When Janis Hughes finished her first high-dose psilocybin trip, she thought she might die at the dining room table. But she felt just fine with that.
“It was the most marvelous state of being I’ve ever experienced. And I felt like it was where I’m going to go when I die,” Hughes, 66, told Filter. She experienced her trip under supervision at her therapist’s home in Winnipeg, Manitoba. “I was floating among the stars, there were vines that I was catching onto, and I was laughing. I just couldn’t stop laughing.”
“I think I feared annihilation. I have such comfort now.”
It’s been over a decade since Hughes was first diagnosed with breast cancer, and a few years since she first was told the word “terminal.” Recently, she’s been using psilocybin-assisted therapies in order to better come to terms with her own death—a concept that had previously thrown her into an unending cycle of distress.
“I was experiencing so much anxiety I couldn’t focus on living,” Hughes said. “I think I feared annihilation. I have such comfort now.”
Psilocybin remains banned in Canada under Schedule III of the country’s Controlled Drugs and Substances Act, even if this is frequently ignored. Some very limited exemptions provide pathways to accessing it legally for therapeutic use.
In an email to Filter, Health Canada said that “psilocybin therapies are not available in Canada because there are no approved therapeutic products containing psilocybin in Canada or elsewhere.” Patients can, however, potentially be treated with the drug through clinical trials, or through the government’s Special Access Program, which allows use of non-marketed drugs for the treatment of serious or life-threatening conditions when no other options are possible.
It certainly hasn’t been an easy journey for Hughes to access psilocybin legally. While she wasn’t afraid of the possible repercussions of ordering illegally online—very few people in Canada have ever faced criminal charges for these types of purchases—she wanted to use psilocybin in a controlled setting, with professionals who were trained in guiding her through the trip.
“They said, ‘No, we won’t give you an exemption, and we’re doing this for your safety.’ Are you kidding me? I’m a terminal patient. What are you saving me from?”
But in February 2022, she was denied a Section 56 exemption from Health Canada, which would have allowed her to receive psychedelic therapies from practitioners working with Therapsil—a nonprofit group of health care professionals seeking to make psilocybin therapy easier to access for terminally ill patients.
“They said, ‘No, we won’t give you an exemption, and we’re doing this for your safety,’” Hughes explained. “Are you kidding me? I’m a terminal patient. What are you saving me from? It’s a kind of mental torture.”
After going public with her story, Hughes was contacted by a therapist in Winnipeg working with psilocybin and other psychedelics. She decided she didn’t have time to wait and see if Health Canada would accept her reapplication, and she started working with the therapist in what she termed a legal “gray area”—first microdosing and reflecting on intent, then working up to a medium and large dose.
“Both trips were fabulous. My fear of dying was totally erased,” Hughes said.
With a newfound acceptance of her own mortality, she has been able to live life again, in a way that she couldn’t for years after her initial diagnosis.
“For many people, their anger isn’t only directed at their disease, it’s the fact that their government would rather they die through MAiD than give them access to the medicine.”
For many other patients dealing with overwhelming end-of-life anxiety, it’s not uncommon to choose Medical Assistance in Dying (MAiD), in the absence of options that make life possible to keep living.
“For many people, their frustration and anger isn’t only directed at their disease, it’s the fact that their own government would rather they die through MAiD than give them access to the medicine that they need,” Therapsil founder Dr. Bruce Tobin told Filter.
According to Tobin, increased psilocybin access for terminally ill patients would decrease the number of people seeking MAiD—opening the door for people who are currently choosing MAiD to be able instead to find peace at the end of their lives.
“Virtually all of us in the psychedelic community consider it a no-brainer that generally speaking, the psilocybin experience will tend to reduce interest in MAiD,” he said. “And people get clarity in their experiences, which allows them to actually make that choice.”
At the same time, Tobin said that for people who undergo psilocybin therapy and then do still choose MAiD, death is often no longer so frightening.
