0:00:16.804,0:00:22.070 3,4-Methylenedioxymethamphetamine: MDMA. 0:00:22.070,0:00:23.399 Now you've probably heard 0:00:23.399,0:00:27.999 of this compound in the context[br]of the recreational drug Ecstasy. 0:00:27.999,0:00:31.768 But today I want to talk about MDMA,[br]not as a recreational drug, 0:00:31.768,0:00:35.629 but as a potential[br]new treatment in medicine, 0:00:35.629,0:00:38.160 and then a very important[br]treatment for psychiatry 0:00:38.160,0:00:41.749 because MDMA could offer us,[br]in psychiatry, for the first time, 0:00:41.749,0:00:45.079 the opportunity to tackle trauma. 0:00:45.079,0:00:46.769 And psychological trauma, 0:00:46.769,0:00:50.069 particularly that caused[br]by child abuse and maltreatment, 0:00:50.069,0:00:57.139 is at the heart of all or most psychiatric[br]disorders due to anxiety and addictions. 0:00:58.269,0:01:02.000 Psychiatry is in need[br]of this innovative approach 0:01:02.000,0:01:04.731 because current treatments [br]are failing patients. 0:01:05.651,0:01:07.820 Hi, my name's Ben Sessa. 0:01:07.820,0:01:09.860 I'm a child and adolescent psychiatrist. 0:01:09.860,0:01:12.349 Now that means[br]I trained as a medical doctor, 0:01:12.349,0:01:14.440 then specialized in mental health, 0:01:14.440,0:01:17.400 and then specialized[br]in child and adolescent mental health. 0:01:17.400,0:01:20.220 But for the last five years,[br]I've been working with adults 0:01:20.220,0:01:24.480 with mental health disorders[br]and addictions due to misuse of drugs. 0:01:24.480,0:01:27.509 And that developmental[br]pathway of my own, 0:01:27.509,0:01:31.919 from working with child abuse into adults[br]with mental disorders and addictions 0:01:31.919,0:01:34.039 has brought me to the door of MDMA. 0:01:34.749,0:01:37.919 And I'm going to propose today [br]that MDMA could be [as] important 0:01:37.919,0:01:42.039 for the future of psychiatry[br]as the discovery of antibiotics was 0:01:42.039,0:01:44.499 for general medicine a hundred years ago. 0:01:44.999,0:01:47.770 So when we think about child abuse, 0:01:47.770,0:01:53.070 we think about physical abuse,[br]mental abuse, emotional abuse, 0:01:53.070,0:01:54.920 sexual abuse, and neglect. 0:01:55.370,0:01:57.990 And we think about noxious environments. 0:01:57.990,0:02:00.090 We think about parents[br]with mental disorders, 0:02:00.090,0:02:02.450 we think about parents[br]who are addicted to drugs, 0:02:02.450,0:02:06.709 and social issues like poverty and[br]poor housing, poor education. 0:02:07.389,0:02:10.257 Now I'm going to illustrate[br]my talk today with a patient, 0:02:10.257,0:02:12.330 and I'm going to call her Claire. 0:02:12.330,0:02:15.920 Now, Claire was no single[br]particular patient of mine. 0:02:15.920,0:02:18.640 Rather, she's an amalgamation[br]of many different people 0:02:18.640,0:02:22.070 I've met in the last 18 years working[br]as a medical doctor. 0:02:23.350,0:02:25.060 She's certainly not the worst. 0:02:25.680,0:02:29.170 Now what was Claire's environment like [br]as she was growing up? 0:02:29.170,0:02:31.380 Well, her mother was depressed. 0:02:31.380,0:02:33.600 Unfortunately, the family doctor[br]didn't have time 0:02:33.600,0:02:36.940 to accurately diagnose[br]and treat depression, 0:02:36.940,0:02:40.480 rather, Claire's mother was put[br]onto one antidepressant after another, 0:02:40.480,0:02:42.630 never really got therapy. 0:02:42.630,0:02:44.960 Claire's mother also had a lot[br]of aches and pains, 0:02:44.960,0:02:48.110 typical of what we call [br]psychosomatic symptoms in depression, 0:02:48.110,0:02:52.850 and, as a result, the family doctor [br]put her onto opiate based painkillers 0:02:52.850,0:02:55.470 which she promptly became addicted to. 0:02:55.950,0:02:59.100 Claire's father, now he was alcoholic[br]and he was often 0:02:59.100,0:03:01.110 not around, in and out of prison, 0:03:01.110,0:03:03.160 which is just as well[br]because when he was there, 0:03:03.160,0:03:06.640 he was physically abusive[br]to Claire and her mother. 