MDMA's Therapeutic Benefits

November 25, 2012 2:18 AM

Ecstasy found to help veterans with PTSD "In a paper posted online Tuesday by the Journal of Psychopharmacology, Michael and Ann Mithoefer, the husband-and-wife team offering the treatment — which combines psychotherapy with a dose of MDMA — write that they found 15 of 21 people who recovered from severe post-traumatic stress in the therapy in the early 2000s reported minor to virtually no symptoms today. Many said they have received other kinds of therapy since then, but not with MDMA... And news that the Mithoefers are beginning to test the drug in veterans is out, in the military press and on veterans’ blogs. 'We’ve had more than 250 vets call us,' Dr. Mithoefer said. 'There’s a long waiting list, we wish we could enroll them all.'"
posted by bookman117 (36 comments total)

This is sad because it has been known for a long time now. The 'therapy + MDMA' having awesome results compared to just therapy alone when treating traumatic conditions was described in the already dusty pharmacological journals I read in the university library stacks back in 1987. This is not new news. This is maybe news rediscovered after being buried in fear inducing Regan era "Just say No" politics.
posted by zengargoyle at 2:42 AM on November 25, 2012 [32 favorites]

It's an interesting subject, and MAPS do some good stuff. I hope the discussion here goes a little smoother than the post I put up a couple years ago.
posted by mannequito at 2:42 AM on November 25, 2012 [1 favorite]

It's so helpful, why don't they just give MDMA to soldiers on the battlefield?

Oh, yeah, I forgot how it just makes you want to lie around and feel the simple touch of another human being, which is probably counter-productive when it comes to war and killing and so forth.
posted by twoleftfeet at 3:21 AM on November 25, 2012 [9 favorites]

Previously: 1, 2, 3, 4.
posted by koeselitz at 3:22 AM on November 25, 2012

twoleftfeet: “It's so helpful, why don't they just give MDMA to soldiers on the battlefield?”

Relatedly, reaching all the way back to 2001, there's this post.
posted by koeselitz at 3:23 AM on November 25, 2012

Ecstasy On The Battlefield
posted by mannequito at 3:26 AM on November 25, 2012

reaching all the way back to 2001, there's this post.

I only reached to 2002, but LSD tested on British troops is still relevant. If we can't douse our soldiers with mind-altering chemicals that could make them rethink the whole simian purpose of war, who can we douse?
posted by twoleftfeet at 3:29 AM on November 25, 2012 [3 favorites]

The Secret Chief is a small book about an early pioneer of MDMA psychotherapy and his clinical methodology. A required read for anyone who wants a baseline understanding of this subject.
posted by clarknova at 3:35 AM on November 25, 2012 [4 favorites]

when it comes to war and killing and so forth

Actually it was the flouro and the glowsticks that really stymied military adoption.
posted by pompomtom at 3:37 AM on November 25, 2012 [9 favorites]

The Secret Chiefs should probably also be listened to when doing MDMA in battle.
posted by mannequito at 3:41 AM on November 25, 2012 [2 favorites]

MDMA posts come up from time to time, and without fail somebody always reminds us that Alexander Shulgin, who more or less made that happen, a man who made so many strange things happen, is now dying of Alzheimers at the age of 87, adrift in a forgotten world, but still remembered.

Thanks, Sasha. We will all see you soon.
posted by twoleftfeet at 3:47 AM on November 25, 2012 [11 favorites]

He said he no longer struggled with post-traumatic anxiety or guilt

I think this is a really interesting avenue to explore in terms of recovery from trauma, but I must confess that the above sentence gives me pause a bit. I would expect someone who took part in warfare to experience guilt. A great deal of the training military personnel receive is geared towards making sure that they are psychologically insulated from the results of their actions, and while I do not have any particular desire that individuals feel pain as some kind of punishment, I do think that the limits of what the human mind can bear impose a valuable check on the brutality of warfare. There are ways of circumventing those limits; some are already in use, but some (like recruiting soldiers as young children) are unacceptable to the modern Western public, and that does limit the commands that can be given. I don't want to sacrifice soldiers' minds to be used as some sort of barrier, but equally I do not want all barriers to be removed and to have soldiers forced to do inhuman things and then be drugged until they no longer recognise those things as inhuman.

