Questions and Concerns About MDMA-Assisted Therapy (MDMA-AT) in Veterans with PTSD Symptoms

Veterans receiving care from the Veterans Affairs system hold a mix of hope, curiosity, and concerns about MDMA-assisted therapy for PTSD. In a story completion task, at least one third of 30 participants mentioned shortcomings of existing treatments, curiosity about the treatment's rationale, hope, and concerns about side effects, subjective effects, and addictive potential. Clear misunderstandings about the molecule, treatment, or its implications appeared in at least 10% of narratives. Allusions to therapist abuse, microdosing, and the role of sitters were rare. These findings can guide development of surveys and psychoeducation materials to address attitudes in larger veteran samples.

Study at a glance

Abstract

MDMA-assisted therapy (MDMA-AT) for post-traumatic stress disorder (PTSD) shows promise, but attitudes and beliefs about this treatment, especially in symptomatic veterans, remain poorly understood. We sought to explore relevant attitudes in veterans receiving healthcare from Veterans Affairs as a step toward designing relevant surveys or psychoeducation materials for future work. We employed a story completion paradigm designed to sidestep aspects of self-report bias. Participants (N = 30) crafted narratives about an anonymous veteran with PTSD contemplating MDMA-AT. Coders rated transcripts, revealing recurring themes. At least one third of the sample mentioned shortcomings of available treatments, curiosity about its rationale, hope, and concerns about side effects, subjective effects, and the possibility of addictive potential. Despite widespread news coverage of the topics, allusions to therapist abuse, microdosing, and the role of sitters were relatively rare. At least 10% of the sample mentioned clear misunderstandings about the molecule, the treatment, or its implications. These data provide directions for the development of standard surveys of psychedelic-assisted treatments, which would help address these attitudes in larger samples. They can also inform psychoeducation materials that might help increase public awareness about this intervention, especially for veterans with symptoms.