In Canada, End-of-Life Therapy May Be the Path to Legal Psilocybin

August 9, 2021

In August 2020, 53-year-old Thomas Hartle became the first Canadian to legally undergo psilocybin-assisted therapy. Hartle, who currently has stage 4 colon cancer, received a federal exemption to use psilocybin to help him process the prospect of death.

“I didn’t have any concept of how life after death could be possible. How could there be an afterlife for me if there was no Thomas?” Hartle told Filter. “Psilocybin gave me an actual experience of consciousness that did not rely on anything connected with this life.”

Psilocybin has been shown to have numerous therapeutic applications, including for end-of-life distress as well as mental illnesses like depression. While breaking ground in the UK and various US cities, psilocybin is a Schedule III substance under the Canadian Controlled Drugs and Substances Act (CDSA) and has so far not been accessible to patients through legal means.

Psilocybin-assisted psychotherapy is generally carried out in three parts: pre-administration sessions to establish goals and build a rapport with a therapist; administration of the psilocybin itself, usually in the form of pills or tea; and “integration,” or processing of the experience.

“It allows me to recover after chemo a lot faster.”

Psilocybin, and psychedelic experiences on the whole, can have powerful, long-lasting therapeutic effects, including for people with terminal illnesses. Hartle said that through psilocybin, he realized that his consciousness was not confined to his body; that his physical form didn’t define him. In addition to helping him cope with end-of-life distress, psilocybin also relieved him of the dread he had felt before his chemotherapy sessions.

“My sympathetic nervous system has calmed down,” Hartle said. “It allows me to recover after chemo a lot faster and I think that must translate into longevity at some level.”

In the year since Hartle was granted his exemption, 45 other patients have received them from Health Canada as well. While most had terminal illnesses, one patient received their exemption for severe depression, and another for ALS. An additional 19 health care professionals working with TheraPsil—a nonprofit patient advocacy group providing psilocybin therapy—were granted exemptions so as to be able to legally use psilocybin as a part of their training. On August 3, TheraPsil submitted a 165-page regulation draft to Health Canada asking the department to regulate psilocybin.

The Parliamentary Review Committee has invited Hartle to testify once it resumes sessions this fall. “I have personally experienced a real improvement in my quality of life,” Hartle told Filter. “I believe that I have a valid opinion, both as a patient who has experienced the treatment and as an advocate.” 

Hartle, who lives in Saskatoon, had his last psilocybin treatment in November and hasn’t needed any since then. But the Section 56 exemption granted to Hartle by Health Canada under the CDSA that allows him to use psilocybin is only valid for one year and expired on August 4. His advocacy for access through a regulatory model is partly because he himself wanted to avoid the lengthy application now facing him again.


A Controversial Opportunity

The opioid-involved overdose crisis, which has worsened under the pandemic, is increasingly fueling the movement for safe supply—and, by extension, prospects of making psilocybin treatment government-regulated. To get the foot in the door, a Canadian nonprofit has launched a campaign to introduce psychedelic medicines to the controversial Bill C-7, which proposes the expansion of the laws governing medical assistance in dying (MAID).

In March 2021, after a five-year review, the federal government made a controversial amendment to the legislation: allowing people with mental illness as their only underlying medical condition (MD-SUMC) to request medical assistance in dying. Psilocybin advocates made a logical argument: If patients with severe mental illness could access prescription medication to help them die, why couldn’t terminally ill patients access prescription psilocybin to help them as they faced death, too? Why couldn’t mentally ill patients pursuing medically assisted dying access prescription psilocybin to ease their own pain—or even to help them explore whether they wanted to live?  

“If patients have the right to end their lives, should we not at least give them the right to try psychedelic-assisted therapy which might ease their anguish?” Trevor Millar, the co-founder of the Canadian Psychedelic Association (CPA), told Filter. The CPA is asking the Parliamentary Review Committee on the bill to include psychedelics as an option for mental wellbeing, and to help palliative patients to die peacefully.

“This would open the door for more legal, regular access for patients.”

The new provision of MD-SUMC to the MAID bill will be implemented in 2023, a year after the Parliamentary Review recommendations are submitted. The committee report is due on March 17, 2022.

“This would open the door for more legal, regular access for patients,” Michael Kydd, CPA’s MAID campaign lead, told Filter. “Instead of having them apply through a Section 56 exemption [of the Controlled Drugs and Substances Act] or a clinical trial or through the Special Access Program.”

However, Canada may hold federal elections in the fall—which could delay the MAID bill’s progress or even reshape the country’s drug policy entirely. 

“Politicians don’t want to take strong positions leading into an election because they could be held to account for those decisions,” Kydd said. Nonetheless, he believes this could be an election issue, although it makes more sense strategically to see who forms the next government and do the heavy lifting from there. The CPA has spoken to around 50 Members of Parliament since launching the campaign, and has received strong bipartisan support so far. 

Kydd said that in the next few months, the CPA will be asking politicians across party lines to address the need for regulatory approval of psilocybin therapy for end-of-life and palliative patients. The association’s forthcoming campaign will aim to connect Health Canada with psilocybin providers to help implement the regulatory framework. It will also push each federal party leader to put out a clear public policy on medical psilocybin access by the end of 2021.


Broad Decriminalization

Regardless of when the election is held, psychedelic reform is becoming a steady fixture in the Canadian political landscape.

A recent Nanos Research survey suggests that 68 percent of Canadians support allowing legal access to psilocybin treatment as part of palliative therapy.

While Vancouver awaits its city-wide Section 56 exemption to decriminalize the simple possession of state-banned drugs, mayors representing seven British Columbia cities have also extended their support on eliminating criminal penalties. Ontario’s Big City Mayors have also called for the broad decriminalization of drugs, and an increase in funding for mental health care.

Around the same time Hartle got his federal exemption, an amendment was made to the CDSA section governing personal possession of drugs in Canada criminal charges, diverting people away from the criminal justice system and into drug treatment courts.

“It isn’t really decriminalization if the drug court can send you to jail.”

“But it isn’t really decriminalization if the drug treatment court can send you to jail,” Dana Larsen, a drug policy activist in Vancouver, told Filter. “By decriminalizing drugs we mean we’ll be decriminalizing people who use drugs. But even decriminalization is not going to reduce deaths significantly. It’s more about stopping the harassment, demonization and the persecution of the vulnerable.”

Larsen has been openly distributing psilocybin mushrooms online since 2019, and now also has a storefront service in Vancouver. He’s now planning to establish a heroin buyer’s club, through which members pool their resources to secure a safe supply. 

“It would provide cheaper and clean access,” Larsen said. “Users struggling with withdrawal symptoms won’t have to suffer from the pain and anguish of supply.”

While public opinion is increasingly shifting in favor of evidence-based policy changes, the Canadian health care system may not be prepared to respond. It’s likely that broad drug decriminalization would be implemented in stages.

“We’ve already seen this happening in Vancouver,” Erika Dyck, Canada Research Chair in the History of Medicine, told Filter. “They’re testing those waters by creating spaces and experimenting with ways to provide harm reduction or psychedelic-guided therapies.”



Photograph via Pixabay

Ritika Dubey

Ritika is a reporter covering drug policy, especially relating to psychedelics. She writes for Truffle Report and is a regular contributor to The Registrar Magazine. She previously worked for Outlook India Magazine. She lives in Toronto.

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