MDMA treatment for alcoholism could reduce relapse, study suggests

Authored by theguardian.com and submitted by mvea

The first study looking into the use of MDMA to treat alcohol addiction has shown the treatment is safe and early results show encouraging outcomes from the approach, scientists have said.

Doctors in Bristol are testing whether a few doses of the drug, in conjunction with psychotherapy, could help patients overcome alcoholism more effectively than conventional treatments. Those who have completed the study have so far reported almost no relapse and no physical or psychological problems.

In comparison, eight in 10 alcoholics in England relapse within three years after current treatment approaches. Dr Ben Sessa, an addiction psychiatrist and senior research fellow at Imperial College London, and who led the trial, said: “With the very best that medical science can work with, 80% of people are drinking within three years post alcohol detox.”

Eleven people have so far completed the safety and tolerability study, which involves nine months of follow-ups. “We’ve got one person who has completely relapsed, back to previous drinking levels, we have five people who are completely dry and we have four or five who have had one or two drinks but wouldn’t reach the diagnosis of alcohol use disorder,” Sessa said.

Most addiction is based on underlying trauma, often from childhood, explained Sessa. “MDMA selectively impairs the fear response,” he said. “It allows recall of painful memories without being overwhelmed.

“MDMA psychotherapy gives you the opportunity to tackle rigidly held personal narratives that are based on early trauma. It’s the perfect drug for trauma-focused psychotherapy.”

The first stage of the new study was designed to show the therapy is safe. Further research, which compares results with a randomised control group who receive a placebo instead of MDMA, will be needed to back up the treatment’s effectiveness.

After preliminary screening, including medical and psychological tests, the participants are given an eight-week course of psychotherapy. In weeks three and six, they are given a powerful dose of MDMA.

Sessions are conducted in a hospital with a psychiatrist and a psychologist present. Participants are given the drug and then spend eight hours with the specialists, mostly lying down, wearing eyeshades and headphones.

“We let them lead the sessions as to where they want to go. What comes up comes up, so it’s not very guided by the clinicians,” said Sessa.

After the MDMA-assisted sessions, patients stay overnight and are telephoned every day for a week to collect data on sleep quality, mood and potential suicide risk. Significantly, this data has shown no evidence of drug withdrawal or comedown symptoms from the MDMA.

“There is no black Monday, blue Tuesday, or whatever ravers call it. In my opinion, that is an artefact of raving. It’s not about MDMA,” said Sessa, referring to recreational users of the drug, which is often associated with clubbing.

“If there was a craze of people going around abusing cancer chemotherapy drugs, you wouldn’t then think: ‘Oh well, it’s not safe to take cancer chemotherapy when doctors give it to you,’” said Sessa. “Scientists know it’s not dangerous. The Sun newspaper thinks it’s dangerous because the tiny number of fatalities that occur every year all get on their front page.”

MDMA was used as a legal prescription drug to enhance the effectiveness of psychotherapy in the US from the 1970s to 1985 and in Switzerland up until 1993. In recent years, MDMA therapy has been studied extensively as a treatment for post-traumatic stress disorder (PTSD).

Speaking at Breaking Convention in London over the weekend about a study published earlier this year, Rick Doblin, founder of the Multidisciplinary Association for Psychedelic Studies, said: “61% no longer have PTSD – that’s after two month’s follow-up. But more importantly, after one year of follow-up, people still keep getting better.”

David Nutt, professor of neuropsychopharmacology at Imperial College London, who was also involved in the study, said the research had faced financial barriers that meant it took two years to set up because of the “profound” legal constraints of working with a schedule 1 drug. “Unfortunately, it’s very difficult to get money for this from government funding. But we have a scientific credibility that will allow charitable funders to support us,” said Nutt.

In response, a government spokesperson said: “We have a clear licensing regime, supported by legislation, which allows legitimate research to take place in a secure environment while ensuring that harmful drugs are not misused and do not get into the hands of criminals.”

factoid_ on August 19th, 2019 at 16:01 UTC »

The whole drug classification system needs an overhaul. The whole schedule 1, schedule 2 nonsense is outdated and doesn't keep up with the science.

There are a lot potentially useful substances locked away in S1 that could be studied in greater depth if not for that restriction.

We need to get rid of that whole concept and come up with something new. There are certainly substances that should be controlled, but ALL substances should be valid for lab study and if you can meet ethical standards and show there's a reasonable chance of positive outcome, for human study as well.

I can't even imagine the hoops a researcher had to go through to get approval to try out MDMA on alcoholics.

folstar on August 19th, 2019 at 14:36 UTC »

Wasn't this already done over 50 years ago but with LSD? https://www.ncbi.nlm.nih.gov/books/NBK99377/

mvea on August 19th, 2019 at 11:18 UTC »

The post title is adapted from the title, subtitle and first paragraph of the linked popular press article here:

MDMA treatment for alcoholism reduces relapse, study suggests

Researchers say drug is safe and appears more effective than conventional treatments

The first study looking into the use of MDMA to treat alcohol addiction has shown the treatment is safe and early results show encouraging outcomes from the approach, scientists have said.

And this section of the abstract:

There have been no serious adverse events related to MDMA, no unexpected physiological responses to the MDMA sessions or changes to blood results or electrocardiograms, measured before and after the 8-week course.

Journal Reference:

Sessa B, Sakal C, O’Brien S, et al

First study of safety and tolerability of 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy in patients with alcohol use disorder: preliminary data on the first four participants

BMJ Case Reports CP 2019;12:e230109.

Link: https://casereports.bmj.com/content/12/7/e230109

DOI: http://dx.doi.org/10.1136/bcr-2019-230109

Abstract

We present the preliminary data in an ongoing open-label safety and tolerability proof of concept study exploring the potential role for 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy in treating patients with alcohol use disorder. At this stage, seven participants have completed the full 8-week MDMA-assisted psychotherapy course, including two therapy sessions each with MDMA. This paper focuses on the safety and tolerability of the therapeutic course for the first four participants to complete treatment. Longer-term outcomes of drinking behaviour will be presented later when the full project data are published. Results show all four participants have successfully tolerated the treatment. There have been no serious adverse events related to MDMA, no unexpected physiological responses to the MDMA sessions or changes to blood results or electrocardiograms, measured before and after the 8-week course. We conclude that the treatment is well- tolerated and are making plans to expand the project into a randomised placebo-controlled study.