MDMA and Psilocybin
Experts say the decision will make Australia the first country in the world to officially recognise MDMA and psilocybin as medicines. From July, (2023) authorised psychiatrists will be able to prescribe the drugs for post-traumatic stress disorder and severe depression.
After decades of “demonisation”, psychiatrists will be able to prescribe MDMA and psilocybin in Australia from July this year. The Therapeutic Goods Administration (TGA) made the surprise announcement on Friday afternoon, (Feb. 3, 2023).
The drugs will only be allowed to be used in a very limited way, and remain otherwise prohibited, but the move was described as a “very welcome step away from what has been decades of demonisation” by Dr David Caldicott, a clinical senior lecturer in emergency medicine at Australian National University.
MDMA, 3,4-methylenedioxy-methamphetamine, is commonly known as ecstasy, while psilocybin is a psychedelic commonly found in so-called magic mushrooms. Both drugs were used experimentally and therapeutically decades ago, before being criminalised.
Specifically authorised psychiatrists will be able to prescribe MDMA for post-traumatic stress disorder, and psilocybin for treatment-resistant depression.
Ecstasy was developed as an appetite suppressant in 1912, but in the 1970s it started being used in therapy sessions in the US. It entered Australia in the 1980s as a party drug, and was criminalised in 1987.
Many species of magic mushrooms grow wild in Australia, but it is illegal to possess or supply psilocybin.
Caldicott said it had become “abundantly clear” that a controlled supply of both MDMA and psilocybin “can have dramatic effects on conditions often considered refractory to contemporary treatment” and would particularly benefit returned service men and women from the Australian defence force.
MDMA & Psilocybin: Issues of Safety
“The safe ‘re-medicalisation’ of certain historically illicit drugs is a very welcome step away from what has been decades of demonisation,” he said.
“In addition to a clear and evolving therapeutic benefit, it also offers the chance to catch up on the decades of lost opportunity [of] delving into the inner workings of the human mind, abandoned for so long as part of an ill-conceived, ideological ‘war on drugs’.”
Cognitive neuropsychologist Prof Susan Rossell, from Swinburne’s Centre for Mental Health, said she still had “a significant degree of caution” about the decision, and that further research was needed. Rossell is the lead researcher on Australia’s biggest research trial of psilocybin’s effectiveness for treatment-resistant depression. “We’ve got no data on long-term outcomes at all, so that worries me a lot, which is one of the reasons why I’m doing my very large study,” she said.
Dr Stephen Bright, a senior lecturer and director of Psychedelic Research in Science and Medicine at Edith Cowan University, said the decision made Australia “the first country in the world to officially recognise MDMA and psilocybin as medicines”. It is an “important step in drug policy reform”, he said, but added that extensive training was needed for the approved psychiatrists.
He said the announcement could also lead to more people accessing the drugs illegally, “through desperation”.
In a statement, the TGA said the decision acknowledged “the current lack of options for patients with specific treatment-resistant mental illnesses”. “It means that psilocybin and MDMA can be used therapeutically in a controlled medical setting,” the TGA said. “However, patients may be vulnerable during psychedelic-assisted psychotherapy, requiring controls to protect these patients.”
First Published in The Guardian, by Tory Shepherd, Feb 3, 2023. https://www.theguardian.com/australia-news/2023/feb/07/prescribing-mdma-and-psilocybin-who-will-get-the-drugs-and-how-will-they-help
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