Written by Darren Kan
Edited by Nishant Kidangan
In what is believed to be Australia's first instance of its sort, a Melbourne doctor who is fighting for authorization to treat a very ill patient with the drug MDMA has brought his case to court.
After the Victorian Department of Health denied the consultant psychiatrist, Eli Kotler’s application to treat the woman, who will not be identified, with the substance more commonly known as ecstasy, Dr Kotler filed a lawsuit, and the case was deferred until early next year to allow for an appeal. MDMA is currently only allowed for medical research and teaching purposes.
In a letter to Dr Kotler, Stefan Tulloch, the acting head officer of medicines and poison control at the Department of Health, stated, "There is insufficient data to show the safety and efficacy... with regards to the safe use of a Schedule 9 poison in clinical practice."
But what exactly is MDMA?
(Kwon, "MDMA Could Be Tailored...", 2019)
MDMA, or commonly known as ecstasy or molly, is a recreationally used psychoactive substance. Changed sensations, greater energy, empathy, and enjoyment are some of the reported outcomes. Effects start in 30 to 45 minutes and continue for 3 to 6 hours when it is consumed.
The company Merck created MDMA for the first time in 1912. Beginning in the 1970s, it was used to augment psychotherapy, and by the 1980s, it had become a popular street drug. Dance parties, raves, and electronic dance music were all typical places to find MDMA. Between the ages of 15 and 64, over 21 million people consumed ecstasy in 2016. (0.3 percent of the world population).
MDMA generally can make the user feel a sense of euphoria, self-confidence and happiness. But there are major downsides to MDMA. Negative short-term effects include teeth grinding, blurred vision, perspiration, and a quick heartbeat. Long-term use can lead to addiction, memory issues, paranoia, and sleeping difficulties.
Overdosing on MDMA can also increase body temperature and dehydration, which have been linked to deaths. Users typically feel gloomy and exhausted after using it.
MDMA works in the brain by enhancing the activity of the neurotransmitters serotonin, dopamine, and noradrenaline. It is a stimulant and hallucinogenic substance that belongs to the substituted amphetamine class of medications.
Why is it important that it may be approved for treatment?
MDMA is prohibited in the majority of countries and has no approved medical applications as of 2018. And only recently, the drug started to be evaluated for clinical usage in the United States by the Food and Drug Administration.
"The patient is exceedingly ill and has a variety of mental health disorders for which it is considered that MDMA would be safe and effective to utilize therapeutically," said Greg Barns SC, the lawyer representing Dr Kotler.
However, the secretary of the Health Department, who rejected the original application, has chosen to oppose the move in court.
Drugs and chemicals in Australia are classed into tiers that determine how easily they can be accessible by the general people. MDMA is currently classified as a controlled substance on the second tier, implying it is illegal.
However, the Therapeutic Goods Administration, which supervises pharmaceuticals, is considering downgrading MDMA and designating it as a restricted substance, allowing it to be used for medical purposes under strict guidelines.
Dr Kotler's appeal will be irrelevant if the medicine is downgraded, which is expected early next year.
References
Alcohol and Drug Foundation. (2019). MDMA - Alcohol and Drug Foundation. Adf.org.au. https://adf.org.au/drug-facts/mdma/
Anderson, L. (2014, May 18). MDMA. Drugs.com; Drugs.com. https://www.drugs.com/illicit/mdma.html
Blackiston, H. (2021, November 15). Doctor Takes Bid To Treat Patient With MDMA To Court. Www.ladbible.com. https://www.ladbible.com/news/latest-doctor-takes-bid-to-treat-patient-with-mdma-to-court-20211115
Tran, D. (2021, November 11). Doctor fights to treat “quite unwell” woman using MDMA in Australia-first case. ABC News. https://www.abc.net.au/news/2021-11-12/doctor-mdma-ecstasy-treatment-patient-court-bid/100614346
Wikipedia Contributors. (2018, November 29). MDMA. Wikipedia; Wikimedia Foundation. https://en.wikipedia.org/wiki/MDMA
Kwon, D. (2019, December 11). MDMA Could Be Tailored to Make It More Suitable for Treating Mental Illness. Retrieved from https://www.scientificamerican.com/article/mdma-could-be-tailored-to-make-it-more-suitable-for-treating-mental-illness/
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