Why Prescription Ecstasy or LSD Could Happen Much Sooner Than You Think
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"With MDMA, the fear circuitry is reduced," Doblin explains. This helps PTSD patients remember and re-examine long-buried aspects of their traumas. Aided by MDMA, "these memories don't immediately go straight to fear." Say you were traumatized by a bat-wielding, red-hatted assailant. Under MDMA, "the neural pathways connecting bats, red hats and fear are not so strong." Recontextualized in an MDMA-activated prefrontal cortex, triggers lose their power -- sometimes forever, he says.
"Under the influence of MDMA, people can make emotional changes that persist after the MDMA is out of their systems." On MDMA, "you operate on this much smoother level, and then you lose it -- but not all of it. You get so much material from that experience, which you can learn to integrate."
This doesn't mean you can recover by hitting a few raves. A key theme of the medical-psychedelics movement is that it's medical. These drugs are so strong and long-lasting that, for clinical use, Doblin says they must be administered in "a safe, supportive, controlled setting" overseen by professionals.
In one MAPS study, 10-hour LSD sessions took place in a medical office. Guided by a psychiatrist and a nurse, patients being treated for severe anxiety lay with their eyes shut, listening to music they had chosen for this purpose. According to a MAPS prospectus, each patient was encouraged to focus "introspectively on his or her sense of self and life-history in order to increase the psychological insights mediated by the LSD treatment." The nurse and psychiatrist would sometimes "use physical touch, such as holding hands." These drug sessions were followed by non-drug sessions in which patients discussed their drug experiences.
In a successful psychedelic therapy session, Doblin says, "there are times when the patient gets extremely lighthearted. You could have laughter. You could have joy. It's like a roller-coaster ride. You could have beautiful memories that give you the strength to go down to difficult memories, then come back to the surface and go back down there again, to a different level, hours later."
In old-school therapy, "it's the analyst who figures out your problems and tells you what your insights should be. But if these insights are disconnected from your emotions, it won't work." With psychedelics, by contrast, "the emotional connection is immediate and personal." Analysts can help you sort it out, "but it's an experience of yourself. The drug has simply given you a window onto yourself."
"There is a need for these substances," says Doblin, who along with his colleagues sees psychedelics as a powerful alternative or at least adjunct to SSRIs and, in the case of pain management, opiates. What's the difference between Zoloft and ecstasy? Legality. In other words: the FDA. MAPS submits its findings to the agency, which Doblin hopes "will put science before politics.
"The main problem with the drug war is the concept that there are good drugs and bad drugs," when what's actually good or bad "is the relationship between the person and the drug, and the context in which the drug is taken."
For instance, naysayers can claim "that MDMA is a drug of abuse and since people with PTSD have a high incidence of drug abuse, they shouldn't be given MDMA. But people with PTSD have a high incidence of drug abuse because they haven't been able to deal with painful emotions that they abuse drugs to escape." If those emotions could be processed via MDMA therapy, "their drive to abuse drugs would be reduced.
"We want to clarify that drugs of abuse can be used well. But the government is still too wedded to the drug war."