Canada’s internationally-acclaimed reputation for progressive health laws comes primarily from the country’s assisted dying policies, as well as a publicly-funded health care program. Additionally, Canada pioneered the drug revolution, after becoming the first Group of Seven country to make cannabis legal in 2018. Although Canada has certainly earned the title of progressive, it seems that current times are calling for the relaxation of restrictions. What with the global pandemic and overdose crises, as well as emerging evidence pointing towards the potential therapeutic benefits of psychedelics, some policies are looking a little old-school. In current times, small groups of patients, doctors, and therapists have been granted government-approved exemptions to use psilocybin. In fact, the country’s health department is contemplating making changes to current policies, to include more psychedelics than magic mushrooms alone. Since 2020, a few companies including publicly traded organizations and non-profit firms have been working with Health Canada. The intention is to promote further access to the compound psilocybin, as well as other hallucinogenic therapies. Although some have chosen to use existing legislation in order to assist those applying for exemptions, others have chosen to support policy changes that would potentially allow doctors to prescribe restricted drugs for patients. One of the first studies to emerge from the psychedelic revolution was conducted in 2016 at the John Hopkins University. The study explored how psilocybin would impact anxiety and depression in patients suffering from terminal cancers. The research revealed that a single dose of psilocybin provided patients with long-term relief (for up to six months after one treatment session). In fact it was reported that 78 percent of participants experienced a decrease in depressive symptoms, while 83 percent reported longstanding relief from anxiety. One patient with stage four colon cancer, 52-year-old Thomas Hartle from Saskatoon, couldn’t believe the results after reading the findings. He felt that the results were too good to be true, adding that when a person suffers from anxiety, they will look for any source of relief. Hartle recruited the assistance of Victoria-based non-profit organization, TheraPsil, in an effort to access psilocybin-assisted therapy himself. TheraPsil has assisted a number of Canadian citizens to apply for exemptions. These include clinically depressed and terminally ill patients, in addition to therapists and doctors. The company makes use of a subsection in the Controlled Drugs and Substances Act that grants the health minister permission to dish out exemptions for scientific or medicinal purposes. The first exemptions were granted in August 2020, to 4 Canadian citizens facing end-of-life depression and anxiety. One of these patients was Thomas Hartle – a husband, father and IT technician. Hartle explains that his anxiety is “specialized to the existential kind,” highlighting the severity of his condition. As a result of his condition, Hartle has volunteered himself as a guinea pig and is eager to share his experiences with the world. Prior to his first treatment session, Hartle underwent extensive preparation with a trained psychotherapist and has since followed up with another session. Hartle claims that the psychedelic therapy sessions have shifted his perspectives surrounding the death. He explains how his fear of the unknown (death) no longer holds power over him, saying that the concept of death no longer feels so unfamiliar. He acknowledges that the human identity is molded from memories and experiences, explaining how with psilocybin his state of consciousness “existed in ways that had absolutely nothing to do with anything in this life.” He goes on to say how he was at peace with the experience of being “identityless” – to simply exist without attaching oneself to concepts of the ego. This experience led Hartle to believe that it may be possible to have “some sort of continuation of consciousness” after death. Hartle goes on to describe a heightened sense of compassion and being more in tune emotionally. Additionally, he has noticed increased creativity in his naturally logical mind. As if all of these benefits weren’t enough, Hartle notes that the treatment also assisted in migraine-associated pain relief. Having suffered from migraines since childhood, he jokingly states that psilocybin has only positive side effects in comparison to other treatments he has tried over the years.
