Front Burner - ‘Magic mushrooms’ and therapy in Canada

Episode Date: August 3, 2021

One woman’s experience using magic mushrooms therapeutically, and why some are now pushing for greater legal access to the drug in Canada.

In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization, empowering Canada's entrepreneurs through angel investment and industry connections. This is a CBC Podcast. Hi, I'm Anthony Nérestain, in for Jamie Poisson. One year ago, the Canadian government made an exception to the country's drug laws. For the first time, they allowed four palliative care patients to try using psilocybin, better known as magic mushrooms,

to help treat the distress they were feeling about the end of their lives. Dozens more exemptions were approved after that, but the pace of approvals has slowed and many are left waiting to access this therapy in a legal way. Today we're going to hear from one Ontario woman about what using psilocybin meant to her and in a bit I'll be talking to journalist Kurt Petrovich about those who haven't yet been approved and are fighting for access. My name is Andrea Bird. I am an artist, have been an artist all my life,

and a teacher of art, and I'm a wife and a mother and a friend. And at this moment, I am in my dying time, which is what I've come to call the last four years since a terminal diagnosis. Yeah, maybe that's enough. Nine years ago, Andrea was diagnosed with breast cancer. She had a lumpectomy, went through chemo and radiation. Then in 2017, she learned a recurring pain in her hip was actually bone cancer and that the cancer was also in her lungs. More recently, she's learned it's in her brain. At first, it's just absolutely being swept away by this prognosis. Lots of waves of tears, sadness, frustration, anger,

kind of reeling, you know, just getting through the days and wanting to grasp what is happening and be present for it as much as possible, but also realizing that this is going to take everything you have in you, Andrea, and those around you, those who love you, to navigate this. to navigate this. So I think it took a good solid year of navigating all that emotional and practical territory before I was ready to contemplate the idea of having a guided psilocybin trip. A guided psilocybin trip, basically taking mushrooms as part of a kind of therapy. Andrea prepared a lot for this experience. It wasn't something she took lightly. It also wasn't

something she took legally. Though she has one now, back then she did not have a legal exemption to use mushrooms. But with the help of a person she refers to as her guide, she spent time honing in on what she was hoping to get out of the trip. And then she embarked on it. She took the mushrooms at home as a tea mixed with ginger and honey. In a comfortable chair with a blanket and a mask over her eyes, she had headphones on, playing a special psilocybin playlist. Her husband had gone out for the day with the dogs,

so there would be no distractions. She was alone with her guide. As the trip began, she felt a bit cold and as she took her own hand for warmth and comfort she felt her husband with her. My left hand actually turned into his hand and when I say that it really felt to me like he was holding my hand,

not just like his hand, it was his hand. And because I've been married to Daniel for over 30 years, and I know what it's like to hold his hand. And he has been a fine, fine companion to go through life with. And his presence, his calmness, his love were all there in that hand holding mine. And that was how the trip initiated. Then I was able to be, okay, okay, I can do this. And then, of course, it brought up a lot of grief about leaving him, about dying before him.

And yeah, all of that arose as well, but from a place of such gratitude that I had had that love in my life. It wasn't just gratitude and grief that arose on Andrea's trip. She says that death itself showed up. So this is all in my mind's eye. I see a dark green cedar tree. And this is the darkest green I've ever seen. And I go closer to it. And I'm just marveling at the lush, dark green needles. And then coming out of the tree is a white hand, like it had been sculpted out of porcelain i mean and i had no previous notion of any of this you know i hadn't thought of death this way ever before but as soon

as i saw that hand i knew that that's what it was that it was death and it wasn't like a part of me was wondering oh i wonder what that is no it was very clearly that's death but it wasn't like a party was wondering, oh, I wonder what that is. No, it was very clearly that stuff. But it wasn't scary at all. The hand was in a position kind of with thumb down, palm up. And I remember in grade seven relay races, when we would run around the track with our little baton and the person waiting for the baton would have their hand in that position so that you could just slap it in there and they would carry on. And I understood that death was waiting for me to pass the baton back to it. And that was my life. But it wasn't in any hurry. There was no urgency about it. The hand wasn't kind of, you know, making any motion like, come on, where's the baton? It was just waiting. Absolutely still and patient. And you've got time, was the feeling. But you will have to pass it back.