0:03:06.640,0:03:08.260 Okay, so what does this kind 0:03:08.260,0:03:13.640 of chaotic, frightening environment[br]do to the developing child brain? 0:03:13.720,0:03:16.710 I'm going to give you a brief[br]neurophysiology lesson, if I may. 0:03:16.710,0:03:19.430 There's a part of the brain[br]called the amygdala. 0:03:19.430,0:03:22.780 Now the amygdala is a very ancient part[br]of the mammalian brain, 0:03:22.780,0:03:26.440 and many other animals[br]other than humans have an amygdala. 0:03:26.440,0:03:29.299 The amygdala lights up when stimulated 0:03:29.299,0:03:32.630 by fear in the environment,[br]by a frightening stimulus. 0:03:32.630,0:03:36.849 It lights up and it says,[br]"Fight or flight, get out!" 0:03:36.849,0:03:40.170 Now, there's another part of the brain,[br]much more sophisticated part, 0:03:40.170,0:03:41.570 called the prefrontal cortex, 0:03:41.570,0:03:44.510 and it's right here[br]at the front above the eyes. 0:03:44.510,0:03:47.360 Now the prefrontal cortex,[br]only humans have, 0:03:47.360,0:03:52.270 and it's in the prefrontal cortex[br]where we use logic and reasoning 0:03:52.270,0:03:55.130 to rationalize the situation[br]and we can use 0:03:55.130,0:03:57.470 our prefrontal cortex to overcome 0:03:57.470,0:04:00.880 that instinctive fear response[br]from the amygdala. 0:04:00.880,0:04:02.640 Now when Claire was growing up, 0:04:02.820,0:04:04.630 she never knew,[br]one moment to the next, 0:04:04.630,0:04:07.780 whether the adult coming into the room[br]was going to give her a kiss 0:04:07.780,0:04:09.770 or a cuddle or do a jigsaw with her, 0:04:09.770,0:04:11.960 or were they going[br]to punch her, or kick her, 0:04:11.960,0:04:14.309 or burn her with their cigarette. 0:04:14.309,0:04:16.709 Or were they going to rape her. 0:04:16.709,0:04:20.409 Because, throughout her childhood,[br]Claire was also subjected to sexual abuse. 0:04:21.630,0:04:25.850 Now, there's a group of disorders[br]called the anxiety disorders, 0:04:25.850,0:04:27.949 and one of the most important[br]is what we call 0:04:27.949,0:04:31.839 posttraumatic[br]stress disorder, or PTSD. 0:04:31.839,0:04:34.841 Now PTSD, some of the core features: 0:04:34.841,0:04:38.770 very low mood, anxiety,[br]high levels of anxiety, 0:04:38.770,0:04:41.169 what we call hypervigilance - 0:04:41.169,0:04:43.249 this edginess, this jumpiness. 0:04:43.249,0:04:47.160 Exactly how Claire felt,[br]throughout her childhood and adolescence. 0:04:47.160,0:04:49.730 Never knowing whether[br]the next assailant or assault 0:04:49.730,0:04:51.849 was around the corner. 0:04:51.849,0:04:56.460 Another core feature of PTSD,[br]what we call re-experiencing phenomena. 0:04:56.460,0:04:58.390 Flashbacks, in which the patient 0:04:58.390,0:05:01.590 has sudden remembrances[br]of painful traumatic memories. 0:05:01.590,0:05:04.520 They could've popped[br]into the head, at any time, 0:05:04.520,0:05:07.460 triggered by some cue[br]n the environment. 0:05:07.460,0:05:10.770 And when they have those experiences,[br]those daytime flashbacks, 0:05:10.770,0:05:14.050 they relive the trauma in all the[br]sensory modalities, 0:05:14.230,0:05:17.550 and this results in them[br]freezing or dissociating 0:05:17.550,0:05:20.000 to try and block out the pain. 0:05:20.000,0:05:23.410 Now, Claire experienced all of this[br]as she was growing up. 0:05:25.160,0:05:29.450 High levels of self-harm and suicide[br]are associated with PTSD. 0:05:29.450,0:05:32.070 Claire would cut her thighs[br]and her breasts. 