Ecstasy trialled as PTSD treatment

[Zaune]

The Guardian

Doctors are planning the first clinical trial of ecstasy in the UK, to see whether the drug can be beneficial to the traumatised survivors of child abuse, rape and war.

Ecstasy and other illegal drugs such as LSD and magic mushrooms are potentially useful in treating people with serious psychological disturbance who cannot begin to face up to their distress, some psychiatrists and therapists believe. But because of public fear and tabloid anger about illegal drugs, scientists say they find it almost impossible to explore their potential.

Professor David Nutt, the psychopharmacologist who used to head the government's Advisory Council on the Misuse of Drugs until he fell out with the Labour home secretary and was sacked, said: "I feel quite strongly that many drugs with therapeutic potential have been denied to patients and researchers because of the drugs regulation. The drugs have been made illegal in a vain attempt to stop kids using them, but people haven't thought about the negative consequences."

Nutt and the Taunton-based psychiatrist Dr Ben Sessa are two of the British scientists who hope to repeat an experiment on patients with post-traumatic stress disorder (PTSD) undertaken in the US which, although small, was successful and has caused some in the scientific community to think what was until recently unthinkable. It involved 20 people who had been in therapy and on pills for an average of 19 years. Twelve were given MDMA – or 3,4-methylenedioxymethamphetamine, the chemical compound found, often adulterated, in ecstasy tablets. The rest had placebo pills but were later also given the chance to take MDMA. Each one had a therapy session, lying back in a reclining chair in a pleasant flower-decorated room in South Carolina, wearing an eyemask.

Sometimes they listened to music on headphones and sometimes they talked to the therapist, all the while thinking about the events that had caused such profound distress that they had been unable to revisit it in past psychotherapy sessions.

The response rate was a remarkable 83% – 10 out of the 12 showed significant improvement two months after the second of two MDMA therapy sessions. That compared with 25% of those on the placebo. There were no serious side-effects and no long-term problems.

"I expected it was going to be effective," said Michael Mithoefer, the psychiatrist who ran the US study and carried out the psychotherapy with his wife, Ann. "I suppose we wouldn't have done it otherwise. But I didn't necessarily expect we'd find such statistical significance in that number [of people]. That was the icing on the cake."

The high number of troops returning with PTSD from Afghanistan and Iraq is attracting special attention to the study in the US. Only one of the 20 was a veteran, while the rest had suffered childhood sexual abuse, rape or other kinds of assault. Mithoefer's next study will be on veterans alone.

Nutt said PTSD is "an extraordinarily disabling condition and we don't have any really effective treatments. In order to deal with trauma, you have to be able to re-engage with the memory and then deal with it. For many people, as soon as the memory comes into consciousness, so does the fear and disgust".

Mithoefer said the participants did not appear to have joined the trial in hopes of some sort of high. "I don't think that was much of a factor at all. Some people were referred by their therapist and had never taken any drugs and were quite anxious about the whole thing and for them it was a last resort.

" Interestingly, several people said after their session: 'I don't know why they call this ecstasy' – because it was not an ecstatic experience. They were revisiting the trauma. It was very difficult and painful work, but the ecstasy gave them the feeling they could do it."

People spoke of getting past a barrier. One said: "I feel like I'm walking in a place I've needed to go for so long and just didn't know how to get there.

"I feel like I know myself better than I ever have before. Now I know I'm a normal person. I've been through some bad stuff, but … those are things have happened to me, not who I am … This is me. The medicine helps, but this is in me."

Another said: "I have respect for my emotions now (rather than fear of them). What's most comforting is knowing now I can handle difficult feelings without being overwhelmed. I realise feeling the fear and anger is not nearly as big a deal as I thought it would be."

Ben Sessa said he hoped to recreate the study in the UK but "with an added twist – lots of neuroimaging". The only brain scans that have been done are of recreational ecstasy users, whose drugs may be contaminated and who have probably taken other substances, too.The death in 1995 of Leah Betts after taking ecstasy, from drinking too much water in response to a campaign warning ravers of the danger of dehydration, had prevented rational debate or scientific advance.

