Friday, December 13, 2024

Treating Covid burnout with ’shrooms

Presented by PBM Accountability Project: The ideas and innovators shaping health care
Dec 13, 2024 View in browser
 
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By Erin Schumaker and Daniel Payne with Carmen Paun

Presented by PBM Accountability Project

THE NEXT CURES

FAIRFIELD COUNTY, CONNECTICUT - DECEMBER 24: Psilocybin "Golden Teacher" mushrooms grow in a humidified monotub in the basement of a private home on December 24, 2023 in Fairfield County, Connecticut. Recent studies have suggested that psilocybin mushrooms, also known as "magic mushrooms" have shown promise in combating anxiety, anorexia, depression, PTSD,   obsessive-compulsive disorder and various forms of substance abuse. Scientists say psilocybin may promote neuroplasticity, a rewiring of the brain that may give patients fresh perspectives on longstanding psychiatric issues. Psilocybin is classified in the United States as a Schedule 1 substance, making it illegal by federal law. Many local municipalities nationwide, however, have moved to decriminalize it in smaller quantities. (Photo by John Moore/Getty Images)

Psychedelics could be useful for doctors, too, researchers believe. | Getty Images

Psychedelics could offer relief to doctors who provided frontline care during the pandemic and later became depressed.

That’s according to a small new study published in JAMA Network Open this month.

Inside the study: Of the 30 participants in the double-blind, randomized trial, half received two preparation sessions; one dose of synthetic psilocybin, also known as magic mushrooms; and three follow-up counseling sessions with a trained facilitator. The other half, the control group, received the same sequence of sessions, except a placebo was swapped for the psilocybin.

While both groups saw their depression symptoms improve, participants in the psilocybin group had faster, bigger and more long-lasting drops in their depression scores.

Because the study was small, its findings can’t be generalized to a wider population.

By the numbers: More than 2,200 clinicians applied for the study’s 30 slots, which were awarded using a lottery system. All participants were frontline Covid-19 health workers who didn’t have a mental health diagnosis before the pandemic and had moderate or severe depression when they enrolled. The 15 men and 15 women chosen for the study ranged in age from 29 to 60.

The group had seen levels of death and dying during the pandemic unlike anything they’d previously experienced, according to Dr. Anthony Back, the study’s lead investigator and a professor at the University of Washington School of Medicine in Seattle.

“I felt inept,” Dr. Sarah Kirsch, a Seattle-based internist who participated in the study, told researchers. “I had limited ability to help people at a time when they’re at the sickest that they’ll be in their life. We have remdesivir and steroids and ventilators, but those are not curative.”

According to Back, the psilocybin treatment helped Kirsch and others in her group reframe their experiences in a way that allowed them to better understand what happened and to have compassion for themselves.

What’s next: The Food and Drug Administration has designated psilocybin as a breakthrough therapy, a label meant to expedite a drug’s path toward approval.

But it’s been a challenging year for the psychedelics industry, which saw enthusiasm for psychedelic medicine cool in August after the FDA rejected Lykos Therapeutics’ application to treat post-traumatic stress disorder with MDMA and talk therapy.

Still, some psychedelics advocates are optimistic about President-elect Donald Trump’s second term. His pick for health secretary, Robert F. Kennedy Jr., has alleged that the agency is keeping psychedelics from Americans, writing on X this fall that he wants to end the “aggressive suppression of psychedelics.”

 

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WELCOME TO FUTURE PULSE

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This is where we explore the ideas and innovators shaping health care.

UnitedHealth Group is strategically limiting access to autism treatment for kids, according to leaked documents unearthed by a ProPublica investigation.

Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@politico.com, Daniel Payne at dpayne@politico.com, Ruth Reader at rreader@politico.com, or Erin Schumaker at eschumaker@politico.com.

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A message from PBM Accountability Project:

Pharmacy benefit managers (PBMs) are taking advantage of Medicare and America’s seniors. It's time for Congress to act. Rein in PBMs by requiring them to increase transparency, share discounts with seniors, and delink PBM profits from the cost of medicines in Medicare. Congress must pass S. 2973 and S. 3430 this year. Learn more.

