Introduction
For decades, scientists and academics have sought to demonstrate the tremendous medicinal potential of psychedelic substances. Time and again, these mind-altering chemicals have shown actual promise in treating some of the most difficult (and costly) disorders that require treatment, including addictions, depression, and anxiety, among many others. However, because the stigma remains, attempts to rebrand and integrate these chemicals into established healthcare systems have been mostly ineffective – until now.
After a groundbreaking scientific experiment gave these specialists new evidence to back up their claims, it appears that we are on the cusp of a rapidly expanding market for psychedelic medicine. People with PTSD frequently live their whole lives in a condition of heightened anxiety that prompts flashbacks, nightmares, and dread reactions as a result of exposure to acute trauma (Granner & Seng, 2021). Recalling these memories can also induce violent behavior since it might be difficult to discern reality from a former experience that feels like it is happening right now.
Post-traumatic stress disorder (PTSD) is a serious mental illness that develops following a mental trauma. Symptoms may emerge soon after the assault or sometime later, even years later. Depression, panic attacks, addictions, suicidal behavior, and violence are all symptoms of PTSD. It appears as a continual “rewinding” of events, with the individual enduring significant continuing stress. 3,4-methylenedioxy-methamphetamine (MDMA) is a potent narcotic hallucinogen that is frequently used in barbiturates and sedatives at a suitable dosage (Oster et al., 2023). The PICOT question is: What is the effect of 3,4-methylenedioxy-methamphetamine (MDMA)-assisted psychotherapy on post-traumatic stress disorder (PTSD)? The aim is to study the effects of MDMA on the course of PTSD in patients. This topic is relevant to the psychotherapy nurse practitioner as it greatly influences the practice of patient care and treatment.
Description of the Practice
MDMA alters the connections between various areas of the brain, including the prefrontal cortex, which is responsible for awareness; the hippocampus, which is responsible for memory formation; and the amygdala, which is involved in the experience of anxiety. Negative experiences are lessened, while positive ones are reinforced as a result of these modifications. It is simpler for a person to communicate and internalize their trauma when they are in this position. This is the foundation of PTSD therapy since traumatic memories in this disease do not travel to long-term memory, allowing people to see it as a past but is instantly lived as a current event from which the individual cannot recover (Smith et al., 2022).
In this sense, the receiving is only a tool that promotes access to awareness; the essential task is treatment. There will be no effect if there is no adequate therapy. As a result, patients who adopt this therapy must have faith in the psychotherapist’s abilities. The opinions reached by a person while under the effect of narcotics are their own, lived, and logical conclusions, not signals from the side. In other words, the psychedelic experience is seen to be genuine.
Since the doses are modest, there will be no reliance. For example, two sessions of MDMA are used to treat PTSD: the first session has 120 mg of the chemical, and the second session contains 80 mg (Smith et al., 2022). This is 2-3 times less than the average consumption (Smith et al., 2022). After the first session, 40% of people’s symptoms disappear (Smith et al., 2022). Furthermore, the patient considers the substance’s use as a component of treatment rather than a novelty, and he wants more. A person does not become worse after consuming modest dosages of pure confirmed material after its activity is over, as is common with medications.
Summary of Evidence
MDMA as a Catalyst for Cognitive and Health Improvements in PTSD Patients
The Multidisciplinary Association for Psychological Research in the United States has revealed the findings of their new project, which represents a new set of more effective and long-term measures for the treatment of post-traumatic stress syndrome. This nerve illness frequently arises as a result of stressful life experiences or during the course of a neurodegenerative disease, making it difficult to rid patients of it and its symptoms.
Experts, on the other hand, have revealed their unique integrative therapy project based on the usage of MDMA-containing drugs.
The new study by psychotherapists is based on the usage of this MDMA drug, two days of which are alternated with sessions of integrative psychotherapy – the team obtained the results today after a year of testing on patients (Vermetten & Yehuda, 2020). It was shown that 76% of individuals suffering from some post-traumatic stress syndrome exhibited substantial improvements in cognitive capacities and overall health – and these gains began with the usage of MDMA (Vermetten & Yehuda, 2020). However, the specialists had to work hard to persuade a Federal Food and Drug Administration panel that their procedure was safe for patients (Morgan, 2020). It was discovered that there are essentially no adverse effects – and those that exist are related to short-term memory impairment, which can be swiftly and readily remedied. Thus, the usage of MDMA as a hallucinogen reinforces the idea that psychedelic chemicals may be regarded as medicinal catalysts that aid in the treatment of a variety of illnesses.
