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It’s Time To Give Our Military The Medicine They Need

Military

Following the American decision to bring their troops home from Afghanistan after some 20 years in that troublesome country, Australia will also soon do the same. After losing 41 Australian lives, 261 wounded in action, facing war crimes allegations and billions of dollars of expense, thousands of our country’s bravest men and women will soon be coming home. Sadly, many of the more than 39,000 soldiers who served in Afghanistan will have varying degrees of post-traumatic stress disorder. This is nothing unique to the ADF. All soldiers everywhere suffer from PTSD. It’s just a question of degree; whether they know it or not.

Imagine the trauma then, when they come to learn that upon their arrival back in the lucky country, how unlucky they are that they still cannot access medicine with an incredibly successful track record in treating PTSD, that is cheap, plentiful and, most importantly, that works.

More than 150 recent empirical studies have shown the remarkable success that the therapeutic use of either psilocybin (the naturally occurring active ingredient in what are colloquially known as ‘magic mushrooms’) and MDMA (known more commonly as ecstasy) can have with people suffering from PTSD. These medicines can assist them in dealing effectively and permanently with the traumas of war. Yet when they return home, our soldiers will not have legal access to these medicines.

Both psilocybin and MDMA remain illegal in Australia and cannot legally be prescribed by doctors for patients, even though more and more people realise that such substances can be of great benefit in dealing with a range of mental disorders including PTSD. They cannot be grown or manufactured in Australia, cannot be imported and cannot be medically prescribed for patients in need, including returning military personnel. Yet they are available through Expanded and Compassionate Access pathways in many of our closest allies, including the United States, Israel, Switzerland and Canada.

Among other critics of the status quo, Dr Simon Longstaff AO, Executive Director of The Ethics Centre says that it is unethical and inhumane to withhold these treatments from those who are suffering. Existing treatments for PTSD lead to remissions in only 5% of patients compared to remissions for 60–80% of those receiving 2–3 medicinal doses of MDMA or psilocybin combined with a short course of psychotherapy.

In a recent trial supervised by the U.S. Food and Drug Administration (FDA), 105 participants (many of whom were veterans and first responders) had been suffering from treatment-resistant PTSD for an average of 18 years. Just three medicinal doses of MDMA with a short course of psychotherapy led to remission in 52% of cases immediately and in 68% of cases at the 12 month follow up.

Brigadier General Sutton, New York City’s Commissioner of Veteran Services said: “If this is something that could really save lives, we need to run and not walk toward it. We need to follow the data.” This same approach should be taken in Australia and inform the recently announced Royal Commission into Veteran Suicide.

Former Defence Force Chief, Admiral Chris Barrie has repeatedly confirmed that psychedelics offer the “only possibility of a cure for post-traumatic stress disorder”.

The Icahn School of Medicine at Mount Sinai in New York has launched a new Centre for Psychedelic Psychotherapy and Trauma Research (one of 6 similar Centres recently launched in the UK and USA), to discover novel and more efficacious therapies for PTSD, depression, anxiety, addiction and other stress-related conditions in the veteran and civilian population. The Centre will focus on studying MDMA, psilocybin and other psychedelic compounds.

Think of the immense suffering, mental illness and suicides that could be prevented if our veterans could finally get well through having access to all medicines that could potentially help them. Wouldn’t it be wonderful if they could lead meaningful and healthy lives contributing their skills and courage to our community?

Our health care system and the services it provides is in many respects the envy of the world. Medicare and private health services provide immediate access to both care and medicine for everyone in need. No one falls through the cracks in this country and no one has to show up in an Emergency Department just to access a doctor, as is the case in one of our closest allies, in particular. We should be justifiably proud of this, but also open to how this remarkable system could be improved.

After all, international laws, including those that have been ratified by Australia clearly recognise the right of everyone to “the enjoyment of the highest attainable standard of physical and mental health”. This must mean that everyone needing effective medical treatment should have access to all medicines that work, including psilocybin and MDMA which are proven to be safer and more effective than existing treatments, particularly when given under professional medical supervision.

The Therapeutic Goods Administration is currently considering rescheduling these medicines, which if successful, will mean that this medicine could then be prescribed by professionally trained doctors for patients that they feel will benefit from its use. It does not mean that these substances will be legal in a recreational sense. However, they will be part of the full medicinal arsenal available to all trained doctors to provide to all people in need, including our soldiers. With mounting pressure, the TGA recently announced an Independent Review on rescheduling both psilocybin and MDMA. A final decision is expected within months, and there is a large and growing chorus of voices who are calling on the TGA to provide medical access to these treatments to prevent further avoidable suicides and suffering.

