Health

Why There’s So Much Promise Around Psychedelics For Mental Health

Once upon a time, you may have taken mushrooms or ecstasy for fun. Today, these drugs—alongside other psychoactive substances—are showing serious promise in treating a range of mental health issues. Here’s what you need to know about the new age of psychedelics.

A colourful, psychedelic-looking illustration of two women in profile.

(Photo: Jacquie Comrie)

If I close my eyes tightly enough, I can still remember the rush of euphoria that hit me the first time I took MDMA (a.k.a. ecstasy) at the age of 16. It was 1998, and my best friend and I had snuck out of her house in Port Credit, Ont., and taken the GO train to downtown Toronto. There, we loaded ourselves onto a magical school bus to attend our first rave. As we arrived in the middle of nowhere, we saw a sea of bodies clad in fun fur, tightly gripping glow sticks and swaying to thumping bass lines. It was like nothing I had ever experienced before. Everyone was welcoming and inviting, happy to share a warm embrace—or some of their favourite party favours, “to help keep the vibe alive.”

Soon after we arrived, a stranger handed me a small purple pill with a tiny star detail pressed into the top, which I immediately gulped down. I should have been scared but, for whatever reason, I wasn’t. Within hours—maybe even minutes?—I felt all of the pent-up anger that I couldn’t quite place, and all of the displaced sadness I harboured for not being the perfect kid my parents wanted, slowly ease out of my body. For the first time in a long time, I felt happy and connected to myself.

This marked my introduction to psychedelics, a class of psychoactive substances—which also includes psilocybin (commonly called magic mushrooms), ketamine and LSD—whose primary effect is to trigger non-ordinary states of consciousness. Little did I know, nearly 25 years later, the party drugs of my youth would be headlining some very promising therapeutic treatments for anxiety, depression, post-traumatic stress disorder (PTSD) and more. Here’s what you need to know about the new age of psychedelics.

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In the late 1930s, a Swiss chemist who worked for a pharmaceutical company synthesized a compound he hoped would stimulate the cardiovascular and respiratory systems. It didn’t, but the chemist, Albert Hofmann, always suspected that this compound, called LSD, might have other uses. After embarking on some “informal” research, he experienced LSD’s hallucinogenic effects first-hand. This discovery kicked off a global round of research into psychedelic-assisted psychotherapy.

Saskatchewan’s Weyburn Mental Hospital soon emerged as a leading facility for such research. There, in the 1950s, psychiatrist Humphry Osmond—who is credited with coining the term “psychedelic”—studied how LSD, mescaline (derived from several types of cactus) and other hallucinogenic substances could be used to help transform mental health care. Around this time, a colleague of his, Colin Smith, conducted a small study on the effects of LSD treatment in 24 people with alcohol issues. About 50 percent saw some improvement; Osmond eventually treated hundreds of patients who overused alcohol with LSD. Recreationally, the drug became incredibly popular in the 1960s and was touted by countercultural icons of the time, like the novelist Ken Kesey and the Harvard psychologist Timothy Leary.

But then came the war on drugs. Psychedelics were placed in the most restricted category in the United States Controlled Substances Act, alongside marijuana, cocaine and heroin. Canada’s Narcotic Control Act also classified them as dangerous drugs with no medical value. As a result of this criminalization, psychedelic research ground to a halt, relegating these drugs to illegal use on the party circuit.

Today, after decades of advocacy, Canadian doctors and researchers are finally being allowed to perform limited clinical trials as they attempt to prove the validity of psychedelics as a treatment for PTSD, depression, anxiety, eating disorders and addiction issues.

Behind much of the push to further the research that first began in the 1950s is the Multidisciplinary Association for Psychedelic Studies (MAPS), a nonprofit that originated in California in the 1980s; it has had a Canadian arm since 2011. MAPS, whose mandate is to advance psychedelic medicine and support legal and regulated access to it, has raised more than $130 million to fund research on MDMA, LSD and other hallucinogens, as well as cannabis. “I still think that people have it in their head that…this is just something you get high on,” says Sabrina Ramkellawan, the research committee lead for MAPS in Toronto, referring to both psychedelics and cannabis. She finds it confusing that people are willing to tolerate the side effects of many pharmaceuticals yet disparage drugs that “give you pleasure and make you happy.”

