0:00:16.804,0:00:22.350
3,4-Methylenedioxymethamphetamine: MDMA.

0:00:22.350,0:00:24.469
Now you've probably heard[br]of this compound

0:00:24.469,0:00:27.719
in the context of the[br]recreational drug Ecstasy.

0:00:27.929,0:00:31.808
But today I want to talk about MDMA,[br]not as a recreational drug,

0:00:31.818,0:00:35.419
but as a potential[br]new treatment in medicine,

0:00:35.619,0:00:37.950
and then a very important[br]treatment for psychiatry

0:00:37.950,0:00:41.749
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.

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And psychological trauma,

0:00:46.769,0:00:50.069
particularly that caused[br]by child abuse and maltreatment,

0:00:50.069,0:00:54.704
is at the heart of all[br]or most psychiatric disorders

0:00:54.704,0:00:57.754
due to anxiety and addictions.

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Psychiatry is in need[br]of this innovative approach

0:01:02.000,0:01:04.731
because current treatments [br]are failing patients.

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Hi, my name's Ben Sessa.

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I'm a child and adolescent psychiatrist.

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Now that means[br]I trained as a medical doctor,

0:01:12.309,0:01:14.290
then specialized in mental health,

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and then specialized[br]in child and adolescent mental health.

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But for the last five years,

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I've been working with adults[br]with mental health disorders

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and addictions due to misuse of drugs.

0:01:24.480,0:01:27.329
And that developmental[br]pathway of my own,

0:01:27.329,0:01:31.919
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.

0:01:34.749,0:01:36.459
And I'm going to propose today

0:01:36.459,0:01:39.459
that MDMA could be [as] important[br]for the future of psychiatry

0:01:39.459,0:01:44.149
as the discovery of antibiotics was[br]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.

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And we think about noxious environments,

0:01:57.990,0:02:00.090
we think about parents[br]with mental disorders,

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we think about parents[br]who are addicted to drugs,

0:02:02.450,0:02:06.709
and social issues like poverty,[br]and 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.

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Now, Claire was no single[br]particular patient of mine.

0:02:15.920,0:02:18.570
Rather, she's an amalgamation[br]of many different people

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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.

0:02:25.680,0:02:29.430
Now, what was Claire's environment like [br]as she was growing up?

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Well, her mother was depressed.

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Unfortunately, the family doctor[br]didn't have time

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to accurately diagnose[br]and treat depression.

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Rather, Claire's mother was put[br]onto one antidepressant after another,

0:02:40.480,0:02:42.570
never really got therapy.

0:02:42.570,0:02:44.960
Claire's mother also had a lot[br]of aches and pains,

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typical of what we call [br]psychosomatic symptoms in depression,

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and, as a result, the family doctor [br]put her onto opiate-based painkillers

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which she promptly became addicted to.

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Now, Claire's father, he was alcoholic,

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and he was often not around,[br]in and out of prison,

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which is just as well

0:03:02.290,0:03:03.530
because when he was there,

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he was physically abusive[br]to Claire and her mother.

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Okay, so what does this kind of chaotic,[br]frightening environment do

0:03:11.360,0:03:13.640
to the developing child brain?

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I'm going to give you a brief[br]neurophysiology lesson, if I may.

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There's a part of the brain[br]called the amygdala.

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Now, the amygdala is a very ancient part[br]of the mammalian brain,

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and many other animals,[br]other than humans, have an amygdala.

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The amygdala lights up when stimulated[br]by fear in the environment,

0:03:30.829,0:03:32.630
by a frightening stimulus.

0:03:32.630,0:03:36.729
It lights up and it says,[br]"Fight or flight, get out!"

0:03:36.729,0:03:40.170
Now, there's another part of the brain,[br]a much more sophisticated part,

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called the prefrontal cortex,

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and it's right here,[br]at the front, above the eyes.

