Rakesh Jain, MD, MPH, on Emergence of Psychedelic Therapies: What Clinicians Need to Know

Sana Symposium steering committee member Rakesh Jain, MD, MPH, clinical professor in the Department of Psychiatry at the Texas Tech University Health Sciences Center School of Medicine and co-investigator for Psychedelics and Wellness Studies, discusses key research findings around psychedelic therapies and what practicing clinicians should know about the emerging treatment option.

Read the transcript:

Doug Edwards:  Hello, I'm Doug Edwards, director of the Psychiatry and Behavioral Health Learning Network.

Today, I'm joined by Dr. Rakesh Jain, clinical professor of psychiatry at Texas Tech University Health Sciences Center School of Medicine, to discuss key research findings around psychedelic therapies and what you, as a practicing clinician, should know about this emerging treatment option.

Dr. Jain is a globally renowned educator in psychiatry and co-investigator of the Psychedelics and Wellness Study, also known as PAWS, and is on the steering committee of the Sana Symposium.

Welcome, Dr. Jain. I'm delighted that you could join us today.

Rakesh Jain, MD, MPH:  Doug, it's a real pleasure to talk about a topic that is very near and dear to my and a lot of my colleagues' heart, so I'm looking forward to it.

Edwards:  Excellent. Tell us, Dr. Jain, in a nutshell, this is a rapidly growing area. We're seeing a lot of headlines, not only in the clinical literature, but also online from public and mainstream news sources. What should clinical professionals know about this emerging therapeutic area of psychedelics?

Dr Jain:  Doug, you're right. It's a blossoming area of interest for the public at large. In fact, it seems to have caught the attention of everybody I talk to. The clinical world, Doug, is not far behind. We are very interested in psychedelic research, and I will describe to you why.

First things first, the current state of affairs with the therapies we're offering our patients are simply not adequate in addressing the needs of the majority of our patients, particularly in mood disorders, post-traumatic stress disorder, to name just two.

When the psychedelic research, which is the modern phase of it -- it's quite new -- came out of Johns Hopkins and Imperial College, it was a revelation, Doug. It showed us there is a completely different way to do things.

Instead of avoiding symptoms, we are provoking during psychedelic therapy some of these difficult emotions. Instead of treating someone on a daily basis to numb their symptoms of depression or anxiety, allowing for them to heal. That's a complete paradigm shift.

Every time paradigm shift happens in psychiatry and the effect sizes are as large as they are, Doug, you can imagine why we have become so excited and interested in psychedelic research and practice.

Edwards: This area is, as you said, it's also relatively new. It's emerging very fast. Where should clinicians be focusing their attention right now as so many different studies, and research, and ideas, and different methods of teaching start to emerge?

Dr Jain:  Psychedelic research and practice is, interestingly, both extraordinarily old and relatively new. In fact, there's evidence emerging that psychedelic therapies, as offered by shamans and healers, may predate the birth of Christ by hundreds of years in multiple cultures around the world.

The first psychiatric treatments may actually have been psychedelics. That is emerging very rapidly from very different centers of archaeology and findings from across the world.

Psychedelic research did have its heyday in the Western world in the 1950s and '60s. Because of the cultural pushback in the '70s, the war on drugs, psychedelics, even though they're not reinforcing and not abusable, nor is anyone interested in abusing them, they got caught in this storm. They were also pushed away.

It wasn't until the 1990s that it re-emerged after a 30- or 40-year hiatus. Since then, Doug, it's been a true blossoming. Where should clinicians focus? They should focus on the most recent phase II and phase III data emerging from psilocybin in major depression. They should also focus on post-traumatic stress disorder.

There's already illegally available medication, ketamine, that is now being utilized as both a psychedelic and non-psychedelic therapy for major depression and PTSD. I've published some on that.

Where should they go? They should do two things. They should perhaps consider reading up on the literature, stay connected. Of course, our Sana Symposium is going to be a wonderful way for them to get all their education and peer-to-peer connections in one single place.

Edwards:  Speaking of the broader psychiatric community as well as the connections you just referenced, what I also find interesting about this growing area of psychedelics is it's starting to break down some of the silos that we have in behavioral health as well, whereas there's psychiatry over here and psychotherapists here and addiction over there.

What do you see, in terms of a more integrative approach as psychedelics come online for different mental health and potentially addiction disorders?

Dr Jain: You stated it very well. Psychedelics clearly have broken down these artificial barriers that have existed in the various specialties in mental health.

For example, my teachers, over the last decade, in terms of psychedelic education and research, have been a combination of psychiatrists, emergency room doctors who have a great deal of experience with it, psychologists, and some who are not degreed but are extremely aware and familiar with psychedelic therapies.

There are no silos as far as I am concerned. Everybody's going to bring something to the table. We have something to teach each other on this particular topic. Perhaps that's the reason why, Doug, in the Sana Symposium approach that we are taking, we're not taking a hierarchical approach.

This is not a MD, or a PhD, or a therapist, or a social worker, or a counselor carving out their own spaces. We will all come together, because psychedelic medicine, the way it'll be practiced -- I think as early as within a year or two -- is going to require for all of us to bring our strengths to the table, whether we are prescribers or not prescribers.

Our backgrounds are not going to be as important as our knowledge and passion will be.

Edwards: That's quite fascinating. Dr. Jain, I'd like to thank you for spending a few minutes with us today.

Ladies and gentlemen, as Dr. Jain referenced, I hope you can join him and myself to learn more about the latest in psychiatric research and treatment strategies for mental health and addiction professionals at the inaugural Sana Symposium. It'll be a virtual event taking place September 17th through the 18th, 2021.

It's from the same team that brings you Psych Congress, the Evolution of Psychotherapy, and the National Conferences on Addiction Disorders. Be sure to visit sanasymposium.com to learn more and to register.