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MDMA-assisted couples therapy investigated in pilot trial
- cmehdy 6y agoLink to the research article: https://www.tandfonline.com/doi/full/10.1080/20008198.2020.1840123 https://www.tandfonline.com/doi/full/10.1080/20008198.2020.1... While studies of this kind are still very hard to make and very limited in scope (in this case, uncontrolled and with a very small sample size), I'm glad to see that we are lifting the unnecessary taboos around things like MDMA so that proper research can begin to get done (with 6-8 decades of delay compared to what we could have had, but still). Props to MAPS (Multidisciplinary Association for Psychedelic Studies) in the US for paving the way to that change.
- PragmaticPulp 6y agoGood to see some progress in this area. As usual, it's important to emphasize that this research is about therapy, with MDMA as an additional modulator on top of the therapy. In this case, 15 therapy sessions over a period of 7 weeks. MDMA was only involved in 2 of the 15 sessions. If I'm reading the paper correctly, patients received 3 therapy sessions before MDMA was introduced and the bulk of reported improvements happened prior to MDMA being added. Looking at the graphs, there aren't any obvious score increases around the MDMA sessions. In fact, I couldn't tell when the MDMA was introduced without reading the methodology section. The study was also limited to 6 couples, with no control group. Note that the control group in this case doesn't have to be a placebo group, because it's too obvious if someone has taken a powerful drug. Instead, the control group would simply receive therapy without MDMA and results would be compared. The difference would begin to show the benefit of therapy+MDMA over therapy alone, which is critically important in these trials. You can't just give people 15 therapy sessions and then attribute the benefits to 2 doses of MDMA. People tend to see these headlines and assume that the drug is doing all the work, or that they can simply replicate the results by taking the drug and seeing what happens. This is usually backed up by a couple of random positive anecdotes in the comment section while anyone with negative experiences is downvoted or dismissed. Please don't assume you can replicate these results with ad-hoc experimentation with street drugs. If you browse Reddit, it's not hard to find anecdotes from people who have mistaken the short-term effects of these drugs for long-term healing, which usually results in them reaching out for more drugs the next time they have problems. Once people convince themselves that the drug is the easy solution to their problems, they're on their way to low-level addiction.
- sneak 6y ago> which usually results in them reaching out for more drugs the next time they have problems "I hate to advocate drugs, alcohol, violence, or insanity to anyone, but they've always worked for me." — Hunter S. Thompson
- PragmaticPulp 6y agoI know this comment was meant to be facetious, but this is actually how many people spiral into addiction. Recreational drugs feel like they're "working" when they make the person's problems temporarily disappear, but in reality the person hasn't solved anything. When the problems inevitably return, the temptation is to reach for more drugs. Tolerance is real, though, so people tend to reach for escalating doses over time. The cumulative effects of drug abuse and avoidance behavior begin to add up, compounding the original problems and digging the person into an even deeper hole. That's why these successful programs are always therapy-first, rather than drug-first. The focus is first on identifying and fixing problems, using drugs to potentially amplify the therapy rather than avoid the problems. Sadly, most of these studies lack any control groups (e.g. therapy-only) to compare against. If you look at the graphs in the study, patients were already reporting massive improvements after the first 3 therapy sessions, before taking any MDMA at all. Unfortunately, I don't think we can draw any conclusions about the MDMA in this study other than it didn't appear to make things worse when it was introduced.
- girvo 6y agoThe other more difficult issue (and was my personal one) is when you lean on drugs (opiates in my case) to try and solve unsolvable issues. That’s a recipe for addiction, more so than anything else.
- RangerScience 6y agoIMO the difference between a drug, a medicine, and a psychedelic is behavioral more than substantive, although different substances do have more or less tendency for abuse. Morphine is a medicine until you take like a drug. MDMA is a psychedelic at a rave and a medicine on a therapist's couch. By all reports, there's no possible way to abuse ayahuasca. You will have more mileage with someone experienced, and more still with a professional, just like you would with other therapy practices that you can teach yourself, like meditation and yoga. AFAIK addiction is mostly about a person's life, and not the things they ingest. That's why rehab clinic success is so heavily dependent on the support network (or lack thereof) the person returns to. You have to have something to avoid in the first place to turn to substances to avoid them.
