UK - ACMD MDMA (ecstasy) Review

[Lunar Loops]

The Advisory Council on the Misuse of Drugs (ACMD) invites members of the public to an MDMA (ecstasy) evidence gathering meeting on the morning of Friday 26th September 2008 as part of its MDMA (ecstasy) review. You have to complete a registration form if you wish to participate (this can be found on their site; just scroogle "ACMD review on MDMA").

This from the official home office website:

The Advisory Council on the Misuse of Drugs (ACMD) invites members of the public to an MDMA (ecstasy) evidence gathering meeting on the morning of Friday 26th September 2008 as part of its MDMA (ecstasy) review.
At the meeting members of the ACMD and attendees will hear evidence from a range of experts in the field relating to the harms of MDMA use. At the end of the morning session there will be an opportunity for attendees to put questions to the council.
The ACMD is a statutory and non-executive non-departmental public body, established by the Misuse of Drugs Act (MDA) 1971. The ACMD has a statutory duty to keep under review the situation in the United Kingdom with respect to the misuse of drugs and to advise ministers of the measures which they consider should to be taken to deal with social problems arising from drug misuse. In addition, the ACMD has a duty to consider any matter relating to drug dependence or misuse that may be referred to them by ministers. The Home Secretary is obliged by law to consult the ACMD before laying Orders or making regulations.
Attending the meeting

The meeting will be held in central London (specific timings and location to be confirmed). A provisional agenda for the meeting will be available on the ACMD website in due course.
Attendance is free but by registration only as places are limited. Places will be issued on a first come, first served basis. To register to attend please complete the registration form and email it to ACMD@homeoffice.gsi.gov.uk

Contact

ACMD Secretariat
3rd Floor (SW Quarter)
Seacole Building
2 Marsham Street
London SW1P 4DF
Tel: 020 7035 0454

[nick23]

Ummm great,because our fine government always listens to the ACMD.

[Lunar Loops]

Originally Posted by nick23

Ummm great,because our fine government always listens to the ACMD.

I understand the cynicism (and I wholeheartedly agree), but that does not devalue the voice of reason and putting forward coherent arguments for change.

True, you can almost see the ACMD coming up with a plan to downgrade the status of MDMA and that then being completely rejected by the government, but this is all about exposure. This is a chance to get arguments aired in a public forum. The media can be utilised by both sides.

[Chemically_Altered]

What's the point in downgrading MDMA? It won't affect who uses it, i guess dealers and users get off slightly lighter but it won't make the drug any safer, it needs to be legalized so it isn't mixed with loads of other shit, downgrading won't help this.

[enquirewithin]

It might be good for those unfortunate enough to get busted with it.

[nick23]

Originally Posted by Lunar Loops

I understand the cynicism (and I wholeheartedly agree), but that does not devalue the voice of reason and putting forward coherent arguments for change.

True, you can almost see the ACMD coming up with a plan to downgrade the status of MDMA and that then being completely rejected by the government, but this is all about exposure. This is a chance to get arguments aired in a public forum. The media can be utilised by both sides.

You're quite right,of course and as you say,I've become cynical.I've participated in civil society consultation in the past and was far from impressed with the process and consequently the results.Still,gotta try.The journey's more important than the arrival and all of that.

[Lunar Loops]

Transform have submitted a briefing to the ACMD review of the classification of ecstasy. A copy of the 10 page PDF is now in the Drug Policy section of the file archive.

For those who may not have the time to peruse the full document, the inoduction, summary and conclusions are given below:


Introduction and summary

Transform’s response to the ACMD’s review of ecstasy operates at two levels. At one level, in the short term at least, we welcome the review as a long overdue response to the many calls for the seemingly anomalous classification of ecstasy to be reviewed. From Transform’s perspective any reduction in unjust criminal penalties for consenting adult drug users is a positive step. At a more profound level, however, we remain deeply concerned that regardless of alphabetic classification, ecstasy will remain illegal, its users will still be subject to serious criminal sanctions, and the control of its production and supply will remain in the hands of unregulated criminal profiteers.

Over the past ten years Transform has argued that the absolute prohibition of drugs in the face of sustained demand inevitably leads to the creation of illicit markets that not only maximise the dangers of drugs for their users but also create a raft of secondary harms to society relating to the organized criminal networks and unregulated dealers who control the trade. There is no evidence that punitive law and its enforcement has anything other than, at best, a marginal impact on levels of drug use or misuse despite the fact that the deterrent effect of the laws’ enforcement is nominally at the heart of the entire prohibitionist model. The model is unique in the public health field in deploying criminal sanctions to reduce social and health harms. It is also uniquely ineffective.

Ecstasy provides an instructive example, its use exploding in the late 80’s from almost zero in 1985 to around 2 million pills being consumed every weekend by the end of the decade, peaking in the 90’s and then falling gradually since the turn of the millennium. During this entire period ecstasy use was Class A and enforcement has not changed significantly. The recent decline in ecstasy use appears to be due to shifting youth culture, with the rise in cocaine use (also Class A for the entire period) evidently filling the void. How ecstasy is classified has been largely irrelevant but, Transform argues, the fact that it is classified within the MDA at all has had profound and dangerous implications. It is hard to imagine any scenario under which harms could be maximised further, and as such any recommendation for ecstasy’s classification maintains its absolute prohibition within the MDA and effectively perpetuates prohibition’s role in maximizing the harms associated with its production, supply and use.

This briefing explores the problems evaluating the harms of illicit ecstasy use, as well as the opportunity such a review presents to compare harms associated with illicit and licit use. It also considers the extraordinary political environment in which policy responses to ecstasy have emerged, and the Government’s unashamed anti-science posturing on the issue.

