By Tyler Hooper
Last month, we learned of a clinical trial researching the benefits of using the drug methylenedioxymethamphetamine (MDMA) in conjunction with psychotherapy to treat post-traumatic stress disorder (PTSD). This article will expand on MDMA, the details of the trial, and how it was conducted.
The MDMA-assisted psychotherapy study that finished its second phase in Vancouver last November is part of a greater global study by a non-profit research organization, the Multidisciplinary Association for Psychedelic Studies (MAPS). The global study is testing the potential use of MDMA to treat those who suffer from PTSD, including military veterans. Early studies and trials are yielding positive results.
The study was conducted with patients who were considered “difficult cases” and who “had to have chronic PTSD.” In the Vancouver trial, there were a total of six patients (including a few Canadian military veterans), all of which experienced three 90-minute preparatory sessions without any drugs being administered. These prep sessions were then followed by an 8-hour session where the patients were administered MDMA in a relaxed setting where they could talk and be monitored by two therapists. The patients then stayed overnight at the clinic, followed by another 90-minute session — without MDMA — the following morning.
“It’s often that they [the patients] are able to have more access to memories and emotions that surrounded their traumatic experience, and it [MDMA] can actually reduce a lot of the fear and pain and allow them to talk with the therapist about what that [traumatic] experience was,” said Dr. Allison Feduccia, MAPS’s clinical trial leader.
In its most simplistic form, when someone experiences trauma, the parts of the brain that deal with “fear response” become overactive. It’s been suggested that MDMA helps reduce this hyperactivity and can even help with the memory process. “The hypothesis is by giving them MDMA, they may be able to reprocess some of the memories that are triggering for them in their everyday life,” said Dr. Feduccia.
MDMA helps release neurotransmitters such as serotonin and dopamine, which are important for memory learning and emotional responses. “The MDMA seems to be like a tool, or amplifier of the therapy,” said Dr. Feduccia, who added that MDMA administered by itself is not going to have the same effect on the patients suffering from trauma as it does when used in conjunction with psychotherapy.
MDMA has both stimulant and psychoactive effects. Those who take the drug often feel a sense of euphoria, reduced anxiety, increased emotional response and greater lucidity.
According to the National Institute on Drug Abuse, MDMA was developed in Germany in the early 1900s. During the 1950s, the United States Army commissioned studies on the drug, which involved testing on animals. During this time, various agencies experimented with the effects of psychoactive drugs. Some infamous examples include psychiatrist and U.S. Army Colonel James Ketchum. At the height of the Cold War, during the 1960s and 1970s, Ketchum tested a number of psychoactive drugs on some 5,000 U.S. military members. It’s also rumoured that the Central Intelligence Agency (CIA) may have experimented with the effect of psychoactive drugs during interrogations. During the 1970s, the drug was experimented upon and used by American psychiatrists as a “psychotherapeutic tool.”
Meanwhile, MDMA gained a reputation as a “party” drug under the street name of ecstasy, often becoming associated with dance parties and raves. In 1985 the Drug Enforcement Agency (DEA) declared MDMA a Schedule 1 drug, which put clinical research of the drug on hiatus.
More recently, drugs like MDMA, LSD, ketamine, and marijuana are being studied, or used to assist, in the treatment of trauma, stress, anxiety and other mental disorders. A prime example would be the rising number of Canadian military veterans using medical marijuana to help treat PTSD.
In May 2016, the Auditor General of Canada’s report on Veterans Affairs Canada’s drug benefits found that almost 1,300 Canadian veterans are using medical marijuana. According to CBC, VAC paid more than $12-million dollars for medical marijuana prescriptions in 2015. But in November 2016, Veterans Affairs Minister Kent Hehr said he’d change the reimbursement limit of medical marijuana from 10 grams a day to three. Hehr cited costs as the reason for the cutback. It was estimated that VAC received more than $75-million in medical pot claims by the end of 2016. Currently, VAC and the Canadian government are not considering MDMA-assisted psychotherapy as a treatment for veterans.
“Veterans Affairs Canada and the Canadian Armed Forces work together to review new, approved treatment options once clinical research trials have been completed. It is also important to note that Health Canada is the national authority that regulates, evaluates and monitors the safety, efficacy, and quality of therapeutic products available to Canadians. The treatment in question has not been approved and is currently not being considered by the Department,” stated VAC in an e-mailed statement to Esprit de Corps.
“Veterans Affairs Canada has a well-established national network of around 4,000 mental health professionals who deliver mental health services to veterans and serving and released RCMP officers with post-traumatic stress disorder and other operational stress injuries,” concluded the statement from VAC.
Despite VAC’s denial of MDMA-assisted psychotherapy, other clinical sessions have shown promising results. In fact, some studies are showing even greater success than currently approved drugs used in the treatment of PTSD. “We’re seeing two-to-three times greater effects with this MDMA therapy compared to the two drugs that are approved for PTSD,” said Dr. Feduccia.
One 2012 study in the Journal of Psychopharmacology saw patient symptoms reduce by 56 per cent after being administered three doses of MDMA while participating in psychotherapy. In the end, almost two thirds of the patients no longer met the criteria for PTSD, and subsequent examinations saw further improvement more than a year after the study.
“It kind of shows that it (MDMA) is not just mitigating the symptoms, but there’s a long-term healing happening and that continues to unfold as the year goes on,” said Dr. Feduccia.
The drug won’t ever be available for patients to take home and use on their own. The goal is to have it approved for clinical use, hopefully by 2021, so that other therapists — after being properly trained — can administer MDMA-assisted psychotherapy for those suffering from trauma.
Phase 3 of the Vancouver trial is supposed to get underway sometime in June. For the drug to be accepted for clinical use, this stage of the research is critical as the results will need to be successfully reproduced on a broader scale, on more participants.