MDMA, politics and medical research: Have we thrown the baby out with the bathwater?

Abstract

3,4-Methylenedioxymethlyamphetamine (MDMA) has penetrated extensively into our culture in the last thirty years. It started life in medicine when adopted as a clinical tool by psychotherapists on the West Coast of America who used it as an alternative to the then banned LSD for facilitating interactions in couples’ therapy. From the therapist’s couch the drug leaked into public use, with a growing recreational use that eventually lead to its prohibition in the mideighties. As with LSD, the medical research on MDMA then stopped but its recreational use continued to grow especially in relation to the rave or party scenes so that by the nineties the drug was becoming demonized by politicians and parents alike. Although the politicians raved against the drug with a similar ferocity to those writhing on the dance floors, the doctors and pharmacologists argued among themselves about the short, medium and long-term dangers of MDMA. In the background, meanwhile, MDMA as a therapeutic tool disappeared from view. Exactly as with LSD before it, the drug had now drifted so far from its clinical origin for this to become forgotten. But are we missing something important by allowing the political agenda to hijack MDMA from science and medicine? Has the politicians’ single-minded demonization of all recreational drugs as ‘Of No Medical Use’ resulted in MDMA becoming an innocent bystander caught in the crossfire of the War on Drugs? After all, MDMA is not the first such drug that has been treated this way. Its prohibition as a class A schedule 1 drug in the UK severely restricts researching the compound on humans and illustrates a profound phenomenon that pervades the field of medical research: that current political restrictions on medical research threatens to undermine our scientific goals of objectivity and the search for evidencebased clinical excellence. In this paper we look at some of the features that make MDMA a potentially useful medical and research tool and asks that these be explored in a dispassionate manner – without the political agenda influencing the scientific argument.