MDMA, he said, "is not about dancing around nightclubs – it's a really useful psychiatric drug".

Nutt said it made him angry that MDMA and LSD had been banned before any doctor could establish their potential benefit. LSD was being tried among terminal cancer patients.

"When I started in medicine in 1969 they were starting to see some interesting data in the use of LSD to help people make sense of dying. I don't think it is fair that because a drug is misused it should be banned from use in medicine," he said Heroin has been around for a hundred years so although it is illegal for street use, at least we have got that..

Leading the movement to get MDMA licensed for medical use is Rick Doblin, the founder in 1986 in the US of Maps, the non-profit Multidisciplinary Association for Psychedelic Studies, which backed Mithoefer's trial. "I think the chances of getting a licence are excellent. We have demonstrated an excellent level of safety. It's worked. It's necessary," he said. "It is probably going to take 10 years and $10m to do it."

Doblin, whose organisation relies on philanthropic donors, has no idea where that money will come from. Nutt and Sessa, whose proposed trial in the UK would boost the chances of MDMA entering the (locked) psychiatric drug cabinet are waiting for a response to their modest grant application from one of the UK's leading medical research funders. Sessa is optimistic; battle-scarred Nutt less so. Ecstasy will for ever be controversial. "If we get the study funded and into the public domain," said Nutt, "the Daily Mail will try to have it banned."

The second comment under the article, from someone with the mildly disturbing handle of "Pigscheese", says it better than I could:

I can already hear the rustle of the daily mail readers as they throw down their rag in disgust and reach for the pen to scribe off some vitriolic shite about how the druggies must be stopped countries gone to the dogs hangings too good for em, in my day the Major would tel you to pull yourself together and carry on fighting blah blah etc etc.
Sounds lie a good idea backed up with albeit so far small but good results. Because of that it will never catch on or be accepted into the mainstream.
Sad narrow minded little shithouse of an island we live on really isn't it?

[NoXion]

Why was MDMA made illegal in the first place?

It can't be for public health reasons, since we have evidence of tobacco and alcohol being more injurious to health.

[CaptainChewbacca]

Prolonged use of MDMA can permanently destroy your brain's ability to produce serotonin, which can lead to lifelong depression and other issues.

[Terralthra]

Prolonged ridiculous abuse of MDMA can permanently destroy your brain's ability to produce serotonin, which can lead to lifelong depression and other issues.

Fixed that for you. The only study which shows that effects is on rats and is a much higher dose per body weight than humans take.

On the other hand...UK studies indicates few significant long-term effects of moderate ecstasy use.

[NoXion]

Prolonged use of MDMA can permanently destroy your brain's ability to produce serotonin, which can lead to lifelong depression and other issues.

And what has this to do with whether MDMA should be legal for adult consumption, like alcohol and tobacco, for which the negative health effects of both substances are well-known?

[CaptainChewbacca]

I don't know. You asked why it was made illegal. I've no clue as to the rationalization behind the choice.

If I had to guess, I'd say its because alcohol and tobacco are billion-dollar industries with lobbyists and Ecstacy has guys in mesh shirts covered in florescent paint.

[Count Chocula]

It was sold in bars until 1985 or 1988 in the US, IIRC. The MDMA variant that is. I think MDA is what's being sold now. You can thank the guys in the mesh shirts for $5.00 bottles of water at bars.

[Sea Skimmer]

People were also doing research using MDMA as a treatment for depression and PTSD in the US before the drug was ever illegal.

I don't know. You asked why it was made illegal. I've no clue as to the rationalization behind the choice.

Combination of people claiming 'our poor children will get intoxicated and light themselves on fire' factor, and a number of incidents of people being poisoned by stuff which was improperly manufactured in home labs or cut with other material. The largely undefined brain damage factor was kind of secondary as far as I can tell. Alcohol and tobacco are legal because they were too well established in culture to die out; if someone had discovered one or the other in the last century it'd be illegal too.

It was sold in bars until 1985 or 1988 in the US, IIRC. The MDMA variant that is. I think MDA is what's being sold now. You can thank the guys in the mesh shirts for $5.00 bottles of water at bars.

