9 responses to “Psychedelics: safely navigating a new frontier”

  1. Very useful article, thank you! I’m really looking forward to more evidence emerging, especially for whether any of the psychedelics that can be taken by a patient at home have sustained benefits for depression, anxiety, PTSD, etc. But this article was an amazing summary of what we know so far, and what we can tell our patients.

  2. Congratulations on your article, Rachel. Really good summary.

  3. This is a very useful snapshot of the current legal status of psychedelics in BC, as dynamic as it is. I am confused about your recommendation that we should be “Refraining from communication suggesting the use of psychedelics that have not yet received regulatory approval”. This seems to conflict with a proper harm reduction approach, which you outlined above, and which might also include a discussion with patients about the possible harms associated with unregulated assistance/therapy used alongside psychedelics (unethical behaviour, lack of standardization/quality in training). Maybe it depends on the substance in question. Perhaps this just highlights the current tension we experience as physicians in this space, where legal requirements and ethical responsibilities may be at odds with each other. Great job and thanks for your work on this!

  4. Very goo!d summary of current situation with psychedelic substances. Thanks!

  5. One point to add is the interaction with lithium (though bipolar is listed as a contraindication) if someone on lithium is considering psychedelics they should be informed about the high seizure risk.

  6. In a very controlled environment, this could be useful, ensuring all interactions of other medication has been reviewed and this doesn’t become as many other Rx have, overused. I feel it would be good if all practitioners that wish to dispense MDMA, Psychedelics and LSD perhaps take a dose themselves instead of just going by research. I am from the 80’s and remember these drugs effects on people. I think having the experience themselves would provide a much better understanding of the effects on the individual. When stating low risk of persistent change in perception, all of this change perception, personality, some for the better many for the worse. An example of this is Marijuana, the increase in clients using Marijuana and now having high anxiety due to the high doses of THC. If these all remain with strict medical control with limited physicians in control it could prove to be beneficial. My concern comes in when it is no longer controlled.

  7. Based on my experience in the emergency department with intranasal ketamine I have been using this at very low-dose as an additional medication in medication resistant depression.
    I have met with significant success. Total dose per day is probably 40 mg IN spread over 2 doses. I have found that the ketamine clinics are charging $500-$750 per injection which is out of the reach of most of my patients.

    Most compounding pharmacies can make this for no more than $100 for 2 or 3-month treatment.

  8. Anyone interested in clinical practice ketamine assisted therapy may want to have a look at KataCanada.org. This is a nonprofit organization (I am on the board of directors) devoted to helping establish guidelines for ketamine therapy outside the hospital.

  9. Hello, thank you for this article. From all I have heard from the UK, it is important that clients are monitored and supervised for side effects and dosing.

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