What is the future of PTSD and Ecstasy?

For over three decades, the federal government decided to block the use of MDMA in research because it is the active drug in ecstasy. Since the war on drugs, it has become very difficult for researchers to use MDMA in trials and funding was impossible to come by. Why?

A neuroscientist at the University of John Hopkins, George Ricaurte and colleagues, reported in a study in 1998, Positron emission tomographic evidence of toxic effect of MDMA ("Ecstasy") on brain serotonin neurons in human beings, that MDMA affected serotonin. While showing the images of brains with and without use of MDMA, they wanted to get young people to think about what drugs could do. This study to me isn't a good reason to block research because they didn't look at cognition or behavior, it only showed the images of the brain. So why would the government not look at the whole picture because it's an illegal drug and can only do damage to us. Yet research done before it was illegal had begun showing positive aspects of use in therapy. 

In the 1970's before Nancy Reagan began the war on ecstasy in the 80's, it was known as the "penicillin for the soul" because it seemed to help patients open up and relax in therapy sessions. Though there were no clinical trials at the time to give the evidence they needed and it became illegal, stopping the use in therapy. It didn't hinder others from trying to use it in clinical trials because by 2000 the FDA approved the first small clinical trial for MDMA.  Even though there has been clinical trials and they have shown that it has a positive outcome for patients with PTSD, the VA (Veteran Affairs) will not be involved in the use of MDMA because "Ecstasy is an illegal drug". If there is no funding from the government and veteran affairs won't have anything to do with it, then where does this leave research on MDMA and PTSD?  

Then there is media that plays on fear and only shows the worst of any research, allowing the population to learn about something that they fully do not understand and only get the scary pieces of something that is far more complex then most could understand. Culture has deemed ecstasy dangerous, yet the crime rates have not been shown to go up in the use of ecstasy, hospitalizations did not increase, and still society thinks of this drug as only a party drug and what the media says about it. 

I am for research with any drug made in a laboratory but with all the negativity behind ecstasy, what do you think researchers should do to receive support on researching and funding of MDMA and PTSD patients? 

Is MDMA the key to treating PTSD?

The military is always looking for a quick fix to get their soldiers back to active status and the therapy being used now just isn't cutting it. It's costing the government a large amount of money each year and the findings from other studies of treatments being used are not very effective. So what if we could use MDMA (ecstasy) to save money and find a faster route to allow veterans to become normal again. 

One study looked at long-term follow up of patients who received MDMA (ecstasy) with psychotherapy.  The article reviewed 19 of the 20 subjects, that either received the drug or with an inactive placebo.  Eventually all 20 subjects were given MDMA but one did not want to take the drug.  For the data collected about the risk of substance abuse, it was found that if used in a clinical setting, there was minimal risk for subjects to become dependent. The findings also found that non of the subjects developed any type of substance abuse with MDMA.  It also showed that while PTSD patients usually have substance abuse, they use this to escape or self-medicate, the good outcome of this study showed that psychotherapy and MDMA use allowed for a subjects motivation for drug abuse would be reduced. 

The study also found that the subjects had improvements in areas of self-awareness, improved relationships, an enhanced spiritual life, and more involvement in the community.  The subjects also reported that there therapy sessions were more meaningful and that their lives improved.  The down fall of a study like this is that some subjects were taking other medications and the sample size was very small. 

The study has shown that the use of MDMA in psychotherapy is beneficial and promising because the methods being used now for PTSD patients, has proven to not be very effective, leaving patients with feeling helpless. This study reported no cases of substance abuse and no reports of neurocognitive decline. With all studies there are limitations but if studies in the future can design a better survey and designs and use military veterans with PTSD, the future may find better methods of using MDMA in a controlled therapy session. Further research could help validate MDMA-assisted psychotherapy and could become a very important treatment option. 

Although this type of study is very controversal, it has shown in numerous studies that it has helped subjects with PTSD symptoms with little or no negative effects on the brain or drug use. I think more research needs to be done on the side effects, if there is neurocognitive decline, and if this would be a more effective quick fix that the military is looking for. 

