Firstly, let us not be naïve about motives. Channel 4 funded this clinical trial and so whether a necessary evil or good publicity it was going happen. The question therefore is ‘Is the programme biased, one way or another?’ But also will it glamorize drug use, after all on the surface it is a Channel 4 programme based on ‘celebrities’ and the like taking a Class A drug.
I for one did not find the programme to be biased, as much as the Daily Fail and its readers would like you to believe. It was not Channel 4’s fault the ‘anti experts’ were unable to effectively put their points across. And it probably didn’t help that most of the published work they referenced was based on recreational users, where the dosage is not controlled and the drug could have been cut with all manner of substances. We know today that a lot of ecstasy pills contain no MDMA but actually contain drugs like PMMA or BZP. It didn’t glamourize drug taking. People take MDMA because of the euphoric effects, the lovey feelings, the closeness it brings. How can you show an unbiased programme without showing the reasons why people take it, to miss this out would surely be a lie?
And then to the point of the clinical trial, because lets not forget this is the reason for all of this! (And the funding is the reason for the programme). For most drugs that fall under the Misuse of Drugs Act 1971 there is a body of work behind the therapeutic uses of them. A good example of this is heroin/diamorphine. Heroin is semi-synthetic, produced from the opium poppy and has a long history of therapeutic uses before its inclusion in the Act; heroin was sold as a cough medicine. Can you imagine if we didn’t have narcotic painkillers because of the number of people abusing heroin and research only showing the negative connotations of its use?
Unfortunately with MDMA its use and abuse meant it quickly became controlled and has since kept its stigma as a Class A party drug. There is no actual empirical evidence on how it may help with disorders such as PTSD or depression, and for all we know it might not. Though from the fMRI results there shows promise.
Many drugs are prescribed which are dangerous, which is why those patients prescribed it are subject to therapeutic drug monitoring (TDM) programs. MDMA may turn out to be a candidate for that. Who knows? No one yet! The programme showed an ex-SAS officer and a priest take MDMA, both with very different reactions. The dose of 83mg was enough to bring about lost memories of a traumatic experience for the priest who had suffered PTSD, showing potential (alongside the therapy sessions from the states). Then there is the ex-SAS soldier, maybe the dose was too high, maybe it wasn’t high enough, or maybe it would not be the right therapy for him. The point is, everyone is different, what drug works for one person may not work for the next. What dose works for one person, may not work for the next. And then there is defining a therapeutic range, should one be necessary. For example clozapine is prescribed for patients with treatment resistant schizophrenia, because other medications have failed. Originally it was banned because of its toxicity but it was too effective to ignore so a TDM program is in place for those who are prescribed it. A therapeutic plasma concentration is known, and doses can range dramatically from a daily starting dose of 12.5mg all the way up to doses of 1.5g.
The fact of the matter is we don’t know enough, if we really know anything of substance at all. There are too many maybes and maynots and this trial aims to change that. Lets not forget it will be published and peer-reviewed, and I look forward to seeing what results it yields.