An open label study of a group of individuals suffering from posttraumatic stress disorder (PTSD) who also reported suffering chronic pain showed that MDMA-assisted therapy led to significant reduction in pain intensity and pain-related disability in participants with highest levels of chronic pain. In participants with medium levels of chronic pain at the start of the study, this treatment lead to a decrease in pain intensity. The study was published in Frontiers in Psychiatry.
MDMA (3,4-methylenedioxymethamphetamine) also known as ecstasy or Molly, is a drug that affects the brain and alters mood and perception. It is often used recreationally because it causes feelings of euphoria and empathy, making people feel more open and connected to others. However, it can also lead to potentially life-threatening adverse health effects including high blood pressure, panic attacks, loss of consciousness, seizures, and others.
Once it is broken down in the body, byproducts created in this way interfere with the body’s ability to metabolize MDMA. Due to this, additional doses of MDMA can produce unexpectedly high MDMA levels in blood increasing the likelihood of an overdose with likely dangerous consequences. Due to this, MDMA is an illegal drug in most jurisdictions, including the United States.
Despite this, potential medical use of MDMA, under controlled conditions, has received much research interest. One promising area of research is MDMA-assisted therapy, which involves trained therapists providing a supportive environment for individuals to explore their emotions, memories, and experiences while under the influence of MDMA. This therapy has shown promise in clinical trials, especially for treating conditions like PTSD. However, its potential effect on chronic pain has not been thoroughly investigated.
Study author Devon Christie and her colleagues recognized that chronic pain (consistent pain lasting at least 3 months) is one of the leading causes of disability worldwide. Approximately one in five people in the U.S. and up to 40% of people globally suffer from chronic pain. The researchers hypothesized that since chronic pain shares similarities with PTSD, MDMA-assisted therapy might also help alleviate chronic pain.
The study analyzed data from 33 participants, 19 of whom were female, who were enrolled in a Phase 2 open-label study called MP-16 conducted by MAPS Public Benefit Corporation. This study aimed to investigate the effects of MDMA-assisted therapy on patients with PTSD. The participants had severe PTSD but did not have a substance use disorder diagnosis within the 60 days prior to the study. They were also asked to discontinue any psychiatric medications for the duration of the study.
At the beginning and end of the study, participants completed an assessment of chronic pain using a tool called the Chronic Pain Grade Scale (CPGS). Based on the initial assessment, participants were divided into three groups based on their level of chronic pain: highest, medium, and lowest. The researchers looked at two aspects of chronic pain: pain intensity and the level of disability caused by the pain. The majority of participants (84%) reported experiencing pain, and 75% reported disability associated with the pain.
During the study, participants attended a series of sessions conducted by two clinicians. They took MDMA on three occasions, with each session lasting eight hours and both therapists present. The MDMA sessions were spaced three to five weeks apart and were preceded and followed by three non-drug therapy sessions that aimed to prepare for and integrate the MDMA sessions. The researchers used a flexible dosing schedule for MDMA, starting with 80mg followed by another 40mg in the first session and increasing to 120mg and 60mg in the second session.
The results showed that both pain intensity and disability significantly decreased after the intervention in the group with the highest levels of chronic pain at the beginning of the study. In the group with moderate levels of chronic pain, pain intensity also decreased after the treatments compared to the start of the study.
“Significant reductions in pain and pain-related disability among participants in the highest pain cluster may be due to higher baseline pain values allowing greater margin for improvement; there may also be a mechanism related to an amygdala-based threat response to higher levels of pain being positively impacted by MDMA assisted therapy, since overlapping brain areas have been shown to be active in both pain related threat perception, and anxiety and fear-based threat perception as typified by posttraumatic stress disorder”, study authors conclude.
While this study contributes to our understanding of managing chronic pain, it’s important to note that it was an open-label study. This means that participants were aware of the study’s goals and procedures, which could introduce bias. Additionally, all assessments relied on self-reports, which could be influenced by participants providing answers they believed researchers were interested in.
In summary, this study suggests that using MDMA-assisted therapy may help reduce chronic pain in individuals with PTSD, particularly those with higher levels of pain. However, more research is needed to further explore this potential benefit.
The study, “MDMA-assisted therapy is associated with a reduction in chronic pain among people with post-traumatic stress disorder,” was authored by Devon Christie, Berra Yazar-Klosinski, Ekaterina Nosova, Pam Kryskow, Will Siu, Danielle Lessor, and Elena Argento.
