From Club To Clinic: How MDMA Could Help Some Cope With Trauma

Sep 14, 2015
Originally published on September 13, 2015 4:02 pm

MDMA, often known as Ecstasy or Molly, has for decades been used as a party drug — consumed in clubs, fuel for all-night raves. But lately, the substance is also being used in very different settings, for a very different purpose: to treat post-traumatic stress disorder.

The Food and Drug Administration has approved phase two clinical studies of the treatment, and they're now underway in four locations. Results so far have been promising, according to reporter Kelley McMillan, who has been investigating this new use of MDMA and has written about it in the current issue of Marie Claire.

"The findings from these most recent studies are supporting the earlier phase two findings, which found that 83 percent of participants were cured of their PTSD — compared to 25 percent who were cured from talk therapy alone," she tells NPR's Rachel Martin.

These conclusions remain preliminary, however, and phase two trials often fail by the time they reach phase three. And McMillan offers a word of caution of her own.

"People should not be going out and taking MDMA recreationally and thinking that they're going to have these healing experiences," she says.

Still, some therapists are hopeful about the ways they've seen the substance help patients who are grappling with PTSD. "One of the psychiatrists I spoke to likened it to mental anesthesia, and she said that ... it allows a person to kind of get right in and get to the malignant thing that needs to be examined."

She talks to Martin about MDMA's physical effects and its spotty history — and they're both joined in the conversation by Brenda, one of the patients profiled in McMillan's story. Only Brenda's first name has been used, for privacy reasons.

Listen to the full conversation at the audio link above.


Interview Highlights

On the effect MDMA can have on the brain

McMillan: Basically, MDMA unleashes a massive release of serotonin, dopamine and oxytocin. And this creates a state in which participants are very calm, and there's a deep feeling of trust with their therapist. So they're able to explore their trauma and process it.

On how this drug came to be used to treat PTSD in the first place

McMillan: Well, this is what I found so fascinating. Really in fact, MDMA was first used in the '70s and early '80s in therapy, in an underground network of therapists — but it wasn't illegal yet.

And then it got coopted by clubbers in the '80s, so consequently MDMA has gotten a really bad rap and has been sort of the subject of a really unfair publicity campaign.

Brenda, on how MDMA has affected her therapy

Brenda: As a child, I was abused and tortured by my father from the time I was 3 until I was 12. And as an adult, I saw a therapist every single week for 15 years — and I still wanted to die. You know, I was suicidal since I was 5 because that was the only way that I thought I could find [a] solution.

Two years ago, I had a colleague who said, "Hey, I've got my wife who has been struggling with PTSD as well. She's seeing this great therapist that's doing a little bit different kind of therapy, trying to process trauma through the body. You might try that" So I went, very skeptically.

And about six months into therapy, I take the medicine from my doctor, and within about an hour, I had a lot of imagery come up for me — some people do. And the first place I saw was this maze. It looked like a maze that I had been to as a kid, and I remember thinking very clearly, "All right, here we go" — and went in. And, yes, there was so much trauma. I had never remembered these terrible, terrible things.

And before MDMA, I really did think it was my fault. I mean, I felt it in my bones that something was so wrong with me, that I deserved those things. And being on the MDMA was the first time I'd ever felt compassion for myself, realizing that I was a child, I had no choice. I had no choice.

On what life is like for Brenda now

Brenda: It's like I've been living life with the mute button on. You know, before the MDMA study, I could see what was happening in the world, and I could kind of make my own conclusions, based on the fact that I couldn't really hear what was happening. And that was because the noise in my head was too loud.

But now, life is good. Spending 35-plus years suicidal was something I don't wish on anyone, and after six months in that study, I am not suicidal. I want to live.

My dad died in 1995, and it really wasn't until session three of the MDMA trial where I really believed he was dead. So I don't live in fear anymore.

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RACHEL MARTIN, HOST:

MDMA is better known as the drug ecstasy. It's a party drug that fuels all-night raves. But the substance is also being used for a much more serious purpose - to treat post-traumatic stress disorder. FDA-approved phase two clinical studies are currently underway in four locations, and results have been promising. But we should note right off the bat, these conclusions are preliminary and phase two trials frequently fail by the time they reach phase three.

