Right now, millions of people are suffering from post-traumatic stress disorder (PTSD) worldwide. Up to 14% of the population of the US will suffer from PTSD in their lifetime. PTSD can develop after any kind of trauma, most commonly sexual assault or combat experience. People with PTSD may find it hard to function normally, re-experiencing their trauma in frequent waking nightmares. It can lead to depression, drug abuse, and even suicide in many cases.
SSRIs (Selective Serotonin Reuptake Inhibitors) and benzodiazepines are the most commonly used medications, but benzodiazepines do not have evidence to support their efficacy, and SSRIs only have moderate efficacy. In fact, one meta-analysis has found that 10 patients need to be treated with SSRIs for 11 weeks before a single patient will respond to treatment. Many PTSD patients who are resistant to these therapies often develop a chronic form of the disorder.
MDMA AND PTSD
The psychedelic MDMA, or ecstasy, is most commonly known for its use as a party drug. But MDMA was originally used as a tool for psychotherapy in the 70s and 80s. Psychotherapists used MDMA to induce an easily controllable emotional state that enhanced communication with their patients. When MDMA leaked into recreational use, authorities became aware of its existence, and it was made illegal in the US in 1985. Its use as a psychotherapeutic wonder-drug was abruptly halted.
That is, until recently. Convinced that thousands of psychotherapists had been onto something, MAPS (the Multidisciplinary Association for Psychedelic Studies) has funded investigations into MDMA’s therapeutic potential.
In their pilot study, 20 patients suffering from acute PTSD, most of them victims of sexual assault, were recruited for MDMA-assisted psychotherapy. They all had failed to respond to previous treatments and therapy, and on average had been suffering from PTSD for over 19 years.
In this double-blind, placebo-controlled experiment, subjects were given MDMA during long, thorough therapy sessions, overseen by healthcare professionals and administered by psychotherapists. After these sessions, the patients were measured for PTSD symptoms using two widely accepted tests.
As little as three days following the therapy, patients that had taken MDMA had significantly lowered PTSD scores compared to the placebo group. Amazingly, 10/12 of the patients who had been given MDMA-assisted psychotherapy no longer met PTSD criteria, meaning they were free of the disorder after many years of suffering. Three subjects, who had previously been unable to work due to the condition, were able to return to work as a result of the MDMA-assisted psychotherapy.
These results are impressive enough, regardless of long-term efficacy. However, the same group performed a long-term follow-up study and found that most of these patients (74%) had remained PTSD-free several years down the line. The authors state that these positive effects are an improvement from typical PTSD treatments, where only a small fraction of sufferers will respond to pharmacotherapy. MDMA-assisted psychotherapy also appears to be an improvement on talk therapy alone, where success rates are varied but generally small.
10/12 of the patients who had been given MDMA-assisted psychotherapy no longer met PTSD criteria.
As with all pilot studies, there are various flaws in the design, mostly relating to the small number of patients. MDMA is not a miracle drug. In this case, both the experimenters and the patients strongly believed that the controlled therapeutic environment was crucial to the success of the trial. Without guided, professional therapy, MDMA self-administration may not have the dramatic benefits shown in this study.
Testimonials from participants in the study are striking:
After witnessing the death of my 34 year old husband and another man in a violent accident, I was diagnosed with PTSD. I participated in the MAPS MDMA/PTSD study and it saved my life […] My PTSD kept me from grieving, which kept me from moving forward in my life, which made me want to die. I participated in the Boulder MAPS study in 2014 and I am finally experiencing the life saving progress everyone told me was possible.
My symptoms of PTSD became “treatment-resistant” after the medication and psychotherapy that the Veterans Affairs provided was ineffective. I began to search for alternative treatment methods, and that’s when I heard about the trial of MDMA-assisted psychotherapy to treat PTSD. After being accepted as a participant and receiving the treatment, I am proud to say that I am no longer on medications, I am able to more fully live my life, and my relationship with PTSD has changed completely.
