Summary: News.com.au reports on Psychedelic Research in Science and Medicine (PRISM), the Australian research organization working to make MDMA-assisted psychotherapy available for Australian military veterans suffering from PTSD. “MDMA has a way of alleviating the anxiety associated with talking about trauma, without clouding their ability to process therapy,” explains psychologist Stephen Bright, Ph.D.
Originally appearing here.
WITH the drug MDMA a step closer to becoming a legal form of treatment for post-traumatic stress disorder (PTSD) in the United States, a group of Australian researchers want to bring a similar system to Australia.
After years of research, the Food and Drug Administration (FDA) has approved the drug for use in a phase-three clinical trial in the US, which is effectively the final stage before it’s approved as a prescription drug.
Psychedelic Research in Science and Medicine (PRISM), an Australian not-for-profit research organisation, has been working to legislate use of MDMA in Australia for war veterans, in response to the number of military personnel taking their own lives.
Previous research has found more war veterans have died by suicide than through dying by war since 1999.
This year alone, 41 military personnel and veterans died as a result of taking their own lives, according to a Sunday Herald Sun investigation revealed.
HOW COULD MDMA HELP TRAUMA PATIENTS?
MDMA — or 3,4-methylenedioxymethamphetamine — is a synthetic, psychoactive drug with an energising, affectionate effect on the user.
This is the drug presumed to be the main ingredient found in ecstasy tablets and capsules. In other words, a “pure ecstasy” pill would contain nothing but MDMA.
Stephen Bright, a clinically-trained psychologist from Curtin’s School of Speech Pathology and Psychology, told news.com.au the drug would be a groundbreaking new way to alleviate long-term mental health trauma in patients.
“The key thing trauma does is it creates a sense of disconnection,” Dr Bright said. “People isolate themselves, they become hermits, they become hypervigilant and hyperaroused. Instead of bonding with other people they shut down completely, and bond with other drugs like alcohol.”
He said it would work as a way for sufferers to increase their social connectivity, open up about their trauma and work through it in a productive manner.
“People either become overwhelmed (by therapy) or they come up with strategies to prevent themselves from really experiencing it,” he said.
“For example, I worked with somebody who found it very difficult to talk about his traumatic experiences, but when he consumed alcohol in large quantities, he could suddenly open up.
“The problem here is when a person is intoxicated they’re not able to process it. MDMA has a way of alleviating the anxiety associated with talking about trauma, without clouding their ability to process therapy.”
So far, the use of MDMA as a form of medical treatment is not legal in Australia.
Mr Bright believes a number of barriers have contributed to this. For one thing, he said researchers are afraid that openly supporting the trial may impact on the funding they receive from the government, which is already limited.
He said there’s also a corporate disincentive, believing its efficiency and relatively low cost would have negative economic consequences for major pharmaceutical companies, which can effectively keep a person on antidepressants for life.
He also believes improper recreational use of ecstasy, and highly-publicised cases of death, have created a negative stigma around MDMA.
HOW WOULD THE PROCESS WORK?
MDMA would only be considered as a last resort, if antidepressants failed to work on the patient.
It would be conducted in the presence of trained staff, Dr Bright said, and would be used a maximum of three times over the course of 12-18 sessions of psychotherapy.
“Because of how MDMA operates, it allows people to talk about it,” explained Dr Bright. “It provides a sense of openness, and enables empathy towards the staff they’re working with. What’s amazing as a psychologist is it also seems to alleviate survivors’ guilt.”
He stressed it’s important to understand the drug is part of a long therapeutic process, rather than a case of simply walking into a clinic, popping a pill and leaving.
“In 12-18 sessions they might achieve what will take someone else five years of psych therapy. It’s essentially MDMA-assisted psychotherapy, and the effects are so profound that they allow people to experience their traumatic events within a window of tolerance.”
Patients might also be given music and eyeshades to help them relax, to encourage them to open up about their experiences.
Dr Bright believes Australia is at risk of falling way behind the rest of the psychological community if it continues to refuse to allow this treatment.
“My biggest concern is this: if MDMA becomes a medicine in the United States — and this is highly likely to happen, they were aiming for 2021 — it will be a shame if Australians are unable to access this medicine. We won’t have had psychologists and psychiatrists undergo the appropriate training, nor will we have overcome legislative hurdles.”
WHAT ARE THE NEGATIVE IMPACTS?
It’s no secret that MDMA has a bad reputation.
On a recreational level, the drug often makes headlines in association with deaths at festivals or parties from ecstasy.
Dr Bright said deaths and complications from ecstasy typically stem from drugs intended to mirror the effects of MDMA, but are potentially far more harmful, such as PMA.
But in this case, the drug would be taken in a controlled environment and monitored by health professionals.
Dr Bright said it has near zero addictive properties, because frequency of use can dramatically diminish its effects, which turns people off taking it on a daily basis.
For this reason, patients would only take it a total of three times across their psychotherapy sessions.
A major potential consequence associated with MDMA use is the “comedown effect”, an episode of depression which commonly hits a day or two after taking the drug, due to the depletion of serotonin in the brain.
But Dr Bright said this impact typically gets worse the more often you use it, and that on a patient, the after-effects would likely be negligible.
“They usually don’t experience a comedown at all in the clinical trial, because we’re recruiting people who haven’t used it in the past,” he said. “If anything, they’d wake up excited for the next session because they’ve been able to get so deep into the next experience — quite the opposite of what you might see on a Tuesday morning among ravers.”
The Multidisciplinary Association for Psychedelic Studies (MAPS), which was responsible for bringing the trial to phase-three in the United States, treated 107 subjects suffering chronic PTSD with MDMA.
Dr Bright understands that only one subject from that study ended up trying it recreationally following his therapy — and immediately regretted it, saying he didn’t have the same positive experience.
For researchers, the ultimate goal would be to see the drug approved and branched out into other areas of
PTSD
— like as a result of sexual trauma or childhood abuse.
The question is whether it can first actually get off the ground.
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