People are selling both, and the ways people make those drugs they often end of making mixtures of MDMA and MDA and just sell it was whatever they fell like calling it.

[Silver Jedi]

I don't know. You asked why it was made illegal. I've no clue as to the rationalization behind the choice.

Combination of people claiming 'our poor children will get intoxicated and light themselves on fire' factor, and a number of incidents of people being poisoned by stuff which was improperly manufactured in home labs or cut with other material. The largely undefined brain damage factor was kind of secondary as far as I can tell.

As I understand it, most of the brain damage stuff came from a single improperly conducted study, because certain parties needed justification for their hysterical screeching.

As he said, the real danger from recreational use of MDMA isn't even from the drug itself, but from the fact that it's usually cut with who knows what. That may be the reason that "serious ravers" (if that makes sense) seem to be moving away from ecstasy pills and towards "molly" or straight MDMA powder. The general perception seems to be that with ecstasy pills, you're as likely to get caffeine and horse tranquilizers as you are MDMA.

[Sea Skimmer]

Its because you can buy test kits off the internet and that's easier to do with something that's already powder; testing pills would require you to grind up part of the pill first which is inconvenient. Either one can be cut with near anything from sand to baby laxative.

[Justforfun000]

In all seriousness...I just popped on and saw this thread commented on again and it got me thinking..

Drugs. Particularly mood-enhancing....high-producing..mind-altering types...they are numerous and quite different in effect and also harm ratio..

What should we as a human species with our best interests at heart judge these as? Should we be leaning towards the Temperance movements of the past...AA and what have you in the main or is there really an argument to be made that we have a beneficial, rational reason why altering our physical and mental makeup for periods of time is A) a right to choose how to live our life..B) A victimless crime for many of the "soft" drugs...C) Simply no one person's right or even a government to judge whether direct personal harm is caused or not as long as it is freely chosen and not impeding other people's quality of life...or many other letters of choice..

When you start off arguing these subjects a lot of people (average joe's..particularly mom and dad's that make up the most vocal section of the debate as a rule..), usually predicate the whole discussion with a sense of what is "right" and "wrong" and typically it stems from some innate belief that we should not be doing anything pleasurable for the sake of pleasure. Do you know what I mean? It's like Hedonism is the brand of stigma that is automatically levied on this type of behaviour..Naturally I'm aware many drugs are directly harmful physically and others cause massive social harm..I'm not arguing that or trying to sidestep that aspect particularly except in this specific philosophy question. Forget all the obvious shit Cocaine, Crack...Meth and other hard drugs cause..I'm thinking more along the lines of THC based things...mushrooms...MDMA.

Ironically I personally despise ALL of the "soft" drugs..I have had nothing but bad trips as a 9 out of 10 rule with marijuana, Magic mushrooms, LSD...etc. These were dabbles with in my teens..over 20 years ago...MDMA is a little diff..I ocassionally tried it and did like the general mood enhancing effects. But it was a rare thing and not an addictive or regular drug whatsoever. At least for me.

I'm curious what you all think is a fair and balanced way to judge substance usage. I had my dabblings of such in the past and as a rule I feel most if not almost all were better left untouched....I still LEARNED something...however others live their lives with it incorporated in their lifestyle....but it's easy to look back and say "Oh...I shouldn't have bothered"...but I could pull the same shit with relationships and other experiences that were both "bad" and "good" and ultimately...enlightening and they made me more experienced and shaped who I am and how I think today. I don't want to make absolute declarations on something foolishly.

Thoughts? I want some feedback to play this out...

[NoXion]

In all seriousness...I just popped on and saw this thread commented on again and it got me thinking..

Drugs. Particularly mood-enhancing....high-producing..mind-altering types...they are numerous and quite different in effect and also harm ratio..

What should we as a human species with our best interests at heart judge these as? Should we be leaning towards the Temperance movements of the past...AA and what have you in the main or is there really an argument to be made that we have a beneficial, rational reason why altering our physical and mental makeup for periods of time is A) a right to choose how to live our life..B) A victimless crime for many of the "soft" drugs...C) Simply no one person's right or even a government to judge whether direct personal harm is caused or not as long as it is freely chosen and not impeding other people's quality of life...or many other letters of choice..