0:05:32.670,0:05:37.269 Pretty common form of cutting[br]in children who've been sexually abused. 0:05:37.269,0:05:40.010 She was being sexually abused[br]by her mother's clients 0:05:40.010,0:05:43.599 because her mother had moved on[br]from the addiction to painkillers 0:05:43.599,0:05:46.890 and was using street heroin[br]when Claire was a teenager. 0:05:46.890,0:05:49.670 And because of the way[br]the war on drugs has set up 0:05:49.670,0:05:54.030 that reduces access to treatment[br]for people with opiate dependence, 0:05:54.030,0:05:56.319 she had to pay for her heroin[br]using sex work, 0:05:56.319,0:05:58.939 and the clients[br]would sexually abuse Claire. 0:06:00.409,0:06:05.289 It's very hard to treat PTSD[br]and it has a high treatment resistance - 0:06:05.289,0:06:09.380 50% of people do not respond[br]to the traditional treatments. 0:06:09.920,0:06:10.960 How do we treat it? 0:06:10.960,0:06:12.459 Well, we can treat it with medications. 0:06:12.459,0:06:14.979 We can treat it with psychotherapies. 0:06:14.979,0:06:18.850 And the medications we use,[br]there's a broad range of drugs. 0:06:18.940,0:06:21.010 No single drug,[br]and this is very important, 0:06:21.010,0:06:24.340 no single drug cures PTSD. 0:06:24.850,0:06:27.430 Rather, we treat[br]the disorder symptomatically. 0:06:27.430,0:06:30.400 If the patient's depressed,[br]give them an antidepressant. 0:06:30.400,0:06:33.800 If their mood fluctuates,[br]give them a mood stabilizer. 0:06:33.800,0:06:36.540 If they can't sleep, give them a hypnotic. 0:06:36.540,0:06:41.000 And if that edginess and that fear [br]spills over into paranoia and psychosis, 0:06:41.000,0:06:43.750 give the patient an anti-psychotic drug. 0:06:43.880,0:06:46.240 And they have to take[br]these drugs day in, day out, 0:06:46.270,0:06:48.240 for weeks, months, decades. 0:06:48.240,0:06:53.710 They have to keep taking them[br]because the drugs we use to treat trauma, 0:06:53.710,0:06:59.320 when it's due to this level of severity,[br]do not attack the root cause of trauma. 0:06:59.320,0:07:01.570 They paper over the cracks. 0:07:01.570,0:07:07.700 A good analogy would be taking aspirin[br]or ibuprofen when you have a fever. 0:07:07.700,0:07:13.100 A fever is caused by an infection,[br]by a microorganism. 0:07:13.100,0:07:15.900 Sure, you can take[br]paracetamol or ibuprofen, 0:07:15.900,0:07:17.770 and this will lower the temperature 0:07:17.770,0:07:22.190 make you feel a bit better[br]but it doesn't attack the root cause. 0:07:22.190,0:07:26.440 And that's what we do when we give[br]these patients these daily SSRI drugs. 0:07:26.440,0:07:27.710 We paper over the cracks. 0:07:27.710,0:07:30.510 We maintain the symptoms[br]at a manageable level. 0:07:32.090,0:07:37.740 We also use psychotherapies to treat PTSD,[br]and there's again a broad range of these: 0:07:37.740,0:07:41.790 DBT, CBT, EMDR, trauma focused[br]psychotherapy, CAT, APT ... 0:07:41.790,0:07:46.450 Now all of them have[br]a pretty similar approach 0:07:46.450,0:07:48.810 which actually is an old wives tales 0:07:48.810,0:07:51.210 which is: a problem shared[br]is a problem halved. 0:07:51.210,0:07:56.320 "Let's talk about your trauma.[br]Claire tell me about your rape." 0:07:56.320,0:08:03.850 Now that's fine for 50% of patients but for[br]a significant half they just cannot do that. 0:08:03.850,0:08:07.440 As soon as Claire is asked to talk[br]about her rape she freezes, 0:08:07.440,0:08:10.360 she flees, she drops out of treatment. 0:08:10.360,0:08:14.320 Now, by the time she was 15 Claire had been[br]removed from the family home and she was 0:08:14.320,0:08:18.320 brought up in a succession of foster[br]placements and children's houses and 0:08:18.450,0:08:21.559 hostels where the abuse continued. 