New Zealand psilocybin prescriber approval

Domain VII · Transpersonal, psychedelic & altered states · Cameron Lacey · 2025 · New Zealand

What it is

This is a regulated-access pathway, not a psychotherapy model. In June 2025 Medsafe approved a single psychiatrist to prescribe, supply and administer psilocybin outside a research setting to patients he had personally assessed and diagnosed with treatment-resistant depression (TRD). Associate…

Format

• The pathway has two layers: what Medsafe requires of an approved prescriber, and the clinical course that patients go through.
• the dosing-session structure and rescue medicines (a medical responsibility; not described here)

Who practises it, and how they are trained or regulated

• The practitioner. A medical practitioner registered with the Medical Council of New Zealand. They need a current practising certificate with an appropriate vocational scope and no conditions that affect the application. They must understand both the medicine and the psychotherapeutic process, with relevant training and experience. Medsafe expects, for example, prior prescribing in a research setting or collegial…
• The product. Pharmaceutical grade only. Mushrooms and non-pharmaceutical extracts are excluded. The prescriber is responsible for sourcing the product and its quality, and every entity involved in import or manufacture must hold the licences it needs.
• Version followed: Medsafe, Guidelines for applications for approval to prescribe psychedelics, Version 1.0 (24 July 2025), issued under regulation 22 of the Misuse of Drugs Regulations 1977. For the clinical frame, this guide uses what has been published about the first approved prescriber's service (Professor Cameron Lacey, Christchurch) and his University of Otago feasibility trial of psilocybin with interpersonal…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Delayed effects that appear days or weeks later. Keep contact open throughout follow-up.
• Symptoms that persist or get worse after the experience. Arrange psychiatric assessment.
• Splitting between providers, and the client not telling one provider what the other has said.
• Confusion that persists, fear, perceptual changes or suicidal thinking. Escalate to the psychiatrist.
• Last-minute fear or ambivalence. The client can postpone, and this should be offered without pressure.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.