I simply don't see why what I put in my body should be anyone else's business. Many of the arguments for keeping recreational drugs illegal, if consistently applied to include all mind-altering substances, fall apart in a welter of special pleading and hypocrisy.

As for those who would want to ban all mind-altering substances, including tobacco and alcohol, I have nothing but sneering contempt for such authoritarian neo-Puritan bullshit.

When you start off arguing these subjects a lot of people (average joe's..particularly mom and dad's that make up the most vocal section of the debate as a rule..), usually predicate the whole discussion with a sense of what is "right" and "wrong" and typically it stems from some innate belief that we should not be doing anything pleasurable for the sake of pleasure. Do you know what I mean? It's like Hedonism is the brand of stigma that is automatically levied on this type of behaviour..Naturally I'm aware many drugs are directly harmful physically and others cause massive social harm..I'm not arguing that or trying to sidestep that aspect particularly except in this specific philosophy question. Forget all the obvious shit Cocaine, Crack...Meth and other hard drugs cause..I'm thinking more along the lines of THC based things...mushrooms...MDMA.

Aside from the obvious kick that some seem to get when they act all sanctimonious about other people having fun, I personally think there is something else to it, especially when it comes to drugs that drastically effect mental processes but are minimal in terms of physical effects (these tend to be psychedelic hallucinogenics such as mushrooms and LSD; cannabis in high doses can also have psychedlic effects IIRC). I think there those who find the prospect of such drastic albeit temporary transformations of the psyche to be subversive and/or threatening to the social order. You aren't "supposed" to be able to have such experiences outside of a religious context and without the intervention of authorised spiritual figures.

If even a hardcore anti-theist such as myself can experience and appreciate the spiritual puissance of a psychedelic trip and see it as a mentally transforming journey that leaves any church service you care to name lying dead in the dust, that could easily be seen as a major threat to establishment-approved ontologies.

Ironically I personally despise ALL of the "soft" drugs..I have had nothing but bad trips as a 9 out of 10 rule with marijuana, Magic mushrooms, LSD...etc. These were dabbles with in my teens..over 20 years ago...MDMA is a little diff..I ocassionally tried it and did like the general mood enhancing effects. But it was a rare thing and not an addictive or regular drug whatsoever. At least for me.

I suppose some people just don't react all that well. My experiences with psychedelics has been overwhelmingly positive. I find that "bad trips" are generally a consequence of poorly-chosen "set and setting", or unresolved personal tensions that the drug brings to the surface.

I'm curious what you all think is a fair and balanced way to judge substance usage. I had my dabblings of such in the past and as a rule I feel most if not almost all were better left untouched....I still LEARNED something...however others live their lives with it incorporated in their lifestyle....but it's easy to look back and say "Oh...I shouldn't have bothered"...but I could pull the same shit with relationships and other experiences that were both "bad" and "good" and ultimately...enlightening and they made me more experienced and shaped who I am and how I think today. I don't want to make absolute declarations on something foolishly.

Thoughts? I want some feedback to play this out...

I don't think this the sort of thing where there are hard and fast rules that should apply to everyone. If someone is determined to experiment with drugs then they should have the opportunity to do so in a safe environment with good company, and drug prohibition not only makes that sort of thing harder, but also encourages the development and proliferation of "harder" drugs (that are often contaminated) by unsavoury individuals.

[madd0ct0r]

what a knowing, consenting adult does of their own free will (or consents to freely) should be allowed.

BUT when it comes to addictive substances, how much free will can be said to be involved?

but then you have to balance that against say coffee, which is incredibly addictive but reasonably harmless.

and the other end of the spectrum - say suicide. Completely nonaddictive, but does result in harm to the individual.

if a person should be allowed to harm themselves, or render themselves an addict, does it follow that harmful addiction should be allowed?

About the closest I've come to a solution is to guess what the person would desire if they had complete free will returned to them.
If you think in the future, once they sobered up, they'll thank you for your intervention, then intervene. If not, let them act (while enforcing the ' do not harm others without consent' part of the social deal' )

[NoXion]

what a knowing, consenting adult does of their own free will (or consents to freely) should be allowed.

