Gambit: The Agony and the Ecstasy: Using the ‘Party Drug’ MDMA to Combat PTSD

Summary: In an article from Gambit, the therapeutic potential of MDMA-assisted psychotherapy for PTSD is explored through the experiences of participants from Phase 2 trials and insights from MDMA researcher Dr. Shari Taylor, who is coordinating the MAPS-sponsored Phase 3 clinical trial in New Orleans, LA. “MDMA seems to promote a ‘heart opening,’” explains Dr. Taylor. “You are looking at the traumatic experience from a different perspective and often it appears there is compassion for yourself and others.”

Originally appearing here.

Lori Tipton discovered the bodies six weeks before Hurricane Katrina.

One was her mother’s. The other two were the women her mother killed before committing suicide.

Tipton dialed 911 and described the crime scene. Julie Carreras and Lark Bennett, both in their 40s, lay crumpled and bloodied on the floor as her mother, Patricia Tipton, 55, sat slumped over a chair in the corner. She shot both women through the heart before turning the gun on herself in what the St. Bernard Sheriff’s Office called a “love triangle.”

Tipton hung up and waited for authorities to arrive. When her brother fatally overdosed four years before, she had a similar sense: None of it felt real, yet nothing would ever be the same. But how to defeat such trauma?

After more than a decade, Tipton found an answer: MDMA-assisted psychotherapy.

MDMA, the illegal party drug known as ecstasy or “molly,” is a psychoactive amphetamine that produces a sense of euphoria by boosting activity in serotonin, dopamine and norepinephrine neurotransmitters. This chemical flood stimulates trust and well-being in users — but some researchers also believe MDMA can help process trauma.

Created in 1912 by the Merck Company, MDMA took off in the mid-1970s when California-based chemist Alexander Shulgin synthesized and experimented with the chemical compound. Shulgin, known as the “Godfather of Ecstasy,” told several psychologists of MDMA’s effects and introduced it to psychedelics pioneer Leo Zeff. Zeff, who reportedly tried the drug in 1977, called it “penicillin for the soul.” Together they promoted MDMA across America to psychologists and psychoanalysts. Soon it would be prescribed to thousands with anxiety disorders, including couples in marriage counseling.

But MDMA also spread to club culture and college campuses throughout the country. The Drug Enforcement Administration (DEA) banned MDMA in 1985 and the Food and Drug Administration (FDA) labeled it a Schedule I drug. That category, which includes heroin and LSD, indicates a high potential for addiction and a lack of medicinal use. Subsequent research reported MDMA causing “permanent physical and psychiatric problems” in addition to triggering 87 fatalities.

Recent studies are showing something else entirely: MDMA as a potential cure for post-traumatic stress disorder (PTSD).

The Multidisciplinary Association for Psychedelic Studies (MAPS), a nonprofit established in 1986 by Rick Doblin to advocate for medicinal use of banned drugs, sponsored six Phase 2 trials of MDMA-assisted psychotherapy. The results were published in the Journal of Psychopharmacology in 2018. In the 107 patients suffering from PTSD, 68 percent of the people in the study who received cognitive therapy with two to three MDMA sessions no longer had the condition a year later.

Robin Eckstein, a 42-year-old disabled veteran suffering from PTSD, joined the Phase 2 trials in South Carolina, and calls MDMA-assisted psychotherapy a “great experience” that gave her optimism. “I saw improvements right away,” she says. “I could see it helping many other people.”

In 2017, the FDA took note and gave MDMA a “breakthrough therapy” designation. This led MAPS to conduct Phase 3 clinical trials nationwide as well as in Canada and Israel. The nonprofit generated nearly $27 million through donations for the study with aims to legalize MDMA for medicinal use by 2021.

The clinical trials remain open to new participants in 11 American research cities, including one in New Orleans. During the study, patients undergo 12 weeks of psychotherapy, which includes three eight-hour sessions on MDMA under the guidance of two psychiatrists.

Dr. Shari Taylor, a somatic therapist coordinating the New Orleans MAPS Phase 3 clinical trials, says MDMA-assisted psychotherapy works by shifting perceptions of trauma in the brain.

“During traumatic events, sometimes it’s hard to consolidate the pain, sometimes people can’t fully remember parts of what happened,” she says. “MDMA therapy allows people to recall the parts they forgot. Patients are then able to process the trauma in a different way, and it allows them to heal.”

The therapy also provides an alternative to selective serotonin reuptake inhibitors (SSRIs) like Zoloft or Paxil.

“You only take [MDMA] a handful of times,” Taylor says, “as opposed to other medicine, which you potentially have to take for the rest of your life and not even treat symptoms effectively. That’s why MDMA works differently. We feel the body move towards healing if given the opportunity and circumstance.”

Dr. Ray Worthy, Taylor’s partner in coordinating the New Orleans clinical studies, says patients already should have access to MDMA-assisted psychotherapy. He wrote a dissertation nearly two decades ago about Vietnam veterans suffering from PTSD and hoped a shift would transpire by now.

“It pains me to see a lifetime go by without adequate treatment for people suffering,” Worthy says. “And we’re now 10 or 15 years into Iraq and Afghanistan and Hurricane Katrina and other traumatic events. … It just makes me think, ‘What if we could have had this therapy available earlier?’”

Dr. Worthy describes MDMA as a game-changer.

