Psych News Alert: January 2025

Friday, January 3, 2025

Congress Extends Telehealth Flexibilities for Medicare Beneficiaries

Key telehealth service flexibilities will be extended for Medicare beneficiaries until March 31, 2025, as part of the American Relief Act, signed by President Biden on December 21. The flexibilities originated in March 2020 in response to the COVID-19 pandemic and have been temporarily extended several times. The Relief Act authorizes the extension of a number of federal services as well as federal relief to victims of natural disasters.

As part of the Relief Act, Medicare beneficiaries can continue to receive telehealth services from any location, including their homes. Additionally, the bill extends the waiver of the requirement for an initial in-person visit prior to a telemental health visit and also continues the extension of telehealth services to federally qualified health centers and rural health centers.

These temporary extensions for Medicare beneficiaries follow on the heels of the decision by the Drug Enforcement Agency (DEA) and the Department of Health and Human Services (HHS)—announced in November—to extend for the third time flexibilities for the prescribing of controlled medications, effective through December 31, 2025. Those flexibilities authorize qualified health professionals to prescribe Schedule II-V controlled medications via telemedicine, including Schedule III-V narcotic-controlled medications approved by the Food and Drug Administration for the treatment of opioid use disorder via audio-only telemedicine encounters.

The DEA and HHS are in the process of developing final telemedicine regulations but sought the latest out of a need for additional time to create a longer-term set of rules for teleprescribing while preventing unnecessary disruptions in care.

For up-to-date information about telehealth rules and regulations, visit the APA telehealth blog.

For related information, see the Psychiatric News article “DEA, HHS Announce Third Extension of Pandemic Telehealth Prescribing Flexibilities.”

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Thursday, January 2, 2025

Special AJP Issue Focuses on Challenges, Opportunities Around Psychedelics

This month’s issue of The American Journal of Psychiatry is entirely focused on the burgeoning field of psychedelic medicine in psychiatry, delving into the ongoing challenges and looming questions within the field.

“This marks a moment of legitimacy for what was once considered a fringe, fledgling movement driven solely by a select group of zealously dedicated scientists and clinicians,” AJP Editor in Chief Ned Kalin, M.D., wrote in an editor’s note co-authored with guest editors Gregory A. Fonzo, Ph.D., and Charles B. Nemeroff, M.D., Ph.D. Fonzo and Nemeroff are co-directors of the Center for Psychedelic Research and Therapy at Dell Medical School at the University of Texas at Austin.

The issue addresses some of the fundamental questions related to the use of psychedelics, such as the substances’ basic pharmacology, their effects on neural circuits, their clinical efficacy, and public health policy considerations. It also explores pressing questions such as whether patients can experience the therapeutic benefits of psychedelics without reaching an altered state of consciousness, and how the drugs interact with the psychological support/therapy component of treatment.

Additional topics explored in the issue include:

Methodological considerations: A review by Roger S. McIntyre, M.D., and colleagues addresses general methodological considerations for psychedelic clinical trials and offers recommendations. The paper is intended to provide guidance for future research and development of psychedelic treatment in psychiatry.
Original research into psilocybin: Scott T. Aaronson, M.D., and colleagues publish the findings of a small open-label trial, in which they demonstrated significant safety and efficacy of a single dose of synthetic psilocybin in patients with severe treatment-resistant depression.
Review of the evidence around short-acting psychedelics: Johannes G. Ramaekers, Ph.D., and colleagues review the evidence for ultra-fast, short-acting psychedelics such as dimethyltryptamine (DMT) and 5-methoxy-dimethyltryptamine (5-MeO-DMT), which potentially offer benefits including individualized dosing regimens to maximize treatment outcome with less complex and less costly implementation.
Potential risks: Sharmin Ghaznavi, M.D., Ph.D., and colleagues review the known and potential harms of psychedelic treatments, which include enduring perceptual disturbances; overuse, misuse, and dependence; challenging experiences or “bad trips”; and acute and cumulative cardiovascular effects. They also make recommendations for further research and monitoring.

“Sufficiently addressing and answering these scientific and clinical questions will be critical for the future clinical success of these agents,” Fonzo, Nemeroff, and Kalin wrote. “The potential for therapeutic strategies utilizing psychedelic drugs is exciting and yet there is a long path ahead toward clinical success.”

For additional information, see the Psychiatric News article “AJP Brings Scientific Rigor to the Study of Psychedelic Medicine.”