Dr. Cameron Lacey has spent years studying how psychedelics might help treat depression and other mood disorders. Last week, he became the first and only psychiatrist in New Zealand allowed to prescribe psilocybin, the hallucinogenic found in “magic mushrooms.”
The approval from New Zealand’s health ministry is the latest boost to a growing global movement to study and use psychedelics like psilocybin and MDMA — long relegated to the fringes of psychiatry — to treat depression, post-traumatic stress disorder, and substance abuse.
Dr. Lacey was chosen because of his extensive experience in safely using psilocybin for psychiatric treatment during clinical trials, according to the health ministry. He said that in 2021, he started looking into a psilocybin clinical trial after he noticed that many of his patients were not responding to antidepressant medications.
The government has said the psilocybin treatments will be strictly controlled. Patients will not be able to simply walk away from an appointment with a tablet or mixture containing psilocybin, which New Zealand still classifies as an illicit drug, alongside heroin and cocaine.
Instead, Dr. Lacey said, they will get their first dose after three sessions of talk therapy. Then, while lying down or sitting in a recliner, wearing eye masks and noise-canceling headphones, patients will receive 25 milligrams of psilocybin in a capsule.
The hallucinogenic experience, or trip, begins around 45 minutes later, he said, as sounds of nature and traditional Māori music play through the headphones. The trip lasts around eight hours.
“People can experience the whole kaleidoscope of emotions and that can be quite intense, quite challenging at times,” Dr. Lacey said in a telephone interview. As with any hallucinogenic, he added, the trips can be difficult or upsetting, and some patients are nervous on the day of the dose because they are expecting an intense experience.
In rare cases, patients can continue to experience hallucinations after the trip has ended. “That can be a distressing experience where people continue to relive some of the experiences that they had during the psilocybin dosing,” he said.
In the therapy sessions after the trip, patients discuss the feelings and memories they experienced while on psilocybin that might be at the root of their depression, Dr. Lacey said. During his clinical trial with psilocybin, two-thirds of the participants showed reduced symptoms of depression, he said. The treatment program is spread over 10 to 12 weeks, Dr. Lacey said.
Dr. Lacey’s research was inspired in part by Māori, the Indigenous people of New Zealand, whose holistic approach to health has been another focus of his research. Some Indigenous people, including Māori, have used certain mushrooms to trigger deep introspection during traditional rituals and ceremonies and to heal mental disorders, according to psilocybin researchers.
Dr. Lacey’s work might pave the way for wider approval, which could also allow health insurers to consider covering psilocybin therapy.
In 2023, neighboring Australia legalized the use of psilocybin and MDMA, the stimulant more commonly known as ecstasy, to treat depression and PTSD.
In the United States, psilocybin is classified as a Schedule I substance by the federal government, a designation for drugs with high potential for abuse and no currently accepted medical uses. However, multiple U.S. clinical trials are underway to study its potential to treat addiction and depression.
Psilocybin’s rising popularity is partly because of successful clinical trials like Dr. Lacey’s, and its lower potential for addiction or overdose compared with other hallucinogenics like ketamine. Ketamine’s antidepressant effect has also been shown in studies to wear off over time, which could lead to abuse.
Dr. Lacey’s psilocybin treatment is not cheap, however. The 10-week program can cost somewhere between $16,000 and $19,500. Despite the hefty price tag, he said, other psychiatrists had contacted him about getting the treatment for their patients, who had previously considered going to other countries for psilocybin therapy.
New Zealand’s health system pays for fully approved mental health treatment and medications. And, Dr. Lacey noted: “There is a high personal cost for the impairment and disability they have suffered through experiences of depression and other conditions that don’t improve fully.”
Francesca Regalado is a Times reporter covering breaking news.
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