MDMA Therapy in Canada
MDMA therapy (also called MDMA assisted psychotherapy) is a form of psychedelic therapy. It combines a powerful psychoactive experience under the influence of MDMA with traditional talk therapy.
The psychedelic experience—sometimes referred to as the “journey”—may allow a client to access memories, emotions, and insights that would not otherwise be available in a normal state of consciousness.
Here’s everything you need to know about MDMA therapy in Canada.
What is MDMA therapy in Canada like?
A course of MDMA assisted therapy may generally be broken down into four steps:
- Step 1: Education. First, the therapist or guide meets with their client and determines whether they’re a good fit for MDMA in therapy. Then the client and their therapist explore treatment options, and consider the potential benefits and drawbacks
- Step 2: Preparation (part of Integration). Once the client and therapist have agreed on a treatment plan, the client attends one or more therapy sessions to help them prepare for their MDMA journey. This is the stage for setting goals and expectations, and learning how the experience will fit within the wider context of treatment.
- Step: 3: Facilitation, or the Journey. The client undergoes the MDMA experience. In some cases, the client may take this step on their own, with a guide or “trip sitter” other than their therapist, then meet with their therapist for the fourth step.
- Step 4: Integration. Possibly the most important step in MDMA therapy, integration consists of one-on-one work with a therapist or healer to contextualize and interpret the psychedelic experience. The client’s experiences during a psychedelic journey may be confusing or distressing. It’s the therapist’s job to help the client fit these experiences into a larger framework, so difficult experiences become a source of new, actionable insights.
MDMA therapy is not a one-size-fits all solution. And it’s just one aspect of a larger modality—psychedelic therapy. For a deeper dive, check out Psychedelics for Therapy 101: What Canadians Need to Know.
Is MDMA therapy legal in Canada?
Under Canada’s Special Access Program (SAP), healthcare practitioners are able to request access to legal, government-supplied MDMA for the purposes of psychedelic therapy.
In every other context, MDMA remains a controlled substance. But some jurisdictions have made moves to decriminalize simple possession for personal use. For instance, in Vancouver, the possession of up to 2.5 grams of MDMA has effectively been decriminalized.
How does MDMA assisted psychotherapy help clients?
Like other forms of psychedelic therapy, MDMA in therapy may be used to treat a wide range of conditions. Therapists and researchers are currently exploring:
- MDMA therapy for depression
- MDMA therapy for anxiety
- MDMA therapy for PTSD and trauma
- MDMA therapy for veterans
- MDMA therapy for OCD
- MDMA therapy for addiction
- MDMA therapy for couples
Beyond the treatment of specific conditions, a client may seek MDMA therapy as part of a spiritual practice, or as a means of gaining deeper insights into their life, attitudes, and relationships.
How does MDMA therapy work?
The integration stage of MDMA therapy helps clients draw insights from their experience, shift perspectives, and progress in their treatment.
Here are some recent papers on MDMA therapy:
MDMA therapy for PTSD
MDMA therapy has received widespread attention for its use in treating PTSD.
PTSD (Post Traumatic Stress Disorder) is a complex disorder that can seriously affect sufferers’ daily lives. Symptoms include anxiety, depression, flashbacks to traumatic events, hypervigilance, panic attacks, and negative changes to an individual’s personality.
During MDMA treatment, therapists encourage PTSD sufferers to revisit traumatic events in their past. Some studies suggest MDMA reduces fear in users, allowing them to reprocess the events that traumatized them and effectively “re-write” their memories. That can lead to lasting and permanent changes to the ways they experience their daily lives.
While there is no “cure” for PTSD, but MDMA treatment has the potential to reduce symptoms and help patients heal from the experiences that hurt them.
What are the effects of MDMA therapy?
MDMA triggers a release of serotonin in the brain and also slows its uptake, allowing it to have a prolonged effect. Dopamine and norepinephrine—neurotransmitters associated with alertness, pleasure, and the sense of reward—are released at the same time.