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Now, the prefrontal cortex,[br]only humans have,

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and it's in the prefrontal cortex[br]where we use logic and reasoning

0:03:52.270,0:03:54.240
to rationalize the situation,

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and we can use our prefrontal cortex

0:03:56.240,0:04:00.880
to overcome that instinctive fear[br]response from the amygdala.

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Now, when Claire was growing up,

0:04:02.460,0:04:04.590
she never knew,[br]from one moment to the next,

0:04:04.590,0:04:07.780
whether the adult coming into the room[br]was going to give her a kiss,

0:04:07.780,0:04:09.670
or a cuddle, or do a jigsaw with her,

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or were they going[br]to punch her, or kick her,

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or burn her with their cigarette.

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Or were they going to rape her.

0:04:16.579,0:04:20.409
Because, throughout her childhood,[br]Claire was also subjected to sexual abuse.

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Now, there's a group of disorders[br]called the anxiety disorders,

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and one of the most important is what[br]we call posttraumatic stress disorder,

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or PTSD.

0:04:31.989,0:04:34.841
Now, PTSD, some of the core features:

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very low mood, anxiety,[br]high levels of anxiety,

0:04:38.770,0:04:41.169
what we call hypervigilance -

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this edginess, this jumpiness.

0:04:43.179,0:04:47.160
Exactly how Claire felt,[br]throughout her childhood and adolescence,

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never knowing whether the next assailant[br]or assaulter was around the corner.

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Another core feature of PTSD,[br]what we call re-experiencing phenomena,

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flashbacks,

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in which the patient[br]has sudden remembrances

0:04:59.750,0:05:01.590
of these painful traumatic memories.

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They can just pop[br]into the head at any time,

0:05:04.520,0:05:07.150
triggered by some cue in the environment.

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And when they have those experiences,[br]those daytime flashbacks,

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they relive the trauma[br]in all the sensory modalities,

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and this results in them[br]freezing or dissociating

0:05:17.620,0:05:20.000
to try and block out the pain.

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Now, Claire experienced all of this[br]as she was growing up.

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High levels of self-harm and suicide[br]are associated with PTSD.

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Claire would cut her thighs[br]and her breasts,

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pretty common form of cutting[br]in children who've been sexually abused.

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She was being sexually abused[br]by clients of her mother

0:05:39.970,0:05:43.559
because her mother had moved on[br]from the addiction to painkillers

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and was using street heroin[br]when Claire was a teenager.

0:05:46.800,0:05:49.650
And because of the way[br]the war on drugs has set up,

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that reduces access to treatment[br]for people with opiate dependence,

0:05:53.980,0:05:56.319
she had to pay for her heroin[br]use in sex work,

0:05:56.319,0:05:58.939
and the clients[br]would sexually abuse Claire.

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Now, it's very hard to treat PTSD[br]and it has a high treatment resistance -

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50% of people do not respond[br]to the traditional treatments.

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How do we treat it?

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Well, we can treat it with medications.[br]We can treat it with psychotherapies.

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And the medications we use,[br]there's a broad range of drugs.

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No single drug,[br]and this is very important,

0:06:21.010,0:06:24.340
no single drug cures PTSD.

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Rather, we treat[br]the disorder symptomatically.

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If the patient's depressed,[br]give them an antidepressant.

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If their mood fluctuates,[br]give them a mood stabilizer.

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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.

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And they have to take[br]these drugs day in, day out,

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for weeks, months, decades.

0:06:48.240,0:06:53.470
They have to keep taking them[br]because the drugs we use to treat trauma,

0:06:53.470,0:06:55.820
when it's due to this level of severity,

0:06:55.820,0:06:59.320
do not attack the root cause of trauma.

0:06:59.320,0:07:01.470
They paper over the cracks.

0:07:01.470,0:07:07.700
A good analogy would be taking aspirin[br]or ibuprofen when you have a fever.

0:07:07.700,0:07:13.100
Now, fever is caused by an infection,[br]by a microorganism.

