The Illegal Drug that Could Help Ease Anxiety About Death

A new study looks at MDMA for treating anxiety related to life-threatening illness.

By April M. Short · 4 Nov 2014

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Picture: Animal New York
Picture: Animal New York

Phil Wolfson is a psychotherapist who lost his 16-year-old son to leukemia more than three decades ago. He wrote the book Noe: A Father-Son Song of Life, Love, Illness and Death about the experience of watching his son navigate adolescence while succombing to the terminal disease. His personal experiences, he says, place him in a strange position of “too much knowledge” when he works with patients who are dealing with devastating loss, as well as anxiety and PTSD symptoms that often come with life-threatening illness.

“I work with lots of people, not only who may have lost children, but who are facing illness and or are involved with treatment that’s very difficult,” he said. “This has been part of my life’s work and certainly accelerated since my son got ill in 1984. I have kind of a personal sensitivity and motivation in the matter.”

Wolfson’s repertoire is unique in many ways, one of the major ones being his experience integrating psychedelics into his practice. In the ‘80s, before it was designated as illegal, Wolfson was among a number of therapists who used MDMA (now often called “ecstasy” or Molly) to assist them in their therapy sessions. The results were overwhelmingly positive at the time, but as more and more people began using it as a party drug, the government cracked down and listed it as a Schedule I illegal substance in 1985. Many of the therapists who used MDMA back then have been fighting to re-legalize it for medical purposes ever since.

Those early MDMA-assisted therapy sessions ultimately restructured the way many therapists work today, with or without the substance*. Rather than cycling patients in and out the door according to a rigid 45 or 50 minute hour, these MDMA therapists were sitting with with people for as long as it took to truly help them.

“When you do MDMA psychotherapy, or other psychedelic psychotherapy, you’re committed to being with people for as long as you need to be,” said Wolfson. “So, that in itself is a revolution. You’re there 3, 4, 5 hours—whatever it takes to be with human beings. A bunch of us were developing a family therapy and systems therapy approach; we weren't so worried about timed sessions, we were more concerned with, ‘How do we affect people’s lives in a positive way? How do we help people to grow?’ The family therapy movement was particularly interested in those things and still is. I was very involved with that, and MDMA psychotherapy was a great boon.”

Three decades later, Wolfson is planning to give MDMA to patients once again. He is slated to head up a newly proposed study of MDMA-assisted psychotherapy in Marin, California, sponsored by the nonprofit Multidisciplinary Association for Psychedelic Studies (MAPS). It will follow 18 adults diagnosed with life-threatening illness, who have a prognosis life expectancy of at least 9 months, and currently have severe anxiety related to a life-threatening illness. It will assess the ability of MDMA-assisted psychotherapy to significantly  reduce their psychological symptoms. The study is part of a global series of Phase II clinical trials looking into the safety and efficacy of MDMA-assisted psychotherapy for treatment-resistant PTSD. Like all MAPS-sponsored studies, it will be government approved, randomized and placebo controlled.

“We really want to help people feel and think about what they’re doing with their lives as they approach the issue of dying,” he said.

The study protocol explains that one of the goals of MDMA-assisted psychotherapy is to help people find a less difficult “perspective and orientation toward death.”

“Given that in this situation, spiritual, familial, psychological and existential concerns all take a position of primary and imminent importance for many people, the development of new treatment modalities to meet these needs is a clear imperative,” the protocol states. “Enabling individuals to face life-threatening illness and all of its concomitant difficulties with dignity, creativity, love, support and kindness is the primary impetus of this research study.”

Prior MAPS studies assessing MDMA-assisted psychotherapy have turned out very promising results. As of 2014, “MDMA has been administered to 1,080 research subjects in both Phase I and II studies,” according to the Marin study’s protocols. And to date just one drug-related “serious adverse event” has occurred. A proof of principle pilot study, which MAPS completed in 2010, was the “first-ever protocol evaluating MDMA’s therapeutic applications in clinical trials,” as explained on the MAPS website, and the results showed significant improvements across the board. A long-term follow-up (which looked at participants an average of 41 months post-treatment) “found that the benefits persisted over time, though a few subjects had relapsed due to new life stressors.” Similar studies in Spain and Switzerland came to similarly encouraging conclusions. Several ongoing studies, in which participants include war veterans, law enforcement officers and victims of childhood abuse and sexual assault, so far point to success as well.

Wolfson said he is personally politically motivated by the prospect of bringing MDMA back to into the above-ground therapeutic world. He said he thinks the war on drugs only promotes unsafe drug use and needlessly fills up prisons and jails.

“I loved [MDMA-assisted psychotherapy] and thought it was very helpful, so my motivation is to try and bring it back and move it from science to a prescription pad,” he said. “We need a different approach to dealing with substances. People use them, and the fact is the year they made MDMA illegal it went from thousands of users to tens of thousands and then millions. Large populations of people have been using psychedelics for long periods of time, and the amount of harm is low.”

Wolfson said legalizing MDMA and other drugs would make them safer because better education about when and where to use them would be more widely available.  

“If it was legalized, I think set and setting would improve vastly, and when harm did occur it would be majorly reduced, because use wouldn't be criminalized and people wouldnt go to jail for exploring their minds and souls.”

Short is an associate editor at AlterNet. Follow her on Twitter @AprilMShort.

This article was originally produced by AlterNet. SACSIS cannot authorise its republication.

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