Ideas - Weekend Listen | Changing Minds: Psilocybin, Medicine, and the Limits of the Law (via White Coat, Black Art)

Episode Date: April 18, 2026

On White Coat, Black Art, trusted ER doctor Brian Goldman brings you honest and surprising stories that can change your health and your life. Expect deep conversations with patients, families and colleagues that show you what is and isn't working in Canadian healthcare.“Pistol” Pete Pearson, a 76-year-old living with a terminal lung disease, says psilocybin-assisted therapy transformed his end-of-life distress after he accessed it outside the medical system. While psilocybin remains illegal in Canada, researchers including UHN psychiatrist Dr. Joshua Rosenblat are running government-funded trials exploring its potential for mood disorders. More episodes of White Coat, Black Art are available wherever you get your podcasts, and here: https://link.mgln.ai/WCBAxIDEAS

The Powering Politics Podcast is available six times a week, but you might not be. If you want to catch up on what happened this week in politics, join me, Laura Dangelow and some of Canada's most tuned-in political strategists to break down the week that was. Short on time, the weekly wrap has you covered with a new episode every Saturday. This is a CBC podcast. Hi there, it's Nala. We have a special bonus episode for Ideas listeners from White Coat Black Art, a podcast host. hosted by emergency physician Dr. Brian Goldman. Each week, they dive into the culture of medicine, demystifying how Canadian health care really works and often doesn't.

The episode we're sharing is called Changing Minds, Silocybin, Medicine, and the Limits of the Law. It's about a terminally ill grandfather who turns to psilocybin to ease his psychological distress, and he calls it life-changing. The drug is illegal in Canada. But federally funded psilocybin trials are showing that when combined with psychotherapy, the psychedelic may help people overcome their treatment-resistant depression. So will access to psilocybin soon change? Have a listen. All right, I'm back at Mortown, Ontario by the St. Clair River.

I can see it behind the house. I'm Dr. Brian Goldman. this is White Coat Black Card. And I'm here to see Pete Pearson and Susie. And this is a visit that I've been waiting for for a while. A revisit. This is my second visit to see Pete and his wife, Susan. The last time I saw Pete was for a show we ran in November, 2024.

Come on in! Is that pistol Pete? This is Pistol Pete. Ryan. I'm saying, that we got rag down from the next season. My ride down from the big city was uneventful. Good. That's the way you wanted. And everybody should know, everybody's listening to this, should know that I'm wearing a mask.

Properly fitted N95 mask because I don't want to risk giving you any germs. So if my voice sounds a little bit muffled at times, that's the reason why. But nice to see you. Good to see you. Yeah. It's been a little while, but I'm still kicking and I'm still fighting. Pete is 76 and has idiopathic pulmonary fibrosis. a progressive lung-scaring disease causing a dry hacking cough and trouble breathing.

At first with exertion and then just sitting around. Pete is already past the median survival of three to five years. When I first met him, Pete was struggling with anxiety and depression related to his life-limiting diagnosis. To deal with his end-of-life distress, Pete wanted to try psilocybin, a psychedelic medication, better known as magic mushrooms. So will I meet with you again when I do the psilocybin? If you want me to, I would. We'd be very happy to come back and bear witness. Okay.

If that's what you want, I would be very happy to do that. I'm definitely happy to be back not because Pete's health is getting worse. He's one respiratory infection away from dying, but because finally he got to tricylocybin. Anyways, my name's David Peter Pearson, born February 23rd, 1950. I've had IPF now for going on eight years. I have had some very difficult days. I did buy some stuff off of my friends up the road, and we did the magic mushrooms or psychosyllabin.

How do you say that word? Psychosyllium? Silocybin. There's a lot to unpack here. When I first met Pete in the latter part of 2024, he and his son Blake, a family doctor in Sarnia, were pursuing psilocybin as a way to ease Pete's end-of-life anxiety. In Canada, psilocybin is an illegal control cell. The only way to obtain it legally is by applying to Health Canada's special access program or by participating in a research clinical trial involving psilocybin.

Pete, his family doctor, and Blake spent many months assembling the paperwork to apply for special access, which Health Canada rejected. We'll get to that part of the story next week in part two. His access to legal psilocybin blocked. Pete instead got some magic mushrooms from his friends up the road, as he likes to say. Finally, he got to tricylocybin right here at his home on January 3, 2026. And I'm telling you, it was the most eventful day of my life. I cannot believe how much my outlook on life has changed.

You can ask my wife, Susan, she can't believe the change in me. My kids can't believe the change in me. I'm not this miserable old rotten SOB that I used to be. He's referring to the Pete Pearson I met back in 2024. I was so easy going and so easy going. Now I'm just a bear. I fly off the handle, like, boom. You know, Susie will say something to me.

