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MDMA (Ecstasy) Is a Lifesaver for Vets with PTSD: It's Time to Bring It Back as a Legal Therapy Tool

Veterans and therapists press the military to overcome misguided fears and opt for a drug policy that helps heal.
 
 
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When Tony Macie returned from Iraq in 2007, he knew deep down something was wrong. The former Army sergeant, who served 15 months in Baghdad as a scout, struggled to readjust to civilian life.

“In Iraq I had to be hypervigilant, five steps ahead. Back home, I was still in the mindset for combat and my brain wouldn’t shut off,” he said. “I wasn’t sleeping, looking at everyone as the enemy.”

Macie went back to college, but his nervous system was stuck on high alert. He was irritable, moody and sometimes paranoid, reliving memories of buddies dying in combat. He drank heavily. He swallowed five or six pills at a time—oxycontin, Xanax prescribed by military doctors, and painkillers for his back injury. He stopped showing up for class.

He was formally diagnosed with post-traumatic stress disorder, or PTSD, but it would take him years to admit it. “At that point I was taking so many different drugs, I was zombied out. Looking back, I was actively seeking help,” he said.

Macie is far from the exception when it comes to combat-related PTSD. Since October 2001, approximately 1.8 million U.S. troops have been deployed to Afghanistan and Iraq, of which 20 percent are estimated to be suffering from PTSD. As PTSD is notoriously difficult to assess, diagnose and treat, the numbers could be much higher. A 2009 National Center for PTSD report states 41 percent of troops have chronic symptoms.

Macie tried therapy, but nothing worked. Then he discovered a clinical trial lead by Michael Mithoefer, using MDMA-assisted psychotherapy to treat chronic PTSD. MDMA is the active ingredient in Ecstasy, the popular dance drug. But due to controversial publicity over the decades, its credibility as a therapeutic tool has largely been ignored.

Macie joined the trial, and after only one session, stopped taking his meds. “It was a paradigm shift. I want all vets to have the same tool at their disposal.”

Macie isn’t alone. An increasing number of researchers, scientists and therapists who recognize MDMA’s beneficial use are pushing to medicalize it, seeing it as a viable option for those suffering from PTSD. Yet the military is slow to catch on due to MDMA’s decades-old stigma as an illicit substance. (The only place MDMA is mentioned on the US Department of Veterans Affair’s website is under substance abuse for veterans with HIV.) Macie, among others, is pressing for the military to overcome its institutional fear of MDMA and opt for a drug policy that helps heal its veterans. 

Emotional Reaction

While MDMA is widely associated with the global electronic dance subculture that swept the '80s and '90s, and the image of blissed-out ravers waving glow sticks, the drug has a longer history. Before MDMA was classified as a Schedule I controlled substance in 1985, it gained traction in therapy circles for what psychiatrists and psychotherapists saw as its most salient effect—not euphoria, but empathy.

“MDMA induces powerful empathetic states and in a therapeutic context, this is a strong, positive predictor of a therapeutic outcome,” said Charles Grob, director of the Division of Child and Adolescent Psychiatry at Harbor-UCLA Medical Center. Grob, a longtime researcher of hallucinogenic drugs, received the first FDA approval to conduct MDMA research in 1992.

Grob’s research was sponsored by Santa Cruz, Calif.-based Multidisciplinary Association of Psychedelic Studies, the world’s only organization funding clinical trials of MDMA-assisted psychotherapy. MAPS is undertaking an ambitious eight-year, $18.5 million plan to make MDMA into an FDA-approved prescription medicine by 2021.

“What MDMA seems to do is decrease fear and defensiveness, which helps sufferers connect with their feelings without being overwhelmed,” said Michael Mithoefer, a psychiatrist practicing in Charleston who specializes in PTSD. MAPS also funded Mithoefer’s trial.

 
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