This is a really good point. It's a therapy, not a prescription per se.

> It's been clear since the beginning that it's psychedelic-assisted therapy — not just psychedelics — that makes the treatment effective.

Thank you for pointing this out. This is the key point that so many people miss by skimming the headlines.

These medication-assisted therapy trials are about the therapy first and foremost. Some of the trials have several dozen therapy sessions in their protocols and only a single or couple medication-assisted sessions.

People taking these drugs on their own at home are not doing anything resembling the therapy discussed in these trials. There are numerous stories of people taking psychedelics ad-hoc and ending up with worsened anxiety, derealization, persistent fears, delusional thoughts, and so on. The common wisdom in psychedelic circles was that set and setting is everything - Taking psychedelics while in a state of depression, anxiety, PTSD, or other conditions outside of the setting of closely monitored professional therapy is potentially quite negative.

> People will use it as justification to buy it illegally.

People already buy it illegally. I don't see how this will meaningfully change the supply or demand.

And?

MDMA very realistically shouldn’t be lumped in with cocaine, heroin, etc. Hell, opiates as a whole! Just based on the effect profile and typical usage patterns, I baselessly posit that one is more likely to be a daily marijuana user than a daily MDMA user, even taking into account the number of people that use each drug in the first place.

Nobody is holding you up with a knife or gun, or stealing the coins out of your car, to get their next fix of MDMA.

Nobody is acting aggressively on the street or in a nightclub because they’ve had MDMA, or not gotten enough of it.

MDMA is certainly not without its risks / dangers. Someone can easily irresponsibly take too much and end up in hospital or dead. Someone can easily take the right amount of the right stuff and end up in hospital or dead just because they had an adverse reaction. You could ruin your relationships, throw your brain off-balance such that you never really enjoy anything again. There’s the whole ‘gateway drug’ argument. Blah blah blah.

Let’s really stop and think very carefully about whether these risks (which unlike say…meth, heroin, etc, have an absolutely negligible societal impact per capita compared to alcohol, tobacco, etc) should even show up on the radar when weighed up against the increasingly proven positive effects of MDMA-assisted psychotherapy.

Because without that justification MDMA hasn't been popular with people buying drugs illegally?

MDMA is no less popular in Europe, than it is in US.

You should read up on harm reduction.