14 ms·

Ecstasy as a Remedy for PTSD? You Probably Have Some Questions

siruncledrew 8y ago
I think part of the bad rep MDMA gets as a theraputic drug comes from street-known MDMA not actually being pure MDMA. It’s often laced with ketamine or some other drugs that give different effects than what’s being used in this PTSD treatment.
- nounaut 8y ago
  It was sort of hailed as a possible antibiotics of the mind before the war on drugs started and basically all research was halted. I think it's likely that that's what caused the bad rep more so than how the dealers mixed it. All drugs that were used in a recreational way was deemed as bad.
  - Nasrudith 8y ago
    The prohibition of ecstasy makes me furious given the has caused how many millions to suffer needlessly for generations? And this in addition to the sheer obliviousness of starting the war on Drugs after Prohibition showed what happens when you try to do so.
  - ssijak 8y ago
    Alcohol, cigarettes, sugary snacks...?
    - froogie 8y ago
      A weak point. Alcohol can not be taken away, it has been tried. Had we not had alcohol in the first place, we'd likely have other things a-ok'd, and alcohol would be treated by its merits compared to other recreational substances. By all reason it would be illegal far before many other substances. Personally I am conflicted: on one hand we can see that the more we let people to have certain drugs, the less functional they are as human beings. On the other hand, if above point was really important, it would make sense to try to let people have the least harmful of these substances, so that, on average, the damage caused by their consumption is lower. A growing part of me thinks that drug policies aren't as much about preventing harms as it seems to be about "playing games". We could do better all around the world. But things move slowly, so slowly. Stigmas hold, people fall to the soothing lull of prejudice and simplistic arguments. This is all just business as usual.
- yashap 8y ago
  Agreed! Been a long time since I experimented with drugs, but when I used to, pure MDMA was really great. Just puts you in a super positive frame of mind, and makes you feel incredibly close and connected to whoever you’re doing it with. Not surprised at all that there’s a lot of therapeutic potential there.
  - simonsaidit 8y ago
    Yes but it’s also pretty common to get into this regularly and soon after what you get one evening you have to give back some weeks later unless you then take all sorts of other drugs to compensate for that. I’ve seen the therapeutic effects up close and they are powerful but they are sadly short lived and hard to manage.
    - meowface 8y ago
      All advice I've seen regarding the substance is to not take it more than once every 3 months. I think people just need to realize it really isn't a party drug you can take every or every other weekend. Not only will tolerance build very rapidly, but you're exposing your brain to excessive oxidative stress and overheating, and are likely causing serotonergic neurotoxicity (even if you take it with all the recommended supplements). It needs to be treated like a rare, therapeutic, and special vacation, not something you take whenever you want to have fun.
      - simonsaidit 8y ago
        yup. but young people in a culture where its quite common to do this every weekend are in a big risk not to follow that advice though.
    - yahyaheee 8y ago
      The MAPS studies tell a different story here, only a couple sessions and over a year later a large majority of the subjects were still symptom free or greatly reduced
      - 8y ago
- toomanybeersies 8y ago
  Generally it's laced with amphetamine/methamphetamine as they're cheaper (per dose), and these days it's often laced with other substituted amphetamines such as mephedrone or PMA, neither of which are substances people would otherwise take as they're nasty shit. Generally when you hear about people being hospitalised or dying after taking ecstasy, it's due to the other shit in the pills. MDMA is a relatively safe drug (although not without its risks, especially taken in a non-therapeutic setting).
  - Fnoord 8y ago
    > and these days it's often laced with other substituted amphetamines such as mephedrone or PMA "Often"? Often where? I'd say no since we'd hear about accidents with ecstasy "often" as well. This happens rarely, still. EDIT: Found some data [1]: "Although more recent ED data are not publicly available, the number of reported poisonings involving “hallucinogenic amphetamines” (which are most commonly MDMA and MDMA-like drugs) rose from 2057 (including 3 deaths) in 2009 to 2514 (including 14 deaths) in 2013" "Ecstasy purity was low in the US in the mid-1990s3 and purity plummeted in Europe around 2009,11 but increased in 2010,8,11 while purity of powder and crystal ecstasy reportedly remained high in Europe (at 75–97%) in 2008–2013.11 However, the presence of synthetic cathinones (“bath salts”) and other novel psychoactive substances (NPS) increased within both pills and powders from 2008–2013.11 Spain in particular had a high prevalence of synthetic cathinones such as mephedrone and methylone detected in powder ecstasy.9 Despite extensive research in Europe, purity of ecstasy in the US over the last decade has not been formally researched." [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5578728/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5578728/
    - toomanybeersies 8y ago
      13 people in New Zealand were put in hospital this summer [1] by MDMA laced with N-Ethylpentylone. It was also discovered after pill testing at a festival in Australia. In January several people in Melbourne were hospitalised one weekend after taking laced MDMA. I couldn't say how often MDMA is laced, and in what quantities, but it's definitely out there. [1] https://www.vice.com/en_nz/article/8xdzpb/heres-what-was-in-the-bad-batch-of-mdma-that-put-13-kiwis-in-hospital https://www.vice.com/en_nz/article/8xdzpb/heres-what-was-in-...
- simonsaidit 8y ago
  Ecstasy != mdma. It’s pretty easy to spot clean mdma visually or tasting or you can just recrystalize it yourself. It’s imoossible to figure out what is in ecstasy.. and is always a combo of above drugs and more. Clean mdma is more common these days than ecstasy in most of Europe atleast.
  - Nursie 8y ago
