In a Swiss research lab, three-dozen doses of a drug that can give a patient the ability to discuss anxiety-provoking topics with greater ease, a sense of self-acceptance, and increased feelings of intimacy with their therapist sit untouched. The drug – MDMA – has already been bought and paid for, but it could be months before it reaches the people who might benefit from it.
Meanwhile in Vancouver, a rape victim experiences persistent flashbacks of her attack. One year later, she still wakes up in a cold sweat, haunted by vivid nightmares of the event. Her therapist, whom she struggles to open up to, has diagnosed her with post-traumatic stress disorder (PTSD). At her therapist’s suggestion, she’s tried several treatments – including psychotherapy and various medications – but none of them have alleviated her symptoms.
Her therapist says to be patient and give the drug Paxil – the latest antidepressant she’s taking – a chance. But she’s been dutifully swallowing the pills for four months now and they haven’t helped. They’re supposed to start working in three.
Sometimes, when the nightmares wake her, she goes online and researches treatments for PTSD. She’s read about something called MDMA which, when used in psychotherapy, has been successful in treating the disorder. She’s also read that her therapist can’t treat her with MDMA because it’s a restricted substance.
MDMA is more commonly known as Ecstasy.
While the pills go untouched in the Swiss lab and the rape victim attends therapy sessions that don’t seem to help, two researchers in Vancouver are preparing for a study that they hope will change everything.
Psychologist Andrew Feldmár and psychiatrist Doctor Ingrid Pacey hope to be the first Canadians ever granted a permit to import MDMA into the country for use in a clinical trial. The pair will examine the effectiveness of the drug, combined with psychotherapy, in treating PTSD.
“What we are trying to show is that even a few sessions with MDMA as an adjunct to therapy will make a huge difference in lowering the scores that measure [patients’] degrees of post-traumatic stress,” explained Feldmár.
“Antidepressants like Paxil and Zoloft don’t work,” he said. “In fact, the people we want [for the study] are the people who’ve tried antidepressants and found they haven’t worked for them.”
Feldmár and Pacey believe that MDMA, when combined with a program of psychotherapy, can succeed where antidepressants have failed. To prove it, they will treat twelve patients over a four-month period.
The study has already been given the go ahead by both Health Canada and an Institutional Review Board. The research team has started recruiting participants while it waits for Health Canada to approve the permits required to access MDMA for medical research.
The patients will all have experienced some sort of trauma – such as rape, violent crime, or war – that has resulted in post-traumatic stress disorder. All will have tried and failed to treat the disorder with at least one other type of therapy before participating in the study.
Eight of the patients will take a full dose of MDMA on three occasions, while the other four will get a placebo containing a very small dose of the drug. Both groups will participate in a number of therapy sessions during the study, and researchers will track the severity of their PTSD using a standard scoring system.
“If we can prove that the people who get the full dose get far greater benefit than the people who get a very small dose, which is our placebo, then we will show that MDMA is effective in shortening therapy, or in making therapy more effective,” Feldmár said.
Using MDMA and other psychoactive drugs for therapeutic purposes is not a new idea. In fact, hundreds of therapists were using MDMA throughout North America and Europe in the 1970s and early 1980s.
MDMA was first created in 1912 by a Merck chemist trying to create a compound that could stop excessive bleeding. Although Merck researchers periodically dabbled in MDMA research over the next few decades, it was largely forgotten by the scientific community. It wasn’t until the 1970s that the drug was rediscovered and synthesized by a researcher at the University of California.
“MDMA was re-discovered and designed by [Alexander] Shulgin, who was looking for an empathogen,” said Feldmár. “He was looking for a substance that would help people who are in therapy to really engage in therapy, to become more open-hearted with their therapist.
“That’s what MDMA was actually made for. Not for raves, not for entertainment and fun. It was designed as an enhancement for psychotherapy.”
MDMA Tightly Regulated
MDMA started gaining popularity as a recreational drug in the 1980s. It was particularly popular among young people attending clubs and raves because it made them feel more self-confident, improved their moods and heightened their senses.
As MDMA became increasingly mainstream, the United States’ Drug Enforcement Administration (DEA) moved quickly to regulate it. In 1985, the DEA classed MDMA as a Schedule I controlled substance. This classification indicates that a drug has “no currently accepted medical use.”
Other countries, including Canada, quickly followed the American example, classifying MDMA as a restricted substance.
Today, a growing number of mental health professionals want to see MDMA re-classified. According to Feldmár, reclassification would “take MDMA off the restricted drug list and make it a prescription drug available to psychologists or psychiatrists who have training on how to use it in therapy.”
But getting MDMA reclassified won’t be an easy feat.