Barinder Rasode is a 53-year-old Sikh woman from Vancouver. On the phone, she candidly shares that she has what “the younger South Asian women have now dubbed Brown Girl Trauma.” She grew up in a loving home, but when she looks back on her childhood, she recognizes just how much intergenerational trauma her parents passed along to her. Therapy was never up for discussion as a way to manage her anxiety and distress. “A lot of whatever you cope with, you bury down deep inside instead of dealing with it or talking about it,” she says.

In 2018, Rasode founded Grow Tech Labs to help the pre-legalization cannabis community navigate new terrain in Canada. In 2020, she co-founded Havn Life Sciences, a biotechnology company developing natural health products, including psychedelics, to treat mental health issues. Her investment followed her personal experience using psilocybin, after her 48-year-old brother passed away suddenly from a heart attack in 2019.

“To say that it had more impact on my life than I ever could have imagined is an understatement,” she explains. Her brother had made sacrifices in his own life to help her care for their aging parents and her three children, which gave Rasode, a single mother, the space and freedom to become a successful entrepreneur. When he died, her support system crumbled—and she had regrets. “I had lost an opportunity to really build a healthy relationship with him, and I didn’t realize that until he was gone,” she says.

As she learned more about the potential mental health benefits of psilocybin, Rasode came to believe that it could help her shift her overwhelming grief and process her trauma in a safe way. She decided to try it.

Psilocybin is a controlled substance in Canada, and only around 90 people have been granted legal exemptions by Health Canada to possess and consume it. In August 2020, the Victoria-based non-profit TheraPsil received legal exemptions to use psilocybin to provide end-of-life psychotherapy to four people with terminal cancer. Spencer Hawkswell, the organization’s CEO, thinks it was a huge win not just for TheraPsil but also for patients in general, as studies have shown that the treatment can help produce significant and enduring positive effects, including reducing anxiety and depression and improving death acceptance. “These people are dying, and they have tried everything. Then sometimes it becomes a reasonable medical decision to try something like psilocybin,” he says. A few months later, 16 additional exemptions were granted to allow health care professionals—including TheraPsil’s director—to use the drug themselves as training. However, for most people, psilocybin remains illegal; it was illegal for Rasode to buy. Still, she trusted her source and took 3.5 grams of mushrooms with a group of friends a few months after her brother died.

She had a very intense, five-hour experience, during which she says she “relived” her entire relationship with her brother. She realized that while, yes, she could have spent more time helping him cope with his own trauma and difficult times, she had also just been surviving and coping herself.

“Of course, I’m still missing him,” says Rasode. “[But] I honestly believe that it would have taken me years of therapy trying to process his loss had it not been for me being able to have that experience where you step outside of yourself and are really honest.” She says that her trip has given her a new perspective on life and on her commitment to making changes for herself.

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Mark Haden has been on the front lines of the crusade to legitimize psychedelic medicine for decades. The former executive director of MAPS Canada, Haden is currently the director of clinical research at Psygen, which plans to produce pharmaceutical-grade psychedelic drug products for clinical research and therapeutic applications. He’s also an adjunct professor in public health at the University of British Columbia School of Population and Public Health.

“Fifteen years ago, you couldn’t have an open discussion about the evidence of psychedelic medicine in the medical community,” says Haden. “Now I have a group of physicians that I meet with regularly.”

Over the past few years, a slew of studies with promising findings has stoked interest—and investment—in psychedelic medicine, both in Canada and around the world.

In February 2021, a human study—one of the first of its kind—conducted at the University of Alberta showed that traumatic or stressful events in childhood can lead to tiny changes in key brain structures, which may increase the risk of mental health issues in adulthood. In a press release about the study, the school’s interim chair of psychiatry, Peter Silverstone, noted that the next step is to focus on treatments that might help mitigate or even reverse these changes. (Research has shown that ketamine enhances synaptic plasticity—the brain’s ability to form new connections and repair existing ones—which can help treat depression.)