Mind Medicine Australia and a rapidly growing global network will soon be releasing a short and, what we hope will be widely applied, Declaration on the Right to Universal Access to All Forms of Safe and Effective Medicine which calls upon governments everywhere to make available, to all persons, every reasonably accessible form of safe and effective medicine — regulated only for reasons of safety and efficacy, and then only to the extent strictly necessary.

Many people, and especially our soldiers, simply cannot afford to wait any longer.


Scott Leckie is an international human rights lawyer. Tania de Jong AM is a social entrepreneur and the Executive Director and co-Founder of the charity, Mind Medicine Australia.

This article was originally published by The Spectator on 6th May 2021.

Scott Leckie

Scott A. Leckie is an international Human Rights lawyer, Law Professor and Director and Founder of Displacement Solutions, an NGO dedicated to resolving cases of forced displacement throughout the world, in particular displacement caused by climate change. He also founded and directs Oneness World Foundation (www.onenessworld.org), a think tank exploring questions of world-centric political evolution and new forms of global governance.

He hosts Jointly Venturing, a podcast dedicated to the question of world citizenship, and manages the One House, One Family initiative, an ongoing project in Bangladesh building homes for climate displaced families. He regularly advises a number of United Nations agencies and conceived of and was the driving force behind more than 100 international human rights legal and other normative standards, including UN resolutions – most recently the Peninsula Principles on Climate Displacement Within States. He has written 22 books and over 250 major articles and reports.

Tania de Jong AM

LL.B (Hons), GradDipMus

Tania de Jong AM is a trail-blazing Australian soprano, award-winning social entrepreneur, creative innovation catalyst, spiritual journey woman, storyteller and global speaker. Tania is one of Australia’s most successful female entrepreneurs and innovators developing 5 businesses and 3 charities including Creative Universe, Creativity Australia and With One Voice, Creative Innovation Global, Mind Medicine Australia, Dimension5, MTA Entertainment & Events, Pot-Pourri and The Song Room.

She works across the public, private, creative and community sectors and is passionate about mental health, innovation, diversity and inclusion.  Tania speaks and sings around the world as a soloist and with her group Pot-Pourri releasing twelve albums. She is Founder and Executive Producer of future-shaping events series, Creative Innovation Global.

She was appointed a Member of the Order of Australia in June 2008. Tania was named in the 100 Women of Influence, the 100 Australian Most Influential Entrepreneurs and named as one of the 100 most influential people in psychedelics globally in 2021. Tania’s TED Talk ‘How Singing Together Changes The Brain’ has sparked international interest. Tania’s mission is to change the world, one voice at a time!

A Mother’s Prayer To The TGA

Woman on boat

I am writing this as a mother, in the hope that my words may open the closed minds of our politicians, the TGA and the RANZCP, who we rely upon to ensure every Australian has access to the latest medical therapies.

Our 26-year-old daughter suffers from treatment resistant PTSD and severe depression as a result of a trauma when she was only 11.  Rape at any age is devasting, but for a child the impact is profound. We live with the daily fact that with the current treatment of anti- depressants and anti- psychotic drugs available to her in Australia, there is only a 5% chance of her getting well. We also live with the fear that we could lose her. We have journeyed with her for the past 15 years and have seen her suffering as she has tried every treatment available to her. We have all been profoundly impacted by her illness. Our current mental health system has failed our daughter. We need answers. We need treatment. And, we need it now. Tomorrow our daughter may not be here.

Unless you have lived with the fear of your child taking their own life, you will never truly know how it feels. Thousands of mothers, live with that fear every day. Our journey has taken us to countless specialists and across the world. We have watched the work with treatment resistant PTSD using Medicinal MDMA, which is often confused with the recreational drug Ecstasy, Ecstasy is frequently adulterated with more dangerous substances and taken in unsafe environments. We learnt about the outstanding remission rates from Medicinal Psilocybin (which in its natural form comes from certain mushrooms) for treatment of depression. We are confident that these medicines offer real hope. We know that no treatment, even the current ones advocated by our government, is without risks and that the answers are not simple. But we deserve hope.