It concludes that any review of the harm of ecstasy, or indeed any illegal drug, is essentially pointless if no distinction is made between harms caused by the drug and those created and or exacerbated by its illegality. Transform has been calling for the ACMD to work at disaggregating policy harms from drug harms for some years now, maintaining that the ACMD’s continued explicit support for the criminalisation of drug production, supply and use (and failure to explore alternative regulatory options) makes them part of the problem instead of being part of the solution. Given the dramatic failure of the existing system and its appalling negative consequences (in both public health and criminal justice arenas) it is absolutely imperative that the ABC classification system itself, and the legislative framework of the MDA 1971 in which it sits, is the subject of the Advisory Council’s expert scrutiny.

Conclusions and recommendations

• In the short term, if the current review finds, as widely expected, that ecstasy is inappropriately classified in Class A then, in the context of the existing system, a recommendation for reclassification to B or C should be made.
• The ACMD’s report should also take the opportunity to make a clear recommendation for adequate resources to be put into targeted education about MDMA/ecstasy risks/harms and how they can be minimised/avoided.
• It is vital that the review report takes the opportunity to make a clear distinction between harms relating to MDMA toxicity specifically, and harms relating to use of ‘ecstasy’ when it is produced, supplied and consumed illicitly.
• Highlighting this important distinction between drug harms and harms created or exacerbated by policy will inevitably prompt a discussion of whether legally regulated production and availability of MDMA (obviously combined with the removal of all criminal sanctions for consenting adult users) would deliver better criminal justice and public health outcomes. The ACMD, as an independent voice of expertise should not shy away from such a discussion, however hysteria-inducing it may be in certain sections of Whitehall or the tabloid media. Indeed it is absolutely appropriate that the ACMD consider such matters in line with their remit to consider “restricting the availability of such drugs or supervising arrangements for their supply”, and the ACMD’s recent recommendation that "the current arrangements to control the supply of illegal drugs should be reviewed to determine whether any cost-effective and politically acceptable measures can be taken to reduce their availability to young people".
• The ecstasy review, however, is a distraction from the fundamental flaws with the classification system outlined above (and in more detail in the appended paper). It is unconscionable for the ACMD to simply proceed with a systematic review of classification of all drugs covered under the MDA (which, at the current rate will take many years to complete) when there is simply no evidence that an ABC system for determining a hierarchy of criminal penalties produces positive public health outcomes, and a substantial amount to demonstrate it is actively counterproductive and harmful.
• It is of paramount importance that the ACMD assert the primacy of a scientific approach not only in terms of producing first class reviews of individual drug harms but also in terms of evaluating the policy impacts of ACMD recommendations, their implementation, and the system within which they operate. This is specifically in reference to the evidential and ethical basis for an ABC drug harm ranking system rooted within punitive criminal justice legislation.
• Transform, therefore, hope that the appointment of a new ACMD chair will provide a fresh opportunity for the ACMD to instigate the long overdue root and branch review of the entire classification system; its aims and objectives, its outcomes on key indicators, and the legislative and institutional structures within which it operates.
• Such a review was promised by the Home Secretary in the House of Commons in 2006, but despite a review consultation paper being fully drafted and ready for dissemination, the review was abruptly cancelled when a new Home Secretary was appointed. Such a review was supported by the Science and Technology Select Committee, the ACMD itself and, to the best of our knowledge, everyone in the drugs field. The absurd reason given by the Home Office for this review being cancelled was that ‘The Government believes that the classification system discharges its function fully and effectively and has stood the test of time’.
• The ACMD cannot stand idly by whilst the Government so blatantly prioritises its own political posturing over rational policy evaluation and review, and dismisses a scientific approach on the basis of entirely un-evidenced ‘beliefs’. That such political games interfere with reclassification recommendations is beside the point (there is no evidence classification changes have any impact anyway). The more significant danger is that a policy infrastructure that has been such a manifest failure for over three decades remains unchallenged, perpetuating systemic failure and in a very real sense, costing lives.
• The ACMD should demand of the Government that the classification review process be re-instigated with some urgency, and failing this undertake or commission such a review themselves.

[KomodoMK]

Yay! Best piece of news I've read in ages!

The government's drug advisers will begin a review of the classification of ecstasy next week, raising the prospect that the drug could be downgraded from class A.

Ecstasy remains the third most popular illicit drug in Britain, with 5% of young adults aged 16 to 24 saying they have used it in the last year.

The decision by the Advisory Council on the Misuse of Drugs (ACMD), chaired by Professor Michael Rawlins, to review the legal status of ecstasy follows a report by the Commons science and technology committee two years ago recommending urgent action.

The case for downgrading it gathered pace after a landmark Police Foundation inquiry chaired by Viscountess Runciman in 2000, which argued for it to be moved to class B. The inquiry found the best estimates of the toxicity of ecstasy suggested it was several thousand times less dangerous than heroin and was probably involved in fewer than 10 deaths a year.

The MPs heard evidence from Professor Colin Blakemore, then chief executive of the Medical Research Council, that ecstasy was "at the bottom of the scale of harm" and "on the basis of present evidence ... should not be a class A drug".

This view was confirmed by Professor David Nutt, the incoming chairman of the ACMD, in evidence to the MPs and in a Lancet paper last year in which he, Blakemore, Dr Leslie King of the Forensic Science Service and William Saulsbury of the Police Foundation argued that alcohol and tobacco were more dangerous than cannabis, LSD and ecstasy.