And then that would fade away. And maybe it happens over a period of 10 minutes who knows time takes on a completely different sense and there you're not time was not even something i i thought it was a concept or all at all at no point was i ever nervous or felt like i was in over my head even with this realization that death was waiting for me to hand my life back, that just felt like a fact, like not like something terrifying. Just even that matter of factness was helpful for me because there was a part of me that kept thinking before the psilocybin trap, oh, if only I do this, this, and this,

maybe I won't have to die so soon. If I can eat really well and blah, blah, blah, I don't know. You kind of grasp onto just about anything. If I wanted to badly enough, I could make this cancer disappear. That also kind of fell away, or it became less important. There was an acceptance in this whole experience,

like this is just part of life. Death is part of life. In fact, it's inseparable. You don't get one without the other. So now I know that. I really know it. This kind of intense psilocybin-assisted therapy, it's not something that you do every day.

Some people only do it once. Andrea has done it twice, but those experiences, they stay with her. It's kind of like when something significant happens in our lives, it just becomes a part of who we are. And the mushroom trip is no different than any other significant experience in a way. You know, it's like very vivid still. And I imagine it will be right up until my dying day

that I will remember what it felt like to really love myself. I will remember what it felt like to encounter death without fear. Music I'm going to go. organization empowering Canada's entrepreneurs through angel investment and industry connections. Hi, it's Ramit Sethi here. You may have seen my money show on Netflix. I've been talking about money for 20 years. I've talked to millions of people and I have some startling numbers to share with you. Did you know that of the people I speak to, 50% of them do not know their own household income. That's not a typo. 50%. That's because money is confusing. In my new book and podcast, Money for Couples, I help you and your partner create a financial vision together.

To listen to this podcast, just search for Money for Couples. As I mentioned earlier, Andrea is one of dozens of Canadians who've been granted a legal exemption to use psilocybin. Her approval came through late last year. But there are others who have been left waiting, and now one of those people is taking the matter to the courts. This is a story journalist Kurt Petrovich has been following closely. After being diagnosed with post-traumatic stress disorder, he himself has undergone psychedelic therapy. Kurt, thank you very much for taking the time to be with us. No problem. Kurt, thank you very much for taking the time to be with us.

No problem. So before we get into the legal debate in Canada, we just heard about Andrea Bird's own personal experience. But what sort of scientific evidence is there for the therapeutic use of mushrooms? There have been a number of double-blind, randomized, controlled studies going back years. Just looking at a few from the past decade or so, there was a study at UCLA in 2009 that found that psilocybin was effective for relieving anxiety in people with end-stage cancer who didn't respond to conventional therapies. There was a result of a study done out of the New York School of Medicine published five years ago. It concluded psilocybin produced immediate, substantial, sustained improvements in anxiety and depression.

And they say it led to decreases in cancer-related demoralization and hopelessness. And it improved people's spiritual well-being and increased their quality of life. They go on. spiritual well-being and increase their quality of life. They go on. Last year, there was a randomized clinical trial by Johns Hopkins in the United States. It found that psilocybin had an effect four times larger than what clinical trials have produced for traditional antidepressants. It's important to know that these studies I've told you about have involved very small sample groups on the order of about two dozen patients. But there are more on the way with larger sizes in the United States and a bit closer to home. So, you know, these results are widely known by advocates for psilocybin's use in a clinical and therapeutic setting.

