Psychedelic-Assisted Therapy

The research so far is promising, with trials suggesting that substances like MDMA, ketamine, psilocybin, and cannabis-derived compounds may help people process trauma when used alongside psychotherapy. However, we want to be absolutely clear: this is not the same as recreational drug use. These trials are conducted in strictly controlled medical environments, using pharmaceutical-grade substances, and under the supervision of trained professionals. 

While the findings are exciting, there is still much to learn. Large-scale trials are ongoing, and psychedelic-assisted therapy is not yet widely available. While some researchers see psychedelic-assisted therapy as a breakthrough, others urge caution. Some psychiatrists argue that long-term effects are still unclear, and there is a need for more robust, large-scale studies before considering mainstream adoption. Additionally, certain groups—such as those with psychotic disorders or a history of substance abuse—may face heightened risks with psychedelics, making careful screening essential. 

PTSD UK acknowledges that drug policy is a complex and evolving issue. Our focus is not on political or legal debates, but rather on ensuring that people affected by PTSD and C-PTSD have access to evidence-based information about potential treatments, in line with ongoing scientific research and regulatory guidance

The Origins of the ‘War on Drugs’ and Public Perception of Psychedelics

For decades, psychedelics and other psychoactive substances have been widely perceived as dangerous and without medical value. This belief is largely the result of historical, political, and social influences rather than scientific evidence. The ‘War on Drugs’, which shaped global attitudes towards these substances, was not initiated due to scientific concerns over their harm but rather as a tool of political and social control.

The Role of Psychedelics in Social Movements

During the 1950s and 1960s, psychedelic research flourished, and substances such as LSD and psilocybin were being explored for their potential in treating mental health conditions (Nutt, 2023). However, these substances also became associated with the growing countercultural movement, particularly in the US, where young people were experimenting with psychedelics as part of the anti-Vietnam War movement, the civil rights movement, and broader social activism.

Governments, particularly the US government, saw the rise of psychedelics as a challenge to authority. LSD and other psychedelics were linked to social unrest and protests, leading policymakers to crack down on their use—not because they were scientifically proven to be harmful, but because they were feared as a catalyst for societal change (Nutt, 2023). As a result, the US government banned LSD in 1967, categorising it as a Schedule 1 drug, meaning it was officially labelled as having no medical use and a high potential for abuse, despite ongoing research showing its therapeutic potential.

Media Misinformation and Fear Campaigns

To justify this crackdown, governments funded research that focused solely on the potential harms of psychedelics, ignoring earlier promising studies. The media played a significant role in shaping negative public perceptions, spreading scare stories about the supposed dangers of these drugs. These media-driven narratives led to a deep-rooted stigma against psychedelics, which persists today. The idea that “all drugs are bad” stems from this era of fear-driven policies rather than from scientific understanding.

The Lasting Impact of Drug Scheduling

With the scheduling of LSD and other psychedelics, research into their medical potential was effectively shut down for over 50 years (Nutt, 2023). This censorship of scientific exploration meant that therapies which could have benefited people struggling with PTSD, depression, and addiction were no longer accessible.

The lasting consequence is that, even today, many people view psychedelics as inherently dangerous, not because of their actual effects, but because of the historical and political context in which they were banned.

Why Perceptions Are Changing Now

In recent years, scientific research has resumed, and studies have demonstrated that psychedelic-assisted therapy has the potential to treat conditions like PTSD, depression, and addiction (Nutt, 2023). As more data emerges, attitudes are slowly shifting, with some governments, such as Australia, beginning to legalise psychedelic-assisted therapy.

However, the stigma remains strong, and overcoming decades of misinformation requires careful education, scientific research, and responsible discussion.

By understanding the true history of why psychedelics were banned, we can begin to separate fear-driven policies from scientific reality and ensure that people affected by PTSD and other mental health conditions have access to every possible tool for healing.

