MDMA, PTSD and Me: Recent Drug Trials Bring Up a Past Life Researching Ecstasy

Originally appearing here. It was Heraclitus, or perplexingly, according to some Internet sources, Pocahontas, who said you can never step into the same river twice. I am experiencing some side of this truism with all the news about the use of MDMA in the treatment of post-traumatic stress disorder. The item has been all over: a small number of labs have been licensed to produce MDMA — 3,4-methylenedioxy-methylamphetamine, an illegal substance much better known by its usual street name, Ecstasy — for research purposes. A handful of therapists have been granted permission to use it. The results in patients suffering from PTSD have been nothing short of miraculous. The word has appeared: cure. Ecstasy treatment may hold promise for post-traumatic stress disorder patients A South Carolina psychiatrist and his wife, a nurse, have taken an uncommon, controversial approach to helping war veterans who suffer from post-traumatic stress disorder by treating them with MDMA, a pure form of the party drug known as Ecstasy. Their studies have found that the psychoactive stimulant decreases fear and defensiveness while increasing trust in those who take it as part of a therapy program, say Dr. Michael Mithoefer and Ann Mithoefer. The MDMA-assisted therapy could eventually provide relief for thousands of Iraq and Afghanistan veterans who suffer from combat trauma, the Mithoefers say, noting that nearly 300 military personnel from around the country have contacted them seeking help. Though concerns may arise about creating drug dependence or abuse by administering a tightly controlled substance, Dr. Mithoefer said he hasn’t seen that problem. About PTSD, I know only what I have read. Post-traumatic stress is said to affect one in ten Canadians at some point during their lives. Post Traumatic Stress Disorder is PTS in severe manifestation, highly associated with war and related to what in other eras was called shell shock, war neurosis or soldier’s heart. That said, people suffering from PTSD are not just those who have seen combat, but also those traumatized by rape, violent crime, accidents, sudden catastrophic illness, or other nightmarish events. The symptoms include debilitating anxiety, nightmares, flashbacks, withdrawal, and can be entirely life-destroying. And I don’t know if it’s one of those situations having to do with new names, or new classifications in psychological manuals, or simple awareness, but there seems to be more Post-Traumatic Stress Disorder going around these days. Every era has its defining illnesses, and in our era, PTSD might be a contender. I have a much more complete understanding of Ecstasy, because in another river, one I will title my youth, I co-wrote a book and then wrote many subsequent articles about the drug. At one point in the late 1990s, I spent most of my working hours writing, thinking and talking about so called “nightclub drugs,” Ecstasy chief among them. It was my niche. My perspective on Ecstasy in those years can be summed up with this single, useful humblebrag: I was called by the Oprah Winfrey Show, to be featured on a program about the growing popularity of Ecstasy among youth at raves and nightclubs, but was nearly immediately deemed “too positive about the drug” for the purposes of their broadcast. At one point in the late 1990s, I spent most of my working hours writing, thinking and talking about so called “nightclub drugs” There have long been studies that have shown MDMA to be a very effective tool for treating issues like trauma-related anxiety. In the 1970s and ’80s, when MDMA was still legal, interest in the substance’s therapeutic powers was expanding among a growing group of U.S. psychologists and psychiatrists. There were the psychedelic sorts, the descendants of Dr. Timothy Leary, but also more establishment types, like professor Lester Grinspoon, at Harvard Medical School. The work of these therapists was 100% cut off in 1985, when MDMA was pushed through as a U.S. Drug Enforcement Agency “Schedule 1” drug — as tightly illegal as heroin or cocaine — due to its growing popularity on the nightclub scene and on campuses, notably in parts of conservative, wealthy, future-leaders-of-America Texas. After that, it seeped quickly into the underground market, where it became a favourite on the burgeoning rave scene. So I have been following what is being called breaking medical news about Ecstasy, a drug that mostly affects serotonin (the same neurotransmitter targeted by anti-depressants such as Prozac, Paxil or Zoloft), with great interest, if only because it’s fascinating to see a scientific baton picked up a few decades after it was dropped. In the Times, a husband-and-wife team of therapists in South Carolina, Michael and Ann Mithoefer, are featured in a Nov. 20 article called “A ‘Party Drug’ May Help the Brain Cope With Trauma.” The Mithoefers were given leave, by the DEA, to use MDMA experimentally to treat people suffering from severe post-traumatic stress. They recently published findings in the Journal of Psychopharmacology, writing that of 21 people treated in the early 2000s, 15 are recovered, reporting nearly no symptoms today. On CNN, Rachel Hope, the Mithoefer’s seventh patient, is interviewed. Physically abused and raped at age 4, she had suffered brutal, seemingly incurable post-traumatic stress for all of her adult life. She says that after eight sessions with MDMA, beginning in 2005, 90% of her symptoms are now gone. I am taking the current claims with a grain of salt The unanimous positivity surrounding this drug in therapy has been so unyielding, it’s intriguing to me, especially when I look back at how draconian the methods for removing MDMA from the scientific table were in the ’80s, when very similar research was going on. So why, now, the panacea angle? I certainly believe Ecstasy is the right key for unlocking some of the clampdown of PTSD. But even I am taking the current claims with a grain of salt. This, for two reasons: First, if you were a street drug, you could only have a worse reputation if you were heroin. So Ecstasy has a lot of bad rap to blow through in order to reach any sort of legality. A fast way to gain respectability is to make it absolutely bulletproof in its medical applications. If people like the Mithoefers are going to be allowed to continue with their work, the general public will need to believe they are not airy-fairy new age weirdos taking patients on some psychedelic placebo trip, but professionals involved in real, powerful medical treatment — treatment that works. Second, I think there is some plain old red-blooded human hope coursing around here: In the U.S., there are seven million people living with PTSD. Since the start of the Iraq war in 2003, the syndrome has become an unimaginably big issue in the U.S. military. And in its treatment, good news is needed. Talk therapies, cognitive-behavioral therapies, hypnosis, nothing has proved overarching in its success. A soldier goes abroad for his country, and he comes back unable to leave his home. It breaks the heart in some urgent way. So when a treatment comes along that seems even anecdotally better than the others, the natural inclination might be to exaggerate the goodness. Because we all want it to be so. But it might be worth going back to Timothy Leary for a moment. It was he who suggested that one’s experience on drugs is affected by “set and setting,” a term he coined, meaning one’s mindset upon ingestion and one’s setting for the experience. In the field of psychedelic therapies set and setting is a big concept, and in these stories about Ecstasy the Good, it’s important to remember that the therapists, sitting with patients like the aptly named Rachel Hope for up to
eight hours at a time, are doing a great deal of the work here. Because an Ecstasy experience can go many ways. You can use a chemical to open a Pandora’s box: It can be the road to some form of enlightenment or a nightmare trip. But it’s how you sort through the contents that will determine the rest of the story. Mireille Silcoff writes for The National Post and shares her passionate perspective regarding MDMA-assisted psychotherapy research and how it can be helpful for people suffering from PTSD.