Can MDMA Save a Marriage?

Now that MDMA is illegal, some providers resort to clandestine MDMA therapy sessions, at times with disastrous results. A recent essay in Slate detailed one man’s harrowing experience after an underground psychedelic coach gave him methamphetamine “cut with a bit of MDMA” instead of the pure MDMA he was expecting during a guided session in 2019.

It is also risky for people to use MDMA on their own, experts warn.

“This can include everything from a ‘bad trip,’ to reckless behavior to psychiatric symptoms like panic attacks or physical effects like hypertension or interactions with other medications,” said Dr. Smita Das, the chairwoman of the Council on Addiction Psychiatry at the American Psychiatric Association.

Typical side effects of MDMA use include involuntary jaw clenching, nausea, racing heart and hot flashes or chills. And prolonged use can damage nerve cells in the brain that contain serotonin, a chemical that relays messages and helps regulate mood, sleep, pain, appetite and more.

“There is more to taking MDMA than making sure the compound is pure,” said Rachel Yehuda, the director of the Center for Psychedelic Psychotherapy and Trauma Research at the Icahn School of Medicine at Mount Sinai.

Some mental health providers are looking for ways to help patients without breaking the law. Last year the company Fluence, an organization that trains therapists to legally integrate psychedelics into their practice, taught more than 300 clinicians how to support clients using illegal psychedelics on their own, said Elizabeth Nielson, a psychologist and one of the company’s founders.

Fluence tells therapists not to advise their clients on how to obtain an illegal drug or how to use it. But they can discuss why their clients want the drug, what they expect will happen when using it and how to reduce harm. Then they can work with clients after they take the drug to process their experience.

Jayne Gumpel, a lead trainer at Fluence and a couples therapist who sees clients in Woodstock, N.Y. and New York City, said the public’s interest in psychedelics “is exploding.” Oregon, Washington, D.C. and a half-dozen municipalities have decriminalized psilocybin, and hundreds of ketamine clinics are popping up in the United States. To stay current, therapists need to have an understanding of these and other psychedelics, including MDMA, Ms. Gumpel added.