I’ve recently seen numerous articles published in the “mainstream media” questioning the use of illegal narcotics in the treatment of PTSD.
This issue isn’t something new; the 60s and 70s saw the same debate, though then it quieted for a while.
Well, it’s back.
The Multidisciplinary Association for Psychedelic Studies (MAPS) held its first US clinical trial using a psychedelic drug, MDMA (ecstasy).
They sponsored the work of Michael Mithoefer, MD who looked at whether MDMA could be useful in the treatment of PTSD for individuals who previously had been “treatment-resistant.” A majority of the 21 participants were women who had been sexually assaulted.
Other researchers are also getting involved, including those at Harvard, NYU and the University of Arizona.
Roland Griffiths, PhD, from Johns Hopkins, has been looking at the effects psilocybin can have on personal meaning and spiritual significance.
Charles S. Grob, MD, from UCLA has studied the use of MDMA with cancer patients.
Brain imagining from these studies suggest that MDMA quiets the amygdala, releases serotonin and dopamine while increasing oxytocin and prolactin. This would decrease fear and increase connectivity with others, perhaps allowing for better treatment of trauma.
Some guidelines have been established for these types of experiments, including the availability of expert monitors in case someone experiences a negative “trip.” MRIs have been taken of participants under the influence of the psychedelic drugs and standard protocols have been established in order to gauge the drug’s effects.
Now, most findings from psychedelic trials are still preliminary. Many critics have noted that further studies allowing for double-blind or triple-blind experiments are needed, as well as larger numbers of participants in each study.
Having lived through the original debate about the use of psychedelics in psychotherapy, I find myself on the fence about whether it’s appropriate or not.
I would love to see more research on the area and quite frankly, make sure that it’s fully safe for the individuals who are opting to use it to treat their PTSD.
PTSD is an important topic, and one we discuss frequently in our programs on trauma treatment.
Do you have an opinion on the use of psychedelic drugs for PTSD treatment? I invite you to leave a message on the comment board.
Good therapy is very hard to get and very inaccessible to most people. And it can take a lot of time and be expensive. If there are any modalities accessible all should be used. It Psychedelics are certainly safe. Here we would be comparing MDMA to pharmaceuticals such as anti-depressants which are often misdiagnosed and useless.
Simon, you are a true inspiration. I meotnined your name today in front of some people from work who commented ooh, have you meotnined that before? as apparently I have become quite repetitive on how amazing I think what you are doing is and the battles you are going through to achieve your aims. I made no apologies for talking about you so often!! It is your example that has led me to thinking I can run a marathon. It is the awareness raising that you have done that has made me consider my colleagues more carefully and look at putting a suggestion to our welfare dept/training that they need to put something out to help people in the organisation I work for. I’d have done none of that without your example.Rest as much as you need, take time for you, we are here for you to help in whatever way possible.love,Sharon x
I have had the same problem since I was young; I have a very strong fear of dying. Often times I will make myself get out of bed and do something to avert my thoughts; mainly I will take a shower and drink a glass of warm milk with vanilla and some sugar. If this doesn’t work, try something a little bit more stimulating that can avert the thoughts, but won’t keep you awake for hours once you lay down. Pick up one of your favorite books, or walk around in your back yard for a bit.. . If it still persists, speak with your doctor. They can prescibe something for you to take when these attacks occur that will sooth your thoughts and help you fall asleep.. . I know how horrible this is. Best of luck.
This fact sheet offers suggestions for choosing a physician and facility for cancer treatment
As someone who was Medical Director of an Evening Chemical Dependence Program and who currently treats veterans with PTSD, I look forward to seeing more trials with MDMA in a veteran population. PTSD is characterized by chronic feelings of distrust and avoidance of painful emotions. It should be common sense that a drug that increases trust and allows people to confront painful emotions should be helpful in the treatment of it!
