The Iraq and Afghanistan wars brought the concept of PTSD to the forefront of America’s cultural consciousness. Seeing so many soldiers come back seemingly unable to process or cope with what they saw or did during their tours of duty shed light on our severe inability to help heal those suffering.
We also realized that it could affect far more than just combat veterans, and in the search to help heal those who have PTSD, many believe MDMA holds the key.
What Is PTSD?
While all of the hype around MDMA-assisted therapy for PTSD often centers around MDMA, it is critical to remember what this treatment aims to resolve.
PTSD (Post-Traumatic Stress Disorder) happens to those who have witnessed a traumatic event like a natural disaster, serious accident, combat, or those who have been personally assaulted.
They often relieve their experiences through nightmares or flashbacks and grow sad, angry, and detached from others. It can be difficult for patients to live everyday lives as seemingly benign events can “trigger” memories of their traumatic experience, leading them to avoid everyday activities and places altogether.
We’re also learning PTSD doesn’t just affect someone with firsthand experience of an event. Those with secondary experience in an event such as police officers handling child abuse cases, emergency medical staff in a refugee camp, or even those working at inpatient drug rehab facilities can all experience PTSD.
It is estimated that 1 in 11 people will meet the criteria for a PTSD diagnosis in their lifetimes. That is a lot of people who need to heal.
Current PTSD Treatment Options
Utilizing drugs like SSRIs (selective serotonin reuptake inhibitor) and SNRIs (selective norepinephrine reuptake inhibitor)
Therapy such as Cognitive Processing Therapy, which focuses on patients’ reactions to traumatic events and helps them work through their “stuck points.”
Short for eye movement desensitization and reprocessing, EMDR utilizes eye movement to help patients reprocess their trauma and negative self-perceptions.
However, we all know that antidepressants can be risky, and many patients are treatment-resistant to things like therapy and EMDR. This is where MDMA comes in.
MDMA Treatment Therapy For PTSD
What Is MDMA?
MDMA (3,4-Methylenedioxymethamphetamine) is an amphetamine.
In 1985 MDMA was classified as a Schedule 1 drug in the US, meaning it had no accepted medical value and a high potential for abuse.
MDMA, also called Ecstasy, is known for inducing euphoria, closeness, and empathy amongst users and is commonly used at dance raves and music festivals.
Unwanted Impurities That Cause Harm
To assess the therapeutic value of MDMA accurately, you must first test the drug for its pureness since it often contains amphetamines, PCP, cleaning supplies, and other harmful compounds.
Very rarely is Ecstasy pure MDMA, and thus Ecstasy containing unwanted impurities has adverse side effects.
Why Is Traditional Therapy Failing PTSD Patients?
Patients are often unable to process painful emotions because, understandably so, they cannot view the events from an objective perspective.
Their memory of the event is so inexorably tied with the feelings they felt during their experience that it is nearly impossible for patients to bypass these painful emotions to get to the actual event.
Many experts ascribe to the Emotional Processing Theory (EPT), which states that emotional processing begins only when patients can separate their emotions from the traumatic experience.
MDMA enables this separation more effectively than any other compound or therapy discovered thus far, which is why so many therapists believe it has the power to heal.
Why Does MDMA Improve Therapy?
MDMA increases the release of serotonin, prolactin, cortisol, and oxytocin in the brain.
An increase in oxytocin decreases our brain’s amygdala (the brain’s fear center) activation enabling patients to view their experience away from a place of fear.
Increased oxytocin also increases social bonding and improves patients’ ability to trust others, both of which PTSD patients struggle with.
MDMA Therapy For PTSD
MDMA is a tool used in therapy, but it is not the focal point. It is also important to remember that relatively few studies have been conducted using MDMA to treat PTSD, so there is no valid “standard” procedure yet.
With that said, the typical MDMA treatment consists of 15 total therapy sessions, only three of which involve MDMA.
The first three 90 minute therapy sessions do not include any MDMA and act to help therapists bond with patients.
Following the first three sessions, patients undergo their first MDMA session.
The MDMA Session
The actual MDMA session involves one male and one female therapist sitting with the patient, which has been shown to facilitate parental transference.
The therapists then engage in non-directive conversation with the patient, meaning they do not drive them toward any predetermined conclusions. Instead, therapists engage in the therapeutic alliance, anxiety management training, cognitive restructuring, and various other tactics to help patients effectively decouple their emotions from the traumatic incident.
What Is The Success Rate Of MDMA Therapy For PTSD?
While there are still relatively few studies done on MDMA-assisted PTSD treatment, they all show tremendous promise.
Patients had an improved mood, increased feelings of well-being, happiness, physical and mental relaxation, increased emotional sensitivity, and sociability.
Patients also feel more open and allow themselves to embrace intimacy in their relationships, something those struggling with PTSD have difficulty doing.
Combat veterans, in particular, cite MDMA as giving them an “ability to forgive themselves” for the atrocities they saw and were potentially part of throughout their time in combat.
CAPS (Clinical Administered PTSD Scale) is a system clinical physicians use to categorize a patient’s PTSD severity.
In one study, MDMA-assisted therapy reduced patients’ CAPS scores by 83%, compared to 25% in the control group that did not receive MDMA.
Several months after the study concluded, 14 of 16 patients stayed in remission (did not exhibit any PTSD symptoms) and reported long-lasting positive impacts from their participation in the study.
Of the three official Phase II trials of MDMA-assisted therapy to treat PTSD, 66% went into remission and saw their overall CAPS scores fall by 47%.
These numbers point to MDMA-assisted therapy as a far superior treatment option than traditional treatment options.
Is MDMA-Assisted Therapy For PTSD Safe?
As we mentioned before, it is imperative not to conflate MDMA with the street drug Ecstasy.
Administered in clinical settings, pure pharmaceutical MDMA is relatively safe.
No patients in the Phase II trials reported any long-term negative side-effects from their participation in the studies.
When Will MDMA-Assisted Therapy Be Legal?
The driving organization behind the legalization of MDMA for therapeutic use has been the Multidisciplinary Association For Psychedelic Studies (MAPS).
Thanks to MAPS, the FDA officially approved the first Phase III trial involving MDMA-assisted therapy.
MDMA has also recently achieved “breakthrough” status from the FDA, fast-tracking it to legalization in clinical settings.
If there are no further significant obstacles, MAPS foresees 2021 as the year MDMA-assisted therapy for PTSD is finally a mainstream clinical practice.
MDMA-assisted PTSD treatment has the potential to help millions cope with and heal from their traumatic experiences.
We look forward to the day when patients can safely, effectively, and legally pursue this avenue of treatment.