. Our hands are really tied. So this is coming as close as we possibly can.”

Growth of subscription-based prescribing sparks concern

Nowadays, you can use your computer to sign up for medication subscriptions just as you use it to select your desired streaming services. Consumers who use such services, like Hims & Hers, Ro, and Lemonaid Health, appreciate how easy it is to access health care and prescription refills. Subscriber beware, says Adriane Fugh-Berman, a Georgetown University researcher. “This isn’t medicine. This is selling drugs to consumers.” 

Providers say they’re simply giving consumers what they want. “The growth we’ve seen on our platform is a testament to how people are looking to get the care they need,” said Hims spokeswoman Khobi Brooklyn. She said Hims screens all patients carefully before providing services. The company is planning further growth: It noted in a recent regulatory filing that it sees strong opportunities in menopause, post-traumatic stress disorder and diabetes.

But Fugh-Berman, a frequent critic of pharmaceutical marketing practices, says the subscription strategy emphasizes prescribing over care. “Mental health care should never just be about drugs,” she told CBS News. Diagnoses and responses to medication change over time, and new side effects also emerge. What people need, she says, is close care and regular monitoring – not frequent automatic refills. But Matthew Walvick, Lemonaid Health’s chief medical officer, said his company routinely follows up with patients to monitor for side effects and update their medical history, he said. And Brooklyn said the Hims program for mental health care includes psychiatry and talk therapy.

While simplicity and ease is attractive to patients, Harvard researcher Ateev Mehrotra says he’s concerned about the overall care people receive from companies that primarily provide one medication to treat one condition. “These companies are very solution-oriented,” Mehrotra said. “They’re not thinking about that comprehensive care.”

In other news…

Looking for books to add to your 12 Month Reading Challenge? Check out this list from Electric Literature; each novel is focused on memory loss. I own Fledgling by Octavia Butler but I haven’t read it yet. The story centers around protagonist Shori, who, when we meet her, is recovering from injuries in a cave and remembers nothing about herself. I’m putting it on my reading list for next month. 

“Dry January” offers a boost to mental health: With three more weeks left in the month, there’s still a solid opportunity to kick-start the year by abstaining from alcohol and see some positive effects. The new year is a good time for people to reset and reflect on their stress-coping mechanisms, including alcohol and social media, says Clarissa Belle, a psychologist based in Lexington, KY. “We have all gone through a difficult time as a nation. And so I really think it’s an important time to really check in with yourself and ask yourself, am I becoming too dependent on something? Am I really presenting the best version of me?” Belle told LEX18.

If you choose to participate in Dry January, Belle suggests making a plan. Know what you’ll use to replace alcohol – mocktails, anyone? Let your close personal supporters know you’re taking the challenge and make time to keep a journal on the changes you see during your abstinence period. If you think you’re dependent on alcohol, reach out to your doctor, a mental health professional or an informal support group for help.

If you or someone you know is in crisis or experiencing suicidal thoughts, call or text 988 to reach the 988 Suicide & Crisis Lifeline and connect in English or Spanish. If you’re a veteran press 1. If you’re deaf or hard of hearing dial 711, then 988. Services are free and available 24/7.