Preparing for psychedelic therapy in Australia

Psychedelic therapy has the potential to treat mental illness, but it still has a long way to go.

After decades in the wilderness, psychedelic remedies are back in clinical research and poised to re-enter medicine. Medications such as psilocybin (included in “magic mushrooms”) and MDMA (included in “ecstasy”), when combined with psychotherapy, have shown significant, rapid and lasting effects on a wide variety of addictions and mental health conditions. bring. post-traumatic stress disorder, depression, end of life pain, alcohol use disorder, When nicotine addictionAlthough there are some important research limitations associated with these studies, the results are compelling.

The field of psychedelic research is expanding rapidly, funding is plentiful, public opinion and political sentiment is shifting. predominantly disturbing or negative About these drugs, full of hope sometimes hypeHistory has shown that some promising treatments have not proven overwhelming, unsafe, unfeasible, or affordable, and psychedelic remedies have not been approved as new drugs. However, this may be about to change, with Australia moving towards a possible availability of psychedelic treatments within the next two years. I’m in a hurry.

Until just a few years ago, psychedelic research was virtually non-existent in Australia. Australia’s first psychedelic study – Psilocybin-supported therapy for end-of-life distress approved at St Vincent’s Hospital, Melbourne. 2019In 2020, researcher Paul Liknaitzky established the first clinical trial in Australia. Psychedelic Institute at Monash University. More than 15 psychedelic clinical trials will be conducted nationwide in 2023. And by 2024, there is a good chance that MDMA-assisted therapy will be approved in Australia for the treatment of post-traumatic stress disorder. It’s strikingly different and has the potential to bring new hope to many people.

However, to deliver on the promise of safe, effective and accessible psychedelic therapy, significant challenges need to be addressed.

To date, trials around the world have used a one-size-fits-all treatment model. Usually 1-3 sessions of medication are surrounded by about 2-4 times the number of psychotherapy sessions over 2-3 months. Although standardized interventions are commonplace in clinical science, future psychedelic therapies as a service will need to consider different patient needs to maximize safety and efficacy. These may include different drug doses and medication sessions, and different amounts and types of psychotherapy. However, no studies have tested the safety and efficacy of long-term psychedelic therapy, relapse prevention, or individual treatments.

With caution, and for regulatory purposes, the eligibility criteria for the trial are narrow and trial participants may not be representative of prospective patients.Also, multiple mental health or addiction conditions occurring simultaneously Doing so is more common among people seeking help, but many trials address only a single isolated condition. New research recruiting participants with multiple conditions is important. , evidence can make better decisions.

Psychedelic therapy includes the use of psychotropic drugs as well as specialized forms of psychotherapy. Future psychedelic clinical services require collaborative care teams that can assess patient suitability, prescribe controlled substances, and provide appropriate care. Screeners, prescribers, therapists, and support staff should receive professional training in psychedelic practice. Optimal treatment centers offer comfortable, aesthetically pleasing private spaces that also have medical and drug storage capabilities.

However, there are currently very few trained professionals with psychedelic clinical experience in Australia, few fit-for-purpose sites, and there is still no consensus on what constitutes best practice standards for training and treatment. has not been obtained. The safety and efficacy of psychedelic treatments can depend on a variety of factors beyond simply putting a psychedelic drug into someone’s body.

One of the most important of these “non-drug factors” is professional support. To do this, thousands of psychologists, psychotherapists, drug prescribers and health care workers need to be properly trained. Psychedelic medicine is not without risks, and it is unusual to use altered states of consciousness alongside psychotherapeutic support to increase contact with the underlying causes of distress. A prudent approach is for already qualified and experienced clinicians to be further trained in this specialty treatment. Psychedelic therapists should undergo supervised practice with their patients, perhaps in a student clinic or under direct supervision. Also, opportunities for clinical teams to experience psychedelics and support their attunement improvement may enhance the ability of therapists. This is what is currently being tested with Monash. clinical psychedelic research Lab.

If psychedelic treatments work as suggested by current trials, governments, insurance companies, and patients will likely see their costs compared to available treatments and ongoing care within a few years. You can save.However, the initial cost of psychedelic treatment is likely to be high, about A$15,000 to A$20,000 A standard 3-dose treatment course over 3 months. Without coverage from governments and insurance companies, the cost of treatment will be out of reach for many who are eligible and in need of new treatment options. Various approaches to reduce costs without compromising treatment safety and efficacy should be considered with robust and realistic economic evaluations.

As with common practice of new treatments, clinical quality registers are important for monitoring real-world and long-term safety and efficacy for large numbers of Australians. This can take the form of a brief monthly survey of patients undergoing psychedelic treatment, and assess changes in symptoms, relapse rates, physical and psychological safety and risk factors, costs and ongoing medical use. , patient needs and complaints, and practitioner needs.

In addition to capacity building and training, future studies will focus on patients with multiple conditions, expand clinical trial eligibility, and explore personalized care, comparisons with frontline treatments, and economic assessments. should focus on developing and testing service-enabled psychedelic therapies. Such studies will yield more than data to inform standards of care, patient suitability, and reimbursement towards evidence-based psychedelic therapy as a service.

Work in the psychedelic research field will be interrupted for psychedelic therapy to mature in the next few years and become a new set of therapeutic options that are useful, safe and accessible. Future patients deserve nothing more.

Paul Liknitsky is the head of clinical psychedelic research I was a principal investigator for the psychedelic pilot program at Monash University. He is a collaborator in the Department of Psychiatry (Clinical Sciences) and the Turner Institute for Brain and Mental Health (Psychological Sciences) at Monash University.

He is a member of the Medical Advisory Board of Incanenex Healthcare Ltd and has no board of directors or shares in the company. He has received research funding from Incanenex Healthcare Ltd, Dr Nigel Strauss, and the Interdisciplinary Association for Psychedelic Research.

Originally published in creative commons To 360 information.

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Preparing for psychedelic therapy in Australia

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