“The psilocybin experience increases death acceptance, so certain patients … come to a place of peace with their understanding that their time to die has come, it’s time to let go, and everything is as it should be,” he said. “So in some cases, the psilocybin experience may actually galvanize the decision to go with MAiD, and people are able to choose to peacefully let go.”
“She was interacting with her family again and cracking jokes, but the other big thing was that she was telling her family and her doctor, ‘I’m ready to go now.’”
One of Tobin’s past patients, Sherry*, chose MAiD after psilocybin therapies. She was suffering with excruciating pain throughout her entire body as a result of terminal cancer, leaving her unable to fully interact with friends and family.
Though Sherry desperately wanted to be free of the pain, her fear of dying stopped her choosing MAiD. It was the morning after her first psilocybin treatment that Tobin got a call from her palliative care doctor to come to the hospital.
“Her pain virtually completely disappeared, they were able to take her off the pain meds and she was fully present,” Tobin related. “She was interacting with her family again and cracking jokes, but the other big thing was that she was telling her family and her doctor, ‘I’m ready to go now.’”
“The following day, she messaged her close friends to come over and say goodbye, and they did,” he continued. “Then she called her MAiD physician, and she died surrounded by her family with ease and acceptance and dignity.”
In this light, Spencer Hawkswell, Therapsil’s president, believes psilocybin also needs to be considered as an adjunct therapy to MAiD, and not only as a replacement.
“We’re talking about human beings who don’t just need medical support in dying, they need medical support in living,” he said. “The entire purpose of our medical system is to ensure that a person is as comfortable as they can be, that we’ve done every single thing that we possibly can to support them in living before we go to that choice of hastening death. Unless we’ve tried psilocybin, we haven’t done everything that we possibly can do.”
“I would love for them to shut down the stores. They should try. The result would be legal psilocybin in this country.”
Hawkswell pointed to illicit psilocybin stores that have been operating openly in Canada in recent years, often online and generally without facing legal consequences. It’s proof, in his opinion, that in upholding its restrictions on treatment, the government is behaving “like a PR firm.”
Hawkswell said the government remains reluctant to prosecute illicit retailers because it would mean a legal case which, he believes, would ultimately prove that Canadians have a Charter right to psychedelic therapy. “I would love for them to shut down the stores. They should try. The result would be legal psilocybin in this country.”
Pointing to the government’s lack of empathy, he asked, “What person in their sane mind would think that it’s okay to deny terminally ill patients access?”
While supporting general legalization, the folks at Therapsil stress the practical and ethical importance of assistance during the psilocybin experience in medical contexts.
“For the right person, done in the right way with the right therapist, this can have profound outcomes,” Dr. Houman Farzin, a trainer and supervisor with the group, told Filter. “But that comes through work, and there’s a misconception that once you do experience it once, it’s all over and everything’s fixed. Usually what happens is you realize what the things are that you need to work on, and then you do that work through therapy and that’s how you make this beneficial.”
“Patients are in a vulnerable state because of the influence of the medicine, so training the right practitioners is of the utmost importance,” he added.
Farzin and the Therapsil team hope that in the coming years, wider access to psilocybin will not only allow more patients to receive better end-of-life care, but also help many other patients—people who may have found other treatments unsuitable or undesirable, and are left unable to live life fully due to pain, anxiety or other conditions.
“My only regret is that I didn’t do it sooner.”
“Psilocybin could be used for all kinds of things, from cluster headaches to anxiety and chronic pain, addiction, so as new research comes out, once it reaches a certain caliber of strength, you may be able to convince Health Canada to grant approval,” he said.
Hughes is equally hopeful that changes could see psilocybin therapies make death less traumatic and more peaceful for families of many other terminally ill patients. Her own experience has been transformative.
“I love myself more. I’m comfortable with myself. I’ve lost so many inhibitions. I laugh more,” she said. “I’m better able to focus on other people and their problems. I just think that’s the best gift you can give your friends and family. My only regret is that I didn’t do it sooner.”
*Name changed to protect privacy.
Top photograph via Peakpx/Public Domain. Inset photograph of Janis Hughes courtesy of Bruno Koehn.