The Role of MDMA Combined with Talk Therapy in Treating Severe PTSD
Another recent research experiment has revealed that the drug MDMA effectively treats symptoms of severe post-traumatic stress disorder (PTSD) when used in conjunction with talk therapy. Ninety percent of trial participants who received MDMA during treatment improved when compared to those who underwent therapy but took inert placebos. Two months after the test began, 67% of individuals showed no evidence of PTSD, compared to 32% in a similar group given a placebo (Nicholas et al., 2022). According to Johns Hopkins University and the University of California researchers, MDMA has no significant adverse effects, only moderate transitory symptoms such as nausea and lack of appetite. The combination of MDMA and conversation therapy, according to neurologist and study lead author Jennifer Mitchell, helps the brain to absorb unpleasant memories and heal itself.
In contrast, typical prescription medicines numb the symptoms of PTSD. However, the neuroscientist is sure that without specialized therapy, MDMA will not have the desired benefits (Chi & Gold, 2020). MDMA is not the only substance that can aid in the treatment of mental illnesses. Scientists have previously undertaken effective medical studies utilizing LSD and hallucinogenic mushrooms to treat symptoms of PTSD, depression, and other mental diseases.
PTSD Recovery Outcomes Among War Veterans, Firefighters, and Police Officers
Another research included 26 war veterans, firemen, and police officers who were suffering from persistent PTSD. The combination of psychotherapy and MDMA was thought to be so effective that two-thirds of the subjects no longer experienced PTSD symptoms following treatment. PTSD is a major problem in the United States and over the world, and it is a leading cause of sadness and trauma, particularly among the general public and survivors. According to research, 9-10 million people in the United States alone have PTSD, with many of them administered medicines on the pharmaceutical market that are ineffective (Brewster et al., 2023).
Exploring MDMA Therapy for Social Anxiety in Individuals with Autism
MDMA also precludes the treatment of anxiety and mental illnesses. MAPS researchers are also working on a Phase II trial of social anxiety in individuals with autism using MDMA. This medication works by reducing the activity of the amygdala, the portion of the brain responsible for fear and anxiety. According to a study, around 16 million individuals in the United States suffer from depression, while 350 million globally (Alshaya, 2022). Antidepressant drugs have a 17-billion-dollar industry in the United States (Alshaya, 2022). MDMA has also been found to be positive in individuals suffering from depression as a result of untreatable infections in studies now being conducted. The chemical provides patients with a sense of serenity and confidence, which helps them cope with their depressed moods substantially. However, according to some academics, MDMA has significantly more theoretical foundation than actual evidence of effectiveness, and its effects on depressed individuals, as in the case of PTSD, have not yet been well explored.
Individual engrams are not just saved as objective data. Memory is related to emotions via the limbic system of the brain, which includes the thalamus, hippocampus, and amygdala, the latter of which is responsible for responding to potentially harmful stimuli and activating the fight or flight response. In other words, not only are the specifics of the incident recalled, but so is their emotional state at the time the engram was produced.
When a memory is recalled, the emotional state might also be reactivated (Speer et al., 2021). If the recollection is painful enough, the resulting psychological stress might overflow the amygdala. Engrams, according to researchers, are malleable. They can be altered by the patient’s emotional state at the time of the recall, which implies that it is theoretically feasible to separate the non-emotional components of a traumatic engram from the emotional components.
In many respects, this form of fear removal and retention is the same theoretical approach that underpins one of the most established therapies for PTSD. Some scientists believe a prediction mistake or a mismatch between a memory trace and present instantaneous occurrences might be a powerful signal that initiates a malleable engram state (Speer et al., 2021). When trauma memories are recovered by MDMA exposure during treatment, a substantial prediction error is formed by the unique internal state of MDMA-stimulated neurochemical/hormonal augmentation and the supporting therapeutic milieu.
A War Survivor’s Recovery from PTSD Through MDMA Therapy
Another proof of the effectiveness of MDMA in the treatment of PTSD can be seen in the case of a war survivor. Jonathan Lubeki returned from Iraq in 2006 after serving 12 years in the military. He was diagnosed with a traumatic brain injury and post-traumatic stress disorder soon after his return. He had numerous sorts of therapy and took hundreds of antidepressant medications for treatment, which merely relieved his symptoms. During this time, Lubecki attempted five suicides. When he was recovering from a previous attempt in the hospital, an intern secretly told him to google MDMA for PTSD.
Jonathan started MDMA therapy in 2015 as part of the MAPS Phase II trial, and he finished the protocol in early 2015. He now claims to have entirely recovered from his PTSD. For years, Lubecki has been leading discussions about PAT in the United States and around the world, holding state-level meetings in the United States Congress, meeting with high-ranking officials, and appearing on world-famous shows (such as Last Week Tonight with John Oliver) on the subject of substance-assisted psychotherapy.
Conclusion
Thus, there is convincing data, and the evidence is accumulating, that psychedelic therapy can provide hope to a limited percentage of patients who have failed traditional therapies. MDMA-assisted psychotherapy seeks to increase psychotherapy efficacy for patients who have PTSD. It consists of up to three doses of the psychoactive chemical that is used in conjunction with psychotherapy in a therapeutic environment under the supervision of a physician.
