Psychedelic-assisted therapy, coming to a health plan near you

Fifty years ago, it sounded unthinkable. Even a decade ago, it seemed like a fantasy. But in 2022, the use of psychoactive chemicals for therapeutic purposes is finally gaining traction. That movement is worth pondering for the design of future mental health benefits. 

A winding down of the War on Drugs and gradual reconsideration of controlled substances' place in society has allowed commercial and private re-examination of their use. It has also encouraged scientific and mental health professionals to study the efficacy of psychedelics such as ketamine, MDMA and psilocybin in the treatment of depression and other mental health conditions. 

With the number of cases involving mental illness unfortunately rising dramatically in recent years, psychotherapists are interested and invested in new avenues of research surrounding their treatments. 

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Human consumption of psychedelics actually dates back thousands of years. Used in religious ceremonies, cultural events, and recreationally, mind-altering substances are as parallel to the human experience as drinking beer and wine.  

Even after modern attempts to legally limit their use as controlled substances, psychedelics have remained prominent in our culture. Now, as their demonization by the U.S. government draws to a close, new doors have opened for the research and study of psychedelics, not just as recreational chemicals but as tools for improving mental health. MDMA, psilocybin and ketamine are some of the most famous examples of psychedelics entering the mainstream of emerging mental health treatments. 

While ketamine is receiving newfound attention from emergency medical services and the operating room, it is also experiencing renewed interest for anxiety and depression. Recent studies support ketamine's effectiveness in combating depression in individuals. Some early research has shown that professionally administering ketamine infusions over a period of time can have beneficial effects on processing speed, memory and verbal learning in depressed patients — while not deteriorating cognitive ability. Though these preliminary results are promising, ketamine's efficacy in treating depression continues to be studied. 

Similarly, MDMA (also known as ecstasy) and psilocybin (colloquially called magic mushrooms) are promising candidates for psychedelic-assisted therapy. The U.S. Food and Drug Administration (FDA) has labelled MDMA-Assisted Therapy for post-traumatic stress disorder (PTSD) a "breakthrough therapy." A recent study showed that MDMA reduced PTSD symptoms in 88% of participants, while 67% no longer met the criteria for a PTSD diagnosis. 

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Psilocybin has also been shown to significantly relieve major depressive disorder symptoms. This relief from symptoms may even last for a year or longer, lending credence to the efficacy of psilocybin and other psychedelic therapies.

The success of these studies and clinical trials appears to be having a major impact on mainstream culture and public policy. In 2020, Oregon became the first U.S. state to create a legal system for supervised psilocybin experiences. California, Vermont and Hawaii are also considering legal frameworks for psychedelics. Most recently, during the U.S. midterm elections, Colorado became the second state to legalize psilocybin use in state-regulated centers. And finally, the U.S. Veterans Administration has been studying psychedelic-assisted therapies — a program that has received support from both political parties.  

Given the potential for psychedelics to treat and improve mental health, it's only natural for benefit brokers and advisers to consider whether employer-provided insurance could (and indeed should) cover psychedelic-assisted therapy. It might sound like a leap from preliminary studies to insurance-subsidized therapy sessions, but costs to individuals can make or break treatment plans amid financial troubles. 

Insurance companies already spend vast sums providing antidepressant care to patients, but their long-term efficacy has been questionable. Suppose psychedelic-assisted therapy shows consistent and proven efficacy in assisting patients in bettering their mental health. In that case, it makes sense from both a business and ethical perspective for health insurers and self-insured employers to at least consider covering these treatments. Public perception and restrictive laws, however, may serve as caveats. 

That being said, if proven to increase longer-term health in patients, such coverage could save money for insurers, employers and health plan members – providing lasting mental health relief to patients in need. One company has already begun offering ketamine-assisted therapy as one of its health benefits. Hemplucid, a CBD hemp products company, offers ketamine psychotherapy to its twenty employees. 

Read more: Could ketamine psychotherapy be the next big mental health benefit?

Similarly, in Australia, the insurance company HIF will soon become the first health fund in the country to offer insurance for psychedelics with clinical studies. This shifting perception has been recognized by major organizations like MAPS, whose clinical studies of MDMA are in the advanced stages. 

MAPS hopes to receive full FDA approval for its MDMA-assisted therapies and advocates for private insurance companies to offer coverage for their treatments. Elliot Marseille, a consultant for MAPS, has argued that psychedelic-assisted treatments could "generate cost savings for insurers of $39.5 million to $46.7 million for each 1,000 patients  over a 10-year time horizon." 

While it is hard to predict precisely, the implication is that psychedelic-assisted therapies may result in better mental health outcomes and significant savings for insurance companies, employers and patients alike.

For decades, the U.S. waged war on illegal drugs, but in the process, dampened efforts to study the efficacy of some controlled substances in treating and managing mental health. However, changing public perception and encouraging results of recent studies are leading to a fundamental reimagining of mental health and therapeutic practices. 

As we continue to better understand the positive impacts of controlled substances such as ketamine when used in conjunction with professional therapeutic methods, we can start to reimagine healthcare as a whole. The effect of these studies, future of potential coverage, and bright light at the end of this mental health crisis all become clearer. As we move toward a society that prioritizes mental health, psychedelic-assisted therapy may be a frontrunner in the treatment of anxiety, depression, PTSD and similar conditions.