Originally appearing at http://www.alternet.org/drugs/151263/ecstasy_as_treatment_for_ptsd_from_sexual_trauma_and_war_new_research_shows_very_promising_results/?page=1. According to outgoing Secretary of Defense Robert Gates, rising health care costs for the military have ballooned from $19 billion in 2001 to over $52 billion in 2011. But there’s a pill for that, explained Multidisciplinary Association for Psychedelic Studies’ (MAPS) executive director Rick Doblin. It’s called MDMA, or ecstasy, and it’s gaining serious traction as a treatment option for soldiers, and civilians, suffering from crippling post-traumatic stress disorder (PTSD). Back when AlterNet first reported MDMA’s potential benefits in 2008, South Carolina doctor Michael Mithoefer was conducting promising MAPS-funded double-blind trials to establish clinical protocols that wouldn’t scare off nations with naive nightmares of acid burnouts. Since then, a distinguished report from political luminaries like ex-United Nations Secretary General Kofi Annan and ex-U.S. Secretary of State George Schulz called for MDMA and cannabis legalization, the Food and Drug Administration (FDA) approved studies for cannabis treatment of PTSD, Swiss psychiatrist Peter Gasser became the first officially sanctioned LSD therapy researcher in 35 years, and the results of Mithoefer’s groundbreaking research, reported last July in the Journal of Psychopharmacology, generated well over 100 media reports. And it didn’t cost anything, compared to the astounding price tags of the Afghanistan and Iraq wars themselves — $421 billion and $782 billion, respectively, and counting. Or the $2 billion to $3 billion, and counting, that it annually costs the government to treat veterans with PTSD. When matched up against that depressing math, the nominal cost of producing MDMA and the $10 million MAPS is looking to spend over a decade to fund its trials is chump change. Even Oprah Winfrey is high on ecstasy. But the best is hopefully yet to come, claims Doblin. “MAPS and Mithoefer’s major breakthrough showed that over 80 percent of the subjects in the MDMA group no longer qualified for a diagnosis of PTSD, as compared to 25 percent in the placebo group,” he told AlterNet. “An even more important breakthrough, which we are currently working to write up in a scientific paper, is from the results of our long-term follow-up evaluations of the subjects, administered at an average of 41 months post-treatment. We found that, on average, the subjects have actually gotten a bit better over time, demonstrating that MDMA-assisted psychotherapy has lasting benefits. This paper, when it’s published, will be even more important than our initial paper.” Another major breakthough is MAPS’ growing relationship with the FDA, which is the “furthest along in their thinking” when it comes to the backward tangle of “science and politics,” added Doblin. In September 2009, the FDA approved MAPS’ protocol to study the psychological effects of MDMA taken by healthy volunteers in a therapeutic setting. That unusual but sensible union knitted MAPS and the FDA, as well as the Drug Enforcement Agency (DEA) and the Institutional Review Board (IRB), the independent ethics committee tasked with monitoring and approving human biomedical and behavioral research, into a professional coalition committed to further legitimation of psychedelic therapy. That’s what happens when science trumps politics. “The other regulatory agencies around the world look to the FDA for leadership,” explained Doblin. “The FDA has the scientific expertise, the commitment to science over politics, and the courage to be the precedent-setters when it comes to psychedelic and medical marijuana research.” The trend is catching heat abroad as well: MAPS’ MDMA campaign is getting closer to approval in Canada and Jordan, and Israel approved MAPS’ MDMA/PTSD study earlier this month. But there’s still a long way to go. Despite the recent science and coverage on MDMA and cannabis treatment, the U.S. Department of Veteran Affairs’ established treatment for PTSD is a mixture of various behavioral therapies and antidepressants like Zoloft, Paxil and others, whose adverse side effects range from the uncomfortable (nausea, headaches, diarrhea, loss of sexual drive) to the deadly (strokes, seizures, heart attacks, suicide). In fact, the only significant places you can find mention of MDMA or cannabis on the USDVA’s official site are in sections on substance abuse, where cannabis users are insulted in the usual manner — “A chronic heavy user can appear apathetic and unmotivated, and may perform poorly at work or school” — and MDMA users are warned against “fatal heatstroke” and “dehydration.” The USDVA did not immediately respond to repeated requests for comment, but one can see why. The antidepressants suggested in its conventional PTSD treatment have been sundered by everything from conflicts of interest and glaring inefficacy to mounting lawsuits and medication abuse. And while its behavioral therapy might yield better results, it has done little to stem the tide of PTSD, which terrorizes close to 10 percent of the civilian population and up to 30 percent of veterans, depending on your favored statistician. Plus, there’s always the military’s institutional fear over what might happen if you start giving soldiers’ cannabis or ecstasy. (As the mighty musical group Oysterhead noted in the tune “Army’s On Ecstasy,” “They stepped up urine testing to make it go away/Because it’s hard to kill the enemy on ol’ MDMA.”) “The American government’s view of its soldiers is fundamentally flawed,” Doblin argued to AlterNet. “The health of the veterans who have served should be of paramount importance over financial concerns. However, the government is not doing all it can to research and provide more effective treatments for PTSD, both for financial concerns and also to support the drug war educational campaigns that falsely claim that marijuana and MDMA are all bad with no beneficial uses.” In a way, MAPS’ continuing research is a proof of that thesis for either side of the military divide. Since 1992, it has worked with Republican and Democratic administrations to mainstream alternative drug therapies that don’t enrich