This article compares how the United States and Canada allow patients with serious health conditions like PTSD and depression to access experimental psychedelic treatments outside of clinical trials. Canada’s program has allowed over 200 patients to access psilocybin and MDMA treatments since 2022, while the US has only approved 50 patients for MDMA. The authors argue that Canada’s approach is more ethical and accessible, and suggest the US should streamline its process to help more patients who have failed conventional treatments.