MDMA (a.k.a. Ecstasy)

The story of the love drug

Before we get into it, a personal anecdote:

Our narrator tried Ecstasy when he was a philosophy student and premed at Swarthmore College. It was among the happiest evenings of his life. For his friends, he felt nothing but pure, unadulterated love. His conversations were deep and meaningful while his emotions felt real and genuine, not drug induced. The feelings of beneficence persisted long after the drug adventure was over. Relationships were improved.

Sadly, at about three in the morning, every single one of our narrator’s friends had fallen asleep. What to do, with a heart bursting with love, and no one to share it with? Of course! Call your parents. “Mom, dad, I just did Ecstasy and I love you so much!” Luckily, his parents were more able to take all of this in context than most parents. Not only were they somewhat used to, and hence insulated from their son’s impulsive, erratic behavior, but -- they had tried MDMA themselves. Our narrator’s father, Dr. Lester Grinspoon, was in favor of ongoing psychiatric access to MDMA. In fact, at that time, during the mid-1980’s, his father had just sued the DEA to prevent it from being locked away into Schedule One of the Controlled Substances Act -- so that its medicinal benefits could be further explored.

My dad’s lawsuit against the DEA.

Ecstasy, or MDMA, has been in the news recently because a FDA advisory panel voted against approval of MDMA-assisted psychotherapy for the treatment of PTSD. The FDA panel shot this application down due to concerns about the safety of the drug and the coherence of the therapy component of the treatment. They were also worried about the integrity of the research. In 2017, the FDA had granted MDMA-assisted therapy a designation as a “breakthrough therapy” allowing an expedited review and evaluation of MDMA-assisted psychotherapy. Many expected the FDA to approve MDMA-assisted treatment and were shocked when it was voted down. Thousands of clinicians, and patients, are hoping, and waiting, to utilize MDMA to treat PTSD and, eventually, other disorders such as addictive disorders, anxiety disorders, and eating disorders.

What is MDMA? Why are proponents so excited about the medical potential? What are the concerns?