Brian Barnett

Psychiatrist | Writer


Preparing for psychedelic medicine's return

Later this year the Food and Drug Administration (FDA) will decide whether MDMA, the drug commonly known as "ecstasy," is a medicine. Last month, Lykos Therapeutics, which has sponsored multiple positive clinical trials of MDMA-assisted psychotherapy for posttraumatic stress disorder, submitted a New Drug Application for the psychedelic to the FDA. Posttraumatic stress disorder affects 7% of Americans and about a third of patients with this frequently debilitating condition are not helped by ex

Perceived Risk of Trying Lysergic Acid Diethylamide in the United States from 2015 to 2019: Are Americans Assessing Lysergic Acid Diethylamide's Risk Profile More Favorably?

Background: Though lysergic acid diethylamide (LSD) use is rising in the United States amid expanding research into the therapeutic potential of psychedelics, little scholarly work exists on whether perceived risk of trying LSD (prLSD) is changing or factors influencing prLSD among the general public. Therefore, we sought to investigate changes in prLSD from 2015 to 2019 and identify characteristics associated with prLSD among respondents to the National Survey on Drug Use and Health (NSDUH). M

Scaling Up Point-of-Care Fentanyl Testing — A Step Forward | NEJM

From the Department of Psychiatry and Psychology, Center for Behavioral Health, Neurological Institute, Cleveland Clinic, Cleveland (B.S.B.); and the Departments of Emergency Medicine (P.R.C.) and Psychiatry (J.S.), Brigham and Women’s Hospital, the Department of Psychosocial Oncology and Palliative Care, Dana–Farber Cancer Institute (P.R.C.), and the Fenway Institute (P.R.C.), Boston, and the Koch Institute for Integrated Cancer Research, Massachusetts Institute of Technology, Cambridge (J.S.)

Psychedelic Use Among Psychiatric Medication Prescribers: Effects on Well-Being, Depression, Anxiety, and Associations with Patterns of Use, Reported Harms, and Transformative Mental States

Mental health problems including depression, anxiety, suicide, and burnout are common among health care providers. Resilience and well-being are factors thought to protect against these incidents. Clinical trials and naturalistic studies of psychedelic compounds have shown decreases in depression, anxiety, and suicidality while suggesting improvements in well-being. This secondary analysis of a large cross-sectional online survey consisting of participants with at least one lifetime psychedelic

Psychedelic Commercialization: A Wide-Spanning Overview of the Emerging Psychedelic Industry

Background: In the wake of positive clinical trial outcomes of psychedelic-assisted psychotherapy for the treatment of various psychiatric disorders, there has been an influx of financial investment into psychedelic drug development from the pharmaceutical and biotech sectors. Psychedelics are now a multibillion dollar industry, with hundreds of companies that are seeking to commercialize therapeutic applications of psychedelics formed over the course of just a few years. Materials and Methods:

Case report: Prolonged amelioration of mild red-green color vision deficiency following psilocybin mushroom use - Brian S. Barnett, Noah Wiles Sweat, Peter S. Hendricks, 2023

The subject was a 35-year-old male with red-green CVD (mild deuteranomalia). Regarding previous psychedelic exposures, he reported use of oral 2C-B (2,5-dimethoxy-4-bromophenethylamine) once, oral MDMA (3,4-methylenedioxymethamphetamine) once, oral psilocybin mushrooms twice, oral LSD five times, and inhaled DMT (dimethyltryptamine) seven times. After prior episodes of psychedelic use, the subject had noted improvement in color vision persisting possibly for months. This led him to quantify the

Three Cases of Reported Improvement in Microsmia and Anosmia Following Naturalistic Use of Psilocybin and LSD

Cultural awareness of anosmia and microsmia has recently increased due to their association with COVID-19, though treatment for these conditions is limited. A growing body of online media claims that individuals have noticed improvement in anosmia and microsmia following classic psychedelic use. We report what we believe to be the first three cases recorded in the academic literature of improvement in olfactory impairment after psychedelic use. In the first case, a man who developed microsmia af

Psychedelic Medicine's Future Depends on Proactive Development of a Robust Medical Billing and Coding Strategy

Background: Although still investigational, psychedelic therapies appear poised to begin securing regulatory approval as medical treatments in the United States within the next 2 years. If approved, one of the most daunting barriers to equitable patient access to these novel treatments is their incorporation into the medical billing and coding system. Since specific billing codes for psychedelic therapy delivery do not exist, modification of existing codes or development of de novo codes will be

