One of the more controversial drug-based treatments for mental illness is called MDMA assisted therapy. MDMA is most commonly known as the “party drug” ecstasy. It is used illegally by people in the US and around the world for recreation. But research has shown that it can be useful for treating post-traumatic stress disorder (PTSD).
A direct consequence of the modern view of mental illnesses as actual medical issues, is that drugs have been developed to treat them. We now know that mental illnesses can be caused by chemical imbalances and other physical processes. Over the past century, antidepressants along with tranquilizers, anti-psychotics, and other forms of medication have helped millions of people around the world recover from various mental illnesses. However, the medicines we have available at present are not perfect, and not everyone responds to them in the same way. Some people find that they help with certain symptoms but not others. Some only experience temporary relief and for others they don’t work at all. There are even cases in which they can exacerbate the problem.
Which is why researchers are still at work developing and testing new ways to treat mental illness. While some are fashioned in the same mold as existing medications, others use very different processes.
Because MDMA is, at present, illegal in the United States, finding information on this therapy can be difficult. To give you a better understanding of the subject, what follows is a guide to MDMA assisted therapy.
Table of Contents
MDMA Assisted Therapy: What is it?
There is a lot of optimism surrounding MDMA as a mental health treatment, but there is also much skepticism. Let’s discuss exactly what MDMA assisted therapy is.
What is MDMA?
MDMA is a synthetic, psychoactive (mind-altering) drug that has hallucinogenic and amphetamine-like properties. It is, in chemical terms, structurally similar to methamphetamine; but it impacts the body in a very different way. Users of MDMA experience intense joy (or ecstasy), a sense of love and affection, as well as high levels of energy.
But MDMA is not just a party drug. It has been used (mostly in a clandestine setting) by therapists to treat individuals suffering from mental illness, PTSD patients in particular. Proponents of MDMA assisted therapy claim that they have used it to help thousands of people. Also, the research that has been done up to now has supported the anecdotal evidence.
Pros and Cons
MDMA assisted therapy provides hope to many people suffering from treatment-resistant PTSD. But, like any other medical treatment, it has its pros and cons.
- MDMA is an alternative to existing treatments that don’t always work. Particularly in cases of PTSD, the chemical options are few.
- The substance “catalyzes” the therapeutic process, rather than simply decreasing the symptoms of PTSD.
- MDMA is not prescribed for chronic use. Rather, the individual has sessions spread out across months. In most cases, the number of sessions won’t exceed three or four.
- When it is used as prescribed by a therapist, addiction is highly unlikely.
- If it is used as prescribed by a therapist, it has no lasting side-effects.
- MDMA is illegal in the United States. While federal agents do not target recipients of MDMA assisted therapy, nonetheless, it has to be administered in secret.
- It is therefore very difficult to find a practitioner of MDMA assisted therapy. In general, patients find practitioners by word-of-mouth or referrals.
- These practitioners may be licensed mental health professionals, but will have no certification in MDMA assisted therapy.
- Since MDMA burns through the serotonin in your brain, many users report feeling depressed in the days that follow. Practitioners can help limit this by prescribing treatments that help replenish the serotonin. However, people who take serotonin-based antidepressants may reach dangerous levels of depression due to the sudden imbalance
Post-Traumatic Stress Disorder Explained
MDMA assisted therapy is primarily used to treat post-traumatic stress disorder. PTSD is a mental illness that affects people who have gone through a major trauma or who have a loved one who has experienced something traumatic. Their physical and emotional response to that trauma continues for months or years after the traumatic event has passed.
People who are diagnosed with PTSD generally have 3 primary types of symptoms:
- Heightened reactivity to stimuli
Intrusive re-experiencing, including:
- Vivid memories
- Emotional numbing
Traditional Treatments For PTSD
Traditional treatment for PTSD has implemented both medicinal and therapeutic approaches. The FDA has approved serotonin and norepinephrine-based medications as treatment for PTSD. These medications increase the chemicals in our brains that allow us to feel positive.
Therapeutic treatments include cognitive-behavioral therapy (CBT) and exposure therapy. CBT trains the individual to test intrusive thoughts against reality, thereby decreasing their power. Exposure therapy involves exposing the individual to the stimuli that provoke responses. Or the places and sounds that are associated with any trauma they may have experienced. This allows the individual to begin to loosen these associations.
Traditional treatments do not work for everyone. Many people are treatment-resistant when it comes to both medicinal and therapeutic approaches. For this reason, alternative approaches are being explored, including MDMA assisted therapy. These treatments are used to catalyze the therapeutic process rather than treat the symptoms of the illness. Often, this makes it easier for the individual to explore their trauma.
Recent statistics show that over 13 million Americans suffer from PTSD at any specific time. If it is left untreated (or treated inadequately) PTSD can lead to a number of other problems, including alcohol and drug abuse.
Sadly, many people who receive treatment do not see positive results and they usually drop out of treatment in the end. There is a drop-out rate of 35% to 55% as far as traditional PTSD treatment is concerned.
