An expert panel reviewing the use of psychedelics to treat Australia’s mental health crisis supports treatments being introduced on a case-by-case basis, under the supervision of doctors and trained therapists.
The review found that these medicinal psychedelic medicines have a ‘strong effect size’ – that is, they actually help people get better from depression, post-traumatic stress disorder, addictions, end-of-life stress and other mental illnesses.
It follows Mind Medicine Australia’s application to Australia’s Medicines Authority, the TGA, to allow these medicinal psychedelics to be used for medical purposes, whilst maintaining the prohibition on the use of psychedelics for recreational purposes.
This step requires these medicinal therapies to be rescheduled as ‘controlled medicines’ under the Poisons Standard.
The review panel emphasised the importance of the medicines being administered in closely supervised settings and with intensive professional support. It is not envisaged that patients will ever be allowed to take these substances away from the clinical environment.
Mental health crisis
Australia’s mental health statistics are some of the worst in the world. According to the Productivity Commission, one in five Australians had a mental illness before the current pandemic, which has significantly worsened mental health outcomes.
One in eight Australians were on anti-depressants, including one in four older people and one in thirty younger people.
The Chair of Mind Medicine Australia, Peter Hunt AM, said ‘These are truly terrible statistics and evidence the enormous amount of suffering in our society. One of our great problems is the minimal innovation in the sector now for decades, and treatment outcomes for many Australians are poor.’
The review panel noted that the conditions that have been explored for potential therapeutic efficacy with MDMA and psilocybin are serious.
For instance, ‘a significant proportion of people living with PTSD or depression and anxiety in the face of serious illness do not obtain adequate relief from existing therapeutic strategies… many people are not helped by any [current] interventions and the social and economic costs are high for unresolved and lifelong PTSD.
‘More effective treatments are needed,’ said the panel. ‘Similarly, many people with major depression do not achieve full or lasting recovery and existing approaches can increase side effects.’
It was also found that there are statistically significant differences for MDMA (when used as part of psychotherapy) in comparison with inactive or active controls.
MDMA was well tolerated by participants in all studies.
Regarding psilocybin, statistically significant results were achieved for in most studies conducted to darte. In all but one of the psilocybin studies reviewed ‘there was a statistically significant difference between psilocybin and active placebo’ with psilocybin remaining as effective as the antidepressant escitalopram.
Psilocybin was well tolerated in all studies.
The Executive Director of MMA, Tania de Jong AM, said ‘Australia is at the crossroads. We know that current mental health treatments don’t work for many Australians and there is increasing suffering and suicides in our community.
‘Our health practitioners desperately need new treatment options. We have a serious mental health emergency in Australia and people need some hope for healing,’ she said.
“Psilocybin assisted therapy (primarily for treatment resistant depression and end of life anxiety) and MDMA assisted therapy (primarily for treatment resistant post-traumatic stress disorder) have both shown remission outcomes of 60-80% in overseas trials after just two to three medicinal sessions in combination with a short course of psychotherapy,’ said Ms de Jong.
‘As the Panel has observed, these medicines are very safe and well tolerated by patients in a clinical environment.’
Peter Hunt concluded by saying, ‘We are very hopeful that these medicinal therapies will now be rescheduled as controlled medicines under the Poisons Standard.
‘This will enable psychiatrists who are already getting approvals from the TGA, to treat seriously ill and suicidal patients under its Special Access Scheme on a case-by-case basis, to apply for individual permits from state and territory governments around Australia,’ he said.
‘What we need now is a nationally standardised approach for providing medical approvals to those who are suffering desperately,’ said Mr Hunt.