Psychedelic treatment explored for veterans with PTSD

U.S. Marine Corps Lt. Col. Ray Brooks was on his way to a 100% service-connected disability rating when he retired in 2021 after nearly 30 years and two high-explosive combat tours in Afghanistan. Post-traumatic stress disorder, chronic pain and assorted other conditions had made the husband and father of four irritable, agitated and difficult. Early this year, he discovered an unexpected pathway to relief: psychedelic-assisted therapy.

He had his first self-administered experience in the desert with psilocybin mushrooms in February, but it was by no means an impulsive whim.

“I had done the research,” Brooks said Aug. 25 at a meeting of The American Legion’s TBI, PTSD and Suicide Prevention Committee during the organization’s 104th national convention in Charlotte, N.C. “I had prepared. I am in school now for a degree in spiritual counseling in psychedelic-assisted therapy. So, it’s not a joke. If we take the path of intention, and the path of respect, for these ancient medicinal agents, that, in turn, leads us down the path of education.”

The national committee under the Veterans Affairs & Rehabilitation Commission has long advocated expanded clinical research into alternative treatments for mental health conditions like PTSD, particularly those that do not rely on traditional prescription drugs. Brooks and Dr. Lynnette Averill of the Veteran Mental Health Leadership Coalition and a nonprofit called Reason for Hope delivered a presentation for the committee that described the science, research so far and their support for careful use of psychedelic treatments – psilocybin, MDMA and ketamine – to manage PTSD and reduce veteran suicide.

Titled “Breakthrough Therapies for Veteran Suicide Prevention,” Dr. Averill’s presentation made the case for expanded research into psychedelic-assisted interventions, removal of obstacles that stall research and a general comparison between forms of medicine that are not FDA-approved or even legal in most states, and traditional anti-depressant/anti-psychotic drugs more commonly prescribed for veterans confronting invisible wounds.

“We are very much in a state of crisis in this country in terms of mental health,” Dr. Averill said. “We know that rates of PTSD are elevating, depression is elevating, anxiety, addiction, substance use, suicidality – all these things are on the rise, and they have been on the rise despite advances in medicine, advances in mental health. What we know is, unfortunately, the interventions we have available, things like SSRIs (selective serotonin re-uptake inhibitors), the anti-depressant medications, talk therapies, any of these things … while they are important, life-saving interventions for a select bit of the population, for many, many people, they do not work well.”

The inherent issue is that psychedelics like psilocybin and MDMA (commonly known as “ecstasy”) are listed as controlled substances by the Drug Enforcement Administration and so do not get much government research funding or support. Dr. Averill told the committee that the Breakthrough Therapies Act has been introduced in both houses of Congress to loosen up restrictions against research and make such treatments accessible on a limited basis for compassionate medical care.

Brooks, a member of Travis L. Williams American Legion Post 65 in Phoenix, said it’s urgent not only for the veteran community but for society in general. “Our country is deeply suffering today. We’ve got schools getting shot up all over the place. Our kids don’t know if it’s safe to go to school. We’ve got division in our societies and – guess where else? – in Washington, D.C., of course. It’s at such a point that we don’t know who we are anymore.”

Veteran groups are in a unique position to open new avenues of research into mental health treatments, Brooks explained. “Thirty percent of veterans have reported to be suffering from PTSD, treated for depression, or for major depressive disorder. This is not something we take lightly, or that we should take lightly. We need to be the one organization, The American Legion, to effect and implement dynamic change by supporting and advocating for different modalities, for different pathways to health and wellness for our veteran community that can then extend into the population itself.”

Dr. Averill said she would like The American Legion, as the nation’s largest organization of veterans, to advocate for “thoughtful policy” on professional research into responsible, structured use of psychedelic intervention that she explained has proven to have lasting, quick effects that outperform prescription drugs.

Fast action is vital, she explained. “If you think about yourself struggling with anything – whether a mental health concern, a physical health concern, wanting a new car, whatever it is – if you’re told it will take weeks or months, and you might get it, that doesn’t feel very good. But we’re not talking about wanting a new car. We’re talking about severe PTSD and depression and thinking maybe life isn’t worth living anymore, and you might want to end it. To tell you in those cases, ‘You know, hang tight for a few weeks or months, and we will see how it goes.’ For some people, that is quite literally a death sentence, and we know that. We know that all too often people try to use medications and end up dying by suicide, end up dying by overdose, end up dying by any number of things.”

The American Legion does not have a national resolution on the Breakthrough Therapies Act or the use of psychedelic-assisted therapy, and members of the committee were curious how veterans might participate in interventions that are not federally approved or legal in most U.S. states.

“There are a couple of ways,” Dr. Averill said. “One is you can look at a website called clinicaltrials.gov. That will take you to every clinical study happening in the country. A challenge with the clinical trials is that they are often hard to get into. They are incredibly focused on safety, which obviously is very important, but sometimes because of that, they are going to exclude people …”

She mentioned in her presentation that retreats outside the United States are another option. She described one in Mexico that specifically attracted special military operators who had seen substantial combat and were not finding relief for severe PTSD through traditional treatments.

“For most of these people, this was a hail Mary pass,” said Dr. Averill, whose Marine Corps veteran father died by suicide when she was a child. “They had tried the VA bank of drugs. They had been on 15 different anti-depressants. They had been on anti-anxiety meds. They had been to therapy and groups, equine therapy and yoga. They had done all the stuff, and they still felt like garbage, maybe felt worse than when they went in.

“Their family was in shambles. They hadn’t been working or had been through 35 jobs. They were using drugs, alcohol, etc. Maybe they had attempted suicide; maybe they hadn’t. They had been inpatient. They had done all that stuff. For many of them, ‘This is either going to work for me, or I’m tapping out, calling it … can’t continue.’ This was a weekend intervention.”

The results, Dr. Averill said, were eye-opening. “PTSD, depression, anxiety, cognitive impairment, suicidal ideation, psychological flexibility … improved wildly. They went to Mexico as a completely different person than (the one who) came back … People thought they had life purpose, meaning, again.”

That was the result for Brooks, who followed up his February experience with a second one about a month ago, he said. “So, what have I learned by tripping on mushrooms out in the desert? I’ve learned that life has deeper meaning than my rank, than my gender, than my title, than my net worth or what kind of car I’m driving … It doesn’t matter …

“The mushrooms taught me that we must admit our own truth. Am I angry? Am I lonely? Am I sad? Am I miserable in my life today? And if I am, what the hell am I prepared to do about it? A few weeks ago, the medicine also taught me that life is about more than just being where we are today. A life of impermanence is what we must embrace. In doing so, we recognize that life goes on. My war in Afghanistan needs to end, so I can move forward.”

The treatments, he said, have helped him pursue that goal. “My relationships have improved with my wife, the children, my friends. I’m a kinder, gentler, more aware and in-tune person, more compassionate, more empathetic, more open and accepting. These modalities tell us that it is time now to heal.”

Brooks and Dr. Averill both say psychedelic interventions are not for everyone. “Psychedelic modalities and psychedelic approaches are not silver bullets,” Brooks said. “We have to look at the other pathways to healing that work, too.”

Certain health conditions can complicate or prevent treatment, Dr. Averill said, noting that it is not a simple as taking a pill and waiting for relief. “It is really hard to treat, but we cannot keep doing the same thing we’ve been doing. We cannot just keep going on the hamster wheel trying to identify another SSRI, another medication that’s going to do the same thing.”