Draconian licensing rules and a lack of public funding are holding back the emerging field of psychedelic medicine in the UK, leading scientists have warned after the release of groundbreaking results on the use of psilocybin to treat depression.
The latest clinical trial found that a single dose of the active ingredient in magic mushrooms, combined with psychotherapy, helped alleviate depression in nearly a third of patients with severe depression. The finding follows other promising results suggesting that psychedelic drugs could be used in treating conditions including anxiety, PTSD, addiction and anorexia.
However, Prof David Nutt, the former government drug adviser and director of the neuropsychopharmacology research unit at Imperial College London, said that unless regulations and attitudes changed, potential treatments would remain “in limbo” at an experimental stage and available only to those who could pay for them in private clinics.
“Patients are being denied access because of the regulations,” he said. “The research is really hampered by the legal status.”
Despite what some are hailing as a “psychedelic renaissance”, Nutt said there had been minimal public funding for research in this area, besides a grant he received from the Medical Research Council to study psilocybin and funding from the National Institute for Health and Care Research for a trial published last week.
“I don’t think there’s any other funding. It’s all philanthropists … and private sector funding,” he said. “It reflects the fact that we still see illegal drugs as drugs to be banned.”
He said basic scientific research was vital for the development of new potential treatments. “This isn’t just some public groundswell of hippy resurrection,” he said. “The science has driven the clinical work.”
Nutt is chief research officer at Awakn Life Sciences, a biotechnology company that operates clinics in London, Bristol and Oslo offering ketamine-assisted psychotherapy for a range of mental health conditions.
It is not feasible to offer psilocybin-based treatments, despite growing evidence for its potential, he said. “The reason we’re working with ketamine is because it’s a legal drug so we can prescribe it off-licence,” he said.
By contrast, psilocybin is a “schedule 1” controlled drug – illegal and not deemed to have medical value. Research into such drugs involves obtaining a Home Office licence and extensive security arrangements. “Psilocybin is controlled in the same way as though it was crack cocaine,” said Nutt. “It takes me months to find an importer to bring in psilocybin for a trial and costs tens of thousands of pounds to get the medicine from America because it’s a class 1 drug.”
Dr James Rucker, who led the latest psilocybin trial, agreed that there were significant challenges to doing research in this area. “There’s been a legal stranglehold on these drugs for years,” he said. “You have to have a Home Office licence to do research and because of that pinch point I don’t think anyone was willing to invest the money.”
Rucker said that some within psychiatry continued to have an “old school” attitude of opprobrium towards the potential of psychedelic drugs as mental health treatments but that this was shifting over time.
Even among those researching the potential of new treatments there is a spectrum of opinion on whether psychedelics will remain on the fringes of psychiatry or become a mainstream treatment option.
“Part of me has always wanted to be an advocate for the rational assessment of drugs and disregarding their legal status. The’ve had such a bad rap historically,” said Dr Ravi Das, a neuroscientist at University College London who is investigating the potential of ketamine and DMT (the psychoactive component of ayahuasca, a psychedelic South American drink) in treating addiction disorders.
“But now there’s an opposite camp, who are evangelists about psychedelics and think it’s a foregone conclusion that they’re a panacea,” said Das. “That’s not borne out in the evidence yet.”
However, Das agreed that more independent research was required to move the field forward.
“These private practice clinics are popping up all over the place for people who can afford them,” Das added. “It can’t be that evidence-based, because the evidence is so lean. People want treatment options and being able to access them is great. It’s just unfortunate that it’s behind such a pay barrier.”