Pharmacists Play Vital Role in Psychedelic Medicine’s Emergence

Michael Haichin, PharmD, BCMAS, co-founder of the Psychedelic Pharmacists Association, discusses the role of pharmacists in the emergence of psychedelic medicine. Haichin explains how in addition to dispensing medications, pharmacists provide patients with accurate information about psychedelics, suggest harm reduction tips and ensure patient safety, and they also play a key part in conducting research.

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. Michael Haichin, a doctor of pharmacy and co-founder of the Psychedelic Pharmacists Association. Today, we will be discussing the role of pharmacists in this emerging treatment option. Welcome, Dr. Haichin. I'm so delighted you could join us today.

Dr. Michael Haichin:  Thank you for having me, Doug.

Doug:  You're welcome. Let's start. You're a fairly recent graduate, what got you interested in the area of psychedelics?

Dr. Haichin:  I've been interested in the science of drugs for a long time in general, but while doing my bachelor's degree in pharmacology about a decade ago, I was introduced to psychedelics when a friend showed me the documentary, "Dirty Pictures."

That might be a misleading title, but it's about Alexander "Sasha" Shulgin, who is the scientist credited with the rediscovery of MDMA, and who synthesized over 200 other psychedelic compounds.

Through this documentary, I found out about the works MAPS was doing with MDMA-assisted psychotherapy for the treatment of PTSD, and the various universities studying psilocybin for a number of conditions.

Since that point, I've been following the research and became increasingly interested during pharmacy school while I was learning about the larger mental health treatment landscape, while the evidence for the therapeutic potential of psychedelics was accumulating.

Doug:  Speaking of that larger landscape, what is the role of pharmacists in the emerging area of psychedelic medicine?

Dr. Haichin:  First, I'd like to take a step back and remind the viewers that pharmacists are much more than the medication-dispensing role that some might associate with the title.

Pharmacists are trained and licensed healthcare professionals with an expertise in all things drugs. If and when these therapies are approved, pharmacists can help in a variety of ways.

Even before there's any regulatory approval for compounds like MDMA or psilocybin, given the constant media coverage of the therapeutic potential of these compounds, people are increasingly self-medicating with psychedelics for mental health reasons, and clinicians are likely being asked about the subject more and more.

As community pharmacists are an extremely accessible healthcare professional, they may serve their community by providing patients with accurate drug information about psychedelics, suggesting harm reduction tips, and ultimately, to ensure patient safety.

Currently, there are pharmacists involved with the research as part of the drug development process. I was happy to see that one of them, Kelan Thomas, who is a clinical psychiatric pharmacist, is presenting at the upcoming Sana Symposium about drug interactions with psychedelics.

This is important for pharmacists and other clinicians to know about, and might not learn about elsewhere. Most of the focus on the actual delivery of psychedelic-assisted therapy has been on psychiatrists and therapists. Rightfully so, given the involvement of the intensive therapy process. However, since it also has a drug component, pharmacists need to be included.

It's important to emphasize that clinical trials involving psychedelics have had very strict exclusion criteria, meaning that a lot of participants interested in being involved with the research have been prevented, perhaps because of a medical condition they have, or medications that they're taking. That results in a clinical trial population being limited in diversity.

While MDMA and psilocybin both appear to be fairly safe within the studied populations, it's unclear whether that's generalizable to a more complex patient population, especially in light of the fact that patients who suffer from mental health conditions often have co-occurring physical or psychiatric conditions.

After the drug is brought to market, we'll learn more about the safety, and we may identify drug-drug and drug-disease interactions. Pharmacists will be integral for monitoring for those, as well as their management.

In clinical settings, pharmacists could work as part of an interdisciplinary team with physicians, therapists, nurses, and other caregivers to assist with the medical screening and provide medication management before and after the psychedelic therapy.

As an example of that, it's somewhat unclear how different psychedelics interact with conventional antidepressants. On the one hand, there's some preliminary evidence that suggests MDMA might not work as well with recent antidepressant use, and the relationship with psilocybin is unclear.

If that does turn out to be the case, pharmacists can help patients with tapering and discontinuing antidepressants in conjunction with their prescriber before they receive the psychedelic therapy.

All in all, pharmacists need to be involved in the circle of care to help mitigate the risks of psychedelic-assisted therapy and to optimize their efficacy for patients.

Doug:  Speaking about pharmacists being involved, you're one of the co-founders of the Psychedelic Pharmacists Association, tell us a little bit about that organization, and how people can be involved?

Dr. Haichin:  Sure thing. The Psychedelic Pharmacists Association is an Oregon non-profit that I co-founded with some pharmacy colleagues for a variety of reasons.

The main reason being that we think pharmacists have a lot to contribute in the area of psychedelics, but we're being left out of the conversations. We found that there was no place for pharmacists with an interest in the subject to find each other.

Our mission has been to educate pharmacists about psychedelics, provide them with networking opportunities, and to advocate for greater pharmacist involvement in the psychedelic-assisted therapy continuum of care, and perhaps most importantly, to advocate for patient safety and equitable access.

We've garnered quite a lot of interest from pharmacists across the globe. I would encourage viewers to check out our website at psychedelicpharmacist.org to sign up, and we also have a LinkedIn group where we actively discuss new research and ongoing events in the psychedelic industry.

Doug:  That's great to hear. Thank you, Dr. Haichin. I'd like to thank you for joining us today. Ladies and gentlemen, I hope you can join Dr. Haichin and myself to learn more about the latest in psychedelic research and treatment strategies for mental health and addiction professionals at the inaugural Sana Symposium.

It's a virtual event taking place this September from the same team that brings you the National Conference on Addiction Disorders, the Evolution of Psychotherapy at site congress. For more details and to register, please visit sanasymposium.com.