Finally, I was able to read the original article and then all the commentaries that have so far been written above as blogs. I, for one, have no personal experience with any illicit or hallucinogenic drugs. I believe that all drugs, especially if not ingested from food {and even some of those substances (e.g. foods) have effects that alter one’s state of mind} have a biochemical effect on our nervous system and affect our body biology/chemistry. So, one is talking about degrees of change, effect, and/or possible distortions, disruptions, destruction of those natural ways our bodies (including our brains) function in the world. I have experience running a social detox inpatient unit, an outpatient unit, long term treatment unit for years and have also supervised several treatment centers in Department of Corrections all dealing with various types of approaches to substance abuse/addiction amelioration and prevention of future such behavior in patients/clients. I also have treated traumatized persons for years. It truly is very difficult for some persons to not self-medicate (if they have active, destructive emotional/behavioral effects from their trauma experiences). Treatments available are not always effective for all in a group (a la Jeannette above), can be lengthy, consequently expensive, and, I agree, with others who pointed out also, that it must be individualized in order to work. It seems to me as though controlled trials of anything available that does not have destructive effects on persons and are able to relieve the symptoms that keep a person suffering from them from functioning properly is worthy of some research in order to check it out. I also would advocate that long-term effects of such trials are checked. Some negative and/or positive effects of substances take years to develop. Patience is advocated. We are just now realizing how pervasive, destructive and pernicious trauma experiences can be for some persons (not all persons are affected that way from difficult experiences). Lets give our researchers, professionals, interested lay persons, and clients/patients some time to figure out how to address these issues the best way possible for each individual. Just like cancer treatments have become much more sophisticated, so will PTSD and other trauma treatment advance – I don’t doubt that progress will occur as long as we keep trying. To not give up is sort of the American Way, isn’t it?
As someone who years ago received enormous assistance from very carefully titrated and controlled therapy with MDMA within a context of ongoing therapy I would ask that people give science a chance to test out the efficacy of this approach. Opinions are easy, lived experience a bit harder. Scientific controlled studies are need to generate evidence based information.I am a psychotherapist of some 30+ years who also many years ago utilized this substance with patients to excellent follow up changes in perception and behaviour. When the substance “hit the streets” so to speak I discontinued the work. The therapy was carefully prepared for and also contained within an ongoing therapeutic alliance, music, earphones, sleep mask, beside the patient all the time, and neither myself nor probably a sample of 30 patients ended up on anti-depressants as a result. However that said the time period between sessions was usually 8 months (for integration), and the total number of sessions did not exceed 4. There was not recreational use with these patients (or myself) either before or afterwards to my knowledge which extended some years.
Simon, what can I say? You are an amazing amaadsbsor for the cause. PTSD affects so many peoples lives, if you haven’t seen it then it difficult to understand. My experience is that the sufferer doesn’t realise or acknowledge the fact that they are affected this is frustrating to say the least but bringing the cause to the public attention will hopefully make it easier to admit or accept. You are an inspiration and I hope you continue to conquer your demons. Running is such an amazing outlet too. I also hope you can stay strong, you have to look after number one when it comes down to it. Hope to meet you one day at a race or event until then i will continue to follow you through your highs and lows. Big respect for you xx
I think the old saying “let’s not throw the baby out with the bath water” applies to this issue. Some of the passionate opinions this issue inspires seem similar to debates over religion, abortion and homosexuality. The emotional charge is understandable. As we all know, the horror and shock is suppose to be a temporary state of being.
It’s a great idea to share our thoughts and feelings while we mull over the data and assimilate new information. Thanks for providing us the opportunity.
I believe we always have to be very carefull with synthetically produced drugs. Stories of young people dying from just 1 Ecstasy pill are still fresh in my mind. On the other hand indigenous cultures have been using hallicinogenic substances for ages. Like Ayahuasca or Peyote.
But when Peyote is given to someone for traumatic experiences, i am just finishing reading a book by Bearheart a native american medicine man, the person making this spiritual journey is also protected by a very knowledgeable shaman, who knows what he is doing, because he has trained to work in these realms for a lifetime. Most psychiaters or psychotherapists will have no clue about this part of the journey. This is why dangerous outcomes, even deaths come about.
