Science & Health

A Guide to MDMA Assisted Therapy

MDMA Assisted Psychedelic Therapy is on the rise across the US. With a recent Breakthrough Therapy Designation, MDMA Assisted Therapy is poised to enter the legal landscape. So, what is MDMA and MDMA Assisted Therapy and how does it work? We break it down in the article below.

Min read
Lydia Mcclendon
May 31, 2024

A Guide to MDMA Assisted Therapy 

MDMA, known colloquially as ecstasy or Molly, has gained attention for its therapeutic potential in treating mental health conditions. In 2024 we’ve seen an emergence in the potential power of MDMA assisted therapy with conditions like PTSD, treatment-resistant depression, and anxiety, and the hope that with continued research there’s even more it can help heal.  Paired with therapy, it's showing promise in easing symptoms and opening connections both through traditional therapy and alternative holistic modalities. 

As research into psychedelic and MDMA-assisted therapy continues, there is a growing push from the public to continue passing legislation that promotes alternative healing options. What people see in the potential of these assisted therapies is a way to redefine healing for themselves. 

What Is MDMA? 

In a category of its own is MDMA. A combination of the blooming effects of hallucinogenic psychedelics, and the electrifying effects of stimulants, MDMA has been a mainstay of pop culture for years. It is known to enhance sensory experiences, and make touch and feel more intense. 

MDMA works within the brain by increasing activity in 3 neurotransmitters. Serotonin is the main neurotransmitter affected when taking MDMA. It helps to regulate mood, emotions and sleep. MDMA causes a large release of Serotonin leading to empathy, well-being, and emotional openness. 

Dopamine also undergoes an interaction with an increase in levels. This spike in the feel-good chemical contributes to euphoria and energy. 

The final neurotransmitter affected by MDMA is Norepinephrine. As the control transmitter for heart rate and blood pressure, an increase in Norepinephrine can make you feel more alert, awake, and able to keep going. 

Chemically, MDMA stands for 3,4-methylenedioxymethamphetamine. As a synthetic compound, it’s made in a lab and is related to both amphetamines (stimulants) and mescaline (a hallucinogen). The combination of the two effects give MDMA its unique properties and have made it a continuously popular addition to everything from late nights out, therapy sessions, and early mornings. 

What Is The History of MDMA? 

MDMA has been a host of things in its lifetime as a non-classical psychedelic. As a once popular party pick for the dance scene on the east, to a college bar staple in the south, and a love enhancer out west, MDMA has always  shown promise for those looking to find non-traditional ways to heal themselves

In the mid-1970s, MDMA was rediscovered by chemist Alexander Shulgin, who explored its psychoactive effects and introduced it to psychotherapists, including Leo Zeff. 

During this period, MDMA, also referred to as "Adam"  for its ability to restore an innocent, unguarded state of mind, was used by a small number of therapists to enhance psychotherapy. 

However it was really an “Eve” that began the therapy focused on MDMA assistance, with Ann Shulgin, wife to Alexander Shulgin and pioneer in the therapeutic front for MDMA. She began to administer MDMA during therapy sessions and from there, the potential blossomed. It was particularly noted for its ability to reduce fear and enhance emotional communication.

MDMA gained popularity as a recreational drug under the name "Ecstasy" in the early 1980s, leading to increased public awareness and —of course —some concern. Although MDMA rose to popularity during the DARE era, there was a grassroots movement to keep MDMA within recreational reach. This included a mass movement to synthesize the product in batches across the US. From college bars in Texas to parties in California and the New York club scene, MDMA was a staple that from the beginning showed promise in its ability to help people heal, and to have fun while doing it. 

1981 saw MDMA take off from a more therapeutic stance to a staple of the underground with a published article on the effects of MDMA for fun, rather than function. With only sporadic batches of MDMA showing up across the U.S. before 1975, it was a fairly new experience for those looking to experience both the hallucinogenic effects of psychedelics, with the ecstasy inducing effects of stimulants. The article highlighted the author's experience with MDMA as joyful, pleasurable, and above all else; ecstasy.

The creators of this wonder drug were unsuspecting chemists, using Ann Shulgin as a baseline for what they would be creating and opening the door for empathy and understanding for generations to come. For a while, MDMA enjoyed a legal gray area with drug enforcement more concerned about cannabis and cocaine.  

In 1985, due to rising recreational use and the usual scare of “potential for abuse”, the U.S. Drug Enforcement Administration (DEA) classified MDMA as a Schedule I substance, making it illegal and putting a stop to the promise in its legal therapeutic use.

Psychedelic-assisted therapy with substances like MDMA, psilocybin (found in magic mushrooms), and ketamine is currently being researched in clinical trials. The FDA has granted breakthrough therapy designation to MDMA-assisted therapy for PTSD, which facilitates its development and review process. 

While this doesn’t give it legal status yet, BTD does give this groundbreaking therapy a chance to show what it can do. Breakthrough Therapy Designation is not given out lightly, especially for non-classical psychedelics like MDMA. This designation means that MDMA is being considered as a treatment for serious, non life threatening conditions, and that preliminary evidence suggests that it may show substantial, clinically significant improvement over available therapies. 

With a wave of support behind it, and continued promise in clinical settings, there is hope that MDMA will prove to be a groundbreaking advancement for accessible, non-traditional healing options. 

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What is MDMA Assisted Therapy and How Does It Work? 

MDMA assisted therapy combines the use of MDMA, a synthetic drug, with psychotherapy sessions. It's different from traditional therapy as it involves guided sessions with a trained therapist in a safe and supportive environment.