psilocybin's use in a clinical and therapeutic setting. But what's also apparent, as you know from Andrea Bird's story, as anecdotal as it might be, these testimonies from patients themselves are really quite profound. So that's a lot of data. But from a perception standpoint, I think a lot of people, when they hear about mushrooms, they might have concerns about bad trips. Is that a risk? Well, you know, the kind of use for psilocybin that we're talking about here is not the scenario in which a patient is given a whack of dried mushrooms, told to go home, take them, see how they feel. In the case of Therasil, which is the BC non-profit that's been leading this exemption battle, the mushrooms, which contain the compound psilocybin, are actually part of a guided, thoughtful, multi-day therapy session. This isn't recreation, and it isn't accidental. So psilocybin, magic mushrooms,

they're still illegal in Canada. They're barred under the Controlled Drugs and Substances Act. And the only way around that is a legal exemption. So why did Canada first start granting these exemptions? Well, you know, the health minister has always had the ability to exempt anyone in Canada from the restrictions under the Controlled Drugs and Substances Act. And it was Therasil, this nonprofit, that for several months last year, they pressured the health minister to use that authority she has to grant Section 56 exemptions

to some patients facing end of life. And they were prepared to go to court for it. But last August, Minister Patty Hajdu issued the first four exemptions, you know, clearly because it was a case of compassionate use. I mean, I wasn't in the room when she signed off on them, but I think it's pretty safe to say that the consequences of being the politician who turned a deaf ear to someone who could be helped by psilocybin were really far worse than any political blowback she might have gotten from letting someone use an illegal drug. And at first, when they started granting these exemptions, they seemed to be responding pretty quickly to these applications. There were dozens of exemptions granted for people,

mostly for those who were dealing with terminal diagnoses, and also for some therapists who would be guiding those trips. But I understand that it seems like things are starting to slow down and that you've spoken to people whose applications don't seem to be going anywhere. What have they told you? Yeah, no, that's right. I think as more applications came in, the process for approving them, which is really rather opaque, well, it ground to a halt. And last week, Health Canada told me that there were a total of 64 exemptions granted since last August,

and that's made up of 45 patients and 19 therapists. But just looking at the numbers that I've seen since last August, it's clear that most of these were granted last year. There are now patients who've been waiting months just to hear a response. Not whether they've been rejected or not, just a response of any kind. And it's important to point out that Health Canada says it has not rejected a single application. Okay, that's true, but it has simply not responded to or not approved a number of these applications in many, many months. So Health Canada is going out of its way to say, listen, we haven't rejected anyone, but do you have a sense, do we have a sense of why those applications are left unanswered at this point? Absolutely not. You know, I've asked Health Canada over the past number of months about this, and they have a fairly standard response, which is not to actually reveal how they come to these decisions in detail. is that magic mushrooms have no approved medical uses. And while the department is aware psilocybin is being studied internationally, Health Canada is emphasizing a reliance on clinical trials to,

as it says, and I'm quoting again, protect the best interests of patients. the best interests of patients. So clearly Health Canada believes that clinical trials are the way towards accessing something like psilocybin that has a possible medical benefit. It does say that it's looking at all of these applications on a case-by-case basis, but clearly the department is now seeing that the opportunity it started giving people a year ago. And, you know, let's be clear here. The department and the minister, I think it's fair to say, took a victory lap for doing what many people saw as the right thing to do for compassionate reasons. But it seems to be turning into something that it's really uncomfortable handling. Why do you think that is? Well, you know, after Patty Hajdu started making these approvals with some celebration, I think what happened was it attracted a number of people who said, hey, that's me. I could benefit from this. And I think in one sense, they became a bit overwhelmed and it started to become an issue of, well, is this something we're

doing out of compassion or are we doing this now as a matter of policy? And I think it's a decision and the consequences of that decision might not be something that the minister wants to have on her shoulders. Okay. And, you know, at this point with the waiting game, like what does that mean for people who are still like in limbo waiting to see if they can get this kind of treatment? What effect does this wait have on them? Well, it's not encouraging. I mean, suggesting that people who are dealing with a kind of crippling mental injuries and illness who are applying for these exemptions should now line up and hopefully be accepted, even if they can find a clinical trial somewhere, but then be accepted, is really quite daunting. You know, perhaps somewhere in the Health Canada bureaucracy, there's a calculus going on that

only people who are facing imminent death will get compassion and an exemption. I don't know, but it would seem that there is an analysis happening internally in the department about whether someone deserves it. The problem for people who've been stuck waiting for months is, okay, well, what's the criteria? You know, who's deciding who's worthy? The problem is that no one knows except the people inside Health Canada who are responsible, and they're really not shedding any light on that. Now, I understand at this point there's a legal challenge that's been filed.

