A party drug could likely be the next breakthrough in treating post-traumatic stress disorder (PTSD), but its potential therapeutic value doesn’t stop there.

MDMA is an illegal substance often referred to by its street names: ecstasy, X, or molly. It has been a staple of late-night clubbing since the 1980s.

However, through a series of recent clinical trials in the United States and abroad, its reputation is changing in the healthcare community.

Currently, MDMA is still a schedule 1 narcotic according to the Drug Enforcement Administration (DEA). That means that it’s considered to have “no currently accepted medical use and a high potential for abuse.”

That designation, however, may soon change.

Researchers recently moved into phase III trials for the drug to treat PTSD, and they say they expect approval from the Food and Drug Administration (FDA) for the drug by 2021.

To understand why public and medical opinion are changing about MDMA, here are four conditions the drug may one day treat:

PTSD

After analyzing psychotherapy conducted with MDMA, researchers recently concluded the drug was successful in treating PTSD in a majority of participants.

Their findings were published this month in the medical journal The Lancet Psychiatry.

The study included 26 participants, including combat veterans, firefighters, and police officers with chronic PTSD.

The researchers said the combination of MDMA and psychotherapy was so effective that following treatment, roughly two-thirds of participants no longer met the clinical criteria for PTSD.

“In a few deep therapeutic sessions with MDMA, people can change decades and decades of patterns of fear based on certain emotions and that’s what’s so remarkable about it,” said Rick Doblin, PhD, an author of the paper and executive director of the Multidisciplinary Association for Psychedelic Studies (MAPS), which funded the research.

PTSD is a major public health problem among military personnel and first responders. PTSD is associated with other psychological issues, including depression, substance use disorder, and risk of suicide.

There are currently only two medications prescribed for the treatment of PTSD. One is sertraline (Zoloft) and the other is paroxetine (Paxil).

However, Doblin and his coauthors note that these treatments offer “limited effectiveness,” particularly in veterans.

Other drugs including SSRIs, benzodiazepines, and mood stabilizers are also sometimes prescribed “off-label” for the treatment of PTSD, although the benefits haven’t been established in clinical trials.

Anxiety

MDMA has been noted for its anxiolytic (anti-anxiety) properties.

Doblin and the MAPS organization have completed small phase II studies for the treatment of social anxiety in adults with autism using MDMA therapy.

They believe the drug could prove helpful for “any cause” of social anxiety, not just in individuals with autism.

MDMA is known to suppress activity in the amygdala, a part of the brain responsible for fear and anxiety.

The drug is described as producing empathetic and prosocial feelings, which help to ameliorate anxiety that’s caused by interacting with other people.

Depression

Previous clinical trials have also looked at the positive effects MDMA can have on individuals with depression and anxiety due to life-threatening illnesses.

Like treatment for other disorders, MDMA’s ability to instill feelings of calmness and trust may be helpful in a therapy setting for individuals dealing with depression and other common comorbidities of PTSD.

However, while the potential use for MDMA to treat depression is “theoretically well-grounded,” according to some researchers, the drug’s use for this indication hasn’t been as well-established as it has for others, such as PTSD and anxiety.

MDMA isn’t the only nontraditional drug to be investigated recently as a depression treatment though.

The drug ketamine has also shown promise in this area despite also being a “party drug.”

Alcohol addiction

In 2017, doctors in the United Kingdom began the first-ever clinical study for MDMA-assisted psychotherapy treatment for alcohol addiction.

Similar to the PTSD study, participants would take the drug while taking part in two supervised sessions with a psychiatrist.

Participants are described as heavy drinkers who have tried and relapsed into using alcohol repeatedly, despite other treatments.

Doblin notes that the clinical use for MDMA treatment of alcohol addiction lies in its potential to treat trauma.

“What drives a lot of alcohol or substance abuse is people running away from trauma,” he said.

“After 100 years of modern psychiatry our treatments are really poor,” Dr. Ben Sessa, a clinical psychiatrist at Imperial College London who is overseeing the trials, told a recent convention gathering. “The chances of relapse for these patients are really high — 90 percent at three years. No one has ever given MDMA to treat alcoholism before.”