Author: Lucas Standing
When I first began my university program at the University of British Columbia, I didn’t think I would be able to explore my interest in psychedelics through an academic lens. I was concerned that drug-related stigmas would prevent me from making academic connections and that I would need to hide this interest under the guise of studying ‘problematic’ drug use. However, once I stepped foot into my first year as an undergraduate student, I realized that psychedelic research had become re-popularized and is slowly being regarded as a legitimate treatment option for mental illness. It has not always been like this.
When LSD emerged as a drug of interest in the 1950s, researchers identified its therapeutic potential and began studying it. Unfortunately, when Nixon’s War on Drugs began in the 1960s, psychedelics became heavily stigmatized, leading Canada to ban all psychedelic research, thus pushing it underground.
Today, a new wave of research is underway, aiming to explore psychedelics’ untapped therapeutic potential. Otherwise known as the psychedelic renaissance, the jump in psychedelic exploration in the 21st century has resulted in various studies regarding the therapeutic nature of psychedelics. So, what do these studies look like?
Clinical Studies are Being Conducted in Canada on the Following Psychedelics:
The Multidisciplinary Association for Psychedelic Studies (MAPS) is conducting trials on MDMA paired with psychotherapy to treat post-traumatic stress disorder (PTSD). These studies primarily examine the therapeutic impact of reduced fear and increased empathy that is commonly associated with MDMA’s psychoactive effects. Thus far, MAPS has completed phase 2 clinical trials (i.e., establishing safety and efficacy) on MDMA for PTSD and Health Canada has approved a phase 3 clinical trial (i.e., comparing MDMA to other standard treatments).
- Psilocybin Mushrooms (AKA ‘magic mushrooms’)
Psilocybin-assisted psychotherapy is also being explored as a treatment option for people suffering from end-of-life distress. Health Canada granted a Canadian treatment centre based out of Victoria, British Columbia, known as Therapsil, the first legal exemption to administer psilocybin to 4 palliative care patients. This is the first time a legal exemption to administer psilocybin has occurred in Canada since the 1970s. More recently, the Government of Canada proposed revisions to the Food and Drugs Regulations which would restore access to psilocybin and other restricted substances through Canada’s Special Access Program, allowing patients to request psilocybin therapy if other therapies have been ineffective.
Ayahuasca is a brew originating from South American Indigenous ceremonies. Active drugs in ayahuasca include the psychedelic drug DMT and an MAOI (a class of antidepressant) that disables enzymes in the gut which otherwise break down DMT when users ingest it by mouth. MAPS Canada has conducted a study examining ayahuasca for treating substance use disorder and compulsive behaviours. The study found ayahuasca significantly decreases cocaine use, with some participants reporting reducing cravings after ingesting ayahuasca. Findings also included improvements in perceived connection with nature and quality of life, which may explain the corresponding reductions in cocaine use.
Ketamine infusion therapy is becoming increasingly available in Canada for inducing long-term mood enhancement in individuals diagnosed with treatment-resistant depression and bipolar disorder. Although research has not determined why this occurs, the Canadian Rapid Treatment Center of Excellence has determined that Ketamine works very quickly to alleviate depression. Compared to conventional antidepressants that can take upwards of 2 weeks for effects to occur, Ketamine can alleviate symptoms of depression in as little as two days, meaning that Ketamine’s efficiency may be life-saving for patients who are experiencing suicidal ideation
Historical Perspectives on Psychedelic Effects
To contextualize modern perspectives on psychedelics, it is crucial to delve into the historical development of psychedelic theories. For the past century and beyond, many pioneers have sought to explore and understand psychedelic medicine. It should be noted that their efforts were often cut short by drug-related stigmas and oppressive drug policies that favoured political motives over evidence based practices. These issues were historically misrepresented as mainstream literature often sided with the war on drugs. For example, drug use patterns of the 1960s counterculture that were deemed irresponsible were overemphasized and often ignored empirical analyses of psychedelic effects.
Model Psychoses Theory
During the 1950s, researchers were trying to classify LSD’s effects, which had recently been synthesized for the first time. They agreed on using the term psychotomimetic, which means “psychosis mimicking” because they noticed that LSD’s effects resembled psychosis (i.e., losing touch with reality). As a result, researchers developed the Model Psychoses Theory to describe how researchers could utilize LSD to model psychosis and thus better understand psychosis and schizophrenia (a disorder characterized by psychosis, among other symptoms).
Notably, the Saskatchewan Mental Hospital in Weyburn, Saskatchewan was responsible for much of the research surrounding the model psychoses paradigm . There, researchers connected the psychotomimetic quality of LSD with delirium tremens (severe alcohol withdrawal), and proposed that LSD could incite recovery similar to how delirium tremens had provoked abstinence for many alcoholics. Studies conducted at the Saskatchewan Mental Hospital tested this proposal and found LSD to be a successful treatment for alcohol use disorder .
