MDMA Therapy

Chavi Weinstock
Medically Reviewed by
Dr. Jefferey A. Berman MD, DFASAM
Last Updated
November 26, 2023

Part of the complete guide to understanding addiction

Table of Contents

  1. What is MDMA?
  2. Is MDMA addictive?
  3. The immediate after-effects of MDMA or Ecstasy
  4. What is PTSD?
  5. MDMA therapy for PTSD
  6. How does MDMA assisted therapy work?
  7. Is MDMA assisted therapy safe?
  8. Conclusion

What is MDMA? 

MDMA is an addictive drug, also known as ‘ecstasy’ or sometimes as ‘molly’. Depending on the dose taken, it can act as a stimulant that speeds up the central nervous system, or it can be hallucinogenic with dissociative properties. At present, MDMA is illegal and available only with special permissions from the government because one may overdose, which is fatal.

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Is MDMA addictive?

It is important to note that addiction, or a substance use disorder, can only be diagnosed when the person has developed tolerance to the drug and they experience withdrawal symptoms upon abstaining from the drug.

Although it is widely believed that one must be physically dependent on a drug (where the body has developed tolerance towards it) in order to be diagnosed with a substance use disorder, this is not true. People may chronically abuse substances and their bodies do not become accustomed to- and therefore dependent on- the drug, and yet they could still have a disorder. Furthermore, a person could become physically dependent on drugs that are prescribed medically but this would not be classified as a substance use disorder because they are taking the amount that they have been medically advised to take in order to control their pain. A disorder can only be diagnosed if the drug is used non-medically, purely for recreational purposes. Hence physical dependence on a drug can not be the defining factor of a substance use disorder.

Additionally, it is unclear whether or not there are withdrawal symptoms as a result of quitting MDMA. Withdrawal symptoms occur when the body has developed tolerance to the drug and therefore when one stops, the body is thrown of balance and must go through an adjustment period as it learns to survive without the drug. Much research has shown that it is likely for an MDMA abuser to develop tolerance to ecstasy but the withdrawal symptoms are mild and mostly psychological rather than physical. If the withdrawal symptoms are not severe, it would suggest that one cannot become physically dependent on MDMA.

In conclusion, it is believed that MDMA may not necessarily be categorized as addictive (or perhaps less addictive in comparison to other drugs) but nevertheless one should seek professional guidance if addicted, as the psychological withdrawal symptoms are difficult to manage otherwise. To learn whether MDMA is a hard or soft drug, read our online resource on this topic.

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The immediate after-effects of MDMA or Ecstasy:

MDMA releases dopamine in the brain, the hormone responsible for our pleasurable feelings. The immediate after-effects are mainly heightened senses, a feeling of happiness, euphoria and calm, less inhibitions and therefore more friendliness, extra energy, self-awareness and empathy.

These effects are usually felt for 3-5 hours after ingesting the drug but can last up to eight hours depending on several different factors including the dose and method of administrating the drug, gender and body weight. The ’crash’ period after the effects wear off can last for a few days.

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What is PTSD?

Post-Traumatic Stress Disorder is a condition diagnosed to people who have been through a traumatic incident such as experiencing abuse, violence or bullying, an accident, watching someone being hurt or killed, surviving a natural disaster, losing a loved one, and other difficult circumstances.

It can be diagnosed by a psychiatrist when one experiences some or more of the following: disturbing and vivid flashbacks and nightmares, feelings of sadness, irritability and angry outbursts, unjust guilt and blame directed to oneself as the cause of the traumatic incident, an inability to experience positive emotions, avoiding any circumstance that may trigger distressing memories, being easily startled and having trouble concentrating or sleeping. These symptoms must occur often and over a long time period in order to be classified as PTSD.

At present, there are no medications that can treat PTSD completely, although there are different medications that can cure some of the disturbing symptoms, in addition to CBT and talk therapy. An estimated 1 in 11 people will experience some form of PTSD in their lifetime.

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MDMA therapy for PTSD:

Since 2017, the FDA has reported that MDMA could be used to assist in treating PTSD symptoms. This is because when administered safely in a clinical setting, it could relax and open a person to discussing, and constructively dissecting, the traumatic event, and therefore remove the trauma.

At the moment, there are studies and research taking place in the US, Canada and Israel, led by MAPS (Multidisciplinary Association for Psychedelic Studies). After one particular study, 67% of the participants no longer suffered from PTSD just one year after MDMA therapy.

In another study, subjects were separated into two groups, with some receiving MDMA and the others a placebo. This was administered over two 8-hour sessions, each about 3-5 weeks apart, together with weekly therapy sessions. When they checked in with the participants at a 2-month check-up, 83% of them no longer fit the criteria for PTSD. These results were consistent even close to four years later.

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How does MDMA assisted therapy work?

A safe dose of MDMA increases oxytocin and prolactin which are hormones that help with trust and bonding. MDMA also reduces anxiety and fear and causes a relaxed and open feeling. This can greatly enhance the therapeutic process for PTSD therapy because the patient can then revisit the traumatic event and discuss it, without being triggered- and inhibited- by the negative feelings associated. Additionally, one of the classic symptoms of PTSD include avoiding memories of the traumatic event. MDMA therapy can help to bring back the memories and relive them, in a non-stressful, anxiety-free way.

There have been reports that all participants in the studies benefitted in some way form the MDMA therapy. It is not a cure for PTSD but it can assist in the therapeutic process, helping to relieve some of the symptoms. It is of the hope that MDMA will become legal for this purpose shortly.

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Is MDMA assisted therapy safe?

The potential for abuse of MDMA is low because it is administered in a safe and controlled setting. MDMA PTSD therapy has shown no adverse effects, even for those with other associated conditions such a depression and alcohol or substance use disorders.

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The potential use of MDMA to assist in treating PTSD is promising. It is possible that this form of treatment will become legal in the US as soon as more research is uncovered. It is vital to remember that it must be practiced in a safe, clinical setting with trained medical professionals in order to ensure the effectiveness and safety of MDMA- assisted therapy for PTSD.

To learn more about MDMA/ecstasy, including what ecstasy tastes like, read our online resources.

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