RYOT News and Action: Utilizing MDMA to Treat Post-Traumatic Stress Disorder

Summary: RYOT News and Action reports on MAPS’ efforts to develop MDMA-assisted psychotherapy into an FDA-approved prescription treatment for posttraumatic stress disorder (PTSD), detailing why alternative treatments are needed to address the PTSD epidemic among veterans. The article explores how traditional PTSD treatments can be ineffective for many people, pointing toward published research results indicating that MDMA-assisted psychotherapy can help people overcome chronic, treatment resistant PTSD."It’s almost impossible to overstate how much of a game-changer MDMA could be in the treatment of PTSD, both in reducing costs and saving lives, and while obvious legal issues still remain in regards to the drugs classification and distribution, we already know what will happen if we do nothing," reports Zach Ash of RYOT.

Originally appearing here.

“It is as though some old part of yourself wakes up in you, terrified, useless in the life you have, its skills and habits destructive but intact, and what is left of the present you, the person you have become, wilts and shrivels in sadness or despair: the person you have become is only a thin shell over this other, more electric and endangered self. The strongest, the least digested parts of your experience can rise up and put you back where you were when they occurred; all the rest of you stands back and weeps.” – The Throat by Peter Straub

Independence Day has been over for weeks in the United States. A holiday marked by barbeques, family gatherings, and of course, copious amounts of rockets hurling towards the sky, creating deafening explosions for the enjoyment of children and adults alike. Though we loathe to admit it, we are a country that loves war. We glorify it in our movies, sing War’s praises in our national anthem, and actively recruit our most vulnerable citizens to serve overseas to “fight for freedom.” But with this too comes a sort of mass-collective amnesia. An amnesia regarding the wars that we’ve fought, the wars that we’re currently fighting, and most especially, the people who have fought those wars for us. Indeed, it’s far easier, on days like The Fourth of July, to wave a flag and watch the rocket’s red glare bursting in the air, than it is to look at the 23-year-old Afghanistan War Veteran sitting on a blanket not 20 feet away with a thousand yard stare and a mind that’s halfway around the world. We call this “honoring our troops” because we don’t know what else to do, and quite honestly, there was little that we could do. Until now.

The way in which our government has treated our returning veterans is nothing short of a national tragedy. Take away any sort of debate about the dubious claims that lead us into our most recent conflict and you still have nearly 20% of the 2.7 million veterans who served in Iraq and Afghanistan meeting the criteria for Post-Traumatic Stress Disorder (PTSD). That figure comes from the Veterans Administration, which has been making headlines intermittently for the past decade for its deplorable, almost criminal incompetence in how it treats veterans. In a 2008 interview with Salon, Army Psychiatrist Douglas McNinch stated that “Not only myself, but all the clinicians up here are being pressured to not diagnose PTSD and diagnose anxiety disorder NOS [instead],” and also reporting that his superiors told him, “we are just counting people. We don’t plan on treating them.” In light these institutional problems, it’s reasonable to assume that the over half a million figure by the Veterans Administration is likely a gross understatement.

So what is to be done? Post Traumatic Stress Disorder is a condition that is notoriously difficult to treat. Ostensibly an anxiety disorder, PTSD is characterized by a state of hyper-arousal brought about by a traumatic event, the classic flight or fight response amplified to the nth degree. If on a certain day, while serving your country in Iraq, you hear a loud explosion that kills your comrade and maims another, your primordial brain will hold onto that trauma indefinitely, and any loud noise; a car door slamming, thunder, or even a firework, will convince your body on the most unconscious level that you are in danger, and death is only moments away. Any treatment of PTSD is contingent on rewiring the brain to distinguish between peace and wartime, to create a narrative for the traumatic event, so that it can be put into context, and eventually moved on from. If one cannot do this, than PTSD will likely last in some form or another for the rest of the patient’s life. And yet perhaps the most important aspect of creating this narrative in order to process a traumatic event is the development of a strong therapeutic alliance between the patient and therapist. This is the crux of the PTSD crisis. Even when a veteran is able to receive treatment, many find it hard to connect with their overloaded and overworked therapists and psychologists. Most of these professionals are civilians who have never seen combat experience, and a feeling of isolation, that others do not know what you are going through, is one of the most prominent symptoms of PTSD, as well as the biggest hindrance to receiving effective treatment. After all, a strong therapeutic relationship isn’t something that you can just bottle up and sell…

The substance 3,4-methylenedioxy-methamphetamine or MDMA is currently classified as a Schedule I drug by the U.S. Drug Enforcement Agency, which means that the government has declared it has no medicinal benefit. In the year 2000, 15 years after it was scheduled, research scientists have been allowed to conduct small pilot studies using MDMA to treat PTSD, and the results of the next fifteen years have been unequivocally positive. A long term study by the Journal of Psychopharmacology published in 2012 reveal treatment breakthroughs that seem almost miraculous. 89% of participants in the study reported an increase in general well-being and increased awareness and understanding, 68% reporting fewer nightmares, flashbacks, and intrusive memories, and over a majority of participants reported improved sleep, improved relationships, increased spirituality, and more involvement in the community/world around them. One participant even said that “The therapy made it possible for me to live.”

Upon review, MDMA seems almost tailor-made to treat PTSD. The neurochemical cocktail that occurs when one takes the substance dovetails perfectly with the therapeutic process. Oxytocin increases in the brain, strengthening the therapeutic alliance, norepinephrine and cortisol help to relearn emotional responses, and activity in the amygdala, where the flight or fight response is located, is severely diminished. There have to date been no issues with neuro-cognitive decline as a result of MDMA-assisted therapy, no potential for addiction, and the time-frame for treatment is reduced to a fraction of traditional treatments. Trauma-Focused Cognitive Behavioral Therapy, the gold-standard for treating PTSD (in terms of efficacy, duration and cost effectiveness) run an average of approximately sixteen weeks. MDMA-Assisted Therapy is typically concluded within 2-3 sessions, and in some cases, only one session is needed in order to cure PTSD, with benefits of the treatment reportedly lasting an average of nearly 4 years.

It’s almost impossible to overstate how much of a game-changer MDMA could be in the treatment of PTSD, both in reducing costs and saving lives, and while obvious legal issues still remain in regards to the drugs classification and distribution, we already know what will happen if we do nothing. The VA Scandals will inevitably continue as an antiquated bureaucracy fails to grapple with a pandemic crisis, rela
tionships will crumble, families will drift apart, service members will take their own lives, and the public will occasionally remember, then certainly forget about those people who we left trapped in the past.