Nutt said last year that young people already knew ecstasy was relatively safe, so making it a class A drug made a mockery of the entire ABC classification system. "The whole harm reduction message disappears because people say, 'They are lying'," he said. "Let's treat people as adults, tell them the truth and hopefully work with them to minimise its use," he was quoted as saying last March.

The ACMD is to hold a special evidence session next Friday during which it will hear the latest data on the drug's neuropsychological effects and its toxicity. The number of recent ecstasy-related deaths will also be reviewed in the context of other drug fatalities.

The ACMD is not expected to produce a final recommendation until next year but the past record of its leading members suggests it is likely to recommend that it should be downgraded from class A to B.

However, such a move is likely to be blocked by ministers, raising a prospect of a rerun of their decision on cannabis. The home secretary, Jacqui Smith, made clear earlier this summer that the cabinet intends to override an ACMD recommendation on cannabis and move the drug back to class B from class C.

Possession of ecstasy, as a class A drug, carries a maximum seven-year jail term while dealing can result in a life sentence.

Drugs minister Vernon Coaker has made clear the government believes it should remain in class A but said he would consider any ACMD recommendation.

Transform, the drugs legalisation campaign, argues in its submission to the review that it is a distraction from the fundamental flaws in the overall classification system, which it regards as "harmful and counterproductive".

Source: http://www.guardian.co.uk/society/20...ol.drugspolicy

[Sippin40oz]

Its a shame the government doesnt listen to these drug experts really as this would be great news! Alas Stalin Brown and his comrades will probably just ignore this report as well as any other report that doesnt fit in with their ideologies. Its a shame really as even the Conservative party seem to take the same stance that all drugs are evil and you should be hung drawn and quartered for even considering taking them! The only party that seem to have a rational view towards drugs is the Green party. And they got as much chance of running the UK as i have of winning the elections!!


For those that are interested heres the Green parties drugs policy:

The Green party accepts the reality of drug use and strives to minimize harm, both to user and to society. Cannabis can be an effective pain relief treatment for patients with incurable conditions and as such it should be re-legalised. Studies show that in countries such as Holland, where cannabis is decriminalized, use is much lower than in the UK. Prohibition means there is no mechanism for controlling the strength of ecstasy or cocaine and this has directly resulted in deaths. Inside a legal framework, drugs would not contain dangerous impurities and doctors would be better placed to offer help. Heroin should be treated as a public health issue and funding for research into halting addiction should be released.

Society be much better off if only people would vote for them!

[nick23]

That's the great thing about cynicism.......you're always right.


Big Vern,is already saying that there's absolutely NO CHANCE of a lessening in e's classification,no matter what the ACMD finds.

You gotta love the drug war.

[Synesthesiac]

More people die every year in the UK from swallowing bee's that have flown into cans.

Judging by the govenments attitude, whats the solution to the problem of killer canned drinks?

Make all canned beverages a class A substance, and put people in prison for drinking out of the killer cans. Thats the only way.

[Alfa]

This is extremely interesting, because this is not just about the UK. After the publication in the Lancet, there have been talks in parliaments of other countries, like the Netherlands.

The Dutch are going to do a similar review of their classification. Though I doubt that this will be a good thing with the current government. But if the review is ready when a more social government is in place, then this may have some good effects.

[Synesthesiac]

I think that its highly likely that MDMA will be legalised for therapy in the coming years. And possibly downgraded to class B. Some of the the army has started using it for soldiers with PTSD. And some media outlets, instead of venting their usual rage at this occurence, seemed quite open to this treatment.

I cant post links yet being the newbie i am, but you can find the article published in the times by googling this: "Ecstasy is the key to treating PTSD"

Now thats a headline I'd never thought I'd see in a mainstream news outlet.

And the independant, which is even more liberal, have a good article about that actually suggests legalization is a good idea following comments by a leading police cheif, under the title: "The Big Question: How dangerous is Ecstasy, and is there a case to review its legal status?"

[enquirewithin]

Originally Posted by Synesthesiac

...I cant post links yet being the newbie i am, but you can find the article published in the times by googling this: "Ecstasy is the key to treating PTSD"

Now thats a headline I'd never thought I'd see in a mainstream news outlet.

It's below now- from the Times too, one of Murdoch's right wing propaganda organs!

And the independant, which is even more liberal, have a good article about that actually suggests legalization is a good idea following comments by a leading police cheif, under the title: "The Big Question: How dangerous is Ecstasy, and is there a case to review its legal status?"

It's a small step forward. Don't forget that the papers have nasty habit of changing their views if they think it sells. The Independent on Sunday once advocated legalizing cannabis, then abruptly turned around and jumped on cannabis-causes-schizophrenia bandwagon and advocated 'complete prohibition.' They miscalculated-- it was one of their most unpopular policy decisions.

The headline and opening lines are all wrong. Ecstasy is not really MDMA. It perhaps should be but in practice often isn't.

Ecstasy is the key to treating PTSD

http://www.timesonline.co.uk/tol/lif...cle3850302.ece

At last the incurably traumatised may be seeing the light at the end of the tunnel. And controversially, the key to taming their demons is the ‘killer’ drug Ecstasy

