Ecstasy as a Remedy for PTSD? You Probably Have Some Questions | Hacker News Reader

Ecstasy as a Remedy for PTSD? You Probably Have Some Questions

nytimes.com

> “I was able to forgive myself. It was like a clean sweep.”

I think this is the overlooked key point in these discussions of MDMA or other treatments as remedies for PTSD: it brings on the ability to see yourself and your actions with compassion and forgiveness that is not present in baseline consciousness.

For my own healing of trauma (which did not involve the use of MDMA), that has been the key. And letting go of deep resentment towards others (e.g., parents, former partners, lost friends) happened pretty much immediately, once I was able to have self-compassion and forgive myself.

As promising as the research around MDMA might be, it's still likely to be a long time before it has clinical and legal approval in most jurisdictions and even then it may not be the be-all-and-end-all for emotional healing.

Whereas there are techniques for bringing on self-forgiveness that are already available, though not yet accepted in the mainstream.

Hopefully that may start to change soon.

Do you mind expanding on letting go of resentment? I was not aware it is a major factor. I was somewhat aware that decisions on how to handle resentment were somehow going back and forth.

In my own experience, I did sense an ability to let go of some deep-seated resentment. At the time it felt as if it had disappeared forever, but the resentment came back after the effects of the drug wore off.

That was a casual experience with the drug, though. Not taken in a clinical setting with the objective goal of dealing with those issues. I could easily see how the drug could be used carefully for such a goal. In fact it was one of my first reactions when I felt it for the first time. I thought "holy shit this would be an amazing therapeutic tool". There really is no way to describe it.

> Whereas there are techniques for bringing on self-forgiveness that are already available, though not yet accepted in the mainstream.

Could you comment on what those are?

There's a bunch of emotional exercises/practices that enable you to connect with unresolved traumas held in the subconscious mind, learn about what they are and how they're affecting you, and let them go. Which as far as I know is what MDMA enables, but they don't require you to have access to MDMA, and are safer for frequent long-term use. The practices all work in different ways too, so I'm sure they enable you to have experiences/insights that are quite different to what MDMA activates.

Some practices I'm familiar with include Holotropic Breathwork (developed by Psychiatrist Stan Grof, who was a pioneer of research into LSD before it was banned), EFT/tapping and Milton Erickson Hypnosis. A friend of mine frequently does Family Constellations workshops and finds them highly beneficial, but I haven't tried that yet.

There are others that are more left-field than I'm willing to go into here but you're welcome to email me (address in profile) if you want to know more.

A religious based modality for this is called Theophostic Prayer.

Careful if you google it. You'll find some bizarre stuff that had nothing to do with my treatment. It's really weird when you read about something that changed your life dramatically for the better and others trash it and talk about it using a description that sounds nothing like your reality. Really makes one wonder about other things getting blasted publicly.

Do you have a link that does explain what you went through?

Unfortunately no.

I can only speak about the times me and my wife had taken it together.

It gave us an ability to talk about everything. Nothing weird, just a fantastic conversation.

The next morning-

>I had 2 TVs side by side as monitors(previously, she was worried about 'what the neighbors would think'.)

>We had our finances planned for how we would deal with upcoming house work.

>We learned about each other during sex, nothing weird, just better.

This is the big stuff that others can likely relate to. It was like 3 hours of fantastic conversation.

Do you ever think it would be a bad idea for a couple to take that trip together?

If you've been holding onto a LOT, it's possible to spend the entire length of the experience processing everything you've lived up to that point. I've seen it in first-time MDMA experiences, notably a friend in his late 20s who'd only recently 'come out of his shell' so to speak.

I think even in that case, his experience was probably wildly useful, despite bearing little to no resemblance to the happy empathic presentation that's commonly associated with MDMA.

My answer is 'yeah, probably.' But ideally this hypothetical couple should ask someone experienced who knows them better.

This is probably the opposite of what you're looking for, but semi-regular, um, psychedelic therapy kept me in a relationship that third parties call "abusive."

During the experiences we were in absolute perfect unity, learned lots about each other, and defaulted to kindness.

This carried over for a few weeks where the experience would be fresh in memory. I fell into the trap of "it is possible for her to be better, so she will get better because she loves me."

It can be an awesome experience om many drugs to share it as a couple. then again e.g mdma can be used for many things. Shulgin's (creator) wife used it a lot and said it was great for reading on.

What on Earth do you have to forgive ?

With apologies to Neal Brennan: if you're asking that question, congratulations on having a great life.

it brings on the ability to see yourself and your actions with compassion and forgiveness that is not present in baseline consciousness

Didn't use MDMA but this was a core part of my treatment for PTSD (combat related). We (semi-religious therapist and I) dove deep into triggering feelings and memories and connected with them and I was basically able to forgive myself and others. Changed my life.

exactly what happens in my Changa trips. hundreds of conversations play out, or someone ends up in the mothers womb feeling her love or many other scenarios often relating to memories of the past. afterwards forgiveness or some issue seeming less of an issue, or just being in the moment more happens. cured my stress, ended my years of heavy marijuana abuse. saved a friends marriage. according to his wife.

The narrative is that an illegal party drug seems to have potential as a psychiatric tool, but this is was it was before it became a party drug.

