Call for review of 'inadequate' psychedelic-assisted therapy laws

A group of medical and health practitioners is calling for a comprehensive review of the current rules, regulations and guidelines for the use of psychedelic-assisted therapy (PAT) in Australia.

The Australian Multidisciplinary Association for Psychedelic Practitioners (AMAPP) is a registered organisation of qualified health practitioners, including doctors, psychiatrists, psychologists, nurses, paramedics and social workers, whose stated aim is to promote the safe and judicious introduction of PAT as a recognised, well-regulated and effective treatment in the Australian mental health field.

In July 2023, the TGA made changes to the classification of the psychedelic medicines psilocybin and MDMA to enable prescribing by authorised psychiatrists for the treatment of certain mental health conditions including treatment-resistant depression and PTSD. To prescribe, psychiatrists must be approved under the Authorised Prescriber Scheme by the TGA following approval by a Human Research Ethics Committee.

“We feel that the current regulations and recommendations made this year by the TGA and the RANZCP leave a lot to be desired,” said AMAPP Chairman Dr Anthony Bloch.

“We understand that the TGA decision made earlier this year was both unexpected and perhaps premature, considering the lack of adequate research up until now into psychedelic medicines, but nevertheless the decision was made and under certain prescribed circumstances PAT can now be legally utilised by suitably qualified and trained psychiatrists.”

Bloch said that the current TGA requirement for a psychiatrist to be physically present at every therapy session and personally administer medication to clients, regardless of their role within the therapy team, was an “impractical and cumbersome practice”.

“Most psychiatrists would not be able to do this in their current model of practice. In some cases, it would be inadvisable and may contribute to worse outcomes in clients that have had to have prolonged and careful preparatory sessions with therapists they have come to trust,” he said.

AMAPP said various other issues still needed to be sorted out, such as appropriate advertising, clinic locations and types, the need for uniform national standards and the future collection of accurate treatment and research data.

“We are proposing that everyone invested in PAT — the TGA, state health departments, HRECs, academic institutions, the RANZCP and all the professional organisations representing our members — get together and formulate ways of significantly improving the current inadequate state of play. Failure to address these issues may push desperate vulnerable patients to unregulated therapists where real harm is more likely,” the organisation said.

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