Keynote Presentation: Cannabis-based medicines, psychedelics and MDMA: viable interventions for youth mental health?

Cannabis, psychedelic drugs (e.g. LSD, psilocybin, DMT) and MDMA (Ecstasy) have historically been considered as enemies of youth mental health, hindering neurodevelopment and increasing the risk of psychosis, depression and school dropout. Our appreciation of the potential harms of these drugs have been moderated recently by the realisation that they all may have certain beneficial therapeutics properties. More than 300,000 Australians have now received a prescription for a medicinal cannabis product and efficacy is emerging for a wide range of conditions including chronic pain, anxiety, insomnia and neurodevelopmental disorders. Recent research by the Lambert Initiative and our partners has shown efficacy of CBD, a non-intoxicating component of cannabis, in treatment resistant youth anxiety. THC, the main intoxicating ingredient in cannabis, was found to be effective in reducing tics and anxiety in Tourette syndrome. Ongoing clinical trials are examining the efficacy of CBD in treating anorexia nervosa, first episode psychosis and pain arising from spinal cord injury. Psychedelic drugs are being tested in clinical trials and are showing promise in treatment-resistant depression and end-of-life anxiety, while MDMA is showing potential in the treatment of PTSD. Our research group is about to launch a trial of psilocybin, the active ingredient in magic mushrooms, in treatment-resistant anorexia nervosa. Clearly, we live in exciting pharmacological times where psychoactive drugs that have traditionally been demonised are now undergoing rehabilitation, in a way that may revolutionise the future of psychiatry. Use of these drugs in children and young adults still requires special consideration given the possibility that they may interfere with the trajectory of brain development. CBD is generally considered safe in children, while use of THC and psychedelics should most likely be reserved for special cases where no other viable treatment options are available.

Professor Iain McGregor

Iain's research is focused on the discovery and development of new medications for the treatment of disease and involves the full pipeline from medicinal chemistry, through cellular and animal models, to clinical trials. Iain has more than 300 peer-reviewed publications and multiple patents. The discoveries of his team around the use of oxytocin-like molecules to treat addiction and social withdrawal led to the successful spinoff company Kinoxis Therapeutics.

The Lambert Initiative for Cannabinoid Therapeutics which was formed in 2015 with a gift of unprecedented generosity from the Lambert family to the University of Sydney. The Lambert Initiative, under Iain’s leadership, conducts world-leading research into the therapeutic benefits of cannabinoids in epilepsy, pain, cancer, addictions and mental health conditions. It has also developed a large library of proprietary small molecules with Dr Sam Banister.

Recently Iain and his team have diversified into psychedelic research and are currently developing plans for a research program around psychedelic drug discovery including a recently-funded clinical trial of psilocybin in the treatment of eating disorders.