0:07:13.100,0:07:15.810
Sure, you can take[br]paracetamol or ibuprofen,

0:07:15.810,0:07:18.860
and this will lower the temperature,[br]make you feel a bit better,

0:07:18.860,0:07:22.020
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:

0:07:37.740,0:07:43.670
DBT, CBT, EMDR, trauma-focused[br]psychotherapy, CAT, APT ...

0:07:43.670,0:07:46.790
Now, all of them have[br]a pretty similar approach

0:07:46.790,0:07:48.550
which actually is an old wives' tale

0:07:48.550,0:07:51.390
which is: a problem shared[br]is a problem halved.

0:07:51.390,0:07:53.030
"Let's talk about your trauma.

0:07:53.030,0:07:56.130
Claire, tell me about your rape."

0:07:56.440,0:07:59.840
Now that's fine for 50% of patients,

0:07:59.840,0:08:03.630
but for a significant half,[br]they just cannot do that.

0:08:03.850,0:08:07.530
As soon as Claire is asked to talk[br]about her rape, she freezes,

0:08:07.530,0:08:10.150
she flees, she drops out of treatment.

0:08:10.150,0:08:11.690
Now, by the time she was 15,

0:08:11.690,0:08:13.960
Claire had been removed[br]from the family home,

0:08:13.970,0:08:17.180
and she was brought up[br]in a succession of foster placements,

0:08:17.180,0:08:21.559
and children's houses,[br]and hostels where the abuse continued.

0:08:22.159,0:08:25.229
She would self-harm cutting,[br]and she started drinking,

0:08:25.229,0:08:29.040
and, by the time she was 18,[br]she was using heroin as well.

0:08:29.260,0:08:32.100
Sometimes working in psychiatry[br]can feel pretty desperate,

0:08:32.100,0:08:34.410
can feel pretty hopeless.

0:08:34.410,0:08:39.090
Sometimes it feels as if psychiatry[br]is a palliative care profession.

0:08:39.090,0:08:41.469
And this is the truth[br]because the treatments we use

0:08:41.469,0:08:44.559
do not get to the root cause[br]of the problem, the trauma;

0:08:44.559,0:08:46.740
they paper over the cracks.

0:08:46.740,0:08:49.660
And I think the pharma industry[br]knows this, and they queue up,

0:08:49.660,0:08:51.800
and they provide us[br]with product after product

0:08:51.800,0:08:54.600
to give to our patients[br]that doesn't quite cure them,

0:08:54.600,0:08:58.380
but it gets them[br]slightly better to function.

0:08:58.380,0:09:00.070
And they have to keep taking them.

0:09:00.070,0:09:02.200
I would say that we're[br]in psychiatry, today,

0:09:02.200,0:09:04.590
where we were in general[br]medicine 100 years ago.

0:09:04.590,0:09:06.520
Now, 100 years ago, in general medicine,

0:09:06.520,0:09:09.970
humanity was losing the battle[br]to the infectious diseases.

0:09:09.970,0:09:12.800
Oh, we were very good[br]at classifying and diagnosing them.

0:09:12.800,0:09:14.770
We knew who got smallpox.

0:09:14.770,0:09:17.480
We knew people died[br]of post-operative surgery.

0:09:17.480,0:09:20.770
We knew there were microorganisms,[br]but we didn't have a treatment.

0:09:20.770,0:09:23.380
And then, at the beginning[br]of the 20th century,

0:09:23.380,0:09:25.820
we discovered the antibiotics.

0:09:25.820,0:09:27.220
Not symptomatic treatment,

0:09:27.220,0:09:29.890
but treatment that goes[br]to the core of the cause,

0:09:29.890,0:09:33.460
and we started getting[br]on top of infectious disease.

0:09:33.870,0:09:37.090
Now, psychiatry, today,[br]is in a similar place.

0:09:37.090,0:09:39.550
We're very good[br]at classifying and diagnosing.

0:09:39.550,0:09:41.600
Our epidemiology is superb.

0:09:41.600,0:09:44.000
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.

0:09:47.070,0:09:48.530
We even know the cause:

0:09:48.530,0:09:51.363
trauma, child abuse, maltreatment,

0:09:51.910,0:09:53.700
poor social conditions.

