The economics of psychedelic-assisted therapies: A research agenda

Marseille, Elliot; Bertozzi, Stefano; Kahn, James G.

doi:10.3389/fpsyt.2022.1025726

Cited by 11 publications

(4 citation statements)

References 70 publications

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“…1960s psychedelic iconoclast Timothy Leary captured something of this sentiment when he imagined a future when parents will ask their children as they return from college not what books they have read but what drugs they have taken. In relation to specific disciplines, psychedelics and PAT have given impetus to new or renewed discussion and innovationfor instance, in relation to clinical trial design, around unblinding and expectancy (Muthukumaraswamy, Forsyth, & Lumley, 2021; Szigeti & Heifets, 2024), and in relation to healthcare economics, measures of maximum health that go beyond the mere absence of disease symptoms (Marseille, Bertozzi, & Kahn, 2022). We may seek to document how the roll-out of PAT could change the very tools at our disposal for understanding psychedelics, PAT, and related phenomena.…”

Section: Outmoded Ways Of Knowingmentioning

confidence: 99%

Real-world evidence of the collective effects of psychedelic therapy: Evaluating from the grassroots

Noorani,

Liebert

2024

JPS

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With a surge in critiques levelled against the evidence generated by randomised controlled trials in the study of psychedelic-assisted therapy (PAT), and the legalization of PAT in select jurisdictions such as Australia, and Oregon and Colorado in the United States, we consider what form the real-world evidence of its effects could take. Specifically, we propose to complement individual-level data-gathering (the usual remit of pharmacovigilance procedures) with evidence of PAT's collective effects. Taking our cue from long-standing claims that psychedelics are agents of social transformation, we draw upon the ‘transformative paradigm’ of evaluation, an approach that is itself oriented around social justice and change vis-à-vis marginalised expertise – or what we approach as ‘the grassroots’. To illustrate the potential of such grassroots evaluations, we offer eight examples of social issues that have been discussed in relation to PAT and psychedelics use and, for each, discuss the kinds of expertise that could be brought into the evaluation team and the kinds of questions that could be asked. We further describe our grassroots approach according to three values inspired by the qualities of grass roots themselves: rhizomatic accountability, dark reflexivity, and more-than-human hosting. We argue that these values align with the contemporary experience, practice, and context of PAT. We hope to generate discussion, innovation, and – ultimately – action toward specific study designs that are adequate to the task of documenting, and working with, the transformative potential of psychedelics in contemporary medicalized societies.

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Section: Outmoded Ways Of Knowingmentioning

confidence: 99%

Real-world evidence of the collective effects of psychedelic therapy: Evaluating from the grassroots

Noorani,

Liebert

2024

JPS

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“…Measure transparently and systematically in harmony with federal guidance for “harm reduction, risk mitigation, and safety monitoring” ( 51 ) to identify markers of differential risk and benefit to deftly maximize safety, economic ( 52 ), and public health benefits ( 53 ).…”

Section: Clinical and Policy Prioritiesmentioning

confidence: 99%

Lifeboat ethics, risk, and therapeutic opportunity: an appeal for equitable psychedelic therapy access in the “high-risk” addiction patient

Black

2023

Front. Psychiatry

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Psychedelic-assisted treatment (PAT) for mental health is in renaissance. Psilocybin and MDMA stand near FDA approval, and US cities and states are decriminalizing or regulating the non-clinical use of psilocybin. However, neither FDA indications nor a regulated use model sufficiently address the complex needs and opportunities for an improved treatment of addiction. When paired with disability and social dispossession, addiction increasingly burdens informal care networks, public safety, and particularly healthcare systems. Stigma and mistreatment alienate people from opportunities for care and multiply the costs of providing care. This dynamic worsens socially determined resource limitations, enforcing stark ethical choices and perpetuating socioeconomic inequities, isolation, mental illness, medical illness, overdose, suicide, and violence. In order for psychedelic treatments to achieve their greatest utility to population health, we must intentionally develop regulatory, clinical, and payment systems supporting clinical research, rigorous safety monitoring, and implementation to address these immense needs and reduce the barriers to engagement for those who now bear the costs, including those who work at the front lines of addiction care. To achieve full fruition, I advocate for a collaborative approach, built from within networks of mutual social support but linked and accountable to public institutions charged with the equitable dissemination of these therapies for the greatest social and health equities. Rather than relegating PAT to the needs of the commercially insured or wellness markets, this is the moment to learn from ancient traditions of ritualized sacramental use, organized around faith in our mutual dependency and accountability, and to capture an opportunity to improve population health and equity. To miss this opportunity is to accept the status quo in the midst of a growing emergency, for lack of moral vision and intention to change our habits.

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“…Important discussions are emerging on how to integrate indigenous theoretical perspectives and approaches while reducing historically-rooted colonial assumptions prevalent in psychology-related fields (George et al, 2019 ; Williams and Labate, 2019 ; Ens, 2021 ; Hauskeller et al, 2022 ; Romero, 2022 ). Not only are there controversies within the scientific and therapeutic realm over the hype, methodologies, and feasibility of psychedelic-assisted therapies (Hendy, 2018 ; Michaels et al, 2018 ; Brody, 2022 ; Marseille et al, 2022 ; Munafò et al, 2022 ; Ona et al, 2022 ), but voters also show sharp rifts in psychedelic support. More counties in Oregon and Colorado recently voted “no” than “yes” on psychedelic decriminalization/legalization initiatives.…”

Section: Introductionmentioning

confidence: 99%