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Medicine PTSD

mr peabody

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How MDMA is changing the treatment of PTSD*

by Rachael Beairsto | Psychiatry Advisor | October 7, 2019

Rick Doblin, PhD, founder of MAPS, anticipates that MDMA will be approved for PTSD by 2021. During his presentation at the 2019 Psych Congress, held October 3 to 6 in San Diego, California, Dr Doblin discussed results of recent research and future directions for treatment of PTSD.

Millions of Americans are affected by PTSD. Among veterans, it is the third most prevalent military service-related disability, which costs the Veterans Affairs disability payments service billions of dollars each year. Furthermore, treatment for PTSD can be challenging given the high number of nonresponders.

MDMA, a known psychoactive drug that is most often used recreationally, has been identified as potential therapeutic modality for this challenging condition. MDMA counters the neurologic effects of PTSD, which manifest as hypoactivity in both the hippocampus and prefrontal cortex and hyperactivity in the amygdala.

MDMA is not the entire therapy for PTSD; instead, it is MDMA-assisted psychotherapy — optimized with thorough preparation and integration of therapeutic outcomes — that has had early success in PTSD in multiple phase 2 trials and has now moved on to phase 3 studies.

In a series of 6 international phase 2 MAPS-sponsored studies, an active dose of MDMA (75-125 mg) was compared with a nonactive lower dose (0-40 mg; placebo group) in MDMA-assisted psychotherapy for chronic, treatment-resistant PTSD over multiple integrative sessions.

At 2-month follow-up, more than half of patients who received the active MDMA dose no longer met the diagnostic criteria for PTSD (56 percent, vs 23 percent in the placebo group). This improvement in PTSD with an active dose of MDMA was even greater at 12-month follow-up: two-thirds of patients (68 percent) were categorized as no longer having PTSD, indicating prolonged healing after MDMA-assisted therapy.

On the day of administration, rates of anxiety, jaw clenching/tight jaw, lack of appetite, and nausea were higher in patients who received the active dose of MDMA, while fatigue and headache were more common in the comparator group. Despite concerns about longer-term neurotoxicity with MDMA, the investigators noted no neurocognitive changes after treatment.

On the basis of these data, the United States Food and Drug Administration (FDA) approved the trial to move to phase 3 and granted breakthrough designation for MDMA-assisted psychotherapy for PTSD in 2017. The European Medicines Agency also approved the study to move to phase 3, with the condition that migrants and refugees be included. An interim analysis of the first of the phase 3 studies is expected around March 2020.

Though costs for MDMA drug development are high — an estimated $34 million before FDA approval and $11 million related to European Medicines Agency approval — MAPS, a nonprofit organization, is refusing investment from pharmaceutical companies in an effort to avoid competing interests. Representatives from MAPS are in conversations with the FDA to discuss expanded access through compassionate use, given that there are millions of patients with PTSD and only hundreds currently being enrolled in clinical trials.

As for next steps, Dr Doblin explained that patients with PTSD have a desperate need for this therapy. While MDMA-assisted treatment will never be a take-home, self-administered cure, he envisions a future with highly trained therapists at thousands of accessible psychedelic treatment centers across the world.

*From the article here:

 
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mr peabody

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To unravel PTSD, she took MDMA*

by Will Stone | Apr 22 2019

Lori Tipton had recounted the details of her mother’s death many times, always with the same detachment as that first 911 call.

“I was the one who discovered their bodies in her home,” Tipton says of that night in 2005. “I completely just disassociated. … I couldn’t believe what I was seeing.”

A murder-suicide, her mother had killed a lover and a close family friend.

It wasn’t Tipton’s first encounter with trauma.

When Tipton was 20 years old, her brother came to visit her in New Orleans for his 21st birthday. He died of an overdose that night in her home.

“In the wake of that experience, I didn’t really allow myself to process any of that, because I immediately began to take care of my mother,” Tipton, now 39 years old, remembered.

Her mother had struggled with mental illness for many years and took a sharp decline after her son’s death.

But Tipton’s diagnosis of post-traumatic stress disorder didn’t come until later, and only by accident when Hurricane Katrina hit.

She was displaced and spent weeks in and out of hotels. Her life felt like a steady stream of loss — the tragedy only compounded by the devastation of the storm and its aftermath.

“Nearly everybody returning to New Orleans was being diagnosed with PTSD,” Tipton said. “I think that partly led me to believe that, maybe, I didn’t have this affliction.”

He describes the years that followed as “seeing the world through dirty goggles.”

“Imagine your brain, you go down a road and to the left is like happiness and joy, and to the right — anxiety,”
she said. “No matter what the circumstances were in my life, my brain would always go right, every single time.”

What happened to Tipton the following year cemented the sense that she was somehow broken, “unable to be saved,” as she describes it.

A close friend of Tipton’s, someone she trusted, raped her.

“I ended up pregnant from that rape and had an abortion,” she said.

Tipton avoided talking about the assault. She says she tried to mask her fear and isolation.

Heart-pounding panic attacks and unexplained dread became a daily part of her life. A specific word or touch, even from someone she loved, could overwhelm her with fear.

“When you have PTSD, you are living in this constantly triggered environment,” she said. “My disorder had become so much a part of who I was.”

She felt as if the universe was punishing her.

“Anytime I felt I could trust myself, I was proven wrong,” she said.

For more than a decade, Tipton searched for a remedy.

She tried everything offered — or that she could think of — to mitigate the symptoms of PTSD: antidepressants, psychotherapy, acupuncture, meditation and hypnotherapy.

She became a yoga teacher, tried Rolfing (a type of deep-tissue massage) and even saw a witch doctor.

Nothing really worked.

Amid a renaissance in psychedelic research, new treatments emerge

In 2017, Tipton came across an online ad for something different: researchers from the Multidisciplinary Association for Psychedelic Studies, also called “MAPS,” were looking for people with chronic, treatment-resistant PTSD.

It was an opportunity to participate in Phase 2 clinical trials for an experimental, yet promising model of treatment: MDMA-assisted psychotherapy.

Tipton was unsure at first.

“I went in there being as open as possible, but with a great deal of skepticism,” she said.

First synthesized in the early 1900s, MDMA is a psychoactive drug that boosts neurotransmitters like serotonin and also dials down activity in the amygdala, a part of the brain that processes fear. It can increase empathy and social connection.

The therapeutic benefits were explored throughout the 1970s, including in contexts like couples therapy. But those efforts stalled when the federal government — alarmed by the rise of the club drug “Ecstasy,” which can contain MDMA — classified it as a Schedule 1 drug in 1985.

Now research into psychedelics has picked up again in the U.S and that is offering hope for treating a variety of mental illnesses — from substance use disorder to depression.

MDMA is on the front line of these emerging treatments. A new drug hasn’t come onto the market to treat PTSD in more than a decade.

In 2017, the U.S. Food and Drug Administration granted Breakthrough Therapy designation to MDMA-assisted psychotherapy, developed by MAPS.

According to the FDA, the designation is reserved for a drug with preliminary clinical evidence indicating that it “may demonstrate substantial improvement over existing therapies on one or more clinically significant endpoints, such as substantial treatment effects observed early in clinical development.”

Phase 3 trials are taking place across the country, as well as in Canada and Israel.

“Seeing what was possible, you can’t go back,” said psychotherapist Saj Razvi of sessions aided by MDMA. “Things that may take months or even years to accomplish, or may never get accomplished, we see people are able to work into that territory.”

Razvi is director of medical education at Innate Path, a clinic based in Colorado. He was also clinical investigator in the Phase 2 trials for treatment-resistant PTSD.

“MDMA allows you to contact feelings and sensations in a much more direct way,” Razvi said.

The MAPS protocol typically consists of two to three sessions when MDMA is administered, each eight hours long. Those are bookended by sessions of therapy to integrate what the person has discovered while under the influence of MDMA.

Razvi, who has observed hundreds of hours of these sessions, says only by returning to the origin of the trauma can you “unpack this material, feel your way through it and get to the other side.”

“These are fundamentally powerful experiences that are corrective in nature, going back to these places where we were crushed,” he said.

It can look painful, he says — what some might call “a bad trip” — but only through this process can the quality of these traumatic experiences change.

“When we are being traumatized, we are fundamentally alone,” he said. “One of the things that MDMA does is, really, lets you know that you are not alone.”

Trauma revisited in the embrace of MDMA

Lori Tipton knew the story of her mother’s death well, but it always felt like it was happening to someone else.

That changed while on MDMA.

“I was able to remember all of those things, like truly able to remember these little pieces that were missing before,” she said.

She could stay present in the most terrifying moment of her life, safe in the “loving embrace of MDMA.”

As those memories emerged, they formed something new — forgiveness.

“I was able to find such empathy for myself. I realized how much I was thinking this was my fault and I should have done something,” she said.

Then she told herself to let it go.

“This is a terrible thing that happened, but you carrying the fear and shame over this, it’s worthless.”

Tipton unearthed other memories, too, feelings of joy and peace that had been sealed away. She was playing in the snow with her brother when they were children.

“I could remember exactly how I felt, that excitement of the first snow,” she said.

But as her last session was coming to an end, one moment still remained out of reach: her rape.

When she spoke of it, the heaviness would return. There was no catharsis.

Her therapists, a male-female duo, suggested something.

“How would you feel about potentially going into one of these poses and seeing what happens?”

Years of practicing yoga, even teaching it, and certain poses Tipton could never do; it took her back to the assault.

She lay on the floor and took the pose, her legs draped over her shoulders.

As the panic surfaced, they offered her a simple question.

“Can you ask what that feeling needs?”

“It needs to be heard,”
Tipton replied without thinking. “I had felt so silenced for so many years, people didn’t believe me … that, I needed that moment for them to understand me.”

They stayed with her, crouched on the floor, and let her know they did believe her.

“It was the first time I had told that story and that had been the response,” she said.

That was the end of Tipton’s treatment with MDMA.

More than a year later, she no longer fits the diagnostic criteria for PTSD. That was the case for nearly 70 percent of those who were given MDMA in the Phase 2 trials. It was a small group, fewer than 100.

Still, the potential of achieving durable remission could be a paradigm shift for millions with PTSD.

Tipton says it saved her life.

“Everything is at my fingertips for me in a way that it never was before,” she said. “I want that for everybody.”

*From the article here:

 
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mr peabody

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MDMA-assisted psychotherapy for PTSD

Posttraumatic stress disorder (PTSD) is a disorder that describes the issues faced by many people after they experience or witness a traumatic event. Anyone who has been exposed to traumatic events that causes a serious fear for their life or the lives of others is at risk to develop PTSD. People typically affected include: survivors of violent acts and disasters, emergency responders to traumatic events, people who experience the sudden death of a loved one, anyone who has been abused, neglected children, and combat veterans. However, many other events can be traumatic as well, particularly to people of color, including police harassment, distressing childbirth experiences, and incarceration.

MAPS is a non-profit research and educational organization that is currently sponsoring Phase 3 clinical trials of MDMA as a tool to assist psychotherapy for severe PTSD. Importantly, MDMA used in these trials is not the same as the street substances known as "ecstasy" or "molly," since these drugs frequently also contain unknown and/or dangerous adulterants. In MDMA-assisted psychotherapy, MDMA is only administered a few times, unlike most medications for mental illnesses which are often taken daily for several years. More information on MDMA can be found in the MAPS Investigator Brochure, which is available online here.

Preliminary studies suggest that MDMA can catalyze powerful psychotherapeutic work in helping people overcome PTSD by reducing fear of traumatic memories and increasing feelings of trust and compassion towards others without causing sensory distortions or inhibiting access to difficult emotions. As such, MDMA could increase the effectiveness of psychotherapy by strengthening the alliance between therapist and patient.

In our site at the University of Connecticut, we are participating in a MAPS-sponsored, FDA reviewed Phase 2 open-label study and then moving on to Phase 3 randomized clinical trials in Spring 2018. We are focusing on the recruitment of ethnoracial minority participants who meet criteria for PTSD. Our team’s work is focused on culturally-sensitive and respectful treatment approaches for people of diverse backgrounds.

