Study's conclusion -- new drug could "offer sufferers a vital window with reduced fear responses where psychotherapy can take effect."
By Craig K Comstock, AlterNet
Posted on July 23, 2010, Printed on July 26, 2010
After MDMA-assisted psychotherapy, over 80% of sufferers from post traumatic stress disorder no longer met the diagnostic criteria for PTSD, as compared to only 25% in the control group. This study, just released, was conducted by Michael Mithoefer, M.D. (and his colleagues) and is published in the peer-reviewed Journal of Psychopharmacology.
According to the media release, MDMA could "offer sufferers a vital window with reduced fear responses where psychotherapy can take effect." MDMA is also called Ecstasy.
On the killing fields of 1914-19, the malady being studied was called "shell shock"; in World War Two, "battle fatigue" or "combat exhaustion"; and now, in the era of military operations in Iraq and Afghanistan, PTSD. It can be caused, for example, by experiencing random explosions, being wounded, or seeing buddies torn open or killed.
The syndrome is hard to treat and can last for years after a soldier climbs out of a trench or an armored personnel carrier.The challenge in therapy is to encourage repeated recall of the trauma ("familiarization") without inducing psychic numbing or just hysteria. Of course it helps to be in a psychotherapist's quiet office, away from any battlefield or dangerous city. But PTSD tends to stay with a person. He may bring it to bed (as partners discover when a returning vet wakes up screaming), to the highway, to workplaces, perhaps to any argument or frustration or hearing of loud sounds. What to do?
The problem is fear--pervasive, invasive, recurrent fear. What MDMA does, according to the research, is to provide at least a brief experience of what life feels like without the aftermath of trauma. In this state, learning can occur. The political system that conducts wars in Vietnam, Iraq, and Afghanistan used to "just say no" to all psychoactive drugs, but now it needs something to help veterans of those wars who suffer PTSD. In this situation, MDMA might be officially repurposed. What was for a while mainly a party drug at raves is now moving back toward (if not yet into) the therapy office.
I once heard a wise scientist say, “in God we trust; all others please bring data.” The 14-page Journal of Psychopharmacology article is about data, not gut feelings.
According to this study of MDMA-assisted psychotherapy on chronic PTSD sufferers, the substance helped by creating a “window” in which participants could, with a much reduced level of fear, revisit the trauma. The learning that could thus occur is about the trauma itself, which fear had prevented the sufferer from mastering. The substance is administered once, is not addictive, and thus causes no dependence.
Facts about MDMA have been obscured, first by panic about the rave culture, then by a well-publicized university study that actually administered a different substance, and then by propaganda associated with the “war on drugs.”
If MDMA is shown to cause more harm than good as a medicine, it would not be used. But that is the opposite of what the study showed. To quote the research paper, “there were no drug-related serious adverse effects, adverse neurocognitive effects, or clinically significant blood pressure increases.” What MDMA appears to offer is a way not merely of producing temporary good feelings or of masking symptoms of PTSD, as in the use of selective serotonin re-uptake inhibitors, but of facilitating effective psychotherapy.
In the town where I live, we had an “Welcome Home” event at which about 700 local citizens heard vets read poetry they’d just written in a private workshop, poetry about their real experience as soldiers. Some of these vets had PTSD. Before speaking one vet dumped a heap of prescription bottles out on the floor. “Anybody want to party?” he asked ironically, adding he was taking the pills to keep other people safe.
If MDMA can help people with chronic PTSD, why not make it available for use by psychotherapists?
Meanwhile, thanks to Rick Doblin and the Multidisciplinary Association for Psychedelic Studies (MAPS) for making this scientific study possible, with its detailed charts of (transitory) side effects and careful consideration of the need for further research. Let data rule.
PTSD is suffered not only by some warriors, but also by rape and other crime victims, by people who have been in accidents, by minors who suffer abuse.
Before being "scheduled" (criminalized) 25 years ago, MDMA was used by a circle of therapists for a variety of purposes, including internal exploration. For example, George Greer, M.D. and Requa Tolbert wrote a paper in 1986 on how they'd given MDMA in a clinical setting. The Mithoefer research just reported is methodologically superior to theirs, and focused tightly on PTSD, but it is hard to find any substantial contradiction of what they wrote in 1985 or to conclude that, because of political hysteria, we have not just wasted a quarter century.
Research is quietly being conducted not only on MDMA (which has been labeled an "empathogen" or "entactogen") but also on classic psychedelics such as psilocybin. Much of this work is sponsored by a group of scientists banded together in the Heffter Institute (a name borrowed from a German pharmacologist born in the mid 19th century). Many of the published papers are technical, with such titles as "psylocybin links binocular rivalry switch rate to attention and subjective arousal levels in humans."
But Heffter also sponsors clinical and basic research friendlier to laypeople. For example, they are supporting studies of the use of psilocybin and other psychoactive molecules, conducted at Johns Hopkins, NYU, Perdue, UCLA, and the University of Zurich. Some of this research deals with cancer patients and people with obsessive-compulsive disorder; some, with the way various molecules work in the nervous system. Heffter has gathered most of the big names in the field, plus some generous supporters.
Along with the Council on Spiritual Practices (in San Francisco), the Multidiscplinary Association for Psychedelic Studies (with an office in Santa Cruz), and the Beckley Foundation (located in England), the Heffter Institute (with an office in Santa Fe) co-sponsored a conference in April in the Bay Area and supports much of the "psychedelic science" being conducted abroad and, as the Federal government gradually allows it, in the U.S.
If pharmaceutical firms could profit from these substances and if the latter hadn't been associated with hedonism in a time characterized by protest against a war and against racism, perhaps this process of official rediscovery would have moved less tardily. Meawnhile, sufferers from PTSD and other maladies can give thanks to the scientists and other pioneers who have kept working to explore the benefits and safe uses of mind-manifesting molecules.
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