Can MDMA save a marriage?

Now that MDMA is illegal, some providers are resorting to clandestine sessions of MDMA therapy, sometimes with disastrous results. A recent essay in Slate detailed a man’s harrowing experience after an underground psychedelic trainer gave him methamphetamine “cut with a little MDMA” instead of the pure MDMA he was expecting during a guided session in 2019.

It’s also risky for people to take MDMA on their own, experts warn.

“This can include everything from a ‘bad trip’ to reckless behavior to psychiatric symptoms such as panic attacks or physical effects such as high blood pressure or interactions with other medications,” said Dr. Smita Das, chair of the Council on Addiction Psychiatry at the American Psychiatric Association.

Typical side effects of MDMA use include involuntary clenching of the jaw, nausea, rapid heartbeat, and hot flashes or chills. And prolonged use can damage nerve cells in the brain that contain serotonin, a chemical that relays messages and helps regulate mood, sleep, pain, appetite and more.

“Taking MDMA isn’t just about making sure the compound is pure,” said Rachel Yehuda, director of the Center for Psychedelic Psychotherapy and Trauma Research at the Icahn School of Medicine at Mount Sinai.

Some mental health care providers are looking for ways to help patients without breaking the law. Last year, the Fluence Society, an organization that trains therapists to legally incorporate psychedelics into their practice, taught more than 300 clinicians how to help clients using illegal psychedelics on their own, said Elizabeth Nielson, a psychologist and one of the founders of the company.

Fluence tells therapists not to counsel their clients on how to obtain or use an illegal drug. But they can discuss why their clients want the drug, what they expect to happen when using it, and how to reduce harm. Then they can work with clients after taking the medication to address their experience.

Jayne Gumpel, a senior trainer at Fluence and a couples therapist who sees clients in Woodstock, NY and New York, said public interest in psychedelics is “exploding.” Oregon, Washington, DC and half a dozen municipalities have decriminalized psilocybin, and hundreds of ketamine clinics are popping up across the United States. To stay current, therapists must have an understanding of these and other psychedelics, including MDMA, Ms. Gumpel added.

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