What can you tell me about it? Yeah, it's an application for mandamus, which is Latin for order, in the federal court to compel the health minister just to answer an application that's been sitting there for over four months. As part of that application, lawyers for the applicant, a BC man by the name of Nathan Krueljack, argue that, among other things, it's unconstitutional to answer and approve some of these applications, but not others. So, you know, in the case of Nathan, he's now 40 years old. He developed a fairly rare form of cancer for a young man when he was 25. He went through cancer therapy. He's in remission. But as a result of that and some other incidents in his life, he has suffered depression, PTSD. Conventional therapies have not alleviated that. And he's wanting to try something to help him restore his life because he's been told that it might work. He's completely in the dark about why the minister has apparently deemed that his application is not

worthy of approval and apparently also not worthy of being rejected. So he's totally in limbo. So going beyond this legal challenge, I wonder, big picture, where do you see the legality of psilocybin heading in Canada? Ultimately, it's headed towards regulation because you can't achieve much by filing a claim against the minister every time she fails to answer an application for exemption. You know, 20 years ago, cannabis went from an illegal drug to something that the courts essentially forced the government to allow as a medical prescription, a matter between a doctor and a patient. It's a medical substance. Given the scientific evidence that we talked about earlier and the studies that are underway now, the very powerful experiences of people who've used psilocybin in psychotherapy, I think it's really just a matter of time. The question is when and who's going to do it. So you see it as basically just a matter of time

before it's regulated. But before we get there, what do you see as obstacles, things that are going to stand in the way of regulation? Well, I think part of it is confusion. You know, there are some people who would argue, oh, well, we don't want psilocybin and magic mushrooms sold the way cannabis is. And I don't think anybody, well, there are obviously some decriminalization advocates who believe that everything should be legal and sold in that fashion. But the people that I've been talking to who are behind the idea that this is a very potent drug for therapeutic purposes, they want it regulated in the sense that it would be something that is prescribed, something that would be available to people with professional advice. So there's that to clarify. But because that sort of idea sort of lingers in a lot of the consciousness of people, this is a government that is also now contemplating

an election. The government is unlikely to suddenly spring into any new policy about a drug that's been banned since 1974, just before they go to the public and ask for reelection. And there is this enormous stigma around psychedelics, you know, despite the fact, for instance, that, you know, Johnson & Johnson is making money hand over fist, selling a patented formulation of ketamine, and ketamine clinics have popped up all over North America, including Toronto and Vancouver, there is still this, you know, this huge stigma around mental illness and injury. I mean, I know I've endured it myself. And now add to that a treatment, you know, as beneficial

as it can be with this label that most people still associate with the war on drugs 50 years ago, and the idea that psychedelics will mess with your brain. And it's an enormous public relations campaign that you've got to mount in order to convince people that this is the right thing to do. Yeah, it'll be very interesting to see how the federal government navigates this issue. Kurt, thank you very much for walking me through this, and thank you for your time. Sure thing. Before we go, on Tuesday, Theracil will be delivering a proposed regulatory framework for the legal use of psilocybin to the Director General of Health Canada.

This proposed set of regulations is based on Canada's medical cannabis laws, first introduced 20 years ago, requiring a medical certificate signed by a doctor or nurse practitioner for use. That's all for today. I'm Antonin Aristin, and thanks for listening to Frontburner. For more CBC Podcasts, go to cbc.ca slash podcasts.