BUT when it comes to addictive substances, how much free will can be said to be involved?

but then you have to balance that against say coffee, which is incredibly addictive but reasonably harmless.

and the other end of the spectrum - say suicide. Completely nonaddictive, but does result in harm to the individual.

if a person should be allowed to harm themselves, or render themselves an addict, does it follow that harmful addiction should be allowed?

About the closest I've come to a solution is to guess what the person would desire if they had complete free will returned to them.
If you think in the future, once they sobered up, they'll thank you for your intervention, then intervene. If not, let them act (while enforcing the ' do not harm others without consent' part of the social deal' )

Addicts can have varying opinions on their own addictions, you know. Shouldn't "what is to be done" derive from that somehow?

I think "free will" is a poor metric for this sort of thing, especially when it seems likely that "free will" is entirely illusory.

[someone_else]

BUT when it comes to addictive substances, how much free will can be said to be involved?

I generally categorize "Free will" as nonsense at the side of "lolberitarianism". It's basically impossible to have free will unless you are alone.

I see instead "needs".

In a society there are needs that do not conflict with other's needs and needs that do conflict. Finding a compromise between conflicting needs is a good course of action. Imposing your own needs on someone else is not a good course of action (unless you are dealing with children, another matter altogether).

Suicide should be discouraged if there is people that wants you alive for good reasons (say you have a family, friends, whatever), if none wants you alive and you don't deal damage to anyone else while doing it (for example train/metro are not a good way, you cause annoyance to loads of people), then you can.

Real addiction (i.e. using something you find extremely pleasurable outside of relatively rare and worthy occasions) to anything really (food, sex, whatever, not specifically drugs) is more or less another kind of suicide in my book, be it simply by degrading your life to a "i live for X" state or to turning you into a criminal (i.e. damaging others more directly) for the addiction. As long as none on earth gives a fuck about you, then you can do that. If you have people relying on you or similar, then it becomes a bad thing to do if to pursue your addiction you have to damage them.

I don't think the logic behind is so bad, but feel free to point out fuckups I haven't noticed.

If even a hardcore anti-theist such as myself can experience and appreciate the spiritual puissance of a psychedelic trip and see it as a mentally transforming journey

It's just another kind of masturbation. You go kick synapses directly with chemical shit, effect varies. Can be fun but has nothing inherently spiritual in it.
It's much more similar to "church journeys" than you may think. You just prefer this kind of flavor.
Whatever floats your boat, as always.

If someone is determined to experiment with drugs then they should have the opportunity to do so in a safe environment with good company, and drug prohibition not only makes that sort of thing harder, but also encourages the development and proliferation of "harder" drugs (that are often contaminated) by unsavoury individuals.

A good point.
Also provides buttloads of money to international criminal organizations. Money that could go to the government instead.
I bet that if drugs are sold only by government (at prices that would be hard to beat) they will lose most of their appeal.

[NoXion]

It's just another kind of masturbation.

Well, occasional masturbation has health benefits, or so I'm told. On the other hand, I can understand why it would be inadvisable for certain individuals to experiment with powerful psychedelics.

You go kick synapses directly with chemical shit, effect varies. Can be fun but has nothing inherently spiritual in it.

Strictly speaking there's nothing inherently spiritual in anything, surely? Maybe there's a better word to encapsulate an ego-unravelling experience that offers one a completely different perspective on one's place in the universe, and the subsequent new appreciation thereafter?

It's much more similar to "church journeys" than you may think. You just prefer this kind of flavor.
Whatever floats your boat, as always.

Difference is, being a religious believer is a full-time thing. I sober up.

[madd0ct0r]

@someone_else

Interesting, you consider satisfying the duties the individual has to others, I consider the individuals right's to act selfishly.

I think i prefer your logic, initially.

Now, under what circumstances can a duty be called upon?
can it only be called from other individuals or other things (like society as a whole, the government (eg conscription) )?

Because there's a long running argument against drug use that 'it is harmful to society'.
IE, even if you are single and there's nobody specifically relying on you, the society you live in would prefer it if you were a productive member.
indeed, the society NEEDS enough productive members to support everyone, and if your addiction makes you a net taker or a freeloader, then you are harming the other individuals in the society.

