Australia Becomes First Country To Approve Psychedelics as Medicine

What’s the story?

• Australia made history as the first country to acknowledge psychedelics as a form of medicine, reclassifying them as “controlled substances” and making them available for use in managed medical settings. 
• Australia’s federal medicine regulator, Therapeutic Goods Administration (TGA), declared that from July 1, 2023, qualified psychiatrists would be authorized to prescribe MDMA (also known as ecstasy) for post-traumatic stress disorder only and psilocybin (commonly known as magic mushrooms) for treatment-resistant depression only.
• Before psychiatrists can prescribe psychedelics, they must receive clearance from a Human Research Ethics Committee and be approved under the TGA's authorized prescriber program. To receive approval, psychiatrists must demonstrate their training and qualifications, patient selection criteria, evidence-based treatment protocols, patient monitoring procedures, and compliance with governance and reporting requirements.
• The TGA said in a statement:

“These measures are necessary because there is only limited evidence that the substances are of benefit in treating mental illnesses, and only in controlled medical settings.”

• Petra Skeffington, associate professor in clinical psychology at Murdoch University, said:

“With the potential for increased access to MDMA and psilocybin-assisted therapies, it is now critically important that high-quality therapist training be made available to promote safe therapeutic conditions when working with these medications.”

What does the research say?

• Ongoing global research and clinical trials show that psilocybin, the active ingredient in psychedelic mushrooms, can potentially treat certain mental health conditions, like depression, and can even be prescribed as an alternative to SSRIs.
• However, some researchers say more large-scale trials are needed. Katrin Preller, group leader at the University of Zurich, said: 

“We still need to find out why these substances are helping patients i.e. the clinical mechanism of action is still unknown. In addition, we need larger trials. Furthermore, we need to find out what the optimal way is to conduct the non-pharmacological part of psychedelic-assisted therapy.” 

What are the barriers to psychedelics in medicine?

• Scholars believe psychedelics were criminalized in the 1970s due to moral panic, which hindered research into their benefits and led to stigmatization. As a result, some therapists feel that offering psychedelic therapy may impact their professional reputation.
• In countries where psychedelics are prohibited, therapists who offer psychedelic harm reduction and integration therapy may be at risk of criminal prosecution. Additionally, there is a risk of being sued for malpractice if a client is harmed while using psychedelics, as the way of therapy is still new and thought to be lacking sufficient scientific evidence.

What is the legal status of psychedelics in the U.S.?

• The FDA categorizes most psychedelics, excluding ketamine, as Schedule I drugs, meaning they are federally prohibited.
• In the U.S., drug regulation is a shared responsibility between federal and state governments. While the Controlled Substances Act determines restrictions and penalties on a national level, states can legalize drugs classified as illegal under federal law, allowing them to experiment and advocate for change in drug policy.
• In 2020, Oregon became the first state to legalize psilocybin for medical treatment, provided it is administered under professional supervision. In Jan. 2023, Oregon legalized psychedelics more widely for personal, adult use. 
• In other states, like Denver, Seattle, and Washington D.C., psilocybin is considered a decriminalized substance. State law enforcement will not arrest or prosecute individuals for using or possessing small amounts of psilocybin for personal use. 

Do you support legalizing psychedelics as medicine?

- Laura Woods

(Photo credit: Wikimedia Commons)