MDMA-Assisted Therapy: How It Works

MDMA (3,4-methylenedioxymethamphetamine) is a psychoactive compound known as an “empathogen,” meaning it enhances social connection, trust, and emotional openness (Mohamed et al., 2022). These effects make it particularly useful in a therapeutic setting, helping people process traumatic memories more effectively without overwhelming fear or re-traumatisation (Elsouri et al., 2022).

A typical MDMA-assisted therapy programme follows a structured process:

• Preparation Sessions – The patient builds trust with the therapist, sets intentions for the treatment, and prepares for the experience.

• Guided MDMA Sessions – The patient takes a controlled dose of MDMA in a safe, therapeutic environment while engaging in psychotherapy.

• Integration Sessions – The patient processes insights gained during the MDMA experience and learns how to apply them in daily life (Elsouri et al., 2022).

Clinical Evidence: MDMA Therapy for PTSD

MDMA-assisted therapy has demonstrated significant success in clinical trials, particularly for people with treatment-resistant PTSD. Key studies include:

• A randomised controlled trial of 20 people with treatment-resistant PTSD found that 83% of those who received MDMA-assisted psychotherapy no longer met PTSD criteria, compared to only 25% in the control group (Mohamed et al., 2022).

• A Phase III trial in 2023 involving 104 participants showed that MDMA-assisted therapy significantly improved PTSD symptoms compared to psychotherapy alone (US Department of Veterans Affairs, 2024).

• A meta-analysis of six clinical trials found that 54.2% of people receiving MDMA-assisted therapy no longer met PTSD diagnostic criteria, compared to 22.6% in the control group (Mohamed et al., 2022).

• Long-term follow-up studies suggest that many participants maintain their improvements months or even years later, highlighting the potential for lasting benefits (Mohamed et al., 2022).

Why MDMA Works for PTSD

MDMA’s unique effects on neurotransmitters like serotonin, dopamine, and oxytocin make it a promising candidate for PTSD treatment. Research suggests that MDMA may:

• Reduce fear and defensiveness, helping people feel safe enough to process trauma (Elsouri et al., 2022).

• Increase empathy, openness, and trust, enhancing the effectiveness of psychotherapy (US Department of Veterans Affairs, 2024).

• Allow people to recall traumatic memories without overwhelming distress, making it easier to work through trauma in therapy (Elsouri et al., 2022).

• Improve fear extinction learning, a process that helps “retrain” the brain to reduce PTSD symptoms over time (US Department of Veterans Affairs, 2024).

One of the most striking benefits of MDMA-assisted therapy is its ability to help people identify and express their emotions, a challenge known as alexithymia—Greek for “no words for emotion.”

People who have experienced trauma or neglect often develop alexithymia as a coping mechanism, learning to suppress or disconnect from their emotions to protect themselves. However, this emotional numbness can make PTSD treatment more difficult, as recognising and processing feelings is essential for healing.

MDMA-assisted therapy has been shown to significantly reduce alexithymia (van der Kolk, 2024), helping people identify and verbalise their emotions more effectively. This ability, known as emotional granularity, improves emotional regulation and resilience, making it easier for people to work through trauma. Notably, this improvement was not observed in those who received therapy with a placebo, highlighting MDMA’s unique role in facilitating deep emotional processing.

Researchers suggest that MDMA helps people access and confront painful memories in a way that feels safe and manageable, allowing for more effective trauma resolution and lasting psychological healing.

The Role of MDMA in Self-Experience and PTSD Recovery

Recent research by Bessel van der Kolk (2024) has reinforced MDMA’s effectiveness, particularly in enhancing self-experience and self-compassion, which are crucial for overcoming treatment-resistant PTSD. In a Phase III trial, patients who received MDMA-assisted therapy showed significant improvements in emotion regulation, self-awareness, and interpersonal relationships, even beyond just reducing PTSD symptoms (van der Kolk, 2024).

