Adam’s son died in the Hunter Valley bus crash. In a NSW first, he’ll try MDMA to ease his anguish

In the months after Adam Bray’s son Zach died in the Hunter Valley bus crash, he couldn’t watch other fathers play with their young children along Manly beach – as he once had – without a monstrous wave of grief and pain crashing over him.

Adam Bray (right) with his son Zach, 29, who was among 10 people killed in the Hunter Valley wedding bus crash. “I’m going to heal because I promised my boy I’m going to heal,” Bray said.

Bray travelled to Thailand, India and Greece in a desperate attempt to escape the “triggers” that reminded him of Zach, 29. He discovered the trauma bound to memories of losing his son, viewing Zach’s body in the morgue, and hearing the graphic details of an autopsy report, was inescapable.

“You can be fine, travelling along, and all of a sudden, this tsunami of grief will just hit you,” he said. “It’s like an old record player – my trauma is on the same track, just going around, and around, and around.”

But he had promised his son he would heal. On June 12 – one day after the first anniversary of the bus crash tragedy that killed Zach and nine others – Bray, 61, will be among the first in NSW, through a Sydney clinic, to trial MDMA-assisted treatment for post-traumatic stress disorder.

The Therapeutic Goods Administration surprised researchers last year when it approved MDMA for controlled use when prescribed by a psychiatrist for people with PTSD. It also approved psilocybin, the active ingredient in magic mushrooms, for treatment-resistant depression. This made Australia the first country to recognise psychedelics as medicines.

There is growing evidence to suggest MDMA, also known as ecstasy, can reduce fear and anxiety for people with PTSD when paired with talk therapy. However, the Royal Australian and New Zealand College of Psychiatrists has previously urged caution, saying psychedelics were not “miracle cures” for mental illnesses.

Associate professor Ranil Gunewardene, who is a psychiatrist and director of Evolution: Medicine Enhanced Therapy, has been approved by the TGA’s authorised prescriber scheme to run the first treatment service and research study in NSW. The first patient will be treated on Wednesday.

Gunewardene said the drugs might not work for everyone, but they offered fresh hope for people who had treatment-resistant depression and PTSD and who found treatments such as talk therapy and medication ineffective.

“It’s an important development to see whether these new treatments can deliver similar benefits for the public,” he said.

Patients will typically attend therapy sessions before the first of three dosing days, when the drugs will be administered under the supervision of two psychologists. Each dosing day will be followed by three psychotherapy sessions. Patients face costs of $17,000 for the three-month treatment course.

Gunewardene said once patients had taken a dose of the drug, their mind would “gradually start exploring its history, experiences, beliefs and emotions, in this altered state”.

“The MDMA switches off the amygdala, which is the fear centre of the brain, and covers the patients in a protective state of wellbeing that allows them to explore these previously highly distressing experiences with the therapists’ support, and to hopefully process them differently; to rewrite that story in a slightly different way that might be more helpful for their ongoing functioning.”

Bray, who has tried meditation, talk therapy and eye movement desensitisation and reprocessing (EMDR) to ease his distress, believes the trial will be beneficial, but he is tempering his expectations.

“I’m ready for this kind of therapy. I’ve spent many hours researching what it does. It’s not like I’ll be bouncing along to my favourite DJ and hugging and kissing my friends. But I’m going to find out.

“I hope – and maybe I’m trying to convince myself of this – that I will heal. And I will heal because that’s one of the promises I made to Zach.”

Panania mother of four Shannon Foster, 51, has used therapy and medication to treat depression and PTSD for more than a decade. Foster, a Dharawal woman, hopes to heal the intergenerational trauma that flowed from her Aboriginal father, and a mother whose dad was a World War II veteran.

Foster says her parents did their best, but she was not unscathed by their painful pasts. She wound up in “incredibly abusive” relationships and “just decades of traumatic and difficult circumstances”.

Dharawal woman Shannon Foster, 51, on the banks of the Georges River in Sydney’s south: “I want to face [my trauma] head on. I want to understand the circumstances that led me here. I want some clarity and peace around them.”Credit: Kate Geraghty

“You want to break the cycle and do things differently. All I want for my kids is that they don’t have to go through what I went through. I’ll do everything – everything – I can.”

“Doing something like this where you can sort of push your humanity safely to the side, and connect to something much bigger and deeper than yourself, I think can only be a good thing in understanding some of that pain and trauma that’s too much to take as you go about your daily life.”

Clinical psychiatrist Colleen Loo, a professor at the University of NSW and the Black Dog Institute, said research suggesting MDMA-assisted treatment could be helpful for PTSD was reasonable but that it was also early in development, and that the evidence base for psilocybin for treatment-resistant depression was at an even earlier stage.

Loo said clinicians were starting the treatment with limited knowledge and that they had to be cautious.

“The public needs to clearly understand what’s being offered to them, and the clinics offering it need to be upfront and honest about what evidence we do have – which is not none, but that it is early compared to many other treatments,” she said.

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