In recent years, psychedelics have received a surge of interest for their therapeutic potential, promising care for those who have been forgotten and a vision of a broader collective transcendence. But as I write in a guest essay for Times Opinion this week, psychedelics research is facing a reckoning over poor clinical trial design and questionable practices that have led to premature confidence about their benefits and minimization of their risks. For instance, we might think of ketamine as a cautionary tale for how other psychedelic therapeutics might be rolled out. While it may be a lifesaving antidepressant for some, it appears to have become another cog in the Rube Goldberg machine of human suffering that is modern Western medicine, turning pain into profits. The risk profile of ketamine is probably better understood than that of other psychedelics, as its Schedule III classification has long allowed for its study. But while the drug has been used to great effect as a one-and-done anesthetic, we need more long-term safety data about repeated use of ketamine or the patented Johnson & Johnson reformulation, Spravato, which is used as an antidepressant. We do know that the acute antidepressant effects, observed in the first 24 to 48 hours after ketamine infusions, do not appear to be lasting. In order to continue to benefit from ketamine, patients typically must use it repeatedly, which can have side effects including addiction, hallucinations, memory problems, delusions, aggression and even toxicity in the liver, kidneys and bladder. This week, a spokesperson for the Drug Enforcement Administration warned that ketamine abuse was starting to resemble the beginning of the opioid crisis. The F.D.A. does not require data collection on adverse outcomes from ketamine clinics, but last fall it issued a warning that unsupervised treatment via telemedicine companies might be putting patients at risk. The dose of a drug is important, but so are the interval, frequency and duration over which they're consumed. With therapeutic ketamine, all of these are being experimented with by individual providers on their patients. As I argue in my essay, it is vital for research on the safety and efficacy of psychedelics to be conducted with more rigor and care, because it is possible to do more harm than good to those who are already suffering.
We hope you've enjoyed this newsletter, which is made possible through subscriber support. Subscribe to The New York Times. Games Here are today's Mini Crossword, Wordle and Spelling Bee. If you're in the mood to play more, find all our games here. Forward this newsletter to friends to share ideas and perspectives that will help inform their lives. They can sign up here. Do you have feedback? Email us at opiniontoday@nytimes.com. If you have questions about your Times account, delivery problems or other issues, visit our Help Page or contact The Times.
|
Saturday, August 24, 2024
Opinion Today: Psychedelics were supposed to revolutionize mental health treatment. What went wrong?
Subscribe to:
Post Comments (Atom)
No comments:
Post a Comment