The disinhibition and mental clarity allows people to open up, "break out of their shell" and talk honestly about themselves and their feelings. And it does this immediately and with ease. It's really something special.

From Wikipedia:

Shulgin was impressed with the drug's disinhibiting effects and thought it could be useful in therapy. Believing MDMA allowed users to strip away habits and perceive the world clearly, Shulgin called the drug "window". Shulgin occasionally used MDMA for relaxation, referring to it as "my low-calorie martini", and gave the drug to friends, researchers, and others who he thought could benefit from it. One such person was Leo Zeff, a psychotherapist who had been known to use psychedelic substances in his practice. When he tried the drug in 1977, Zeff was impressed with the effects of MDMA and came out of his semi-retirement to promote its use in therapy. Over the following years, Zeff traveled around the United States and occasionally to Europe, eventually training an estimated four thousand psychotherapists in the therapeutic use of MDMA. Zeff named the drug "Adam", believing it put users in a state of primordial innocence.

If you think this is important, donate to MAPS! Yes they accept crypto.

https://store.maps.org/np/clients/maps/donation.jsp?campaign...

It's interesting that both PTSD-suffering veterans described the benefit of MDMA with the same words: "I was able to forgive myself."

Whether you call it conscience or superego, how we judge ourselves seems to be important for mental health.

https://en.wikipedia.org/wiki/Shadow_(psychology)

Interestingly, in the documentary _Dirty Pictures_[0], and in the books PiHKAL and TiHKAL, Ann Shulgin (widow of Alexander Shulgin, the chemist that re-synthesised MDMA and re-introduced it to the world) talks a lot about the shadow and her work as a therapist whilst working with MDMA shortly after it's effects became known. MDMA was initially trialled by psychiatrists working with the shadow.

[0]: https://www.youtube.com/watch?v=7SxjCE0f9_4

I've seen the documentary, but never realised her reference to the shadow was more than just explaining why we can get into dark thought loops whilst on psychedlics often times going over and over something (sometimes inconsequential things) that raises our paranoia to terror levels.

Seems like I have some reading material to put off working until this afternoon now :)

I think part of the bad rep MDMA gets as a theraputic drug comes from street-known MDMA not actually being pure MDMA. It’s often laced with ketamine or some other drugs that give different effects than what’s being used in this PTSD treatment.

It was sort of hailed as a possible antibiotics of the mind before the war on drugs started and basically all research was halted.

I think it's likely that that's what caused the bad rep more so than how the dealers mixed it. All drugs that were used in a recreational way was deemed as bad.

Alcohol, cigarettes, sugary snacks...?

A weak point. Alcohol can not be taken away, it has been tried.

Had we not had alcohol in the first place, we'd likely have other things a-ok'd, and alcohol would be treated by its merits compared to other recreational substances. By all reason it would be illegal far before many other substances.

Personally I am conflicted: on one hand we can see that the more we let people to have certain drugs, the less functional they are as human beings. On the other hand, if above point was really important, it would make sense to try to let people have the least harmful of these substances, so that, on average, the damage caused by their consumption is lower.

A growing part of me thinks that drug policies aren't as much about preventing harms as it seems to be about "playing games". We could do better all around the world. But things move slowly, so slowly. Stigmas hold, people fall to the soothing lull of prejudice and simplistic arguments.

This is all just business as usual.

The prohibition of ecstasy makes me furious given the has caused how many millions to suffer needlessly for generations? And this in addition to the sheer obliviousness of starting the war on Drugs after Prohibition showed what happens when you try to do so.

Agreed! Been a long time since I experimented with drugs, but when I used to, pure MDMA was really great. Just puts you in a super positive frame of mind, and makes you feel incredibly close and connected to whoever you’re doing it with. Not surprised at all that there’s a lot of therapeutic potential there.

Yes but it’s also pretty common to get into this regularly and soon after what you get one evening you have to give back some weeks later unless you then take all sorts of other drugs to compensate for that. I’ve seen the therapeutic effects up close and they are powerful but they are sadly short lived and hard to manage.

All advice I've seen regarding the substance is to not take it more than once every 3 months. I think people just need to realize it really isn't a party drug you can take every or every other weekend. Not only will tolerance build very rapidly, but you're exposing your brain to excessive oxidative stress and overheating, and are likely causing serotonergic neurotoxicity (even if you take it with all the recommended supplements).

It needs to be treated like a rare, therapeutic, and special vacation, not something you take whenever you want to have fun.

yup. but young people in a culture where its quite common to do this every weekend are in a big risk not to follow that advice though.

The MAPS studies tell a different story here, only a couple sessions and over a year later a large majority of the subjects were still symptom free or greatly reduced

My personal studies tell Otherwise... and those studies probably doesnt consider how easy it is to self medicate and get the oppersite effect. It Works Well but its a temp fix and its hard to handle yourself Especially if you are Young abd part of a culture that uses this recretional.

Where have you published your studies?

They are personal ;) luckily I now don’t take everything I read for truth and had the guts to look at the risk/benefit in person. Few who ever did studies had any real exposure to what they write about or have the insight to get near the relevant data to make a proper study. First hand experience beats that anyday and having seen more than most I can not recommend any recreational drugs perhaps more that once but keeping it to that is insanely difficult so I’d say you have to be in a specific pet if your life to even try. By I regard Changa as medicine that few would ever use recreational but it’s also not for everyone.

