Can Medical Professionals Prescribe Psychedelics?

Timothy Leary’s turn on, tune in, drop out mentality has been superseded by a new attitude when it comes to psychedelics—one in which they hold a significant and respected position in medical science. The past several years have been especially significant for psychedelic science, as recent research has produced promising results of psychedelics’ healing capacities, especially when it comes to mental health ailments that are resistant to conventional therapies and medications. 

Psychedelic assisted therapy has emerged as a hopeful solution for the nearly 47 million people who live with a mental illness. So then, can doctors prescribe psychedelics? In certain situations, and with certain psychedelics, yes, they can—however it’s not a “pick up from your local pharmacy and self-administer at home” methodology. 

And though this could be a potential option down the road, it is probably unlikely you’ll be able to pick up a prescription of MDMA or LSD soon. In this article, we’ll discuss parallels to medical cannabis programs, what prevents take-home psychedelic prescriptions today, and where you might be able to access psychedelics now and in the future. 

What Does Legal Cannabis Teach us About Psychedelics?

If you would have asked someone in the 1970s or 80s if they could imagine a world in which a doctor could provide them with a prescription for medical marijuana, they might have laughed in your face. Now, however, in states with medical programs, doctors can authorize medical marijuana cards. 

Cannabis is one of the most commonly used drugs in the US, and as of 2018, there are more than 2.1 million medical marijuana patients—a figure that’s sure to be even larger with the current legislative trend. While many states don’t allow doctors to prescribe or recommend specific strains or products, this too is changing. 

Due to the prohibition of cannabis in the US, scientific research is catching up. In the next 10 or 15 years, we could actually see doctors ‘prescribe’ specific marijuana strains. What’s more, at the time of this writing there are 11 states plus the District of Columbia that have legalized recreational cannabis, and research suggests that many of these recreational users are consuming cannabis for medicinal purposes. 

So what does this have to do with psychedelics? The legalization of cannabis in most states is a reflection of the social, regulatory, and scientific acceptance of marijuana use. This comes at a time in which American society is also starting to view psychedelics in a positive light. 

So if medicinal and legal cannabis continues on this trend, psychedelics can take advantage of the forward momentum, paving a faster route to legal psychedelic prescriptions. However, the accessibility and use of psychedelic substances may take on a different form depending on a number of factors we’ll discuss below. 

A couple million medical marijuana users is just a drop in the hallucinogenic ocean when compared to more than 30 million psychedelic users in the United States. America is thinking about psychedelics, talking about psychedelics, and obviously doing psychedelics more than we ever have before. In 2017 alone, more than 1.31 million young people consumed LSD—up from just 317,000 in 2004. 

We’re in the midst of a psychedelic renaissance, one in which decades of taboo and regulation are starting to dissipate and the substances are being studied to demonstrate very significant benefits. Thanks to books like Michael Pollan’s How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence, psychedelics are being discussed in novel ways, and more people are able to benefit from the properties that indigenous populations have been harnessing for millennia. 

Psychedelics in Modern Medicine

It’s safe to say that we’ve come a long way in terms of how society views certain psychedelics. New scientific studies are being published all the time that further recognize the medical benefits offered by psychedelics. From treatment-resistant depression to PTSD, researchers are becoming increasingly aware that these psychedelic drugs may play a significant role in therapy and mental health. 

One such psychedelic has been in the spotlight recently—ketamine. Ketamine was developed in the 1960s and used as a very effective and unique anesthetic. In the 1990s, it was discovered that ketamine was also effective in acting as an antidepressant. In the past two decades, ketamine has been increasingly used to treat a range of mental illnesses and is now being administered in ketamine therapy clinics around the US. 

Because ketamine is a Schedule III drug (more on this below), doctors are unable to prescribe ketamine to be used at home. However, they are able to use it legally if under direct supervision by a licensed medical professional. 

Although specific requirements vary by state, with a medical license and a controlled substance license, medical practitioners are able to administer ketamine in therapeutic uses. The dosage and mode of administration also vary; health practitioners need appropriate training and certification to administer intravenous (IV) or intramuscular (IM) infusion ketamine, but requirements around ketamine lozenges are less stringent. 

Ketamine is the only psychedelic substance currently approved for legal psychedelic assisted therapy, although psilocybin and MDMA are sure to follow suit. Recent studies indicate that both LSD and psilocybin not only produce antidepressant effects similar to ketamine, but their results are likely more persistent and long-term. LSD, among many other psychedelics, is currently undergoing clinical trials. 

Research into the mental health benefits of psychedelics is abundant, and MDMA and psilocybin have both been designated “breakthrough therapies” by the FDA, meaning that they’re well on their way to be used legally in therapy. 

While you most likely won’t be able to pick up a psilocybin prescription from your pharmacist unless the drug is federally descheduled, you’ll likely be able to access it therapeutically with a medical practitioner.  

It’s a very exciting time for psychotherapy. Conventional modalities are being supplemented with the use of psychedelics. Cannabis and ketamine assisted therapy is now practiced around the US. 

If you’re interested in learning more about these cutting-edge therapies, we suggest you connect with one of our psychedelic coaches. We’ll help you determine if these are viable options, provide actionable information, and give you the tools and insights to use psychedelics to address your mental health issues safely and effectively. 

What Prevents Psychedelic Prescriptions Today?

It’s true, we’re seeing ketamine, magic mushrooms (psilocybin), acid (LSD), MDMA and DMT used more frequently in research settings to determine not only their safety, but also their potential for treating a range of conditions, including addiction, anxiety, and depression. While the medical community has become more welcoming of these substances and their healing potential, we’re unlikely to see them available at a local pharmacy any time soon. But why? 

