It’s Time to Reschedule Psilocybin

by Eddie Jacobs


When otherwise polarised groups are shown to agree on some political measure, the smart politician takes note. To that end, the magic mushroom story du jour should make for particularly interesting reading in Westminster.

It transpires that, whichever way you segment the population of the UK – by age group, gender, region, referendum vote or party alignment – there are always majorities to be found in support of relaxing the restrictions that obstruct the medical and research uses of psilocybin, the compound that puts the ‘magic’ into magic mushrooms.

A fertile field of research into the clinical applications of psychedelics like LSD and psilocybin was hastily concreted over in the early 1970s. In the UK this was done by a government marching in lockstep with a Nixon administration gripped by a drug panic. The Misuse of Drugs Act 1971, which placed psilocybin under the tightest controls permissible by law, has proven ineffective at reducing the harms from the misuse of drugs – witness the year-on-year rises of drug-related deaths in the UK – but has effectively stomped out some of the most promising research into the controlled medical use of the ‘bad’ drugs, as evinced by the almost total lack of research into psilocybin for more than four decades.

But, as Pablo Neruda wrote, you can cut all the flowers, but you cannot stop the spring. Despite the concreting over of psilocybin research – which remained technically legal but practically all-but-impossible – the most resolute researchers at Imperial College London have in recent years managed to jump each of the Home Office’s elaborate hurdles in order to conduct psilocybin research.

What has burst through the concrete has given the scientific community, and, as we know now, the British public, significant cause for optimism. In comparison to antidepressants, psilocybin-assisted therapy offers a radically novel treatment option for treating mental health conditions. Patients in registered clinical trials often report the experience as one of the most meaningful of their lives. The psychedelic ‘trip’ induced by psilocybin is not simply a pleasurable, distracting, or numbing drug high. Rather, it allows patients to more easily access, explore, and emotionally metabolise the sources of their psychiatric distress, as well as offering new insights into their traumas, relationships, and other problems they are facing.

The few early trials in the UK and US have provided strong signals that therapy assisted by psilocybin can provide relief from some of our most difficult-to-treat mental health conditions: OCD, treatment-resistant depression, addiction, and anxiety and depression secondary to life-threatening cancer. Each of those trials represents a Herculean effort on the part of researchers to meet the myriad regulations imposed on legitimate scientific investigation of psilocybin.

In the UK, the reason all these efforts are necessary is psilocybin’s Schedule 1 status – a designation that requires a string of permissions not from the Department of Health, the Science Minister, or the Minister for Universities, but rather from the Home Office, a department whose remit is to focus on the harms of drugs. Perhaps unsurprisingly, the Home Office’s response to previous calls to reschedule psilocybin have left much to be desired: Schedule 1 status is not a problem for research, because it does not absolutely prohibit research.

But there is a difference between technical permissibility and practical feasibility. Moving psilocybin to Schedule 2 of the Misuse of Drugs Regulations would mean that hospitals and research departments still had to secure, oversee, and administer it with as much care as they have to treat far more harmful drugs like heroin and cocaine. But this shift in status would cut through a mesh of red tape that leads to excessive costs, delays, and administrative burdens. By removing the Schedule 1 restrictions that artificially raise the barriers to performing life-transforming research, clinical studies with psilocybin will be significantly quicker and more streamlined, ultimately allowing it to reach patients in need sooner.

What evidence has accrued about psilocybin in the fifty years since it was placed under the strictest controls has shown that the original evaluation of its potential for harm was gravely mistaken. Psilocybin has a low toxicity, is not dependence- or addiction-forming, and when carefully used has been demonstrated to be associated with very low risks of harm. The Home Office, with its unflinching focus on the risks of drug-related harms, may not see the value in relaxing the restrictions on psilocybin research. But the results of our nationally representative YouGov poll suggest that the British public does.

55% actively support relaxing research restrictions, so long as this had no impact on the Class A status of magic mushrooms in criminal law. This includes majorities across voters for each of England’s main three parties, and in every region of the UK. Resistance to relaxing research restrictions was low, with less than 1-in-6 people opposed, and 31% unsure.

Support for reform does not stop with research. The majority of Brits would also support changes in the law to permit patients with exceptional clinical need to access psilocybin-assisted therapy, should they so wish. Both veterans and terminally ill patients are clinical cohorts with complex psychiatric distress, who respond poorly to the currently available conventional treatments. 55% of those polled supported granting access to veterans to treat combat-induced trauma, and 58% were in favour of allowing access for the terminally ill. Studies have repeatedly found that psilocybin-assisted therapy could play a profound role in the future of palliative care, with the treatment providing substantial relief from demoralisation, anxiety and depression in those who face a life-threatening illness. Once again, active opposition was low (13% and 12%), dropping to just 9% when respondents were informed about clinical advances and policy developments elsewhere.

While some politicians may view the issue of drug policy reform as fraught with electoral danger – just as liable to alienate voters as to attract them – this is demonstrably not the case for rescheduling psilocybin. Psilocybin-assisted therapy has the potential to play a significant role in the future of mental health treatment, currently characterised by a substantial unmet need. The scientists who conduct this work, and the public who will ultimately be its beneficiaries, want the process to be made easier. It is now time for the politicians to listen and act.

This piece was written by Eddie Jacobs, Director of Research, Psilonautica. Tweets @EddieTalksDrugs

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