That's not me. I'm frustrated that I'm not the person that I used to be. There's anger there, definitely. You know, why me? You know, I was a good person. Why, why? Why? You ask that. To me, the transformation in Pete's outlook on life is startling.

I'm astonished at where I'm at right now. I totally astonished. I just can't believe how good I feel for being a sick person that's supposed to be dying. Hi, my name is Susan Pearson, and I'm Pete Pearson's wife. He did do the psilocybin, and I must say he seems to feel just happier, and I'm just amazed at how effective that treatment was, and it's continued to last. How'd you get the name Pistol? I played hockey and I played baseball and I was always very aggressive and I would snap pretty easily and that's how I got pistol. We saw each other, first of all, do you remember the golf cart? Yeah, for a tour.

We went for a tour, yeah, and it was like a roller coaster to me. I didn't think that darn thing was going to stop. You'd just like to do that. A little fear hurts. No one. The opposite of fear is excitement. I was probably more excited than I'd been in a while. And we weren't even golfing. We weren't even golfing.

That's right. Just joyriding. Yeah. Yes, an ecstatic joyriding. So how's your health been? You've been in and out of hospital with respiratory issues. Oh, constantly. Like, the nurses practically know me by first name.

And I feel so bad going in all the time. but shortness of breath, pain, pain in the chest. In the 16 months since I first met Pete, he's been in and out of hospital more than 10 times. He's gone from being able to garden to being short of breath just sitting in a chair. He uses oxygen in the home all the time. His greatest fear is suffocating.

Pete leads me to the sunroom right beside the kitchen with a big window overlooking the St. Clair River. This is where he went on his psilocybin trip. And what do we got here? This is where I... I did the psychosyllum on that couch. It pulls out into a cone. This is my breathing machine.

Okay, come on over here. Oh, you've got to bring me the tubing with you? You get caught. Pete took psilocybin as part of psilocybin assisted psychotherapy. It's a method that provides structure, safety, and meaning for people who take the psychedelic. It's done by trained health professionals, in Pete's case, a psychotherapist and a social worker. The therapist guides clients before, during, and after the time they take psilocybin. Pete's psychotherapist helped guide him through a session in his home that lasted eight hours.

Another person came with the therapist to sit with Pete. They're an I laid in this bed. It's a sofa bed. Yeah, just spent. They sat up an altar in front of my big window out there, and I got a little fireplace under it. And they put a single candle on the altar. They put a snail on the altar to slow me down. That's what that was supposed to signify.

and they said, if you got anything that's got any meaning to you, and I said, yes, I do, as a matter of fact. I said, I'm Scottish descent, and my wife or my sister's got my dad's kilt, but I've got the sporn that goes on the front of it. I said, I'd like that on there. And so they did that, and the session lasted like eight hours or so. Just looking at the altar, bring back any memories? Good ones, because all I can see is that snail.

And, like, I was a bugger to go. So that's why they put the snail there. But that snail there just, it did. It just brought me right down. It's just the symbolism. And the single candle that just touched my heart. So they made it for you and they said, you keep it here.

And now it's a permanent fixture here. The altar reminds Pete of something he hopes he's ready to give up permanently. You were feeling anxiety. Oh, yeah, through the roof, right? Yeah, I was so anxious and so worried about the whole world. you know, especially my daughters and grandkids. And I just, I'm just so thankful that that's all behind me. And I've laid out the rules to them.

I said, look, Daddy loves you all, grandpa loves you all. I can be your foreman on your job. You want to hang curtains or drill holes. I got the drills, I got the tools, I got the know-haul. I'm the foreman from now on. Pete the foreman is a profound change from the guy I met a year and a half ago whose life-limiting illness made him feel like he had no control. Do you do your own gardening?

Yeah. Yikes. It's all slowing down, though, because I can't... I just can't do it anymore. So that's why I bought this golf cart, so it's frustrating. I'm just... I can try to get things neat and tidy and... This little job right here.

This is this little bit. dead here. Yeah. Now the weeds are grown back in again, but two weeks ago, there was rose bushes out of control there, everything. I cleaned it took me all day, before it would take me an hour. So that's... Just having to stop, catch your breath and pace yourself. Yeah. Got it. Any exertion I'm poached. He gets even more poop today. He's closer to his life's end. What's different is that he's no longer trying to do what his body says he can't. And I took it a step further. I hired somebody to rip out all the flower gardens and I hired somebody to trim all the bushes and trees and everything

The only thing I'm going to try to do because I want to get out in the fresh air I want to wave to my neighborhood It's this summer I want to get out I got a riding lawnmower to cut all my grass So I'm going to do that And I even hired a guy to do all the whippers stuff Because I can't do the whippersnip in either So I'm positive

I'm ready to get moving again Yeah Were you worried or anxious at all about the psilocybin itself. I know you'd had the prep therapy. I had the prep therapy because I knew so many people that have done it, not legally, but, you know, I know a lot of friends that do those things. And they're all normal people.

