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RUBY:

From Schwartz Media, I’m Ruby Jones. This is 7am.

A major new study has found that the therapeutic use of the illicit drug MDMA, more commonly known as ecstasy, could cure people suffering from Post Traumatic Stress Disorder. The landmark findings could radically change the way PTSD is treated.

Now, an Australian psychologist is finally embarking on Australia’s first ever clinical trial using the drug. Today, contributor to The Monthly, James Bradley, on the healing power of MDMA and why Australia has been so slow to explore its possibilities.

It’s Monday, September 20.

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RUBY:

James, the last time we spoke, you were talking about your experience using psychedelics to treat depression. Since then, you've been looking at other mental health treatments that also use illicit drugs. Can you tell me about what you've been looking into, what researchers are finding?

JAMES:

It's really fascinating. There's been research going on for about 20 or 30 years into trying to use MDMA in particular kinds of therapeutic contexts.

Archival Tape -- Unidentified Reporter:

“A new study published in Nature Medicine shows that for people suffering with severe PTSD, the benefit of talk therapy could be greatly improved with an unlikely drug.”

JAMES:

The big thing that's happened recently is in June, there was a major study published looking into the use of MDMA with patients suffering from PTSD.

Archival Tape -- Unidentified Reporter:

“It involves using a club drug known as MDMA, or ecstasy, paired with regular therapy sessions.”

Archival Tape -- Unidentified Reporter:

“The authors hope it will lead to an FDA approved treatment for PTSD by 2023.”

JAMES:

It was a really major study. It was spread across 15 institutions in the US and Canada and Israel. And it was coordinated by MAPS, which is the big Multidisciplinary Association for Psychedelic Studies.

Archival Tape -- Unidentified Speaker:

“It's also the first FDA approved phase three study of any psychedelic assisted psychotherapy. Not even in the 60s did we get this far.”

JAMES:

And what it showed was really, really significant, in a sense, it confirmed what the earlier studies have shown, which is that when used in the context of a structured psychotherapy programme, MDMA isn't just safe for the use with people suffering from PTSD. It's actually incredibly effective and it delivers markedly improved outcomes for patients and this is incredibly significant.

RUBY:

Can you tell me a bit more about PTSD? What is it like for a person who has it and why researchers are looking at MDMA as a way to treat it?

JAMES:

People with PTSD. Suffer from a whole range of symptoms. They have the flashbacks that we know about, they have anxiety, they have depression, they have mood swings, they've feelings of agitation and terror, a whole lot of, kind of, avoidance behaviours that they engage in. And PTSD happens when we kind of get overloaded by an experience, and what happens is that, you know, an experience is so traumatic, it's so shocking, it's so frightening, that it kind of over stimulates the parts of our brain that govern fear responses and the kind of memories that come from that, from those kind of experiences, they get laid down in our limbic system, which is the part of our brain that manages emotions. And what that means is that whenever we come into contact with the thing that triggered, anything that reminds us of the original trauma. Suddenly, we have this kind of collapsing of time, almost, where suddenly we're thrown straight back into the experience. I think in our culture, we tend to link it a lot with the experiences of military personnel...

Archival Tape -- Dialogue from Born on the Fourth of July:

What did they do to you? What happened in that war? You need help Ronnie..

JAMES:

Particularly for my age, because there are endless movies in the 80s and 90s about Vietnam vets.

Archival Tape -- Rambo:

“Back there I could fly a gunship, I could drive a tank, I was in charge of a million dollar equipment, back here I can’t even hold a job!”

