Canada’s new special access program opens the door for medical psychedelic use

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Health Canada is now allowing access to psychedelic medicine for select patients. With this new ruling, physicians will be able to use Canada’s special access program to request psychedelic medicine such as psilocybin and MDMA for their patients with life-threatening conditions who have tried every other treatment. 

Canada’s special access program offers physicians access to drugs or medical equipment that have not yet been given the green light for sale in the country. With this program, physicians can request drugs. However, Health Canada only allows access to the drugs if “conventional therapies have failed, are unsuitable or are unavailable.” 

Psilocybin and MDMA are examples of the types of psychedelic drugs that could be accessed through the program. Psilocybin, one part of the ingredient included in “magic mushrooms” is a hallucinogen that can cause people to see, feel, hear, and experience things that don’t exist. 

Many psychedelics have been criminalized in Canada over the years, but mounting research has uncovered the medicinal benefits of using them responsibly. Some recent research has shown that psychedelics can be used to treat patients struggling with their mental health, especially in situations where the patient’s condition has not responded well to other treatments. 

The chemical factors found in psychedelics like psilocybin and LSD have been known to help patients dealing with anxiety or depression due to a terminal illness. Research shows that, oftentimes, patients only need a small dose to improve their mood and the reaction to the drug treatment is seen in a short amount of time. 

The study of psychedelic use in medicine is not new in Canada. In fact, there has been a lot of research on psychedelics in the country throughout the past century.

In the 1950s in Saskatchewan, patients in mental health asylums were provided treatment with psychedelics and it was reportedly to give researchers a better understanding of psychotic disorders, and to help with addictions research.

As research on psychedelics for medical treatment, especially to treat mental health illnesses continued, some researchers saw patients benefiting from a single-dose of psychedelic medicine, equating its effect to spending time in therapy.

In the 1960s, the Canadian government changed the laws around the use and research of psychedelics after thalidomide, a drug found to cause birth defects, was banned. This caused members of parliament to discuss what kind of drugs should be prohibited, and psychedelics were one of the drugs placed on Canada’s controlled substance list. 

As years have gone by, the interest for use of psychedelics in medicine is beginning to grow, however, just because researchers are finding ways to use psychedelics to treat patients, doesn’t mean Canada will take it off its controlled substance list. This is why organizations have started advocating for its use in the medical field. 

TheraPsil is a Canadian non-profit organization that provides “psilocybin-assisted psychotherapy to treat end-of-life distress.” The work done at TheraPsil began in 2019 and it includes advocating for access to psilocybin-assisted therapy and providing psilocybin therapy to patients in need with approval from Health Canada

In order for TheraPsil to conduct psilocybin-assisted psychotherapy for their patients, they need to complete and receive special exemption. 

The CDSA (Controlled Drugs and Substances Act) has an exemption under which gives the Minister of Health permission to allow a person to use certain controlled substances once they’ve filled out the exemption form and the health minister finds that the “exemption is necessary for a medical or scientific purpose or is otherwise in the public interest.” 

Physicians and patients who require access to a controlled substance need to fill out a seven-page form detailing their information, the substance they require, and the reason for it. TheraPsil assists their patients in filling out and submitting the forms, as well as supporting their approval for the exemption. 

Holly Bennett, communications director at TheraPsil says their patients’ approval for the exemption allows them legal access to the psilocybin-assisted psychotherapy. 

At TheraPsil, psilocybin-assisted therapy works in what Bennett calls a “three-phase model.” In the three-phase model, patients start with a medicine and drug-free therapy session. Bennett says this phase is called “intention setting” and its purpose is to create a trusting relationship with the patient and therapist as well as an understanding of what the patient hopes to uncover with their therapy session. 

Patients are not given psilocybin until they’ve completed multiple sessions of “intention setting.” Before the psychotherapy begins, the two therapists conducting the therapy session give the patient a blindfold as well as a specific music playlist to listen to. Bennett says the music is to help patients go “inward and deep into their consciousness” and the psychotherapy is a “six-to-eight hour journey inside themselves.” 

