Could Ecstasy Offer Hope for Trauma Survivors?

Authored by Emma Davila

Art by Nabiha Zaman

The drug ecstasy, or “molly”, often has a negative stigma given its association with drug abuse.  However, previously illegal and controlled substances are increasingly being approved by the Food and Drug Administration for various medical purposes. Ecstasy, or MDMA, is one of them. In a study conducted by MAPS Public Benefit Corporation this September, researchers found MDMA successful as a form of therapy for PTSD patients [1]. After the study, 72% of the treatment group did not display the symptoms to be diagnosed with PTSD [2]. MDMA-AT used with talk therapy was found to decrease PTSD symptoms and improve the quality of life for  participants with moderate and severe PTSD [1]. These exciting new results offer hope of a brighter future for survivors of trauma with this condition. 

PTSD itself faces stigma as a mental health disease, often being overlooked in the field of medicine and lacking needed research attention. In fact, the current therapies for PTSD are only proven to help 50% of victims, yet it affects roughly five percent of American adults [1]. Furthermore, one study found that various socioeconomic factors may lead to higher rates of PTSD in Black and Latino adults, suggesting there may be a specific need for a new type of therapy in certain marginalized communities and attention focused on how these groups are disproportionately affected [3]. In these communities and beyond in the United States, there is stigma around mental illness and a notion that mental health illnesses do not have a cure, leaving individuals with a sense of hopelessness. One doctor, Dr. Stephen Xenakis, a board-certified psychiatrist with published research on PTSD, even said that he feared many people struggling with PTSD feel so forgotten that the only option for them is suicide [1]. Recent studies have given hope to people with PTSD and if approved this therapy will be the first new development of its kind in over 20 years. 

The study conducted by MAPS showed that more than half of the participants identify as ethnically diverse making it the first research study about psychedelic therapies with a diverse study population. 26.9% of participants identified as Hispanic/Latino and 33.7% identified as non-white [3]. Research studies, regardless of their focus, are historically known to have only white-male participants. According to the National Institute of Health, African Americans and Hispanics make up 30% of the United States population, but only make up 10% of genetic studies [4]. Many health conditions being studied have the greatest prevalence in marginalized communities [4]. This presents the question of whether the results of studies can even be generalized to greater populations, especially those needing the most help. Many non-biological factors influence the development of a disease, the likelihood of contracting it, and the response to a treatment [4]. Thus, research studies that lack a diverse group of participants create gaps in our medical knowledge. This issue highlights a notable element of the MAPS study, as the organization is placing an emphasis on creating options for low-income individuals to receive the new therapy including discounts and even free treatment [1]. It is efforts like these that will begin to close the gap of inaccessible mental and medical care for trauma survivors, yet these novel designs present their own hurdles to overcome. 

The legalization and approval of highly controlled drugs as medical therapies is captivating and offers inventive solutions, but because of drug abuse, there are barriers to overcome. MDMA has been a controlled, Schedule 1 drug since 1985, meaning that the FDA considers the drug to be at an extremely high risk of misuse [1]. Because there is a stigma associated with controlled drug therapies, gaining acceptance from the general public and dismantling implicit fear and bias will be difficult and will require powerful marketing campaigns and persuasive endorsement from respected physicians and healthcare providers.

Although it is still early in the approval process and it could be months until there are prescriptions available to the general public, the results of the MAPS study offer a glimmer of hope for people suffering from PTSD. MDMA therapy could be a trailblazing solution as other options like talk therapy and different prescription drugs are not adequately effective for trauma survivors today. 

Works Cited

1. Nuwer, R. (2023, September 14). MDMA Therapy Inches Closer to Approval. The New York Times. https://www.nytimes.com/2023/09/14/health/mdma-ptsd-psychedelics.html 

2. Johnson, C. K. (2023, September 15). Psychedelic drug MDMA eases PTSD symptoms in a study that paves the way for possible US approval. AP News. https://apnews.com/article/mdma-ecstasy-ptsd-study-molly-fda-1155a374305027567d5f41910022022d

3. Sibrava, N. J., Bjornsson, A. S., Pérez Benítez, A. C. I., Moitra, E., Weisberg, R. B., & Keller, M. B. (2019). Posttraumatic stress disorder in African American and Latinx adults: Clinical course and the role of racial and ethnic discrimination. The American psychologist, 74(1), 101–116. https://doi.org/10.1037/amp0000339 

4. Mitchell, J.M., Ot’alora G., M., van der Kolk, B. et al. MDMA-assisted therapy for moderate to severe PTSD: a randomized, placebo-controlled phase 3 trial. Nat Med (2023). https://doi.org/10.1038/s41591-023-02565-4 

5. Perez-Stable, E. (2018, June 27). Communicating the value of Race and ethnicity in research. National Institutes of Health. https://www.nih.gov/about-nih/what-we-do/science-health- public-trust/perspectives/science-health-public-trust/communicating-value-race-ethnicity-research 

6. Smith, K. W., Sicignano, D. J., Hernandez, A. V., & White, C. M. (2022). MDMA-Assisted Psychotherapy for Treatment of Posttraumatic Stress Disorder: A Systematic Review With Meta-Analysis. Journal of clinical pharmacology, 62(4), 463–471. https://doi.org/10.1002/jcph.1995