Yeah, all drugs can have big negative impacts on people’s lives if not taken in moderation. This is true of legal recreational drugs like alcohol, and pharmaceuticals like opioid painkillers. But most people use these drugs responsibly.

I think if MDMA really does work great for PTSD in therapeutic settings, it’d be a worthwhile treatment, even though some percentage of patients would abuse it.

What about the rebound effect ("tuesday dip")?

Exactly. :)

from what I understand, in a medical setting, those treated with MDMA are not / have not been regular users.

New recreational users very often do not get a prolonged comedown / tuesday blues / suicide wednesday. Which is more indicative of heavier user, multiple doses, staying up all night, taking over drugs (including alcohol).

In a controlled setting, with a correct one time dose, in a clinical environment, not running around like a loon, sleeping and eating well, in one off sessions, the mid week comedown can be mitagated away

i didn't experience this. the next day, i was mostly just tired from not having slept. then again, it was a one-off thing. might be harder for regular users.

As senorjazz mentioned, I wonder how much of the really bad recoveries are due to taking too much, mixing it with other drugs, staying up super late, etc?

I only did it a handful of times, a long time ago, but if I took a reasonable amount and just had a chill night on the beach with friends, the recovery wasn’t so bad. One day of feeling tired/down, but similar intensity to a moderate hangover.

MDMA, when I used it, was always combined with dancing or walking or physical activity. I also always had a coming down which had a bottom peak a few days after (the infamous Tuesday dip). With psilocybin I had not much of a coming down, at worst a headache the day after. With MDMA though, the coming down additionally had my mood being down as well. I become agitated and inward, very much in contrast to the peak and moderate upper effect (there are some movies which portrait this, such as the movie Human Traffic [1]). Then again, this is anecdotal, and I am very sensitive to drugs in general, especially the contrasts (alcohol, beer makes me often tired, MDMA, SSRIs, amphetamine). The reason for that might very well be related to ASD, I do not know for sure though. I just know that I do have ASD. But because I have ASD, my anecdotal experience isn't typical in this case. However the Tuesday dip is widely known among MDMA users.

[1] https://en.wikipedia.org/wiki/Human_Traffic

so known so people use additional things to avoid it. personally i'm also very affected by the comedown. whatever makes everything feel great comes as just a big price in the other direction. this is also the reason that perhaps stuff like depression might make it feel even worse.. and only solution would seem is to do it again more regular.

Generally it's laced with amphetamine/methamphetamine as they're cheaper (per dose), and these days it's often laced with other substituted amphetamines such as mephedrone or PMA, neither of which are substances people would otherwise take as they're nasty shit.

Generally when you hear about people being hospitalised or dying after taking ecstasy, it's due to the other shit in the pills. MDMA is a relatively safe drug (although not without its risks, especially taken in a non-therapeutic setting).

> and these days it's often laced with other substituted amphetamines such as mephedrone or PMA

"Often"? Often where? I'd say no since we'd hear about accidents with ecstasy "often" as well. This happens rarely, still.

EDIT: Found some data [1]:

"Although more recent ED data are not publicly available, the number of reported poisonings involving “hallucinogenic amphetamines” (which are most commonly MDMA and MDMA-like drugs) rose from 2057 (including 3 deaths) in 2009 to 2514 (including 14 deaths) in 2013"

"Ecstasy purity was low in the US in the mid-1990s3 and purity plummeted in Europe around 2009,11 but increased in 2010,8,11 while purity of powder and crystal ecstasy reportedly remained high in Europe (at 75–97%) in 2008–2013.11 However, the presence of synthetic cathinones (“bath salts”) and other novel psychoactive substances (NPS) increased within both pills and powders from 2008–2013.11 Spain in particular had a high prevalence of synthetic cathinones such as mephedrone and methylone detected in powder ecstasy.9 Despite extensive research in Europe, purity of ecstasy in the US over the last decade has not been formally researched."

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5578728/

13 people in New Zealand were put in hospital this summer [1] by MDMA laced with N-Ethylpentylone. It was also discovered after pill testing at a festival in Australia. In January several people in Melbourne were hospitalised one weekend after taking laced MDMA.

I couldn't say how often MDMA is laced, and in what quantities, but it's definitely out there.

[1] https://www.vice.com/en_nz/article/8xdzpb/heres-what-was-in-...

See PMA wikipedia page* for some documented examples of this sort of thing. The MDMA precursor safrole is aggressively controlled so a strong incentive exists to substitute other substances/analogs. I would regard black market MDMA with some skepticism these days.

* https://en.wikipedia.org/wiki/Para-Methoxyamphetamine

> Generally when you hear about people being hospitalised or dying after taking ecstasy, it's due to the other shit in the pills.

Sometimes that's the case. This is one set of problems.

At the moment in the UK though, one of the major problems is massively dosed pills. 250-300mg+ in a single tablet. At these doses people get into danger.

That's an issue too. That poor girl who died at Mutiny took over half a gram of pure MDMA, that's just an insane amount to drop in one go, especially for an 18 year old girl.

especially with a culture where double and triple dropping is the normal.

