Melissa ParkerMelissa Parker

UPDATED Dec. 28: The head of a local nonprofit health organization recently completed training on using MDMA to treat people suffering from post-traumatic stress disorder, or PTSD.MDMA (3,4-methylenedioxy-methamphetamine) outside of clinical trials currently remains illegal to have or to use.

MDMA is often known as a party drug or street drug referred to colloquially as “Ecstasy” or “Molly.” Recreational use of MDMA in an unregulated, crowded setting carries risks including elevated blood pressure, temperature and heart rate, among others, as described by this website from the National Institutes of Health.

Although MDMA is usually classified as a stimulant, hallucinogen or psychedelic, a federal website notes that MDMA has also been described as an entactogen — a drug that can increase self-awareness and empathy — properties that some psychotherapists believe can help patients in a carefully controlled clinical environment.

Artlington-based nonprofit

Melissa Parker, president of the board of Healing Options for Post-traumatic Experiences, or HOPE, based in Arlington, took the 100-hour Multidisciplinary Association for Psychedelic Studies Public Benefit Corporation's MDMA therapy-training program.

According to her résumé, Parker, a graduate of Goddard College and Lesley University, has more than a decade’s worth of experience as a therapist and counselor at a facility under the auspices of the Edinburg Center of Bedford; the Justice Resource Institute of Lexington and Boston; Eliot Community Human Services in Everett; and, currently, Center Psychotherapy in Winchester.

Parker's 100 hours of clinical training  earlier this year -- 60 hours asynchronous online and 40 hours in person -- has facilitated her learning the theory, skills and practice of MDMA-assisted psychotherapy, she said in a recent interview conducted by email.

Results from phase 3 clinical trials have shown that MDMA, when used in conjunction with psychotherapy, can offer a safe and effective way to catalyze the therapeutic process for those who live with chronic PTSD. Phase 3 clinical trials found that 67 percent of study participants no longer qualified for a diagnosis of PTSD, and 88 percent of participants experienced a clinically significant reduction in symptoms.

FDA approval expected to be sought in 2023

Many articles written about the clinical trials mention in passing that researchers think the federal government may approve its use for treatment as soon as next year. Contacted by YourArlington in late December, MAPS PBC spokeswoman Amanda Meglio-Dougherty said, “MAPS PBC is planning to seek FDA approval in Q3 of next year.”

Dr. Jennifer Mitchell, professor at University of California San Francisco and principal investigator under whose auspices the most recent studies were carried out, told YourArlington in mid-December, “If the submission is deemed complete, 6-10 months” is the usual time for a reply from the FDA, or Food and Drug Administration.

“MDMA-assisted psychotherapy allows individuals to stay regulated while continuing to be present and connected to the therapeutic process,” Parker said in a recent news release. “It creates a safe environment for therapists to help survivors process their trauma and achieve inner healing in a lasting way.”

The proposed regimen for therapeutic use is a rigorous one, as she described it to YourArlington in an interview conducted by email.

“The current protocol of MDMA-assisted therapy is a process that unfolds over a four-month period. Starting with intake and preparatory sessions, the proposed model of assisted therapy consists of at least three 90-minute preparatory sessions prior to the first experiential [MDMA] session,” Parker said. “Experiential sessions are eight hours long and are facilitated by a team of two co-therapists. Between experiential sessions are usually three integrative sessions; there are typically three eight-hour experiential sessions per course of therapy,” she continued.

“A course of MDMA-assisted therapy is capped off by at least three 90-minute therapy sessions focused on integrating aspects of the MDMA experience into the client’s daily life. Following experiential sessions, clients are asked to remain on site overnight. Integration sessions begin the morning after experiential sessions.”

How therapy differs

The amounts proposed to be used as part of therapy for recovery from PTSD are not necessarily dramatically different from those that may be ingested in a typical rave or party scene. However, in therapy, it is the intent, training, supervision and setting that make the difference.

“When used recreationally, MDMA users vary greatly in their dosage of MDMA. While a standard recreational dose of MDMA is usually in the range of 80 to160 mg, the average dose is 120 mg,” Parker said. “When used therapeutically, dosage is determined by the prescribing physician and will typically range between 80 to 120 mg; if desired a booster of 40 or 60 mg may be offered later in the session.”