So when using drugs to make shamanic journeys one needs to consult a specialist and not go to someone who just qualified for a piece of paper in some university, which merely educateds the thinking brain. However much appreciated, it is not the part equipped for protecting clients in dark spiritual realms.
Really great comments, I’m open-minded (I’m still on the side of not getting clients into “drugs”) but I am aware that Shaman used to guide the ‘trips’ of their people. I would also first want some more info about MDMA, some facts both in its natural form (you could get this at some health food stores back in the 80’s) and chemical – of which I have no experience.
Being a Mental Health professional and a recovering addict myself I have been exposed to everything from 12 Step to the new S.M.A.R.T. Recovery, (which advocated Harm Reduction, Motivational Interviewing, WRAP and “cutting down” as opposed to cold turkey quitting), to medications that have made some of my clients (and myself at times) even crazier than ever (ambian, xanax, vicodin, soma, to name only a few of the legal multi-billion dollar pharm-crockracy chemicals being handed out to millions) and psychotherapy (cog-beh, Positive Psych, guided imagery tools, etc), and the new Energy Psychology methods that worK wonders EFT, EMDR, TFT, etc. of which I practice daily.
I have also used natural things like 5-HTP which helps seratonin, DMAE which helps dopamine (a little stimulating), melatonin or valerian for sleep, DHEA helps testesterone (helps with sexual side affects of some meds), Rhodiaola Rosea which has kept me in a good mood for months now and the newer Ashwagandha from India that they have used for depression and grief for centuries).
I’d like to see more studies on what natural remedies there are out there – let’s save the rain forest for more! India and China have AMAZING herbal remedies that usually need to be personalized by a trained practitioner (what works for me might not work for you.)
I can remember times where drugs “helped” me in some form or another temporarily with PTSD/child abuse issues, self-medicating, whatever you want to call it, getting insights or a break or smoking pot to contain the inner rage boiling inside (ever see a pot head rob a bank?) Marijuana Anonymous talks about cross-over addiction and not having to “hit bottom” from hard drugs and hard times to get clean. Prayer and meditation (hypnosis) – also good highs.
BUT – I also see and have learned how the brain’s neural networks are affectedd by all sorts of things from drugs to hugs. We can’t grow more brain cells but we can work with it’s plasticity to create new pathways and break down others, but this takes TIME and repetition and if someone has gone too far (crystal meth etc.) they may never recover brain-wise and may need medications for life to prevent suicide and hospitalizations. I do have experience with the mentally ill in a downtown area with the aging baby boomers who have fried their brains out and end up in nursing homes, it’s not pretty.
You really need a good diagnosis and a treatment plan that includes a variety of things from a well stocked toolbox, no ONE drug or treatment works or fits all.
But beware and be aware that not all helping professionals are “healthy” either and I would want to test for personality disorders in any researcher who wanted to use drugs on people. Sorry if I offend, but there are bad and misguided people out there as you all should know by now, and some of them come with degrees and ties.
Please be careful.
I do try to keep an open-mind, but as always I will go WITHIN and ask my questions and follow my inner love and wisdom on what works for me and how I can help the client in front of me.
Thanks
JP Bailey, MA, IMF, MHRS, ACH, EFT-CC, etc. etc. certs on the wall….
Check out my RecoveryTapping.blogspot.com for using EFT Tapping and Recovery for helping adult children, codependency and emotional issues. Great debate! This is America were we all get to have our say. And my mama was a hippie and my daddy went to war, I was born in ’64.
TLC
Jeanette
It seems to me that the willingness to consider lots of ways for people to find not only healing but perhaps deeper meaning to be a worthwhile pursuit. If the use of MDMA in therapeutic settings helps, why should it not be used?I find the idea that there is “one right way” to deal with any issue problematic. For some, all the modalities mentioned above are helpful, but none are universally so. I also am amused by “purists” given the level of chemical substances we all live with daily. My guess is that we are exposed to many more toxins in food, cleaning compounds, fertilizers, etc. than anyone would be by the controlled and infrequent use of MDMA.
