Biotech company Emyria trials MDMA therapy with first responders as industry scrambles to market
Emma White’s life is splintered between anxiety-riddled days, sleepless nights, and fragments of anguish from memories of late-night emergency call-outs.
WARNING: This story contains references to self-harm.
“Slowly, the jobs that you go to wear down on you until it comes to a point,” the paramedic said.
“I all of a sudden stopped sleeping, became really anxious all the time, really hypervigilant.”
After a decade on the front line, Ms White realised she needed to address her trauma when she started having thoughts about taking her own life.
“I used to go to a lot of suicides where I’d see the absolute heartache and trauma that families go to, and then somehow I ended up heading down that path myself,” she said.
Therapy and medication have helped, but Ms White said progress had plateaued and she had developed treatment resistant post-traumatic stress disorder (PTSD).
Now she is considering what she believes is her final bastion of hope — MDMA, also known as ecstasy, or molly.
Australia leading the psychedelic frontier
Australia is the first country in the world to approve the use of psychedelics to treat some mental health conditions, with very strict conditions.
The Therapeutic Goods Administration’s (TGA) surprise decision last year brought with it a surge in both public and private interest.
But the cost of the treatment — up to $30,000 — is prohibitive, and companies will need to prove its viability to major health consumers to bring down the cost to consumers.
Companies like drug developer Emyria, backed by Andrew Forrest’s private investment group Tattarang, have been looking to scale up their services.
In its latest move, the company will be trialling free MDMA-assisted therapy on first responders grappling with treatment-resistant PTSD, in partnership with charity Reach Wellness.
The charity has pledged to fund the 12-to-16-week treatment — which includes three, eight-hour long dosing days with two therapists — for up to 50 first responders at Perth’s Pax Centre.
Reach Wellness founder Rick Green said first responders were in need of novel mental health treatments.
“These are extremely stressful roles physically, but more so mentally, and that is evident by the high levels of PTSD and mental health conditions that we see in those who help others first,” he said.
A cautious start
Prescriptions of psychedelics have been slow to take off — Emyria is one of just a handful of services across Australia approved by the TGA to prescribe MDMA, which can only legally be used in psychotherapy.
Lead psychiatrist Jon Laugharne said international evidence backed the efficacy of the drug, but the industry was still learning how to manage its real-world application.
“We’re doing what we see as best practice right now, based on the current research, but that’s very likely to evolve over time,” he said.
Dr Laugharne said the clinical trial with first responders would help inform best practice, including training for the two therapists they required in each dosing session.
“To be a psychedelic-assisted therapist does require some extra training, and even that is a little bit of a challenge at the moment,” he said.
“It’s not very clear to everyone how the training is supposed to be developed and transmitted.”
Wider risks still to be seen
Clinical psychologist Petra Skeffington, who is not affiliated with Emyria, is co-conducting Australia’s first MDMA-assisted therapy trial which started in mid-2022.
Dr Skeffington said the treatment was safe under the strict conditions of clinical trials, but that would not necessarily extend more broadly if patient screening requirements were more lenient in commercial settings.
“MDMA is quite physically safe, the lethal dose is very high, and we don’t see many cases of people using only MDMA in a safe setting having an adverse reaction,” she said.
“What’s more likely to happen is that [the patients] may have some underlying psychological vulnerability … this can make them more vulnerable during the treatment.”
Dr Skeffington urged people considering psychedelic therapy to temper their expectations, and said sensationalised media coverage had been harmful.
“It’s very flashy, and very ‘here’s your magic pill that’s going to cure all of your problems’,” she said.
“To have [PTSD] cured through this treatment, doesn’t mean that the rest of your life suddenly becomes OK.”
“There is a longer term investment needed by them, with their own therapists, in understanding how to rebuild their life without PTSD.”
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