Tuesday, 9 July 2013

Should ecstasy be a prescription drug?

Next week, BBC Panorama will air an edition focusing on Post-Traumatic Stress Disorder and how it affects serving soldiers, veterans and their families. Curiously the Ministry of Defense releases suicide statistics of serving soldiers but ignores the rate of suicide in veterans. According to a 2004 article in The New England Journal of Medicine, 18% of soldiers returning from Iraq and Afghanistan had PTSD and more died from suicide than in combat. Obviously as the war in Iraq became more violent, more soldiers died from combat, it's reasonable to assume the number returning with PTSD also increased, and as a result the suicide rate increased. Hopefully Panorama will be able to back these assumptions up with facts, as yet I haven't found anything I deem reliable on the subject for 2012.

If large numbers of soldiers are returning with PTSD, you'd assume that doctors could treat afflicted people in the most effective and efficient way. This isn't the case. Doctors currently treat PTSD with selective serotonin re-uptake inhibitors and benzodiazepines with limited results short term, suffers can be left unable to function in society for years despite receiving treatment.

In 2011, the first randomised controlled pilot study into the safety and efficacy of methylenedioxy-methamphetamine (MDMA/ecstasy) in a psychotherapy setting was published. The study found that after two sessions of ecstasy assisted psychotherapy, 10 out of 12 subjects no longer had the disorder. That's an 83% success rate over a matter of weeks or days. The study also found that there where no negative neurocognitive effects and they had no negative drug related events. Under the supervision of a doctor, fatal or damaging reactions to ecstasy are almost unheard of.

Why don't we give people the opportunity to relieve disorders such as PTSD with a drug shown to be effective? We allow cancer patients to pump themselves full of incredibly toxic drugs or be exposed to radiation in the hope that it will increase their life expectancy. Major surgery can have serious risks of death but we afford people the opportunity to make an informed decision; ecstasy should be no different.

So why is ecstasy still a controlled and class A drug and unavailable to doctors?

Put simply, some illegal drug policies are written on misinformed public opinion and not evidence based. The majority of the British public view ecstasy as extremely dangerous; yet when scientists such as Dr David Nutt use evidence and years of research to show that alcohol is far more harmful to users and society than ecstasy, he's branded a 'mad man' by the Daily Mail. David Nutt was sacked from the Advisory Council on the Misuse of Drugs because he used scientific evidence to show that horse riding was a more dangerous activity than taking ecstasy. He was appointed to advise on drugs, yet when he did just that he was sacked because it wasn't what Home Secretary Alan Johnson wanted him to say. If the public are misinformed and view ecstasy in the same light as cocaine and heroin, Johnson knows that he and his party will lose votes by going against that view whether it be evidence based or not.

In my opinion ecstasy should be available for doctors to prescribe. The UK government has sent thousands of men and women to fight unnecessary wars in foreign countries in the last decade, if they survive the least we can do as a society is help them return to a 'normal life'. Can you imagine if a banned drug cured 83% of cancers and the government criminalised patients?

As always, thoughts welcome.