Why Psychedelics Should Be Approved As Medicines

I shall endeavor to illuminate the intricacies surrounding the growing consensus that psychedelics possess impressive therapeutic potential for various mental health conditions. Some critics argue that broad legalization could result in increased recreational use, with potentially negative consequences for public health and safety. Also, some concerns persist about broad legalization resulting in inadequate regulation and control, which could lead to unsafe use and distribution of these substances. Some are also apprehensive about the potential adverse effects on mental health, particularly among vulnerable populations such as adolescents and those with pre-existing mental health conditions. These are legitimate concerns that are in many ways mirrored by the BCSP survey results. However, many of these concerns can be mitigated by approving psychedelics as medicines, where prescription, distribution, and administration can be safely and responsibly managed by the medical community, as with other treatments for mental health disorders.

The landscape of psychedelic legalization for medical use is a complex tapestry, varying across nations, states, and cities. Some countries, such as Canada, Australia, the Netherlands, Brazil, and Jamaica, have decriminalized or legalized psychedelics in some way, while others maintain strict prohibitions. In the United States, the situation differs from state to state and continues to positively evolve.

The burgeoning movement to decriminalize and legalize psychedelic compounds in various locales across the United States stems from an increasing appreciation for their potential therapeutic benefits, as well as a call for criminal justice reform and an end to the War on Drugs. Some recent milestones include the decriminalization of psilocybin in cities such as Denver, Colorado, and Oakland, California. These measures do not legalize the sale or distribution of psilocybin, but rather deprioritize enforcement of laws against personal use and possession.

Other cities and states have similarly taken strides toward decriminalizing other psychedelics, including ayahuasca, ibogaine, and DMT. In Oregon, a 2020 ballot initiative legalized the therapeutic use of psilocybin under the supervision of licensed professionals, potentially paving the way for its use in treating mental health conditions such as depression, anxiety, and PTSD, although the nuanced regulations regarding medical use are complex, and I don’t intend to delve into those complexities here.

The decriminalization and legalization of psychedelics is not without controversy. Concerns about potential risks, proper regulation, and oversight cannot be ignored. However, the growing movement towards decriminalization and legalization reflects a shift in attitudes and a burgeoning recognition of their potential therapeutic benefits.

If psychedelics are to be legalized for medical use, healthcare professionals will need education and training on their use, benefits, and risks, as with all therapeutics. The legalization of psychedelics for medical use is a multifaceted issue, with both potential benefits and some manageable risks. While there is mounting evidence for the therapeutic potential of psychedelics, concerns about their potential for abuse and negative effects on mental health, if not responsibly administered, must be addressed, potentially through the adoption of thoughtful safety protocols and REMS programs. As research progresses and public opinion evolves, it is crucial to maintain a nuanced and informed dialogue about psychedelics' potential benefits and acceptable risks for medical use. Ultimately, safety and efficacy data from robust, randomized clinical trials is likely to provide the most probable pathway to the safe and ethical use of psychedelics to treat mental health disorders.

Some proponents of psychedelics argue for comprehensive legalization, while others propose a more targeted approach focused on medicinal use. Approving psychedelics as medicines permits a controlled and regulated method, ensuring safety and efficacy through rigorous testing and evaluation, as well as clear guidelines for use. This helps minimize harm to patients and maximize the benefits of psychedelic therapeutics for those in need.

Legitimizing the use of psychedelics in therapeutic contexts by approving them as medicines reduces stigma and increases public acceptance. Medicinal use also ensures equitable and affordable access to psychedelic medicines and advances our understanding of their therapeutic potential through rigorous clinical trials and evaluations. As the field of psychedelic therapeutics evolves, it remains essential to be vigilant about ethical considerations and to work towards ensuring the utmost care and respect for patients.

In the grand milieu of mental health treatment, a compelling pharmacoeconomic argument can be made for the approval of psychedelics as medicines, as their potential benefits may not only offer relief to patients, but also alleviate the economic burden on healthcare systems.

