There are 40 planned and ongoing clinical trials about psychedelics therapies and post-traumatic stress disorder (PTSD), most using MDMA. But what researchers are finding out is that trauma comes in many forms.
There is racial trauma, trauma as experienced by combat veterans, trauma associated with violence and emotional and sexual abuse, and even environmental, economic and social trauma. Here we take a look at three main areas of trauma being addressed by psychedelics:
- Trauma and race. What is often missing from the studies of PTSD and psychedelics is the trauma suffered by people of color, since racism is rarely identified as a source of trauma.
In one study from 2011, the lifetime prevalence of PTSD was highest among Blacks (8.7%), intermediate among Hispanics and Whites (7.0% and 7.4%) and lowest among Asians (4.0%). All minority groups were less likely to seek treatment for PTSD than Whites, according to the study, and fewer than half of minorities with PTSD sought treatment. Worse, minority groups have been vastly unrepresented in clinical trials for PTSD and psychedelics, as reported in another study using a methodological search of psychedelic studies from 1993 to 2017 to evaluate ethno-racial differences in inclusion and effective methods of recruiting people of color.
Of the 18 studies that met full criteria, 82.3% of the participants were non-Hispanic White, 2.5% were African-American, 2.1% were of Latino origin, 1.8% were of Asian origin, 4.6% were of indigenous origin, 4.6% were of mixed race, 1.8% identified their race as “other,” and the ethnicity of 8.2% of participants was unknown. “Inclusion of minorities in future studies and improved recruitment strategies are necessary to better understand the efficacy of psychedelic-assisted psychotherapy in people of color and provide all with equal opportunities for involvement in this potentially promising treatment paradigm,” the study concluded.
An article published in “Psychological Medicine” found that, when PTSD affects U.S. race/ethnic minorities, it is usually untreated. “Large disparities in treatment indicate a need for investment in accessible and culturally sensitive treatment options.”
- Trauma and military combat. Most veterans who suffer PTSD from the trauma of combat find out that there is not much to treat them except for medications that either numb them out or otherwise mask their symptoms. Mental health for veterans coming back from overseas combat was described by one veteran as simply a “fast track to medication. It was really a sort of a maintenance program as opposed to overcoming my mental health issues.” PTSD among veterans is reportedly reaching epidemic status, with up to 20 percent of vets returning from recent battlefields diagnosed with PTSD.
Now there are a handful of nonprofit groups helping to connect veterans with a wide range of psychedelics to treat PTSD. And more veterans are taking the fight for access to psychedelics therapeutics to lawmakers as well. The Veterans Administration is monitoring psychedelic use for PTSD, according to Lisa Brenner, clinical research psychologist director, Rocky Mountain Mental Illness Research Education and Clinical Center, U.S. Dept. of Veterans Affairs at the Rocky Mountain Regional Medical Center in Aurora, Colorado. “We are watching very closely both clinicians and researchers connected with the VA working on these projects with their affiliates,” she said, speaking at a Congressional committee hearing in September. “We are tracking very closely the recent trials underway and eagerly anticipating the results of those trials. And then we will determine next steps.”
Meanwhile, the Michael Debakey VA hospital in Houston was recently enabled by the state to do its own research on psilocybin, MDMA, and PTSD.
- Trauma and emotional and sexual abuse. Psychedelic use may have therapeutic benefits in treating the trauma of child maltreatment, such as emotional abuse and neglect usually correlated with complex trauma symptoms and internalized shame, according to a study. Child maltreatment is often referred to as developmental trauma, identifying the lasting and global effects of prolonged exposure to trauma on the child’s cognitive, affective, social, and biological development. While early results with psychedelics are encouraging, researchers agree that more work is needed.
And a study in Brazil with three participants who were all victims of sexual abuse—the kind of trauma that severely impacts mental health and psychopathology—all benefited from MDMA treatment, ranging from small but clinically significant improvement to strong improvement.
There is more scientific research and there are more clinical trials coming to help understand and treat trauma that either is diagnosed as PTSD or does not quite rise to the level of PTSD but is still a concerning mental health condition in line with what psychedelics can help with. “If I had to bet on the direction of where things will go, then yes, that’s where I would lay my bets,” James Lanthier, CEO, Mindset Pharma, (OTC: MSSTF) told Psychedealia about psychedelics and trauma. “I think these different mood disorders, these neuropsychiatric disorders, they’re all pretty close cousins to one another, between depression, post-traumatic stress, anxiety. There’s really at least some level of preliminary evidence that psychedelics offer potential relief for a really wide range of different illnesses, mental illnesses beyond just treatment-resistant depression and post-traumatic stress.”
But there is even a deeper subcontext of trauma and psychedelics, as discussed by Dr. Rachel Knox, a policy and regulatory consultant on cannabis and psychedelics, speaking during a psychedelics and trauma zoom conference organized through Harvard University. Knox is also a member of Oregon’s Psilocybin Advisory Board. “We have to recognize the complexities of just the constructs that are continuing to allow trauma to persist and percolate, and attack the systems that continue to enable trauma,” she said. “I just don’t think we are going to solve the problem until we take that step back and recognize the systems that play here beyond therapeutics that need reform.”