Together, these chemicals produce a sense of deep connection and empathy with other people, a softening towards yourself, and an euphoric state overall. Sensory information—colours, textures, light—takes on a more vivid hue. Emotions dial up and inhibitions dial down.
These effects are often accompanied by a reduction in motor skill and coordination. Memory and judgement are typically impaired, and someone under the influence of MDMA may become confused. Because of these effects, a safe (and preferably clinical) setting is essential during MDMA therapy.
Most people who have used MDMA are familiar with its aftereffects, the so-called “hangover.” The surge of neurotransmitters set off by MDMA use swings the other direction once its effects wear off. The “morning after” is usually characterized by lethargy, listlessness, irritation, anxiety, and depression. Depending on the user, these effects may last longer than a single day.
Long-term effects of MDMA use
Some studies suggest that repeated, long-term use of MDMA can damage serotonin receptors in the brain. That can lead to abnormal performance in the long term. The extent of these effects relative to the frequency of MDMA use, and the possible reversibility of damage to the brain, is still being studied.
The paper MDMA and the Brain: A Short Review on the Role of Neurotransmitters in Neurotoxicity looks closely at the effects of long-term use.
MDMA therapy: Anecdotal evidence
No single description can capture the experience of undergoing MDMA therapeutic treatment.
To get a better sense of what it feels like, and the effects MDMA therapy may have, it helps to turn to anecdotal evidence:
- See an MDMA-Assisted Therapy Session: Segment from TV show The Doctors in which a patient discusses her experience undergoing MDMA therapy for PTSD. The segment includes footage from her MDMA therapy session.
- MDMA Therapy — Drugs, Inc.: Clip from the National Geographic documentary series Drugs. Inc. featuring a psychedelic therapist and her client during an MDMA therapeutic session.
- What Actually Happens During an MDMA Psychotherapy Session?: Interview with Marcela Ot’alora, an experienced therapist whose practice includes psychedelic therapy. It includes a detailed conversation about how MDMA therapy sessions are conducted.
- Veterans say psychedelic MDMA helped treat their PTSD: Profile of a US Armed Forces Veteran who successfully underwent MDMA assisted psychotherapy to treat his PTSD.
MDMA and antidepressants
The combination of MDMA and SSRIs can lead to serotonin syndrome, a serious and potentially fatal condition. Many therapists recommend tapering of antidepressants and other pharmacological drugs before undergoing MDMA therapy.
Before you stop taking any drugs you’ve been prescribed to treat depression—whether by stopping all at once, or by tapering off your dosage—talk to your prescribing doctor.
Quitting antidepressants may cause antidepressant discontinuation syndrome, which has wide ranging negative effects. It might also lead to an increase in depressive symptoms, including suicidal ideation.
Where to find an MDMA therapist in Canada
Interested in trying MDMA therapy in Canada? Before you begin your search for a qualified MDMA therapist, healer, or guide, it’s important to understand both the risks and benefits of psychedelic therapy in Canada.
For a start, check out our guide to everything Canadians need to know about psychedelic therapy.
Then visit First Session to find psychedelic therapists in Canada:
The personal video interviews on First Session can help you get a sense of what it would be like to work one-on-one with different therapists—so you can spend less time searching online and more time getting treatment.
Key takeaways:
- On its own, MDMA is not an effective treatment for mental health challenges. It needs to be combined with one-on-one treatment from a qualified therapist, healer, or guide
- The integration stage of MDMA therapy is crucial for examining and contextualizing the psychedelic experience
- MDMA affects each client differently; it’s impacted by the dosage and the type of treatment being given
- Before embarking on MDMA therapy, take time to find a therapist who is right for you
Use First Session to find the right therapist for you.
Frequently Asked Questions
Bryce Warnes
Bryce Warnes is a freelance content writer. He specializes in actionable advice and guidance for small business owners, including those in the mental health space. He currently writes about therapy practice finance, admin, and marketing for Heard.
