The former chief of the Australian defence force, Chris Barrie, is campaigning to remove barriers stymying doctors from using MDMA to treat veterans suffering post-traumatic stress disorder and depression, saying he hopes “common sense is going to prevail”.
Late last year, the Therapeutic Goods Administration decided against downgrading the classification of psilocybin or MDMA as a prohibited substance to a controlled substance, a move which would have increased patient access.
It did so despite an independent expert panel telling the TGA that the drugs “may show promise” in treating mental, behavioural or developmental disorders, including treatment-resistant PTSD.
The TGA did leave the door open to further reconsideration, though, acknowledging the “potential benefit” of using MDMA to treat PTSD and allowing clinical trials to continue.
“Pending the outcome of current clinical research, the scheduling of MDMA could be reconsidered in future applications,” the TGA said.
Barrie is hopeful that the TGA will soon allow the drugs to be more readily accessed to treat PTSD.
“We’re hopeful that that rescheduling will take place,” he told Guardian Australia. “There are 1.5 million sufferers in our country, whose lives are simply ruined because of this issue. And here’s an offer for a cure that [could] make their lives so different.”
Currently, doctors can apply for special access to use unapproved drugs like MDMA and psilocybin to treat individual patients on a case-by-case basis through the TGA’s special access scheme.
But even that limited access is frustrated by the laws of state and territory jurisdictions. In the ACT, for example, laws on recreational use would still hold doctors criminally liable for attempting to treat their patients with MDMA and psilocybin, even with TGA approval.
The Catch-22 exists despite the ACT pushing to decriminalise MDMA and psilocybin more broadly.
Barrie, a retired admiral and board member of Mind Medicine Australia, said if the ACT was successful in decriminalising the drugs, it should also remove any barrier to using the drugs to treat patients suffering from treatment-resistant depression and related post-traumatic stress disorder.
“If this happens, it would be ridiculous if a medical practitioner, properly trained in the application of psychedelic-assisted therapies, couldn’t prescribe MDMA or psilocybin to treat a patient suffering from treatment-resistant PTSD or treatment-resistant depression in a much safer clinical environment,” he said.
“Sufferers with treatment-resistant PTSD or treatment-resistant depression can be at severe risk because, by definition, they have exhausted conventional treatments.
“Allowing a medical practitioner in the ACT with special access scheme approval from the TGA to provide psychedelic-assisted therapy gives the patient the opportunity of receiving a treatment that has been shown to be safe with high remission and response rates.”
In November, the TGA’s independent experts found the drugs held some promise as a treatment for conditions such as PTSD, though only where they were “administered in closely clinically supervised settings and with intensive professional support”.
“Although we were only able to combine results from nine studies for either beneficial or adverse effects, we did demonstrate statistically significant differences of the two psychedelic agents between both inactive and active treatments for either continuous scores or dichotomous responses,” the experts found. “However, it is important to note that this was in highly supportive and structured environments including intense psychotherapy sessions in many cases.”
Other nations, including Canada, Switzerland, Israel and the United States, enable a similar level of access to Australia by assessing medical practitioners and their patients on a case-by-case basis.