Medium: Psychedelic Medicine Comes to the VA

Summary: “Dr. [Rachel] Yehuda’s work marks the first time that the VA has gone on record supporting research into MDMA, which remains a Schedule 1 drug,” explains Marc Gunther. Dr. Yehuda and her team plan to conduct a MAPS-sponsored Phase 2 controlled comparative study on the effectiveness of MDMA-assisted therapy in U.S. Veterans with chronic PTSD at the VA, pending DEA approval.

Originally appearing here.

A hundred years ago — before anyone put together the initials PTSD — a public hospital in the Bronx, NY, began to care for World War I soldiers who suffered from “mental and nervous disorders.”
Shell shock, it was called. It was notoriously hard to treat. PTSD remains so.
That hospital, now known as the James J. Peters Medical Center and run by the US Department of Veterans Affairs, will soon try a new approach: It will offer combat veterans talk therapy assisted by MDMA, an illegal drug better known as ecstasy that has shown great potential for alleviating the suffering caused by PTSD.
Dr. Rachel Yehuda, who has spent decades treating veterans with PTSD, will lead a clinical trial at the Bronx hospital. Dr. Yehuda, who is director of The Center for Psychedelic Psychotherapy and Trauma Research and a professor of psychiatry and neuroscience at Icahn School of Medicine at Mount Sinai, is careful to say that much remains unknown about MDMA and how it works.
But, after reading the science and trying MDMA herself, Dr. Yehuda says she is “hopeful and optimistic” that it will make a difference.
“This could be a real game changer for men and women who have served our country,” she tells me, via Zoom.

Dr. Rachel Yehuda
Dr. Yehuda’s work marks the first time that the VA has gone on record supporting research into MDMA, which remains a Schedule 1 drug. (That classification is reserved for drugs that, according to the Drug Enforcement Administration, have no approved medical use and a high potential for abuse.) In a press release, Margaret O’Shea Caplan, director of the James J. Peters facility, says the hospital has been “at the forefront of testing evidence-based approaches to the treatment of combat veterans with PTSD.”
Billionaire donors
The research is being funded, not by taxpayers, but by two colorful billionaires. The foundation of Bob Parsons, the founder of and PXG (Parsons Extreme Golf), and his wife Renee will give $5 million to Mount Sinai, they announced. Steven A. Cohen, the hedge fund founder and owner of the New York Mets, and his wife Alexandra, will give $2.1 million to support the upcoming clinical trial, their foundation said.
For both men, the issue is personal. A combat veteran of Vietnam, Parsons has talked about his own struggles with PTSD for years; he found relief from psychedelic treatment. “It’s a game changer,” he said. Cohen became a major supporter of veterans’ causes after his son, Robert, served as a Marine in Afghanistan, he says.
Both donors contributed to the Capstone Challenge to fund research into MDMA-assisted therapy for PTSD being led by the Multidisciplinary Association for Psychedelic Research, or MAPS. MAPS aims to secure FDA approval for the treatment. Through his foundation, The Bob & Renee Parsons Foundation also funded a small clinical trial of MDMA-assisted at a veterans hospital in Loma Linda, CA, that began quietly last summer, while the Steven & Alexandra Cohen Foundation has been a major donor to the world-renowned Center for Psychedelic and Consciousness Research at Johns Hopkins University.
Via email, Jeanne Melino, executive director of the Cohens’ foundation, told me that they believe that “psychedelic-assisted psychotherapy may hold the key to combating treatment-resistant mental health conditions and addiction” including PTSD.
A Burning Man connection
Dr. Yehuda came to psychedelic medicines via an unusual path. On a trip to the Burning Man festival with her husband, she met Rick Doblin, MAPS’ executive director. Through its Zendo Project, MAPS provides support to people who are having difficult experiences with psychedelics at events like Burning Man.
Dr. Yehuda and Doblin bonded over their shared interest in treating people with PTSD. She went through a training program in Israel run by MAPS for clinicians who want to practice MDMA-assisted therapy; as part of the FDA-approved training, she took MDMA under clinical supervision. The drug is intended to promote trust, empathy and introspection, all of which enhance the sessions of talk therapy that come before and after MDMA sessions.
Dr. Yehuda said later:
It really taught me a lot about psychotherapy. It just taught me about the power of an altered state of consciousness and helping identify things that we usually just don’t allow to come to the surface. Things that we all bury because we don’t think any good will come of bringing them up. And the power of being in a room with two therapists who are helping hold your process and helping you understand and make connections between various events in your life. I mean, to me, it felt like in eight hours what one might do in the course of 10 years in psychotherapy.
In the upcoming clinical trial, Dr. Yehuda and her associates plan to compare the effectiveness of two versus three sessions of MDMA-assisted therapy to help combat vets. MAPS’ current protocol uses three sessions; if two work equally as well, that will reduce treatment costs and broaden access.
With the Parsons foundation grant, Dr. Yehuda plans to develop a protocol using group therapy. For many veterans, the opportunity to share experiences with others “is itself very healing,” says Laura Mitchell, executive director of The Bob & Renee Parsons Foundation. “Bob first found relief from his own PTSD when he was reunited decades later with his Vietnam platoon.” The Parsons grant will also enable Mount Sinai train therapists who have experience treating PTSD in the use of MDMA.
Dr. Yehuda has been a pioneer of trauma treatment since studying the brain chemistry of PTSD as a postdoctoral fellow at Yale Medical School in the late 1980s. The daughter of a rabbi, she later studied the biomarkers of Holocaust survivors and their offspring in the suburbs of Cleveland where she grew up.