MDMA recognized as most promising treatment of PTSD

Posted on June 28, 2011 by Ralph Metzner

In the 1980s, before it was made illegal, MDMA (which later became popularized as the rave drug Ecstasy) acquired a reputation among psychotherapists as being one of the most effective, fast and safe ways of helping people heal from severe trauma, as well as opening up interpersonal communication in couples. I was one of a couple of dozen therapists who were initiated into this healing modality by the late Leo Zeff, whose work has been described in the book The Secret Chief, by Myron Stolaroff, available from the MAPS website. A useful compilation of essays on MDMA research and applications is Ecstasy: The Complete Guide, by Julie Holland MD. [Read online]

Unlike most psychiatric drugs, such as anti-depressants or sedatives, but like other psychedelic drugs, such as LSD and psilocybin, the use of MDMA as an adjunct to therapy requires an experienced guide and a protective setting for its benefits to be realized.  Also like these other drugs, this first and ideal use in individual or small group settings, with a healing and spiritual orientation,  did not prevent the spread of MDMA into the street-drug culture – where it morphed into Ecstasy, consumed by thousands at rave clubs and gatherings around the world.

Unlike the classical psychedelics however, MDMA is distinctive in that the main effect is a heightening of positive interpersonal feeling awareness, or empathy, with a reduction of fear, while perception is not altered at all and there are no hallucinations or visual distortions.  As one client of mine observed when first experiencing this, “everything looks just the same, but I feel completely differently about it.”  That’s why I suggested the term empathogenic – generating a state of empathy – for this class of substances (though some European researchers prefer to use the term entactogen).

In my book MindSpace and TimeStream, I speculate about the possible neurochemical basis of the MDMA effect.

In the case of MDMA, for which I coined the term empathogenic (“empathy-generating”) in its subjective effects, the serotonin enhancing effect may be the basis of the calm, non-anxious, emotional balance that is particularly valuable in the therapeutic treatment of interpersonal conflict, trauma and PTSD. The dopamine releasing effect, which the other amphetamines also have, probably accounts for its role as Ecstasy, the drug of choice at hours-long dance parties with pulsing music, known as “raves.”  In addition, the presence of MDMA in the body triggers the release of prolactin – the hormone released during mother-infant bonding and breast-feeding – perhaps the paradigmatic example of empathic, non-striving, relaxed empathic mergence of two beings. (page 134)

In my 1985 book Through the Gateway of the Heart, which is now out of print (though copies maybe available from some libraries)  I collected accounts of therapeutic experiences with MDMA (and other empathogenic substances) and offered guidelines for its use in that context. I concluded then and still believe that, because of the reduction of fear (which can be greatly magnified with the classical psychedelics), the three most promising applications of MDMA in psychotherapy would be (1) in heightening empathic communication – e.g. in couples relationships; (2) in the training of psychotherapists, for whom conscious empathic understanding (not unconscious sympathy, and not mere verbal expressions of understanding) is core to the process; and (3) in the treatment of trauma (PTSD), where the person is locked into a limbic system emotional stress reaction that can be triggered by a chance stimulus.

Officially sanctioned research on using MDMA in the treatment of war trauma has recently been gaining some attention. The MAPS organization has sponsored the research of Michael Mithoefer, MD who is conducting protocol studies on the use of MDMA with veterans. http://www.alternet.org/health/151263

According to some estimates there are something like 350,000 US veterans suffering from wars in Vietnam, Iraq and Afghanistan. The suicide rate among returning veterans is disturbingly high (as much as 15 per week, according to some reports). The only approved treatments, psychotherapy with anti-depressant drugs like Prozac, provide maintenance only at best, while underlying trauma patterns are not resolved or healed.

MAPS and Mithoefer’s major breakthrough showed that over 80 percent of the subjects in the MDMA group no longer qualified for a diagnosis of PTSD, as compared to 25 percent in the placebo group,” he told AlterNet. ”An even more important breakthrough, which we are currently working to write up in a scientific paper, is from the results of our long-term follow-up evaluations of the subjects, administered at an average of 41 months post-treatment. We found that, on average, the subjects have actually gotten a bit better over time, demonstrating that MDMA-assisted psychotherapy has lasting benefits.”

In the 1980s, before MDMA was illegalized, I did a successful one-session MDMA therapy with a traumatized vet from Vietnam, who went on to found a group called Veterans for Peace, which conducted educational sessions in LA area high schools, informing potential recruits for America’s war system of the real personal costs of war.

This story was recently written up in the form of a dialog and published in the MAPS Bulletin. From Traumatized Vet to Peacemaker Activist by Ed Ellis and Ralph Metzner (maps bulletin, vol XXI, No. 1)

Sad to say, officially VA-approved PTSD-MDMA treatments are still a long way away, despite the promising research. As Rick Doblin writes:

We’ve been trying for 15 years to motivate the VA to explore MDMA-assisted psychotherapy for PTSD in veterans, and this was the first time we were told the research is important and somebody, but not the VA at this time, should be doing it. Such is the progress in our field!

While discussing this depressing situation recently with a friend and colleague familiar with the drug culture in both Israel and the US, he informed me that the news that MDMA (or Ecstasy) can be demonstrably helpful in dealing with war trauma has permeated the culture to such a degree that veterans familiar with the drug have, on their own initiative, started to provide self-help empathogenic therapy for their comrades. This was news that gladdened my heart and gave me hope!

