…Earlier this year PRISM obtained approval to give psilocybin to 30 terminally ill patients at St Vincent’s Hospital in Melbourne to ease their end-of-life anxiety and crisis. It’s a phase II trial, which is the second-last step before a government’s regulatory body can approve a new drug. If the results are positive, it could be sooner rather than later that the government will need to decide whether it will allow psychedelics to be prescribed.
What’s important to note, Dr Bright stresses, is that it’s not the drug itself that’s a magic bullet. In the vast majority of trials, psychedelic substances are only taken a couple of times to help open up the mind: it’s still therapy that does the hard work.
It’s an important distinction to make, particularly given Dr Bright often gets emails asking him how to access the substances illegally. Indeed, Grace participated in an underground ayahuasca ceremony in Byron Bay on her return from Costa Rica, but this time around it made her more anxious, as the shamans weren’t experienced enough. And several subjects of off-the-record case studies who spoke to Vogue are already taking part in psychedelic sessions held by therapists in their clinics after hours.
Until these treatments are available in controlled settings with trained practitioners, they’re not something Dr Bright can recommend. “If people are doing it in an unregulated environment without quality control, it can be dangerous,” he says. “With these drugs, the environmental setting really is everything.”
This is something that 29-year-old Melissa Warner knows well. She’s the education and communications officer at Mind Medicine Australia, a charity that helps fund psychedelic research for mental health, including the St Vincent’s trial. Warner was studying neuroscience at the University of Melbourne when she became interested in psychedelics. She’d never actually taken any (“I was the nerdy, video game-playing, science-loving kid,” she says), but she was intrigued by the research.
Then, in her final year of university, she was sexually assaulted, a trauma that left her with severe post-traumatic stress disorder (PTSD). “My mind and personality completely changed; I became insular and disconnected. I dropped out of uni for a time,” she explains. “I tried conventional psychotherapy, but I couldn’t go back to the memory without having a panic attack.”
This is something that’s common for PTSD sufferers, and one of the key reasons therapy can fail. Knowing that the rate of success for antidepressants and PTSD was only around 20 to 30 per cent, she convinced her parents she should go to Portugal, a country where psychedelics have been decriminalised, to take part in a MDMA-assisted therapy session. She describes the aftermath of the experience as waking up from a deep, dark nightmare.
“I hadn’t realised how trapped I was at the moment of my trauma,” she says. “With the MDMA-assisted therapy, I was able to reconnect to myself. I no longer had flashbacks and could talk about the trauma. It became an inspiration to help others.”
This is because MDMA acts on serotonin receptors, which are triggered when we feel happy and relaxed. “When the brain recalls something, it doesn’t just take it out of the filing cabinet, read it and put it back. It takes it out, shreds it and rewrites it,” says Warner. “By remembering a traumatic memory on MDMA, which induces those feelings of safety and compassion, you re-encode that memory, altering the emotional tone.
“It’s not a panacea; I still had to do work to get my confidence back and my trust back, but it helped me to break through the biggest hurdle,” she says.
Image: Jonathan Daniel Pryce