A congressional subcommittee will hear testimony on Thursday about emerging therapies for veterans, including the use of psychedelic-assisted treatments for mental health disorders. It’s the first time that federal lawmakers have ever convened a formal hearing primarily to discuss how entheogenic substances such as psilocybin and MDMA could help address an epidemic of veteran suicides.
Members of the House Veterans Affairs’ Subcommittee on Health will hear from two panels of experts during the hearing, titled “Emerging Therapies: Breakthroughs in the Battle Against Suicide?” The first group consists of select officials from the Department of Veterans Affairs (VA), while the second will include comments from outside stakeholders, including advocates for psychedelics reform and a veteran who successfully used MDMA to treat PTSD and suicidal ideation after returning home from a 2005 deployment to Iraq.
In written testimony filed before Thursday’s scheduled hearing, Carolyn Clancy, VA’s assistant undersecretary for health for discovery, education and affiliate networks, said the agency’s top goal is veteran safety.
“Based on our assessment of the literature to date, there is still much to learn, and much yet to be understood, about the potential benefits of psychedelic compounds,” she wrote. “Our Department is not only focused on finding the best innovative treatments and cures, but doing so safely.”
Clancy noted that last month that VA hosted a so-called State of the Art conference in early September to address two major objectives. “The first objective was to better understand the current state of scientific evidence and to identify a strategic framework to consider future psychedelic treatment research for select mental health conditions,” she wrote. “The second objective was to determine the necessary next steps for potential VA system-wide clinical implementation for psychedelic compounds for potential future use.”
While studies do indicate that psychedelics can help treat mental health conditions, she acknowledged, one of the “key gaps in research” is how to apply treatment to the “unique and diverse population” of veterans who receive care through the Veterans Health Administration.
Two other VA officials, Ilse Wiechers and Rachel Yehuda are also scheduled to appear Thursday. Wiechers is the deputy executive director of VA’s Office of Mental Health and Suicide Prevention, while Yehuda directs the patient care center at the Bronx VA Medical Center in New York.
Among those set to testify from outside the government is Frederick Barrett, a professor of psychiatry and behavioral sciences at the Johns Hopkins Center for Psychedelic and Consciousness Research. In written comments, Barrett said that studies from his institution and others “are building a growing record of information demonstrating both the relative safety and potential efficacy of psychedelic therapies in a wide range of psychiatric indications.”
“These studies have been funded nearly entirely by private philanthropy,” he noted. “Only recently has the National Institute on Drug Abuse and the National Center for Complementary and Integrative Health come through with a notable grant for the investigation of clinical use of psychedelics.”
Barrett noted that psychedelic-assisted therapy protocols still need further refinement as it becomes more widely available, pointing to recent Phase 3 clinical trials into MDMA’s potential to treat PTSD.
“As we anticipate approval of psychedelic drugs as medicine by the FDA, we are also faced with numerous questions that have yet to be answered,” he wrote. Among them: “Will some disorders require higher or lower doses of psilocybin or MDMA for treatment? Will some individuals require follow-up or repeated visits?” and “How can we predict who will respond well and who will not respond to treatment, and can we optimize the delivery of care to maximize the chances that someone will have a therapeutic response?”
Another speaker, Michael Mullette, the COO for the Multidisciplinary Association for Psychedelic Studies (MAPS) Public Benefit Corporation, commented more directly on FDA’s potential approval of MDMA. His group led the clinical trials that now position MDMA for possible FDA approval as soon as next year.
“The Veterans Administration,” Mullette said in written comments, “has the opportunity to create innovative care models to ensure treatments for PTSD are scalable, accessible and, importantly, covered in a timely manner for veterans in need.”
He added that while MDMA-assisted therapy is a novel treatment, “the components are not new.”
“Both prescription treatments and talk therapy are currently used to treat mental health conditions,” Mullette wrote. “What is unique is using them together. In our clinical studies, the participants received either MDMA and therapy or placebo and therapy three times over a twelve-week period, with three therapy sessions prior to commencing the medication sessions and three therapy sessions after concluding the medication sessions.”
Jonathan Lubecky, an Army National Guard and Marine veteran who has spoken in the past about how MDMA-assisted therapy helped him overcome PTSD and suicidal ideation, shared his personal journey with lawmakers. Through the use of MDMA, he said in written testimony, “for the first time I was able to freely talk about my demons, without my body betraying me.”
Likening the psychedelic to anesthesia that allows a patient to undergo intensive surgery, Lubecky said MDMA itself “doesn’t fix anything” but instead “puts the mind, body and spirit in the place it needs to be so the therapy can work.”
Another speaker scheduled to testify at the hearing, Rajeev Ramchand, of the RAND Corporation’s Epstein Family Veterans Policy Research Institute, said in written comments that more research funding is needed to speed the understanding and development of psychedelic-assisted therapy. While “the clinical quality of mental health care provided in VA is often better than non-VA care,” Ramchand added, that “does not mean, however, that we should not invest in new, promising treatments.”
Many veterans drop out of existing treatment programs or find that they simply do not work, Ramchand said, arguing that the situation “points to a pressing need for treatments that work for more veterans and that yield better outcomes.”
