Three Toronto centres offering psychedelic-assisted therapy
Where to go for guided trips
The snazzy one
Field Trip is Toronto’s new kid on the psychedelic-enhanced-therapy block. Its spa-like location in the Entertainment District offers integrated ketamine therapy for those with treatment-resistant mental health conditions like depression, generalized anxiety disorder and trauma.
A treatment cycle consists of three parts: preparation, exploration and integration. In the first phase, patients establish their goals with a therapist and discuss safety and consent measures. Next, they’re brought to a treatment room, “designed quite carefully to be aesthetically comfortable and welcoming and bright,” says Ronan Levy, the clinic’s co-founder and executive chairman. Then, with a social worker, psychotherapist or psychologist present, the patient gets a dose of ketamine, puts on eye shades and noise-cancelling headphones, and is invited to look inward.
“Sometimes, patients will have very colourful experiences full of imagery,” says Levy, “kind of like you’d imagine a stereotypical psychedelic experience to be; sometimes, they’ll have a lot of quiet, and they’re able to have some peace. It really gives people perspective and objectivity about what’s going on in their lives.”
Following the guided trip—which typically lasts an hour—patients head to a lounge with tea, coffee and water, where they can stay as long as they want. Then, for the final phase, they speak with their therapist again, in a session that includes conventional cognitive behavioural therapy. Typically, patients go for three or four cycles over two months, and many say they see noticeable changes in their mood and behaviour.
In addition to its in-clinic offerings, Field Trip has taken on the role of spreading the gospel of psychedelics—via blog posts, a podcast and an app—to provide broader education on the novel therapy. “The best way to get broad-based buy-in and support is to focus on doing really good medicine, being thorough and showing great results,” says Levy. Suite 400, 30 Duncan St. Starting at $750 for an introductory session.
The holistic one
Remedy is what psychologist and founder Anne Wagner describes as a home for both research and practice. The team—which includes psychologists and social workers—facilitates individual, group and couples therapy and specializes in research on psychedelic therapies using MDMA.
Wagner opened Remedy in 2018, after running a pilot study in Charleston, South Carolina, that used MDMA as a treatment for PTSD. She’s currently recruiting patients for an upcoming clinical trial combining cognitive processing therapy for PTSD with MDMA. That drug is still classified as an illegal substance in Canada, but Health Canada allows exemptions for certain uses in research and clinical settings. Potential participants are screened for eligibility then prepped for takeoff.
For the trial, a therapist stays with the patient in one of the clinic’s stylish, minimalist rooms. The duration of the guided trip runs about eight hours, depending on the dosage, which varies from patient to patient. Wagner says many patients wear headphones and listen to a playlist that’s designed to help unfold their emotions. “We’re with them to support any strong emotions or somatic experiences that come up.”
A treatment cycle includes two sessions with MDMA, plus several therapy sessions, which will integrate the insights gleaned from the trips. “We see these psychedelic sessions as being an adjunct to psychotherapy,” Wagner says. “They’re catalysts for the psychotherapeutic process, and they’re embedded within a full treatment.”
Wagner is optimistic that ongoing studies on the drug’s ability to aid PTSD sufferers will open the door for more medicinal and therapeutic use in the future. “We’re not that far away from MDMA being prescribed as medicine,” she says. “If used consciously and with intention, it can be an incredible tool for healing and growth by helping patients tap into the nuances of their buried traumas.” Unit 201, 703 Bloor St. W. No cost for trial participation. $150 to $265 per session for psychotherapy.
The one that’s expanding
Canadian Rapid Treatment Centre of Excellence
Mississauga and Summerhill
CRTCE, which is owned by Braxia Scientific, specializes in treating mood disorders with ketamine. They opened their first location, in Mississauga, three years ago. Since then, they’ve launched outposts in Ottawa, Montreal and—in November of 2020—a midtown Toronto location, and have treated hundreds of patients for depression, PTSD and OCD.
Ketamine is not recommended for the everyday blues. “To be eligible, you need to have what’s called treatment-resistant depression,” says Roger McIntyre, a psychiatrist, pharmacologist and the founder of CRTCE. “That’s defined as a mental illness that has not benefited from at least two types of conventional approaches.”
After an initial assessment to determine eligibility, patients are counselled on what they may experience and discuss which delivery method is right for them—that can sometimes be a case of affordability. Clinicians at CRTCE administer ketamine in one of three ways: via a nasal spray, an IV drip or a pill. The drip is the most reliable, but also the costliest.
Treatments typically last between 45 and 60 minutes. Since one side effect of ketamine is a spike in blood pressure, clinicians recommend lyric-free, down-tempo music during the sessions. The typical dose is relatively low (0.5 milligrams per kilogram), so the patient doesn’t experience hallucinations, like with psilocybin, MDMA or LSD treatments. But patients cannot undergo therapy while experiencing the effects of the drug. “For over 90 per cent of our patients, there’s no way they would be able to engage in a conversation,” says clinician Joshua Rosenblat, “because the dissociative effects are very, very strong.”
McIntyre and Rosenblat say the main benefit of ketamine therapy is that it works quickly: patients with treatment-resistant depression often report a significant change in attitude after the second week of treatment. “A common outcome is not just the depression being gone,” Rosenblat says, “but also actually being able to experience joy.” Unit 6, 1100 Dundas St. W., Mississauga; Suite 6, 315 Avenue Rd. Prices vary based on route of administration (intravenous, nasal spray or oral), with an acute one-month course of treatment starting at $1,000.
This story appears in the November 2021 issue of Toronto Life magazine. To subscribe for just $29.95 a year, click here.