Accessing psilocybin in the UK


Accessing psilocybin in the UK

A debate on ‘Psilocybin Access Rights’ is expected to be heard in the House of Commons later this month. The session, scheduled for three hours,  provides an opportunity for MPs to advocate for the rescheduling of psilocybin to enable better access to the psychedelic medicine.

Contribution from Crispin Blunt MP, Chair of Conservative Drug Policy Reform Group, for The Psychedelics as Medicine Report: Fourth Edition

The  enhanced ability to recognise patterns is a property of the psychedelic experience consistently noted in clinical trials. One’s ability to notice patterns, however, does not need enhancing to notice a sobering parallel between the legacy of earlier research from the Centre for Psychedelic Research at Imperial College London on psilocybin and the launch of the world’s largest medical psilocybin access and data project, Project Solace.

Both involve British innovation, but in the UK psilocybin remains subject to the strictest possible scheduling in British law, meaning its enormous potential benefits to public health are under wraps on home turf and reaped exclusively in other jurisdictions. 

A better example of British innovation in biosciences in recent years than the 2017 psilocybin for depression study at Imperial College is hard to find. Psilocybin’s scientifically unjustified placement in Schedule 1 of the Misuse of Drugs Act 1971 meant that it was conducted against the odds of increased expense and aggravated difficulty over an extended time period – hurdles which preclude clinical research on psychedelics taking place in the UK at a volume conducive to rapid advances in treatment development. On its completion, the study, which was led by Dr. Robin Carhart-Harris, launched a global research effort to develop psilocybin into a licensed treatment for depression. 

Leaving the UK to work somewhere which began embracing evidence-based drug policies was a no-brainer for many of the UK’s clinical researchers in the years that followed — including Carhart-Harris who took up a directorship at the University of California in 2020. 

Oregon led the way in the United States in providing access to psilocybin with Measure 109 in November 2020. Generalised Anxiety Disorder (InCannex),Major Depressive Disorder (Usona) and treatment-resistant depression (Usona), alcohol dependency (B. More, and Clairvoyant) are some key areas of focus for clinical trials now progressing in the US. 

Imperial College London are recruiting participants for clinical trials with psilocybin in the treatment of  anorexia, fibromyalgia and obsessive compulsive disorder.. The success of trials with  psilocybin for treatment-resistant depression enabled the Institute of Psychiatry, Psychology & Neuroscience and South London and Maudsley NHS Foundation Trust to hatch further plans for psilocybin-assisted therapy in the treatment of post-traumatic stress disorder. . The first trials of psilocybin therapy as a treatment for adjustment disorder by Europe’s first commercial psychedelic research facility Clerkenwell Health begin in the UK in August 2022, in collaboration with Canadian bio-technology company, Psyence

Outside of qualifying to participate in forthcoming clinical trials, however, where can British citizens suffering from major depression, end of life distress, cluster headaches and addiction – some of the many diverse treatment applications of psilocybin – seek solace? 

No patient access scheme can grant it, as there is no UK equivalent to Project Solace, which will enable Canadian patients to access therapies assisted by psilocybin by collecting real-world treatment data to further widen the scope of patient access. Project Solace is ironically modelled almost exactly on DrugScience’s UK-based Project Twenty21, which enabled UK patients to access medical cannabis at a capped price and have their treatment tracked by DrugScience – but medical cannabis products, crucially, were moved from Schedule 1 to Schedule 2 of the Misuse of Drugs Act 1971 precisely to enable doctors to prescribe them when appropriate. A similar scheduling decision – while this would be appropriate for psilocybin and commensurate with its proven clinical efficacy and low toxicity and profile of harms – eludes us in the UK; even though according to national YouGov polling in 2021 the majority of the British public are supportive of it; simply due to the inaction of a Home Office as yet unready to engage with the evidence, despite the Prime Minister himself signing off on rescheduling psilocybin in a meeting with me in May 2021. 

Risking our stake in a global psychedelic treatment development market that is projected to reach $10.75 by 2021 is a given the longer we delay in rescheduling psilocybin for research and treatment development. As long as psilocybin remains in Schedule 1, investment in the UK’s advances in psychedelic treatment provision is confined to the realm of clinical trials. Depression is the greatest contributing factor to suicide, a caue of disability and costs the UK £10 billion annually, according to research from the Faculty of Public Health. Employment costs associated with mental ill-health cost the UK £94 billion per annum, as discussed in the Conservative Drug Policy Reform Group’s report joint-published with the Adam Smith Institute, Medicinal Use of Psilocybin (July 2020). 

Outdated drug law based on flawed policy making obstructing the necessary research is all that obstructs the rapid expansion of patient access to vital treatments with psilocybin like those currently under clinical trial in the UK. When the Conservative Drug Policy Reform Group polled Members of Parliament between June and July 2021, it found that more than three-quarters of MPs, even within the Conservative party, believe that it is time to update UK drug laws based on evidence – which points overwhelmingly to the need for the Home Office to heed the anticipated recommendation from the Advisory Council on the Misuse of Drugs to reduce existing barriers to research and reschedule psilocybin.

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