I was amused by Conal Urquhart's description in the Observer of the novelist Lionel Shriver being sucked into an MRI brain scanner "that resembles a giant washing machine". I see her tumbling around with the rest of the laundry, including actor Keith Allen and former MP Evan Harris, to emerge bright and uplifted.
The three of them were participants in a brain imaging study into the effects of MDMA ("ecstasy") on brain function, parts of which will be televised on Channel 4's Drugs Live documentary on Wednesday and Thursday night.
Harris, who is also a doctor, said the trial could "pave the way to further research into potential therapeutic uses of MDMA, such as in the treatment of PTSD [post-traumatic stress disorder]". But others have raised doubts. Urquhart quoted a Home Office spokesman as saying that "televising the use of illegal drugs risks trivialising a serious issue".
Surely, though, developing improved treatments for severe health problems is also a serious issue?
Readers may remember my article earlier this year about a similar brain-imaging study on psilocybin, the active ingredient in magic mushrooms. The research formed part of the Beckley Foundation/Imperial College Psychopharmacological Research Programme, a collaboration between the Beckley Foundation, which I founded and direct, and Professor David Nutt's group at Imperial College. The MDMA study featured in Channel 4's Drugs Live is a continuation of that programme.
Contrary to expectations, psilocybin decreased cerebral blood flow, particularly to brain regions that act as "connector hubs" responsible for filtering and co-ordinating the flow of information through the brain. These hubs impose a top-down control on our awareness, integrating sensory inputs and prior expectations into a coherent, organised and censored experience of the world. By reducing blood supply to the hubs, and thereby decreasing their activity, psilocybin allows a freer, less constrained state of awareness to emerge.
This finding provides a neuroscientific underpinning for the metaphor of the brain as a "reducing valve" whose censoring activity is turned down by psychedelics – an idea popularised by the novelist Aldous Huxley in his 1954 essay The Doors of Perception.
Besides providing insights into consciousness and brain function, the results from our psilocybin studies highlight important new therapeutic possibilities. One of the hubs throttled back by psilocybin is known to be chronically overactive in depression. By lowering the activity of this region, psilocybin may allow the unremitting ruminative thought patterns that underlie depression to be reset. On the back of this finding, the Medical Research Council has awarded a major grant for a study of psilocybin in the treatment of severely depressed patients, which has just begun.
Psilocybin reduces the blood supply and activity of another "connector hub", which is overactive in cluster headaches. Cluster, nicknamed the "suicide headache" because it is so agonising, is notoriously difficult to treat – though anecdotal evidence suggests that psilocybin and LSD provide relief. Unfortunately, patients currently have to obtain these substances illegally, without the benefit of medical advice and supervision.
As these results prove, brain imaging research can add invaluable insights to knowledge gained from other scientific and clinical fields. The new MDMA research aims to do just that.
Growing out of the Beckley/Imperial psilocybin research, the MDMA work also uses fMRI to monitor activity in different parts of the brain, and compares the effects of the drug with those of an inactive placebo.
MDMA is a pure form of the club drug ecstasy, which is often contaminated with other substances. The drug used in these studies is held legally under a Home Office licence (so Channel 4 is not "televising the use of illegal drugs"). The MDMA is administered at a controlled dose, with informed consent, using procedures for which we have gained ethical approval.
Our brain imaging research complements work in progress in America into the efficacy of MDMA-assisted psychotherapy as a treatment for PTSD: the participants include war veterans, police officers and firefighters. The research is urgent because Pentagon statistics released in June show suicides among active troops running at about one per day, significantly outnumbering combat deaths.
Our imaging study is still incomplete, but preliminary results provide fascinating insights. After taking MDMA, positive memories were experienced as more vivid than after placebo. Correlating with this subjective experience, MDMA evoked an increased activation of the visual cortex compared with placebo. By contrast, during recollection of negative memories, the brain scans showed a decreased activation under MDMA compared with placebo.
Our finding suggests that MDMA may enable PTSD patients to access negative memories without a feeling of overwhelming threat, which could enable subjects to better confront and wash out their traumatic experiences.
The scans have also shown that MDMA reduces the connectivity – that is, the degree of synchronisation – between two important "connector hubs" in the brain that show elevated connectivity in depression. The finding suggests that, like psilocybin, MDMA could be valuable in the treatment of depression, by breaking over-rigid, introspective thinking patterns.
Securing funding for research of this kind is not easy. Using MDMA and other controlled drugs for scientific purposes is legal, so long as the appropriate licences are granted and complied with. However, the prohibitionist policies towards psychoactive substances create a strong taboo, which makes many scientists, universities and funding bodies unwilling to become involved.
Evan Harris is surely right that research into potentially valuable treatments for serious and intractable conditions should be encouraged. While a small charity like the Beckley Foundation does the best it can to initiate, support and collaborate in scientific research, we need to raise awareness in order to attract further funding.
