Australia legalises psychedelics for mental health

https://www.bbc.co.uk/news/world-australia-66072427

by mjfisher • 3 years ago

114 49 3 years ago

bbc.co.uk

This sounds great on paper, but there's a devil lurking in the detail:

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.

How exactly is this supposed to work then? Are psychiatrists supposed to order MDMA/psilocybin directly from the companies that produce the two for research use, which presumably involves fearsome bureaucracy and markups?

It sounds like this would make the law effectively a dead letter until a regular pharma company goes through the Australian approval process and gets the drugs into pharmacies. Medical marijuana in Australia has suffered from similar issues, with an onerous approval process in many states making it very difficult to get a prescription.

mtlmtlmtlmtl• 3 years ago

Mdma is tricky, but psilocybin is easy. Psilocybe cubensis can be grown easily at significant scale outside its natural ecosystem, due to work by the late Terence Mckenna and his brother Dennis.

Treatment centers could grow them on site pretty easily needing only basic cleanliness to avoid contamination.

osullip• 3 years ago

Are psychiatrists supposed to order MDMA/psilocybin directly from the companies that produce the two for research use,

As I understand it, yes.

Legalisation hasn't meant it has gone mainstream.

It is still going to be administered in very selective cases where the current range of medication and therapy has not been effective.

It may only be tens or low hundreds of people who receive these treatments in the first year.

The efficacy of the treatment will be monitored and the hope is that these patients outcomes are positive, which will add to the body of work supporting MDMA/psilocybin as an antidepressant.

CTDOCodebases• 3 years ago

It's the first step. When cannabis was legalised for medicinal purposes the doctors prescribing it had to import it from overseas suppliers.

Yes I imagine the next step is a local supplier company goes through the valid approval process and gets their product approved.

Medical marijuana in Australia has suffered from similar issues, with an onerous approval process in many states making it very difficult to get a prescription.

I live in NSW so maybe I am a bit naive but it is possible to see a doctor over the internet that works for a dispensary in another state and have them issue you a prescription if you fit the criteria for medicinal cannabis.

I was cynical about the idea of these dispensaries having their own in house doctors but upon further thinking it makes sense since some doctors still don't acknowledge the medicinal benefit of cannabis.

robbiep• 3 years ago

Accessing medical cannabis is weird - each state has different access requirements and you must apply in the state(s) you practice in for permission (which isn’t hard) and then to the TGA for approval to prescribe.

The industry/clinic space is really bizzare. I have been bombarded with requests to work as a telehealth prescriber. Because of the restricted product supply, ‘clinics’ are popping up to offer telehealth consults and then push their products.

There are multiple issues with this:

- the doctors doing the prescribing are often junior doctors, not GPs or pain specialists

- they have a limited supply of stock and no real understanding of ‘what is right when’

- pretty much all the stoners I know have now switched to medical marijuana (which is fine but for the next point)

- the TGA will at some point come down on doctors who are doing shitty consults and just writing the prescription with a cursory ‘whatever’ - because the TGA and medical board in this country are not as toothless as in the US

So basically anyone can get a prescription, and the clinics are pushing their own (or their own imported) product so they get fat margins, and there’s some médico-légal risk.

Over time (and even now) there are increasing numbers of GPs who can prescribe and there are websites that can point you to them which is what I’d recommend if you or a loved one actually has a medical condition, as opposed to just wanting to get stoned.

williape• 3 years ago

It’s still a fantastic step in the right direction, giving medical practitioners the flexibility to explore new medicines for treatment. I know my perception of these substances changed after reading How to Change your mind by Michael Pollan: https://michaelpollan.com/books/how-to-change-your-mind/

Stevvo• 3 years ago

It's not like either is complex to manufacture/extract. And "fearsome bureaucracy" is quite normal, not a big deal.

andrewstuart• 3 years ago

But marijuana is illegal most places in Australia.

So young people who want to get high have to go to drug dealers who also offer meth and other drugs.

Thanks, conservative Australian politicians.

artdigital• 3 years ago

You can get medical marijuana

shortcake272• 3 years ago

I believe the parents point is that Australia is lagging behind other countries in regards to legalisation of marijuana. So it’s surprising to see Australia leading the charge with psychedelics.

stubish2• 3 years ago

Yes, and people who want to get high have the choice between purchasing non-medical marijuana illegally or medical marijuana illegally. Because 'I want to get high' isn't a legitimate reason for prescription, so instead people lie to a Doctor to gain access to a controlled substance. I'm not sure which is legally considered the worse crime.

enneff2• 3 years ago

Experts say there is still the risk of a "bad trip", which is when the user has an unpleasant experience while under the influence of drugs.

