Circa: MDMA by Prescription? Psychedelic Therapy Shows Promise for Treating PTSD and Addiction

Summary: Circa explores research into the potential medical benefits of psychedelic-assisted therapy, highlighting reports of long-lasting improvements for a variety of mental health conditions.

Originally appearing here.

Imagine being prescribed MDMA — the popular festival drug also known as “molly” — for post-traumatic stress syndrome. Or being prescribed hallucinogenic mushrooms to curb your cigarette addiction.

Researchers at last weekend’s Horizons Conference in NYC see these alternative treatment methods becoming reality in the very near future.

Scientists, scholars, and doctors took the stage to discuss their ongoing research in the field of psychedelic therapy, as well as their hopes for furthering the movement.

Rick Doblin, PhD, founder of MAPS, expects MDMA to be available as a medicine by 2021.

The movement to legitimize the use of hallucinogenics in therapy is one based strongly in lab studies.

When researching substances like MDMA, psilocybin, and LSD, a lot of careful decisions need to be made. A psychedelic trip can depend heavily on circumstances surrounding the experience. Factors like the dose, the setting, and the “sitter” can have an enormous impact.

At the conference, researchers explained the methodology behind their studies, giving us a look at the most interesting aspects of psychedelic research.

PTSD to eating disorders

There’s a lot of potential for the applications of psychedelic therapy, and researchers are covering a wide variety in their studies.

For example, preliminary research found that the mystical experience associated with psilocybin predicted decreased smoking cravings. Hallucinogens have also facilitated behavioral change for alcohol dependence.

And results of psilocybin studies also suggest the potential for increased life satisfaction.

Stephen Ross, MD, discussed directions for psychedelic research at NYU. They’re exploring both a broad range of both psychedelics and potential applications.

Which substances? LSD, DMT, ketamine, MDMA, and psilocybin, to name a few.

And the applications? It’s a diverse list, including: alcoholism, opioid addiction, anorexia, bulimia, OCD, PTSD, narcissistic personality disorder, antisocial personality disorder, suicidal thoughts, criminal recidivism and depression.

Ross explained that a number of accredited universities are exploring psychedelics.

The lab might look a lot like your living room

When you envision a lab, it probably isn’t comfortable. But the session room for the Johns Hopkins Psilocybin Research Project has warm lighting, Buddha statues and a comfy couch. There’s artwork on the walls and a flower arrangement on the table. It’s designed for total comfort.

Roland Griffiths, PhD, a professor at Johns Hopkins, explained that their treatment room may actually be optimizing the psychedelic experience.

In addition to lab research, the university also conducted several anonymous surveys. Individuals completed the survey based on their single most profound psychedelic experience in a non-research setting.

Overall, they found that the lab participants reported a higher mystical experience in the questionnaire than the anonymous responders, suggesting that the lab design optimized the trip.

The treatment room used by the NYU Experimental Therapeutics Research Group is very similar.

They’re studying the effects of psilocybin on cancer patients, seeking to learn if it can have a therapeutic effect on the feelings of hopelessness, anxiety and depression that can come with the diagnosis.

The study’s website describes the room as, “an especially-for-this-study designed room with comfortable furniture, artwork and dim lighting, providing patients with a relaxing and comfortable living room-like setting.”

Monitors during the trip

Before a participant is given any substances, it’s customary that they’ll meet with the session monitors to establish trust, often for an extended period of time. Feelings of trust lead to more openness on the part of the participant.

Just like physical comfort, emotional comfort is an essential component in determining the experience.

Currently, many studies are exploring the idea of having two monitors present during the trip, one male and one female.

One researcher trying out the presence of co-monitors is Michael Mithoefer. Mithoefer is the lead clinical investigator for MDMA-assisted psychotherapy research, currently looking at the drug’s potential for treating PTSD.