United States National Institutes of Health grant funding for psychedelic-assisted therapy clinical trials from 2006-2020

Background: Medicine is currently experiencing a "psychedelic renaissance", said by many to have commenced in 2006. Since then, clinical trials have consistently demonstrated promising findings for psychedelic-assisted therapies in the treatment of various mental health conditions and addictions. While most of this work has been privately funded, governmental biomedical research funding bodies in countries such as Australia, Canada, Israel, New Zealand, and the United Kingdom have begun supporti

Opinion | Let Former Opioid Users Keep On Trucking

You’ve heard about supply-chain disruptions causing shortages and inflation, but here’s a surprising contributor: misguided drug policy. The U.S. trucking industry is short some 80,000 drivers in a country where more than 70% of commercial goods reach their destination via truck. One reason is that the U.S. Department of Transportation makes it extremely difficult for would-be truckers to obtain commercial driver’s licenses if they’re being treated for opioid-use disorder with buprenorphine or m

Psychedelic Knowledge and Opinions in Psychiatrists at Two Professional Conferences: An Exploratory Survey

Despite resurgent interest in psychedelic-assisted therapy, our insights into psychiatrists' knowledge and opinions about medicinal psychedelic applications are surprisingly narrow. Therefore, we anonymously surveyed psychiatrists attending psychedelic didactic presentations at two national meetings about these issues using a 26-item questionnaire. Response rate was 40.20% (106/264). Respondents were 41.73 ± 13.31 years old (range: 24-80) and 64.42% were male. They largely believed psychedelics

Intentional Overdose Prevention in the Era of the 90-Day Prescription

The market share of 90-day prescriptions has risen dramatically in recent years, primarily because of increasing incentivization by insurers, pharmacies, and pharmacy benefit managers. Although 90-day prescriptions may benefit patients, they are potentially dangerous for those at risk for suicide. Prior authorization requirements by some insurers for coverage of shorter prescriptions and some pharmacists' newfound ability to unilaterally convert 30-day prescriptions with refills into 90-day supp

Psychedelic Psychiatry and the Consult-Liaison Psychiatrist: A Primer

Background: Psychedelic compounds such as lysergic acid diethylamide (LSD), psilocybin, and 3,4-Methylenedioxymethamphetamine (MDMA) share a long and complex history with psychiatry. A half century ago, psychedelics were widely employed by psychiatrists in investigational and clinical settings, with studies demonstrating promising findings for their use in the treatment of mental illness and substance use disorders. However, concerns were also raised about their abuse potential and other adverse

NIH: It's time to make your mark on the renaissance of medicinal psychedelics

Just a few years ago, investments in medicinal psychedelic research were rare in even the riskiest of financial portfolios. But with entrepreneurs and financiers now pouring money into developing psychedelic treatments for mental and behavioral health issues, it’s clear that investors, like many scientists, envision a psychedelic path for psychiatry. There’s a notable holdout though: the National Institutes of Health, the world’s largest public funder of medical research. The NIH’s absence from

Opinion | Biden Fumbles Early on Opioid Addiction

Among the Trump administration’s last and best decisions was to allow almost all physicians to prescribe buprenorphine, one of the most effective treatments for opioid addiction. Previously, only doctors who had completed an eight-hour training course and obtained a license from the Drug Enforcement Administration could do so. Only 7% of physicians are certified to prescribe the drug, and more than half of rural counties lacked a single prescriber as of 2018. President Biden had promised during

The Invisible People Behind Our Masks | Annals of Internal Medicine

In response to widespread shortages of personal protective equipment (PPE) that have plagued coronavirus disease 2019 (COVID-19) response efforts, hospitals in the United States have developed innovative PPE optimization strategies. Coupled with increased industrial production, these interventions have helped sustain our PPE supply, allowing medicine to continue saving lives while minimizing harm to clinicians. Unfortunately, while combatting COVID-19, our health care system, like those elsewher

Your Liberty or Your Gun? A Survey of Psychiatrist Understanding of Mental Health Prohibitors

This first-of-its-kind national survey of 485 psychiatrists in nine states and the District of Columbia (DC) finds substantial evidence of clinicians being uninformed, misinformed, and misinforming patients of their gun rights regarding involuntary commitments and voluntary inpatient admissions. A significant percentage of psychiatrists (36.9%) did not understand that an involuntary civil commitment triggered the loss of gun rights, and the majority of psychiatrists in states with prohibitors on
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