In Canada, our tax-funded healthcare system—a cornerstone of our national identity—guarantees equal access to a wide range of treatments, from anti-depressants and antibiotics to life-saving surgeries, and even methadone and Medical Assistance in Dying (MAiD). Yet, there’s a significant and progressive element missing from this list: psilocybin-assisted therapy.
Across the nation, healthcare spending decisions, such as which treatments are included under various provincial Medical Service Plans (MSPs), rest in the hands of our elected representatives. For instance, British Columbia has made significant investments in opioid antagonist therapies; annually, thousands access methadone for opioid addiction. Equally notable is the increasing demand for MAiD, with over 2,000 British Columbians opting for MAiD out of a total of 10,000 nation-wide in 2021. While these are necessary solutions, they have their limitations.
Methadone, while helpful for many, can lead to new dependencies and health complications. Its potential for abuse and diversion is a known concern. On the other hand, psilocybin represents a markedly different approach, offering a novel alternative. Yet, the lack of funding under MSPs across Canada restricts its accessibility to those who can benefit from it. This, in turn, forces people like Jesse Merks, a 28-year-old British Columbian who has successfully used psilocybin to get off opioids and methadone, to seek treatment underground. Without healthcare funding, Merks and his doctors are struggling to keep the treatment going. It is worth noting that in British Columbia, a province-wide Section 56 exemption legally permits the consumption and possession of fentanyl, heroin, cocaine, as well as other opiates. However, similar requests to access medical psilocybin through Section 56 exemptions have been denied by health ministers Mark Holland and Ya’ara Saks.
This access discrepancy prompts a crucial question: why do our health ministers allow possession of heroin, fentanyl, and cocaine, but not psilocybin? And why not consider both, especially when doctors are requesting medical access for their patients?
With the anticipated 2024 amendments expanding MAiD access to include mental illness as a sole indicator, the need for stringent safeguards and alternative treatments becomes even more pressing. Social determinants to health, like economic stability, housing, health coverage, and geographic location can limit access to safeguard alternative therapies. With so much need for effective safeguards, we must not let the cost of psilocybin-assisted therapy and the lack of accessible regulations be a barrier for those who could use psilocybin as an alternative or complementary therapy to MAiD.
As a human rights advocate at TheraPsil, I have seen the transformative effects of psilocybin-assisted psychotherapy on individuals grappling with end-of-life distress and terminal conditions. The story of Janis Hughes, a Manitoba woman who pursued underground psilocybin-assisted psychotherapy, underscores this point. She said: “I may well have exercised my right to MAiD if I had not taken matters into my own hands.”
Hughes and many other patients have struggled to get legal access through the Special Access Program (SAP), an expensive “pay-to-play” option only available to those who have the necessary extensive medical resources to navigate the often insurmountable red tape of the SAP.
It is unfair and saddening that in Canada it is easier for folks like Merks and Hughes to access drugs like fentanyl and heroin, and life-ending treatments like medically-assisted death, than it is to access life-affirming psilocybin-assisted psychotherapy.
But Merks and Hughes are fighting back.
Alongside Bruce Tobin, Jim Doswell, Thomas Hartle and hundreds of doctors and healthcare professionals, they are suing Ministers Holland and Saks, who they claim are violating their charter rights by not granting exemptions to psilocybin. Similar lawsuits have legalized cannabis and MAiD in Canada, but similar to others, this one will probably take years longer than Canadians like Merks and Hughes can afford.
I write this piece not to criticize our health ministers, but to call them to action and to bring attention to a grave injustice with a simple compassionate solution. I ask our ministers to exercise their power and grant these Canadians access to their medicine.
In February of this year, the Special Joint Committee on Medical Assistance in Dying made the following recommendation: “That Health Canada reviews the Special Access Program, other programs and policies, and relevant laws and regulations to determine whether there are ways to improve access to promising therapies, such as psilocybin-assisted psychotherapy, for both research purposes and for individual use as part of palliative care supports.”
Without immediate medical exemptions and a plan for funding and regulations, we can expect thousands of Canadians to make a tough choice between a difficult and expensive but potentially life-saving therapy (psilocybin) and more affordable, yet less effective, alternatives such as pharmaceuticals, opioid replacement therapy, and MAiD.
We stand at a pivotal moment in the Canadian healthcare system as we expand MAiD and liberalize access to illegal drugs. Funding clinical trials or providing SAP access for psilocybin treatments is not just a policy decision, but a moral imperative. As we push for equitable healthcare, it's crucial to explore novel treatments that could revolutionize recovery and wellness.
We need to expand subsidized access to psilocybin for Canadians in medical need. Last year, TheraPsil drafted medical regulations which are based on medical cannabis regulations and would help thousands of patients and healthcare professionals access legal psilocybin, and crack down on illegal sales and replace it with a regulated market (they can be read here).
Regulations take time. So in the meantime, I, along with hundreds of other Canadian healthcare professionals and patients engaged in the courts, implore Honourable Minister Holland and Honourable Minister Saks to grant Section 56 exemptions to psilocybin on compassionate grounds.
I urge our governments, at both provincial and federal levels, to consider funding psilocybin therapy as an essential service. It is time to embrace innovation and compassion in our healthcare system, providing hope and new avenues for treatment to all Canadians in medical need.
Spencer Hawkswell is president and CEO of TherapSil: a non-profit coalition dedicated to helping Canadians in medical need access legal, psilocybin-assisted psychotherapy and medical psilocybin.