It was important, though, for you to have the therapy before, to be prepared. Oh, yeah. As opposed to just getting it and giving it again. I wouldn't know what to expect. How did you consume the psilocybin? I drank it as a tea. They ground it up. There was five pieces. They ground it up as a tea, and they put it with ginger and lemon.

Then they covered me up with a blanket on my bed and put an earmuffs on, soundproofing earmuffs. They played music. And then I had a black mask on so I couldn't see anything. It can be hard to describe a psychedelic experience after the fact. So the therapist recorded P's trip and made him a transcript. One of the things that you said a number of times was let it go, let it go, let it go. What does that mean? That means let go of all my ugliness, my being ticked off at the world.

And, you know, poor Peter, I'm used the son of a gun, I can't do anything. And it was trying to get all that evil stuff out of me. And it's out with spades. It's gone. It's gone. You met your son who passed away. Yeah, yeah. Yeah, that was a tough one.

That was really tough. He was my second born and got to hold him for two or three hours before he did finally succumb. And when I saw him up there, he just looked like my other two boys, tall, good-looking, like the mother. Not me. But he wasn't upset. And it was just It's amazing, amazing, amazing experience You know

Who else did you meet? I met my mom, my dad, my grandparents I met my uncle Bob that used to work for me And he was a wonderful guy, my uncle Jim And I even saw some neighbors Who I grew up next door to It just brought back all. all this unity that I felt when I was a kid, you know?

Unity. Yeah. It was like you were recapping your life. Did you meet? Yeah. Yeah, it was. It was really like that, right from the get-go. It just brought everything together and put it in perspective for me.

And I said, okay, I can see the progression of this, the progression. And now I'm just waiting for this lovely feeling to just last to the end of my life. Whenever that is. One person who was not present during Pete's psilocybin session was his wife, Susie. Where were you? When, during his experience? I went to, I went to Sarnia. Oh, actually, I went to my daughter's house and just hung out there.

By design, you weren't there? Yes. I think they probably feel, as a wife there, you might be a bit of a distraction. So they did ask me to not be present. How did you feel about that? Actually, I didn't mind. I had faith in that it was going to be a positive experience. I couldn't imagine that they would set him up for anything other than that. At the end of the day, I did come back home at about 8 o'clock at night. And honestly, it was, as he spoke, it was as though he had truly experienced heaven. And the only reason Blake was here, he was down in the basement doing his own work. But he was there just in case something happened to me. like, you know, my heart or whatever, kicked out or whatever.

But he was just there for that. They did invite him up at the closing ceremonies. And we all hugged and set our little pieces. And what was your first impression when you saw your husband? He was very calm. He just kept saying, you won't believe it. I saw my mom. I saw my dad.

I saw Andrew. He just was, Andrew, that's our son that passed. and he was just so joyful. Have you had, I know you're supposed to have an integration session coming up. You had it yesterday. Yeah. Oh, what was that like? It was great.

It was great. They were happy with the results. They said, you know, we think you're doing better than average. And you just keep on going. And if you feel down the road that should you want another session, by all means, just give us a call and we'll get it all set up. And he said, but we don't think you're going to need to do anything extra. Just call us.

Just call us. So I said, I feel wonderful. And they said, just try not to go down the rabbit hole. Where you used to, where one negative thought would lead to another and another and another, and that's the rabbit hole. That's the rabbit hole. I kept going down, all of them. You're listening to White Coat Blackheart.

This week, Pete Pearson has a life-limiting illness. called idiopathic pulmonary fibrosis. He tried psilocybin or magic mushrooms to help him feel less anxious during the time he has left. Pete's good trip is like a lot of testimonials you read in books and on the internet these days. But in Canada, as in many other countries, psilocybin remains an illicit controlled substance. What's new is that Health Canada is investing millions of dollars in research. Dr. Josh Rosenblatt is a psychiatrist and the head of research for mental health at University Health Network in Toronto. He did Canada's first psilocybin study in 2024

and has seven other federally funded trials in the works. There's a pervasive belief that psilocybin is safe because it's a natural product. Based on your own clinical experience, what would you say about that? Yeah, it's a great question that I get asked all the time and certainly there is growing safety data. And at the same time,

I'm always one to say we need to pump the brakes and appreciate that there are serious side effects, especially during the six to eight-hour psychedelic experience or trip, sort of speak, where these are very strong molecules or compounds that create an incredible non-ordinary state of consciousness that can be quite unpredictable. So it could bring up positive feelings, but it could bring up very negative emotions.

