E for Ecstasy by Nicholas Saunders
Appendix 1: Reference Section
- 28 Subjective reports of the Effects of MDMA in a Clinical Setting
by George Greer and Requa Tolbert from Journal of Psychoactive Drugs Vol.
- This trial was carried out legally in California between 1980 and 1983
following recommendations of the State Medical Board and its findings are
the best clinical evidence available on the effects of MDMA. "Because
it [MDMA] had been patented in Germany in 1914 and was therefore no longer
patentable, no pharmaceutical manufacturer could be found who was interested
in sponsoring an Investigating New Drug application with the Food and Drug
Administration or in sponsoring research, " the authors say. The primary
purpose of the study was to assist the 29 subjects in achieving their particular
goals rather than to evaluate MDMA and it therefore does not include 'double-blind'
controls, independent evaluations or examination of the physiological effects
- Subjects were screened by questionnaire, briefed on the possible side
effects of MDMA, and warned not to take part unless they were prepared to
deal with any disturbing experience they might have as a result. Those with
hypertension, heart disease, hyperthyroidism, diabetes, hypoglycemia, seizure
disorder, glaucoma and diminished liver function were not allowed to take
part. Pregnant women and people with a psychiatric history were also excluded.
- To ensure a secure atmosphere, the following agreements were made:
- 1. Everyone would remain on the premises until it was mutually agreed
that the session was over.
- 2. The subjects would refrain from any destructive activity.
- 3. There was to be no sex between therapists and subjects.
- 4. The subjects were to follow therapists' instructions when they took
part in a structured session.
- Most sessions were held at people's homes, individually or in groups
and couples. The subjects were asked to fast for the preceding 6 hours "to
ensure rapid absorption and prevent nausea". Doses varied from 75 to
150 mg according to subjects' body weight and the type of session and a
second dose of 50 to 75 mg was offered after about 2 hours in order to "prolong
the session and provide a more gradual return to normal consciousness".
Sometimes inner experiences on the higher doses were facilitated by instrumental
music and eyeshades, with the therapists being attentive and responsive
- About half of the subjects reported that they had minor psychological
problems before taking part in the study, including feeling dissatisfied
with themselves, being afraid of rejection and lacking self confidence.
Some also experienced mild depression, anxiety, sadness at being alone,
"normal existential despair" or difficulty in making life choices.
- Benefits felt by the subjects during sessions.
- All the subjects felt closer and more intimate with all others present
and many reported that they were more communicative and were more able to
receive both compliments and criticism. All the subjects experienced positive
changes in their attitudes or feelings. Three quarters of them reported
cognitive benefits such as enhanced mental perspective; insight into personal
patterns or problems; and an enhanced ability to understand themselves and
resolve issues. Half of the subjects felt warmer, fresher or more alive
or reported euphoric or loving feelings. One third of them said that they
felt more self-confident and another third felt that their defences were
lowered. One quarter said that they went through a therapeutic emotional
process during a session. One sixth of subjects said they had had a transcendental
experience and a similar fraction reported fewer negative thoughts and feelings.
Subjects also reported: feeling more aware more "grounded" and
feeling "blessed" and at peace. All of those who tried low doses
to improve their creative writing found it "quite useful", with
some reporting clear thinking or greater presence of mind.
- Undesirable effects felt by the subjects during or after sessions.
- Three quarters of the subjects experienced jaw tension or teeth clenching
during the session, sometimes accompanied by shaking. For a few subjects
these side effects persisted into the following day. Most felt tired afterwards
and for half of the subjects this lasted up to 2 days. One quarter felt
nauseous for between 5 and 30 minutes. One third found it hard to sleep
afterwards, but 10 per cent slept better. Subjects noticed that they sweated,
felt cold and lost their appetites during the sessions, but did not regard
these reactions as a problem.
- In addition to these general side effects, some individuals had a strong
negative reaction. A 74-year-old woman who had been given an extremely high
dose of 350 mg because she had not responded to lower doses suffered most
of the unpleasant effects mentioned above during the session and for two
days afterwards. Tension in her jaw lasted even longer and she also experienced
a visual illusion. Another subject's appetite increased and they gained
weight. A third had difficulty coping with people and had anxiety attacks
which caused him to miss work for a week. He said he was not receptive to
the sensation of MDMA, though he stressed that the session itself was not
the cause of anxiety: "Rather, I think it served to open up some tightly
controlled emotions that spilled out in a frightening way." A year
later he said: "It probably was a good thing. It speeded up processes
that needed to happen". Side effects reported by individual subjects
during sessions included: jittery vision, lip swelling, shakiness, numb
hands and face, headache and fainting - this last effect occurred when a
subject thought about a difficult relationship.
