Daily Low-Dose MDMA in the Treatment of Chronic Pain

I am now 46, and I have lived with chronic pain for the last 10 years of my life, with good moments and bad, or very bad moments. A car accident in the mid 90's left me with a very weak cervical spine, and after the acute phase was resolved, I paid no more attention to the whole thing and went on with my life as a busy, happily overworked and enthusiastic employee in a big corporation. Gradually, over the following years, insidious changes began to make my life more and more difficult. Then in '98, I had to admit I could no longer function properly and had to go on sick leave, pressed to do so by my doctor. During the following two years, I experienced terrifying periods of intense pain alternating with days of stupor and exhaustion which left me feeling like a zombie and made me doubt that I could have any kind of future ahead of me.

I was following a treatment with the local hospital, but the progress was slow, if not elusive. I was prescribed vast amounts of medications to deal with the pain and the other effects of the illness; I was given antidepressants for their analgesic properties, muscle relaxants, pain-killers, vitamins, food supplements of all kinds, and even anti-parkinsonian and anti-epilectic drugs my doctor believed would help. For a year and a half, I dragged myself to the hospital once a week to receive magnesium intraveinously. Luckily, with the help of a Chinese doctor a friend referred me to, I gradually managed to recover, very slowly, in a more efficient way.

Two years after I went on sick leave, I was able to go back to work, to my employer's utter disappointment. The pain wasn't gone, but at least I knew ways of controlling it as much as possible. Unfortunately, as the economic situation was deteriorating, I wasn't surprised when I was laid off; for eighteen months, I had resisted the pressure and the harassement, but finally there I was, without a job, not being sure of my physical capacity to hold another job, with a gap of two years in my resume, and being a woman over 45. Life didn't look good.

I was still using a lot of medication. I had given up most pain-killers and muscle relaxants because they made me feel drowsy and I had already fallen asleep twice while driving Ð the screams of my passengers had woken me up at the last moment. I wasn't happy with the antidepressants (SSRI's) as they had a definite unpleasant effect of my mood and energy level, and their effect on the pain was far from being satisfying, particularly at a time when I needed my mind to be sharp and fast- reacting, and my body to be able to follow. I did some research on chronic pain and the different options of treatment. At some point I tried a medication which was not an antidepressant but also acted on the serotonin levels: sibutramine. I used it for two years, but was concerned with the unknown effects of long-term use; it was better than the antidepressants, but the pain was still present. It was also terribly expensive.

At the end of 2002, the pain had gradually returned and as I was still unemployed, I became very anxious about my future; I wasn't sure of my capacity to work full- time again, and yet I had to continue apply for jobs and send resumes presenting myself as a fully fit and functional candidate. I checked with a neurologist, and a series of tests, x-rays and scans showed that there was permanent damage to the cervical and lumbar segments of my spine. The initial pain syndrome was well controlled, but in the mean time, the disk damage which had gone unnoticed had worsened, for lack of treatment, and by then the main cause of my pain was due to nerve compression and irritation, causing constant muscle and nerve pain in the neck, shoulders and arms, as well as in the legs. Fear came back stronger than ever, as I could see that this would be difficult to repair. Determined to fight to the end, though, I established a routine of postural work, manual therapy and minimal medications to prevent further deterioration of the situation. On good days, I would feel perfectly normal, and on bad days I would spend all my time massaging my neck, stretching the muscles, and applying all the tricks and techniques I had learned in the previous years; but I couldn't do any work.

Some time before the New Year, I made friends with younger people, who told me of their interest for raves and dancing. Their description of the New Year party they were planning to attend sounded nice, and I decided to go along with them. That's when I tried MDMA for the first time. They had told me how it made them feel happy and connected with their fellow party-goers, and I couldn't see any reason to refuse to give it a try. I had a most pleasant night out, and came home tired, but feeling fine. Then it occured to me that I hadn't felt this way in a very long time. Over the following months, I went to several parties with these friends, and we would always pop half a tablet or a tablet of MDMA during the night. Then some things started to strike me as odd.