What do you think future research should do to get more participants?  Or do you think this is just a joke and we should focus on legal ways to help PTSD patients? 

Mithoefer, M. C. Durability of improvement in post-traumatic stress disorder symptoms and absence of harmful effects or drug dependency after 3,4-methylenedioxymethamphetamine-assisted psychotherapy: a prospective long-term follow-up study. Journal of psychopharmacology (Oxford). (01/2013) ,  27 (1), p. 28 - 39. 

Psychedelic Pioneer

Rick Doblin was born on November 30, 1953 and is known for wanting MDMA (or Ecstasy) to become FDA-approved. He obtained his psychology degree in 1987 from New College of Florida and earned a doctorate in public policy in 2001 from Kennedy School of Government, Harvard University. He is a founder and executive director at Multidisciplinary Association for Psychedelic Studies (MAPS).

            Before all this he began experimenting with LSD and mescaline, soon he dropped out of school and worked in construction for ten years. When he returned to college, he tried MDMA at a workshop for personal self-discovery.  His experience MDMA was a better one than LSD, the introduction to MDMA allowed him to be open and look deep at himself, and was gentler than LSD. The experience gave him focus on treating PTSD and terminally ill patients with drug.  In this time the DEA made MDMA illegal, which redirected Doblin in earning his Ph.D. in clinical psychology to his Ph.D. in public policy.

His path changed and wrote his dissertation on regulating medical use of psychedelics and marijuana. His Master’s thesis at Harvard, about a survey of oncologists about smoked marijuana vs. oral THC pill in nausea control for cancer patients. His undergraduate thesis was a 25-year follow-up to Timothy Leary’s Concord Prison Experiment. He studied with Dr. Stanislay Grof and was one of the first people to be certified as a Holotropic Breathwork practitioner. 

           He set up MAPS to research and develop a therapeutic use of the once legal drug, ecstasy (MDMA). He wanted to find a way to work with the Food and Drug Administration, which meant they needed to develop it as a prescription medicine and bring MDMA back to being legal in some context, using MAPS as a non-profit pharmaceutical company.  By founding MAPS he has helped researchers like Michael and Ann Mithoefer, conduct research on MDMA and Post-traumatic Stress Disorder. The hope is further research with war veterans with PTSD and the use of ecstasy and psychotherapy together.  

             While psychedelics are not new to being used therapy, more researchers are using them because the ability of the drug to alter how the brain processes signals. Will Doblin prediction come true, that doctors could begin legally prescribing MDMA by 2021?  

Do you think that the FDA will allow MDMA use in psychotherapy for patients with PTSD?  Do you think that Dolin is crazy for even thinking that it will become legal?  What do you think would need to be done for the FDA to make it legal?

 

Is there science behind psychedelic drugs and PTSD?

(blog post 2)

When soldiers come home from war they can only hope for a normal life.   There is a large number of soldiers coming home from Afghanistan and Iraq wars with Post-Traumatic Stress Disorder (PTSD). There has also been a spike in suicides among veterans and  veterans commit suicide every 80 minutes.  With this number being so high, the VA (veteran affairs) needs to look into more mental health solutions but what if science has shown that ecstasy works, how do we get around the drug laws to help these soldiers to have a normal life?

With current treatments for PTSD not being effective for veterans Michael Mithoefer wanted to find other alternatives for veterans.  Michael Mithoefer, a psychiatrist in Charleston, S.C., started his study of Ecstasy-assisted therapy for post-traumatic stress disorder  and found in his 2010 study that 83% of PTSD patients treated with MDMA-assisted psychotherapy were cured, compared to 25% of those treated with psychotherapy alone. Then when the follow-up study was conducted, the results showed that the patients treated with MDMA had remained symptom-free, showing that this treatment gives positive results for the long-term.  This study shows that the drug once used for parties, could be used by veterans with PTSD in therapy sessions. Giving the patient a chance to re-live their experience in a safe environment. 

