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I thought people would appreciate some background on yesterday's news that Medsafe has granted approval for the use of psilocybin as part of psychotherapy. I'll start by noting that we actually broke this news in part two our documentary 'Mind Menders', which you can watch for free on Sky Go (just create an account) or on Neon. So ... This approval has been granted to one practising psychiatrist, for the use of psilocybin alongside intensive psychotherapy. I haven't seen the detail, but it's likely to only be approved for use in treatment-resistant depression, meaning you'll have to have tried other treatments first. That psychiatrist is Professor Cameron Lacey, who has a clinic called Elimbias Health in Christchurch. He has a very strong record in health research, especially Māori health (he is Te Atiawa) and three years ago conducted a trial of psilocybin for depression under the wing of Otago University. That background will have had a lot to do with his approval being granted. He's also a good, caring man with a low-key manner. You're not going to be able to rock up to any old doctor (or psychiatrist) and get on the shrooms. This is a one-off approval under Section 22 of the Misuse of Drugs Act, which allows any controlled drug to be prescribed by an "authorised prescriber". It's not a law change: this provision has always been there and I wrote a couple of years ago about how that route was available if someone wanted to jump through all the hoops, which Professor Lacey has done. But I do think it's significant. The first (and only previous) time this provision has been used was 10 years ago, when Peter Dunne allowed CBD to be prescribed to Alex Renton, who suffered (and eventually died) from status elipticus. That's essentially where the road to the Medicinal Cannabis Scheme began. Medsafe, which granted the approval (not David Seymour, he just gets to announce it), has been regulating psychedelic research trials for five years now, starting with the Auckland LSD microdosing trials. In that time they've been slow, cautious and sometimes outright obstructive. But I think they've seen that the sky hasn't fallen in and they're not dealing with crazy people. Again, this will only apply to psilocybin used along with intensive psychotherapy – and it's the human time of psychotherapy where the cost lies. Professor Lacey reckons he can provide the treatment for less than the $20-$30,000 that has been speculated about, but it still won't be cheap. Don't expect Health NZ to subsidise it – conventional SSRI anti-depressants are cheap as chips (like, the total annual bill for the whole country isn't much more than $10 million) and they will remain the first-line treatment for the foreseeable. But there may be more interest from the likes of ACC, which has long-term trauma patients on its books, and possibly private insurers. Depending on results, the people behind the marae-based Tū Wairua trials in Gisborne might be expected to seek approval for tikanga-guied psilocybin mushroom therapy for meth addiction in two or three years. That's quite exciting, not least because it would truly break psychedelics out of the neo-Freudian therapeutic frame favoured by the major psychedelic advocates in America. But that's the future. The other thing that should happen, but likely won't, is a review of psilocybin mushrooms' legal status. They are a Class A controlled drug and there is really no good reason for that. The drug harm index created in 2023 by a multidisciplinary study at Otago University placed psychedelics (they actually used the term "hallucinogens") near the bottom of the harm scale, between kava and vaping. Decriminalising "plant psychedelics" (yes, friends at Manaaki Whenua, I know mushrooms aren't plants, but ...) as has happened in other territories would be a good step. I'm not holding my breath for this government to do anything of the kind, sadly. But anyway, yes, this is a significant announcement.