We recognize that doing things the way they have always been done will not be sufficient to open the doors of these therapies to people of color. A culturally-informed approach must be used. Here are some of the efforts that have been made to date to ensure the ongoing MDMA research is culturally inclusive:

- Addition of a study site focused on the ethnic minority trauma experience
- Revision of informed consent documents for all sites to improve understanding and acceptability to people of color
- Diversification of the UConn treatment team at every level
- Ongoing cultural training for all UConn team members, with an emphasis on cultural humility
- Re-examination and revision of the setting and music used during MDMA sessions for cultural congruence
- Recognition and validation of experiences of racial oppression at a cultural and individual level
- Integration and specialized training for independent rater pool, with ongoing supervision for cultural differences

http://www.mentalhealthdisparities.org/mdma-trauma-study.php
 

mr peabody

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Bob Walker has suffered from PTSD for over 30 years. He's not alone in this struggle,
but he claims to have found a way out, through MDMA therapy. A group of specialists
across the country are using it to heal trauma victims in ways previously unimaginable.



Ecstatic states

by Lessley Anderson

Can an illegal drug heal crushing trauma?

In the Vietnam War, Bob Walker was a helicopter mechanic who saw his best friend decapitated by an incoming helicopter’s propeller blade. Ever since then the 69-year-old Paradise, CA vet has struggled with PTSD — a psychological condition that afflicts 7–8 percent of the population. It hits people who have been exposed to highly stressful situations in which their “fight or flight” response has been activated. Rape survivors. War veterans. Policemen.

People with PTSD can be highly irritable and suffer from insomnia, nightmares, and the inability to sustain deep relationships. Or, like Walker, they can walk through life feeling eternally numb. “Over the years, I tried everything from prescription drugs to biofeedback,” says Walker. “But nothing really worked. I knew something just wasn’t right.”

Then one day three years ago, Walker saw a segment on CNN about an experimental drug trial going on in South Carolina to treat people suffering from PTSD. In the study, patients took MDMA, more commonly known by its street name ecstasy, in the company of psychotherapists. The drug’s famous warm-and-fuzzy ability to enhance a person’s well-being and create a surplus of empathy allowed many of the participants to revisit painful memories without their usual fear. In neurochemical terms, MDMA decreases the fear response in the amygdala. It also stimulates the release of the feel-good neurotransmitter serotonin, as well as oxytocin and prolactin, which cause feelings of love and bonding. After taking the drug, many patients could look at their lives in a new way, reprocess trauma, and rewire their own brains.

"I got it, right away," says Walker, about watching the segment detailing the experiments. He figured, living right next to a college town, he could ostensibly score drugs easily. Why not try it himself?

"Finding MDMA was harder than I expected," he said. Asking around and attending a psychedelics event got him connected to some people doing sweat lodge and peyote ceremonies, but no ecstasy. But he finally tracked down ecstasy through a friend of a friend’s son and contacted a former therapist, who agreed to work with him while he was high. Jennifer*, who asked that her real name not be used because she feared she could lose her license, was a self-described "conservative" single mom who was typically scared of drugs. But she felt a warmth for Walker and trusted him. "For some reason, it didn’t feel wrong," she said. "He had really done his research." The first time was a therapy session like no other. "He didn’t seem high, he just seemed ‘real,’" she said. "We were able to carry on an intimate conversation for the first time."

"You lose your sense of connection,"
says Walker, describing the feeling of having PTSD. But on MDMA, Walker felt deeply connected, not just to his therapist, but also to himself, something he’d long struggled with.

The drug trials that inspired Walker were the work of MAPS. It’s one of a small handful of organizations worldwide trying to establish scientific evidence that psychedelic drugs have therapeutic value.

In the study looking at how MDMA could treat PTSD, the drug was given in conjunction with talk therapy. Patients lay down in a therapist's office and listened to soothing music with headphones, wearing eyeshades. They had the option of talking about what they were experiencing, and received counseling before and afterwards to integrate what happened to them while on the drug into their everyday lives. According to MAPS, 83 percent of the 19 people treated in a recent group had breakthroughs in this MDMA-assisted therapy and showed significant improvement in their PTSD symptoms.

"The MDMA allowed me to be my very, very, very best self, and I got to take care of my most broken self with my best self," says Rachel Hope, a sexual-abuse survivor who participated in the study. MAPS’ results from this study were encouraging enough to the FDA that it was able to expand its efforts into what’s known in drug-trial parlance as "Phase 2 studies." It’s now doing the same study with four new groups of patients in South Carolina, Colorado, Israel, and Vancouver.

In addition to the MDMA-to-treat-PTSD study, MAPS has also studied how LSD can help soothe anxiety in people with terminal illnesses, and in March received approval to study the effects of marijuana to alleviate PTSD. The latter study will be one of only two government-approved medical marijuana trials ever conducted.

Similarly to MAPS, the Santa Fe-based scientific research group the Heffter Research Institute has been collaborating with scientists at UCLA, Johns Hopkins, and NYU to study the therapeutic applications for psilocybin, the active ingredient in hallucinogenic mushrooms. In one study, published in 2011, it investigated how the drug might be used to make terminally ill cancer patients feel less anxious and depressed, and reported that of 11 patients given the drug, 30 percent reported an elevated mood that lasted long after the drug wore off. Now, Heffter scientists are looking at how psilocybin might help cure alcoholism and get people to quit smoking.

In many ways, this research isn’t new. Besides the thousands of years of indigenous peoples’ ritual use of mind-altering plants like ayahuasca and peyote, there was some modern scientific exploration of these kinds of substances, too. Before it was criminalized in 1968, LSD was being used by some doctors as an experimental method for treating alcoholism and anxiety. MDMA, prior to being outlawed in 1985, was used by hundreds of psychotherapists in the United States to treat a variety of phobias, addiction, trauma, and even relationship problems. In an interview with psychiatrist Julie Holland, author of the book Ecstasy: The Complete Guide, one of these therapists recalled: "When it came to, for instance, couples therapy, it was a remarkable catalyst."

Hopes for relief

MAPS and the Heffter Research Institute were founded with the mission of reintroducing these types of investigations and documenting their results in peer-reviewed journals. MAPS opened in 1986 and Heffter in 1993, after LSD, MDMA, and psilocybin became illegal. But until the 2000s this type of research would have been virtually impossible. The National Institute on Drug Abuse and negative media coverage throughout the ’80s and most of the ’90s depicted drugs like ecstasy, pot, and acid as a scourge without any therapeutic value. But personnel changes in the FDA and a softening of attitudes within the DEA and Institutional Review Boards, both of which greenlight drug trials, have opened up the field of psychedelic research like never before.

"A lot of the demonization of drugs as evil in all walks of American life has really calmed down," says Jeffrey A. Fagan, professor of law at Columbia University. "And that’s a great thing. There’s no reason why we can’t think in careful and responsible steps about the therapeutic value of controlled substances." As scientific evidence begins to mount, psychedelic researchers are looking towards a day when drugs like ecstasy, pot, LSD, and psilocybin will be categorized as "Schedule 2" drugs — that is, drugs that have risks associated with them, like Ritalin or Oxycontin, but can be prescribed by a doctor.

Rick Doblin, the founder of MAPS, says he envisions a future when hospice centers for the terminally ill sit next to psychedelic therapy centers, and licensed doctors can prescribe MDMA in clinics similar to the way methadone is handled. "Things are lining up in our culture and we have the opportunity to reintegrate psychedelics," says Doblin. "They’ll have an honored place rather than a suppressed place."

Harsh realities

But it may be too early for Doblin and his colleagues to get too excited. By the FDA’s own reporting, only 5 percent of all investigational new drugs actually make it through the testing and approval process. If any of the drugs that MAPS and the Heffter Research Institute are studying ultimately get approved for therapeutic use, the organizations’ research will have to show positive results among hundreds of participants.

Conducting these larger "Phase 3" studies will cost millions of dollars. Unlike commercial pharmaceutical companies with deep pockets, MAPS and the Heffter Research Institute are privately funded, acting, essentially, as nonprofit pharmaceutical companies. The drugs they’re studying have patents that have expired, making them of little interest to Big Pharma. Anybody could ostensibly make generic versions of them, driving down price and potential earnings.

Raising millions more from the public to continue this research won’t be easy, particularly because at least in the case of the Heffter Institute, psychedelic research operated under the radar for years. Dr. David E. Nichols, president and co-founder of the Heffter Research Institute says that his organization tried to keep its work on the down-low because it was widely considered controversial. Take the research around psilocybin and people with terminal illnesses, for example: "There are a lot of taboos about how people die," says Nichols. But when Nichols describes the effects the drug can have on people dying of cancer, he presents a moving case that would be hard for anybody to ignore.

"We had one woman say, ‘I realized how precious the people are around me — and I want to enjoy them while I still have time here,’" says Nichols, referring to a cancer patient who took psilocybin in his study and is now deceased. "She said that it changed her completely, and she was able to embrace the life she had left, and it should be there as an option for people to do if they want."

Nichols believes that, culturally, we’re getting closer to that reality. "Young people are more accepting of things formerly viewed as social ills, like same-sex marriage and certain illegal drugs," he says.

"The people who thought psychedelics were dangerous drugs are getting old and dying off," says Nichols. "It may be that when future generations approach that time of life, they’ll do so with an open mind, and regulations may follow."

 
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mr peabody

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Riccardo Vitale


This war zone anthropologist used ayahuasca to heal his PTSD

by Ocean Malandra | reset.me

“What lives in my head is an abnormally long horror film about the monstrosities of the human race,” says anthropologist Riccardo Vitale, Ph.D. After two decades of working in some of the most violent and war torn regions of the world, as an advisor and researcher for large international aid and development agencies, he found himself struggling with a serious case of post-traumatic stress disorder (PTSD).

PTSD is a condition that develops after exposure to a traumatic event. Although it is closely associated with war veterans who witness and experience horrific and violent acts on the battlefield, it is also common among women who have been physically or sexually assaulted and those who go through terrifying and life threatening events, like Riccardo.

“In Mexico I did participant/observation research and worked with human rights organizations documenting abuses against indigenous peasants,” Riccardo tells Reset. “Most of this time I lived with indigenous Tzeltal, Chol, Tojolabal and Tzotzil communities."

“In 1996, after receiving some death threats, I was told to leave the country for my own security,”
he continues. “And I did, but I came back two months later.”

A year after he was warned to leave Mexico, Riccardo was abducted in broad daylight.

“As I walked near the Zocalo, in the middle of the day, someone approached me and said my name,” he tells us. “An car appeared and I was pushed in as the vehicle drove away. I was kept for about a day inside an old, beaten, unmarked car in the middle of a field in a rural area near Tuxla Gutierrez, the capital of the State of Chiapas.”

Although Riccardo was released the next day and forced to fly out of the country, his kidnapping and deportation coincided with a massacre of forty-five indigenous Tzotzil as they celebrated mass in a small chapel.

“As a young, enthusiastic, budding anthropologist I identified strongly with the indigenous people of Chiapas. The massacre and the deportation devastated me emotionally,” Riccardo explains.

“Because of Acteal (the village where the massacre took place) I stopped celebrating Christmas and New Year’s for more than seven consecutive years. I actively avoided family, people, and festive gatherings. I spent many Christmases and New Year’s locked in hotel rooms or alone in Cambridge working on my PhD.”

According to the Sidran Institute, an international non-profit that helps people understand and treat PTSD, sufferers may feel emotionally detached, withdraw from friends and family, and lose interest in everyday activities. They can also become very irritable and prone to anger.

“I became very uncompromising with myself and with others. Rigorous in my work, but also inflexible, belligerent, and temperamental,” Riccardo says. “Anger and poor mental hygiene were issues.”

Numerous studies have shown that the trauma and extreme stress that triggers PTSD actually causes brain changes and even brain damage, meaning that the emotional symptoms of the disorder have physical dimensions and it is not simply something that people can snap out of. In fact, most people with PTSD suffer for years as psychologists still struggle to manage the disease.

For Riccardo, however, the experience in Mexico was just the beginning. After the deportation and massacre in Mexico, he soon found himself right back in the hot zone again.

“Towards the end of my Ph.D. I did some work with refugees along the Iraqi borders,” he tells us. “In two different trips I had to witness some atrocious episodes and scenes. I can’t talk about these experiences out of decency, out of respect for the victims, and out of pain. The images are just too horrible and sad to convey.”

These events only served to worsen Riccardo’s PTSD symptoms.

“The relationship with my family deteriorated. I couldn’t relate to anyone anymore,” he says. “I was only interested in human rights and social causes. I stopped all hobbies. The concept of vacation was foreign to me. My life-long passions for skying, sailing, and scuba diving went to sleep."

“When my grandfather and then my grandmother died, I felt so estranged from family that I didn’t even think about catching a short flight to attend their funerals. This is something I will always regret.”


