On 8th February, a talk was held titled “Trauma, MDMA and Psychedelic Therapy: A New Paradigm for Psychiatry”, organised by Students for Sensible Drug Policy, the Neurological Society, the Institute for Neuroscience and the Psychology School. It saw Dr Ben Sessa made a bold case for the use of MDMA as a way to help those who have endured childhood trauma in a more meaningful way than the current world of therapy and pharmacology allow. Sessa – an NHS consultant, psychiatrist and psychedelic drug researcher – is quick to address concerns about a more relaxed approach to drugs: he explains that his is a data-driven approach, and that the persecution of drug users does more harm than good. Sessa relates that there is a stronger link between childhood trauma and addiction than between obesity and diabetes, making the War on Drugs – a term first used by Richard Nixon in 1971 – “a war on traumatised people who just need help”.
He posits that childhood trauma leads to insecure attachment, which itself spawns a narrative of the world characterised by mistrust and paranoia. Sessa tells an anecdote about his patients who, in looking down from his office and onto the high street, regard passers-by with extreme suspicion: “he looks really dodgy”, “I wouldn’t trust him” and “she’s gonna screw me over” are a few choice phrases. With such mistrust of the world, it’s no wonder 50% of childhood trauma survivors experience what Sessa calls “treatment resistance”, elucidating that getting such people into therapy to open up about the trauma they’ve been trying to block out with drugs and alcohol for years often isn’t effective. Going as far as to offer an apology “on behalf of my profession”, he begins to make the case for MDMA, a powder drug that acts as the primary active ingredient in ecstasy pills.
Sessa explains that the drug “ticks all the right boxes” of treatment: short acting, almost always pleasurable, psychedelic enough to allow for new ways of thinking while still remaining lucid, safe in therapeutic applications and able to provide access to traumatic memories. He also claims that the infamous comedown from MDMA is not seen in a therapeutic context, arguing much of the comedown is attributable to factors outside the drug itself, such as sleep deprivation and excessive drinking (though it should be noted that the serotonin depletion caused by MDMA can also be a factor). In his studies, Sessa’s team pay £9 000 for a single gram of the drug – joking that he’s got a mate who could do it for £35 – to ensure a high purity, and also points out that the risks of MDMA are reduced by hourly monitoring of blood pressure, temperature and heart rate, as well as having a psychiatrist and psychologist sit with patients for the entire experience.
As drug policy in the UK and US becomes more relaxed, final stage studies have been approved by the Food and Drug Administration (FDA, an American body) for using MDMA to treat PTSD, meaning the drug could be legal in the US for medicinal purposes as early as 2021. Meetings with the European Medicines Agency (EMA) held last year could make that the case in the EU as well, meaning Sessa’s wish of using MDMA for therapy could well come true.
The talk did leave certain issues unaddressed. One issue with the drug is potential side-effects that come even with moderate use, such as paranoia and memory damage; there is also the high cost (mentioned above), though this is likely to fall once the study gets out of the trial stage and more MDMA is needed (which counter-intuitively reduces price per gram, owing to the high cost the companies producing it charge for smaller quantities of the drug). While promising, many still find ecstasy a hard pill to swallow.
Last modified: 14th February 2019