Speaking on the study, van der Kolk said “People really felt liberated from their past. Trauma is not a memory. Trauma is something that’s imprinted on your being. Instead of people feeling imprinted by their trauma and feeling like they were deeply hurt, damaged people, they were able to say, ‘Yes, terrible things happened to me, but it happened in the past.’ People were able to create a perspective about what happened to them, but not be dominated by their past.” 

MDMA may be especially beneficial for those with developmental trauma (e.g., childhood abuse), who often struggle with emotional numbness, low self-worth, and difficulties in interpersonal relationships. By helping people process trauma with increased self-compassion, MDMA-assisted therapy provides a more holistic path to healing (van der Kolk, 2024).

Other Psychedelics Being Studied for PTSD

Ketamine

Ketamine has antidepressant properties and is already approved for treatment-resistant depression in some countries. Unlike other psychedelics, it has been studied as both:

1. A standalone treatment – A study of 41 people with PTSD found that a single intravenous ketamine infusion significantly reduced symptoms for up to seven days (Mohamed et al., 2022).

2. Ketamine-assisted psychotherapy – Combining ketamine with mindfulness-based cognitive therapy (MBCT) resulted in longer-lasting symptom relief (34 days vs 11 days) compared to MBCT alone (Elsouri et al., 2022).

Psilocybin (Magic Mushrooms)

Psilocybin, the active compound in some mushrooms, is being researched for depression, anxiety, and PTSD. It works by:

• Increasing psychological flexibility and openness (US Department of Veterans Affairs, 2024).

• Encouraging emotional breakthroughs, which may help process trauma (Elsouri et al., 2022).

• Reducing amygdala activity, which is typically overactive in PTSD (Mohamed et al., 2022).

Cannabis and PTSD

Some research has explored cannabis-based therapies for PTSD, particularly for managing nightmares, sleep disturbances, and anxiety. However, there is limited clinical trial data, and the long-term risks of cannabis use for PTSD remain uncertain (Mohamed et al., 2022).

Potential Risks and Ethical Concerns

While psychedelic-assisted therapy is showing promise as a potential treatment for PTSD and C-PTSD, it is essential to recognise that it is not without risks. These risks can be physiological, psychological, and logistical, and careful consideration is needed to ensure that any future implementation of these treatments is done safely and ethically.

Physiological risks are a significant concern, particularly for people with pre-existing health conditions. Psychedelics, including MDMA and psilocybin, can cause increased blood pressure and heart rate, which may be dangerous for those with cardiovascular issues (Mohamed et al., 2022). Additionally, common side effects such as nausea, headaches, and temporary confusion have been reported during psychedelic therapy sessions (Elsouri et al., 2022). While these effects are generally short-lived, they highlight the importance of medical supervision to manage potential complications.

Psychological risks must also be taken seriously. Some people undergoing psychedelic-assisted therapy have reported experiencing panic, paranoia, or dissociation during sessions (US Department of Veterans Affairs, 2024). These reactions can be distressing and may pose challenges for individuals with pre-existing mental health conditions, particularly those with a history of psychosis or severe dissociative symptoms. Another critical concern is the risk of re-traumatisation—psychedelic experiences can bring distressing memories to the surface in an intense and sometimes overwhelming way (Elsouri et al., 2022). Without the right therapeutic support, this could worsen symptoms rather than alleviate them.

Beyond the medical and psychological risks, there are significant equity and accessibility concerns. Many current clinical trials for psychedelic-assisted therapy take place in major cities, making participation difficult for people living in rural areas who may lack access to specialised treatment centres (UK Parliament, 2023). Even if these treatments were to become approved for wider use, access may remain a challenge. Another major issue is cost—psychedelic therapy is expensive, and without NHS funding, it may only be available to private patients who can afford it (Elsouri et al., 2022). This raises ethical concerns about fairness and the potential for psychedelic therapy to become an exclusive treatment option rather than one accessible to all who need it.

As research continues, it is crucial that these risks and ethical concerns are addressed to ensure that if psychedelic-assisted therapy does become an approved treatment, it is both safe and accessible for all people affected by PTSD and C-PTSD.

