IS IT LEGAL TO FACILITATE THERAPY WITH MDMA (ECSTASY) IF IT IS DONE UNDER THE FIGURE OF «SUPERVISED SELF-CONSUMPTION»? WHAT IS A «TRIP SITTER»?



The Netflix series «How to Change Your Mind» has produced a boom in demand from people who want to experience assisted therapy with LSD, psilocybin, MDMA and mescaline. These substances are still illegal and there are very few therapists or facilitators who have experience with them. Their illegality has for decades neutered research with them, the training of qualified therapists and the benefits that millions of people can receive from them. With the rise of the psychedelic renaissance several organizations initiated clinical trials that demonstrated that MDMA, the so-called «love drug» of discotheques, is the most effective tool combined with talk therapy for healing PTSD (post-traumatic stress disorder) from all types of trauma whether from war veterans, sexual abuse, bulling, the aftermath of racism or homophobia … as well as the most liberating tool for the healing of people with PTSD (post-traumatic stress disorder)…. as well as the most liberating tool in couple therapy and sexual therapy of reconnection with the source of love and desire, as well as a hope of communicative openness in people with autism levels. For all these reasons it has gone from being called a drug to a medicine in clinical settings by psychologists, psychiatrists and doctors who work with it and it is called medicine by thousands of people who have benefited from this therapy in their lives. It is important to note that it is not the substance alone that works, but the combination with support, environment and companionship as well as the deep intention of the person taking it and their deep willingness to be liberated.

The administration of the current US president has already announced the anticipated approval of MDMA in 2023 and psilocybin in 2024. The latter has proven to be a great and very effective tool in the treatment of treatment-resistant depression in clinical trials conducted by Compass Pathways. There are also clinical trials conducted by Debora Gonzalez and Beckley Med that have demonstrated the effectiveness of ayahuasca-assisted therapy in prolonged grief. And there are ongoing clinical trials by Mindmed of the therapeutic effectiveness of Mdma combined with Lsd in Switzerland, others with mescaline by Colab and other trials with 5-meo-dmt by Gh Research. Dutch Health Minister Kuypers has said that the Netherlands should be at the forefront of Mdma-assisted therapy.I am not promoting with this article the compulsive use of Mdma in daily life, but talking about a way of using it that has been proven beneficial.

In Spain it is likely that MDMA-assisted therapy will not be legalized until 2024 or 2025 when the clinical trials being carried out by some hospitals in Barcelona together with universities are completed. However, there are therapists and facilitators who have been doing it clandestinely for years, holding sessions where they supply the substance. This way of doing it involves legal and criminal risks. However, there is a way of doing it that does not involve legal sanctions and it is the legal figure of «supervised self-consumption» or «assisted self-consumption» that is available in Spain and other countries. This implies that the person signs a paper in which he declares that he brings the substance and the facilitator only accompanies him while he lives the experience. As the name suggests, the person self-consumes the substance but does so in the presence of someone who takes care of him/her. As there is no supply of the substance there is no crime of trafficking and as there is no passing of the substance from one hand to another there is no crime of alterity.
It supports you to explore the potential of the experience and to reduce the risks.

It is a service of risk reduction and exploration of potentials. In fact it is recommended that before taking the substance you bring it to a free purity analysis service like the one energy control has in Spain to verify that it is MDMA and that it is not adulterated with anything. Ecstasy is a relatively easy substance to synthesize for an expert and has a low production cost so normally those who distribute it do not usually cut it with other substances and those who request it receive a high quality mdma, however sometimes cathinones are sold as Mdma or other similar phenitelamines and that is why it is always recommended to make sure, are things that must be done due to the consequences of prohicibionism that has relegated the manufacture of these substances to a black market that often lacks sensitivity about what it provides, however there is talk that there is a black market of mdma producers who market the substance aware of what it can catalyze and generate in people unlike other traders such as cocaine whose only purposes are economic and are far from any kind of subversive revolution that goes beyond those terms. As a curious fact, the MDMA used in clinical trials must have a label called Good Manufacturing Practices (GMP) and costs 10,000 dollars per gram due to the high taxes that must be paid to manufacture it because of its illegality. On the black market it costs about 50 euros. When the FDA and AEM approve it, it will no longer cost the same. In fact the MAPS organization is quite committed to making mdma therapy accessible to everyone and it is not a patentable substance since it was discovered at the beginning of the 20th century and the patent has already expired. In fact, it is not even possible to create something similar in the laboratory because any modification would differ from the master formula of MDMA and its unmistakable effects.
MAPS also has an intensive on-line training for MDMA therapists that lasts 3 months and is worth 5000 euros, is reserved for people who have qualifications in the field of psychology and psychotherapy and consists of several theoretical modules and ending with the presentation of a supervised case in which the student tells how has been the monitoring of the process of a client with whom he has done the therapy. This training has no live practice and involves the trainee taking the training at once without the supervision of another experienced therapist. Compass Pathways has an analogous training in the assisted use of psilocybin (specifically the variable that they have synthesized and patented). It should be noted that since MAPS has completed clinical trials with Mdma that demonstrate its effectiveness, they will have the authority for 5 years to be the only ones officially authorized to train people for the facilitation of this therapy.

