Letter from Rick Doblin - MAPS President

Emotionally powerful anecdotes, as well as clinical research, are needed in the effort to communicate to a wary culture the potential value of psychedelics and marijuana. A synchronistic, chance discussion at a recent neighborhood festival brought home to me the persuasive value of the moving personal report. While continuing to chronicle scientific developments, MAPS will try to leaven its reporting with a few well-chosen personal accounts intended to illustrate the potential benefits to even the most conservative members of our society of the resumption of research into psychedelic drugs and marijuana.

My family (my wife, Lynne and our kids, Eden and Lilah) went to Belmont Town Day in mid-May, shortly after we moved to Belmont, Massachusetts, just four miles from Harvard Square and the Kennedy School of Government. We made this move to make it easier for me to devote more of my time to writing a dissertation analyzing potential policies for the regulation of the medical use of psychedelics.

We were talking at Town Day with the owner of a water purification company about the quality of the local water when he pointed to a couple at the next booth looking at an exhibit of a group called Belmont Against Racism. "That's ex- Boston Mayor Ray Flynn and his wife," he told us. Mayor Flynn recently returned from Rome where he had been the Clinton Administrations' representative to the Vatican and was now running for the Congressional seat to be vacated by Joe Kennedy, Jr.

When Mayor Flynn and his wife walked by, we all said hello and struck up a conversation. I mentioned that I had studied the medical use of marijuana at the Kennedy School, and Mayor Flynn asked me what I thought about the issue. I cited research about marijuana's efficacy and said that I didn't buy the argument that the medical use of marijuana would send the wrong message to our kids. Mayor Flynn was listening but didn't seem entirely in agreement.

Then, something magical happened. The owner of the water purification company shared with us that his wife had died of cancer several years ago and that the only medicine that helped her with the severe nausea associated with her chemotherapy was smoked marijuana. He said she was not a recreational drug user and would never have used marijuana if she hadn't needed it medically. He added that she had tried Marinol, the legally available oral THC pill, but that it had not worked for her, nor had any of the other legally available medicines. Only smoked marijuana worked, making her last days a little more comfortable.

I couldn't have dreamed up a more compelling account of the need for medical marijuana. Mayor Flynn then told us that emotional stories like this were just what he needed to hear to be convinced of the potential value of the medical use of marijuana, and that personal testimonials as well as research provided the political cover people in office would need to advocate a policy shift. As Mayor Flynn and his wife walked on, I was left feeling that there is a deep reservoir of support for fundamental social change, if only we work to bring it to the surface.

As you think of the goals shared by our growing MAPS community, please consider speaking to just one friend about joining MAPS. Word of mouth is the best way for public officials to hear about medical marijuana and also the most effective way for MAPS to grow and find new members. As MAPS grows, it will be able to work more dynamically for a time when people who need unconventional medicines can get them, and can focus on their healing process rather than on fear of punishment.

Best wishes for a full and productive summer, Rick Doblin,
MAPS President

Note to Members

Dear MAPS Members:
We hope that you have been enjoying the first MAPS Bulletin of 1998, which was sent to you in March. This issue is much shorter than those to which you've become accustomed--we are experimenting with this new format for two reasons. First, many of you feel that the long issues take a while to read through (the last issue was 61 pages, the next one will about the same length). With this shorter Bulletin, we would like to give readers an opportunity to catch up with current research in a short, easily- readable format. The longer issues will continue to include more in-depth and thought-provoking articles. Secondly, we would like to commit more staff time to the MAPS website over the next six months.

The Janiger LSD Follow-up Project

The MAPS-funded and coordinated Janiger follow-up study, in which approximately 40 subjects were interviewed nearly forty years after initially ingesting a dose of LSD in a controlled study, is in the data analysis phase. The original research was conducted in Los Angeles from 1954 to 1962 by Dr. Oscar Janiger, a physician who was sent LSD by Sandoz Pharmaceuticals to explore its effects on psychologically normal human volunteers. This initial research was conducted before there was any great understanding of the effects of LSD or a language to describe the experience itself.

