Supplementing psychotherapy with small doses of MDMA could be an effective strategy to prevent relapses of alcohol addiction in patients, an ongoing small clinical trial suggests. The research is yet another example of how scientists and doctors are finding or rediscovering therapeutic uses for recreational and illicit drugs.
MDMA-assisted therapy is actually an old idea, which enjoyed some popularity in the 1970s and 1980s. Though the exact mechanisms are unclear, the synthetic drug’s euphoric effects are thought to amplify the positive patterns of thinking taught by therapy, as well as make people feel less anxious during sessions. Of course, these same mood-boosting attributes made MDMA a popular recreational drug. This popularity led the U.S. government to ban MDMA in 1985, by classifying it as a Schedule 1 drug with no accepted medical use.
More recently, though, researchers and organizations such as the Multidisciplinary Association for Psychedelic Studies (MAPS) have slowly but successfully lobbied governments to reconsider the blanket ban on MDMA. Currently underway in the U.S., for instance, is a Phase III clinical trial—the last stage an experimental treatment needs to pass before it can be approved by the Food and Drug Administration—for MDMA-assisted therapy as a treatment for post-traumatic stress disorder.
In the UK, the first Phase I clinical trial for MDMA-assisted therapy as a treatment for alcohol use disorder has been going on since 2018, led by researchers from the Imperial College London. Phase I trials are intended as a way to test the safety and optimal dose of a new treatment in a small group of people, rather than to show its effectiveness. But the early results, reported by the Guardian on Monday, do seem to be promising.
The trial involves eight weekly sessions of psychotherapy at the study site, two of which mix in MDMA. In these weeks, volunteers take small doses of the drug, then have an eight-hour counseling session. Afterward, the volunteers stay overnight, where they’re monitored for any side-effects; they then stay in touch with the researchers via phone every day for the next week. Some volunteers, acting as a control group, had eight weeks of therapy, but instead got a placebo during those assisted sessions.
According to Ben Sessa, an addiction psychiatrist and senior research fellow at Imperial College London, 11 volunteers have gotten the treatment and gone through the entire trial so far, which also involves nine months of follow-up after treatment. Of these, all but one has seemingly avoided relapse as of now.
“We’ve got one person who has completely relapsed, back to previous drinking levels, we have five people who are completely dry and we have four or five who have had one or two drinks but wouldn’t reach the diagnosis of alcohol use disorder,” Sessa told the Guardian.
Assuming that rate holds up over time and with more patients, it would be substantially better than existing treatments. “With the very best that medical science can work with, 80 percent of people are drinking within three years post alcohol detox,” Sessa noted.
These are still early days for MDMA-assisted psychotherapy and other forms of psychedelic medicine. But just this year, a version of another recreational drug—ketamine—was approved as a treatment for difficult, non-responsive cases of depression. There’s been similarly encouraging research for psilocybin, the psychedelic ingredient in so-called magic mushrooms, as a depression treatment (the movement for decriminalization in the U.S. is also picking up steam). And assuming the Phase III trial of MDMA-assisted therapy for PTSD goes as well as the preliminary data shows, MAPS expects it to be approved by the FDA as early as 2021.