Gretchen Ertl for The New York Times
Hundreds of Iraq and Afghanistan veterans with post-traumatic stress have recently contacted a husband-and-wife team who work in suburban South Carolina to seek help. Many are desperate, pleading for treatment and willing to travel to get it.
The soldiers have no interest in traditional talking cures or prescription drugs that have given them little relief. They are lining up to try an alternative: MDMA, better known as Ecstasy, a party drug that surfaced in the 1980s and ’90s that can induce pulses of euphoria and a radiating affection. Government regulators criminalized the drug in 1985, placing it on a list of prohibited substances that includes heroin and LSD. But in recent years, regulators have licensed a small number of labs to produce MDMA for research purposes.
“I feel survivor’s guilt, both for coming back from Iraq alive and now for having had a chance to do this therapy,” said Anthony, a 25-year-old living near Charleston, S.C., who asked that his last name not be used because of the stigma of taking the drug. “I’m a different person because of it.”
In a paper posted online Tuesday by the Journal of Psychopharmacology, Michael and Ann Mithoefer, the husband-and-wife team offering the treatment — which combines psychotherapy with a dose of MDMA — write that they found 15 of 21 people who recovered from severe post-traumatic stress in the therapy in the early 2000s reported minor to virtually no symptoms today. Many said they have received other kinds of therapy since then, but not with MDMA.
The Mithoefers — he is a psychiatrist and she is a nurse — collaborated on the study with researchers at the Medical University of South Carolina and the nonprofit Multidisciplinary Association for Psychedelic Studies.
The patients in this group included mostly rape victims, and experts familiar with the work cautioned that it was preliminary, based on small numbers, and its applicability to war trauma entirely unknown. A spokeswoman for the Department of Defense said the military was not involved in any research of MDMA.
But given the scarcity of good treatments for post-traumatic stress, “there is a tremendous need to study novel medications,” including MDMA, said Dr. John H. Krystal, chairman of psychiatry at the Yale School of Medicine.
The study is the first long-term test to suggest that psychiatrists’ tentative interest in hallucinogens and other recreational drugs — which have been taboo since the 1960s — could pay off. And news that the Mithoefers are beginning to test the drug in veterans is out, in the military press and on veterans’ blogs. “We’ve had more than 250 vets call us,” Dr. Mithoefer said. “There’s a long waiting list, we wish we could enroll them all.”
The couple, working with other researchers, will treat no more than 24 veterans with the therapy, following Food and Drug Administration protocols for testing an experimental drug; MDMA is not approved for any medical uses.
A handful of similar experiments using MDMA, LSD or marijuana are now in the works in Switzerland, Israel and Britain, as well as in this country. Both military and civilian researchers are watching closely. So far, the research has been largely supported by nonprofit groups.
“When it comes to the health and well-being of those who serve, we should leave our politics at the door and not be afraid to follow the data,” said Brig. Gen. Loree Sutton, a psychiatrist who recently retired from the Army. “There’s now an evidence base for this MDMA therapy and a plausible story about what may be going on in the brain to account for the effects.”
In interviews, two people who have had the therapy — one, Anthony, currently in the veterans study, and another who received the therapy independently — said that MDMA produced a mental sweet spot that allowed them to feel and talk about their trauma without being overwhelmed by it.
“It changed my perspective on the entire experience of working at ground zero,” said Patrick, a 46-year-old living in San Francisco, who worked long hours in the rubble after the Sept. 11, 2001, attacks searching in vain for survivors, as desperate family members of the victims looked on, pleading for information. “At times I had this beautiful, peaceful feeling down in the pit, that I had a purpose, that I was doing what I needed to be doing. And I began in therapy to identify with that,” rather than the guilt and sadness.
This article has been revised to reflect the following correction:
Correction: November 21, 2012
An article on Tuesday about using MDMA, or Ecstasy, in combination with psychotherapy to treat post-traumatic stress described incorrectly the office arrangement that a husband-and-wife team use to conduct therapy sessions using MDMA. The couple, Michael and Ann Mithoefer, hold the sessions in an office in a converted house; they do not conduct the sessions in their home office. And because of an editing error, an accompanying picture carried an incorrect credit. The photograph of the Mithoefers was taken by Hunter McRae, not by Gretchen Ertl.
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