Amy Turner

An Ecstasy tablet. That’s what it took to make Donna Kilgore feel alive again – that and the doctor who prescribed it. As the pill began to take effect, she giggled for the first time in ages. She felt warm and fuzzy, as if she was floating. The anxiety melted away. Gradually, it all became clear: the guilt, the anger, the shame.
Before, she’d been frozen, unable to feel anything but fear for 10 years. Touching her own arms was, she says, “like touching a corpse”. She was terrified, unable to respond to her loving husband or rock her baby to sleep. She couldn’t drive over bridges for fear of dying, was by turns uncontrollably angry and paralysed with numbness. When she spoke, she heard her voice as if it were miles away; her head felt detached from her body. “It was like living in a movie but watching myself through the camera lens,” she says. “I wasn’t real.”
Unknowingly, Donna, now 39, had post-traumatic stress disorder (PTSD). And she would become the first subject in a pioneering American research programme to test the effects of MDMA – otherwise known as the dancefloor drug Ecstasy – on PTSD sufferers.
Some doctors believe MDMA could be the key to solving previously untreatable deep-rooted traumas. For a hard core of PTSD cases, no amount of antidepressants or psychotherapy can rid them of the horror of systematic abuse or a bad near-death experience, and the slightest reminder triggers vivid flashbacks.
PTSD-specific psychotherapy has always been based on the idea that the sufferer must be guided back to the pivotal moment of that trauma – the crash, the battlefield, the moment of rape – and relive it before they can move on and begin to heal. But what if that trauma is insurmountable? What if a person is so horrified by their experience that even to think of revisiting it can bring on hysterics? The Home Office estimates that 11,000 clubbers take Ecstasy every weekend. Could MDMA – the illegal class-A rave drug, found in the system of Leah Betts when she died in 1995, and over 200 others since – really help? Dr Michael Mithoefer, the psychiatrist from South Carolina who struggled for years to get funding and permission for the study, believes so. Some regard his study – approved by the US government – as irresponsible, dangerous even. But Mithoefer’s results tell a different story.
) ) ) ) )
MDMA was patented in 1912 by the German pharmaceutical company Merck. To begin with, it was merely an intermediate chemical used in creating a drug to control bleeding. In the 1920s MDMA was used in studies on blood glucose as a substitute for adrenaline. The Merck chemist Max Oberlin concluded that it would be worth “keeping an eye on this field”. Still, no further studies were carried out until 1952, when the chemist Dr Albert van Schoor tested the toxicity of MDMA on flies. “Flies lie in supine position, then death,” he recorded.
MDMA’s therapeutic potential wasn’t realised until 1976, when the American chemist Alexander Shulgin tried it on himself. He noted that its effect, “an easily controlled altered state of consciousness with emotional and sensual overtones”, could be ideal for psychotherapy, as it induced a state of openness and trust without hallucination or paranoia. It quickly became known as a wonder drug, and began to be used widely in couples therapy and for treating anxiety disorders. None of these tests was “empirical” in the scientific sense – no placebos, no follow-up testing – but anecdotally the results were almost entirely positive.
Word, and supplies, of the new “love drug” got out, and in the early 1980s it became popular in the fashionable clubs of Dallas, LA and London, where it was known as Ecstasy, X or “dolphins”. As use became widespread, the US authorities panicked, and by 1985 MDMA was an illegal, schedule-1 drug. UK laws were even tighter: MDMA, illegal under the 1971 Misuse of Drugs Act, was categorised class A in 1977, carrying a sentence of up to seven years for possession.
Criminalisation put paid to MDMA research almost overnight, at least until Mithoefer’s current programme began. But it didn’t stop the ravers. The drug was popular in the late 1980s and early 1990s for its energising, euphoric effects. There are no official figures for that period, but the Home Office estimates that in 2006/7, between 236,000 and 341,000 people took Ecstasy. Experts say the drug is far less fashionable now than in its heyday in 1988, the second so-called “summer of love”.
The MDMA used in the studies – the drug Dr Mithoefer gave Donna and other patients – was the pure chemical compound, not the black-market Ecstasy bought by recreational users. “A lot of Ecstasy pills aren’t MDMA at all,” says Steve Rolles of the drug-policy reform group Transform. “They may be amphetamines, or unknown pharmaceuticals, or they can be cut with almost any drug in pill or powder form. That’s when you magnify risks associated with taking a drug that’s already toxic. Plus, people use it irresponsibly, mixing it with other drugs, not drinking enough water or drinking too much.”
The images of Leah Betts and Lorna Spinks lying in hospital on life-support, bloodied and bloated, are familiar to all of us – we know drugs cost lives. But has MDMA’s reputation been tarnished so badly that its potential medical value has been overshadowed? That question is the reason that Donna agreed to speak to The Sunday Times about her MDMA treatment. “It’s so important people know what it did for me, what it could do for others,” she says. Her voice trembles: it isn’t easy to talk about what she went through.
) ) ) ) )
In 1993, Donna was brutally raped. She was a single parent living in a small town in Alaska, working as a dental nurse for the Air Force. She was due to work an early shift the next day and her two-year-old daughter was staying with a friend for the night. She was alone at home. At midnight she opened the door to a stranger who said he was looking for his dog. He asked if her husband was at home, and a second’s hesitation was enough. He burst in, backing her up against the fireplace in the living room. Donna picked up a poker to defend herself. He said: “If you co-operate, I won’t kill you. I’ve got a gun.” And he reached into his jacket.
“I dropped the poker and that was it,” she says. “I thought, this is how I’m going to die. No life flashed before my eyes, I didn’t think about my daughter. Just death. I left my body and I stayed that way. The next thing I remember, the cops were coming through the door with a dog.”
She endured the rape with her eyes squeezed shut. That she hadn’t physically struggled would later form a large part of the guilt and shame that contributed to her PTSD. “I guess a lot of women would say, ‘Someone would have to kill me before I’d let that happen.’ Well, I did what I thought I had to do to survive,” she says. When she heard a shuffle of feet outside the door she screamed for all she was worth. Her attacker beat her. Two policemen, probably alerted by a neighbour, broke down the door and arrested the man, then drove Donna to the Air Force hospital where she worked. “Of course it was full of people who knew me,” she says. “It was completely embarrassing. And after that, nobody knew what to say. People avoided me, they looked at me funny. It was miserable.”
Afterwards, convinced that getting on with life was the best thing for herself and her child, Donna carried on as usual. She was embarrassed that people who knew her also knew about the rape, particularly as she was still working at the hospital. But she couldn’t remember much of the attack itself, and didn’t try. So she was surprised when, four years later, her symptoms started to kick in. “I had no idea it was PTSD. I couldn’t understand why I was so angry, why I was having nightmares, flashbacks, fainting spells, migraine, why I felt so awful, like my body was stuffed with cotton wool. Things had been going so good.”
