Psychedelics have ‘potential to be transformative’ in saving health care system millions

Key takeaways:

• Psilocybin and other psychedelics may represent a radical shift in the health care paradigm due to lower costs.
• Obstacles remain to clinical trials, chief among them psilocybin’s listing as Schedule I drug by DEA.

Long-term treatment with psychedelics holds the potential to transform the health care industry through millions in savings, according to an expert at a congressional briefing hosted by Johns Hopkins University.

“One in five adults in the United States have a mental illness and one in 25 have a serious mental illness, and there’s an enormous treatment gap,” Matthew Eisenberg, PhD, associate professor at Johns Hopkins Bloomberg School of Public Health, said during the briefing. “The current standard of care for treatment involving long-term use of medications as well as cognitive therapy ... these are quite costly and the standard is to stay on them for a very long time.”

The efficacy of psychedelics in clinical trials demonstrated shorter treatment cycles, Eisenberg continued, along with the “potential to save the health care system millions or billions” of dollars through reduced medication costs, decreased need for inpatient care and less reliance on long-term disability benefits.

Nonetheless, certain obstacles remain before psychedelics can be considered a scientific, ethical and financial benefit to the general public.

“These are illegal drugs, but they are regulated,” Sandeep Nayak, MD, assistant professor at the Johns Hopkins Center for Psychedelic and Consciousness Research, noted. “If you have a legitimate scientific reason to investigate, you get approvals from various governmental bodies ... then you can actually study illegal drugs, legally.”

The highly regulated process means the period between acceptance of the study’s subject matter and trial commencement can take a long time, with particular attention paid to inclusion of safeguards against misuse of psychedelic substances, Nayak acknowledged.

Another roadblock to the scientific process is the inability to study certain drugs due to existing regulatory rules, according to Frederick S. Barrett, PhD, associate professor of psychiatry and behavioral sciences and director of the Johns Hopkins Center for Psychedelic and Consciousness Research.

Barrett cited the example of ketamine, of which the scientific community possesses more knowledge compared with psilocybin, due to its classification as a Schedule II drug by the Drug Enforcement Agency. Despite its lack of potency compared with ketamine, psilocybin remains classified as a Schedule I substance, which expressly prohibits prescription and is restricted for clinical purposes.

“Many of those studies (which are rejected or not allowed) are of compounds which have been used recreationally or explored outside a controlled context that do not yet have enough data behind them to warrant a human clinical trial,” Barrett said.

It is a problem, he added, that can be solved with a substantial investment in creating and conducting toxicology and safety trials for substances comparable to psychedelics already accepted for study.