Welcome to Back from the Abyss in the start of Season 6. This is a place for stories of hope and healing, recovery, and redemption. I'm Dr. Craig Hecock.

We're getting a later start to the new season, and I'm sorry about that. I typically start

recording stories for the new season early in the summer, but for almost half of this summer,

I was basically totally incapacitated with the back pain. But fortunately, I had very

successful and fairly urgent back surgery and all my gratitude to Dr. Coaster for going out of

his way to help me. And now I'm back doing all the things, including a podcast, and my beloved

trail running. I'm so grateful. Now, a number of you reached out to me after last month's fairly shocking FDA decision

to not approve MDMA for medical use, wondering about my thoughts on this.

Well, first, I'm deeply disappointed, but not demoralized.

I think MDMA's momentum and great promise will eventually carry it to the

finish line of medicalization. We might just have to wait a few more years. One thing that the

FDA was all worked up about, and I can see their point here, was the lack of an effective double

blind in the study. Basically, most of the participants and study therapists

accurately guessed whether they got MDMA or not, and this really shouldn't come as a surprise to

anyone. I do wonder about using an active placebo in any follow-up studies, maybe something like

methylphenidate, also known as ridolin or amphetamine, such as Adderall.

I think that using a stimulant as the active placebo comparator could greatly diminish the likelihood

that participants or therapists would know for sure what they got. And I really can't imagine

how methamphetamine or amphetamine would meaningfully shift the needle on PTSD symptoms.

Another thought on the FDA denial. Imagine if ketamine were a brand new investigational drug for PTSD or depression.

It might never get approved.

With its tendency to greatly elevate blood pressure,

...