She started drinking heavily and went from relationship to relationship, finding men hard to trust and get close to. Convinced that she was dying and wouldn’t live to see her next birthday, she went to the Air Force psychiatrist. “And that’s where it started – take this pill, that pill. I’ve been on every kind of antidepressant – Zoloft, Celexa, Lexapro, Paxil. Wellbutrin made me feel suicidal. Prozac did the same. The pills were just masking the symptoms, I wasn’t getting any better.”
Yet she met her “soul mate”, Steve, and married him in 2000. “When I first saw him I thought, ‘This is the man I’m going to spend the rest of my life with.’ We were like one person, finishing each other’s sentences,” she says. They muddled along, with Donna putting on a brave face. She had two more children. But getting close wasn’t easy: “The longer we were married, the worse I got.”
Once, Steve and Donna were watching TV when she had a vivid flashback to the night she was raped. “I looked at the door, I saw it open, and that feeling came over me all over again.
I thought, ‘My God, why won’t this go away?’ Steve tried to understand, but unless you’ve been through this, you don’t know what it’s like.”
Donna moved to South Carolina in 2002 when Steve – also in the services – was posted there. She began seeing a psychiatrist called Dr Marcet, who diagnosed her with PTSD and attributed it to the rape. It helped to know that whatever it was had a name and a cause: “I was like, why hasn’t anybody told me this before?” It was Marcet who referred her to the Mithoefers.
Donna had never taken Ecstasy before. “I was a little afraid, but I was desperate. I had to have some kind of relief. I didn’t want to live any more. This was no way to wake up every morning. So I met Dr Mithoefer. I said, ‘Doctor, I will do anything short of a lobotomy. I need to get better.’ ” That’s how, in March 2004, Donna became the first of Mithoefer’s subjects in the MDMA study. Lying on a futon, with Mithoefer on one side of her and his wife, Annie, a psychiatric nurse, on the other, talking softly to her, she swallowed the small white pill. It was her last hope.
“After 5 or 10 minutes, I started giggling and I said, ‘I don’t think I got the placebo,”’ she recalls. “It was a fuzzy, relaxing, on-a-different-plane feeling. Kind of floaty. It was an awakening.” For the first time Donna faced her fears. “I saw myself standing on top of a mountain looking down. You know you’ve got to go down the mountain and up the other side to get better. But there’s so much fog down there, you’re afraid of going into it. You know what’s down there and it’s horrible.
“What MDMA did was clear the fog so I could see. Down there was guilt, anger, shame, fear. And it wasn’t so bad. I thought, ‘I can do this. This fear is not going to kill me.’ I remembered the rape from start to finish – those memories I had repressed so deeply.” Encouraged by the Mithoefers, Donna expressed her overwhelming love for her family, how she felt protected by their support and grateful for their love.
MDMA is well known for inducing these compassionate, “loved-up” feelings. For Donna, the experience was life-changing.
So what happened when she went home? Was she cured? She sighs. “I don’t know if there’s such a thing as a cure. But after the first session I got up the next day and went outside, and it was like walking into a crayon box – everything was clear and bright. I did better in my job, in my marriage, with my kids. I had a feeling I’d never had before – hope. I felt I could live instead of exist.”
) ) ) ) )
What makes MDMA so useful, Mithoefer believes, is the trust it establishes. “Many people with PTSD have a great deal of trouble trusting anybody, especially if they’ve been betrayed by someone who abused their trust, like a parent or a caregiver,” he says. “MDMA has this effect of lowering fear and defences. It also allows more compassion for oneself and for others. People can revisit the trauma, feel the original feelings but not be retraumatised, not feel overwhelmed or have to numb out to cope with it.”
Before they can take part in Mithoefer’s study, every participant undergoes rigorous testing. There are 21 participants per phase and the study is now in its second phase. First, they must be diagnosed with PTSD. Then its severity is measured on the Clinician Administered PTSD Scale (Caps) – it must be at least “moderately severe”. They must be “treatment-resistant”, meaning they have failed to respond to at least one other type of psychotherapy and also drug treatment with an SSRI (selective serotonin reuptake inhibitor) antidepressant. They must sign a 20-page document giving informed consent; they cannot have an addiction, psychosis or bipolar disorder, because these conditions affect the ability to give consent. Then they have a physical examination, a full medical-history check and lab tests for cardiovascular disease.
After the screening, the patient has two 90-minute “preparatory sessions” with the Mithoefers, to begin to build trust and get an idea of what may lie ahead. “We make sure they understand that symptoms will be stirred up, that painful feelings will come before they feel better and that they should experience them as fully as they can, and express them, rather than blocking them out,” Mithoefer says. “We have one rule: during the session they don’t have to talk at all if they don’t want to, or they can talk about anything they feel like. But if, after an hour, the trauma topic hasn’t come up, we can bring it up. But it always does come up,” he chuckles.
The patient lies on the futon in the Mithoefers’ living-room-style office in Charleston, South Carolina. They wear eye shades to encourage introspection, and headphones through which relaxing music is played. Annie keeps an eye on the blood-pressure cuffs and temperature gauge. Mithoefer sits opposite, taking notes. Each patient is given a recording of their session afterwards.
The patient takes either a 125mg tablet of MDMA or a placebo pill, followed by a 62.5mg dose about two hours into the therapy session. The study is double-blind, so only the emergency nurse who carries the drugs from the safe to the office knows whether the patient is getting the drug. “We can always tell whether it’s real or placebo. The patient can’t – some people thought they got MDMA when they didn’t,” says Mithoefer. “But we’re seeing very encouraging results. There’s a real difference between placebo patients and patients who got MDMA, in terms of their ability to relive the trauma.”
Michael and Annie Mithoefer “aren’t your typical kind of therapists”, says Donna. She was dubious about Michael’s ponytail and sandals when they first met, but she is emotional as she talks about him now. “I don’t think I’ve ever met two people who cared so much about people getting well. I’d see tears in their eyes when I told them what I went through.” Three other former patients of the Mithoefers who contacted me about this article described them as “heroes”, “pioneers”, even “life-savers”.
At the time the Mithoefers treated Donna, in March 2004, their study had been a long time in the pipeline. Convinced of MDMA’s potential, Rick Doblin, founder of the Multidisciplinary Association for Psychedelic Studies (Maps), had been in and out of the courts seeking permission from the Food & Drug Administration for clinical research since 1984. Maps, a group set up to fund psychedelic research, agreed to fund Mithoefer’s study in 2000. The next year the FDA approved it. Then approval was withdrawn because of research by the neurologist George Ricuarte, at Johns Hopkins University, claiming that MDMA was lethally toxic. Even a single use, he reported, could cause brain damage and possibly Parkinson’s disease. Ricuarte retracted his findings in 2002 when it turned out that bottles had been mixed up and the monkeys used as subjects had received lethal doses of methamphetamine (speed), rather than MDMA. “It was incredibly frustrating,” Mithoefer says.