The clinical trials are showing that adverse events are not serious. However, at the same time, we know that there are some very significant and adverse effects, particularly on the day that someone has a dose of psilocybin. And we did have our first Canadian national consensus statement on classic psychedelics, including psilocybin, not only for depression, but for depression and anxiety related to end-of-life distress. And in there, we were very clear that it's too early. And the main recommendation from that national task force was that we need more research,

we need to do more trials, and that this isn't ready for prime time yet. We shouldn't just start treating people for depression or end-of-life distress with psilocybin. until we have more evidence. So ask another way from where you stand, should Canadians be using psilocybin right now on their own for mood disorders? I would recommend against use on their own for mood disorders in terms of like illicit use.

You know, certainly psilocybin is highly available. In Toronto where I live, it's available seems like, on every quarter. But in that task force report, we did recommend against taking matters into our hands because also the unpredictable nature. I didn't mention suicidal thoughts can come up as well when you're having psilocybin, especially for people with severe depression. So for those reasons, I think it's much better to access it within clinical trials or in special circumstances through the special access program. And you're not arguing theoretically here.

You're actually concerned that somebody using this on their own might find that their distress increases. That's right. That's right. That's right. And I've bared witness to that. You know, I've seen it firsthand. This doesn't work for everyone. it can be helpful, it could be neutral, or for some people it can actually make the course. I know you're not commenting on Pete Pearson's quest for psilocybin, but I did want to ask you this. He said to us that psilocybin reduced his end of life anxiety and changed his perspective. And as you've already mentioned, there are lots of testimonials like that on the internet, on social media.

As a researcher, what are your thoughts on positive testimonials like that? Yeah, I think they're very, very helpful. a believer that we should utilize and leverage all sources of evidence, including patient testimonials. I, of course, believe that the highest level of evidence is actual randomized placebo control clinical trials, but this doesn't mean that we should disregard individual patient testimony. We need to acknowledge that there's limitations and bias and all these different things when we're talking about an individual or a Reddit thread or any other sort of online testimonials, but I still, I learned from all these patients.

It doesn't have to be within a clinical trial that we can learn about the potential for these substances to be harmful or helpful. As for Pete Pearson, psilocybin has definitely been helpful. Now, when I saw you the first time and you were telling me why you wanted to give psilocybin a try, do you remember what you said? I can remind you.

You said, keep me from losing my mind. Yeah. Keep me from being a complete jerk to everybody. Keep me from being so hard on Susie. Do those ring about? Yes, yes. Unfortunately, they do. And now she vouched for me that I am a changed person.

And my kids notice the difference. She noticed the difference. Most importantly, I notice the difference. You know, I'm saying, what can I do to help Susie out today? She's been slugging garbage cans out to the road. I got a 500-foot dryaway. She's been slugging all winter long. So she was away yesterday, so I thought, I'm going to help my wife out.

So I thought, how am I going to do that? Because I only got 50 feet of hose, and then I take my portable out of cracks in the coal. So I just opened the trunk of the car. I put the blue garbage can in and the regular garbage can in. I backed all the way out, unloaded them at the road, and I drove back again. And it was a piece of cake. And I thought, why didn't I think of that before? And, you know, you start to learn different ways to do the same thing,

but you've got to learn different ways to do it. Susie, is he less of a jerk? Absolutely. That's tricky. He's really never been a jerk. But in terms of having less patience and those kinds of things, he absolutely is a changed person, calmer, more joyful, and it's really nice to see.

And then, of course, people respond to him in that way. So it goes back and forth. It's like self-reinforcing. Very much. So can you give you a story? Is there about something that was different in the last few weeks where you thought, boy, a year ago, and it wouldn't have been like that? It was Pete's birthday on the 23rd.

And so we had, some of our family was down. And we have this Christmas decoration that's a reindeer. And when you pump the leg, it dances all over the place and sings. He had that on and was going all around the house. Now, somebody might think he's a little. crazy, but we know that's the real Pete. So it was just fun to see him do such a spontaneous thing. This was in the video. I will turn it on. And this is... In this video, Pete is wearing a battery-operated reindeer on his head that laughs and sings. I'm not looking at the reindeer. I see a 76-year-old man

who's laughing in the face of his disease and seeing what's good and funny about life. And you can see why my grandkids like that. Star is born. You know what? I just figured out something. The switch has been flipped. Instead of fearing what you're not going to have, now you're in the moment and you're enjoying the moment. Yeah, and that's what I do. I go to bed at night.

I say my prayers. I thank God. And then I wake up in the morning. I think God forgive me another day. And I said, today's going to be a good day. And every day that I've been saying that, it's been a good day, whether it's cloudy or blowy or windy. I find a way to make it a good day.