Ecstasy != mdma. It’s pretty easy to spot clean mdma visually or tasting or you can just recrystalize it yourself. It’s imoossible to figure out what is in ecstasy.. and is always a combo of above drugs and more. Clean mdma is more common these days than ecstasy in most of Europe atleast.

This is not really true. Several things look quite a lot like MDMA, and one of the problems with Ecstasy tablets in Europe at the moment is that they contain too much MDMA for a single dose.

Always test your drugs people, and start low.

If you know this stuff you also know the taste and looks of the crystal and why eg it got the color it does. There is no easy way of knowing what is inside a tablet but the “pure” crystallized products are easy to recognize mdma especially. And it would have to be a damn big tablet to contain too much mdma... by bet is on what else is inside.

> There is no easy way of knowing what is inside a tablet

Chemical tests.

> but the “pure” crystallized products are easy to recognize mdma especially

Lots of the extended amphetamine family (including the various -drones) share very similar tastes, and crystallise very similarly. If you wash MDMA that contains these other substances you'll end up recrystallising those as well.

> And it would have to be a damn big tablet to contain too much mdma... by bet is on what else is inside.

Then your bet is factually wrong and likely dangerous.

Test your stuff. Know what you're getting, start low, and don't listen to people who 'know what the real stuff looks like'

I don’t disagree to starting low but definitely listen to people who knows where the good stuff is. Trusting your network is more realistic than having tested everything you get. In the perfect world I’d run around with a lab in my pocket sure....

The only foolproof-ish way of knowing what is inside a tablet is tests done by some rather precise, expensive equipment that separates elements into their component parts (chromatography), and then analyzes the mass of the separated components (spectrometry) and compares them to a database of known components. Nuclear magnetic resonance (NMR) spectroscopy is also an option.

It is unlikely most people will have access to equipment with the precision necessary at home. There is an organization out there (https://www.ecstasydata.org/) that does anonymous GCMS tablet tests of MDMA in particular for $40 (and other substances for a higher price).

The typical tests out there for most people are reagent tests -- chemicals known to react with a desired substance to turn a certain color. Reagent tests are not foolproof -- the main thing you know is that if you do not get the desired color, you most likely don't have the correct product. It is possible to fool a reagent test. They are better than nothing for sure.

Taste, color, and crystallization are not really reliable ways of identifying the product.

Again you Seem to have little knowledge about the subject when you keep mentioning tablets.. mdma usally comes in crystal form and has a distinct taste. Ecstasy is a whole other thing usally containg amfetamine, ketamin and many other things.

Either can be many other things these days. Your sense of taste is really not an adequate guide.

No it’s true that anything can be poisoned even your beer leaving it on a table. Usally your supplier and the people in the culture will know what is good and where to get it... it’s only a concern I would have getting stuff from random people.

Your advice is terrible, I'm sorry, it's just awful. Your advising the use of drugs as 'safe' which present various dangers, you're advising eyeballing MDMA to know what's right, and now you're basically saying to trust your supplier.

This is all very poor advice.

Get chemical test kits, use drug testing services where they are available, be cautious.

And if you read my comments again I actually advice against most drugs. I’m arguing against comparing mdma with ecstasy pills which is pretty much impossible for the dealer or any to figure out what is inside but in regard to mdma crystals is much easier to reason about a clean product when you take others experience around you and looks and taste knowing it... but yes there is always a risk like leaving a beer unattended. This could be different but In my part of the world we can usally trust what we are provided.

> I’m arguing against comparing mdma with ecstasy pills

Which is pretty terrible itself, powders and crystals can be just as adulterated as pills. Relying on sight and taste to tell what you've got is very unreliable.

Ketamine? Combined with MDMA and its analogues??? In which country? Do you have links to drug reports / analysis?

Lol I'm with you. MDA, meth, uppers etc are far more likely adulterants in the US it seems, though perhaps K was more popular adulterant in the 90s [1].

1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5578728/#R6

It's not a common adulterant, so your skepticism is warranted, but using the advanced search at EcstasyData, I'm seeing about 6% of pills/substances they've tested that had both MDMA and ketamine in them.

804 results for MDMA + anything else: https://www.ecstasydata.org/search.php?search_field=adv&name...

50 results for MDMA + ketamine: https://www.ecstasydata.org/search.php?search_field=adv&name...

Hmm, would be interesting to have some kind of graphs with this to see where in the world these pop up most.

its quite common to buy these things separate and mix it. we call it candy--something

> It’s often laced with ketamine

No it isn't.

Other MD like drugs, sure, but ketamine no, not often

Is the ability to “forgive oneself” sustainable? Does the initial “help” from MDMA empower the person to learn to permanently see themselves and their experiences in a new way? As someone who believes that developing ourselves comes from the traditional hard work of life and spiritual development (or whatever you may call it) with no quick fixes, I find the prospect surprisingly compelling.

You can reinforce headspaces and practice those abilities like any other habit.

The best way I've heard MDMA therapy being described is this - you have a large group of extremely painful neurons/memories, and going there is shocking and horrific to the point that you begin to grow a big moat of fearful neurons/emotions next to anything that connects with them. The point of therapy in general is to 1. Break down that fear moat (which frequently grows to be more painful than the underlying issue), and 2. Start drawing those painful neurons and memories out, but in as positive and understanding an environment as possible. At that point the memories/neurons get re-stored, still painful but with the added context of the environment they were last accessed.

