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Why MDMA therapy for alcohol use disorder? And why now?

Ben Sessa

Neuropharmacology November 1, 2018 Peer reviewed DOI: 10.1016/j.neuropharm.2017.11.004 via PubMed

Summary

Patients with alcohol use disorder who have completed medical detoxification may benefit from MDMA-assisted psychotherapy, a treatment not previously explored for substance use disorders. Historically, psychedelic therapy was used to treat alcoholism but fell out of favor. Recent interest in psychedelic clinical research is reviving the potential of these treatments, particularly for conditions like PTSD, which share commonalities with alcohol use disorder due to associated traumatic experiences.

Study at a glance

Population patients with alcohol use disorder who have undergone medical detoxification
Key finding MDMA-assisted psychotherapy may provide benefits for patients with alcohol use disorder after detoxification.

Abstract

Alcohol use disorder represents a serious clinical, social and personal burden on its sufferers and a significant financial strain on society. Current treatments, both psychological and pharmacological are poor, with high rates of relapse after medical detoxification and dedicated treatment programs. The earliest historical roots of psychedelic drug-assisted psychotherapy in the 1950s were associated with Lysergic acid diethylamide (LSD)-assisted psychotherapy to treat what was then called, alcoholism. But results were varied and psychedelic therapy with LSD and other 'classical' psychedelics fell out of favour in the wake of socio-political pressures and cultural changes. A current revisiting of psychedelic clinical research is now targeting substance use disorders - and particularly alcohol use disorder - again. 3,4-Methylenedioxymethamphetamine (MDMA)-assisted psychotherapy has never been formally explored as a treatment for any form of substance use disorder. But in recent years MDMA has risen in prominence as an agent to treat posttraumatic stress disorder (PTSD). With its unique receptor profile and a relatively well-tolerated subjective experience of drug effects when used clinically, MDMA Therapy is ideally suited to allow a patient to explore and address painful memories without being overwhelmed by negative affect. Given that alcohol use disorder is so often associated with early traumatic experiences, the author is proposing in a current on-going UK-based study that patients with alcohol use disorder who have undergone a medical detoxification from alcohol might benefit from a course of MDMA-assisted psychotherapy. This article is part of the Special Issue entitled 'Psychedelics: New Doors, Altered Perceptions'.

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