Ben Sessa reageert op Andy Parrott's brief naar de Telegraph waarin ie zegt dat ie te weinig spreektijd heeft gekregen.
In reply to letter by Andy Parrott, to The Telegraph.
I was staggered to hear Professor Parrott felt he was not given adequate airtime to express his opinions on Channel Four’s ‘Drugs Live’ programme last month. I believe he was given far too much exposure for his minority views that are not representative of either the medical research community or the general public.
I am currently planning the UK’s first clinical study looking at using MDMA-assisted psychotherapy to treat Post Traumatic Stress Disorder (PTSD) and I too was in the audience those nights at Channel Four’s Drugs Live, haven given up two days away from my patients, invited by the producers and promised airtime to discuss my research project.
Throughout the show I was told: “Stand by! You are on next!” but was never spoken to by Jon Snow, as again and again the presenters went back to Parrott for his opinion about “the dangers of ecstasy”. My appearance had been pulled at the last minute because of a decision by Channel Four anxious at appearing ‘soft on drugs’ to present a ‘balance’. So back we went (I counted five times) to Parrott’s ‘ecstasy’ research and ‘Shabs’ the ‘ecstasy’ user. It seems that after all these years neither Channel Four nor Andy Parrott can entangle the difference between recreational ecstasy use and clinical MDMA.
Parrott’s non-clinical research is flawed for several important reasons. He looks at poly-drug using recreational “ecstasy users” (whatever they are – the quality of tablet ecstasy being so poor these days as to be a virtually abstract concept) and describes minute, sub-clinical neurocognitive changes in his subjects. I say sub-clinical because we know (those of us who work with patients) that despite 25 years of ecstasy use in the UK - with some 30 million doses of ecstasy taken recreationally every year – the levels of mortality and morbidity from this drug remains very low indeed. There have of course been some tragic high-profile deaths that the media are always keen on reporting in stark contrast to the great many more everyday deaths from other drugs. Deaths from ecstasy toxicity are very rare indeed. And so too are non-fatal psychiatric disorders. I challenge any psychiatrists reading this to tell me they see their wards and clinics full of casualties of ecstasy use. Where is all this neurocognitive damage Parrott claims to have picked up with his microscope? The truth is that after a quarter century of heavy ecstasy use in this country the massive epidemic of casualties we were promised back in 1988 simply has not happened.
Furthermore Parrott’s fails to take into account the concept of risk-versus-benefit analysis, which again betrays his non-clinical roots. Everyday doctors know to weigh up the costs and benefits of the treatments we prescribe. We understand that no drug or other medical intervention is 100% risk free. Everything has a cost. Yet Parrot irrationally demonises the medicine MDMA because he sees – quite rightly – that the illegal drug ecstasy has its risks. This is a terrible example of medical practice and Parrott would not last a minute in a clinic setting if he were so rigidly expecting this fantasy zero cost for his patients.
But the main reason why I, and the vast majority of the scientific and medical field object so strongly to Parrott’s minority approach is that RECREATIONAL ECSTASY DOES NOT EQUAL CLINICAL MDMA! (Forgive the capitals, I cannot shout this loud enough). Parrott’s endless studies on recreational drug use are meaningless next to the proposed medical interventions myself and other colleagues are trying to introduce to the British public with our research on clinical MDMA. It is like reporting heroin abuse by junkies as justification for doctors not prescribing morphine in childbirth (though in fact much less so, as MDMA is no way near as toxic as the opiate drugs).
Clinical MDMA, carefully prescribed under strictly controlled supervised conditions could have real potential to alter the course of the severely damaging and growing scourge of PTSD – a disorder with a high treatment-resistance that is desperately in need of novel and creative approaches.
We hear about the ethics and controversy of ecstasy. The real controversy is Channel Four’s effort to give Professor Parrott’s clinically unjustified argument as much airtime as they did. In their attempt to produce a ‘balanced argument’ Parrott had his moment of fame and he blew it. The undoubted benefits of clinical MDMA are not a 50:50 issue – as evidenced by the tweets coming in to Drug’s Live that night. The general public are overwhelmingly in support of hearing the positive message about MDMA – not the silly antics of ravers and minority scare stories supporting a dated socio-politically motivated agenda. Channel Four missed a trick that night. And if Parrott is allowed to continue to peddle his irrationally biased argument against clinical MDMA the patients will be missing out too. Now that is unethical.
Dr Ben Sessa MBBS BSc MRCPsych
Consultant Psychiatrist and MDMA for PTSD Researcher, Bristol. UK.
The mind is a jungle.