“We feel it mirrors a parental situation.” —Michael Mithoefer, psychotherapist “Sequences of trauma often date back to early childhood, so the presence of a male and female co-therapist team gives a sense of safety to the patient,” he said.

Different substances require different experiences

For studies examining psilocybin’s effects, the participant is usually given headphones and eyeshades. “We aren’t interacting with them, except on an as-needed basis,” said Griffiths.

But when it comes to MDMA studies, eyeshades might not be the best idea. “MDMA is a social substance, so we want the participant to interact,” explained Alicia Danforth, PhD. Danforth’s research explores the effects of MDMA on social anxiety.

In her research, Danforth works with adults on the autism spectrum who suffer from social anxiety. To connect with the patients, she uses a deck of cards with different emotions written on each. Participants are asked to pick out the cards that represent how they feel.

Danforth also encourages a visual diary, seeing differences in images drawn by those in the placebo condition and by those who are given MDMA.

The placebo images tend to be “concrete” and “goal-oriented,” while the MDMA images use more symbolic imagery.

“Despite being told that people with autism don’t respond well to metaphors or figurative language, some of the most beautiful, meaningful imagery has come out of this study,” said Danforth.

One participant listed out dates spanning 100 years. They drew a line between 2016 and 2017, separating the dates into two distinct sections.

The participant explained that their life had been full of hardships prior to the study. But after taking MDMA, they were able to see that they had many years ahead of them.

Safety is a huge priority

While many studies are finding positive benefits to psychedelic therapy, they’re also careful to monitor any adverse effects.

Erowid, a source for substance info, warns that psilocybin can cause headaches, nausea, and fear. In NYU’s cancer patient research, they kept a record of reported adverse effects, though none were found to be serious.

In Danforth’s study, participants were first given a small dose of MDMA. The dose was then increased only with their explicit permission.

The environment of a trip can play a large role in informing a participant’s overall experience, so researchers strive to make the participant feel safe and at ease.

Monitored for many months

The effects of psychedelic usage don’t wear off immediately upon completion of the trip.

At Johns Hopkins, researchers studied the effects of psilocybin on the practices of long-term meditators.

Even two months after the dosing session, they found that participants who received psilocybin reported significantly higher life satisfaction than the placebo group. Lasting effects were also found in a study with novice meditators.

In another study at the university, researchers explored the effects of psilocybin on healthy participants without any prior psychedelic use. Immediately following the experience, participants reported decreased hatred and
increased tolerance of others.

The researchers continued to monitor the participants for over a year. At the 14-month follow-up, they found that the initial effects appeared to be sustained.

And the finding of sustained effects is not limited to experiences with psilocybin.

Danforth shared several quotes from participants in her study.

“I feel like I understand people just a little bit better and that pushed me into the area of confidence that I needed to be in. And that’s stayed with me ever since,” the anonymous participant said of their MDMA experience.

Repeatedly, studies have found that the reported benefits of the treatments are long-lasting.

Placebo patients invited back to try the real thing

If a study finds positive effects of psychedelic therapy, it might seem unfortunate to have been given the placebo.

But after Danforth breaks the blind, she invites those in the placebo condition to try MDMA. For people on the autism spectrum, a lot of the available pharmacotherapy is ineffective for treating social anxiety. So she gives them the opportunity to try a new kind of treatment.

The future of psychedelic research might be powered by women

Ross shared the stage with Sarah Mennenga, PhD, and Samantha Podrebarac, representing the NYU Experimental Therapeutics Research Group.

“I’m seeing more and more women enter into the field, and I believe that future research will be powered by women,” said Ross. He showed pictures of their team, and it was composed primarily of women. The crowd at the conference was incredibly diverse, giving weight to Ross’s prediction.

The explosion of psychedelic research is showing no signs of stopping or slowing down.

This was the 10th anniversary of Horizons Conference. In the past 10 years, much progress has been made with psychedelic research, and researchers are predicting enormous changes in the next 10.