The goal of this follow-up research is to determine the role of an LSD experience in the context of each subject's life many years later. In the past year over forty audio-taped interviews have been completed and several meetings with Dr. Janiger have been conducted. Each interview has been included in an official log and assigned a confidential code number. A transcriber who analyzes data and the lead researcher are currently transcribing and qualitatively analyzing each interview. Analysts will constantly compare all transcribed interview data and findings agreed upon by the researchers will be considered valid and reliable only after they meet several criteria using constant comparisons: the findings are deemed qualitatively meaningful; researcher effects are examined; outliers and negative evidence are examined and determined not to change the finding; and spurious relations and rival explanations are excluded. With this in mind, researchers hope to gain an understanding of how participants interpreted their initial experience, and now situate that experience in the context of their lives.

Although it is far too early to draw any real conclusions, early results are indicating a significantly positive subject disposition toward their experience, both at the time and in the context of their lives, with apparently little harm resulting from the ingestion of LSD in the experiment.

Russia: Ketamine Psychotherapy (KPT) with Heroin Addicts

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Evgeny M. Krupitsky, M.D., Ph.D. and his research team have treated 54 patients as part of a three-year study of ketamine psychotherapy (KPT). Preliminary results seem promising, but the outcome won't be evaluated until the study is completed around the end of 1999. Post-treatment follow-up consists of a schedule of psychiatric evaluation, psychological tests and drug testing through urine analysis.

Dr. Krupitsky is currently one of two medical scientists in the world conducting clinical research into the therapeutic potential of a psychedelic drug. The other researcher is Dr. Deborah Mash, conducting a study in St. Kitt of the use of ibogaine in the treatment of heroin and cocaine addiction.

An $8,000 grant awarded to Dr. Krupitsky from MAPS in April 1998 is the second of three annual payments. In addition to support from MAPS, Dr. Krupitsky receives a grant of $5,000 a year from the Heffter Research Institute.

Follow-Up Study of Concentration Camp Survivors Treated with LSD Therapy

See also:
The LSD Therapy Career of Jan C. Bastiaans, M.D.
Tribute to Professor Jan C. Bastiaans: 1917-1997

MAPS has pledged $5,000 to Nicole Maalste and Hans Ossebaard, Addiction Research Institute, University of Utrecht, for a follow-up study to Dr. Jan Bastiaans' research with LSD therapy and concentration camp survivors. This will be an efficacy outcome study that will not rely on pre-treatment/post-treatment comparison, since such data does not exist, but would simply be a self-report survey. The investigators plan to contact several institutions which have already expressed their approval of a broader proposal (a process study to evaluate the methodology used by Dr. Bastiaans) and are specialized in the treatment of war survivors. The investigators will seek to publicize the study through the institutions' publications, with a request that ex-patients contact the researchers. They will also request to check their databases, since people have often kept in contact with the clinic or center where they were treated for war-related trauma. If this does not yield enough study subjects, ads could be placed in national journals.

Ex-patients who contact the researchers will be sent a letter and a short questionnaire with about fifteen questions, which they can return to the university. They will be asked if they would like to participate in a bigger study later on, should funding become available. Both closed and open questions will be asked to give respondants the opportunity to tell their own stories, and to try to find out as precisely as possible which experiences could have resulted from LSD therapy and if they had positive or negative effects. The data will be assimilated into an article.

Israel: MDMA-Assisted Psychotherapy in Post-Traumatic Stress Disorder Patients (PTSD)

MAPS has pledged $50,000 to support the efforts of Dr. Moshe Kotler, University of Ben-Gurion of the Negev, to design and conduct a study into the use of MDMA-assisted psychotherapy in Post-Traumatic Stress Disorder patients. This partnership with Dr. Kotler represents an important milestone in MAPS' effort to catalyze MDMA/PTSD research.

Dr. Kotler reports about the proposed research:

Post-Traumatic Stress Disorder (PTSD) is prevalent in Israel, a country with a high rate of war survivors and car accidents. Almost a third of the general population will be exposed to severe traumatic events during their lifetime. Ten to twenty percent of them will develop PTSD, a severe and highly distressful mental disorder. This disorder is relatively resistant to conventional psychological and biological therapies leading to many refractory chronic cases.

We propose to study implementing the use of MDMA assisted- psychotherapy in PTSD patients based on numerous previous reports where MDMA helped patients with severe mental pain following the exposure to traumatic events. Such a technique might help those patients to bring up painful repressed memories in the therapeutic encounter and also help them through the process of coping with traumatic memories.