    This is not really true. Several things look quite a lot like MDMA, and one of the problems with Ecstasy tablets in Europe at the moment is that they contain too much MDMA for a single dose. Always test your drugs people, and start low.
    - simonsaidit 8y ago
      If you know this stuff you also know the taste and looks of the crystal and why eg it got the color it does. There is no easy way of knowing what is inside a tablet but the “pure” crystallized products are easy to recognize mdma especially. And it would have to be a damn big tablet to contain too much mdma... by bet is on what else is inside.
      - Nursie 8y ago
        > There is no easy way of knowing what is inside a tablet Chemical tests. > but the “pure” crystallized products are easy to recognize mdma especially Lots of the extended amphetamine family (including the various -drones) share very similar tastes, and crystallise very similarly. If you wash MDMA that contains these other substances you'll end up recrystallising those as well. > And it would have to be a damn big tablet to contain too much mdma... by bet is on what else is inside. Then your bet is factually wrong and likely dangerous. Test your stuff. Know what you're getting, start low, and don't listen to people who 'know what the real stuff looks like'
        simonsaidit 8y ago
        I don’t disagree to starting low but definitely listen to people who knows where the good stuff is. Trusting your network is more realistic than having tested everything you get. In the perfect world I’d run around with a lab in my pocket sure....
- Fnoord 8y ago
  Ketamine? Combined with MDMA and its analogues??? In which country? Do you have links to drug reports / analysis?
  - simonsaidit 8y ago
    its quite common to buy these things separate and mix it. we call it candy--something
  - dillondoyle 8y ago
    Lol I'm with you. MDA, meth, uppers etc are far more likely adulterants in the US it seems, though perhaps K was more popular adulterant in the 90s [1]. 1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5578728/#R6 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5578728/#R6
    - deleted 8y ago
      [deleted]
  - meej 8y ago
    It's not a common adulterant, so your skepticism is warranted, but using the advanced search at EcstasyData, I'm seeing about 6% of pills/substances they've tested that had both MDMA and ketamine in them. 804 results for MDMA + anything else: https://www.ecstasydata.org/search.php?search_field=adv&name=&field_test=&substance1=2012&substance2=-3&id=&color=&colorexact=0&city=&source=&m1=&y1=&m2=&y2=&state=&country=&sold_as_ecstasy=yes https://www.ecstasydata.org/search.php?search_field=adv&name... 50 results for MDMA + ketamine: https://www.ecstasydata.org/search.php?search_field=adv&name=&field_test=&substance1=2012&substance2=79&id=&color=&colorexact=0&city=&source=&m1=&y1=&m2=&y2=&state=&country=&sold_as_ecstasy=yes https://www.ecstasydata.org/search.php?search_field=adv&name...
    - Fnoord 8y ago
      Hmm, would be interesting to have some kind of graphs with this to see where in the world these pop up most.
- senorjazz 8y ago
  > It’s often laced with ketamine No it isn't. Other MD like drugs, sure, but ketamine no, not often
tomhoward 8y ago
> “I was able to forgive myself. It was like a clean sweep.” I think this is the overlooked key point in these discussions of MDMA or other treatments as remedies for PTSD: it brings on the ability to see yourself and your actions with compassion and forgiveness that is not present in baseline consciousness. For my own healing of trauma (which did not involve the use of MDMA), that has been the key. And letting go of deep resentment towards others (e.g., parents, former partners, lost friends) happened pretty much immediately, once I was able to have self-compassion and forgive myself. As promising as the research around MDMA might be, it's still likely to be a long time before it has clinical and legal approval in most jurisdictions and even then it may not be the be-all-and-end-all for emotional healing. Whereas there are techniques for bringing on self-forgiveness that are already available, though not yet accepted in the mainstream. Hopefully that may start to change soon.
- ltempaaay 8y ago
  Do you mind expanding on letting go of resentment? I was not aware it is a major factor. I was somewhat aware that decisions on how to handle resentment were somehow going back and forth.
  - tenaciousDaniel 8y ago
    In my own experience, I did sense an ability to let go of some deep-seated resentment. At the time it felt as if it had disappeared forever, but the resentment came back after the effects of the drug wore off. That was a casual experience with the drug, though. Not taken in a clinical setting with the objective goal of dealing with those issues. I could easily see how the drug could be used carefully for such a goal. In fact it was one of my first reactions when I felt it for the first time. I thought "holy shit this would be an amazing therapeutic tool". There really is no way to describe it.
- technotony 8y ago
  > Whereas there are techniques for bringing on self-forgiveness that are already available, though not yet accepted in the mainstream. Could you comment on what those are?
helloworld 8y ago
It's interesting that both PTSD-suffering veterans described the benefit of MDMA with the same words: "I was able to forgive myself." Whether you call it conscience or superego, how we judge ourselves seems to be important for mental health.
- unfunco 8y ago
  https://en.wikipedia.org/wiki/Shadow_(psychology) https://en.wikipedia.org/wiki/Shadow_(psychology) Interestingly, in the documentary _Dirty Pictures_[0], and in the books PiHKAL and TiHKAL, Ann Shulgin (widow of Alexander Shulgin, the chemist that re-synthesised MDMA and re-introduced it to the world) talks a lot about the shadow and her work as a therapist whilst working with MDMA shortly after it's effects became known. MDMA was initially trialled by psychiatrists working with the shadow. [0]: https://www.youtube.com/watch?v=7SxjCE0f9_4 https://www.youtube.com/watch?v=7SxjCE0f9_4
  - senorjazz 8y ago
    I've seen the documentary, but never realised her reference to the shadow was more than just explaining why we can get into dark thought loops whilst on psychedlics often times going over and over something (sometimes inconsequential things) that raises our paranoia to terror levels. Seems like I have some reading material to put off working until this afternoon now :)