MDMA takes step 2 and adds the most positive neurological/chemical setting possible for you to pull those painful neurons and memories out, and puts them in what can be described as a comforting blanket. It can absolutely quicken the process and help you eventually neutralize the traumatic and painful bundle of memories. Calling it a quick fix is such a misnomer - it is incredibly hard work to heal one's self from the inside, no matter the external helpers.

Propanalol, which is dramatically less illegal, is meant to help with this too, and there are studies showing it too; my understanding (from using it for anxiety) is it basically blocks you from being able to feel stress. This allows you to more easily process painful memories.

It blocks the physical manifestations of stress - increased heartrate, sweating, etc that can form a feedback loop, and downregulates a bit of thyroid hormone production. How does one know they're stressed? The feeling of those symptoms.

I imagine it could help, and probably be better than therapy alone, but lessoning of the negative feelings around painful memories can be treated with opiates too (which are far more addictive than MDMA, despite MDMA being far more euphoric). The problem is PTSD, anxiety disorders and personality disorders are incredibly intractable with the tools we have - if a therapeutic session could have 10x efficacy and safely get someone to a healthier state in 1 year rather than 10, it should absolutely be looked into.

I would answer both of those questions with "sometimes" or "maybe".

Psychedelic experience is often a trigger that allows the one going through it to quickly bypass some (but not all!) obstacles on their Path.

e.g. a single MDMA experience might allow the person going through it to be more forgiving (albeit temporarily!) than they would otherwise have been able to, seeing the value of such a perspective and increasing the likelihood that they will engage in the on-going work that you describe.

As with most experiences, its impact (and duration of) exist on a spectrum.

I’ve seen it first hand but short lived sadly.

This is the difficult truth. But outright it's like telling a severely depressed 120 lb man who can barely get out of bed he needs to start weightlifting, so we get these threads and these ideas.

Spiritual health is literally the most important need of any intelligent human, and yet it's incredibly hard to achieve in our current culture. We're a nation of drugged out, traumatized zombies starving for answers, and the loudest voices belong to snakes and idiots. It's an absolute disaster.

The first baby step of a solution is allowing and encouraging people to discover and to speak plainly about what is Good, what is Beauty, what are our obligations to ourselves and others, and why.

But everyone's brains are fried. They've simply accepted the ambient dull-minded morality seeped into our cultural fabric by a host of unmoral forces (and a few immoral), and the process of spiritual development for many has become a weakly cathartic but useless raging at the failure of their community to succeed within this framework. Then they're told: when this exhausts you, reach for the pill bottle.

It's incredibly sad.

> Spiritual health is literally the most important need of any intelligent human

Tell that to someone who is starving.

Hierarchy of needs: https://en.wikipedia.org/wiki/Maslow%27s_hierarchy_of_needs

Explain hunger strikes.

Hunger strikes are a form of protest to affect social or political change. Social and political issues are often slow, endemic, and creeping. Cleverly, hunger strikes transform these issues into something that is visual, easily empathized with, and quickly escalating.

Indeed, this illustrates quite well that physiological needs are the most important needs - if they were't, then they couldn't serve as a tool to escalate the stakes of the protest.

If spiritual needs were more important, you would have spirit strikes instead of hunger strikes.

What does a hunger strike make happen in people's heads that compels them? Do they think "Oh, these poor strikers will starve to death, and that is too terrible to allow." or "This striker's conviction is genuine and powerful, I should listen and be receptive to what he has to say."

It is the content of their souls that allows them to do what they do and this recognition that makes their demonstration compelling.

By the way, spirit strikes are very much a thing, and they are far uglier than hunger strikes.

That's a nice write up :) Language plays a big role in helping people out of their holes. Check out Marshall Rosenberg's Non-violent Communication and then think about how you could rewrite the same comment. It will push you to get past just expressing the problem well.

This comment hurt my feelings and so I will disregard it.

>As someone who believes that developing ourselves comes from the traditional hard work of life and spiritual development (or whatever you may call it) with no quick fixes, I find the prospect surprisingly compelling.

You may find the Good Friday experiment to be of interest:

https://en.m.wikipedia.org/wiki/Marsh_Chapel_Experiment

By the way. I believe everyone should try MDMA at least once in their lives. Do it with your friends, with your loved ones, etc. If it wasn’t so stigmatized I would have already bought some for my parents.

It really is incredible. Although I've tried cocaine, and personally I found MDMA much harder to resist multiple doses with. So for me, I have to be super careful else I could end up harming myself or becoming psychologically dependent on it.

It's definitely got a risk factor, but the sheer experience is something everyone should have once.

Compared to cocaine, smoking and the like it is not very probable that anyone becomes psychologically dependent on it because of the way it works:

It releases serotonin stored in your body, and thus depletes those stores. So multiple doses feel less and less good. The body needs several weeks/months to refill those serotonin storages. All you do is risk getting serotonin syndrome [1] which is a whole other story/problem. But becoming "addicted" (physically or psychologically) in the classical sense is not an immediate issue as it is with cocaine, smoking, weed, etc.

