How Ecstasy Transcended Its Stigma — And Became A Treatment for PTSD

It once had a bad rep, now it's being used to help people suffering from trauma.

By Michael Quinones
February 27, 2020

In 2012, after Madonna asked concertgoers, “How many people in this crowd have seen Molly?”, the popular DJ Deadmau5 went on an online tirade, accusing the superstar of advocating illegal drug use to young music fans.

This represents a snapshot in the evolution of MDMA (aka. 3,4-methylenedioxymethamphetamine). Ecstasy, the previous street name for MDMA in pill form, had become an unknowable drug mashup in the early aughts. Maybe it had some MDMA in it, but also heroin or cocaine, or maybe even some supplement like Hydroxycut, or worse. Who knew? By the late aughts, Ecstasy had a bad reputation and was thus being increasingly reconstituted in its “pure” powder form and rebranded as “Molly” in clubland and colleges.

And then Madonna named her aforementioned tour and album MDNA, a thinly veiled reference to the mild psychedelic. Despite the pleas of Deadmau5, by 2013, Kanye West, Lil’ Wayne and Miley Cyrus — who sang about “dancing with Molly” in one of her most popular songs “We Can’t Stop” — dragged it into mainstream American pop culture.

That same year the New York Times wrote about the drug’s cultural renaissance. It was no longer just for underground raves and music festivals: “MDMA has found a new following in a generation of conscientious professionals who have never been to a rave and who are known for making careful choices in regard to their food, coffee and clothing.”

According to Ben Sessa, one of the foremost researchers studying the drug in the U.K., MDMA is not a “classic” psychedelic, but an “entactogen” that generates a more gentle physiological state compared to LSD. Shorter acting than acid or psilocybin mushrooms, the easier-to-tolerate substance “enhances feelings of empathy and bonding and allows users to access and process memories of emotional trauma,” Sessa has written.

By 2015, Molly-gobbling was all over the screen—in shows like Transparent, Looking, Californication, and It’s Always Sunny in Philadelphia—and seemingly no big deal. That year, a list could be compiled of 21 positive pop references to Molly.

In some ways, by creating a culture of acceptance toward the drug, artists and musicians helped pave the way for MDMA-facilitated medical breakthroughs starting in 2010. The first study to show the drug’s efficacy in improving patient’s lives included 20 patients with “treatment-resistant PTSD.” After using MDMA-assisted psychotherapy in a few sessions, more than 80 percent of the participants shed PTSD symptoms over the length of a year.

That promising start came to fuller fruition in January of this year when the Multidisciplinary Association for Psychedelic Studies (MAPS) issued a press release announcing that the U.S. FDA has for the first time approved a program to allow qualifying PTSD patients to receive MDMA-assisted psychotherapy in clinical trials.

MAPS founder and executive director Richard Doblin breaks down how the therapy works on the organization’s website: “What I would like people to really understand is that MDMA itself is not the treatment. MDMA facilitates psychotherapy, so it’s really psychotherapy that does the healing and the MDMA facilitates the psychotherapy…. The MDMA reduces activity in the amygdala where we process fear yet increases activity in the prefrontal cortex where we think more logically and increases connectivity between the amygdala and the hippocampus. We’re able to help people process that and move those memories into long-term storage.”


After giving MDMA to thousands of patients in the 1970s, researchers Leo Zeff, Alexander Shulgin and David Nichols published the first paper on the drug in 1978 in The Psychopharmacology of Hallucinogens. In the 1980s, despite efforts by the clinical research community to contain what they had nicknamed “Empathy,” MDMA spread as the decidedly non-clinical rave drug Ecstasy. By 1984, when large amounts were being confiscated, the DEA began banning the compound. As Sessa writes, despite a challenge from the clinical MDMA research community, in May 1985, MDMA was designated “an emergency Schedule One category…where it has stayed ever since—hugely restricting opportunities for its research.”

According to Sessa, MDMA researchers, including MAPS, fought to prove that MDMA was “safe in controlled circumstances” against that backdrop of “media and politicians who favored strict prohibition to control recreational use.” Other mood-influencing industries, such as beer brewers in the U.K., even launched campaigns to malign the drug, lest their business be “eroded by Ecstasy use.” The pushback by governments and special interests had been consistent and effective in the U.S. and Europe for nearly two decades until the confluence of the Molly rebrand, the 2010 scientific study and pop superstars began to normalize it.

Today, MDMA is not just being tested for treatment with PTSD, but also for alcoholism, autism-based social anxiety and mood disorders, among other things.

“The tide of public opinion has certainly changed, and we are set to see this becoming a mainstream treatment for mental disorders in the next few years,” Sessa says.

About the Writer:
Michael Quiñones is a freelance storyteller/journalist/editor with decades of experience developing content for everything word-related from sci-fi novels and plays to major lifestyle brands, hard news and pop media. Born in the suburbs of Dayton, Ohio, he makes frequent trips back there from his home base in New York City, where his two young daughters and two cats keep him up nights.

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This site is for educational purposes and not a substitute for professional medical care by a doctor or otherwise qualified medical professional. The information provided by Outlier Magazine is on the understanding that it does not constitute medical or other professional advice or services.

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