Questions from Tatiana Pronin, Responses by Rick Doblin

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1. How and when did you start your psychedelic studies?

When I first tried LSD in 1971, when I was 18. It was my first year in college and I knew right away I am stumbled on something valuable to me and to others, and politically important.

2. At the Ecstasy Conference in San Francisco last February, Sue Stevens told how taking the drug helped her and her husband coping with cancer. She said that they spent six hours confronting their fear, and that was really helpful. Do you think that is the most important benefit from MDMA?

Confronting fear is very important. However, I'd say the most important benefit of MDMA is self-acceptance.

2A. Do you think other hallucinogenic drugs, like LSD, can give the same benefit?

Yes, but it's more difficult to get to that spot of self- acceptance with LSD. On the other hand, LSD has powers that MDMA doesn't, and as a result has its own place in the psychedelic firmament.

3. I think you've heard about people who stopped drinking after using ayahuas ca in Brasil. They use it in a religious context. Don't you think this cases could be compared with people who have "changed" after being converted into protestantism? I mean, what is more important in this case: the drug or the religion?

Excellent question. I don't think the answer is the same for everyone. Some people thrive in a community (religion) while others need a direct mystical experience (the drug). Many need both. One important distinction to make is whether the person gives away their power to the group or the drug or whether the person becomes more empowered and builds bonds based on mutual interdependence rather than dependence.

4. What are the most important MDMA research projects, in your opinion? (I've read about the use with Parkinson's disease and other one in Madrid).

The research with PTSD patients and the research with terminal cancer patients. The way I look at it, the Parkinson's research isn't as important since it isn't based on MDMA's psychological properties. However, if I had Parkinson's, that might be the most important to me. Also, MDMA for couples therapy and, to be honest but controversial, for teenagers in rites of passage rituals. We don't protect the kids through the drug war, we endanger them. We need to acknowledge the struggles they are going through and try to channel their experimentation in more healthy directions rather than drive it underground and increase the risks.

5. Is it difficult to have the FDA approval? Why did you say at the conference that FDA would approve the therapeutic use of MDMA in five years?

Yes, it is very difficult to obtain FDA approval but I think it can be done. If we get FDA permission for the MDMA/PTSD study this summer, which I think we will, it will have taken 16 years from the time MDMA was criminalized in 1985 to get permission in the US for the first study of the therapeutic use of MDMA! I said at the conference that we could move MDMA through the FDA system in five years if the decisions are based on science and not drug war politics. Since science really is second to drug war politics, it may take longer. But if we can show MDMA can help people face death and deal with trauma, I think we will be able to overcome political resistance. People are more afraid of paina and suffering and death than drugs.

6. What is the difference between using the drug alone and using it with the therapist assistance?

A therapist can help you see where you are not facing something directly but are dancing away from a difficult reality. People can learn to internalize the therapeutic perspective and can reach important emotions and realizations if they take MDMA on their own, but it's a bit more difficult to catch yourself taking the easy way out. Several of my most important MDMA experiences have been when I took it alone. Also, with a therapist, people can relax a bit more into the experience since they don't need to deal with external reality, the therapist is there to guide them to safety in case of a fire or some other emergency.

7. If someone have a propension to become addicted, wouldn't be danger trying a therapy like that?

Yes, that would be a risk that might or might not be worth taking. But MDMA isn't a great drug to get addicted to, which is why it has a low potential for addiction. As tolerance develops, higher doses help for awhile but then the person gets more of the unpleasant side effects and less of the desired effect. I know of several people who used MDMA to help them get over cocaine addiction. MDMA helps bring repressed material to the surface, like how people are hurting themselves with addictive behaviors. The decision to use MDMA to treat addiction depends in part on what sorts of social support system the patient has, how much access they have to MDMA outside of therapeutic settings, and what else has been tried.

8. The MDMA effects diverge from one to another, like, for instance, Prozac does?

Yes, people react differently. Still, the MDMA experience is remarkably consistent across people. It is the most inherently therapeutic of all the psychedelics. This depends in part on how much painful emotional material people have suppressed. MDMA can bring this to the surface and if someone isn't prepared and tries to keep these emotions buried after taking MDMA, they could end up feeling much worse.

9. People who use acid say that the "love" and "understanding effect" of the drug lasts for a long time. It doesn't happen at all with alcohol or marijuana. Why?

I can't say about alcohol since I don't drink. The LSD experience goes to the core of each person's hold on reality, self-concept and self-acceptance, and willingness to face the unknown. Positive experiences are deep and have lasting consequences. The LSD experience is imprinted in memory at a very deep and powerful level. I'm not sure why. MAPS conducted a 40 year follow up study of about 60 people who has taken LSD about 40 years before. It was amazing how many of the subjects had very clear memories of portions of their LSD experience. Marijuana can also lead to long-lasting feelings and insights, but it is more intellectual than the soul-searching of LSD and MDMA. Marijuana can be very emotional, but its at a somewhat different level than the LSD. Anyway, the love and understanding effect is more about the context of the use of LSD than about the drug itself. This gets back to your question about which is more important, the drug or the religion. We need to keep in mind the drug is just one element in the total experience, and is often outweighed by the context.

10.You said people need what MDMA has to offer in terms of understanding, love and therapy. Do you think everyone would be happier with more serotonin, or only certain people and in certain circumstances?

Some people are happy as they are and wouldn't be better off if they tried MDMA. Some people are unhappy and would be made more unhappy if they tried MDMA, especially if they did it outside of a therapeutic context. It's not for everyone, but everyone should have the freedom to decide if they wanted to experiment.

April 5, 2001 Follow-up Questions by Tatiana, Responses by Rick Doblin

1. About the MDMA/PTSD study you've mentioned: who are the researches? Is it similar to the Spanish trial? Are you waiting for the FDA permission?

The primary researchers are Dr. Michael Mithoefer and Annie Mithoefer, RN (registered nurse). This study design is a bit different than the Spanish protocol in that we are seeking permission to give subjects two MDMA sessions, each with 125 milligrams, scheduled from 3-5 weeks apart. We will submit the protocol to the FDA within about four weeks and expect to hear back from FDA within 4 more weeks.

2. You said it would be the first clinical trial approved by FDA since it was criminalized. So, FDA has never approved any study of the therapeutic use of MDMA?

FDA has NOT approved any study of the therapeutic use of MDMA.

3. (In Wired magazine, they say that "only one clinical trial using the drug was approved by FDA from 92 to 99, when one more study was approved to look at the drug's effects on the psyche of terminal cancer patients", that's why I'm a little confused).

Wired was incorrect. FDA approved 3 studies with MDMA from 1992- 1999, all safety studies and none in patients. FDA did not approve a study in cancer patients. In 1999, FDA agreed in principle to approve a study in cancer patients and indicated that it would not require more animal studies or more human safety studies before approving a study in cancer patients. However, the exact design of the study in cancer patients still needs to be negotiated, therefore no specific study in cancer patients has yet been approved.

4. In Brasil, the studies of marijuana and ayahuasca that are being conducting since now don't have any government approval because the psychiatrists don't give the drug to their patients, they only observe the users. How does it work in USA? The therapists are able to prescript MDMA to their patients without any kind of gov. permission?

No therapists are legally able to prescribe MDMA to their patients. The only use of MDMA that is legal is when MDMA is given in the context of an FDA-approved study.