Medium: Could MDMA Become One of the Greatest Drugs Ever?


Summary: Marc Gunther examines the potential applications of MDMA-assisted therapy in a variety of contexts, claiming that “MDMA is having a moment.” Along with an assessment of the “impressive results” of MAPS’ first Phase 3 clinical trial of MDMA-assisted therapy for PTSD, Gunther shares that psychedelic researchers and “experienced users” alike “say that the drug could be an effective way to treat other psychological ailments, while improving the health and happiness of so-called ‘healthy normals.'”

Could MDMA become one of the greatest drugs ever?
It could help people suffering from trauma, people who drink too much, couples in therapy and, importantly, the rest of us.

Originally appearing here.

In 1976, Alexander “Sasha” Shulgin, a brilliant and eccentric chemist who concocted hundreds of psychoactive drugs in a home-based laboratory in the hills of Berkeley, California, cooked up a batch of MDMA, the drug that later became known as Ecstasy or Molly. He then tried some, as was his habit.
He loved it. “I feel absolutely clean inside, and there is nothing but pure euphoria,” he wrote in his lab notes afterwards. “I have never felt so great, or believed this to be possible. The cleanliness, clarity, and marvelous feeling of solid inner strength continued throughout the rest of the day and evening. I am overcome by the profundity of the experience.”

This is quite the endorsement, if only because Shulgin took a lot of drugs during his long life.
Thirty five years later, MDMA is having a moment. A clinical trial of MDMA-assisted psychotherapy for PTSD, run by the Multidisciplinary Association for Psychedelic Studies, or MAPs, produced impressive results, moving the combination of MDMA and therapy closer to FDA approval. The first study of MDMA-assisted therapy for alcohol-use disorder, conducted by researchers at Imperial College in London and the University of Bristol, delivered encouraging, albeit very preliminary, findings. Researchers studying MDMA, as well as experienced users, say that the drug could be an effective way to treat other psychological ailments, while improving the health and happiness of so-called “healthy normals.”

Microdose, a media company that tracks the business of psychedelic drugs, this week ran a daylong conference on MDMA that explored the drug’s potential. Scientists offered assurances that it is safe, despite the warnings of drug warriors. Business people described its commercial potential. Users said it left them feeling open, accepting and connected to those around them, and that the feelings persisted after the drug has left the body. Enthusiasts say that MDMA, along with the classic psychedelics, has culture-changing potential.

“Imagine MDMA replacing alcohol as our primary social lubricant,” said Charley Wininger, a New York psychotherapist and author of the book, Listening to Ecstasy: The Transformative Power of MDMA. Because MDMA brings out the best in people, Wininger speculates that it could someday become a fixture of backyard barbecues, holiday celebrations, and, for companies, “the ultimate offsite experience to bond and align your workforce.”

“Couples therapy could be one of the very best uses,” said Rick Doblin, the founder and executive director of MAPS, which has done more than any other organization to develop the potential of MDMA. Speaking from personal experience, he said: “For those of you who have ever done MDMA with a lover, it’s pretty phenomenal.”

Equally upbeat was Ben Sessa, a physician, psychedelics researcher and the chief medical officer at AWAKN Life Science, a startup that aims to deploy psychedelic medicines to improve mental health. Sessa, who led the study of MDMA and alcohol addiction, said MDMA produces a “massive enhancement of empathy” and invites people “to look at old situations in new ways.”

Already, MDMA has bridged political divides. To raise about $50 million for its PTSD clinical trials, MAPs turned to people on the left like David Bronner, the CEO of family-owned soap-maker Dr. Bronner’s and those on the right like Rebecca Mercer, a major donor to conservative groups. Both oppose the drug war and want to help veterans and victims of sexual abuse. Doblin has been invited to NBC’s Today and to Fox News to talk about MAPS’ work.

Doblin and MAPS have big plans. They are training therapists to deliver MDMA in anticipation of the drug’s FDA approval. “We think we can treat a million people with PTSD, ten years after approval,” he said. That will change public attitudes about psychedelics in much the same way as medical marijuana helped bring about legalization of cannabis. Doblin’s ultimate goal is to help create a movement of people who recognize our common humanity, bring an end to wars and solve the climate crisis.
“Our goal is mass mental health, not amassing private wealth,” Doblin says.

Yes, it sounds utopian, especially in light of the fact that US government still classifies MDMA as a Schedule I drug, a category reserved for drugs with no currently accepted medical use and a high potential for abuse. (Marijuana, remarkably, is also still stuck on Schedule I.) The FDA probably won’t approve MDMA as a medicine until the end of 2023, at the earliest, so an ecstasy-inspired revolution in global consciousness can’t begin until then.

Yet the excitement around MDMA is understandable, for some of the same reasons that researchers are bullish about the healing potential of LSD and psilocybin, the active ingredient in so-called magic mushrooms. First, the results from early-stage clinical trials are surprisingly good. Second, subjects tell researchers that the transcendent states induced by psychedelics — more so for LSD or psilocybin than for MDMA — rank among the most meaningful experiences of their lives. Third, conventional treatments for PTSD, addiction, depression and anxiety don’t work very well.

There are practical reasons, too, for the excitement around MDMA. Like the classic psychedelics, it is not addictive. But, unlike LSD or psilocybin, MDMA does not provoke hallucinations, altered perceptions, or a loss of control, so there’s little risk of a “bad trip.” The effects of MDMA also persist for less time — four to six hours, perhaps — than those of LSD or psilocybin, making it a better fit for clinical settings.

“I would argue that MDMA is the perfect tool for trauma psychotherapy,” Sessa said. “Indeed, if you were to invent a tool for trauma psychotherapy, you’d come up with MDMA.”The drug motivates clients to engage in therapy while also relaxing them, he explained, selectively inhibiting their fear response while leaving them free to reconsider their trauma and encouraging them to see the good in others and in themselves.

The study he led, which was published earlier this year in the Journal of Psychopharmacology, looked at just 12 patients with alcohol-use disorder who were given therapy and two doses of MDMA over an eight-week period. The study measured the safety and tolerability of MDMA and, predictably, found no problems.

More interesting was a secondary finding about alcohol use. Going in, the patients consumed an average of 130.6 units of alcohol a week — a single, small shot of spirits is one unit — and by the end of nine months, they were down to 18.7 units a week. The vast majority had sharply curbed their drinking, which Sessa described as a “staggering result.” He noted that this this was an open-label study and not a randomized controlled trial; those will come soon.

If all MDMA did was to alleviate the suffering from PTSD and alcohol-use disorder, it could lay claim to being one of the world’s most important drugs. But its potential is much greater.

In theory, at least, MDMA-assisted therapy might be able to treat other addictions and trauma-related conditions, in much the way psilocybin-assisted therapy has done in research at such medical schools as John Hopkins and NYU. Smoking and excessive use of alcohol are major causes of disease and premature death.

Beyond that, if Wininger and Doblin are right, MDMA could have far-reaching cultural impact. In a moving presentation, Wininger described how a recent gathering of people on MDMA helped his wife, Shelley, heal from the death of her son just a few days earlier. This the same drug, he noted, that became famous at parties known as raves where hundreds or thousands of people dance for hours with wild abandon.
“Is there any other substance on the planet that can claim such a range of applications?” he asked. I can’t think of any.