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MDMA and C4's 'Drugs Live'

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Channel 4's drugs live programme this week is essentially a mini-MDMA research trial looking to explore what MDMA does in the brain, and especially whether these effects may have some utility in the management of distress.

David Nutt, courting controversy once more, has said that the work is near impossible to obtain funding for via usual grant giving bodies (at least in the UK - some European groups have conducted such research, and work is on-going in the US), and so engaging with a viewer chasing TV channel was the way forward.

As someone who has worked in recreational drug research for nearly 20 years, I'm very aware of the difficulties in getting research money to look at the effects of substances used by millions worldwide. However, I remain cynical about this particular project, in terms of the message it may send to some viewers about drug use (their own and others) and, separately, how this feeds into a continuing focus on a chemical-based approach to 'treating' mental ill-health.

There are problems with showing people having positive drug experiences on TV (whether live or recorded...not sure what the use of the term 'live' is supposed to add here - danger perhaps?). MDMA (as ecstasy) and countless other drugs are enjoyed by many people, but as uncontrolled substances vary in strength and content; and, especially in the UK, tend to be used at higher doses than any experiment will ever use, and very often mixed with other legal and illegal drugs.

Showing, over two days, that one of these drugs is ok, or even really quite good, in the artificial TV lab environment tells us nothing about the short and long term effects of taking it with a system full of alcohol, a few lines of cocaine, bit of ketamine etc. This will be something not examined in the programme, and something that has not really been seriously considered in any other proclamations from David Nutt or others about the relative safety of MDMA.

Looking at drugs in isolation gives us a very limited view for both the science of drug use and the perception of the safety of drugs amongst users and soon-to-be users. Our work at UEL, and that by many others, has shown that what we call 'poly-drug' use (use of more than one drug on one occasion and over time) is problematic for many people, and that MDMA as part of this mix may be especially so. My colleagues Andy Parrott, from Swansea University, and Derek Moore here at UEL, are both to be featured on the programme and will no doubt rehearse various points of this argument.

Now those involved in the programmes, and supporters, will no doubt point out that the programme is more targeted in what it wishes to explore. It's not about the fun and excitement to be had with MDMA (though the advertising contradicts this a little), it's about the possible benefits to seriously unwell individuals.

There are a few studies which have looked at MDMA as a treatment for negative mood states and most recently post-traumatic stress. There is some evidence that this drug may facilitate psychotherapy and I believe this is important research, that is being done already, and should be continued - without TV and celebrities. I think the case for the value of the media and the participants involved remains to be convincingly made.

One final point that I feel also needs a brief mention is that this programme may also reinforce some other potentially unhealthy behaviours, notably amongst scientists and psychiatrists (who are generally not the same creature). The treatment of serious mental health problems has a very dark history, which has seen the reduction of distress to the language of receptors and neurotransmitters, and the portrayal of pharmacology as the way forward. In recent years the poverty of direct evidence for neurochemical imbalances in the brains of people with mental ill-health diagnoses, and of the relative weaknesses of the chemical cure (especially for schizophrenia and depression) have shown the flaws in the standard psychiatric/medical model of managing such problems.

These trials with MDMA, though interesting, are also worrying from this perspective too; in part continuing this drug-focussed tradition, obsession perhaps, of those charged with helping us navigate madness.