A new survey of American psychiatrists suggests that some psychoactive drugs should be reclassified by the DEA
Psychoactive drugs have remained a controversial topic for many decades. While several studies have helped show the medicinal properties of drugs like psilocybin, current government policies in the United States classify these drugs as Schedule I drugs according to the Controlled Substances Act.
However, this classification may change over time, as new investigation shows a significant difference between US policies on these drugs and how psychiatrists perceive their safety, which could eventually lead to a push towards new classifications in the coming years.
Background: What are Schedule I drugs?
The United States Drug Enforcement Association (DEA) classifies drugs into five categories schedules depending on the medicinal properties of the drug and the likelihood of drug abuse. Annex I contains drugs that have a high abuse factor and can be addictive. As the schedules increase in number (from II to V), the abuse factor decreases, allowing the drugs to be safer to use. Current Schedule I drugs include LSD, peyote, cannabis, heroin and psilocybin.
While drugs like heroin have little medicinal benefit and tend to be highly addictive, other Schedule I drugs like psilocybin and cannabis have been shown to have more medicinal value, suggesting that they should be reclassified.
Analysis: A Survey of Psychoactive Drugs
To see if this need for reclassification was a broader trend, researchers at Ohio State University recruited 181 psychiatrists from across the country to give their opinion. Participants had been practicing for an average of 16 years. Each participant received one of the four scenarios where a patient had found relief from symptoms of depression with an off-prescription medication.
The hypothetical patient wanted to incorporate the drug into a more formal treatment using either psilocybin (a Schedule I), methamphetamine (a Schedule II drug), ketamine (a Schedule III drug), or Xanax (a Schedule IV drug). The choice of these four drugs was a deliberate choice by the researchers. According to the first author Adam Levineresearcher at Ohio State University, “Psilocybin may not be timed appropriately, and we felt the risk may be underestimated for Xanax. Methamphetamine and Ketamine, Review Says literature, are fairly consistent with their schedules. And then we wanted to see if psychiatrists perceived any incongruities.
From the survey, the researchers found that psychiatrists’ opinions on the safety and abuse factors of the four drugs differed significantly from the Controlled Substance Act enforced by the DEA. Participants were more likely to rate psilocybin and ketamine as safe, while Xanax and methamphetamine were rated as less safe. Because Schedule I drugs like psilocybin are more restricted, they are more difficult for scientists to study, creating gaps in accessibility and possible future treatments. To address these issues, the researchers suggested that clear policy changes were needed.
Outlook: reclassification will not be easy
“Generally, I would suggest that the policy reflect the scientific evidence,” Levin explained in an interview with the debriefing. “In some cases, that would mean placing certain high-risk drugs on more restrictive schedules, as happened with alprazolam in Australia in 2014. In other cases, that would mean removing drugs that are relatively safe and have therapeutic potential of the most restrictive categories as will likely occur with psilocybin in the United States once it is approved for medical indication by the FDA.
Although some drugs like psilocybin may be reclassified in the future, the process will not be easy. “Even beyond the initial rescheduling, it will be important to continue updating policies to reflect emerging data and expert opinion,” Levin added. “This could include patient and provider education initiatives and other strategies to maximize treatment benefits and minimize risks.”
It seems that the current US administration is beginning to realize that a reclassification is necessary, as a multidisciplinary federal task force has been created to address the issue. We hope that this working group will play a key role in enforcing a reclassification, helping to create much-needed change in the health and pharmaceutical sectors in the years to come.
Kenna Hughes-Castleberry is a Debrief Writer and Science Communicator at JILA (a partnership between the University of Colorado at Boulder and NIST). His writing beats include Deep Tech, Metaverse, and Quantum Tech. You can find more of his work on his website: https://kennacastleberry.com/