Psychedelic Medicine: Using Ecstasy to Treat PTSD

What MDMA does, according to the research, is to provide at least a brief experience of what life feels like without the aftermath of trauma. In this state, learning can occur.
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After MDMA-assisted psychotherapy, over 80 percent of sufferers from post traumatic stress disorder no longer met the diagnostic criteria for PTSD, as compared to only 25 percent in the control group. This study, just released, was conducted by Michael Mithoefer, M.D. (and his colleagues) and is published in the peer-reviewed Journal of Psychopharmacology.

According to the media statement, MDMA, recreationally referred to as Ecstasy, could "offer sufferers a vital window with reduced fear responses where psychotherapy can take effect." According to the paper, participants in the study experienced "no drug-related serious adverse events, adverse neurocognitive effects or clinically significant blood pressure increases."

On the killing fields of 1914-19, the malady being studied was called "shell shock," in World War Two, "battle fatigue" or "combat exhaustion," and now, in the era of military operations in Iraq and Afghanistan, PTSD. It can be caused, for example, by experiencing random explosions, being wounded or seeing buddies torn open or killed.

The syndrome is hard to treat and can last for years after a soldier climbs out of a trench or an armored personnel carrier. Of course it helps to be in a psychotherapist's quiet office, away from any battlefield or dangerous city. But PTSD tends to stay with a person. He or she may bring it to bed (as partners discover when a returning vet wakes up screaming), to the highway, to workplaces, perhaps to any argument or frustration or hearing of loud sounds. What to do?

The problem is fear--pervasive, invasive, recurrent fear. What MDMA does, according to the research, is to provide at least a brief experience of what life feels like without the aftermath of trauma. In this state, learning can occur.

The political system that conducts wars in Vietnam, Iraq and Afghanistan used to "just say no" to all psychoactive drugs, but now needs something to help veterans of those wars who suffer PTSD. In this situation, MDMA might be officially repurposed. What was for a while mainly a party drug at raves is now moving back toward (if not yet into) the therapy office.

PTSD is suffered not only by some warriors, but also by rape and other crime victims, by people who have been in accidents, by minors who suffer abuse.

Before being "scheduled" (criminalized) 25 years ago, MDMA was used by a circle of therapists for a variety of purposes, including internal exploration. For example, George Greer, M.D. and Requa Tolbert wrote a paper in 1986 on how they'd given MDMA in a clinical setting. The Mithoefer research just reported is methodologically superior to theirs, and focused tightly on PTSD, but it is hard to find any substantial contradiction of what they wrote in 1985 or to conclude that, because of political hysteria, we have not just wasted a quarter century.

Research is quietly being conducted not only on MDMA (which has been labeled an "empathogen" or "entactogen") but also on classic psychedelics such as psilocybin. Much of this work is sponsored by a group of scientists banded together in the Heffter Institute (a name borrowed from a German pharmacologist born in the mid 19th century). Many of the published papers are technical, with such titles as "psylocybin links binocular rivalry switch rate to attention and subjective arousal levels in humans."

But Heffter also sponsors clinical and basic research friendlier to laypeople. For example, they are supporting studies of the use of psilocybin and other psychoactive molecules, conducted at Johns Hopkins, NYU, Perdue, UCLA, and the University of Zurich. Some of this research deals with cancer patients and people with obsessive-compulsive disorder; some, with the way various molecules work in the nervous system. Heffter has gathered most of the big names in the field, plus some generous supporters.

Along with the Council on Spiritual Practices (in San Francisco), the Multidiscplinary Association for Psychedelic Studies (with an office in Santa Cruz), and the Beckley Foundation (located in England), the Heffter Institute (with an office in Santa Fe) co-sponsored a conference in April in the Bay Area and supports much of the "psychedelic science" being conducted abroad and, as the Federal government gradually allows it, in the U.S.

If pharmaceutical firms could profit from these substances and if the latter hadn't been associated with hedonism in a time characterized by protest against a war and against racism, perhaps this process of official rediscovery would have moved less tardily. Meanwhile, sufferers from PTSD and other maladies who are helped can give thanks to the scientists and other pioneers who have kept working to explore the benefits and safe uses of mind-manifesting molecules.

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