WASHINGTON, DC — Marine and Army veteran Jonathan Leubecky suffered from PTSD and several suicide attempts following deployment to Iraq. His first attempt to take his life was only two months after his return home in 2006. His last was seven years later, in November 2013—not long before he entered a trial involving the psychedelic drug MDMA. Almost a decade later, Leubecky remains symptom-free and credits the controversial therapy with saving his life.
One of an estimated 7% percent of veterans who experience PTSD, Leubecky shared his story in the first episode of the new VA podcast “New Horizons in Health: Bringing Health Care into the Future.” Hosted by Under Secretary for Health Shereef Elnahal, MD, the podcast features subject-matter experts as well as veterans who have benefited from the cutting-edge research edge and treatments discussed. In the inaugural episode—which focused on psychedelic-assisted therapies for veterans experiencing a number of mental health conditions—Elnahal was joined by Leubecky, as well as Ilse Wiechers, MD, MPP, MHS, executive director of the VA Office of Mental Health and Suicide Prevention, and Joshua Woolley, MD, PhD, associate professor of psychiatry at UCSF Weill Institute for Neurosciences and the San Francisco VA Medical Center.1
Once embraced by the counterculture, psychedelic drugs like MDMA (known as Molly or Ecstasy) and psilocybin (magic mushrooms) are making their way into mainstream medicine as research examines their benefits for people with PTSD, anxiety, depression and addiction.
The trial in which Leubecky took part consisted of 12 therapy sessions of 90 minutes or 8 hours. Three of the sessions were conducted while he was under the influence of MDMA.
Leubecky, who had been on as many as 42 pills at a time before joining the trial, said it was not the MDMA itself that healed him but the drug’s ability to open his mind to therapy. “MDMA is a tool that opens up the mind, body and spirit to the place it can be so that you can heal and process all of those memories and all the things, trauma, that are causing you issues,” he said. “Without it, people with PTSD, they have issues with trust, they have issues—they don’t want to talk about it. They also either shut down emotionally and can’t process, or they become hyperemotional and can’t process. So the MDMA puts you in this, this middle ground, where you stay in a place where you can talk about trauma without having panic attacks, without your body betraying you and look at it from a different perspective.”
He likened the drug to the anesthesia given for surgery. “The thing is, the medicine, the MDMA, isn’t what fixes you. I had back surgery three weeks ago. They gave me very powerful drugs as anesthesia to knock me out so the surgeon could go in and do the work. This is very similar.”
Combined With Psychotherapy
Weichers, too, stressed the importance of therapy. “The psychotherapy piece is the essential piece,” she said. “I mean, the psychotherapy piece is kind of the cornerstone, so it really needs to be a combination of the medication and the psychotherapy together to ensure great success like Jonathan has had.”
Though Lubecky’s results have been impressive, they are not unique. “There have been large what are called pivotal trials conducted both for MDMA psychotherapy and psilocybin psychotherapy and those have shown very promising results for PTSD and depression,” said Woolley, whose research focuses on psychedelic-assisted therapy. “There have also been trials for substance abuse disorder with psilocybin.” The results have been “quite dramatic,” he said. “So there is a lot of excitement about this.”
While the panelists expressed optimism, they also advised caution for anyone wanting to try the drugs, stressing the importance of taking them only in a medical trial setting.
“In one of our research studies, we can guarantee a high quality medication grade,” said Weichers. “On the street, you don’t know what you are taking and what is in that pill.”
Participation in a clinical trial also ensures that patients are screened and monitored carefully, the panelists said, with Woolley noting that “psilocybin and MDMA can increase blood pressure and have other effects, so a lot of effort goes into making sure it’s safe for this particular person to take the drug at the doses that the intervention requires.”
The panelists agreed further research on the drugs is needed—including more studies focused on veterans, within the VA, using VA providers. Research is also needed to answer questions as to who can most benefit from the drugs and the optimal dosing. Woolley said there was need for a pragmatic trial to compare the psychedelic-assisted therapies to current evidence-based treatments and to answer questions about how these drugs can be used to augment or accelerate the process of other therapies.
While the Food and Drug Administration approval process is long and involved, the first step in that process—submission of trial data to the FDA—could be happening soon, said Weichers. Among other things, approval would require DEA reclassification of the drugs—which are currently considered Schedule 1 controlled substances, meaning they have no approved medical use and high abuse potential—that would allow for clinical use, she said.
“If and when this becomes available, VA will be able to scale it, I think, better than any other healthcare system because of our focus particularly on veterans,” Elnahal said.
In a written statement to U.S. Medicine, VA Press Secretary Terrence Hayes said, “VA is committed to safely exploring all avenues that promote the health of our nation’s veterans. In line with this goal, VA conducts research studies under stringent protocols at various facilities nationwide to identify if compounds such as MDMA and psilocybin can treat veterans with post-traumatic stress disorder (PTSD) and other serious mental health conditions.”
“VA also monitors ongoing psychedelic research and remains committed to following science and pursuing evidence-based policies,” Hayes wrote. And, like the podcast panelists, he stated, “it is extremely important to note that the VA does not recommend psychedelics be used as part of a self-treatment program.”
- Elnahal. S. (Host). (2023, September 26). Exploring psychedelics for the treatment of Veterans (No.1) [Podcast episode]. In New Horizons in Health: Bringing Veteran Healthcare into the Future. Veterans Administration. https://news.va.gov/124415/exploring-psychedelics-treatment-of-veterans/