Ecstasy as Therapy: Have Some of its Negative Effects Been Overblown?

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Although ecstasy (MDMA) — a drug best known for enhancing feelings of empathy and love — has been demonized by parents and politicians, researchers have been quietly studying its potentially therapeutic effects, and they’ve discovered that the data is not bearing out the worst fears about the drug’s harmful effects.

Just this week, for example, a new study, which was funded by the National Institute on Drug Abuse and published in the journal Addiction, found that regular ecstasy use was not associated with cognitive impairment — contradicting some prior studies that did find lasting mental deficits associated with ecstasy use, such as problems with memory and attention.

The problem with those earlier studies, however, is that they had not adequately controlled for the fact that most MDMA users also take other drugs. Further, the control groups involved in past studies were not similar enough to the drug users for appropriate comparison.

For the new study, led by Harvard University’s John Halpern, researchers compared 52 long-term MDMA users, aged 18 to 45, with 59 nonusers. Unlike in prior research, both users and nonusers had participated in the “rave” subculture — meaning that they had all been exposed to potentially brain-altering experiences like dancing all night to repetitive music without adequate hydration. The MDMA users were also drug-tested before taking the cognitive tests, ruling out impairment from current drug use.

(More on TIME.com:  Ecstasy Shows Promise for PTSD)

Although the study found a small, possible increase in impulsivity in the ecstasy users, the researchers theorized that this is what initially prompted users to take ecstasy in the first place, rather than the other way around. In other words, ravers who are higher in impulsivity were more likely to take ecstasy than people who are less impulsive; ecstasy doesn’t seem likely to have made those who chose to use more impulsive. On all other cognitive measures, there were no differences.

Prior research on brain damage related to MDMA in animals is also notoriously problematic. Most famously, a study published in Science in 2002 purportedly showed that a single recreational dose of ecstasy could cause brain damage in monkeys that was extensive enough to lead to future Parkinson’s disease. That research had to be retracted, however, when researchers discovered that the drug administered to the monkeys had been methamphetamine, not MDMA. Ironically, some research now suggests that MDMA or similar drugs could help treat Parkinson’s.

(More on TIME.com:  Drug Surprise:  Meth is (Almost) as Cuddly as Ecstasy)

There is still the outstanding question of whether long-term regular MDMA use damages serotonin neurons, potentially affecting mood. Data from some animal studies and trials involving a drug that works similarly to MDMA have suggested these effects. Nonetheless, short-term use for the treatment of conditions like post-traumatic stress disorder is considered safe enough that the FDA has approved clinical trials and these are generating a great deal of excitement.

Oprah’s O Magazine this month has a fascinating feature on the experience of some of the participants in those trials; the article also includes a description of the writer’s own MDMA experiment. Here’s a preview:

Supporters of legalized MDMA therapy believe it can be applied in couples counseling and in treatment for depression, body-image disorders, chronic pain management, and end-of-life anxiety. But many advocates think its best chance at mainstream acceptance is as a tool for people with PTSD. Later this year, Michael Mithoefer, MD, a psychiatrist in Charleston, South Carolina, will publish the long-term follow-up results of the small pilot study that Sarah first heard about six years ago. The outcome: Seventeen of 20 subjects no longer met the diagnostic criteria for PTSD after just two or three sessions of MDMA-aided therapy led by Mithoefer and his wife, Ann, a psychiatric nurse.

The future of ecstasy seems promising.

(More on TIME.com:  Finding the Best Drug Treatment for Teens)

2 comments
SeanRonson
SeanRonson

ts pretty clear that the media, and even scholarly study is so biased about drugs that they open any discussion by assuming the drug is bad - lets not forget that most of the synthetic drugs (MDMA, diazepam, amphetamines, heroin, LSD, etc ... ) were all developed by researchers as legal drugs. LSD, MDMA both have strong uses as psychological drugs which are overshadowed by the silly war on drugs mentality.

This nonsense is so bad that you can go into a hospital now and see people in palliative care refusing narcotics so they won't get "hooked"??? pain management is important, and the small number of people who will become addicted are not what we should be worried about, we should be treating the causes of addiction, not the whole population.

bradls2010
bradls2010

nteresting how science investigation changes over time! It's downright embarrassing that the scientist gave the wrong drug to the monkeys! It now appears from the scientific investigation that they had it all wrong in the beginning and now have corrected their mistake. I would be interested in the chronic pain anagement aspect of ecstasy due to spinal fusion C3 through C7 cervical disc.

It is great that just two or three sessions with ecstasy relieved PTSD symptoms! That would indicate that the drug needs to be fast tracked for use in PTSD treatment. We have a lot of soldiers that after years of combat need some relief from the damage of many rotations into combat.