Inside Alberta's promising psychedelic-assisted therapy industry

The view from Cena Life’s new clinic in a South Edmonton high-rise looks out clear to the edge of the city. And in the row of treatment rooms that line the office space, you can see the optimism within the company that the psychedelic-assisted therapies offered have a strong future in mental health care in Alberta.

It’s a big step up from the single room prototype space where Cena Life’s team of health professionals first began integrating ketamine, psilocybin, and MDMA with psychological counselling for persistent conditions like PTSD, major depression, and anxiety.

“It was a one room shop that let us build the process and the clinical pathway, and transition what was in the evidence into operationalizing it,” said Jacque Lovely, Cena Life chief operating officer.

Alberta became the first province to regulate the use of psychedelic therapies for the treatment of mental health disorders in 2022. The rules allow licensed clinics under the direction of a psychiatrist to provide psychedelic-assisted treatments and outline how the patient is to be monitored while in an altered state.

For ketamine, which has other longstanding medical applications, these regulations allowed it to be used in combination with psychotherapy. Psilocybin and MDMA are both still illegal, but registered practitioners can get approval for use with a specific patient through Canada’s Special Access Program.

Cena Life, partnered with Calgary-based company ATMA as ATMA CENA Psychedelic Healthcare Solutions, is one of few providers who have navigated the strict administrative process required to gain special access approval for each patient and legally provide these cutting-edge therapies. As psychedelic-assisted therapies become more widely known, accepted, and integrated into existing health care networks, Lovely anticipates the field, and their business, will grow steadily.

“Awareness continues to grow. We do a lot of public awareness. And with the Alberta Blue Cross announcement, the whole issue is in the news all the time. So, we’re seeing more and more inquiry calls,” he said.

In March, Alberta Blue Cross announced it would include psychedelic-assisted therapies in its insurance coverage plans, the only insurance company in Canada to do so. Initially, this will only cover ketamine therapy but is designed to include psilocybin and MDMA treatments once the drugs are legalized for therapy.

MDMA is expected to be approved for use in the United States this summer, and Lovely said it will likely be okayed in Canada shortly after.

The precedent-setting coverage from Alberta’s largest health care plan provider is a sign of the normalization of these long-studied, long-prohibited treatments. It will also reduce one of the largest barriers patients who qualify for treatment face – cost.

All psychedelic-assisted therapies are delivered in private clinics in Alberta. A Ketamine-assisted program costs $4,800 and up, depending on the number of sessions. The price tag for MDMA-assisted therapy is around $7,000.

The drug itself is relatively inexpensive. The 20 hours of nursing care, and 23 hours of psychology that come with two MDMA sessions, however, are not.

Lovely said he expects up to 70 per cent of the cost to be covered through ABC, though the exact amount will depend on the individual plans.

Right now, only around 30 per cent of people who inquire about treatment with ATMA CENA follow through, with expense being the primary deterrent, he said.

There is a hype bubble that surrounds all things psychedelic, but there is also a growing body of evidence that supports some of this boosterism within mental health care.

For complex, debilitating disorders like PTSD, patients who have had little or no success with conventional treatments have been shown to experience a significant reduction in symptoms through MDMA-assisted psychotherapy, and the U.S. Food and Drug Administration has given it a “breakthrough therapy” designation.

In a randomized, placebo-controlled phase three trial for MDMA-assisted therapy for PTSD, 71 per cent of participants in the MDMA group no longer met the diagnostic criteria for PTSD at the end of the 18-week trial, compared with 47 per cent from the group that got a placebo along with therapy.

The results have been so promising that some people suffering from PTSD aren’t willing to wait out the slow legal and cultural changes that will make treatment widely accessible and affordable.

During his 25 years as an emergency first responder in Alberta, Riley, whose name Great West Media is withholding for privacy reasons, experienced an occupational stress injury which left them unable to work. Not only did the traumatic psychological injury program they initially went through not alleviate PTSD symptoms, “I got worse, like way worse.”

While off work, Riley started taking training courses for psychedelic-assisted therapists, which helped them break through a “healthy fear of drugs” and made them want to try MDMA-assisted therapy.

“A lot of people that have PTSD, they've done so many things. They reach that point where they're like, ‘Okay, I have to try it because nothing else has worked,’” Riley said.

Though Riley met the diagnostic criteria, treatment was not covered through Workers’ Compensation benefits, and the out-of-pocket expenses for multiple sessions at a private clinic were well beyond the income support from WCB.

After sourcing MDMA and having it tested to ensure there were no other toxic substances mixed in, Riley recreated the regulated treatment sessions at home, with their partner’s monitoring and guidance.

“After a full year of doing MDMA-assisted psychotherapy, I currently don't meet the diagnosis of having PTSD anymore. I could probably go back to my career if I so choose. But I'd say MDMA was the catalyst for a big change.”

“It opens up a very magical window, which allows you to reconnect with yourself,” Riley said.

“And for many first responders, we've learned to shut down feeling so well. And in order to get out of that PTSD state, we have to start feeling again. And it's so funny that a club medication like MDMA, can actually reconnect you with yourself can put you in this place where you can actually start to feel how you are in your body.”

Riley said they think ATMA CENA and Cena Life will do “an amazing job” of bringing these life-changing treatments to more people, but they hope one day it will be available for anyone who truly needs it.

“I'd love to see it covered one day. I think we're going go through a big learning curve, where people are going to have to pay out-of-pocket in order to get better. But I'm hoping one day, all of these things will be covered.”

Brett McKay, Local Journalism Initiative Reporter, St. Albert Gazette