The first stage in our proposed project will be designing a research protocol based on scientific grounds that will satisfy the local and state Review Boards. For this stage we will collaborate with a group of international scientists who have already gained rich experience in this field.

We hope that after the approval of the research protocol we will be able to proceed to the study phase where the use of MDMA in PTSD patients will be assessed and studied.

The Safety of MDMA in Cancer Patients Protocol

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The research team is revising the protocol according to recommendations which resulted from the most recent FDA review. In March 1998, MAPS donated $5,500 to Dr. Russell Poland, Harbor- UCLA Medical Center, to support this protocol redesign process. The revised protocol will be resubmitted to the FDA before the end of Summer 1998.

Changes which are being considered are using a more homogeneous population of cancer patients, increasing the number of subjects at each dose level of the study, restricting the subject life expectancy range, excluding medically treated hypertensives, and creating formal stopping rules. The proposed dose range for this safety study is 0.25 mg/kg to 2.25 mg/kg.

Serotonin and Dopamine System Interactions in the Reinforcing Properties of Psychostimulants: MDMA and d-amphetamine

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To date, there are no well designed, double blind studies of MDMA compared with prototypical psychostimulants or 5-HT releasing drugs. The main goal of this study is to increase our understanding of the interaction between serotonin (5-HT) and dopamine systems in mediating subjective, discriminative stimulus, and reinforcing effects of psychostimulant drugs in humans. It will provide important information about the effects of MDMA (see "Serotonin and dopamine system interaction in the reinforcing properties of psychostimulants: A research strategy," Manuel Tancer, M.D. and Charles R. Schuster, Ph.D., MAPS Bulletin Vol. VII No. 3, Summer 1997). This study has been approved for funding and is scheduled to begin in June 1998.

David Nichols, Ph.D., Purdue Department of Medicinal Chemistry and founder of the Heffter Research Institute, was able to provide ultrapure MDMA to the Wayne State research team from a supply of MDMA commissioned in 1985--by the organization that ultimately evolved into MAPS--for use in federally-approved research projects.

Two $1,000 Research Grants Awarded to Graduate Students

In February 1998, MAPS awarded a $1,000 stipend to Marcus Lumby, for travel to the Takiwasi Center in Tarapoto, Peru, in the context of his research into the biopsychosocial dynamics of the long-term attitude changes consequent to the ritualised near-death- type experience components of ayahuasca-based healing initiatives. Lumby is completing a Ph.D. in Social Anthropology at Cambridge University, "Religions of the Twice-Born: Northwest Amazonian Ayahuasca Shamanism and Near-Death Experience." His project will contribute to international multidisciplinary research initiatives investigating hallucinogenic plant-induced altered states of consciousness with a view to developing new therapeutic treatments in the West for a variety of mental disorders.

In March 1998, MAPS awarded a $1,000 grant to Roger Marsden, a Ph.D. student at the California Institute of Integral Studies. Marsden is completing a dissertation studying guided, structured group use of entheogenic medicines. The focus is on three groups with in-depth interviews of the guide and four participants in each group. Committee members are David Lukoff, Harrison Voigt and Richard Yensen.

The dissertation is now well past the half way point. The qualitative data will be worthy of a book after the completion of the dissertation stage. Marsden received a $6,000 grant from a family foundation to support his work in 1997.

Marijuana Research Update

In May 1998, MAPS donated $1,000 to Dr. Ethan Russo, University of Montana, for the preparation of a grant application to the National Institutes of Health for a study investigating the use of smoked marijuana and oral THC in the treatment of migraine headaches. Dr. Russo is currently the only researcher in the United States (of whom we are aware) trying to obtain an NIH grant to study the medical use of marijuana in a patient population. Dr. Russo's previous NIH grant application was rejected and he is submitting a revised application for the July 1 deadline. This latest $1,000 grant is for a statistician to do study sample size calculations for the revised protocol. MAPS has previously awarded Dr. Russo two grants for the preparation of the NIH applications: $1,500 in March 1998 and $3,500 in 1997.