All drugs are foreign substances that leave a mark not just on our bodies but spiritualy as well.Energy medicine and touch therapies have many ways of helping a person to heal without drug side effects.
This is a very rich discussion to which I would like to add another, perhaps controversial, viewpoint. Controversial because it’s not universally accepted or “measurable” in conventional terms.
For the past 24 years I have been balancing energy in individuals with all kinds of personal histories. I am NOT doing therapy, and I often refer individuals for therapy. I have worked with individuals with PTSD whose progress was swift and lasting using energy balancing as an adjunct to other therapies. I have also worked with individuals who were suffering from various discomforts related to drug use, both in recreational and ritual settings.
I would like to bring into the discussion the necessity of support to the subtle energies, energies that act in synergy with the nervous system, in any treatment approach; especially those involving drugs. Pharma or non-Pharma. Energy support is particularly useful in easing the transition between the different states that the drugs catalyze. This approach would certainly broaden the opportunities to approach the varied needs of suffering individuals.
The more I read about the early days of psychedelics, the more I’m inclined to think that these drugs were banned not because their opponents feared they were dangerous (though those dangers exist) but because they feared the positive, culturally disruptive effects the proponents were claiming that the drugs could catalyze. It seems less to me like a conspiracy of “pharmaceutical companies” or “the government”, but a broader cultural phenomenon.
First let me say that I have had several years of experience both working as an addictions therapist and mental health therapist, as well as personally embracing a number of concepts in natural/alternative healing. I have also grown up in the generation that has included the phenomenon of “rave culture” and other places where psychedelics can be found.
I want to point out that there is a dearth of research on psychedelics in treatment, primarily because the U.S. Government took it off the table for us, not because it was proven ineffective. It’s difficult to get official clearance to do the research and get the drugs to use for it–it requires jumping through a lot of hoops, even now. I’ll leave it to the conspiracy theorists to debate about why psychedelics have been classed Schedule 1, rather than some of the more habit-forming (and legally prescribed) substances out there.
That said, there has been some evidence in the culture that psychedelics can be useful for trauma and also for curing drug addictions. Read Daniel Pinchbeck’s report of Iboga/Ibogaine in “Breaking Open The Head”, for example.
Based on my experience, I’d bet that if we did a very large study that looked at correlations between the overall amount of people with mental illnesses, such as anxiety and depression, and the overall amount of people who attempt to regulate their symptoms with marijuana, the match-up would be astounding. People are using psychoactives to treat themselves already, shouldn’t we find out why? And how well/whether it’s working?
As far as the treatment of PTSD specifically, I would venture that the use of psychedelics could be beneficial. Plenty of ancedotal reports tell us that psychedelics can profoundly change one’s attitude and outlook on life, and in some cases, instill a sense of spiritual or existential meaning in the user. This is, of course, if the “trip” is guided by a skilled therapist or other professional, and if what is learned out of that experience is then carried over into every day life. The other reason it might be beneficial, is that in some cases clients do not want to re-live their trauma– some have been through so much that it would be harmful to bring it back out again. Or, some clients cannot consciously remember what has happened. It seems to me that finding ways to ease symptoms without having to re-live a horrifying experience would be the more humane approach.
I think that, in a world increasingly faced with traumas, co-occuring disorders, and challenges, we should embrace as many different modalities of healing as we can get our hands on: Ones that work, and ones that clients can make use of, no matter what they might initially look like. Let’s support more research and see how many healing treatments we can find.