- yboris 6y agoA very related book on the topic: Love Drugs: The Chemical Future of Relationships by Brian D. Earp And Julian Savulescu https://www.sup.org/books/title/?id=27130 https://www.sup.org/books/title/?id=27130
- werber 6y agoMy family went through some pretty tumultuous times that created a giant rift where there was no communication from my early adolescence into early adulthood with one side of my family and one night of taking mdma with my closest cousin from childhood was able to facilitate a remediation. However when I’ve taken it recreationally without a goal in mind it has been such a painful experience in the following days, which isn’t every users experience, but for myself without meaningful emotional resolve the drug left me feeling incredibly depressed. With that being said, I hope anyone who wants to experiment with it invests in a safety kit ( https://dancesafe.org/product/mdma-testing-kit/ https://dancesafe.org/product/mdma-testing-kit/ ), no matter your intention
- taurath 6y agoAlso supplements are mandatory to prevent a really large comedown period - the most important being alpha-liproic acid, to avoid neurotoxicity.
- loves_mangoes 6y agoI'm glad to learn about alpha-liproic acid, and on the same theme the beta (and alpha1) blocker Carvedilol taken 1h before has been found [0] to reduce hyperthermia and other cardiotoxic effects of MDMA without "affecting the subjective effects". This is your threadly reminder to practice harm reduction if you plan to take neuro- and cardiotoxic drugs like MDMA =) [0] https://pubmed.ncbi.nlm.nih.gov/22404145/ https://pubmed.ncbi.nlm.nih.gov/22404145/
- bennysonething 6y agoGenuine question, is mdma cardio toxic? Thought that was cocaine?
- pvarangot 6y agoIt's not clear it's cardiotoxic even on heavy users. Most research points out that it is, but the mechanism is not well understood so it may be a correlation as most heavy users will not be leading a healthy vascular life.
- tlb 6y agoThe value of a dramatically improved relationship can be equivalent to several years of life. Ask anyone who's been in a failing marriage. So the value of a therapy that helps fix relationships would rank among the great breakthroughs of modern medicine. It's a shame that research has been hampered by the war on drugs. Some day our descendants will look back on the prohibition on research towards such therapies as one of the great own-goals of our species.
- el_dev_hell 6y agoNote: the below is an anecdote from my life. I have no medical/psychological training past a psy 101 class in uni. I took a fair amount of MDMA in my late teens/early twenties. Mostly in nightclubs and music festivals. It was cool at the time (great memories and the music 100% was better). In my late twenties (after 5+ years without MDMA), my partner and I decided to roll after getting some MDMA off the dark web. We went to a bar, which was my past go-to, and had an OK night. We left pretty early and went home. When we got home, we had 100mg left each and decided to roll in the peace of our house. We both dropped a cap and spent the next 6 hours having very deep conversations and just caressing each other (I especially enjoyed touching her hair). We didn't have any major issues in our relationship leading up to that night, but we did have a bit of friction over our future plans. After that one night, our relationship was at least 30% more pleasant and we both felt significantly closer to each other. We still have a great relationship 2 years later. Obviously, the MDMA isn't the only factor, but it helped to dramatically strengthen our feelings towards each other. One downside was sex. She was very in the mood and I was unable to perform on MDMA. YMMV.
- GordonS 6y agoJust wanted to say that I appreciate you sharing this interesting, personal story!
- ttul 6y ago20mg Cialis, just saying.
- qwerty456127 6y agoIndeed. There is a cocktail of pill to consider taking before MDMA: it's piracetam, magnesium, vitamins, anti-oxidants (all these contribute to improving the trip, minimizing harm and preventing hangover[1]) and Viagra/Cialis. Even if you are young and healthy (and especially if you are - AFAIK Viagra is kind of unsafe to mix with other stuff if you're old). [1] https://www.youtube.com/watch?v=jwTqlw8yGnI https://www.youtube.com/watch?v=jwTqlw8yGnI But don't ever take Viagra (I don't know about Cialis) with MDMA alternatives like 6APB - that's supposed to be a particularly cardiotoxic combination.
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- proverbialbunny 6y agoI'm all for MDMA PTSD therapy. It's a godsend for those who need it, but for couples therapy, it's not as straight forward. I met a couple who was breaking up. A friend of mine noticed this and mentioned how good it was. What she said caught me off guard, but I was young and didn't ask why. Later on that night someone gave them mdma which turned into a kind of unofficial couples therapy. They got back together and 10+ years later they're still in a long loving relationship today. Great, right? Well.. it turned out he was enabling her, and she was the breadwinner, but she desperately needed some therapy, unable to keep a job due to personality reasons. If he wasn't around to enable her, she would have have grown, and things probably would have ended up pretty well. Instead, for at least the last 5 years they've been homeless living together in a vehicle. Love is a wonderful and beautiful thing, but not all relationships are good ones. A therapist, even a professional, blindly mending a falling apart relationship should exceed caution. Sometimes it's better when people go their own way.
