From 1 July 2023, under specific circumstances, certain medical practitioners will be able to prescribe:
- 3,4‑methylenedioxy‑methamphetamine (MDMA) for post-traumatic stress disorder (PTSD) and
- psilocybine for treatment-resistant depression in Victoria.
For details of this change, see the Therapeutic Goods Administration (TGA) website and their update.
MDMA and psilocybine are unapproved therapeutic goods in Australia. There are no Schedule 8 MDMA or Schedule 8 psilocybine products approved by the Therapeutic Goods Administration (TGA) or registered on the Australian Register of Therapeutic Goods (ARTG). This means MDMA and psilocybine products have not undergone safety, efficacy and tolerability evaluation.
Who can be supplied with MDMA and Psilocybine?
MDMA and Psilocybine cannot be dispensed or supplied directly to patients or clinical trial participants under any circumstances. Penalties apply.
MDMA and Psilocybine can only be supplied to:
- A psychiatrist with Authorised Prescriber approval for MDMA or psilocybine OR
- A medical practitioner engaged in a clinical trial for MDMA for the treatment of post-traumatic stress disorder (PTSD) or for psilocybine for treatment resistant depression (TRD) OR
- A medical practitioner, nurse practitioner or nurse authorised by the psychiatrist in (i) or medical practitioner in (ii) to act on their behalf
Schedule 8 MDMA and Schedule 8 psilocybine can only be administered to patients or participants by authorised medical practitioners, nurses or nurse practitioners.
Psychologists, therapists, counsellors and pharmacists cannot administer Schedule 8 MDMA or Schedule 8 psilocybine to patients or participants. Penalties apply.
When are MDMA and psilocybine considered to be Schedule 9? When are they considered to be Schedule 8?
If MDMA or psilocybine is supplied by a pharmacist, all MDMA and psilocybine dose forms are classified as Schedule 9 substances until they are:
- labelled and dispensed by the pharmacist for a specific patient on a prescription issued by a specialist psychiatrist with Authorised Prescriber approval for MDMA for the treatment of post-traumatic stress disorder (PTSD) or for psilocybine for treatment resistant depression (TRD) OR
- labelled and dispensed by the pharmacist for a specific patient on a prescription issued by a medical practitioner engaged in a clinical trial for MDMA for the treatment of post-traumatic stress disorder (PTSD) or for psilocybine for treatment resistant depression (TRD).
If MDMA and psilocybine is not supplied by a pharmacist, all MDMA and psilocybine dose forms are classified as Schedule 9 substances until they are:
- in possession by a psychiatrist with Authorised Prescriber approval for MDMA for the treatment of post-traumatic stress disorder (PTSD) or for psilocybine for treatment-resistant depression (TRD) respectively OR in possession by a medical practitioner engaged in a clinical trial for MDMA for the treatment of post-traumatic stress disorder (PTSD) or for psilocybine for treatment-resistant depression (TRD) AND
- the MDMA or psilocybine substance is in the process of being administered to a specific patient or participant.
This means that Schedule 9 legislative requirements apply to MDMA and psilocybine for the chain of custody (manufacturing, import, wholesale, compounding).
MDMA remains as a Schedule 9 substance for indications other than post-traumatic stress disorder (PTSD).
Psilocybine remains as a Schedule 9 substance for indications other than treatment-resistant depression (TRD).
MDMA and psilocybine must be stored and records retained in accordance with the Drugs, Poisons and Controlled Substances Regulations 2017. Storage and record keeping requirements are the same for Schedule 8 and Schedule 9 substances. Information about these requirements is available at the Possession and storage webpage.
MDMA and Psilocybine legislative requirements for importers, wholesalers and manufacturers
Importers
For importers, MDMA and psilocybine are Schedule 9 substances and the relevant legislative requirements for Schedule 9 substance apply.
Importers are required to obtain a Victorian license/permit in addition to obtaining the necessary licences and permits from the TGA or the Office of Drug Control to import the substances. Importers also need to comply with Commonwealth legislative requirements.
Wholesalers
For wholesalers, MDMA and psilocybine are Schedule 9 substances and the relevant legislative requirements for Schedule 9 substance apply.
Wholesalers are required to apply for a Victorian wholesaler license to supply Schedule 9 substances, in addition to complying with Commonwealth legislative requirements.
Manufacturers
For manufacturers, MDMA and psilocybine are Schedule 9 substances and the relevant legislative requirements for Schedule 9 substance apply.
Manufacturers are required to apply for a Victorian manufacturing license to manufacture and supply Schedule 9 substances. Manufacturers must also comply with Commonwealth legislative requirements such as obtaining a Good Manufacturing Practice (GMP) licence from the TGA to manufacture MDMA and psilocybine as finished products for human therapeutic use.
MDMA and Psilocybine legislative requirements for pharmacists and medical practitioners
Pharmacists
Pharmacists are required to comply with Schedule 9 requirements when handling MDMA and psilocybine, including compounding of MDMA and psilocybine.
If pharmacists import or wholesale MDMA or psilocybine, they must comply with wholesale and importation requirements, in addition to complying with Commonwealth legislative requirements.
Pharmacists must not dispense or supply MDMA or psilocybine directly to patients or their representatives, even if patients present with a prescription for MDMA or psilocybine or pharmacists are directed to do so by a medical practitioner. Penalties apply.
Pharmacists can only dispense and supply MDMA or psilocybine to
- A psychiatrist with Authorised Prescriber approval for MDMA or psilocybine OR
- A medical practitioner engaged in clinical trial for MDMA for the treatment of post-traumatic stress disorder (PTSD) or for psilocybine for treatment resistant depression (TRD) OR
- A medical practitioner, nurse practitioner or nurse authorised by the psychiatrist in (i) or medical practitioner in (ii) to act on their behalf
Psychiatrists with TGA Authorised Prescriber approval
Psychiatrists need to ensure that MDMA and psilocybine products are appropriately stored in secure facilities (i.e. a drug safe) prior to its administration. Psychiatrists are required to maintain appropriate records (i.e. a compliant drug register) in relation to handling of MDMA and psilocybine. Please see further information on storage and recording requirements.
MDMA and psilocybine must be stored and records retained in accordance with the Drugs, Poisons and Controlled Substances Regulations 2017. Storage and record keeping requirements are the same for Schedule 8 and Schedule 9 substances.
Medical practitioners engaged in clinical trials for Schedule 8 MDMA and Schedule 8 psilocybine
Medical practitioners need to ensure that MDMA and psilocybine products are appropriately stored in secure facilities (i.e. a drug safe) prior to its administration. Medical practitioners are required to maintain appropriate records (i.e. a compliant drug register) in relation to handling of MDMA and psilocybine. Please see further information on storage and recording requirements.
MDMA and psilocybine must be stored and records retained in accordance with the Drugs, Poisons and Controlled Substances Regulations 2017. Storage and record keeping requirements are the same for Schedule 8 and Schedule 9 substances.
MDMA and psilocybine FAQ for psychiatrists and other medical practitioners
Updated