Utah research into the therapeutic use of psychedelic drugs could benefit from recent local and national political moves. These are Schedule I drugs like psilocybin found in so-called magic mushrooms and MDMA, commonly known as ecstasy.
President Donald Trump signed an April executive order to speed up research and approval of psychedelics for therapy, and here in Utah, bipartisan legislation this year authorized a clinical study on psychedelic therapy in veterans. It was signed into law by Gov. Spencer Cox in March and provides a pathway to fund a clinical trial.
“This executive order described allocating additional federal funds to match or support state-level funds for psychedelic research. That is potentially very significant in relation to HB 390” said Dr. Benjamin Lewis, principal investigator of the University of Utah Psychedelic Science Initiative.
He expects more information in the coming weeks about what that will look like and how it will affect Utah in particular.
Lewis said the state-funded psychedelic trial provides a pathway to healing for U.S. military veterans with treatment-resistant post-traumatic stress disorder.
There are good reasons for that in Utah.
“First and foremost, there's just an inordinate number of U.S. military veterans that suffer from PTSD,” Lewis said. “And the impact of that is even larger in a state like Utah. There are a host of downstream consequences from untreated or inadequately treated PTSD, including higher rates of suicide and significant impacts on families and the Veterans Administration hospital system.”
2023 Utah veteran suicide data bear that out. After accounting for age differences, the veteran suicide rate in Utah was significantly higher than national figures. Veterans here die by suicide at a rate of nearly 60 per 100,000 compared to around 18 nationally.
“There is just a huge unmet need for new effective treatments for this condition,” he said.
And he thinks the federal government’s plans to expedite the Drug Enforcement Administration rescheduling process is key to addressing this issue.
“Psychedelics are really classified as Schedule I drugs, meaning that they are deemed to have essentially no medical value and high abuse potential. And for them to be used as clinical tools, they first need FDA approval following completion of phase III trials. But they then need to be federally rescheduled by the DEA. And this executive order also looks to be expediting that process.”
Already, the Food and Drug Administration has announced that three psychedelic drugs under development for mental health will be offered a priority review. Two companies are studying psilocybin, and the third is studying methylone, a drug related to MDMA.
This interview has been edited for length and clarity.
Pamela McCall: What has your research into psychedelics for conditions like PTSD, depression and addiction revealed?
Benjamin Lewis: The main compound that has been studied and moved towards FDA approval pathways to date has been MDMA and MDMA assisted therapy specifically for PTSD. Those studies have demonstrated really remarkable efficacy, even with a small number of treatments – maybe three treatments. That is remarkably rapid and also sustained for people who have otherwise not had benefits with other treatments.
PM: How do psychedelics enable patients to feel better or emerge without PTSD in such little time?
BL: In terms of their therapeutic engagement with a drug like MDMA, which has effects of increasing openness, lowering defensiveness, lowering arousal, memories and traumatic memories in particular, traumatic experiences are much more amenable to being parsed in a psychotherapeutic way, whereas with standard evidence-based therapies for PTSD, that's often intolerable for patients who are so overwhelmed with some of that content. And so one way of thinking about that drug in particular is that it allows for a certain kind of therapeutic process that is otherwise difficult to access and difficult to facilitate for a person who's highly traumatized.
PM: What might we be able to see down the road with psychedelic treatment for other Utahns who are susceptible to suicide?
BL: Utah has an inordinate burden of suicide and suicide completion, as does the Intermountain West in general. And Utah, like many states, really, as in the country, is really facing a crisis of mental health. So I think it's very exciting to be having the possibility of new treatments that might be helpful for a number of patients.
PM: What are the risks associated with psychedelic treatment?
BL: In relation to, say, classic psychedelics, those are drugs that are really acting on the serotonin system. Those are drugs like psilocybin, the active ingredient in magic mushrooms, or LSD. The predominant risks for those drugs are not medical or physiological, necessarily. They're predominantly psychological risks and risks related to overwhelming experiences, perhaps in context that might not be well supported or unsafe. Those are risks also in relation to people with underlying mental health conditions that might be destabilized by those experiences or those drugs.
PM: To what extent is Utah ahead of the curve when it comes to researching psychedelics?
BL: I think we are leaders in the respect of running trials that have utilized and established group protocols. Treating a group of individuals or cohorts of individuals with interventions that are otherwise very resource-intensive and difficult to scale, difficult to imagine rolling out in an equitable and accessible way.
Editor’s note: KUER is a licensee of the University of Utah but operates as an editorially independent news organization.