For the next ten years Riccardo worked for various human rights organizations in Colombia, often on the front lines of conflict, advocating for the victims of the half century of violence that has rocked this incredibly bio-diverse but tragic land. During a break between consulting jobs, Ricardo was traveling along the southern Putumayo River, when he encountered the Amazonian medicine known as yage or ayahuasca.

“I had traveled several hours south in the Putumayo River — this is a definite no-go area of Colombia,” he tells us. “Whilst in navigation, I spotted some Red Cross boats flashing their huge identifying flags. Great, I thought, I’m freelancing in a war zone without any assignment. I got that familiar, stomach churning, alert, alert, adrenaline boosting feeling."

“A couple of days later, at the old man’s wooden hut, in a remote area on the Ecuadorian side of the river, I was served a large chalice filled with a large portion of yage. A few small candles dimly lit the room. The old man and I were the only two people present."

"Just as I gulped down a first portion of the brew, a mortar went off in the distance, the sky lit up for a short moment. Then for a few seconds we heard gunfire. ‘It’s far away in Colombia,’ muttered the old man as he smiled compassionately."

“As the loud concert of the tropical forest reclaimed the night, I thought: ‘There is a reason why I am here and closed my eyes to wait for yage to start its work.’”


A highly hallucinogenic tea made from mixing N,N-Dimethyltryptamine (DMT) containing leaves with a particular rainforest vine, yage has been used since time immemorial by a large number of different indigenous societies across the Amazon. They consider it to be a sacred medicine that heals at a deep spiritual level. But the process is often quite intense.

“The famous ayahuasca purges, the diarrhea and vomiting, were just minor nuisances — a relief in fact — compared to other physical, spiritual, and mental hurdles that these experiences posed,” Riccardo recalls. “I felt so miserable that I wished I would die. I saw a huge red octopus-like creature convulsing inside my body. It was terrifying.”

But that ‘red octopus’ experience was a turning point for Riccardo, as the darkest ayahuasca ceremonies often turn out to be the most cathartic.

“I feel that yage continues to work in the weeks and months following the ceremonies,” Riccardo tells us. “The integration period is quite long. Only about six or seven months after my last ritual in 2015, I became aware of substantial and profound changes in my personality."

“At the end of 2015, after almost two decades of conflictive relations, I told each member of my family how much I loved them. I also said that I had forgiven myself for all of my mistakes and forgiven the mistakes of anyone else in my family.”


The profound healing power of ayahuasca, which often takes the participant into deep emotional places and forces them to re-live memories, is something that is creating a momentum of advocacy for its use to deal with modern day health crisis’s — like addiction and PTSD.

“The numerous anecdotal accounts of people reporting that ayahuasca experiences helped them overcome their PTSD justify a scientific study,” Rick Doblin, the founder and executive director of the Multidisciplinary Association for Psychedelic Studies (MAPS), tells Reset.

MAPS has initiated several important studies that prove that psychedelics are perhaps the most powerful treatment options available for certain disorders, including the first North American observational study of the safety and long-term effectiveness of ayahuasca treatment for addiction and dependence.

They also recently published a bulletin on how PTSD affects the memory functioning of the human brain, and how ayahuasca can be used as treatment for the disorder.

“In the psychotherapy of the future, it’s possible that people with PTSD will be treated with a several month process of psychotherapy including a series of psychedelic-assisted psychotherapy sessions, some with MDMA and others with more classic psychedelics like ayahuasca, LSD, ibogaine, mescaline, or psilocybin, along with the option of marijuana,” says Doblin. “The long-term goal would be to enable people to function without symptoms of PTSD and without the need for any further medications.”

For Riccardo, working with ayahuasca over the last two years has continued to pay off. He feels that the PTSD has been resolved and that dramatic change and real healing have taken place in his life.

“In 2016, the ceremonies brought me some very different experiences,” he says. “The utter agony was gone. There was some pain, but eventually that also changed. I realized that I’m on a learning path. Yage is showing me a way. It’s an interesting, significant, yet difficult and slow learning process. The ceremonies of 2016 focused on the equilibrium between matter and spirit; self control and the power of the mind over matter."

“I have learned to process adversities and obstacles, even daily minor ones, as learning opportunities that you can resolve with clarity and grace.”


Riccardo now makes his home in Colombia, and has developed deep relationships with several indigenous communities in the Putumayo area.

“An Inga friend, an experienced yage drinker, told me that the medicine dismembers your defenses and your ego. It takes you apart. Until you are a nothing but pieces of disconnected raw material. Everything is there though, all the hurt, the pain, the joy. At this point your task is to reassemble everything. To rebuild yourself,” Ricardo explains.

And rebuilding his life is now what occupies Riccardo’s time. Although he continues to do advocacy and research work on human rights issues here in Colombia, he has also teamed up with a handful of anthropologists and human rights professionals to create an anthropology-based organization in partnership with local Inga communities and the Union of Traditional Indigenous Yage Medics of the Colombian Amazon (UMIYAC). Together they aim to assist indigenous communities that are experimenting with alternative development models based on cultural exchanges, small scale farming, and traditional healing practices.

“Now we are marketing, raising more necessary funds and organizing a crowd-funding campaign for an Amazonian Center for Ancestral and Spiritual Plant Knowledge and Education,” Riccardo tells us. “This is a community-based initiative. It’s an educational hub were youth from the Amazonian basin can learn and practice ancestral medicine from elderly healers. This is a key issue, because every year that goes by we are losing a huge patrimony of autochthonous knowledge about plants and healing.”

This indigenous knowledge may be the key to not just preserving traditional ayahuasca practices, but the very world we live in as well.

“We have adopted a development model that is unsustainable,” says Riccardo. “We are stressing the ecosystem. Indigenous people are on the front line of extractive economy. They see their forests and rivers dying because of unscrupulous, aggressive mining, logging, oil perforations, flooding, droughts, cattle ranching or mono-crop cultivations of eucalyptus, soya, and African palm."

“Concerned about these environmental catastrophes, indigenous spokespeople are proposing an alternative development model based on their millenarian experience, their philosophy, their cosmology, and their spirituality. We should listen and incorporate this vision into all development models.”


In the end, this is the same message that ayahausca is delivering to us. The damage that we are wreaking on the earth is also the same damage we are inflicting on ourselves as manifested in war and ensuing mental illnesses like PTSD. The incredible medicinal power of ayahuasca is not that it is a magic cure-all, but a teacher that points us towards another way of being.

“I don’t believe in panaceas,” says Riccardo. “If the world is experiencing a psychological fallout, we need to work on structural changes. Happiness is not about finding the perfect medicine; it’s about resetting our value system and the implementation of social and environmental reforms."

“Love and compassion should replace profit as the driving force of development. This however is not going to occur as long as our quintessential spirituality is kept dormant.”


In other words, in order to save the world, to save ourselves, maybe we should all go native.

http://reset.me/story/this-war-zone-...heal-his-ptsd/
 
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mr peabody

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Study finds 'frozen' fear response may underlie PTSD

by Bill Snyder | Medical Xpress | Dec 4 2019

Learned fear responses enable animals—including humans—to flee or freeze in the face of a perceived threat. But if these behaviors persist after the danger lifts, they can become paralyzing and disabling. That's a key element of posttraumatic stress disorder (PTSD).

To explore how fear becomes entrenched, researchers at Vanderbilt University Medical Center have traveled down the precise neuronal pathways in the brains of mice that trigger fear responses, and which normally extinguish the behaviors once the danger has passed.

This scientific journey, detailed recently in Nature Neuroscience, challenges conventional wisdom about how the brain is "remodeled" in response to the intrusion—and subsequent removal—of fear-inducing stimuli.

It's widely assumed that the brain's advanced seat of cognition, the cerebral cortex, decides how to respond to a threat and its order "filters down" to a more primitive part of the brain, the central amygdala, where the flee-or-freeze response is executed and terminated.

But the Vanderbilt scientists found something unexpected: initiation and termination of learned freezing responses occur in cortical parts of the amygdala via a flexible remodeling of excitation onto two distinct subtypes of central amygdala "output channels."

It is here that the animal learns to fear certain stimuli through one neuronal channel and "unlearns" the fear through the other channel once the threat is gone.

"You don't want too much thinking going on" in the face of danger, explained Sachin Patel, MD, Ph.D., the paper's corresponding author and director of the Division of General Psychiatry at Vanderbilt.

"You want very distinct outputs to happen independently so the animal can choose very quickly—should I freeze, run or just go about my business? That's part of the novelty here."

"There's a lot of learning-related plasticity and remodeling in the brain that's occurring at some of these more 'primitive' central amygdala synapses rather than just within the cortical-like areas,"
he said.

How might this knowledge apply to the human condition?

People who have been exposed to stress or trauma can form associations between environmental cues and the fear that their lives are in danger. If the association persists after the threat is gone and the environmental cues continue to trigger anxiety and fear, that can lead to PTSD.

"It's like they're stuck on the freezing channel and can't flip back to the … normal behavior channel," said Patel, also the James G. Blakemore Professor of Psychiatry and professor of Molecular Physiology and Biophysics and Pharmacology. "That's a theory (but) it might be related to some sort of deficit in this synaptic flexibility mechanism we've discovered."

Currently PTSD is treated by gradually exposing patients to the environmental cues that trigger their fear responses to help their brains "re-learn" to extinguish the behaviors. But exposure therapy is intense. Some patients can't tolerate the anxiety it can cause.

The next step for the researchers is to look for receptors or proteins expressed by cells in one channel but not in the other. "That would provide opportunities to pharmacologically manipulate the dynamic switching between those channels," Patel said.

"It's not so far-fetched and people are doing it" he added. "If we knew that they had a different molecular composition, maybe there's a way that we could inhibit the 'freezing' channel, the fear channel, and promote the other channel."

Patel said the knowledge gained about the fear response may advance understanding of other brain disorders including drug and alcohol abuse.

"Addiction in part is driven by aberrant learning … cues triggering drug seeking and relapse," he said. "We know the amygdala is important in both fear-learning as well as making associations between rewarding effects of drugs and environmental cues. A lot of the same mechanisms might be at play."

 
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mr peabody

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Patients may soon have 'expanded access' to MDMA—even before the FDA approves it*

by Stephie Grob Plante | DOUBLE BLIND | Dec 23 2019

MDMA-assisted therapy trials for PTSD may still be underway, but we’re already seeing efforts to expand access outside a research setting for those who are seeking treatment. In the next calendar year, Somatic Center Portland in Oregon plans to open the doors of a brand new MDMA-Assisted Therapy Center—slated to be the first ever of its kind. Six therapists (including licensed professional counselors, a psychologist, a marriage and family therapist, and a licensed clinical social worker) are on deck to treat folks suffering from PTSD throughout the duration of an unprecedented program sponsored by the for-profit wing of MAPS. MAPS is comprised of both a nonprofit entity, which conducts research, as well as a Public-Benefit Corp (PBC), which trains therapists, sponsors research sites, and submitted the protocol to the FDA for expanded access to MDMA.

This new center would be the first time, since MDMA became a Schedule I drug in 1985, that patients would be able to receive legal MDMA-assisted therapy outside of a research environment. “We want to get this treatment to as many people as quickly as possible,” says Brad Burge, director of strategic communications at MAPS. “And expanded access is a way to do that.”

Expanded access, also known as “compassionate use,” is a term defined by the FDA as a “pathway” for patients with serious or life-threatening conditions to gain access to investigational drugs outside of clinical trials, when no other treatment options are available or have worked. In the case of MDMA, MAPS requested that the FDA approve expanded access to treat PTSD, for which there is no reliably effective treatment option. The FDA established expanded access in 1978, after community college instructor Robert C. Randall sued the US government over the right to treat his aggressive and worsening glaucoma with marijuana. This would be a regulatory first for psychedelic medicines, to be sure; but it would also be the first time for any drug-assisted therapy to achieve expanded access, at all.

As such, this approval would come at the end of a monthslong back-and-forth process between MAPS PBC and the FDA. It also follows nearly three decades of negotiations over each step of the MDMA research process. Those efforts landed a major win back in 2017 when the FDA labeled MDMA-assisted psychotherapy for PTSD a “Breakthrough Therapy,” which is meant to expedite drug development for potentially life threatening conditions (that includes the threat of suicide, in the case of PTSD). If expanded access is secured, MAPS would sponsor approximately nine more expanded access sites to follow Somatic Center Portland’s lead. Each of the ten sites would be independently funded (“sponsorship” in this case means that the FDA approval MAPS’ will have secured would extend to the sites that the organization handpicks for the program).