zakum1 8y ago
Is the ability to “forgive oneself” sustainable? Does the initial “help” from MDMA empower the person to learn to permanently see themselves and their experiences in a new way? As someone who believes that developing ourselves comes from the traditional hard work of life and spiritual development (or whatever you may call it) with no quick fixes, I find the prospect surprisingly compelling.
- taurath 8y ago
  You can reinforce headspaces and practice those abilities like any other habit. The best way I've heard MDMA therapy being described is this - you have a large group of extremely painful neurons/memories, and going there is shocking and horrific to the point that you begin to grow a big moat of fearful neurons/emotions next to anything that connects with them. The point of therapy in general is to 1. Break down that fear moat (which frequently grows to be more painful than the underlying issue), and 2. Start drawing those painful neurons and memories out, but in as positive and understanding an environment as possible. At that point the memories/neurons get re-stored, still painful but with the added context of the environment they were last accessed. MDMA takes step 2 and adds the most positive neurological/chemical setting possible for you to pull those painful neurons and memories out, and puts them in what can be described as a comforting blanket. It can absolutely quicken the process and help you eventually neutralize the traumatic and painful bundle of memories. Calling it a quick fix is such a misnomer - it is incredibly hard work to heal one's self from the inside, no matter the external helpers.
  - psergeant 8y ago
    Propanalol, which is dramatically less illegal, is meant to help with this too, and there are studies showing it too; my understanding (from using it for anxiety) is it basically blocks you from being able to feel stress. This allows you to more easily process painful memories.
    - taurath 8y ago
      It blocks the physical manifestations of stress - increased heartrate, sweating, etc that can form a feedback loop, and downregulates a bit of thyroid hormone production. How does one know they're stressed? The feeling of those symptoms. I imagine it could help, and probably be better than therapy alone, but lessoning of the negative feelings around painful memories can be treated with opiates too (which are far more addictive than MDMA, despite MDMA being far more euphoric). The problem is PTSD, anxiety disorders and personality disorders are incredibly intractable with the tools we have - if a therapeutic session could have 10x efficacy and safely get someone to a healthier state in 1 year rather than 10, it should absolutely be looked into.
Fnoord 8y ago
Its annoying the NYT used the term ecstasy (XTC) as that doesn't describe the drug. The drug which would be considered as a remedy for PTSD, is MDMA and its closely related counterparts (MDA, MDEA/MDE). These drugs are called empathogens or entactogens [1]. [1] https://en.wikipedia.org/wiki/Empathogen%E2%80%93entactogen https://en.wikipedia.org/wiki/Empathogen%E2%80%93entactogen
- egypturnash 8y ago
  "3,4-Methylenedioxymethamphetamine (MDMA),[note 1] commonly known as ecstasy (E), is a psychoactive drug primarily used as a recreational drug." - Wikipedia[1] 1: https://en.wikipedia.org/wiki/MDMA https://en.wikipedia.org/wiki/MDMA Hail Eris.
simonsaidit 8y ago
Mushrooms, mdma, lsd, ketamine are often praises as therapeutic but I’ve had close relations with all of them and been in a culture where that belief is there and seen so many scenarios it’s unbelievable. Yes they might have a short lived effect but they are incredibly hard to manage. I advise everyone to try once in their life but keep it at that and try to use the effect for something... which might be the hard part. Today the only drug I believe is fairly safe and has a much harder effect is Changa(dmt + Maoi) which might end the need for all other drugs and help stress or bad thoughts Which it had to me and over 70 people I took through it.
- DanBC 8y ago
  The therapeutic dose for ketamine is far lower than the recreational dose. (I don't know anything about the others.)
  - senorjazz 8y ago
    What it the suggested clinical dose for ketamine for a user with no tolerance? Also what would be a recreational ketamine dose? As ketamine is almost like two separate drugs at the dosage spectrum. From a small bump to get a bit floaty / wobbly all the way to deep immobile kholes
- Fnoord 8y ago
  > which might end the need for all other drugs There is no such thing as one drug which makes all other drugs redundant. Disulfiram (brandname Antabus(e)) works well for alcohol addiction. Methadone for heroin addiction. Bupropion (brandname Zyban) for smoking cessation. As for DMT + MAOI (which I know as Ayahuasca), care should be taken when using a MAOI. Most importantly it must not be combined with a plethora of other drugs and foods, but there are some additional sharp edges to take into account beyond that. I've only used Ayahuasca once recreationally. It was the most interesting experience, compared to Psilocybin. They say that with MDMA, only your first experience is magic. I've used it approx 10 times, and can attest to that. I do not recommend everyone should use this or any other drug once in their life. From the drugs you mentioned, there's one which you didn't which is relatively mild, safe, and that is Muscimol (found in A. Muscaria aka fly agaric). My advice is very simple and universal (caveat [1]): go to your doctor instead of recreationally using drugs, and exhaust all options there. It was then, through rough milling and various therapists, that I found out that I have ASD. Which explained far, far more than any recreational drug usage I've had. And I have had my take as the above might suggest. Of all the drugs I have used, I feel marihuana was the most dangerous one because I had multiple psychoses on that one. [1] Though I do realise not everyone in the world has access to quality, affordable healthcare
stef25 8y ago
