Perspectives on the therapeutic potential of MDMA: A nation-wide exploratory survey among substance users
In a nation-wide survey of 918 people with alcohol or substance use disorders, most respondents supported medical research into MDMA, believed MDMA-assisted therapy might be useful, and 58.8% were willing to try it; support and belief did not differ by race or ethnicity, though small disparities arose in willingness and concerns. These findings indicate broadly positive patient-level attitudes toward MDMA-assisted therapy and point to areas to address for equitable access and more diverse research participation.
Abstract
Background
Alcohol and other substance use disorders are commonly associated with post-traumatic stress disorder (PTSD), and the presence of these comorbidities is associated with worse treatment outcomes. Additionally, disparities in substance and PTSD prevalence have been associated with minority races and ethnicities, and minorities have been shown to be less likely to engage in treatment. Psychedelic-assisted treatments, including 3,4-methylenedioxymethamphetamine (MDMA), have shown preliminary trans-diagnostic effectiveness, however it is unknown how individuals with substance use disorders view the therapeutic potential of MDMA therapy. Previous studies have also shown that minority races and ethnicities are under-represented in the MDMA trials, leading to concerns about inequitable access to clinical treatment.
Methods
To explore demographic characteristics related to patient-level perspectives on the therapeutic potential of MDMA-assisted therapy, this study describes data from a nationwide, cross-sectional survey of 918 individuals self-reporting criteria consistent with alcohol or substance use disorders.
Results
Overall, a majority of individuals reported support for medical research of MDMA (68.1%), belief that MDMA-assisted therapy might be a useful treatment (70.1%), and willingness to try MDMA-assisted therapy if it were determined to be an appropriate treatment for them (58.8%). No race or ethnicity differences were found in support for further research or belief in effectiveness, however there were small disparities in terms of willingness to try MDMA-assisted therapy and concerns related to use of this treatment approach.
Conclusion
These results provide insights and future directions as the field of psychedelic-assisted therapy seeks to provide equitable access to clinical care and to diversify research participation.
Research Summary of 'Perspectives on the therapeutic potential of MDMA: A nation-wide exploratory survey among substance users'
Introduction
Substance use disorders commonly co-occur with post-traumatic stress disorder (PTSD), and each condition increases the risk and treatment refractoriness of the other. Previous epidemiological work cited by Jones indicates elevated PTSD prevalence in several minority racial and ethnic groups and lower treatment engagement and completion among these groups. Existing pharmacotherapies have limited trans-diagnostic efficacy for combined substance use and PTSD, and interest has grown in psychedelic-assisted treatments for their putative trans-diagnostic effects. MDMA, which received FDA Breakthrough Therapy designation in 2017, has been studied in multiple Phase II and Phase III trials for PTSD and produced large symptom reductions in at least one Phase III trial (reported reductions in diagnostic status and remission rates compared to placebo), while secondary analyses have suggested potential reductions in alcohol use severity but mixed findings for drug use severity. This study set out to describe patient-level opinions about the research and clinical potential of MDMA-assisted therapy among people with probable substance use disorders, and to examine whether those opinions vary by race and ethnicity. Specifically, the investigators assessed (1) support for further clinical trial research into MDMA-assisted therapy, (2) belief that MDMA-assisted therapy could be a beneficial treatment (for disorders such as PTSD and addiction), and (3) individual willingness to try MDMA-assisted therapy if it were proven safe, effective, and appropriate. The survey also asked about specific concerns participants might have about psychedelic-assisted therapies and explored demographic differences in responses.
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Study Details
- Study Typeindividual
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- APA Citation
Jones, J. L. (2023). Perspectives on the therapeutic potential of MDMA: A nation-wide exploratory survey among substance users. Frontiers in Psychiatry, 14. https://doi.org/10.3389/fpsyt.2023.1096298
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Papers cited by this study that are also in Blossom
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Nicholas, C. R., Wang, J. B., Coker, A. et al. · Drug and Alcohol Dependence (2022)
Sessa, B., Higbed, L., Durant, C. et al. · Journal of Psychopharmacology (2021)
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