During the Covid-19 pandemic, healthcare systems across the world have struggled to handle the influx of patients and shortage of front-line medical workers. Even worse, physicians and researchers do not currently have effective therapies against the novel coronavirus.
This dire situation has resulted in the medical community rapidly adapting to manage the crisis. For example, in order to facilitate expanded access to medical care for patients, the Department of Human and Health Services and the Centers for Medicare and Medicaid Services have relaxed regulations surrounding telehealth on a “temporary and emergency basis,” particularly around privacy, payments, and prescribing. Because patients do not have time to wait for new Covid-19 therapies to undergo the usual decade-long FDA approval process, pharmaceutical companies and physicians all over the world have taken matters into their own hands to accelerate innovation and try experimental medicines. A great example is the FDA issuing an emergency-use authorization for remdesivir to treat hospitalized patients with severe Covid-19, despite limited clinical data that showed ambiguous efficacy. In a crisis, there is no other choice – the field of medicine must move quickly when its back is against the wall.
The pandemic’s impact is not limited to physical health: mental health during the pandemic has become an acute problem, and the pandemic is likely to bring about a long-lasting mental health crisis. For instance, the US national hotline providing emergency mental health assistance had received nearly nine times more calls than usual in early April, with government officials warning of an impending “mental health crisis.” Nearly half of adults in the US reported that Covid-19 had negatively impacted their mental health. Research has shown that disasters and disease can cause significant mental health effects (including depression and PTSD) that worsen over the months after the event.
The US already had a mental health crisis before the pandemic; now, the catastrophe has severely worsened. Just as the medical community and regulatory bodies rapidly adapted to a cataclysm in response to respiratory illness, so too these groups must quickly adapt to the mental health crisis. The medical and regulatory communities need to utilize the same acceleration of research and expanded access of experimental therapies to help everyone who needs it, especially because the number of mental health care providers is drastically low and antidepressants are notoriously ineffective.
Treatment protocols should be amended to minimize long periods of trial-and-error, and should instead focus on efficient, curative approaches. Psychedelic medicine is one such approach that should play an enhanced role, just as remdesivir has. The clinical data for psychedelic treatments for mental health (including ketamine, MDMA-assisted psychotherapy, and psilocybin) are more convincing than are the data supporting remdesivir to treat Covid-19.
As the deadly coronavirus pandemic continues to grow, the looming mental health crisis creates an urgent need for innovation, putting a spotlight on psychedelic-assisted treatments, says the co-founder of Advanced Integrative Medical Science Institute (AIMS) in Seattle.
The FDA last year approved an esketamine nasal spray for drug-resistant depression and called psychedelic psilocybin “a breakthrough therapy.” Many companies that are still in early stages of research and clinical trials may need to accelerate their efforts to help address the psychological implications of the pandemic, says Dr. Sunil Aggarwal, affiliate clinical assistant professor at the University of Washington School of Medicine and an UW affiliate assistant geography professor.
The pandemic “puts an additional impetus to innovate in our community for those of us who are already doing this,” says Aggarwal, a physician who has spent more than 15 years at the forefront of research into cannabis and psychedelic therapy in hospice and palliative care.
The coronavirus outbreak is happening at an unprecedented global scale, which has imploded financial markets and dominated headlines, and it is taking a toll on mental health as millions experience paralyzing anxiety and struggle to navigate social isolation. Suicide hotlines across the country have reported an influx of calls, with some states including mental health protections in their responses to the pandemic.
While the FDA approved ketamine decades ago as an anesthetic, AIMS and other clinics around the country that have been experimenting with off-label use of the drug see significant improvements in patients struggling with PTSD, trauma and depression.