Clinical trials with medicinal MDMA conducted overseas demonstrate remission rates between 60-80% for treatment resistant PTSD. We were confident Australia would embrace this research in an applied way. Surely, we would act when potentially one of the greatest shifts in psychiatric medicine is knocking on the door? You can imagine our dismay when the TGA refused to reschedule MDMA in its recent Interim Decision. The news was heartbreaking.

The irony is that the TGA is already authorising individual requests from psychiatrists to use these medicines with therapy under its Special Access Scheme, but their listing as prohibited substances in Schedule 9 of the Poisons Standard means that there is no ability to get State and Territory Government approval which is also required so that patients can be treated and have a chance to finally get well.  All this will change if they become Schedule 8 Controlled Medicines.  What a cruel system we have. Providing hope with one hand and taking it away with the other.

I contacted the TGA for answers and found their response deeply disturbing. Their justifications were not based on data or science, but rather demonstrated deep bias and misrepresentation (for example, calling these medicines ‘illicit substances’ when they would, in fact, be used only in clinical medical environments). Their responses were offensive to sufferers and their families.

I contacted the RANZCP in the hope that they would show the capacity to lead us out of this crisis. It was clear that they cannot accept the facts which are undeniable and globally supported by leading experts, that these treatments are a viable and safe treatment option.

These bodies MUST begin to rely upon the validated data generated by the wider medical community. Do they suggest the outstanding research done at the leading Universities around the world is not valid or sufficient? Do they believe that countries that have enabled psychiatrists to use these therapies under Expanded Access Schemes have done so without high levels of regard?  These therapies have been granted Breakthrough Therapy Designation by the USA regulator and my daughter should be given the chance to access these therapies in Australia. Sadly, the Australian community is losing trust in the ability of our institutions to lead us forward. They risk becoming irrelevant as more and more Australians seek treatments conducted illegally by underground therapists.

I contacted every Australian Senator and the common response I have received was “we are sorry for your suffering but it is in the hands of the TGA and RANZCP”. These responses reveal that the TGA and RANZCP have too much power; beyond that of even my elected representatives. I elected my politicians to speak for me and lead us forward, and, as yet, few seem willing to ask if these bodies are advising them correctly and acting in the best interests of Australians. Who will challenge them on my behalf? Has my government forgotten they are here to serve my daughter?

This is so much bigger than my daughter. I speak also for those who don’t have a voice. For the lives already lost and for the families too enmeshed in simply surviving to speak out. Our nation is in a mental health crisis where 1 in 5 Australians have a chronic mental health condition and at least 1 in 8 are on antidepressants including 1 in 4 older adults and 1 in 30 young children.

Anxious adult

Australia should be leading the world in treatment, but instead our system is on its knees, bogged down by regressive thinking that places us as one of the poorest performing countries. We need innovation and leadership from our politicians and our medical establishment.  We can make Australia a leader in this field.  I imagine a day when the world looks to us. A day when no Australian suffers unnecessarily or dies from a treatable mental health illness.

I have NO doubt that the tide is turning and we will see these medicines rescheduled. The push from Australians like myself, WILL bring about this change. I believe the government knows this too.  They know they WILL lose the battle but don’t seem to care about those that will die in the final days of this “war”.

So, it’s time. Enough procrastination, posturing and politics. Our representatives MUST do the job that we have a right to expect of them.

I am praying that the TGA’s announcement this week, that it will be seeking further advice before making the final rescheduling decisions for MDMA and psilocybin will at last mean that the data and facts will come to the surface and block out the bias and stigma. Then finally, change will happen. The TGA has promised an Independent Expert Review into the therapeutic value, risks and benefits to public health outcomes for these medicines. My daughter and so many other sufferers need this so urgently, but I am not holding my breath.

If our government and health agencies continue to fail us, we will be forced to re-mortgage our house and attempt go overseas for treatment. To countries that lead the world in the treatment of mental health. To countries that care in actions, not just words. I will then shout from the roof tops, that my government has failed me and I am deeply ashamed of the country we have become.

Annie Mason

Annie Mason is an educator with a wide range of experiences including classroom teaching K-12, Special Education and Student Wellbeing. She was a Principal for over 15 years and has a special interest in Gender Equity, Social Justice and Women in Leadership. She is a strong advocate for the legal and ethical rights of those with mental health issues.

