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News Australia to allow prescription of MDMA and psilocybin for treatment-resistant mental illnesses

thegreenhand

thegreenhand

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Australia to allow prescription of MDMA and psilocybin for treatment-resistant mental illnesses​

Tory Shepherd
The Guardian
3 Feb 2023

Excerpt:
After decades of “demonisation”, psychiatrists will be able to prescribe MDMA and psilocybin in Australia from July this year.

The Therapeutic Goods Administration made the surprise announcement on Friday afternoon.

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.

3,4-methylenedioxy-methamphetamine (MDMA) 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.
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can any aussies comment on if this was an expected development? it seems rather surprising to me that folks were able to get this legislation passed, but admittedly i follow american drug policy much more.
 
Thanks for posting this news.

I’ve been in the drug policy reform space for 20 years down here in Australia. And this development was a surprise. Especially since recently the TGA (similar to the US FDA) had published an interim ruling firming against rescheduling.

Indeed that interim ruling had some outdated statements in it implying that the risks associated with diversion of MDMA into the recreational space would be disastrous. While no one would argue that pure MDMA is 100% safe, I’ve given evidence at Australian coronial hearings after young people have died due to taking unusually high strength doses, as well as adulterated ones. All victims of prohibition. Not related to the risks of pure known-dose drugs.

So to see this turn around was quite a trip, excuse the pun.

In terms of the detail, it’s a very short timeframe to develop a robust and safe system. To be launch 1 July this year (less than 5 months from now!) psychiatrists will be able to apply for special access to provide either MDMA for PTSD or psilocybin for treatment resistant depression. It’s unclear how easy it will be to get approved. It’s also unclear how the psychotherapy part will be dealt with - especially as psychiatrists aren’t going to be hanging out with these patients for multiple hours - that’s the work of psychotherapists. So we assume the psychiatrists will work in multidisciplinary teams, but these details are not yet clear.

What will be the training requirements? How much will it cost?
How available will it be?

My guess is that it will cost a lot (some estimate 20-30K AUD for a treatment course). So, this won’t be available to most people.

Another part of the equation in terms of equity of access is the importance of decriminalisation of the prohibition of MDMA and psilocybin. as it becomes harder to argue that these substances have no possible benefits when we now have a government agency that states they indeed are bone fide medicines. And this is the claim that perpetuates their continued criminalisation.

Watch this space for sure!
 
Tronica said:
some estimate 20-30K AUD for a treatment course
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Imagine if it cost 20-30k for a prescription for anti-depressants?

I suspect that the price is just an artificial barrier and not a true barrier. And I also suspect the government doesn't really want people to access this, because they're in the pockets of pharmaceutical companies pushing their typical bill of fare.
 
I think it's just the reality of the treatment - the psychedelics and the psychotherapy are both expensive as they are in-patient. It's nothing like prescribing a tablet to take at home with no supervision.

but for people with c-PTSD who can't work who are on disability, and if they can be cured as such, there's a huge benefit to society financially as well as just being excellent for the people who are sick - hopefully governments can see that's there's massive potential and it may make sense to subsidise it. But for the moment while it is new, it won't be government subsidied so it'll only be the rich who benefit.

But it's like that in Australia for all experimental treatments.
 
Wow. It will be interesting to see where they go from here. Is this ruling part of a movement to legalize the substances? Will they add more substances to this list?

I was wondering about specialized or additional training for the psychiatrist or psychologist. I wouldn’t feel comfortable being the patient unless I knew the Dr had the training to facilitate the treatment.

I would also like to see some long term studies about these drugs. People who have completed the treatment or took the drugs/medications for extended periods of time.

I’m excited psychotherapy and psychiatry are expanding.
 
thegreenhand said:

Australia to allow prescription of MDMA and psilocybin for treatment-resistant mental illnesses​

Tory Shepherd
The Guardian
3 Feb 2023

Excerpt:
Click to expand...
S/ but ecstacy kills! There trying to kill us!. Seriously though this is good news it's been known for some time to have massively beneficial effects on serious long term conditions. And the side effects at high purity and low doses are minimal and definitely benign compared to other medications. I suffer from CPTSD and it literally changed my life, the effects aren't permanent though. But compared to heroin or even nalaxone which makes people suicidal as a side effect, it gives me hope that they aren't just grabbing any old chemical and testing it untill theyve got something to point to and go " that's not a bug its a feature", which is what they seem to have a history of doing.
 
I’m curious to see how adverse reactions will be handled. Even if not super prevalent, some people experience worsened symptoms after psychedelic therapy.

It’ll be interesting to see how they will plan for those contingencies. It’s essentially dealer’s choice, as this will be the first “large scale” legal psychedelic therapy
 
I'm still just stunned that this is happening in... Australia. Where I come from, and where I've been working in drug policy research for 20 years and been watching so many conservative moves, and then... this.

This is an interesting article by some critical senior folks on the fastness of this process, the concern that it was influenced more by lobby groups than the evidence and the risks of going too fast.


I hope Australia is about to make this work, rather than get it wrong which risks putting back the clock globally.
 
Tronica said:
FYI Mind Medicine Inc. and Mind Medicine Australia are two separate and I believe unconnected entities. Just to confuse things!
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that is good to know

regardless of any formal connection between them, it'll be interesting to see how these for profit companies shape the legislative reform around psychedelics
 
They can legally prescribe class A drugs in New Zealand technically aswell.

Lsd is being prescribed to people in auckland via the university there.

Legalize all psychedelics and ban ssris
 
Tronica said:
the psychedelics and the psychotherapy are both expensive as they are in-patient
Click to expand...
I personally wouldn't be able to accept in-patient psychedelic therapy... I need to be at home with my comforts and my friends~

So this is a good first step, but I'm still hoping for the day when I can legally buy LSD for home use.

TripSitterNZ said:
Ssris are drugs they to give to folk to keep them enslaved in the matrix 9-5 grind instead of helping them
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Not to mention that they are also just neurotoxic enough to induce permanent dependence after more than a couple years. The damage they do from long-term use never goes away. So if you get on SSRIs for some years and then stop, you might never get back up to your previous baseline, not even after decades of total abstinence. To what extent that could be called withdrawal I am not entirely sure.
 
@Benu Love these questions.

Much will unfold over the coming months!
 
If someone asked me to pay $30k for an experimental treatment I'd tell them to kiss my arse and lick the shit off the soles of my shoes.

There's just no way in hell that this "experimental" treatment is worth 30k. It's not even worth 1/100th of that.
 
@Benu why would c-PTSD be excluded? I would imagine these are exactly the kinds of folks that PAP would have utility for. As in, people with severe PTSD who have tried other methods but failed.

But it's true I don't know all the details... yet! Not many people do as it is being rushed to the finish line for July 1.
 
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