Doctors Now Have Access to Psilocybin Too
Dr Emma Hapke, co-chair of TheraPsil’s research team is one of 16 therapists, doctors, social workers, and nurses to have been granted exemptions recently. The exemptions were granted in order to allow professionals to prepare for therapy sessions with patients. Hapke is part of TheraPsil’s training committee, focused on creating a program for hallucinogen-assisted therapy. She states that the organization feels strongly that therapists should experience psychedelics and altered states of consciousness for themselves, in order to have the experience necessary to guide future patients. Hapke highlights the fact that although hallucinogenic substances have been found beneficial in people suffering from various mental health disorders, it is necessary to combine psychedelics with therapy so as to achieve optimal long-term relief. She believes that psilocybin alone is not what causes the emotional healing, but the combination of entering an altered state with the guided experience of a therapist. This allows patients to access various parts of the psyche, and to view problems from multiple perspectives. The combination of therapy and hallucinogens is known as integrated therapy, and without the psychotherapy aspect, it is difficult for a trip to lead to long-term change. TheraPsil’s CEO, Spencer Hawkswell, mentions that prior to 4 August obtaining exemptions for end-of-life patients seemed like an insurmountable challenge. In current times this has changed and his team has found renewed optimism. Hawkswell ruminates over his disbelief, saying how he had never dreamed that the process could be so easy, or that Health Canada would be so cooperative. He passionately declares how terminally ill patients are “empowered Canadians”, with rights and systems designed to support them. That being said, the system is failing to meet the needs of the masses, due to the strict policies surrounding drugs and mental healthcare. Hawkswell says it is the goal of TheraPsil to show that there are options “beyond the current policy regulations” and norms of healthcare in the country of Canada.
Numinus Lab Advocates Special Access Program (SAP) Reform
Health Canada’s SAP grants healthcare practitioners permission to request access to restricted drugs for patients who have tried other treatments unsuccessfully. Technically, the Special Access Program allows medical practitioners to request access to psilocybin and other drugs such as LSD or MDMA. However, in 2013 access to restricted drugs was banned under Stephen Harper, the prime minister of the time. Since the prohibition, the only method of obtaining these substances is through clinical trials. Health Canada announced its plans to reverse these regulations on December 12 and opened a 60-day period for public comments and feedback. The chief medical officer from Numinous, Dr. Evan Wood, has been pushing for change since as early as 2019. He says that by changing the Special Access Program’s provision on controlled substances, Health Canada will be able to realign with the Helsinki Declaration. The Helsinki Declaration is a set of global guidelines for ethics that states that if a patient finds a controlled drug to be beneficial in a clinical trial, the patient should have the right to receive continuous therapy. As it stands, if a Canadian citizen were to access a hallucinogenic drug or another controlled substance through clinical trials (even with the co-operation of a medical practitioner), and find it beneficial, they are unable to progress with treatment. Wood says that in his opinion this decision centers around stigma and the “cultural baggage associated with these molecules.” He believes that the exemptions are bringing Canada into alignment with the global ethics guidelines, and sees a window of opportunity for Canada to pioneer change in the psychedelics sector. Although Wood admits that the worldwide pandemic has understandably taken up most of Health Canada’s focus in 2020, he is happy to see that hallucinogen-assisted therapy has now become an area of focus, and he accredits the agency for the propositions of regulatory reversals. If the shift in SAP policies is made, Wood believes that access to ground-breaking psychedelic treatments may have the potential to increase dramatically. This is because all patients interested in the process would only need to locate a doctor willing to apply for access to psychedelics. After this, applications would be processed on an individual basis, but this would be much easier than an application for a Section 56 exemption. When it comes to organizations such as Numinus, Wood believes changes will enable the company to establish the infrastructure of the business better. Additionally, the training of staff and other safety factors would come into play. Although psychedelics substances are known to be safe, there are a number of risks to be aware of. Wood explains that the hallucinogen-assisted therapy might not work for everyone, but goes on to say that the mere hope of a “cure in the context of mental health challenges is a total paradigm shift.” Although some may say that decriminalization should be the logical next step, Health Canada does not yet agree. Spokesperson, Minister Hajdu, made a statement that said the agency is committed to thoroughly reviewing all requests for exemptions. He goes on to say that decisions would only be made after weighing up the risks versus benefits. He adds that there is much to learn about the risks, explaining that this is the reason that psilocybin is still illegal.