I noticed that my response to it seemed to be rather different than that of the people around me who used it, and particularly that it did seem to alleviate my pain to a level that the conventional, legal drugs and treatments I had been trying since 1998 never quite reached, I began to investigate the nature of MDMA and, in fact, anything I could find about this molecule. I was surprised to see that it normally kept people awake, if not jittery, while I would naturally fall asleep if I took it in the evening, and I certainly didn't experience any of the muscle tightening and twitching my friends reported. On the contrary, MDMA made my muscles relax completely for several hours. I began to compare the effects to those of the only medication I was still taking in an attempt to act on my serotonin levels, which by that time, I was convinced were one of the main causes of my low pain threshold.

After a couple of months of search and some very helpful answers and suggestions from MAPS members, I decided to take the risk of trying out what seemed to make a lot of sense to me, medically speaking: I would try taking low doses of MDMA on a continuous basis, during several months, as a replacement of the medication I had been using sofar, and see if this would give better results than the medications and treatments I had followed sofar.

By low doses, I meant a maximun of 30 mg, as opposed to the usual 100-150 mg recreational dose, and by continuous I meant every day, and more than once if needed. Typically, I would ingest up to 100 mg per day, sometimes less, and sometimes more.

My main problem was that nobody I had talked to had any idea of the effect of such a experiment, and I hadn't found anyone doing what I was doing, whether because of a pain problem of any other kind of problem. However, not trying was out of the question. I was running out of money and could not afford the necessary weekly visits to the physiotherapist I had needed since 1998, and the high cost of the sibutramine I was still taking also meant I would no longer be able to afford it either.

I have now been taking continuous low doses of MDMA for more than six months, and I must admit that sofar the results are beyond my expectations. I have, for the first time in 6 years or so, the impression that I am really getting my life back. I can work - given certain conditions not related to any of the usual effects of MDMA, but to the current state of my spinal column, such as maintaining a correct body posture, working in a adapted, ergonomic environement, monitoring my cervical spine status, etc. -, I can do most of the things a healthy person does. I work as a freelance professional, which means that I may not have much to do for a while, then I must cram in as many hours of work as possible to finish my projects in time, depending on my customers' requirements. This system has advantages and drawbacks, but MDMA helps me manage those situations in a rather balanced way. One of the striking things I noted was that nobody can tell, upon meeting me or living around me, whether I am 'under the influence' of MDMA or not, including my long-term lover, my neurologist and the psychiatrist who's been seeing me 3 times a week for the last 10 years. But I know and feel the difference. My body is more comfortable, it controls the pain more than it is controlled buy it, and I have indeed developped a higher resistance to pain itself. I still pay attention to it, as I've learned that pain can be an ally instead of an enemy, if one knows how to decipher its messages, and act accordingly. However, when it would normally be in the way between me and the things I must do to maintain myself, socially and professionally, MDMA helps me be in control, instead of letting the pain dictate what my life can be.

Incidentally, given the nature of MDMA and its potential effects on the human body and psyche, I have discovered that it helps me not only with the chronic pain, but also in several other areas of my life: psychologically and spiritually, particularly, and that I am gradually changing into a 'better' person (this is, of course, my own perception, but I don't think I'm much mistaken). I am, of course, trying to include as much personal experimentation and research as possible into my global MDMA experiment, as I feel I am given an rare opportunity to give my future a direction which nobody would have deemed possible a couple of years ago.

Living with pain changes an individual, in the sense that it makes one aware of the unescapable connection of the body and the mind, and of the fact that will alone is not enough to be or remain one's own master: one cannot ignore the pain, and if nothing stops it, it can change the personality more than most things I can think of. Those who have used torture, or have been subjected to it know this very well. MDMA is a tool for me to be better armed against pain, and while it keeps it at an acceptable level, it also offers me the time and space I need to continue to develop my own intrinsic abilities to become all I can be, a conscious being, aware of reality and able to fulfill my role as part of the human species, and not as a cast-off.

MDMA is not a miracle drug, but it's getting closer to this notion as any of the substances I have tried before, legal or not. I hope this strange molecule will be a good companion to me and that one day, I can rely solely on my self to keep walking - and running and jumping, too! - along my path to completion and self-realization.

Antwerp, July 2004