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Policy pathways and historical insights: Canada's evolving approach to psychedelic access for end-of-life distress

Sarah Kratina, Robert Schwartz, Carol Strike, Christopher Lo, Brian Rush

International Journal of Drug Policy July 6, 2026 DOI: 10.1016/j.drugpo.2026.105414 (opens in new tab)

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AI-extracted from the abstract
Characteristics Theoretical or philosophical paper Peer reviewed
Topics End-of-life distress
Keywords Parallels Medicalization Psychological intervention Public policy Politics Corporate governance Palliative care Decriminalization Public health Public relations Evidence-based policy Criminology Formative assessment Government linguistics Distress Public administration Contingency
Key points Argues that Canada's evolving psychedelic drug policy trajectory aligns with international trends toward cautious medicalization and regulated access to psychedelic therapies, while offering an instructive case for how end-of-life frameworks and federal-provincial governance shape policy development.

Abstract

Canada's evolving attitudes toward psychedelic interventions in palliative and end-of-life care reflect a departure from historically prohibitionist policies and an emerging recognition of their therapeutic potential for individuals facing end-of-life distress. This shift parallels international regulatory developments in jurisdictions such as the United States, Australia and parts of Europe, where cautious policy liberalization has signaled growing acceptance of psychedelics within clinical contexts. Canada is also a relevant case because of its formative role in the development of modern palliative care, its contemporary frameworks emphasizing holistic approaches to suffering at the end of life, and its experience with medical assistance in dying, all of which have shaped national conversations about suffering, autonomy, and end-of-life care. Additionally, Canada's distinctive historical approach to drug regulation-marked by federal flexibility, mechanisms for compassionate access, and responsiveness to patient advocacy-combined with rising public demand and incremental provincial changes, may uniquely position the country along a transitional pathway toward clinical integration of psychedelics in palliative care. At the same time, Canadian drug policy remains heterogeneous across substances and provinces, underscoring the political contingency of reform. Within this dynamic landscape, Canada's psychedelic drug policy trajectory aligns with broader international trends toward cautious medicalization and regulated access to psychedelic therapies, while also offering an instructive case for how end-of-life frameworks and federal-provincial governance shape policy development.

Comparable studies

Other theoretical and historical papers on end-of-life distress, most cited first.

Study Year Design Participants
Palliative Nursing and Sacred Medicine: A Holistic Stance on Entheogens, Healing, and Spiritual Care. Patients with advanced serious illness 2019 Theoretical or philosophical paper
Psychedelics and Dying Care: A Historical Look at the Relationship between Psychedelics and Palliative Care. Historical context of dying care 2019 Historical analysis
Psychedelics, spirituality, and existential distress in patients at the end of life. 2025 Theoretical or philosophical paper
Psychedelic Ethics in Palliative Care. 2025 Theoretical or philosophical paper
Responding to existential distress at the end of life: Psychedelics and psychedelic experiences and/ as medicine 2024 Theoretical or philosophical paper

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End-of-life distress Mystical experience Psychedelic-assisted therapy