Washington Post’s otherwise well-reported story on ecstasy for PTSD skirts evidence discussion

Does the story adequately explain/quantify the harms of the intervention?

Satisfactory

Harms do get acknowledged, albeit rather low in the story.

Does the story commit disease-mongering?

Satisfactory

Recent and ongoing military conflicts overseas have dramatically increased the numbers of PTSD sufferers returning to the U.S., and, one independent source notes, existing drug treatments fail two thirds of those patients.

One interesting thing to note on measuring how common it is: For U.S. soldiers, those with PTSD in our military get disability payments for the rest of their lives. Rates of PTSD are much less frequent in ex-British soldiers who served in the same places, and they don’t have the generous compensation system we do.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

We rate this a just-passing “Satisfactory.” The story could have been more overt about the funding support of an organization dedicated to ending the US government’s ban on psychedelics. A careful read of the text will allow the reader to infer that the group—the Multidisciplinary Association for Psychedelic Studies, or MAPS—is funding the clinical trials on which an FDA assessment of MDMA’s efficacy will be based.

But a more overt description of that causal chain would have been helpful, as MAPS has a clear agenda. Sources and their relationship (or lack thereof) to MAPS are clearly delineated, and the story does offer contrasting views on the safety of MDMA. But it will be hard for the reader to determine where the bulk of experts sits on this issue.

Does the story compare the new approach with existing alternatives?

Satisfactory

Drugs such as Zoloft and Paxil are mentioned, along with more traditional talk therapy. All are deemed seriously flawed.

This is sufficient, but more could have been said about cognitive and exposure treatments, too.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The text is clear that the FDA has not yet approved the use of MDMA and that large-scale clinical trials must be conducted before a federal evaluation will take place. But the street version of the substance, called Ecstasy, is, of course, widespread. The story cautions that the street drug often contains harmful contaminants so should not be used in place of MDMA, but one wonders how hard it may be for someone desperate for a way to moderate PTSD symptoms to wait.

Does the story establish the true novelty of the approach?

Satisfactory

Small clinical studies of the impact of MDMA on PTSD sufferers have been under way for a number of years, and journalists have been writing about that possible link along the way.  The hook for this story is really the recent FDA classification of MDMA as a “breakthrough therapy,” which puts it on a faster track for review (and often a lower bar of evidence is required).

Does the story appear to rely solely or largely on a news release?

Satisfactory

This appears to be an intensively reported enterprise story that goes well beyond a MAPS news release.