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Turn on, tune in to psychedelics’ benefits

The ideas and innovators shaping health care
Feb 14, 2023 View in browser
 
Future Pulse

By Erin Schumaker, Ruth Reader and Ben Leonard

THE NEXT CURES

Psychedelics researcher David Olson examines the molecules.

Psychedelics researcher David Olson examines the molecules. | Courtesy of David Olson

David Olson is the founding director of the newly launched Institute for Psychedelics and Neurotherapeutics at the University of California, Davis. Olson spoke with Erin about the prospect of developing next-generation non-hallucinogenic versions of drugs like psilocybin to treat brain disorders like depression, post-traumatic stress disorder and addiction and the regulatory barriers his research is up against.

The interview is edited for length and clarity.

Psychedelics startups and research centers seem to be popping up everywhere. What makes yours unique?

Psychedelics are remarkable compounds in that they have profound effects on the brain. What the institute wants to do is understand the molecular and circuit-level mechanisms that allow psychedelics to do what they do and then reverse translate that to produce better, safer and more effective therapeutics that can be more widely accessible to a greater patient population.

Several years ago, we had the idea that maybe we could separate the subjective effects of psychedelics from some of their beneficial effects on neuroplasticity and their antidepressant-like effects.

We call those types of next-generation compounds nonhallucinogenic psychoplastogens. We believe those might be more scalable alternatives [to hallucinogenic psychedelics] that could be take-home therapies. By making molecules that are safe enough that you can take them home and put them in your medicine cabinet, you might be able to reach a larger patient population.

You’re studying psychedelics and their analogues as potential treatments for depression, PTSD and addiction. Can you explain how that works?

All of those disorders share a very interesting commonality. If you look at the part of the brain called the prefrontal cortex, if you look at the neurons in that brain region, they tend to look atrophied — their branches are retracted, their synapses have been pruned away. That’s really important because that brain region communicates with other brain regions that control fear, motivation, reward and cognition.

The hypothesis for many years has been that if you can find a compound that can regrow those atrophied neurons, you can have a very broadly efficacious therapeutic. When we started studying psychedelics, we were looking for these plasticity-promoting compounds. And in 2018, we published a paper showing that they were really, really good at this.

The other thing I want to emphasize is that cortical atrophy lies at the heart of many brain disorders. Right now, we’re focused on neuropsychiatry, but we’re moving in the direction of neurodegeneration — think Alzheimer’s disease, Parkinson’s disease, frontotemporal dementia. There’s a lot of potential to actually reverse some of this — we think — some of the atrophying before the cells die.

Controlled substances are notoriously difficult to research. Have regulatory barriers affected your research? 

In order to be able to work with these compounds, you have to be willing to do a lot of paperwork. You have to get licenses from both the federal and state governments. That has drastically limited the number of investigators that can be involved in this type of work.

But at the end of the day, aren’t these substances controlled for a reason? 

They’re powerful substances that impact the brain. They need to be respected as such. But we also need to be able to understand how they do what they do if we’re ever going to fully understand how the brain works.

I’ll give you a pretty shocking example. It’s easier for me to study the effects of cocaine than psilocybin. There’s less red tape, it’s cheaper, more efficient, I could do it quickly. That doesn’t make a whole lot of sense to me.

 

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WELCOME TO FUTURE PULSE

SYDNEY, AUSTRALIA - FEBRUARY 13: Picked roses are seen at the Bagala Bros flower farm ahead of Valentine's Day on February 13, 2022 in Sydney, Australia. With Australians predicted to spend an average of $111 on Valentine's gifts this year according to research from the Australia Retailers Association, and roses on the top of the gift list, the Australian flower industry is preparing for a busy   weekend. Michael Bagala said, “As soon as Covid-19 hit our sales dropped dramatically, easily 60% down. And then after that, once people started to realise this wasn’t just going to be a two-week lockdown, it was going to be months upon months of lockdowns - they were at home and one of the few ways of contacting loved ones was by sending flowers. That was the really nice thing about our industry, we were still able to operate and people were able to send beautiful flowers when obviously we couldn’t see each other in person. We were just grateful we were still able to work.” Established for over 40 years, Bagala Bros is a second-generation flower farming company,   wholesaler and importer, with a rose farm situated in New South Wales's Horsley Park. Growing a variety of roses all year round in a production facility using hydroponics technology they're working around the clock in preparation for this year's Valentine's Day celebrations. (Photo by Lisa Maree Williams/Getty Images)

Happy Valentine's Day, readers! | Getty Images

This is where we explore the ideas and innovators shaping health care.