Therapy sessions typically involve three phases: preparation, MDMA session, and integration. During the MDMA session, individuals are guided through their experience by a trained therapist, helping them process emotions and insights.

MDMA works by increasing the activity of neurotransmitters such as serotonin, leading to feelings of empathy and emotional openness. In therapy, this can help individuals process difficult emotions and experiences more effectively.

Within these sessions, the goal of the therapist is to help you probe deeper into the root of trauma, without causing any undue distress to you. Because sessions are multi hour you have an opportunity to treat these sessions like traditional therapy. While there will be a team monitoring you, you’ll have the chance to dive deeper into the causes and effects of your personal trauma and use MDMA and its emotional openness qualities to face them head on. 

That isn’t to say you’re left to your own devices afterwards. Post MDMA therapy can look different for everyone, but just as with any psychedelic assisted therapy— integration plays a key role in how successful your experience is. For many, that is continued therapy sessions to find ways that you can integrate insights into your daily life. 

How is MDMA Assisted Therapy Different from Regular Therapy? 

Sessions with MDMA are usually longer (6-8 hours) and require the presence of trained therapists to provide support and guidance. The focus is on creating a safe environment where patients can explore emotions and memories without overwhelming anxiety. Integration sessions are crucial for helping patients make sense of their experiences and incorporate insights into their daily lives.

Psychedelic Assisted Therapy: 

Other Psychedelics (e.g., Psilocybin, LSD): These substances primarily act on serotonin receptors, particularly the 5-HT2A receptor, inducing altered states of consciousness, vivid imagery, and profound changes in perception and thought processes. This can lead to transformative experiences and insights. Similar to MDMA, these therapies involve preparation, the psychedelic experience itself, and integration sessions. The intensity and nature of the experiences can vary widely. Sessions can also be long and require a supportive environment. The experiences can be more unpredictable and intense, sometimes involving profound mystical or transcendent experiences.Integration is equally important due to the often profound and sometimes disorienting nature of the experiences.

Traditional Therapy: 

Traditional therapies like cognitive-behavioral therapy (CBT) or psychodynamic therapy rely on talk-based methods and do not involve the use of psychoactive substances. They focus on identifying and changing maladaptive thoughts and behaviors through dialogue and exercises.

Traditional Therapy can involve regular, often weekly, sessions over an extended period. Progress is generally incremental and relies on the patient's ability to engage in self-reflection and behavioral change without pharmacological enhancement. Sessions are typically shorter (45-60 minutes) and occur in a standard clinical setting. The therapeutic process is more gradual and less intense per session.Integration happens more gradually over time as patients reflect on sessions and implement changes in their lives.

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What Conditions are Treated with MDMA Assisted Therapy?

MDMA Assisted Therapy may be particularly effective in treating PTSD, anxiety disorders, and depression. Studies have shown significant reductions in symptoms and improved overall well-being in participants. 

MDMA is showing potential in treatment, alongside therapy, for PTSD and anxiety disorders in adults through its ability to help reduce fear and anxious thoughts. It’s thought that MDMA allows prospective patients to confront and process traumatic memories without the usual overwhelm that can come with it. MDMA is known to increase and enhance emotional connections and empathy— making deeper therapeutic work more possible. 

MDMA is also showing promise in easing anxiety around terminal illness. Those facing terminal diagnoses usually experience a constant state of heightened anxiety and existential dread. MDMA was made to come in and calm down, with a sense of peace and emotional understanding. While it won’t reverse a diagnosis, it does allow for patients to improve their quality of life and cope with their condition in better ways. 

Social anxiety is another condition that can’t stop MDMA therapy. In adults with autism, or other socially triggered conditions, MDMA is helping people feel more comfortable and connected, allowing the space to improve social skills and relationships. 

While these are just the beginning, clinical trials have demonstrated the efficacy and safety of MDMA Assisted Therapy. Studies have shown that a majority of participants experience significant reductions in symptoms, with effects lasting long after treatment.

Where Can I Find MDMA Assisted Therapy?

MDMA Assisted Therapy is currently being offered in clinical trials and research settings. It's important to seek treatment from qualified practitioners who adhere to safety guidelines and ethical standards. This doesn’t mean that it isn’t accessible— it just means there’s a small wait. The projections show that MDMA assisted therapy has the backing to be approved and in production by August of 2024, and although the lack landscape can change, there’s promise that this time it will stick. 

While there are programs to become certified to be an MDMA facilitator, with the new policies not yet in place it’s important that you vet potential guides and therapists accordingly. 

MDMA Assisted Therapy offers a promising approach to addressing mental health conditions like PTSD, and treatment resistant mental health conditions— providing hope for those who have not found relief through conventional treatments. With ongoing research and support, it has the potential to transform lives and promote healing for new generations as opposed to being hidden behind stigma. 

The benefits to MDMA assisted therapy have shown to be far reaching, so far, with preliminary research pointing us in a positive direction for alternative medicine. Those handling mental health conditions could see improvement in quality of life through emotional insight, deeper connection to themselves and others, and the opportunity to develop an understanding of their triggers and how to handle them. 

The most important thing is to do your due diligence before deciding that MDMA assisted therapy is for you. Read research, speak to professionals, and develop a personalized plan for your own MDMA assisted therapy journey. 

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About the Author

Lydia Mcclendon

Lydia Mcclendon is a freelance writer and editor within the world of psychedelics, plant medicine, parenthood and the intersection of working in marketing for a taboo industry. She has written for a wide variety of publications, worked within editorial coordination, and loves the creativity and chaos that creative content brings.

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