Could MDMA be used to treat alcoholism?

In the documentary Psychedelic Soldiers, two US veterans tell the story of how legally administered MDMA helped them to recover from post traumatic stress disorder (PTSD). “I felt love towards my life that I hadn’t felt in two years, especially love towards my family,” says James, an ex military doctor. “It’s been three years since my last session and I’m still in control of my life.”
Recent studies, like the one James participated in, have found that MDMA in conjunction with psychotherapy is effective in helping people to overcome the psychological and emotional damage caused by trauma. Now, a British psychotherapist at Imperial College London thinks that the drug could help people with alcohol addiction too, and is carrying out a new study to investigate.
In an interview with the podcast Psychedelics Today, Dr. Ben Sessa explains the urgency for a new therapeutic model for treating addiction. “There’s a sense of helplessness pervading psychiatry at the moment,” he says. “We’ve gotten used to treating people, but not actually curing them.” He compares the current psychiatric treatment of mental health conditions to the treatment of diseases in the 19th century, when people were dying in their thousands due to insufficient medical understanding of the illnesses that were killing them.

“Alcohol abuse disorder is associated with childhood trauma in the vast majority of cases”

Recent studies show that trauma can be an underlying factor in alcohol abuse, highlighting to Ben the potential for MDMA as a promising treatment option. “Alcohol abuse disorder is associated with childhood trauma in the vast majority of cases,” he says. “I would argue that although our cases haven’t been diagnosed with PTSD, many of them do have it.”
The new study investigating MDMA’s efficacy in treating alcohol abuse disorder is in its early stages after being granted ethical approval in July 2017. The trial will include twenty participants who have been identified as heavy drinkers - typically consuming the equivalent of five bottles of wine a day - and who had repeatedly relapsed after trying other forms of treatment.

Alcohol abuse is endemic in the UK, with 25% of the population using alcohol at levels considered harmful to their health. Last year, alcohol was responsible for 3,700 deaths and 41,000 hospital admissions. 90% of alcoholics relapse after just four years, highlighting the ineffectiveness of conventional treatment options. To Dr Sessa, the treatment of alcohol abuse is “absolutely ripe for something innovative.” When it comes to treating things like addiction and trauma, he argues that current models are effective in managing symptoms, but not treating the root cause. “If you have a fever due to an infection, you can take an ibuprofen or paracetamol to bring your temperature down. That’s a good thing to do, you feel better, but it’s ultimately not going to kill the infection.” What’s more, patients can be taking medications daily for years, or even a lifetime, whereas in MDMA-assisted psychotherapy MDMA is only administered a few times, with lasting results.

“This is not really about the drugs, what we’re doing is using pharmacology in a clever and focused way to provide an optimum piece of psychotherapy.”

Many people will be familiar with MDMA as the main ingredient in ecstasy, a drug which rose to popular use in the 1990s along with rave culture. One of the effects of the drug is that it releases a flood of serotonin into the brain and makes people more talkative. This can affect the way that people talk about significant others and facilitate deeper conversations. However, Dr Sessa says that because many people associate the drug with partying, they stigmatise MDMA therapy because of preconceived notions. “This is not really about the drugs, we ultimately believe that talking therapies are the best way to cure people, but what we’re doing is using pharmacology in a clever and focused way to provide an optimum piece of psychotherapy.”
Despite promising evidence, research in these areas has traditionally been slow. “It’s expensive to study, and currently most human pharmacology research is carried out by the pharma industry because they’ve got a product to sell at the end of it,” explains Dr Sessa. However, the recent flood of evidence on the potential benefits of illegal drugs like MDMA, magic mushrooms and ayahuasca is starting to attract some high profile donors. In 2017 The Pineapple Fund made a $1 million donation to the Multidisciplinary Association for Psychedelic Studies in bitcoin to help fund their studies on MDMA for PTSD, and this new study on alcohol abuse is also funded entirely by one philanthropic donor.
Drug and alcohol addiction services in the UK have been severely cut in recent years, with drug-related deaths hitting record highs - including deaths related to ecstasy. However, proponents of drug therapy are quick to stress that the drugs used in medical studies are often entirely different in content and context than the stuff bought on the streets. “This is not a fringe subject, it’s careful, methodical, extremely rigorous science,” says Sessa - so it’s safe to say you shouldn’t go trying this at home anytime soon.

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