Debate should be fostered, not stifled, so I see the involvement of Channel 4 as serving an important educational purpose. We would have no problem with a documentary investigating how a substance such as pethidine – a Class A drug like MDMA – alleviates obstetric pain. Why treat MDMA differently?
The illegal status of many psychoactives is a key policy challenge of our time, and seriously interferes with scientific research. Let us hope that before too long, the stain of the taboo will be washed away, and scientific evidence will prevail.
Amanda Feilding is director of the Beckley Foundation, a thinktank working for health-oriented drug policies based on scientific research
Comments
26 September 2012 8:11AM
i think society really needs to grow up and realise that cutting off its own nose to spite its face, isn't going to get us anywhere. scientific research into how ANY kind of drug might benefit psychological or physiological ailments should be enjoying the limelight of grants and experimentation. these illnesses affect everyone; everyone should be supporting this research.
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Share26 September 2012 8:23AM
Just legalize all drugs, anyone who is an addict can get proper treatment and not resort to crime. Why does society have to be geared towards the wishes of the minority of uninformed hysterics? it's not helpful to them, never mind the rest of us.
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Share26 September 2012 9:48AM
Fascinating stuff.
Now let's wait for the hysterical outbursts from those moral crusaders who can't entertain the thought of allowing a substance that makes life a bit nicer, without causing the kind of damage alcohol does, to be freely available.
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Share26 September 2012 10:08AM
MDMAZING :)
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Share26 September 2012 11:21AM
"The illegal status of many psychoactives is a key policy challenge of our time, and seriously interferes with scientific research"
It really is. We need a strong politician/party standing up and saying, does prohibition increase or decrease the harmful effects of drugs? that should be the starting point, then rationally develop policy specific to each drug.
.
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Share26 September 2012 11:45AM
The benefits have been known for some time, similarly LSD could have and should have been used as a wonder drug. The real fear from tptb back in the 70's wrt to LSD was that it could cause millions to drop out and tune in, arguably that's when the puritanical rage versus drugs kicked off in the modern era.
But when you have guys who should be lauded such as Professor Nutt who was castigated by all the mainstream media sources and politicians, who then skulked off due to their own personal 'problems', you realise you cant swim versus the tide of manufactured public opinion. "Drugs bad, drink to oblivion cos the lobby firms say it's OK, good.."
Nutt was the voice that could have brought the discussion into the light and into the living room, far too scary a concept for our political leaders who will happily cover up the hundreds of deaths this week through alcohol and have their apparatchiks scour the news feeds for that one evil event dubiously caused by taking a pill, or tab, or having a spliff..
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Share26 September 2012 11:52AM
so it could be that MDMA cures any number of ills: however, the money's not in the cure, it's in the medicine. there's a perverse logic to banning it, but it's not about health
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Share26 September 2012 11:57AM
MDMA might alleviate depression temporarily but most illegal drug takers will testify that the after effects can be crippling. Comedowns aren't pretty. If only you could come down the same way you went up.
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Share26 September 2012 11:58AM
Three points:
- Very interesting and worthy experiment
- Good luck with the come downs
- Professor Nutt - beautiful nominative determinism
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Share26 September 2012 12:04PM
Well if it was manufactured by a 'Walter White' obsessed with near on perfection, as opposed to guys obsessed with profit, that wouldn't be an issue would it?
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Share26 September 2012 12:05PM
If you go out and bosh 8 pills in a night, you'll get a comedown. However, keep it 'sensible' and you won't. I think the research is now pointing to lack of sleep, food, etc being more responsible for the comedown than the drug itself.
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Share26 September 2012 12:09PM
Fascinating. The alcohol industry shat itself at the rise in popularity of ecstasy, as the consumption of booze plummeted at events where the punters had taken ecstasy, and the relentless tabloid scare-stories did the alcohol industry a great favour in demonizing ecstasy. How beneficial or harmful ecstasy is should be decided in laboratory conditions, not in the pages of moronic tabloids.
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Share26 September 2012 12:11PM
My experience on MDMA is of being completely open and honest, with myself and with others, in my emotions, and a deep sense of love and kinship for those I love and my friends.
How did a drug with such wonderful properties become illegal?
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Share26 September 2012 12:12PM
You're supposed to put them in your mouth Jon.
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Share26 September 2012 12:12PM
That is just not true. It's effect decreases in a soft, gradual, almost elegant way . No idea what happens if you take too much though, as I have never seen anyone in that situation.
You have never tried it. Am I wrong?
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Share26 September 2012 12:14PM
Some people get comedowns on medium doses, some people dont.
