Guff: Why MDMA May Be the Ultimate Psychotherapy

Summary: Guff reports on MAPS’ ongoing clinical studies that are showing potential benefits from MDMA as an adjunct to psychotherapy for posttraumatic stress disorder (PTSD), anxiety associated with life-threatening illness, and social anxiety in autistic adults. “I keep getting the message from the medicine, ‘trust me.’ When I try to think, it doesn’t work out, but when I just let the waves of fear and anxiety come up it feels like the medicine is going in and getting them, bringing them up, and then they dissipate,” reports one study participant.

Originally appearing here.

“To fathom hell, or soar angelic, just take a pinch of psychedelic.” Psychiatrist Humphry Osmond’s early forays into psychopharmacological research gave us more than the word “psychedelic.” For the last 50 years, a growing number of researchers, therapists and religious leaders have made it their life mission to get the power of psychedelic-assisted psychotherapy into the hands of trained professionals in America and around the world.

This ambitious plan faces many challenges, from combatting public perceptions, to winning over conservative politicians, to dealing with the incredible harm caused by the illegal drug trade. However, in recent years, organizations like MAPS, the Multidisciplinary Association for Psychedelic Studies, have made headway. Today, clinical studies throughout the United States are testing the safety and efficacy of MDMA-assisted psychotherapy for patients dealing with PTSD from rape, war and other traumas.

MDMA, or 3,4-Methylenedioxymethamphetamine, is most popularly associated with rave culture. The drug was first synthesized in 1912, and the chemist Alexander Shulgin made significant inroads into documenting its effects during the 1970s. He was extremely interested in the drug’s therapeutic potential. However, that decade also saw the first recreational use of the drug, use which ballooned during the 1980s, 90s and 2000s. Due to the social stigma surrounding MDMA, it is worth noting that street MDMA, commonly referred to as “Molly” or pressed into “Ecstasy” pills, is rarely, virtually never, laboratory grade. Street MDMA is often cut with other substances:, an organization that promotes testing, reports that in 2014, only 22% of substances sold as MDMA were pure — and 32% contained no MDMA at all. Which is all to say that these studies have almost nothing in common with street use.

From the beginning, chemists and psychologists noted the powerful effects of MDMA and its potentially therapeutic properties. MDMA commonly produces feelings of emotional openness and connection, and can even catalyze what participants have described as a “spiritual” experience. Advocates at MAPS believe that these properties make it an ideal fit for controlled use in psychedelic-assisted psychotherapy sessions, and they’ve launched a $20 million dollar campaign to get the substance approved by the FDA within 6 years.

To earn approval, the method must first pass several regulatory hurdles. It is now in the testing phase, with laboratory studies on the way in Colorado, British Columbia, Israel and South Carolina. Proof of Principle studies and Relapse studies have already been completed, with favorable results. It is also worth noting that studies for social anxiety in autistic adults and anxiety associated with life-threatening illnesses are underway as well.

MAPS’ studies are comprised of several elements. First, a safe and supportive therapeutic alliance is crucial if therapists hope to earn the trust of their patients — people suffering from traumas that make it difficult to trust others. Participants have said that, “I keep getting the message from the medicine, ‘trust me.’ When I try to think, it doesn’t work out, but when I just let the waves of fear and anxiety come up it feels like the medicine is going in and getting them, bringing them up, and then they dissipate.”

MAPS’ studies also focus on the physical environment that patients are in to ensure that they feel at home and at ease. MDMA might be administered three times over several months of therapy, with a majority of sessions proceeding without the drug. The studies are double or triple-blind to ensure that therapists don’t change their behavior in unconscious anticipation of the results.

While the larger studies are still ongoing, the pilot studies show positive results. In one pilot study, the first randomized control study in history, the rate of clinical response for patients within the MDMA group stood at 83%, compared to 25% in the placebo group. The long-term results from that same group show that benefits were sustained an average of 3.8 years after the conclusion of therapy.