The narrative is that an illegal party drug seems to have potential as a psychiatric tool, but this is was it was before it became a party drug. The disinhibition and mental clarity allows people to open up, "break out of their shell" and talk honestly about themselves and their feelings. And it does this immediately and with ease. It's really something special. From Wikipedia: Shulgin was impressed with the drug's disinhibiting effects and thought it could be useful in therapy. Believing MDMA allowed users to strip away habits and perceive the world clearly, Shulgin called the drug "window". Shulgin occasionally used MDMA for relaxation, referring to it as "my low-calorie martini", and gave the drug to friends, researchers, and others who he thought could benefit from it. One such person was Leo Zeff, a psychotherapist who had been known to use psychedelic substances in his practice. When he tried the drug in 1977, Zeff was impressed with the effects of MDMA and came out of his semi-retirement to promote its use in therapy. Over the following years, Zeff traveled around the United States and occasionally to Europe, eventually training an estimated four thousand psychotherapists in the therapeutic use of MDMA. Zeff named the drug "Adam", believing it put users in a state of primordial innocence.
jarmitage 8y ago
If you think this is important, donate to MAPS! Yes they accept crypto. https://store.maps.org/np/clients/maps/donation.jsp?campaign=11 https://store.maps.org/np/clients/maps/donation.jsp?campaign...
projectramo 8y ago
At the ever present risk of being downvoted: should we be able to chemically forgive ourselves for anything/everything? Aren’t there some things that are so terrible that we should continue to feel guilty?
- foxyv 8y ago
  Yes, if your only goal is to punish then making sure that people are eternally guilt ridden would make sense. If your goal is to reduce human suffering then no that doesn't make sense. In the case of this soldier he is most definitely deserving of help and respect.
  - projectramo 8y ago
    I am not asking if it should be done in any particular case, but in every case. I can concoct particular examples but it gets dramatic quickly. I am sure you can come up with some extreme examples. Are you saying you are okay with the person forgiving themselves in every example you can think of? Does it matter if the person can forgive themselves "easily" i.e. immediately after the act, and for all time with no consequences?
    - seatdrummer 8y ago
      On principle our justice system is based on preventing harm of law abiding citizens, and not to harm the guilty. Allowing the guilty to forgive themselves might be a luxury, but it wouldn't violate justice even though it feels merciful.
- Broken_Hippo 8y ago
  Only if you want folks to suffer and have trouble being part of society. I'll add that PTSD doesn't only happen to people that have done things - it happens to folks that have been through some sort of trauma. Victims of child abuse or spousal abuse, for example. Sometimes folks that have been in car accidents, fires, and other such things. I know a person that is in inpatient treatment right now because it got so bad... again. She's mostly in treatment because the thought of her children going through a parental suicide made her feel badly. And I'll add this as well: Soldiers don't always have the real choice to do things differently, especially in draft situations or if someone has been lied to in recruitment (really common). And I'll add that forgiving oneself is not the same as being OK with everything that happened, simply that the overriding guilt doesn't own your life and affect everyone that you know. People change but their past often doesn't (there are some exceptions, such as missed information, but what you thought is still what you thought).
yahyaheee 8y ago
Glad to see more research happening on this. The outcome of these studies is very promising for people with treatment resistant PTSD. Support MAPS to help continue this effort.
baby 8y ago
By the way. I believe everyone should try MDMA at least once in their lives. Do it with your friends, with your loved ones, etc. If it wasn’t so stigmatized I would have already bought some for my parents.
- tenaciousDaniel 8y ago
  It really is incredible. Although I've tried cocaine, and personally I found MDMA much harder to resist multiple doses with. So for me, I have to be super careful else I could end up harming myself or becoming psychologically dependent on it. It's definitely got a risk factor, but the sheer experience is something everyone should have once.
  - dnate 8y ago
    Compared to cocaine, smoking and the like it is not very probable that anyone becomes psychologically dependent on it because of the way it works: It releases serotonin stored in your body, and thus depletes those stores. So multiple doses feel less and less good. The body needs several weeks/months to refill those serotonin storages. All you do is risk getting serotonin syndrome [1] which is a whole other story/problem. But becoming "addicted" (physically or psychologically) in the classical sense is not an immediate issue as it is with cocaine, smoking, weed, etc. [1] https://en.wikipedia.org/wiki/Serotonin_syndrome https://en.wikipedia.org/wiki/Serotonin_syndrome
  - another-cuppa 8y ago
    MDMA quickly loses its effect, though. I've done it twice in a month before and even then the second time wasn't that great. I'll only experience full waves once a month at most. And you can't just take more next time. It doesn't work. It will just give you a suicide tuesday.
- ridewinter 8y ago
  Try it once. The salient point about drugs like ecstasy is that they don’t actually add to the chemicals to your brain that make you feel good - instead they release the reserves in your brain all at once. Those incredible highs are all of your nice feelings for the next couple weeks getting released at once. It’s a trade off I don’t want to make.
egypturnash 8y ago
> After taking the drug, the patient lies on a futon amid candles and fresh flowers, listening to music. Two therapists — one female, one male — sit at the patient’s side as guides. That session lasts eight hours. My version was "lounging around under the stairs in a mostly-abandoned hotel lobby late at night at a furry con, with two friends". It worked pretty well. Still probably took about eight hours.
nopacience 8y ago
One common thought under the influence of MDMA is: The world could end now. Everything is perfectly fine.