The demand is strong. More than 50,000 people have subscribed to MAPS for updates on clinical trials and expanded access, says Burge. At Somatic Center Portland, as well as the nine other treatment centers that MAPS would “sponsor,” patients must first fit the criteria for PTSD based on CAPS—the Clinician Administered PTSD Scale—which is a structured diagnostic interview that’s become the “gold standard” in analyzing PTSD. Once they’re screened and evaluated, says Somatic Center Portland’s founder Timothy Crespi, patients would then participate in several preparation sessions ahead of their MDMA-assisted psychotherapy sessions. After each MDMA-facilitated session, patients would process their experience during an integration session, where there would be no MDMA administered. Finally, Crespi plans for the program to include several more integration sessions on the backend after the active MDMA-facilitated sessions are complete.

Therapists must complete MAPS’s MDMA Therapy Training Program, and facilities must adhere to MAPS PBC’s (and the FDA’s) site specifications. For instance, participating treatment centers must maintain a secure drug storage room, have an overnight plan for patients who might need to stay after hours, and obtain a DEA Schedule I license (which requires that the site have a DEA Schedule I license holder, who’s often an MD).

It won’t be cheap. Insurance doesn’t cover MDMA-assisted therapy. The treatment, for now, would be entirely out-of-pocket. Crespi, a licensed counselor specializing in PTSD, estimates that the protocol would cost patients around $15,000. Crespi acknowledges that this therapy would require a huge lump sum upfront, which is why Somatic Center hosted a fundraiser in November to offset costs for those who can’t afford it. The event raised $55,000 for the program in a single night, a to-be-determined portion of which will be allocated to scholarships.

In the context of an entire lifespan, during which someone might grapple with such a debilitating condition, Crespi says he feels that the high price tag isn’t quite so high, after all. “When you compare that [$15,000] to what it costs the average person with severe PTSD over many years of treatment, it’s a drop in the bucket,” he says. “We’re offering a potential cure for PTSD, so it’s worthy of going forward, by far.”

*From the article here:

 
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polojr2

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How psychedelics saved my life: My experience with anxiety and PTSD

I was drawn to journalism at a young age by the desire to provide a voice for the ‘little guy’. For nearly a decade working as a CNN investigative correspondent and independent journalist, I became a mouthpiece for the oppressed, the victimized, the marginalized. My path of submersion journalism brought me closest to the plight of my sources, by re-living the story to get a true understanding of what was happening.

After several years of reporting, I realized an unfortunate consequence of my style - I had immersed myself too deeply in the trauma and suffering of the people I’d interviewed. I began to have trouble sleeping as their faces appeared in my darkest dreams. I spent too long absorbed in a world of despair and my inability to deflect it allowed the trauma of others to settle inside my mind and being. Combine that with several violent experiences while working in the field and I was at my worst. A life spent reporting on the edge had led me to the brink of my own sanity.

Because I could not find a way to process my anguish, it grew into a monster, manifesting itself in a constant state of anxiety, short-term memory loss and sleeplessness. Heart palpitations made me feel like I was knocking on death’s door.

Why I chose psychedelic medicines

Prescription medications and antidepressants serve a purpose, but I knew they weren't for me. I first heard of the healing powers of psychedelics as a guest on the Joe Rogan Experience podcast. Joe told me that psychedelic mushrooms transformed his life and had the potential to change the course of humanity for the better. My initial reaction was one of amusement and somewhat disbelief, but the seed was planted.

Psychedelics were an odd choice for someone like me. I grew up in the Midwest and was fed 30 years of propaganda about how bad these substances were. You can imagine my surprise when, after the Rogan podcast, I found so many articles and studies on the prodigious medicinal effects of these substances… and the examples of how we’ve been misled by authorities who classify psychedelics as Schedule 1 narcotics with ‘no medicinal value’ despite dozens of scientific studies proving otherwise.

Tripping Around the World

Having only ever smoked the odd marijuana joint in college, in March 2013 I found myself boarding a plane to Iquitos, Peru to try one of the most powerful psychedelics on earth. I ditched my car at the airport, packed my belongings in a backpack and headed down to the Amazon jungle placing my blind faith in a substance that a week earlier I could hardly pronounce: Ayahuasca.

Ayahuasca is a medicinal tea that contains the psychedelic compound dimethyltryptamine, or DMT. The brew is rapidly spreading around the world after numerous anecdotes have shown the brew has the power to cure anxiety, PTSD,depression, unexplained pain, and numerous physical and mental health ailments. Studies of long-term ayahuasca drinkers show they are less likely to face addictions and have elevated levels of serotonin, the neurotransmitter responsible for happiness.

If I had any reservations, doubts, or disbeliefs, they were quickly expelled shortly after my first ayahuasca experience. The foul-tasting tea vibrated through my veins and into my brain as the medicine scanned my body. My field of vision became engulfed with colors and geometric patterns. Then I saw a vision of a brick wall. The word ‘anxiety’ was spray painted in large letters on the wall. “You must heal your anxiety,” the medicine whispered. I entered a dream-like state where traumatic memories were finally dislodged from my subconscious.

It was as if I was viewing a film of my entire life, not as the emotional me, but as an objective observer. The vividly introspective movie played in my mind as I relived my most painful scenes - my parents divorce when I was just 4 years-old, past relationships, being shot at by police while photographing a protest in Anaheim, and crushed underneath a crowd while photographing a protest in Chicago. Ayahuasca enabled me to reprocess these events, detaching the fear and emotion from the memories. The experience was akin to ten years of therapy in one eight-hour ayahuasca session.

But the experience was terrifying at times. Ayahuasca is not for everyone - you have to be willing to revisit some very dark places and surrender to the uncontrollable, fierce flow of the medicine. Ayahuasca also causes violent vomiting and diarrhea, which shamans call “getting well” because you are purging trauma from your body.

After seven ayahuasca sessions in the jungles of Peru, the fog that engulfed my mind lifted. I was able to sleep again and noticed improvements in my memory and less anxiety. I yearned to absorb as much knowledge as possible about these medicines and spent the next year traveling the world in search of more healers, teachers and experiences through submersion journalism.

I was drawn to try psilocybin mushrooms after reading how they reduced anxiety in terminal cancer patients. The ayahuasca showed me my main ailment was anxiety, and I knew I still had work to do to fix it. Psilocybin mushrooms are not neurotoxic, nonaddictive, and studies show they reduce anxiety, depression, and even lead to neurogenesis, or the regrowth of brain cells. Why would governments worldwide keep such a profound fungi out of the reach of their people?

After Peru, I visited curanderas, or healers, in Oaxaca, Mexico. The Mazatecs have used psilocybin mushrooms as a sacrament and medicinally for hundreds of years. Curandera Dona Augustine served me a leaf full of mushrooms during a beautiful ceremony before a Catholic alter. As she sang thousand year-old songs, I watched the sunset over the mountainous landscape in Oaxaca and a deep sense of connectivity washed over my whole being. The innate beauty had me at a loss for words; a sudden outpouring of emotion had me in tears. I cried through the night and with each tear a small part of my trauma trickled down my cheek and dissolved onto the forest floor, freeing me from its toxic energy.

Perhaps most astounding, the mushrooms silenced the self-critical part of my mind long enough for me to reprocess memories without fear or emotion. The mushrooms enabled me to remember one of the most terrifying moments of my career: when I was detained at gunpoint in Bahrain while filming a documentary for CNN. I had lost any detailed recollection of the day when masked men pointed guns at our heads and forced my crew and I onto the ground. For a good half an hour, I did not know whether we were going to survive.

I spent many sleepless nights desperately searching for memories of that day, but they were locked in my subconscious. I knew the memories still haunted me because anytime I would see PTSD ‘triggers’, such as loud noises, helicopters, soldiers, or guns, a rush of anxiety and panic would flood my body.

The psilocybin was the key to unlock the trauma, enabling me to relive the detainment moment to moment, from outside of my body, as an emotionless, objective observer. I peered into the CNN van and saw my former self sitting in the backseat, loud helicopters overhead. My producer Taryn was sitting to the right of me frantically trying to close the van door as we tried to make an escape. I heard Taryn scream “guns!” as armed masked men jumped out of security vehicles surrounding the van. I frantically dug through a backpack on the floor, grabbing my CNN ID card and jumping out of the van. I saw myself land on the ground in child’s pose, and I watched as I threw my hand with the CNN badge in the air above my head yelling “CNN, CNN, don’t shoot!!”

I saw the pain in my face as security forces threw human rights activist and dear friend Nabeel Rajab against a security car and began to harass him. I saw the terror in my face as I glanced down at my shirt, arms in the air, praying the video cards concealed on my body wouldn’t fall onto the ground.

As I relived each moment of the detainment, I re-processed each memory, moving it from the “fear” folder to its new permanent home, the “safe” folder in my brain’s hard drive. Five ceremonies with psilocybin mushrooms cured me of my anxiety and PTSD symptoms. The butterflies that had a constant home in my stomach have flown away.

Psychedelics are not the be-all and end-all. For me, they were the key that opened the door to healing. I still have to work to maintain the healing with the use of floatation tanks, meditation, and yoga. For psychedelics to be effective, it’s essential they are taken with the right mindset in a quiet, relaxed setting conducive to healing, and that all potential prescription drug interactions are carefully researched. Ayahuasca can be fatal if mixed with prescription antidepressants.

I am blessed with an inquisitive nature and a stubbornness to always question authority. Had I opted for the doctor’s script and resigned myself in the hope that things would just get better, I never would have discovered the outer reaches of my mind and heart, and I might still be in the midst of my battle with PTSD.

https://www.sociedelic.com/how-psych...saved-my-life/
So incredible,,,thank you for sharing,,,
 

Captain.Heroin

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Everyday use of mdma is rediculous which makes it impossible as a medicine for PTSD. I suffer from it and it helps in the greatest way while on it but mdma can't be used so very often or you will hit depression and possible other negative side-effects.
MDMA, s-ket do not help.

Occasional 2c-_ would but haven't had in like 10 years. WHY ARE THEY NOT DOING PTSD trials for 2c-_ chemicals? That's the only thing that made me feel like life was worth living again in a joyous, all-positive rounded optimistic way.

Of course IV DMT does it too, but it feels like you're dying and is super scary and could seriously mess up people not ready for something that intense.

Ugh.

MDMA, s-ket are not the answer IMO. You can't take them often enough to keep up w/ symptoms.

Stuff like LSD or 2c-_ would be better.
 

Aeon Psyche

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I agree, wait what IV DMT? Ok, whatever floats your boat. Psychedelics are great in resolving trauma. Anything but ayahuasca. That straight sended all my traumas towards me, pushing them so I would overcome them but my past is just to painfull. I actually just watched porn for a few hours to pass the time.
 

MountainTrails

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Study finds potential new treatment for preventing Post Traumatic Stress Disorder (PTSD)

Research led by the Centre for Addiction and Mental Health (CAMH) published in the Journal of Clinical Investigation
points to a groundbreaking discovery about a new potential treatment and prevention for post-traumatic stress disorder (PTSD).

The research team, led by Dr. Fang Liu, Senior Scientist and Head of Molecular Neuroscience in CAMH’s Campbell Family Mental Health Research Institute, and Professor and Co-director of Division of Neuroscience and Clinical Translation, Department of Psychiatry at the University of Toronto, recently identified a protein complex that is elevated in PTSD patients. The researchers also developed a peptide to target and disrupt the protein complex. They found that the peptide prevented recall or encoding of fear memories in early tests. This suggests that the peptide could treat PTSD symptoms or prevent them entirely.

“The discovery of the Glucocorticoid Receptor-FKBP51 protein complex provides a new understanding of molecular mechanisms underlying PTSD,” said Dr. Liu. “We believe this protein complex normally increases after severe stress, but in most cases, levels soon go back to baseline levels. However, in those who develop PTSD, the protein complex remains persistently elevated, and so this could be a blood-based biomarker for PTSD as well as being a target for pharmacological treatment. In addition, the peptide we developed could be given after a traumatic event, and could possibly prevent the patient from developing PTSD. This is a completely new approach to PTSD and for psychiatric disorders in general.”

PTSD occurs in some people after experiencing or witnessing traumatic events, such as sexual assault or military combat. Patients can suffer from debilitating flashbacks, nightmares and anxiety which can severely impact quality of life. There are currently no laboratory diagnostic tests for PTSD, and existing treatments have limited efficacy. According to a recent study published in the British Journal of Psychiatry, Canada has the highest prevalence of PTSD among 24 examined countries, and 9.2 per cent of Canadians will develop PTSD in their lifetimes.