“Congress can expedite this research by making the process for conducting research on psychedelic compounds more efficient,” Ramchand continued. “Many of the most promising psychedelic compounds, including MDMA and psilocybin, are classified as Schedule I drugs, requiring researchers to register with the Drug Enforcement Administration for permission to use them and comply with the necessary security regulations. As Director of the National Institute on Drug Abuse Dr. Nora Volkow recently testified, these steps are notoriously time-consuming, confusing, and expensive for researchers.”
A final speaker, retired Marine Corps Lt. Gen. Martin R. Steele, who is now CEO of the group Reason for Hope and president of the Veteran Mental Health Leadership Coalition, said in written testimony that hundreds if not thousands of veterans had already traveled abroad to seek access to treatments like MDMA-assisted therapy for PTSD and psilocybin for treatment-resistant depression and major depressive disorder. “Veterans with co-morbid PTSD and major depressive disorder face a significantly increased risk of suicide,” he wrote, “making accelerated access to these Breakthrough Therapies imperative.”
A number of the subcommittee’s members—Republicans especially—have expressed interest in psychedelics reform before. Rep. Jack Bergman (R-MI), for example, is the co-founding member of the Congressional Psychedelics Advancing Therapies (PATH) Caucus, a bipartisan group relaunched this past March.
Another member, Rep. Morgan Luttrell (R-TX), has publicly shared how treatment with ibogaine and 5-MeO-DMT “changed my life” and was “one of the greatest things that ever happened to me.” Earlier this year, he and several other GOP lawmakers spoke in favor of a bill to create a $75 million federal grant program to support research into the therapeutic potential of psychedelics for certain health conditions among active duty military service members.
And House subcommittee’s chair, Rep. Mariannette Miller-Meeks (R-IA), led a roundtable this summer to discuss emerging therapies for PTSD and substance abuse.
House Republicans – led by Health Chairwoman @RepMMM – held a roundtable on modern, emerging therapy treatments for PTSD + substance abuse in June.
17 veterans a day are still losing their lives to suicide and we’re working hard to further research on every treatment that helps… https://t.co/cA4FfJgBaZ
— House Committee on Veterans’ Affairs (@HouseVetAffairs) October 6, 2023
“As a doctor, former director of the Iowa Department of Public Health and 24-year U.S. Army veteran, the mental, emotional and physical health of my constituents and fellow veterans is one of my top priorities in Congress,” Miller-Meeks said at the time. “The new FDA guidance that presents considerations for designing clinical trials for psychedelic drugs will give patients and their doctors increased access to effective treatments, rather than alternatives such as opioids.”
Lubecky, a leading advocate for psychedelic-assisted therapy being accessible to veterans, told Marijuana Moment on Wednesday that “in the House of Representatives, Republicans are driving the bus on psychedelic policy.”
That same point was made by former Texas Gov. Rick Perry (R) in a recent documentary from the publication Reason. Though he said the issue shouldn’t be about politics, Perry went on to assert that GOP lawmakers are more open to psychedelics reform than Democrats are—at least among those in Congress.
“At the federal level, this is more supported by the Republicans,” he said.
At the state level, however, blue states have taken the lead on psychedelics reform. Oregon in 2020 legalized psilocybin therapy in addition to decriminalizing possession of all drugs. The state approved the first legal psilocybin service center this past May.
And in Colorado, Gov. Jared Polis (D) signed a psychedelics regulation bill into law in May, setting rules for a psychedelics legalization law that voters passed last year.
In California, meanwhile, Gov. Gavin Newsom (D) recently vetoed a psychedelics legalization bill. In a veto message, however, he said he wants the legislature to send him a new bill next year establishing guidelines for regulated therapeutic access to psychedelics and also consider a “potential” framework for broader decriminalization in the future.
California officials cleared a campaign this summer to begin signature gathering for a 2024 ballot initiative to legalize the possession, sale and regulated therapeutic use of psilocybin. It’s one of two campaigns in the state that are seeking to enact psychedelics reform through the ballot process next year.
Another California campaign filed a proposed initiative for the state’s 2024 ballot this summer that would create a $5 billion state agency tasked with funding and promoting psychedelics research that it hopes will accelerate federal legalization of substances like psilocybin and ibogaine.
Last month VA launched a new podcast about the future of veteran health care, with its first episode focused on the healing potential of psychedelics.
Some feel VA still isn’t doing enough to prioritize therapies that involve controlled substances, even as states have legalized medical marijuana and some move to legalize possession of some psychedelics.
Earlier this year, House lawmakers passed a spending bill with a number of veteran-focused marijuana and psychedelics amendments. One would allow VA doctors to issue medical cannabis recommendations to former servicemembers, and the other would encourage research into the therapeutic potential of psychedelics.
In August, three bipartisan co-chairs of the Congressional Cannabis Caucus wrote to VA Secretary Denis McDonough expressing “deep concern” over a recent VA marijuana directive that continues to prohibit its doctors from making medical cannabis recommendations to veterans living in states where it’s legal.
Rep. Earl Blumenauer (D-OR), one of the authors of that letter, recently sent a separate letter to McDonough and Department of Defense Secretary Lloyd Austin slamming their departments for perpetuating a “misguided denial of services” by recommending against the use of medical marijuana by veterans with post-traumatic stress disorder (PTSD).
VA and DOD “have a long history of claiming the best interest of our veterans and service-members only to deny the reality of medical marijuana as a key treatment option for those impacted by PTSD,” he wrote, referencing recently updated joint clinical practice guidelines that the departments released in July.
Image courtesy of Kristie Gianopulos.
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