Study highlights barriers to discussing therapeutic psychedelics with physicians

Feeling safe and comfortable are key when discussing your health and wellbeing with your primary care provider.

However, that feeling of comfort and safety can't be taken for granted among many people who have turned to psychedelic substances-;including psilocybin-;to help control their symptoms of depression, anxiety or PTSD. Now, a team of UBC Okanagan researchers in the Irving K. Barber Faculty of Arts and Social Sciences has published a study looking into patient perspectives and potential issues when it comes to discussing psychedelics for therapeutic use with their physicians.

Dr. Michelle St. Pierre conducts research with Dr. Zach Walsh in UBC's Therapeutic, Recreational, and Problematic Substance Use Lab. Their latest paper, published in Psychedelic Medicine, determined that concern about having an open discussion regarding psychedelic substances with a physician can create a roadblock to that conversation.

A core component in the provision and receipt of appropriate medical care is trust and communication between patients and physicians. However, the stigmatization of psychedelic use for therapeutic purposes may complicate this process."

Dr. Michelle St. Pierre

In Canada, to legally obtain psychedelic substances for therapeutic use, a doctor must determine there is a genuine need for these psychedelics and then apply to Health Canada's Special Access Program for their patient.

"The threshold for legal access to psychedelics for therapeutic purposes is high. Our team is aware that some patients with serious illnesses have been discouraged from pursuing legal avenues and have instead turned to unregulated providers, often due to difficulties in finding a physician willing to approve this emerging therapy."

Fear of stigmatization, perceived lack of knowledge by their care provider and concern of damaging a long-term relationship with their physician can also stop the conversation.

The study analyzed data from approximately 800 adults who use psychedelics, with about 80 per cent endorsing their use for therapeutic purposes. Some 78 per cent of respondents reported facing barriers to access, while one-third said they had discussed using psychedelics with their doctor. For those who managed to have the conversation, 13 per cent said their doctor recommended psychedelics. Despite this, nearly 60 per cent of respondents felt less satisfied with the communication about psychedelics they'd had with their physician compared to previous conversations, and more than half felt discriminated against by their physician for raising the topic in the first place.

As policies evolve to improve access to psychedelic medicines, it's crucial to also focus on fostering open and transparent communication between patients and physicians," says Dr. St. Pierre. "In particular, there is a need for educational resources and guidelines to support health-care practitioners in understanding the therapeutic potential of psychedelics, especially for patients seeking new treatments for conditions like PTSD and depression."

Source:
Journal reference:

St. Pierre, M., et al. (2024). Patients’ Experiences Discussing Psychedelics for Therapeutic Purposes with Physicians and Other Health Care Providers. Psychedelic Medicine. doi.org/10.1089/psymed.2023.0060.

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