Psychedelic and Cannabis Prescriptions Surge in Australia Amidst Growing Evidence Concerns
Australia is witnessing a significant increase in prescriptions for psychedelic drugs and cannabis, particularly for the management of mental health conditions like depression. However, a growing chorus of experts is urging a measured approach, citing recent studies that reveal a concerning lack of robust evidence supporting their efficacy for these disorders.
Recent research, including two studies published in JAMA Psychiatry, has directly compared the effectiveness of psychedelics against conventional antidepressant treatments. These investigations aimed to clarify whether substances like LSD, psilocybin, peyote, and ayahuasca offer a distinct advantage over established therapies.
- First JAMA Psychiatry Study: This comprehensive review of clinical trials involving LSD, psilocybin, peyote, and ayahuasca concluded that these substances did not demonstrate superior outcomes compared to traditional antidepressants in treating depression.
- Second JAMA Psychiatry Study: This trial focused specifically on psilocybin, the active compound in magic mushrooms. The results of this study were deemed inconclusive, failing to provide definitive evidence of efficacy.
Adding to this body of evidence, another significant study published in The Lancet this week examined data from 54 clinical trials. This research found no conclusive evidence to support the use of cannabis and cannabinoids as effective treatments for depression, anxiety, or post-traumatic stress disorder (PTSD).
Jack Wilson, a lead author of the cannabis study and a research fellow at the University of Sydney, acknowledged that the absence of current evidence does not entirely negate the potential of these treatments. However, he stressed the paramount importance of rigorous scientific validation. “When we have access to medicines, we want to make sure that they’re safe and effective, and we want to make sure that there’s adequate evidence for them,” Dr. Wilson stated. “The absence of evidence here really does not justify the widespread use of these medicines.”
The Challenge of Studying Psychedelics and Cannabinoids
A primary hurdle in rigorously assessing the therapeutic value of cannabinoids and psychedelic drugs lies in the inherent difficulties of conducting the “gold standard” of medical research: the double-blind clinical trial. In these trials, participants are unaware whether they are receiving the actual treatment or a placebo, a crucial element for preventing bias.
According to Dr. Wilson, the distinctive psychoactive effects of cannabinoids and psychedelic drugs make it exceptionally challenging to create convincing placebos. “Participants usually know what they’re taking. So this can influence the results,” he explained.
To circumvent this issue, the authors of the first JAMA Psychiatry study adopted a comparative approach. They meticulously analysed all publicly available clinical trials on psychedelics and depression. Crucially, these trials were then compared exclusively with antidepressant trials where participants were aware of their prescribed medication. This method aimed to create a more equitable comparison by standardising participant awareness of their treatment.
Sam Moreton, a lecturer in psychology at the University of Wollongong, commented that the findings of psychedelics not outperforming antidepressants were not entirely unexpected. “The hype around psychedelic therapy has consistently run ahead of what the evidence actually supports,” Dr. Moreton observed. “There are good theoretical reasons to think psychedelic-assisted therapy could help with depression and other mental health conditions, and I think it’s absolutely worth researching properly. But the field has serious methodological problems that have been well documented.”
Dr. Moreton highlighted the methodological rigour of the second JAMA Psychiatry study, which employed a low dose of psilocybin as a control alongside a full dose and a placebo. This design aimed to maintain participant blindness to their treatment group. Despite these efforts, a significant 86 per cent of participants were still able to accurately identify which group they belonged to, underscoring the persistent challenges in blinding participants.
Dr. Wilson emphasised the ongoing need for more research, such as the trials conducted for the JAMA Psychiatry publication, to deepen our understanding of these treatments. The Australian Therapeutic Goods Administration (TGA) took steps in 2023 to reschedule psilocybin and MDMA, thereby improving patient access to these substances as medicines.
“I think we should be very wary of psychedelic-assisted therapies going down the same path as medicinal cannabis,” Dr. Wilson cautioned, drawing a parallel to the evolution of cannabis prescriptions.
The Crucial Role of Psychotherapy in Psychedelic Treatment
Susan Rossell, a neuropsychologist at Swinburne University of Technology with extensive experience in psychedelic and depression trials, echoed the sentiment that the findings of the first JAMA Psychiatry paper were not surprising. Professor Rossell believes that current research into psychedelics must pivot towards identifying specific conditions and patient profiles that are most likely to benefit from these therapies.
She also pointed out a critical deficiency in many of the psychedelic clinical trials reviewed: the lack of adequate psychotherapeutic support. “Having watched at least a hundred people go through this, making sure that you have qualified psychotherapists that can really help them unpack their experiences, and they don’t go away more lost than they were originally, is absolutely critical,” Professor Rossell asserted.
She shared sobering experiences, noting that “We’ve had a couple of people come through our programs and actually relapsed. So I guess we could say that we’ve made them worse, which is awful.” Professor Rossell anticipates that future research integrating comprehensive psychotherapy alongside psychedelic administration will yield more favourable evidence.
While Professor Rossell supports the exploration of psychedelics as a potential therapeutic avenue for depression, she strongly advocates for a cautious approach, recommending their consideration only after conventional treatments have been exhausted. “There are safety issues, whichever intervention that you take on board. And there are some very tried and tested interventions already existing for a lot of mental health conditions,” she explained. “The reason why we’re working on these experimental interventions is because there are people that are not getting better with what we’ve got, but this is should certainly never be a person’s first foray into a mental health intervention.”
Cannabis Prescriptions for Depression: A Scarcity of Evidence
Medicinal cannabis was first legalised in Australia in 2016. Dr. Wilson recalled the initial regulatory landscape: “Medicinal cannabis originally had many hoops to jump through, like psychedelic-assisted therapies do in Australia now. But in 2021, things streamlined and it became much easier to access.”
His study, mirroring the methodology of the first JAMA Psychiatry paper, meticulously reviewed clinical trials on cannabis and cannabinoids published between 1980 and 2025. While the research identified some tentative evidence suggesting potential benefits for conditions such as Tourette’s syndrome and insomnia, it found no supporting evidence for its effectiveness in treating depression, anxiety, or PTSD.
“Those three are quite important because they’re three of the leading mental health conditions for which they’re prescribed,” Dr. Wilson emphasised. He expressed particular concern over the absence of any randomised controlled trials specifically examining cannabis use for the treatment of depression. “In fact, there was actually not a single randomised controlled trial that examined cannabis use for the treatment of depression, which is really concerning.”
Both cannabis and psychedelic substances carry the risk of exacerbating certain mental health conditions, including psychosis, according to Dr. Wilson. “There are risks in taking these medicines, so we need to make sure that we get this one right,” he concluded.
