It’s October 2018 and Sam* is settling down to meditate. This is his fifth attempt of the week. Like every other time, he’s readied himself by exercising, eating a balanced meal, and getting a good night’s sleep. But just like every other time, his mind spirals out of control as soon as he starts.

“I’d think that I was nothing but a huge disappointment,” he explains. “That it would be fine if I died. That if I got hit by a car, it would be for the best.”

That shattered state of mind was Sam’s brain on Bupropion, the second antidepressant his family doctor had prescribed to try to get him back to some semblance of a normal life. “You generally start antidepressants because you’ve tried therapy and it wasn’t working. So you’ve gone to your doctor for help. You’ve explained how you can’t get up in the morning, and how things that are usually no big deal have become impossible for you.”

“I really didn’t want to take antidepressants. I was very hesitant. But in the end, I realized I had to try.”

Thus began a medical journey with its share of low points and very low points. First he tried Citalopram. “It just made me feel very dull. I wasn’t in a state of constant torment every day, but I wasn’t ever happy either,” Sam relates. “To top it off, my libido was totally gone.”

After a few months, feeling defeated, Sam went back to his family doctor. She convinced him that they would find the right medication together. Next up was Bupropion. It didn’t work, either: his thoughts grew darker and, though he had always been a gentle person, he even began showing signs of aggression.

Getting better felt like a distant possibility, but they weren’t going to give up. They moved on to a third antidepressant, Venlafaxine, which put him back at square one: Sam shuffled along like he was half-dead. That’s when his family doctor suggested a promising new antidepressant not yet covered by Québec’s public drug plan. They applied for an exemption; it was denied. “When I got the letter, I was so disappointed in our system. I thought, ‘I’m really trying to get on track, I think I can contribute to society, and it’s not working out. So whatever, fine!’” It wasn’t until Sam went looking for a solution outside this system that things began to change for the better.

Depression, studies, shrooms
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The past five years have seen an explosion of literature on the therapeutic use of psychedelic, or “magic,” mushrooms. Studies suggest they could be a game changer in treating not only depression but also other conditions like post-traumatic stress, anorexia, and alcoholism. These precious fungi seem to offer a thousand benefits, from boosting creativity to treating serious anxiety disorders. There’s a catch, though: it’s currently illegal to possess and consume shrooms in Canada.

The unique properties of magic mushrooms come from the hallucinogenic compound psilocybin. Serious scientific research on therapeutic psilocybin remains limited, despite the recent profusion of media articles. Largely known as a recreational drug, these mushrooms also appeal to thousands of people like Sam, who use them in hopes of overcoming their inner demons.

There are two main ways of consuming magic mushrooms therapeutically: microdosing and psilocybin-assisted psychotherapy. People who opt for microdosing generally turn to the internet, where they will inevitably come across the work of psychologist James Fadiman, the “father of microdosing.” Followers of his protocol consume about 5 to 10 per cent of a recreational dose, roughly two or three times per week, over a period of time.

“The perfect microdose is the one you don’t know if you took,” explains researcher Rotem Petranker. “It’s the one where you’re saying, ‘Is it a very good day or am I on drugs?’” Petranker co-founded the Psychedelic Studies Research Program at the University of Toronto and the Canadian Centre for Psychedelic Science with the specific goal of helping build knowledge on the topic. “Psychedelics are cool, and they show a lot of promise,” he adds. “But we have to do the science right.”

Due to budgetary constraints, Petranker and his colleagues looked to Reddit in 2017 to recruit microdosers. The response was immediate: 1,000 participants answered a series of questions about their DIY therapy.

These benefits are substantial, especially when compared to the relatively minor drawbacks. “According to users, the biggest problem with psilocybin is that it’s illegal, which is not so much about the effects of the drug itself. Otherwise, reported side effects include shivers and having a hard time falling asleep.”

One year later his team repeated the experiment at a larger scale, in partnership with the independent organization Global Drug Survey. Over 8,000 people worldwide answered their questionnaire, with similar results.

Had Sam participated in the study, his responses would likely have echoed the others. “The first time I tried microdosing, I was studying,” explains the young man in his twenties, who was working on his MBA at the time. “Strangely, I felt particularly focused. There wasn’t any sort of revelation, just little chills and a sort of wakefulness.” He then took a few microdoses, spaced a few days apart, in a controlled setting at home. He found himself wanting to see his friends and connect. He found himself feeling good. It had been more than two years since he’d felt anything like that.

A large number of participants in Rotem Petranker’s studies reported a similar surge of well-being. The next step for his team is a Health Canada-approved clinical trial of microdosing. For Petranker, it’s crucial to enlist at least 100 participants so the study achieves statistical significance and increased credibility, regardless of whether the results are positive or negative. A fervent defender of open research, Petranker laments the fact that all too often researchers publish only the results that they want to show.

“Every week, there are two new scientific papers with titles like ‘Should We Incorporate Psychedelics into Mental Health Care?’” Petranker says. “These texts just rehash old data; we don’t need them. We need to build upon our knowledge and increase the impact of our results.”

