Ethics and MDMA-Assisted Psychotherapy

I was recently interviewed about my experiences working as an MDMA-assisted psychotherapist treating post-traumatic stress disorder in an FDA-approved research study here in Boulder, Colorado.  Among the questions that came up was this:

What ethical issues are you faced with in MDMA-assisted psychotherapy work?  

Although there are many layers to this question, and a novel could be written about ethics and integrity required in this or any body of work, my answer is simple.  The biggest ethical concern I have is that we in the mental health profession, myself included, are not making this treatment more widely available.  This incredibly safe and effective treatment is only available in an extremely limited research context, to a very elite few.  There are hundreds of people on the waiting list to receive this treatment, while the number of veteran suicides increases at alarming rates and the epidemic public health crisis that is post-traumatic stress disorder is preventing individuals in our society, and society as a whole, from moving forward and living healthy and fulfilling lives.  As a therapist fortunate enough to have had the opportunity to treat people through the use of MDMA, I saw the deep and lasting changes that are possible.  When 83% of research participants receiving this treatment recover from their trauma and no longer qualify for the PTSD diagnosis even 3-4 years after treatment (see www.mdmaptsd.org), how can we look away from that data?  Aren't we ethically required to make this treatment available as soon as possible?      

In my private practice (which is separate from the research context I was involved in) I see clients with severe trauma make progress, deep progress, but nothing like what’s possible when MDMA is involved in their treatment.  They come in every week and spend immense amounts of time, energy, and money on their treatment.  They work so hard at getting better, yet still the process is slow and can feel tedious as times.  Meanwhile, I know of something that would help them heal faster and more deeply, enabling them to move on with their lives and discharge the trauma from their nervous systems almost immediately.  I cannot offer it to anyone due to the criminalization of MDMA.  

Now that’s criminal.  Watching people suffer and not offering them the one thing I know with absolute certainty would turn their lives around, is criminal.  Yet I am required by law to withhold appropriate treatment from my clients.  Can you imagine if a team of researchers discovered the cure for cancer, yet withheld the treatment from people and watched them die?  This is what is currently going on with MDMA-assisted psychotherapy, and it breaks my heart.