MDMA used to treat addiction
In Bristol, a company called Awakn Life Sciences is trialling the use of MDMA to treat addiction. MDMA isn’t a classical psychedelic drug - in fact, as a rave drug it’s also known as ecstasy - but as psychiatrist Ben Sessa told Phil Sansom, in the clinic it has some very useful psychedelic properties...
Ben - It has an amazing capacity to induce a state of empathy, and to turn off the fear response. Now this is very important with people who have trauma related disorders, particularly addictions, post-traumatic stress disorder... it's very difficult for people to do therapy with these disorders because the trauma is so intense. They can't recall the painful memories without wishing to flee and end the treatment. MDMA has a remarkable quality to turn off the fear, and allow you this brief few hours in which to carry out trauma-focused psychotherapy.
Phil - Interesting. So you can still remember what you're thinking about, but you don't feel afraid.
Ben - Absolutely. It's quite pharmacologically unique, MDMA, in that it just turns off the fear response whilst leaving the other faculties intact.
Phil - Based on the study that you've done - how well does it actually work?
Ben - It was what we call an open-label pilot study, and we need to do some randomised control studies to further that research, but the outcomes were very positive indeed. With the control group around 75% of people at nine months had returned to pre-detox levels of drinking, compared to just 20% in those that underwent our MDMA therapy.
Phil - That does sound like a big change. What's the link though between trauma, which MDMA is helping people access, and alcoholism?
Ben - There so often is trauma, particularly childhood trauma, abuse, and maltreatment, that emerges very early in life and causes disruption to a person's attachment relationship. Now the attachment relationship is the blueprint for our psychological functioning throughout life. It's very well-known that damage to attachment relationships is associated with most, if not all, chronic mental disorders. So it's no surprise that those patients who become addicted to drugs of all kinds so often have these difficult childhoods and poor attachment relationships.
Phil - So is it as simple in your studies as, you give people a pill and then they feel better? Because I think people are quite wary about the idea that you can solve a mental health problem that's got so many different causes with a single drug.
Ben - Absolutely. I think the interesting thing about psychedelic research in general is this is the antithesis of the way we currently use drugs in psychiatry. Most mental health medications one takes on a daily basis for weeks, months, decades, in order to mask symptoms. The interesting thing about psychedelic-assisted psychotherapy is you only need to take the drug on a few occasions mixed with psychotherapy, and that's where it really works.
Phil - Oh, so it's 'talk talk talk talk', 'drug', 'talk talk talk talk talk'.
Ben - Yes, the bulk of the work is done in the non-drug post integration sessions.
Phil - You rarely get a one size fits all medicine in the field. So how many people does this actually seem to work for?
Ben - Well the results of psychedelic research of the last 15 years have been staggeringly good for a range of different compounds - psilocybin, ketamine, MDMA - across a wide range of psychiatric disorders including addictions, anxiety disorders, depression. So it remains to be seen how well psychedelics could be used in psychiatry, but so far the results suggest that the applications could be very wide indeed across multiple disorders. Indeed, we may one day look back and think, "why did we ever do psychotherapy without drug assistance with psychedelics?"
Phil - You really think it's that big of a deal?
Ben - We have to be very careful not to get ahead of ourselves here. One of the reasons this research died in the 60s was because there was too much of a messianic approach that these drugs were panaceas. They're not panaceas. Mental health is complex. There's psychological factors, social factors, as well as biological and genetic factors. But it certainly seems looking at the results of the last 15 years that the results are extremely good indeed.
Phil - Where do you think this is going then Ben? Am I going to be able to go to my GP and they prescribe me some MDMA?
Ben - If the research continues at the pace it's going, then we should see MDMA approved as a drug to treat trauma-based disorders in around 2023. Psilocybin, a couple of years after that. Ketamine is already available for the treatment of these disorders. One of the big goals we have is to make sure that this appears on the public health service. It's no good if it's just confined to private medicine. So we need to work with the regulatory authorities and with the funding authorities to make sure that this is free, public access healthcare for everyone.