Why did Australia let psychiatrists prescribe psilocybin and MDMA in 2023?
On 1 July 2023 two substances that had been banned for decades moved to a different legal shelf in Australia, and the change shows how medicine and law argue about the same drug.
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Australia let psychiatrists prescribe psilocybin and MDMA in 2023 by changing where the two substances sat in its drug schedules. From 1 July 2023 the Australian medicines regulator permitted psychiatrists to prescribe psilocybin for . On the same date MDMA was from Schedule 9 (prohibited) to Schedule 8 (available on prescription) when used in the treatment of post-traumatic stress disorder, . For every other use, MDMA stayed in Schedule 9.
The decision came from the Therapeutic Goods Administration, or TGA, the medicine regulator of the Australian Government. The TGA regulates the safety, quality, efficacy and advertising of therapeutic goods, which include medicines, and biologicals. Some summaries describe the 2023 change as an approval, but for MDMA it is described as a rescheduling: a prescribing pathway, not a marketing launch.
Schedule 8
- Available on prescription
- MDMA for , from 1 July 2023
- Only by specially authorised psychiatrists
Schedule 9
- Prohibited
- MDMA for every other use
- Where MDMA sat before the change
The pathway is narrow. MDMA can be prescribed only by psychiatrists with specific training and authorisation, and the same kind of authorisation applies to psilocybin. Elsewhere the picture was different. As of 2021, psychedelic drugs were controlled substances in most countries and psychedelic therapy was not legally available outside clinical trials, with some exceptions. MDMA has limited approved medical uses in a small number of countries.
How strong is the evidence? suggest MDMA-assisted therapy may substantially improve symptoms compared with psychotherapy alone, but the certainty of the evidence is low to very low and safety data are limited. Most psilocybin trials for depression have had financial conflicts of interest and significant risk of bias. The Australian decision is therefore best read as a regulated, cautious opening, not a verdict that these treatments are proven.
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Recap
Rescheduling in 2023 opened a narrow path for authorised psychiatrists, not a general approval of the drugs.
💡 A trick to remember it · A key, not an open door: eight for the clinic, nine for everything else.
Surprising fact · MDMA moved from Schedule 9 to Schedule 8 only for PTSD treatment and stayed prohibited for every other use.
Sources (4)
No source, no claim. Every fact in this lesson (11 claims) cites at least one of these.