I think part of the bad rep MDMA gets as a theraputic drug comes from street-known MDMA not actually being pure MDMA. It’s often laced with ketamine or some other drugs that give different effects than what’s being used in this PTSD treatment.

nounaut 8y ago
It was sort of hailed as a possible antibiotics of the mind before the war on drugs started and basically all research was halted. I think it's likely that that's what caused the bad rep more so than how the dealers mixed it. All drugs that were used in a recreational way was deemed as bad.
- Nasrudith 8y ago
  The prohibition of ecstasy makes me furious given the has caused how many millions to suffer needlessly for generations? And this in addition to the sheer obliviousness of starting the war on Drugs after Prohibition showed what happens when you try to do so.
- ssijak 8y ago
  Alcohol, cigarettes, sugary snacks...?
  - froogie 8y ago
    A weak point. Alcohol can not be taken away, it has been tried. Had we not had alcohol in the first place, we'd likely have other things a-ok'd, and alcohol would be treated by its merits compared to other recreational substances. By all reason it would be illegal far before many other substances. Personally I am conflicted: on one hand we can see that the more we let people to have certain drugs, the less functional they are as human beings. On the other hand, if above point was really important, it would make sense to try to let people have the least harmful of these substances, so that, on average, the damage caused by their consumption is lower. A growing part of me thinks that drug policies aren't as much about preventing harms as it seems to be about "playing games". We could do better all around the world. But things move slowly, so slowly. Stigmas hold, people fall to the soothing lull of prejudice and simplistic arguments. This is all just business as usual.
yashap 8y ago
Agreed! Been a long time since I experimented with drugs, but when I used to, pure MDMA was really great. Just puts you in a super positive frame of mind, and makes you feel incredibly close and connected to whoever you’re doing it with. Not surprised at all that there’s a lot of therapeutic potential there.
- simonsaidit 8y ago
  Yes but it’s also pretty common to get into this regularly and soon after what you get one evening you have to give back some weeks later unless you then take all sorts of other drugs to compensate for that. I’ve seen the therapeutic effects up close and they are powerful but they are sadly short lived and hard to manage.
  - meowface 8y ago
    All advice I've seen regarding the substance is to not take it more than once every 3 months. I think people just need to realize it really isn't a party drug you can take every or every other weekend. Not only will tolerance build very rapidly, but you're exposing your brain to excessive oxidative stress and overheating, and are likely causing serotonergic neurotoxicity (even if you take it with all the recommended supplements). It needs to be treated like a rare, therapeutic, and special vacation, not something you take whenever you want to have fun.
    - simonsaidit 8y ago
      yup. but young people in a culture where its quite common to do this every weekend are in a big risk not to follow that advice though.
  - yahyaheee 8y ago
    The MAPS studies tell a different story here, only a couple sessions and over a year later a large majority of the subjects were still symptom free or greatly reduced
    - 8y ago
toomanybeersies 8y ago
Generally it's laced with amphetamine/methamphetamine as they're cheaper (per dose), and these days it's often laced with other substituted amphetamines such as mephedrone or PMA, neither of which are substances people would otherwise take as they're nasty shit. Generally when you hear about people being hospitalised or dying after taking ecstasy, it's due to the other shit in the pills. MDMA is a relatively safe drug (although not without its risks, especially taken in a non-therapeutic setting).
- Fnoord 8y ago
  > and these days it's often laced with other substituted amphetamines such as mephedrone or PMA "Often"? Often where? I'd say no since we'd hear about accidents with ecstasy "often" as well. This happens rarely, still. EDIT: Found some data [1]: "Although more recent ED data are not publicly available, the number of reported poisonings involving “hallucinogenic amphetamines” (which are most commonly MDMA and MDMA-like drugs) rose from 2057 (including 3 deaths) in 2009 to 2514 (including 14 deaths) in 2013" "Ecstasy purity was low in the US in the mid-1990s3 and purity plummeted in Europe around 2009,11 but increased in 2010,8,11 while purity of powder and crystal ecstasy reportedly remained high in Europe (at 75–97%) in 2008–2013.11 However, the presence of synthetic cathinones (“bath salts”) and other novel psychoactive substances (NPS) increased within both pills and powders from 2008–2013.11 Spain in particular had a high prevalence of synthetic cathinones such as mephedrone and methylone detected in powder ecstasy.9 Despite extensive research in Europe, purity of ecstasy in the US over the last decade has not been formally researched." [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5578728/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5578728/
  - toomanybeersies 8y ago
    13 people in New Zealand were put in hospital this summer [1] by MDMA laced with N-Ethylpentylone. It was also discovered after pill testing at a festival in Australia. In January several people in Melbourne were hospitalised one weekend after taking laced MDMA. I couldn't say how often MDMA is laced, and in what quantities, but it's definitely out there. [1] https://www.vice.com/en_nz/article/8xdzpb/heres-what-was-in-the-bad-batch-of-mdma-that-put-13-kiwis-in-hospital https://www.vice.com/en_nz/article/8xdzpb/heres-what-was-in-...
simonsaidit 8y ago
Ecstasy != mdma. It’s pretty easy to spot clean mdma visually or tasting or you can just recrystalize it yourself. It’s imoossible to figure out what is in ecstasy.. and is always a combo of above drugs and more. Clean mdma is more common these days than ecstasy in most of Europe atleast.
- Nursie 8y ago
  This is not really true. Several things look quite a lot like MDMA, and one of the problems with Ecstasy tablets in Europe at the moment is that they contain too much MDMA for a single dose. Always test your drugs people, and start low.
  - simonsaidit 8y ago
    If you know this stuff you also know the taste and looks of the crystal and why eg it got the color it does. There is no easy way of knowing what is inside a tablet but the “pure” crystallized products are easy to recognize mdma especially. And it would have to be a damn big tablet to contain too much mdma... by bet is on what else is inside.
    - Nursie 8y ago
      > There is no easy way of knowing what is inside a tablet Chemical tests. > but the “pure” crystallized products are easy to recognize mdma especially Lots of the extended amphetamine family (including the various -drones) share very similar tastes, and crystallise very similarly. If you wash MDMA that contains these other substances you'll end up recrystallising those as well. > And it would have to be a damn big tablet to contain too much mdma... by bet is on what else is inside. Then your bet is factually wrong and likely dangerous. Test your stuff. Know what you're getting, start low, and don't listen to people who 'know what the real stuff looks like'
      - simonsaidit 8y ago
        I don’t disagree to starting low but definitely listen to people who knows where the good stuff is. Trusting your network is more realistic than having tested everything you get. In the perfect world I’d run around with a lab in my pocket sure....
Fnoord 8y ago
Ketamine? Combined with MDMA and its analogues??? In which country? Do you have links to drug reports / analysis?
- simonsaidit 8y ago
  its quite common to buy these things separate and mix it. we call it candy--something
- dillondoyle 8y ago
  Lol I'm with you. MDA, meth, uppers etc are far more likely adulterants in the US it seems, though perhaps K was more popular adulterant in the 90s [1]. 1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5578728/#R6 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5578728/#R6
  - deleted 8y ago
    [deleted]
- meej 8y ago
  It's not a common adulterant, so your skepticism is warranted, but using the advanced search at EcstasyData, I'm seeing about 6% of pills/substances they've tested that had both MDMA and ketamine in them. 804 results for MDMA + anything else: https://www.ecstasydata.org/search.php?search_field=adv&name=&field_test=&substance1=2012&substance2=-3&id=&color=&colorexact=0&city=&source=&m1=&y1=&m2=&y2=&state=&country=&sold_as_ecstasy=yes https://www.ecstasydata.org/search.php?search_field=adv&name... 50 results for MDMA + ketamine: https://www.ecstasydata.org/search.php?search_field=adv&name=&field_test=&substance1=2012&substance2=79&id=&color=&colorexact=0&city=&source=&m1=&y1=&m2=&y2=&state=&country=&sold_as_ecstasy=yes https://www.ecstasydata.org/search.php?search_field=adv&name...
  - Fnoord 8y ago
    Hmm, would be interesting to have some kind of graphs with this to see where in the world these pop up most.
senorjazz 8y ago
> It’s often laced with ketamine No it isn't. Other MD like drugs, sure, but ketamine no, not often

