How Nurses Use Psychedelic-Assisted Therapies for Mental Health
June 27, 2022 · 5 Min Read
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Psychedelic-assisted therapy offers hope for patients with mental health conditions and substance use disorders who are resistant to treatment. Nurses play a significant role in administering the drugs, monitoring the patients, and applying therapeutic emotional support.
On this page, two psychedelic-assisted therapy nurses discuss the innovative use of professionally supervised drug therapy. These have shown both safety and efficacy, even in treatment-resistant conditions.
It is crucial that nurses are aware of the treatment options for patients whose conditions may not respond to traditional therapies.
The Role of Nursing in Psychedelic-Assisted Therapies
Vianey Ariadna Perez is a nurse on the healthcare team at Clear Sky Recovery. She has assisted in the administration of ibogaine for over 500 patients.
Ibogaine is a psychoactive substance found in the root bark of an African shrub. As Perez explains, ibogaine is used to treat:
- Posttraumatic stress disorder (PTSD)
"Of all the psychedelics, ibogaine is the one that most requires nursing staff and doctors to be present during treatments," she says.
This is a high-risk patient population, and the drug is known to have cardiovascular side effects. Until the 1960s, it was sold as an antidepressant in France for over 30 years.
When used in patients with opioid addiction, it competes at opioid receptors and in the serotonin and dopamine systems. The drug can relieve withdrawal symptoms and reduce cravings.
Nurses closely monitor the patients in the treatment center where Perez works. Each patient has one nurse assigned to them to monitor and protect the patient's heart while receiving ibogaine.
This is an important role. However, as Perez shares, nurses do much more than traditional patient care.
"I have also had the privilege of carrying out other roles, such as being a confidant, motivator, and counselor to patients," she says. "I've had to give emotional support on many occasions and also help our patients integrate what they take out of their experience into their everyday lives."
Perez finds it fulfilling to watch patients who enter the clinic with little hope, leave after treatment "with a glimmer back in their eye." The results at the treatment center leave patients "motivated and feeling empowered to go back out into the world, and create the life they so badly want, now believing they deserve and can achieve it," she says.
Andrew Penn is a psychiatric nurse practitioner who practices at Veterans Affairs in San Francisco. He is active in psilocybin and MDMA research. These are drugs used in psychedelic-assisted therapy. Psilocybin is a naturally occurring hallucinogen found in mushrooms.
Penn is a therapist studying the use of psilocybin-assisted therapy to treat depression and Parkinson's disease. He believes that nursing is about delivering care to patients and helping them "access an innate ability to heal, working with both the physical body and the psyche."
Understanding the Purpose of Psychedelic-Assisted Therapies
The field of psychedelic-assisted therapy is developing. Penn believes that mental health nurses must determine their role in the clinical use or research of these substances. He proposes that nurses become familiar with the history and findings of the research. Nurses should also examine their thoughts and opinions about using psychedelic-assisted therapy.
The evolution of the therapy means there are new opportunities for nurses to be involved in the delivery. There are several popular ways nurses can use psychedelics in patient care. Psychedelic-assisted therapy incorporates nondrug interventions before and after the administration of the drug.
Nurses remain with the patient during the dosing session to monitor their physical status, maintain patient safety, and guide the patient. Immediately after, they stay with the patient to discuss what happened. They work to integrate any experiences they had during the session.
Current studies have examined MDMA-assisted therapy for PTSD. Psilocybin has also been examined for use in:
- Alcohol use disorder
- Anxiety at the end of life
- Eating disorders
- Other difficult-to-treat conditions
Perez finds that patients can shift their perspectives and heal during these sessions. This happens when the psychedelic-assisted session allows them to revisit traumatic events without emotional baggage.
"This allows the patients to look at those memories from a different perspective, which allows for true healing of traumatic experiences," she says.
Perez explains the treatment center uses ibogaine to help regulate dopaminergic and serotonergic systems. Additionally, the medicines may aid the body in neurogenesis and synaptogenesis. This promotes healing through neuroplastic properties in the brain.
"This could explain how ibogaine seems to help treat depression, anxiety, and PTSD, even more so when we combine it with consistent, high-quality preparation and integration therapy," she says.
