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Psychoactive Drug Schedule Classification Out of Sync With Psychiatrist Views
US psychiatrists consider the nonprescribed use of methamphetamine and alprazolam more concerning and less acceptable than nonprescribed use of psilocybin and ketamine, according to a study published in the International Journal of Drug Policy.
“Evidence points to an incongruence between international drug policy and expert opinion about safety, abuse potential, and therapeutic potential of specific drugs,” wrote corresponding author Alan K. Davis, PhD, of the Center for Psychedelic and Consciousness Research at Johns Hopkins University, Baltimore, Maryland, and study coauthors. “However, no prior studies have directly explored psychiatrists’ attitudes about the current drug schedule.”
Recognizing psychiatrists as specialists in the prescription and abuse of psychoactive drugs, researchers conducted a quasi-experimental survey of 181 US psychiatrists to assess their expert perspective of current drug scheduling placements.
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Participants, whose average age was 49, randomly receive one of 4 clinical vignettes depicting a depressed patient reporting relief from depressive symptoms after nonprescribed use of a psychoactive drug: psilocybin (Schedule I), methamphetamine (Schedule II), ketamine (Schedule III), or alprazolam (Schedule IV). Participants answered questions about the scenario and then rated the safety, therapeutic, and abuse potentials of each of the four drugs as well as alcohol.
According to the study, psychiatrists rated methamphetamine and alprazolam as less safe, having less therapeutic potential, and having more abuse potential, than psilocybin and ketamine.
Average safety and abuse/therapeutic potential ratings for alprazolam and methamphetamine were equivalent to those for alcohol. All 3, researchers pointed out, were considered by psychiatrists as more harmful than psilocybin and ketamine.
“American psychiatrists’ perceptions about safety and abuse/therapeutic potentials associated with certain psychoactive drugs were inconsistent with those indicated by their placement in drug schedules,” researchers wrote. “These findings add to a growing consensus amongst experts that the current drug policy is not scientifically coherent.”
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