A new study published in the Archives of General Psychiatry trumpeting the dangers of Ecstasy use received a lot of attention recently. Its findings were in direct contrast to a large study released earlier last year that reached the opposite conclusion.
To help sort this out, I lobbed a few questions at Brad Burge of the Multidisciplinary Association for Psychedelic Studies:
Q. Your group financially supports MDMA research and also hopes to get FDA approval for the drug as a prescription treatment. One of the authors of this new paper says their findings provide the “strongest evidence to date that the drug causes chronic loss of serotonin in humans.” What do you say to that?
A. In fact there is nothing new to this claim. Government-funded researchers have been making these claims ever since the media started reporting on recreational Ecstasy use in the early 1980s. Most researchers, including the authors of this study, fail to ask or answer a number of important questions: (1) Were the users they observed only taking Ecstasy, or were they taking other drugs at the same time (e.g. cocaine, alcohol, caffeine, etc.)? (2) Ecstasy is not the same as MDMA—did the drugs these women take actually contain MDMA, or contain MDMA in addition to other substances? (3) How much were they really taking? (4) Since this was an observational study, causal statements such as these should not be made.
Q. “Government-funded researchers” is a bit of a dismissive phrase. Lots of researchers are supported by funding from federal agencies. Is the implication here that, when it comes to MDMA, research financed by the government is not credible?
A. It would be more to the point to say that when it comes to MDMA, much research funded by the government has not been credible. Lots of studies, including Cowan’s [Ronald Cowan of Vanderbilt University is the study’s co-author], have been methodologically flawed concerning polydrug use, unknown contents of black-market Ecstasy, and quantity of use.
Even worse, media have distorted the results to make huge, fear-based claims. There is no connection between Cowan’s study results and the associated claim that “Ecstasy causes permanent brain damage.” There are big differences between two years and forever, between changed serotonin levels and brain damage, between Ecstasy and MDMA, and between recreational and clinical use.
Studies have to be designed carefully enough that they actually measure what they claim to be measuring, and their results have to be reported responsibly.
Q. You’re certainly right that headlines overstated the case (for instance: “Ecstasy Causes Long-Term Brain Damage”). But in interviews, Cowan cautioned against assuming causation and pointed out that there’s “a difference between using the drug recreationally and using it therapeutically, at a low dose in a controlled setting.” So is this really a case of a biased study, or is it just—as you put it—irresponsible news reporting? Researchers aren’t responsible for bad headlines, right?
A. Right, as long as they carefully qualify their results and don’t leap to conclusions. Cowan’s statements and qualifications are definitely reasonable.
Irresponsible reporting of scientific results can cause real harm. Sensational headlines evoke fear, which makes it harder for people to accept research results in a rational, unbiased way.
Q. What’s the next step for MDMA research?
A. Increasingly, researchers and regulators alike are starting to take the science of MDMA at face value. Rather than ignore results or push their own agenda, a fast-growing field of researchers is studying MDMA from a clinical perspective.
We’re now in the midst of Phase 2 clinical trials of MDMA-assisted psychotherapy for posttraumatic stress disorder, and we’re showing that in the right circumstances and with the appropriate preparation MDMA can be a profoundly effective therapeutic tool. We are also offering a $10,000 grant to a team of researchers who can develop a protocol for MDMA therapy as a treatment for autism spectrum disorders.
We’re not a policy organization, we’re a research organization. We don’t lobby to change laws, but we do recognize that the research we do has a context. Part of that context is the war on drugs. When research shows, as it has, that it is possible to use MDMA, other psychedelics, and marijuana in safe and responsible ways, that undermines the logic of the war on drugs that blindly assumes that these substances can only be harmful. The fate of psychedelic research may very well depend on the quality of the public education—and journalistic coverage—that surrounds it.