Clinical trial in South Africa to investigate the effectiveness of psilocybin in women living with HIV and depression

Regardless of how effective treatment for HIV and AIDS has become in the so-called “first world,” the disease is still devastating in places like South Africa. In fact, HIV infection poses one of the greatest public health challenges in the country. South Africa has the tragic distinction of being the country with the highest number of people infected with the disease in the world and the fourth highest according to UN statistics HIV prevalence rate in adults. A whopping 13% of the population is infected.

In addition, the demographics are different from those in Western countries. It is not a disease that primarily affects gay and bisexual men, but straight, black women. In fact, women in sub-Saharan Africa are twice as likely to contract HIV. Tragically, women between the ages of 15 and 19 account for 6 in 7 new infections and account for 63% of those newly infected. In 2020, 4,200 women between the ages of 15 and 24 were infected weekly.

AIDS contributes to about a quarter of all deaths in the country.

Beyond the complications of AIDS, however, there are two other major and looming problems.

About a third of all South African HIV patients are also comorbid with tuberculosis. In addition, mental illness, particularly major depressive disorders, is a widespread and untreated problem. According to available data, 40% of South Africans living with HIV also suffer from depression and 60% from PTSD.

Both of these conditions also appear to affect compliance with the retroviral treatments necessary to live rather than die with HIV.

Psilocybin as a compliance tool in South Africa?

A new study led by Cannsun, Africa’s largest existing commercial medicinal cannabis facility in the Western Cape, and TASK, a research organization focused on communicable diseases, aims to understand whether psilocybin administered to this population causes comorbid mental illnesses – and as a by-product also create better drug compliance with retroviral therapy.

The study will build on academic work published earlier this year by Roland Griffiths, a pioneer in this research, who studied the effectiveness of psilocybin over the course of a year in patients suffering only from MDD. Griffiths’ study showed that psilocybin had significant antidepressant effects that lasted about 12 months.

The South African study is innovative – and for several reasons that go beyond the treatment. It starts with the focus: women are routinely underrepresented in mental health studies everywhere.

Each patient is admitted for a minimum of three months. The process will take about eight. The researchers plan to publish the results in spring 2023.

Cannabis and Psilocybin – Psychedelics at the New Frontier of Medicine?

The process is also interesting for another reason. Not surprisingly, the cannabis industry is becoming increasingly interested in other psychedelic drugs, including psilocybin.

However, the first commonality beyond the modern trend towards medical use is also the disease in question. For the past forty years, cannabis has been used by people suffering from the symptoms of AIDS and HIV – starting with nausea. Recent research has found a link between cannabis use and reduced inflammation from HIV.

The second is the renewed interest in treating major depression with psilocybin.

Their combined use is also increasingly questioned in modern medical research on the effectiveness of cannabis and psilocybin.

The reality is that people have been combining the two compounds for centuries. In a modern context, a 2006 study found that nearly 60% of the 149 college students surveyed used both substances.

Most of what is known about the combination of these drugs comes from anecdotal reports, as there have been no formal studies. It is unclear how these drugs could be taken together to enhance the therapeutic effects of both.

The good news is that as cannabis reform continues to evolve around the world, more studies are to be expected on both – individually and, of course, in combination.

MDD related to serious terminal illnesses and compliance is a problem that extends well beyond South Africa.