With FDA Studies, Advocate Might End Agony of Ecstasy Stigma
By Matthew Perrone
WASHINGTON (AP) — Growing up amid the tumult of the Cuban Missile Crisis and the Vietnam War, Rick Doblin says he became convinced that humanity was “crazy” and “inherently destructive.” As a teenager, he came to see the mind-expanding effects of psychedelics — including LSD and psilocybin, or magic mushrooms — as the antidote to mankind’s inner demons.
He set out to prove it. And now, after 32 years of false starts, setbacks and regulatory hurdles, he has brought MDMA — the illegal, all-night party drug also known as ecstasy — to the brink of medical legitimacy.
The Food and Drug Administration has labeled the drug a potential “breakthrough” for post-traumatic stress disorder (PTSD) and cleared late-stage studies of up to 300 patients. The studies are to be conducted by Doblin’s nonprofit group dedicated to promoting mind-altering drugs, the Multidisciplinary Association for Psychedelic Studies, or MAPS. Researchers will begin screening patients in November 2018.
The goal is to win FDA approval by 2021. MDMA would become the first psychedelic drug — currently in the Controlled Substances Act’s Schedule I, the same ultra-restrictive category as heroin and cocaine — to make the leap to prescription medicine.
Doblin does not plan to stop there. His aim is the legalization of all psychedelics for recreational use by 2035.
“Psychedelics have been used for thousands of years for healing and spiritual purposes,” said Doblin, 64. “I thought my contribution would be to bring them back.”
MAPS’ work is part of a resurgence of interest into the therapeutic potential of psychedelics, a field that captivated researchers in the 1950s and 1960s before the government ban on LSD and other hallucinogens slammed the door shut in 1970.
“This field was so taboo it was essentially erased from the history books,” said Stephen Ross, a New York University psychiatrist who is studying psilocybin, the ingredient in magic mushrooms, for depression and alcohol addiction.
Ross and other researchers are largely funded by the Heffter Research Institute, the other psychedelic nonprofit in the field. But Heffter executives adamantly oppose recreational use of psychedelics. They say the drugs are too risky to be used without professional supervision.
“Talking about full legalization of all psychedelics makes quite a number of people uncomfortable,” said David Nichols, co-founder of Heffter and a retired pharmacology professor at Purdue University in Indiana. “But that’s Rick, he’s got his base of people who give him a lot of money because they want to see him kick down the doors of government regulation.”
A Spectrum of Support from Dr. Bronner to Breitbart
Funding MAPS and the MDMA studies has meant relentless fundraising, more than $70 million over the years from by a wide array of wealthy backers.
“Rick has this beautiful vision of healing the cultural divide of the sixties; having veterans and counterculture icons coming together,” said David Bronner, CEO — what he says stands for “cosmic engagement officer” — of Dr. Bronner’s Magic Soaps, the organic brand known for its quirky labels. Bronner has given $3.1 million to MAPS since 2005 and currently chairs its board of directors.
Earlier this year Rebekah Mercer, the billionaire Republican and co-owner of Breitbart, pledged $1 million to fund the PTSD trials.
“America’s veterans deserve the very best care,” Mercer said in a statement announcing the grant.
If prescription MDMA is ever approved, revenue would flow to a pharmaceutical company entirely owned by MAPS. According to the company’s charter, profits would fund research into new uses for MDMA and other psychedelics.
Back to a Psychedelic Future
The small studies published by MAPS and Heffter are dwarfed by research conducted roughly a half-century ago. Between 1950 and the mid-1960s more than 1,000 papers were published documenting 40,000 patients receiving LSD and other psychedelics for conditions such as depression and addiction.
Only later would psychedelics become intertwined with the day-glow counterculture of the 1960s and figures such as Timothy Leary, the ex-Harvard professor who promoted psychedelics as a pseudo-religion.
MDMA had its own medical history before being adopted by the electronic rave culture of the 1990s, thanks to its ability to trigger intense feelings of euphoria, intimacy and connection.
