Australia has approved the legal use of medical MDMA and psilocybin - UK laws and what does it treat?

Australia has recently approved the medical use of MDMA and psilocybin to treat mental health patients.

The Australian Therapeutic Goods Administration will soon make it possible for psychiatrists to prescribe psilocybin and MDMA as early as July of this year.

But what are the benefits of medical MDMA and psilocybin, and what are the rules for these medicines in the UK? Here’s what you need to know.

Why has Australia approved medical MDMA and psilocybin? 

According to a release by the Australian government, the move comes from an acknowledgement of "the current lack of options for patients with specific treatment-resistant mental illnesses”. It said: “It means that psilocybin and MDMA can be used therapeutically in a controlled medical setting. However, patients may be vulnerable during psychedelic-assisted psychotherapy, requiring controls to protect these patients."

This will make Australia the first country in the world where psychedelics are officially recognised as medicines.

“Prescribing will be limited to psychiatrists, given their specialised qualifications and expertise to diagnose and treat patients with serious mental health conditions,” said a statement from the TGA.

According to Criminal Defence Lawyers Australia, psilocybin was prohibited in 1985, while MDMA was criminalised in 1987, after first appearing in the 1980s.

What do medical MDMA and psilocybin treat?

MDMA

MDMA, full name 3,4-Methyl​enedioxy​methamphetamine, is commonly taken in a tablet form and is known as ecstasy.

However, the treatment for medical MDMA is assisted - and should be done in conjunction with a psychiatrist using a form of therapy such as cognitive behavioural therapy (CBT). The MDMA releases neurotransmitters which include “feel-good” hormones like dopamine, serotonin, and norepinephrine, as well as oxytocin, prolactin, cortisol, and vasopressin.

This, in return, can cause feelings of empathy, self-awareness, sensory pleasure, more energy, less anxiety, ability to open up about emotions and differences in how you see time and space. The symptoms MDMA can give may create a setting in which people can open up about difficult emotions and work through events that could have triggered their emotions.

In Australia, MDMA will be available for patients suffering from PTSD in conjunction with their therapy.

Psilocybin

Medicines containing the psychedelic substance psilocybin (the active compound in magic mushrooms) will be eligible in Australia for a prescription to treat patients with treatment-resistant depression.

Psilocybin-assisted therapy sees a patient taking psilocybin in the care of a therapist and going on a psychedelic journey which lasts around six-eight hours. The aim is to navigate emotional obstacles and long-term problems.

Taking psilocybin can make users very giggly, euphoric, in awe of the people and things around them, energised and excited.

What is the UK law surrounding medical MDMA and psilocybin?

The 2005 Drugs Act amended the Misuse of Drugs Act 1971 to clarify that both fresh and prepared (e.g. dried or stewed) magic mushrooms containing psilocin or psilocybin (such as the liberty cap) are Class A drugs. MDMA is also a Class A drug under the same act.

Class A drugs mean it’s illegal to have for yourself, give away or sell, but it also is viewed as having “no currently accepted medical use”.

However, there have been a number of trials exploring the use of MDMA for PTSD and psilocybin for depression.

Professor Dr David Nutt is the head of the centre for psychedelic research at Imperial College London. On the use of psychedelics, he says they “can only be used for research in the UK”. “The legal constraints make it much more expensive for grants than it should be. The expense plus the uncertainty of getting ethics approval as well as the illegal status (of the psychedelics) makes funders hesitant,” he said.

However, he says that “the benefits could be enormous”. In a paper titled The Current Status of Psychedelics in Psychiatry, Dr Nutt explains that: “psychedelics probably work by disrupting brain systems and circuits that encode repetitive thoughts and behaviours. The psychedelic experience opens a therapeutic window that disrupts entrenched thinking and allows insight” which could then help with re-association.

Studies show that dose of psilocybin produced alteration in brain function - similarly to an antidepressant effect. However, there is a challenge with scaling the treatment up. Dr Nutt says: “The current model is time and therapist intensive, and even though only a couple doses of medicine are required, this is currently costly because of the many regulatory challenges associated with psychedelics still being scheduled as very dangerous, illegal drugs under the UN Conventions and all Western governments’ drug laws. Another issue is how to provide enough psychedelic-trained therapists and ensure good practice through structuring, manualizing, monitoring, and delivering quality training and practice.”

He added: “This form of therapy does become more widely used, more formal training of large numbers of therapists will be required.”