One of the most welcome developments of recent years is that we have become much more open about discussing mental health issues. No longer do people have to suffer in silence or experience overwhelming stigma, and sufferers can find communities of people facing similar challenges, along with a wide range of mental health professionals.
This is certainly a discussion worth having. Depression alone is one of the most significant public health challenges we face; it is the greatest contributing factor to suicide, a leading cause of disability, and it costs the economy around £10 billion a year. That’s without mentioning the myriad of other invisible disabilities faced by millions. While we continue to become more open to talking honestly about the experience of mental health challenges, there is still a long way to go before acceptance is mainstream and treatments stop being taboo.
Patients diagnosed with depression, PTSD, or anxiety are often prescribed tried-and-tested medicines that have worked well for others. But what about the significant proportion of people who are resistant to medicinal treatment?
In Britain almost a third of those suffering from depression, 1.2 million people, are living with a treatment-resistant form of the illness. Even worse, there have been no major advances in the treatment of depression for decades. There is clearly an urgent need for more research into novel therapies for treatment-resistant cases.
Enter psilocybin, a compound found in over 100 species of fungi, commonly known as ‘magic mushrooms’. It is a psychedelic that induces temporary changes in mood, perception and cognition via activation of serotonin receptors in the brain.
What’s more, it’s quite safe. It is associated with a low potential for harm relative to other classes of psychoactive drugs: it has very low toxicity and is not associated with the development of physical dependence, nor with acquisitive or other crime, while deaths attributed to its abuse are extremely rare.
Despite this, it is listed in Class A of the Misuse of Drugs Act 1971 and in Schedule 1 of the Misuse of Drugs Regulations 2001. There is overwhelming scientific consensus that the current legal status of psilocybin is based not on evidence, but on overstated historical assumptions of harm (partly due to an anti-hippie backlash from the 1960s).
So what does this have to do with mental health treatment?
Psilocybin shows real promise as an alternative approach to existing mental health therapies. Early studies show that it can be administered safely and in a controlled manner to patients, is well tolerated, and is likely to have lasting therapeutic effects.
“There were times in the whole experience where I felt like I was being purged of self doubt, guilt and was being shown ways of handling all that was bringing me down,” one clinical trial participant reported back. “It was like having the best therapist in the world inside your mind, but all the answers were within.”
These promising early results will need substantiating with larger-scale phase 3 trials in order to create a robust evidence base. However, as is so often the case, government red tape is holding up progress. The Home Office’s classification of psilocybin as Schedule 1 drug makes pharmaceutical trials expensive and time-consuming. The stigma associated with Schedule 1 status also reduces funding opportunities and approval from ethics boards. Compliance with regulations and obtaining licenses from the Home Office costs precious time and money which would be better used creating much-needed treatments.
In the latest paper from the Adam Smith Institute, in conjunction with the Conservative Drug Policy Reform Group and researchers from the University of Manchester and King’s College London, we call for psilocybin to be rescheduled as a Schedule 2 drug, like cannabis now is.
In practice this would mean universities could study the drug without any additional licensing or red tape, ensuring further medical trials can be conducted to determine the feasibility of psilocybin as a treatment for debilitating mental health conditions like depression and PTSD. We cannot allow our outdated approach to drug classification to hamper research into medicinal use of traditionally recreational drugs with strong therapeutic promise.
A simple reclassification would be a big step forward in pursuing a treatment that has huge potential. With a growing mental health crisis following months of isolation, anxiety, financial stress, and bereavement caused by Covid-19, now is the time to pursue every avenue available to us to bring relief to those of us who are silently struggling.
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