- SA should follow Australia’s lead and allow healthcare professionals to prescribe psychedelic drugs in some cases, say some experts
- Drugs including ketamine and MDMA are seen as viable methods to treat conditions including depression, and post-traumatic stress disorder (PTSD).
- The psychedelics markets is expected to almost double to over the next five years.
- For more financial news, go to the News24 Business front page.
South Africa should follow Australia’s lead in allowing healthcare professionals to use psychedelic drugs in the treatment of certain mental illnesses, some business leaders and psychologists say.
In February, Australia became the first country in the world to recognise MDMA and psilocybin – or “magic mushrooms” – as medicines that can legally be used to treat depression and post-traumatic stress disorder (PTSD). Both substances were used by psychiatrists decades ago, although trials were brought to an abrupt halt when the war on drugs was launched in the US and quickly went global.
From July, however, authorised psychiatrists in Australia will be able to prescribe the drugs in highly controlled settings.
Jamie Elkon, a clinical psychologist at the Lighthouse Clinic in Cape Town, believes South Africa should follow suit.
The Lighthouse Clinic uses ketamine – a psychoactive drug that is legal in some medical circumstances – to tackle PTSD, depression, anxiety, obsessive compulsive disorder and other mental disorders. Over the past four years, it has administered more than 2 000 of these treatments.
“When done in a responsible way, we see lifesaving turnarounds,” Elkon tells News24, adding that many suicidal patients who recovered would probably not have been saved by traditional medications.
Cilo Cybin CEO Gabriel Theron says mental health problems place a substantial drag on wellbeing and the economy, and promising research into the use of psychedelics is prompting regulators in other markets to take note.
Cilo Cybin, which last year failed to secure enough funding for a JSE listing, has applied to the South African Health Products Regulatory Authority for a permit to research psychedelic treatments.
Studies show the psychedelics market will grow from $4 billion (R72.8 billion) in 2021 to $7.5 billion in 2026, Theron says, adding that he expects “resistance” from large pharmaceutical companies that sell daily doses of chronic medications.
“There’s definitely a business case for this – it’s a massive market globally. The challenge is the regulatory environment.”
While Cilo Cybin shelved its listing ambitions, Theron says “there are some big things coming”.
Long road ahead
But Elkon warns that despite growing evidence that psychedelic-assisted therapy is effective and safe in the right setting, there is a long road ahead for the industry.
Regulators have largely ignored the opportunity, and private medical aids have not lent any support to the cause either, he says.
“Medical aids should take some responsibility considering that this approach to treatment could save them lots of money.”
Rather than funding a member’s chronic medication needs into perpetuity, a medical aid could cover a once-off, or infrequent, psychedelic-assisted therapy session.
Elkon also believes universities should be introducing training programmes so that healthcare professionals will be equipped to use psychedelics in treatments once they are legalised – a scenario he believes is an inevitability in time.
Mental healthcare clinics will need to know how to screen for psychosis – where an active case is evident, psychedelics should be avoided in some cases – and how to manage the treatment process.
Dr Stephen Bright, a senior lecturer and director of Psychedelic Research in Science and Medicine at Australia’s Edith Cowan University, agrees that training programmes for healthcare professionals will be critical.
This is why Dr Bright worries that Australia has moved too fast in embracing psychedelics. The decision to legalise these treatments came as a surprise, and the healthcare industry is not yet geared to manage them responsibly.
If Australia’s foray into psychedelic therapies fails, this could discourage other countries from moving in the same direction, he adds.
Regulators could have started by decriminalising these substances while the correct structures were put in place in the healthcare industry, he says.
This is because those using it illegally will be hesitant to seek help if they are abused by underground therapists, for instance. Further, the state will need to take steps to ensure these treatments are accessible by all income groups, otherwise much of the industry will remain underground.
Nevertheless, Bright says there have been “promising signals” from initial studies on psychedelics used to treat mental illnesses, although larger, more standardised studies are still needed.
Last year, researchers at Johns Hopkins University School of Medicine found that “the substantial antidepressant effects of psilocybin-assisted therapy, given with supportive psychotherapy, may last at least a year for some patients”.
“Our findings add to evidence that, under carefully controlled conditions, this is a promising therapeutic approach that can lead to significant and durable improvements in depression.”
Natalie Gukasyan, MD and assistant professor of psychiatry and behavioural sciences at the institution, said in a statement at the time.
Some small-scale trials are already underway in South Africa, including one that is studying the effects of psilocybin on HIV-positive women who are struggling with depression.