[1] https://en.wikipedia.org/wiki/Serotonin_syndrome

MDMA quickly loses its effect, though. I've done it twice in a month before and even then the second time wasn't that great. I'll only experience full waves once a month at most. And you can't just take more next time. It doesn't work. It will just give you a suicide tuesday.

Try it once. The salient point about drugs like ecstasy is that they don’t actually add to the chemicals to your brain that make you feel good - instead they release the reserves in your brain all at once. Those incredible highs are all of your nice feelings for the next couple weeks getting released at once. It’s a trade off I don’t want to make.

> Those incredible highs are all of your nice feelings for the next couple weeks getting released at once.

This is a massive simplification. It represents the pop-psych nonsense like serotonin is the happiness molecule. It really depends. Mood and brain chemistry are much more complex than: serotonin, dopamine, acetylcholine, norepinephrine

My anecdata: most of my friends have a down day 1-2 days after, then they’re fine. A couple have a really hard down day, others don’t have comedowns. This comment is irresponsible in that it confuses anecdote for data and uses a very inaccurate metaphor.

Good advice here is: if you want to try MDMA:

1. Test your product. Almost none of the MDMA on the streets is actually MDMA. It’s usually bath salts or something else unsavory

2. Dose correctly. MDMA is dosed generally based on body weight. If you don’t have the luxury of weighing you should probably take 75mg to 100mg.

3. Spend some time during your experience grappling with things that have bothered you lately. This is purely anecdotal, but this helps me with both the comedown and helps me figure out difficult things I’ve recently had difficulty with.

4. Expect some sad feelings 1-2 days after, so if you can plan those days around close friends in non stressful environments.

>Almost none of the MDMA on the streets is actually MDMA.

That is not really true. At least not in Europe. Real MDMA is incredibly common.

I have read that Europe has less fake MDMA, but regardless everyone should be testing.

From rollsafe.org:

> 87% of “Molly” analyzed by the DEA between 2009 and 2013 contained 0% MDMA, instead mostly containing “bath salts.”

> 46% of Ecstasy tablets analyzed in a study contained 0% MDMA.

That’s interesting...almost the opposite result was found by the Dutch drugs monitoring institute, with over 90% of analyzed pills containing MDMA.

https://energycontrol-international.org/wp-content/uploads/2...

By and large, most of the "ecstasy"/"MDMA" sold at the street level is a mix of cheap research chemicals and amphetamines. I volunteered at a tent that tested drugs at festivals, and for every 10 people that thought they had pure MDMA maybe 1-2 in 10 tested positive for containing any MDMA

That's one way to get people to be more skeptical of the psychotropic substances they're taking. Wish kits like this were wide spread.

This is not universally true, at least it is certainly false in the Netherlands.

https://energycontrol-international.org/wp-content/uploads/2...

See figure 7.

Very interesting. Did you publish any data or do you have any references you could share?

A massive simplification - sounds like a compliment. Perhaps people need the complexities of brain chemistry simplified to understand what they’re getting into.

The important thing is that all of those chemicals you described get released at once, and while you may only notice the acute effects for a couple days, the subtle effects last a lot longer. To massively simplify again - a week later maybe you can’t enjoy a sunset as much as you normally do, whether you’re cogniscent of it or not.

To massively simplify, you are focused entirely on the negative effects which can be mitigated especially in a clinical setting.

What you're describing as a "bad" thing is that all the chemicals get released at once - what that does is create the perfect mental environment to deal with issues or trauma that would be literally too painful to access otherwise. Often times the benefit of getting through or starting a journey of healing of some long-standing problem will hugely outweigh the minor downregulation of neurochemicals afterwards (you will feel a little slow).

If I thought the side effects could be mitigated I’d be doing it all the time ;) But I’m skeptical and don’t buy into all of those downplaying the effects as “minor”.

The mechanism still depletes your stores of neurotransmitters, but the neurotoxic effects and the "regrowth" period can be mitigated with supplements. Nobody should do it more often than once every 2 weeks under any circumstances, and only then in a clinical setting - once ever 2-3 months is okayish, but again the more environmental control the better.

This is not my experience. If you overdo it, this can happen, but with the proper dosage there is no noticeable happiness hangover.

I think drugs should be scientifically researched for all the same reasons we research neuroscience in general.

I disagree that everyone should try (any) drugs. It's hard enough to trust your own mind (and those of everyone around you). Adding drugs to the mix compounds this uncertainty.

Its annoying the NYT used the term ecstasy (XTC) as that doesn't describe the drug. The drug which would be considered as a remedy for PTSD, is MDMA and its closely related counterparts (MDA, MDEA/MDE). These drugs are called empathogens or entactogens [1].

[1] https://en.wikipedia.org/wiki/Empathogen%E2%80%93entactogen

"3,4-Methylenedioxymethamphetamine (MDMA),[note 1] commonly known as ecstasy (E), is a psychoactive drug primarily used as a recreational drug." - Wikipedia[1]

1: https://en.wikipedia.org/wiki/MDMA

Hail Eris.

Mushrooms, mdma, lsd, ketamine are often praises as therapeutic but I’ve had close relations with all of them and been in a culture where that belief is there and seen so many scenarios it’s unbelievable. Yes they might have a short lived effect but they are incredibly hard to manage. I advise everyone to try once in their life but keep it at that and try to use the effect for something... which might be the hard part. Today the only drug I believe is fairly safe and has a much harder effect is Changa(dmt + Maoi) which might end the need for all other drugs and help stress or bad thoughts Which it had to me and over 70 people I took through it.

