Post traumatic stress disorder (PTSD) is an anxiety type disorder that can occur following psychological trauma such as exposure to combat horror, rape and assault, prison time, or a Taylor Lautner omnibus.
Common symptoms of PTSD are a lack of ordinary emotion, flash-back type re-experiences, and an inability to focus, like Lautner’s acting. Sufferers commonly fail to engage in ordinary work or social life, and thus reports of marital breakdown and suicide are common. Current treatments for this devastating condition are laborious and commonly fail.
Thereby it is essential that any potentially beneficial intervention should at least be tested for efficacy and safety …
Sounds straightforward enough. Test the drugs we have at our disposal for the treatment of the people who need them. Right?
The problem is that certain prudish elements within the establishment turned basic research into a political controversy that is only now being reversed. Thanks in part to recently published research, it appears that large trials of MDMA are finally in the pipeline for PTSD patients.
Yep, that’s chem nerd short hand for 3,4-methylenedioxymethamphetamine. But try pronouncing that in the bathroom of your local drum n bass club—hence ‘ecstasy’, which rolls off the tongue far more readily, and so on down the digestive tract. Once there MDMA can readily spread from the blood stream to induce acute effects on brain function.
Current understanding of the function of MDMA goes beyond the recognition that it induces saucer eyes and gurning mouths.
MDMA is known to have multiple effects on the brain, which is part of the reason opponents of its use suggest that we not bother testing it. If we applied that criteria to all potentially life saving drugs then we would all be dead, diseased and dour.
Three of the most significant effects of MDMA are:
-dampening activity in the amygdala, the ‘fear centre’ of the brain
-inducing production of oxytocin, the ‘bonding’ hormone
-secreting of serotonin, the ‘euphoria’ hormone
Oxytocin is woman’s best friend, as it eases birthing and sponsors breast milk production. Mothers even secrete it into breastmilk, effectively spiking it—drugging poor baby into believing that mother is an object of affection.
Under no other circumstance would blatant doping of innocent children be acceptable. Drug addicted children take years to be weaned off the bonding drug, to realise that mothers are very nagging and controlling. Tragically some boys never escape.
In combination with activation of the monoamine neurotransmitter serotonin, oxytocin-induced bonding effects are hypothesised to give PTSD sufferers a bond with their therapist and allow them to contemplate traumatic events.
If MDMA were any ordinary drug this research would have happened many years ago, therapy might now be mainstream, and people who have already suffered too much might be able to re-integrate with society.
The controversy surrounding MDMA treatment of PTSD, or indeed any other condition, is obviously that MDMA is the major active ingredient in the street bought illegal party drug, ecstasy. There is thereby an obvious political motivation for not wanting to give positive publicity to this un-taxed drug—this bane to the alcohol industry.
Proponents have long pointed out that MDMA is only one component of dirty street bought ecstasy, and that many of the negative complications of ecstasy abuse might be related to contaminants or to coincidental factors.
Ecstasy users often co-imbibe in smoking, drinking, and other drugs, dancing stupidly into dehydration, staying awake for long periods, not eating, and engaging in other self harming activities. It goes without saying there are not glow sticks and skimpily clad dancers in the MDMA clinical environment, and that it is not ordinary to listen to bangin’ progressive trance music while in a doctor’s arms.
Also confounding the potential benefits of MDMA based therapy is that most data collected on the use of MDMA is based on ecstasy users who might already be more likely to be of a personality susceptible to psychopathology, drug dependence, or self harm.
In this latest research published in the Journal of Psychopharmacology, treatment-resistant PTSD patients were studied over a longer time period than had previously been attempted.
Although the study, entitled Durability of improvement in posttraumatic stress disorder symptoms and absence of harmful effects or drug dependency after 3,4-methylenedioxymethamphetamine assisted psychotherapy: a prospective longterm follow-up study, was only small, and larger more statistically significant studies are in the pipeline, the research suggests that PTSD sufferers can be successfully treated with lab made disco biscuits, with no serious side effects … aside from the immediate jaw grinding, sweating, elevated heart rate, extreme thirst, and increased desire to engage in unsafe sex with the nearest half decent stranger.
