A roadmap for psychedelic pharmacy in Canada: A proposed policy and operations approach for controlled access to select psychedelics for treatment of mental illness
The unprecedented progress in the science and clinical investigation of psychedelic medicine will require those in healthcare leadership and the legislative policy arena to conceptualize how future reforms, policy creation, and clinical practice should occur to broaden access to these agents while simultaneously maximizing effectiveness and mitigating harm. The pharmacy profession has surprisingly had little engagement on this front. This article provides a perspective commentary and overview of potential future strategies in legal reform, professional regulatory authority policy creation, and pharmacy operations regarding the psychedelic agents’ psilocybin and methylenedioxymethamphetamine, using Canada as a national case study.
The general awareness and excitement surrounding psychedelics as potential “breakthrough treatments” for a range of mental health disorders and associated psychiatric situations have perhaps never been higher in the Western world (Aday et al., 2020; Basky, 2021; Lamkin, 2022). This is evidenced by a PubMed search wherein just the word “psychedelic” alone demonstrated that the 3 years with the highest number of published records, starting from 1957, were 2020, 2021, and 2022 (Hadar et al., 2023; Plesa and Petranker, 2022). Additionally, in Canada, news stories and media coverage have further excited the public consciousness as to their potential as treatments for severe depression and anxiety, post-traumatic stress disorder, obsessive–compulsive disorder, and addiction (to name only the most prominent indications for which these agents have been studied) (Bloomberg, 2022; CBC News, 2022; Global News, 2022).
The purpose of this paper is to propose a future pharmaceutical access policy and operational framework approach whereby pharmacists, as medication experts and trusted overseers of patient medication safety, can be enabled in the future medical distribution of these agents using Canada’s federalist legislative model as an example. This is based on the potential for the continued accumulation of research data to develop favorably in the direction of legislative changes toward their access and broader acceptance in society. Many believe this to be a possible eventuality given the promising early evidence combined with the recent access to psychedelic medicine by a small number of patients through Health Canada’s federal special access program (Udoh, 2022).