Psychedelic drugs such as MDMA, ketamine, DMT, and magic mushrooms often conjure up stereotypical images of party-goers and ‘hippies’, yet increasing evidence is supporting the use of these drugs in therapeutic medicine. As the medical and public perception of these substances continues to evolve, what is the potential for psychedelic medical treatment in the UK?
In December, the Medicines and Healthcare products Regulatory Agency (MHRA) approved a clinical trial that would explore the potential of dimethyltryptamine (DMT) as a treatment for a range of mental health disorders, including depression. Furthermore, January 2021 will see the opening of the UK’s first medical psychedelic clinic in Bristol.
AWAKN Psychedelic Psychotherapy Clinic
The clinic will aim to offer psychedelic drug treatments for conditions such as post-traumatic stress disorder (PTSD), anxiety, depression, and addiction. Among the available treatments will be ketamine-assisted psychedelic psychotherapy. Ketamine is legal in the UK as a medical product and is often used as an anaesthetic.
On the other hand, MDMA and psilocybin – the psychedelic compound found in ‘magic mushrooms’ – are currently listed in schedule 1 of the Misuse of Drugs Regulations 2001. This means that a Home Office license is required for production, possession, and supply, and, while these substances can be used in clinical trials, it is not yet legal to prescribe them outside of this setting.
In addition to ketamine-assisted psychedelic psychotherapy for 30-40 patients per month, the clinic will also offer training in psychedelics to therapists. The clinic will also carry out further research into MDMA and psilocybin to support their use in psychotherapy in the future.
Professor David Nutt, Professor of neuropsychopharmacology at Imperial College London, is one of the UK’s leading voices on drug reform. In addition to being a chairman of the Scientific Advisory Board of the AWAKN clinic, Prof. Nutt is also leading Europe’s largest patient access scheme to medical cannabis – Project Twenty21.
Clinical Research into Psychedelics
A number of clinical research projects are taking place around the world in order to gather the evidence needed to support meaningful policy change on the legality of psychedelics. For example, London-based mental healthcare company COMPASS has set up the largest global clinical trial to assess the potential of psilocybin in the treatment of depression.
COMPASS Pathways received FDA Breakthrough Therapy designation for their programme of psilocybin therapy in treatment-resistant depression in 2018. There are now 216 patients enrolled in the current phase of the trial at 21 sites across North America and Europe.
In an interview with the Metro, Tracy Yeung, Chief Communications Officer at COMPASS Pathways, stated:
“We’re generating the evidence that can be used to get into national health systems. At the moment, we’re in the stage of rigorous clinical trials to show that this treatment works, to give people the confidence to eventually use them as [a] clinical therapy.”
While there is a growing evidence base to support the use of psilocybin in the treatment of depression, MDMA may also prove useful in the treatment of alcohol addiction. Chief Medical Officer at AWAKN Clinic, Dr Ben Sessa has previously published his research that found MDMA to be significantly promising in the treatment of alcohol use disorder.
Sessa’s study, which was published in the journal Neuropharmacology, focused on the cause of alcohol addiction which, in many cases, is rooted in past trauma. The research was based on the idea that “MDMA Therapy is ideally suited to allow a patient to explore and address painful memories without being overwhelmed by negative
Changing Policy around the World
While psychedelics remain illegal in a majority of nations, we are beginning to see a shift in the public perception. In November 2020, the state of Oregon voted to legalise the therapeutic use of psilocybin. In addition, Oregon voters also opted for the decriminalisation of small quantities of all drugs.
In Canada, it also became legal for terminally ill patients to use psilocybin as part of psychotherapy treatment. Access to the psychedelic substance began when Health Minister Patty Hajdu granted access to psilocybin therapy to four palliative patients in April 2020. The possession of ‘magic mushrooms’ and psilocybin has also been decriminalised in countries such as Portugal, Spain, the Czech Republic, and Austria, and is legal in Brazil.
Despite slow changes to policy surrounding psychedelics around the world, the UK is yet to act. The reluctance of UK health officials to embrace the potential of psychedelics is somewhat reminiscent of the delay in uptake of cannabis medicines in the country. Despite the legalisation of medical cannabis in the UK in 2018, few patients have been able to successfully access the medicines, and most of those that have been successful have had to rely on private clinics.
While the UK remains undeniably behind the USA, Canada, and much of Europe on the medical cannabis issue, it is hoped that this will not be the case for psychedelics.