Without wanting to provide ammunition to the naysayers, it is clear that studies of this nature are almost impossible to properly control. No, I am not suggesting the researchers cannot be trusted with their reagents—a functional placebo for MDMA is impossible.
MDMA has acute and significant effects on users/patients. A subject given placebo is as ignorant, and about as pleased, as a clubber who has just paid 10 quid for an aspirin in the toilet at Ministry of Sound.
Those on placebo know they are on placebo. Those on the drug know they are on the drug. And what was that bacon about knowledge and power?
This knowledge obviously ruins any placebo effect. Worse still, if you go out of your way to engage in a drug trial and then discover the joke is on you, you are the placebo, generally you might get a little peeved. This was abundantly clear in a recent English TV ‘study’ on Channel 4. They looked at the effect of MDMA on ‘healthy’ volunteers from various segments of society. Many subjects were eagerly looking forward to their drug treatment.
And that is the crux of it all. For some patients treatment with MDMA or other psychoactive drugs is not only a medicine, but an experience.
How disappointing for the placebo takers when they realise that their experience, as well as their treatment is all smoke and mirrors, without the lasers and highs! Then throw PTSD into the mix—nobody wants to be at that festival.
A further issue brushed over by the researchers, and even more so by media reports hyping the Journal of Psychopharmacology study, is that PTSD sufferers tend to engage in activities that confound analysis.
Of the 20 participants, 8 reported cannabis use during the trial period, another reported use of psilocybin containing fungi, yep magic mushies, and one even tried street ecstasy. With their huge cohort partying itself out of contention the panicked researchers attempted to control the damage by stating that the ecstasy user had imbibed the illegal drug in a ‘quasi therapeutic setting’.
What … a disco?
And as you might expect from a bunch of party animals, all subjects in the trial heartily answered yes to the question:
“Do you believe more MDMA sessions would have been helpful?” for further treatment of PTSD, set either “at a later time point” or “soon after the last one.”
One could argue that although the evident high percentage of illicit drug use among PTSD sufferers confounds study of them, perhaps this is ‘street’ or ‘alternative medicine’ or ‘guru’ evidence that some of these mind altering substances are efficacious in the treatment of PTSD—like a sick dog eating grass and not knowing why.
But then perhaps that is offensive to sick dogs. Dogs might have a long and proud history of grass roots medicinal knowledge.
Clearly the field of MDMA research has its highs and lows. But with small scale clinical trials being conducted around the globe it is clear that larger more statistically significant trials are on the horizon.
If MDMA can help PTSD sufferers overcome their illness, then bring it on. It’s not the fault of the PTSD sufferers that ravers discovered the drug first. But which politicians are going to be the first to legislate?
Some might point to the very eager Lib Dem politician Evan Harris for his live on TV participation of the Channel 4 study. But he’s not a real politician—crucially, he is an ex Lib Dem … and besides, he’s a Lib Dem. Good luck convincing David Cameron to join that party.
Endorsement of this kind of research could be political suicide because if legalisation of MDMA for medical purposes is passed, there will surely be a massive upsurge in reporting of PTSD. All of these patients will report that MDMA therapy is working, but that it might be some time before they are cured, just one more session please. No doubt there will also be a significant shortage of ‘medicine’ on weekends and around festival season. Who would want to be the pollie remembered for that?
Prospective patients might even report traumatic events that never happened.
“I was raped yesterday. Gimme some drugs doc. Hurry up yeah, Oakenfold is playin’ a massive set at the Hacienda tonight and all the old crew will be there. I really need to recover from that trauma. Gimme me the pink ones with the cherry pressing. They’re da bomb. Init.”
For other Science Satire Serpentry go HOME. Off with ya.
Photo credit: By National Institutes of Health [Public domain], via Wikimedia Commons