MDMA, PTSD and the amygdala: Promising approach for treating SUDs

Summary

Many people with substance use disorder also have anxiety or post-traumatic stress disorder, often using drugs or alcohol to self-medicate, though not effectively. In PTSD, the amygdala, the brain's emotional center, becomes dysregulated: it generates positive feelings but also detects threats, failing to distinguish between physical and emotional threats. As a result, feeling fearful, sad, or unloved is experienced as a threat, driving substance use.

Study at a glance

Abstract

Most patients with substance use disorder (SUD) also have anxiety, and many have post‐traumatic stress disorder (PTSD), using drugs or alcohol to self‐medicate (although not effectively). What happens with PTSD occurs in the amygdala, explained George Koob, Ph.D., director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), in an interview with ADAW last week. The emotional part of the brain, the amygdala gets out of control with PTSD, because it not only gives positive emotional feelings, but it also senses threat. It doesn't distinguish between a physical and an emotional threat, so feeling fearful, sad and unloved can all be felt as threats.