Indeed, in-depth studies are exactly what is currently lacking, and they are needed for the Canadian government to approve the decriminalization of psilocybin. Health Canada’s website lists a range of negative side effects of the drug, including anxiety, paranoia, and increased heart rate.

Psilocybin-assisted therapy and the law
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In Vancouver, several brick-and-mortar shops brazenly display their shroom wares. In Montréal, an experienced mycologist admits that he’s helped develop a major underground production lab. The project is going really well. Clearly, there’s a growing appetite for magic mushrooms. And so far, law enforcement is mostly turning a blind eye, according to advocates.

Today, Canadians who want to use psilocybin without breaking the law have two options: they must either be participating in a clinical trial or obtain an exemption under section 56(1) of the Controlled Drugs and Substances Act. “In Canada, drug laws exist for the sole purpose of protecting people. At this point in time, they’re doing the exact opposite; people don’t have access to their medicine,” explains Spencer Hawkswell, CEO of TheraPsil, a BC-based organization that advocates for access to psilocybin-assisted therapy. From the point of view of this young advocate, Canadian drug laws make no sense.

Hawkswell’s group has received thousands of requests from Canadians wanting to use psilocybin legally and therapeutically, in the presence of a psychotherapist trained to guide them through their trip. Specialists in this emerging field offer exactly that service.

Dave Phillips joined the TheraPsil team in 2019. With two degrees in psychology, Phillips has been practising and working with trauma survivors since the 1980s. “At the beginning, I was very dismissive of psychedelics [for therapeutic purposes],” he explains. “All I knew was what I had grown up with: ‘they’re bad, don’t do them.’” But when he came across a study from the renowned Johns Hopkins University, his perspective began to change. “The more I read, the more I was amazed. Any psychologist who treats trauma will tell you the same thing: we get very little results with the methods we’ve developed so far.”

Officially, he has guided three patients through psilocybin-assisted psychotherapy. Unofficially, before joining TheraPsil he’d clandestinely helped hundreds of other people in distress. He estimates the success rate of psilocybin-assisted therapy at around 80 per cent.

Phillips now teaches other mental health professionals who want to follow in his footsteps. TheraPsil’s first cohort graduated in June, and dozens of experts all across Canada are lining up to complete the program. These professionals learn to guide their patients up to the moment where they take their first dose of psilocybin. Trust is crucial, because patients can expect to have a veritable psychedelic experience.

The exemption process takes a long time: patients sometimes die awaiting the government’s blessing, while others are denied it entirely. It’s an issue close to Hawkswell’s heart: “The government seems to be saying that they’ve got favourites. That some people deserve compassion, but others don’t. Why not them too?”

Health Canada claims that each request is carefully analyzed, “on a case-by-case basis, taking into account all relevant considerations, including evidence of potential benefits and risks or harms to the health and safety of Canadians.” Advocates, who see first-hand the positive effects of psilocybin-assisted psychotherapy, feel that’s far too little.

Dave Phillips’ eyes sparkle when he talks about his patients. “It’s humbling, it’s moving, it’s gratifying,” he explains. “I have a patient with colon cancer whose life was miserable. She was so anxious that she would totally withdraw from social life. After psilocybin, she reconnected with her children and her husband. Her heart is now full of joy. She has wonderful energy. And she’s dying.”

Early approvals gave advocates hope, but it proved to be short-lived. While a wave of exemptions were quickly granted in 2020, the rate has slowed to a trickle since the spring of 2021, according to Hawkswell, who suspects an anti-psilocybin lobby at work.

So far, three clinical trials have been approved in Canada. But no drug approval application for psilocybin has been filed, which means that Health Canada has not yet assessed its treatment efficacy. Clinical trials take time and, above all, money. Organizations like TheraPsil lack the financial resources necessary for these kinds of studies. Members of TheraPsil are now preparing to go to court to uphold Canadians’ rights to access a treatment that could change their lives.

***

One in eight Canadians will suffer from major depression at some point over the course of their lives, and for almost a third of them, antidepressants will provide no relief. Given those facts, it’s not hard to understand why some seek a different, even illegal, solution. It’s especially clear when you see someone you care for in so much pain.

Perched on his balcony in Limoilou, Sam watches people go by with a crooked smile. He seems at peace.

Happily, Sam found his own solution.

*Not his real name.

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Around the World

Several countries are currently exploring the therapeutic potential of psilocybin. Canadian companies such as Compass Pathways have joined forces with study groups in Europe and the United States to conduct clinical trials.

Oregonians recently voted in favour of legalizing psilocybin-assisted therapy, and the simple possession of almost all drugs has been decriminalized in the state. State authorities even point out that psilocybin is not addictive.

In the Netherlands, magic mushrooms are considered a soft drug: you can consume them legally, just like cannabis. In Jamaica, the sale and possession of mushrooms are fully legal, and you can even attend spiritual retreats centred around magic mushrooms.

A look into the past shows the importance hallucinogens have long held for peoples all around the globe. Several centuries before the Common Era, the Aztecs were using a variety of mushrooms in rituals. On the walls of prehistoric Australian caves, depictions of mushrooms have been found alongside decidedly psychedelic drawings. When it comes to hallucinogenic plants, history reminds us of where we came from — and may well help guide us where we’re going.

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