The term «trip sitter» refers to the role of the person who takes care of the person in the experience, meaning «trip sitter». It is also called co-pilot. This person does not have to have any kind of academic degree or official training, although it is advisable that he/she has experience in this role and has gone through this type of experience as well. What he/she does is to guarantee the safety of the person and to measure a series of parameters of the environment and context of the experience so that it develops in an optimal way. The figure of the psychedelic therapist goes beyond simply taking care that a person does not get hurt or panic. This harm and risk reduction service is provided by associations such as Zendo Project or Cosmic Care at music festivals where some people who are in the middle of a trip or psychic exploration need support. The psychedelic therapist completes this wonderful service with an integration, a use of the experience for an experience of liberation and transformation, that is to say, he takes care of the person or persons who carry out the experience but also offers a service of integration before, during and after the experience that implies several hours of what any therapy session implies and for which he can be remunerated since he is carrying out a work of great energetic effort and of time.

On the other hand, the facilitator does not incite the person to consume the substance for the therapy. Something that should not be illegal given the recommendability according to the results seen in clinical trials, however in current legal terms it can still be charged as incitement to consumption. This is also reflected in the declaration, the person makes the decision to take the substance in full use of his mental faculties, under his total responsibility and without any kind of coercion or incitement by third parties.

The directionality is not from the facilitator to the therapist, but the opposite. The person has seen the benefits of this therapy in documentaries or media or recommended by people who have experimented with it and comes to be supported and hosted in that experience they want to live, the therapist or facilitator offers that service which the state currently lacks given the prohibition and stigma that has been so far. In this sense the MDMA assisted therapy facilitators who offer this service of companions and caregivers are not only offering a service to the person but to the whole state itself and to humanity. They are covering a need that until now was unattended and unsatisfied and exposed to the person had no choice but to do it on the sly and without the recommendations, care and requirements of the optimal environment.

There are lawyers in Spain who are underpinning at a legal level the basis of this indispensable work for the times of global health crisis in which we live. The interesting thing about this legal framework is that it protects and completely democratizes access to all people who want to experience this therapy without having to have received a prior diagnosis of any pathology and on the other hand opens the way to a multitude of therapeutic ways to work with the Mdma and accompany sessions that are not only the biomedical or psychiatric monopoly. Since when mdma therapy is legalized, only those who are trained in the way that is authorized and by those who are authorized to authorize it will be able to practice as therapists, and also only those who meet the diagnostic criteria of any pathology will be able to receive it. However, this parallel framework covers and protects against unrestricted access. Regarding the possession of MDMA in Spain the amount stipulated as self-consumption is 2.4 grams and if it is seized and there is a sanction this is a fine of between 300 and 600 euros. However, for one session only 75 to 250 mg of MDMA are needed, the standard dose being 125 mg. I also want to mention that legalizing a substance like MDMA only for therapeutic use is also another type of monopoly that stigmatizes recreational use, it is as if only what is proven to be therapeutic can be legal and the recreational use of some substances is still stigmatized, that is, as if the pleasure alone is not enough reason to live an experience or the pleasure itself is not a key liberating element and essential component of any therapy that leads to a deep release. However, other types of trivializations are allowed with substances that have never even been used in clinical settings and are not used in therapy, such as an advertisement I saw recently for an alcoholic beverage that showed the bottle and said «your therapist’s therapy».

The therapy with mdma facilitates an experience in which the heart opens and allows from that love and self-compassion to re-signify experiences without fear and judgment distorting the experience and in that way one can access a new experience of oneself and others, an inner integration promoted by the sincere expression and an inner unification in an oceanic, joyful and pleasant love.

The therapists who attend this type of sessions simply remain present, provide water when necessary, listen to the person when they need to talk and encourage and accompany them to go through whatever they feel from trust, from inner permission, expression and deep self-embracement.

This therapy not only implies a liberation from psychological suffering but also reaches deep down, making it possible for millions of people who do not have any diagnosed disorder to have access to profound liberations and internal transformations that favorably influence the gradual development of a global peace as a collective consequence of the birth of an internal peace in people with themselves and harmony with their social and innermost circles.

From here I am grateful for the courage and determination to follow their heart and conscience of the people who have been doing this work for years and opening the way, I hope that more and more therapists, protected by this and by the paths that are opening, will attend to all those people who need and are crying out for help at this time of their lives. Many of them suffer for having to wait for it to be legalized and feel that they do not have time because they can not stand the suffering anymore, these tools are not a panacea but they are the best psychopharmacological tools we have, so circumventing the law taking advantage of its loopholes of opportunity opens with a transgression at the service of love a great opportunity of liberation for thousands and thousands of people who are asking for it from the depths of their soul.

Sergio Sanz Navarro

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