Recent Government of Alberta Regulations Limit Access to Ketamine Assisted Therapy - An Analysis

VANCOUVER, British Columbia - Oct. 23, 2022 - PRLog -- -
The Ketamine Assisted Therapy Association of Canada (KATA), a not-for-profit organization supporting the development of ketamine-assisted therapy (KAT) practice in Canada has concerns about the Government of Alberta announcement made on October 5, 2022 to regulate the use of psychedelic drugs within medical and therapeutic settings. Ketamine has been included in this legislation which KATA predicts will significantly impact accessibility in the province.

Ketamine, an anesthetic medication, has a proven safety and efficacy record for the treatment of mental health conditions including depression. The recent announcement has significant drawbacks as it limits which practitioners are able to deliver these services as well as where they can be done.

KATA supports the need for clinical practice guidelines that maintain patient safety (see KATA's "Outpatient Use of Ketamine for Mental Health Conditions - Practice Standards Recommendations"). However, as has been seen frequently in the past, these types of restrictive requirements erect barriers for patients who often have life-threatening mental health conditions. Currently, in Canada, it is extremely difficult to access timely psychiatric care and KATA is forecasting that these regulations will lead to an increased burden for psychiatrists in an already completely overwhelmed health care system. With wait times of 6 months or more to see a psychiatrist in Alberta, it is likely to be difficult to find enough psychiatrists who can oversee these treatments.

"We are concerned that a lack of access may leave patients no choice but to seek this therapy through unregulated means." Dr. Ian Mitchell - Emergency Medicine Physician, Royal Inland Hospital, KATA Canada Board Member

Surprisingly, the announcement by the government of Alberta has key differences from the May 2021 published College of Physicians and Surgeons of Alberta (CPSA) Ketamine and Esketamine: Key Considerations Clinical Toolkit. The changes made by the Alberta Government reduce the autonomy of physicians trained in mental health care to prescribe ketamine. Every patient that will be given ketamine in conjunction with psychotherapy now must be approved by a psychiatrist. This will likely create a bottleneck that will delay critical treatment for mental conditions, ranging from clinical signs of stress to suicide.

The Alberta government is now legislating that a psychiatrist must be consulted for every patient if ketamine is to be given in conjunction with psychotherapy. This will likely create a bottleneck that will delay critical treatment for mental conditions, ranging from clinical signs of stress to suicide.

Analysis of the New Alberta Regulations:

Regulations	Impact
These regulations consider ketamine to be a psychedelic drug and require that providers apply and hold a license under the Mental Health Services Protections Act.	Key unanswered questions that will likely immediately limit or prevent timely access to treatment for people seeking relief and cure from mental problems. 1) What is required to attain a license?  How often does it need to be renewed? What will the cost be?
In the regulations, physicians with additional training can hold a license to provide ketamine. However, they will still be required to consult with a psychiatrist for every single patient with ketamine who is considered to be receiving a "psychedelic" dose.	This requirement will impede access to patients because there is already an existing extreme shortage of psychiatrists in Alberta. This additional strain will inevitably create a bottleneck in the treatment approval process. Physicians, including GPs across Canada have the training and competency to diagnose and treat certain mental health conditions. They already independently prescribe ketamine safely and effectively. This existing access will be eliminated in Alberta.
The regulations state that if psychotherapy is to be provided it must be done by a regulated health professional who is authorized to perform psychosocial interventions including: Physicians, Occupational Therapists, Psychologists, Registered Nurses, Registered Psychiatric Nurses and Social Workers.	Since mental health counsellors are not a regulated profession in Alberta, they will not be eligible to provide ketamine-assisted or psychedelic-assisted psychotherapy. Counsellors and other trained but non-regulated professionals are the largest body of therapists who are currently trained in KAT and are among existing teams of healthcare professionals already delivering KAT. Alberta's highly-restrictive regulations are likely to disrupt treatment.
The regulation stipulates that a medical director who is a psychiatrist must be appointed by the licensed service provider to oversee all clinically related aspects of the licensed services.	Requiring that a psychiatrist be the medical director of a facility which delivers ketamine for mental health conditions creates an even greater severe constriction on existing and future treatment availability.

KATA Canada is encouraging regulators to consult with experts in their respective fields. KATA is also encouraging patient groups and other stakeholders affected negatively by these regulations to share their feedback with the Alberta government.