“We are thrilled this CAMH-led discovery can potentially help millions of people put trauma behind them,” added Dr. Liu.

The study has been supported by CIHR and the CAMH Discovery Fund. CAMH has filed a patent for the peptide and diagnostic aspect of Dr. Liu’s invention. Dr. Liu and her team will conduct further testing and refining of the peptide before conducting human clinical trials.
 

mr peabody

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How ibogaine is helping former Special Op soldiers with TBI and PTSD

by Wesley Thoricatha | psychedelic Times | 28 Jan 2020

In this continuation of our first conversation with Marcus and Amber Capone of VETS, we discuss ways that traumatic brain injury (TBI) can overlap and complicate post-traumatic stress disorder (PTSD), and how the psychedelic root bark iboga and it’s derivative ibogaine can treat both disorders. Marcus is a former SEAL Team operator who exhausted every conventional treatment for depression, PTSD and TBI before finding lasting healing with ibogaine and 5-MeO-DMT. You can read the first part of our interview with Marcus and Amber here.

Marcus and Amber, thank you again so much for speaking with us. One of the things I love about your story is that it’s the story of both of you. The majority of the time when you hear about veterans healing from PTSD, it’s all about the veteran themselves, but of course behind every vet there are families and loved ones who also carry incredible burdens.

One thing I’m curious about is how your community is responding to the work you are doing with VETS and helping people find psychedelic treatments. How do the veterans and Special Forces guys react? And Amber, how do the wives and families react?


Amber: There is an unprecedented level of trust in the SEAL community, so this has taken on a life of its own due to the growing number of guys who’ve had profoundly positive results.

That being said, at first some people can be skeptical and may say, “Oh that’s not for me.” I say to those who are hesitant, “I hope you’re never at a point where you are so desperate that you will consider anything, but if you find yourself there, we can help.” That’s where I eventually found myself… willing to consider anything to save my marriage, my husband and my family – which required me to think outside the box.

Marcus: Former Special Operations veterans I’ve worked with are all across the board when they hear about this kind of treatment. Some guys are scared to death; others are extremely excited because they’ve found out how many individuals are actually having positive outcomes. They say, “Wait there’s something out there that really works? Sign me up!” Others give it careful thought over a long period of time and try many other things before deciding to pursue this path. These treatments are not risk free, so careful consideration is necessary before making a final decision.

There are around 16 million people in the US with major depression, and close to a hundred million people worldwide. Individuals with brain injuries are spending millions of dollars on these brain clinics, and yes, a lot of people have successful results from them, but also a lot don’t get better—and it’s those individuals that are seeking out this treatment.

At the end of the day, if psychedelic-assisted therapy allows you to be a better person, be a better husband, and have a better relationship with your kids, then who’s going to argue that? Whether you have a brain injury, post-traumatic stress, or you’re depressed, or just an angry individual, these treatments work.

Amber: Marcus spent weeks at brain clinics which was so monotonous and, for him, ineffective. We were at a point where I felt like Marcus was a dead man walking. I told my parents that I believed he would be dead within two years if I left him because our family was the only stabilizing force in his life. Removing his last piece of identity and stability (us) would almost certainly push him over the edge. Whether he drank himself to death, committed suicide, or wrapped his truck around a pole from driving drunk, it just was bound to end badly. We were willing to try anything at that point because we felt that we were out of options.

Many other wives are in a similar position and don’t know what to do. It’s agonizing because you feel that you’re going to lose no matter what. I never wanted to leave Marcus, but at some point, I felt I had no other choice. There is a lot of pressure with that.

These women have already endured so much throughout their husband’s time in service. It’s unbelievably difficult… but they are also incredibly tough. I’ve tried to encourage spouses to have an open mind that these treatments could work—to give it a shot and be supportive, realizing that many of their husband’s struggles may currently be beyond his control due to TBI. If he is willing to commit to seeking treatment, clearly he wants to be better too, so this could be the beginning of something very positive!

Yeah, I’d love to hone in on the TBI element of all this, because the sound bite that most people hear is that vets come back suffering from PTSD, which then gets healed in this emotional release kind of way, particularly with MDMA-assisted psychotherapy. You guys talk a lot about TBI and how significant it was in your equation, so I’m curious if you can speak more on that.

Marcus: When we talk about head injuries, there is still a lot to be learned, especially with blast injury. I don’t believe that even the medical community fully understands how or why the various levels of severity and suffering exist. We do know, however, that TBI is the “signature injury” from OIF and OEF. We also know that other communities, particularly professional contact sports, are experiencing their own TBI epidemic. The coming years will be pivotal in understanding and addressing these increasing concerns.



Around 2008 I was getting really bad headaches and taking handfuls of ibuprofen, but I was still operating at the time. Later in 2011 or 2012, I realized something was not right. I started to get very impulsive and angry, and things were not lining up correctly. I remember talking to one of my colleagues and they strongly recommended that I seek out the SEAL psychologist; maybe he could provide me with some medicines that may help with whatever I was struggling with. So I tried this, and went through eight years of consistent SSRI use, and all kinds of other medications. Some worked for a short amount of time, some didn’t work at all, and others made me want to climb up a wall. They were just terrible. Later I went through multiple brain clinics, and the scans showed many signs of TBIs. What’s more concerning, however, is what can’t be seen on traditional imaging; the microscopic damage that isn’t yet detectable in the living.

Amber: One of the things I remember was that you went to a clinic and came back and said, “Today they found that I had trouble with memory and recollection, and balance and coordination.” And I’m like, what? You’re 38! You know, memory recollection, okay, I’ve seen that… But balance and coordination? To me, Marcus has always been this stellar athlete, the most capable human being I know… how can this be that he’s lacking balance and coordination? It wasn’t until Marcus’ friend’s brain autopsy came back showing blast injury that everything started to make sense. The other symptoms correlated, as well…

Before ibogaine, Marcus had gotten lost driving, he couldn’t remember people’s names, he would repeat things over and over, and he had horrible headaches, insomnia, rage, impulsivity, depression, vision changes, confusion, suicidality, you name it…. And his go-to coping mechanism was alcohol, which was like pouring gasoline on a fire. The ibogaine treatment worked on some deep psychological traumas, but it also it also really did a number on his brain. I’m no scientist, but I can tell you that something physiologically changed in his brain. For me, the most exciting thing that came out of Marcus’ ibogaine treatment was the return of his cognitive functioning. Obviously much more research needs to be done to support our observation of this, which we hope to raise funding for in the future. The other significant benefit was the cessation of his drinking, which has lasted for over two years now.

Marcus, you mentioned in our first interview that you had never done cannabis or any psychedelic before your ibogaine treatment. Ibogaine is a “big daddy” of a drug, and is known for sometimes being an extremely intense ordeal of a journey. What was your experience like under the effects of this entheogen?

Marcus: I’ve never had an ayahuasca treatment, but I’ve heard from others about how it can comfort you, and provide you with an easier journey to whatever you’re seeking. Ibogaine just backhands you. It’s a Mack truck running you over again and again; it’s like going to hell and back. Everyone’s experience is different, but for the majority of people, the deeper the hurt you’re dealing with, the harder the experience is going to be. It’s laughable that as a Schedule 1 drug in the US, Ibogaine is considered to have a “high likelihood for abuse.” Ibogaine is the most non-recreational medicine, and I can’t think of anyone in their right mind would ever want to use Ibogaine recreationally. I’d rather do just about anything than have another Ibogaine treatment.

When you have deep-rooted trauma and throw in some mild traumatic brain injury on top of it with a bunch of other war trauma and bad shit that’s happening in your life, it’s a recipe for an excruciating journey. I dealt with some shit that I really didn’t want to deal with again. Past emotions hanging out in my subconscious that were affecting my relationships with my wife, my kids, my friends and my parents. I dealt with them during this ibogaine experience because that’s exactly what the medicine does. During the Ibogaine experience, a psychotherapist sits at your side throughout the journey. Their job is to help create space and bring those deep-rooted traumas and hurts to the surface so they can be dealt with once and for all.

Regardless of the type or extent of these traumatic experiences, you’re probably going to deal with them on ibogaine for eight or ten or twelve hours. I mean, how bad does it suck that you have to relive these experiences again? But it’s a critical component to the healing.

Ibogaine is one of the hardest experiences I’ve ever been through. Many psychedelic-assisted therapy experiences are similarly described this way; but I feel they are likely some of the best therapies for veterans, and especially my teammates, because in order to truly deal the bad, dark trauma, you have to face the darkness that is impeding your livelihood head on. You need to go deep, and ibogaine takes you down. I mean, it takes you all the way down and then it brings you back. You come out of the experience feeling like, “Wow, there’s hope, and you know what? Life is not that bad.”

Think of an Ibogaine experience as a heavy backpack weighted down with rocks, and as your journey plays out in front of you literally like a movie, you face these demons; the backpack gets lighter because the rocks are being dumped out. It truly sets you free. Sometimes you’re crying, sometimes you’re screaming, but at the end you’re like, “Holy shit, I’m good! I feel great!” When Amber walked in after my experience was over, she just said this glow was around me, and it was like, “Oh wow, Marcus is back!”

Amber: It was crazy! When I walked into the room, I felt like it was as if we were in college again. His countenance was different, his eyes were different, his whole energy was different. I was in complete shock!

Marcus: I don’t want to confuse people and make everyone think that by taking a pill, one time, will cure them forever, though for many, including myself, Ibogaine and the 5-MEO combination can be the most profound experience of their lives. My coach/therapist reiterates to me on a regular basis, “Marcus, you’re going to have to deal with this deep-rooted crap, and put in the daily work to continue to get better." She’s says, “Your job is to now go help ten thousand others, or a hundred thousand, or a million other people. You’ve been cursed with the darkness, but you are now blessed with the light, and you have the ability to help save many others.” And I think what Amber and I are doing with VETS is right on par with that; it’s the coolest and most humbling thing imaginable.

Amber: This is a bigger movement than just Marcus and me; there’s something very special happening in the veteran community, and quite honestly, in our world. It’s exciting that there’s so much momentum behind psychedelic research, and that much of it is focused on treating and helping veterans. It also doesn’t end with the veteran… this impacts marriages, families, and generations to come.

Healing is happening on physiological, psychological, and spiritual levels… bondages are being broken, lives are being saved, and families are being reunited. It’s absolutely the most incredible thing we’ve ever been a part of; giving back to this amazing community that has given us so much is humbling beyond words, and is proving to be worth every day of struggle we endured.

 

Painful One

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I find the PTSD situation particularly heartbreaking and I think the way it is being handled in the Western countries with a particular catastrophe with it from all of the imperialist wars and maybe very well from some domestic things is an abomination. The best of the best volunteer for a nearly impossible job and do it professionally even if politicians are being completely ignorant and insane about what they have to do, and then they come home with this rock to push up the mountain.

I am glad to see that there is some research on peri-exposure chemoprophylaxis protocols to make it less likely. Quite some time ago I figured that some combinations of beta blockers, mild stimulants, and weak to midrange opioids with conservative doses of ketamine may do it, and I would not at all be surprised to hear MDMA helps before, during, and after.
Thanks for this information!

I have been looking for something to help one of my good friends @FutureReference
He is a veteran and is suffering chronic pain, PTSD, depression- terrible things.

@FutureReference have a look at this thread.
It has some great information in it.

@mr peabody has done an excellent job with cutting edge therapies that could help a lot of people who are really suffering!
Thank you @mr peabody , your efforts are much appreciated!

❤❤❤
 

Nicomorphinist

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Everywhere
Thanks for this information!

I have been looking for something to help one of my good friends @FutureReference
He is a veteran and is suffering chronic pain, PTSD, depression- terrible things.

@FutureReference have a look at this thread.
It has some great information in it.

@mr peabody has done an excellent job with cutting edge therapies that could help a lot of people who are really suffering!
Thank you @mr peabody , your efforts are much appreciated!

❤❤❤
Thank you very much -- I have updated that post for clarity as it seems about 135 words disappeared in different places somehow leading to three sentences merging into something I even I couldn't follow . . .
 

MountainTrails

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How using MDMA during therapy helps people heal from trauma
https://www.mic.com/p/how-using-mdma-during-therapy-helps-people-heal-from-trauma-21781407

By Suzannah Weiss
Feb 6, 2020

CJ Hardin, a 40-year-old avionics manager and aircraft mechanic in Charleston, SC, developed PTSD after serving in the military. This qualified him to participate in a study several years ago by the Multidisciplinary Association of Psychedelic Studies (MAPS), which used MDMA — commonly known as molly when used as a party drug — to aid in psychotherapy sessions.

