MDMA moves from club drug to real therapy
scientificamerican.com
scientificamerican.com
First off, MDMA isn’t unique, there are a lot of other empathogens. MDA, 5-MAPB, 6-APB, etc.
It’s just the most studied because it’s the most popular/oldest one.
Since they all cause serotonin dumps, I kind of doubt (uneducated guess) that this would be effective, is there any reason to believe that they should create the same tolerance?
An exogenous drug acts way quicker though
I’m not saying it’s a good or productive option, but if compared to certain death, it’s at least recoverable.
Richard Branson is a pretty successful person by any metric and has been open about smoking weed since even before it was widely legalised
Your statement is factually incorrect. Opiates are used frequently in clinical settings with significant positive outcomes.
I'm surprised I have to spell it out - booze and opiates never helped anyone who was in a bad situation already.
Even alcohol might be very helpful fo some people in certain situations.
The issue is the rather poor risk/reward ratio due to dependence and abuse potential.
How can you gauge other people's suffering? It can easily be completely crippling, not unlike extreme poverty is so stressful that it effectively blocks people from working themselves out of it.
I am not just bashing you, I went through something similar, the worst breakup in my life was the motivation for me to start working out in the gym, lean even more on cool extreme sports, start running etc. But I know people in similar situation that simply couldn't move, stuck in vicious circle of self-pity, grief, self-harm in various ways, and more regrets.
What we should do as society be tolerant, humble and accept that nobody, especially politicians with actual power know everything. Give people tools, explain or even guide them, be helpful, give a hand if needed, but otherwise let people be. You can't protect stupid from their own stupidity anyway, not through regulation.
You couldn't be further from truth. Suffering sucks, trying to quench it with booze and opiates increases suffering in the long game (perhaps except acute pain right after severe injury, surgery or some such).
> How can you gauge other people's suffering?
Corresponding professionals developed meaningful tools to measure both physical pain and mental distress.
>It can easily be completely crippling, not unlike extreme poverty is so stressful that it effectively blocks people from working themselves out of it.
Fair enough. You being unhappy with my comment however suggests that drinking and doping helps these people in any way.
>I am not just bashing you, I went through something similar, the worst breakup in my life was the motivation for me to start working out in the gym, lean even more on cool extreme sports, start running etc.
Good on you.
>But I know people in similar situation that simply couldn't move, stuck in vicious circle of self-pity, grief, self-harm in various ways, and more regrets.
What does that prove? Would you recommend that they drink or dope?
>What we should do as society be tolerant, humble and accept that nobody, especially politicians with actual power know everything.
Sure should. We also should be blunt about things we do know, such as that alcohol and opiates do not help against poverty, depression, loneliness and pretty much any other adverse condition - this is what I wrote earlier and I don't understand why you'd object to that.
>You can't protect stupid from their own stupidity anyway, not through regulation.
Yes you can, at least you can prevent the kind of stuff going on in China around Opium Wars. (And don't you dare pull Rat Park on me).
Hell, in Buddhism it's a core theme.
And religion or not, it's undeniable that suffering is a part of the human experience.
Who are you to say what is proper? Sure, most things they say not to use at all - but at the same time, many drugs aren't really going to harm you if you are using occasionally for a fun escape.
And I don't know if you know this, but some folks simply aren't going to escape their misery. Being just above poor for many years just sucks, for example. Having physical pain sucks. Past trauma sucks. Boredom sucks, and is absolutely miserable for some folks.
Heck, I don't view my own life as bad, and I find some things as a positive escape that I just can't get anywhere else. It is more akin to finding different flavors of life. When I was miserable, I was also always sober save for nicotine and caffeine... the sobriety wasn't the cause of the misery though.
It just isn't for you - not with that attitude, and perhaps you've not met folks with a decent attitude for it. And that's OK.
It is sad that libertarians are trying to argue for live and let live in the case of drugs. Did they not learn from tobacco companies that commerce does not live and let live. They persuade petulantly until everyone is a customer. Nevermind if it is healthy.
I'm going to be down voted by the drug loving crowd, but I won't stop fighting for people to see and understand that drugs should never be a commercialized enterprise.
People take drugs, and they're going to do so whether they're legal or not. People have addictions and control issues with food too, we're not talking about banning MSG or sugar. The majority (not all) of the harm comes from the illegal market they exist in. A controlled environment can only make things safer for people, and provide a basis for supporting people with issues. This works everywhere it's been tried.
Illegality creates lots of friction.
As for it being harder to start - tell that to the 16 year olds who get their hands on alcohol. It certainly never stopped me.
Have you tried asking around? :P
But as I said - this creates friction. Now you have to look for shady people or go to shady darknet markets, telegram groups, etc.
And in many jurisdictions even purchase/usage can get you a criminal record.
Or you can simply go to a grocery store and buy as much alcohol as you want.
Depending on where you live, of course. Saudi Arabia doesn't allow alcohol. Sweden limits the purchase of high ABV drinks to state run stores, as do some states in the US. Dry counties exist in the US too, and those places have _massive_ issues.