However, many of the research subjects reported experiences characterized by bliss, transcendence, and connection. These experiences were inconsistent with the model psychoses theory. So, researchers abandoned this classification and began searching for a new one .
Humphrey Osmond, one of the primary researchers in the Saskatchewan Mental Hospital’s LSD studies, argued that the term psychedelic (meaning “mind manifesting”) is a fitting word for LSD and other hallucinogens. Aldous Huxley expanded on this term in a letter he wrote to Osmond by proposing the Filtration Theory, which states that we process information through a cerebral reducing valve. To help us survive, the brain runs incoming information through a restrictive filter, organizing it in a manner that allows us to make sense of it. According to this theory, psychedelics turn the reducing valve offline, allowing our perception to be temporarily unrestricted. Thus, filtration theory posits that psychedelics expand the mind by allowing unfiltered access to its latent content.
Psychoanalytic Theory: Ego-dissolution (AKA Ego-death)
Psychedelics may profoundly impact how the brain constructs our identity. Sigmund Freud, the father of psychoanalysis, coined the term ego to describe how the mind interprets information from the external world. In line with filtration theory’s rationale, the ego filters incoming information for the brain by mediating the relationship between our inborn impulsive desires (internally-motivated drives) and our learned moral standards (externally-motivated drives); it shapes our identity at the intersection between the self and environment.
Many psychedelic users report ego-dissolution, a temporary experience commonly referred to as ego death. Ego death is characterized by feelings of disconnection with one’s self and physical body and experiencing a connection with one’s surroundings, other people, and the universe at large. By temporarily inhibiting the ego, the psychedelic experience may allow for self-reflection without interference from the ego. This could explain the therapeutic nature of psychedelics, as they may enable individuals to gain control over toxic thought patterns that result from ego malfunctions.
Inaccuracy of Historical Theories
Historical theories of psychedelic effects weren’t very accurate. Their inaccuracy often stemmed from a lack of pre-existing research literature that could be used to shape new theories. Also, generalizing from the existing theories of drug effects – which mostly focused on dependence formation – was not effective; unlike most classes of recreational drugs, psychedelics do not directly produce dependency.
The absence of literature only increased when drug-related stigma (i.e., the view that drugs used for recreation lack therapeutic value and those that use them are immoral and irresponsible) began to circulate, making transparent psychedelic research nearly impossible. Through the late 1900s, these views were perpetuated by the war on drugs as a way to destabilize racialized groups and control counterculture movements that opposed the status quo. Underground research became the norm for developing clinical theories of psychedelics, which became contaminated by psychedelic sensationalization and pseudo-mysticism.
Modern Theories of Psychedelic Effects
Thankfully, restrictions have loosened in recent times which has normalized psychedelic discourse and created an opportunity to bridge the historical gap in our understanding of psychedelics. The following theories are examples of how contemporary research is exploring this gap.
Functional Connectivity & Default Mode Network Inhibition
Brain imaging has revealed that psychedelics dampen activity in the default mode network (i.e., brain regions that activate when a person is not focusing on external tasks and is at rest or daydreaming). There is evidence that the default mode network plays a role in sustaining the ego, which may explain why the ego appears to go offline during psychedelic experiences.
Additionally, neuroimaging has identified that psychedelics increase functional connectivity between brain networks that do not otherwise communicate simultaneously. The expanded interconnectivity between these brain networks is associated with the intensity of psychedelic effects and neuroplasticity (i.e., the ability for the brain to create new neural pathways). With this in mind, the therapeutic effects of psychedelics may occur by dampening the ego while simultaneously increasing overall brain connectivity.
Entropic Brain Theory
The Entropic Brain Theory, developed by Dr. Carhart Harris, expands on the functional connectivity caused by psychedelics. According to this theory, the brain exists in a balance between entropy (i.e., disorder) and order. Order in the brain makes us rigid by maintaining patterns of thinking and behaving. On the other hand, entropy in the brain allows us to be flexible and change over time. Certain brain networks maintain order as, when activated, other networks respond by becoming inactivated, resulting in mutually exclusive activation between these networks. Psychedelics increase entropy by causing these networks to activate simultaneously and overlap in unusual manners. As they overlap, the separation between key mental processes controlled by these networks becomes unpredictable and less restricted by usual (ordered) patterns of communication.
This theory has been used to argue that the psychological flexibility associated with entropic brain states could allow for personal growth; entropic brain states may allow people to alter entrenched habits or behaviours that lead to distress.
Moving Forward, What Must We Consider to Regulate Psychedelics?
Although modern psychedelic research is shaping our understanding of how and why psychedelics produce therapeutic benefits, many Canadians are beginning to wonder about the political context psychedelic therapy will take place in. Currently, public discourse surrounding psychedelic regulation is rich in perspectives that often overstate the potential of psychedelics to heal broad mental and even physical ailments. Moreover, the promise of a new therapeutic paradigm has inspired capitalist interests from various investors and corporations. However, those seeking to make quick money off the psychedelic renaissance may not have the best interests of those who could benefit from psychedelic therapy in mind; access to psychedelics under corporate programs provide greater access to upper class white people compared to lower class indigenous people.
