How ecstasy and psilocybin could be used to treat mental health issues in CT

A bill clearing the way for the use of psychedelics as mental health treatment has passed a key state legislative committee.

The bill, intended to “increase access to mental health drugs,” would license and fund three treatment sites dedicated to the use of MDMA, commonly known as ecstasy or “molly,” and psilocybin, the psychedelic substance in so-called “magic”. ” mushrooms for use against treatment-resistant post-traumatic stress disorder, depression and other mental health problems.

The bill was unanimously approved by the state’s public health committee. Committee co-chairman State Rep. Jonathan Steinberg, D-Westport, said he was surprised at the unanimous, bipartisan support.

“I think it’s a testament to our committee members doing their homework,” he said.

Psychedelics have been “stigmatized over generations,” Steinberg said, but the committee “heard some really compelling evidence” that helped them understand that it was “in fact, effective therapy.”

State Senator Saud Anwar, D-South Windsor, a practicing physician and one of the bill’s co-sponsors, said the committee heard how “in a select group of patients, it was a game-changer “.

“When you hear directly from the people who have been affected,” Anwar said, “it has a deeper impact on you.”

“Felt like a cure”

The United States Food and Drug Administration has already authorized the use of MDMA and psilocybin for research and limited treatment purposes.

A previous Yale study sought to evaluate psilocybin as a treatment for mental health, and one study participant called the experience transformative.

“To me, it definitely looked like a cure,” said the study participant, whose name Hearst Connecticut Media Group agreed to withhold the name to protect his identity. “For me, it was like getting to the bottom of what was tormenting me and creating a lasting result.”

The participant said he had had three depressive episodes in his lifetime, the last of which “rendered me completely unable to work”.

“Not being able to do my job is so awful,” they said. “I found myself literally unable to pursue the most important thing in my life.”

Taking antidepressants, they said, does not address the root cause of depression.

“When I was on antidepressants, it was symptom-free. The best you can get out of it is clearing the symptoms of depression,” the participant said.

Psychedelic-assisted therapy, however, is different. “The realm you are immersed in is truly magical,” the person said. “It gives you an entirely different perspective on your life and allows you to view that life with empathy for yourself.”

Although MDMA and psilocybin have been used recreationally, it is different in a treatment setting. The patient wears goggles, for example, and listens to low-key, soothing instrumental music, so “it’s an entirely inner journey,” the study participant said.

“Instead of being at a rave or at a party or whatever recreational setting, you’re in a safe environment here,” the person said. “And, of course, you’re with two experienced therapists, which eliminates a lot of danger.”

A narrow way

Jesse MacLachlan, a former Connecticut state legislator, said psychedelic-assisted therapy “could probably be one of the biggest developments in mental health care in decades.”

After leaving the legislature, MacLachlan was appointed to the legislative committee examining the possibility of using MDMA and psilocybin for the treatment of depression, anxiety, PTSD and other mental health conditions.

MacLachlan now volunteers with Reason for Hope, which he described as “a nonprofit policy and advocacy organization focused on maximizing the public benefits of psychedelic-assisted therapy.”

He also said he was surprised that a bill authorizing psychedelic therapy passed the committee unanimously.

“It was surprising,” MacLachlan said. “This issue comes with a lot of stigma from years and years of misinformation.”

MacLachlan said the bill was intentionally very narrow. The FDA is expected to clear MDMA as a treatment in 2023 and psilocybin in 2024. In the meantime, they are both cleared under the FDA’s Expanded Access Program.

This bill proposes funding of $1.5 million divided among three treatment sites, which have not been identified, to prepare for FDA clearance in the coming years.

The bill, MacLachlan said, ensures that “the state is ready to respond to the demand that will occur during an FDA approval because we have about 18 to 24 months to prepare for what is a different form of treatment than anything currently available”.

The bill as written is aimed at specific groups of patients: Connecticut residents who are veterans, first responders, direct care healthcare workers, or who come from “a historically underserved and who have a serious or life-threatening mental or behavioral health disorder and without access to effective mental or behavioral health medications.

One of the problems is that psychedelic-assisted therapy is labor intensive. The drugs are cheap to produce, but the therapy requires hours of preparation in addition to the actual therapy.

Current protocols call for, MacLachlan said, “five to eight hours of preparatory therapy,” and then there’s an “intervention session where the patient receives psychedelic-assisted therapy treatment,” which lasts six to eight hours. .

“And then you have between five and eight hours of integration therapy,” he said. “So you’re looking at 20 to 30 hours of work, and that’s expensive.”

The therapeutic model “doesn’t fit neatly into our current mental health care framework,” MacLachlan said. “What other treatment combines both the work of the clergy and that of psychiatry and cognitive-behavioral therapy?

That means the state “is in a position where we need to start thinking about how to license and qualify therapists, we need to start thinking about how to approve treatment sites, we need to start thinking patient safety protocols, diversion prevention methods and patient follow-up,” he said.

‘Step-by-step approach’

Steinberg said a bill that had passed unanimously in committee would generally have a “pretty good” chance of becoming law. This year, however, the legislative session is short.

“The biggest challenge we face is that in this very short session not all bills will be heard,” he said.

It might not have been heard at all were it not for the pandemic, which Steinberg says has highlighted and exacerbated existing mental health issues around the world.

“Most of us are aware that we had both access and quality issues in mental health before the pandemic hit us,” he said. “It took the pandemic to highlight the real gaps and gaps in mental health care provision and access. It forced us to be more open-minded, a bit creative. It also led us to take a fresh look at alternative therapies.

This measure could be combined with others in “a merging of bills”, Steinberg said, but if passed, Anwar believes it is only the first phase.

While the treatment shows promise, it’s “worthy of taking slow steps and watching what happens closely,” Anwar said. “It’s going to be a phased approach.”

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