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Health-care professionals fight decision to reject access to psilocybin for training

Health Canada: no evidence therapists ingesting psychedelics helps provide more effective treatment

Canada violated the rights of hundreds of patients awaiting access to psilocybin-assisted psychotherapy when it rejected applications from health-care professionals to consume the restricted drug for training purposes, a lawyer for the workers argued in Federal Court on Tuesday.

But Health Canada argued it hasnB次元官网网址檛 seen evidence that therapists ingesting the psychedelic trains them to provide more effective treatment.

The health workersB次元官网网址 lawyer, Nicholas Pope, said there arenB次元官网网址檛 enough health-care professionals licensed to provide psilocybin-assisted psychotherapy and Health CanadaB次元官网网址檚 decision means patients may have difficulty accessing therapists offering the treatment.

Pope and Health Canada made their argumentsas part of a request for a judicial review of Health CanadaB次元官网网址檚 June 2022 decision that denied applications from 96 health-care professionals to possess and consume psilocybin B次元官网网址 the psychedelic compound produced by magic mushrooms B次元官网网址 as part of training to obtain a licence to prescribe the drug.

The health workers B次元官网网址 including doctors, psychologists, clinical counsellors, social workers and nurses B次元官网网址 had requested an exemption under the Controlled Drugs and Substances Act.

Pope said the workers want the court to order Health Canada to retract its rejection of their applications to use the drug.

B次元官网网址淭housands of patients across Canada who suffer from treatment resistant depression, major depressive disorder, and end-of-life distress have tried countless treatments and medications but have found no relief,B次元官网网址 he told the court.

B次元官网网址淓ach day that goes on, the delay increases risk of harm B次元官网网址 Six of the waitlisted patients have testified that theyB次元官网网址檝e contemplated or attempted suicide.B次元官网网址

Psilocybin-assisted psychotherapy involves ingesting consciousness-altering substances like psilocybin in a clinical setting as part of more traditional psychotherapy. A trained, licensed clinical practioner then provides therapy that guides patients as they experience the effects of psilocybin.

Pope cited in his arguments several peer-reviewed studies that found such psychotherapy can safely and effectively treat patients dealing with psychological and physical pain that is otherwise treatment resistant.

In 2020, Health Canada started granting exemptions under the Controlled Drugs and Substances Act to patients suffering from end-of-life psychological distress, treatment-resistant depression and major depressive disorder.

In December 2020 and January 2021, Health Canada granted exemptions to 19 health-care practitioners to consume and possess psilocybin as part of a psilocybin-assisted psychotherapy training program offered by TheraPsil, a non-profit organization that offers training to health-care practitioners and is working with patients to obtain psilocybin.

B次元官网网址淗ealth-care practitioners have reported that the training improved their ability to treat patients, and no negative effects have resulted from this training or the exemptions,B次元官网网址 documents submitted to court by the health workers said.

Pope told TuesdayB次元官网网址檚 hearing that about 80 Canadians have ingested psychedelics to treat their pain, with the governmentB次元官网网址檚 permission, since 2020.

Hundreds more inquire about it daily to alleviate their anxiety, depression, suicidal ideations, opioid use disorder, post-traumatic stress disorder or other illnesses, he said.

B次元官网网址淏ut there arenB次元官网网址檛 enough professionals in the country to provide the treatment,B次元官网网址 Pope said.

B次元官网网址淭wo Manitoba health-care practitioners requested exemptions. If these two exemptions were approved, patients who otherwise have no qualified health-care practitioners within thousands of kilometres could gain access to psilocybin-assisted psychotherapy.B次元官网网址

The health workers are arguing the backlog of patients needing the service is so huge, Canadian doctors who are currently trained in the therapy donB次元官网网址檛 have the capacity to meet the demand.

Pope also said there are reports of people who are untrained but are offering psilocybin therapy B次元官网网址渁nd people are suffering harm.B次元官网网址

Pope noted that Health Canada had urged health-care professionals to participate in an existing clinical trial or create their own but that doesnB次元官网网址檛 work for several reasons.

One is that existing trials are costly, and are impractical in terms of timing and location, Pope said. Some professionals also donB次元官网网址檛 want to participate in existing trials because the trialsB次元官网网址 purpose is to research psilocybin, a potential ethical problem for professionals whose focus is training.

Jennifer Francis, a lawyer for Health Canada, said the health professionals have not proven that therapists ingesting the drugs during training leads to better treatment.

There are Canadians who provide the psychotherapy without having consumed magic mushrooms during their trainings, Francis said.

She also said the minister believes the health-care professionals are making B次元官网网址渟weeping and conclusive statements about the state of the scientific evidenceB次元官网网址 on psychedelics.

B次元官网网址淚n worst-case scenarios, people have jumped from buildings after having taken psilocybin,B次元官网网址 she said. B次元官网网址淟esser effects of whatB次元官网网址檚 known as a bad trip (are) characterized by anxiety, fear, panic, unhappiness and paranoia.B次元官网网址

In response to the ministerB次元官网网址檚 concerns, Pope said itB次元官网网址檚 important to note that the therapy requires a clinical expert to monitor a patient at all times so safety concerns with psychedelics are significantly reduced.

Yassie Pirani, a Vancouver-based registered clinical counsellor who is part of the case, said in a phone interview it is B次元官网网址渁bsolutely essentialB次元官网网址 for experts who support patients during their psychotherapy to experience the psychedelics themselves.

B次元官网网址淚tB次元官网网址檚 believed that by experiencing this non-ordinary state of consciousness first-hand, therapists B次元官网网址 are going to be better able to intervene and, more importantly, know when not to intervene,B次元官网网址 she said.

There are medications doctors currently prescribe, for example, that can lead to irreversible sexual dysfunction, but B次元官网网址減silocybin has a lot less risk and this is known in the research,B次元官网网址 said Pirani, who helps treat anxiety and depression.

Pope said in a phone interview he is expecting a decision within six months.

B次元官网网址擣akiha Baig, The Canadian Press

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