First responders in Arizona, like police and firefighters, have a tough job. Many of them end up with PTSD because of the things they see and do every day. Now, there’s hope that a type of therapy with a drug known as MDMA, often called ecstasy or molly, could help them. But this depends on whether the Food and Drug Administration (FDA) approves it.

The FDA’s Decision

Next month, the FDA will decide if MDMA-assisted therapy can be used to treat PTSD. Earlier, an FDA advisory committee said no to this idea on June 4. But many people are still hopeful.

Jonathan Lubecky, a military veteran who tried this therapy, said, "The question is, will it be August or will it be two to five years from now? It’s up to the FDA how many people die before it’s approved" (Cronkite News). He thinks it’s crazy not to let people use MDMA when PTSD can lead to depression and suicidal thoughts.

Arizona’s Move

The Arizona Legislature recently added MDMA-assisted therapy to treatments covered by workers' compensation for first responders with PTSD. Governor Katie Hobbs signed this new law last month, but it all hinges on the FDA’s decision.

What is MDMA?

MDMA, or methylenedioxymethamphetamine, is both a stimulant and a hallucinogenic. It's meant to be used with talk therapy. It helps patients become more aware of themselves and tolerate revisiting painful memories. This leads to deep thinking and reflection. According to Lykos Therapeutics, the company behind the new drug application, MDMA makes therapy more effective.

In clinical trials, 71% of the people who took MDMA no longer had PTSD, compared to 48% of those who took a placebo.

How Therapy with MDMA Works

Stephanie Miller, a clinical therapist, says, “It lifts that fog and then they’re able to process more in therapy” (Cronkite News). Miller has patients in Arizona and Texas who she often refers for ketamine treatment, another controversial therapy. But like ketamine, MDMA isn’t FDA-approved for treating psychological disorders, even though doctors can prescribe it.

Many first responders are hesitant. Miller said, "MDMA and ketamine are the same things they’re arresting people for on the street" (Cronkite News). About half of the first responders she treats have tried ketamine. Miller finds these therapies especially helpful for people who have a hard time letting their guard down.

“When we have assisted therapies like ketamine and MDMA, it kind of cuts to the chase,” she explained (Cronkite News).

Real-Life Stories

Lubecky, who lives in Washington, D.C., shared his experience with MDMA therapy. “I just started talking,” he said. “I knew I would be talking about things that happened in Iraq. I ended up talking about every trauma in my life over the three sessions” (Cronkite News).

Before the therapy, he was taking 42 prescription pills every day and had tried to end his life five times. But after MDMA therapy, things changed. “The Fourth of July before I did the therapy, I was in my closet, wearing my body armor, with my service dog, having flashbacks,” he recalled (Cronkite News). He said he hasn’t had a PTSD episode since the treatment, even when he went to Ukraine to treat injured soldiers.

However, Lubecky warns, “MDMA is not a silver bullet. If you’re not doing therapy, then you’re just doing drugs” (Cronkite News).

The Bigger Picture

A study by Nova Southeastern University’s College of Psychology found that over 80% of first responders experience traumatic events on the job. Between 10% and 15% of them are diagnosed with PTSD.

Michael Carleton, a retired Tempe police sergeant, said, “We have so much cumulative stress and trauma with the job that everybody gets their turn on the roller coaster” (Cronkite News).

Current PTSD Treatments

The FDA has only approved two medications for PTSD: sertraline (Zoloft) and paroxetine (Paxil). These are SSRIs (selective serotonin reuptake inhibitors) that help regulate mood, anxiety, and sleep. But they don’t address the deep-rooted fear response of PTSD.

Facing the Stigma

Many first responders avoid seeking help for PTSD because of stigma. A survey by the University of Phoenix in 2019 found that 57% of first responders feared negative consequences from their peers or department if they sought counseling.

Carleton added, “Somebody calls 911 and we go run and give help, but we never asked for help” (Cronkite News).

The consequences of untreated PTSD can be severe. Phoenix Police Officer Craig Tiger, for example, died by suicide after a traumatic incident at work. This led to the Craig Tiger Act in 2018, which mandates Arizona employers to provide counseling for firefighters and police officers after traumatic incidents.

“That law has done more for removing the stigma from law enforcement and firefighters than anything I’ve seen in the last 25 years,” Carleton said.