Last week, we received monumental psychedelic news out of Australia. There, regulators decided to allow psilocybin-assisted therapy to treat depression, and MDMA-assisted therapy to treat PTSD (with proper diagnosis and a prescription).
This makes Australia the first country to legalize the two psychedelic-assisted therapy treatments.
And while this is amazing news for those with mental illness Down Under, as a North American I am left wondering whether Australia’s decision will set a precedent for their Anglo cousins in Canada and the USA (and of course their French-speaking friends in my home province of Quebec).
So, given Australia’s move, could either Canada or the USA legalize medical psilocybin and MDMA?
Psychedelic Legalization in the USA
Starting in the USA, the answer seems to be yes, but not immediately. Given the fact that MDMA has completed its second Phase 3 clinical trial — and that the results, though not yet released, are said to be very positive — it is only a matter of time before the FDA gives MDMA-assisted therapy for the treatment of PTSD the green light. The best estimate for timing is in early-2024. So, next year.
Likewise, psilocybin for treatment-resistant depression — which is in its first Phase 3 trial — will likely follow in 2025.
But could the US federal government, seeing the medical writing on the wall, jump the gun and legalize these medicines before all the i’s are dotted and the t’s crossed, as was done in Australia?
Almost certainly not.
Putting aside the moral arguments of whether or not they should, the American political system is gridlocked and there is about as much chance of Republicans and Democrats coming together to pass legislation as there is overdosing on marijuana.
It’s just not happening.
At the state level, however, things are much more interesting. While deciding what drugs are illegal is technically a federal responsibility — as we have seen with marijuana, and more recently psilocybin therapy centers in Oregon and Colorado — the federal government seems more than happy to allow states the right to decide the rules within their own borders.
Here, there are many potential initiatives to keep an eye on. To start, as mentioned above, Oregon is in the early stages of allowing psilocybin-assisted therapy, and Colorado will follow suit in about two years’ time. In both states, any adult 21 years of age or older is eligible for the treatment, no doctor’s note is required.
There are also many states where a variety of legislation is being debated. This includes attempts to decriminalize psychedelics, as we see in California and New Hampshire, as well as allowing psychedelic therapy to treat mental illnesses, as is being debated in Missouri.
While it is too early to say which states are the most likely to pass said legislation, the fact that the debate is happening in so many states is a good sign that at least some will allow the treatment. To learn more about different state psychedelic debates, check out 4 More States Propose Psychedelic Legalization and Research
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Psychedelic Decriminalization in Canada
Moving to Great White North, land of maple syrup, apologizing too much, and bountiful legal marijuana, the chances of political or regulatory leaders allowing MDMA and psilocybin-assisted therapy is much greater. Though of course, even if they don’t, Canada will likewise legalize the treatments if and when the clinical trial process has run its course.
To start, the government in power, Justin Trudeau’s Liberals, is the same government that legalized marijuana and allowed the province of British Columbia to decriminalize most drugs. If they believe that allowing these medicines to be used in specific circumstances could improve their progressive bona fides with voters, there is a good chance they pull the trigger.
The Minister of Mental Health and Addictions, Carolyn Bennett, has even traveled to Oregon to learn about their psilocybin-assisted therapy healing centers and Tweeted nice things about the program. While this is the extent of the tea leaves we can read on the question of whether a political decision could be made in Canada to legalize MDMA and psilocybin-assisted therapy, the move certainly would be in keeping with the Liberals’ ideology. Plus, the fact that the Trudeau government could just say it was following Australia’s lead would make the decision easier.
Thank you to @OregonGovBrown and her team for a fantastic discussion about the State’s subsequent response to decriminalization including their additional actions on housing, social and health supports across the state! pic.twitter.com/LIzs0YKZn9
— Carolyn Bennett (@Carolyn_Bennett) August 25, 2022
But the federal government is not the only one who could make the decision. Health Canada, basically Canada’s FDA, could also decide whether the evidence is strong enough to allow the treatments now.
However, as they are currently fighting in court to block patients’ access to psilocybin-assisted therapy, that seems unlikely. On the topic of the court case, if Health Canada loses, it could effectively legalize psilocybin-assisted therapy in Canada, at least for some people.
Like with the USA, it is also possible that Canadian provinces could independently legalize these treatments. We have already seen conservative Alberta taking a large step in this direction. There, the governing United Conservative Party announced plans to regulate psychedelics as medicines, though many details still need to be fleshed out.
To summarize, given a couple of years, it is almost certain that both Canada and the USA, through their health agencies, will legalize the therapeutic use of both MDMA-assisted therapy for PTSD, and psilocybin-assisted therapy for depression. Once the required two Phase 3 clinical trials with positive results are completed, the FDA and Health Canada will likely move to allow the treatments.
In terms of the federal government proactively moving to get people the help they need through other legalization measures, it is possible that Canada could act, though it is quite unlikely the same will happen south of the border. Either way, specific states and provinces might take matters into their own hands, and move ahead without waiting for their respective federal governments.
In the end, time will tell.
