MDMA has been approved for clinical use in Australia. From July, authorised psychiatrists will be able to prescribe it for PTSD. But before you go thinking popping pills is good for your mental health, check out what this development really means.
Alongside Psilocybin, which has been approved for clinical use (by authorised psychiatrists) in Australia for treatment-resistant depression, MDMA has been approved for clinical use for the treatment of PTSD in Australia.
This is a world first, with Australia now leading the globe in this kind of experiment. Before you celebrate with a drug-fuelled rave, however, think again. You need to be prescribed them by an authorised professional, and the recognition of psychedelics as potential mental health tools is just that – an acknowledgement of their potential, for a small range of people, under the guidance of an authorised professional.
According to NIDA, “MDMA was developed by a German pharmaceutical company in 1912.” Per NIDA: “Originally known as ‘Methylsafrylaminc,’ it was intended as a parent compound to synthesize medications that control bleeding, not to control appetite as is often incorrectly cited.”
“MDMA gained a small following among psychiatrists in the late 1970s and early 1980s, despite the fact that the drug had not undergone formal clinical trials nor received approval from the U.S. Food and Drug Administration (FDA) for use in humans” (NIDA).
“Some psychiatrists believed that it enhanced communication in patient sessions and allowed patients to achieve insights about their problems.”
That said, NIDA explains: “In 1985, the DEA declared an emergency ban on MDMA, placing it on the list of Schedule I drugs, defined as substances with no currently accepted medical use and a high potential for abuse.”
MDMA has remained a Schedule I substance since then in the USA and in most other countries in the world, including Australia. Fears over its potential for abuse have also stemmed from the fact that you don’t know what you’re really getting, with many recreational MDMA users unknowingly ingesting synthetic drugs and harmful adulterants the MDMA is cut with or replaced by. On top of that, MDMA is known for leaving users dehydrated, depressed and anxious (after the initial high). There are also often risks of overheating, memory loss, strokes and overdose.
Now that MDMA has been approved for clinical use in Australia, not a lot is likely to change on that front, with MDMA remaining illegal except in a very slim range of clinical circumstances. The Royal Australian and New Zealand College of Psychiatrists president, associate professor Vinay Lakra, for instance, said: “So this is a baby step in the right direction and what it does is allow us to do things in an appropriately safe way for everyone… and if necessary take a step back as well.”
As for who is doling them out, The Guardian reports that psychiatrists “will need to get approval by a human research ethics committee, then approval under the TGA’s authorised prescriber scheme.”
The TGA said: “these measures are necessary because there is only limited evidence that the substances are of benefit in treating mental illnesses, and only in controlled medical settings.”
Vice reports that due to these measures, “even if your regular psychiatrist really wants to give you a script, it’s not as simple as that.” Vice also spoke to a medical cannabis industry expert who told them it will be similar to the early years of legal medical weed in Australia, saying: “It took several years for the friction to be reduced [and] I can imagine similar issues emerging with psychedelics.”
“In terms of accessibility, I think it will still be quite challenging for psychiatrists to get Authorised Prescriber status for these drugs.”
How accessible will MDMA and psilocybin be, following the Australian government’s decision to make them available as Schedule 8 controlled drugs?
— Rhys Cohen (@rhyscohen) February 3, 2023
Probably not very accessible at all, for a bunch of reasons:
According to NIDA, “The evidence on MDMA’s therapeutic effects is limited thus far, although research is ongoing in this area. Proponents of MDMA-assisted therapy recommend that it only be used for reactive disorders such as post-traumatic stress disorder because it can worsen some psychiatric conditions.”
Dr David Caldicott, a clinical senior lecturer in emergency medicine at Australian National University, told The Guardian that: “The safe ‘re-medicalisation’ of certain historically illicit drugs is a very welcome step away from what has been decades of demonisation” and said that a controlled supply of MDMA could be particularly beneficial for returned service people.