A far cry from the peat I met a year and a half ago. No one knows that better than Susie. He's always enjoyed the little things. He loves the water, loves being outside in the grass and the sun. So, yeah, I just think with the psilocybin, hopefully it will just level things out and he'll just feel relaxed and calm. And I think when you're relaxed and calm, even if you're in discomfort or anything that's going on,

you can handle it if you are feeling calm. You can kind of take it in your stride. But like I'm at the point now, I take enjoyment. Just watching a squirrel run across the grass or playing with us and nuts trying to hide them or the robins. I saw some robins. It's the smaller things that are grabbing my attention out, the clouds. Like we're always watching the boats and the rivers,

Susie and I and the ducks and the swans and the geese. it's kind of a good place in that he's not so fearful. You know, he's feeling good now. His perception on things is very positive, which really helps. He's much more joyful. And so having said that, if he slipped away tomorrow, I think we'd all, all the family would be thinking, you know what, he was happy right up to the end.

Whereas if circumstances were different and he had not done the psilocybin and he was carrying on with the mood that he had months ago. Everybody's affected. Everybody feels so bad. You feel guilty about even going somewhere, right? Even going shopping or something. You feel guilty leaving. So I think that seeing Pete in such a positive, calm mood,

everyone is picking up on that and thinking, well, we'll all accept what will be will be. Pete has stopped fretting over what he no longer has the breath to do. I quit golf and I give my golf clubs to my son. But I've golfed over here for 30 years at this parkway. And so this friend of mine, Hal, he's a avid golfer. He said, why don't you just come over and drive the cart? You still be with all the boys.

You can drive the cart. And if you want to take the odd shot, you can. I said, that sounds like a heck of an idea. And also, I'm going to do that this summer too. Just see. And, you know, if it's very hot, I won't go over. but if it's my perfect temperature, I'll go over. You're stopping an all or none guy,

where you're either playing 18 holes or not at all. Yeah. Exactly. I'm a blessed person, you know. Well, Pete Pearson, Susan Pearson, I want to thank you so much for inviting me back into your home to get part two, the continuation of this story. Well, it was our pleasure.

We'll be right back. On Big Lives, we take a single cultural icon. People like Jane Fonda, George Michael, Little Richard. And we pull apart the story behind the image. And we do this by digging through the BBC's vast archives. Discovering forgotten interviews that change exactly how we see these giants of our culture. We're here for the messy, the brilliant, the human version of our heroes. I'm Immanuel Jochi.

And Kai Wright. And this is Big Lives. Listen to Big Lives, wherever you get your podcasts. In October 2024, Pete's family physician applied to Health Canada's special access program, aided by Pete's son, Blake, who is also a family doctor. The program allows patients to get medications that are not yet approved by Health Canada on an emergency or compassionate basis. For more, here's Pete's son, Dr. Blake Pearson.

Nice to see you. Yeah, you too. I heard you had a good visit back in Moretown. You heard. Yeah. It was, you know, for me, I have. have to say it was emotional. Oh, yeah, yeah. There's been a lot of that going around. Hi, my name's Dr. Blake Pearson. I'm a family physician located in Sarinia, Ontario. More than a physician,

I'm a son of Pistol Pete Pearson and have been, you know, along for his journey over the last 12 months or more in trying to access psilocybin guided psychotherapy. Dr. Blake Pearson, welcome back to White Coat Blackheart. Thank you, Brian. I first met you a year and a half ago. Your dad was trying to access psilocybin legally through Health Canada. How hopeful were you at the very beginning of that process of trying to obtain it legally that your dad would get approval to obtain and give psilocybin a try? I was very hopeful. Looking back, maybe a little naive, certainly did not understand the time, the delays, the multiple revisions that we're going to ensue. And ultimately, of course, did not expect a no from Health Canada. You helped to get that package together.

Remind us what it was like trying to complete the application. I helped his family physician with really putting the package together because there was so much that went into it, even literature reviews, supporting documentation from the different studies that are out there. Even this, the SAP form, I think for a lot of physicians, it's a barrier right there knowing how much time it is to simply fill it out. I was there. I met your dad during that process. What did this do to your dad's state of mind? Well, that's really, there's a lot of sad things to the story, of course, but that unknown, you know, when is it going to happen? Is it going to be approved? And you've met my daddy can be a fiery guy. His anxiety was already getting so bad from the multiple exacerbations,

the chest pain. As you can imagine that that dysmia or shortness of breath is quite distressing. You layer on that to his anxiety. It really was getting out of control. And ultimately, truthfully, was the reason for a few hospital admissions was, was, that unmanaged anxiety as opposed to maybe more of the pulmonary fibrosis exacerbations. Nine months after filing the application, Health Canada rejected the request. Here's how Pete reacted to the news. I was terribly, terribly ticked off. I couldn't believe it.

All kinds of doctors working on it. My son included, but a lot of doctors in London trying to help out. I don't remember when the paper, they got the paperwork wrong. It had to be corrected. You get that in. And it's a cumbersome, difficult application process as it is. Yeah. And what it does, it just made me a wreck.

