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Research has found ecstasy to be an effective treatment for PTSD, which could lead to the drug's legalization—but there are still a number of logistical hurdles to overcome.

The second phase of an ongoing $21-million dollar, FDA-approved study published in the Journal of Psychopharmacology found that nearly 83 percent of PTSD patients treated with MDMA—the clinical term for ecstasy or molly—were symptom-free after a year. Patients who only received psychotherapy and a placebo had a 25 percent success rate.

The third and last phase of the study is currently being planned, and if it's successful, the drug could get FDA approval by 2021, a spokesperson from the Multidisciplinary Association for Psychedelic Studies (MAPS), which is carrying out the studies, told NTRSCTN in a statement. 

If it is approved, doctors could begin prescribing MDMA for use during psychotherapy. 

Under this treatment method, patients discuss their traumatic memories after taking ecstasy in therapy. MDMA improves this therapeutic technique because it reduces activity in the amygdala, a brain region that's overactive in PTSD patients, which decreases defensiveness and fear, according to the MAPS spokesperson.

"The MDMA was like armor that I put all over my body so that I could dive into the darkness of my PTSD, and then come back unscathed," one patient told ABC.

The MAPS spokesperson added that ecstasy releases the hormones oxytocin and prolactin, which can help patients trust therapists, and increases activity in the prefrontal cortex, which can enhance memory and focus. 

These hormones might also explain why MDMA can help couples bond. A 2015 study in the Journal of Psychopharmacology found that people talked about their significant others more favorably while under the influence of the drug. One of its authors told The Huffington Post that the findings suggest MDMA could be useful for couples counseling. In the 1980sMDMA-assisted couples' therapy was common, according to OZY. 

According to Richard C. Shelton, M.D., a professor in the department of psychiatry and behavioral neurobiology at the University of Alabama at Birmingham, the use of MDMA to treat mental illness isn't new. It's been around since 1912, and was used in therapeutic settings before the U.S. declared it illegal in 1985, he told NTRSCTN in a statement.

Despite MDMA's illegality, it's still "used by some therapists to facilitate response to psychotherapy, especially for PTSD," since it can cause "increased feelings of empathy and caring for others and reduced intensity of fear reported," Shelton said. "In fact, recent research has shown that MDMA enhances a process called fear extinction, which is an important part of the successful treatment of PTSD." 

However, Shelton added, there are still a few obstacles to legalization that haven't been addressed.

First of all, companies that manufacture MDMA may assume liability risks. "The release of new drugs usually results in lawsuits for the manufacturers," he said. 

Another obstacle: in the U.S., only M.D.s are allowed to prescribe drugs, and they're not usually the ones giving therapy. "It remains unclear if physicians (or their malpractice insurance companies) will be willing to assume the risk of administering a drug in the context of psychotherapy provided by someone else," Shelton said.

Lastly, even if ecstasy is legalized, Shelton said that the drug would likely have strict regulations that involve a complex licensing process and a high risk of robbery. "This is a big challenge that advocates do not seem to understand well."

Nevertheless, MAPS is hopeful, believing legalization is "very likely" if the study's third trial goes as well as the first two. 

The spokesperson added that the drug's legalization for medical usage is unlikely to increase recreational use. "In the last 30 years during which MDMA has been illegal, the use of MDMA in recreational contexts has only increased, especially among young people. Despite billions of tax dollars spent enforcing the War on Drugs, illegal drug use continues to increase and avoidable deaths continue," he said.

"MAPS’ careful scientific research into MDMA will mean that more people will have access to trustworthy information about the relative risks and safety of the drug in different contexts."

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