tomhoward 8y ago

> “I was able to forgive myself. It was like a clean sweep.” I think this is the overlooked key point in these discussions of MDMA or other treatments as remedies for PTSD: it brings on the ability to see yourself and your actions with compassion and forgiveness that is not present in baseline consciousness. For my own healing of trauma (which did not involve the use of MDMA), that has been the key. And letting go of deep resentment towards others (e.g., parents, former partners, lost friends) happened pretty much immediately, once I was able to have self-compassion and forgive myself. As promising as the research around MDMA might be, it's still likely to be a long time before it has clinical and legal approval in most jurisdictions and even then it may not be the be-all-and-end-all for emotional healing. Whereas there are techniques for bringing on self-forgiveness that are already available, though not yet accepted in the mainstream. Hopefully that may start to change soon.

ltempaaay 8y ago
Do you mind expanding on letting go of resentment? I was not aware it is a major factor. I was somewhat aware that decisions on how to handle resentment were somehow going back and forth.
- tenaciousDaniel 8y ago
  In my own experience, I did sense an ability to let go of some deep-seated resentment. At the time it felt as if it had disappeared forever, but the resentment came back after the effects of the drug wore off. That was a casual experience with the drug, though. Not taken in a clinical setting with the objective goal of dealing with those issues. I could easily see how the drug could be used carefully for such a goal. In fact it was one of my first reactions when I felt it for the first time. I thought "holy shit this would be an amazing therapeutic tool". There really is no way to describe it.
technotony 8y ago
> Whereas there are techniques for bringing on self-forgiveness that are already available, though not yet accepted in the mainstream. Could you comment on what those are?

helloworld 8y ago

It's interesting that both PTSD-suffering veterans described the benefit of MDMA with the same words: "I was able to forgive myself." Whether you call it conscience or superego, how we judge ourselves seems to be important for mental health.