0:08:22.159,0:08:25.339 She would self-harm cutting and[br]she started drinking and 0:08:25.339,0:08:29.260 by the time she was 18,[br]she was using heroin as well. 0:08:29.260,0:08:34.010 Sometimes working in psychiatry can feel[br]pretty desperate, can feel pretty hopeless. 0:08:34.410,0:08:39.160 Sometimes it feels as if psychiatry[br]is a palliative care profession. 0:08:39.160,0:08:42.109 And this is the truth because[br]the treatments we use do not get to the 0:08:42.109,0:08:44.559 root cause of the problem, the trauma. 0:08:44.559,0:08:46.740 They paper over the cracks. 0:08:46.740,0:08:50.090 And I think the pharma industry know this[br]and they queue up and they 0:08:50.090,0:08:53.510 provide us with product after product to[br]give to our patients that doesn't quite 0:08:53.510,0:08:58.380 cure them but it gets them[br]slightly better to function. 0:08:58.380,0:09:00.370 And they have to keep taking them. 0:09:00.370,0:09:04.800 Indeed I would say that we're in psychiatry today where[br]we were in general medicine 100 years ago. 0:09:04.800,0:09:06.540 100 years ago in general medicine, 0:09:06.540,0:09:10.160 humanity was losing the battle[br]to the infectious diseases. 0:09:10.160,0:09:12.800 Oh we were very good at classifying[br]and diagnosing them. 0:09:12.800,0:09:14.770 We knew who got smallpox. 0:09:14.770,0:09:17.320 We knew people died of post-operative surgery. 0:09:17.320,0:09:20.640 We knew there were microorganisms [br]but we didn't have a treatment. 0:09:20.640,0:09:25.850 And then at the beginning of the 20th[br]century we discovered the antibiotics. 0:09:25.850,0:09:29.810 Not symptomatic treatment but treatment[br]that goes to the core of the cause 0:09:29.810,0:09:33.660 and we started getting on top [br]of infectious disease. 0:09:33.760,0:09:37.090 Now, Psychiatry today is in a similar place. 0:09:37.090,0:09:39.550 We're very good at classifying and diagnosing. 0:09:39.550,0:09:41.670 Our epidemiology is superb. 0:09:41.670,0:09:44.000 We write these thick diagnostic manuals. 0:09:44.000,0:09:45.529 We know who gets depression. 0:09:45.529,0:09:47.070 We know who gets anxiety. 0:09:47.070,0:09:53.700 We even know the cause: trauma, child abuse,[br]maltreatment, poor social conditions. 0:09:53.700,0:09:56.150 But our treatments are lousy. 0:09:57.810,0:10:00.820 And I'm quite shocked the way the empathy 0:10:00.820,0:10:05.030 switch and our understanding of these[br]patients seems to be switched off. 0:10:05.550,0:10:09.520 We have lots of gushing sentimentality for[br]the little five and six year old who's 0:10:09.520,0:10:14.710 being abused and we throw money at our[br]television sets on these campaigns to 0:10:14.710,0:10:17.930 improve the lives of these[br]poor little innocent victims. 0:10:17.930,0:10:21.000 But let me tell you what happens to[br]that little five or six year old, 0:10:21.000,0:10:23.180 when they're 11 or 12. 0:10:23.180,0:10:26.830 On goes the hood, start smoking weed. 0:10:26.830,0:10:29.240 By the time they're 16 they're[br]buying and selling amphetamine 0:10:29.240,0:10:31.490 and by the time they're Claire's age[br]in their mid-20s, 0:10:31.490,0:10:33.670 they're addicted to heroin and alcohol. 0:10:33.670,0:10:36.580 And suddenly we have lost our empathy. 0:10:36.580,0:10:39.450 These people are public enemy number one. 0:10:39.450,0:10:45.160 "It's your fault Claire. You brought this[br]upon yourself. It's your lifestyle choice." 