The therapeutic dose for ketamine is far lower than the recreational dose. (I don't know anything about the others.)

What it the suggested clinical dose for ketamine for a user with no tolerance?

Also what would be a recreational ketamine dose? As ketamine is almost like two separate drugs at the dosage spectrum. From a small bump to get a bit floaty / wobbly all the way to deep immobile kholes

> which might end the need for all other drugs

There is no such thing as one drug which makes all other drugs redundant.

Disulfiram (brandname Antabus(e)) works well for alcohol addiction. Methadone for heroin addiction. Bupropion (brandname Zyban) for smoking cessation.

As for DMT + MAOI (which I know as Ayahuasca), care should be taken when using a MAOI. Most importantly it must not be combined with a plethora of other drugs and foods, but there are some additional sharp edges to take into account beyond that.

I've only used Ayahuasca once recreationally. It was the most interesting experience, compared to Psilocybin. They say that with MDMA, only your first experience is magic. I've used it approx 10 times, and can attest to that.

I do not recommend everyone should use this or any other drug once in their life. From the drugs you mentioned, there's one which you didn't which is relatively mild, safe, and that is Muscimol (found in A. Muscaria aka fly agaric).

My advice is very simple and universal (caveat [1]): go to your doctor instead of recreationally using drugs, and exhaust all options there. It was then, through rough milling and various therapists, that I found out that I have ASD. Which explained far, far more than any recreational drug usage I've had. And I have had my take as the above might suggest. Of all the drugs I have used, I feel marihuana was the most dangerous one because I had multiple psychoses on that one.

[1] Though I do realise not everyone in the world has access to quality, affordable healthcare

> They say that with MDMA, only your first experience is magic. I've used it approx 10 times, and can attest to that.

My first time was fairly meh, but one of the last times I took it, after a multi-year break, was pretty magical.

Changa is much more intense but t less a strain on the body. Changa is smoked and doesn’t work the same way although benefits are similar to ayahuasca but no you do not risk cheese syndrome from the Maoi in the same way as ingested. The literature is not big on the subject yet but dig and you will find. My advice is uppersit stay away from most doctors or atleast research what they are trying to do to you. Seen a lot of life’s ruined by them sadly. And yes Changa is so strong you probably won’t feel the need for any cravings a while alcohol sugar coffe weed and whatever doesn’t mean much on top of this experience which you can probably live on the next 40 years. I don’t get my ideas from only reading but first hand experience. Myself quit 15 years of daily weed abuse from one day to the other. I don’t feel a need for any substances anymore. Lots of people did similar after one and only one trip of 1 hour. Worked with alcohol and weed and stress and being an idiot from my experience. It’s easy to go back to bad habbits but with this it’s also easy not to. It’s about the mindset you ned in not the body’s reaction which will ofcourse be there a while. And cook your own Changa the one you buy don’t have enough active alkaloids and is made for profit.

> Today the only drug I believe is fairly safe and has a much harder effect is Changa(dmt + Maoi)

Erm, sorry, but I'm really not sure the words 'safe' and 'maoi' should be in the same sentence there. There are a lot of precautions one needs to take to make sure you don't end up with severe hypertension and requiring a trip to an emergency room.

I think we should probably take the outcomes and evidence of the ongoing scientific research, for what is safe or not.

To my understanding, MAOIs only pose a hypertension risk in combination with stimulants like tyramine, caffeine, amphetamine and derivatives, etc. DMT isn't a stimulant.

Also, hypertension risks are generally a problem for MAOI prescriptions: people who take MAOIs every day. With DMT, a MAOI is only consumed once, with the DMT. DMT is rarely taken on a regular and frequent basis, so it's unlikely someone would be consuming a very risky quantity of MAOIs over the long term.

MAOIs may increase DMT risk in other ways, but I don't believe hypertensive crisis is an issue for that specific combination.

> To my understanding, MAOIs only pose a hypertension risk in combination with stimulants like tyramine, caffeine, amphetamine and derivatives, etc

They pose a risk with alcohol and lots of different foodstuffs too - https://www.mayoclinic.org/diseases-conditions/depression/ex...

> MAOIs may increase DMT risk in other ways, but I don't believe hypertensive crisis is an issue for that specific combination.

Not with DMT itself, but if taking an MAOI at all you need to take a lot of precautions (fasting, avoiding certain foods and drink etc) to avoid the possibility.

It's manageable, clearly, but just blanket saying not only that it's fairly safe, but that it's the only fairly safe drug disregards the specific risks associated with MAOI use over and above those presented by (for instance) LSD or MDMA.

All those precautions is when you ingest it. Research.

I actually had a bunch of caveats like those in my original comment, but edited them out because I felt like they were unnecessary. Yes, MAOIs definitely shouldn't be taken in combination with foods or beverages or substances which are contraindicated for it, but that's mostly an issue for "non-selective" MAOIs, and is unlikely to affect someone who only takes a single MAOI dose once per year.

I just meant DMT isn't known to pose a particular risk when combined with a MAOI, unlike taking a MAOI with amphetamine or something. Obviously people should research what they should and shouldn't take with them.