Federal Scheduling of Psychedelic Substances

A huge obstacle is the Controlled Substances Act, which requires the Drug Enforcement Agency (DEA) to categorize drugs under five different schedules. The range goes from Schedule I, which means the substance has a high potential for abuse with no currently accepted medical use, to Schedule IV, which implies the drug has a low potential for abuse but contains limited quantities of narcotics. 

Most psychedelic drugs, including cannabis, are still Schedule I despite the overwhelming scientific research of their medical benefits. As such, these drugs are prohibited for all use aside from “scientific and very limited medical purposes…in medical or scientific establishments which are directly under the control of their Governments or specifically approved by them.” 

To provide some context, cocaine, opioids such as oxycontin and fentanyl, and methamphetamines such as Adderall and Ritalin are Schedule II despite their potential harm to users. Ketamine is Schedule III, meaning the prescription of these substances only allows for use under the direct supervision of a doctor. 

While medical practitioners have been relatively successful in accessing substances for research purposes, the same is yet to be said for drugs outside of these contexts. Though the landscape is improving, psychedelics still face social stigma and critical public perception. While approving drugs for use in controlled clinical trials has become easier, the federal scheduling of these drugs continues to be the major hurdle to legalizing psychedelics for patient access. 

Pharmaceutical Companies Generally Aren’t Interested

Another big barrier to large-scale approval and medical use of psychedelics is the cost. According to Rick Doblin of MAPS, the average cost to research and develop just one drug can be up to $1 billion. When a drug is presented to the scientific community for research, the funding is normally backed by large pharmaceutical companies with research budgets in the tens of billions of dollars. 

So why aren’t pharmaceutical companies like Merck and Pfizer dipping their toes in the world of psychedelics? Well, psychedelics are different in a lot of ways—most notably, their profitability.

Most drugs on the market are those that are used regularly. Let’s take the example of depression—most antidepressants are used daily for at least four to nine months, sometimes much longer. In some cases, depression medications are used for several years. 

Compared with something like ketamine, with an ability to provide sustained antidepressant effects after just a single dose, it’s no wonder that drug companies aren’t lining up to spend billions of dollars to only have their drug used a handful of times. 

However, while most pharmaceutical companies have steered clear of psychedelics, some have been interested in using them to inspire and synthesize prescription medication. Natural and synthetic forms of both THC and CBD (two of cannabis’ main cannabinoids—THC being the psychoactive one) have made their way into several FDA-approved drugs. 

Recently, one of these medications has actually been removed from the Controlled Substances Act, which means that it can be prescribed by any doctor, not just one who is permitted to prescribe DEA scheduled substances. However, you might wonder why synthetic cannabinoids have been descheduled whereas the plant-form of cannabis remains Schedule I? 

Another exception is Spravato (esketamine), which is a ketamine derivative that was approved by the FDA in 2019 for use in treatment-resistant depression. While it still remains a Schedule III substance, Johnson & Johnson is the pharmaceutical company behind the possibly mind-altering nasal spray and could be considered the first of possibly several to go through the US regulatory process with a psychoactive substance. 

While the marketing of a psychedelic-like substance or its derivatives by a pharmaceutical company could in theory make psychedelics more accessible to the general population, there are many people who are trying to prevent this from happening. 

Some in the pharmaceutical industry may try to lobby against legalization and supervised use of psychedelics as it could threaten existing markets for their drugs. And with the involvement of large pharmaceutical companies, the development and formulation of these psychedelic drugs may be patented, raising prices and therefore limiting access to the general public. 

So, Where Can Psychedelics Be Accessed?

We may never live in a country where prescriptions of DMT or psilocybin can be filled by our neighborhood pharmacist. However, recent changes do appear to be making other legal psychedelic options more accessible. 

Psychedelic assisted therapy has made psychedelics like ketamine and cannabis available to those who want to access their mental health benefits. Once breakthrough therapies like psilocybin and MDMA become approved by the FDA, doctors and medical practitioners who have met DEA recommendations for administering scheduled drugs will be able to do so. They’ll both likely join ketamine as Schedule III substances with some accepted medical uses. 

Within the next couple of decades, we’ll be likely to have multiple types of psychedelic-assisted therapies approved in many countries around the world. Clinical trials have paved the way for researchers and health practitioners to begin using a range of psychedelics in treating a variety of mental illnesses. 

The next several years are sure to welcome even more clinical studies, as well as more patients requesting to use psychedelic therapy treatments—and more and more doctors prescribing to meet that demand. 

While doctors can technically prescribe some of them, most psychedelics will probably never be available as a take-home, self-administered medicine. 

However, they’ll likely become increasingly available to those who need them. The development of MDMA, psilocybin, and other psychedelics into legally recognized medical drugs can provide a source of hope for many of the thousands of sufferers who haven’t found solutions in conventional therapies.

If you’re interested in diving deeper into the various ways to access psychedelic substances, we suggest you read our comprehensive guide that covers the 4 legal ways to acquire psychedelic drugs.

Final Thoughts

Modern research has changed the way the medical and scientific community looks at psychedelics. Currently, clinical trials are legitimizing MDMA and psilocybin as effective treatment options, with new studies using a range of psychedelics being introduced every day. 

However, if you’re someone who believes psychedelics can positively change your life and mental health, the information and options available are rather limited. That is exactly why we created Psychedelic Passage. 

We exist to bridge the gap between research, legalization, and personal use, so that people like you can safely harness the benefits offered by psychedelics NOW while we wait for legislation to catch up. Don’t put your mental health and wellbeing off any longer—connect with one of our psychedelic mentors today!

**Originally posted on www.psychedelicpassage.com on September, 16, 2020**