Canada Calls for Reformative Action in the Opioid Crisis

Worldwide, substance use disorders are on the rise, causing a high financial and social cost, yet the current model helps only a fraction of those suffering.

Substance use disorders have exacerbated overcrowding of the healthcare system, which has forced policymakers around the world to seek out more modern and compassionate healthcare alternatives and preventative harm-reduction measures.

Canada appears to be taking a progressive yet patchworked community healthcare approach to alleviating the current opioid and substance-use crisis. At the Federal level, Health Canada appears to be taking promising steps toward easing the surge in pandemic-related relapse rates and the troubling rise in overdose deaths that reached pandemic proportions before the arrival of COVID-19.

In February 2017, the Federation of Canadian Municipalities’ (FCM) Big-City Mayors’ Caucus (a collective of representatives from 22 of Canada’s biggest cities) launched a task force dedicated to curate best practices around substance use to prevent deaths and save more lives. This initiative has put together a comprehensive list of recommendations that call for a coordinated, nationwide approach requiring actions by all government levels.

To execute these proposed recommendations, the FCM recommends further action at the community-level would bolster the success of Canada’s drug strategy four-pronged approach: harm reduction, treatment, prevention and enforcement. As an alternative, they suggest replacing incarceration for possession of illegal substances with increased access to health care, treatment and social services. However, there is considerable debate regarding the efficacy of such a wide-scale change of legislation, suggesting that more research and discourse are first required.

Nevertheless, in addition to these efforts, Health Canada has released a letter that demands government ministries “conduct a thorough assessment of any barriers to access medicines that could contravene public health advice for social distancing and self-isolation, when appropriate.”

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Multiple Barriers to Substance Use Disorder Treatments

As highlighted in at least one past entry, the barriers vary and come loaded with socio-economic nuance. They include:

  • Current regulations around illegal substances
  • Restrictions imposed by medicated-assisted treatment protocols
  • Costs associated with traditional treatment models
  • Lack of effectiveness associated with standard treatment models

Even using the “most effective” legal methods of treating alcohol dependence, long-term patient outcomes are limited, with most patients relapsing the first year following a purely psychosocial based intervention. It is usual for a patient to require repeated stays at 90-day treatment centres. Without insurance coverage, the modality is too costly for the average citizen to afford.

In Canada, programs exist covered by provincial health care; however, patients can find themselves wait-listed for treatment when demand for detox and in-patient programs rises. In the context of these harsh realities, many researchers are focused on drug discovery to find modern efficacious uses for known or overlooked psychedelic chemical compounds that may provide long-term symptom relief for specific use-cases.

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Why Consider Psychedelics for Substance Use Disorders?

There are many programs in place to address substance use disorders (SUDs), including government-run programs, social programs run by non-government entities, and religious programs.

As a member of Entheon’s influential team of scientists and researchers, Dr. Christopher Gondi, Ph.D., M.Sc. seeks to explore the therapeutic benefits of psychedelic substances in helping patients reconcile their views and past traumas. From his lab at the University of Illinois College of Medicine Peoria, Dr. Gondi shared with us some insight into why religious-leaning programs like Alcoholics Anonymous (AA) and Narcotic Anonymous (NA), which require individuals to surrender to a higher power, are perceived to have a higher success rates (actual rate is challenging to determine due to the insistence on anonymity) than non-religious detox programs.

“Those programs help more than the structure where you go through a detox period for some time and then you’re kicked out. [Those patients] come back. Why? Because they have not reconciled their deep-seated emotional trauma and emotional need that needs to be addressed. For some reason – and I have no answer for this – the touching on the spiritual needs of an individual is something that psychedelics have helped.”

Indeed, one of tne of the naturally-occurring psychedelic molecules Entheon Biomedical is studying, called DMT or N, N-Dimethyltryptamine, is given the moniker “the spirit molecule.”

Johns Hopkins Magazine recently resurfaced findings from a DMT survey study, noting that:

“The vast majority of the respondents said DMT brought them into contact with a “conscious, intelligent, benevolent, and sacred entity,” most commonly described as a “being” or “guide” in an interaction that oozed joy, trust, love, and kindness. Eighty percent reported that the experience had fundamentally altered their perception of reality, and 72% said that the entity continued to exist after the experience “in a different plane of reality.” Perhaps most startling was that more than half of those who had previously self-identified as atheists—28% of the sample—described some type of belief in a higher power or God after taking DMT, according to Griffiths, director of the Johns Hopkins Center for Psychedelic and Consciousness Research.”

The advent of psychedelic-assisted therapy is a significant moment in human history, and the fact that it may be sparking an entheogenic-related religious curiosity seems to be part of the course with these powerful substances. However, insurance companies are not about to cover substances that are not legal, even if they result in a longer-lasting reduction of drug-seeking and drug-taking behaviours.

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Who Will Prevail in Helping to Make Psychedelics Accessible to Patients in Canada?

We want to highlight two groups taking unique approaches to entheogenic (psychedelic) drug reform in Canada.

TheraPsil is a non-profit organization that supports Canadians in palliative care and experiencing end-of-life distress to exercise their charter right to seek compassionate treatment using psilocybin through an application for exemption of section 56(1) of the controlled substances and drug act (CDSA).

The palliative care patient’s use case is admittedly different from that of drug-dependent individuals, yet both sets of people are looking for some of the same things, relief from trauma being part of that.

On August 4th, 2020, four Canadians suffering from end-of-life distress became the first individuals to access an exemption to access psilocybin therapy legally. Today, the organization has secured six exemptions and is now asking Canada’s Ministry of Health to review physician requests to use psilocybin to better understanding patient outcomes. Not only has Federal Minister of Health Patty Hajdu been granting these exemptions, but she has also gone on record about her “open(ness)” to drug decriminalization.

Dr. Ryan Patchett-Marble from Marathon, Ontario (Thunder Bay district), is one such physician who recently told a local media outlet his reason for applying for the exemption through TheraPsil. “The reason I think it’s important for physicians or therapists themselves to have experiential training, this is not like when I prescribe antibiotics for an ear-tract infection, I don’t need experience with the antibiotic, this is prescribing,” he said. “This is more akin to a guide. You want the guide to have personal experience in what they are guiding you in.”

In a separate motion that could potentially increase access to entheogens to all Canadians, a petition to decriminalize plant medicines in Canada was presented in the House of Commons by Paul Manly MP on September 30th, 2020. The Canadian government has 45-days from then to respond to the petition from the Canadian Psychedelic Association that is now undersigned by 15,000 Canadians.