0:10:45.160,0:10:50.400 And I'm quite shocked and having worked in[br]pediatrics and seen the developmental 0:10:50.400,0:10:55.300 trajectory that is so inevitable from[br]early trauma into adolescent and then 0:10:55.300,0:10:59.799 adult mental health and addictions, we have[br]to hold on to that sense of compassion 0:10:59.799,0:11:04.470 and evidence-based understanding[br]about the developmental trajectory there. 0:11:05.720,0:11:08.720 So it does sound desperate,[br]but all is not lost. 0:11:09.740,0:11:14.220 MDMA. MDMA has some fascinating qualities. 0:11:14.220,0:11:19.410 Indeed, I would suggest that if you were to invent[br]a hypothetical drug to treat trauma, 0:11:19.410,0:11:21.940 it would be MDMA. 0:11:21.940,0:11:25.610 The way it works in terms of its receptors[br]and its subjective psychological effects 0:11:25.610,0:11:27.550 ticks all the right boxes. 0:11:27.550,0:11:31.420 At one level of receptors it causes[br]an increased positive mood. 0:11:31.420,0:11:34.200 Lowering of depression, lowering of anxiety. 0:11:34.200,0:11:37.160 At another group of receptors it speeds[br]the patient up, 0:11:37.160,0:11:41.570 mild stimulation which motivates them[br]to engage in therapy. 0:11:41.570,0:11:45.140 At another level it relaxes[br]the patient paradoxically 0:11:45.140,0:11:50.120 at the same time as the stimulation and this[br]puts the patient into the optimal arousal 0:11:50.120,0:11:53.330 zone where they can engage in psychotherapy. 0:11:53.330,0:11:58.610 But perhaps the most important thing about[br]MDMA and the most important clinical tool 0:11:58.610,0:12:06.020 is its ability to provide a sense of empathy[br]and understanding and emotional security. 0:12:06.960,0:12:12.230 It can hold the patient in a place where[br]they can think about and access their trauma 0:12:12.230,0:12:15.310 like they've never been able to do before. 0:12:15.710,0:12:17.690 One of the ways in which MDMA works is 0:12:17.690,0:12:21.650 is it increases the release of a[br]hormone called oxytocin. 0:12:21.650,0:12:25.600 Oxytocin is released from the brains of[br]breastfeeding mothers. 0:12:25.600,0:12:28.760 It's a hormone that engenders a sense of[br]attachment and bonding. 0:12:28.760,0:12:32.710 And that's what's happening in the[br]patient who takes MDMA. 0:12:32.710,0:12:36.450 And also it acts directly on[br]the amygdala to reduce 0:12:36.450,0:12:41.280 that fear response whilst at the same[br]time boosting the prefrontal response, 0:12:41.280,0:12:44.240 allowing the patient to see things in a new light. 0:12:44.240,0:12:46.130 A positive light. 0:12:46.130,0:12:48.320 So let's go back to Claire. 0:12:48.320,0:12:50.340 She's 40 now. 0:12:50.340,0:12:52.950 She's been in and out of psychiatric hospitals, 0:12:52.950,0:12:55.210 having tried to take her own life[br]in the inception. 0:12:55.210,0:12:58.780 She's been on all the antipsychotic and[br]antidepressant mood stabiliser drugs. 0:12:58.780,0:13:01.560 She's tried all the psychotherapies[br]but she cannot engage 0:13:01.560,0:13:05.890 because she will not talk about her feelings. 0:13:05.890,0:13:11.160 So she comes into a course of[br]MDMA-assisted psychotherapy. 0:13:11.860,0:13:13.379 What does it look like? 0:13:13.379,0:13:17.809 It's weekly sessions, maybe eight, ten,[br]twelve weeks long. 0:13:17.809,0:13:20.599 There're two therapists, male-female pair. 0:13:20.599,0:13:25.359 You do not take MDMA everyday,[br]you do not take it every week. 0:13:25.359,0:13:29.259 Over that course of 12 sessions you'll[br]take the MDMA three times and the 0:13:29.259,0:13:34.390 other sessions you talk about the material[br]that's released on the MDMA session. 0:13:35.010,0:13:39.909 So what does Claire actually feel[br]when she takes this MDMA? 0:13:39.909,0:13:46.289 What she feels is a sense of warmth and[br]understanding and a sense of containment 0:13:46.289,0:13:51.099 within that relationship she's having[br]with the therapist. 