The Role of MDMA Assisted Therapy in the Treatment of PTSD
MDMA assisted therapy has been used as an alternative to traditional PTSD treatments. Due to its legal status, many people are skeptical about its efficacy and worry about its safety.
To help demystify the process, here is some information on how MDMA assisted therapy is used in the treatment of PTSD.
How Does it Work?
MDMA assisted therapy is not meant to be a holistic cure for PTSD. Rather, it is intended for use in conjunction with psychotherapy. The aim of using MDMA is to catalyze the processing of one specific trauma or various traumas. It facilitates trauma processing, which leads to a decrease in hyper-arousal symptoms. It may also lesson the individual’s sensitivity to the negative, or fear-inducing, aspects of people and situations.
Is it Effective?
Practitioners of MDMA assisted therapy claim that they have seen thousands of people use MDMA to help them recover from PTSD. Those who are licensed mental health professionals, however, put their license and reputation at risk by administering this treatment due to their conviction that it works.
In addition to this anecdotal evidence, there is research that supports the usefulness of MDMA in treating PTSD.
When administered by a professional in a therapeutic setting, MDMA may be safe. The practitioner should be sensitive to all the potential reactions that the individual may have, as well as any dangers that the environment might present. People using antidepressants have a higher risk of experiencing adverse effects in the days after their treatment. Practitioners should be aware of this and they should take care to monitor the person’s well-being.
The FDA has deemed MDMA safe enough to approve clinical trials. Adverse side effects such as jaw-clenching, nausea, and dizziness are temporary and manageable. This is also true for the potential fatigue and depressed feelings that may follow its administration.
MDMA Clinical Research
Government-sanctioned research on the efficacy of MDMA in the treatment of PTSD has been ongoing since 2008. Thus far, the finalized studies show a remission rate of around 66%, with evidence that the changes are maintained over time.
There are a number of studies that are currently ongoing, and the future of MDMA assisted therapy looks promising. However, it will likely take a number of years still before it reaches legal status as an FDA-approved treatment.
Which Other Concerns is MDMA Assisted Therapy Good For?
MDMA assisted therapy has also been used for treating social anxiety in adults with autism. Early studies have shown promising results, but more research is still needed.
What Happens in an MDMA Assisted Therapy Session?
A typical MDMA assisted therapy session will occur in the context of a broader treatment program. The therapist will work with the individual beforehand to establish whether MDMA is right for them.
An MDMA assisted therapy session will take place in a quiet and safe environment. The person will be given MDMA tablets to take. They will then put on an eye mask after which they are encouraged to surrender to the experience. The person will feel intense somatic and emotional reactions. These feelings will not necessarily be positive or negative. This is the stage at which the trauma is processed. It occurs internally, with the therapist there to guide the individual if they need to talk.
Later on, the therapist will help the person process their experiences on MDMA in between sessions.
MDMA Assisted Therapy Critique
There are critics who consider MDMA assisted therapy unscientific. They argue that not enough studies have been done to draw conclusions on its efficacy and that practitioners are relying mostly on anecdotal evidence. Whereas other treatments that have not been scientifically proven to work may be innocuous, the legal issues with MDMA lead some of these critics to disregard it as a potential treatment (at least for now).
Clinical vs Recreational Use
Some people may consider MDMA assisted therapy to be dangerous. They worry about the addictive potential of MDMA. Their perceptions of MDMA are likely shaped by its use as a party drug. Indeed, when used in excess; it may cause serious health issues, including brain damage. However, the levels used in therapy are nowhere near significant or regular enough to cause such problems.
The fact remains that MDMA assisted therapy is faced with having to contend with the substance’s reputation. There are undoubtedly people who will never be able to see it as anything other than a dangerous drug taken by impressionable individuals. On the other hand, it is interesting to know that even FDA-approved medications are viewed with suspicion by certain groups of people.
Multidisciplinary Association for Psychedelic Studies
MDMA assisted therapy is one of a number of alternative therapies associated with mind-altering or psychedelic substances. The Multidisciplinary Association for Psychedelic Studies (also known as MAPS), a non-profit research and educational organization, mainly aims to engage regulators and researchers regarding the potential use of these drugs in the treatment of mental illnesses. To date, studies that test the efficacy of MDMA, LSD, ibogaine, ayahuasca and marijuana for treating a number of illnesses are ongoing.
The Future of MDMA Assisted Therapy
MDMA assisted therapy is not yet legal, but it has strong backing from many practitioners who attest to its efficacy in the treatment of PTSD. Clinical research is underway and has, up to now, indicated that their claims are in accordance with the evidence.
PTSD is one of the most common mental illnesses in the United States. Unfortunately, many individuals suffering from PTSD are treatment-resistant. MDMA assisted therapy may offer them an alternative way to recover. For now, however, they will need to actively seek a practitioner out and be willing to take the legal risk.