But it is worth it, for the experience. And that is why it is proven to help with depression, marriage counselling etc. It allows you a freedom and honesty to release your inner demons. A powerful catharsis with which so many people could do with.
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Share26 September 2012 12:21PM
More the reason to let trained scientists research the effects rather than relying on the colloquial testimonies of "illegal drug users".
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Share26 September 2012 12:22PM
I have indeed tried it. I think it is a wonderful experience. And I have taken it on occasion over the last 10 years. Birthdays and Bank Holidays. I agree that the wearing off stage is very pleasant. It's the three days later that has a marked effect.
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Share26 September 2012 12:23PM
I have taken MDMA, LSD and psilocybin so I can talk from experience here. Such approaches to disorders are worthwhile and positive in my experience and there should no longer be any taboos regarding these drugs.
Are you aware of Samuel Widmer and his movement in Switzerland, and the First International Congress for Alternative Psychiatry, Real Psychotherapy and Psycholytic Therapy in June 2013?
It's time to talk about this issue and get to work helping people with depression in this way.
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Share26 September 2012 12:24PM
This can't approach this in a rational manner, politics is about perception & self preservation. The pro-drugs lobby needs massive funding and PR experts, then maybe some traction could be gained.
The biggest weapon they have is that economically (in so many ways) it makes sense, maybe as the economy shits itself further, alternate policies can be more relevant.
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Share26 September 2012 12:27PM
Hopefully not, but there is still a lot of ground to cover. The most open of open investigations in less than a handful subjects is more of a publicity stunt than science, and still leaves us a long, long way away from clinical use, and even further from a licence. The precedent set by Sativex shows that the regulator is unlikely to turn down a viable medicine for the reason that it is begat from a class A drug. However, my main reservation is that MDMA, a compound arising from the pharmaceutical industry, is (I think) celebrating its centenary this year and to date still hasn't got a clinical use. Surely that industry would have at least used it as a lead to something in the meantime? The biggest question I have at present is what - if any - unpublished data remains on file with anyone? Important work may have already been conducted, and the fact that we can't answer that question either way with confidence is possibly the greatest disappointment of all thus far. "Data on file" should be consigned to history.
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Share26 September 2012 12:28PM
Well you're the expert but I suspect the neural activity decreases first and then after a delay the blood flow reduces.
Do you have any way of knowing whether the net neural activity is on balance excitatory or inhibitory?
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Share26 September 2012 12:29PM
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26 September 2012 12:30PM
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26 September 2012 12:32PM
David Nutt's excellent book published this year, Drugs - Without the Hot Air: Minimizing the Harms of Legal and Illegal Drugs is a fascinating and highly informative read.
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Share26 September 2012 12:42PM
what goes up will come down even with 1 pill. proprer MDMA has quite a hit for many folks
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Share26 September 2012 12:46PM
I enjoyed a single 150mg dose of MDMA last Friday. I didn't re-dose, I was asleep by 2am, and I avoided alcohol.
The result? A wonderful evening, and absolutely no hangover or comedown whatsoever.
You only get a comedown if you cane it. Which is obviously not a good idea.
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Share26 September 2012 12:47PM
Good article. I can't wait to watch this, should be interesting.
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Share26 September 2012 12:47PM
Rubbish, the participants in this trial didn't get any comedown. The idea that you can take a single moderate dose of MDMA and be emotionally crippled by the comedown is pure ignorant fantasy.
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Share26 September 2012 12:48PM
get on one.
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Share26 September 2012 12:50PM
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26 September 2012 12:55PM
Expect nothing resembling a reasoned response from government with their 'drugs are bad mkay' attitude.
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Share26 September 2012 12:57PM
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26 September 2012 12:57PM
Won't somebody please think of the children!
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Share26 September 2012 12:57PM
That's all very well, my experience too, but the tragedy is that people are so averse to being like this in their 'normal' lives. You shouldn't need to take a drug to be open about yourself. As ever, therapeutic treatments, not drugs, are the ultimate answer - drugs are a (useful) stopgap.
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Share26 September 2012 12:58PM
I've had good quality MDMA countless times. Here's a theory. If you take one pill and taking another pill would still work, then surely your brain is still capable of producing seratonin? It's the people who bosh pills on a night until they stop working that really suffer.
Anyway, I think Nutt has things to say about comedowns and whether they're strictly a product of the drug or more to do with skipping a night's sleep.
The only real side effect I get from occasional *sensible* MDMA use is sleep paralysis a couple of nights later (though that can be solved with anti-anxiety type prescription meds).
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Share26 September 2012 12:58PM
I have 3 tickets to Jon Snow's televised debate on this.. anyone fancy a night out after?
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Share26 September 2012 12:58PM
I though any fule kno this already.
