Following recent exemptions by Health Canada for psilocybin prescriber learning purposes, there have been discussions regarding similar experiential learning opportunities for physicians with sublingual, intramuscular and intranasal ketamine, as well as other psychedelic medicines.
Though Health Canada may consider experiential learning a reasonable use of psychedelic medicines, it does not remove the professional responsibilities of a physician who prescribes or supports the non-prescription use of these medications to a colleague for this purpose. When any prescription for a medication is provided, the physician-patient relationship has been created, and the responsibilities of care then exist. CPSA supports that a similar physician-patient relationship has been established if the clinician supports the use of a psychoactive agent which may not be technically prescribed (e.g., under the auspices of an exemption by Health Canada).
Any physician prescribing a medication to, or supporting the use of a psychoactive medication in, a physician-colleague for purposes of experiential learning is accepting full professional responsibility and accountability for its use and any associated outcomes. This would include the expectation of obtaining informed consent and a comprehensive documented assessment to support prescribing in each case, as well as offering support and follow up as appropriate to the circumstances.
Physicians considering this experimental drug use are encouraged to review CPSA’s Practicing Outside of Conventional Medicine, Informed Consent and Prescribing: Drugs Associated with Substance Abuse Disorder or Substance Related Harm Standards of Practice and to contact the Canadian Medical Protective Association (CMPA) for further guidance.