Canada has started the new year with an expansion to its Special Access Policy. This program allows physicians to ask for illegal treatments for patients under specific circumstances. The expansion includes psychedelics like psilocybin and MDMA, but it has some limitations. Let’s answer the question: can I get psychedelics in Canada?
If you are suffering from severe disease or illness and other treatment methods haven’t worked, your physician can now request access to psychedelics for you under the expanded Special Access Policy, or SAP. The expansion applies specifically to patients suffering from an emergency and life-threatening illness that has been resistant to other treatments.
The expansion does not make psilocybin and MDMA legal in Canada. Psychedelics are still illegal for the public, and unauthorized use is still a criminal offense.
While we still have a ways to go to increase access to psychedelic medicine, this expansion is a big step in the right direction for Canada. Let’s talk about Canada’s history of psychedelic access, and what this expansion means for Canadians.
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Psychedelic Access in Canada
Before the expansion, the only other ways for people to access medical psychedelic treatment were through clinical trials and Section 56 exemptions.
Clinical Trials have long been a way for select people to access experimental treatments and drugs. But access to them is very limited, and often takes months or years. Treatment groups are typically small, and many people who participate end up getting a placebo or other treatments. Still, for a few people, clinical trials have helped them access treatments that they wouldn’t have been able to otherwise.
Section 56 exemptions are written authorizations for psychedelic use from the Minister of Health . The intent of Section 56 is to help Canadians access treatments that are still experimental but have shown effectiveness in early trials.
However, this system limits access to very few. The wait time is also long, with initial requests waiting over 100 days for a response. In the long term, this is not a sustainable model for increasing access, but it does show Canada’s intention to help its sick citizens.
In 1999, the Health Minister allowed the first legal medical cannabis use under exemption 56. The high number of exemption requests drove Canada to legalize medical cannabis in 2001, and fully legalize adult cannabis use in 2018. It’s our hope that medical psychedelics can follow a similar path for increased access and legalization.
The nonprofit group Therapsil was formed in 2019 to help patients with medical needs get psilocybin therapy in Canada. They help patients and practitioners navigate the application process. So far they’ve helped 28 patients and 19 healthcare professionals get psilocybin access in Canada .
Last August, Therapsil drafted proposed regulations that could increase psilocybin access . They called for an expanded regulatory system that will help people get legitimate access to psilocybin. It looks promising for the SAP expansion to be a step towards this goal.
For now, physicians and pharmacists can request access to psilocybin and MDMA on behalf of their patients. Requests go through Canada’s SAP .
Canada’s Special Access Policy and Psychedelics
The SAP was established in 2005 as a way for patients to access treatments before being fully vetted through clinical trials. Since the substances a physician can request through the SAP is always changing, there is no public list. Substances on the SAP list are in phase 2 or 3 clinical trials. Physicians can request access to this list by contacting the SAP through their website .
While this expansion is a step in the right direction for psychedelic policy and patient care, it’s a measured one. The announcement points out, “This regulatory change will not result in large-scale authorization for access to restricted drugs.” The change does not decriminalize or legalize psychedelic substances for the public and is designed only to be used in specific, emergent cases .
The SAP expansion is not intended to be a fast-track for drugs that are still in clinical trials. Health Canada is also very clear that substances granted for use under SAP still have risks, and clinicians need to make that clear to patients .
Authorization will be granted on a case-by-case basis, and Health Canada says they will try to respond to requests within one day. But what does the application process look like? Let’s talk about how physicians can request access for patients who have treatment-resistant and life-threatening conditions.
How can practitioners access psychedelics in Canada?
Licensed practitioners, mostly medical doctors, can now ask for psilocybin and MDMA on behalf of their patients. This process is surprisingly simple, and is designed to be faster and easier than section 56. Of course, we won’t know how well this system works until more people have tried it. Here’s what the application process will look like :
In non-emergent requests for specific patients, practitioners can fill out and fax the SAP request form on the Health Canada website. If a patient needs access emergently, practitioners can call the SAP phone number instead. Health Canada will try to respond to all requests within a single workday.
If appropriate, a physician can also request access for future use. The circumstances and reason for this need to be made clear in the future use form.
Once use is granted, the SAP notifies the drug manufacturer and sends a copy to the physician or pharmacist. The manufacturer then gives the drug or substance directly to the physician or hospital pharmacy .
Once a treatment has been used, clinicians are required to report outcomes from SAP substances back to Health Canada. This helps Health Canada gather evidence on effective treatments, and can help them make decisions about future SAP applications.
Health Canada hopes that this expansion will lead to better care for people who really need it. They plan to expedite the approval process in cases when a drug has already been used successfully for a diagnosis. They also plan to take decisions by the United States Food and Drug Administration and the European Medicines Agency into account.
The cost of substances granted under SAP is up to the manufacturer and is not covered by Canada’s state insurance. In some cases, SAP drugs end up being free for use.
The future of psychedelic access for Canada
This expansion isn’t the end of psychedelic legislation for Canada, and we hope for more options for access in the future. But it is a step in the right direction, and it shows that Canada really cares about its citizens and wants them to be able to access substances that are still being researched.
Health Canada has not stated any interest in expanding access for the public at this time. More evidence, more clinical trials, and more physician involvement in psychedelic medicine will help urge Canada and other countries to consider psychedelics as legitimate medicine.
Psychedelics like MDMA and psilocybin could help people with terminal cancer, PTSD, anxiety, and self-exploration. By learning more about psychedelic medicine, you move the field forward and can help increase access for patients. Check out our free courses page for more information about psychedelic therapy and research.
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