In May 2021, a double-blind, placebo-controlled study funded by MAPS garnered worldwide headlines for finding that MDMA-assisted therapy led to “a significant and robust” decline in symptoms for those with severe PTSD. “[MDMA] has the potential to [help] millions of people who live with the impacts of complex trauma and other clinical conditions,” Ramkellawan of MAPS Canada says. “I think that we’ll be amazed at what we see.”

And in June 2021, the University of Calgary announced the Parker Psychedelic Research Chair, a position with a mandate to conduct research on the potential of psychedelics to improve mental health. The position came about via a $3-million commitment by alumnus Jim Parker, who saw his niece recover from severe PTSD thanks to intravenous ketamine therapy.

“It’s not about just taking psychedelics to have a lot of fun,” explains Haden. “It’s about what is the research and what is the medicine here.”

In Canada, ketamine has conventionally been used by doctors and veterinarians as an anesthetic and painkiller. But in 2020, Health Canada approved a ketamine nasal spray called Spravato for treatment-resistant depression. It has also starting allowing for off-label use of the drug outside of hospitals and academic research settings. For those who have run out of options with other mental health treatments, it seems to be showing a lot of potential.

In Toronto, Field Trip Health launched its first ketamine treatment clinic in March 2020. Across Canada, similar clinics have opened, offering ketamine-assisted therapy, with some provincial health care plans offering partial or full coverage.

Field Trip’s clinical operations director, Monica Mina, was formerly a nurse practitioner at a major Toronto hospital, and says that many of her patients weren’t helped by traditional treatments for mental illnesses. “[They] would often try to commit suicide,” she says. “I would be caring for a lot of people who were really struggling.”

When Mina saw the job posting for Field Trip Health, she started doing her own research into the psychedelics field. What she read led her to apply; she’s now been with Field Trip Health for two years.

“I think psychedelics can do a lot of good in terms of relationships,” says Mina. “A lot of our clients are talking about this feeling of connectedness [on ketamine], this love and compassion they feel for others.” Many clients come to Field Trip with relational trauma, she says, and the therapy needed to help with this can be intensive. Ketamine and other psychedelic treatments seem to help during the process, and in creating a lasting commitment to healing.

For many people, Field Trip Health is a last resort—patients must be referred by another health care practitioner, and most have exhausted other existing options, including antidepressants and even electroshock therapy. After a referral, the Field Trip team evaluates patients to determine if a ketamine-based treatment truly is the best course of action. Each session lasts between 45 and 90 minutes, and every drug session is followed by a debriefing with a psychotherapist. Currently, this specific therapy is not covered by Ontario’s provincial health care plan: A treatment series—which includes multiple sessions of ketamine therapy and psychotherapy—starts at $4,700.

While many doctors, researchers and patients are enthusiastic about the future of psychedelic treatments, some also worry about psychedelics going the way of cannabis; namely, that the marginalized communities who have suffered most from criminalization will be left behind, and people in need of health care will scramble to pay for expensive treatments while investors cash in. Some market research suggests the sector could be worth as much as US$10.75 billion by 2027.

Jessica McKeil is a cannabis writer from Salt Spring Island, B.C., who began microdosing psilocybin—taking a tiny amount, not enough to cause a hallucinogenic effect—in 2019 to help with her panic and anxiety disorders.

The changes were subtle at first, says McKeil, who is 35. She became less anxious about deadlines, for example, and was more in the moment during daily tasks, like walking her dog. One rainstorm walk was particularly memorable: “I would stop to look over at the field in the pouring rain, and I just thought it was so beautiful and I would just have good days,” she says. “Yes, days became good!”

While McKeil is worried about the commercialization of psychedelics, she also wishes there was more of a push to educate, train and create a structure around professionals in the psychedelics space. There are many people offering guided trips on Salt Spring Island, she says, and “it would be so much better if there were a few more safety protocols.”