Healing A Troubled Mind: A Personal Perspective On Victoria’s Stagnant Mental Health System

Person standing near lake

The Royal Commission’s report on the Victorian mental health system sent shockwaves throughout the State, one of which landed squarely on a patient of mine. They noted that Victoria’s mental health system is “not geared for…change”. Just to ensure we got the message, and despite a Federal Government TGA approval, my request to treat my traumatized patient with MDMA-assisted therapy was declined by our state’s regulatory authority.

To be clear, my disappointment lies not with the state government regulators, nor with the medical opinions suggesting MDMA-assisted therapy should not be used for treatment of traumatized patients (despite excellent emerging evidence that it works with little risk). I understand these opinions, though I certainly do not agree with them.

My issue is a more troublesome one. Underlying these opinions is a problem with how we practice psychiatry, which in turn reflects the alienated community in which we live. Mental health paradigms are always a reflection of the society which supports them. You see, us Australians are alienated both intra-personally (from our own emotional worlds) and inter-personally.

Our current paradigms tend to view mental illnesses in a biologically reductive way. In other words, mental illnesses are both understood and treated primarily as biological diseases (which they are not). The posters at your doctor’s rooms will teach you – depression is just like any other medical disease, such as heart-failure or emphysema. In this paradigm, entities such as addictions and depression are seen as distinct phenomena. They are treated in our current system as totally different diagnoses by entirely different teams. The alienated individual who suffers from depression and addiction is labeled with the alienating and erroneous term ‘dual-diagnosis’, which enshrines the division. Furthermore, if addictions are understood (as they are) as inherited conditions (which they are not), and primarily as brain diseases based in dysfunctional dopamine rewards circuits, they will be primarily treated as inherited brain diseases, by doctors with medications.

But what if we have got it all wrong (which we do). You see, addictions are heritable but not inherited (there is a big difference, I recommend looking it up), and the chemical dopamine in no-way explains addictions. Rather, it is the human experience of dopamine (along with numerous other chemicals) which explains addictions, suggesting that addictions are rooted in difficulties with the human experience of life, rather than the neural correlates of those experiences.

The events which lie at the root of illnesses such as addictions and depression are those which overwhelm the mind’s ability to process and integrate. We know that the presence of adverse childhood experiences is present in the majority of (if not all) people with addictions and chronic depression. But rather than seeing these conditions as consequences of trauma (which they are) and treating the underlying emotional issues (which would help), our society mistakes the symptoms (depression and anxiety) for the disease itself. We treat depression as depression and addiction as addiction and all the while we are missing the forest for the trees. The real disease is the high prevalence of trauma, alienation, and neglect in our society. After all, it is these conditions which twist and distort the mind into the contortions which fill the latest catalogues of mental illnesses.

Which brings me back to my patient. Traumatized when young, she has suffered from every diagnosis a psychiatrist’s finger can point at. She has had every treatment a medical guideline can fathom. Yet her trauma remains in place, because no-one has been able to reach it. Suddenly, on the horizon, a change is coming. Treatments like MDMA-assisted therapy appear to touch the root of the trauma, allowing individuals to process the unintegrated parts of their minds, and offer the chance of real healing. But we don’t change. Our outlooks have ossified, our diagnoses have desiccated. And all the while we suffer in our own blindness. People continue to kill themselves, and my patient will continue to suffer in silence until the Victorian Government allows me to access a new treatment which may finally bring peace to a troubled mind.

Dr Eli Kotler

MBBS MPM FRANZCP Cert. Old Age Psych. AFRACMA

Eli is a consultant psychiatrist, holds an academic position at Monash University through the Alfred Psychiatry Research Centre, and is the medical director of Malvern Private Hospital, the first addiction hospital in Australia. He is a member of the Australasian Professional Society on Alcohol and other Drugs (APSAD). Clinically, Eli is interested in the deep connections between trauma and addiction and works within a neuro-psychoanalytic framework. Eli has overseen the development of a clinical program for addictions focused on trauma, particularly developmental trauma. This has led to an interest in medication-assisted trauma therapy. Eli worked for many years researching neurodegenerative diseases and was the principle investigator on numerous trials for novel therapeutics. He is founding member of the Melbourne Neuropsychoanalytic Group and welcomes new members. Through involvement with Monash University, Eli oversees the addiction rotation for medical students.

Eli graduated from the first intake of the Certificate in Psychedelic-Assisted Therapies (CPAT) in June 2021. He has also been recently appointed as the Principal Investigator to lead Emyria’s upcoming MDMA trial.

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