Kratina, Sarah, Schwartz, Robert, Strike, Carol, Lo, Chris, and Rush, Brian (2026) Policy pathways and historical insights: Canada's evolving approach to psychedelic access for end-of-life distress. International Journal of Drug Policy, 155. 105414.

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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.

Item ID:	92575
Item Type:	Article (Research - C1)
ISSN:	1873-4758
Copyright Information:	© 2026 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
Date Deposited:	18 Sep 2026 05:52
FoR Codes:	52 PSYCHOLOGY > 5203 Clinical and health psychology > 520304 Health psychology @ 50% 44 HUMAN SOCIETY > 4407 Policy and administration > 440706 Health policy @ 50%
SEO Codes:	20 HEALTH > 2002 Evaluation of health and support services > 200205 Health policy evaluation @ 35% 28 EXPANDING KNOWLEDGE > 2801 Expanding knowledge > 280112 Expanding knowledge in the health sciences @ 35% 13 CULTURE AND SOCIETY > 1307 Understanding past societies > 130706 Understanding the past of the Americas @ 30%
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