Australia Becomes First Country To Allow Psychedelic Medicine
Last week, Australia became the first nation in the world to allow psychiatrists to prescribe psychedelic medicine.
As Grace Browne wrote in Wired Magazine, the fact that it’s Australia’s conservative government—and not the United States—that’s leading the way created “a sense of surprise” around the globe. Momentum seemed to be stronger in the United States, especially given the “predictions that the US Food and Drug Administration will approve MDMA for the treatment of PTSD in 2024” and the fact that “Oregon became the first US state to allow adult use of psilocybin under the supervision of a state-certified facilitator.”
But Australia’s decision followed a careful process informed by an expert panel composed of psychiatrists, physicians, and researchers. Guided by the recommendations of this panel, the Therapeutic Goods Administration, which is Australia’s equivalent of the Food and Drug Administration, decided that psychiatrists could start prescribing psilocybin to combat treatment-resistant depression and MDMA to treat post-traumatic stress disorder later this year.
Australia’s historic move generated a flood of international media coverage, most of which centers on the reaction of mental health physicians, clinicians, and researchers on what allowing psychiatrists to prescribe psychedelics medicines would (and wouldn’t) mean for treatment of serious mental illnesses like PTSD and depression. Here are the highlights:
Mike Musker, a clinical researcher at the University of South Australia who focuses on mental health and suicide prevention, told Agence France-Presse that he welcomed Australia’s “long-awaited” leadership. Musker emphasized that for many “experiencing post-traumatic stress disorder and depression, particularly army veterans and people who have worked in emergency services, standard psychiatric drugs have not worked and offer no relief.”
For The Guardian, Tory Shepherd interviewed two experts who had different interpretations of whether the Therapeutic Goods Administration took a big enough step forward.
Vinay Lakra, president of the Royal Australian and New Zealand College of Psychiatrists, told Shepherd that he “welcomes” the decision. For Lakra, the Therapeutic Goods Administration appropriately took only a “baby step in the right direction”. Though the promise of psychedelic medicine is both broader and deeper than allowing specific drugs to be prescribed to treat two specific conditions, Dr. Lakra suggested that a measured approach is better than “one giant leap.”
Sarah-Catherine Rodan, the lead investigator on a psilocybin trial, told The Guardian that the Therapeutic Goods Administration’s decision “should be extended to all treatment-resistant psychiatric disorders including nicotine [and] alcohol dependence, obsessive compulsive disorder, and end-of-life distress.”
The Guardian also spoke with Petra Skeffington, a clinical psychology professor, who flagged that “it is now critically important” for the medical community to respond to “increased access to MDMA and psilocybin-assisted therapies” with a corresponding increase in “high-quality therapist training to promote safe therapeutic conditions when working with these medications.”
For the Sydney Morning Herald Natassia Chrysanthos and Aisha Dow interviewed professor David Caldicott, an emergency department doctor who recently testified in front of the Royal Commission into Defence and Veteran Suicide. The difference between Australia and the rest of the world is a question of politics not science, as “the evidence suggests that there’s potentially quite a lot of use in using it,” Caldicott said. He also stressed that psychedelic medicines might do more than provide better results than other medications, they also might mean that a person might be on the medication for a much shorter period: “The conditions for which these drugs might be used are currently conditions for which you’re basically destined to a lifetime of drug use. Whereas the MDMA particularly is used to facilitate psychotherapy, only for a few doses.”
Rhys Cohen, who serves on the advisory board at the University of Sydney’s Brain and Mind Center, told Vice Magazine’s Aleksandra Bliszczyk, that what “the Australian Government has taken a really positive step in the right direction,” but the decision to allow psychiatrists to prescribe the medication is “just the beginning of the process.” The next steps, which involve complicated logistical questions around drug delivery and developing best practices for prescriptions, are critical to ensuring that “some of the most acutely unwell members of the community, with profound psychiatric conditions, who have often exhausted all other therapeutic options” are able to access treatment.
