Monday 19 July 2010

On The Use of Illicit Drugs in Legitimate Therapy

Many of you will already know that I have extremely strong views on drugs and drug use.  I know that America is losing the war on drugs and I know there are many social problems that would most likely be alleviated if we decriminalised the drug trade but I still am against drugs of all kinds.  I do not believe in safe or so-called soft drugs and I don’t think there is such a thing as reasonable or safe drug taking.  What I do know is that drugs destroy lives and they have torn apart the lives of many people close to me.  I know addicts as well as the victims of crimes that were committed by people on drugs and alcohol and I think something has to budge. 

Quite simply, I believe that there are people who get rich and powerful by peddling drugs to the most vulnerable people on the planet.  Those people may be vulnerable due to their socioeconomic status or may be predisposed towards addiction due to mental illness, sexual or physical abuse or childhood traumas.  This cycle has to end.

I’m not objective though and my thoughts are scattered and not well formed.  In the interest of fairness and objectivity, I thought I’d share a really interesting discussion I had today with my friend Joe who has given me permission to share what he said. 

The Drug Trade
Reuters: Rafiq Shirzad [Photo source]

Link: Ecstasy Helps Treat PTSD Patients, Trial Finds [CBS News]

Joe posted this link and I stated that from my own experience with a post-trauma experience that drugs could only serve to assist the patient in repressing the experience and that eventually it would all come out into their consciousness.  I believe that rather than running away from the experience and helping the brain to further repress it, the experience should be approached in a safe and controlled environment.  Joe said that this was exactly what the article was about and that ecstasy had been shown to provide such a safe environment in a much shorter period of time.  I still wasn’t convinced but he had this to say:

“As a drug user you may think I am biased in my views. This is not the case. I KNOW there are MANY bad effects of drugs. I have not only experienced some of them but have also seen people like M. go through absolute hell.

However, I do think that there is the potential for certain illegal drugs to have good effects. Look at the case of medical marijuana. Also, MDMA was first developed as an aid to therapists before the rave culture usurped it for its own less noble purposes. LSD was developed (and actually used) for the same purposes.

Did you know that there is a scheduled analogue of speed (it is called dextroamphetamine sulphate) which has all the desired effects of speed (alertness, better concentration, higher levels of energy) and none of the side effects (difficulty sleeping after the come down, aching muscles and a sense of wanting more more more). It is used in low doses (when combined with amphetamine aka speed) to treat ADHD and narcolepsy. In higher doses, the US and EU governments give it to astronauts and certain armed forces units (usually special ops) to use because it actually has MANY benefits and the few negative side effects (both physical and psychological), if experienced at all, are considered safe enough to risk in those circumstances.

MANY illegal drugs started out as innocent medicines and it was only when their recreational value was discovered that the governments of the world were forced to illegalise them. This was due to the consumption outside of a controlled system i.e. the supervision of a GP and without the supervision, the potential for problems was higher.

My argument is this. There are LOADS of drugs that are illegal to have without prescription (methadone for example) or permission (vets are allowed to have ketamine). Why can't drugs like LSD or MDMA, which were classified in the 70's and effectively banned altogether, be reclassified under similar rules to drugs like methadone, amphetamine and ketamine? That way the medical community can take advantage of the benefits (which were proven when they were first made) of these drugs”.

Joe is in fact correct and even I can see that despite my strong views.  The difficulty is that a message goes out to young people that if drugs can be used safely then they are safe.  The problem is that it is the most vulnerable young people who need to believe that the most but when combined with the experience of a broken home, mental illness or sexual abuse, drugs always seem to destroy the person eventually. 

But if we return briefly to what we were in fact debating which was the long-term efficacy of using MDMA with trauma patients I have one major reservation.  Sure, you can approach great trauma when your chemical and mental state is altered but what about when you sober up?  Anyone who has ever done something as legal as drowning their sorrows knows of the absolute clarity you get when you are drunk and how it all falls apart again when you’re sober. 

I know of one girl who spoke of the most incredible trauma every time she was on drugs.  Time after time, every last shocking detail was relived and shared.  Years after cleaning up that issue is still there and continues to be a massive entity in her life but she is no closer to sorting it out.  I watch her now and I know she is running scared and I imagine that if she ever did make it into therapy that they’d have to start all over again and break down those ego defences one by one.

What do you think?

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2 comments

Anonymous said...

An important subject with a interesting article attached. I agree that drug use is an escalating global problem and it's going to take something VERY radical to address the problem. What that radical action is, I cannot even begin to imagine.

One thing though. You asked a question that I believe, in this instance, is an irrelevant question. You ask what happens when people sober up after taking the MDMA.

With any person who takes the drug but is not given therapy, the problem will still be there when sobriety returns. However, in the drug trials described, the MDMA is used to ensure that the therapy given whilst still "high" is more effective. This means that if the therapy IS effective, when sobriety does return, the problems that were there before are diminished if not altogether gone. You see, MDMA is not the treatment, it is the catalyst for treatment.

I think more studies into this approach are definitely needed but if they prove to be effective, then I don't see why the re-evaluation of MDMA should not be considered. On the flip side, if trials discover side effects that are outside the acceptable safety parameters, then re-evaluation should not be considered at all.

Mandy said...

@ Anonymous: Hi! Thanks for your comment. I can only really speak from my limited experience but let's talk about this girl I knew for a while. She spent years talking to me about the horrific sexual abuse she experienced as a teen. As time wore on, she came to trust me more and to reveal more and more of what had happened to her. We moved through a process not dissimilar to the therapeutic process and what is viewed as the power of talking through your problems.

When she sobered up, none of that progress had remained. She was at step one and back to her experience of a living nightmare. She lives like a hermit and cannot bear to interact with people and she directly attributes that to the trauma that she experienced.

In my mind, I simply cannot see how the progress made by these patients on MDMA can extend to situations in which their mind is not altered.

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