Patient hopes Canada will introduce regulations for psychotherapy with 'magic mushrooms'

As the first terminally ill cancer patient in Canada to legally use so-called magic mushrooms to treat anxiety, Thomas Hartle is hopeful that more temporary approvals from the federal government signal a permanent regulatory regime may be in the works.

Hartle, 53, received a one-year exemption from the Controlled Drugs and Substances Act last August to use psilocybin, the active psychedelic ingredient in magic mushrooms, during psychotherapy.

Since then, Health Canada has approved 24 more applications from cancer patients for treatment of end-of-life distress. It has also granted exemptions to 19 health-care providers, giving them the right to possess and use mushrooms containing psilocybin for professional training purposes, a spokesperson said in a statement.

The department has yet to decide whether it will allow the public to use any psychedelics for therapeutic purposes beyond the exemptions it has granted so far.

Hartle has had two psychedelic psychotherapy sessions at his home in Saskatoon, the last one in November, with psilocybin from mushrooms he grew and dried himself using a coffee grinder to turn them into powder and placed into capsules for precise dosages.

The IT administrator, who is on leave from his job, said anxiety over dying from colon cancer and leaving his wife and two children, who are both on the autism spectrum, became unbearable after his inoperable condition was diagnosed in 2016.

However, taking psilocybin during his two sessions with the help of his regular clinical psychologist helped him manage his anxiety to the point that he hasn't felt the need to have any more psychedelic-assisted therapy while he continues traditional therapy, Hartle said.

"I think that's probably obvious to most people who have interacted with me before and after my sessions,'' he said of the marked improvement in his anxiety.

"I've been talking about subjects I would previously have considered almost impossible to talk about and keep a clear voice and not break down into a very emotional state. Instead of focusing on the pain or discomfort, I'm focusing on making lunch for my family, or something like that," he said.

Before each of the two sessions, Hartle said he met with his therapist and completed paperwork to gauge his anxiety level in order to establish a baseline that could be compared with how he would feel afterwards.

The first session lasted about six hours, during which he took three capsules about an hour apart, containing a total seven grams of psilocybin, he said.

His therapist and a friend remained by his side as he lay blindfolded and wearing a headset while listening to music from a playlist compiled by Johns Hopkins University as part of its research into psychedelics.

Hartle said the range of music, from classical to chanting as well as South American and African beats, elicited different emotions and he saw multiple colours and geometric shapes as he entered "a state of other," which made it impossible for him to recall the names of his family members.

"It was very serene and comforting to me to realize that I could have consciousness and awareness that had nothing whatsoever to do with this existence."

Hartle said that prior to his cancer diagnosis, he had never used illegal substances and only started taking cannabis oil to deal with the nausea brought on by chemotherapy as part of his cancer treatments.

Focused psychotherapy sessions before, during and after his two sessions were crucial to his use of psilocybin, Hartle said.

"It's not like you take a pill and suddenly everything is fantastic. It doesn't work like that any more than regular therapy does. There is work to be done. There are challenges to face. There are issues that need to be worked through the same as any other session," he said.

"The main difference is that with the psychedelic-assisted therapy, it can get your ego out of the way so you can get at some things."

Health-care providers exploring psilocybin options

Spencer Hawkswell, CEO of TheraPsil, a Victoria-based advocacy group for patients, said it helped Hartle apply for exemptions to use psilocybin on compassionate grounds based on Canadians' right to medical assistance in dying.

He said access to assistance in dying should also give terminally ill patients the right to try mushrooms to reduce their emotional suffering.

"When we can't manage someone's symptoms, that's often when they choose MAiD. [Psilocybin] deserves to be put in between the treatment options that are failing those patients and MAiD.''

"It's not like you take a pill and suddenly everything is fantastic ... The main difference is that with the psychedelic-assisted therapy, it can get your ego out of the way so you can get at some things.''- Thomas Hartle, psilocybin patient

TheraPsil has helped people from six provinces apply for exemptions.

Health-care providers who have received exemptions to use psilocybin themselves before leading psychedelic-assisted sessions include family doctors, nurses, psychologists, psychiatrists, clinical counsellors and social workers, Hawkswell said, adding the group is putting together a training program that will need partnerships with provincial governments.

'The next big thing'

Psilocybin is just one of several psychedelics being considered to treat mental health conditions while a growing number of private companies promote their potential use for multiple issues including obesity, smoking, alcohol dependence and addiction to illicit substances.

Mark Haden, chair of the board for the Canadian chapter of the Multidisciplinary Association for Psychedelic Studies, or MAPS Canada, said psychedelics appear to be seen as the new cannabis before it was legalized.

"A lot of venture capitalists went into the cannabis world. Many of them made money. Some of them lost a huge amount of money, so the cannabis bubble exploded and then burst. So, all of that money is saying, 'Where do we go next? What's the next big thing?' And they've latched their view on psychedelics," Haden said.

MAPS Canada is currently conducting a Phase 3 clinical trial in Vancouver on the use of MDMA, commonly known as ecstasy, to treat post-traumatic stress disorder.

Haden said the small trial involving about 12 people is expected to be completed next year as part of the research by over a dozen sites in the United States and Israel.

Traditional PTSD therapy has a high dropout rate, may involve patients taking medication for years and has an effectiveness rate of 10 to 25 per cent, said Haden, who is also an adjunct professor at the University of British Columbia's School of Population and Public Health.

"With MDMA, it takes a few months and the effectiveness is 60 to 80 per cent,'' he said of research findings elsewhere.