We asked an expert to explain psychedelic-assisted therapy

Nov 30 2022, 5:00 pm

Editor’s note: This article mentions and discusses overdosing and suicide. 

Canada, like many other countries, is currently in the grips of a mental health crisis, with one in two Canadians experiencing mental health struggles before the age of 40.

In response to alarming statistics such as this, new methods of treatment are actively being developed by healthcare providers and researchers, as data also shows that current treatments and services are inadequate to meet public need. One of these potential solutions is psychedelic-assisted therapy, a practice that combines traditional therapy with the use of psychedelic substances such as ketamine, MDMA, and psilocybin, in combination with traditional therapy, to facilitate and deepen healing and make improvements to daily life.

Over the past decade, research has emerged, supporting the efficacy of such therapies in the treatment of numerous mental health issues, including depression, anxiety, substance use disorders, and PTSD. So as these drugs begin to enter mainstream psychiatry, it raises the question — could they be the future of mental healthcare?

According to Dr. Reid Robison, psychiatrist and chief medical officer at Numinus, a leading Vancouver-based company developing psychedelic-based therapies and delivering mental health services in clinics across Canada and the US, this could certainly be the case. Dr. Robison has been working with innovative mental health treatments for over a decade and is especially known for his significant contributions to ketamine-assisted therapy for conditions such as depression — one of the treatments offered at Numinus.

“As we all know, there’s an urgent need for new and improved treatments. Far too many people are suffering,” he says. “Medicines like ketamine are not only effective, but faster acting and get at the root cause of mental health conditions, rather than some of the traditional approaches that are just treating symptoms.”

As Dr. Robison explains, ketamine-assisted therapy works by combining the psychoactive drug with forms of counselling provided by trained mental health professionals. “The client has an experience where the ketamine brings about what we call a therapeutic state of consciousness where they can see themselves and their lives in a new perspective. Some of the walls that were present in their day-to-day lives are melted away. There’s often a lot of insight that comes with the process and, as they come out of that experience we do some processing to help make sense of these insights.”

Dr. Robison has seen the “game-changing” and unique benefits of this treatment multiple times throughout his career, recalling one particular moment from his early years researching ketamine. “I had a client who came in after an intentional drug overdose, which was a suicide attempt, into the ICU. I talked to my colleagues about what they thought about me giving a dose of ketamine to help them emerge from this state of severe hopelessness. At the time, we had read that ketamine had been a new treatment for severe depression, so we decided to try this new approach. And I was amazed at the impact it had on the mental health of this patient.”

“The individual felt as if there was a huge weight lifted off their shoulders… We actually had a glimmer of hope. Of course, [the effect of] ketamine doesn’t last forever. But it can be such an important tool, especially when people are stuck or not responding to other treatment methods or need something that works faster to help get them on the right path… Ketamine was a really important door-opener on their path to wanting to get better.”

For some of us, ketamine-assisted therapy and other similar treatments will be totally new concepts — and might even seem a little unusual, as there can be a tendency to associate such things with recreational drug use and substance abuse. Dr. Robison admits the journey toward mainstream acceptance hasn’t always been smooth, but these treatments have become much more widely accepted in recent years.

“There’s so much openness, especially coming out of the COVID-19 pandemic, which shone a light on the mental health needs of so many people in Canada and the US,” he says. “I’ve seen ketamine and other psychedelics welcomed with open arms by clinicians, clients, and family members — even more so than I would’ve imagined. I think it’s because we’re all rallying together around this urgent mental health crisis that we’re facing and embracing new opportunities to heal and ways of getting more at the root cause, rather than just trying to keep symptoms at bay.”

According to Dr. Robison, ketamine-assisted therapy is just the beginning when it comes to using psychedelic medicines in the treatment of various mental health disorders. For example, Numinus is managing clinical trials with MDMA for PTSD and other research areas. This will further advance research to inform Health Canada and other federal health regulators to create better-informed policy changes around these medicines in the future.

“We are entering a new era in mental health where tools like ketamine are showing so much promise to help people who are suffering, especially where other treatments haven’t worked,” he says. “It’s a great time to be doing this work because the need is so high, and we finally have some new options to help people heal and grow.”

In Canada, ketamine-assisted therapy can be legally prescribed for off-label use to those with a medical need. In January 2022, Health Canada amended the federal Special Access Program to make other psychedelic-assisted therapies, including psilocybin and MDMA, available outside of clinical trials on a case-by-case basis to patients with severe need. As of October 2022, Alberta has also announced plans to provincially regulate and standardize psychedelic-assisted therapy.

In Canada, Numinus operates clinics in Vancouver, Montreal, and Toronto, and also operates a fully licensed research laboratory in Nanaimo where cutting-edge research takes place. For more information about psychedelic-assisted therapy or the treatments offered at Numinus, click here.

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