In a one-of-its-kind legalization, Australia becomes the first country in the world to legalize the use of psychedelics to treat certain mental health issues.
From July 1, those suffering from post-traumatic stress disorder and treatment-resistant depression can now have MDMA and Psilocybin prescribed to them by authorized psychiatrists.
Australia's Therapeutic Goods Administration (TGA) shocked many in the Medical and Science world in February when it reclassified MDMA and Psilocybin so they could be used for therapeutic purposes.
The TGA declared the drugs "relatively safe" when used in a "medically-controlled environment" for patients "with serious mental health conditions". Otherwise, both MDMA and Psilocybin are illegal in Australia.
The decision in February received mixed reactions from health professionals as the move has been deemed hasty.
MDMA, also known as Ecstasy or Molly, is a synthetic drug that acts as a stimulant and psychedelic and works in a therapy setting by temporarily reducing activity in the amygdala, a brain region associated with fear.
Psilocybin, too, has a hallucinogenic effect and is found in magic mushrooms. It has been used for centuries in shamanic rituals.
Treatment is going to be expensive as patients are expected to pay between $15,000 and $25,000 for a round of psychedelic-assisted sessions.
Gary Payinda, Whangārei Emergency Doctor said, “They should be introduced into clinical practice as part of a rigorously controlled clinical trial or at the very least, a clinical registry.”
“Instead, Australia is opening the door to clinical use with the most minimal of record-keeping requirements. And no real clinical oversight, uniform guidelines, or supervisory authority.” Payinda also states that the risks could be compared to the introduction of vaping in New Zealand, which was supposed to help people stop smoking cigarettes but has now become a harmful habit.
Dr. Mike Musker, a Mental Health Researcher at the University of Australia, told the BBC that the use of psychedelics would be carefully monitored and not a case of “take a pill and go away.”
“Patients will be able to access these only in supervised clinical settings. There’s no dispensing for home use.”
He called the move a “game changer” and “one of the biggest evolutions in psychiatry in the last 70 years.”
"I have read about stories where people have had what you call bad trips, or actually they've re-experienced their trauma, and so we've got to take great caution," Dr Musker said.
Associate Prof Daniel Perkins, Co-Executive Director of the Psyche Institute in Melbourne said that “There is a huge discrepancy between what we anticipate the demand will be and clinicians who are appropriately trained to facilitate the work”.
He said that it will “probably be at least 12 months before it's up and running.”
Adverse effects of MDMA include high blood pressure and pulse rate, faintness, and panic attacks, and in some rare cases, it can cause loss of consciousness and trigger seizures amongst other side effects.
Professor Susan Rossell, a Cognitive Neuropsychologist and Professorial Research fellow at Swinburne's Centre for Mental Health said, “I have a significant degree of caution about this decision because these treatments are not well established at all for a sufficient level of broad-scale implementation.”
She addressed the need for “substantial further research.”
Some countries have other methods of regulated access like Switzerland, Canada, Israel, New Zealand, and the United States which have pathways including exceptional permits and special access programs to access psychedelics.
The TGA acknowledges that there is unknown and inconclusive evidence, but says "there are promising signs" that controlled therapeutic use of the drugs may improve mental health for some people and that the "benefits for some patients ... will outweigh the risks".
The regulator says there are currently no approved products that contain MDMA or psilocybin. However, the reclassification means psychiatrists will be able to access and legally supply certain medicines that contain them, even if they have not been evaluated for safety or effectiveness.
Experts must not oversell the uses of psychedelics until there has been more rigorous research about its uses and effects.
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