Clinical Work Using MDMA in Switzerland Since 1985

Summer 1992 Vol. 03, No. 3 Building on Common Ground

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Swiss narcotics law grants spedally trained physicians exemption regarding the therapeutic use and scientific research of Schedule 1 substances. Although MDMA was placed on the list of Schedule 1 substances in 1986, extensive experience with this substance was gained prior to that date. In 1988, we were granted official permission again which has allowed us to gather a broad range of experience in the use of this substance. Presently, we are five licensed psychiatrists who have this permit, myself having been appointed as the physician overseeing the project. Since we have trained quite a large number of therapists according to the requirements of the Swiss Department of Health (BAG) over the past years, we expect several more permits to be issued in the near future. Presently we are working together with the BAG and its commissions (Ethical Commission supervisor Prof. Dr. Ladevic of the Psychiatric University Clinic, Basel) to establish spedtic criteria for the issuing of such permits, taking into account international standards and practices. Our work consists in psychotherapeutic applications of the study of human consciousness, however, since the drugs are non-prescription, our work is categorized as scientific research. This is based on an evaluation by the Ethical Commission that the therapeutic value of MDMA by far exceeds any possible negative effects.

Our working procedures:

Working within our individual medical practices, we administer MDMA and other psychoactive substances with selected patients in the course of psychotherapy. The treatment consists of ongoing psychodynamic therapy with two to four treatment sessions per year with MDMA or other psychoactive substances. These sessions are held in groups of ten to fifteen persons who are under constreat intensive supervision by myself and two or three assistants. The treatment sessions are held behind dosed doors and last for a whole day. To date we have treated several hundred patients with great success. These therapeutic sessions are embedded in ongoing conventional therapeutic treatment methods, with intensive preparation prior to and follow-up after the event.

Possible Negative Implications of MDMA:

In our work with MDMA in psychotherapy so far, we have not observed any negative effects, either of a psychological or physical kind. The tremendous usefulness in healing severe psychological disturbances outweighs the occasional stress on the organism through these substances. Most importa tly, no addictions to MDMA have been observed after use of MDMA. To the contrary, we have been able to confirm what had already been doctxmented by others, that other addictions (alcohol, medical drugs, heroin, etc) were greatly reduced by MDMA-supported psychotherapy and even led to a significant reduction of those addictions in the patients. It is vital for success to keep in mind the importance of the therapeutic setting and the patient / therapist relationship.

The suspicion of a possible toxicity to the nervous system, which had been considered a possible side effect of MDMA, was not substantiated by our use of therapeutic dosage of this substance. This finding has been confirmed by recent scientific research, not yet published, by George Ricaurte, USA. Following the treatment of primates with therapeutic dosages, no damaging effects on the nervous system were observed.

Regarding The Listing of MDMA as a Schedule 1 Narcotic:

In our opinion, psychoactive substances such as MDMA, LSD and others which have proven therapeutic application, have been erroneously placed on the list of Schedule 1. We are working to correct this mistake on the international level, and even though in Switzerland it is possible under current law to obtain exemption permits, these procedures could be greatly simplified. In our opinion, psychoactive substances such as MDMA do not belong to the category of narcotics, since no narcotic effects are in evidence, but rather, on the contrary, facilitate the laying bare of emotional structures. They can thus help in bringing clarity and insight into unconscious mechanisms, a realm hardly ever reached by conventional methods. They have been of such great help in our psychotherapeutic work that we see tremendous loss if these substances are not made available on a broader scale.