Hardin underwent three eight-hour therapy sessions, which each involved two therapists, under 125 mg of MDMA. “I was able to access my feelings without fear and convey them to people who were not in my immediate circle,” he recalls. “[The MDMA] allowed me to talk about things that I wouldn't normally talk about, and it also allowed me to have the introspection to look back and determine the history of how I got to my condition and diagnosis. Once I was able to do that, the healing process seemed to happen without my assistance.”

Since then, he’s been able to get married and hold a full-time job that involves working with people, which he hadn’t considered possible before the treatment. “I had resigned myself to a life of numbing myself and communicating to the outside world via Facebook whenever I wasn't too anxious to open the page, which was often.”

Hardin is one of only a few people to have participated in this kind of trial, but soon, MDMA-assisted therapy will be available to more people. In January, the FDA announced that it was opening 10 sites across the country for 35 more people with treatment-resistant PTSD to receive MDMA-assisted psychotherapy through its Expanded Access program, which may grow to accommodate larger numbers of patients if the new motion yields positive results.



Marcela Ot'alora G., MAPS’s principal investigator for MDMA-Assisted Psychotherapy Research, is leading a phase III study — the last needed before applying for FDA approval — on MDMA-assisted psychotherapy as PTSD treatment. She tells Mic the typical process includes three MDMA-assisted therapy sessions (or placebo-assisted sessions so the researchers can see which benefits are attributable to the MDMA), as Hardin experienced, and three preparatory therapy sessions before and after each.

Participants are given the option to use headphones and eyeshades to focus on their internal experiences, and music is usually played throughout sessions. Ot'alora has seen patients develop greater trust in themselves and others, healthier coping strategies, and better understanding of who they are after undergoing this process.

These benefits may stem from MDMA’s ability to down-regulate activity in the amygdala, the brain region responsible for fear, so people are able to discuss and work through things that would previously trigger them, explains Bruce Poulter, a sub-investigator on MAPS’s MDMA-assisted psychotherapy studies. As a result, they can potentially develop better relationships to these memories. MDMA may also improve therapy sessions by fostering a sense of closeness between the therapist and the client.

While it may feel cutting-edge, this type of therapy has been happening since long before researchers began formally investigating it. People received an estimated 500,000 doses of MDMA in psychotherapy sessions in North America before the US criminalized it in 1985, according to a MAPS brochure on the topic, and it continues today underground. Anthony, a 29-year-old project manager in Denver who chose not to disclose his last name to avoid legal ramifications, underwent this kind of therapy with his husband last year. They first participated in four months of non-drug-assisted therapy with a licensed psychotherapist, then the therapist came to their home and did a day-long MDMA-assisted session with them.

Both of them delved into past traumas; Anthony recalls punching a pillow while expressing pent-up anger from childhood. “I recognized that my experiences had warped my perspectives on the world, but now, that warped lens was shattered,” he recalls. “It was one of the most liberating moments of my life.” Similar to Hardin, Anthony describes MDMA as allowing him to “waltz into the bank vault of [my] mind without setting off all the internal alarm bells and protections that are usually barricading the entrance.”



Even after the drug wore off, Anthony retained the emotional space it brought him into. “I got a very different view of my mind. In turn, I learned a very different way to interact with all the feelings and thoughts that come into it on a daily basis,” he says. “My neutral state is a lot calmer than it used to be, I interact with myself and others more mindfully, and I've started living a life more centered around my values and what is important to me instead of revolving my life and choices around the management of my own feelings.” Even though couples’ therapy wasn’t the intended purpose (sometimes it is), the session also brought Anthony closer to his husband.

Using MDMA is not without risks, recreationally or therapeutically. When patients relive painful memories under the drug, there’s a chance that they could be retraumatized, says Poulter. However, this problem is usually avoided with proper emotional support from therapists.

MDMA can also have negative physical side effects, including depression in the days following treatment due to depletion of the neurotransmitter serotonin. Telaroli describes feeling “less social and more introverted” in the weeks after his MDMA session and says 5 HTP supplements helped restabilize his mood.

Research on MDMA as therapy is still in its nascent stages but in the meantime, health experts are working to make it a reality for people who can benefit from it. MAPS has proposed that once the first 35 patients in the new program have received treatment, it will submit data to the FDA and seek approval to expand it. The organization is also wrapping up its phase III trials for MDMA-assisted psychotherapy, which could make this type of therapy a legal prescription treatment for PTSD if it yields positive results.

“I did feel a bit overwhelmed by the sheer volume of changes that started happening on their own in my life as I unpacked all that I had learned,” he says. “Continuing to go to therapy helped me stay centered and grow. I have continued to remind myself that I need to be gentle with myself and integrate changes slowly and lovingly, and so far, I’m happy to say that I’ve succeeded at doing so.”
 

mr peabody

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A guide to taking MDMA as safely as possible*

by Gavin Butler | 10 November 2019

Despite some 100 years of police, politicians, and lawmakers telling us drugs are bad, about half a million Australians will have willfully taken an ecstasy pill by the end of this year. On a purely survival basis, that may seem reckless—but there are good reasons why people take illicit substances. Drugs are usually euphoric, invigorating, and enlightening, as almost anyone who’s ever used them recreationally will attest.

Sometimes, though, they’re none of these things. Of the half a million Australians who will have taken ecstasy by the end of this year, thousands will likely be forced to seek emergency medical treatment. The causal factors for this are manifold, but they can often be traced back to a general lack of understanding around the contents of pills, their effects, and the safest way to take them. And that’s because, in the midst of the cacophanus shouting match around whether or not people should be allowed to take drugs, few authorities are bothering to properly educate users on how to minimise the risks.

So we remain at an impasse. People will continue to take drugs—blindly, for the most part—and many will subsequently run the risk of overdose, and even death. But if the authorities won’t provide information and tools for harm minimisation, we will.

Here’s how to take pills as safely as possible. Think of it as a guide to your night on the gear—along with some bonus tips to help you deal with that inevitable comedown.

Preparing for your night

There are typically two main factors to consider when looking at the contents of an ecstasy pill: purity and dose. Purity essentially refers to how much of your pill is actually MDMA (the active ingredient) and how much of it is something else—whether that be an innocuous cutting agent, a toxic contaminant, or some chemical that's a bit like MDMA but cheaper and/or more readily available. Dose refers to how potent the pill is, and thus determines how intense its effects are going to be. It’s the dose that makes the poison, according to an age-old adage of toxicology—which is to say that while cyanide can be harmless at small enough doses, even water can be poisonous if consumed in excess. It all depends on how much you’re having.

It’s therefore worth stressing that pure, unadulterated ecstasy will still kill you if you ingest too much. MDMA triggers a sharp rise in internal body temperature, and this can pose serious problems in the case of a particularly strong batch—especially if taken within certain circumstances, or in combination with other substances. We’ll talk about ways that you can mitigate these risks, but ideally you’ll have at least a semi-informed understanding of what it is you’re taking beforehand.

This starts at the point of sale. Just as you’d exercise due diligence to ensure that any food, drink, or general substance you’re about to put into your body isn’t going to make you sick, you should do the same with drugs.

Buying from someone you know and trust is ideal, though not always possible. If you’re getting the ecstasy in the form of a pressed pill, you can usually find info about your particular pill on Pill Reports and do your research on what to expect according to some user-generated reviews. Short of that, and in lieu of more official pill testing services, you can take matters into your own hands and test the pills at home with an over-the-counter reagent testing kit. You should be able to pick up one of these at your local pharmacy, tobacconist, or online for about $20 AUD.

These kits are essentially a litmus test for drugs, offering a rudimentary method of figuring out what a pill’s main ingredient is—whether it be ecstasy, meth, ketamine, or something else. Pour a little bit of your pill or powder onto a plate, remove the cap of the reagent bottle, squeeze a few drops of the substance (usually a combination of formaldehyde and sulfuric acid) onto the sample and wait to see what colour it changes to. By comparing this against the colour chart provided, you should be able to get some loose indication of the pill’s main ingredient.

To be clear though, reagent testing kits are not a bulletproof way of verifying whether your drugs are safe. As Monica Barratt, Senior Research Fellow at RMIT University’s Social and Global Studies Centre, told VICE in 2017: "it's a presumptive test. It's saying that an ecstasy-like substance is present, but it's not telling you necessarily what else is present… and the thing you can't really do is go for 'how many milligrams have I got.'"

Further to these three precautionary measures—buying from a reliable source; doing your research online; and using a reagent kit to get at least some idea of what’s in your pills—the next most effective way of knowing what you’re looking at is by taking a small amount of the drug in a safe, controlled environment with sober people or tripsitters you can trust. Take a crumb or one small hit of powder and really focus on what the effect is. If the drugs make you feel speedy, nauseous, anxious, hot, or uncomfortable in literally any way, you should reconsider taking them.

And finally, if you’re buying your MDMA in a crystal or powder form, then some extra precautions are probably called for. “Dipping” from the bag can be risky, as there’s little to no way of keeping track of how much you’re taking in each hit or how much you’ve already had. If you can, get your hands on some scales and some gelatin caps—the latter should also be going cheap at your local pharmacy—and prepare your own carefully measured doses. The standard dose of an MDMA cap is typically between 70 and 125 milligrams, but half-doses will give you more control over how high you’re getting, and how quickly.

Getting through the night

Of course, even when you feel that you have a fairly good idea about the effects of the drug you’re taking, you should remain diligent. MDMA, no matter how pure, can have different effects in different circumstances, and that adds some level of unpredictability.

Start by taking a small amount—maybe a half or quarter-dose—and see how it makes you feel. Most of the time it will kick in after about 45 minutes to an hour, but it’s best to wait at least an hour-and-half to be sure of the effects. Some of the more common adulterants that have been showing up in ecstasy pills recently have a delayed release and are slower to start, but hit much harder when they do—which can lead to serious problems for users who get impatient, thinking they’ve taken a weak pill, and then drop a very dangerous second dose.

Another factor worth considering is something called “dose-response”: that is, the relationship between the size of a drug dose and the effect it has on the user. Alcohol has a linear dose-response, meaning each standard drink has the same effect as the one that preceded it. This means two drinks will more or less make you twice as drunk as one drink, but half as drunk as four drinks, and so on. As Dr Barratt points out, though, this is not how MDMA works.

“MDMA is different to alcohol in that it doesn’t appear to have a completely linear dose response, which makes it difficult,” she told VICE over the phone. “Non-linear means if you add an extra 50 milligrams on top of 100 milligrams you’re not necessarily going to get 50 percent more.”

“There are also some people who can have a normal dose of MDMA but have much stronger effects,” s
he added. “Even if someone knows they’re having 100 milligrams, there are people out there for whom that dose would be too much."

“There’s something non-linear and a bit idiosyncratic about how MDMA affects people. We don’t know where the tipping point is for some people, so it’s not as simple as some other drugs in terms of dose-response.”


Hence, the most important thing to keep in mind when taking ecstasy is to always be circumspect. Take small doses. Be aware of what you’re feeling, and how much the drugs are affecting you. Always wait at least two hours before taking another dose. And never double-dunk.

There’s a good chance you already know this, but you should also avoid combining MDMA with other drugs. If you know you’re going to be mixing it with alcohol, don’t drink too much before your first dose, and make sure you keep track of how much you’re drinking while high. It’s unlikely that you’re going to get many of the positive effects out of alcohol once you’re rolling anyway, so if you’re only swigging the drinks out of habit then maybe just save your money. Beyond that, don’t add any other chemicals to the mix.

One of the ways MDMA can be fatal is by triggering a condition known as “serotonin syndrome”, where the body loses its ability to regulate heat. This is particularly worrisome in already hot settings, and so it’s important to keep tabs on how you’re travelling temperature-wise. If you’re feeling inordinately hot, you may be at risk of overdosing. Alex Wodak, a physician and former Director of the Alcohol and Drug Service at Sydney’s St Vincent's Hospital, suggests taking some time out to minimise the risk of this happening.

“Avoid overheating by spending 10 minutes every hour NOT dancing,” he told VICE via email. “If there is a cool, air-conditioned area, go there for 10 minutes every hour.”

Dehydration is also a risk, of course, but so too is overhydration. There is such as thing as drinking too much water, and this can lead to something called hyponatremia: a condition that arises from a low concentration of sodium in the blood and which has, in the past, led to MDMA-related deaths.