unfunco 8y ago
https://en.wikipedia.org/wiki/Shadow_(psychology) https://en.wikipedia.org/wiki/Shadow_(psychology) Interestingly, in the documentary _Dirty Pictures_[0], and in the books PiHKAL and TiHKAL, Ann Shulgin (widow of Alexander Shulgin, the chemist that re-synthesised MDMA and re-introduced it to the world) talks a lot about the shadow and her work as a therapist whilst working with MDMA shortly after it's effects became known. MDMA was initially trialled by psychiatrists working with the shadow. [0]: https://www.youtube.com/watch?v=7SxjCE0f9_4 https://www.youtube.com/watch?v=7SxjCE0f9_4
- senorjazz 8y ago
  I've seen the documentary, but never realised her reference to the shadow was more than just explaining why we can get into dark thought loops whilst on psychedlics often times going over and over something (sometimes inconsequential things) that raises our paranoia to terror levels. Seems like I have some reading material to put off working until this afternoon now :)

zakum1 8y ago

Is the ability to “forgive oneself” sustainable? Does the initial “help” from MDMA empower the person to learn to permanently see themselves and their experiences in a new way? As someone who believes that developing ourselves comes from the traditional hard work of life and spiritual development (or whatever you may call it) with no quick fixes, I find the prospect surprisingly compelling.

taurath 8y ago
You can reinforce headspaces and practice those abilities like any other habit. The best way I've heard MDMA therapy being described is this - you have a large group of extremely painful neurons/memories, and going there is shocking and horrific to the point that you begin to grow a big moat of fearful neurons/emotions next to anything that connects with them. The point of therapy in general is to 1. Break down that fear moat (which frequently grows to be more painful than the underlying issue), and 2. Start drawing those painful neurons and memories out, but in as positive and understanding an environment as possible. At that point the memories/neurons get re-stored, still painful but with the added context of the environment they were last accessed. MDMA takes step 2 and adds the most positive neurological/chemical setting possible for you to pull those painful neurons and memories out, and puts them in what can be described as a comforting blanket. It can absolutely quicken the process and help you eventually neutralize the traumatic and painful bundle of memories. Calling it a quick fix is such a misnomer - it is incredibly hard work to heal one's self from the inside, no matter the external helpers.
- psergeant 8y ago
  Propanalol, which is dramatically less illegal, is meant to help with this too, and there are studies showing it too; my understanding (from using it for anxiety) is it basically blocks you from being able to feel stress. This allows you to more easily process painful memories.
  - taurath 8y ago
    It blocks the physical manifestations of stress - increased heartrate, sweating, etc that can form a feedback loop, and downregulates a bit of thyroid hormone production. How does one know they're stressed? The feeling of those symptoms. I imagine it could help, and probably be better than therapy alone, but lessoning of the negative feelings around painful memories can be treated with opiates too (which are far more addictive than MDMA, despite MDMA being far more euphoric). The problem is PTSD, anxiety disorders and personality disorders are incredibly intractable with the tools we have - if a therapeutic session could have 10x efficacy and safely get someone to a healthier state in 1 year rather than 10, it should absolutely be looked into.

Fnoord 8y ago

Its annoying the NYT used the term ecstasy (XTC) as that doesn't describe the drug. The drug which would be considered as a remedy for PTSD, is MDMA and its closely related counterparts (MDA, MDEA/MDE). These drugs are called empathogens or entactogens [1]. [1] https://en.wikipedia.org/wiki/Empathogen%E2%80%93entactogen https://en.wikipedia.org/wiki/Empathogen%E2%80%93entactogen

egypturnash 8y ago
"3,4-Methylenedioxymethamphetamine (MDMA),[note 1] commonly known as ecstasy (E), is a psychoactive drug primarily used as a recreational drug." - Wikipedia[1] 1: https://en.wikipedia.org/wiki/MDMA https://en.wikipedia.org/wiki/MDMA Hail Eris.

simonsaidit 8y ago

Mushrooms, mdma, lsd, ketamine are often praises as therapeutic but I’ve had close relations with all of them and been in a culture where that belief is there and seen so many scenarios it’s unbelievable. Yes they might have a short lived effect but they are incredibly hard to manage. I advise everyone to try once in their life but keep it at that and try to use the effect for something... which might be the hard part. Today the only drug I believe is fairly safe and has a much harder effect is Changa(dmt + Maoi) which might end the need for all other drugs and help stress or bad thoughts Which it had to me and over 70 people I took through it.

DanBC 8y ago
The therapeutic dose for ketamine is far lower than the recreational dose. (I don't know anything about the others.)
- senorjazz 8y ago
  What it the suggested clinical dose for ketamine for a user with no tolerance? Also what would be a recreational ketamine dose? As ketamine is almost like two separate drugs at the dosage spectrum. From a small bump to get a bit floaty / wobbly all the way to deep immobile kholes
Fnoord 8y ago
> which might end the need for all other drugs There is no such thing as one drug which makes all other drugs redundant. Disulfiram (brandname Antabus(e)) works well for alcohol addiction. Methadone for heroin addiction. Bupropion (brandname Zyban) for smoking cessation. As for DMT + MAOI (which I know as Ayahuasca), care should be taken when using a MAOI. Most importantly it must not be combined with a plethora of other drugs and foods, but there are some additional sharp edges to take into account beyond that. I've only used Ayahuasca once recreationally. It was the most interesting experience, compared to Psilocybin. They say that with MDMA, only your first experience is magic. I've used it approx 10 times, and can attest to that. I do not recommend everyone should use this or any other drug once in their life. From the drugs you mentioned, there's one which you didn't which is relatively mild, safe, and that is Muscimol (found in A. Muscaria aka fly agaric). My advice is very simple and universal (caveat [1]): go to your doctor instead of recreationally using drugs, and exhaust all options there. It was then, through rough milling and various therapists, that I found out that I have ASD. Which explained far, far more than any recreational drug usage I've had. And I have had my take as the above might suggest. Of all the drugs I have used, I feel marihuana was the most dangerous one because I had multiple psychoses on that one. [1] Though I do realise not everyone in the world has access to quality, affordable healthcare

