From regulation to practice: A scoping review of prescribers’ roles in psilocybin-assisted therapy
Authors
Gabriel Bélanger, Sue-Ling Chang, Marianne Masse-Grenier, Marie-Joëlle Tremblay, Houman Farzin, Nicolas Garel and Michel Dorval
Published
October 7, 2026
Abstract
Psilocybin remains prohibited in most jurisdictions, but Switzerland, Canada, and Australia have established tightly regulated clinical access pathways. In this developing landscape, prescribers are pivotal to safe access and must navigate conflicting guidance, uncertainty, and legal risk. Clarifying how current regulations define prescribers’ roles is therefore important for understanding how regulated clinical access pathways operate in practice. Our study thus aimed to map prescribers’ legal and professional practice contexts for psilocybin-assisted therapy in Switzerland, Canada, and Australia. We conducted a scoping review of Embase, Medline (Ovid), PsycINFO, CINAHL Complete (EBSCO), Web of Science and gray literature from 2000 to 30 April 2025, for documents focusing on required professional qualifications, training and experience, as well as prescription-, treatment- and staff-related responsibilities. Two reviewers independently screened documents, assessed full texts, and charted data, resolving disagreements by consensus. A total of 3641 documents were retrieved from databases and 3422 from gray literature. Twelve documents met the inclusion criteria (Switzerland: n = 2; Canada: n = 5; Australia: n = 5). In Canada, Australia, and Switzerland, prescribers are regulated health professionals authorized to prescribe controlled drugs, although the specific professional qualifications differ. Training requirements are specified in each country, but experience requirements are defined only in Australia. Prescription- and treatment-related responsibilities are clearly delineated and closely aligned across the three countries, whereas staff-related responsibilities are more heterogeneous. Overall, the practice for the prescription of psilocybin is similar across jurisdictions, with variations mainly reflecting legislative and administrative differences. Under current regulatory frameworks, prescribers play a central role in clinical decision-making and oversight within regulated access pathways for psilocybin-assisted therapy, but guidance on training and responsibilities remains uneven. Examining how regulatory requirements operate in practice will be important for informing the continued development of regulated clinical access pathways internationally.
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