Like I was getting worse and worse and worse and like panic attacks and everything else because of these dummies and Health Canada. Do you remember anything about the language of the rejection that's stuck in your head? Yeah, I couldn't understand any of it. It was all big, fancy words that meant nothing to the normal person. I think it was like six pages of bull crap. Pete and Blake showed us Health Canada's 14-page rejection letter. It said that Pete was, and I'm quoting here,

clinically stable and not nearing the end of life. It went on to say that the request for psilocybin does not meet the threshold for emergency use, and that the evidence does not demonstrate that psilocybin would be any safer or more effective than scientifically supported standard of care treatment options. In fact, Pete had tried at least three medications for depression and anxiety, as well as meditation and psychotherapy, to quell his end-of-life distress. What do you make of their reasoning for denying your dad access to psilocybin?

I think it's not valid at all. I think it's pretty ridiculous, to be honest. My interpretation of the 14 pages, essentially, you're not sick enough. I think they really spelt out there's not a month left or two months, right? But when is it the right time to process your own death? He's on full-time oxygen. He can no longer walk out the driveway. Multiple hospitalizations, quality of life reduced. To me, that does warrant end-of-life distress.

And I just find a very odd that Health Canada dictates when someone can process their own death, especially when it comes to, he's tried other avenues. He exhausted therapy, exhausted, let's say the traditional classes of medications. Really, that's what they want to see. He wants to have peace and comfort with those remaining months left. And a lot of people actually end up accessing made because they're so anxious about dying that some people leave them access made because they can't deal with that distrable. stress. While Pete was waiting for the special access program decision, he also applied for medical

assistance in dying or made. It took just three weeks for Pete to be approved for that. Was it a hard decision to come to? Not at all. No, not what I was going through. I was so rotten and miserable and just not healthy at all. And the doctors have told me, like, they said, you don't want to die by this death. Just gaspment for air, gaspment for air, gaspment for air, gaspment for air. See, I saw my grandmother die when I was about 15, and I think she had what I've got. That was the most excruciating thing I ever had to watch my life. In fact, I ran out of the hospital, went on the sidewalk and cried like a baby.

Yeah, so I just can't believe it. A year out of my life fighting the government to live, and then they say we can kill you faster. I think it sucks. It's terrible. It's inhumane, and it makes it so much harder on the patient because of all the uncertainty. Are you afraid of dying? Nope. Nope, not now.

I was. I was terrified of it. Now that I got my ace in the hole, I'm not scared. I'm not scared. In its rejection letter, Health Canada suggested that Pete tried to find and get enrolled in a clinical study involving psilocybin. Failing that, they also recommended that Pete's doctor organize a one-off clinical trial, known as an open-label individual patient trial or O-LIP. More about that later in the show.

We asked Health Canada to comment on how long it takes for people to receive a response from the special access program and how that compares to the time it takes to get approval for Maid when death is reasonably foreseeable. Health Canada responded that, and I'm quoting here, Maid Access and psilocybin access via the Special Access Program are not comparable, as clinicians assess made through provincial systems. It added that special access program timelines vary and are triage based on factors like clinical urgency, available alternatives, proposed treatment dates, and the comprehensiveness of the information provided. Health Canada added, we have great compassion and understanding for individuals diagnosed with end-of-life anxiety and depression.

Given the precarious state of Pete's health, I asked Blake how realistic it would have been for Pete and his doctor to take Health Canada's suggestion and organize a psilocybin clinical trial. That is not realistic at all. To think that you're going to apply for an end of one clinical trial and someone who's dealing with this existential distress could have the patients and the time to develop our own clinical trial is ridiculous. His family physician knows he's struggling. Really, doctor-patient struggling. doctor writes the prescription for psilocybin.

There's trained psychotherapist all over Canada. So the infrastructure is there, and we don't necessarily need those SAP forms. And certainly doing your own clinical trial doesn't make any sense. I'm going to ask you to take your son hat off for a second and keep that physician hat on firmly. Health Canada makes the point in the rejection letter repeatedly that psilocybin is, has not been studied sufficiently to get a clear sense of its benefits and potential risks. Do you see that point of view? No, no. I think it's a lazy point of view. I often see that in cannabinoid medicine as well.