The medical marijuana research of Dr. Donald Abrams, UC San Francisco, has finally begun. Dr. Abrams' protocol, "Short-term Effects of Cannabinoids in HIV Patients," was approved and awarded a $978,000 NIH grant in September 1997; a supply of marijuana will be provided by NIDA in conjunction with this grant. This study will take about two years to conduct. Subjects taking protease inhibitors will be hospitalized for almost a month, administered either smoked marijuana, oral THC or placebo, and extensively evaluated. An article by Dr. Abrams about the five and a half year effort to obtain approval for this study appears in the Journal of Psychoactive Drugs Vol. 30, No. 2, April-June 1998. (To obtain a copy of this issue, you can contact the JPD at 415-565-1904.) A comprehensive MAPS report on this effort with links to supporting documents, including the approved protocol, is online at www.maps.org/mmj/.

In other marijuana research news, MAPS and California NORML have co-sponsored an analysis of samples of marijuana used by medical marijuana patients around the country. Samples are being tested for levels of THC, CBD and CBN. Details will be reported in an upcoming MAPS Bulletin.

New on Ketamine

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The following article is likely to be of interest to MAPS readers:
Bowdle TA; Radant AD; Cowley DS; Kharasch ED; Strassman RJ; Roy-Byrne PP. "Psychedelic effects of ketamine in healthy volunteers: relationship to steady-state plasma concentrations." Anesthesiology, 1998 Jan, 88(1):82-8. Here is the abstract:

BACKGROUND: Ketamine has been associated with a unique spectrum of subjective "psychedelic" effects in patients emerging from anesthesia. This study quantified these effects of ketamine and related them to steady-state plasma concentrations.

METHODS: Ketamine or saline was administered in a single- blinded crossover protocol to 10 psychiatrically healthy volunteers using computer-assisted continuous infusion. A stepwise series of target plasma concentrations, 0, 50, 100, 150, and 200 ng/ml were maintained for 30 minutes each. After 20 minutes at each step, the volunteers completed a visual analog (VAS) rating of 13 symptom scales. Peripheral venous plasma ketamine concentrations were determined after 28 minutes at each step. One hour after discontinuation of the infusion, a psychological inventory, the Hallucinogen Rating Scale, was completed.

RESULTS: The relation of mean ketamine plasma concentrations to the target concentrations was highly linear, with a correlation coefficient of R=0.997 (P=0.0027). Ketamine produced dose- related psychedelic effects. The relation between steady-state ketamine plasma concentration and VAS scores was highly linear for all VAS items, with linear regression coefficients ranging from R=0.93 to 0.99 (P<0.024 to P<0.0005). Hallucinogen Rating Scale scores were similar to those found in a previous study with psychedelic doses of N,N-dimethyltryptamine, an illicit LSD-25-like drug.

CONCLUSIONS: Subanesthetic doses of ketamine produce psychedelic effects in healthy volunteers. The relation between steady-state venous plasma ketamine concentrations and effects is highly linear between 50 and 200 ng/ml.

One interesting aspect of the paper is the brief descriptions of the subjective effects of ketamine: Volunteers also had the opportunity to make written comments on the HRS form. Several of them described altered physical sensations or body image: "tingling sensation in the limbs, followed by numbness"; "floating, very carefree feelings throughout entire body"; "felt so different. Wasn't able to describe the way I was feeling"; "floating in space"; "almost complete annihilation of physical self, shrunken"; "dizzy, shaky lightheaded." One subject wrote the following summary: "The experience seems to be a mystical experience, an incomprehensible comprehension of of the universe. There seemed to be no past, present or future, no time, just existence. Life and death at the same time." It is a shame that psychopharmacology research (indeed, science in generally) so seldom attempts to measure religious or mystical experience.

The Heffter Review of Psychedelic Research Now Available

The Heffter Research Institute plans to continue publishing a review of psychedelic research. David Nichols and Mark Geyer will co-edit future volumes. The publications will be collections of short reviews by the Founders and Scientific Advisors of the Institute and other interested scientists. The topics may include anything related to consciousness, or the pharmacological, neurobiological, or clinical effects of psychedelic or other psychoactive drugs. Reviews are intended to be for a general readership of nonscientists who have a high level of education.

The Heffter Review is available from MAPS. (Price: $9.95 plus shipping. Within the United States add $3.00 shipping, outside the country add $6.00 shipping).