Drugs themselves should be entirely outside the scope of law enforcement. Plenty of the things that are brought up by prohibitionists would still be illegal under a host of other laws, outside of possession and use itself. Rob someone to get your next fix? Congrats, robbery is still illegal, off to jail with you.
The history on this is pretty clear. Drug prohibition has caused more harm than it has protected people from. It can also springboard into discussion of historical (and current) racial disparity, as such laws almost inevitably affect the disenfranchised and downtrodden disproportionately.
Drugs are not a criminal issue. They are a public health issue. Harm reduction policies work.
Also straw purchasing a legal substance is much easier than finding a dealer of an illegal one.
You say that as if it's a given, but it really isn't. It's region-specific, if anything. I live in Tennessee, and I would guess that it might be easier for a teen to acquire meth than alcohol. That depends on who the particular teen happens to know. Don't forget, there is also straw purchasing of illicit substances too, people who know someone who knows someone, but don't have the direct access to the one with the substance, they're also straw purchasing.
It’s like I don’t know how to create good laws so therefore I should not be create laws at all.
Get real.
(e.g. David Nutt on the British advisory council for misuse of drugs)
I see you're also pretty much arguing for criminialization of alcohol, which very definitely and spectacularly failed. Although I will agree that it's probably the most harmful substance that still allowed to be regularly consumed.
Paracetamol (acetaminophen) is the other substance that's been grandfathered in. Its surprisingly low lethal dose would not meet modern safety standards.
And hypothetically, if there was a way to improve mental health at the expense of physical health, what is the right call here? Is there one globally optimal call? Who better to make this decision than the individual?
https://www.bbc.co.uk/blogs/thereporters/markeaston/2010/11/...
MDMA is much too intense of an experience to integrate into the daily life of most people and there isn’t really a craving to take more once it has worn off.
You try it first and feel that "MDMA magic". You try it again and yes, you still feel something pleasant but the magic is lost. Most probably forever.
I heard it many times and experienced myself.
In my late 20s MDMA did something wonderful for me. It was like going from BW interlaced 320p to TrueColor 4K.
But it was 3-5 times most. Every 2-3 years I tried again but no luck
If a drug intoxicates you, then it is bad.
Permanent reduction of brain cells? Accidents? Disproductivity?
Of course you would try to stretch that effect on to lots of causes. And then argue for the same treatment to those elements. But you got to know that is a logical fallacy.
I would argue the opposite, in many cases
And who wants to be productive 24/7? That just sounds miserable.
with drug use, harm reduction in the modern era is essential. pushing it away from the legal sphere means that people will not manage to reduce their harm as much.
all of this authoritarian shit doesn't stop people from doing things, it just stops them from doing it safely and getting help without being arrested.
diet sodas have aspartame which contains phenylalanine which can increase dopamine levels in the brain.
in this argument, tea, alcohol, diet soda, everything like that gets illegalized.
there's nothing wrong with intoxication, just being irresponsible with it and not reducing the harm you cause or suffer yourself through intoxication.
furthermore, amphetamine does the opposite of "lost productivity". so we should make that OTC by this merit? :p
everything meaningful is going to contain chemicals including those of a psychoactive nature or a nature that changes biochemistry, nothing will stop being chemicals.
Nicotine is of course addictive but it’s not a particular dangerous and potential has some positive effects. Not that different to caffeine.
In such cases, why would you legalize intoxicants? you would only promote intoxicants that way.
Also what you’re proposing seems like an extremely slippery slope. What’s the issue with intoxicants? They are harmful? Well a lot of things are.. why don’t we ban sugar, saturated fat, maybe all the things that encourages sedentary behavior? Television, sofas, comfy beds? All illegal.
What’s the objective?
Why is it any of your or mine business what substances people consume if they don’t hurt anyone by doing that?
Drug traffickers would do everything to increase their profit and fund their operations.
This further supports the idea that commercialization of drugs only creates more problems.
Still a horrible outcome of course; opioid dependence sucks. The Buvidal injection is a life changer for me.
My total clean time is almost 7 years now. I wish more people knew about Sublocade and Buvidal. I always tell people that opioid addiction pretty much has a cure these days but they are so hesitant to start the injections because they never heard of it.
It’s infinitely better not waking up every morning in mild withdrawals. It’s a godsend, and everything I’ve heard is coming off it is pretty easy, well as easy as it could really be anyway.
The "worst" part of quitting Sublocade so far was the one day, also around 3 months, when I felt a little tired and my emotions came back. I felt like I had the most mild cold ever, but what bothered me was the intense fear that I was about to go into legitimate withdrawal.
8 hours later I felt fine and have felt fine since.
If the US and state governments really wanted to solve the opioid crisis, getting Buvidal/Sublockade to anyone who asks for it, for free, would go a very long way.
It’s free for me paid for by my state government here in Aus, and it changed my life.
SSRIs do not result in anything resembling a "high". Neither do tricyclic antidepressants, lithium salts for bipolar disorder, and so on.
