MEMPHIS, Tenn. — Researchers have long studied the effects of psychedelic substances. Now, the focus has turned to microdosing some psychedelics to better mental health.
In 2008, the VA estimated that one in three veterans show symptoms of depression. Health scientists said it is the most common mental disorder in the country, but there is research that doctors said shows promise for helping many veterans.
Surviving has always been a struggle for AJ Williams. She was an interrogator linguist for the US military.
“Before that, in basic training, I was sexually assaulted. It happened again at the A-school,” said Williams. “I met my second ex-husband, and that was a relationship short lived. It was less than 18 months. During that time, I alienated my family and my friends because of said ex-husband.”
She felt she was hitting rock bottom.
“There were times when I needed to call the suicide crisis hotline,” said Williams. “There were times when I wanted to get a gun, and they talked me out of it.”
Williams spent 10 years seeing a psychiatrist and trying different medications.
“We found out I have treatment-resistant depression, where we tried every pill and it wouldn’t work,” said Williams.
Her doctor suggested ketamine treatment.
“I said, ‘You know what? We’ve tried everything else. Why not?’ Lo and behold, it took off like fireworks,” said Williams.
Dr. Hugh Caldwell, Memphis VA In-Patient Psychiatrist, said ketamine is a dissociative anesthetic.
“It’s been out since 1970. It's used usually to put people to sleep for procedures or surgery,” said Dr. John Spollen, Central Arkansas Veterans Healthcare System Psychiatrist.
Dr. Caldwell and Spollen both studied ketamine treatment.
“It’s technically not a psychedelic. People often refer to it as one. The traditional psychedelics are LSD and psylocibin,” said Dr. Spollen.
Doctors said it does have similar effects.
“It does cause some brief kind of dissociation, which is kind of like a floaty intoxication, but it’s not considered a true psychedelic,” said Dr. Spollen.
Little Rock’s VA has been using ketamine to treat PTSD, severe depression and suicide since 2019. It is the closest VA facility to Memphis to offer it.
“We follow the best research designed which is to do six treatments over three weeks twice a week for three weeks. The infusions are 40 minutes long. It takes about 30 minutes to recover afterwards,” said Dr. Spollen.
It is survival for Williams, who drives three and half hours every other week from Tupelo, Mississippi to Little Rock, Arkansas for treatment.
“It helps elevate my mood,” said Williams. “I can put things on a shelf now and stow it away, whereas before it would eat at me and eat away at me.”
According to Dr. Spollen, research studies say ketamine works by increasing neurogenesis.
"In other words, you get nerve growth in your brain,” said Dr. Spollen.
Psychiatrists say trauma actually damages neurons in your brain. Typically, the body can heal itself, but doctors say that does not happen all the time. That’s where substances such as ketamine and psychedelics may help.
“It’s not that they open up areas of the brain that have been opened, but they may make connections with parts of the brain that weren’t quite the same as they were before,” said Dr. Caldwell.
Doctors say ketamine and psychedelics can do what anti-depressants do in weeks in a matter of hours. Dr. Spollen described it as a repair.
“It seems to anecdotally improve emotional regulations for the things that people didn’t tolerate before - sadness, anger, irritability - that would kind of send them into a spiral,” said Dr. Spollen.
“For the most part, it’s euphoric. I float. I dissociate most of the time,” said Williams. “We’ve had people that couldn’t talk, couldn’t finish a sentence because of the anxiety. Now, they’re going back to work…Have a better relationship with their spouse, their children.”
"People's first inclination is that these might be unsafe treatment modalities, but when done in a safe clinical setting with that support around, it is very safe,” said Dr. Caldwell.
The program is not easy to enroll in at the VA.
“You had to fail four antidepressant trials beforehand. Typically, people have been severely depressed for years by the time they come to our program. We assess them to make sure they’re psychiatrically appropriate for it and medically appropriate for it,” said Dr. Spollen.
Doctors say there is a promising success rate.
“I would guess it’s probably around 60-percent, which has been roughly what the research studies have shown as well,” said Dr. Spollen.
This treatment is just now coming to the forefront along with psychedelic treatments.
“It had a surge in popularity with recreational use. For some time, there was this conception that was a party drug. That kind of tarnished its reputation there,” said Dr. Caldwell. “A lot of research into ketamine, I imagine, kind of helped open the doors for some of this ongoing research and some of the more traditional psychedelics such as psylocibin.”
Doctors say early studies suggest psilocybin may be promising for conditions other than depression and trauma, such as addiction. As scientists learn more, Memphis VA is looking to add ketamine treatment to its facility along with ECT, electric convulsive therapy.
“This is a really exciting area of study that’s ongoing. We’re learning more every day,” said Dr. Caldwell. “The possibilities are on the horizon. My hope is certainly, of course, as we develop these new treatments, that we do see a reduction in suicide.”
Williams said the treatment in "lifesaving."
“Oh, I want this to become available to all VA hospitals across the nation and beyond,” said Williams. “It’s stunning turnaround for a lot of people.”
Since its start, Little Rock’s VA has treated roughly 85 veterans and done about 3,000 ketamine infusions. After the first round of treatment, some veterans may no longer need help, while others need more. Naturally, there are some concerns over safety and drug usage. In June, the FDA issued its first draft guidance for psychedelic clinical trials with considerations for new drug applications, safety, data collection and trial conduct.