In Sydney, Australia, Rebecca Huntley had been seeking psychiatric care on-and-off for thirty years when she heard from an otherwise straight-edged friend about her experience going through MDMA-assisted therapy. At the time, MDMA, also known as the party drug ecstasy, had been outlawed in Australia since 1987, despite research suggesting the drug can treat mental illness. But Rebecca’s friend connected her with an underground therapist providing this service to a select clientele. After a rigorous vetting process, their first session took place at Rebecca’s house, a quiet place surrounded by trees.
“I felt like I needed something other than what I was doing,” she told Salon. “I was grinding my gears in terms of my mental health; I was pretty angry all the time. So I thought I’d give it a go.”
“It’s like you’ve jumped forward in light-speed to an accelerated point in your mental health journey,” Rebecca added. “For me, particularly the first session released an enormous amount of pain and grief and sadness that I had been spending years trying to push to the periphery of my consciousness. And the next day, after the drug was pretty much out of my system, I woke up feeling like I'd woken up in a different kind of body, a calmer body, a body that was more grounded.”
After that it was a six month process, including two more trips with MDMA and follow-up integration sessions to make sense of the experience. Rebecca wrote a book, “Sassafras,” about her journey.
“It's up there with giving birth to my three children in terms of genuinely life-changing experiences,” she said.
In 2023, Australia became the first country in the world to legalize both MDMA and psilocybin-assisted psychiatric therapy, strictly under very specific conditions: MDMA for post-traumatic stress disorder (PTSD), and psilocybin (the drug in “magic” mushrooms) for treatment-resistant depression.
"I woke up feeling like I'd woken up in a different kind of body, a calmer body, a body that was more grounded."
In the United States, the psychedelic renaissance was led by the charismatic Rick Doblin and his Multidisciplinary Association for Psychedelic Studies (MAPS), whose groundbreaking clinical studies appeared to show astounding results in treating PTSD with MDMA. The drug can spur patients away from inhibition and anxiety, which can be useful for therapists trying to get someone to open up. Doblin believed psychedelics could change the world, and openly admitted that just like medical marijuana, psychedelic therapy was a backdoor to legalization.
Over a decade ago, MAPS spun their pharmaceutical development arm into a subsidiary known as MAPS Public Benefit Corporation, later renaming it Lykos Therapeutics. But last year, the U.S. Food and Drug Administration (FDA) rejected MDMA as a prescription medication, taking issue with Lykos’ scientific rigor, dashing the hopes of patients and psychonauts alike.
“I was quite frustrated at some of the questions that were being asked [at the FDA hearing] that indicated the folks asking the questions clearly didn't have a real understanding of MDMA,” Dr. Stephen Bright, a drugs expert at Edith Cowan University in Perth, Australia, told Salon. “There were concerns that people might develop problems with other substances after being administered MDMA, and within the course I teach, we're teaching the students not to frame things within that disease model. So it's a bit frustrating to see a prestigious U.S. government department promoting that model.”
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As medicinal MDMA’s future in America looks uncertain, are there any lessons to be learned from Australia?
If America had Rick Doblin, then Australia has Peter Hunt and his wife, opera singer Tania de Jong, the power couple behind Mind Medicine Australia (MMA) — essentially MAPS Down Under. Hunt, a multimillionaire investment banker, was haunted by losing his father to suicide when he was thirteen. The pair were inspired to launch MMA after a shroom trip in Amsterdam.
“The experience was so powerful that we felt compelled to help support the legal development of psychedelic-assisted therapies in Australia and start a charity to ensure safe and equitable access to these transformational treatments,” Tania told Salon.
Like the FDA, Australia’s Therapeutic Goods Administration (TGA) refused to clear MDMA and psilocybin at first, turning down MMA’s initial application in October 2022 on the grounds there wasn’t enough evidence, potential health risks, and clandestine diversion of drugs to the black market. But just a few months later, in February, the TGA abruptly reversed course, moving MDMA from Schedule 9, for prohibited substances like heroin, to Schedule 8, a category for controlled medicines.
To get this to happen, MMA mobilized an immense letter-writing campaign, flooding the TGA with 13,000 submissions initially, plus another 3,000 upon news of the rejection from individuals describing how the substances helped them or why they should be legal. These mainly consisted of personal, not professional, viewpoints, but apparently this was enough to sway the decision.
"Our advocacy efforts focussed on a limited rescheduling of MDMA and psilocybin as unregistered medicines, whereas MAPS was pursuing registration of MDMA."
Citing new research into psychedelic medicine, the TGA finally allowed MDMA and psilocybin in a therapeutic context. Prominent researchers like Prof. David Nutt, a renowned neuroscientist from Imperial College London, flew in to show his support. The decision was still controversial to some experts, who cautioned against rushing ahead since psychedelics aren’t for everyone and some vulnerable patients might actually wind up worse after a trip. Meanwhile, skeptics accused the TGA of caving in to peer pressure (“C’mon TGA, be cool”). The TGA replied that the benefits outweighed the risks.
