By Charalampos Karouzos,
MDMA acquired and used at a Saturday-night event, however, is a whole different story, very far from the sphere of the drug’s medical usage for treating serious psychological diseases, a field with great potential. Ecstasy, by acting on the brain, and specifically on the connections of different nerves (synapses) can be used as an enhancer of psychotherapy or medication to treat severe PTSD (Post-Traumatic Stress Disorder), a disease that is increasingly diagnosed worldwide. Indeed, a groundbreaking paper was published in May 2021 in the prestigious Nature Journal, showing great results incorporating MDMA in psychotherapy for treating PTSD. The researchers identified that MDMA-assisted therapy is highly efficacious in individuals with severe PTSD and treatment is safe and well-tolerated, even in those with comorbidities.
Although the results were produced in one clinical environment and certainly more extensive research must take place to understand ecstasy’s role in treatment, undoubtedly the results are astounding. As one of the lead authors of the groundbreaking research told the NYT, “Unlike traditional pharmaceuticals, MDMA does not act as a band-aid that tries to blunt symptoms of PTSD. Instead, in people with PTSD, MDMA combined with therapy seems to allow the brain to process painful memories and heal itself.” In addition to that, mental health experts believe that PTSD is just one psychological condition that may be treated with psychedelic-assisted therapy, with more conditions including substance abuse, obsessive-compulsive disorder, phobias, eating disorders, depression, end-of-life anxiety, and social anxiety in autistic adults being put under rigorous research.
MDMA’s safety profile is a subject of both interest and concern. While the adverse reactions identified during clinical research are few to none in controlled dosages, the safety of the drug when used recreationally has raised questions. The lack of regulated production and varying purity of illicitly purchased ecstasy tablets voices alarm, as cases associated with dehydration, overheating, and serotonin syndrome have been reported. Indeed, quoting a statement of Matthew Johnson, a professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine “In Britain, where around half a million people take MDMA each year, authorities report an average of about 60 annual MDMA-related deaths, most of which involve additional substances. Deaths related to MDMA do happen, although they are far rarer than those caused by several other legal and illegal drugs, such as alcohol or cocaine.”
Expanding treatment alternatives, particularly on certain psychological diseases with limited effective options, undoubtedly holds promise for humanity, nevertheless; the reintegration of previously prohibited psychedelic amphetamines into medical practice has raised a plethora of pivotal questions. Ecstasy, remains among the most widely abused drugs worldwide, sustaining a position in the annals of the 20th century, with ethical concerns to prevent future misuse being valid. Striking a harmonious balance between harnessing MDMA’s benefits as a novel, prosperous option in treating psychological diseases, while simultaneously curbing the risks associated requires an incredibly complex regulatory framework that allows controlled administration of the drug in a medical context. Collaboration among medical professionals, policymakers, ethicists, and the public presents the right step to establish guidelines ensuring the well-being of both patients and communities.
In conclusion, the role of MDMA in the 21st century is still unclear affected by a series of intricate and multifaceted factors spanning from its historical roots to its intricate cultural significance and promising medical possibilities. The complex duality of the drug emerging from the 20th-century rave counterculture to a profound impact on culture, to being a subject of medical exploration cannot be overlooked. Yet its potential for therapeutic application, particularly in treating conditions like PTSD, underscores a new chapter in its story. Continued research along with policy regulators and ethicists are collectively called into action to establish the strategy for MDMA’s responsible utilization, aiming to, in this evolving landscape, identify a balanced approach between the profound capabilities of the drug and the risk of misuse.
- Morbidity and Mortality Weekly Report (MMWR) Centers for Disease Control and Prevention. Available here
- Mitchell, J.M., Bogenschutz, M., Lilienstein, A. et al. MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study. Nat Med 27, 1025–1033 (2021).
- Panton, M., Kim, J., Van Alstyne, ·. K., & Anagnostara, S. (2021). MDMA and memory, addiction, and depression: Dose-eﬀect analysis.
- Nuwer, R. (2023) MDMA is one of the safer illegal drugs. but there are risks., The New York Times. Available here
- MDMA (2021) Bristol Drugs Project. Available here
- Nature Research (2020). MDMA-assisted therapy for severe PTSD: A randomized, double-blind, placebo-controlled phase 3 study. Nature Medicine.
- Griffin, D., Black, N. and DiCarlo, P. (2018) 9 things everyone should know about the drug Molly, CNN. Available here