When the Usual Treatments Don’t Work: A New Path Forward with Psychedelic-Assisted Therapy through Health Canada’s Special Access Program

By Dr. Lindsay Mackay, MD

Addiction Medicine Physician | Researcher

Over the years, I’ve worked with countless patients navigating the complex and often frustrating landscape of mental health treatment. Many have spent decades trying everything that conventional medicine has to offer including antidepressants, mood stabilizers, antipsychotics and various therapy modalities. For some, these tools help, but for others, in particular those with severe PTSD, treatment-resistant depression or deep existential distress at the end of life, nothing seems to alleviate the core of their suffering.

As a physician and researcher in this space, I’ve felt deeply disheartened at times. We are expected to optimize medications, tweak doses, or try yet another variation on the same class of medications, even when patients have already tried five, ten, or fifteen of them. All the while, their lives continue to feel unlivable. That’s why I’ve been drawn to a different kind of medicine: MDMA and Psilocybin-assisted therapy and why I’ve chosen to offer it to certain patients through Health Canada’s Special Access Program (SAP).

A New Kind of Breakthrough

Medicine assisted therapy is about creating a guided and supported therapeutic process, leveraging the unique effects of substances like psilocybin (from “magic mushrooms”) and MDMA (often known as ecstasy, though it’s very different in medical form) to unlock psychological and emotional healing that many patients didn’t think they would be able to achieve. 

Through the Health Canada SAP, I’ve applied for legal, medically supervised access to these therapies for individuals who are struggling with severe mental health conditions and who have already exhausted every standard option. What I’ve witnessed has been moving.

I've seen patients after years of numbing and surviving feel connected again, process their trauma, and begin to rebuild a life that feels meaningful. Not every story is dramatic or fast. But many are deeply significant. These sessions don’t “cure” anyone in a single day, but they can offer a sense of relief, hope and a renewed sense of possibility.

Why the Special Access Program Matters

Health Canada’s Special Access Program was never designed to be a shortcut or an easy alternative. It exists for patients with serious or life-threatening conditions who have exhausted conventional treatments. Each application involves careful documentation, medical justification, and sourcing of a legal, pharmaceutical-grade supply from licensed, Health Canada approved manufacturers. It also requires a treatment plan that includes appropriate preparation with experienced therapists, supervision, and integration therapy afterward.

Unfortunately, access to MDMA and Psilocybin through the SAP is still limited. Not all providers feel comfortable navigating this process, and not all patients know they can even ask. That’s one of the reasons I’m writing this. If you’ve been dealing with long-standing treatment resistant depression, PTSD, or emotional suffering around a terminal illness, you should know this option exists.

What I Tell My Patients

I tell patients that MDMA and Psilocybin assisted therapy is not for everyone, and it’s not a miracle cure. It’s work. It requires courage, time investment and being willing to face difficult parts of your story and emotions you may have buried for years.

But with proper preparation, medical supervision, and integration with experienced providers, the impact and changes can be profound.

Sometimes, the shift is subtle - a patient describing they no longer feel constantly trapped in a loop of negative self-talk. Other times, it’s bigger - forgiveness, release of shame, reconnection or a renewed will to live. Others, a peace in letting go. For many, it's the first time in years that they feel supported and hopeful again.

You Don’t Have to Navigate This Alone

If you’re reading this and wondering whether psychedelic-assisted therapy through the SAP might be right for you, start by talking to your doctor or therapist. Clinicians like myself and others in this growing field are working hard to build bridges for patients and other healthcare providers looking to refer to CMAT or learn.

Final Thoughts 

There’s a quiet but powerful shift happening in mental health care. For the first time in decades, we’re seeing real innovation in how we treat emotional and existential pain. But this isn’t about hype, this is about returning to something human - healing in relationship, meaning-making, and expanding our idea of what mental health treatment can look like.

I’ve been part of this shift from both the research and clinical side, and I’m continually learning from the patients who pursue medicine assisted therapies. It’s not always easy, but it can be transformative.

—Dr. Lindsay MacKay, MD CCFP