Tania dismissed these criticisms as “nonsense.”
“There is a lot of clinical trial evidence to support the safe and effective use of these therapies in clinical environments,” she said. “We have an increasing mental health epidemic in Australia with an estimated 1 in 4 people suffering with mental illness. There have been no substantive innovations in mental health treatments for over 50 years. Whilst further research is important – we are financially supporting a number of innovative trials – the argument that we don’t have enough data to support limited accessibility in highly supervised clinical environments is not valid given the amount of supportive evidence and the high levels of suffering.”
So why has the TGA proven more flexible than the FDA?
“Our advocacy efforts focussed on a limited rescheduling of MDMA and psilocybin as unregistered medicines, whereas MAPS was pursuing registration of MDMA,” Tania explained. “With registration in the U.S., MDMA is likely to be more widely accessible for PTSD and able to be used off label for other relevant mental illnesses where there is research support for this, whereas in Australia MDMA, as an unregistered medicine, is available only for PTSD patients and psychiatrists must apply for a permit to become an ‘authorized prescriber.’ By pursuing a limited rescheduling, we were able to support limited access for those most in need, while the evidence base continues to grow to support wider scale accessibility.”
This model, according to Tania, is more restrictive than what was proposed in the States, but allowing each clinician to prescribe at their discretion. But only those blessed by an ethics committee may become authorized prescribers.
“Most psychiatrists don't have the sort of experience with research to be able to write a protocol that's going to be approved by an ethics committee, which is why it's really limited how many authorized prescribers there are in Australia,” Bright explained.
As a result, rollout has been slow — with the first-ever non-research medical prescription for 180mg of MDMA only written by a Melbourne doctor in January last year — and it came with an expensive price tag. Clarion Clinics, Australia’s first private psychedelic therapy centre that opened in February last year, charges an eye-popping 27,000 Australian dollars (approx. $16,500 USD) for a full nine-month course, well out-of-reach for most Aussies. Medical marijuana too is legal in Australia, but so prohibitively priced that 78% of patients still score from dealers.
“I worry that people who are unwell aren't going to be able to access it — and desperate people will do desperate things,” said Bright. “My worry is that people will access these treatments either in an underground setting or try a DIY approach, and that could potentially result in harm. We've actually seen a significant increase in calls to the poisons hotline related to MDMA and other psychedelics.”
Recreational molly is still illegal in Australia, manufactured or imported by crime syndicates like the ‘Ndrangheta, mafia clans from southern Italy who made their riches in Australia’s drug game by growing weed in the Outback. In 2016, Pasquale Barbaro, the scion of a mob family behind a plot to smuggle a whopping 15 million ecstasy pills weighing 4.4 tonnes hidden in tins of peeled tomatoes, was gunned down by a biker gang while leaving a friends’ house in Sydney. And since the drugs are prohibited, there’s no telling what’s inside and they often mixed with other substances: recently, partygoers at festivals have been victims of nitazene poisoning, a synthetic opioid.
“I think the early evidence is that it can be, again, life changing, so I'm very excited,” said Rebecca. “But I've got to say there's some trepidation about how it's going to go and who's going to have access to it. And of course, there's a massive underground … My therapist who I worked with is just top-notch; so good, so diligent, so professional … But there are people who aren't. There are people who aren't really doing the due diligence, aren't really working out whether the person that they're treating is ready for the therapy.”
There are also efforts to bring down the cost.
“MMA has set up a patient support fund to help those in need who can’t otherwise afford the treatment with up to 50% of upfront costs for the therapy program being covered by the Fund,” Tania said. “Additionally, we’re seeing funders begin to support the therapies. Work Cover and the NDIS have subsidised treatment for some patients, the Department of Veterans’ Affairs has announced that they will begin assessing applications for funding by the end of March 2025, and multiple private health insurers are preparing pilot programs for their members.”
Another company, Emyria, is offering free MDMA-assisted therapy trials to first responders grappling with PTSD.
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Another danger that could arise is a moral panic. The media certainly has the incentive to sensationalize drug use, followed by calls to ban this “sick filth,” but prohibition certainly offers no solutions to the mental health crisis or actually stops drug use. In 2001, a supervised injection facility run by Australia’s Uniting Church opened in King’s Cross, Sydney — a district at the epicentre of the overdose crisis, claiming 10% of all deaths nationwide.
This was a place where narcotic consumers could safely inject under the supervision of trained medical staff. Anyone overdosing can be instantly attended to. A few years later, a newspaper splashed images of dozens of syringes littering the street over its front page. It turned out that the used needles actually belonged to the owners of a diabetic cat named Trotsky, who’d momentarily left their rubbish unattended only for it to spill over and be photographed by reporters.
“I'm largely very positive, but of course as we know with these things, there's so much stigma around the drug and so much bullshit around mental health, that it could all unravel,” Rebecca reflected. “I feel like the world is looking at us and saying, you know, how might Australia do it? And so I really don't want us to f**k it up!”
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