MDMA education website RollSafe suggests drinking about two glasses of fluid per hour if you’re dancing—ideally something with electrolytes in it, like Gatorade—and one glass per hour if you’re not. If you can’t get your hands on electrolytes, make sure you eat some salty foods. Typical symptoms of hyponatremia include nausea, vomiting, headaches, confusion, and fatigue.

In the event that something does go wrong—if you or someone close to you starts feeling or acting strange—seek help immediately. Call security, first aid, or venue staff and tell medical personnel what you or your friend have taken, as well as how much and how long ago. The more information the better. If your friend can’t stand up, place them on their side in the “recovery” position on their side. We really can’t stress this enough: do not be afraid to ask authorities for assistance.

The New South Wales coroner’s court heard this year that 19-year-old Alex Ross-King, who died at a music festival in January, started showing signs of distress several hours before she overdosed. “Alex told me a number of times, ‘I’m fucked up’ and ‘I’m hot,’” a friend said in their statement to the court, adding that they initially thought it was due to the sweltering conditions inside the festival. “I just felt like, oh, me too, I was the same.”

It was only when Ross-King was spotted by a nearby medical officer, after bumping into a group of people and falling over, that she was taken to the medical tent—with a body temperature of 41 degrees and a rapid and irregular pulse. She was transported to Westmead hospital shortly thereafter, arrived unconscious, and quickly went into cardiac arrest. After four hours of attempted resuscitation she was declared dead.

“Be aware of how you’re feeling, and seek medical treatment if you feel unwell,” says Dr Barratt. “That’s one of the biggest issues: people being afraid to seek treatment, or people saying ‘I’ll sleep it off’ or ‘I’ll ride it out.’ We know of people who have done that and they haven’t been able to get up again, and nobody’s gone to get medical help, and that’s been the end. That is a huge message: don’t be afraid to seek medical treatment.”

Surviving the next day

For most people, the hardest part of the trip is usually the aftermath: when the trace elements of the pill start to fizzle out, the serotonin reservoirs dry up like a parched creek bed, and the dreaded comedown rears its ugly head.

Try and get some relatively decent sleep—as naturally as you can in your state—and if possible drop a Berocca or two before you rest your weary head. When you do finally rise from the dead, make sure you reimburse your body for the punishment you’ve just inflicted upon it. Have a shower—a cold one, if you can manage it—and replenish yourself with some water and half-decent food. Dark fruits, nuts, and fatty, omega 3-heavy fish like salmon is ideal, but if we’re being honest you’re probably just ordering takeaway to your door anyway. That’s fine too—just as long as you’re eating something to try and fill the cold, dead hole that’s growing inside you. If you’re in no state to eat, try a smoothie or a light soup.

From there on it’s just a matter of waiting out the storm. Surround yourself with positive people, go easy on the physical exertion, and don’t watch, read, or listen to anything that could potentially topple your fragile emotional state. Also try to wait a little while before you take MDMA again—ideally at least three to five weeks. You’ll be better placed to maximise the benefits that way.

In summary:

- Buy the drugs from a reliable source: someone you know and/or trust
- Do your research: know what you’re taking
- Test for contaminants with a reagent kit and, if possible, sample the drugs first in a safe and controlled setting
- If possible, create your own carefully measured caps instead of consuming straight powder
- Don’t take pills alone (or any drugs, for that matter)
- Go slow; take a small amount first and see how you feel after about an hour to an hour-and-a-half
- Don’t redose until at least two hours after your last drop
- Never double drop
- Avoid combining MDMA with other substances
- Stay cool; take at least 10 minutes every hour to sit down and chill out
- Drink fluids, but not too much: between one and two cups every hour
- Be aware of how you’re feeling
- If things start going wrong or feeling uncomfortable, get security or first aid and tell them what drugs have been taken, how much, and how long ago
- Don't be afraid to ask for help
- Take care of yourself, and each other

*From the article here:

 

mr peabody

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War, morality, and MDMA: A conversation with an anonymous military psychologist

by Wesley Thoricatha | Psychedelic Times | 23 Apr 2019

In a continuation of our first interview with an anonymous military psychologist and MDMA therapy recipient, we look to the future implications of MDMA therapy in the military, and discuss the broader moral questions and imperatives raised by this kind of treatment for war veterans.

As we were discussing before, MDMA-assisted psychotherapy changed your life and cured your PTSD, and as a psychologist who works in suicide prevention and PTSD treatment, you are very excited about it becoming more widely available for therapeutic work. How would you like to see this treatment adopted by the military? Would it just be for people being discharged from the military, or for active duty service members as well?

One thing to clarify: the military does not actually discharge troops who have PTSD. You can be in the military and have a diagnosed mental health condition as long as it does not impair your ability to deploy and function on military deployment. I have quite a few troops who have a diagnosis of PTSD and remained in the military, and they are good at their jobs.

This may surprise you, but a lot of troops with PTSD from combat actually want to go back. They volunteer to go back to Iraq or Afghanistan in part because when you are deployed, everything makes more sense. For example, if you are aggressive and quick to react with violence in Afghanistan, they give you medals for that. But when you come home to the States, if you are aggressive and quick to react with violence they put you in jail. Being deployed actually makes more sense in this case, because in that role we tend to be prone to aggression and preemptively acting on concerns for threats.

One of the things about PTSD is the constant belief “I am not safe, I need to be able to protect myself at all times” and so we are constantly scanning crowds and surroundings for potential signs of danger or threat. Going downrange is actually something we want to do. I volunteered to go back because it made more sense. So a lot of my troops want to deploy, and they can do fine downrange— it’s just home station where they can’t do well. They struggle with their marriage, with civilians, with their job, and with the civilian world.

MDMA-assisted psychotherapy could be an option in the military, because the protocol that MAPS is using is only 90 days, and they are getting astounding results. We could do that in the military— we just remove you from being deployable for 90 days while we treat you, then most likely they would want to see you 90 days after that to see that you are stable. So we’re talking about 6 months total. That would be doable under the current system— you could get treatment, get better, and stay in.

This therapy could save the military a lot of money in terms of needing to recruit new people, because when we train people, particularly for certain jobs like special forces, you’re spending a lot of money. With some special ops positions it takes half a million dollars to recruit and train somebody, so if they get discharged or they leave the service because of PTSD, that’s money that we’ve invested in a soldier that we can’t get back. We have to recruit and train another person at half a million dollar cost, so this is something that could save our troops’ careers, and save taxpayers a lot of money, while increasing military readiness. This is something I’m really excited about from a readiness perspective, as well as doing the right thing for our troops and getting them treatment that will work.

This is also something that I’m convinced would restore a lot of our troops to being deployable and qualified worldwide. Currently, the goldline medication recommendation for PTSD is Sertraline which is an SSRI. It’s well tolerated and relatively effective with few side effects, but the problem is that you can’t deploy to certain locations on Sertraline without them really closely scrutinizing your record. If you are on Sertraline and you deploy to Africa for example, we don’t have a medical infrastructure there like we have in the Middle East. Even if you have a supply of medication for months, let’s say you run out or lose it— we don’t know if you’re going to remain stable if you discontinue it. MDMA therapy could be a game changer because we know you’re stable and not reliant on a medication you are taking indefinitely. I think this would make things easier from a military readiness and deployability perspective because we don’t have to take you off medication and see if you are stable.

Interesting points. Do you think that after going through this kind of treatment soldiers could be reluctant to deploy again, or perhaps be less inclined to violence?

I know after I came back from Afghanistan and before my treatment, I didn’t kill anything for years. I didn’t fish, I didn’t hunt, I didn’t even kill bugs. A lot of times people come back from war with a renewed reverence and respect for life because they see how quickly and easily it can be extinguished, and how valuable it is.

I could definitely see how being under the influence of MDMA seems to foster a sense of oneness and connectedness with others as well as with all beings—animals, the earth, the connectedness of all life. I could see how MDMA could influence people in that direction, but at the same time, I pretty much became anti-war after I returned from Afghanistan, yet stayed in the military. My rationalization is that I’m a medic, and medics will treat anybody, be they our soldiers, or Taliban, ANA (Afghanistan National Army) troops, and so on. So I’m rationalizing staying in because I’m here to help people. A lot of our military people rationalize that war itself is evil, killing is evil, but doing it to serve their country is a necessary sacrifice that someone has to make.



I recently had two different soldiers come through my office, and both had over 10 years in service. Usually if you are over 10 years in, you want to stay until 20 because then you can retire with a check. Both said they were done and were on their way out—they didn’t believe in war anymore, didn’t believe in killing. One said, “If my country was attacked I would go to war, but this war is not a moral war; there’s no reason for it.” The other one had become very much a pacifist and thought war was illegitimate under any circumstances. Neither one of them had used MDMA or anything else, but their experience of war had led them to that conclusion.

So I could see how drugs in this class could influence people in that direction, but I think that most of our military people have already rationalized their role and how it sometimes includes violence, and the people who are becoming reluctant to continue are arriving at that conclusion on their own without MDMA.

That’s fascinating. I wonder if a soldier gets PTSD and is treated with MDMA, is it a good thing if they have more reverence for life, or would it get in the way of the operational necessities of following orders? It seems like you can’t have everyone trying to make a moral judgement all the time, you just have to follow what your superiors are saying.

The oath that we take is that we will obey all lawful orders, and part of our training is to instantly obey those orders unless you don’t think they are lawful. You’re right— I went through a 2-year period where I asked myself if I could stay in the military because of my concerns about the morality of killing. After I came back from Afghanistan, I was no longer enlisted or in combat arms, I was in medical, so I was actually helping people. So that’s how I was able to rationalize it.

I had a soldier a few months ago who was able to rationalize it because he was in communications. He was no longer in a killing position, so he could continue on. A lot of times when people are no longer comfortable doing one job, they simply transfer and retrain into a different job. So that could be an option for some people if that were to happen. I think that would be a small percentage of people, but I could be wrong— because you’re right, it does really give you a renewed perspective on life and on the act of killing. Until you brought it up, I hadn’t really thought about it. That would be an interesting research question.

I would wonder what the top brass thinks about this issue.

I think our first ethical responsibility is to treat our wounded service members, because we put them in harm’s way. Our first obligation should always be to do what’s right for our troops. And then if it were to become a problem that they no longer felt right with violence and couldn’t serve in the military, then you know what? They served honorably, they went downrange, they did what we asked them to do and got hurt, we treated them, and now we’re going to release them in a good state back into the civilian world instead of in a damaged state where they could be a liability to others. When we harm people, we have a moral obligation to restore them before they reenter society, in whatever way possible. This is how we do right by our troops. So worst case, we would have at least restored them and made them whole before releasing them on the public again.

I completely agree. This is a vast moral question, but the one thing that I feel is rock solid is that these soldiers absolutely deserve help. And I’m curious too, out of those who are reluctant to go back to Afghanistan specifically, how many would still be willing to protect the country in a war that was more understandable and not morally vague.

I think there’s a difference when your country has been attacked or threatened versus a preemptive war. A preemptive war by definition violates the Christian doctrine of just war theory which is widely taught in the military as a moral perspective. When a military action is taken which doesn’t seem like self defense, I think that in the future you’re probably going to see more people questioning it, because it has happened so often.

We’ve been almost continuously at war for decades, and we’ve only been attacked once. I used to think the US was a peaceful country, but I think now we’re pretty militaristic and violent. It’s hard to argue that we’re a peaceful country when we’re always attacking countries that never attacked us. I could see how wider use of medications such as MDMA or other similar ones could increase respect for life and awareness of the value of life, and cause some to question the use of military force around the world.

Right, and maybe that’s a good thing. Of course there has to be a balance— we can’t just naively give up all security and readiness, because then someone else would exploit us. But in my opinion, if we seek a peaceful world and want to retain legitimacy at home and abroad, we should be more discerning and reluctant to use force unless absolutely necessary.

Today I still believe that war is sometimes necessary. I don’t like war, I hate war, but I think it’s sometimes necessary. I think it’s possible that we have sometimes been too quick to use the military and go to war.

Right, and as you were saying, many people are already having these second doubts, so the military has to deal with this issue whether MDMA becomes legal or not. It’s just that this therapy might somewhat accelerate that process.

For some people, maybe. As powerful as the MDMA experience is, the realities of war and killing already force people to face this moral issue, so I doubt it will be disruptive.

Do you think that once MDMA therapy is legalized, the military will instantly adopt it? Will there be a lag time?

I don’t think there will be much of a wait, because it addresses so many problems. One of the things about the military is that a lot of people don’t report and don’t seek mental health treatment because they are afraid to be kicked out. But if they know they can get treatment and get better and stay in their jobs, they will be more likely to seek help. And for those on their way out, we can get them the help they need so they can reenter society without a debilitating condition. With MDMA, we are not treating the symptoms or relying on an ongoing prescription, we are actually treating the trauma itself—and that’s one of the most remarkable things about this medication.

