Ecstasy (Part II): Illegal Drug…PTSD Miracle Cure…or Both?
Editor’s Note: This is the second installment on the subject on the drug Ecstasy (i.e., 3-4 methylenedioxymethamphetamine; MDMA). Please read Dr. Conkey’s first article of this three-part series, Ecstasy: Understanding the Love Drug, for a more comprehensive background of the drug Ecstasy.
By Dr. Allan Conkey, full professor of criminal justice at American Military University
In this article, I will focus on the potential use of Ecstasy for treating post-traumatic stress disorder (PTSD). It’s important to make it clear that when referring to Ecstasy (MDMA) as a means of treating PTSD, I am referring to the distribution and use of this drug in a clinically controlled manner and environment.
Those reading this article should understand that clinically given MDMA is a pure form of the drug, which is not frequently sold on the streets. Street versions of the drug, also referred to as Molly, are often mixed with other chemicals and illegal drugs (such as Speed). Those additives can greatly increase additional psychedelic effects—not to mention a variety of potential health risks (as discussed earlier during the first installment of this series).
PTSD: The Numbers and Implications
As identified by the National Vietnam Veterans Readjustment Study (NVRS) it’s estimated that upwards of 30 percent of Vietnam veterans and 10 to 20 percent of those who served in the Iraq or Afghanistan wars will suffer from PTSD in their lifetime (U.S., 2014).
Those latter numbers of veterans are very similar to research findings focused on the occurrence of PTSD in law enforcement officers. To that end, research conducted from 1997 to 2008 has shown PTSD affliction rates among police officers range from 7 to 19 percent (Yuan, Wang, Inslich et al., 2011). This finding is almost identical in scope to U.S. veterans who served in Iraq and or Afghanistan.
Such similarities may be explained in a number of ways. First, the duties of both professions would seem to place individuals at an increased rate of exposure to psychological hardship whether it be a horrific vehicle fatality, police shooting, duty-related loss of a co-worker, or combat. Another explanation may be the reality that a growing number within law enforcement have prior military service, and currently serve in the National Guard or Reserves. Such individuals are, therefore, susceptible to PTSD from more than once occupational venue.
When we look at the scope of PTSD as a whole, which is estimated to afflict more than 5 million adults in the U.S. (U.S., 2014), one can easily see that the PTSD net of victims represents all walks of life and occupations within U.S. society. Similarly, upon review, it becomes apparent that the causes of PTSD are equally diverse. Whether based on childhood trauma, abuse, experiencing a natural disaster, loss of a loved one in a manner that is traumatic, to a myriad of other potential origins, the harm caused to those afflicted can be significant. Such numbers and variety of causes highlight the need for effective treatments for those suffering from PTSD.
Yet currently many of those afflicted with this disorder don’t receive adequate care. For example, in regards to law enforcement officers and military members diagnosed with PTSD, it’s estimated that less than 10 percent of them are getting appropriate treatment. Similarly, when all PTSD-diagnosed patients are considered, it’s estimated that anywhere from 25 to 50 percent of them are not able to be effectively treated with currently approved methods and medicines.
Whether or not MDMA or other methods are used, it is clear is that such numbers illustrate the need for more alternatives to treating PTSD. In the case of MDMA, it’s usage would require extensive human trials, which is not an easy thing to get approved when talking about a Schedule I drug.
Ecstasy (MDMA) and PTSD: Limited Human Trials
A Schedule I drug implies, by definition, that a drug has no known or approved medical use. Yet in the case of Ecstasy/MDMA this is far from a clear definitive. Before it was categorized by the DEA as a Schedule I drug in 1985, it is estimated that more than 4,000 physicians in just the state of California were actively using it for treatment of PTSD and various psychological disorders.
In fact, from a historical perspective, the initial judge (i.e., Judge Francis Young) who was ruling on the case of making MDMA a Schedule I drug, actually agreed with those physicians’ standpoint that it should not be listed as such. In fact, Judge Young offered the opinion that Ecstasy in its pure form (i.e. MDMA) did have valid medical uses—such as treatment of PTSD—and subsequently recommended MDMA be listed as a Schedule III drug. Yet on review (and despite requests from the medical community), MDMA was nonetheless reaffirmed as a Schedule I drug in 1988. This act made it illegal to prescribe MDMA for treatment of PTSD, despite reported clinical success at the time.
In 2001, the U.S. Food and Drug Administration finally approved human testing of MDMA to treat PTSD. This was followed by other studies such as the MAPS Post-Traumatic Stress Disorder Study in 2006, among others. While approved studies have been few in number, the results have in large part been promising. With the latter study, and while small in scale (i.e., only 19 subjects), 83 percent of PTSD-afflicted participants who received MDMA-assisted psychotherapy no longer met the criteria for PTSD after just 2 to 3 short sessions.
While it’s still not fully clear how MDMA works, minus making one more receptive to talking about their problems and diminishing certain memories and fears (all arguably related to successfully being able to overcome PTSD), the initial evidence has supported the use of MDMA-assisted psychotherapy as a form of treatment for PTSD. Hence, it’s no surprise that studies are being conducted and/or planned in a variety of settings and locations ranging from Australia, the U.S., Canada, Great Britain, Israel, Spain, and Switzerland.
Yet the ability to use Ecstasy/MDMA to treat PTSD may require more than just positive results in human trials, it may also require a change in culture, especially for some professions such as law enforcement.
It can be argued that for badge wearers, the actual climate of law enforcement could work against allowing such treatment, even if it is shown to be effective. As highlighted by Scoville (2013), law enforcement represents a culture that is known for making it hard to implement effective support and treatment systems for its own. This is a reality this author and retired officer would support, especially given that treatment would involve a drug that is currently a Schedule I drug. Officers would likely have a hard time accepting this drug as treatment, especially since it is widely abused by people who are looked down upon and considered druggies by the law enforcement community.
The issue of Ecstasy usage is also compounded by the current debate about the legalization of marijuana. Marijuana also started out as an illegal substance, then it was allowed for medical purposes in a number of states, and now it is currently approved for recreational use in some states (e.g., Colorado and Washington). Could Ecstasy follow a similar path?
About the Author: Dr. Conkey is a retired officer and a decorated veteran of both the first and second Gulf Wars. Dr. Conkey’s career opportunities have included being a criminal investigator, confinement officer, senior U.S. customs officer in Japan, and exchange officer with the Japanese National Police Forensics Laboratory in Northern Japan. As Commander of the Air Force’s Elite Guard, for two years he commanded plain-clothed security details in support of dozens of world leaders and heads of state to include President Bush and Afghanistan President Hamid Kharzai. He is a three time Military Chief of Police and member of the National Association of Chiefs of Police. In all, Dr. Conkey has over 25 years of active service in the law enforcement and security realm. Today, a published author and faculty member for American Public University System, Dr. Conkey teaches within the criminal justice department, and holds the academic rank of Full Professor.
Scoville, D. (2013) Police and PTSD. Police, 37(2), 34-37.
Yuan, C., Wang, Z., Inslich, S. S. et al. (2011). Protective factors for posttraumatic stress disorder symptoms in a prospective study of police officers. Psychiatry Research, 188(1), 45–50.
U.S. Department of Veterans Affairs (2014). PTSD: National Center for PTSD. Retrieved from http://wqww.ptsd.va.gov