Psychedelic Research: A Global Perspective

Australia’s Historic Step Forward

In July 2023, Australia became the first country in the world to approve the use of psychedelics for mental health treatment. The Therapeutic Goods Administration (TGA) now allows psychiatrists to prescribe MDMA for PTSD and psilocybin for treatment-resistant depression (Australian Government, 2023).

However, strict safeguards are in place:

• Only psychiatrists with pre-approval from the TGA’s authorised prescriber scheme can prescribe these substances.

• Psychedelic-assisted therapy can only take place in supervised clinical settings.

• There is no provision for home use or self-administration to ensure safety and prevent misuse (Australian Government, 2023).

Research in the UK and Beyond

Psychedelic research is expanding worldwide, with trials taking place in the UK, the US, Canada, and Israel. Some key developments include:

• In 2022, the Multidisciplinary Association for Psychedelic Studies (MAPS) was granted an Innovation Passport for MDMA-assisted therapy for PTSD in the UK (UK Parliament, 2023).

• King’s College London is conducting research on psilocybin’s effects on PTSD (UK Parliament, 2023).

• The US Food and Drug Administration (FDA) has been reviewing MDMA-assisted therapy for PTSD, with potential for future rescheduling and approval (US Department of Veterans Affairs, 2024).

The UK Parliament has acknowledged the potential benefits of psychedelic-assisted psychotherapy but highlights the need for larger clinical trials before any widespread approval (UK Parliament, 2023).

Our Position on Psychedelic-Assisted Therapy

At PTSD UK, we are committed to providing clear, evidence-based information about emerging treatments for Post Traumatic Stress Disorder (PTSD) and Complex PTSD (C-PTSD). The research into psychedelic-assisted therapy is undoubtedly exciting, with studies indicating that substances such as MDMA, ketamine, and psilocybin may offer new hope for those who have struggled with traditional treatment options. However, while these findings are promising, it is essential to acknowledge that research is still in its early stages. Large-scale clinical trials are ongoing, and more data is needed to fully understand the safety, effectiveness, and long-term impact of psychedelic-assisted therapy.

We strongly believe that psychedelic therapy should only be considered within clinical trials or carefully regulated medical settings. These substances are not currently licensed treatments for PTSD or C-PTSD in the UK, and their use outside of clinical research remains illegal. The controlled environment of a clinical trial ensures that participants receive medical supervision, appropriate psychological support, and carefully monitored doses of pharmaceutical-grade substances. This is very different from unregulated or recreational use, which carries significant risks, including adverse psychological reactions, re-traumatisation, and potential interactions with existing mental health conditions or medications.

It is also crucial to highlight the clear distinction between regulated medical use and recreational use. Psychedelics are powerful substances that can profoundly alter perception, emotions, and cognition. While these effects may be beneficial in a therapeutic setting, they can also be unpredictable and potentially harmful when used outside of proper medical oversight. Self-medicating with psychedelics is not safe and not recommended—not only is there a risk of negative psychological effects, but unregulated substances may also contain unknown additives or varying potency, further increasing the dangers.

At present, traditional, evidence-based therapies remain the first-line treatment options for PTSD and C-PTSD. Approaches such as trauma-focused Cognitive Behavioural Therapy (CBT), Eye Movement Desensitisation and Reprocessing (EMDR), and other established psychological interventions have been extensively researched and are recommended by organisations such as the NHS and the National Institute for Health and Care Excellence (NICE). These approaches currently have the most robust evidence base in helping people process trauma safely and effectively.

As new research emerges, PTSD UK will continue to monitor developments and share responsible, science-based information about psychedelic-assisted therapy. Our priority is to ensure that people affected by PTSD and C-PTSD have access to accurate, unbiased resources that help them make informed decisions about their treatment options. While psychedelic-assisted therapy may become a viable treatment in the future, we encourage caution, critical thinking, and engagement with trusted medical professionals when considering any treatment for PTSD or C-PTSD.