Though past research as proven successful, there still needs to be more research conducted on MDMA use for veterans with PTSD. There have been several studies showing that MDMA can have negative effects too. Dr. Eugene  Kiyatkin's study showed moderate doses of pure MDMA can be lethal to rats. Michael Mithoefer argued against this, stating the only negative effects seen in the controlled setting with pure MDMA are slightly elevated blood pressure and pulse. 

The evidence from the Drug Enforcement Agency had reported that 13% of Molly seized in New York from 2009-2013 didn't even contain MDMA. What does this say about the research being conducted? While the patients obtain the street drug, what are they really getting themselves into and what other drugs are not being accounted for in the studies?  For this study to be fully beneficial in proving MDMA is effective, the study may have to obtain their own Ecstasy or create it in a lab, to make sure that it is 100% MDMA with nothing else in it.  It also is like playing the game Russian roulette.  Is the FDA really going to take the chance to approve MDMA in therapy sessions for PTSD?  If we really think about the future of these studies, I can't imagine it ever being fully approved and if this is the case what is the point in further research? 

There will always be limitations to a study but if future studies could get the proper approval and bring this to political discussions, we could have better control over what the substance contains and have training in the new therapy.   

Do you think there should be further research done on MDMA and PSTD?  Or, do you think that there are to many ethical issues?  Would you want to be a part of the future research?

PTSD and Illegal drugs

Is using illegal drugs in treating patients with Post-traumatic stress disorder ethical or unethical?  All drugs, illegal or legal, if given in the wrong dosage can cause them to become lethal. So, if we can give ecstasy (illegal drug) in an appropriate amount and found it to be effective in helping with PTSD in veterans, then why not try.  If we did try this method then who would fund it, who would pay for the therapy, would Veteran Affairs pay? 

What is PTSD?  The Mayo Clinic states that, PTSD symptoms are generally grouped into four types: intrusive memories, avoidance, negative changes in thinking and mood, or changes in emotional reactions.  It is a debilitating disease effecting veterans from the Iraq and Afghanistan war at an estimated 118,829 men and women since 2004. The current treatment usually involves the use of selective serotonin reuptake inhibitors (SSRIs), psychotherapy, or a combination of the two. The only FDA-approved SSRIs for PTSD are sertraline and paroxetine. While psychotherapy and SSRIs help PTSD, there is evidence that they do not work at all and the need for better and more treatments is necessary.

With these treatments there are costs and the estimated cost of the first year of treatment for one veteran is $8,300, the total cost for the 118,829 veterans equals, $986,280,700. This a lot of money for treatment for one year and the majority of PTSD patients need years of therapy. So what if talk therapy and ecstasy work, what would the cost of this drug and treatment be and what would be more effective?

MDMA, or the street name Ecstasy is a synthetic, psychoactive drug that has similarities to both the stimulant amphetamine and the hallucinogen mescaline. The feeling one may get using this drug is euphoria and it diminishes the anxiety that a veteran with PTSD may face. Dr. Shulgin first came about MDMA in the 70's and found that it helped in clinical therapy sessions and allowed the patient to open up and feel more relaxed. If this drug helps veterans open up and face the traumatic event quicker and more beneficial to all, then why not consider the use under supervision.  It has been found that existing treatments for PTSD are limited and ineffective for between 25-50% of patients and trials using ecstasy have been found to help treat PTSD in patients.

The other issues regarding illegal drug use is the ethical dilemmas that will be faced in the treatment. With the war on ecstasy dating back to the 80's by Nancy Reagan, banning MDMA, how could trials be done without the ethical issues that they may face?  What do we do and where do we go to find a balance between ethics and possible effective treatments that pose problems to ethical boundaries?

How do you feel about the drug use and the psychotherapy, do you think it works or do you think it will cause more damage then good? On the other hand if you think this could be a breakthrough, what would you suggest in handling the ethical issues that the treatment will face?