I haven't used MDMA or other hallucinogens myself as I have a medical issue which for various reasons wouldn't mix well with them, but I have been around people who have used them and I do think that their users occasionally risk confusing the feeling of love and connectedness that the drug gives them with the harder and more dispiriting work of actual love and connectedness. People can end up feeling terribly well-disposed towards the people around them, but utterly oblivious to their real needs and desires. A lot of the time that's almost enough, and for many people the feeling that they get really does propel them, in a sober state, to engage with the hard work of reality. But it's possible for people to get stuck in a state where they feel morally superior but are still acting like a massive dick. That's a minor social problem when the misperceived actions are on the level of everyday arseholery, but a bigger problem when ex-military personnel are trying to reach a considered evaluation of the actions they took and were ordered to take.
posted by Acheman at 4:39 AM on November 25, 2012 [15 favorites]

I wish there were other treatment regimens that people could be put into with this.

One of my housemates suffers from severe PTSD along with a number of other issues (sufficiently severe that she is considered 'totally disabled' as a result). I read about a similar study going on in this area a while back, and keep looking for it to open up.

And yes, she suffers from terrible guilt - the guilt of having family tell her that her psychological issues are just 'made up', along with everything else that happened to her, amplifying a lot of her self-destructive tendencies. Something to relieve that might make her able to do things like leave the house on her own more than once every other month or so.

(Example: she has trouble loading the dishwasher because she has to convince herself that we won't throw her out for loading it 'improperly'. Consciously she knows this won't happen, but the back of her head thinks it will.)

If she could have a better life, one where she can function with other humans besides us, who live with her, that would be worth... so much.
posted by mephron at 4:58 AM on November 25, 2012 [6 favorites]

From the previously.

U.S. Military worried about Ecstasy use among soldiers

The party that I used to DJ at in dc was actually raided by military police a few months after that article. They were investigating soldiers who were buying pills there and taking them back to base to sell, but ended up busting dozens of people. The party ended up being forced to move to Baltimore and didn't come back to dc until two years later under a different name.
posted by empath at 5:55 AM on November 25, 2012 [1 favorite]

we wish we could enroll them all

Haha, I see what you did there, Dr. Mithoefer
posted by jake at 6:27 AM on November 25, 2012 [3 favorites]

this survivor, a writer, had treatment with LSD for PTSD, done in Netherlands by guy specializing in holocaust survivors. He claims in his book about his treatment t5hat he was greatly helped and he lived into his 90's. I had met his wife.

Harper & Row, 1989 - 115 pages
A rare and haunting account of the author's experiences in a Nazi death camp as he relives them under LSD therapy. Translated from Hebrew by Eliyah Nike De-Nur and Lisa Herman.
posted by Postroad at 6:39 AM on November 25, 2012

Isn't it about time that as a society we turn back from this massive fear and disapprobation of drugs solely on the basis of the fact that they mediate transformative mental experiences? Particularly when we seem to be just fine with granting medical access to powerful and massively addictive opiates and amphetamines? No? Great, well, I'm just going to crawl under the bed for another four years.
posted by nanojath at 7:23 AM on November 25, 2012 [5 favorites]

I think this is a really interesting avenue to explore in terms of recovery from trauma, but I must confess that the above sentence gives me pause a bit. I would expect someone who took part in warfare to experience guilt. A great deal of the training military personnel receive is geared towards making sure that they are psychologically insulated from the results of their actions, and while I do not have any particular desire that individuals feel pain as some kind of punishment, I do think that the limits of what the human mind can bear impose a valuable check on the brutality of warfare.

I can't speak for everyone who has PTSD, but you seem to be assuming that the guilt has its roots in the sufferer's actual behavior, that they actually have something to feel guilty about. In the cases of post-war PTSD in the people I personally know, that's not the case. One person I know who has severe PTSD never personally engaged in combat. He had horrible survivor's guilt, though.
posted by the young rope-rider at 7:33 AM on November 25, 2012 [20 favorites]

So much of what we call mental illness is often deeply connected to the inability to emotionally connect with other people around you in a meaningful way. I am not surprised in the slightest that MDMA has a therapeutic effect on many people: I've seen it change the lives of people I know and love.

That said, self medication can be problematic. This is why we need science like this to help us chart the fine line between utility and danger.
posted by Freen at 7:44 AM on November 25, 2012 [2 favorites]

I do think that the limits of what the human mind can bear impose a valuable check on the brutality of warfare

The problem with this is that if these limits are exceeded, the result is not that the war stops. The burden is borne by the individual soldiers alone, not by any of the people who are primarily responsible for engineering the war.
posted by en forme de poire at 7:52 AM on November 25, 2012 [8 favorites]

I was going to say that this was not the first time that I had read about positive results with this kind of regime. I'm wary of folks who want people to jump feet first into drugs to deal with psychological issues, but PTSD seems like a case where the benefits outweigh the risks. You have to wonder whether "easing the pain of our military" is enough to counterbalance the forces that have labeled MDMA a "bad drug" (and I don't mean by schedule either).
posted by immlass at 8:53 AM on November 25, 2012

2001 BBC documentary on Ecstasy & Parkinson's

Parkinson's Disease is caused by the loss of a brain chemical called dopamine, which is vital for movement. The result in Tim is the slow freezing up of his body. But, like many people who contract the illness early in life, Tim suffers just as badly from the drug he takes to combat the disease, which gives him wild, flailing movements called dyskinesias. These are the devastating side-effects of L-DOPA, the drug he is prescribed to unlock his frozen limbs.