JAMES:

But it's something that's much more widespread than that. It can be caused by all kinds of traumatic events. You know, a very large number of of PTSD sufferers are people who've suffered various kinds of sexual assault and sexual abuse. You know, so it's, it's a dreadful condition for the people who suffer it. Now, there's what they call the gold standard treatment is what they called exposure therapy. And exposure therapy works by basically bringing people into contact in a controlled way with the source of the trauma. And what happens is you reprocess the memories and you lay them down as more normal memories, you get them out of the kind of emotional thing. So, the problem is that for a significant minority of people who've got PTSD, exposure therapy is just too hard. The process of actually approaching their trauma, the process of actually trying to kind of deal with it is so incredibly overwhelming that they end up re-traumatised or they just can't do it and they drop out of the treatment programme. They just can't deal with it. They can't go there. And that's where MDMA comes in.

RUBY:

Mm. And so, what is it about MDMA then that makes it useful in this space? How does it help?

JAMES:

The way MDMA works is that it triggers the release of serotonin and dopamine in the brain, and that creates these kind of feelings of well-being and happiness and reduces anxiety in the brain and also increases the level of oxytocin, which is the hormone that kind of handles bonding and relationship building. And so, what the researchers said to me is that if you give people, and people with PTSD have this overactive fear response, but if you give them MDMA, it suppresses that fear response. It brings down all of these kinds of triggers for anxiety, once you've got people into that state, it allows them to kind of engage in exposure therapy. So what they can do is they can actually approach the trauma. They can think about the trauma, they can talk about it without triggering these incredibly powerful responses. And that allows them to actually do what they need to do, which is to kind of reprocess the memories and to kind of go through the process that's too hard for them otherwise.

RUBY:

OK, so MDMA essentially creates the conditions where people can revisit trauma and process it properly, and that's especially useful, it sounds like, for people who are so traumatised that doing it without any kind of help is just too overwhelming. So can you tell me about how this is playing out in the research? Is this, is it successful when people are undertaking this in a clinical environment?

JAMES:

Yeah, it's been incredibly successful. And that's what was so fascinating about this big study that's just been done. So there've been a number of smaller studies which showed really great results. And one thing that I do need to emphasise here is it's not like you give people the drug and they get better. What people are doing is coming in for some sessions with therapists, they do three long sessions with the MDMA. And then they come out the other end, but the results were really startling. I mean, they had people who just did three of these MDMA sessions, 88 percent of the patients experienced a meaningful reduction in symptoms and two thirds of them no longer qualified for a diagnosis. And the thing that's really exciting about this is that because of the way exposure therapy works, because of the way this MDMA therapy works, this isn't about managing symptoms. What happens is once you've reprocessed the memories, you're actually cured. The PTSD goes away. So this is not just a management regime. This is actually a cure.

RUBY:

We'll be back after this.

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RUBY:

James, we’re talking about how MDMA can be used to treat Post Traumatic Stress Disorder and there seems to be real momentum for this research overseas but what about here in Australia?

JAMES:

Yeah, look, so Australian universities and other organisations have been really slow on the uptake of this stuff, and a lot of that has changed. There's various things kind of in motion now, but we've been a long way behind the curve on this.

Archival Tape -- Dr Stephen Bright:

“I get up to one hundred emails a week from people asking how do I access this treatment?”

JAMES:

I spoke to Dr Stephen Bright, who's a psychologist at Edith Cowan University, and he said that, look, the issue we have in Australia, Australia's drug policy generally is incredibly conservative.

Archival Tape -- Dr Stephen Bright:

“In the US you can access MDMA treatment outside of clinical trials through a compassionate access scheme. And we can't do that in Australia. The limitation is that the government still sees MDMA as the same as heroin. It doesn't see it any differently.”

JAMES:

So of these very kind of conservative attitudes to drugs at an official level in Australia, And he said to me, look, you know, we talk a lot about harm minimisation when we talk about drug policy in Australia. But his view is we need to stop talking about harm minimisation and actually start talking, you know, shift the dial completely, start talking about benefit maximisation. What are the things we can actually do? You know, what can we take from looking at this group of people who are using drugs.