The recommended use of MDMA to treat trauma is not “over time.” You don’t take it everyday. The substance allows a deep experience that can be curative, sometimes. One or two times might be all it takes to attain a level of insight and forgiveness that, as one person, a prominent voice in modern Christianity, said, it take monks a lifetime to acquire. The effective dose of MDMA does not deplete serotonin anymore than LSD damages chromosomes. These myths are government sponsored propaganda meant to justify a martial attitude, not a scientific one, towards these drugs…
I am greatly concerned at the side effects of MDMA in treating anything, especially PTSD. Over time, MDMA depletes seretonin levels, and can cause serious depression.
There are other, drug free and dramatic ways to bring healing to PTSD.
Hundreds if not thousands, of underground therapists have known for decades that MDMA can be useful in skilled hands as a tool to help relieve PTSD and a million other things. Government funded scientists, beginning with Dr. Charles Schuster, then of the University of Chicago Drug Abuse Research Unit, at the request of the government, trumped up false reasons to make this drug illegal, and wasted taxpayer dollars (millions of them) to further their deception over the next twenty years. Hundreds of thousands, if not more, sufferers from PTSD, and other conditions brought on by our insane militaristic society, could have been helped in the decades since then.
At the root of this problem is our profit driven health care and pharmaceutical system. MDMA can not be patented, or a company would have invested the hundreds of millions it cost to bring a drug to market. It is immensely valuable in human terms, but since it can not be profited from it must be relegated to the margins of society, where all the really smart people are.
I’m not sure it is a step forward if the Pentagon takes an interest in it. As a veteran commented in a recent Scientific American article on this topic, the Pentagon will be delighted if a large percentage of PTSD sufferers symptoms abate. They won’t have to pay for their disability anymore. There are better uses of this drug. How about we do some studies to see if it can undermine the psychological basis of war. That would be progress.
For a 2-volume collection of chapters written by leading biological researchers and medical doctors, I recommend Psychedelic Medicine: New Evidence for Hallucinogenic Substances as Treatments (2007). Winkelman, Michael, and Roberts, Thomas (eds.) Praeger/Greenwood, Westport, Ct/London.
If I recall, MDMA, the “Love Drug” was first utilized in a therapeutic setting with warring couples, to suspend the hostilities for a while. It did make them amorous for the duration of the high, but when the drug wore off so did the effects. Therefore it wasn’t seen to be clinically effective and was discontinued. I would wonder if the same might not be true with PTSD or other concerns. Something more than administering the drug alone is called for. I’ll be interested to hear how it unfolds. But it does bring back the notion there is nothing new under the sun…
Good article. I do like your stance Ruth. Let us see what comes of this. Although, I am not too sure about a lot of the comments. Sure, we need more research, but we also have to leave the decision to use or not use this drug to the person experiencing trauma. Let them decide and do it in a safe and loving environment. People should have choice about what they want to do, not be told what they should and should not be doing by professionals who do not really know much about this substance. Of course there are other methods of treatment, but these are not effective for everyone! Just because it is a drug does not mean people will get addicted after one trial! This is about pain and trauma, not addiction. I say let the experiments begin and lets see how it turns out. It is about time.
I am much more open to the utilization of naturally occurring rather than pharma producing. And, lets not forget the best drug of all…absolute unconditional love…the best drug in the world. The patient is never any more healed than the therapist see him/her at the first moment of meeting.
I am definitely open-minded about the possibilities of using MDMA to treat PTSD. I agree with some of the above commentary that the non-drug options may work for some people but definitely not all and certainly not without a good deal of hardship getting there much of the time. I can say this from personal experience myself of having tried a number of non-drug strategies for dealing with my traumatic reaction patterning. This is still an ongoing issue. Don’t get me wrong. In the past, I have typically gone to great lengths not to go to a drug option for many different health issues in my life, and I understand that there can be issues (as mentioned in other replies) going the drug route too. However, let’s face it. So many people suffering from traumatic reaction patterning end up self-medicating because they are desperate to make it stop. There is something to these substances that directly impacts and interferes with the problematic brain patterning. Maybe it’s not a black and white issue of straight out abuse of substances to escape the pain. Maybe there’s some wisdom in here too. Maybe this research demonstrates a responsible way to take advantage of what these drugs may have to offer. I really don’t know, but I’m willing to listen.
