General News — 18 March 2014

It costs about $US2,000 to buy an ounce of the illegal drug, the  therapist said – enough for roughly 150 doses. She pays her longtime dealer in  cash; he gives her a small plastic bag of white powder.

Back home, she scoops the contents into clear capsules. She calls it “the  medicine”; others know it as MDMA, the active ingredient in the party drug  Ecstasy.

MDMA has been banned by the US federal government since 1985 as a dangerous  recreational drug with no medical value. But interest is rising in its potential  to help people suffering from psychiatric or emotional problems.

A loose-knit underground community of psychologists, counsellors and healers  has been administering the drug to patients – an act that could cost them their  careers.Pills

“I do what is morally right,” said the therapist, who lives in Northern  California and did not want to be identified. “If I have the tools to help, it  is my responsibility to help.”

A series of clinical trials approved by federal drug authorities is now under  way to see if the drug’s ability to strip away defensiveness and increase trust  can boost the effectiveness of psychotherapy.

One of the key studies focuses on MDMA’s effect on military veterans  suffering from post-traumatic stress disorder.

Farris Tuma, head of traumatic stress research at the National Institute of  Mental Health, said he’s sceptical because there is no plausible theory so far  about how the drug’s biochemical effects on the brain could improve therapy.

“They’re a long way between where they are now and this becoming a standard  clinical practice,” he said.

A surge in Ecstasy-related deaths at raves has reinforced the compound’s  destructive reputation.

But some of those who have given MDMA to patients are optimistic.

The therapist said she became a believer in the late 1980s after it helped  her deal with her own trauma. She has since conducted roughly 1,500 sessions  with patients, leading them on four-hour explorations of their feelings.

She uses only the purest MDMA – in contrast with street Ecstasy, which is  typically contaminated – and none of her patients has ever experienced an  adverse event, she said.

The therapist said she knows roughly 60 professionals in her region who use  MDMA in their practices – and the number is growing.

“We are responsible therapists doing respectable work,” she said.

MDMA – or 3,4-methylenedioxy-N-methamphetamine – was first synthesised a  century ago by chemists at Merck & Co. Inc., which patented it as a  precursor to a blood-clotting medication.

Toxicity experiments secretly conducted for the US Army and later  declassified have fuelled speculation that the military was interested in MDMA  in the 1950s as a chemical weapon or truth serum.

Then in 1976, Alexander Shulgin, a former Dow Chemical Co. researcher who  devoted his life to research and self-experimentation with psychedelic drugs,  synthesised MDMA and tried it.

“I have never felt so great, or believed this to be possible,” he later wrote  about the experience. “The cleanliness, clarity, and marvellous feeling of solid  inner strength continued through the rest of the day, and evening, and into the  next day.”

The following year he gave the drug to Oakland psychologist Leo Zeff, who was  so impressed he came out of retirement and began introducing it to therapists  across the country.

By some estimates, as many as 4,000 therapists were using MDMA in their  practices before federal authorities banned the drug.

“We lost a major tool that was really growing,” said Dr Phil Wolfson, a San  Francisco psychiatrist who used the drug in his practice when it was legal.

MDMA’s chemical mechanism remains unexplained beyond the broad effect of  raising levels of serotonin and oxytocin – brain chemicals related to well-being  and social bonding – and triggering the amygdala, a region of the brain involved  in processing memory and emotion.

Therapists say MDMA can put patients in an emotional sweet spot that allows  them to engage difficult feelings and memories.

Bob Walker, a 69-year-old Vietnam veteran from Chico, tried Ecstasy on his  own after hearing it was being used to treat PTSD.

A few weeks after his first Ecstasy trip, he took it again and had his  girlfriend drive him to a therapy appointment. His therapist had no experience  with the drug but had agreed to the session.

Walker said the experience released him from haunting images of seeing a  friend killed in a helicopter crash and watching a young Vietnamese boy die in a  truck accident. “I didn’t lose any memory of what happened,” he said. “I lost  the anxiety.”

The therapist, who did not want to be identified, said Walker seemed to open  up. “This barrier that had been there was suddenly gone,” she said.

Despite worries that she was risking her career, she agreed to conduct two  more three-hour sessions over the next several months.

“Once his soul was open, it didn’t fully close again,” she said. “Each time,  I feel that he was closer to his truest nature.”

Tim Amoroso, a 24-year-old Army veteran, was tormented by memories of looking  for body parts after a suicide bomber killed five US soldiers in Afghanistan. He  said antidepressants and anti-anxiety pills prescribed by doctors at the VA  provided little relief.

Now a student at the University of New Hampshire, Amoroso bought Ecstasy at a  music festival last summer and later took the drug with a friend watching over  him.

“I feel like I found meaning again,” Amoroso said. “My life wasn’t as bad as  I thought it was.”

The new research into MDMA’s therapeutic potential largely stems from the  efforts of Rick Doblin, a former hippie who earned a doctorate in public policy  at Harvard University to help his quest for drug legalisation.

Doblin’s nonprofit Multidisciplinary Association for Psychedelic Studies,  which runs on donations, has sponsored all research into clinical uses of MDMA.  Doblin hopes the drug follows the same path as marijuana, whose approval for  medical purposes led to broad public acceptance.

In 2004, South Carolina psychiatrist Michael Mithoefer launched a clinical  trial involving 20 patients suffering from PTSD – mostly female victims of  sexual violence who had unsuccessfully tried other therapies.

Ten of the 12 who received MDMA during two sessions improved so much that they no longer qualified for a PTSD diagnosis. Patients who received a placebo fared worse. A follow-up study published in 2012 found that, for the most part, the patients who improved continued to do well.

Mithoefer is now conducting a study looking at whether MDMA has a similar  effect on veterans, firefighters and police officers afflicted with PTSD.

One participant is a 57-year-old retired Army major who has struggled with  memories of a young soldier killed in an ambush in Iraq. The major hadn’t been  able to talk much about it in earlier sessions without the drug.

“The kid, he’d shown me pictures of his young kids and wife and all that,”  the soldier said in a videotaped therapy session. “To get to know someone and  trust him, and now you know he’s dead – it’s tough.”

In subsequent testing, the severity of the major’s PTSD declined, the  researchers said. The study’s full results on 24 subjects are expected late next  year.

Among other studies, a trial set to begin at Harbor-UCLA Medical Centre will  test MDMA’s ability to combat social anxiety in high-functioning autistic  adults. Bay Area researchers also are planning to conduct a study of whether  MDMA can reduce anxiety in patients facing deadly illnesses.

Experts not involved in trials said they haven’t seen enough data to draw  conclusions. They noted that in a Swiss study funded by Doblin’s group, the drug  did not significantly reduce symptoms of PTSD.

With a budget of $US2 million a year, Doblin’s group doesn’t have the money  to pay for the wide-scale trials needed for scientific clarity and FDA approval.  His hope is that the government will step in with funding.

Doblin has met with officials at the Pentagon and the Department of Veterans  Affairs, but so far the government has kept its distance.

“Ecstasy is an illegal drug and (the) VA would not involve veterans in the  use of such substances,” a spokesman said in an email.

This article first appeared on ‘Brisbane Times’ on 18 March 2014.


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