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Canadians have seen many hopeful headlines about psychedelics in recent years, as evidence mounts that the drugs can help people with treatment-resistant conditions.
A woman with chronic pain is fighting to get her insurer to cover ketamine treatments in Halifax. In Manitoba, there’s a waiting list for people seeking psilocybin treatment. Psychotherapists in BC have been trained to use MDMA — better known as ecstasy — with patients with post-traumatic stress disorder.
And last week, a new Canadian psychedelics research centre opened in Kingston, Ontario. Psychedelics hold promise for health care and have been used for centuries by indigenous communities around the world, according to the centre’s director, psychiatrist and researcher Dr. Claudio Soares.
“In Brazil, where I grew up, for example, ayahuasca is used in the Amazon region during religious ceremonies,” Soares says.
But because it’s a new field, he said, scientists are still working to answer some fundamental questions about the use of psychedelics. Who should take them and under what circumstances?
The Centre for Psychedelics Health and Research, a joint project between Kingston’s Providence Care and Queen’s University, is expected to build on existing research at Queen’s.
Dr. Claudio Soares, a psychiatrist and director of the new Centre for Psychedelic Health and Research in Kingston, Ontario, says psychedelics can provide “transformative” experiences for people with a variety of mental health conditions.
Researchers want to know, among other things, whether psychedelics can serve as a treatment on their own. Two lines of thought are being tested, says Dr. Soares.
The first focuses on the use of psychotherapy in combination with psychedelics.
The second attempt is to determine whether the experience of ‘tripping’ and the use of therapy techniques are necessary for the patient to experience the benefits of psychedelics.
“It’s almost like having a surgical approach to an injury or a physical therapy approach to an injury,” Dr. Soares said. “I would say there’s no right or wrong.”
Concerns about patient care
But a health care professional in Kingston said they are concerned about how well the research center will care for its patients. CBC agreed to give them confidentiality because of their concerns about professional repercussions.
Providence Care operates a ketamine clinic at its eponymous hospital in Kingston.
The health care professional said the high-pressure environment of a medical clinic is not suitable for patients who are in the “manipulable state” induced by ketamine.
“[The clinic is] just treat [ketamine] like a chemical,” he said. “People come out [of the clinic] very confused, they don’t know how to understand it. They don’t know how to navigate the experience.”
According to Dr. Argel Aguilar-Valles, a neuroscientist at Carleton University, the way a person responds to their environment affects the outcomes of psychedelic treatment.
“Usually the experience is very positive when someone feels safe and secure in the environment,” he said. “That’s where you usually see signs of effective treatment. And we’ve known [that] “for quite some time now.”
He said some researchers want to know whether tripping on psychedelics is therapeutically necessary, but their work involves microdosing: giving patients doses that are too low to make them trip.
Providence Care’s ketamine clinic gives its patients a dose high enough to induce a trip, the anonymous health care provider said.
They said they are working to prepare their patients for their experience at the clinic, but that is something the clinic itself should do. They said the clinic staff should also take a course in first aid for psychedelics.
The Future of Psychedelics
Soares said he can understand the concerns of health care professionals because the clinic uses “the medical model of ketamine for depression, which is not integrated with psychotherapy.”
“There are probably lost opportunities to capture what happens to those patients under ketamine and to explore that with them,” he said. “Or at least to be aware and sensitive to that experience, which for some patients may be more intense than for others.”
He said he plans to reach out to colleagues and suggest they gather information about their patients’ experiences with ketamine to look for “common themes,” which they can then share with patients and other researchers.
“I think there are probably opportunities to enrich the academy and clinic experience,” he said.
The research center will bring together professionals from different disciplines, Soares said, and there will be “opportunities for cross-training and sharing of experiences.”
Kingston psychotherapist Richard Tyo said he is pleased to see the research expand because he has seen firsthand how effective the safe use of psychedelics can be.
“A lot of [traditional therapy] is just talking about problems and not really getting into the emotional content or the somatic or bodily experience of it,” Tyo said. “And that’s where [psychedelics] can really help.”
