It is a criminal offense to possess a Schedule I substance. But what if an illegal substance held the key to mental health stability for those suffering from post-traumatic stress disorder?

As firefighters know all too well, PTSD is one of the most damaging disorders among first responders. The continuous and cumulative day-to-day stress from on-the-job exposure to death, shootings, child abuse, violence and other trauma often leads to post-traumatic stress.

This becomes a disorder, PTSD, when the duration of the stress reactions from trauma lasts more than one month and creates problems with one’s daily living. Reversing the effects of trauma is not easy, either.

MDMA also known as Ecstacy and/or Molly (Photo/Wikipedia)

Many options are available to treat PTSD: pharmacotherapy, psychotherapy and meditation, among others. One less accepted but potentially more effective treatment is MDMA (street names of variations include Molly and Ecstasy).

MDMA as a treatment for PTSD

Known best by its street name Ecstasy, MDMA, or methylenedioxymethamphetamine, is a substance that increases the activity of at least three neurotransmitters (the chemical messengers of brain cells): serotonin, dopamine and norepinephrine. These chemicals enable nerve cells in the brain to communicate with one another.

Serotonin is a neurotransmitter that plays an important role in the regulation of mood, sleep, pain, appetite and other behaviors. The excess release of serotonin by MDMA causes mood-elevating effects in users. The effects last between three and eight hours.

Recently, psychiatrists have taken an interest in MDMA as a catalyst to psychotherapy due to its ability to decrease fear and defensiveness while increasing trust and empathy. It may open a "window of tolerance" in patients undergoing psychotherapy for PTSD and hold it open long enough for them to step through, as Multidisciplinary Association for Psychedelic Studies puts it.

In 2008, MAPS completed double-blind, placebo-controlled, MDMA-assisted psychotherapy study on 21 subjects. The results were promising: 83 percent of patients with PTSD who were enrolled in the study showed progress. MAPS is currently working on a PTSD MDMA-assisted psychotherapy treatment pilot specific to veterans, firefighters and police officers.

In 2013, Canada won approval from Health Canada and the Institutional Review Board to test MDMA as well. After funding has been completed and MDMA secured for study, the trial will bring in a small group of soldiers, police officers and sexual assault victims suffering from chronic PTSD to see if the drug can ease their symptoms.

MAPS is undertaking a roughly $20 million plan to make MDMA into a Food and Drug Administration-approved prescription medicine by 2021.

History of MDMA and psychotherapy

MDMA was first developed in Germany in the early 1900s as a parent compound to be used to synthesize other pharmaceuticals. During the 1970s, it saw a brief period of therapeutic use in psychiatry, but in 1985, the DEA ruled that the drug had high abuse potential and no approved medical use, making it illegal to possess. Thus, psychiatric research has been difficult to conduct.

MDMA does not come without dangers, especially if manufacturing of the drug is unregulated. Substances created on the street likely contain unknown and/or dangerous adulterants. In 2015, 12 students at Wesleyan University in Connecticut were poisoned by the MDMA they took, which was likely cut with another substance.

The National Institute on Drug Abuse also cautions that, by releasing large amounts of serotonin, MDMA causes the brain to become significantly depleted of this important neurotransmitter, contributing to the negative behavioral aftereffects that users often experience for several days after taking MDMA. A giddy high can lead to a crushing low.

It’s too soon to make definitive decisions supporting MDMA’s benefits, or lack thereof for PTSD treatment, but it’s an interesting theory to consider. And it is important to remember that situational and prescribed use of MDMA is different than recreational use and abuse.

For more information on services and resources for PTSD, click here.