New Zealand followed the US in criminalising the use and possession of LSD in 1967, not only banning its cultural use, but also curtailing decades of research since it was synthesised in 1938. The return of psychedelic research to the mainstream over the past decade has produced an intriguing picture of science, shamanism – and money. Potentially, lots of money.
An article in the journal JAMA Psychiatry last year projected that the American market for “psychedelic substances” would grow to US$10.7 billion by 2027, “a growth rate that may even outpace the legal US cannabis market”. Some of that money is coming to New Zealand.
Berlin-based Atai Life Sciences has been trialling its proprietary version of DMT (a powerful, short-acting psychedelic) on healthy volunteers in New Zealand and also has a trial underway in Auckland of its variant of the popular party drug MDMA, with a view to treatments for depression and post-traumatic stress disorder respectively.
In either case, proving the efficacy of a particular formulation and a protocol to go with it could be very profitable.
Australian-based MindBio Therapeutics, which is helping to fund the Auckland LSD microdosing trials, is also supporting a pending trial of microdosed LSD in advanced cancer patients, developed by Dr Lisa Reynolds of the University of Auckland, who has a background in the psychology of cancer.
The organisation that has done more than any other to rekindle interest in the potential of psychedelics, the US-based Multidisciplinary Association for Psychedelic Studies (MAPS), has also reached out to New Zealand.
MAPS, whose MDMA protocol is edging towards Federal Drug Administration approval in the US as a therapy for PTSD, has donated the drugs for a joint New Zealand trial by Otago and Auckland universities to explore the potential of MDMA to treat end-of-life depression and anxiety.
MAPS will also fund the training of about a dozen therapists for the trial. Even then, the New Zealand trial design has pared back the MAPS protocol to one dose instead of three and two psychotherapy sessions instead of three, because of the costs.
University of Otago professor of psychiatry Paul Glue, who is overseeing the MDMA trial, thinks ACC, which currently funds ongoing counselling for PTSD patients, may see a case for funding an intervention that could eliminate the need for further therapy.
His co-investigator, Dr Will Evans, is also the physician on the Auckland LSD microdosing trials – and something of a bridge between the emerging medical sphere and what might be called the psychedelic community. Both agree the MAPS therapeutic manual, which draws heavily on the work of the Freudian psychiatrist Stanislav Grof, will not be the answer everywhere.
Evans has also advised another project offering a different, and unique, model of therapy. In Gisborne, Manu Caddie, co-founder and former chief executive of medicinal cannabis company Rua Bioscience, is preparing a marae-based trial of an indigenous psychedelic mushroom, Psilocybe weraroa, as a treatment for methamphetamine addiction. He has brought state agencies and universities together with marae whānau and local tohunga practitioners to design the trial.
Evans believes the Māori healing model and the tikanga around it are a key advantage for New Zealand in the emerging field of psychedelic therapies.
“That’s where the study in Gisborne, I think, is going to be pretty important –the fact that they already have a framework that’s centuries old that they can insert this [healing] catalyst into.”
The upsurge in medical interest has coincided with an easing of the social sanction around psychedelics – most of which are still Class A controlled drugs alongside heroin. In the US, some states are decriminalising use of psilocybin (the active ingredient in magic mushrooms), and slickly packaged magic mushroom chocolate can be bought illicitly.
Australia’s Therapeutic Goods Administration, the equivalent of our Medsafe, surprised everyone early this year by reclassifying psilocybin and MDMA for prescription by approved psychiatists from July 1 for treatment-resistant depression and PTSD respectively.
There’s an argument that New Zealand should not rush to follow its neighbour in medicalising psilocybin at least, to avoid what has happened with medicinal cannabis – where product regulations are onerous and the skill base is scant.
The NZ Drug Foundation this year called for the decriminalisation of magic mushrooms in the meantime, arguing “the harm of a criminal prosecution on someone’s life would far exceed the harm from psilocybin”. (UK expert David Nutt’s cited drug harm index ranks magic mushrooms as the least harmful of 20 studied substances – alcohol and heroin are at the top.)
The drug Glue and his Otago colleagues have studied the most is ketamine, which is not a classic (or serotonergic) psychedelic, but shares some key attributes. It is used as an anaesthetic for children, but was made a Class C drug under the Misuse of Drugs Act in 2009 when its use as a party drug became evident. Ketamine’s short-term antidepressive effects are well established, but Glue has been advising Auckland’s Douglas Pharmaceuticals on ways to sustain its benefits. Douglas’s slow-release tablet is in phase-two trials.
In a decade’s time, Glue says, the tablet could be available from specialists.
The potentially frustrating scenario is that psychedelics could turn out to be safer, better tolerated and more effective for depression than conventional SSRIs, but most people stay on SSRIs because they are cheaper.
The evidence of psychedelics’ safety has made it relatively easy to gain ethics approval for trials in New Zealand. But it seems everyone in the field is frustrated with Medsafe, which authorises the importing and use of the drugs under the Misuse of Drugs Act, and the Ministry of Health in general.
A ministry spokesperson told the Listener, “The majority of applications to import controlled drugs are generally processed within 4-8 weeks of being received, however we acknowledge that delays can happen.”
“It took us perhaps two years to get an import permit [for the MDMA trial],” says Glue. “And maybe some of that was related to the wrong things being put on the wrong forms, but it’s a very unresponsive group who seem to have no sense of urgency. If I had a magic wand, the first thing I would do is get rid of the Misuse of Drugs Act, because it’s hopelessly out of date. But high up on the list of wishes would be getting a much more responsive and focused Medsafe.”
The urgency may come from across the Tasman. Auckland University’s Suresh Muthukumaraswamy, who is running the LSD microdosing trial, is on the steering group tasked with developing therapeutic guidelines for the use of psilocybin and MDMA in Australia.
“We don’t want to get into a situation where New Zealand patients are flying over to Australia to get therapy,” he says. “Once they’re up and running over there, there’ll be clinics rolling it out. Someone could just fly over to Melbourne, get psychotherapy, stay in a hotel the night and come back. That could happen.”
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