Psilocybin Treatments

Danny Kruger Excerpts

Thursday 18th May 2023 Commons Chamber

[Danny Kruger (Devizes) (Con)]

May I add my voice to those who have paid tribute to the speech of the hon. Member for Warrington North (Charlotte Nichols)? She said she was not asking for sympathy, but she has the sympathy of the House and, I am sure, of anybody who watches that speech on film, which I hope many will do. My heart goes out to her for all that she has been through. I also hope more people see the speech of my hon. Friend the Member for Reigate (Crispin Blunt), which deserves wide circulation. He is a tremendous campaigner on many issues, not all of which I join him on, but I sympathise with what he is trying to do today. I particularly acknowledge and want to add to my voice to his point about the suffering of our veterans. As a Member with a large military community, I echo that. Too many of our former servicepeople suffer appallingly from PTSD and we need to do more to help them. Psilocybin might be part of the answer.

Both the hon. Lady and my hon. Friend cited studies suggesting that the efficacy of psilocybin is similar or superior to that of pharmaceutical interventions, and selective serotonin reuptake inhibitor drugs in particular. That is significant and we need more research to test that because, if true, it is tremendously positive news. Crucially, the evidence suggests that psilocybin is not dependency-forming and not toxic. I speak as the chair of the all-party parliamentary group for prescribed drug dependence. Research by colleagues supporting that APPG has laid bare the degree of dependence on prescribed drugs that exists in our country. I am talking not about illegal drugs here, but about drugs administered by doctors, generally in response to mental health conditions, and depression most of all.

A fifth of the adult population is on some sort of dependency-forming drug, such as SSRIs. Many of those are absolutely appropriately prescribed—the hon. Member for Warrington North mentioned that she takes an SSRI—but that is a very high rate. Crucially, and most worryingly, many people who are taking prescribed drugs were only prescribed them, according to the guidance that accompanies them, for a certain number of months. However, because doctors repeat prescriptions and we have such an inadequate system of withdrawal support for people in this country, they are prescribed these drugs for years and years, well beyond the healthy and safe guidance that was given. Of course, if they try to withdraw on their own without the support they need, they suffer terribly. Often they are re-prescribed the drugs because the doctor thinks they are having a relapse, when actually all they are doing is going through the agonies of withdrawal.

We need to do so much more to support people who take these prescribed drugs. There is also a huge amount—at least £500 million a year—spent on prescribed drugs for people where the prescription has gone beyond the period in the guidance. They should not be receiving these drugs, but they are doing so and it is costing the taxpayer half a billion pounds a year. We can think of the knock-on effects in terms of the health costs, and my hon. Friend the Member for Reigate mentioned huge figures there, the welfare costs and the human cost. We need to go beyond these pills. We need to get to an approach to mental health that does not only rely on what he calls the chemical cosh.

I have some concerns about psilocybin being the next big thing or the next SSRI, treated and imagined as if it will be some sort of silver bullet—another pill and another shortcut to what is a profoundly complex set of mental health circumstances, which derive in many cases from trauma and deep-rooted adverse social and emotional conditions that cannot just be wished away by the administration of a new pill.

[Crispin Blunt]

rose—

--- Later in debate ---

[Danny Kruger]

I am happy to give way. I am about to repeat my own argument, but my hon. Friend will do it better than me.

[Crispin Blunt]

My hon. Friend was kind enough to reference the work that has already gone on. I could cheerfully read into the record the list of 15 separate studies where the evidence is gradually being developed, despite the schedule 1 status, about efficacy. That addresses his proper concern about treating this as another mythical silver bullet that solves the issue. There is only one way for us to fully establish this, but it is already evidentially established sufficiently that we should be doing everything we possibly can to enable this treatment to get under way.

[Danny Kruger]

I echo that point. The point I am making more generally is that I am concerned that we withdraw from a medicalised model. It is a bigger topic, but the way we approach health in general can often be over-medicalised, and that is particularly so for the mental health field. I echo my hon. Friend’s point that we have sufficient evidence to justify a more official review and I support the call for that. The hon. Member for Warrington North put the point very well. What we understand to be the case with psilocybin is that it creates this therapeutic window where talking therapies can be even more effective, or can be effective, because frankly often they are not effective at the moment.

If the administration of this non-toxic, naturally occurring substance can create an opportunity where talking therapy can be effective, that should be welcomed, and there is sufficient evidence to justify us looking at that. I am open to suggestions, and I am interested to hear what the Minister says—not from his script—about what might be done. It may be that the chief medical officer is the best office to review this. We need to be careful, and I retain my note of caution about leaping for another solution that might not deliver what we hope it will, but I also share the hope and inspiration that Members have mentioned.

I recognise the point—I do not know whether the Minister will make it—that it is possible to conduct research under schedule 1. As my hon. Friend the Member for Reigate said, it is difficult and expensive. In fact, it is usually just done by pharmaceutical companies that see the opportunity for big profit from new drugs. I am concerned that we do not class this research in that guise. In fact, I hope there will not be big profits to be made from this naturally occurring substance. This is another topic, but I am concerned about the MHRA, how it is funded and how it licenses treatments. I am not entirely sure we are doing the right thing by giving it the power to rubber-stamp licences that have been given abroad. I am not sure that speeding up approvals is always right, but in this case we need to conduct the research.

I find myself in the strange position not only of agreeing with my hon. Friend—actually, I do agree with him on many important matters, just not on others—but of taking inspiration from places such as Oregon and Colorado that I regard as unhelpful places, given the other things they are up to; they are the leading jurisdictions promoting assisted suicide, of which I strongly disapprove. I notice that Australia is also in the gang, and presumably Canada, if it is not so already, will be full steam ahead for psilocybin. Liberals do not get everything wrong, I suppose is my conclusion, because these places are paving the way and in this case we should follow them.