Rick Doblin, advocate for MDMA-assisted therapy for PTSD, discusses the potential benefits and challenges of using psychedelics for therapy. He explores the success rates of clinical trials using therapy and MDMA, the structure of MDMA-assisted therapy, and the concept of neuroplasticity. Doblin also reflects on his journey in the field of psychedelics and the impact of vulture decline on human health.
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Quick takeaways
MDMA-assisted therapy has the potential to address the root causes of trauma and provide lasting relief for PTSD.
MDMA-assisted therapy aims to rewire the brain and promote social reward learning and pro-social neural connections.
Expanding access to MDMA-assisted therapy beyond veterans can address a wide range of traumas and promote collective healing.
Deep dives
MDMA-assisted therapy shows promise for PTSD treatment
In this podcast episode, the guest, Rick Doblin, discusses the potential of MDMA-assisted therapy for the treatment of post-traumatic stress disorder (PTSD). He explains that traditional therapies and medications for PTSD have limitations and often only provide symptom management. In contrast, MDMA-assisted therapy aims to address the root causes of trauma by combining therapy sessions with the controlled use of MDMA, commonly known as ecstasy. Doblin shares the results of phase three clinical trials, which showed that two-thirds of participants no longer qualified for a PTSD diagnosis after the therapy. He also discusses the challenges faced in gaining approval from the FDA and the cultural and political biases surrounding the use of MDMA in therapy. Overall, the podcast highlights the potential breakthrough that MDMA-assisted therapy could bring to the treatment of PTSD and the importance of further research and widespread adoption.
Understanding the impact of trauma on the brain
Doblin explains that PTSD is characterized by a hyperactive amygdala, which processes fear, and reduced activity in the prefrontal cortex, which is involved in logical thinking. This imbalance leads to an exaggerated fear response and difficulty in processing traumatic memories. Current treatments, such as SSRIs and psychotherapies, have limited success rates and often require long-term use. Doblin highlights the need for new therapies that can address the core trauma and provide lasting relief. MDMA-assisted therapy aims to rewire the brain by reducing amygdala activity, increasing prefrontal cortex activity, and facilitating the storage of traumatic memories in long-term memory. The therapy also releases neurotransmitters and hormones, such as oxytocin, which promote social reward learning and the formation of pro-social neural connections.
The challenges and breakthroughs in gaining approval for MDMA-assisted therapy
Doblin shares the long and arduous journey of gaining FDA approval for MDMA-assisted therapy. He emphasizes the importance of rigorous methodology and scientific evidence in the face of critics who question the validity of the therapy. Doblin discusses the breakthrough therapy designation granted by the FDA, which expedites the review process for promising treatments. He also addresses concerns about the recreational use of MDMA and clarifies that the goal is to make MDMA-assisted therapy available as a prescription medicine covered by insurance, while advocating for the decriminalization of MDMA for responsible personal use. Doblin acknowledges the bias in traditional pharmaceutical approaches and the need for a new paradigm that combines therapy with psychedelic-assisted treatments to address the root causes of mental health disorders.
The potential for MDMA-assisted therapy beyond PTSD
While PTSD, especially among veterans, has received significant attention, Doblin highlights that MDMA-assisted therapy has the potential to address a wide range of traumas and mental health conditions. He discusses the broader impact of trauma, such as gun violence among inner-city youth and the lasting effects of sexual assault and domestic violence. Doblin emphasizes the need to expand access to MDMA-assisted therapy beyond veterans and highlights its potential for addressing multi-generational trauma and promoting collective healing. He envisions a future where MDMA-assisted therapy becomes a mainstream treatment for a variety of mental health conditions, leading to a more compassionate and empathetic society.
Rick Doblin's lifelong commitment to psychedelics and social change
Doblin shares his personal journey and the driving forces behind his commitment to psychedelic research and therapy. He recounts early experiences with psychedelics that sparked a realization of interconnectedness and the potential for consciousness change. Doblin discusses the challenges faced in pursuing his dreams, including resistance from societal norms and the pharmaceutical industry. He emphasizes the need for perseverance, deep principles, and a long-term vision to bring about meaningful change. Despite his personal successes, Doblin acknowledges the importance of recognizing survivor bias and encourages a diverse range of individuals to pursue their unique paths toward making a positive impact on the world.
For 37 years, Rick Doblin has been pushing the F.D.A. to approve treating post-traumatic stress disorder with MDMA, better known as Ecstasy. He tells Steve why he persisted for so long, why he doesn’t like calling drug use “recreational,” and what he learned from his pet wolf.