The AZ psilocybin “trials” are more than hopeful. Even taking into account a mild researcher positive bias, nonetheless we are looking at profound improvements that other approaches cannot begin to touch in efficacy. Demonizing this useful and natural healing substance is altogether too predictable a response by the Federal government over the past 44 years now. Apparently, those who control how life is lived here in America are eternally concerned about minimizing even the potential for American citizens to have thoughts that are not entirely congruent with the shared hallucination created and maintained by them that this is a good and healthy reality we are living — this life — a hallucination that is coming apart at the seams as the tragedy of misdirected vested power resonates around the globe and the world continues catching on fire.
I am not a “professional” – I’ve had PTSD almost all my life – The symptoms have finally abated. Let me say I’ve tried everything known to “professionals” and I finally learned I had to find an answer to my suicide – laden depressions myself. ETF does not work for me – none of your meds worked and therapy was useless for the most part. I have FINALLY achieved recovery after many many years using marijuana for the most part. It is the ONLY substance that has ever worked in terms of bringing relief. It also assists in understanding myself and bringing me closer to God.
There are so many other ways to work with PTSD (EFT, NLP, InterActive Guided Imagery, spiritual path…), why take the chance with a drug?
I had to respond to the last post. Science in this field is not devoid of opinion. Just because we measure qualitative information does not mean it is science. Much of our science is based on colonialistic ways of sorting and measuring information. The questions researchers ask are always influenced by the ideas and education they’ve received. They bring their own preconceived opinions to the research. I’m kinda leaning towards a good gut instinct that says ‘Just say no’ to drugs.
I think you took exactly the right tone, Ruth. Opinions are cheap, plentiful, and often passionate. Whether ecstasy or any psychodelic is useful and safe for treatment is a matter for science, not opinion. We’ll see.
Thanks for the article.
I have to agree with Heather. MDMA does indeed cause nerve damage. In general I think drugs are not needed for successful PTSD treatment, except in cases where stabilization may be needed to begin treatment. There is also new, promising treatment for trauma and addictions with Peak States work.
David
You are Kidding Right!
As a Drug and Alcohol Counselor let’s look at the negative impact of use of Ectasy on people! This drug burns brain cells and users are left with the need to be on SSRI’s for the rest of their lives in order to help the brain survive.
I am concerned that some counselors left over from the 60’s movement will see this as a comfortable answer. Let’s get the books out, do some research on what we know about these drugs before we traumatize people.
There was someone who did a study to teach the Moderation Movement for drug users. They thought you could sit a drunk down at a bar and teach them to only drink so many and they would be responsible. The person who began the Moderation Movement is doing Life in Prison for Vehicular Homicide by DUI.
This is one of those places where people who are mental health counselors need to leave the drug counseling up to the Certified Addictions Professionals.
To correlate the “moderation” test
and the legal status of it’s creator with a treatment using MDMA in a structured, evidenced-backed protocol seems misguided to me. How many chemicals are legal, but if abused would cause unnumerable consequences? You may not be making a fair comparison.
There’s a tremendous opportunity to promote positive outcomes in less than a year, compared to SSRIs for 30 years. Both in the impact on client well being and cost to society.
If a treatment can claim such powerful results, does it matter what the name of the medicine is? Or how it affects people when abused inappropriately without clinical supervision? We have controls in place for SO many chemicals. What makes this any different?
When I think about the level of stress that is so prevalent in our society these days I think that the controlled and therapeutic uses of Ecstacy and other substances can be considered a spiritual calling designed to combat the level of malaise in the collective psyche of our time.
This can be done responsibly; I wonder about using innovative forms of participatory/qualitative research designed to establish safe protocols and to establish maps of experiential learning. I reckon a good deal of this is happening in isolated pockets.
There is such a huge cry for healing these days. Thanks for this article!
Dennis Mendonca MA, MFT