The Times Australia
The Times World News

.

Psychedelic medicine is on its way. But it's not 'doing shrooms with your shrink'. Here's what you need to know

  • Written by Nigel Strauss, Psychiatrist and Clinical Associate at The Centre of Mental Health, Swinburne University of Technology
Psychedelic medicine is on its way. But it's not 'doing shrooms with your shrink'. Here's what you need to know

Many people in Australia, including psychiatrists, were surprised[1] when earlier this year the medicines regulator down-scheduled[2] MDMA, known colloquially as ecstasy, and psilocybin, from magic mushrooms.

This means that under certain circumstances from July 1, authorised psychiatrists[3] will be able to prescribe MDMA to treat post-traumatic stress disorder and psilocybin to treat depression that has not responded to other treatments. Patients must also undergo psychotherapy (talking therapy).

It all sounds very certain but it’s not really.

Read more: Explainer: what is post-traumatic stress disorder?[4]

Beware the hype

The Therapeutic Goods Administration decision has left a lot of questions unanswered[5] about how the new scheme will be implemented and operated, both effectively and safely.

There are a small number of countries where psychedelic-assisted therapies are used outside clinical trials – in a very limited manner. However, this is the first time a national government has altered the way these substances are formally classified.

So the world is watching closely how “psychedelic-assisted therapy”, as it’s officially called, is rolled out in Australia.

It’s a hot topic, with much public interest[6]. But for researchers, there are concerns the hype is getting way ahead of the research.

Read more: The TGA has approved certain psychedelic treatments: the response from experts is mixed[7]

The first steps

The Royal Australian and New Zealand College of Psychiatrists this week released guidance[8] to their members about how this would work in practice.

As researchers in this field, we helped develop these guidelines. They cover topics such as patients’ suitability for this therapy, and how to administer and monitor it.

The guidelines also stress the importance of patient safety and appropriate training for prescribers, and advocates for continued research.

What does this mean for patients?

This has several implications for potential patients:

  • their existing psychiatrist may not be authorised to prescribe these psychedelics. So patients will have to ask their psychiatrist or GP for a referral to one who is

  • the psychiatrist authorised to prescribe these psychedelics will need to assess whether the therapy is suitable for each individual patient. This involves a detailed and comprehensive assessment. If the treatment is suitable, several sessions of further assessment and therapy are required before the actual dosing session

  • patients will be informed of what to expect before, during and after treatment, and need to give consent to proceed. We also recommend psychiatrists tell patients this therapy is not guaranteed to work, and provide patients with a clear account of the risks and possible negative side effects of psychedelic medications.

Read more: Psychedelics: how they act on the brain to relieve depression[9]

Expectations are high, but clear evidence is lacking

Despite a growing body of evidence[10], psychedelic-assisted therapies are in their infancy.

In a time when demand for mental health services far outstrips supply[11], exaggerated promises about the effectiveness of these drugs, before the research results are in, has many researchers worried. Patient expectations remain high but good clear evidence is still lacking.

Australian research is just getting under way and so far most psychedelic research has been done overseas. Yes, early findings have been quite promising[12], but numbers are small, long-term follow-ups sparse, and potential risks and dangers still need to be explored.

Destigmatising these drugs has allowed us to begin our research, but sensationalising their effectiveness has the potential to disappoint and even harm patients because we really don’t know enough about how they work and who is suitable for this treatment.

Older man, sitting on sofa, palms together, with therapist taking notes
We still don’t know who is suitable for this treatment. Shutterstock[13]

Psychedelic-assisted therapy is no miracle cure. Espousing the benefits without a thorough examination of the risks and limitations is not only a misrepresentation of the science, it is arguably unethical.

Very few psychiatrists have had much experience in this fascinating but challenging field. We still have a lot to learn about the use of psychedelic medicines to treat psychiatric illness.

Undue haste in translating psychedelic-assisted therapy conducted in clinical trials to community clinics could affect how well these treatments work and their safety. Outside clinical trials, patients will also need to shoulder the cost[14] of this therapy, raising equity issues.

Read more: The tricky economics of subsidising psychedelics for mental health therapy[15]

There’s potential for harm

Psychedelic-assisted therapy is not simply “doing shrooms with your shrink”.

There is potential for psychedelic substances to cause fear, panic or cause psychological damage if given to susceptible and vulnerable people who have been inadequately screened or assessed.

Paranoia, traumatisation, worsening depression, and even suicidal behaviour, among other serious[16] side-effects[17], have been observed[18] in some cases.

So we need ongoing monitoring of outcomes, including adverse events.