Given these issues, it is important for Canada to deeply consider the following points.
- White supremacy. Indigenous peoples introduced many psychedelics to western societies. For example, Maria Sabina, a Mazatec curandera (healer) from Mexico, used psilocybin mushrooms in ceremonies and shared the sacred mushrooms with white people, who later popularized and profited on psilocybin in America. Despite the historical roots of plant medicines, there is limited Indigenous and Black representation in psychedelic studies, and few racialized individuals in leadership positions for psychedelic research. Research by Monnica Williams, an expert in racial trauma, has also revealed that psychedelics can reduce racial trauma, indicating the need for more psychedelic research involving Black and Indigenous people of colour.
Given the colonial origins of psychedelics, it is essential to ask how psychedelic regulation will impact communities of colour. Moreover, we must consider how neocolonialist practices may perpetuate colonization through economic power dynamics that commodify plant medicines by white people seeking ceremonies as a touristic experience. These experiences, mixed with the underrepresentation of Indigenous people in psychedelic research, have contributed to the tokenization and appropriation of Indigenous culture and ceremonies.
- Accreditation is a significant area of concern. Will administering psychedelics require licensure? How will licensing affect access? Various drug policy experts discussed accreditation in an article titled “A Public-Health-Based Vision for the Management and Regulation of Psychedelics”. The article determined that Canada should implement a regulatory body that controls licensure, referred to as a College of Psychedelic Supervisors. MAPS also recommends that harm reduction should be considered for developing regulatory requirements.
- Medicalization vs. Decriminalization. Psychedelic advocates have recommended both medicalization and decriminalization, each involving advantages and disadvantages. Medicalizing psychedelics would follow a similar timeline as cannabis pre-legalization; it would exclusively support individuals seeking treatment. Those who favour medicalization argue that it protects individuals from unsafe use and may lead to the public becoming more favourable towards psychedelics and the prospect of future decriminalization. People who support medicalization believe these benefits would stem from the stability and control offered by the medical system.
Alternatively, decriminalization removes judicial punishments for individuals using psychedelics in personal amounts, allowing for more accessibility but less governing control. Proponents of this model believe it will reduce medically-based stigma towards people who use psychedelics by allowing non-medical uses of psychedelics. Decriminalization also reduces the two-tiered system of regulation where legal and illegal drug markets coexist.
Despite these differences, many people advocate for psychedelic therapy (medicalization) and decriminalization simultaneously. Others suggest we should medicalize psychedelics first and then consider decriminalization.
What Does the Future of Psychedelic Psychotherapy and Policy Look Like?
As the President of the Okanagan chapter of Canadian Students for Sensible Drug Policy (CSSDP), one of our goals is to provide a youth-focused perspective on the future development of psychedelic drug policy in Canada. Considering the inequality and discrimination entrenched in Canadian drug policy, we also advocate for the voices of racialized, impoverished, and substance-using groups to be consulted at every stage of psychedelic policy development (I.e., The issues of white supremacy, accreditation, and medicalization versus decriminalization should be primarily determined in consultation with these populations). Positioning these voices at the forefront of psychedelic policy developments will promote equitable representation, access to psychedelics, cultural sensitivity, and therapeutic benefits for those who have been historically discriminated against by the war on drugs.
Although there is some uncertainty around the future of psychedelic psychotherapy, MAPS appears to be the leading organization in psychedelic research and is currently following the medical model. The founder of MAPS has stated that psychedelic psychotherapy could be available to the commercial market by as early as 2021, but nothing has been confirmed yet. However, with psychedelic therapy on the horizon, MAPS has a responsibility to address the recent allegations of racist behaviour by MAPS Canada’s leadership. In the open letter to MAPS, the writers also pointed out how MAPS lacks racial representation among staff. As such, CSSDP supports the call to action for MAPS to develop and continually expand on a thorough equity, diversity, and inclusion plan that includes the voices of underrepresented people.
With psychedelic research increasing, and more people experiencing therapeutic effects, psychedelics are gaining widespread public support. Health Canada’s new developments, such as the proposed revisions to the Food and Drug Regulations, are significant milestones towards making psychedelic psychotherapy readily available to Canadians. Canada is undoubtedly on a trajectory to expand access to psychedelic therapy, allowing many Canadians to become pioneers in the psychedelic renaissance.
 Weyburn Mental Hospital – Erika Dyck (2012). Psychedelic Psychiatry: LSD on the Canadian Prairies. pp. 26-28
Contributors: Special thanks to Erika Dupuis and Taylor Flemming for assisting in writing and publishing this work.