December 21, 2011
Without Ecstasy, I Would Not Be Here Today
By: Eleanor Fox
MAKO News (Israel)
An Israeli news source describes MAPS’ upcoming Israeli study of MDMA-assisted psychotherapy for PTSD. The article includes an excellent interview with Tali Nachshoni, M.D., who was one of three therapists who recently participated in MAPS training study for MDMA-assisted psychotherapists in the U.S. Dr. Nachsoni describes her own experience undergoing MDMA-assisted psychotherapy as part of MAPS’ training program for clinical MDMA-assisted psychotherapy investigators. The study will begin enrolling and treating subjects in early 2012.
The following is an English translation of the original Hebrew article. Originally appearing here.
“I have arrived on the scene of many bombings, but it was only after the incident of the bombing on Desingoff St, where I witnessed 22 pieces on the floor, that I began to realize that something within me was wrong,” describes a Yom Tov Naftali a former ambulance driver, age 41, regarding the difficult everyday life during the 1990’s that left such a deep scar on his soul. He has been diagnosed with PTSD since that very bombing in Tel Aviv in 1994.
He lives with his mother in an old apartment in the city of Holon, which has neither a television or hot water and is having trouble sleeping at night, despite his use of sleeping and anti-anxiety pills. The healthy and tanned appearance of Yom Tov does not disclose the difficult emotions and memories which often times overwhelm him, but the small wrinkles forming at the sides of his eyes give a clue as to his life experiences, the part of himself he would surely rather forget.
“I forced myself to solitary confinement”
“You should have seen me three years ago. I was like a zombie who no longer connected or communicated with society and my environment. I forced myself to solitary confinement for long periods.” He tells his story and explains his own decline to living on the streets in 1999.
A decade later, following a divorce from the mother of his son, Naftali coincidentally heard about this study being conducted at the Psychiatric Hospital in Be’er-Ya’akov. When he made a request to receive medical marijuana he was told about the study being conducted in Israel treating PTSD using MDMA, which is the active ingredient in ecstasy, without added stimulants or other substances for that matter.
“For a matter of hours, I went back to being the same man I once was.” He remembers the effects of the drug, and discusses its contributions, “Ever since I took the MDMA, my condition is good in comparison to how I was before hand. Without this study it stands to reason that I would not be here at all in order to speak to you today.”
The study began 3 years ago - and was discontinued for improvements
The initial study with MDMA in Israel began in 2009 headed by Prof. Moshe Kotler, the hospital administrator and director of the day shift, Dr. Sergio Marchevsky, who works under him, with the approval of the Ministry of Health, but was discontinued for some improvements. In the near future, phase 2 of the research study is to begin with the participation of ten new subjects.
“The results of the initial study were fantastic. Four of the five participants who were diagnosed with chronic PTSD showed dramatic improvement. The fifth participant did not respond to his treatment.” says Dr. Marchevsky and explains that “the experiment was stopped when we decided to improve the quality of the treatment. We are dealing with a unique treatment that the hospital doesn’t have prior experience with, and so we made sure the therapists received better training and we added more therapists. We hope to restart the study this month.
“Production of this substance is not lucrative and therefore receives no attention from pharmaceutical companies.” Dr. Rick Doblin, President of the organization which funds this research
Try It For Yourself
“Within half an hour I was already feeling the effects of the substance. The feeling was super visual, a sense of lack of inhibitions and euphoria, feelings of happiness and supreme highness that I had never before felt naturally. I started making associations to musical lyrics and to hum.” This quote was not taken from a young girl after a wild trip to India, rather the testimony of psychiatrist Dr. Talley Nachshoni describing her experience with MDMA as part of the experimenter’s role in the study. Dr. Nachshoni is one of three therapists who were sent to the United States to be treated with the drug themselves, as part of their training for their role in the study. Upon her return to Israel, she tells about the experiences of the unique treatment that in the future she would administer herself.
“A tremendous sense of connection to myself”
“I lay in a bed with an eye cover and in the background there was “New-Age” music playing that was nice. At some point I was no longer able lay down, so I stood up and began to dance.” she describes and confesses that simply talking about her tremendous experience is making her hands shake. “When the therapists arrived to check in on me, I wanted for them to also experience this amazing feeling I was experiencing, so I invited them to join me . These were awesome sensations of deep connection, not only to myself, but to the whole world.”
Dr. Marchevsky thinks that it is exactly these sensations which indicate the success of the treatment, to float the issue of the patients trauma to the surface and to allow the patient to deal with it.
In preparation for the study, the participants were requested to cease consumption of their psychiatric medications and furthermore, to fast from the evening before consuming the experimental drug. When the therapist gives the patient the MDMA pill, the patient is immersed in an 8 hour therapy session. The patients are not informed of whether they receive the actual drug or the placebo.
The effect of the substance is supposed to be noticeable after 45 minutes, so the patients are asked to remain with their eyes closed and to “be with themselves” for the duration of an hour. After that then also begins a discussion. At times they also draw or dance. “The intention is to direct the discussion in the direction of the trauma while the patient is in this open state,” explains Dr. Marchevsky, “but it is important that the therapist directs the conversation. The therapists message will be: ‘Only if you let the medicine help you and guide you, will you be able to help yourself.’”
“Before the treatment itself some standard preparatory meetings are held with the patient. After that, a series of medical tests are administered and forms are filled out with an emphasis that the patient does not have suicidal tendencies,” explains Dr. Nachshoni. In addition, once the effects of the drug have subsided, the patient remains to sleep the night in the hospital. “The next day, and hour long therapy session is conducted where there is a continued conversation with the patient processing the events of the previous day, and for the first week they keep in touch by phone. For the following month after the initial treatment, a one hour weekly meeting is held with the patient,” she explains.