Mithoefer’s study, which looks set to cost $1m by the time it finishes in four years’ time, is scrupulously monitored. Doblin had 1,000g of MDMA made specially, each gram costing $4. Mithoefer had to obtain a licence from the Drug Enforcement Administration (DEA), which keeps track of exactly how much MDMA each licence-holder has, and periodically checks the stocks for purity. A defibrillator must be kept in the building at all times in case of cardiac arrest, and an emergency nurse must be present during the treatment session. Once the study is complete, it will be subject to peer review. Then, all being well, Mithoefer hopes to see MDMA therapy available on prescription, administered in controlled surroundings, in 5 to 10 years.
Interest is growing in the UK too, but scientists admit it will take time to change hearts and minds. Dr Ben Sessa of Bristol University’s Psychopharmacology Unit has been writing papers on MDMA therapy for two years. “The Mithoefers’ struggle has been ludicrous,” he says. “There’s plenty of anecdotal evidence that it could be really useful in psychotherapy. There they are, qualified doctors with experience and medical backup, giving people this tiny dose of MDMA with safeguards in place. It took them 20 years for Maps to get it off the ground and it costs $1m. The irony is that thousands of people are taking this stuff every weekend and there’s a 15-year-old on the street corner who’ll sell it to you for a tenner.”
Sessa would like to set up a programme of research in the UK, pointing to the thousands who could benefit: “For severe, unremitting PTSD sufferers, it could be a lifeline. What they’re seeing in the US is people who have suffered for years suddenly saying, ‘Wow, for the first time in my life I can talk about this, I can live with it.’ And these are not young ravers. They’re people in their thirties, forties, fifties who have never taken drugs. It’s quite remarkable.”
But what about the potential for post-study abuse? Might someone who felt deflated after the elation of their MDMA session find the urge to self-medicate irresistible and pop to that 15-year-old on the corner for a quick fix? Not at all, says Sessa. “I prescribe Valium all the time, and when the course is finished the patient could go and buy Valium on the street, but they don’t. Very few people are interested in recreational drugs.”
I ask Donna the same question. “Would I take the drug again? Yes, definitely,” she says. “But not without a therapist. It’s illegal.”
Another former patient of Mithoefer’s, a 42-year-old woman, had severe PTSD after being repeatedly and horrifically beaten and locked in a basement by her father during childhood. She wished to remain anonymous because she is still in contact with her parents. When I asked her the question, she replied: “I did it to get better, not to get high. Before the treatment, I would drink to hide my symptoms. But I don’t want to get drunk now, let alone take drugs. I just don’t need it any more.”
The harmful effects of MDMA are still under investigation. The type of research that is carried out – normally with animals or with recreational users who also take other drugs – means that the exact levels of toxicity it causes are unknown. In 2006 Dr Maartje de Win of the University of Amsterdam published research showing that Ecstasy could cause depression, anxiety and long-term memory damage after one small dose. “We really don’t know how much Ecstasy affects the brain in the long term,” she says. “I would be very cautious about giving it therapeutically. We need to conduct much more research. And even then it should only be given as a last resort, after weighing the benefits against the risk of harm.”
Sessa is adamant that research into MDMA is justified. “Look at heroin. It’s a class-A drug that’s dangerous when used recreationally, but it’s used widely in medicine, and so it should be – it’s a very useful drug. Can you imagine saying to the Royal College of Anaesthetists, ‘You can’t use morphine or diamorphine [heroin] or pethidine or codeine or any opiate-based drugs because heroin is dangerous and people abuse it?’ It’s culturally bound. MDMA has been demonised.”
In 2004, the most recent year for which there are records, 46 people died after taking Ecstasy, as against 8,221 alcohol-related deaths. And most of those who die with MDMA in their system have mixed it with substances such as alcohol or cannabis, which confounds the picture.
Earlier this year, the police chief for North Wales, Richard Brunstrom, called for the drug to be reclassified, claiming it was “safer than aspirin”. He was widely shouted down, but Steve Rolles of Transform believes he may have a point. “It’s not appropriate to have Ecstasy in class A. In terms of indicators of harm – toxicity, mortality, addictiveness and antisocial behaviour – it’s not comparable to heroin or cocaine. But the government won’t reclassify it. Reclassifying cannabis [from class B to C] in 2004 caused years of grief from opposition parties and the media.”
The minister for drugs policy, Vernon Coaker, declined to comment on reclassification for medical purposes, but a spokesman said: “The government has no intention of reclassifying Ecstasy. It can and does kill unpredictably; there is no such thing as a ‘safe dose’. We firmly believe it should remain a class-A drug. In addition, the government warns young people of the dangers of Ecstasy through the Frank campaign.”
It does. But it also gives advice on safe Ecstasy use – or “harm minimisation”. This is precisely the mixed message that Rolles believes is damaging. “Harm reduction is reducing the harm that’s created by illegal supply in the first place,” he says. “So you have harm-reduction information within a legal framework that maximises harm. It’s a clear contradiction.”
Then there is the problem of funding. MDMA therapy is based on the idea of a single treatment, or a course of treatment sessions, rather than long-term prescriptive use. This presents little or no benefit to drug companies that have huge budgets for research as long as there’s a saleable product at the end. And if MDMA does prove effective, companies could stand to lose millions from lost sales of long-term antidepressants prescribed for PTSD.
Sessa says: “There’s no financial incentive for the pharmaceutical companies to look into it. Psychotherapy is notoriously underfunded and discredited by the drug companies. It could benefit the government to look into MDMA, but their funding is a drop in the ocean next to a company like Pfizer’s research budget. So who’s going to pay for a multi-centre psychotherapy trial for 10,000 people – the couch-makers?”
PTSD therapy currently costs the NHS £14m a year, and with more veterans returning from Iraq and Afghanistan, that figure is set to rise. Last year, 1,200 new veterans sought treatment for PTSD from the organisation Combat Stress, compared with 300 in the year 2000. But realistically, would the government ever sanction MDMA research? “It’s not impossible, but it’s improbable,” says Sessa. “It takes a very brave politician to look at the evidence and say, ‘Well, there might be positive aspects to this class-A drug. Let’s look into it.’ It’s a conceptual, social battle which won’t be easy to win.”