However, within 90 minutes of taking an Ecstasy tablet, Tim is able to get off the floor and perform backflips, somersaults and swallow-dives in a gym. The trouble is, of course, that Ecstasy is dangerous and illegal - a Class A drug deemed of no therapeutic value.
posted by Bwithh at 9:39 AM on November 25, 2012 [1 favorite]

In the cases of post-war PTSD in the people I personally know, that's not the case. One person I know who has severe PTSD never personally engaged in combat. He had horrible survivor's guilt, though.

Yes, PTSD is found amongst non-combatants of all kinds in war zones too. not uncommon for aid workers to have PTSD and survivor's guilt for instance.
posted by Bwithh at 9:42 AM on November 25, 2012

I can't speak for everyone who has PTSD, but you seem to be assuming that the guilt has its roots in the sufferer's actual behavior, that they actually have something to feel guilty about.

Too, I'd say there's a difference between feeling guilt and feeling remorse or regret. If you've done something bad, it's appropriate to feel sorry about it, and to empathise with the person that you did it to, and to wish to make amends ... but there's a kind of guilt that simply crushes a person beyond any kind of health.

And if you're crushed under the weight of that kind of guilt, actually you're probably less able to make any kind of amends for whatever you've done. Guilt is an inturned emotion; it's an emotion much more about self-esteem than about our relationships with others, and if you're too hobbled by feeling bad about yourself there's a limit to how much good you can do anybody else. Certainly the people I know who've been best at making amends for their bad behaviour have been the people with the fewest guilt issues. Being sorry and being guilty are two different things.

I agree that some of the time drugs are the emotional equivalent of sensual pleasures, something that gives you the sensation of connection, confidence, intelligence or whatever else without actually making connections, improving your qualities or making you any smarter. But on the other hand, psychological injuries can be the equivalent of sensory pain. The effects of trauma can produce 'emotional sensations' that are no more appropriate than the sensations of a high - and for that reason, tackling them with other emotional sensations can be meeting them where they're at.

For instance: I've had postnatal depression with a smattering of PTSD mixed in; it was pretty much directly the result of a traumatic experience of birth. I had all sorts of psychological symptoms, including guilt, and they really weren't related to having done anything I needed to feel guilty about because I hadn't done anything wrong. I was doing what a lot of traumatised people do, which is blame yourself for being unable to prevent something bad from happening or being done to you. Guilt is just one of those things you feel in response to being humiliated, and humiliation is what you feel when you've been rendered vulnerable. I tried non-chemical methods of feeling better, but they simply didn't work because it was like trying to 'walk off' a broken leg. I tried antidepressants and within a couple of weeks went from barely functional to completely normal. My brain had a chemical problem and it needed a chemical solution.

Like you, Acheman, I'm a little sceptical when someone talks like enlightenment and virtue can be found in a pill; in terms of life lessons you can take out of the trip, I don't think narcotics do much more than shuffle around what was already in our heads to begin with. But if the contents of our brains have been knocked all out of place by a bad experience, then sometimes a reshuffle can exactly be what we need.
posted by Kit W at 10:23 AM on November 25, 2012 [4 favorites]

I think this is a really interesting avenue to explore in terms of recovery from trauma, but I must confess that the above sentence gives me pause a bit. I would expect someone who took part in warfare to experience guilt.

----------

Two monks were once travelling together down a muddy road. A heavy rain was falling. Coming around a bend, they met a lovely girl in a silk kimono and sash, unable to cross the intersection.
"Come on, girl," siad the first monk. Lifting her in his arms, he carried her over the mud.

The second monk did not speak again until that night when they reached a lodging temple. Then he no longer could restrain himself. "We monks don't go near females," he said. "It is dangerous. Why did you do that?"