I have long since lost it, but many years ago a friend of mine wrote down his experience of temporarily stopping his bipolar medication in order to do a burst of work during the hypermanic phase. It made it very clear that, for him, _not_ taking the drugs resulted in a dramatic and sometimes hazardous high/low cycle with a frequency of days, in a way that resembles the experience other people have with recreational drugs.
In my experience taking sertraline, years ago, it actually did feel like a very mild sort of high. I remember noticing that colors seemed to have literally become brighter, and physical sensations were more pleasant in general. If it were possible to microdose MDMA, I imagine that might feel similar.
people would even say the world feels or seems grey when they're depressed.
that we should just give people the capacity to do what they are going to do either way, safely properly and teach them how to reduce their self-harm and societal harm with what they are doing!
Well no one is to say that because the serotonin hypothesis was shown to be wrong, or at least incredibly dubious.
I've been donating to MAPS monthly for years. Those FDA trials were not cheap to run.
We can see in real time with kratom what happens when drugs are allowed to be sold recreationally without FDA approval, and it's not good at all.
Psychoactive properties were discovered later
Can you expand on this? I'm not sure what it means.
Shortly speaking, Mithoefer, some enthusiast that practice MDMA "trips" for women for decades (and only for women, what the hell???), only plans to do something in the future. It does not mean that he will do it in the future. It does not mean that FDA will accept his application. It only means that he continually feeds the media with rumors that his experiments in drugging abused women with currently illegal drugs will allegedly gain some kind of legitimacy in the future.
It was like the best therapy ever. Dancing till the break of dawn with many people, vibing to the music. What a shame it was all so illegal.
I thought 50s rock 'n' roll was cool and the whole scene around that, by the time I was 20, there was no way I was going to drive a El Dorado convertible to a milk bar and do the twist while watching Elvis perform hound dog. Times just change.
Anyway, one day he comes right up to me and says, apropos of nothing:
"They never used to let me have fun... but they do now"
and then he just walked off.
So many memories... that cannot be shared in public.
(It was an acquaintance's 21st birthday party on a Mon or Tues night in the front room, attended by about 50 people, and I was terrible. The friend I was helping became a pro DJ a bit later. I certainly didn't).
Great days.
I didn’t make it all that often to the daylight hours, but my god when I did, those all nighters were something to behold.
And that 24 hour bottle shop up near Dandenong road was quite handy for the after party too.
They must’ve been on LSD, because it seemed like the most amazing thing they’d ever seen. The spent minutes holding up and gazing at it in wonder. Before dropping it on the floor and taking it in turns trying to slide on it like a cartoon character would (but barely moving a centimetre). Two trippers just having the absolute time of their lives while the rest of the chaos continued around them, everyone oblivious to it.
I want to tell a story about Lucy the Lesbian, but I’m not going to.
That said, the Thai food was remarkably good if you went in early enough.
The real waste is trying to gatekeep experiences, or closing oneself to experiences because you deem there's just "one right way" to do it.
I'm not a club goer, but the people I know who do come back feeling energized and refreshed. They understand something about themselves that I don't, and I'll always envy that.
Depressive effects aren't typically the greatest concern with this population. The risk to manage is traumatic material and sensations coming on more strongly afterward and overwhelming the person's capacity to regulate. This is one of the reasons the trauma informed psychotherapy aspect of the treatment is important.
So the question is not so much "does it fix something?" as it's been already answered at the time, the question is more "how to be the most effective with this type of treatment" which more research is needed for. PTSD seems to be a prime candidate for the effects of MDMA, if you've ever taken MDMA recreationally you understand how the openness it enables to talk about your feelings could be therapeutically used, what's needed to be honed down is the method to do it clinically consistently.
MDMA was first synthesised and patented by Merck in the 1910s as a chemical precursor. It was researched by various people mainly in animals as an analogue to dopamine/noradrenaline at various times between then and the 60s. Very limited recreational use already started happening, possibly in the late 60s, certainly by the early 70s. Shulgin tried it mid 70s and also made and shared the drug with some of his friends. Some of those were interested in using the drug therapeutically.
>MDMA was first synthesized by German pharmaceutical company Merck KGaA in 1912 as an intermediate in the synthesis of another compound. Its psychoactive effects were not noted until the early 1960s. In the 1960s and 1970s, the drug was used in psychotherapy, although it was not an approved drug and no clinical trials had been performed. The drug was studied in Switzerland for use in individual, couple, and group therapies until 1993, when the Swiss Ministry of Health withdrew permission to use MDMA and LSD by psychiatrists due to concerns about lack of research methodology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6435835
>In 1986, MDMA was classed as a Schedule 1 drug by the United Nations according to its Convention on Psychotropic Substances of 1971 due to its high potential for abuse, and most research was stopped. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7218633
But thanks for the further information! I actually didn't know Switzerland kept it going until 90s. I thought all research ended in the 80s
There's actually a mistake in that wiki article though. If you look at the source, it does in fact say Shulgin's friend Zeff was the first to start using it therapeutically since 1976. It says nothing about therapeutic use in the 60s, though it does mention LSD, which was used in the 60s before it was banned.