MDMA-assisted therapy is associated with a reduction in chronic pain among people with post-traumatic stress disorder

Introduction Increasing evidence demonstrates 3,4-methylenedioxymethamphetamine (MDMA)-assisted therapy (MDMA-AT) may be a safe and effective treatment for post-traumatic stress disorder (PTSD). There is growing interest in MDMA-AT to address a range of other health challenges. Chronic pain and PTSD are frequently comorbid, reciprocally interdependent conditions, though the possible role of MDMA-AT in treating chronic pain remains under-investigated. The present analysis examined the impact of manualized MDMA-AT on chronic pain severity among participants with PTSD who were enrolled in a Phase 2 clinical trial investigating MDMA-AT for PTSD (NCT03282123). Materials and methods Exploratory data from a subset of participants who completed chronic pain measures ( n = 32) were drawn from a Phase 2 open-label study sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS). Multivariable analysis of variance (ANOVA) was utilized to compare pre- vs. post-treatment Chronic Pain Grade Scale (CPGS) values, adjusting for demographics (age, sex, and ethnicity). K-means clustering was then used to group the sample into three clusters to denote high ( n = 9), medium ( n = 11), and low ( n = 12) baseline pain severity, and the same analysis was repeated for each cluster. Results Among the 32 participants included in this analysis, 59% ( n = 19) were women, 72% ( n = 23) were white, and median age was 38 years [interquartile range (IQR) = 31–47]. Overall, 84% ( n = 27) reported having pain, and 75% ( n = 24) reported disability associated with their pain. Significant reductions in CPGS subscales for pain intensity and disability score , and overall CPGS severity grade were observed among participants in the highest pain cluster ( n = 9, p < 0.05), and for pain intensity in the medium pain cluster ( n = 11, p < 0.05) post- vs. pre-treatment. Discussion Findings demonstrate a high prevalence of chronic pain in this sample of people with severe PTSD and that chronic pain scores among medium and high pain subgroups were significantly lower following MDMA-AT. While these data are preliminary, when considered alongside the frequency of comorbid chronic pain and PTSD and promising efficacy of MDMA-AT for treating PTSD, these findings encourage further research exploring the role of MDMA-AT for chronic pain.