Ecstatic States

The Verge debuts their all-new longform report on the benefits of MDMA-assisted psychotherapy for treating posttraumatic stress disorder (PTSD). The report highlights personal testimonials and researchers’ perspectives about healing trauma with MDMA-assisted psychotherapy, notes the positive shift in public perception about the therapeutic potential of psychedelics, and illustrates the need for significant funding into the future of research into MDMA-assisted psychotherapy to treat PTSD. Vietnam veteran Bob Walker shares how MDMA-assisted psychotherapy helped him recover from PTSD, stating, “I did in 3 sessions what I couldn’t do in thirty, forty years.” MDMA-assisted psychotherapy study participant Rachel Hope also revisits the moment when she found out that she overcame treatment-resistant PTSD. “He comes back and sits down and says, ‘Rachel, you don’t have posttraumatic stress disorder any more,'” recalls Hope, on the verge of tears. “‘You don’t have it.'”

Originally appearing here.


In the Vietnam War, Bob Walker had been a helicopter mechanic, and he’d watched as his best friend was decapitated by an incoming helicopter’s propeller blade. Ever since then the 69-year-old Paradise, CA vet has struggled with post-traumatic stress disorder — a psychological condition that afflicts 7–8 percent of the population. It hits people who have been exposed to highly stressful situations in which their “fight or flight” response has been activated. Rape survivors. War veterans. Policemen.

People with PTSD can be highly irritable and suffer from insomnia, nightmares, and the inability to sustain deep relationships. Or, like Walker, they can walk through life feeling eternally numb. “Over the years, I tried everything from prescription drugs to biofeedback,” says Walker. “But nothing really worked. I knew something just wasn’t right.”

Then one day three years ago, Walker saw a segment on CNN about an experimental drug trial going on in South Carolina to treat people suffering from PTSD. In the study, patients took MDMA, more commonly known by its street name ecstasy, in the company of psychotherapists. The drug’s famous warm-and-fuzzy ability to enhance a person’s well-being and create a surplus of empathy allowed many of the participants to revisit painful memories without their usual fear. In neurochemical terms, MDMA decreases the fear response in the amygdala. It also stimulates the release of the feel-good neurotransmitter serotonin, as well as oxytocin and prolactin, which cause feelings of love and bonding. After taking the drug, many patients could look at their lives in a new way, reprocess trauma, and rewire their own brains.

“I got it, right away,” says Walker, about watching the segment detailing the experiments. He figured, living right next to a college town, he could ostensibly score drugs easily. Why not try it himself?

“Finding MDMA was harder than I expected,” he said. Asking around and attending a psychedelics event got him connected to some people doing sweat lodge and peyote ceremonies, but no ecstasy. But he finally tracked down ecstasy through a friend of a friend’s son and contacted a former therapist, who agreed to work with him while he was high. Jennifer*, who asked that her real name not be used because she feared she could lose her license, was a self-described “conservative” single mom who was typically scared of drugs. But she felt a warmth for Walker and trusted him. “For some reason, it didn’t feel wrong,” she said. “He had really done his research.” The first time was a therapy session like no other. “He didn’t seem high, he just seemed ‘real,’” she said. “We were able to carry on an intimate conversation for the first time.”

“You lose your sense of connection,” says Walker, describing the feeling of having PTSD. But on MDMA, Walker felt deeply connected, not just to his therapist, but also to himself, something he’d long struggled with.

The drug trials that inspired Walker were the work of MAPS, a nonprofit research organization whose name stands for Multidisciplinary Association for Psychedelic Studies. It’s one of a small handful of organizations worldwide trying to establish scientific evidence that psychedelic drugs have therapeutic value.

In the study looking at how MDMA could treat PTSD, the drug was given in conjunction with talk therapy. Patients lay down in a therapist’s office and listened to soothing music with headphones, wearing eyeshades. They had the option of talking about what they were experiencing, and received counseling before and afterwards to integrate what happened to them while on the drug into their everyday lives. According to MAPS, 83 percent of the 19 people treated in a recent group had breakthroughs in this MDMA-assisted therapy and showed significant improvement in their PTSD symptoms.

“The MDMA allowed me to be my very, very, very best self, and I got to take care of my most broken self with my best self,” says Rachel Hope, a sexual-abuse survivor who participated in the study. MAPS’ results from this study were encouraging enough to the FDA that it was able to expand its efforts into what’s known in drug-trial parlance as “Phase 2 studies.” It’s now doing the same study with four new groups of patients in South Carolina, Colorado, Israel, and Vancouver.

In addition to the MDMA-to-treat-PTSD study, MAPS has also studied how LSD can help soothe anxiety in people with terminal illnesses, and in March received approval to study the effects of marijuana to alleviate PTSD. The latter study will be one of only two government-approved medical marijuana trials ever conducted.