Maybe people just forgot ;o)
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Share26 September 2012 12:59PM
Moderation, education, quality-control... like anything else really
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Share26 September 2012 1:01PM
MDMA MAY help treat depression, so might alcohol reduce social anxiety, a healthy diet and frequent exercise may protect from diabetes and obesity, studying hard at school may lead to exam success and may indicate positive future career prospects, economic prudence may lead to wealth, snake oil, rhino horn and viagra may turn you into a stallion overnight. Or maybe not.
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Share26 September 2012 1:01PM
MDMA certainly would tackle depression....until the 'Miserable Mondays', 'Terrible Tuesdays' or the 'Wank & Weepy Wednesdays'. I'm not depressed but after taking pills on the weekend, even I struggle with the comedown.
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Share26 September 2012 1:02PM
And depression is an inevitable outcome of the capitalist system that is in place in most of the western world- it objectively makes most people spend a lot of their waking hours doing jobs that are fundamentally meaningless outside of making profit for someone else. It's a sane reaction if that depresses you, not some kind of 'mental health' problem. So giving people drugs is a profoundly reactionary solution to the underlying problem, much as they may initially seem like a godsend (I speak as someone with plenty of experience of taking anti-depressants)
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Share26 September 2012 1:04PM
150mg? That's the holy grail (well, 132mg, for most, allegedly). Where did you get it, man, woman, pet?
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Share26 September 2012 1:08PM
I was once prescribed fluoxetine. The community mental health nurse who instigated the prescription told me there were a whole range of new drugs coming onto the scene (this was 2006!) that were effective, not addictive, and not associated with weight gain, unlike the older but similar drugs. He sat and stroked his chin like a philosopher on the verge of a breakthrough and then in a flash of inspiration said 'fluoxetine might work'.
At the time I wasn't au fait with the drugs scene, so didn't realise this was the great Prozac. In essence he'd sat there looking clever when he knew all along it was the only drug he had any intention (or power) to recommend.
I raised the question of what SSRI drugs do: if they inhibit the reuptake by the brain of serotonin doing the rounds, why not leave that process alone and stimulate additional serotonin? That would surely be the same: I joked - why not just take some 'E'? He said this was completely unthinkable.
As it turned out, the Prozac worked, for about a month, then things returned to exactly the way they were. I lost half a stone, then gained a stone and have kept it on ever since. The drug quickly became a habit and missing a dose meant added anxiety, all for no actual benefits at all. In the end I came off it, but what a total waste of time.
Ironically it now turns out his vehement dismissal of the potential of MDMA was as stupid as his vehement advocacy of fluoxetine. Why am I not surprised?
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Share26 September 2012 1:13PM
I'm only going to watch it if I can see John Snow mashed up.
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Share26 September 2012 1:23PM
I think this is correct. When I work for clubs and gigs professionally I do not take MDMA or anything else including alcohol. Yet I keep the same hours, often much longer hours and I feel the same as if if I had a dose of MDMA. I have said to many friends over the years that I do not suffer comedowns. Simply tiredness.
Im 40 now, never suffered from Depression which is more than can be said for a few friends who never take anything.
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Share26 September 2012 1:23PM
I think this is correct. When I work for clubs and gigs professionally I do not take MDMA or anything else including alcohol. Yet I keep the same hours, often much longer hours and I feel the same as if if I had a dose of MDMA. I have said to many friends over the years that I do not suffer comedowns. Simply tiredness.
Im 40 now, never suffered from Depression which is more than can be said for a few friends who never take anything.
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Share26 September 2012 1:25PM
On a serious note, though:
makes perfect sense to me (albeit anecdodally, so sorry about that).
My experience here is that MDMA acheives a similar effect to CBT (cognitive behavioural therapy), in that users tend to view events in the same way as CBT trainees are encouraged to perceive emotions - neither as positive nor negative, but just as... arising. Unburdened by negativity, it's a lot easier to process them and feel empathy rather than depression. And this doesn't last only for as long as the drug is in the bloodstream. The mind remembers and reinforces positive strategies revealed while "under the influence". That's my feeling, anyway. It will be fascinating to see whether the research agrees.
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Share26 September 2012 1:31PM
I'm addicted to an opiate drug. I indulge in it roughly every other day, though yesterday's session didn't last long enough to get high. I don't find the comedown very hard at all, it usually happens in the shower afterwards. Sorry, didn't I say? the opiates I'm addicted to are Endorphin, Enkephalin and Dynorphin and my brain makes and secretes them after I've been running for about 30minutes. The comedown is much the same whether I've run 5miles or 15, though the longer sessions are the ones that get you really addicted.
You are ignorant of biology and pharmacology. Don't spout off until you know something.
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Share26 September 2012 1:34PM
Bit of MaDMAn and then off for a jog.
(Apologies to those of you not on the 'Depression and exercise' blog yesterday. For fuck's sake don't take me seriously.)
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