PMID- 37682446
OWN - NLM
STAT- MEDLINE
DCOM- 20231107
LR  - 20231109
IS  - 1535-1645 (Electronic)
IS  - 1523-3812 (Linking)
VI  - 25
IP  - 10
DP  - 2023 Oct
TI  - Psychedelic-Assisted Therapy in Military and Veterans Healthcare Systems: 
      Clinical, Legal, and Implementation Considerations.
PG  - 513-532
LID - 10.1007/s11920-023-01446-4 [doi]
AB  - PURPOSE OF REVIEW: This review discusses the current and projected landscape of 
      psychedelic-assisted therapy (PAT), with a focus on clinical, legal, and 
      implementation considerations in Department of Defense (DoD) and Department of 
      Veterans Affairs (VA) healthcare systems. RECENT FINDINGS: 
      3,4-Methylenedioxymethamphetamine (MDMA)- and psilocybin-assisted therapy have 
      shown promising outcomes in efficacy, safety, tolerability, and durability for 
      PTSD and depression, respectively. MDMA-assisted therapy is already approved by 
      the Food and Drug Administration (FDA) on an Expanded Access ("compassionate 
      use") basis for PTSD, with full approval projected for 2024. Psilocybin-assisted 
      therapy is projected to be FDA-approved for depression soon thereafter. Other 
      psychedelics are in earlier stages of development. The VA is currently conducting 
      PAT clinical trials. Although there are clear legal pathways for the VA and DoD 
      to conduct PAT trials, a number of implementation barriers exist, such as the 
      very high number of clinical hours necessary to treat each patient, resource 
      requirements to support treatment infrastructure, military-specific 
      considerations, and the high level of evidence necessary for PAT to be 
      recommended in clinical practice guidelines. Ongoing considerations are whether 
      and how PAT will be made available to VA and DoD beneficiaries, feasibility and 
      cost-effectiveness, and ethical safeguards that must be implemented to prioritize 
      access to PAT given the likelihood of extremely limited initial availability. 
      However, with imminent FDA approval of PATs and considerable national interest in 
      these treatments, DoD and VA policymakers must be prepared with clearly 
      delineated policies and plans for how these healthcare systems will approach PAT.
CI  - (c) 2023. This is a U.S. Government work and not under copyright protection in the 
      US; foreign copyright protection may apply.
FAU - Wolfgang, Aaron S
AU  - Wolfgang AS
AUID- ORCID: 0000-0002-5238-4451
AD  - Walter Reed National Military Medical Center, 4494 Palmer Rd N, Bethesda, MD, 
      20814, USA. aaron.wolfgang@yale.edu.
AD  - Uniformed Services University, Bethesda, MD, USA. aaron.wolfgang@yale.edu.
AD  - Yale University School of Medicine, New Haven, CT, USA. aaron.wolfgang@yale.edu.
FAU - Hoge, Charles W
AU  - Hoge CW
AD  - Walter Reed Army Institute of Research, Silver Spring, MD, USA.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20230908
PL  - United States
TA  - Curr Psychiatry Rep
JT  - Current psychiatry reports
JID - 100888960
RN  - 0 (Hallucinogens)
RN  - KE1SEN21RM (N-Methyl-3,4-methylenedioxyamphetamine)
RN  - 2RV7212BP0 (Psilocybin)
SB  - IM
MH  - United States
MH  - Humans
MH  - *Veterans
MH  - *Hallucinogens/therapeutic use
MH  - *N-Methyl-3,4-methylenedioxyamphetamine/therapeutic use
MH  - Psilocybin/therapeutic use
MH  - United States Department of Veterans Affairs
MH  - Delivery of Health Care
OTO - NOTNLM
OT  - MDMA
OT  - Military
OT  - Psilocybin
OT  - Psychedelics
OT  - Review
OT  - Veterans
EDAT- 2023/09/08 12:42
MHDA- 2023/11/07 06:46
CRDT- 2023/09/08 11:13
PHST- 2023/08/04 00:00 [accepted]
PHST- 2023/11/07 06:46 [medline]
PHST- 2023/09/08 12:42 [pubmed]
PHST- 2023/09/08 11:13 [entrez]
AID - 10.1007/s11920-023-01446-4 [pii]
AID - 10.1007/s11920-023-01446-4 [doi]
PST - ppublish
SO  - Curr Psychiatry Rep. 2023 Oct;25(10):513-532. doi: 10.1007/s11920-023-01446-4. 
      Epub 2023 Sep 8.