Australia legalises psychedelics to treat some mental health conditions, but therapists warn it is no miracle cure
When patients nervous about taking psychedelics for the first time ask their therapist if they’ve tried it, only a handful are able to say yes.
Clinical psychotherapist Marg Ryan is one of them. In a world-first trial, it was part of her training at Monash University’s Clinical Psychedelic Lab.
“Pretty much every participant says to you, ‘Have you done this? And is it safe?'” Dr Ryan says.
“And you can with your hand on your heart say that you have done it authentically and that you know what they’re going through and that they are safe.”
Paul Liknaitzky, who heads up the lab, believes the experience is worthwhile.
“It was an incredibly useful form of training where therapists had the opportunity to lie here in the dosing room and receive a truncated version of the same treatment that their patients received,” Dr Laknaitzky says.
He says it’s the only way to truly begin to understand what participants go through.
“[Therapists] may need to have some sort of personal understanding of at least an altered state of consciousness that is dramatic and unusual,” Dr Laknaitzky says.
It’s just one of the groundbreaking research projects underway in Australia, which has become the first country to legalise the use of psilocybin and MDMA for the treatment of depression and post-traumatic stress disorder. Other countries have allowed it on limited grounds, but Australia is the first country to recognise psychedelics as medicine at a national level.
ABC program Compass, presented by Indira Naidoo, examines the healing powers of psychedelics, the risks involved, and whether Australia is ready for this new era of mental health treatment.
‘A box of understanding’
Up until July 1, the drugs could only be legally accessed through clinical trials.
Some like Gabrielle, who did not want to use her last name, took matters into their own hands.
The treasurer of the Australian Psychedelics Society turned to ayahuasca, a plant-based psychedelic from the Amazon basin, to help deal with her troubled relationship with her mother.
“My mum had me very young, and she had a really rough upbringing and had a lot of trauma and we had a really chaotic life,” she says.
She had not spoken to her mother for at least 10 years.
“So my point of doing the medicine was to delve into that, in order to release it,” she says.
The first thing she remembers about the experience is the feeling of her mother giving her a hug.
She was confronted with painful and emotional memories, but says the medicine showed her that what she was feeling was what her mother had gone through as a child.
“In that moment, it was like this box of understanding towards my mum cracked open and respect and compassion, and just overwhelming love for her,” Gabrielle says.
Since then, she has reconnected with her mother.
“It was like I was carrying around this big weight on my shoulders that I didn’t even know I had and it was just gone,” she says.
‘Too little time’
The term psychedelic refers to a broad class of compounds derived from plants, fungi, and synthetic sources.
“These compounds produce dramatically altered states of consciousness that seem to occasion very different perspectives on yourself or the world, new views on old problems,” Dr Liknaitzky explains.
The traditionally conservative Therapeutic Goods Administration’s (TGA) decision to legalise them for persistent mental health issues took many researchers by surprise.
“Psychedelic science was a very small, barely known cottage industry only five years ago,” Dr Liknaitzky says.
“Now everybody knows about it. So I think there’s already been that massive surge in interest in psychedelics and, to date, access has been incredibly limited.”
While he sees enormous potential, he is not sure the profession is ready.
“My greatest concern is that there’s been far too little time given for the workforce that is going to step forward to deliver this treatment, to equip themselves to train up,” Dr Liknaitzky says.
The TGA says psychiatrists will need to show they have the necessary training, competency, and evidence-based treatment protocols in place to control the risks to patients.
An intention, eye mask, and curated playlist
The Monash University trial treating people for anxiety focuses on creating an environment that helps participants relax.
Before taking the medicine, they have several sessions and set their intention for the day.
They lie down on a couch with an eye mask and headphones.
“They’ll be listening to a curated playlist and waiting for the medicine to start to work,” Dr Ryan says.
“Then it gathers momentum as we head towards peak with the medicine where some material might be coming up for them or they might be seeing some images or thinking about some memories.
“There’s stronger music in case there’s some anger or conflict or different emotions that they’re dealing with.”
She says most participants’ experiences had been positive.
“One of the things that we most hear is that it’s been one of the most life-changing experiences that they’ve ever had,” Dr Ryan says.
“It’s not for the faint of heart, or I should say it’s not for the ill-prepared. It’s courageous work,” Dr Liknaitzky says.
“There is enormous promise in psychedelic-assisted therapies if we continue to do a good job of delivering the treatment well.”
Setback fears
Not all trials have shown such a success rate.
Professor Susan Rossell, a cognitive neuropsychologist and researcher at Swinburne University of Technology, is leading a trial of psilocybin for treatment-resistant depression.
The results of the pilot study show one-third of participants are doing well, one-third are doing really badly, and one-third have mixed experiences.
“The important thing here is that this isn’t the miracle cure for some people and finding out why it doesn’t work for some people is going to be really important because this intervention is going to be expensive,” Professor Rossell says.
Estimates of the cost of treatment suggest it could be as high as $20,000 or $30,000 per person.
Professor Rossell says the worst-case scenario is that the TGA decision actually proves to be a setback.
“There are people who have had bad trips, there are people who commit suicide post bad trips, and it just sets everything back and they change the legislation and make research even harder to do,” she says.
You can watch the full Compass episode Psychedelics — Healing the Spirit? on ABC iview.
https://www.abc.net.au/news/2023-07-26/psychedelics-mdma-psilocybin-legal-mental-health-conditions/102643756 Australia legalises psychedelics to treat some mental health conditions, but therapists warn it is no miracle cure