Wednesday, 30 August 2017

Ecstasy in Perspective

The Dangers

The drug MDMA, popularly known as “ecstasy” is extremely lethal in its forms on the street. As reported in Metro:

“Several people have been taken to hospital over a ‘potentially lethal’ batch of MDMA. Police warned that a bad batch of the drug has been circulating in Jersey. In a message posted on the States of Jersey Police’s Facebook page, a spokesman said: ‘We have been made aware of a potentially lethal drug, believed to be MDMA or ecstasy circulating in the Island after a number of young persons have been admitted to hospital this weekend. ‘Please remember not only are these drugs illegal, they can cause serious illness or even death.”

It is a drug which either in a pure form taken as a recreational drug or as so often is the case, adulterated, causes death. Cornwall news recently noted that:

“A heartbroken family is warning of the dangers of taking drugs after the death of a young woman who believed she had taken ecstasy. Amy Vigus collapsed after returning home from two days in London. She died the same day, August 21, in a hospital intensive care unit due to a reaction to what she believed was the popular party drug.”

The website Noisepm.Com explains the dangers very well:

“Basically, almost half of ecstasy pills that you will see are cut with adulterants in some way. Unless you have a pill-testing kit handy, there is no way to know what is really in a drug marketed as ecstasy or ‘molly.’”

“Pure ecstasy would contain a single ingredient: MDMA. But unfortunately, anything that is not pure can include hazardous chemical components, some of which can be deadly.”

“It’s important to note that even users who ingested pure MDMA experienced adverse effects of the drug, such as nausea, chills, seizures and loss of consciousness.”

The Benefits (under controlled medical supervision)

However, there is always a danger of throwing out the baby with the bathwater. Unsupervised, often adulterated, there is no doubt that MDMA is a killer.

But the last four years have seen new research that it could in fact have major benefits – provided it is given under medical supervision, with the right dosage, as part of a therapeutic treatment – when more conventional treatments fail.

The Charleston Gazette, 2014, has an article on “Exploring MDMA as Healing Stress Reliever”. It notes that:

“MDMA has been banned by the federal government since 1985 as a dangerous recreational drug with no medical value. But interest is rising in its potential to help people suffering from psychiatric or emotional problems.”

“A series of clinical trials approved by federal drug authorities is now under way to see if the drug's ability to strip away defensiveness and increase trust can boost the effectiveness of psychotherapy.”

“One of the key studies focuses on MDMA's effect on military veterans suffering from post-traumatic stress disorder.”

And it could also be used for other stress disorders:

“In 2004, South Carolina psychiatrist Michael Mithoefer launched a clinical trial involving 20 patients suffering from PTSD - mostly female victims of sexual violence who had unsuccessfully tried other therapies. Ten of the 12 who received MDMA during two sessions improved so much that they no longer qualified for a PTSD diagnosis.”

This was also reported in “MDMA: A Healer? Nonprofit Navigates Politics, Science to Put Drug in Clinical Use” in the : Pittsburgh Post-Gazette of 2014.

“The Santa-Cruz-based Multidisciplinary Association for Psychedelic Studies is making serious headway toward bending the boundaries of modern medicine. In several federally-approved clinical trials, the group is effectively treating psychiatric disorders - notably post-traumatic stress disorder - with MDMA, commonly known as ecstasy.”

“‘It permits the possibility of cures, whereas current psychiatric medications are about minimally reducing symptoms,’ said Rick Doblin, the Harvard-educated founder and executive director of MAPS.”

“The early returns are more than positive. Studies are showing MDMA several times more effective than either the antidepressants Zoloft or Paxil at treating PTSD. And unlike those medicines, patients do not need to keep taking the drug to see the benefits - MDMA seems to permanently restructure a patient's relationship to trauma.”

A more recent article was “MDMA Making a Comeback: The Love Drug Explored as PTSD Treatment” in Clinical Psychiatry News:

“MDMA's comeback as a potentially valuable medication in psychiatry can be traced to the first report of the drug's impressive success when used as an adjunct to psychotherapy in a randomized, placebo-controlled pilot study. Michael C. Mithoefer, MD, a psychiatrist in private practice in South Carolina, and his co investigators stunned the psychiatric world by reporting that 10 of 12 patients with chronic PTSD refractory to both medications and psychotherapy showed significant clinical improvement in response to just two sessions of MDMA-assisted psychotherapy supplementing a more conventional course of psychotherapy.”

“Moreover, the benefits proved durable: In a subsequent paper, the investigators reported the clinical benefit of this two-dose treatment program persisted at a mean 3.8 years of follow-up and no safety concerns had been seen”

“This study, which eventually drew the attention of military veterans' groups with political clout, proved hugely influential, especially since PTSD is so common and often is highly treatment resistant.”

What seems to happen in such cases is that MDMA actually helps with the extinction of fear memories by the way in which it reacts inside the brain.

“Dr. Nutt and his co investigators performed the first whole-brain study of the effects of MDMA using functional MRI. This double-blind, placebo-controlled, crossover study in healthy volunteers used measurements obtained through arterial spin labelling and analysis of blood oxygen level-dependent resting state functional connectivity.”

“Matthias E. Liechti, MD, head of the psychopharmacology research unit at the University of Basel, explained that at present Switzerland is the only country in the world where it's legal to prescribe MDMA. Ditto LSD. Psychiatrists can do so on a case-by-case basis outside of a clinical trial setting in patients with treatment-resistant PTSD or anxiety disorders.”

“‘Luckily, the effects of MDMA wear off quickly, and when it's used with psychotherapy we may be giving only one or two doses in a lifetime, so it shouldn't be a concern,’ he said.”

And there may be other benefits. A study reported in the Pasadena Star-News indicates that MDMA may also help dispel anxiety in autistic people

“Dr. Charles Grob, a psychiatrist at Harbor-UCLA and investigator at Los Angeles Biomedical Research Institute, or LA BioMed, was the first to win approval from the federal Food and Drug Administration and the Drug Enforcement Administration to begin clinical trials of MDMA. Since he began the testing about 20 years ago, he has found that the drug may be helpful to adults grappling with symptoms from varying degrees of autism.”

"The question is: 'Can we re-engage this area in a responsible, objective way to explore methods of a treatment?' " Grob said. "But to do so in a responsible way, unlike what happened in the '60s."

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