Even prior to the pandemic mental health disorders such as depression, anxiety, PTSD  and alcohol and other drug use have been increasing not just in the US but around the world, and things since COVID have continued to worsen. Mental Health crises can be a huge burden both emotionally and economically for individuals, families and healthcare systems. It has been clear for awhile that newer more effective therapies are needed, particularly for those who do not respond to what is traditionally available-- but for practitioners like myself, improving resilience, distress tolerance, and coping has been mostly the best we could provide. In 2017, the US Food & Drug Administration granted ‘breakthrough therapy’ status to psilocybin for the treatment of depression and MDMA for the treatment of PTSD (MAPS, 2017a). In 2019, at the Annual APA convention in Chicago, I saw Michael Pollan, author of How to Change your Mind, and Matthew Johnson, Ph.D a researcher from Johns Hopkins and MAPS present the outcomes of the latest research on psychedelic treatments for some of the most intractable mental health conditions that lead patients to despair. It was an exhilarating and exciting presentation, and for the first time in probably my entire career, conversation included terms like "complete remission" and "cure." Findings cited by Dr. Johnson, indicate therapeutic benefit has been demonstrated major depressive disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), anxiety associated with life threatening illness, alcohol dependence, and long-term tobacco smoking, with a lower risk of toxicity and dependency than many front line medications currently available. Having supported clients with extensive trauma, I decided during the pandemic to seek out additional training to support more effective treatment options. Since completing my training with IPI, the number of clinics and medical providers prescribing off-label Ketamine (a psychedelic treatment originally designed and used internationally to treat pain in emergencies) has increased substantially. According to the latest MAPS announcements, MDMA and Psilocybin are entering the last phase of preapproval by the FDA, and outcomes of the lates research indicated a significantly higher proportion of patients diagnosed with PTSD to have reached full remission in comparison to a placebo (2/3 of MDMA patients, vs 1/3 of controls). In early 2023, Australian regulators announced that medicines containing the psychedelic substances MDMA and psilocybin will be able to be prescribed there to treat post-traumatic stress disorder (PTSD) and treatment-resistant depression. In Oregon and Colorado, in addition to Ketamine, psilocybin is currently legal to use for treatment of PTSD and Depression. According to MAPS, FDA approval is projected for MDMA and psilocybin sometime in 2024.

 

How does it work?

According to research Psilocybin, LSD, Ketamine, and ayahuasca, and MDMA) may have ‘mind altering’ effects via a different neurochemical pathway (Carhart-Harris & Goodwin, 2017; Gill et al, 2022). These effects seem to quiet down the fight or flight responses to negative stimuli, while increasing neuroplasticity by increasing the activity of more parts of the brain. While no one is completely sure how the process works, the mental health benefits for many many patients are increasingly well documented and clear. Here in California, while the only legally available medication is Ketamine, as a practitioner with recent and up to date training, when it is possible to use MDMA and psilocybin medications, I will be at the forefront of the practice. 

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What is the process?

Those who are interested in seeking psychedelic assisted therapy (currently only available with Ketamine), would first undergo a screening to ensure this is an appropriate treatment for their needs (conducted at my office in person). Once it is determined this is an appropriate treatment, referral for clinical intake will be coordinated with the Be The Change Clinic in Santa Rosa. At this time the protocol is that patients participate in an intake, 1-2 preparation sessions, 6 medication sessions (at Be The Change Clinic) followed by 1-2 integration sessions after each medication session. Preparation sessions (1-2) will take place either in person at my office in Petaluma or online prior to medication sessions. At each medication session at the clinic in Santa Rosa, I will be present to facilitate and support the process. Within 1-3 days after each medication session patients will participate in at least one integration session (online or in person). These sessions can take place over the period of 6-10 weeks, and the number of individual sessions can be increased as needed.

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All services provided by me either via telehealth and/or in person at my office at 134 Howard St. in Petaluma.

  

References:

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Carhart-Harris, R. L., & Goodwin, G. M. (2017). The therapeutic potential of psychedelic drugs: past, present, and future. Neuropsychopharmacology, 42(11), 2105-2113.

 

Hartej Gill, Parnian Puramat, Pankti Patel, Barjot Gill, CéAnn A. Marks, Nelson B. Rodrigues, David Castle, Danielle S. Cha, Rodrigo B. Mansur, Joshua Daniel Rosenblat, Roger S. McIntyre, The Effects of Psilocybin in Adults with Major Depressive Disorder and the General Population: Findings from Neuroimaging Studies,Psychiatry Research, Volume 313, 2022  https://doi.org/10.1016/j.psychres.2022.114577

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Johnston, C. B., Mangini, M., Grob, C., & Anderson, B. (2023). The Safety and Efficacy of Psychedelic-Assisted Therapies for Older Adults: Knowns and Unknowns. The American Journal of Geriatric Psychiatry, 31(1), 44-53.

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Luoma, J. B., Chwyl, C., Bathje, G. J., Davis, A. K., & Lancelotta, R. (2020). A meta-analysis of placebo-controlled trials of psychedelic-assisted therapy. Journal of Psychoactive Drugs, 52(4), 289-299.

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Penn, A., Dorsen, C. G., Hope, S., & Rosa, W. E. (2021). Psychedelic-assisted therapy: emerging treatments in mental health disorders. The American journal of nursing, 121(6), 34.

 

Wheeler, S. W., & Dyer, N. L. (2020). A systematic review of psychedelic-assisted psychotherapy for mental health: An evaluation of the current wave of research and suggestions for the future. Psychology of Consciousness: Theory, Research, and Practice, 7(3), 279.

 

Watts, R., & Luoma, J. B. (2020). The use of the psychological flexibility model to support psychedelic assisted therapy. Journal of Contextual Behavioral Science, 15, 92-102. Chicago