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

Alcohol use disorder imposes heavy clinical, social, and financial burdens, and current treatments often fail, with high relapse rates. Early research in the 1950s used LSD-assisted psychotherapy for alcoholism but yielded mixed results before falling out of favor. Now, psychedelic research is revisiting substance use disorders, including alcohol use disorder. MDMA-assisted psychotherapy has not been formally tested for substance use disorders, though it is being studied for PTSD. MDMA's receptor profile and tolerable subjective effects may help patients explore painful memories without being overwhelmed. Because alcohol use disorder frequently co-occurs with early trauma, the author proposes a UK-based study where patients who have undergone medical detoxification from alcohol might benefit from MDMA-assisted psychotherapy.

Study at a glance

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'.