How Psychiatrists Are Preparing to Prescribe MDMA

Some therapists aren’t just running ecstasy studies — they’re also enrolling


Photo: Jena Ardell/Getty Images

BBen Sessa was 18 years old in 1990 and working as a DJ in the early days of the London rave scene. “I was very much exposed to ecstasy,” he says. He doesn’t want to discuss the drugs he may or may not have taken back then. But he does admit to taking ecstasy a few years ago, this time for science, and is happy to talk about his trip.

Sessa, now a psychiatrist based in Bristol, U.K., is leading a clinical trial of MDMA, the technical name for the psychedelic, for treating alcoholism. His is one of several ongoing studies investigating whether the main ingredient in ecstasy might help people cope with serious psychiatric issues, such as post-traumatic stress disorder (PTSD), depression, and addiction. He is also enrolled in an MDMA study as a participant. That one is for therapists who are leading trials and who hope to offer the drug alongside therapy for patients with PTSD, substance abuse disorder, or other mental health issues. Sessa is one of a hundred therapists in several countries preparing to prescribe MDMA by trying it themselves — and rewriting our understanding of the power of altered states in the process.

Although MDMA (3,4-methylenedioxymethamphetamine) gained popularity in the 1990s rave scene, the chemical has been around since the early 20th century, after a German drug developer synthesized it by accident for Merck in 1912. The U.S. government briefly toyed with its use in psychological warfare, and psychotherapists suggested it for their patients in the 1970s and 1980s. But soon after people started using it recreationally, the Drug Enforcement Agency (DEA) classified it as a Schedule I drug, making it illegal and more difficult for researchers to study.

TThe notion that altered states could help people working through trauma has a long history. Hypnosis, meditation, trances — all of these capitalize on the mind’s ability to leave ordinary consciousness temporarily and create therapeutic pathways that are normally unavailable. People might talk more than usual, for example. Or they may be less resistant to facing conflict or painful memories. They may feel safer with their therapists. For this reason, many professionals…



Jessica Wapner, journalist, author and podcaster

Jessica Wapner writes for The New Yorker, The Atlantic, Scientific American & elsewhere. She co-hosted the podcast One Click and has written two books.