0:09:53.700,0:09:55.850
But our treatments are lousy.

0:09:57.810,0:10:01.650
And I'm quite shocked[br]the way the empathy switch

0:10:01.650,0:10:05.380
and our understanding of these patients[br]seems to be switched off.

0:10:05.380,0:10:07.940
We have lots of gushing sentimentality

0:10:07.940,0:10:10.660
for the little five and six-year-old[br]who's being abused,

0:10:10.660,0:10:12.850
and we throw money at our television sets

0:10:12.850,0:10:17.760
on these campaigns to improve the lives[br]of these poor little innocent victims.

0:10:17.760,0:10:21.040
But let me tell you what happens[br]to that little five- or six-year-old

0:10:21.040,0:10:22.986
when they're 11 or 12.

0:10:23.570,0:10:26.800
On goes the hood, start smoking weed.

0:10:26.800,0:10:29.420
When they're 16, they're[br]buying and selling amphetamine,

0:10:29.420,0:10:31.890
by the time they're Claire's age,[br]in their mid-20s,

0:10:31.900,0:10:33.760
they're addicted to heroin and alcohol.

0:10:33.760,0:10:36.580
And, suddenly, we have lost our empathy.

0:10:36.580,0:10:39.450
These people are public enemy number one.

0:10:39.450,0:10:40.890
"It's your fault, Claire.

0:10:40.890,0:10:42.770
You brought this upon yourself.

0:10:42.770,0:10:45.160
It's your lifestyle choice."

0:10:45.160,0:10:48.060
And I'm quite shocked,[br]and having worked in pediatrics

0:10:48.060,0:10:52.440
and seeing the developmental trajectory[br]that is so inevitable,

0:10:52.440,0:10:53.830
from early trauma

0:10:53.830,0:10:57.510
into adolescent, and then adult[br]mental health and addictions,

0:10:57.510,0:10:59.799
we have to hold on[br]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.

0:11:09.910,0:11:11.240
MDMA.

0:11:11.240,0:11:13.960
MDMA has some fascinating qualities.

0:11:13.960,0:11:17.330
Indeed, I would suggest[br]that if you were to invent[br]

0:11:17.330,0:11:19.410
a hypothetical drug to treat trauma,

0:11:19.410,0:11:21.110
it would be MDMA.

0:11:21.770,0:11:25.470
The way it works, in terms of receptors[br]and subjective psychological effects,

0:11:25.470,0:11:27.550
ticks all the right boxes.

0:11:27.550,0:11:31.420
At one level of receptors,[br]it causes an increased positive mood,

0:11:31.420,0:11:34.200
lowering of depression,[br]lowering of anxiety.

0:11:34.200,0:11:37.160
At another group of receptors,[br]it speeds the patient up,

0:11:37.160,0:11:41.570
mild stimulation which motivates[br]them to engage in therapy.

0:11:41.570,0:11:45.140
At another level, it relaxes[br]the patient, paradoxically,

0:11:45.140,0:11:47.470
at the same time as the stimulation,

0:11:47.470,0:11:51.180
and this puts the patient[br]into the optimal arousal zone

0:11:51.180,0:11:53.620
where they can engage in psychotherapy.

0:11:53.620,0:11:56.070
But perhaps the most[br]important thing about MDMA,

0:11:56.070,0:11:58.390
and the most important clinical tool,

0:11:58.390,0:12:01.310
is its ability to provide a sense[br]

0:12:01.310,0:12:05.740
of empathy, and understanding,[br]and emotional security.

0:12:07.170,0:12:09.400
It can hold the patient in a place

0:12:09.400,0:12:12.230
where they can think about[br]and access their trauma

0:12:12.230,0:12:14.780
like they've never been able to do before.

0:12:15.950,0:12:17.770
One of the ways in which MDMA works

0:12:17.770,0:12:21.490
is it increases the release[br]of a hormone called oxytocin.