 
WASHINGTON WATCH

Kenneth Weston, from left, and his friend Cruz Dillard, together with AIDS survivors, their families and advocates, look at the display of AIDS Memorial quilts spread over the South Lawn at the White House during a ceremony to commemorate World AIDS Day, Sunday, Dec. 1, 2024, in Washington.

To keep HIV/AIDS funding flowing, advocates need to promote PEPFAR and emphasize the risk of complacency in fighting the virus. | Manuel Balce Ceneta / AP

U.S. health experts and officials are looking for new ways to fund the fight against HIV amid questions about America's commitment to it.

“Traditional funding models, reliant on government grants and bilateral aid, are increasingly vulnerable to budget constraints and shifting political priorities,” Drs. Victor Dzau, the president of the National Academy of Medicine, and Carlos del Rio of the Emory University School of Medicine, wrote in JAMA this week.

They point to resources from multilateral development banks and low-interest loans “to secure sustainable funding for HIV/AIDS programs.”

Why it matters: A key concern is uncertainty surrounding the future of the President’s Emergency Plan for AIDS Relief, better known as PEPFAR, which is credited with saving 25 million lives over two decades, Dzau and del Rio wrote.

For the first time since its creation during the Bush administration in 2003, Congress this year reauthorized PEPFAR only for one year — until March 2025 — instead of five years, as in the past.

It’s unclear if the program, which has spent more than $120 billion on antiretroviral medicines, HIV prevention and research, will be reauthorized for five years when Republicans take control of Congress and the White House next year.

To secure continued political and public support for PEPFAR, Dzau and del Rio argue that advocates need to promote the program's results and speak out about the risk of complacency in the HIV fight.

Big picture: The debate about PEPFAR's sustainability started years ago with a push for beneficiary countries to take more ownership of their domestic HIV programs and invest more of their own money in them.

South Africa and Kenya made significant progress financing their national HIV/AIDS responses, with the former funding more than 80 percent of their response, Dzau and del Rio wrote.

But many developing countries with high HIV burdens also have high debt, making it difficult to invest more of their domestic budgets in fighting the virus and the disease it can cause.

What’s next: Starting next year, the State Department plans to set up co-investment agreements with beneficiary countries, Rebecca Bunnell, principal deputy U.S. Global AIDS Coordinator for PEPFAR, said at a Council on Foreign Relations event in Washington this week.

Governments commit to policy and financing objectives through those agreements to ensure PEPFAR's work against HIV continues.

 

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WASHINGTON WATCH

Senator Chris Murphy speaks during a press conference at the U.S. Capitol.

Sen. Chris Murphy's (D-Conn.) bill to address loneliness passed the Senate this week. | Francis Chung/POLITICO

Sen. Chris Murphy (D-Conn.) is making good on his promise to help lonely Americans.

Murphy’s bill, the National Resource Center for Engaging Older Adults Act, passed the Senate unanimously as part of a reauthorization of the Older Americans Act this week. It previously passed the Senate health committee by a bipartisan vote.

The bill supports expanding programming and services that promote social connection for older adults and adults with disabilities, two particularly socially isolated groups, at area agencies on aging and at community organizations like libraries and senior centers.

“Nothing is more important for finding happiness and fulfillment in life than having quality relationships with other people,” Murphy said in a statement. “I’m proud we got this done, and I’ll continue to look for ways the federal government can support local places that build community.”

Zoom out: Murphy is part of a cadre of policymakers who’ve identified loneliness and a lack of social connection as forces making Americans sick, unhappy and unfulfilled. They’re trying to determine whether policy can be part of the solution.

What's next: Reauthorization of the Older Americans Act heads to the House for consideration.

 

A message from PBM Accountability Project:

There’s consensus in Congress – real PBM reform is needed NOW.

Both sides agree we need to: improve transparency, break the link that allows PBMs to tie their profits to the price of the drug, and force PBMs to share discounts with seniors.

Congress: It is time to finish the job and pass bipartisan senate bills 2973 and 3430. America’s seniors are counting on it. Learn more.

 
 

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