"I left the girl there," the first monk said. "Are you still carrying her?"
posted by crayz at 10:26 AM on November 25, 2012 [9 favorites]

you seem to be assuming that the guilt has its roots in the sufferer's actual behavior, that they actually have something to feel guilty about

Maybe you're right. I certainly wouldn't say it's straightforward and people should feel X rather than Y. But as someone with mental health problems myself, I do think there are, from time to time, problems with the way we approach guilt as a symptom of mental illness, and that distinguishing between irrational guilt and reasonable, human guilt is fiendishly difficult. I live and have lived with a great deal of guilt about the fact that I live a Western lifestyle when many people do not, and that many of my material advantages come at the cost of the suffering of those whose labour was exploited to provide me with food and clothing, and the future generations who may be endangered by the fuel use my life demands. I live in a shared house, don't drive and haven't flown in years, but I know that these and other efforts I have made to mitigate the harm I do are ultimately little more than cosmetic. At times, this guilt has made me want not to live, but there were other things pushing me in that direction as well, and I am now mostly ok with viewing that as a symptom of something I am trying to overcome. As far as the guilt itself goes, however, I really can't quantify at all how much of it is a sane moral response and how much is the result of prolonged illness. One doctor in particular kept asking me if I felt any irrational guilt and I would always say no, because I felt I could justify every feeling of guilt I had ever had. And in many ways, I still can. I don't really know what to think about that.
posted by Acheman at 11:26 AM on November 25, 2012 [1 favorite]

The amazing professor Ricardo Doblin McBean with his magical wonderful trauma-off machine!
posted by telstar at 11:46 AM on November 25, 2012

Acheman, that's a crappy way to have to feel. I'm sorry that you're going through that.

That said, I have learned through long experience to take any insistence by the mentally ill about how they deserve to feel what they're feeling and how relief is somehow a bad thing with enough boulders of salt to kill a person five times over.

There are crimes that rate confinement, sometimes for a very long time. There is no crime (or "crime") that makes someone deserve to have the extreme mental anguish PTSD sufferers deal with. Or people who suffer from depression, or extreme anxiety, or anything else. These negative feelings do not help anyone. They don't help the soldier or criminal be a more moral person, they don't help society by keeping people from doing bad things. In fact, it hurts us all by forcing them to be less productive and less able to deal with their trauma. Besides, most people who suffer from mental illnesses are neither former soldiers nor criminals.

So much crime and extreme poverty is just a manifestation of some mental illness or another. Antediluvian concepts of mental illness as punishment or a just result somehow keeping people in line only make it harder for people to overcome their demons.
posted by wierdo at 12:46 PM on November 25, 2012 [1 favorite]

Thanks for posting this.

A friend of mine is in that article and I hope that many others who would benefit from MDMA therapy have the opportunity to do so soon.
posted by univac at 12:52 PM on November 25, 2012 [1 favorite]

What on earth motivates people to want to withhold drugs like this to people with serious cases of PTSD?

Like with chronic pain and opioid, but at least you can argue that the substances are highly addictive - ecstasy isn't all that addictive, right? As far as I know, anyway.

I always assume that the reason people oppose drugs in general is that they supposedly prevent people from being "productive members of society" - but seems like these conditions (chronic pain, or PTSD) would prevent people from being productive members of society anyway so what exactly is it that causes people to freak out about these things? It just seems like pointless cruelty.
posted by delmoi at 7:40 PM on November 25, 2012

What on earth motivates people to want to withhold drugs like this to people with serious cases of PTSD?

It is a drug that people can enjoy recreationally and therefore it is bad, because drugs are bad.
posted by girih knot at 8:20 PM on November 25, 2012 [1 favorite]

I'm looking forward to Obama's brave endorsement of this therapy to help our wounded veterans. Oh, wait, he's still fighting medical marijuana. I guess the wounded veterans will have to wait a few more decades until it becomes politically safe to actually help them.
posted by mrhappy at 11:11 PM on November 25, 2012 [1 favorite]

I'm actually surprised LSD works for PTSD. I would think that LSD would induce triggers and cause horrible tripping. I wouldn't know. Just speculating. I tried Seroquel for insomnia per doc's recommendation (15 mg) and I had the weirdest, f'-ed up dreams. 1/2 lobster/ 1/2 centipede with a human face stuck in my heater vent and taunting me. I asked my psyc if the drugs induce those types of dreams because of anxiety/PTSD and she said possibly.

Nothing I would like to repeat on LSD, that's for sure.
posted by stormpooper at 6:35 AM on November 26, 2012

MDMA for PTSD not ready for prime time.
posted by fragmede at 7:31 AM on November 27, 2012

fragmede: "MDMA for PTSD not ready for prime time."

"desperate patients"
"experimental treatment"
"husband & wife team"
"illegal drug"
"party drug"

No hint of bias there.
posted by clarknova at 4:41 AM on November 29, 2012

They played a short clip of audio from one of the patient's sessions on CNN right now. Wow it sounded like she was rolling hard. I will not be at all surprised if additional studies bear out the therapeutic benefits of a controlled session like these, but it did sound like there should be glow sticks involved.
posted by Justinian at 2:04 PM on November 30, 2012