0:12:21.490,0:12:25.600
Now, oxytocin is released from the brains[br]of breastfeeding mothers.

0:12:25.600,0:12:28.760
It's a hormone that engenders[br]a sense of attachment and bonding,

0:12:28.760,0:12:32.220
and that's what's happening[br]in the patient who takes MDMA.

0:12:32.790,0:12:35.760
And, also, it acts[br]directly on the amygdala

0:12:35.760,0:12:37.790
to reduce that fear response,

0:12:37.790,0:12:41.440
while, at the same time,[br]boosting the prefrontal response,

0:12:41.470,0:12:44.240
allowing the patient[br]to see things in a new light,

0:12:44.240,0:12:45.780
a positive light.

0:12:46.040,0:12:48.140
So let's go back to Claire.

0:12:48.550,0:12:50.340
She's 40 now.

0:12:50.340,0:12:52.780
She's been in and out[br]of psychiatric hospitals,

0:12:52.780,0:12:55.210
having tried to take[br]her own life in the inception.

0:12:55.210,0:12:58.830
She's been on all the antipsychotic,[br]antidepressant, mood-stabilizing drugs.

0:12:58.830,0:13:01.790
She's tried all the psychotherapies,[br]but she cannot engage

0:13:01.790,0:13:05.340
because she will not talk[br]about her feelings.

0:13:06.320,0:13:11.510
So she comes into a course[br]of MDMA-assisted psychotherapy.

0:13:11.780,0:13:12.889
What does it look like?

0:13:12.889,0:13:17.689
Well, it's weekly sessions,[br]maybe eight, ten, twelve weeks long,

0:13:17.689,0:13:20.372
with two therapists, male-female pair.

0:13:21.079,0:13:25.359
You do not take MDMA every day,[br]you do not take it every week.

0:13:25.359,0:13:28.939
Over that course of 12 sessions,[br]you'll take the MDMA three times,

0:13:28.939,0:13:30.370
and the other sessions,

0:13:30.370,0:13:35.010
you talk about the material[br]that's released on the MDMA session.

0:13:35.410,0:13:39.549
So what does Claire actually feel[br]when she takes this MDMA?

0:13:40.529,0:13:44.049
What she feels is a sense[br]of warmth and understanding,

0:13:44.049,0:13:46.419
and a sense of containment

0:13:46.419,0:13:50.219
within that relationship[br]she's having with the therapists.

0:13:51.099,0:13:55.550
MDMA is like a life jacket,[br]like a bulletproof vest,

0:13:55.550,0:13:58.870
to wear to go into battle[br]with your trauma.

0:13:58.870,0:14:00.669
This is not ecstasy!

0:14:01.169,0:14:06.310
She's not enjoying some[br]raver's euphoric ecstasy delight.

0:14:06.310,0:14:08.490
This is still trauma-focused[br]psychotherapy,

0:14:08.490,0:14:11.120
and it's still hard[br]and distressing for her,

0:14:11.120,0:14:14.929
but she can just about do it[br]with MDMA on board.

0:14:14.929,0:14:19.559
So when the therapist says,[br]"Claire, tell me about your rape" -

0:14:19.559,0:14:22.320
In the past, just the word rape,[br]and she'd be out the door,

0:14:22.320,0:14:26.619
but on MDMA she says,[br]"Yeah, I can talk about that!

0:14:26.619,0:14:29.429
I can see him now coming into the room,

0:14:29.429,0:14:31.899
I can smell the whiskey on his breath,

0:14:31.899,0:14:35.829
and I can feel the stubble on his face[br]as he's raping me."

0:14:35.829,0:14:38.260
And she talks about it,[br]and she explores it,

0:14:38.260,0:14:40.119
and she reflects upon it,

0:14:40.119,0:14:42.989
and she can begin the process of healing.

0:14:42.989,0:14:45.639
And from here, she can start her journey.

0:14:45.639,0:14:49.119
She can attack the root cause[br]of her problems,

0:14:49.119,0:14:52.729
not just maintain the symptoms at a level.

