Inspired by the home care model and the need to address restricted access to communities, Les Moires has been (re)imagined as spaces for assisted exploration for individuals wishing to use psychedelic substances in a more ethical framework. We aim to honour the diversity of human experiences through exchanges conducive to individual and collective reconciliation.
With this in mind, Les Moires takes the form of nomadic safe spaces that encourage deep introspection. Our approach finds its roots in respect for traditions and self-determination, in thoughtful collaboration with evidence-based practices and harm reduction approaches. We are particularly sensitive to aspects related to interdisciplinarity and interculturalism, which lie at the very heart of the use of psychedelics for therapeutic purposes.
Les Moires offers contemplative breaks, supported by health and counselling professionals, away from the outside world pressure, in a supervised setting where support and safety are our main concerns.
We bring together the voices of individuals with diverse and marginalized identities (BIPOC-2SLGBTQ+), who wish to positively influence public discourse, sometimes polarizing, without unwanted morality, and above all with the aim of limiting harm.
Les Moires offers four different operating structures according to the needs:
Preparation and/or integration for those who choose to explore emotional and altered states induced by psychedelics (individual or group)
Individual or group assistance for those who choose to explore emotional and altered states induced by psychedelics (trip sitting)
Formal medical evaluation for those who would be eligible for the submission of a request for an unapproved psychedelic treatment (psilocybin or MDMA) based on the presence of specific diagnoses that have not responded to conventional therapies (treatment-resistant depression, post-traumatic stress disorder and end-of-life existential distress), and according to the requirements of Health Canada’s Special Access Program (SAP)
Medical supervision of ketamine-assisted therapy as an off-label treatment for major depressive disorder and for treatment-resistant depression based on comprehensive informed consent and adequate understanding of risks.
Our team, made up of healthcare and counselling professionals, aims to cultivate humility in the face of the sociocultural aspects surrounding the use of psychedelics. We are committed to working diligently and being mindful of our unconscious biases, in order to build environments that allow the capacities of individuals and communities to flourish.
We wish to emphasize that, despite significant progress compared to other provinces, the Régie de l’assurance maladie du Québec (RAMQ) does not cover all aspects of psychedelic treatments (e.g., medication costs, fees for other non-medical interveners necessary for the co-therapy schema, etc.), which can become a hurdle to accessibility for many. We are committed to billing any medical intervention to public insurance, in order to abolish medical costs, advocate for eventual universal access, and align with Rick Doblin’s “Net Zero Trauma by 2070” (MAPS).
As a family physician in practice since 2016, I work in an FMG in downtown Montreal, as well as part-time in the intensive care unit of a rural hospital in the Laurentians region. From the beginning of my professional journey, I have been committed to improving care for marginalized communities (substance use disorders, sexual health, trans-affirmative medicine).
I am hopeful that Les Moires will become a continuation of my hopes for empowerment and change in individual and social mindsets, in order to create greater openness to the necessity of psychedelic treatments in mental health.
Les Moires comes at a time when I feel an urgency to live fully and an imperative need for affirmation in the face of oppressive rhetoric that seeks to erase and constrain us in our creativity. In recent years, disillusionment and compassion fatigue, fuelled by the relentless pace of our broken systems and Québec’s impoverished medical practice, have accompanied the blows to endure. The loss of my best friend’s battle with his mental health was a culminating turning point that continues to fuel a visceral need to do better. Like me, he was a non-heterosexual and visibly racialized physician. I shared with him praises and disappointments in a nihilistic poetry. I finally bring him with me into this project, as I find in it our Atropos, the goddess who cuts the thread of our lives and urges us to become aware of our fragility, to exist fully, and to revalue quality human exchanges in safety and ethics.
I consider myself a sensitive and empathetic human being, whose personal and professional journeys have profoundly shaped the understanding of human individuality. My path has encouraged me to further explore the complexity of the human being. My experience managing a medical clinic specializing in substance use disorders has allowed me to develop a natural ease for intervention and counselling. With limited resources, despite the importance of my role, much of my work at the clinic involved regular intervention with clients and dealing with crisis situations and psychological distress. This clientele revealed my ability to create calm and safe environments, imbued with kindness and openness.
Outside of the medical and clinical world, I have been involved in the implementation of educational programs related to the opioid crisis and the distribution of naloxone in our communities. These experiences have strengthened my conviction in the importance of gentleness in our interactions with others.
The use of psychedelics for therapeutic purposes is an emerging practice area with many unknowns.
Les Moires wishes to emphasize that most psychedelics are controlled substances, except for ketamine, which is legal and regulated for non-recreational medical use. For other psychedelics, more commonly psilocybin and MDMA; sale, distribution and possession currently remain illegal, unless authorized by Health Canada or exempted under subsection 56(1) of the Controlled Drugs and Substances Act.
Given the interruption of scientific research for political reasons since the 1970s, there are still no studies related to long-term risks, despite encouraging scientific data regarding the safety of these substances. The use of psychedelics in mental health therefore remains an off-label practice with an uncertain risk profile.
Les Moires does not in any way encourage the use of psychotropic substances, and if personal use occurs, supervision and an understanding of the potential risks associated are strongly recommended (informed consent*). Furthermore, Les Moires has no affiliation with any pharmaceutical and/or corporate entity. Any
medical activity will be conducted in accordance with ethical obligations, and any insurable service will be billed to RAMQ according to current standards.
*will be explained during meetings