Pubdate: Mon, 22 Apr 2013
Source: Cincinnati Enquirer (OH)
Copyright: 2013 The Cincinnati Enquirer
Contact: http://enquirer.com/editor/letters.html
Website: http://enquirer.com/today/
Details: http://www.mapinc.org/media/86
Author: Lisa Bernard-Kuhn

ECSTASY STUDIED TO TREAT PTSD

Legalizing Ecstasy for Ptsd Treatment Would Go Counter to Decades of 
Government Policy Declaring the Drug Useless With a High Risk of Abuse.

Dubbed the "hug drug" and "X" by its users, the illegal drug ecstasy 
is being researched as a possible treatment for sufferers of serious 
stress disorders.

But a lot more research is needed before ecstasy-assisted 
psychotherapy would ever be made legal in the U.S., says Gary 
Gudelsky, a University of Cincinnati professor who has spent 25 years 
studying side effects of the drug on the brain.

"It's got a lot of baggage to overcome," says Gudelsky, who teaches 
at UC's James L. Winkle College of Pharmacy.

Known clinically as MDMA (3,4-methylenedioxy-methylamphetamine), the 
drug's effectiveness is the focus of a privately funded study 
involving at least 12 U.S. military veterans, police officers and 
firefighters with post-traumatic stress disorder (PTSD). The study is 
being conducted in conjunction with the Medical University of South 
Carolina and the Multidisciplinary Association for Psychedelic 
Studies (MAPS), a Santa Cruz, Calif.-based non-profit that raises 
money for research aimed at developing psychedelics and marijuana 
into prescription medicines.

Backers of the research say MDMA's ability to induce feelings of 
euphoria and affection allow users to become comfortable discussing 
difficult or traumatic emotions and memories. That's been proved in 
some preliminary studies in the U.S. and abroad, Gudelsky says.

A popular rave-party drug in late 1980s and 1990s, MDMA was banned 
from production in the U.S in 1986 and listed as a Schedule I drug 
under the Controlled Substances Act. It shares that category with 
other drugs that include heroin and have been deemed by the 
government to have no medical use and have a high potential for abuse.

In recent years, however, the Food and Drug Administration has 
approved MDMA's production for research in some U.S. labs.

Participants in the MAPS study, under way now, receive weekly 
non-drug related psychotherapy sessions, along with three day-long 
therapy sessions involving varying levels of MDMA, according to MAPS. 
The findings will be compared with a previous study that examined the 
use of MDMA with women survivors of sexual abuse and assault.

Updates on the study are being posted on MAPS website, www.maps.org. 
Officials with the organization could not be reached for comment.

MDMA is similar to methamphetamine in it's chemical makeup, but it 
has very different psychological and physiological affects in its 
users, said Gudelsky.

"If I gave 50 people MDMA, I'd have 50 new best friends, not because 
they are tripping, but because they would just feel more connected," he said.

That's because, in low doses, the drug increases serotonin levels in 
the brain which impacts oxytocin and prolactin hormones that are 
associated with trust and bonding. MDMA is not highly addictive, like 
heroin or meth, and Gudelsky said most deaths associated with it have 
been the result of users who have mixed it with other illegal drugs, 
or drug dealers who have mixed it with other compounds.

Much of Gudelsky's research has been on the drug's impact on 
serotonin during and after prolonged periods of use. His research 
well documents the damage that is done in the brain by heavy MDMA 
abusers, including memory impairments and a depletion of serotonin levels.

Though he's not involved in the MDMA study on PTSD, Gudelsky says 
he's watching the project closely.

"I think there is some very interesting dialogue that's going to come 
down the pipe in terms of risks and benefits of its use, especially 
as we have a large number of people coming back to the U.S. with 
PTSD," he said. "I think it's politically, a difficult (treatment) 
for the federal government to recommend, considering it has spent 
years trying to paint this drug as something that can blow holes in 
your brain."

As many as 20 percent, or 1 in five of the 2.5 million soldiers 
deployed in Iraq and Afghanistan could one day suffer from PTSD, 
according to estimates from the Department of Veterans Affairs.

Just this month, Cincinnati's Veteran Affairs Hospital in Corryville 
was tapped to play a key role in $9 million study for PTSD, said 
Kathleen Chard, an expert on the disorder at UC who is one of three 
investigators in the research.

500 veterans, soldiers in study

The study will involve up to 500 military veterans and active duty 
soldiers and include 17 sites across the country, says Chard, who is 
director of the hospital's PTSD division, based at the VA Medical 
Center facility in Fort Thomas. The local hospital, she said, offers 
the only in-patient programs in the U.S. for military members 
suffering from PTSD, serving around 20 individuals at a time.

"Our outpatient numbers are booming right now," she added. "We 
receive about 100 referrals a month."

Chard's study, which should take about 3 1/2 years to complete, will 
compare two treatments for PTSD - cognitive processing therapy (CPT) 
and prolonged exposure (PE). Both treatments are most commonly used 
now in combination with antidepressants and sleep aids to treat PTSD.

CPT focuses on the patient's thoughts and feelings, Chard says, with 
an emphasis on how traumatic experiences changed the patient's 
thoughts and beliefs. PE, on the other hand, focuses on allowing the 
patient to work through painful memories by re-experiencing the 
traumatic event or events in a safe environment.

Chard said the goal of the study is to better understand which 
approach works better in certain circumstances.

She says she's aware of the studies involving MDMA, but says the VA 
is sticking with "evidence-based treatments" such as those involved 
in her studies.

"I don't think it's appropriate to make our veterans guinea pigs," 
she said. "We know that ecstasy cannot be used long term. The jury is 
still out on whether, short term, there is enough benefit to be 
helpful enough with PTSD."

[sidebar]

What is PTSD?

A type of anxiety disorder that some people get after seeing or 
living through a dangerous event. People who have PTSD may feel 
stressed or frightened even when they're no longer in danger. Anyone 
can get PTSD at any age  including war veterans and survivors of 
physical and sexual assault, abuse, accidents, disasters and many 
other serious events. Symptoms of PTSD include re-experiencing the 
traumatic event, such as flashbacks or repeated upsetting memories; 
avoidance, such as feeling detached or having a lack of interest in 
normal activities; and hyper-arousal, such as difficult concentrating 
or startling easily.

Source: National Institute of Mental Health
- ---
MAP posted-by: Jay Bergstrom