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People living with HIV face unusually high rates of PTSD and depression. The ongoing health issues and stigma they face could make these conditions harder to treat. Psychedelic research often targets treatment resistant PTSD and depression, but only one study looked at people living w HIV.

In the US, companies have already rolled out psychedelic therapy as a luxury service. When the FDA approved Spravato, a nasal ketamine formulation, for treatment resistant depression, they included lots of safety regulations. So companies found the loopholes. Insurance doesn't cover loopholes.

Since Spravato can only be prescribed with rigid safety restrictions, most ketamine therapy clinics instead opt for formulations approved as anaesthetics, or compounded formulations. These are no less risky than Spravato. But it’s legal to prescribe them for off-label purposes, like therapy.

Since most ketamine therapy clinics prescribe off label, insurance companies can call the treatments “experimental” and refuse to cover them. Which is a bit of a Catch 22, because what makes these treatments so expensive is not the drug itself, which is cheap. It’s the therapy part that’s $$$.

Since therapy contact hours are the main thing driving up the cost of psychedelic therapy, one potential cost cutting measure is group therapy to process instead of individual therapy. Intuitively, this makes sense to me. Because I’ve known psychedelics primarily as communal tools.

The one study on psychedelic therapy for ppl living w HIV includes group sessions as a key component. It’s a fascinating read for a number of reasons. The authors mention potential cost cutting as part of their reasoning for group therapy, bc it lowers the number of hours billed per person.