Will Magic Mushrooms, LSD, MDMA and Co. soon be available on prescription?

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Intoxication on prescription

In Germany, psychedelics such as magic mushrooms, LSD and MDMA are prohibited. At the same time, they are being researched worldwide as a remedy for mental illnesses. Is it only a matter of time before intoxication is available on prescription?

Psychedelics have long been discredited as drugs. An image that is changing: Because they should also be able to heal. Prince Harry, for example, spoke openly about how magic mushrooms helped him come to terms with his mother’s death like medicine. And bestselling author Bas Kast recommends in his new book psychedelic substances even as one of ten strategies for better mental well-being. In fact, psychedelics seem to reduce anxiety and depression, and some are already being used as medicines.

The idea of ​​using LSD or magic mushrooms to alleviate mental suffering is not new. It already existed in the hippie era, but it didn’t catch on then. Research in this field has been making a comeback for several years now and is making more and more breakthroughs. A study on therapy with psychedelic drugs is also currently underway in Germany. The Central Institute for Mental Health in Mannheim, together with the Charité Berlin, is testing the substance psilocybin on 144 patients with treatment-resistant depression. This is the ingredient in magic mushrooms, psychedelic mushrooms. Psilocybin is a party drug, but it’s been around for a long time indications of itthat it can lighten the mood in the long term. As early as the 1960s, there were considerations of using psilocybin as an antidepressant. Then the substance was banned in Germany as an intoxicant until its therapeutic potential was rediscovered.

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Andrea Jungaberle is an emergency doctor and psychotherapist in training and is involved in the current study with psilocybin. She also works in a Berlin practice specializing in psychedelic therapies. So far, only the active ingredient ketamine can be used legally in Germany. Ketamine has been used as an anesthetic for many years and is also approved for the treatment of depression in certain circumstances. Jungaberle uses ketamine “off-label” in therapy-resistant depression, anxiety disorders and post-traumatic stress disorder. The patients take ketamine a few times in their practice, are prepared for it therapeutically and accompanied during their trip and the processing of this experience. If, for example, feelings of panic or physical side effects occur, Jungaberle can intervene if necessary.

Open to new insights through psychedelics

She explains why psychedelic substances have the potential to significantly alleviate mental illnesses such as depression. “Ketamine and other psychedelics are known to affect brain plasticity. After ingestion, greater neuron growth can be observed.” The brain of the chronically mentally ill should be imagined as an English lawn: “Little grows there. But under the influence of psychedelic substances, it turns into a wildflower meadow, where maybe a few bumblebees still fly.”

In fact, there is also a similarity to the mode of action of common antidepressants. These should usually increase the concentration of the messenger substance serotonin in the brain, which is also considered the “happiness hormone”. Psychedelic substances such as LSD, psilocybin or DMT (the active ingredient in ayahuasca) are known to act on the same receptors as serotonin, says Jungaberle. This means that they can probably trigger a similar effect as the hormone. MDMA, on the other hand, increases the release of serotonin. Other psychedelic substances such as ketamine would also affect metabolism or sensitivity to neurotransmitters that affect mood.

What can also be used therapeutically is the psychedelic experience itself. Psychedelic is derived from the ancient Greek terms psyche = mind and delos = evident. Psychedelic means that a substance alters or, as is often described, enhances consciousness. And that is exactly what is desired in clinical depression. “As so-called ‘dirty drugs’, psychedelic substances have many different effects,” says Jungaberle. “It makes you come into contact with yourself in a different way. Brain areas communicate that otherwise do not communicate with each other. In the phase after the session you are open to new insights and experiences, which we can use for the therapeutic indication.” to shake off.

Therapist advises against self-experiments

The therapy with ketamine that Jungaberle offers is currently still a self-pay service and costs around 3000 euros. This is because, she says, the practice has a specialized team of psychiatrists and anesthesiologists and three to four therapeutic sessions per week are required. Anyone who would like to take psychedelic substances under supervision can also do so abroad: supervised retreats with psilocybin are offered in the Netherlands, and in Mexico with the psychedelic plant extract ayahuasca. Here, too, the costs can amount to several thousand euros. And these are usually not real therapeutic settings, but rather self-awareness workshops. Nevertheless, there are indications of a positive effect: A group of Australian researchers had 53 participants in an ayahuasca ritual fill out a standardized questionnaire on their psychological well-being before and after the session. Seven days and one month after the ritual, the participants scored lower scores on the stress, depression, and anxiety scale.

Because real therapy using psychedelic substances is expensive or difficult to access, there is a risk that people with mental illnesses will simply go and get drugs themselves. “But I advise mentally ill people in particular not to carry out their own experiments,” says Jungaberle. “If someone is mentally stable, a bad shroom trip might just be uncomfortable. If not, it can also have a more negative impact.”

properly weigh the risks

Even in the accompanying therapy, psychedelic substances are not completely safe. “It’s a disruptive intervention, it messes up the brain. While this can help, it can also be an undesirable state if it persists,” says the therapist. It is important to assess the risks correctly and to select the patients well. The procedure is not suitable for those who have a history of mania or bipolar disorder. With ketamine, for example, there is almost no risk that it could trigger psychoses. In the case of LSD, yes – especially when it is mixed with other substances, which is often common for personal use. The development of addiction, on the other hand, is ruled out with classic psychedelics.

Jungaberle hopes that more psychedelics will be approved for the treatment of the mentally ill in the coming years. MDMA, an ingredient often found in ecstasy pills, has the potential to help with post-traumatic stress disorder. Psilocybin and LSD could help with addictions, anxiety, and depression that occur after a fatal diagnosis, for example. In Australia, for example, MDMA and psilocybin for mental illnesses will soon be available on prescription. If such therapies were approved in Germany, they might one day be reimbursed – but Jungaberle believes that there is still a long way to go. This is also due to the fact that common antidepressants are very cheap. Although these do not help everyone, the hurdle is greater that alternatives are paid for by health insurance companies.

“But of course we hope that these therapies will eventually become accessible to everyone,” says Jungaberle. The authorities are “not so averse to this topic anymore.” She still has to contend with prejudice in her work, even though she operates within the legal framework and conducts scientifically sound research. There is still a stigma attached to “drug therapy”. A while ago, your practice wanted to place a job advertisement in the magazine of a large professional association. The ad was rejected because it contained the word psychedelic.