Critique of the Royal Australian and New Zealand College of Psychiatrists Psychedelic Therapy Clinical Memorandum, Dated May 2020

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) opposes medically controlled access to MDMA and psilocybin-assisted therapies, citing safety concerns. However, a review of the RANZCP's references and current literature finds no evidence from the last 70 years that these substances, when administered in controlled clinical settings, cause mental illness or negative health outcomes. Instead, research shows MDMA and psilocybin are safe, non-toxic, non-addictive, and efficacious in such environments, with risks only in uncontrolled use. The RANZCP's position relies on outdated and misinterpreted evidence, and the authors warn that positive media coverage may encourage self-medication, underscoring ethical and social responsibilities.

Study at a glance

Abstract

Objective: The Royal Australian and New Zealand College of Psychiatrists (RANZCP) has positioned itself against medically controlled patient access (at this current time) to 3,4-methylenedioxymethamphetamine (MDMA) and psilocybin-assisted therapies in its Therapeutic Use of Psychedelic Substances Clinical Memorandum, May 2020. The main reason given by the RANZCP for its stance is safety concerns. Methods: Every reference in the clinical memorandum (CM) was checked against the original publications used by RANZCP to justify its position. In addition, the search engines Google Scholar, PubMed, ScienceDirect, the Multidisciplinary Association for Psychedelic Therapies (MAPS) website, the Therapeutic Goods Administration (TGA) website, relevant Australian and New Zealand legislation were searched for pertinent and up-to-date- information. Results: There is no scientific or medical evidence from the last 70 years to suggest that either psilocybin or MDMA, when administered as an adjutant to therapy in a controlled clinical setting, are linked to either mental illness or negative health outcomes. On the contrary, MDMA and psilocybin have been shown to be safe, non-toxic, non-addictive, and efficacious when administered in a medically-controlled clinical environment. All associated risks are apparent in an uncontrolled setting. Conclusion: The RANZCP’s position is based on outdated, irrelevant, misinterpreted, and misinformed evidence. With the recent positive media coverage of the efficacy of these medicines when used as an adjunct to therapy, there is an intrinsic risk of self-medication or underground therapy. This means that any medical discussion must also purvey the ethical responsibilities and social duties associated with these substances.