In short: in Canada, ketamine is a controlled substance that doctors can legally prescribe. Esketamine is an approved medicine. Psilocybin, MDMA, LSD and most other psychedelics are illegal to possess or sell, but there are legal routes to access for some people: clinical trials, Health Canada’s Special Access Program, and exemptions under section 56 of the Controlled Drugs and Substances Act.
How drugs are controlled in Canada
Most of these substances are listed in the Controlled Drugs and Substances Act (CDSA), which sorts drugs into schedules. Being on a schedule means possessing, selling or producing the drug is illegal unless it’s authorized, for example by a prescription, a licence, a clinical trial or an exemption.
| Molecule | Status in Canada |
|---|---|
| Ketamine | CDSA Schedule I. Legal when prescribed; used in anaesthesia and, off-label, for depression |
| Esketamine (Spravato) | Approved by Health Canada (2020) for treatment-resistant depression |
| MDMA | CDSA Schedule I. Not an approved medicine |
| Psilocybin and psilocin | CDSA Schedule III. Not an approved medicine |
| LSD, DMT, mescaline, 2C-B | CDSA Schedule III. Not approved medicines (peyote itself is exempted from the mescaline listing) |
| Ibogaine | Not on the CDSA, but listed as a prescription drug, so it can’t be legally sold without authorization |
Stores selling “magic mushrooms” operate illegally in Canada, even where enforcement is limited.
Legal routes to access
1. Clinical trials. Health Canada authorizes clinical trials of psilocybin, MDMA, ketamine and other substances. This is the main legal route for most people. See our clinical trials tracker and filter by “Sites in Canada”.
2. The Special Access Program (SAP). The SAP lets a practitioner request a drug that isn’t approved in Canada for a patient with a serious or life-threatening condition, when conventional treatments have failed, aren’t suitable or aren’t available. Since January 2022, practitioners can request restricted drugs such as psilocybin and MDMA through the SAP. Requests are decided case by case.
3. Section 56 exemptions. The federal health minister can grant exemptions from the CDSA for medical or scientific purposes. In 2020, Health Canada granted the first exemptions allowing some patients with advanced cancer to use psilocybin, and later granted exemptions to some health professionals for training.
Provincial rules: Alberta
Provinces regulate how health services are delivered. In January 2023, Alberta became the first province to regulate psychedelic-assisted therapy, requiring clinics that use substances such as psilocybin, MDMA and ketamine for psychiatric treatment to be licensed and to have psychiatric oversight. Federal rules on the substances themselves still apply.
Elsewhere in the world
- United States: esketamine was approved in 2019. In 2024, the FDA declined to approve MDMA-assisted therapy for PTSD. Oregon began licensed psilocybin services in 2023, and Colorado has created a state-regulated program.
- Australia: since July 2023, specially authorized psychiatrists can prescribe psilocybin for treatment-resistant depression and MDMA for PTSD.
- Europe: esketamine is approved in the European Union. Psilocybin and MDMA remain investigational, with some compassionate-use programs.
Laws change
This is a fast-moving area. We review this chapter regularly, but always check current rules with Health Canada, your province, or a lawyer before making decisions.
This chapter is general information, not legal advice.