the pockets of Pfizer and other pharmaceutical titans. And it has done so without painting the Pentagon paisley or diluting military pride at home and abroad. “Our psychedelic research started under the first President Bush and has continued through President Clinton, the second President Bush, and now President Obama,” Doblin added. “We’ve been unaffected by changes in presidents ever since.” For that dogged loyalty to mental health and liberal drug policy, MAPS has even scored support from the Pentagon. And although it is so far seriously gun-shy, even Veterans Affairs seems to be warming to the winds of change, and the unavoidable science on the matter. That should only accelerate as the conventional treatments for PTSD start to lose their luster, and the kind of economic and sociopolitical crunches Gates warned of become too unsustainable to continue. “I was contacted by the military’s senior psychiatrist from the Department of Defense, who worked out of the Pentagon, and about two months ago, several senior psychiatrists met for a discussion about MDMA research with the director of the National Center for PTSD, which is part of the VA,” said Doblin. “We were told the research was still ‘too politically complex’ for the VA to get involved in any formal way, but that the research itself was important and somebody should be doing it. We’ve been trying for 15 years to motivate the VA to explore MDMA-assisted psychotherapy for PTSD in veterans, and this was the first time we were told the research is important and somebody, but not the VA at this time, should be doing it. Such is the progress in our field!” Currently, MAPS’ MDMA/P
TSD study is focusing entirely on veterans with chronic, treatment-resistant PTSD from Iraq, Afghanistan and Vietnam, with roughly equal numbers of male and female subjects. And while the VA isn’t referring subjects or supporting the study, Doblin said the study has more subjects than MAPS can enroll. There are high hopes that once the study is concluded, the Department of Defense and the VA will have all the data they need to get formally involved. But such hopes could turn out to be troubled, if the situation mirrors the maddening fits and starts of officially sanctioned cannabis research, which has been hampered by the Obama administration’s inability to recover from a last-minute Bush administration maneuver that killed a MAPS-sponsored medical marijuana production facility at the University of Massachusetts. As explained in David Jay Brown’s High Times expose “Crop Blockers” (PDF), the National Institute for Drug Abuse, which “holds a government-enforced monopoly of the legal supply of research cannabis,” has routinely blocked efforts for researchers to obtain medical marijuana, in spite of the FDA’s approval for study. When MAPS tried to get around that pointless gridlock with its own federally regulated but privately funded facility, recommended in 2007 by DEA administrative law judge Mary Ellen Bitner, it got no help from the Obama administration, which nominated medical marijuana opponent Michelle Leonhart — the same Bush administration holdover who killed the University of Massachusetts facility, blocked scientific research on cannabis and oversaw federal raids on medical marijuana facilities and providers –for DEA Administrator. Everything old is new again. “We’re currently waiting for the DEA to issue its final ruling rejecting Judge Bitner’s recommendation,” Doblin explained. “Then we can appeal in the D.C. Circuit Court of Appeals, where we could put up a valiant fight but still probably lose in the end. I currently estimate that it’s 50-50 whether we will ever be able to obtain approval from NIDA to sell us the marijuana we need for our study. In the ’90s, we had two FDA- and IRB-approved medical marijuana protocols that NIDA refused to sell us the marijuana to conduct, preventing the studies from happening. From 2001-2008, NIDA refused to sell us 10 grams of marijuana for vaporizer analytical research, which wasn’t even for a study in humans! Finally, our analytical lab gave up in frustration.” What’s missing in this battle for forward-thinking mental health care and medical therapy is massive public mobilization, especially among the military. Until the global village, and its soldiers — who are currently being exploited by everything from improper foreclosures to exorbitant luggage fees — collectively decide that the convincing science on the matter should override decades-old stigmas that have more to do with anachronistic political maneuvering and less to do with hard data, these Kafkaesque bureaucratic runarounds won’t end. And with everything from increasing economic stagnation to environmental disaster on the docket, they need to end sooner rather than later. “Citizens can petition their elected officials to let them know that they want them to end the NIDA monopoly on supply and that they want NIDA to agree to provide marijuana to all FDA-approved protocols,” said Doblin. “The redundant, slow and politically created PHS/NIDA protocol review process, which exists for marijuana but for no other drug, should be eliminated.”
With health care costs for veterans rising dramatically and effective treatments limited, researchers and therapists are reaching out to find new ways of treating trauma. As this in-depth and well-researched article explains, MAPS is at the center of multiple attempts to develop safe and effective treatments for trauma associated with sexual assault and war. MDMA-assisted psychotherapy is being shown to be effective for treating trauma in individuals whose illness has been resistant to other forms of treatment. Even MAPS’ planned medical marijuana study, which was recently approved by the FDA, represents a potential breakthrough in treatments for PTSD–as long as public and governmental attitudes to these innovative treatment continue to improve.
Note: MDMA is not Ecstasy. Substances sold on the street under the name Ecstasy do often contain MDMA, but frequently also contain ketamine, caffeine, BZP, and other narcotics and stimulants. In laboratory studies, pure MDMA–but not Ecstasy–has been proven sufficiently safe for human consumption when taken a limited number of times in moderate doses.