The direct costs associated with existing mental health treatments are substantial. Traditional therapies such as pharmacological interventions and psychotherapy can be expensive and often require long-term commitment. In contrast, intermittent psychedelic therapy may offer a more cost-effective alternative. Emerging clinical trials have shown that a limited number of psychedelic treatment sessions can lead to significant and lasting improvements in symptoms for conditions such as depression, anxiety, and PTSD, freeing patients from symptoms for weeks or months at a time, from just a few doses.

The indirect costs of mental health disorders are immense, encompassing lost productivity, disability, and strain on healthcare systems. By providing effective and rapid relief, psychedelic therapy has the potential to reduce these indirect costs. As patients experience improvements in their mental health, they could re-engage in the workforce, reduce their reliance on disability benefits, and decrease the frequency of healthcare visits.

Integrating the potential cost savings from reducing comorbidities into the pharmacoeconomic argument for approving psychedelics in the treatment of mental health disorders further strengthens the case for their use. Mental health disorders are often accompanied by comorbid conditions, both physical and psychological, which can significantly impact the overall cost of care and quality of life for affected individuals.

Reducing physical comorbidities: Mental health disorders are frequently associated with physical health complications, such as cardiovascular disease, diabetes, and obesity. These comorbidities can exacerbate the severity of mental health issues, complicate treatment plans, and lead to higher healthcare costs. By effectively treating mental health disorders with psychedelic therapy, it may be possible to mitigate the risk factors for these physical comorbidities. Consequently, this could reduce the need for additional medical treatments, lower healthcare expenditures, and improve overall patient well-being.

Reducing psychological comorbidities: Mental health disorders often co-occur with other psychological conditions. For example, depression and anxiety are commonly seen together, as are PTSD and substance use disorders. By addressing the primary mental health condition with psychedelic therapeutics, patients may experience improvements in comorbid psychological conditions as well. This could lead to a decrease in the use of additional psychiatric medications, reduced frequency of therapy sessions, and lower overall mental healthcare costs.

Preventing the development of comorbidities: Early and effective intervention in treating mental health disorders can help prevent the development of comorbid conditions. By introducing psychedelic therapeutics as viable treatment options, patients may experience improvements in their mental health sooner. This could reduce the likelihood of developing comorbidities that often arise from chronic, untreated mental health issues, such as substance use disorders or chronic pain conditions, even diabetes, ultimately leading to cost savings in the long term.

Incorporating the potential cost savings associated with reducing comorbidities bolsters the pharmacoeconomic argument for the approval of psychedelics to treat mental health disorders. By addressing the primary mental health condition effectively and in a timely manner, psychedelic therapeutics have the potential to not only improve patient outcomes but also to lessen the economic burden on healthcare systems and society.

The societal costs of mental health disorders should not be underestimated. High rates of mental illness are associated with increased crime, homelessness, and substance abuse. By offering a novel and effective treatment option, psychedelic therapies could contribute to the reduction of these societal issues, thereby lessening the financial burden on public services such as law enforcement, social welfare, and emergency care.

The approval of psychedelics for treating mental health disorders could stimulate investment in research and development. This could lead to the discovery of more efficient and targeted therapies, expanding the range of treatment options available and potentially driving down the overall costs of mental healthcare.

It is crucial to consider the potential cost savings associated with the prevention of mental health crises. By offering an effective treatment option as an alternative to traditional therapies, psychedelic therapies could prevent the need for more intensive and expensive interventions, such as hospitalization or long-term disability support.

The pharmacoeconomic argument for approving psychedelics in the treatment of mental health disorders extends beyond the realm of direct treatment costs. It encompasses the potential to reduce indirect costs, societal burdens, and stimulate further research and development in the field. By carefully considering these factors, we can appreciate the multifaceted advantages of approving psychedelics as medicines for mental health treatment, not only for patients, but also for the broader healthcare system and society as a whole.

- Doug Drysdale