Reporter Kelly McMillan has been investigating this new use of MDMA, and she's written about it in the current issue of Marie Claire magazine. Kelly McMillan joins us from studios of WBUR in Boston. Welcome to the program, Kelly.

KELLY MCMILLAN: Hi, Rachel.

MARTIN: We're also joined by Brenda in Denver, who is one of the patients who was profiled in your story. Welcome to the program, Brenda.

BRENDA: Thank you.

MARTIN: And I'll just note we are using only your first name for privacy reasons. Kelly, if we can start with you, tell us what effect MDMA can have on the brain. How does it make a person feel?

MCMILLAN: So basically, MDMA unleashes a massive release of serotonin, dopamine and oxytocin, and this creates a state in which participants are very calm, and there's a deep feeling of trust with their therapist. And so they're able to explore their trauma and process it.

MARTIN: But let's back up. How did this drug come to be used to treat PTSD in the first place?

MCMILLAN: This is what I found so fascinating was really, in fact, MDMA was first used in the '70s and early '80s in therapy in an underground network of therapists, but it wasn't illegal yet. And then it got co-opted by clubbers in the '80s, so consequently, MDMA has gotten a really bad rap and has been sort of the subject of a really unfair publicity campaign.

MARTIN: But you're saying that the drug somehow allows a patient to unlock a particular traumatic memory and start to explore it in a different way?

MCMILLAN: Yes. One of the psychiatrists that I talked to likened it to mental anesthesia. And she said that, you know, MDMA is like mental anesthesia, and it allows the person to kind of get right in and get to the malignant thing that needs to be examined.

MARTIN: And they're doing this with the help. They're doing this with the help of a therapist who is there in the moment to help them guide them through the experience.

MCMILLAN: Yes, I mean, I think we all want to be very cautious in making it very clear that, you know, people should not be going out and taking MDMA recreationally and thinking that they're going to have these healing experiences.

MARTIN: Brenda, if I could turn you, would you mind sharing how you came to this kind of therapy? What was the trauma?

BRENDA: Sure. So as a child, I was abused and tortured by my father from the time I was 3 until I was 12. And as an adult, I saw a therapist every single week for 15 years, and I still wanted to die. You know, I was suicidal since I was 5 because that was the only way that I thought I could find solution. So two years ago, I had a colleague who said, hey, you know, I've got my wife who has been struggling with PTSD as well. She's seeing this great therapist that's doing a little bit different kind of therapy trying to process trauma through the body. You might try that.

So I went very skeptically. And about six months into therapy, I take the medicine from my doctor, and within an hour, I had a lot of imagery come up for me. Some people do. And the first place I saw was this maze. It looked like a maze that I had been to as a kid. And I remember thinking very clearly, all right, here we go and went in. And, yes, there was so much trauma. I had never remembered these terrible, terrible things. And before MDMA, I really did think it was my fault. I mean, I felt it in my bones that something was so wrong with me that I deserved those things. And being on the MDMA was the first time I had ever felt compassion for myself, realizing that I was a child. I had no choice. I had no choice.

MARTIN: Kelly, what's the status of the clinical trials of these studies?

MCMILLAN: The findings from these most recent studies are supporting the earlier phase two findings, which found that 83 percent of participants were cured of their PTSD compared to 25 percent who were cured from talk therapy alone. So I think, you know, scientists are all very cautiously optimistic.

MARTIN: Brenda, what's life like now? How are you doing?

BRENDA: (Laughter) It's like I've been living life with the mute button on. You know, before the MDMA study, I could see what was happening in the world, and I could kind of make my own conclusions based on the fact that I couldn't really hear what was happening. And that was because the noise in my head was too loud. But now, life is good. You know, spending 35-plus years suicidal was something I don't wish on anyone. And, you know, after six months in that study, I am not suicidal. I want to live. My dad died in 1995, and it really wasn't until session three of the MDMA trial where I really believed he was dead. So I don't live in fear anymore.

MARTIN: Brenda in Denver and Kelly McMillan in Boston. McMillan's article, "The Agony And The Ecstasy," appears in the current issue Marie Claire magazine. Thanks to you both.

BRENDA: Thank you.

MCMILLAN: Thank you. Transcript provided by NPR, Copyright NPR.