White Coat Black Art26:30First Responder Psychedelics
Ketamine helped one police officer get through a childhood trauma. Some experts say psychedelics could help people with PTSD but much more research is needed.
Jas Kainth didn’t want to walk through the doors of the Calgary police psychological services building. For years, colleagues had referred to it as “Dr. Bonkers.”
But he wasn’t sleeping. He lacked empathy. And he was thinking about self-harm.
“When I actually did go to seek help and I decided it’s time, I actually used the illusion of a health check to go in to talk to psychological services,” he told Dr. Brian Goldman, host of CBC’s White Coat, Black Art.
“When I sat down, I said, ‘Just so you know, I don’t want to waste your time. I’m not here for the health check. I need help and this is what I need help with.'”
Now a staff sergeant with Calgary Police Services, Kainth said he needed help after dealing with an incident while working in the child abuse unit, something he hasn’t been able to speak about publicly yet.
He would learn that he was stuck in what’s known as a trauma negative loop. Though it may have been triggered by the child abuse case, its roots stretched to when he was sexually assaulted himself at six years old.
Kainth sits in one of the chairs at The Newly Institute, a mental health services clinic in Calgary. (Brian Goldman/CBC News)
“It just compounded and compounded and compounded,” he says.
“So whenever I endured stress such as interviewing a victim of child abuse, I would disassociate from that and focus on just the job that needed to be done … I tried my best to push it away and soldier on and get the job done like everybody expected me to.”
Kainth was diagnosed with complex post-traumatic stress disorder (PTSD). He tried seeing therapists, but it wasn’t working.
‘I used it and it helped’
After reading about ketamine, he reached out to staff at The Newly Institute in Calgary to be in the first cohort of an intensive, four-week outpatient program that involved combining ketamine treatments with therapy.
Ketamine, an anaesthetic that was once a party drug, has been shown to work as an antidepressant for some.
“I’ve never smoked a cigarette, I’ve never smoked marijuana, I’ve never finished an alcoholic drink,” Kainth says. “I went from zero to, ‘I’m going to use a psychedelic that’s going to alter my mental state.’
“But that’s desperation. I used it and it helped — and I’m here.”
Though Kainth found ketamine worked for him, there is still limited scientific research on the use of psychedelics in long-term clinical treatment.
But clinicians and researchers are studying whether it may be a new avenue.
‘Trauma after trauma’
Since last year, staff at The Newly Institute have worked with first responders like Kainth and veterans with complex mental health issues.
“Many just have trauma after trauma after trauma,” says Dr. Robert Tanguay, chief medical officer and co-founder of The Newly Institute, a private, for-profit mental health network of clinics.
That’s why he says it’s important to start treating incident trauma but also focus on a patient’s earliest trauma memory.
One of the ways that staff at the therapy centre do that is through an intensive outpatient program that pairs ketamine treatments with psychotherapy.
“What ketamine is — and maybe what we’ll learn about psilocybin and MDMA — they are catalysts,” says Tanguay, adding that ketamine can help reduce symptoms of depression.
“They can turn the fight or flight off immediately to allow someone to breathe.”
The clinical use of psychedelics alongside psychotherapy is a growing area of research for PTSD treatment, especially among first responders.
And studies have shown that first responders have higher-than-average rates of PTSD.
Dr. Peter Silverstone, a professor of psychiatry at the University of Alberta and author of The Promise of Psychedelics, cautions that percentages of first responders with PTSD can vary widely in studies. But he notes that it is often a considerable percentage.
“It is a very significant minority,” he says.
Experts say there is also the risk of suicide or substance use among this population. And many first responders with PTSD often relive their traumatic memory, explained Dr. Ruth Lanius, a professor of psychiatry and the director of the PTSD research unit at Western University.
“They’re plagued with these reliving episodes, where they feel like they’re back at the scene of the trauma,” she said. “They have real difficulty being in the present; often they avoid their feelings because they’re so intense.”
She says some have childhood trauma, but others may be dealing with guilt or shame because “they couldn’t do more.”
“This often first comes up when individuals in this population see children die or they can’t save kids,” she said. “That often brings the PTSD to the forefront, I find.”
An early spate of research and big injections of investor money have triggered a renaissance for psychedelics. (Duk Han Lee/CBC News Graphics)
Silverstone says there are very few treatments for PTSD that are effective.
That’s why many are intrigued by the possibility of psychedelics, he said, but he recognizes there is still a lot of research that needs to be done in this area.
“If I had a family member who had PTSD and they had an option to try this, I would recommend it to them. But I would also say that our evidence base is still quite thin,” Silverstone says.
Authors ofa study recently published in the journal Cureus found that PTSD-specific clinical trials are “still scarce.”
They went on to say that psychedelics could be “a revolutionary method of treating PTSD” but that more research is needed to figure out their safety and efficacy as treatment — and who they would work best for.
Lanius says there’s emerging evidence that psychedelics are helpful but emphasizes that they don’t work for everyone.
“It’s unlikely the answer to everything — nothing is,” she says. “But the more treatments we have, the more we can personalize those treatments, especially in that substantial population that don’t respond to the mainstream treatments.”
Canada a research leader
Ongoing research into other psychedelics like psilocybin or methylenedioxymethamphetamine (MDMA) as treatment for those with PTSD is still in the early stages.
Silverstone, who last year helped found the biopharmaceutical company Zylorian, expects more definitive evidence on these drugs in about two to three years.
Provincial governments in Alberta, British Columbia and Ontario are already investing in psychedelic research, he says.
“Canada is leading the way because America has so many limitations on this type of research that it allows Canadian companies to come to the fore,” he says.
And the Newly Institute is one of them. Tanguay and the Newly Institute just signed an agreement with WorkSafeNB in New Brunswick to study how ketamine treatments may be able to help workers.
“[Our] ultimate goal is to get [them] back to a healthy life, get back to work and build resiliency to keep it that way,” Tanguay says.
And for Kainth, after completing the initial outpatient program at the clinic, he says he’s feeling better now. But he’s still working through his trauma.
Ketamine has helped him to see people differently, he says, and has changed how he interacts with people as a police officer.
He says there was a lot of preparation, treatment and support to get him to the point where he can finally share what happened to him.
“My motivation for coming forward is to let one person know that they’re not alone.”
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
