As the psychedelic renaissance continues to forge ahead and present potential treatment options for historically challenging to treat mental health conditions, one of its most notable criticisms is the lack of racial and ethnic diversity in the scientific research conducted in this space. Unfortunately, the lack of gender, racial, and ethnic diversity in clinical research in the U.S. is an ongoing and significant issue impacting the quality of care for most of the population.
Historically, medical research has been conducted on predominantly white male populations resulting in a standard of care modeled and optimized for a small segment of the population. While some progress has been made to include white women in clinical trials, a recent report by The National Academies Of Sciences, Engineering, and Medicine demonstrated that there has been very little change over the past three decades to recruit more representative and diverse study groups that include racial and ethnic minority populations. Unfortunately, this underrepresentation paired with systemic health and healthcare disparities results in significant consequences for these minority populations.
A recent data analysis study by the Department of Psychiatry at Harvard University aimed to examine whether race and ethnicity moderate the reported positive benefits of non-clinical MDMA/ecstasy use and psilocybin use on major depressive episodes (MDEs).
The researchers analyzed data from The National Survey on Drug Use and Health (2005-2019) that explored the connection between race and ethnicity and MDMA/ecstasy use and psilocybin use for predicting lifetime, past year, and past year severe MDEs.
The results demonstrated that race and ethnicity significantly moderated the links between MDMA/ecstasy use and psilocybin use and MDEs. While for White participants, MDMA/ecstasy use and psilocybin use were both associated with lowered odds of all three MDE outcomes (adjusted odds ratio (aOR) range: 0.82-0.92), the Hispanic participants experienced lowered odds of only a past year MDE for both MDMA/ecstasy and psilocybin use (MDMA/ecstasy aOR: 0.82; psilocybin aOR: 0.79). Results further demonstrated that for Non-Hispanic Racial Minority participants, MDMA/ecstasy and psilocybin use did not result in lowered odds of any MDE outcomes.
This simple analysis of a large data set demonstrates that race and ethnicity impact the efficacy of psychedelics with regard to mental health outcomes. Researchers should both explore the validity of existing research on the efficacy of psychedelics for the treatment of mental health conditions in minority populations, and also ensure that future research study designs include racial and ethnic representation and effectively monitor the outcome variables.