It is important to note, however, that psychedelic therapy is not a miraculous medicine that promises speedy healing. People who are already potentially vulnerable may reasonably be disturbed or dissatisfied if their experience does not live up to the therapy’s expectations. Fear, panic, and re-traumatization can be caused by psychedelic chemicals. There are concerns if a comprehensive clinical assessment and good dialogue with those seeking therapy are not performed.
Traditional medications mainly mask the symptoms of PTSD. However, the combination of ecstasy and talk therapy enables the brain to process and recover from traumatic experiences. However, the researchers stressed that using ecstasy without the assistance of an expert will not always result in beneficial effects. MDMA is an unusual therapy for PTSD; nonetheless, the core hypothesis underlying its effectiveness in treating the non-dissociative subtype of PTSD appears to be sound.
Furthermore, the techniques he proposes to employ are not dissimilar to standard exposure therapies that have been used since the XNUMXs. The medication’s euphoric impact simply hastens the dissociation of anxiety-inducing stimuli and psychological trauma, and this detachment persists even after the drug is stopped. More study is also needed to determine how this method impacts a subset of PTSD patients with dissociative symptoms; this looks to be a potential line of research for a disorder that is frequently curable.
Future Implications
A new medicine takes a long time to get licensed for sale. At best, the human clinical trial procedure can take five to seven years. For decades, the nonprofit Multidisciplinary Association for Psychedelic Studies (MAPS) has worked to find MDMA therapies for PTSD. The FDA’s permission for increased access is conditional, meaning the drug will only be available to “moderately to severely treatment-resistant PTSD patients.” Health insurance may not reimburse patients’ fees because the therapy has not yet been properly approved. MAPS has previously estimated that the first cost of an MDMA-assisted psychotherapy program per patient would be around $15,000 (Chi & G old, 2020). MAPS is also exploring psilocybin as a treatment for PCP, which might be regarded as a future stage and solution in treatment in addition to MDMA therapy.
It is also worth noting that the usage of 3,4-methylenedioxy-methamphetamine for the treatment of alcoholism is a possibility in the future. The majority of drinkers have experienced trauma at some time in their lives. Scientists anticipate that MDMA, which is known to help users build empathy, would strengthen the link between patients and therapists, allowing patients to delve deeper and address a slew of long-buried problems.
References
Alshaya, D. S. (2022). Genetic and epigenetic factors associated with depression: An updated overview. Saudi Journal of Biological Sciences, 29(8). Web.
Brewster, P. R., Bari, S. M. I., Walker, G. M., & Werfel, T. A. (2023). Current and Future Directions of Drug Delivery for the Treatment of Mental Illnesses. Advanced Drug Delivery Reviews. Web.
Chi, T., & Gold, J. A. (2020). A review of emerging therapeutic potential of psychedelic drugs in the treatment of psychiatric illnesses. Journal of the Neurological Sciences, 411. Web.
Granner, J. R., & Seng, J. S. (2021). Using theories of posttraumatic stress to inform perinatal care clinician responses to trauma reactions. Journal of Midwifery & Women’s Health, 66(5), 567-578. Web.
Morgan, L. (2020). MDMA-assisted psychotherapy for people diagnosed with treatment-resistant PTSD: what it is and what it isn’t. Annals of General Psychiatry, 19(1), 1-7. Web.
Nicholas, C. R., Wang, J. B., Coker, A., Mitchell, J. M., Klaire, S. S., Yazar-Klosinski, B., Emerson, A., Brown, R. T. & Doblin, R. (2022). The effects of MDMA-assisted therapy on alcohol and substance use in a phase 3 trial for treatment of severe PTSD. Drug and alcohol dependence, 233. Web.
Oster, E., Čudina, N., Pavasović, H., Crnić, A. P., Božić, F., Fadel, C., & Giorgi, M. (2023). Intoxication of dogs and cats with common stimulating, hallucinogenic and dissociative recreational drugs. Veterinary and Animal Science. Web.
Smith, K. W., Sicignano, D. J., Hernandez, A. V., & White, C. M. (2022). MDMA‐assisted psychotherapy for treatment of posttraumatic stress disorder: A systematic review with meta‐analysis. The Journal of Clinical Pharmacology, 62(4), 463-471. Web.
Speer, M. E., Ibrahim, S., Schiller, D., & Delgado, M. R. (2021). Finding positive meaning in memories of negative events adaptively updates memory. Nature communications, 12(1), 6601. Web.
Vermetten, E., & Yehuda, R. (2020). MDMA-assisted psychotherapy for posttraumatic stress disorder: A promising novel approach to treatment. Neuropsychopharmacology, 45(1), 231-232. Web.
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