0:13:51.099,0:13:55.550 MDMA is like a lifejacket like[br]a bulletproof vest 0:13:55.550,0:13:58.870 to wear to go into battle with your trauma. 0:13:58.870,0:14:01.169 This is not ecstasy! 0:14:01.169,0:14:06.310 She's not enjoying some raver's euphoric[br]ecstasy delight. 0:14:06.310,0:14:10.790 This is still trauma focused psychotherapy[br]and it's still hard and distressing for her, 0:14:10.790,0:14:14.929 but she can just about do it with[br]MDMA on board. 0:14:14.929,0:14:19.909 So when the therapist says:[br]"Claire, tell me about your rape". 0:14:19.909,0:14:22.320 In the past just the word rape[br]and she'd be out the door, 0:14:22.320,0:14:25.889 but on MDMA she says:[br]"yeah, I can talk about that! 0:14:25.889,0:14:31.899 I can see him now coming into the room.[br]I can smell the whiskey on his breath and 0:14:31.899,0:14:35.829 I can feel the stubble on his face[br]as he's raping me". 0:14:35.829,0:14:40.280 And she talks about it and she explores it[br]and she reflects upon it 0:14:40.280,0:14:42.989 and she can begin the process of healing. 0:14:42.989,0:14:45.639 And from here she can start her journey. 0:14:45.639,0:14:48.889 She can attack the root cause of her problems. 0:14:48.889,0:14:52.729 Not just maintain the symptoms at a level. 0:14:54.989,0:14:56.829 So, does it work? 0:14:56.829,0:14:59.439 Well, we've known about MDMA[br]for a very long time 0:14:59.439,0:15:04.530 and indeed we've used MDMA in[br]underground therapy for 30 or 40 years. 0:15:04.530,0:15:07.409 And there are thousands of[br]positive anecdotal cases. 0:15:07.409,0:15:12.729 I get five emails a week from all over the[br]world: "Dr. Sessa, I've had PTSD for years. 0:15:12.729,0:15:17.389 I've tried everything and now I tried MDMA[br]and I'm starting to make a breakthrough!"[br] 0:15:17.469,0:15:21.269 Now, anecdotal reports like that are[br]interesting but they're not science so 0:15:21.269,0:15:23.150 we've done the science. 0:15:23.150,0:15:26.119 And some important studies in recent years. 0:15:26.119,0:15:32.609 Big study in the States showed that a single[br]course of MDMA therapy, 16-week course, 0:15:32.609,0:15:36.459 patient takes MDMA three times[br]tested against a placebo. 0:15:36.459,0:15:44.129 At the end of that course 85% of the people no[br]longer met the diagnostic criteria for PTSD. 0:15:44.129,0:15:48.820 Not just a relief of symptoms,[br]they didn't have PTSD! 0:15:48.820,0:15:54.010 Now that cohort were then followed up[br]three years later, the same no PTSD. 0:15:54.010,0:15:57.949 Many of those people had come of[br]their daily medications. 0:15:57.949,0:16:03.190 They were cured! We don't use[br]the "cure" word in psychiatry. 0:16:03.190,0:16:08.350 We've become learned helplessness[br]position of--This is the truth! 0:16:08.350,0:16:11.999 If you're diagnosed with a severe[br]mental disorder like anxiety or depression 0:16:11.999,0:16:16.580 in your 20s, and the developmental route[br]of that disorder is severe child abuse, 0:16:16.580,0:16:19.429 there's a pretty good chance--[br]and I'm sorry to say this-- 0:16:19.429,0:16:21.769 there's a pretty good chance you[br]will still be going to 0:16:21.769,0:16:24.589 psychiatric clinics in your 60s and 70s. 0:16:24.589,0:16:30.749 Now that is not good enough and we're in this[br]position because we're not tackling trauma. 0:16:31.749,0:16:35.130 So, it works but is it safe? 0:16:35.130,0:16:39.599 When we talk about safety of[br]clinical MDMA, what we must not do is 0:16:39.599,0:16:43.659 look at the risks of recreational ecstasy. 0:16:44.179,0:16:47.000 I don't even know what ecstasy is anymore! 0:16:47.000,0:16:49.370 Ecstasy is over here, what is ecstasy? 