Turn on the TV or flip through the latest bestseller list and it’s clear there’s a renewed interest in the potential of psychedelic drugs to provide emotional healing.
Shows like Nine Perfect Strangers, based on the novel of the same name, and books like Michael Pollan’s How to Change Your Mind look closer at the revolutionary treatment of psychedelics for severe forms of mental suffering. Meanwhile, a small but growing body of recent research has shown these substances may be just what clinicians need to help the most treatment-resistant cases of mental illness in Canada.
Psychedelics, also known as hallucinogens, refer to various substances including LSD, MDMA and ketamine. Another common one is psilocybin, a naturally occurring psychedelic produced by more than 200 species of fungi, also known as magic mushrooms.
While psychedelics have been used by some Indigenous cultures for centuries, ones like psilocybin are currently illegal in Canada – except under rare exemptions for medical or research purposes. Some believers are trying to change that.
The benefits of psilocybin
While psilocybin research has only started gaining momentum in recent years after a decades-long ban tracing back to the war on drugs in the 1970s, what research has come out has been promising.
For instance, psilocybin has been theorized to help people overcome mental blocks that get in the way of processing an issue, such as post-traumatic stress disorder (PTSD) or end-of-life anxiety, which is the distress a person feels when they know they are nearing death.
“Rather than backburnering something that’s bothering you, or backburnering some trauma, some have speculated that it’s like getting you over that hump, so you can address what’s at the core of your distress and suffering,” says Katrina Hui, a psychiatrist and clinical research fellow at the Canadian Centre for Addiction and Mental Health (CAMH) and the University of Pennsylvania who has been involved in psychedelic drug research.
One practical usage of psilocybin is to pair it with talk therapy, Dr. Hui says. Under the supervision of a therapist, a patient will take a dosage of psilocybin and be guided through a counselling session focusing on whatever problem they may be facing.
“Psilocybin mushrooms can almost unveil parts of oneself that maybe they weren’t willing to face yet,” says Michelle St. Pierre, a PhD candidate at the University of British Columbia’s Okanagan campus, who researches psychedelics. For those using the substance for end-of-life anxiety, she says, “psilocybin can help them create meaning out of that, that might have otherwise been difficult to do without.”
Much of the focus on psilocybin therapies in Canada has been on end-of-life treatments because it was the reason for the first legal exemptions for medical usage.
In August 2020, then-federal health minister Patty Hajdu granted four palliative Canadians to use psilocybin to cope with end-of-life anxiety. The four patients had applied for exemptions with the help of Therapsil, a non-profit organization advocating for medical access to psilocybin.
Therapsil chief executive officer Spencer Hawkswell says the approvals were a step in the right direction. Still, he doesn’t understand why there is no legal supply of psilocybin in Canada, leaving the 64 Canadians currently approved for exemptions unable to legally obtain the drug.
“Why do we go from treatments that don’t work right to medically supervised death?” asks Mr. Hawkswell. “It is absolutely ridiculous that this substance wouldn’t be allowed for someone who’s essentially three days away from medical death.”
Ms. St. Pierre adds that “it’s currently easier to get medical assistance in dying approval than it is to access psilocybin for end-of-life anxiety.”
Psychedelics becoming more accepted
Public attitudes around psychedelics are shifting: A recent Nanos Research survey, commissioned by the Canadian Psychedelic Association, found that 82 per cent of Canadians are in favour of psilocybin-assisted therapy in end-of-life illness, while 78 per cent of those polled support legalizing it to improve the quality of life for palliative and end-of-life patients.
The growing acceptance could be in part attributed to psilocybin research that is debunking myths around the substance.
Ms. St. Pierre’s work has challenged long-held ideas around drug usage, such as the preconception that using drugs makes a person more likely to be violent. Her research has found that not to be the case.
Therapsil’s Mr. Hawkswell says psychedelics have also been proven to be useful in dealing with substance-use disorders.
“People are using psychedelics for addiction because we know that trauma so often is the root of many addictions,” he says.
Helping treat hard-to-treat mental health conditions
Research supporting the use of psychedelics in treating various illnesses is giving the Canadian medical community hope that they’ve found another tool to address the growing mental health crisis, which has been made especially clear with the ongoing COVID-19 pandemic.
Still, Dr. Hui notes Indigenous peoples have been using these substances for centuries and the medical community should take care not to co-opt this knowledge. In recent years, there’s been more of a push in psychedelic research to focus specifically on decolonizing the field and incorporating Indigenous knowledge. Some Canadian research on how to integrate psychedelics into the health care system has also begun to take Indigenous history into consideration, although this type of work is still sparse.
Dr. Hui also worries people hearing more about psilocybin will attempt to self-medicate without understanding the risks involved, especially given that research around the drug is still in its infancy.
It’s also difficult to control how each individual will react to the drug. For instance, there have been reported cases of people experiencing hallucinations or becoming paranoid after taking the substance, among other adverse side effects.
These reactions are a major roadblock holding back research on psychedelics, as scientists need to be very careful to control the environment in which the experiment takes place and do their best to prevent bad trips.
“I do think it’s important to also message that these things are still being researched and they’re not without harms,” Dr. Hui says.
Echoing that, Ms. St. Pierre agrees that psilocybin is not a miracle treatment but hopes that more research will eventually help integrate psychedelics into mainstream Canadian health care.
“It’s not a cure-all,” Ms. St. Pierre says. “But it’s certainly one more good tool that we need to have in our toolbox.”
On Nov. 30, The Globe and Mail hosted a virtual event called Regenerative medicine: Where will stem cells take us? Presented by Bayer, the webinar explored the way researchers are working on stem cell advances that could change the future of medicine. Read more here.