Comparing healthcare in the United States to Canada is widespread among disgruntled Americans. Admittedly, the contrast is pretty stark: Canada allows people to access psilocybin for medical reasons, but in the U.S., Congress routinely denies the compound has any medical utility despite decades of research indicating otherwise.
Canada is also the only G7 nation to fully legalize cannabis. In the UK, as just one example, Cannabis remains illegal for recreational use, and even though it is technically legal to prescribe, only four prescriptions have been issued through the National Health Service (the UK’s public healthcare system) due to a lack of awareness and education among physicians on the medical benefits of marijuana for epilepsy, cannabis, and pain. In recreational matters, Tory politicians such as Home Secretary Suella Braverman are even discussing moving cannabis back into the most restrictive category for criminal prosecution, Class A, on par with heroin and cocaine.
However, when they look inward, the U.S. presents an even more complex and often confusing tapestry of state, federal, and local cannabis regulations that can often be at odds with each other. For example, Cannabis has been legalized and decriminalized in some form or another in 37 states yet remains on the Schedule 1 List of Controlled Substances, the very same list that includes drugs like heroin. Unfortunately, U.S. psychedelic laws are taking a similarly disorganized path. States like Oregon and Colorado are setting their own tune while the federal government continues to show a distinct lack of interest in rescheduling.
But does Canada really have such progressive legislation compared to others like the UK and here at home? Drilling into the legalese, paperwork, and fine print reveals the reality is not as simple or impressive as the headlines convey.
When we closely examine the psychedelic goings-on in Canada, we see something that’s perhaps not as progressive as we envisioned. And in some ways, it’s downright disappointing. Legal access has been possible for the terminally ill since 2020, formalized in law in 2022 with two programs approved: “Section 56”, which allows anyone to apply to grow mushrooms for their own use, demonstrating a medical need; and the “Special Access Program” that grants permits to medical doctors to deliver psilocybin therapy and report back to Health Canada on the outcomes.
However, the approval process for an application to try novel drugs like psilocybin is convoluted, and approval is not guaranteed.
Thomas Hartle, who has terminal bowel cancer, made history in 2020 when he became the first Canadian to receive psilocybin therapy with a Section 56 license. Just as others have reported for two decades, since early trials with cancer patients two decades ago at Johns Hopkins and UCLA, the experience transformed his perspectives on death, allowing him to more fully enjoy the time he has left. Despite the horrors he continues to endure, he somehow manages to laugh through them with optimism and good humor, such as when his colostomy bag exploded in the car on his way for an appointment, and he “arrived covered” in his “own poop.”
Hartle underwent his 81st round of chemotherapy last month, and yet made time to speak to us, just hours before the appointment. Saying the need to publicize the importance of psilocybin is more important than his comfort.
Despite his urgent need for a novel treatment like psilocybin-assisted therapy, Hartle faced significant challenges accessing this new, experimental treatment.
Hartle had to wait 106 days for his license in 2020. Many patients never even receive that approval: denials are given for various reasons, as each case is evaluated individually, but the most common reason is “patient safety.” Which is ludicrous, says Hartle. “Psilocybin is safer to take than Advil – so to deny anyone psilocybin due to the ‘safety profile’ of the drug is one of the most ridiculous things I have ever heard.”
Plus, if having to wait 106 days wasn’t bad enough, Health Canada’s bureaucrats took 511 days to reply to his second application for a license. And the answer was no.
“My particular kind of cancer kills most people within 18 months – so they waited my entire expected lifespan just to give me a response. If that doesn’t say ‘we hope you die before we have to deal with this,’ I don’t know what does,” he says. Given that euthanasia has been legal for Canadian citizens since 2016, he’s not exaggerating.
You read that right: You can legally undergo physician-assisted suicide in Canada, but you cannot receive psilocybin therapy for a life-threatening condition that makes life unbearable.
“In 2020, it really felt like we’d made progress, but now it truly feels like we’re just going backward. Telling Canadians that Section 56 is a viable way to access this therapy gives people false hope – it’s ridiculous to the point of being embarrassing for Canada,” he says. “The government keeps saying they need more research – but what happened to all the Canadian research from the 1950s?”
There is some cause for Canadians to feel a sense of pride. Long before Canada legalized cannabis, it was home to one of the most important, ground-breaking, and paradigm-bending psychedelic studies in history.
When British psychiatrist Humphry Osmond – best known as the man who gave mescaline to Aldous Huxley, inspiring the book The Doors of Perception – was unable to legally administer LSD in the UK, he moved to the Canadian province of Saskatchewan to continue his work in 1951.
For those unfamiliar with Canadian geography, Saskatchewan is a flat, sparsely populated prairie province in the middle of the nation, home to farmers, good manners, and socialist values. Square and sweet, it is as far removed from swinging London or glamorous Hollywood as it gets. But in rural Canada, at the Weyburn Mental Hospital, Osmond was given permission to treat over 2,000 people for alcohol use disorder – including Bill Wilson, founder of Alcoholics Anonymous. Osmond found that at least 40% quit drinking entirely or dramatically reduced their intake afterward. If a 40% success rate doesn’t seem impressive, consider that AA’s true success rate is only 5-8%.
Why would the government approve Hartle’s first application but deny his second if he had no adverse reaction the first time? Given that Hartle has been outspoken in mainstream news outlets and highly critical of Health Canada, it feels possible that the rejection was personal. Though, we can’t know that for sure.
Why not just take mushrooms illegally with an “underground” therapist?
“I do feel that this is all pushing me to use underground and illegal routes, but right now, it’s about the principle of the matter: I want to create a path for other people to follow easily. And what we really want is access to the therapy. Finding mushrooms is easy, but what we need is safe access to therapy with qualified professionals,” he says. “I am supportive of anybody who turns to the black market, but the fact of the matter is that in the underground scene, there will be untrained and unqualified people providing treatments. It’s extremely concerning to me. Undoubtedly, somebody will be abused or injured. And if that happens, that will be the hammer that Health Canada uses to drive everything back into the underground again.”
Hartle’s journey through the tangled web of Canada’s psychedelic laws serves as a striking mirror to the larger discourse on psychedelic therapy.
His story, both triumphant and tragic, illustrates the clash between evolving science and stagnant policy. While Canada can take pride in its pioneering contributions to psychedelic research, the present situation casts a shadow on this legacy. Hartle’s experience echoes a broader call for change—a plea for policies that reflect the growing body of evidence supporting psychedelic therapy and recognize the profound impact it can have on individuals like him. As the debate continues, Hartle’s experience stands as a poignant reminder of the human cost of legislative inertia and the urgent need for a more enlightened approach to psychedelic therapy. His story is not just about the struggle for access to life-altering treatments, but a reflection on the very nature of progress, and the often-painful journey towards a more compassionate and scientifically-informed society.