Demand for psychedelics on the up

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People are using drugs such as LSD, MDMA and psilocybin to self treat mental distress, with one pharmacist hoping they will be dispensed as medicines in the near future

Results from the latest Global Drug Survey, released on Friday, reveal that more people including Australians are turning to psychedelic drugs to self-treat mental illness and emotional distress.

Among 110,000 respondents worldwide – with 10% of the sample coming from Australia – 6500 people responded to the section exploring self-treatment with psychedelics.

Nearly 1400 reported use of any psychedelic (i.e. LSD, magic mushrooms, MDMA, ketamine, DMT, 1p-LSD, ayahuasca, 5-Meo-DMT) in the last year to self manage emotional distress for a specific psychiatric condition.

LSD, MDMA (ecstasy) and psilocybin (the psychoactive component of magic mushrooms) were the substances most commonly used for self-treatment of a psychiatric disorder or emotional distress, according to the survey.

Over one third reported self treating with LSD, while one quarter had used MDMA and around one fifth had used magic mushrooms.

The most common underlying factors for self-treatment with psychedelics were depression, anxiety, relationship problems and trauma.

“The findings suggest there are many people with common pre-existing conditions for whom existing treatment modalities are either insufficient or unattractive to engage with,” the report found.

Using psychedelics for self-treatment is not without risk. Of those who reported use for this purpose in the last year, 4.2% reported seeking emergency medical treatment.

The head of the Australian arm of the survey, RMIT University’s Dr Monica Barratt, said the findings reveal that people are already using psychedelics as a DIY mental health treatment.

“As Australia awaits the progress of clinical trials of these substances for mental health conditions, we need to recognise the demand for them is increasing and this demand may end up being filled outside of the medical setting,” Dr Barratt said.

Bavly Nasralla, clinical pharmacist and research officer at Mind Medicine Australia, told AJP he’s not surprised by the survey findings.

“With the current state of the mental health crisis, both in Australia and worldwide, the treatment options we’ve got are proving inadequate if you’re just looking at the numbers,” said Mr Nasralla.

“Given that and the historical, political and legal complexities surrounding psychedelics, I think people are getting desperate and wanting to self treat as best they can. That’s why you see these numbers of people self treating this way using these underground therapies.”

The Therapeutic Goods Administration does not currently recognise MDMA and psilocybin as medicines for the treatment of psychiatric conditions, although this could change depending on the results of clinical trials currently underway.

Applications for the rescheduling of both psilocybin and MDMA were recently knocked back in an interim decision handed down by a delegate of the Secretary of the Department of Health, who ruled that Schedule 9 remains appropriate for both drugs.

This was despite the overwhelming majority of submissions supporting their rescheduling.

The delegate shared concerns that both drugs have high potential for misuse, and that downscheduling them would be “premature” given the emerging evidence base regarding safety and efficacy.

However they noted that the drugs’ scheduling could be reconsidered in future applications pending the outcome of current clinical research regarding their use in an assisted psychotherapy setting.

Mind Medicine Australia has made a resubmission critiquing the interim decision, with hopes for a change of mind.

“We were quite disappointed because, as they outlined, one of the reasons was that if they reschedule there will be increased recreational use of these substances and more underground therapy – but the reality is it actually does the opposite,” said Mr Nasralla.

“By rescheduling we would actually able to take a step forward in giving these to medical practitioners to use for treatment, and manufacturing companies could ensure medical grade formulations of the drugs. We could also develop clinical guidelines.”

Mr Nasralla believes pharmacists will “one hundred per cent” be dispensing these substances as medicines in the near future.

“It’s more a matter of when, not if. As pharmacists, we have a responsibility to ensure patients can access medicines with a therapeutic value to treat their condition,” he said.

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1 Comment

  1. Andrew

    I’ve got an interesting case study on an adverse effect from mushrooms from last year’s season.

    Pt presented with a question regarding short-lived myasthenia of legs, developing into near paralysis 4-6 hours after she consumed what she believed were “P.subs” from a wooded area. This happened three days prior and she reported full recovery by day after consumption. Others in group had only very mild symptoms apparently.

    Turns out there’s a phenomenon called “wood lovers paralysis” increasingly recognised whereby psychedelic mushroom pickers experience varying degrees of limb paralysis in the hours after consumption.

    I couldn’t find a MoA for the condition but guessed maybe something to do with acetylcholine based on the symptoms. Google came up with a couple of theories but nothing conclusive.

    The patient was naturally concerned and curious, but had apparently made full recovery by the next day. She said Google told her benadryl may be useful but she didn’t try it because she slept it off and woke up next day with no symptoms.

    Seems a weird one. Maybe useful to know coming in to this year’s season.

    This was the best (only) information I could find online.

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