0:14:54.989,0:14:56.649
So, does it work?

0:14:56.649,0:14:59.179
Well, we've known about MDMA[br]for a very long time,

0:14:59.179,0:15:04.790
and, indeed, we've used MDMA[br]in underground therapy for 30 or 40 years,

0:15:04.790,0:15:07.409
and there are thousands[br]of positive anecdotal cases.

0:15:07.409,0:15:10.149
I get five emails a week[br]from all over the world,

0:15:10.149,0:15:12.729
"Dr. Sessa, I've had PTSD for years.

0:15:12.729,0:15:15.209
I've tried everything,[br]and now I tried MDMA,

0:15:15.209,0:15:17.629
and I'm starting to make a breakthrough!"

0:15:17.629,0:15:20.009
Now, anecdotal reports[br]like that are interesting,

0:15:20.009,0:15:21.570
but they're not science,

0:15:21.570,0:15:22.940
so we've done the science

0:15:22.940,0:15:25.799
and some important studies[br]in recent years.

0:15:26.219,0:15:30.899
Big study in the States showed[br]that a single course of MDMA therapy,

0:15:30.899,0:15:36.309
16-week course, patient takes MDMA[br]three times, tested against the placebo -

0:15:36.459,0:15:37.839
At the end of that course,

0:15:37.839,0:15:44.129
85% of the people no longer met[br]the diagnostic criteria for PTSD.

0:15:44.129,0:15:48.640
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.

0:15:54.010,0:15:58.179
Many of those people had come[br]off their daily medications.

0:15:58.179,0:15:59.950
They were cured!

0:15:59.950,0:16:03.010
We don't use the "cure"[br]word in psychiatry.

0:16:03.180,0:16:06.990
We've become learned helpless[br]in this position of ...

0:16:07.350,0:16:08.350
This is the truth!

0:16:08.350,0:16:10.729
If you're diagnosed[br]with a severe mental disorder,

0:16:10.729,0:16:13.049
like anxiety or depression, in your 20s,

0:16:13.049,0:16:16.650
and the developmental route[br]of that disorder is severe child abuse,

0:16:16.650,0:16:19.379
there's a pretty good chance,[br]and I'm sorry to say this,

0:16:19.379,0:16:20.779
there's a pretty good chance

0:16:20.779,0:16:24.449
you will still be going to psychiatric[br]clinics in your 60s and 70s.

0:16:24.449,0:16:27.079
Now that is not good enough,

0:16:27.079,0:16:30.599
and we're in this position[br]because we're not tackling trauma.

0:16:31.749,0:16:34.130
So, it works, but is it safe?

0:16:34.940,0:16:37.709
Well, when we think about[br]safety of clinical MDMA,

0:16:37.709,0:16:39.399
what we must not do

0:16:39.399,0:16:43.659
is look at the risks[br]of recreational ecstasy.

0:16:44.179,0:16:47.000
I don't even know what ecstasy is anymore!

0:16:47.000,0:16:49.220
Ecstasy is over here; what is ecstasy?

0:16:49.220,0:16:53.340
Some dodgy pill, bought in some[br]dodgy club, off some dodgy geezer,

0:16:53.340,0:16:55.924
that may or may not contain MDMA,

0:16:55.924,0:16:59.964
plus or minus whatever[br]far more toxic substance.

0:17:00.970,0:17:04.199
And indeed, when you hear[br]about the very high-profile deaths

0:17:04.199,0:17:05.969
of people who take ecstasy,

0:17:05.969,0:17:08.518
it invariably is not MDMA.

0:17:10.078,0:17:13.400
So, let's not look at ecstasy[br]as a measure of MDMA.

0:17:13.420,0:17:15.220
Let's look at clinical MDMA.

0:17:15.220,0:17:20.029
Now, when you use clinical MDMA,[br]you take it under medical supervision,

0:17:20.029,0:17:21.229
it is pure.

