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Beliefs and Perceived Barriers Regarding Psychedelic-assisted Therapy in a Pilot Study of Service Members and Veterans With a History of Traumatic Brain Injury

Joshua C. Gray, Mikela A. Murphy, Sierra Carter, Matthew W. Johnson, Aaron Wolfgang, Michael J. Roy, Jessica L Maples-Keller

Military Medicine December 24, 2022 DOI: 10.1093/milmed/usac400 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Cross-sectional survey with pre-post psychoeducation component Pilot study Peer reviewed
Sample size 21
Population Service members and veterans with a history of traumatic brain injury and co-occurring cognitive and psychological symptoms
Duration Single session (pre- and post-psychoeducation assessment)
Topics Psychedelic-assisted therapy
Keywords Service member Military medicine Navy Military service Traumatic brain injury Military personnel Service business
Citations 10
Key findings After psychoeducation, service members and veterans reported significantly more positive views of psychedelic drugs and greater interest in psychedelic-assisted therapies, and most supported their availability in medical settings.

Abstract

ABSTRACT Introduction Posttraumatic stress disorder (PTSD) and depression are common in service members and veterans, and the response to currently available treatments is often modest at best. Recent studies suggest potential benefit with psychedelic-assisted therapies (PATs), particularly 3,4-methylenedioxymethamphetamine-assisted therapy for PTSD and psilocybin-assisted therapy for depression. This study examined beliefs and perceived barriers regarding PAT among service members and veterans to inform the delivery of these treatments if they are approved by the FDA.

Materials and Methods: Twenty-one service members and veterans (67% male, 81% White, and 43% active duty) with a history of traumatic brain injury and co-occurring cognitive and psychological symptoms completed a measure assessing baseline knowledge and views of PAT, read a brief psychoeducation regarding PAT, and then responded to questions related to their beliefs and perceived barriers to PAT.

Results: Before psychoeducation, participants reported a neutral view of psychedelic drugs (M = 2.76; range: 1-5), PAT (M = 3.33), and interest in PAT (M = 3.10). After psychoeducation, participants reported a significantly more positive view of psychedelic drugs (M = 3.24, P = .014) and interest in PAT (M = 3.67, P = .016). Overall, participants indicated that they would support PAT availability in medical settings if proven beneficial (M = 4.52; 5 = “agree strongly”) and they would support a loved one engaging in PAT (M = 4.29). The most frequently reported health concerns were concern of long-term effects (43%), fear of losing their mind (33%), fear of personality changes (33%), and fear of traumatic brain injury complications (24%). The most frequently endorsed barriers were time commitment, transportation, financial concerns, work, and childcare (33%-19%), with 48% reporting no barriers.

Conclusions: This is the first study to explore beliefs and perceived barriers regarding PAT among service members and veterans. These results indicate that military populations may be interested in PAT, particularly if psychoeducation and outreach regarding these treatments occurred. If FDA approved, it will be important to facilitate command support and address logistical barriers to ensure appropriate access within military contexts.

Comparable studies

Other non-randomized and open-label trials on psychedelic-assisted therapy, most cited first.

Study Year Design Participants
Psilocybin with psychological support for treatment-resistant depression: six-month follow-up. Patients with severe, unipolar, treatment-resistant major depression 2017 Open-label trial n = 20
Durability of improvement in post-traumatic stress disorder symptoms and absence of harmful effects or drug dependency after 3,4-methylenedioxymethamphetamine-assisted psychotherapy: a prospective long-term follow-up study. Adults with chronic, treatment-resistant PTSD 2013 Long-term follow-up of a completed trial n = 19
Psilocybin therapy increases cognitive and neural flexibility in patients with major depressive disorder. Patients with major depressive disorder 2021 Open-label study n = 24
Ketamine Psychedelic Therapy (KPT): A Review of the Results of Ten Years of Research Alcoholic patients 1997 Controlled clinical trial n = 211
Exploratory study of the dose-related safety, tolerability, and efficacy of dimethyltryptamine (DMT) in healthy volunteers and major depressive disorder. Treatment-resistant individuals with major depressive disorder (MDD) and healthy controls 2022 Open-label, fixed-order, dose-escalation exploratory phase 1 study n = 10

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