It's not looking at the whole body of evidence. You know, there's adequate bench science. We understand the physiology. If you have your finger on the pulse, and unfortunately, medicine, it does move slow. And certainly the governing bodies move even slower. How much did all this end up costing? The psychotherapy, the psilocybin. The cost all in, I would say, is probably about $2,500 when you get to the counseling, which for most people, it's a huge barrier. Once there is a better pathway and access, the next frontier is going to be the coverage, because the people who need it most will not be able to afford it. So we need to figure out the access stream too, because it will be the halves and have-nots initially. I'm betting that the $2,500 for psychotherapy related to the use of psilocybin cost a lot more than the psilocybin itself. Yes, the guy down the road for five grams, that might be like $40. Dr. Blake Pearson, thank you so much for speaking with us again. My pleasure. Thanks, Brian. You're listening to White Coe Blackheart. This week,

the case for psilocybin or magic mushrooms as a treatment to relieve end-of-life distress. Right now, Health Canada classifies psilocybin as an illegal controlled substance. To get approval as a bona fide treatment requires studies that demonstrate that psilocybin is both effective and safe. Now, let's meet a leading researcher working to make that happen. Hi, my name is Dr. Joshua Rosenblad. I'm a psychiatrist and the head of research for mental health at University Health Network. I'm a researcher specializing in clinical trials and mood disorders. Tell us about the federally funded research,

trials that you have going on at the moment for psilocybin? Yes, we've been very fortunate to receive several grants from the federal government, where we have one study that we're trying to figure out how many doses of psilocybin do you need to maximize the benefits. Another one where we're trying to optimize the type of psychological support or psychotherapy that you're receiving. We're evaluating new indications as well. For example, bipolar disorder has been an exclusion criteria for previous trials, but we're testing now psilocybin specifically for bipolar depression, looking at adding on psilocybin to existing antidepressants. It's also evaluating if maybe we're able to use psilocybin as an add-on treatment,

not only as a monotherapy on its own. So quite a few studies that we're running right now through the federal support. How many research trials do you have going on related to psilocybin? Related to psilocybin specifically seven studies. Wow. You completed a psilocybin trial in 2024. What were you looking for and what did you actually find? I had several patients that had tried everything, 20 plus medications, electric convulsive therapy, shock therapy, all these different things, and were still very depressed and unwell.

So I had gone to get an exemption for them, even before the special access program was in existence for psilocybin. And unfortunately, after years of applying, was not able to get that exemption. So health candidate made the suggestion to me that if I wanted to treat patients with psilocybin, I should really do a clinical trial. So that's what we ended up doing. We ended up expanding that further and doing a nice 30-person randomized controlled study. And we wanted to see, can we keep people well by giving them repeated doses over the series of several months? So a number of new things that we tried to accomplish in this first study. And this was actually Canada's first psilocybin study.

And your trial used psilocybin-assisted psychotherapy. Do you have a concept of how and why the psychotherapy piece is important? what's going on in the brain, what's going on in the heart, that would enhance and make the experience of being on psilocybin so much richer? I find the most compelling hypothesis circles around neuroplasticity, the brain's ability to change, where what we know with psilocybin and related psychedelics is it creates a window of neuroplasticity where your ability, your brain's ability to rewire is greatly amplified in the hours, days, and even weeks following a psilocybin experience.

So what this means is we have this window of time where we can help your brain become more adaptive in the way that it's thinking. So in the case of depression, you have these hardwired pathways that are driving you to think very negatively. You get this release from that, maybe temporarily, maybe long term. But if we combine with psychotherapy, the idea is that we can almost coach the new neural pathways into forming into more adaptive ways of thinking. What do we know currently about the efficacy of psilocybin assisted psychotherapy for end of life distress? specifically for someone like Pete Pearson, for instance. I know you're not familiar with his situation, but you can speak to this issue in general. Yeah, absolutely.

So there has been a handful of studies now looking at people near the end of life, people with palliative diagnoses, people with end of life distress, with death anxiety, which all have been fairly promising, suggesting that it seems like it is helpful that we're seeing scores for depression and anxiety go down, other scales that measure existential distress specifically seem to improve as well. A number of limitations just that these are pretty small sample sizes, so we still believe it is early days, but promising nonetheless. So I'm quite excited to see where this research goes. After his request for special access to psilocybin was rejected, Pete applied for a Section 561

exemption under the Controlled Drugs and Substances Act, which would exempt him from the legal ramifications of using an illegal controlled substance. Health Canada denied that request as well. Health Canada said there is not sufficient scientific evidence to demonstrate psilocybin's safety and efficacy for clinical use. Dr. Josh Rosenblatt knows a lot about that too. I want to share some data that we received from Health Canada from 2022 to February 25th, 2026. 525 requests for psilocybin were made through the special access program, and 338 of those requests were authorized at 64%. The majority of authorizations were for depression, and 28% were specifically for end-of-life distress. What do you make of those numbers? That's the first time I'm hearing those

numbers. So it's great that you got that data. That seems to make sense. It also aligns with sort of my own experience, too, where I've applied through the SAP for many of my patients, and 64% is probably about the same rate that I've had as well. If anyone knows how to fill out those rather arduous applications for special access, it would be you? How realistic is it to expect people with major depressive disorder or end-of-life distress to undertake the SAP application process, say, with their family doctor or other primary care provider?