The Fall the Day After the Treatment
As with any other powerful drug, even with MDMA, “the love drug,” the effect of the euphoria wearing off can be accompanied by an intense feeling of deterioration of the patients mood. “If they had asked me to do the treatment again, I would not have been able to.” Says Yom Tov Neftali because in lieu of the effect that the drug had in his life, the come down from the effects of the drug would have put him at in the category of “at risk.” “The morning after the treatment there is a sense of a “down.” In my condition, as of today, I would not be able to survive it,” he explains.
As such, there are instances where the hospital cannot take such a risk. From the first, the study rules out any patient who has suicidal tendencies or those who suffer from personality disorders.
Israel: a leader in the Field of Trauma
This study, at a cost of $90,000, was created by the Multidisciplinary Association for Psychedelic Studies (MAPS) who studies such psychedelic drugs such as LSD, MDMA, and medical marijuana, for example, around the world. MAPS, a non-profit organization doing fund raising for these studies, provides training for therapists in different countries and guidance for the proper use and administration of these substances. Drug-induced therapy sessions during the study are recorded with video cameras, photographic materials are sent to the United States for review by the facilitators of the study, Dr. Michael Mithoefer and his wife Annie, clinical researchers from the organization, who view the treatments and monitor the studies progress and integrity.
“The success of the study in Israel is important to us,” explains Dr. Rick Doblin, President and Founder of MAPS, “Israel has a history of treatment for PTSD, especially because of the extensive traumas Israelis are exposed to. The success of the study in Israel, will raise awareness of treatment elsewhere in the world.”
Another study conducted by MAPS in the United States showed significant improvement in the majority of participants and in a study in Switzerland only one subject withdrew, while the majority were cured - although some eventually returned to their original state.
Dangerous drug or life saving treatment to be approved within the next decade?
Despite the impressive results of studies conducted by MAPS to date, Dr. Doblin explains that the advancement of this research is slower than other projects. “Production of MDMA is not profitable for pharmaceutical companies,” explains Dr. Doblin, “If the drug were to be legalized, it would still not be sold in pharmacies. Medical MDMA would be sold very inexpensively and exclusively to doctors who have received proper training for it use. Patients would undergo only a small number of treatments under the influence of the drug, and therefore pharmaceutical companies do not show interest in research funded by donations.”
In addition, the bad name of MDMA and its definition as dangerous and illegal does not make it easy for the researchers in this field. “The pills used in the study were imported from a pharmaceutical company in Switzerland at an inexpensive price, about 10 dollars per pill,” explains Dr. Doblin, “However, the screening and certificates of transfer, along with the testing of the pills themselves takes a lot of time and money.”
However, despite the many difficulties, Dr. Doblin, graduate of Harvard University in Public Policy, believes that he has not devoted the last 25 years of his life to this subject in vain. “Because I love Israel, I see it as a calling, a mission, to bring this research, which can change lives, to Israel as well.” He says and predicts a positive outcome for this field, “I estimate that within 10 years, when the extensive research which is required will culminate, treatment with MDMA will be legalized and licensed clinics will receive proper training and open.”
The Israeli Anti-Drug Authority also supports such research.
Surprisingly, of the factors with whom he collaborated in Israel, Dr. Doblin chooses rather to commend the Israeli Anti-Drug Authority. As part of the authorization process, Dr. Haim Mahal, Director of Treatment and Rehabilitation, speaks to the Ethics Committee for approval of human trials, where the authority has expressed its support for the research. “The Authority does not object to use of the intended substance as medicinal drugs and therefore supported the experiment, but remember this is only research and wait until we see actual evidence,” says Dr. Mahal.
However, ISA Vice President, Attorney Eytan Gurney would like to add and emphasize: “It is very important that they understand that there is a vast difference between those cases where the drugs are taken independently, at parties, for example, which we already know that people have been harmed or died in the past, and the cases in which they were taken under medical supervision, when the dose can be measured, legitimately manufactured materials used, and it is know exactly what substances are present in the pills. It is also important to remember that the subjects in the experiment are in bad emotional shape, so in this case the benefits could out way the damage .”
The Ministry of Health reported on the research that: “This is a preliminary phase of the study and there are no conclusive results yet, but it shows a satisfactory trend.”
Despite the Drug - The Daily Struggle of the Disorder
Naftali’s story is not the ideal story we would like to hear, like one with a fairytale ending. In moments of despair he managed to get himself entangled with the Municipality of Holon, and is on trial for this matter. He speaks often of death, and explains that he is still not recognized as a victim of a hate crime because he simply, “doesn’t have the facilities to deal with it.” “I struggle with myself daily not to go back to living on the streets, there I am doing just fine and I have almost no worries at all,” he describes his daily struggle with a humiliated demeanor.
Despite moments of breakdown, Naftali continues the rehabilitation process and manages to keep some little optimism, “I believe, if I would have had a better base to return to after the treatment, my condition as of today would look completely different.” he says, but adds that in the recent months he has been regaining custody of his son who has given him an excellent reason to improve himself and return to the path which leads to a new life. ” I am currently in a process that will eventually lead me to be able to live independently. I believe that within three months my situation will be different and everything will already look very different,” says Naftali and expresses hope that maybe soon he will be able to receive a follow up treatment at one of Dr. Doblin’s clinics.
Back to MAPS in the Media