Filed under: Consciousness, Current Events, MindSpace & TimeStream, Modern History, Politics, Psychedelics, Science | Tagged: , , , , , , , , , , , , , , , , , | 3 Comments »

Unexpected and Welcome Openings toward Peace in the War on Drugs

Posted on February 12, 2010 by Ralph Metzner

1. Prague – The Czech government today approved the list of hallucinogenic plants and mushrooms, including hemp, coca, mescaline cactus and magic mushrooms, and decided that people would be allowed to grow up to five pieces of such plants and keep 40 magic mushrooms at home. http://www.ceskenoviny.cz/news/zpravy/czech-govt-defines-rules-of-hallucinogenic-plants-growing/411010

2. An Alternet article reported on a poll that showed 53% of Americans support legalization of marijuana and that the growing acceptance is fueled largely by women having joined the movement for reform. http://www.alternet.org/blogs/DrugReporter/144496/daybreak_for_marijuana%3A_most_americans_support_legalization

In 2005, only 32 percent of polled women told Gallup they approved legalizing pot, but this year 44 percent of them were for it, compared to 45 percent of men. In effect, women have narrowed what had been a 12-point gender gap. Women are also smoking more weed. The most recent National Survey on Drug Use and Health shows that current marijuana use increased from 3.8 to 4.5 percent among women, while there was no significant statistical change for men.

The avenue through which women have been foremost leaders in the movement is medical marijuana advocacy. There are currently 13 states that have legalized medical marijuana use and at least 14 other states with pending legislation or ballot measures. In California, where cannabis has been legalized for medical use since 1996, a Field poll found 56 percent support for adult legalization — and the matter may very well make its way onto the 2010 ballot. Every woman I spoke to referenced cannabis’ medicinal properties as a major reason they are so personally impassioned by the marijuana reform debate.

The article tells the story of several women with severe medical problems of intractable pain, who overcame deeply ingrained prejudices to find relief with medical marijuana and became advocates for reform.

Julie Holland, a clinical assistant professor of psychiatry at the NYU School of Medicine, has been called onto NBC’s Today Show twice now to explain why women are gravitating towards weed. During one of her appearances, Holland seemingly shocks the hosts by telling them that 100 million Americans have tried weed — 25 million of them over the past year. The most recent National Survey on Drug Use and Health shows that 10.6 million women used marijuana in 2008. Also surprising to the TV hosts was Holland’s assertion that marijuana is the least addictive substance among many. According to a 1999 Institute of Medicine report, the rate at which people who try a substance and go on to become addicted is 32 percent for nicotine, 23 percent for heroin, 17 percent for cocaine, 15 percent for alcohol, and 9 percent for cannabis. “Look at what the choices are. Cannabis isn’t toxic to your brain, to your liver, it doesn’t cause cancer, you can’t overdose, and there’s no evidence that it’s a gateway drug,” Holland said. “I believe that the majority of adults can healthfully integrate altered states into their lives, and it makes sense to do it with the least toxic substance you can. ” The public seems to agree.

The article goes on to raise the question “Why do girls smoke pot?”

Natalie Angier, for example. In her book Woman: Intimate Geography, this Pulitzer Prize-winning science writer interjects a personal note of — and case for — female empowerment through weed: All the women in my immediate family learned how to climax by smoking grass — my mother when she was over thirty and already the mother of four. Yet I have never seen anorgasmia on the list of indications for the medical use of marijuana. Instead we are told that some women don’t need to have orgasms to have a satisfying sex life, an argument as convincing as the insistence that homeless people like living outdoors. As Angier writes, alcohol is a “global depressant of the nervous system” so marijuana can be a woman’s best friend. In that vein, Holland has clinically observed that many of her female patients choose marijuana over alcohol — for all kinds of social situations — because it makes them “more present instead of absent. You can relax but not be incapacitated.”

The movement for marijuana legalization has a powerful economic argument in it’s favor.

With the largest economic recession since the Great Depression firmly in place, more people see the benefits of taxing and regulating marijuana for adults. Economist Jeffrey Miron has calculated that, assuming a national market of about $13 billion annually, legalization would reap state and federal governments about $7 billion each year in extra tax revenues and save about $13.5 billion in law enforcement costs.

Trends indicate that as more states legalize the use of cannabis for medical purposes, more people will discover first-hand that legalization of marijuana does not equate with anarchy and instead with more effective control of a substance so readily available to Americans — and American kids — across the country. And as Californians may next year, Americans will soon be exposed to the choice between regulating marijuana for adult use or continuing a failed drug war that incarcerates 850,000 people a year — tearing apart families, ruining futures, and siphoning from public funds that might otherwise benefit the next generation. All this for a relatively mild psychotropic that at least a third of us has tried. As the recession continues to unravel communities across the country, the economic incentive to end this drug war will affect the opinions of many who might never otherwise have considered legalization. The time may very well be now. Similar to the prohibition of alcohol in the early twentieth century, what we have today is a federal policy that is at odds with public opinion. It is a policy without a plurality of citizen supporters. And many women are at the vanguard of the movement that recognizes this and is fighting for change.

Filed under: Consciousness, Current Events, Ecology, Holistic Healing, Psychedelics, Spirituality | Tagged: , , , , , , , , , , , , , , | Leave a Comment »

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