Proper Consultation Needed to Ensure Safe Access to Psychedelic-Assisted Psychotherapy

Published in Calgary Herald January 10th 2023 | Original Article

Psychedelics certainly are having a moment. If you’re a Netflix watcher, podcast listener, or you’ve delved into the reams of peer-reviewed research on psychedelics – you probably already know that modern science and clinical evidence now validate what humans have understood for thousands of years: psychedelics are safe, and they can transform how we treat chronic pain and mental health.

 Our coalition of patient groups, healthcare providers, service providers, researchers, and manufacturers of psychedelics feel compelled to bring into the open critical issues with the Government of Alberta’s forthcoming regulations for psychedelic-assisted psychotherapy.

 While we are encouraged by their initiative to create new regulations governing psychedelic-assisted therapies, we are deeply concerned with the impact these regulations will have on patient safety and access, and we are disappointed by the lack of genuine consultation to create these new laws that will come into force just 100 days after they were first announced to the public and most impacted stakeholders.

 Canada’s first framework for PAP ought to be a best-in-class example that other provinces and policymakers around the world can follow. It should be on the best available clinical data and leading research. Instead, Alberta’s example was built behind closed doors and is an obvious harbinger for deleterious patient access and safety issues. These regulations were approved unilaterally by former Premier Jason Kenney’s cabinet in the final days of his leadership, unchecked by Premier Smith’s transition into office, and unseen in the legislature by Alberta’s NDP opposition.

 The new regulations restrict clinical oversight of psychedelic-assisted therapy treatments exclusively to psychiatrists. While we certainly agree that psychiatry must play an outsized role in assessing patients for these novel treatments, other qualified healthcare providers, including anesthesiologists; neurologists; chronic pain, palliative care, and addictions physicians; family doctors and nurse practitioners with training in chronic pain and/or mental health – have relevant expertise and should also be permitted to prescribe and oversee these treatments in collaboration with psychologists and other licensed therapists.

 Expanding these criteria to include adequately trained medical professionals would prioritize patient safety and is reflective of best medical practices. It is also important to note that unlike with anesthesiologists, ER physicians, palliative care specialists and other medical specialties – psychiatric training does not typically include the use of anesthetic agents like ketamine or associated resuscitative techniques. 

 Wait times of 6-18 months to see a psychiatrist in Alberta may lead some patients to seek access to these promising treatments from illicit and/or unregulated sources. For patients impacted by treatment-resistant depression and/or PTSD, extensive treatment delays could lead to unbearable pain and tragic outcomes. Simply put, there is no evidence-based justification for specialty or subspecialty requirement for healthcare providers within the regulations. Amending this part of the regulations to include other qualified healthcare providers will reduce wait times and ensure safe, legal access with no negative consequences for any patients in Alberta.

 These regulations will also directly contradict the College of Physicians & Surgeons of Alberta’s recently released guidelines for the IV administration of ketamine in community-based clinics, which allow ketamine delivered via IM, intranasal, and lozenges to be prescribed by any qualified healthcare providers within medical offices and regular community clinics. This change will further restrict access and remove currently available treatment options for qualifying patients, despite no evidence of harms associated with current provincial practices.

 In less than a week, Alberta’s rush, ill-informed and overly restrictive regulations become law. This will inevitably lead many patients to self-medicate using an unregulated drug supply or access underground treatment options. This change will also make it easier for many eligible patients across the province to access MAID than psychedelic-assisted psychotherapy. 

 We could not agree more with Premier Smith when she said, “You can make fast decisions, but they’re not necessarily the best decisions. It is better to take a little bit of a slower track to make sure that everybody has a chance to have their viewpoint heard.” (Citation:https://nationalpost.com/pmn/news-pmn/canada-news-pmn/alberta-set-for-2023-election-one-premier-just-got-the-job-the-other-wants-it-back)

 We would welcome an opportunity to contribute our real-world and leading expertise with psychedelic assisted-treatments and patient access issues in a transparent and inclusive process to create well-informed, evidence-based regulations that prioritize public safety and balance safe, legal access to psychedelic-assisted psychotherapy for patients in need.

Psychedelics Canada, Psychedelic Association of Canada, The Ketamine Assisted Therapy Association of Canada, Vanguard Wellness, Heroic Hearts Project Canada, SABI Mind, ATMA, Bloom Psychedelic Therapy and Research Centre, Wayfound, Psygen Industries, Filament Health, EntheoTech, Absolem Health Corp, PharmAla Biotech, Psychedelic Development Corporation