In early 2022, Canada became one of the first developed countries to allow patients limited access to psychedelic therapies. Only available for emergency purposes and specifically for patients experiencing treatment-resistant conditions, this change may represent a new era of regulated psychedelic-assisted treatment options.
Canada is taking a tentative approach, but one that is guided by a growing body of clinical research. In a world where patients and healthcare practitioners are attempting to balance excitement with precautions, it may be an approach worth replicating elsewhere.
2022 Updates to the Special Access Program
According to Health Canada, the Special Access Program (SAP) provides healthcare professionals access to “non-marketed drugs and medical devices not yet authorized for sale in Canada.” This program has been designed for limited use — to conduct research, bypass clinical trials and lengthy reviews, and encourage the early use of drugs or medical devices.
Under the SAP, it was technically possible up until 2013 to access restricted substances under exceptional circumstances. But in that year, changes to the Food and Drug Regulations (FDR) removed that clause. Moreover, the change came at a time when psychedelic research was just ramping up.
Yet since 2013, there has been a flurry of activity in the psychedelic realm. Research has come so far that even Health Canada now highlights the medicinal potential of these substances, stating, “There is ongoing research looking at the potential of psilocybin to treat various mental health disorders such as anxiety, depression, obsessive-compulsive disorder and problematic substance use.”
Because of the growing demand for access from healthcare professionals, patients, and researchers, the federal government pushed through new changes to the SAP earlier this year. On January 5th, 2022, Health Canada amended the FDR and the Narcotic Control Regulations to reopen access to restricted drugs through the SAP. This made worldwide news, as Canada became the first developed country to legalize access to the medicinal use of psychedelics.
A Changing Political Climate and Growing Public Support
Canada didn’t crack open the door to legal psychedelic therapy out of the blue. In the last several years, the number of robust controlled clinical studies exploring psychedelic drugs as medicine has skyrocketed. From ketamine for anxiety to psilocybin for depression, there are a lot of exciting results rolling out.
Before changing the SAP in 2022, Health Canada performed a lengthy consultation process with healthcare professionals, relevant organizations, researchers, licensed dealers, and the general public. The overwhelming support the government received from the 392 responses was telling.
As per Health Canada, “Overall, nearly all comments were supportive of the proposed regulatory amendments and/or increasing access to psychedelic substances more broadly. The Department received very little opposition to the proposal, making up less than 2% of all responses.”
A poll conducted by Nanos Research Survey in 2021 reported similarly strong levels of support nationwide. The survey indicated that “82 percent of Canadians approve the use of psilocybin-assisted therapy for people suffering from an end-of-life illness,” while “78 percent would support a government that legalized psilocybin-assisted therapy to improve the quality of life for palliative and end-of-life patients.”
Clearly, practitioners, patients, and the general public support better access to these formerly demonized drugs. And while the changes to SAP don’t decriminalize or legalize psychedelic drugs, these recent modifications open up access for emergency treatments, especially for treatment-resistant cases. It is an essential first step, balancing public safety with potentially life-saving treatment options.
Canadians Are Already Accessing Psychedelic Therapy
Interestingly, before 2022’s monumental amendment to SAP, a handful of Canadians were already granted special access to psychedelic therapies under a special exemption to the CDSA issued by the federal Minister of Health. Although this avenue required a rather daunting application process, there were several success stories.
Several dozen people were approved starting in 2020 under what is known as a 56(1) exemption. According to a report in the National Magazine, 47 Canadians were given exemptions for end-of-life psychological distress, 19 for training for healthcare professionals, and a few more specifically for research. The magazine indicated “another 149 exemption applications in the pipeline.” It’s unknown how many more the minister approved before the changes to the SAP.
Yet, there are other channels for access for patients in Canada, although these fall outside the preview of federal regulation. Long before Canada began exploring changes to the SAP, integrated therapy programs and centers were popping up all over the country. Examples include ketamine-assisted therapy centers, unaccredited counsellors providing trip-sitting services, and unregulated shamanic centers.
Plus, many patients are following their own route to healing in the Canadian black market, often in desperation. In Vancouver, Toronto, and other urban centers, it’s relatively common to find flyers for psychedelics (i.e. microdosing supplies) posted on bus stops and telephone poles. Several online black market dispensaries also openly sell psilocybin capsules, blatantly serving Canadians mail order psychedelics.
At the time of writing, these unlicensed, unaccredited realms are without any criminal repercussions.
Canada Ushers in a New Era for Psychedelic Therapy
Canada may be the first, but it isn’t alone in its subtle shift in regulation around psychedelics. To date, several municipalities in the US have decriminalized certain psychedelics, and there is growing scientific support for the potential benefits. What’s more, several countries have either helpful legal loopholes or no outright restrictions on psilocybin, which has facilitated the recent boom in psychedelic startups and clinical trials.
The world is ushering in a new era of acceptance, study, and access to psychedelics as medicine — and it seems to be doing so relatively quickly. Especially compared with the slow pace of changes to cannabis legislation globally, psychedelics are already getting the fast-track treatment. Canada likely won’t be alone for long in its pursuit of increased access to psychedelic therapy.