Ethical considerations for psychedelic-assisted therapy in military clinical settings
Scott Hoener, Aaron Wolfgang, David A. Nissan, Edmund G. Howe
Journal of Medical Ethics May 30, 2023 DOI: 10.1136/jme-2023-108943 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Theoretical or philosophical paper Peer reviewed |
|---|---|
| Topics | Psilocybin Psychedelic-assisted therapy |
| Keywords | Military personnel Mental health Clinical trial Psychotherapist Informed consent Active duty |
| Citations | 6 |
| Key points | Argues that MDMA-assisted therapy is a promising treatment that should be more rapidly investigated for active-duty US service members, while accounting for military-specific uncertainties. |
Abstract
Psychedelic treatments, particularly 3,4-methylenedioxymethamphetamine (MDMA)-assisted and psilocybin-assisted therapies, have recently seen renewed interest in their clinical potential to treat various mental health conditions. Clinical trials for both MDMA-assisted and psilocybin-assisted therapies have shown to be highly efficacious for post-traumatic stress disorder and major depression. Recent research trials for psychedelic-assisted therapies (PAT) have demonstrated that although they are resource-intensive, their effects are rapid-acting, durable and cost-effective. These results have generated enthusiasm among researchers seeking to investigate psychedelic therapies in active-duty service members of the US military, particularly those with treatment refractory mental health conditions. At the same time, psychedelics remain in early stages of clinical investigation, have not yet achieved regulatory approval for general clinical use and may confer unique psychological and neurobiological effects that could raise novel ethical considerations when treating active-duty service members. Should psychedelics achieve regulatory approval, military relevant considerations may include issues of access to these treatments, appropriate procedures for informed consent, confidentiality standards, and possible unanticipated mental health risks and other psychological sequelae. A service member’s deployability, as well as their ability to return to full military duty following PAT, may also be of unique concern. The authors argue that MDMA-assisted therapy currently represents a promising treatment that should be more rapidly investigated as a clinical therapy for service members while still taking a measured approach that accounts for the many military-specific uncertainties that remain.
Comparable studies
Other theoretical and historical papers on psilocybin and psychedelic-assisted therapy, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Theorizing that Psychedelic Assisted Therapy May Play a Role in the Treatment of Trauma-Induced Personality Disorders. | 2024 | Theoretical or philosophical paper | |
| Towards psychedelic apprenticeship: Developing a gentle touch for the mediation and validation of psychedelic-induced insights and revelations. | 2022 | Theoretical or philosophical paper | |
| Psychedelics and Psychotherapy: Cognitive-Behavioral Approaches as Default | 2022 | Theoretical or philosophical paper | |
| The influence of therapists’ first-hand experience with psychedelics on psychedelic-assisted psychotherapy research and therapist training | 2018 | Theoretical or philosophical paper | |
| The Yale Manual for Psilocybin-Assisted Therapy of Depression (using Acceptance and Commitment Therapy as a Therapeutic Frame) | 2020 | Theoretical or philosophical paper |
Citations in the library
Cited by 2
- Psychedelic-Assisted Therapy in Military and Veterans Healthcare Systems: Clinical, Legal, and Implementation Considerations. Current Psychiatry Reports October 1, 2023
- Expert opinions on implementation of MDMA-assisted therapy in Europe: critical appraisal towards training, clinical practice, and regulation. European Journal of Psychotraumatology 2024
Cites 6
- Psilocybin with psychological support for treatment-resistant depression: six-month follow-up. Psychopharmacology (Berl) November 8, 2017
- Efficacy and safety of psilocybin-assisted treatment for major depressive disorder: Prospective 12-month follow-up Journal of Psychopharmacology February 1, 2022
- Effects of psilocybin therapy on personality structure Acta Psychiatrica Scandinavica June 19, 2018
- Distinct acute effects of LSD, MDMA, and d-amphetamine in healthy subjects Neuropsychopharmacology November 16, 2019
- Ethics and ego dissolution: the case of psilocybin Journal of Medical Ethics May 27, 2020
and 1 more in the library