The drug was discovered in 1912 by a German drugmaker researching chemicals to control bleeding. A chemical cousin, MDA, became a drug of abuse in the late 1960s, producing a combination of hallucinations and intensified emotions. Users dubbed it the “love drug.”
MDMA was largely forgotten until a handful of psychotherapists reproduced it in the late 1970s to enhance therapy sessions.
Doblin first met some of the drug’s proponents at the Esalen Institute in Big Sur, California, in 1982, a seaside mecca for New Age teachers and seekers. In college at the time, Doblin became convinced that the drug has the power to enhance communication and healing, after an MDMA session with his girlfriend. His original plan was to become a therapist working with MDMA. But the federal government’s 1985 ban on the substance pushed him into activism instead.
George Greer, co-founder of Heffter, was among the West Coast psychiatrists who first prescribed then-legal MDMA to treat anxiety and other issues, including domestic problems between couples. Greer and his wife, a psychiatric nurse, treated more than 80 patients with MDMA between 1980 and 1985.
The Brain on Ecstasy
It’s not entirely clear how MDMA works, but Greer and others point to its effects on two key brain chemicals: It boosts the feel-good chemical serotonin, similar to antidepressants, and also increases the stimulating brain chemical dopamine, like amphetamines. The effect, Greer said, is that patients feel less fear and more motivation to face their traumatic memories.
The current standard of care for PTSD includes antidepressants and several forms of therapy. But only about a third of patients recover after treatment.
In studies funded by MAPS, more than 50 percent of patients who completed MDMA-assisted therapy no longer had PTSD, compared with 23 percent of patients who received therapy with either a dummy pill or inactive dose of MDMA, depending on the study.
Processing the Past
Nigel McCourry, a lance corporal in the Marines, returned from Iraq in 2004 beset by nightmares of ambushes, exploding mortars and gun battles. For years, he suffered insomnia, sometimes standing at his apartment door convinced that someone might break in and kill him.
He was especially haunted by one incident in which he accidentally shot and killed two young girls who were riding in a truck that approached his platoon during a firefight.
“A lot of what was tearing me up was having this viewpoint that I was a monster and dangerous,” McCourry said. “On MDMA, I was able to forgive myself in a way that felt meaningful.”
After MDMA treatment, McCourry was able to sleep through the night and stop taking antidepressants and anti-anxiety pills.
But MDMA has its own risks. When abused as a party drug, ecstasy can cause life-threatening dehydration. And heavy, long-term users have shown signs of problems with memory and thinking.
Still, leading psychiatrists are cautiously supportive of MAPS’ research, noting the need for new treatments. More than 800,000 U.S. veterans receive disability for PTSD, and the risk of suicide among veterans is 22 percent higher than other adults.
Tufts University psychiatrist Paul Summergrad said he wants to see larger, more rigorous trials to confirm the benefits of MDMA and psilocybin.
Doblin says part of MAPS’ mission is “harm reduction” to help people use psychedelics safely.
In August, MAPS flew several staffers out to Burning Man, the Black Rock Desert festival that attracts up to 70,000 people each year, including many who use hallucinogenic drugs.
Doblin and his staff trained festival volunteers who counseled 380 attendees through what they call “psychedelic crises,” or bad trips.
These days, Doblin said he only occasionally uses MDMA for “therapeutic purposes.”
“I don’t go to raves and dance all night — although I certainly did,” he said.
Banner image: For decades, Rick Doblin has advocated for psychedelic drugs including LSD, psilocybin, and MDMA to be studied as possible therapies for mental illness. His aim is to move drugs known as acid, magic mushrooms, and ecstasy to be legal for recreational use by 2035. His group, the Santa Cruz, California-based Multidisciplinary Association for Psychedelic Studies (MAPS), has secured Food and Drug Administration (FDA) authorization to conduct late-stage studies for ecstasy as a possible treatment for post-traumatic stress disorder (PTSD). (Associated Press Photo/Gregory Bull)