0:16:49.370,0:16:53.050 Some dodgy pill bought in some[br]dodgy club of some dodgy geezer, 0:16:53.050,0:16:59.929 that may or may not contain MDMA plus or[br]minus whatever far more toxic substance. 0:17:01.240,0:17:05.969 And indeed, when you hear about the very high-profile[br]deaths of people who take ecstasy, 0:17:05.969,0:17:10.018 it invariably is not MDMA. 0:17:10.018,0:17:13.420 So, let's not look at ecstasy as a[br]measure of MDMA. 0:17:13.420,0:17:15.600 Let's look at clinical MDMA. 0:17:15.600,0:17:21.229 When you use clinical MDMA, you take it[br]under medical supervision. It is pure. 0:17:21.229,0:17:25.720 The MDMA that I'm using in[br]my studies is 99.98% pure! 0:17:27.280,0:17:31.029 Very expensive! [br](laughter) 0:17:31.029,0:17:34.930 We do it under medical supervision with[br]a doctor and a nurse and a psychologist. 0:17:34.930,0:17:40.180 And under those conditions the risks are [br]reduced to an absolute minimum. 0:17:40.180,0:17:42.850 Indeed, after 40 years of MDMA research, 0:17:42.850,0:17:47.610 there has not been a single serious[br]adverse drug reaction, not one! 0:17:47.610,0:17:51.090 And certainly no deaths. 0:17:51.090,0:17:53.580 So, we need to do this research and 0:17:53.580,0:17:59.580 we need to do this research in[br]an evidence-based, compassionate way. 0:17:59.580,0:18:02.070 Looking at the data. 0:18:02.070,0:18:05.039 We need to ignore the socio-political[br]agenda that says any drug 0:18:05.039,0:18:11.110 that's being used recreationally must[br]also be very bad and dangerous. 0:18:11.110,0:18:14.270 That sort of attitude hampers research. 0:18:15.490,0:18:18.340 And we need scientists to drive this. 0:18:18.900,0:18:20.860 It works, it's safe. 0:18:20.860,0:18:24.640 And it offers patients like Claire for the[br]first time in their life an opportunity 0:18:24.640,0:18:30.220 to break through from that trauma and not[br]become a lifelong chronic PTSD sufferer. 0:18:30.220,0:18:32.790 So, where were we going with MDMA research? 0:18:32.790,0:18:35.630 Well, we've had some studies,[br]we've got more coming here. 0:18:35.630,0:18:39.509 I'm doing a study in Cardiff with neuroimaging[br]in which we're going to give patients 0:18:39.509,0:18:43.980 with PTSD, MDMA and placebo and[br]we're going to look at that relationship 0:18:43.980,0:18:47.420 between the amygdala and the[br]prefrontal cortex. 0:18:47.420,0:18:53.739 We're also doing a study here in Bristol giving[br]MDMA to patients with alcohol use disorder 0:18:53.739,0:18:58.040 because underlying the root[br]of this addiction is trauma. 0:18:58.040,0:18:59.950 This is an exciting time. 0:18:59.950,0:19:01.849 Now people say: "This is controversial!" 0:19:01.849,0:19:04.320 And indeed, I was introduced[br]as a controversial speaker. 0:19:04.320,0:19:07.530 I'm not controversial, I'm a very boring[br]conservative doctor. 0:19:07.530,0:19:10.040 I like data. 0:19:10.040,0:19:13.620 I like evidence-based data that[br]helps my patients. 0:19:13.620,0:19:15.669 I'll tell you what's controversial! 0:19:15.669,0:19:20.580 What's controversial is that more people[br]have died returning from Afghanistan and Iraq 0:19:20.580,0:19:24.190 because they've committed suicide[br]because of their untreated PTSD 0:19:24.190,0:19:26.980 then ever died in the conflict out there. 0:19:26.980,0:19:30.590 That is controversial and that is unethical! 0:19:32.370,0:19:35.330 So, this is an important time for science. 0:19:35.330,0:19:40.140 MDMA could be the antibiotic that[br]psychiatry has been waiting for. 0:19:40.140,0:19:43.619 We owe that population of patients[br]who are being failed, 0:19:43.630,0:19:46.040 we owe them this research! 0:19:46.040,0:19:47.748 We owe this to Claire! 0:19:47.748,0:19:55.328 Thank you.[br](applause)