 
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First responders report lasting personal benefits after MDMA-assisted psychotherapy

by Christian Rigg | PsyPost | 23 Mar 2020

While a number of pharmaco- and psychotherapies exist to treat post-traumatic stress disorder (PTSD), a large group of individuals, including military veterans and first responders, have demonstrated resistance to classical approaches. As a result, less traditional treatments have been explored, including the use of MDMA.

A long-term follow-up qualitative study, published in the Journal of Psychoactive Drugs, found that many veterans, police officers, and firefighters described experiencing lasting personal benefits and enhanced quality of life after receiving MDMA-assisted psychotherapy.

The goal of the study, and what sets it apart from previous research, is a focus on MDMA-assisted psychotherapy in a long-term context. The results of this novel intervention were encouraging. One year after an MDMA-assisted clinical trial for treatment-resistant PTSD, 15 of 19 participants showed significant (> 30 percent) reduction in symptoms.

However, researchers wanted to delve deeper into the results of the therapy. To this end, a supplementary questionnaire was given to the participants, to better understand real-life benefits of the intervention beyond symptom reduction. Among the most significant improvements reported were increased self-awareness, improvements in relationships and social skills, and reduced substance abuse, and openness to continued therapy.

“The reemergence of psychedelic-assisted psychotherapy has allowed for more research to present evidence of safety and efficacy for these treatments. Based on the quantitative outcomes, the FDA designated MDMA-assisted psychotherapy for PTSD as a ‘Breakthrough Therapy.’ Findings from this retrospective qualitative analysis of a phase 2 MDMA-assisted psychotherapy trial illuminate a range of outcomes from the treatment that are not fully covered in quantitative explorations,” the researchers wrote in their study.



A number of limitations apply to the current study, well enumerated by the researchers. First and foremost, this was a qualitative study conducted after the start of a clinical trial. As a result, it was necessary to adapt the study’s method to pre-existing protocols. This included, for example, having one of the original trial therapists for the clinical trial conduct the interviews for this study, which may have influenced participants’ responses. Additionally, not only is the population size quite small in general, but it was almost exclusively male and White/Caucasian.

The use of psychedelic drugs in therapeutic interventions is not without controversy, given their potential for abuse, presence in the media, and colorful legal status. Much more data is needed to understand exactly how and why MDMA-assisted treatment was able to improve the quality of life of these individuals. Nonetheless, studies like this have already demonstrated their efficacy in treating psychopathologies, especially those which fail to improve through traditional interventions.

The study, Perceived Benefits of MDMA-Assisted Psychotherapy beyond Symptom Reduction: Qualitative Follow-Up Study of a Clinical Trial for Individuals with Treatment-Resistant PTSD, was authored by William Barone, Jerome Beck, Michiko Mitsunaga-Whitten, and Phillip Perl.

 
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Mike Arnold, the founder of Silo Wellness, weighs psychedelic mushrooms
during a trip to Jamaica where they are grown legally.



Oregon psychedelic startup tests nasal spray for PTSD

by Anastasia Ustinova | GeekWire | 20 April 2020

If you want to know just how quickly public sentiment around psychedelics is changing, consider this: Gwyneth Paltrow sent her staffers to psilocybin-assisted therapy in the first episode of the Netflix docu-series the Goop Lab. Meanwhile, billionaires attending the World Economic Forum in Davos heard a pitch from a company developing a psychedelic drug to treat opioid addiction.

With Oregon activists pushing for state-wide decriminalization of magic mushrooms for therapeutic use this year, one local startup wants to keep the momentum going. Silo Wellness, based in Springfield, Oregon, has developed a nasal spray for microdosing psilocybin meant to aid with anxiety, PTSD and depression. The company now hopes to spread the good word, offering seminars for volunteers who normally wouldn’t try it on the black market to test the device in a controlled setting in Jamaica, where magic mushrooms are legal.

“My hypothesis being that this has the best chance of catalyzing legalization in the United States, when people go back and tell their peers and friends on Facebook that they tried mushrooms,” Mike Arnold, a former trial attorney and the founder of Silo Wellness, said in January before the COVID-19 outbreak.

Arnold says his goal is to “get psychedelics in the hands of as many people as quickly and inexpensively as possible.”

A growing number of researchers, companies and institutions are betting that the long-shunned psychedelics could be poised for growth amid rising scientific evidence for their efficacy in treating some of the toughest mental health and addiction challenges.

Over 260 million people of all ages suffer from depression, which is a leading cause of disability worldwide, according to the World Health Organization. With the rise of awareness around mental health and mental illness, more startups are targeting the underserved market than ever before, says Stephen Hays, the founder of What If Ventures, which invests in early-stage mental health and addiction recovery focused companies.

More than 700 startups are building solutions for mental health and emotional well-being, with just over $4.5 billion invested, according to Hays’ estimates. About a dozen are focused on psychedelics, laying the groundwork in the anticipation of their removal from Schedule 1 category, which may happen in the next two years.

“Because the regulation is being crafted from scratch and the laws have to be changed, there are going to be a lot of people who start businesses and then get blindsided by the bureaucracy of the system,” said Hays. “It’s a really hard place to invest early without getting a little bit lucky.”

Earlier this month, the U.K.-based Compass Pathways, which is conducting the world’s first large-scale psilocybin therapy clinical trial, raised $80 million in a Series B round from investors, including ATAI Life Sciences, Founders Fund and Able Partners. The company, which holds a US patent relating to methods of treating drug-resistant depression “with a psilocybin formulation,” is also backed by Silicon Valley billionaire Peter Thiel, who has invested in other companies focused on psychedelics.

Meanwhile, Johns Hopkins University and Imperial College London last year opened new research centers, with more than $20 million in commitments from wealthy private donors, to study compounds like LSD and psilocybin for mental health disorders, depression and addiction.

Psilocybin is officially listed as an “eligible investigation drug” for terminally ill patients under the Right to Try Act passed by President Trump in 2018. According to one study, most cancer patients experienced “significant decreases in depressed mood and anxiety” after a session, while two-thirds said it was among the most meaningful experiences of their lives.

“For the first time in decades, psychiatry has a real shot at having approved treatments that not only alleviate the symptoms, but empower patients, and we simply cannot afford to miss that chance,” Ekaterina Malievskaia, chief innovation officer and co-founder of Compass Pathways wrote on LinkedIn in December.

Oregon could become one of the first states to decriminalize the psychedelic mushrooms this year, with activists collecting signatures for several 2020 ballot initiatives, including for therapeutic uses. California and Vermont may follow suit.

Silo Wellness’s Arnold says he got involved in the industry for real purpose. After building a lucrative career as an “intimidating cross-examiner, a rugby-playing lawyer” with poor anger management skills, Arnold felt a profound transformation thanks to a guided meditation with a handful of magic mushrooms. That experience sent him on a quest to make the healing opportunities of fungi available to a much wider audience.

Thus was born the “spore to door” psychedelic therapy company, which formulated its product in Jamaica with a team led by pharmacologist Parag Bhatt and Marine combat veteran Scott Slay. Arnold also partnered with Michael Hartman, a former senior scientist at the pharmaceutical giant Novartis and the inventor of a cannabis and hemp inhaler.

The spray allows users to get the effects of a metered sub-psychedelic dose without the complications of an upset stomach. When inhaled, psilocybin goes directly to the bloodstream through the nasal membranes and eventually the liver for metabolizing. The company has no plans for commercial release yet.

"Unlike with cannabis, where patients knew about the benefits of marijuana long before the capital market, this time high net worth individuals and institutional investors got on board early, which may create a threat for the industry, making it follow a big-pharma, prescription-only model," says Arnold.

“This is not the type of medicine you should have to go to a pharmacy and pay a lot of money for,” he said.

 

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Michael Mithoefer, MD


MAPS reports significant difference in PTSD symptoms after MDMA-assisted psychotherapy

MAPS | 12 May 2020

Today, the non-profit Multidisciplinary Association for Psychedelic Studies (MAPS) announced the results of an interim analysis of the data from the first of its two Phase 3 clinical trials of MDMA-assisted psychotherapy for posttraumatic stress disorder (PTSD). This is the best-case scenario for an interim analysis, and suggests that MAPS’ research program is on track for approval by the U.S. Food and Drug Administration (FDA).

The analysis was conducted by an independent Data Monitoring Committee, which reviewed the results from the first 60 out of 100 participants. The analysis revealed a 90% or greater probability that the trial will detect statistically significant results when all participants have been treated, and that the trial will not require additional participants beyond the first 100. The interim analysis was approved by the FDA as part of MAPS’ Statistical Analysis Plan approved by the FDA.

The results strongly suggest that the FDA made the right decision in granting MAPS both (1) Breakthrough Therapy Designation for MDMA-assisted psychotherapy for PTSD, which accelerates the clinical trial process and acknowledges MDMA-assisted psychotherapy as a potentially significant advance over currently available treatments for PTSD, and (2) Expanded Access, which will allow some patients early access to MDMA-assisted psychotherapy for PTSD prior to approval.

Not all interim analyses are successful. For example, in February 2020, Tonix Pharmaceuticals’ Tonmya®, the only other drug granted Breakthrough Therapy Designation by the FDA for PTSD, failed its interim analysis.

“In the pharmaceutical drug development community, this is what you dream about,” says Rick Doblin, Ph.D., MAPS Founder and Executive Director. “The results of the interim analysis of MAPS’ pivotal first Phase 3 trial are the most powerful evidence yet that MDMA-assisted psychotherapy could help transform the lives of people suffering from PTSD. We have trained approximately 70 new therapists to work on Phase 3, so these results also show that the treatment is scalable, eventually to tens of thousands of therapists worldwide.”

To complete this research and make MDMA a legal medicine, MAPS, in collaboration with the Psychedelic Science Funders Collaborative (PSFC), has launched the $30 million Capstone Fund. The Capstone Fund has already secured the first $12 million, and has brought together a diverse array of supporters committed to healing PTSD globally.

“Psychedelic medicines show incredible promise for treating a range of mental health conditions, but psychedelic research has been underfunded for decades,” says Joe Green, Co-Founder and President of PSFC. “This first look at data from the first-ever Phase 3 trial of a psychedelic-assisted therapy only makes us more confident that we’re standing on the cusp of a breakthrough. The approval of MDMA-assisted psychotherapy would be a catalytic event that brings psychedelic medicine into the mainstream. That’s why we are excited to partner with MAPS in creating the Capstone Fund to bring this research across the finish line.”

MAPS is continuing its Phase 3 clinical trials of MDMA-assisted psychotherapy for PTSD at 15 sites in the U.S., Canada, and Israel. The Phase 3 trials are expected to be completed in 2021, meaning that the FDA could approve the treatment as early as 2022. MAPS is also in the process of obtaining regulatory approvals for Phase 2 trials in the UK, Germany, Czech Republic, and the Netherlands.

PTSD affects millions—and soon to be millions more—due to the global trauma of the COVID-19 pandemic. This includes victims of the disease and their families, health care and emergency service professionals, as well as front-line workers who are risking their lives to provide essential services.

As a non-profit organization focused on mental health services, MAPS is committed to protecting the safety of its study staff and clinical trial participants. MAPS is taking active measures to minimize the risk of exposure to the COVID-19 virus and adhere to physical distancing. As a result of this initiative, new enrollment of participants in MAPS-sponsored trials is temporarily postponed, with treatments continuing for some participants as evaluated on a case-by-case basis.

“I believe this medication-assisted treatment will be a breakthrough in treating trauma,” says Amy Emerson, Executive Director of MAPS Public Benefit Corporation (MAPS PBC). “I would like to thank the investigators leading the studies, study volunteers for their time and participation, the independent Data Review Committee for their careful analysis, and the amazing research team at MAPS PBC who helped us achieve this milestone in non-profit pharmaceutical development.”

About MDMA-assisted pAsychotherapy for PTSD

MDMA-assisted psychotherapy uses MDMA to improve the effectiveness of psychotherapy for PTSD. The treatment involves up to three administrations of MDMA in conjunction with psychotherapy in a controlled clinical setting as part of a course of psychotherapy. Once approved, patients will not be able to take the MDMA home—patients won’t be filling their prescriptions at their local pharmacy. Instead, MDMA-assisted psychotherapy treatment will only be available through a doctor and only in supervised therapeutic settings from certified clinicians.

 
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