- pmoriarty 6y agoA really interesting point. However, there's no guarantee that letting them "go their own way" would have actually resulted in a better outcome. People in abusive relationships often bounce from one abusive relationship to another, not to mention the potential trauma of a break up. It's hard for outsiders who have no insight in to the relationship to judge its worth. Yeah, maybe this couple you speak of is homeless, but that doesn't mean they're not happy. Not everything is about money, financial or material security. And maybe there are things about their relationship that make it all worth while. It's impossible to guess, given so little information, and I'd hesitate on judging. Also, the same argument you use against intervention with MDMA therapy could be used against any intervention of any kind. Using the same argument you could argue that maybe it's better for a doctor to let an injured person die, because, well, maybe they're a bad person and the world would be better off without them. A doctor in an ER doesn't really know the person they're treating, but they generally try to help anyway. Could such help wind up causing more problems? Sure. But we as a society have generally decided that help for those in need, even if we don't know who they are and even if we can't foresee the ultimate consequences.
- fromtheabyss 6y agoInteresting community for clinical work in this field: https://horizons.nyc/ https://horizons.nyc/ Includes psilocybin research
- radicalriddler 6y agoInterestingly, I was at a party last weekend and one of my friends took half a tab. He opened right up, was willing to talk about his long term relationship and how he feels, which is something he doesn't do often with us, his best friends of so many years. I can see how this might help in couples therapy.
- efwfwef 6y agoI took MDMA with my now wife, pretty early in our relationship. It was the first time she was doing drugs, and I had had wonderful experiences with friends taking MDMA. She went kind of crazy, yelling and running around in the hotel room we were staying. At some point she went on her knees and asked her to marry her, I said no so she started crying for a few seconds, then went into another thought. Sexually it got pretty wild also, things that she would never accept doing ever since. Unfortunately, I was unable to keep it up.
- JacobSuperslav 6y agodefinitely too much information
- joncrane 6y agoWe owe a debt of gratitude to Rick Doblin for all this. He's been crusading for the therapeutic use of MDMA for over 25 years now. We went to the same college (New College in Sarasota) and he was a famous alum as "the guy who's trying to make Ecstasy legal" in 1992.
- fudged71 6y agoDo this for cofounder conflict and you could make billions
- nickthemagicman 6y agoRead that fast and thought for a second they were giving MDMA to pilots and was like that sounds dangerous.
- Glyptodon 6y agoWhile this makes sense to me for actual not terrible people legit trying to work things out, I do wonder if it could be kind of a dangerous therapy for an abusive or toxic relationships.
- 737min 6y agoHave you known anyone who died from MDMA overdose? I have - a very special human. It can happen. So please be careful.
- JacobSuperslav 6y agoit's very dangerous for the heart. especially if you got afibs
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- Noos 6y agoLook, I get people saying "use LSD for depression!" even if i dislike it thoroughly..their ideal goal is to deal with mental illness and chemistry in the brain using a different substance. I cannot look at this and not say "slippery slope." This is not biochemistry, this is not a medical condition, this is couples counseling. There isn't a condition you need to use drugs to get yourself back to the center to be able to act normally. This is more like thinking you need to drink alcohol to ask a girl out. I literally wonder what is next. It keeps getting worse every time I see posts here.
- JacobSuperslav 6y agoyou could say the same about antidepressants. of course we need to deal with the underlying problems but why not use the tools if they help?
- tpm 6y agoEverything in our lifes is biochemistry. Apart from that, MDMA was used in couples therapy before it was banned, because it just makes sense when you try it. For many people, they can talk about stuff they otherwise can't, they can process it, which is why it's also used in PTSD / trauma therapy. It can cure PTSD where there is no other known cure (there are already studies for that) so why not try it for couples too?
- pombrand 6y agoI think you're missing the point, the thing is that LSD gives you a new perspective on yourself, not necessarily that it just boosts the happy molecules in your brain.
- crowf 6y agoso scientists are working on changing who you love based on drugs. How is that so much different than gay conversation therapy?
- bayesian_horse 6y agoMy first (immature) thought was: can they make it a reality TV show?