- Half the subjects reported undesirable emotional symptoms. 15 per cent
felt anxiety or nervousness during the session while 7.5 per cent felt mildly
depressed next day. One subject felt paranoid for up to 3 minutes during
the session and another felt lonely and sad. Others felt: more emotional,
more vulnerable, had a racing mind, felt waves of "emotional crud"
or confused about a relationship or indulged in "negative self-talk".
- All but one of the subjects set goals for what they wanted to achieve
in the sessions before they started. Half felt that these were completely
realised, and another quarter felt they were partly realised. This group
included subjects who wanted to understand themselves better and, of these,
one third were fully satisfied but half made no progress. Of those seeking
a mystical experience, three quarters were satisfied. Subjects looking for
personal or spiritual growth, self exploration, fun and enjoyment, or closeness
with their sexual partners all achieved their aims.
- All of those who aimed to change their personalities or resolve particular
inner conflicts or experience a different state of consciousness or increase
their awareness of their feelings or become less afraid of rejection, felt
they had achieved some degree of success.
- After the session most subjects felt in a better mood and this typically
lasted for a week. One third of them felt more calm and relaxed, while some
felt more energetic.
- 80 per cent of subjects reported positive attitude changes, and for
some this lasted for at least two years [the researchers last contact with
the subjects was two years after the trials]. Of this 80 per cent, half
said they had more self-esteem; half said they were more able to accept
negative experiences and were more patient and half said the sessions had
changed their beliefs in various positive ways, including seeing death as
a change rather than an ending and therefore feeling less afraid of it.
Other benefits claimed by subjects ranged from a greater acceptance of others
to an appreciation of being alive and feeling they could be more warm and
- Nearly all the subjects reported positive, mostly long-lasting, changes
in their relationships. This included those whose partners did not take
part in the sessions. Two couples who had problems in their relationships
before the trials, resolved significant conflicts under MDMA. Negative changes
were experienced by the man mentioned earlier who had difficulty coping
with people, and some subjects whose relationships were already in decline
reported no improvement: one woman felt "more guilt around men for
a while" and proceeded from a separation with her husband to a divorce.
Many subjects reported that their feelings were stronger after sessions
and some said that they now avoid superficial social meetings such as cocktail
parties. Conflicts were also resolved with non-partners and a variety of
other improvements including self esteem and empathy with others were reported.
- Half the subjects reported positive changes at work for a week or so
after sessions, such as: feeling less tense and driven, having more fun,
having energy to spare and getting along better with others. 20 per cent
of subjects reported new personal interests, from hobbies to creative writing
and spiritual growth. Some of them said MDMA-like states occurred during
meditation and one man who used to meditate before he took part in the study
said that taking MDMA had improved his meditation.
- Half the subjects said they used drugs less (including alcohol and caffeine)
but ten per cent said they used more. Those who used less drugs, turned
away from drugs per se: they did not swap one drug in favour of another.
However one woman said she would take only MDMA in future "because
she learnt from it".
- Half the subjects changed some of their 'life goals' after sessions,
and all of these implied the change was positive. Most involved a shift
away from materialism and towards spirituality or wellbeing.
- Half the subjects found they were released from attitudes that prevented
them from actualizing their potential. Half of these said they had gained
lasting insight into their psychological problems; three felt less guilty
about enjoying themselves and two became less "self-limiting".
One said he had got rid of "a load of rubbish he had been carrying
around"; another felt less anxiety and another felt less self-conscious.
- In the discussion, the authors conclude that MDMA may "predispose
people to a recurrence of previous psychological disabilities". They
also note that people "who want MDMA to cure their problems" make
poor subjects, while those who want to use it to learn about themselves
are most suitable. Their main conclusion is that "the single best use
of MDMA is to facilitate more direct communication between people involved
in a significant emotional relationship". They also recommended MDMA
as an adjunct to insight-orientated psychotherapy, and for promoting self-understanding
and spiritual and personal growth.
E is for Ecstasy by Nicholas Saunders (firstname.lastname@example.org)
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by Nicholas Saunders