As a tablet, it's ecstasy. In crystal form, it's molly. But for some Australians, MDMA is now simply medicine.
As of Saturday, authorised psychiatrists in Australia will become the first in the world able to prescribe doses of MDMA to treat post traumatic stress disorder (PTSD) and psilocybin, or magic mushrooms, for treatment-resistant depression.
The Therapeutic Goods Administration (TGA) flagged the inclusion of the psychedelics on their list of approved medicines from July back in February.
Even the scientists working at the forefront of neuromedicines were shocked by the pioneering move.
"The TGA’s decision took many by surprise," says Professor Chris Langmead, Deputy Director of the Neuromedicines Discovery Centre at the Monash Institute of Pharmaceutical Sciences.
"However, whether the sector likes it or not, Australia is now at the forefront of research in this field globally, and we need to seize the opportunity.
“Despite the profound prevalence of difficult-to-treat mental illness throughout the community, very few advancements in new safe and effective treatments have emerged over the last 50 years - this simply isn’t good enough," Prof Langmead said.
He hopes the TGA’s decision will pave the way for the development of new safe, effective and widely accessible medicines to significantly improve the lives of those living with mental illness.
The news has been welcomed by many, but some experts are concerned the roll-out could face hurdles, particularly the prohibitive cost to patients of about $10,000 for treatment.
For some, the TGA's inclusion has come too quickly and without sufficient evidence or education.
"There are concerns - that evidence remains inadequate, and moving to clinical service is premature; that incompetent or poorly equipped clinicians could flood the space; that treatment will be unaffordable for most; that formal oversight of training, treatment, and patient outcomes will be minimal or ill-informed," said Dr Paul Liknaitzky, head of Monash University's Clinical Psychedelic Lab.
“Many professionals working at the coalface are concerned that soon-to-be prescribers, therapists, and decision-makers probably don’t know that they don’t know about some of the essential elements of safe and effective psychedelic therapy.”
Decades of accumulated negative stigma surrounding use of the drugs might also make it difficult for legislators to "break the shackles" and support the prescription of these drugs, BehaviourWorks Australia research fellow Brea Kunstler added.
"There is a sense of cautious optimism," said Dr Kunstler.
Regardless, the opportunity to access these groundbreaking treatments was an incredible opportunity, said Dr Liknaitzky.
"There’s excitement about drug policy progress ... about the prospect of being able to offer patients more suitable and tailored treatment without the constraints imposed by clinical trials and rigid protocols."
