Magic mushroom therapy out of reach for terminally-ill Saskatoon man due to regulations

Thomas Hartle has end-of-life anxiety stemming from a terminal cancer diagnosis, and in 2020, the 54-year-old became the first person in Canada to legally gain access to psilocybin-assisted therapy to deal with it.

“My cancer is very, very difficult to detect, so doctors can't tell me how long I've got. It's impossible to give me a prognosis,” he said.

He says doctors were only able to discover more than 40 tumours throughout his body after seeing them during surgery.

“My surgeon told me that likely outcomes for me would be either a rupture in my intestines because of the weak spots that were in there from the tumours, or a blockage in the intestines, which I've had in the past, and either one of those things would be rapidly terminal for me.”

Hartle says because his cancer can’t be detected by any sort of medical scans, physicians have no way to warn him if one of those events was going to happen.

“When you live in a state where you don't know if you are going to be hit by a bus today or tomorrow, but you are absolutely going to get hit by a bus, it changes your perspective in some very unhealthy ways,” he said.

“For me, that manifests as end-of-life anxiety.”

'COMPLETE RADIO SILENCE'

In 2021, Hartle reapplied to get a renewal of the exemption but says Health Canada questioned him about whether or not his doctor was still supportive of psilocybin-assisted therapy. They have not responded to his application.

“It has been really complete radio silence. To have end-of-life anxiety and to be just ignored by the Minister of Health feels very wrong to me I have to tell you,” said Hartle.

“I have terminal cancer. I'm dying. There's no question about that. I have found the one thing that actually provides me with some relief from the daily anxiety that robs me of my enjoyment of what days I have left, and Health Canada is acting more of a roadblock to that treatment than they are as a conduit to providing relief.”

In a statement, Health Canada says no therapeutic products containing psilocybin have been approved in Canada.

“While some early clinical trials examining the effectiveness of psilocybin in treating various mental health conditions such as anxiety, depression, obsessive-compulsive disorder, and substance use have shown promising results, further research is still needed,” the statement said.

“Health Canada recognizes that access to unauthorized drugs may sometimes be appropriate. Currently, the best way for patients to access psilocybin is through participation in a clinical trial.”

Health Canada says alternatively, patients can talk with their healthcare provider to inquire about the possibility for them to submit a request to the Special Access Program.

Hartle says Health Canada’s position creates different problems for him; he says a clinical trial could make access years down the road, and he might not live that long. There aren’t many doctors in Saskatchewan familiar with psilocybin-assisted therapy, forcing him to go to British Columbia.

“For people like myself who have a terminal condition but have been fortunate enough to live longer, the process of getting access to this treatment is increasingly more difficult,” he said.

CHARTER CHALLENGE

As a result, Hartle says he and six others are taking the Government of Canada to court to challenge the constitutionality of the current controlled substances status of psilocybin.

“What we believe is that having access to psychedelic therapy is a right of all Canadians because that is a substance that has an extremely good safety profile,” he said.

“If the legislation is a roadblock to providing health care, then it is necessary to get that legislation changed to something that actually promotes wellbeing among Canadians.”

Hartle says he’s been asked why he won’t go through different channels to access psilocybin, like purchasing it online or illegally.

He says he wants to effect change for the better.

“I would like people who need and could benefit from this therapy to be able to just go to their doctor, and the doctor gives them a referral the same way as a doctor would give you a referral for physiotherapy or for any other procedure,” he said.

“This, to me, is a health question. It should be between a patient and a doctor and that's really the end of it. This whole deal of having this be between a patient and a doctor and a bureaucrat doesn't really fit a good medical model.”

Dr. Valorie Masuda is a palliative care physician and Associate Professor of Clinical Medicine at UBC who works with TheraPsil, a non-profit coalition helping Canadians to access legal psilocybin, and Roots to Thrive, a practice where therapy sessions are legally performed.

She says she believes the charter challenge will succeed, and the government needs to start creating ways to access psilocybin.

“We need really the government to be proactive,” she said.

“Other governments are looking to be proactive, even in the U.S., certain states are being proactive and saying, 'Okay, how can we give patients access, who really need this to alleviate suffering and distress in a rational way'. So that's what [Thomas is] really fighting for, and really the charter challenge is pushing the government to start looking at this now as opposed to leaving it on the back burner.”

FINDING PEACE THROUGH PSYCHEDELICS

Hartle says the six therapy treatments he’s done greatly help him deal with some very emotionally difficult subjects and feel a lot more comfortable with the idea of death and dying, as opposed to masking anxiety as an antidepressant would.

“The way that it does that is to sort of allow me to approach those topics in a way that separates me from the emotional hot potato element of that and examine those things in a way that would be closer to say, how you would be giving advice to a friend,” he said.

“If I had a friend who was going through this experience, I'd be able to talk to them and give them some advice or be able to discuss what they're going through without actually feeling what they're going through in anything more than an empathetic way, and the psilocybin assisted therapy allows me to examine what I am going through myself in a similar sort of way.”

Dr. Masuda says there are cohorts of patients at Roots to Thrive who only think about their terminal illnesses.

“All they can think of is every sensation, every cough, they think, 'Is this it? Am I dying?' They have so much anxiety about the process of dying, or they have this tremendous anxiety about not understanding who they are in the world anymore. They're no longer able to be the provider, so they have all this distress. They feel that life has no more meaning or purpose,” she said.

“[Psilocybin assisted therapy] allows your brain to make different connections. It allows your brain to think outside of their cancer. For example, I have one patient who comes out of the psilocybin experience that says, 'For the first time I wake up and I don't think about my cancer. I think about what I'm going to do for the day.”