I was prescribed many medications to treat my PTSD symptoms, but none of the treatments helped me […] My diagnosis developed into treatment-resistant PTSD and I began to drink extremely heavily and smoke upwards of two packs of cigarettes a day. […] I found out about the study conducted by MAPS and I applied to participate. I was accepted to the study and I saw a profound difference in my symptoms after the first treatment. After only 3 sessions of therapy with MDMA, I no longer qualified for a diagnosis of PTSD. Now that I have recovered from PTSD, I am able to lead a happy and productive life again. I can enjoy my beautiful relationship with the love of my life and my friends and family. It is my personal goal to spread awareness about research into this treatment method so that veterans and others suffering from traumatic events can also experience life without PTSD in the near future.
There are also various reports of people using MDMA self-administration to dramatic effect, although this is not recommended:
After deployment I developed a mild case [of PTSD]. The VA like to fix it by giving you disability checks in the mail…. So I took that money and bought drugs. Now three years later I can say I am a much happier person; less outbursts, better emotional control, I actually want to wake up in the morning and go to work, overall just have a better outlook. Over this time I have taken quite a bit of MDMA.
My PTSD was induced in childhood and was DID [Dissociative Identity Disorder] by the time I started MDMA at 19 […] The chemical broke down all my internal walls, made me whole. It still does to this day, but the chemical acted as a guide to integration so there’s a lot less division than there once was.
I have PTSD associated with my parents divorce and mothers subsequent drug addiction. [MDMA use] was the first time I ever felt comfortable with myself and started the process of building my self-esteem. A tremendously beneficial experience.
AYAHUASCA AND PTSD
Although there have been no clinical studies of other psychedelics and their potential to treat PTSD, there are dozens of reports of people experiencing healing effects from the psychedelic brew ayahuasca. The therapeutic shift in perception that ayahuasca offers could hold great promise in the treatment of PTSD.
Russ Binicki is a US combat veteran who experienced devastating PTSD symptoms after returning home from the Vietnam War. After years of unsuccessful treatment, he heard about the healing potential of ayahuasca from someone in his support group. Interested in any treatment that could help him, he travelled to Peru, where he took part in eight ayahuasca ceremonies:
I learned a lot of the reasons for my behaviors that I thought were normal, but really weren’t.
The experience allowed him to see himself from a new perspective and helped him revisit the traumatic memories of Vietnam in a positive light. He is not attending regular PTSD therapy sessions and recommends ayahuasca to any PTSD sufferer.
Richard Stroder, another US combat veteran, has also found therapeutic benefits from ayahuasca experiences. He was a victim of numerous sexual assaults in the military, which left him with severe PTSD. He found no relief in typical pharmacological treatment, and eventually traveled to Peru as part of MAPS’ program for veterans. With other veterans beside him, Richard participated in three ayahuasca ceremonies:
I was able to recall trauma and remember parts of my experiences that had previously been blocked out. I was able to process not only experiences from the military, but also from throughout my entire life and see how they synthesized into the person I had become. I felt a love and acceptance like never before. Negativity and pain lifted from my shoulders and released from my body in what felt like what I can only describe as a psychedelic baptism.
Stories like these are appearing more frequently as more veterans and victims of traumatic events discover the healing benefits of ayahuasca.
I felt a love and acceptance like never before.
THE FUTURE OF PSYCHIATRY?
Currently, MAPS is funding several further investigations into MDMA-assisted psychotherapy and has already received approval for Phase III clinical trials by the FDA. These promising developments mean that MAPS hopes to have MDMA approved by the FDA as a therapeutic drug by 2021.
Although taking MDMA at home may not be enough to help you work through a traumatic experience, when used in a clinical setting with a professional therapist, it could help to turn modern psychiatry on its head.
As Dr. Ben Sessa says in his TED talk, MDMA could be to psychiatry what antibiotics were to medicine. MDMA could be the key to opening up mental health disorders and treating all sorts of personal trauma. It may not be long until you can get a prescription from your doctor. Until then, if you decide to self-medicate, do so safely and sensible. MDMA can cause irreparable damage if used irresponsibly.
Important Note: This is a constantly evolving document. If you believe we’re missing something important, please let us know.