“Some patients have said they have met family that have passed away during their trips. They have said they’re able to visualize their cancer or their disorder in ways that they haven’t before, which can allow them to kind of separate it from themselves and personify their disorders or their diseases,” Bennet says. 

After the patient comes back to a conscious state of mind, another session called “integration sessions” begins in which the patient discusses the journey they went on with their therapist and try to find the meanings in the trip.

Bennett says the therapy is also used for patients who are living with a life-ending condition and are struggling to cope with their mental health. 

“If you’re diagnosed with a life-threatening cancer diagnosis, you may begin to have lots of thoughts about your own mortality, and really difficult, challenging emotions to go through,” she says. 

Bennett says talk therapy is one of the usual treatment options provided for patients struggling to process difficult emotions from their life-ending condition. Though when talk therapy or antidepressants don’t get to the root of their emotions, TheraPsil uses psilocybin-assisted therapy as a treatment option. 

She says when patients use psilocybin, it helps them access part of their emotions that they wouldn’t be able to access if they were in their usual state of mind. 

TheraPsil has been able to help 27 patients access psilocybin-assisted psychotherapy and the special access program provides them another way to continue to help patients. While the country-wide program is a step forward, Bennett says it has both benefits and drawbacks. 

With the special access program, she says patients will have safe access to psilocybin because the exemption does not actually give patients legal access to purchase psilocybin, and many still have to purchase their supply in unsafe markets. 

“Through the special access program, doctors can now request psilocybin from a Health Canada approved licensed dealer on behalf of their patients,” Bennett says. 

Bennett says the program does not address this because it wasn’t created for the purpose of psychedelic use, and often is for emergency situations only. 

“So, you can imagine that the majority of people who may benefit from psilocybin-assisted psychotherapy, patients who have depression, anxiety, PTSD for example, or chronic pain. We don’t know what Health Canada deems an emergency,” Bennett says. 

“They’re not very clear in terms of saying you have to tick X, Y, and Z boxes for us to know it’s an emergency, it’s still placing the discretion of access in the hands of somebody at the special access program,” says Bennett. 

Bennett says the special access program now gives TheraPsil two ways to help their patients, but right now they can mostly help patients through the exemption form, though they are working to figure out how to use the special access program to support their patients. 

Approved patients only have a year to use the exemption, and some of the patients Bennett has worked with have accessed the psilocybin therapy up to three times in a year. 

Bennett says there can be a future where psychedelics are used in Canadian medicine and that is a future that TheraPsil is trying to make a reality. She says right now the special access program may not always help the people who need it, and the legalization of psychedelics in the medical field is the approach Health Canada should be taking instead. 

She says if a patient is diagnosed with depression, talk therapy and antidepressants are treatments that would be available to them, and believes psychedelic assisted therapy should be included in those options. 

“If a patient and a doctor decide together that psilocybin-assisted psychotherapy is the best treatment option … that patient would then ideally be able to access psilocybin from a licensed producer,” Bennett says. 

She also wants the medical legalization of psychedelics to include proper training for the healthcare professionals conducting the psychedelic treatment. 

“We believe that these healthcare professionals need personal experience with this medicine and with this modality,” Bennett says.

“Although a doctor doesn’t necessarily need to know what it’s like to have cancer in order to prescribe chemotherapy, a therapist — whether that’s a massage therapist or a cognitive behavioural therapist — they need to actually go through that therapy themselves for them to be able to provide that therapy for their patients.” 

TheraPsil continues to advocate for the medical legalization of psychedelics and they’ve created a document which details the steps the government can take to regulate it. Bennett says the document follows the framework that was used to legalize cannabis in 2018, which provides a pathway towards expanding access to medical use of psychedelics that the government can implement.