A sober look at Ecstasy

A round of applause, please, for the often criticized cautious bureaucrats at the Food and Drug Administration. They have approved a major study of the street drug Ecstasy as a treatment for post-traumatic stress disorder, or PTSD.

If Ecstasy becomes a prescription drug, however, the FDA may have to establish tough restrictions to avoid the same kind of explosion in illicit use that gave rise to the current opioid epidemic.

Ecstasy, also known as Molly and MDMA (the shorthand version of its chemical name), has been around since the 1970s. It was called the “love drug” for the feelings of euphoria, trust and affection it produced though stimulation of three brain chemicals. The Drug Enforcement Administration banned it in 1985.

Two small clinical trials have produced encouraging results. Two-thirds of 130 patients no longer met the criteria for PTSD at the end of the trial and stayed that way for a year of follow-up. That led the FDA to approve a study of many patients that could lead to approval as a prescription drug.

PTSD afflicts not only soldiers but almost anyone suffering severe trauma. It is hard to treat — only 30 percent to 40 percent of patients benefit from the best current therapies, said Dr. Charles Marmar, head of psychiatry at the Langone School of Medicine at New York University, who was not involved in the study. “We know people are prone to abuse” MDMA, with prolonged use producing brain damage, he told The New York Times.

The FDA has experience in controlling dangerous drugs. For example, to use isotretinoin, sold to treat serious acne though it can cause birth defects, doctors, patients, pharmacies and drug companies must work under elaborate computer supervision to ensure that a user is not pregnant. Something similar, perhaps with mandatory training for physicians, could avoid an Ecstasy epidemic.