Alberta will become the first Canadian jurisdiction to regulate the use of psychedelic drugs for people in therapy, the province announced Wednesday.
Associate Minister for Mental Health and Addictions Mike Ellis also introduced new rules to limit who can prescribe high-potency drugs to people with difficult-to-treat opioid addictions.
The changes aim to protect the public, ensure patients receive high standards of care and prevent risky drugs from inadvertently ending up on the street.
Dr. Rob Tanguay, a psychiatrist who specializes in addiction medicine and pain medicine, said patients are vulnerable while taking psychedelics and need protection.
“The risk is much lower with a regulated psychologist who is registered with their university than with someone who printed [a certificate] off the Internet and then went on the Internet to announce, “I’m a psychedelic therapist, come see me,” Tanguay said at a news conference in Edmonton on Thursday.
Researchers are increasingly studying the use of psychedelic drugs such as psilocybin (magic mushrooms), LSD and ketamine to help people with post-traumatic stress disorder, anxiety or depression resistant to conventional treatments.
Calgary psychiatrist Dr. Rob Tanguay of the center says patients are in a vulnerable state when taking psychedelic drugs and should only be monitored and treated by qualified health professionals. Tanguay attends a press conference Oct. 5, 2022, in Edmonton, with Associate Minister of Mental Health and Addictions Mike Ellis, left, and David Fascinato, executive director, Heroic Hearts Project Canada, right . (Janet French/CBC)
Although these drugs are illegal in Canada, doctors and researchers can apply to Health Canada to use them in clinical trials, obtain special access for therapy, or seek an exemption that is in the public interest.
Health Canada was unable to provide information Wednesday on how many people are authorized to prescribe the drugs. Advocates for its use have previously said obtaining permission is rare.
At a technical briefing Wednesday, Alberta health officials said they are establishing a regulatory foundation in the province as the field is expected to grow.
New Alberta regulations would require medical directors to apply for a license before treating patients with psychedelics for mental health disorders. A psychiatrist would have to oversee any treatment, according to regulations that will come into effect in January 2023. Healthcare professionals would not be able to charge money for the drugs and a qualified professional must only give the drug to patients in a medical facility, unless that the person is in palliative treatment. cure
Staff must monitor patients while they are in an altered mental state and report any serious injury or death to the government immediately.
The rules are looser for doctors who prescribe ketamine or drugs at doses too low to cause psychedelic effects.
Dr. Peter Silverstone, an Edmonton psychiatrist who was not involved in Thursday’s announcement, said Alberta’s new standards are good news for patients.
Dr. Peter Silverstone is an Edmonton psychiatrist who has written and participated in research on the use of psychedelic drugs in the treatment of mental health disorders such as anxiety, depression and post-traumatic stress disorder. He says the new regulations for practice in Alberta are a positive step to help protect patients. (Submitted by Peter Silverstone)
Silverstone, author of a book called The Promise of Psychedelics, says there is evidence that taking the drugs can make patients’ brains more malleable and receptive to psychotherapy. The regulations are a pragmatic way to prevent harm as the field evolves, he said.
“It’s great to have the potential for new tools,” he said. “The promise is huge. We’re not doing it in an unsafe way.”
Prescriptions for opioid addictions
Doctors sometimes prescribe opioid-addicted patients precise doses of less harmful opioids to help gradually reduce their dependence on the drug.
However, some people do not seem to respond to more common treatments, such as methadone or buprenorphine.
In these cases, doctors may prescribe stronger drugs, such as hydromorphone, diacetylmorphine, or fentanyl for a shorter time. They carry more risk, but can help the patient move to a safer course of addiction treatment.
The Alberta government says getting these high-potency drugs to treat addiction will soon only be available through the Opioid Dependence Program managed by Alberta Health Services (AHS). Officials are also committed to expanding clinics offering the service beyond Edmonton and Calgary to Grande Prairie, Red Deer, Lethbridge and Medicine Hat.
Dr. Nathaniel Day, medical director of Alberta’s Virtual Opioid Dependence Program, says the province needs to balance making more treatment options available to people with addictions while preventing dangerous drugs from falling in the wrong hands
He said expanding access to more powerful opioids will help stabilize people with the most severe and difficult-to-treat addictions so they can move on to more conventional treatments.
“There is hope,” he said at the government press conference. “People can bounce back from this challenge and they do every day.”
Patients will have to take their medications in front of the health professionals on site. Physicians who prescribe the drugs should state why they are being prescribed and should try to transition patients to a less risky course of therapy as soon as possible.
In one month, family doctors who prescribe these drugs and work outside of AHS clinics will no longer be able to start new patients on these high-risk therapies.
Day said despite these new restrictions, the goal of the program is to expand access in the province, not limit it.
The changes will be phased in over the next five months.
The regulations do not apply to doctors who prescribe drugs to treat pain.
Associate Minister Ellis also announced a $500,000 investment in a provincial pain strategy, which should help doctors more responsibly prescribe opioids for pain treatment while preventing addictions.