Juliana Mercer went to Costa Rica, not for fruity drinks or white sand beaches, but for the psilocybin, more commonly known as magic mushrooms.
The 15-year Marine Corps veteran, who served stints in both Iraq and Afghanistan, had found herself in what she called a “black hole” — a place with no purpose — after returning home.
She got in contact with a non-profit that connects vets with psychedelic therapies, traveling to the Central American country, where more treatments were legal.
Mercer, now the veterans advocacy director for veteran support group Healing Breakthrough, advocates for the use of MDMA and other psychedelic assisted therapies for veterans suffering from a range of mental health problems.
“Once I had my own experience and my own healing, that was seemingly overnight, I began to advocate to be able to connect veterans to these therapies,” Mercer told Military Times.
While MDMA is more commonly known as ecstasy or molly, there are major chemical differences between street psychedelics and the varieties used in treatments.
Psychedelics are considered entheogens, which produce an altered perception of reality when consumed. This is the traditional chemical reaction experienced by users taking it as a party drug.
On the other hand, the MDMA therapies that groups like Healing Breakthrough pursue are entactogens. That type of chemical property leads to “profound states of introspection and personal reflection” and “affiliative social behavior,” according to an article in Frontiers of Psychiatry by medical chemist David Nichols.
Researchers have already received promising initial results. In 2017, the U.S. Food and Drug Administration designated MDMA as a “breakthrough therapy” for treatment of post-traumatic stress disorder. Psilocybin to treat anxiety and depression received that designation in 2019.
The Multidisciplinary Association of Psychedelic Studies, or MAPS, has researched the effects of MDMA for more than 30 years. It was tasked with conducting further studies on the treatment, the most recent of which was a multi-site clinical trial and the second phase III trial.
The second trial confirmed the results of the first phase III trial. More than 86% of participants who received the MDMA-assisted therapy experienced “clinically meaningful” improvement 18 weeks after starting the trial, according to MAPS. Greater than 71% of participants who had MDMA-assisted therapy also no longer met the diagnostic criteria for PTSD at the end study, compared to little more than 46% of participants who had the placebo plus therapy.
“Participants in the MDMA-assisted therapy group experienced a significant reduction in PTSD symptoms versus participants receiving placebo,” according to MAPS.
The psychedelic therapies allow entactogens to put patients in a better introspective and reflective mindset to process PTSD.
“They open doors and allow us a window of opportunity to really do the work to process the different feelings and thoughts that come up during that psychedelic experience,” said Ilse Weichers, deputy executive director of the VA office of mental health and suicide prevention, on the VA’s podcast New Horizons in Health.
Joshua Woolley, who leads the University of California-San Francisco translational psychedelic research program, said phase III trials of MDMA and psilocybin have shown “very promising results” in treating PTSD, depression and substance abuse disorder.
“The effects are quite dramatic,” Woolley said on the VA podcast. “PTSD symptoms can go away for months or even years after one or a few treatments, so there’s a lot of excitement about this.”
Woolley added that the studies are focused on “ideal conditions” of candidates who suffer from exact medical issues and do not have other extenuating circumstances.
“Psychedelic-assisted therapy consistently accelerates symptom improvement and leads to rapid and significant reduction in PTSD scores, often rendering the diagnosis unnecessary,” Mark Seelig, a clinical psychotherapist and panelist on psychedelics at MCON, a November convention on military and veteran culture, told Military Times.
“I have no doubt that we are currently witnessing how safe and responsible use of psychedelics is ushering in a revolutionary era for psychiatry and psychotherapy,” he added.
Mercer expects the FDA to approve the treatment by next year, while psilocybin is four or five years behind it.
The success of initial trials comes as a mental health crisis sweeps through veteran communities. According to the Department of Veterans Affairs, one in 10 male veterans and nearly two in 10 female veterans suffer from PTSD.
Veterans of Operation Iraqi Freedom and Operation Enduring Freedom suffer from near-epidemic levels of PTSD, as nearly 30% of those veterans say they have suffered from PTSD at some point in their lives.
Suicide levels among veterans are higher than what the federal government once thought, too. America’s Warrior Partnership, in partnership with the University of Alabama and Duke University, found thousands of suspected or confirmed veteran suicides in eight states from 2014 to 2018 that were not counted by federal officials.
If the study was replicated across other states, researchers believe that would increase the veteran suicide rate from 17 deaths a day — the VA’s official estimate — to 44 deaths a day.
Currently, there are seven trials taking place across the country through the VA. But the problem, Mercer said, is that each study is philanthropically funded.
“There’s no federal support, no federal funding on this treatment that has the potential to fix the veterans suicide epidemic and the PTSD problem,” Mercer said. “So we’re educating our lawmakers, telling them that we need to support the VA financially so that they can figure out how to basically roll out MDMA-assisted therapy as soon as it’s FDA-approved.”
Lawmakers, in response to the trend, are now pushing for more MDMA therapy research throughout the VA.
Reps. Lou Correa, D-Calif., and Jack Bergman, R-Mich., recently submitted an amendment to the Veterans Affairs appropriations bill that would direct the department to set up pilot programs for breakthrough therapies, including MDMA, across the country. The pair co-chair the Psychedelics Advancing Therapies Caucus.
“It’s crucial that the VA do all it can to ensure that those who would benefit most from these potentially lifesaving therapies can get access to them — as soon as possible,” Correa said in a statement. “Congress has the power to fix this, and with this amendment, we’ll push the VA to research the impact of breakthrough therapies, like psychedelics, that are already saving the lives of veterans in this country.”
“This amendment will help steer the federal government towards doing more and providing better options to help our veterans overcome some of the hardest battles they will fight,” Bergman added.
The amendment — and greater VA appropriations bill — remains on an uncertain timeline. Legislative measures in the House of Representatives were stalled for three weeks when a handful of GOP representatives joined Democrats to oust former Speaker Kevin McCarthy. Now, lawmakers are trying to negotiate a budget for fiscal 2024 before a Nov. 17 deadline that would shutdown the government, the VA funding bill included.
No matter the state of the amendment’s final passage, Mercer sees MDMA therapies as a great hope for any veteran suffering from PTSD.
“It’s the big, bright light at the end of the tunnel for those of us that have been looking for solutions to the veteran suicide epidemic,” Mercer said. “And it’s something that I think is going to not just save and heal a lot of veterans. I think it’s going to revolutionize mental health in our nation as we know it.”
Zamone “Z” Perez is a rapid response reporter and podcast producer at Defense News and Military Times. He previously worked at Foreign Policy and Ufahamu Africa. He is a graduate of Northwestern University, where he researched international ethics and atrocity prevention in his thesis. He can be found on Twitter @zamoneperez.