stef25 8y ago

The narrative is that an illegal party drug seems to have potential as a psychiatric tool, but this is was it was before it became a party drug. The disinhibition and mental clarity allows people to open up, "break out of their shell" and talk honestly about themselves and their feelings. And it does this immediately and with ease. It's really something special. From Wikipedia: Shulgin was impressed with the drug's disinhibiting effects and thought it could be useful in therapy. Believing MDMA allowed users to strip away habits and perceive the world clearly, Shulgin called the drug "window". Shulgin occasionally used MDMA for relaxation, referring to it as "my low-calorie martini", and gave the drug to friends, researchers, and others who he thought could benefit from it. One such person was Leo Zeff, a psychotherapist who had been known to use psychedelic substances in his practice. When he tried the drug in 1977, Zeff was impressed with the effects of MDMA and came out of his semi-retirement to promote its use in therapy. Over the following years, Zeff traveled around the United States and occasionally to Europe, eventually training an estimated four thousand psychotherapists in the therapeutic use of MDMA. Zeff named the drug "Adam", believing it put users in a state of primordial innocence.

jarmitage 8y ago

If you think this is important, donate to MAPS! Yes they accept crypto. https://store.maps.org/np/clients/maps/donation.jsp?campaign=11 https://store.maps.org/np/clients/maps/donation.jsp?campaign...

projectramo 8y ago

At the ever present risk of being downvoted: should we be able to chemically forgive ourselves for anything/everything? Aren’t there some things that are so terrible that we should continue to feel guilty?

foxyv 8y ago
Yes, if your only goal is to punish then making sure that people are eternally guilt ridden would make sense. If your goal is to reduce human suffering then no that doesn't make sense. In the case of this soldier he is most definitely deserving of help and respect.
- projectramo 8y ago
  I am not asking if it should be done in any particular case, but in every case. I can concoct particular examples but it gets dramatic quickly. I am sure you can come up with some extreme examples. Are you saying you are okay with the person forgiving themselves in every example you can think of? Does it matter if the person can forgive themselves "easily" i.e. immediately after the act, and for all time with no consequences?
  - seatdrummer 8y ago
    On principle our justice system is based on preventing harm of law abiding citizens, and not to harm the guilty. Allowing the guilty to forgive themselves might be a luxury, but it wouldn't violate justice even though it feels merciful.
Broken_Hippo 8y ago
Only if you want folks to suffer and have trouble being part of society. I'll add that PTSD doesn't only happen to people that have done things - it happens to folks that have been through some sort of trauma. Victims of child abuse or spousal abuse, for example. Sometimes folks that have been in car accidents, fires, and other such things. I know a person that is in inpatient treatment right now because it got so bad... again. She's mostly in treatment because the thought of her children going through a parental suicide made her feel badly. And I'll add this as well: Soldiers don't always have the real choice to do things differently, especially in draft situations or if someone has been lied to in recruitment (really common). And I'll add that forgiving oneself is not the same as being OK with everything that happened, simply that the overriding guilt doesn't own your life and affect everyone that you know. People change but their past often doesn't (there are some exceptions, such as missed information, but what you thought is still what you thought).

yahyaheee 8y ago

Glad to see more research happening on this. The outcome of these studies is very promising for people with treatment resistant PTSD. Support MAPS to help continue this effort.

baby 8y ago

By the way. I believe everyone should try MDMA at least once in their lives. Do it with your friends, with your loved ones, etc. If it wasn’t so stigmatized I would have already bought some for my parents.

tenaciousDaniel 8y ago
It really is incredible. Although I've tried cocaine, and personally I found MDMA much harder to resist multiple doses with. So for me, I have to be super careful else I could end up harming myself or becoming psychologically dependent on it. It's definitely got a risk factor, but the sheer experience is something everyone should have once.
- dnate 8y ago
  Compared to cocaine, smoking and the like it is not very probable that anyone becomes psychologically dependent on it because of the way it works: It releases serotonin stored in your body, and thus depletes those stores. So multiple doses feel less and less good. The body needs several weeks/months to refill those serotonin storages. All you do is risk getting serotonin syndrome [1] which is a whole other story/problem. But becoming "addicted" (physically or psychologically) in the classical sense is not an immediate issue as it is with cocaine, smoking, weed, etc. [1] https://en.wikipedia.org/wiki/Serotonin_syndrome https://en.wikipedia.org/wiki/Serotonin_syndrome
- another-cuppa 8y ago
  MDMA quickly loses its effect, though. I've done it twice in a month before and even then the second time wasn't that great. I'll only experience full waves once a month at most. And you can't just take more next time. It doesn't work. It will just give you a suicide tuesday.
ridewinter 8y ago
Try it once. The salient point about drugs like ecstasy is that they don’t actually add to the chemicals to your brain that make you feel good - instead they release the reserves in your brain all at once. Those incredible highs are all of your nice feelings for the next couple weeks getting released at once. It’s a trade off I don’t want to make.

egypturnash 8y ago

> After taking the drug, the patient lies on a futon amid candles and fresh flowers, listening to music. Two therapists — one female, one male — sit at the patient’s side as guides. That session lasts eight hours. My version was "lounging around under the stairs in a mostly-abandoned hotel lobby late at night at a furry con, with two friends". It worked pretty well. Still probably took about eight hours.

nopacience 8y ago

One common thought under the influence of MDMA is: The world could end now. Everything is perfectly fine.