There’s been a lot of news recently about the use of MDMA, sometimes known as ecstasy or molly, combined with psychotherapy, as a novel treatment for trauma. Partly, the news has been good. Really good, in fact. MDMA-assisted psychotherapy (MAP) for trauma has been studied by a top-notch group of researchers at several leading universities, and the results have been impressive.

The bottom line: MAP is generating a lot of excitement because it has shown great promise as an effective and acceptable treatment of both adult-onset PTSD and complex PTSD stemming from prolonged childhood trauma.

The bad news? The U.S. Food and Drug Administration recently rejected an application to legalize the use of MAP. Although there were certainly flaws in the design and conduct of the two major trials that were conducted to demonstrate the safety and efficacy of the treatment (see a discussion of these here), the disappointing decision seems to me to have been based on some conceptually flawed and frankly hypocritical grounds. Although the FDA’s rejection letter has not been made public, what we know so far is troubling.

There seems to be serious concern about the confounding role of psychotherapy in the use of MDMA. Essentially, the FDA is asking how we can know the true effects of MDMA if it’s being administered together with psychotherapy. Some experts are concluding........

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