It used to be that smoking marijuana was on par with the seven deadly sins. But pot’s made a PR comeback of late. An increasing number of states have legalized it not only medically but recreationally, and many states include autism on the list of acceptable reasons to fill a medical marijuana prescription.
Perhaps due to this softening view on marijuana, scientists are taking a look at another drug on the taboo-list: MDMA (or ecstasy, Molly, or “the party drug”). But convincing the world that the hallucinogenic drug has treatment potential that outweighs its risks is not a light undertaking.
Ecstasy is not marijuana, and suggesting that people with autism be given the drug, even in controlled circumstances, sets off ethics alarms in even the strongest proponents of marijuana legalization.
Here, we’ll look at three things: What MDMA does, what the potential benefits (and detriments) might be for people with autism, and the difference between MDMA as a clinical intervention and a “party drug.”
What does MDMA do?
In short, MDMA (aka methylenedioxymethamphetamine) makes you feel gooooooood. It prompts the release of hormones that increase empathy and prosocial behavior. It increases extroversion, enhances feelings of well-being, and increases both emotional openness and sensory perception.
MDMA is known for being a rave or party drug. It’s a powerful stimulant that allows people to party for long periods and experience psychedelic effects. It was banned in the US in 1985 and named a Schedule I drug, which the DEA defines as a drug with no accepted medical use and a high potential for abuse.
Because the drug decreases social anxiety and increases openness, it has been effective in clinical trials in reducing symptoms of PTSD when combined with psychotherapy. Some researchers feel that MDMA could be life-changing for adults with autism who deal with social anxiety.
How might MDMA benefit people with autism?
A pilot study, published in the journal Psychopharmacology, tested the effects of MDMA on adults with severe autism and social anxiety. Eight adults received an MDMA dose in a controlled, clinical setting, and four adults received a placebo in the same setting. Doses were spaced a month apart, and each dose was followed by three non-drug psychotherapy sessions. Results were measured at baseline, one month after the second experimental session, and again six months after the last experimental session.
Though small, the study showed that participants receiving MDMA showed “rapid and durable” improvement in social anxiety symptoms compared to the control group. The study measured results using the Leibowitz Social Anxiety Scale. Those in the group receiving psychotherapy alone reduced their social anxiety an average of 19.3 points, while those who received psychotherapy and MDMA reduced anxiety by an average of 44.1 points.
The trial was prompted by doctoral research by Alicia Danforth, who surveyed adults with autism and found that 91 percent reported greater feelings of connectedness and empathy and 86 percent experienced easier communication after using MDMA in, ahem, non-clinical settings. Anecdotal reports from people with autism and Asperger’s syndrome have confirmed that the drug can help overcome social anxiety and enhance communication.
But… is it safe?
MDMA is not marijuana. Drugabuse.gov discusses both the short-term benefits of MDMA use (warmth, openness, ability to maintain vigorous physical activity) as well as serious short- and long-term side effects. These include high blood pressure, panic attacks, faintness, loss of consciousness, or even seizures. The drug also compromises a person’s ability to perceive or predict motion, making driving after taking the drug extremely dangerous.
Long-term use of MDMA is associated with disturbed sleep, difficulty concentrating, depression, heart disease, and decreased cognitive function. It’s unclear if the drug is addictive, although it does produce behaviors that are associated with substance abuse disorder, and some users have reported symptoms of addiction.
In short, it looks like there’s more research to be done. But taking MDMA on the street and using it in a controlled setting have important differences.
Clinical MDMA vs. “The party drug”
In the September 2018 study, researchers were clear that small doses of a MDMA in a therapeutic setting were safe. Some participants reported fatigue, headaches, and sensitivity to cold, but there were no serious side effects. They were also clear that the MDMA was combined with psychotherapy, not used alone. The study on the effect of MDMA on those with PTSD also used the drug in conjunction with psychotherapy.
And thankfully, the drug hasn’t been put forth as a way to “fix” people with autism, but rather as a way to ease a sometimes debilitating side effect.
A study on MDMA in mice found that it may be possible to use MDMA in conjunction with a drug that blocks MDMA’s rewarding properties without damaging its prosocial effects. This creates hope that future research could isolate the elements of MDMA that increase empathy and reduce anxiety without the negative side effects or possible addiction.
If the positive properties of MDMA could be separated from the negative (in much the same way that CBD has the calming effects of marijuana but not its psychoactive effects), then it might prove a powerful aid for those struggling with social anxiety.
In the meantime, recreational use remains illegal in all 50 US states.
Katie Taylor started writing in 5th grade and hasn't stopped since. Her favorite place to pen a phrase is in front of her fireplace with a cup of tea, but she's been known to write in parking lots on the backs of old receipts if necessary. She and her husband live cozily in the Pacific Northwest enjoying rainy days and Netflix.