A Conversation With Dr. Valorie Masuda, Physician and Psilocybin Access Advocate

February 23, 2023

Dr. Valorie Masuda is a palliative care physician, Associate Professor of Clinical Medicine at The University of British Columbia, and a leading advocate for psilocybin access in Canada. Through Roots to Thrive, the Vancouver Island healthcare practice she co-founded with Dr. Shannon Dames and Dr. Pamela Kryskow, Dr. Masuda provides psilocybin-assisted and ketamine-assisted group therapy to patients in need. 

We spoke to Dr. Masuda about her important work facilitating access to the healing potential of psychedelics.

1. Tell us about your background and what led you to pursue this area of medicine.

I worked as an emergency physician for over 20 years. During that time, I started to realize that we were not giving patients good information on their disease and treatment options in a way that allowed the patients to make good decisions which aligned with their beliefs and values. I returned to complete extra training in palliative care and oncology. During my time working in palliative care these last 10 years, I’ve witnessed existential distress, depression and anxiety related to terminal illness. I had the opportunity to support one patient with psilocybin (with a therapist) and it was transformative for both her and me! I realize that psilocybin therapy is an essential element in palliative care.

2. The work you and your team do at Roots to Thrive is unique and hugely impactful - can you explain more about it?

Roots to Thrive uses a group model for preparation and integration AND delivery of psychedelics. Historically psychedelic healing was done in community, whereby the participants are held in a safe container of unconditional positive regard. This is extremely effective, allows for a more financially sustainable model of care, as well as creates a supportive community around the participants to improve durability of response.

3. As a key advocate for psilocybin access in Canada, why do you think it is so valuable for people suffering from mental health conditions?

The pharmaceutical industry has been pushing antidepressants for decades with a promise of treating depression and anxiety. These drugs cover the symptoms of mental illness without addressing the root cause. This means that Canadians are dependent on these drugs, which never heal them. We have seen 20% or more Canadians suffering from depression and anxiety. We see increasing disability, isolation, loneliness and substance use disorder or epidemic proportions. Young people are dying daily of opioid overdose. Psychedelics have the potential to heal people and allow them to carry on with their lives without daily medications. The research is demonstrating promising results in substance use. With the mental health crisis, we cannot afford NOT to use these medicines, with the proper contained of set and setting.

4. What is the process for accessing psilocybin through the Special Access Program? 

A confusing one. The SAP was never intended for this use. It is a program whereby a physician can access a drug not available in Canada for use in the patient who is suffering from life-threatening illness. The physician is responsible for procurement, storage, administration and reporting to Health Canada. Most physicians do not have the training or confidence to take this on. There are very few physicians in Canada that are trained in this medicine and its safe use.

5. You’re one of a handful of Canadian physicians who is successfully prescribing patients with psilocybin through the SAP, why do you think that is?

I took a year certification course through the California Institute of Integral Studies (Certification in Psychedelic Training and Research), a training course with Therapsil in order to feel more comfortable using these medicines. I always use with a therapist, and now with a multidisciplinary team of counselors, nurses, physicians and allied health professionals. Not many physicians have the time or ability to set up such a supportive system. Canadian universities are just starting to develop certification courses. The training and education has not caught up to the need.

6. Have you witnessed any positive outcomes for patients who’ve received treatment via the SAP? Are there any details or stories you’re able to share?

I’ve seen about an 80% success rate - meaning that about 4 in 5 patients have a good response to the psilocybin. The patients who did not have success were theones who were not able to commit to the preparatory work and/or the integration work. They were not committed to looking in and making change. Psychedelics are not miracles. They give patients the OPPORTUNITY to make changes to their behaviours and thought patterns, but this means a commitment to change. Going forward, we’re going to have more strict requirements for patients so that we can improve our success rates.

For patients where it has worked I have seen unrelenting pain become manageable, I’ve seen patients who are waking nightly screaming in terror of dying, no longer waking at night. I’ve seen patients having daily panic attacks no longer having panic attacks. I’ve seen patients with severe depression, contemplating MAiD, no longer contemplating MAiD.  

7. You recently visited Parliament Hill in Ottawa to lobby the government for improved access to psilocybin - can you tell us about the trip and what the outcome was?

Three messages:

  1. The decision for access to psilocybin for a patient is a clinical decision - not a political decision. It is one made by a physician who feels it it the best treatment option for their patient.
  2. Psilocybin is safe. We have enough evidence to demonstrate this! If Health Canada wants more clinical trials, they should be funding these. This is not big Pharma with all the money behind it, but grass roots organizations, small businesses, private donors who are left to fund these trials. Health Canada needs to put money where their mouth is!
  3. How can we offer a lethal injection to patients with mental illness or terminal illness - but deny them access to a medicine that has the potential to change that illness and allow for real healing!
  4. We can’t afford to wait - people are dying now of opioid overdose. Next year mental health patients will be dying from MAiD.