Archival Tape -- Dr Stephen Bright:

“We've got excellent public health care services that are going to need a bit of persuasion because there's a lot of conservatives in there in terms of whether or not this is just a bunch of hippies pushing MDMA. But we have some really good practitioners working in the public health system who can ensure that these treatments are delivered in a safe manner…”

JAMES:

Stephen's been pushing along with various other people to actually get Australian studies into MDMA therapy off the ground and, you know, he's finally been successful, it's taken a long time but they've got a study that. He's one of the lead investigators on a study that they're doing at Edith Cowan University later this year. It will be the first study into the use of MDMA therapy for PTSD in Australia.

Archival Tape -- Dr Stephen Bright:

“It's a huge step in the Australian context because we've been trying for ten years, this is the third attempt and it will be the first time in Australia that an Australian participant or patient has been administered MDMA in a regulated clinical trial.”

RUBY:

Can you tell me about the trial? What's it going to focus on?

JAMES:

Yeah, look, it's quite a small trial and it's, you know, in a sense it'll be replicating some of what's been done overseas. But the thing I found really fascinating was that Steve Bright got into these questions around MDMA because he's actually a psychologist who's worked for years in substance use disorders. And so what he said he began to find was that there was this kind of revolving door that he was stuck in with his patients.

Archival Tape -- Dr Stephen Bright:

“And we sort of patch them up, send them back out on their way and we see them again in three months time. It does feel like this revolving door of people. And so what initially sparked my interest in this was the data itself.”

JAMES:

So he became interested in the research from overseas because it seemed to show a way of actually kind of breaking out of that cycle of actually getting you know, he was saying, look, if we could deal with people's PTSD, perhaps we could deal with some of these substance use disorders.

Archival Tape -- Dr Stephen Bright:

“And I just thought this is the sort of new treatment that we need in our AOD services so that we can treat the trauma and the substance use issues at the same time.”

JAMES:

That was really, really interesting to me. That link between trauma and addiction and the idea that MDMA might be one of our ways to transform treatment of lots of kind of substance use disorders.

RUBY:

And James, right now, MDMA, it's still classified as an illegal drug, and that doesn't seem like something that's likely to change anytime soon. But given the success of these trials and the potential to improve people's lives, do you think that we might see MDMA approved as a form of therapy here in Australia at some point?

JAMES:

Look, it's a way off yet, but one thing Steve said to me, and I think he's right, is that the public is a really long way ahead of politicians and regulators on this. People all over our community have mental health problems and they recognise that the treatments we have aren't working. There's a real kind of hunger for things that will actually deal with things that we can't deal with at the moment. I also think there's been some change at an official level. The Association of Australian Medical Research Institutes has a medical research future fund and they've just allocated fifteen million dollars to research into innovative mental health therapies, which is essentially MDMA and psychedelics. And in fact, we're actually only the second country in the world that has put government money into this research. In Europe and America, they may well be using MDMA for PTSD within a couple of years. We're nowhere near that. But trials like Stephen’s and the research overseas and the experience overseas continues to grow. You're going to see a push for it here as well.

RUBY:

Hmm. James, thank you so much for your time. It's been fascinating.

JAMES:

Thanks Ruby

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RUBY:

Also in the news today...

In a press conference on Sunday afternoon, the Prime Minister, Scott Morrison, announced that former Attorney General, Christian Porter, had stepped down as industry and science minister. The ministerial reshuffle follows revelations that Porter’s legal fees in a recent defamation case against the ABC were paid by anonymous donors.

And the Victorian government has unveiled its roadmap out of the state’s lockdown, announcing plans to ease restrictions when 70 percent of the population is fully vaccinated. That’s expected to occur on October 26. From that date outdoor hospitality can reopen and public gatherings will be capped at 50 people. The next trigger for restrictions easing will be when 80 percent of the population is fully vaccinated. At that point home visits will be re-allowed and all retail and hospitality will reopen, with density limits. However, modelling released by the government estimates that daily new case numbers could peak at over 1,400 and hospitals could be at “moderate” risk of reaching capacity.

I’m Ruby Jones, this is 7am. See ya tomorrow.