[Lunar Loops]

The article above and the one here from The Independent are one of the reasons why the exercise is not a waste of time. It's all about changing perceptions and there has to be a general shift in the perception of the populous before actual change can take place. None of this is going to happen overnight.

Anyway, this is from The Independent (article link):

Sophie Morris: Can we calm down about Ecstasy

The 50,000 people who spent last weekend expanding their minds and sensory perceptions on ecstasy will probably have missed the news that the drug might soon be reclassified from A down to B. The fact that it is officially considered one of the most dangerous drugs on the streets of Britain has most likely escaped them too, for if the after-effects of a night taking ecstasy gave even a hint to users that it should be ranked alongside heroin, they would probably have stuck to the vodka and tonics.


Those convicted of possession of ecstasy face up to seven years' imprisonment and dealing could confer a life sentence; the point of the archaic classification system being to match the punishment with the harm caused by the drug, something it fails to do. "Harm" here means the harm caused to the person taking that drug, not those around them.

The charity DrugScope says that, "after taking ecstasy users may feel very tired and low and need a long period of sleep to recover" and that regular use could lead to sleep problems, lack of energy, dietary problems, depression and anxiety. There are also fears that we are sitting on a timebomb generation of potential Parkinson's sufferers, yet the acid house crew are pushing on a bit now, and there is little evidence that they are unravelling.

Ecstasy is not an addictive drug and it is already eight years since a Police Foundation inquiry found it to be several thousand times less dangerous than heroin and to play a part in fewer than 10 deaths per year. Ever since the tragic death of Leah Betts in 1995, though, it has been difficult to shake ecstasy's reputation as a killer.

The dangers of ecstasy should not be underestimated. It can lead both directly and indirectly to death, and the associated and cumulative negative effects it can have on the health of users are potentially serious. Yet they pale in comparison with the consequences of alcohol and tobacco abuse. When he was chief executive of the Medical Research Council, Professor Colin Blakemore said ecstasy was "at the bottom of the scale of harm", a view which has since been corroborated by other leading experts in science, medicine and the police service.

In concentrating on the health fall-out of drugs, Home Office classifications short-sightedly ignore the social impact of drug use (though ministers are pushing for such consequences to be considered), rendering the system as arbitrary as when it was introduced under the 1971 Misuse of Drugs Act.

Does anyone remember the one about the clubber who was so blissed out on ecstasy that he started a fight on a bus and stabbed an innocent bystander? What about the group of lads who each necked a handful of pills and gang raped a fellow raver? Or the party-goer who stands accused of date rape and is using the fact that he took ecstasy with his accuser as a defence? Then there's the woman who broke into her own parents home and stole and pawned her mother's jewellery to fund her ecstasy habit.

Of course you haven't heard any such tales, because ecstasy does not lead to the sort of violent and aggressive behaviour that alcohol does, nor does it develop into a dependency which users turn to crime to fund.

Professor David Nutt, the incoming chairman of the Advisory Council on the Misuse of Drugs, has admitted that young people know that ecstasy is "relatively" safe. Pretending any different undermines having any classification system at all, where one is much needed.


