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This is your brain on drugs (continued)

Indeed, Mithoefer’s post-traumatic-stress-disorder study is a watershed moment. He’s working with 20 prescreened survivors of sexual assault: 12 of them are given a controlled dose of MDMA, while eight receive a placebo. Mithoefer talks each through their experiences, slowly and deliberately, drawing out their traumas. Ideally, the MDMA will allow the subjects to feel more at ease as they discuss repressed memories and separate them from their present environment. Mithoefer expects the study, which started in March, to last another year or so.

Does he foresee MDMA becoming an FDA-approved drug? "It’s premature to know the answer to that, because we haven’t finished this study, and we don’t have the data yet. It depends what the data show," Mithoefer says. "We’ll need to have another pilot study if this goes well. And then if that goes well, we’ll need to have larger multi-center trials. So there’s a lot to be done to answer that question. But I think if the data support it, it’s certainly a possibility."

Halpern’s work at Harvard could potentially be just as momentous. MAPS and Halpern have already devised a pilot study at McLean Hospital assessing MDMA’s effects on neurocognitive ability. "So what we’ve done is built credibility with the people there," Doblin says. "They’re not worried they’re going to be attacked as the new Timothy Leary, that Harvard’s gone crazy again. They’ve reviewed all the literature on the risks. They’re experts. And they know how to balance risk and benefits."

To Doblin, the idea that this sort of research could soon be going on right in his back yard is thrilling. "There has not been anything done with psychedelic research at Harvard in 39 years," he says. "I feel like it’s been a proverbial 40 years in the desert. And so next year, we have the chance of starting, after exactly 40 years, psychedelic psychotherapy research at Harvard."

Further afield, MAPS, with the Heffter Research Institute, has co-funded a University of Arizona study on psilocybin as a treatment for obsessive-compulsive disorder. MAPS is also working with researchers in England on a protocol to explore the use of ibogaine (a psychoactive drug derived from the root bark of an African rain-forest plant; it’s legal in Canada, Mexico, and the UK — but not the US) to treat addiction to drugs like cocaine and heroin. In parts of Africa, ibogaine is central to sacred rituals, and is even given to children. "[You can] protect kids with honest information, and also access to altered states," says Doblin. "It actually immunizes them against drug abuse if the culture provides appropriate context for this."

SOME BELIEVE Rick Doblin is naive or even dangerous, touting ecstasy and ibogaine like they’re aspirin and Novocain. It’s true that all drugs carry risks. People have died from ecstasy-induced hyperthermia, and, once the drug’s effects wear off, users show depleted serotonin levels for varying periods of time. Researchers are still debating how serious this is and whether it foretells any lasting brain damage.

Repeated phone calls from the Phoenix to the DEA, NIDA, the Office for National Drug Control Policy, and the Partnership for a Drug-Free America did not yield comment. But some health-care professionals continue to assert that any perceived therapeutic value these drugs might have is gravely overshadowed by their risks.

Dr. Eric Voth is an internal-medicine and addiction specialist with a private practice in Kansas; he also chairs the Institute on Global Drug Policy, a division of the Drug Free America Foundation. It’s in that capacity that he’s spent about 15 years tangling with Doblin over the risk-benefit dynamics of psychedelics and marijuana. "Why this big push to try to find medical legitimacy for something that is fundamentally a drug of abuse?" he asks of MAPS’s crusade. "How much potential downside is there for a supposed upside? If you look at the literature — despite [Doblin’s] allegations that the literature is flawed, and that the DEA has tried to manipulate it, and all that stuff that he always spews out — there is a lot of literature out there on hyponatremia [salt depletion], seizures, memory problems, serotonin depletion. And, besides that, [look at the] people who get in trouble abusing it because it’s such an intense high."

Doblin doesn’t argue that, when used under the wrong circumstances or in the wrong doses, ecstasy can be very dangerous. "The fundamental point I’d like to make is that MAPS needs to be at the forefront of looking at risks as well as benefits," he says. "We want to avoid some of the mistakes of the ’60s, where people were promoting benefits, out of balance with acknowledgment of the risks."

But he also accuses the government and anti-drug groups of having lost credibility when it comes to educating the public about those risks, in part because they deny any benefits whatsoever. "Like when they say this girl died at a rave. They leave the impression that you’ve got a really good chance of dying at a rave if you take MDMA. It’s better for [MAPS] to say, yes, there are a few people who’ve died at raves. But the chances are one in a million, and these are the reasons, and here’s what we do to stop it. It’s up to us to acknowledge the risk, and then to put it in some sort of balance, not for us to ignore it. Ultimately, I think our credibility, and our ability to win the trust of the society and move beyond this massive fear, is really contingent on how balanced and believable we are."

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Issue Date: October 8 - 14, 2004
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