Which isn't far from what you argued, but i'm saying you can never escape a duty to the people around you, therefore the use of addictive disabling drugs (got to keep my coffee) should be illeagel

[someone_else]

Well, occasional masturbation has health benefits, or so I'm told.

That's because it keeps working stuff that otherwise sits dormant. I think I have read that it decreases the chances of contracting prostate cancer (prostate is heavily involved in preparing sperm to be ejected). I doubt there are substantial health benefits in using any kind of drug. The best you can get away with is not causing damage and getting in turn a good experience to add to your memories.

Difference is, being a religious believer is a full-time thing. I sober up.

Which makes your case of drug use not horribly harmful on the long run. It's the unconstrained addiction that causes damage, not the thing you are addicted to.

Hell, if we have to ban everything that is harmful I'd ban Mac Donalds and crap foods well before I'd start looking at drugs.

Interesting, you consider satisfying the duties the individual has to others, I consider the individuals right's to act selfishly.

Not exactly. There are no "duties", just contracts most people agree with. The existence of "duties" assumes the existence of a superior entity saying what is right and what is not. Given that there is no proof of such entity (sadly, if I might say), the next best thing you can get is a negotiation between more or less equals to get a contract that satisfies each one.

I respect your needs if you respect mines. If you don't respect my needs I don't see why i should respect yours.
If I have ways to coerce you to do what I want, you will need to convince me that you can do more for me if I respect you more than I would normally. That's a contract.

It kinda reminds me something that Wong has(had?) in his sig (from my memory): "Freedom is not a gift, nor a right, but a reward. What have you done today to earn it?"

If the contract is broken, then there is no more mutual gain, then there is no good reason for the old natural laws to not apply, and whoever is stronger (or smarter) does whatever he likes while weaker/dumber cower in fear. And numbers usually win.

Which happens when say a thief is caught. His needs suddenly become irrelevant and he is coerced to do whatever the people agreeing to the contract decided to do to thieves. Given that the average nation is theoretically stronger than the average thief, he has no chance. Might makes right just as in the beginnings. There is nothing inherently right or wrong, just something that the strongest dog in town (hopefully the government, in turn hopefully expression of the will of its citizens) enforces.

The lack of a superior authority telling what is right/wrong means that you don't have to necessarily agree to the contract, you can make what you want, but then you must have the smarts and balls to live without the support that most contracts that make up a society gives you (and fight against it when necessary).

Everyone does what looks more convenient to him.

Now, under what circumstances can a duty be called upon?

Depends from the contract. Putting the thing I said above in more modern terms, those contracts are laws, and democracy should theoretically ensure that the majority of the population agrees with them.
As long as most of the people agree that something must be done, everyone else has to obey or face the consequences of their combined force.
Being democratic, the process of making a contract/law should be a negotiation where the needs of all parties are satisfied.
In theory.

Which isn't far from what you argued, but i'm saying you can never escape a duty to the people around you, therefore the use of addictive disabling drugs (got to keep my coffee) should be illeagel

Not exactly. Any real addiction has the same net effect. And generally a similar cause.
The differences between a person weighting 4-5 times the normal weight and a crack whore are mostly cosmetic. And still none thinks to outlaw sugar.

Now, since the goal is having only useful members in your society, and not just being TOUGH ON CRIME, you have to enact measure that have the highest chances of removing addiction, not necessarily drug use. Making stuff illegal like it is now is at best a damage control measure, and a very crappy one if I may add. People can get addicted to more or less anything with similar results, and you cannot outlaw anything. Even assuming you manage to enforce that law 100% which is unrealistic.

So yes, in an ideal society (where the ruling class gives a shit about the well being of other citizens, or in a democracy where there is a majority of intelligent people) drugs won't be outlawed (although their use would likely be restricted to some places for convenience and safety, like with smoke and alcohol today), but there will be mechanisms that stop the addiction to something (anything) before it begins to damage society. And the people that somehow slip through this first line of defence will be forced to be cured of their addiction by the law.

I bet you understand why that would be an ideal society.