Can MDMA Play a Role in the Treatment of Substance Abuse?
B. Berra Yazar-Klosinski.
A wider array of treatments are needed for people with substance abuse disorders. Some psychedelic
compounds have been assessed as potential substance abuse treatments with promising results. MDMA may also help
treat substance abuse based on shared features with psychedelic compounds and recent reports indicating that MDMAassisted
psychotherapy can reduce symptoms of PTSD. Narrative reports and data from early investigations found that
some people reduced or eliminated their substance use after receiving MDMA, especially in a therapeutic setting. MDMA
is a potent monoamine releaser with sympathomimetic effects that may indirectly activate 5-HT2A receptors. It increases
interpersonal closeness and prosocial feelings, potentially through oxytocin release. Findings suggest that ecstasy,
material represented as containing MDMA, is associated with deleterious long-term effects after heavy lifetime use,
including fewer serotonin transporter sites and impaired verbal memory. Animal and human studies demonstrate moderate
abuse liability for MDMA, and this effect may be of most concern to those treating substance abuse disorders. However,
subjects who received MDMA-assisted psychotherapy in two recent clinical studies were not motivated to seek out
ecstasy, and tested negative in random drug tests during follow-up in one study. MDMA could either directly treat
neuropharmacological abnormalities associated with addiction, or it could indirectly assist with the therapeutic process or
reduce symptoms of comorbid psychiatric conditions, providing a greater opportunity to address problematic substance
use. Studies directly testing MDMA-assisted psychotherapy in people with active substance abuse disorder may be
Keywords: 3, 4-methylenedioxymethamphetamine, entactogen, MDMA, oxytocin, psychedelic, psychotherapy, addiction.
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