MDMA may have protected Nova attack survivors from trauma, study suggests

As dawn approached on the morning of 7 October 2023, many of the partygoers at the Nova music festival near Gaza’s border took illegal recreational drugs like MDMA or LSD.

Hundreds of them were high when, shortly after sunrise, Hamas gunmen attacked the site.

Now neuroscientists working with survivors from the festival say there are early signs that MDMA – also known as ecstasy or molly – may have provided some psychological protection against trauma.

The preliminary results, currently being peer-reviewed with a view to publication in the coming months, suggest that the drug is associated with more positive mental states – both during the event and in the months afterwards.

The study, carried out by scientists at Israel’s Haifa University, could contribute to a growing scientific interest in how MDMA might be used to treat psychological trauma.

It is thought to be the first time scientists have been able to study a mass trauma event where large numbers of people were under the influence of mind-altering drugs.

Hamas gunmen killed 360 people and kidnapped dozens more at the festival site where 3,500 people had been partying.

“We had people hiding under the bodies of their friends for hours while on LSD or MDMA,” said Prof Roy Salomon, one of those leading the research.

“There’s talk that a lot of these substances create plasticity in the brain, so the brain is more open to change. But what happens if you endure this plasticity in such a terrible situation – is it going to be worse, or better?”

The research tracked the psychological responses of more than 650 survivors from the festival. Two-thirds of these were under the influence of recreational drugs including MDMA, LSD, marijuana or psilocybin – the compound found in hallucinogenic mushrooms – before the attacks took place.

“MDMA, and especially MDMA that was not mixed with anything else, was the most protective,” the study has found, according to Prof Salomon.

He said those on MDMA during the attack appeared to cope much better mentally in the first five months afterwards, when a lot of processing takes place.

“They were sleeping better, had less mental distress – they were doing better than people who didn’t take any substance,” he said.

The team believes pro-social hormones triggered by the drug – such as oxytocin, which helps promote bonding – helped reduce fear and boost feelings of camaraderie between those fleeing the attack.

And even more importantly, they say, it appears to have left survivors more open to receiving love and support from their families and friends once they were home.

Clearly, the research is limited only to those who survived the attacks, making it hard to determine with any certainty whether specific drugs helped or hindered victims’ chances of escape.

But researchers found that many survivors, like Michal Ohana, firmly believe it did play a role – and say that belief, in itself, may help them to recover from the event.

“I feel like it saved my life, because I was so high, like I’m not in the real world,” she told me. “Because regular humans can’t see all these things – it’s not normal.”

Without the drug, she believes she would have just frozen or collapsed to the floor, and been killed or captured by the gunmen.

Clinicians in various countries have already experimented with MDMA-assisted psychotherapy for Post-Traumatic Stress Disorder (PTSD) in a trial setting – though only Australia has approved it as a treatment.

Countries that have rejected it include the US, where the Food and Drug Administration cited concerns about the design of the studies, that the treatment may not offer long-lasting benefits, and about the potential risk for heart problems, injury and abuse.

MDMA is classified as a Class A drug in the UK, and has been linked to liver, kidney and heart problems.

In Israel, where MDMA is also illegal, psychologists can only use it to treat clients on an experimental research basis.

The preliminary findings from the Nova study are being closely followed by some of those Israeli clinicians experimenting with MDMA as treatment for PTSD after 7 October.

Dr Anna Harwood-Gross, a clinical psychologist and director of research at Israel’s Metiv Psychotrauma Centre, described the initial findings as “really important” for therapists like her.

She is currently experimenting with using MDMA to treat PTSD within the Israeli military, and had worried about the ethics of inducing a vulnerable psychological state in clients when there is a war going on.

“At the beginning of the war, we questioned whether we were able to do this,” she said. “Can we give people MDMA when there’s a risk of an air raid siren? That’s going to re-traumatise them potentially. This study has shown us that even if there’s a traumatic event during therapy, the MDMA might also help process that trauma.”

Dr Harwood-Gross says early indications of therapeutic MDMA use are encouraging, even among military veterans with chronic PTSD.

It has also upended old assumptions about the “rules” of therapy – especially the length of sessions, which have to be adjusted when working with clients under the influence of MDMA, she says.

“For example, it’s changed our thoughts about 50-minute therapy sessions, with one patient and one therapist,” Dr Harwood-Gross told me. “Having two therapists, and long sessions – up to eight hours long – is a new way of doing therapy. They’re looking at people very holistically and giving them time.”

She says this new longer format is showing promising results, even without patients taking MDMA, with a success rate of 40% in the placebo group.

Israeli society itself has also changed its approach to trauma and therapy following the 7 October attacks, according to Danny Brom, a founding director of the METIV Psychotrauma Centre at Herzog Hospital in Jerusalem, and a senior figure in the industry.

“It’s as if this is the first trauma we’re going through,” he said. “I’ve seen wars here, I’ve seen lots of terrorist attacks and people said, ‘We don’t see trauma here’.

“Suddenly, there seems to be a general opinion that now everyone is traumatised, and everyone needs treatment. It’s a wrong approach.”

What broke, he said, is the sense of security many Jews believed Israel would provide them. These attacks uncovered a collective trauma, he says, linked to the Holocaust and generations of persecution.

“Our history is full of massacres,” psychologist Vered Atzmon Meshulam told me. “As a psychologist now in Israel, we are faced with an opportunity to work with lots of traumas that weren’t previously being treated, like all our narratives for 2,000 years.”

Collective trauma, combat trauma, mind-altering drugs, sexual assault, hostages, survivors, body-collectors, the injured and the bereaved – Israel’s trauma specialists are facing a complex cocktail of issues from the clients now flooding into therapy.

The scale of that mental health challenge is mirrored in Gaza, where vast numbers of people have been killed, injured or left homeless after a devastating 15-month war – and where there are scant resources to help a deeply traumatised population.

The war in Gaza, triggered by the Hamas attacks on Israeli communities in October 2023, was suspended in January in a six-week truce, during which Israeli hostages held by Hamas were exchanged for Palestinian prisoners in Israeli jails.

But there is little sense on either side that the peace and security needed to begin healing has arrived.

The truce expired last weekend, with 59 Israeli hostages still in Hamas captivity. Many Gazans are waiting, with their bags packed, for war to resume.

Meanwhile Nova survivor Michal Ohana says she feels that with the passage of time, some are expecting her to have moved on from the attacks, but she is still affected.

“I wake up with this, and I go to sleep with this, and people don’t understand,” she told me.

“We live this every day. I feel the country supported us in the first months, but now after one year, they feel: ‘OK, you need to go back to work, back to life.’ But we can’t.”

Additional reporting by Oren Rosenfeld and Naomi Scherbel-Ball