Since psychedelics remain illegal while interest in their therapeutic benefits grows, the underground industry is booming, fuelled by clients willing to take risks because they feel like they’re out of other options. “Either we put the power into the doctors’, health care practitioners’ and patients’ hands, and they allow for there to be medical supervision,” says TheraPsil’s Hawkswell, “or the alternative is no medical supervision. And that’s what’s happening now.”

The world of unlicensed psychedelic treatments has “exploded,” says Haden, calling it the “Wild, Wild West,” where many self-designated therapists have no medical or therapeutic training at all. He says unlicensed therapy can range from “excellent” to “abusive.” A lack of structure means a lack of medical support in case of an emergency. A lack of medical training, meanwhile, could mean failing to know whether patients’ other pharmaceuticals might cause a bad interaction—patients on medication for schizophrenia, for example, could be at risk of setting off a psychotic episode. “We want patients and doctors to work together when they’re using these substances,” explains Hawkswell.

Zach Walsh, a professor of psychology at the University of British Columbia who specializes in research on cannabis and psychedelics, notes that psychedelics are less toxic than many legal drugs. He hasn’t seen significant negative mental health consequences from controlled psychedelic experiences in his own research, and says that while there have been concerns that frequent use could lead to symptoms similar to cannabis-induced psychosis—a rare but serious side effect of frequent cannabis use—he hasn’t seen the same pattern among psychedelics users.

Instead, like Haden and Hawkswell, Walsh worries about people who might experience a bad trip without proper medical support. “People looking to explore [psychedelics are] looking to have an experience that’s going to enhance their wellness,” he says. “If they don’t get support, they might find the experience disorienting and unpleasant, rather than something that creates a meaningful change.” Above all, he says choosing to use psychedelics is a big decision, and it can take time to decompress from the experience. “Like most medicines, effects vary across individuals,” he says. “Psychedelics are certainly not a panacea that can resolve all problems.”

Professional support is also important given the heightened vulnerability that comes with some psychedelic experiences. During his time at MAPS, Haden advised that psychedelics sessions be led by two therapists of mixed genders who would report back to a therapeutic college of psychedelic supervisors and be accountable for their behaviour. He believed this would be important in case those participating in studies (or eventually going for psychedelic therapy) needed to report an oversight or incident that occurred with a therapist.

The risk of sexual assault is a consideration with MDMA therapy in particular, since the drug increases one’s feelings of empathy as well as friendliness and playfulness with others. “It reduces people’s sense of boundaries and it increases a sense of closeness,” explains Haden. “So people have to be very professional as a result and [respect] what those boundaries are.” There is also a small amount of physical touch between therapists and patients that can take place, such as hand holding through an emotional session or body work using finger pressure. “There will always be a discussion in advance with the subject, with a lot of detailed clarity that there is a difference in touching and it’s not sexual touching.”

MAPS itself isn’t immune to issues that could compromise patient safety. In 2018, a Canadian participant in a MAPS clinical trial for MDMA accused one of the two therapists present during her sessions of sexual assault. MAPS Canada agreed to pay $15,000 to the patient so that she could obtain therapy while she sought legal action. (The patient filed a sexual assault complaint with the RCMP, but upon investigation, no charges were laid. She also filed a civil claim, which was settled out of court on undisclosed terms.) MAPS severed its relationship with both therapists and, in 2019, released a code of ethics, including a section that forbids sexual relationships between therapists and their patients. For his part, Haden says he was not involved in the hiring, training or supervising of the therapists who led the session in question. He resigned from MAPS Canada in 2021.

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Throughout my teens and early 20s, I used psychedelics like MDMA and ketamine to numb myself to the realities of my traumas. At the time, I chalked it up to a drug problem. But now I wonder if seeking out those euphoric forces was an attempt to deal with my then undiagnosed depression. Psychedelics seem poised to help a lot of people in a lot of pain; my hope is that they’re taken seriously and developed in a way that ensures safe, credible and accessible care. Above all, I know that the healing process is a long, bumpy road for which there is no magic pill.

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