Similarly to MAPS, the Santa Fe-based scientific research group the Heffter Research Institute has been collaborating with scientists at UCLA, Johns Hopkins, and NYU to study the therapeutic applications for psilocybin, the active ingredient in hallucinogenic mushrooms. In one study, published in 2011, it investigated how the drug might be used to make terminally ill cancer patients feel less anxious and depressed, and reported that of 11 patients given the drug, 30 percent reported an elevated mood that lasted long after the drug wore off. Now, Heffter scientists are looking at how psilocybin might help cure alcoholism and get people to quit smoking.

In many ways, this research isn’t new. Besides the thousands of years of indigenous peoples’ ritual use of mind-altering plants like ayahuasca and peyote, there was some modern scientific exploration of these kinds of substances, too. Before it was criminalized in 1968, LSD was being used by some doctors as an experimental method for treating alcoholism and anxiety. MDMA, prior to being outlawed in 1985, was used by hundreds of psychotherapists in the United States to treat a variety of phobias, addiction, trauma, and even relationship problems. In an interview with psychiatrist Julie Holland, author of the book Ecstasy: The Complete Guide, one of these therapists recalled: “When it came to, for instance, couples therapy, it was a remarkable catalyst.”

Hopes for relief

MAPS and the Heffter Research Institute were founded with the mission of reintroducing these types of investigations and documenting their results in peer-reviewed journals. MAPS opened in 1986 and Heffter in 1993, after LSD, MDMA, and psilocybin became illegal. But until the 2000s this type of research would have been virtually impossible. The National Institute on Drug Abuse and negative media coverage throughout the ’80s and most of the ’90s depicted drugs like ecstasy, pot, and acid as a scourge without any therapeutic value. (This was the era of the infamous PSA: “This is your brain on drugs!”) These drugs
are all, in fact, categorized as “Schedule 1” by the Controlled Substances Act along with quaaludes and heroin, and are defined as having “high potential for abuse and dependence” and “no currently accepted medical use.” But personnel changes in the FDA and a softening of attitudes within the DEA and Institutional Review Boards, both of which greenlight drug trials, have opened up the field of psychedelic research like never before.

“A lot of the demonization of drugs as evil in all walks of American life has really calmed down,” says Jeffrey A. Fagan, professor of law at Columbia University. “And that’s a great thing. There’s no reason why we can’t think in careful and responsible steps about the therapeutic value of controlled substances.” As scientific evidence begins to mount, psychedelic researchers are looking towards a day when drugs like ecstasy, pot, LSD, and psilocybin will be categorized as “Schedule 2” drugs — that is, drugs that have risks associated with them, like Ritalin or Oxycontin, but can be prescribed by a doctor.

Rick Doblin, the founder of MAPS, says he envisions a future when hospice centers for the terminally ill sit next to psychedelic therapy centers, and licensed doctors can prescribe MDMA in clinics similar to the way methadone is handled. “Things are lining up in our culture and we have the opportunity to reintegrate psychedelics,” says Doblin. “They’ll have an honored place rather than a suppressed place.”

Harsh realities

But it may be too early for Doblin and his colleagues to get too excited. By the FDA’s own reporting, only 5 percent of all investigational new drugs actually make it through the testing and approval process. If any of the drugs that MAPS and the Heffter Research Institute are studying ultimately get approved for therapeutic use, the organizations’ research will have to show positive results among hundreds of participants.

Conducting these larger “Phase 3” studies will cost millions of dollars. Unlike commercial pharmaceutical companies with deep pockets, MAPS and the Heffter Research Institute are privately funded, acting, essentially, as nonprofit pharmaceutical companies. The drugs they’re studying have patents that have expired, making them of little interest to Big Pharma. Anybody could ostensibly make generic versions of them, driving down price and potential earnings.

Raising millions more from the public to continue this research won’t be easy, particularly because at least in the case of the Heffter Institute, psychedelic research operated under the radar for years. Dr. David E. Nichols, president and co-founder of the Heffter Research Institute says that his organization tried to keep its work on the down-low because it was widely considered controversial. Take the research around psilocybin and people with terminal illnesses, for example: “There are a lot of taboos about how people die,” says Nichols. But when Nichols describes the effects the drug can have on people dying of cancer, he presents a moving case that would be hard for anybody to ignore.

“We had one woman say, ‘I realized how precious the people are around me — and I want to enjoy them while I still have time here,’” says Nichols, referring to a cancer patient who took psilocybin in his study and is now deceased. “She said that it changed her completely, and she was able to embrace the life she had left, and it should be there as an option for people to do if they want.”

Nichols believes that, culturally, we’re getting closer to that reality. Young people, he notes, are more accepting of things formerly viewed as social ills, like same-sex marriage and certain illegal drugs.

“The people who thought psychedelics were dangerous drugs are getting old and dying off,” says Nichols. It may be that when future generations approach that time of life, they’ll do so with an open mind, and regulations may follow Ecstatic states.