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The EMDR technique is used in conjunction with psychotherapy and it has proven very effective for statistically significant numbers of patients in controlled studies (Breslau, Lucia, & Alvarado, 2006; Gerrig & Zimbardo, 2008).
Ethical Issues in Treating PTSD in Returning Combat Veterans with MDMA
A much more ethically controversial approach involves the use of low doses of MDMA in conjunction with traditional psychotherapy. That is because MDMA is an illicit drug with a very well-deserved reputation for being notoriously popular with recreational users and addiction. While their may be beneficial therapeutic uses of MDMA in certain patients, the population of U.S. armed services veterans suffering from PTSD are also, demographically and psychologically, at the greatest risk of drug addiction and to mental instability that could be worsened by non-therapeutic use of consciousness-altering substances, particularly in connection with unauthorized and unmonitored or controlled use.
It is not necessarily never appropriate to treat PTSD with MDMA after all other therapeutic modalities have been exhausted unsuccessfully. However, it behooves all stakeholders to limit that use of MDMA by criteria that are sufficiently strict to exclude those prospective patients whose other risk factors for negative responses to MDMA treatment may preclude that approach. It is appropriate that the potential benefits of MDMA in this application are being examined critically; likewise, it is appropriate to limit any approved use of this nature to patients receiving intensive monitoring and concurrent psychotherapy. In that regard, there is a strong argument against prescribing MDMA for any patients with any prior history of illicit drug use, or dependence on alcohol. However, assuming only that the use of MDMA in this application can be properly regulated and that patients are carefully screened and then monitored closely, the use of MDMA may be appropriate to treat combat veterans and others suffering from PTSD despite traditional forms of treatment for the disorder.
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Frain, M.P., Bishop, M., and Bethel, M. "A Roadmap for Rehabilitation Counseling to Serve Military Veterans with Disabilities." Journal of Rehabilitation, Vol 76,
No. 1; (2010): 13-21.
Gerrig, R, and Zimbardo, P. (2008). Psychology and Life. New York: Allyn & Bacon.
Mithoefer, M.C., Wagner, M.T., Mithoefer, a.T., Jerome, I., and Doblin, R. "The
safety and efficacy of ±3, 4- methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study." Journal of psychopharmacology (July 19, 2010). Retrieved January 15, 2011 from: http://jop.sagepub.com/content/early/2010/07/14/0269881110378371
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