Yeah, I mean, I think you need a doctor in many ways, speaking candidly here, that is willing to put in a lot of time and a lot of sort of unpaid labor against, speaking frankly here. It's something that, you know, I'm very passionate about this area. And so I've put in those hours and evenings and weekends to fill in these forms. But it is very, very hard, it's very challenging on the physician and the patient for sure. What are your thoughts about the open label individual patient trials or OLIP trials? Health Canada suggests you can try an OLIP. What do you think of that? Theoretically, it makes a lot of sense where the rationale with an OLIP is that if you're going to be,

administering psilocybin, given how preliminary the research evidence is right now, you should do it within a clinical trial where we're carefully collecting the efficacy and safety data and publishing those results. And it's been recommended to me as well, you know, when applying for the SAP. But the big challenge is that it's very hard to run a clinical trial, even to do an end of one open label type trial. The big challenge I find is it's not only about getting the Health Canada no objection letter, but you also need to get a research ethics board and RAB to approve the protocol. So that means you need to write a research protocol and you need to find a research ethics board to actually review it. I work at a hospital that has an ethics board

that could review it. But if you don't work at a hospital, you need to go through a community or private ethics board, which would have quite a significant price tag as well, where you're basically paying people to review your protocol and give you ethics approval. Then there's the sourcing the psilocybin. you would still need a Section 56 exemption in addition to the no objection letter and the RAB approval. So you're looking for three approvals, basically. And that's assuming that the psilocybin is in the country because sometimes we need to import because then in addition to that, you need to get an import license, which is a completely separate application and also requires a dealer's license. So sorry, I went on a bit of a regulatory tangent there, but all that to say,

it's very hard to run clinical trials. You know, I do this all day all night and I have a team of 30 people. So it's hard for an individual to produce, you know, what's needed, to run a clinical trial, in my opinion. And just to give you further information, we asked Health Canada, and since 2015, Health Canada has greenlit one approved O-LIP in 11 years for psilocybin. Does that number surprise you? It doesn't because it's a bit of a unicorn in my mind of who, I'm curious, I don't know who this person is, like what? A unicorn.

Yeah. It's interesting. What do you mean by that? Just in terms of when you think about the type of physician and patient that would actually have the resources available to bring forward a clinical trial for a single patient. They probably have to be wealthy enough to hire the right people, I would think. That could be a factor, and I think that gets into another whole ethical challenge in terms of how are people paying for the SAP and all these things.

You have literally millions of dollars of federal funding to look into psilocybin for mental illness and depression. What does that say about the importance of this research to Health Canada? I think it's become very clear to me that it's very important to our federal government. This is something that is really new within the past few years where there hadn't been any federal funding towards psilocybin clinical trials up until five years ago. About three years ago, the federal government put out a call saying that they would give a million dollars to three groups to conduct clinical trials. One would be psilocybin for depression. one would be psilocybin for end-of-life distress, and one would be psilocybin for alcohol or substance use disorders. And this really let the field on fire where tons of us came out and put out out applications that were really excited because a million dollars is a lot of money for Canadian researchers.

I'm very grateful for that move. And I think, you know, Health Canada's support in this area as well. What are the prospects that research by you and others might make routine access to psilocybin or reality? So psilocybin might actually be available for prescription as soon as a year or so from now. Wow. So things are looking actually quite positive in terms of the availability and the approval. The efficacy data looks quite good, but we still need to see the safety data. But it could be as soon as a year from now that doctors in North America could be prescribing

psilocybin for clinical use on label. And the question would be, can we start prescribing off label early, where if this gets approved for treatment-resistant depression, I could envision something. where even if it's approved for treatment or decision, depression, we might be able to prescribe it off label for end-of-life distress, for example. Dr. Josh Rosenblad, this has been really interesting. Thank you so much for speaking with us. Thanks so much for having me.

When Pete Pearson tried and failed to get psilocybin legally, he was able to obtain it from what he calls his friends up the road. Thanks to ongoing research, Health Canada may approve legal access a lot sooner than many of us might have imagined. That's our show. this week. For more on Pete's story, check out part one of our series on psilocybin in our podcast feed and our website, cbc.ca.ca.com. And for more about what we do and don't know about psilocybin's health benefits, head over to the dose, where Dr. Josh Rosenblatt answers the question,

what do we know so far about psilocybin as a medical treatment? Our email address is whitecoat at cbc.c.c. Whitecoat Blackart was produced this week by Jennifer Warren with help from Stephanie Dubois and Samir Chabra. Our digital producer is Philip Drost. Our senior producer is Colleen Ross. I'm Brian Goldman, and I'm proud to bring you stories from the Canadian side of the gurney. That was Changing Minds,

psilocybin, medicine, and the limits of the law from White Coat Black Art. If you like what you heard, you can find White Coat Black Art and its full archive of stories wherever you get your podcasts. Thank you for listening. For more CBC podcasts,

go to cbc.com. slash podcasts.