</EM>

Reputation Comments on this post:

Excellent stuff LL.

[MrG]

Of course you haven't heard any such tales, because ecstasy does not lead to the sort of violent and aggressive behaviour that alcohol does, nor does it develop into a dependency which users turn to crime to fund.

Finally, a journalist who is willing to actually state the facts instead of pandering to the reactionary gin&tonic middle-england set.

Bravo!

[KomodoMK]

Originally Posted by MrG

Finally, a journalist who is willing to actually state the facts instead of pandering to the reactionary gin&tonic middle-england set.

Bravo!

Unfortunately these journalists seem to be very few and far between.

You can bet you ass that many of those journalists who do report badly on drugs probably use a few lines of cocaine in a trendy wine bar at the end of their day.

[Methadrone]

It's a step in the right direction. Swim has not taken 'ecstasy' or should I say MDMA for about 8 years not coz he don't want to but, coz you can't get any decent quality anymore. In the early 90's the quality of Swim's pills were such that they we're £20 a pop but, lasted ALL night.

The simple fact is MDMA alone has not killed anyone (to my knowledge) its been other substances cut in MDMA or the fact the user has drank too much water and effectivly 'drowned' themselves.

If this was to be made legal and sold they could make sure the dose was correct and also issue users with a leaflet to tell them what to do and what not to do. Unfortunately this won't happen.

SWIM has taken 1,000's of the buggers and considers himself totally of the same sanity and mindset as he was before swim took MDMA.

In a perfect World ALL Drugs would be legal, freedom of choice. Unfortunately we don't live in a perfect World.

[adzket]

did not the amcd advise the uk govenment to keep canabis as class c, instead they re-rased it to class b. though swim thinks it's good there talking swim doubt's they will listern. is there still a drug's zar in uk?

[KomodoMK]

The UK Drugs Policy Commission says classifying illegal drugs on a “danger scale” of classes A, B or C needs to be overhauled because they do not affect drug use.

The news comes ahead of a meeting this Friday when the Home Office’s independent Advisory Council on the Misuse of Drugs will discuss whether to downgrade ecstasy from class A.

Ecstasy remains the third most popular illicit drug in Britain, with five per cent of young adults aged 16 to 24 saying they have used it in the last year.

The council, which is made up of 21 academics and drugs experts, provides advice to Governments on illegal drug use and is expected to recommend downgrading the drug from A to B.

Reports from the Police Foundation in 2000, the Commons Home Affairs Committee in 2002 and the Commons Science and Technology Committee in 2006 have all favoured the move.

However the Commission warned the council in a submission that Home Secretary Jacqui Smith is likely to over-rule any decision to downgrade, in a re-run of the row over cannabis earlier this year.

Then, the council's recommendation that cannabis should remain a class C drug was ignored by Miss Smith who decided to reclassify the drug on health grounds.

The Commission says: “The UKDPC does not want to second-guess the council’s final conclusions about ecstasy. However were it to recommend a lower classification then it is not unreasonable to anticipate a political response to that with cannabis.”

The Commission was heavily critical of what it describes as the “increased polticisation” of drugs’ classification.

Roger Howard, Chief Executive, UK Drug Policy Commission, told The Daily Telegraph yesterday: “The purpose and operation of the drug classification system has become increasingly confused amongst politicians and the public in recent years.

“The time has come for an independent wholesale review of the system to clarify how a scientific rating of drug harms should be used for drug classifications and for wider applications such as setting policing priorities or public health messages.”

Members of the commission include the chairman Dame Ruth Runciman, a former council member who chaired a Police Foundation inquiry which argued for ecstasy to be moved to class B seven years ago, Professor Colin Blakemore, the former chief executive of the Medical Research Council and David Blakey, a former Chief Constable and HM inspector of constabulary.

The council is expected to make its decision on ecstasy next year.

Source: http://www.telegraph.co.uk/news/news...perts-say.html

[Spare Chaynge]

This is very interesting.

[Lunar Loops]

A new entry has been added to the file archive (thanks KomodoMK). It is the UK Drug Policy Commision's (UKDPC) submission to the ACMD review on the classification of Ecstasy). It takes a slightly different approach in that they feel they can add little in the way of evidence specific to ecstasy, but they are rather more concerned with :

"the recent debate over the issue of cannabis classification and

the subsequent decision by the Government to reject the Advisory Council’s advice to
keep cannabis in Class C raises a range of deeper questions about drug policy than
simply which class a drug should be placed in. For example, it challenges the role of
expert advisory bodies and the analysis of scientific evidence in the formulation of policy.
It also demonstrates a lack of clarity and understanding in some quarters about the

purpose of the classification system and the ways by which “harm” is assessed."


It makes interesting reading. Here is the link:

http://www.drugs-forum.com/forum/loc...id=105&id=5924

[MrG]

Whoa! Go UKDPC! I would SO love for the papers to start asking the government some tougher questions after that submission!

[KomodoMK]

Originally Posted by MrG

Whoa! Go UKDPC! I would SO love for the papers to start asking the government some tougher questions after that submission!

Wishful thinking in my opinion. Would be nice though, especially as the media is so powerful, even if it is only because the majority of the world population is so gullible and believes everything they read.

[Lunar Loops]

Another new entry to the file archive:

http://www.drugs-forum.com/forum/loc...id=105&id=5928

Release submission for ecstasy reclassification reviewWritten Evidence to the Advisory Council on the Misuse of Drugs (ACMD) as part of its review of the classification of Ecstasy September 2008. 4-page PDF.

Like the UKDPC submission, they also concentate on drug classification and the law as a whole (although they do provide some evidence specific to MDMA).