All psychiatric treatments have a risk of a bad experience, including talk therapy.

JimtheCoder2• 3 years ago

A bad trip on Shrooms will have a much more negative effect than a bad talk therapy session...

Don't ask me how I know this.

dkjaudyeqooe5• 3 years ago

Bad therapy can have a longer lasting effect and be much more corrosive than a bad trip.

Don't ask me how I know this.

shortcake272• 3 years ago

Yeah, I laughed when I read that.

If antidepressants are known for anything, it’s the side effects. It seems people must still go through these before psychedelics, what a shame. Hopefully this will change over time. We need more data, but I have a feeling there will be fewer side effects compared to current treatments.

dkjaudyeqooe5• 3 years ago

MDMA - also known as the party drug ecstasy - is a synthetic drug that acts as a hallucinogen.

This is misleading. It's 3,4-Methylenedioxymethamphetamine, an amphetamine and a stimulant. It has minor psychedelic effects and no one in their right mind would consider it a hallucinogen.

eindiran• 3 years ago

It does sound kind of misleading, but the nomenclature is correct. It's being used in the broad sense of hallucinogen (ie the drug is a dissociative, deliriant, or psychedelic). MDMA definitely has psychedelic effects, though less pronounced than eg MDA and much less pronounced than eg LSD.

dkjaudyeqooe5• 3 years ago

definitely has psychedelic effects

Does it though? In my (and friend's) experience it intensifies emotions and senses but doesn't produce anything new, nor is it so intense as to be a "deliriant". I can't help but think people are labeling this drug over broadly without controlled research, because of its illegal status.

sterlind2• 3 years ago

calling MDMA an amphetamine is technically (i.e. structurally) correct but also misleading. it's structurally an amphetamine, but so are DOB, Sudafed and Wellbutrin. it's stimulating, but in a different way from regular amphetamines, because it doesn't release dopamine.

the psychedelic effects are lesser than e.g. DOB, but if you look at its cousin MDA you can see it's on the spectrum of psychedelia. a better category for MDMA is "empathogen/entactogen."

chimeracoder• 3 years ago

calling MDMA an amphetamine is technically (i.e. structurally) correct but also misleading. it's structurally an amphetamine, but so are DOB, Sudafed and Wellbutrin. it's stimulating, but in a different way from regular amphetamines, because it doesn't release dopamine.

MDMA is more selective for serotonin, but it does release dopamine as well.

Comparing it to Wellbutrin, a nonstimulant, is far more misleading. MDMA is an amphetamine, and it acts similarly (but not identically) to other amphetamines that people are familiar with.

srameshc• 3 years ago

That's great !! Aussie rock should be precribed along with psychedelics for better results

crtified3• 3 years ago

It's nice to hear, in principle.

Also expensive.

The requirement that, for the entire (up to 8-10 hour) duration of the trip, a suitably qualified therapist be on hand, must dictate that each non-trivial dosage under this regime will have a ticket price of several thousand dollars per-time.

It's one of the catch-22s in medicine. That a poor person on the street can have the same experience for $50 as a rich person has for $5000, with the difference in cost being the literal $4950 more of specialists and testers and monitors and side experts that the rich person is paying for. For reasons, yes, but that doesn't change the numbers, the fact that for every one of the latter there are 10 of the former.

viraptor2• 3 years ago

poor person on the street can have the same experience for $50 as a rich person has for $5000

Not the same. You mentioned the ongoing support through the whole trip already. Then there's guidance for the purpose of the experience rather than possibly just getting lost in the feeling/escape. Then there's validated source/safety of the drugs. Finally, if anything goes wrong, you have a person hopefully trained in how to respond immediately.

crtified3• 3 years ago

That is basically the qualification I included in my later statements within the same post:

"..the difference in cost being the literal $4950 more of specialists and testers and monitors and side experts that the rich person is paying for. For reasons, yes..."

louthy• 3 years ago

Also the experience is likely to be worse with some medical professional staring at you through the entire trip!

stubish2• 3 years ago

It remains to be seen if treatment will be covered by Medicare, and how large the payment gap will be in practice.

richardjam73• 3 years ago

It will probably be only covered by health insurance for a long time. It takes a long time for new treatments to get to Medicare.

yosame• 3 years ago

The PBS won't cover the drug portion of the treatment at least until there's good quality stage 3 clinical trials that support it's use. Even then, given the need for a long therapy session next to the drug, they'll likely have to create a special access scheme to cover both.

I'd say it's very unlikely that these treatments will ever be government subsidied for anything except very treatment resistant depression/PTSD (for psilocybin/MDMA respectively).

Australia legalises psychedelics for mental health

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