Trauma Under Psychedelics: MDMA Shows Protective Effects During the Peritraumatic Period

Traumatic events (TEs) play a causal role in the etiology of psychopathologies such as depression and posttraumatic stress disorder (PTSD). Recent research has highlighted the therapeutic potential of psychoactive substances and especially 3,4-methylenedioxymethamphetamine (MDMA), in alleviating trauma symptoms in chronic patients. However, little is known regarding the consequences of trauma that is acutely experienced under the influence of psychoactive substances. Here we investigated the acute experiences and peritraumatic processing of 657 survivors from the high-casualty terror attack at the Supernova music festival in Israel on October 7th, 2023. Data were collected four to twelve weeks following the TE. Approximately two-thirds of survivors were under the influence of psychoactive substances at the time of the TE, offering a tragic and unique natural experiment on the impact of psychoactive compounds on TE processing. Our findings reveal that individuals who experienced the trauma while under the influence of MDMA demonstrated significantly improved intermediate outcomes compared to those who were under the influence of other substances or no substances at all. Specifically, the MDMA group reported increased feelings of social support, more social interactions and enhanced quality of sleep during the peritraumatic period, yielding reduced levels of mental distress and reduced PTSD symptom severity. These novel findings suggest that the influence of MDMA during the TE may carry protective effects into the peritraumatic period, possibly mediated through the known effects of MDMA in reducing negative emotions and elevating prosociality. These protective effects in turn may mitigate the development of early psychopathology-related symptoms. Current preliminary results underscore the need for further understanding of the cognitive and physiological processes by which psychedelic substances intersect with trauma recovery processes.