The reputation of the synthetic drug MDMA has changed dramatically since it was outlawed in 1985. Right now, it’s the centerpiece of a Food and Drug Administration-approved Phase III clinical trial on its ability to help heal the damage caused by post-traumatic stress disorder when used alongside therapy. While those trials are underway, scientists are seeking to understand the long-term impacts of MDMA, preparing for a future where it’s widely used to treat illness.
A study released Tuesday in the Journal of Psychopharmacology suggests there’s no reason to be concerned. Long-term MDMA users, it shows, have higher levels of empathy than long-term users of other drugs. This runs contrary to previous studies suggesting long-term MDMA use could cause heightened social distress. It’s more evidence that MDMA, the study authors argue, can be safely used as a long-term treatment that doesn’t harm the social brain.
“Our study suggests that mild MDMA use is not associated with any problems in how we function socially,” senior author and University of Exeter professor Celia Morgan, Ph.D. said Friday. “Instead, it seems to make people better at empathy when compared to drug users who don’t use MDMA, with a suggestion of better empathy compared to alcohol users.”
In the study, Morgan and her team studied empathy in 25 people who have used multiple drugs including MDMA, 19 people who have used multiple drugs but not MDMA, and 23 people who have only used alcohol. Other drugs, in this case, refer to ketamine, cocaine, and cannabis, and the participants who had used MDMA were “long-term but mild users,” meaning each had only used MDMA a minimum of ten times. This number, the researchers write, reflect the number of doses that would be used for medical purposes.
Notably, the MDMA used by these participants were doses of “street MDMA,” rather than pharmaceutical MDMA. The former is also known as ecstasy, and can vary in purity and quantity compared to the MDMA given in FDA-approved studies.
The team asked all 67 participants about how they perceived their own ability to empathize with others and their history of drug use. Then, all of them participated in a computerized task in which had to identify emotions on people’s faces then describe how they felt while looking at those faces. These tasks measured both cognitive empathy — how well one understands the emotions of others — and emotional empathy, the actual act of experiencing an emotion because how others feel.
Ultimately, the MDMA users self-reported a significant sense of emotional empathy compared to the other groups, which the team writes “suggests a greater concern for others in these individuals, compared with poly-drug users who do not take MDMA.” Furthermore, the MDMA users also had significantly greater cognitive empathy than the poly-drug users. These observations, the team writes, are evidence that long-term MDMA users “exhibit normal psychosocial functioning in regard to empathy and social pain, and had higher subjective emotional empathy.”
While it’s still not clear whether the differences in empathy can be chalked up to MDMA use or that people who use MDMA are just more empathetic, the study shows that long-term MDMA use doesn’t hinder empathy in general, which is the important takeaway from this study.
When someone takes a dose of MDMA, the drug causes a release of the chemicals noradrenaline, dopamine, and, importantly, serotonin. Scientists previously wondered whether long-term MDMA use would result in serotonin depletion, plausibly causing a downstream effect on empathy and other social processes. If that was true, long-term use would effectively achieve the opposite effect of short-term use: So far, studies on MDMA have show that short-term increases empathy and induces heightened levels of compassion and generosity.
Now, this study says that long-term use can do the same, regardless of how the drug impacts serotonin. That could be great news for the 7.7 million Americans who have PTSD and are searching for a salve.