The US Food and Drug Administration (FDA) has recently approved the use of 3,4-methylenedioxymethamine (MDMA), commonly known as Ecstasy, in a major clinical trial into its effectiveness in the treatment of post-traumatic stress disorder (PTSD) (1). It is proposed that MDMA will be used in controlled psychotherapy sessions to assist the patient “to confront their trauma, either by remembering it or re-experiencing the event”. Whilst MDMA is known to produce feelings of euphoria and cause users to become more alert and affectionate, it can also cause serious side effects such as nausea, accelerated heart rate, high blood pressure, confusion and in some cases, even death (2).
In Australia the organisation Psychedelic Research in Science and Medicine, (PRISM) has also applied for approval to conduct similar trials and hopes that the FDA decision may influence Australian authorities. If the clinical trials are successful there is the possibility that MDMA could become a restricted medication in Australia.
As outlined, MDMA is potentially impairing and one of the drugs currently being tested in both urine and oral Australian Standard workplace testing programmes. Currently there are no legitimate reasons for a positive MDMA result in a workplace situation, however if the drug is approved for clinical use then there may be workers who are being legitimately treated by this drug. In these circumstances MDMA will need to be treated like other drugs that can be both abused and used as medications such as amphetamines and opiates. Disclosure with medical certificates and fitness for work assessments should be provided by the worker and the level of the drug detected in any positive drug test should be assessed by a qualified Medical Review Officer (MRO). DASA can assist an organisation to navigate these complex issues with expert advice including from its own in house MRO, Dr David Allen MBBS(Hons), DPH, FAFOEM.