She says that when MDMA is used in a clinical setting it has proven to be very safe. 

“Per my training, clients are carefully screened by medical professionals prior to acceptance into MDMA therapy, as some medical conditions -- some seizure disorders, heart conditions, pregnancy/lactation, liver issues and malignant hypothermia -- and medication interactions (such as with MAO inhibitors, SSRi’s, CYP2D6 metabolized drugs, CYP2D6 inhibitors and alcohol) can create serious health risks,” she noted. “Throughout the experiential sessions, client health is monitored, and a physician is on call for the duration of the course of therapy. MDMA is prescribed by a physician, and is self-administered by the client at the start of an experiential session. Therapists are advised to have training in first-aid.”  
Her own training 
Asked about her own status in this regard, she said, “I have had previous basic first-aid training. As I get closer to providing MDMA-assisted therapy, I plan to work towards certification.”
 

HOPE, a 501(c)(3) organization, works to overcome the significant barriers to accessing quality care and treatment for trauma survivors, Parker’s initial statement says -- including marginalized populations, especially people of color and people living in poverty.

Parker says HOPE’s goals going into 2023 are as follows:

  • Enable access to culturally responsible, high-quality support and training for mental health professionals;
  • Support access to effective, respectful and cutting-edge trauma therapy to survivors regardless of the survivor’s ability to pay;
  • Recruit, support and nurture the  talents and abilities of BIPOC, LGBTQIA+ non-profit and mental-health professionals; and
  • Rely on the experiences of laypeople and mental health professionals who have lived experience to guide and inform HOPE’s work.

Founded in 2020, HOPE, at 4 Water St., states that it intends to support individuals impacted by trauma by creating positive, progressive and lasting changes in their lives and communities. In a formal statement, HOPE’s leaders say they believe everyone deserves to find safety in themselves and that their organization achieves this by advocating for the opportunity to practice specialized treatment for psychological trauma and expanding access to this therapy to trauma survivors in a fair and equitable manner. 

Research ongoing at MGH 

MAPS-PBC and UCSF are not the only organizations assessing the potential of hallucinogens in mental-health therapy. The Harvard-affiliated Boston-based hospital Massachusetts General Hospital last year established a program to study, among other possibilities, clinical use of psilocybin, the active ingredient in “magic mushrooms.” 

The  website for MGH's Center for the Neuroscience of Psychedelics states in part that "Psychedelic compounds—in particular psilocybin, 3,4-methylenedioxymethamphetamine (MDMA) and N,N-Dimethyltryptamine (DMT)—have emerged as promising treatments that may increase the brain’s capacity for change."

It continues, "Studies suggest that psychedelics may facilitate neuroplasticity at the cellular and network levels, allowing the brain to form and reorganize connection. This creates a unique opportunity to change patterns in brain activity, and in turn, improve symptoms, behavior and functioning, to ultimately eliminate suffering."

It also notes, "The center's first study, led by Dr. Sharmin Ghaznavi, will explore psilocybin's effect on rumination, a process which contributes to depression, anxiety and other mental illnesses."

Training in psychedelic-assisted therapy is taking place on both coasts. The California Institute of Integral Studies in San Francisco offers it, according to this NBC account, and CIIS programs also take place in Boston. The article quotes another physician at MGH's neuroscience center, and also one at Harvard-affiliated Dana-Farber Cancer Institute who is looking into potential future psychedelic use to help cancer patients come to terms with their condition. And it mentions NYU's Center for Psychedelic Medicine's research into the possible use of psychedelics to treat alcohol use disorder.

 

This article, based on information and interviews with the HOPE organization of Arlington along with perusal of online sources whose links are contained within the article, was published Dec. 12, 2022. It was updated Dec. 22, 2022, with quotes from a MAPS PBC spokeswoman and a UCSF principal investigator about the process of applying to the FDA requesting approval of clinical use of MDMA. It was again updated, on Dec. 28, 2022, to provide information on other research centers studying the possible use of psychedelics in psychological treatment.