We also know psychedelic substances render patients particularly vulnerable. Boundary issues and safeguards are vital considerations for patient safety, particularly when patients are under the influence of the psychedelic drug. For instance, it is important to discuss and agree with patients beforehand about the nature and timing of any touch during treatment sessions, so any touch is appropriate and done with full informed consent.

An exciting prospect

Despite the potential harms, we remain excited at the prospect of psychedelic-assisted therapy becoming an established treatment to help a select group of patients.

But we want to do this in a safe, controlled and sustainable manner.

If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.

References

  1. ^ surprised (theconversation.com)
  2. ^ down-scheduled (www.tga.gov.au)
  3. ^ authorised psychiatrists (www.tga.gov.au)
  4. ^ Explainer: what is post-traumatic stress disorder? (theconversation.com)
  5. ^ questions unanswered (theconversation.com)
  6. ^ public interest (www.abc.net.au)
  7. ^ The TGA has approved certain psychedelic treatments: the response from experts is mixed (theconversation.com)
  8. ^ released guidance (www.ranzcp.org)
  9. ^ Psychedelics: how they act on the brain to relieve depression (theconversation.com)
  10. ^ body of evidence (www.ranzcp.org)
  11. ^ far outstrips supply (theconversation.com)
  12. ^ quite promising (www.ranzcp.org)
  13. ^ Shutterstock (www.shutterstock.com)
  14. ^ cost (theconversation.com)
  15. ^ The tricky economics of subsidising psychedelics for mental health therapy (theconversation.com)
  16. ^ serious (pubmed.ncbi.nlm.nih.gov)
  17. ^ side-effects (pubmed.ncbi.nlm.nih.gov)
  18. ^ have been observed (journals.sagepub.com)

Read more https://theconversation.com/psychedelic-medicine-is-on-its-way-but-its-not-doing-shrooms-with-your-shrink-heres-what-you-need-to-know-208568

Times Magazine

What AI Adoption Means for the Future of Workplace Risk Management

Image by freepik As industrial operations become more complex and fast-paced, the risks faced by workers and employers alike continue to grow. Traditional safety models—reliant on manual oversight, reactive investigations, and standardised checklist...

From Beach Bops to Alpine Anthems: Your Sonos Survival Guide for a Long Weekend Escape

Alright, fellow adventurers and relaxation enthusiasts! So, you've packed your bags, charged your devices, and mentally prepared for that glorious King's Birthday long weekend. But hold on, are you really ready? Because a true long weekend warrior kn...

Effective Commercial Pest Control Solutions for a Safer Workplace

Keeping a workplace clean, safe, and free from pests is essential for maintaining productivity, protecting employee health, and upholding a company's reputation. Pests pose health risks, can cause structural damage, and can lead to serious legal an...

The Science Behind Reverse Osmosis and Why It Matters

What is reverse osmosis? Reverse osmosis (RO) is a water purification process that removes contaminants by forcing water through a semi-permeable membrane. This membrane allows only water molecules to pass through while blocking impurities such as...

Foodbank Queensland celebrates local hero for National Volunteer Week

Stephen Carey is a bit bananas.   He splits his time between his insurance broker business, caring for his young family, and volunteering for Foodbank Queensland one day a week. He’s even run the Bridge to Brisbane in a banana suit to raise mon...

Senior of the Year Nominations Open

The Allan Labor Government is encouraging all Victorians to recognise the valuable contributions of older members of our community by nominating them for the 2025 Victorian Senior of the Year Awards.  Minister for Ageing Ingrid Stitt today annou...

The Times Features

How to Tell If Your Eyes Are Working Harder Than They Should Be

Image by freepik Most of us take our vision for granted—until it starts to let us down. Whether it's squinting at your phone, rubbing your eyes at the end of the day, or feeling ...

Ways to Attract Tenants in a Competitive Rental Market

In the kind of rental market we’ve got now, standing out is half the battle. The other half? Actually getting someone to sign that lease. With interest rates doing backflips and ...

Top Tips for Finding the Ideal Block to Build Your Home

There’s something deeply personal and exciting about building your own home. You’re not just choosing paint colours or furniture, you’re creating a space that reflects your lifes...

The Home Buying Process Explained Step by Step

Buying a home is a thrilling milestone, but it can also feel like navigating a maze without a map. With paperwork, finances, and decisions at every turn, understanding the home-b...

Thinking of Selling Your Home? Here’s What You Need to Know

Selling a home is more than just putting up a “For Sale” sign. It’s a strategic process that involves preparation, pricing, and negotiation - all aimed at getting the best value ...

Smart Ways to Earn Passive Income from Real Estate

Imagine making money without doing much work. You get paid even while you sleep, travel, or do fun things. This is called passive income. Indeed, real estate has great ways to do...