In a groundbreaking shift toward unconventional therapies for first responders grappling with PTSD, Arizona could soon green-light the use of MDMA-assisted therapy, pending federal approval. This therapy, potentially covered by worker’s compensation, hinges on the impending decision by the Food and Drug Administration which, despite a recommendation against approval on June 4, will cast another vote next month on the matter, as reported by AZPM.
Last month, Gov. Katie Hobbs signed legislation to include MDMA therapy for first responders suffering from PTSD in Arizona's worker’s comp plan, dependent on, the FDA's stance. MDMA, also known as ecstasy or molly has properties that can aid in patient introspection during therapy, making it a promising tool for some clinicians and advocates who are pushing for its regulated therapeutic use. Advocates like Jonathan Lubecky, a military veteran who benefited from the therapy during a clinical trial, are vocal about the urgency of granting access. Lubecky told AZPM, “The question is, will it be August or will it be two to five years from now? It’s up to the FDA how many people die before it’s approved.”
The treatment involves combining MDMA with talk therapy, leveraging the drug's ability to elevate self-awareness and reduce resistance to revisiting traumatic memories. Lykos Therapeutics, which submitted the application for MDMA-assisted therapy to the FDA, highlighted the results of two clinical trials. These showed promising outcomes, with 71% of those treated with MDMA no longer meeting PTSD criteria, in stark contrast to the 48% efficacy rate in the placebo group.
Stephanie Miller, a clinical therapist who treats patients in Arizona and Texas virtually, referred to other treatments such as ketamine, also controversial but increasingly popular among first responders. According to her practice, about half of the first responders she treats have received ketamine treatment. However, as Miller noted in an irony not lost on her, "MDMA and ketamine are the same things they’re arresting people for on the street.” This reality raises concerns, and perhaps even hesitations, among law enforcement officials considering such treatment options, she conveyed to AZPM.
The Nova Southeastern University College of Psychology, in a 2018 study, revealed that more than 80% of first responders have faced traumatic events on the job, with 10% to 15% being diagnosed with PTSD. Conventional treatments, namely SSRIs like sertraline and paroxetine, do not directly address the conditioned fear response at the heart of PTSD, which is where treatments like MDMA and ketamine could significantly alter the therapeutic landscape. The urgency of addressing PTSD in first responders is underscored by their reticence to seek help, largely due to stigma; with a University of Phoenix survey finding that 57% of first responders feared negative repercussions for seeking counseling.
This hesitance can have tragic consequences, such as the suicide of Phoenix Police Officer Craig Tiger after a harrowing incident. Arizona's Officer Craig Tiger Act was a legislative response aiming to mandate counseling for peace officers or firefighters exposed to trauma. Retired Tempe police sergeant Michael Carleton told AZPM about the importance of such legislation in removing stigma, saying, "That law has done more for removing the stigma from law enforcement and firefighters than anything I’ve seen in the last 25 years." With Arizona poised to adopt MDMA therapy, many are watching closely as the FDA's decision could set a precedent, opening the door for a new chapter in treating PTSD among first responders.
