A study reported online today in the Journal of Psychopharmacology finds lasting benefits from MDMA-assisted psychotherapy for people diagnosed with posttraumatic stress disorder (PTSD). The researchers, led by South Carolina psychiatrist Michael Mithoefer, followed up on 19 subjects, mostly victims of sexual abuse or assault, who took MDMA (a.k.a. Ecstasy) during three sessions interspersed with drug-free psychotherapy. Initial results reported two years ago indicated that subjects who received MDMA were much more likely than subjects who received a placebo to show improvement on the Clinician-Administered PTSD Scale. After that study, the eight controls were invited to use MDMA, and all but one agreed. The 19 subjects completed follow-up evaluations an average of three and a half years after the MDMA sessions.

"There was an enduring, clinically meaningful benefit from MDMA-assisted psychotherapy to PTSD patients," Mithoefer et al. write. "No subjects reported any harm from study participation and all of them reported some degree of benefit….These results indicate that there was a favorable long-term risk/benefit ratio for PTSD treatment with just a few doses of pure MDMA administered in a supportive setting, in conjunction with psychotherapy. Should further research validate our initial findings, we predict that MDMA-assisted psychotherapy will become an important treatment option for this very challenging clinical and public health problem."

Subjects' comments on questionnaires shed light on MDMA's function as a catalyst for productive talk therapy. "It increased my ability to stay with and handle getting through emotions," said one. "The MDMA provided a dialogue with myself I am not often able to have," said another, "and there is the long-term effect of an increased sense of well-being." A third subject said: "I was always too frightened to look below the sadness. The MDMA and the support allowed me to pull off the controls, and I…knew how and what and how fast or slow I needed to see my pain."

Before the Drug Enforcement Administration banned MDMA in 1985 because it had become popular as a party drug, Mithoefer and his colleagues note, "uncontrolled published reports suggested that [MDMA], when administered in conjunction with psychotherapy, could yield substantial benefits for those afflicted with a variety of disorders." Now, after decades of government-engineered neglect, the psychotherapeutic benefits of MDMA are once again coming to the fore, thanks largely to the efforts of the Mutidisciplinary Association for Psychedelic Studies (MAPS), which funded Mithoefer's study and guided it through the legal obstacles created by MDMA's Schedule I status. If MDMA does indeed become "an important treatment option" for PTSD, it will be a huge victory for the MAPS strategy of working within the system to gradually loosen arbitrary government restrictions on useful psychoative substances.