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How COVID-19 Opened the Door to a New Era in Psychedelic Medicine

5 minute read
Dr. Shoshana Ungerleider is a practicing internal medicine physician in San Francisco, host of the TED Health Podcast and founder of endwellproject.org.

From Wall Street to Hollywood, psychedelics are having a cultural moment. For those of us who grew up in the “this is your brain on drugs” era, it’s hard to let go of stigma—and the mental image of an egg sizzling on a hot pan. But as a growing number of states and cities move to decriminalize drugs, and investors flock to an emerging market for psychedelic health care, substances like psilocybin, ketamine and LSD are edging into mainstream culture—and setting the stage for a paradigm shift in modern medicine.

Within the next few years, we could see psychedelic therapies prescribed for refractory depression and post-traumatic stress disorder (PTSD), or used in palliative care among those facing a life-limiting illness. But first we need to more deeply understand the benefits of psychedelic treatments. Right now, we are in the perfect storm to accelerate continued study—and health care workers are on the front lines.

It’s no coincidence that psychedelics are entering the conversation at the moment we most sorely need new ideas in mental health care. The world is experiencing mass trauma from COVID-19. It’ll take years for us to truly understand the magnitude of the pandemic’s toll on our collective mental health, but on the front lines, the picture is much clearer. In a recent survey of more than 20,000 frontline medical workers, 38% reported experiencing anxiety or depression during the pandemic, and 49% suffered burnout. Another survey found nearly one-quarter of all health care workers showed signs of probable PTSD.

When the American Association of Critical-Care Nurses surveyed 6,000 of their members this year, 66% said they had considered leaving their jobs because of the pandemic. “No amount of money could convince me to stay on as a bedside ICU nurse right now,” a Seattle-area nurse wrote in a resignation note posted on Twitter. “I can’t continue to live with the toll on my body and mind. Even weekly therapy has not been enough to dilute the horrors I carry with me from this past year and a half.”

Among health care workers, the prolonged battle against COVID-19 has intensified a long smoldering problem. Facing a fragmented medical sytem with frequently misaligned incentives, health care workers have been grappling with anxiety and depression—even before COVID, the suicide rate among doctors was more than twice that of the general public. From support groups and training to apps that monitor mental health, there are a number of programs that aim to solve and treat the problems leading to clinician burnout. But most have barely scratched the surface, and the prevalence of burnout during the pandemic has led researchers to explore alternative solutions—including psychedelic therapies.

A new study at the University of Washington is evaluating the efficacy of psychedelic-assisted psychotherapy using psilocybin for frontline health care workers experiencing COVID-related distress. “The situations that frontline doctors and nurses are facing is unprecedented,” says Dr. Anthony Back, who’s leading the study. “The symptoms of depression, burnout and moral injury call out for research that looks at whether psychedelics can play a role in healing the healers.” The U.S. is not alone in seeking alternative therapies for the growing number of health care workers in crisis: at Vancouver Island University in Canada, the Roots to Thrive ketamine-assisted therapy program treats health care providers and first responders with PTSD, depression, anxiety and addiction.

Realizing the potential of psychedelic-assisted therapy with health care workers is not without its challenges. For medical professionals, there’s a culture of perfectionism that makes asking for help a sign of weakness. Not only do health care workers seeking psychedelic-assisted therapy face the stigma associated with the use of these medicines, but there’s a stigma around seeking help in the first place.

Just past these barriers and stigmas, however, there’s enormous potential. If these studies and programs are successful, they have the potential to alleviate the symptoms of stress, burnout and depression that health care workers are feeling. They may even stop medical professionals from leaving the workforce at an alarming rate and avert the looming disaster of a worldwide health care worker shortage. The halo effect could be enormous and offer the possibility of treating others in high-stress fields.

Healing the healers is a win-win, and everyone can potentially benefit from better health care outcomes. The pandemic’s toll on health care workers affects the level of care that they’re able to provide—and you probably don’t need the World Health Organization’s official definition of burnout to tell you that it’s characterized by reduced effectiveness at work.

If psychedelic treatments have the potential to alleviate any person’s suffering, they are worth studying. But because they have the potential to alleviate a great many peoples’ suffering—both directly and indirectly by improving the mental health of our frontline clinicians—we need to invest in studying them further and faster.

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