Colorado took a leap into uncharted waters with the passage of SB23-290, the Natural Medicine and Legalization bill (Weed Between the Lines, “Laying down the law,” May 11, 2023). That bill decriminalized five natural psychedelic substances for therapeutic use: psilocybin, psilocin, DMT, ibogaine and mescaline. On top of that, licensed physicians in this state can also legally prescribe the FDA-approved ketamine nasal spray or tablets for patients suffering from specific mental health disorders.
That’s six psychedelic substances that are now legally available for Coloradans suffering from treatment-resistant depression, anxiety, addiction, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), addiction and more.
But one substance that remains illegal — at least for now — is considered by some to be the most effective PTSD treatment ever created. Commonly called “Molly” or “ecstasy” 3,4-Methylenedioxymethamphetamine (MDMA) isn’t a classic psychedelic. Technically it’s an empathogen–entactogen with stimulant and minor psychedelic properties. And according to the federal government, it is a highly dangerous, highly addictive Schedule I substance with no known medical benefits.
Scientists tend to disagree with that, though. As our understanding of this drug has grown along with research conducted by organizations like the Multidisciplinary Association for Psychedelic Studies (MAPS), the psychiatric benefits possessed by MDMA are showing greater and greater potential.
MDMA was invented in 1912 by the drug company Merck. And in fact, it was first used to enhance psychotherapy in the 1970s. But by the 1980s it had been adopted as a party drug. It was classified as a Schedule I substance in 1985 and subsequently found its way into concerts, dance parties, raves and music festivals over the next 40 years via the black market.
But as the science of psychedelics has slowly progressed, so has our understanding of this strange molecule’s potential uses and benefits. Throughout the ’90s and into the ’00s, MAPS funded many different clinical trials around the globe investigating MDMA-assisted psychotherapy for PTSD and more.
It wasn’t until 2004 that the FDA and DEA approved the first U.S. clinical trial of MDMA in humans. The study, published in the Journal of Psychopharmacology in 2010, was a randomized, placebo-controlled Phase 2 trial with 20 patients all suffering from treatment-refractory PTSD. At the end of the study, 83% of the paricipans no longer qualified for PTSD as measured by the Clinician-Administered PTSD Scale (CAPS).
In 2006, MAPS funded a Phase 2 study of MDMA for PTSD treatment that showed a similar reduction in CAPS scores, with even greater reductions at the one-year follow-up.
“If you were to design the perfect drug to treat PTSD, MDMA would be it,” Rick Doblin, founder and president of MAPS recently told the Washington Post.
But PTSD isn’t all this drug can treat. MDMA has also shown promise as a couple’s therapy drug, a treatment for anxiety in autistic adults, anxiety in those facing life-threatening illnesses, and even for treating eating disorders. According to MAPS, since the classification of MDMA as a Schedule I substance, “there have been over 5,000 articles written about the compound in academic journals, and over 1,100 volunteers have taken MDMA in clinical settings.”
Still, MDMA was not included in the ballot measure or subsequent bill (SB23-290) that decriminalized psychedelics for psychotherapy in Colorado. According to state and federal law, possession of less than four grams of MDMA is a Class 4 felony in Colorado, and anything more than that is a Class 6 felony.
That is, until the federal government permits the use of MDMA itself. In June 2022 Governor Jared Polis signed HB22-1344 into law. The “FDA-approved Prescription 3,4-Methylenedioxymethamphetamine Drug Use” bill would legalize prescribing, possessing and using MDMA if and when the Food and Drug Administration (FDA) eventually approves the substance as a prescription drug.
Which could happen sooner in the U.S. than one might expect. MAPS has already applied for FDA approval of MDMA, and Doblin is hopeful for its chances of success. He told Fox Business Live that it’s “quite likely that FDA will indeed approve MDMA-assisted therapy for PTSD, we think, sometime around April-May 2024.”
At which point, Colorado will follow suit. And this state will then have seven different psychoactive drugs at its disposal to treat some of the most insidious mental health disorders facing Coloradans today.
