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A door cracked open, but barely
In 2022, Health Canada opened its Special Access Program so doctors could request psilocybin for patients with serious or life-threatening illness. It was a real step forward, but it was built for emergencies, not everyday care.
Access is granted one patient at a time, at a reviewer's discretion. Wait times have stretched past a year, some patients have gone to court just to get an answer, and in 2025 approvals fell by roughly half. For most Canadians who could benefit, it is not a realistic path.
What the program actually is
The Special Access Program lets a licensed prescriber request a drug that isn't approved for sale in Canada, for a patient whose other treatments have failed or aren't suitable. The prescriber applies, the patient never possesses the medicine themselves, and Health Canada decides each case individually.
It is an emergency route, not a standing prescription. The program covers MDMA and other restricted drugs too; here we focus on psilocybin. The table below shows how it compares to the other ways Canadians reach psilocybin today.
Three pathways, side by side
| Special Access Program | Section 56 exemption | Regulated access (our goal) | |
|---|---|---|---|
| Who decides | Health Canada, one case at a time | Health Canada / the Minister | A patient and their prescriber |
| Source of psilocybin | Licensed dealer (regulated) | Unregulated market | Licensed dealer (regulated) |
| Patient may possess it | No, held by a provider | Yes | Yes |
| Speed of access | Often weeks to months | Has taken 300+ days | Predictable |
| Access for clinician training | No | Limited | Yes |
View the full comparison chart (PDF), with sourcing, reporting and cost.
For patients & providers
For patients
You cannot apply to the Special Access Program yourself. Your healthcare provider must submit the request. To be considered, you generally need:
- A serious or life-threatening condition where conventional treatments have failed, are unsuitable, or are unavailable.
- A prescriber willing to submit the request and accept responsibility for the treatment.
- Strong clinical rationale: your history, treatments tried, and supporting evidence.
For healthcare providers
If medical psilocybin is a suitable option for a seriously ill patient, you can request it once other treatments have failed. A few realities to plan for:
- The request form runs about 8 pages and can take up to 2 hours; a follow-up form is required after each administration.
- In requesting a drug through the program, you assume liability for its use.
- A class exemption lets qualifying providers possess and administer approved psilocybin; others need an individual Section 56 exemption.
- The program cannot be used for your own experiential training.
Common questions
Who is eligible for psilocybin through the program?
The request must be for a patient with a serious or life-threatening condition where conventional treatments have failed, are unsuitable, or are unavailable in Canada. Health Canada has recognized conditions such as intractable depression and terminal cancer. What counts as "serious" or "emergency" is decided case by case, and substantial clinical rationale is required.
How does a patient apply?
Patients cannot apply themselves. A physician or nurse practitioner submits a patient-specific request on their behalf and completes a follow-up form after each administration. A future-use request is also available. If you need help, reach out to TheraPsil and we will support you and your provider through the process.
Do patients still need a Section 56 exemption?
Since 2022, Health Canada has directed patients to try the Special Access Program first. A Section 56 exemption is generally considered only after a request has been denied or deemed unsuitable. If that happens, TheraPsil can help a patient apply for a Section 56 exemption instead.
What are the main trade-offs of the program?
Approved patients receive a regulated, quality-controlled supply rather than sourcing psilocybin from the unregulated market, and there is a defined process for how a request is handled. But access is limited to emergency use, a government reviewer rather than a patient's doctor decides, the paperwork is heavy, patients never possess their own medicine, and there is no access for clinician training.
The program isn't enough
The Special Access Program cracked the door open, but lasting change means regulated access, so a patient and their doctor can decide together, the way they would any other treatment. It is what we have proposed to Health Canada, and what Thomas' Bill would make law.
Patients should not have to be special to access their medicine.
The original white paper & resources
This page grew out of a detailed white paper we published in January 2022, with a one-year update in February 2023. The full record is kept here.
- Read the original 2022 white paper and February 2023 update (archived) — set this link to your archived page
- SAP vs. Section 56 vs. Proposed Regulations comparison chart (PDF)
- Access to Psilocybin for Medical Purposes Regulations, proposed draft (PDF)
Government of Canada references: SAP, request a drug · SAP guidance · Psilocybin and psilocin
This page does not constitute medical or legal advice. It reflects TheraPsil's interpretation of the Special Access Program based on the available literature and our experience. Last updated: September 2026.
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