Treating Post-Traumatic Stress Disorder with Ecstasy

SBS Originally appearing here.

Segment begins at 4:20

Post-Traumatic Stress Disorder is often a symptom of prolonged violence, sexual abuse, wars, and serious accidents. It sometimes takes months or years for sufferers to get back to a state of normality – and often it can’t be cured. But can the party drug MDMA, aka Ecstasy, actually be used as a treatment for people with PTSD?

Looking at Rachel Hope now, it’s hard to imagine that for 20 years she suffered from severe Post Traumatic Stress Disorder or PTSD.

“PTSD is for me like getting stuck,” she says. “It’s like a record skipping with a traumatic memory playing over and over and not just replaying in my mind or my dreams but it was replaying in the sensations in my body.”

“The phone would ring and I would jump and scream which is a pretty ridiculous reaction but I had no control over it.”

“I would go into a total terror mode and my heart would be racing and it took me a few minutes to regain calm.”
“I had completely disrupted sleep, constant nightmares and night terrors they were so vivid and so real that I would have a hard time believing that they hadn’t happened again. I couldn’t leave the house for weeks and I was just a wreck, hardly sleeping for years.”

For Rachel, that traumatic memory was linked to a history of sexual abuse.

“If there was a predator around and I couldn’t get away I got caught. I was very neglected and nobody was watching me and I was running around and taking care of myself. By the time I was six I was given over to my grandmother and it stopped but a lot of damage was done by several different perpetrators.”

For decades after, sounds, smells and sensations triggered painful memories and crippling fear.

Rachel looked for a solution turning to any treatment she could try. But nothing seemed to work.

“I sought every treatment that they recommended,” she says. “Psychotherapy, different medications, rapid eye movement therapy, anything I could do to try and get well and I just kept getting worse.”

But that changed nine years ago when Rachel came across a clinical trial for a drug touted as a potential cure for PTSD.

As part of the trial Rachel underwent two psychotherapy sessions – two months apart. Just before each session, she was given one dose of the trial drug.

That medicine was MDMA, widely known as Ecstasy.

“It was only these two 8 hour sessions that I continued to get better well into the future without any meds at all so yeah this stuff is amazing,” she says. “This medicine is amazing.”

Martin Williams the founder of Psychedelic Research in Science & Medicine (PRISM) wants MDMA to be trialled on Australian PTSD sufferers.

“It’s a very interesting question as to whether MDMA has been misrepresented or somewhat exaggerated,” says Mr Williams. “The key to the action of MDMA is… its ability to open up feelings and emotions in the taker and so these effects can have a profound impact on people’s ability to communicate, to open up to others.”

Mr Williams says the results of the US research study are very encouraging.

The research trial started in 2004. 20 adult patients were chosen to participate based on their incurable history of PTSD. 12 were given MDMA, 8 were given a placebo.

All 20 then took part in an eight hour psychotherapy session and that process as repeated two months later.

The study found a decrease in PTSD symptoms for 83 per cent of those given MDMA – compared with 25 per cent of those given the placebo.

Since then, there’s been one more completed trial in Switzerland with 12 patients that yielded similar results.

The drawback however is that both trials had very small sample sizes.

Having such a small number of patients makes it harder to find countries – including Australia – to take the trial forward.

There’s also another barrier to bringing it here.

For any more research to be done a qualified psychiatrist must be willing to put their name to it. And according to PRISM no psychiatrist wants the bad reputation of MDMA associated with theirs.

Discovered in 1912 MDMA – or methylene dioxy methyl amphetamine – was first used by therapists in the 1970s to help with couples counselling. But by the 80s it had escaped the clinic and found its way onto the street.

In 1985 MDMA was classified in the strictest Schedule 1 category and criminalised in the US. Australia followed suit, classifying MDMA as a Schedule 9 drug with heroin and LSD. S9 means the drug is thought to have no medical value and a high abuse potential.

MDMA is the key ingredient in the party drug, Ecstasy – an arbitrary concoction of illicit substances and potentially harsh chemicals.

It’s estimated that 8 per cent of the Australian population has at one point tried ecstasy. Between 2000 and 2008, there were more than 100 ecstasy-related deaths.

There’s simply no telling what chemicals have been added to the MDMA if bought on the street.

In the clinic is a very different story according to Mr Williams. Researchers know exactly what’s been added meaning the MDMA is 99 per cent pure.

“We are only interested in working with pure MDMA, the effects of which in participants are well categorised and the safety profile is well established,” he says. “Ecstasy has nothing of the same reassurances as to its safety profile.

The short term effects of clinically administered MDMA include increased heart rate, blood pressure and core temperature. But the long term effects are yet to be fully recognised.

Rachel Hope reclasped this year and was eligible for a third and final dose. She says that was the final nail in the coffin of her PTSD.

“My life is incredible,” she says. “I was grateful to just get a little relief but I’m cured of PTSD.”

“I was cured so that means that I don’t have nightmares, it means I sleep. It means I hold down my food. It means my daughter doesn’t have to be embarrassed in front of her friends that her mother jumps and screams or has panic attacks and has to pull off the road when she’s driving her.”

Rachel is a strong advocate of a similar trial now underway in the US that’s targeting war veterans. She’s also a very keen to see the trial moved to Australia.

“Personally I think it’s immoral and unethical and an insult to the scientific process not to research this process at least fairly on par with every other pharmaceutical drug that’s getting researched like nothing and I can’t understand why so many people are needlessly suffering”.

“I got well, I can’t understand why there’s not a public outcry demanding that this be researched. Doesn’t make any sense to me.”
SBS interviews Rachel Hope about how her life changed after participating in MAPS’ clinical trial of MDMA-assisted psychotherapy for treating PTSD. Martin Williams, founder of Psychedelic Research in Science & Medicine (PRISM), talks about his hopes to bring similar research to Australia, stating, “We are only interested in working with pure MDMA, the effects of which in participants are well categorised and the safety profile is well established.” Rachel Hope describes the impact and effectiveness of this treatment, saying, “My life is incredible,” she says. “I was grateful to just get a little relief but I’m cured of PTSD.”