0:17:21.229,0:17:25.720
The MDMA that I'm using[br]in my studies is 99.98% pure!

0:17:27.400,0:17:29.129
Very expensive!

0:17:29.129,0:17:31.029
(Laughter)

0:17:31.029,0:17:32.680
We do it under medical supervision

0:17:32.680,0:17:35.150
with a doctor, and a nurse,[br]and a psychologist.

0:17:35.150,0:17:40.340
And under those conditions, the risks [br]are reduced to an absolute minimum.

0:17:40.340,0:17:42.850
Indeed, after 40 years of MDMA research,

0:17:42.850,0:17:47.870
there has not been a single serious[br]adverse drug reaction, not one!

0:17:47.870,0:17:49.916
And certainly no deaths.

0:17:51.090,0:17:53.700
So, we need to do this research,

0:17:53.700,0:17:59.430
and we need to do this research[br]in an evidence-based, compassionate way,

0:17:59.430,0:18:01.310
looking at the data.

0:18:02.070,0:18:04.279
We need to ignore[br]the sociopolitical agenda

0:18:04.279,0:18:07.129
that says any drug[br]that's being used recreationally

0:18:07.129,0:18:10.350
must also be very bad and dangerous.

0:18:11.370,0:18:14.270
That sort of attitude hampers research.

0:18:15.490,0:18:18.120
And we need scientists to drive this.

0:18:18.900,0:18:20.520
It works, it's safe,

0:18:20.520,0:18:23.680
and it offers patients like Claire,[br]for the first time in their life,

0:18:23.680,0:18:26.290
an opportunity to break through[br]from that trauma

0:18:26.290,0:18:30.025
and not become a lifelong[br]chronic PTSD sufferer.

0:18:30.440,0:18:32.440
So, where are we going with MDMA research?

0:18:32.440,0:18:35.630
Well, we've had some studies,[br]we've got more coming here.

0:18:35.630,0:18:38.119
I'm doing a study[br]in Cardiff with neuroimaging

0:18:38.119,0:18:42.139
in which we're going to give patients[br]with PTSD MDMA and placebo,

0:18:42.139,0:18:44.190
and we're going[br]to look at that relationship

0:18:44.190,0:18:46.997
between the amygdala[br]and the prefrontal cortex.

0:18:47.470,0:18:49.789
We're also doing a study here in Bristol,

0:18:49.789,0:18:53.699
giving patients with alcohol[br]use disorder MDMA,

0:18:53.699,0:18:57.800
because underlying the root[br]of this addiction is trauma.

0:18:57.800,0:18:59.790
So, this is an exciting time.

0:18:59.790,0:19:01.849
Now people say, "This is controversial!"

0:19:01.849,0:19:04.470
And indeed, I was introduced[br]as a controversial speaker.

0:19:04.470,0:19:05.520
I'm not controversial.

0:19:05.520,0:19:07.530
I'm a very boring conservative doctor.

0:19:07.530,0:19:09.357
I like data.

0:19:09.680,0:19:12.950
I like evidence-based data[br]that helps my patients.

0:19:13.870,0:19:15.819
I'll tell you what's controversial.

0:19:15.819,0:19:18.370
What's controversial[br]is that more people have died

0:19:18.370,0:19:20.770
returning from Afghanistan and Iraq

0:19:20.770,0:19:24.280
because they've committed suicide[br]because of their untreated PTSD

0:19:24.280,0:19:26.980
than ever died in the conflict out there!

0:19:26.980,0:19:30.590
That is controversial,[br]and that is unethical!

0:19:32.370,0:19:35.510
So, this is an important time for science.

0:19:35.510,0:19:40.070
MDMA could be the antibiotic[br]that psychiatry has been waiting for.

0:19:40.070,0:19:43.749
We owe that population[br]of patients who are being failed,

0:19:43.749,0:19:46.040
we owe them this research!

0:19:46.040,0:19:47.808
We owe this to Claire!

0:19:47.808,0:19:49.179
Thank you.

0:19:49.179,0:19:51.169
(Applause)