People don’t know much about the subject Maoi smoked and ingested works differently. I’m fine relying on my 20 years of personal experiences and the little literature there is on the subject.

You probably shouldn't be advising people that it's the only safe drug. That's all. MAOI use presents risks that are not found with other drugs, so it requires as much or more care and attention to be safe.

But in the case of this maoi Which is different than found in Pharma.. a vs b. in the way it Works smoked vs ingested there is No evidence it should cause harm. Its Been used for centuries. I have enough experience to say that most recretionaæ drugs are unsafe and i do not put changa in this catagory. Most people here just talk about What they read.

If they read good science, I'd put that above your anecdotes every time.

Many things have been used for centuries, including Belladonna. Doesn't mean a lot

A ten second google search will show you examples of people who have had this side effect from "Changa".

Care to share this finding. I worked at festivals with 40k people doing everything u can imagine and have yet to come cross anyone. I’ve seen people die or ruin their life from most drugs including ordinary pharma apart from dmt and Changa which is always described as life changing best experience ever.

MDMA is by no means harder to manage than DMT. 100mg with some friends in the couch and 99.9% of people is going to have a blast and will look back at it as an experience that was really worth having, probably with some lasting insights.

The DMT experience is not something for everyone. Adding a MAOI makes it more dangerous physically.

No there is no evidence of anyone having cheese syndrome by smoking. It’s for oral and it works differently there.

At the ever present risk of being downvoted: should we be able to chemically forgive ourselves for anything/everything?

Aren’t there some things that are so terrible that we should continue to feel guilty?

Yes, if your only goal is to punish then making sure that people are eternally guilt ridden would make sense. If your goal is to reduce human suffering then no that doesn't make sense.

In the case of this soldier he is most definitely deserving of help and respect.

I am not asking if it should be done in any particular case, but in every case.

I can concoct particular examples but it gets dramatic quickly. I am sure you can come up with some extreme examples.

Are you saying you are okay with the person forgiving themselves in every example you can think of?

Does it matter if the person can forgive themselves "easily" i.e. immediately after the act, and for all time with no consequences?

On principle our justice system is based on preventing harm of law abiding citizens, and not to harm the guilty. Allowing the guilty to forgive themselves might be a luxury, but it wouldn't violate justice even though it feels merciful.

Only if you want folks to suffer and have trouble being part of society.

I'll add that PTSD doesn't only happen to people that have done things - it happens to folks that have been through some sort of trauma. Victims of child abuse or spousal abuse, for example. Sometimes folks that have been in car accidents, fires, and other such things. I know a person that is in inpatient treatment right now because it got so bad... again. She's mostly in treatment because the thought of her children going through a parental suicide made her feel badly.

And I'll add this as well: Soldiers don't always have the real choice to do things differently, especially in draft situations or if someone has been lied to in recruitment (really common). And I'll add that forgiving oneself is not the same as being OK with everything that happened, simply that the overriding guilt doesn't own your life and affect everyone that you know. People change but their past often doesn't (there are some exceptions, such as missed information, but what you thought is still what you thought).

Soldiers in particular seem to be a very polarizing example.

As a philosophical point, I am okay with non-soldier examples.

Does you argument still stand?

I'd say it absolutely does. PTSD is primarily caused in people that had a traumatic experience. Trauma in one's childhood from abusive or neglectful situations is probably more common than soldiers. The point there isn't to "chemically forgive", its to help people realize they weren't at fault in the first place.

Still, if you think the point or goal of the topic here is "chemical forgiveness" then you're way off base in the first place - someone can be so horrified they can't even internalize the shame of what they did. The point isn't to feel good about doing bad things.

Yes. Being a soldier shouldn't mean you suffer for the rest of your life to the point that you cannot really participate in life. Not all soldiers who wind up with PTSD have committed atrocities. You can be a medic and get PTSD. A translator. And so on. At the same time, some of those folks that do horrible things do not always wind up with PTSD.

Not only that, but such things take a toll on society. Their families suffer - children, spouses, parents, siblings - and it is a drain on medical care. Why would we not make it so folks can lead a better life?

I'm not even a supporter of much of what a military does. They war, and rarely do the rebuilding or giving back to the community outside of a PR stunt. (NASA gets a break here, they don't seem to be a warring segment). But that doesn't mean the little folks on the ground need to suffer for life. I don't think most folks are happy about the thing that gave them PTSD, but that's not what the drug does. (Side note: I've taken this particular drug). It simply makes it so you aren't caught up on it and can get back to living in the present. That thing stops eating your brain and linking that thing to more innocent things in every day life.

May be, but I didn't see examples of those things in the article.

Glad to see more research happening on this. The outcome of these studies is very promising for people with treatment resistant PTSD. Support MAPS to help continue this effort.

One common thought under the influence of MDMA is:

The world could end now. Everything is perfectly fine.

> After taking the drug, the patient lies on a futon amid candles and fresh flowers, listening to music. Two therapists — one female, one male — sit at the patient’s side as guides. That session lasts eight hours.

My version was "lounging around under the stairs in a mostly-abandoned hotel lobby late at night at a furry con, with two friends". It worked pretty well. Still probably took about eight hours.

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