This is your brain on psychedelics

The ideas and innovators shaping health care

Feb 27, 2023 View in browser   By Erin Schumaker, Ben Leonard and Ruth Reader THE NEXT CURES Some doctors think psilocybin, the psychoactive ingredient in mushrooms, holds promise for treating mental illness. | AP The key to treating intractable mental health disorders could be regrowing shrunken brain cells. “Growth is good” when it comes to treating neuropsychiatric diseases, says David Olson, founding director of the Institute for Psychedelics and Neurotherapeutics at the University of California, Davis. That’s because those brain cells, prefrontal cortex neurons, tend to be atrophied, with branches retracted and synapses pruned back, in the brains of people with conditions like depression, PTSD and substance-use disorder, Olson told Erin. Olson coauthored a new study, published in Science, which looked at how the chemical serotonin and psychedelics affect nerve cells in the brain. The study found that psychedelics like DMT (found in ayahuasca), psilocin (found in magic mushrooms) and 5-MeO-DMT (found in certain toad species), could cross cell membranes more easily than serotonin could, triggering brain cells to regrow. Doctors typically prescribe selective serotonin reuptake inhibitors, or SSRIs, like Prozac or Paxil, to people who have depression to increase serotonin levels and improve communication between their neurons. How psychedelics compare to SSRIs: “Traditional SSRIs will promote the growth of those cortical neurons, but they do so very, very slowly,” Olson said. “It takes weeks to months for those neurons to grow back. That just so happens to be the exact same time frame that symptoms start to be addressed.” What this finding could mean: Psychedelics' superior ability to cross the nerve cell membranes might be one reason why the drugs seem better at promoting cortical neuron growth than SSRIs, according to Olson. Looking to the future: While people typically take SSRIs daily to sustain their effect, Olson thinks psychedelics might promote neuron growth for a longer period, allowing patients to take medication less often — maybe once a week, once a month or even once a year. Exactly how long that psychedelic-triggered neuron growth might last is unclear and could depend on the patient and their environment and the disease’s severity. “This takes us one step closer to potentially identifying safer and more effective therapeutics for treating diseases like depression,” Olson said.   JOIN POLITICO ON 3/1 TO DISCUSS AMERICAN PRIVACY LAWS: Americans have fewer privacy rights than Europeans, and companies continue to face a minefield of competing state and foreign legislation. There is strong bipartisan support for a federal privacy bill, but it has yet to materialize. Join POLITICO on 3/1 to discuss what it will take to get a federal privacy law on the books, potential designs for how this type of legislation could protect consumers and innovators, and more. REGISTER HERE.     WELCOME TO FUTURE PULSE Mt. Sunapee, N.H. | Shawn Zeller This is where we explore the ideas and innovators shaping health care. Preventing infections after surgery could save many lives and Ondine Biomedical, a Canadian life sciences company, hopes it’s hit on a remedy. Its product is a germ-killing solution that’s activated by a laser to kill pathogens in a patient's nose, from whence many infections come. Results are promising, Bloomberg reported, although for now the technology is only approved in Canada and Mexico, with clinical trials underway in the U.S. 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. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp. Today on our Pulse Check podcast, host Katherine Ellen Foley talks with Erin about research presented at a recent panel at Harvard T.H. Chan School of Public Health on the science of sleep and how nonmedical factors like race, education, socioeconomic status and zip code can contribute to the quality of your sleep. Listen to today's Pulse Check podcast CHECKUP Telehealth will lose some of its utility if the DEA goes forward with a new regulation. | LM Otero/AP Photo The Drug Enforcement Administration plans to revoke pandemic telemedicine rules that made it possible for patients to get some common medications without seeing a doctor in-person. The rules, which will take effect when the public health emergency ends in May if the agency finalizes them, are a significant blow to advocates of telemedicine. Patients seeking Adderall to treat attention-deficit/hyperactivity disorder, or Oxycontin for pain relief, will need to go to a doctor’s office before they can start taking the drug. Patients who need buprenorphine for opioid use disorder, testosterone for gender-affirming care, or ketamine for depression, could get an initial 30-day supply via telemedicine, but would need to visit a doctor’s office to continue taking those medications. The proposed rule would give patients who started medications during the pandemic a 180-day grace period to comply with the in-person visit requirement. The DEA said the proposal was a compromise that scales back the pandemic waiver, but allows more use of telemedicine than existed before Covid arrived. “DEA is committed to the expansion of telemedicine with guardrails that prevent the online overprescribing of controlled medications that can cause harm,” DEA Administrator Anne Milgram said in a statement. But telemedicine advocates were disappointed.  “If the Biden Administration was proud of this, they wouldn’t have put it out at 7 p.m. on Friday,” said Krista Drobac, executive director of the Alliance for Connected Care, a telehealth lobbying group that had pushed for the DEA to maintain telemedicine access. “It’s absolutely antithetical to their goals on mental health.”   LISTEN TO POLITICO'S ENERGY PODCAST: Check out our daily five-minute brief on the latest energy and environmental politics and policy news. Don't miss out on the must-know stories, candid insights, and analysis from POLITICO's energy team. Listen today.     WORLD VIEW The World Health Organization wants European governments to build more bike lanes. | Chris Eades/Getty Images Americans aren’t alone in failing to get enough exercise. Europeans’ lack of physical activity is costing EU countries a whopping €8 billion a year, according to a report out Friday by the World Health Organization and the Organisation for Economic Co-operation and Development. More than a third of European adults don’t meet the WHO’s physical activity guidelines of at least 150 minutes of moderate-intensity physical activity a week. The analysis said better exercise habits could prevent 11.5 million new cases of noncommunicable diseases by 2050, including 3.8 million cases of cardiovascular diseases, nearly 1 million cases of type 2 diabetes and more than 400,000 cases of cancer. And, given exercise’s benefits to mental health, it would also prevent 3.5 million cases of depression by 2050. The report recommends some initiatives for policymakers: — Promote activity-related commuting options like bicycling or walking. — Invest in neighborhood sports infrastructure like tennis courts or running trails. —Fund local sports clubs. Even so: Differences among countries were significant. More than 70 percent of adults in Finland, Sweden, Switzerland and the Netherlands met the guidelines, while in Portugal, Germany and Italy, more than 40 percent didn’t.   Follow us on Twitter Ben Leonard @_BenLeonard_ Ruth Reader @RuthReader Carmen Paun @carmenpaun Erin Schumaker @erinlschumaker   Follow us

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