Psychedelic History: Explained
Research into the use of psychedelic-assisted mental therapy took off in the 1950s. It quickly came to a standstill in the 1970s after the Controlled Substances Act was passed. Since the 1990s, researchers have investigated psychedelic drugs' effectiveness in mental health.
Current research uses clinical evaluations and imaging studies to understand the effect these drugs have on the neurological system. Doctors and patients have long struggled with treatments for depression, PTSD, addiction, and social anxiety.
Psychedelic drugs are on the list of Schedule I drugs, which is the most restrictive classification. This makes it illegal to use the drugs and difficult for researchers to evaluate its use. However, now scientists are finding that psychedelic-assisted therapy has the potential to profoundly alter the future of mental healthcare.
Penn is quick to point out that the use of psychedelic-assisted therapy is not "about using these drugs as intoxicants, but rather as medicines in carefully controlled, safe, clinical settings."
Perez notes the lack of interest from the pharmaceutical companies may be tied to the lack of financial benefit from healed persons.
"Unfortunately, because of all the media hype and old legal policies from the 1960s around the dangers of psychedelics, it creates this taboo way of thinking," she says, "that makes it harder for older generations to understand the importance of this type of medicine and potentially get the relief that could benefit them and their families."
The Importance of Psychedelic-Assisted Therapies in Patient Health
Depression is one of the leading global causes of disability, according to Penn.
- The prevalence of depression, anxiety, and PTSD rose dramatically during the past two years.
- Rates of anxiety and depression were four times higher in 2021 than in 2019.
- According to one study, the rate of PTSD in the general population was just 3.6% of U.S. adults in 2003. A more recent study shows that now 15% live with PTSD.
As a whole, the effectiveness of the available antidepressant medications is 40-60%. While there are some benefits, there are also significant side effects.
"We have few medication treatments for PTSD. Psychotherapy can be helpful, but can often take a long time," Penn says. "Making things even more challenging is that there is a shortage of mental health providers in many parts of the country."
Treatment with psychedelics and nursing care are important parts of this treatment. Psychedelic-assisted therapy works more quickly than conventional treatment. It also does not create the side effect burden patients face from a daily medication regimen.
But it is important to note that they are not without side effects. Many of the potential harms noted from LSD, MDMA, and psilocybin are associated with illicit and unsupervised use outside of the clinical setting. These side effects include:
- Hallucinogen-persisting perception disorder
- Neurocognitive deficits
- Sleep disruption
During therapy, some acute adverse events may occur, including nausea and mild headaches. With prolonged daily drug use, patients have experienced many side effects. These include, but are not limited to, the following:
- Stomach pains
- Mood swings
- Abnormal thoughts
- Sexual dysfunction
- Suicidal ideation
Administration of psychedelic-assisted therapy just a few times avoids challenges with addiction and the side effects from chronic use.
Perez is excited by the growing acceptance in society of the idea that there is a strong mind/body connection. She finds people are more open to the interconnectedness of emotions, physical well-being, and energies. She notes that physicians, like Dr. Gabor Maté, research links between some physical illnesses in adults and childhood traumas.
"Psychedelic-assisted therapies can help us heal those traumas, which could lead us to heal physically from certain cancers, digestive problems, or other chronic degenerative diseases like diabetes or hypertension," she says.
Perez experiences fulfillment when her patients arrive at the treatment center a mere shell and leave empowered. Nurse-led psychedelic-assisted therapies can facilitate this transformation in patients.
Meet Our Contributors
Andrew Penn, MS, NP, PMHNP-BC
Andrew Penn is a UCSF-trained psychiatric nurse practitioner. He serves as an associate clinical professor in the UCSF School of Nursing and practices at the San Francisco Veterans Affairs. He is a cofounder of the Organization of Psychedelic and Entheogenic Nurses (OPENurses.org). Penn has published in the American Journal of Nursing, Frontiers in Psychiatry, and The Journal of Humanistic Psychotherapy.
Vianey Ariadna Perez, RN
Vianey Perez is a registered nurse with emergency room, intensive care unit, neonatal intensive care unit, and OB/GYN delivery room experience. Perez earned her bachelor of science in nursing from a private nursing university. Born in Tamaulipas, Mexico, and raised in Atlanta, Georgia, she has worked in the General Hospital of Cancun. In 2018, she began working at Clear Sky Recovery as part of the medical team overseeing hundreds of client's ibogaine experiences.
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