A group of 400 Israeli survivors of the October 7 Hamas attack, including civilians, released hostages, and soldiers, could be offered MDMA-assisted psychotherapy in a potentially trailblazing study to commence later this year.
The patients would undergo two sessions with the drug each in small groups, in what would be the largest MDMA-assisted therapy study anywhere to date — a milestone in the passage of psychedelic medicine into mainstream acceptance.
“We hope it will demonstrate high levels of safety and effectiveness and enable us to offer the program in other places over the region and the world.”
The study is being organized by the Multidisciplinary Association for Psychedelic Studies Israel, or MAPS Israel, an independent nonprofit that develops psychedelic research programs, and an affiliate of the U.S.-based MAPS that has worked to bring MDMA therapy to the brink of approval stateside. The MAPS Israel study would break new ground in group MDMA therapy.
“Our goal is to create a therapy model that can serve universally, with the intention and prayer to help people,” said Dr. Keren Tzarfaty, CEO and co-founder of MAPS Israel, which is already running trials evaluating MDMA-assisted therapy for the treatment of post-traumatic stress disorder, depression, and eating disorders. “We hope it will demonstrate high levels of safety and effectiveness and enable us to offer the program in other places over the region and the world, not only to treat PTSD but to help people open their hearts and expand their minds.”
The study comes as Israel’s war on the Gaza Strip continues, with nearly 30,000 Palestinians killed and allegations in international court that Israel is engaged in a genocide. The deaths, as well as imminent famine, a collapsed medical system, and massive levels of destruction, are sure to leave extraordinary psychological trauma of their own, with the dire conditions making evaluations, let alone treatments, impossible.
MAPS Israel’s planned therapeutic program would be one of the most high-profile studies in what is a burgeoning, global industry of psychedelic therapy research. MDMA is a stimulant, also known as ecstasy or molly, that sparks empathic feelings of love and openness, yielding potentially revolutionary treatment for some mental health issues.
Even the notoriously reticent U.S. government is opening to the field. The U.S. Food and Drug Administration is expected to announce approval this year for using MDMA as a treatment combined with therapy for patients suffering from PTSD. The Department of Veterans Affairs announced recently that it will also begin funding psychedelic-assisted therapy, and Congress passed legislation to research psychedelic treatments for active-duty military members.
In a departure from most past MDMA studies, the Israeli patient groups — drawn from soldiers who were ambushed on October 7, festivalgoers from a hard-hit rave, and villagers who were attacked — will be dosed in small groups of around six. The organizers thought group therapy could be beneficial since the traumas are collective. It also reduces costs and provides treatment quickly at a greater scale, an important factor considering that untreated PTSD can intensify over time.
Tzarfaty, the MAPS Israel head, who was also a clinical investigator in other MDMA-assisted psychotherapy studies in Israel, said, “Trauma can take over on a personal and social level if left unaddressed.”
Collective Therapy for Whom?
The Israeli Ministry of Health has already given the green light to multiple psychedelic studies in recent years. Israel was the first country in the world to sanction a compassionate psychedelic access program in 2019, allowing for dozens of people with PTSD to undergo MDMA-assisted therapy outside of trials. The program has now become a small study.
For the study including October 7 survivors, MAPS Israel is finalizing the proposed protocols and forging agreements with the country’s leading hospitals before requesting approval from the Ministry of Health. On the cusp of securing $2.2 million in private funding, the group expects approval to be given in time for the study to begin in the fall. (The Ministry of Health did not respond to a request for comment.)
There is a significant healthcare disparity, including for mental health, between Jewish Israelis and Palestinians living under Israeli occupation. The issue is especially acute in the Gaza Strip, where the healthcare system has been brought to near-total collapse by the Israeli military assault. Leaders in Palestinian healthcare have spoken about being unable to deal with the psychological aftermath and disorders created by Israel’s occupation, especially with the large-scale medical emergency unfolding in Gaza.
In 2019, the head of the Palestinian Ministry of Health’s mental health unit Samah Jabr wrote an article about the need for collective therapy for the collective trauma experienced by Palestinians. “In Palestine, traumatic threats are ongoing and enduring. There is no ‘post-traumatic’ safety,” Jabr wrote at the time. “We understand to a degree the feelings of mistrust and alienation felt by oppressed societies, but the individualized model of PTSD ignores the collective aspects of the psychological experience of Palestinians.”
The disparity in treatment has been noted by the U.S.-based MAPS. Natalie Ginsberg, the MAPS global impact officer, said that the organization had been working on ways to increase access to MDMA-assisted therapy for Palestinians. MAPS Israel has trained 13 Palestinian facilitators in recent years to work with Palestinian patients, two of whom will conduct a planned study for survivors of sexual abuse.
“MAPS is continuing to create more educational opportunities for prospective Palestinian therapists at this heart-wrenchingly traumatic and polarized time,” she said, “and planning to announce a therapist education program for Arabic-speaking practitioners in the Middle East outside of Israel.”
“Traumatized During Psychedelic Experiences”
Across Israel, rates of adult PTSD — an often debilitating condition with distressing symptoms including persistent nightmares, flashbacks, and a constant heightened sense of anxiety and fear — could be as high as almost 30 percent or higher among soldiers and veterans.
Some of the survivors of the October 7 attack, the worst civilian massacre in Israel’s history, were at a music festival called Nova in the southern desert. Just 5 kilometers from the border with Gaza, some 3,500 people, mostly younger Israelis, had been dancing to a type of electronic music called psytrance.
During the surprise invasion at sunrise, Hamas militants streamed in on motorized paragliders and vehicles, killing 364 people and taking around 40 hostages. A survey suggests that more than half of the ravers were under the influence of psychedelics such as LSD and MDMA, as is typical at psytrance raves.
Dr. Rick Doblin, founding president of the U.S.-based MAPS and a longtime advocate for using psychedelic therapy in the Israeli–Palestinian conflict, said that the study would serve as a seminal piece of research into whether psychedelic-assisted therapy can help large groups of traumatized people.
“People who are traumatized during psychedelic experiences are imprinted at incredibly deep levels,” he said, referring to the music festival attendees. “While other therapies can be helpful, psychedelic therapy could offer unique and especially powerful healing potential.”
Roy Salomon, a cognitive neuroscientist at the University of Haifa who has been supporting survivors since the immediate aftermath and is now working on a study said that little is known about how people traumatized while under the influence of psychedelics respond to treatment with psychedelics.
“Hundreds of people took MDMA and LSD at this party and underwent serious trauma; hiding under the bodies of fallen friends and running away,” he said. “We’re now trying to understand how these people are feeling, how we can help them to hopefully avoid going into PTSD, and how this relates to the substance they took and their experience.”
At Sheba Medical Center in Tel Aviv, there are soldiers with PTSD who have been admitted to the mental health ward as well as people kidnapped from the rave and since released who are also suffering from the condition. Dr. Revital Amiaz, head of Sheba’s psychiatry department which will treat the festivalgoers in the MAPS Israel study said more than 1,000 survivors from the rave have already contacted her department seeking help.
“If we find a way to treat several patients at once it will help us reach more people,” she said commenting on the group therapy protocol that could be trialed for the first time globally in Israel.
The nature of ongoing war could also pose challenges for the study participants’ healing processes according to Leor Roseman a neuroscientist at University of Exeter who is working with group of Palestinian and Israeli activists to create psychedelic peacebuilding program.
“I imagine that it is harder to heal when wound is still very much open,” Roseman said. MDMA therapy for soldiers he added might act as tonic for moral wounds caused by their own actions but it could also have pacifying force and help transform society because trauma feeds into violence.
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