As Canada gradually moves towards the legalization of MDMA, psilocybin, and other psychedelic medicines, the only way practitioners can offer Psychedelic-Assisted Psychotherapy is via Canada's Special Access Program (SAP). Licensed prescribers (i.e. Medical Doctors or Nurse Practitioners), can now apply for a safe supply of psilocybin, or another scheduled substance, on behalf of their patients with serious or life-threatening illnesses. SAP grants are approved on a case-by-case basis and are at the discretion of the government.
Formerly, patients were required to apply for a Section 56 exemption to legally use, possess, transport and destroy a certain amount of a substance for medical use under certain circumstances and guidelines (i.e for use in psychotherapy). It essentially decriminalizes a small amount of a substance for a patient so that they can legally pursue psychotherapy with said substance. Patients with section 56 exemptions had to procure their own substance of choice from unregulated sources. The SAP now addresses this.
Health Canada states that the “request must be for treating a patient with a serious or life-threatening condition where conventional treatments:
– have failed
– are unsuitable or
– are not available in Canada
Exactly which conditions and circumstances that Health Canada deems to be ‘serious’ or ‘life-threatening' are still unclear. However, it has been stated that ‘Intractable depression’ along with ‘terminal cancer’ are considered serious enough, as outlined by Health Canada. Individuals with debilitating mental health symptoms are encouraged to apply.
Psychotherapists at AEM Counselling can work with a client's family physician to fill out the SAP application form. Our trained therapists can offer professional consultation to the client's medication prescriber so that they can be advised on the client's mental health condition. As one can imagine, although the medical prescribers have been designated as the gatekeepers, the health care provider that sees the client on a week to week basis is the one that will have the most informed opinion on the client’s mental health status.
Why is the government making allowances for these once restricted drugs for health-care reasons? Well there has been a long history of the research into the potential for psychedelic drugs to induce meaningful outcomes for the mind and overall well-being.
The exploration into the therapeutic application of psychedelic substances for physical and mental illnesses has exploded within the last decade, and especially in the last few years. The research is picking up from where it left off 70 years ago, where a long period of misinformation, stigmatization, and political posturing stifled the encouraging results people like psychiatrist Humphry Osmond were seeing in patients who were receiving LSD as a treatment for alcoholism and various mental disorders in the early 1950s.
Government-authorized research and more than a dozen privately-funded studies are picking up where the initial research left off. Findings from hundreds of subjects are available from research funded by institutions such as MAPS and the Beckeley Foundation, and which is carried out in clinical settings like NYU, London’s Imperial College, and John Hopkins.
What do we know? The field is still growing, but as it emerges, classic psychedelics such as Psilocybin, LSD, mescaline, and ayahuasca as well as non-psychedelic hallucinogens like Ketamine and MDMA may have genuine therapeutic applications for the treatment of psychological conditions including depression, PTSD, substance abuse, and anxiety disorders, to name a few.
Along with Psilocybin, MDMA is making significant headway as a therapeutic treatment, specifically for PTSD. The US Food and Drug Administration (FDA) approved regulated Phase 3 clinical trials for MDMA-assisted psychotherapy in the treatment of PTSD starting in 2019. These large scale, multi-site, randomized, placebo-controlled clinical trials are required by the FDA to demonstrate safety and efficacy prior to any prescription use. MDMA-assisted psychotherapy for PTSD has progressed to Phase 3 FDA drug development research, with FDA approval anticipated by the end of 2021 or early 2022.
This is an encouraging and positive step in the right direction from those in the US and Canada suffering from PTSD for whom current treatment options are not yielding significant enough results. It is estimated that about 8% of Canadians who experience a traumatic event develop PTSD (Canadian Mental Health Association, 2013). In Canada, the estimated lifetime prevalence rate of PTSD is 9.2% (Ameringen, Mancini, Patterson, & Boyle, 2008). In the US, PTSD affects around 3.5% of the population, approximately 8 million Americans, in a given year.
Many agree that there is a growing abundance of evidence that this group of drugs is capable of improving our mental functioning for a more peaceful, functional society. And with careful collective effort towards accessing and using these drugs in a safe, controlled and measured way, and under medical supervision, we can demonstrate to the world that these drugs have a profound ability to bring about a deep sense of calm, creativity, and connectedness (CCC) to the outside world. The CCC’s are what psychotherapist here at AEM Counselling consider to be the ultimate goal of psychological treatment.