“It may take a year for a change to go through, but with a catalyst it will go through in five minutes,” he says. “MDMA is a catalyst.”

Author Tucker Max, who wrote “I Hope They Serve Beer in Hell,” agrees. After undergoing four MDMA-assisted treatments, he told Gambit he felt “more empathetic” and “healthier” and believed his relationships improved overnight. “The main thing is it helped me bring up and process all kinds of residual trauma that therapy never got to,” he says. The only downside, he adds, was waiting until age 42 to try it.

Others warn against calling MDMA a magic bullet.

Psychologist Susan Merle Gordon, writing in Scientific American, calls MDMA a “dangerous substance.”

“Even occasional, light users of MDMA risk overdose and premature death,” she wrote. “Moderate to heavy users risk addiction, as well as long-term impairments in psychological and cognitive functioning. All users of MDMA at least temporarily lose their ability to relate to and enjoy being with other people without the influence of a mind-altering, dangerous substance.”

Dr. Charles R. Marmar, head of psychiatry at New York University’s Langone School of Medicine and a specialist in PTSD research, has said MDMA potentially can have addictive and harmful effects on the brain.

“It’s a feel-good drug, and we know people are prone to abuse it,” he told The New York Times. “Prolonged use can lead to serious damage to the brain.”

Nonetheless, Taylor believes healthier emotions can emerge from therapeutic MDMA use. “MDMA seems to promote a ‘heart opening,’” she says. “You are looking at the traumatic experience from a different perspective and often it appears there is compassion for yourself and others.”

Lafayette theater shooting survivor details continued PTSD battle, recovery: ‘This doesn’t go away’
Lafayette theater shooting survivor details continued PTSD battle, recovery: ‘This doesn’t go away’
The triggers are everywhere: Lights turning on, a dish crashing to the floor.

Tipton evacuated New Orleans before Hurricane Katrina and the levee failures and lived in New Mexico for months after the event. She moved back in October 2005 to work at a French Quarter gentleman’s club. She also was officially diagnosed with post-traumatic stress disorder. “But everybody coming back to New Orleans was being diagnosed with PTSD,” she says. “It made me believe that maybe I didn’t have it.”

Tipton didn’t appear weakened by the condition. After completing her degree in psychology at Tulane University, she held down jobs and remained proactive in fighting off depression. But a few months into her return, she noticed small triggers at work. Whenever someone clapped their hands or slammed a drink on the club’s bar, she jumped. She often worried about vague destructive forces. “I had a constant fear that something would happen,” she says.

That fear was realized a year after she moved back.

It began when Tipton received a call from a friend and co-worker who was drunk at a nearby bar. He told her he was having a bad day and asked her to watch a movie with him. She went to his apartment but moments into the film, the man sexually assaulted her as she repeatedly said “no.” When the ordeal ended, she ran to the bathroom, splashed water on her face and vomited. A man she trusted had raped her. Weeks later she found out she was pregnant.

Tipton had an abortion, which taxed her emotionally. Instead of steeping in the hurt, she grew even more determined to heal.

She became a certified yoga instructor, continued cognitive therapy, developed a support system of friends, tried Rolfing (deep tissue massage therapy), met with a dietician, took anti-depressants, practiced reiki crystal healing and even consulted a witch doctor. Yet the more she pushed, the less progress she saw.

“I was willing to try anything, but nothing had lasting effects for me,” she says. “Internally I felt like I was falling apart.”

When Tipton first saw the MDMA clinical trials announced on Facebook she was doubtful. After all, nothing else had worked. Regardless, she applied and joined MAPS Phase 2 trials in December 2017. After meeting with Taylor and Worthy, she had a catharsis.

MDMA in combination with therapy allowed her to revisit the St. Bernard Parish house where her mother and her friends died. “I lost the three most important women in my life that day in 2005 and only now could I see it clearly,” she says of her first MDMA treatment. “I was able to go into the memory of that day and stay present with myself. The day it happened it was like watching a movie that was someone else’s life. Even when I called 911, I was calm, no screaming. I was simply telling someone else the story.”

Because MDMA dulls the amygdala, which is the brain’s fear center, and enhances the prefrontal cortex, which processes memory, she was able to uncover a different tale — one that was clear in detail but lacked the overwhelming emotional weight.

“I was able to have so much empathy for myself in that situation,” she says, holding back tears. “I was able to recount that day differently, and I was able to forgive myself for the first time for not doing enough.”

During a later MDMA treatment she had trouble processing the rape at first. When Taylor and Worthy sat in the room with her, they wondered if a novel approach would work. Remembering her experience as a yoga teacher, they wondered if she could try a pose to go into the memory and heal. For years she refused contorting her body into certain positions because it conjured dark memories and spurred panic. With the doctors in the room, she gave it a try. When the anxiety surfaced, they asked her a question.

“Can you ask what that feeling needs?”

“It needs to be heard,” Tipton said without thinking.

The two doctors remained on the floor with her and coached her through the process. For the first time her brain responded differently to trauma.

Her final MDMA-assisted psychotherapy treatment took place in March 2018. Today she says she no longer has PTSD and feels happier than ever before.

Tipton, 39, now bartends at the Ace Hotel and is writing a book titled, “In the Heart, Not the Head: An MDMA Memoir.” Her mission is to help others by telling her story.

“This literally saved my life,” she says. “I’m not saying it will work for everyone, but people deserve to have the opportunity to try it. It could save their lives, too.”