Clinical

Unlocking psychedelic medicine: a guide to accessing legal MDMA and psilocybin in Australia

Australians can now legally access psychedelic-assisted psychotherapy which involves taking either psilocybin (magic mushrooms) or 3,4‑methylenedioxy‑methamphetamine (MDMA) to treat mental health disorders.

The Therapeutic Goods Administration (TGA) permits the prescribing of MDMA for the treatment of post-traumatic stress disorder (PTSD) and psilocybin for treatment-resistant depression (TRD). When used therapeutically in a controlled medical setting, psilocybin and MDMA are listed as Schedule 8 (Controlled Drugs). However, for all other uses, they will remain in Schedule 9 (Prohibited Substances). 

From 1 July 2023, the TGA allows authorised psychiatrists to prescribe medicines containing these drugs. 

These specifications are important to know because they restrict who can access psychedelic-assisted therapy (PAT) and under what circumstances they can do so. 

Where can I get psilocybin or MDMA?

There are currently no TGA-approved products containing psilocybin or MDMA.These drugs are not available at a pharmacy over-the-counter nor behind-the-counter. Your family doctor cannot prescribe them, and your therapist, councillor or other ancillary healthcare professional can not offer them medically. 

Only authorised psychiatrists can legally supply patients under their care with an 'unapproved' medicine containing these substances. 

This prescription is limited to specific uses:

  • Patients with post-traumatic stress disorder (PTSD) may receive MDMA doses as part of therapeutic treatment.
  • Patients with treatment-resistant depression (TRD) may receive psilocybin doses as part of therapeutic treatment.

Who is eligible for psychedelic-assisted therapy?

The eligibility for psychedelic-assisted therapy is limited to individuals with a medical diagnosis of PTSD or depression. These mental disorders can be diagnosed by a general practitioner (GP) and typically treated using antidepressant medications, such as SSRIs.

While antidepressants are proven and effective treatments for these conditions, some patients may experience side effects from the medication, find that the medication does not produce the desired result, or be opposed to taking the medication. In such cases, patients may explore alternative treatments as part of their journey to find effective treatment options.

Psychedelic-assisted therapy 

Getting psychedelic-assisted therapy in Australia currently involves a lengthy, expensive, and resource-intensive process. It requires significant time and financial investment from individual patients to manage their own healthcare.

Patients with confirmed diagnoses of PTSD or TRD are responsible for finding a clinic that can offer them the necessary services.

Present Mind is not aware of any government database of clinics that offer this service. We propose that the approving ethics board should publish data regarding approved prescribers to improve transparency and accessibility. [Editor: But that’s a conversation for another time.]

Clinics known to offer a psychedelic-assisted therapy program:

Each clinic may have a different patient intake process and clinical therapy program, but generally, the whole process may include:

  1. Pre-Screening Stage: this stage is designed to determine initial eligibility.
  2. Assessment Stage: clinical assessment to qualify eligibility.
  3. Preparation Counselling: three non-drug therapy sessions.
  4. Dosing Sessions: three 8-hour psychedelic dosing sessions.
  5. Integration Counselling: three non-drug therapy sessions for integration after dosing.

Please note that this is not a guideline. The example provided is from one program offered by a specific clinic with an approved prescriber. Different clinics and programs may have variations in their patient intake processes and therapeutic procedures.

How much does psychedelic-assisted therapy cost?

A program of psychedelic-assisted therapy typically costs ~$20,000. However, the exact prices will vary from clinic to clinic, and the breakdown of costs and concession may be factored into the total costs differently.

Assessment

Patients should be aware that there will often be screening and assessment service fees. For example, the fee for a clinical psychologist assessment is $200 (no rebate available) and a fee for an assessment by an authorised prescriber who delivers the treatment is $800, there may be a $554 Medicare rebate. 

This is an example from one specific clinic, patients should ask their clinic for a breakdown of Medicare rebate and out-of-pocket costs, as it is likely they will differ from this example. 

Dosing and therapy

Using one clinic as an example, the cost of their psychedelic assisted therapy program is $25,000. After Medicare rebates, the out-of-pocket cost is $17,516.50, or $13,415.30 if you have reached your Medicare safety net threshold. There is a reduced fee of $19,000 for self-funded private patients.

Note:

  • The payment may be required upfront.
  • If you are funded by a third party such as DVA, Workcover, or NDIS, your clinic may request funding approval for your program, however this is not guaranteed.

This is an example from one specific clinic, patients should ask their clinic for a breakdown of Medicare rebate and out-of-pocket costs, as it is likely they will differ from this example. 

Psychedelic trials

Participating in a trial is one way to avoid the costs of psychedelic-assisted therapy. ANZCTR is an online registry of clinical trials conducted in Australia, New Zealand. Use the ANZCTR trial search to find psilocybin, MDMA, ketamine, LSD, DMT and other psychedelic-drug trials. 

Please note:

  • Trials come with associated risks. 
  • There may not be a trial available that is suitable for your specific health disorder or location.
  • Upon screening, you may find yourself ineligible for trials due to not meeting specific criteria, often without being informed of the reason being. Present Mind urges applicants to be honest when applying.
  • There is a 50 percent chance of receiving a placebo if you are successfully enrolled.

Affordable alternatives to psychedelic-assisted therapy

For Australians with Medicare, affordable alternatives to psychedelic-assisted therapy are available. Considering the high time, cost, and accessibility barriers associated with PAT, there are effective options worth exploring in the meantime, even if they may not be your preferred treatment.

Mental health care plan

Individuals with Medicare can access a Mental Health Care Plan, which allows them to claim up to 10 individual and 10 group sessions with a mental health professional each calendar year. Book a longer appointment with your doctor, and say that you are interested in a mental health treatment plan. This way, you and your doctor will have enough time to discuss your mental health.

rTMS

Repetitive Transcranial Magnetic Stimulation (rTMS) is a mild form of brain stimulation that uses magnetic fields to stimulate a small area of the brain. Medicare provides funding for an initial course of TMS. It is important to note that this funding does not cover longer-term maintenance treatment. Refer to the MBS schedule for the most up-to-date coverage information.  

Need help now?

In an emergency, call 000.

Find a list of services that can help you right now at Head to Health. Help is available 24 hours a day, 7 days a week, anywhere in Australia. If you need help now, call:

  • Lifeline – 13 11 14
  • Kids Helpline – 1800 55 1800
  • Mental Health Crisis Assessment and Treatment Team in your state/territory
  • Beyond Blue – 1300 224 636.

We try to keep this article as up to date as possible. It is our hope that information will change, especially witnessing the price dropping, number of clinics multiplying, and the process optimised to prioritise patient care. If you have information that would improve this article, please send an email to natasha@presentmind.com.au

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