Health policy wonks flocked to Twitter today to share #HealthPolicyValentines as part of Kaiser Health News' annual contest. This year, Erin tasked ChatGPT with penning its own valentine for our Future Pulse newsletter. Enjoy!

A ChatGPT Valentine tweet

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Share any thoughts, news, tips and feedback with Ben Leonard at bleonard@politico.com, Ruth Reader at rreader@politico.com, Carmen Paun at cpaun@politico.com or Erin Schumaker at eschumaker@politico.com.

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Today on our Pulse Check podcast, Ben talks with Ruth about HHS’ new pilot program that aims to help patients access their health data more easily.

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Listen to today’s Pulse Check podcast

INNOVATORS

Medical record folder

HHS envisions a new world of seamless data sharing. | Pixabay

Seamless and universal sharing of electronic medical records could reduce health care costs and save lives, the Biden administration believes.

The Department of Health and Human Services took a step Monday toward saving those lives, naming six companies and organizations to participate in a nationwide data-sharing network.

The six are:

– electronic health records firm Epic

– data-sharing trade group CommonWell Health Alliance

– interoperability platforms Health Gorilla and Kno2

– health information network eHealth Exchange

– KONZA, a nonprofit that supports health information exchanges

All of them still must complete preproduction testing but hope to become operational this year.

The 21st Century Cures Act — enacted in 2016 — called on HHS’ Office of the National Coordinator for Health IT to create a trusted exchange framework and common agreement, or TEFCA, to share health care data. HHS released a first draft of the framework in January 2018 and finalized it in January 2022.

Why it matters: In addition to connecting providers, the initiative aims to speed up how quickly public health agencies can send and receive information to and from doctors, hospitals and other health care organizations.

HHS believes the effort can bolster patient care by giving providers a long-term picture of patients’ medical history, enhancing research and ensuring that patients have access to their data.

What’s next: Participating in the data-sharing is voluntary, but since the project needs critical mass to achieve its full potential, HHS needs to seek buy-in.

The project also has implications for security standards across the industry. Participating organizations must abide by the federal health data privacy law HIPAA and sometimes go beyond it.

 

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TECH MAZE

 A man uses a cell phone.

Some data brokers will gladly sell your health data to pretty much anyone. | Jenny Kane, File/AP Photo

Data brokers sell patients’ mental health data, complete with names, addresses and demographic information without considering who’s buying it, according to new research. The report comes as regulators try to find ways to crack down on the collection of personal health data from websites, apps and fitness wearables.

Joanne Kim reported her findings for Duke University’s Technology Policy Lab after researching the policies of 10 data brokers selling mental health data.

Kim, who did not provide the names of the data brokers, found:

— They offered highly specific sets of information about people’s medical conditions, including depression, bipolar disorder, post-traumatic stress disorder, cancer and strokes.

— While some datasets offered only aggregated batches of information, others provided individualized data, including people’s home and email addresses.

— The data is often paired with demographic information such as age, ethnicity, gender, religion, net worth and marital status.

— The data brokers failed to vet potential buyers or limit how the data can be used after it’s sold.

— Others had no restrictions in place, with one data broker offering to sell data on people with depression and anxiety with no use limits for $2,500 each.

Regulators are grappling with how to tamp down on broad sharing of sensitive, often health-related, data from websites, apps and devices outside the formal health care system. The Federal Trade Commission recently cracked down on telehealth provider GoodRx for sharing such data without user consent. More action is expected later this year.

 

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