Rise of Hallucinogen Use Report

The National Institute of Justice (NIJ) October 1997 Research in Brief features the article "Rise of Hallucinogen Use" by Dana Hunt, Ph.D., Senior Scientist with Abt Associates, Inc. To request a copy of this report, you can call the NIJ at 800-851-3420. It is also available online at www.ncjrs.gov.

The report discusses the history of hallucinogen use in the United States, a comparison of past and present user groups, and the impact of today's use and distribution patterns on law enforcement and public health safety. Its target audience is drug enforcement and drug treatment practitioners, college and university officials, high school administrators, public health officials, drug policy coordinators, and researchers.

New Entheogen Review

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The Vernal Equinox issue of Entheogen Review is excellent. It is the first to be put out by the new editor, David Aardvark, who took over the helm from Jim DeKorne, who is busy writing and researching on the Kabbala. The Entheogen Review is now more scholarly and better researched, and they have gone to great lengths to try and answer readers questions thoroughly. For example, Alexander Shulgin was contacted to help clarify a few points regarding mushroom chemistry, and K. Trout is now the technical editor. K. Trout is the author of Trout's Notes, a series of over 20 papers that delves into the subjects of mescaline-containing cacti and tryptamines with impressive skill and attention to detail. The new ER has an in-depth article on Trichocereus peruvianus by K. Trout, complete with pictures showing the morphological differences of T. peruvianus plants from four different commercial sources and one botanical garden. This is the first time, to my knowledge, that such comparisons have been done. There is also an article by Terence McKenna on Salvia divinorum, plus book reviews and the usual thought provoking letters from subscribers.

Subscriptions to the Entheogen Review are $25.00 (USA), $35.00 (foreign) for one year (four issues). For subscriptions to ER, write to: Entheogen Review, 564 Mission St., Box 808-M, San Francisco, CA 94105-2918. The Entheogen Review is not available at newsstands, although a compilation of back issues is available from Mind Books, www.promind.com.

Psychoactivity: A Multidisciplinary Conference on Plants, Shamanism & States of Consciousness

A Multidisciplinary Conference on Plants, Shamanism & States of Consciousness, Amsterdam, Netherlands, October 1-4, 1998

Following the success of the first conference in San Luis Potosi in Mexico (1992), the second in Lleida, Catalunya, Spain (1994) and the third in San Francisco, USA (1996), an independent group of scientists, authors, and business people will convene a fourth conference in Amsterdam in this series on Shamanic Science. The focus of this conference, "Psycho-activity," will be visionary art, anthropology, botany, and psychotherapy. Talks, discussions, presentations, and extra-conference events are planned. One day will be devoted to discussing psychedelic rituals in the Netherlands, the political situation, and the past and future of psychedelics in European countries and around the world.

Confirmed speakers include: Sasha Shulgin, on the process of discovery of new psychedelics; Ann Shulgin, Donna Dryer, and Richard Yensen on MDMA and LSD-assisted psychotherapy; Jonathan Ott, on his studies of Jurema and Pharmahuasca; Ralph Metzner on LSD therapy and ecology; Christian Raetsch on the ethnology of psychoactivity; Alex Grey on connecting his visionary art to psychedelics; Paul Stamets on psilocybin mushrooms; Stacy Shaefer on recent research on peyote and Huichol women; Manuel Torres on the iconography of South American snuff tablets; and Peter de Smet on ritual enemas and snuffs in the Americas. More speakers are expected.

The conference fee is US$237.50 or Dutch 475.00 FL. Hotel and food are not included. Registration must be accompanied by Eurocheque or money order to: "Psychoactivity" c/o Conscious Dreams, Schinkelkade 59-61, 1075 VL Amsterdam, Netherlands. Fax: 31-20-470-7616 (31 is the country code). E-mail: codreams@xs4all.nl, Web: http://neturl.nl/codreams/. Cancellations before July 31, 1998, 50% refund. No refund for cancellations after this date will be granted. Space is limited to 500 people. Hotel reservations can be made through the Amsterdam Tourist Office, E-mail: vvvadam@pi.net.

ECSC/ECBS Update

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The European College for the Study of Consciousness/Europaeisches Collegium fuer BewuBtseinsstudien (ECSC/ECBS) held its annual membership meeting on November 29, 1997 near Stuttgart. Several members reported on the present state of psychedelic research in Switzerland and Germany.

Christian Beck reported very interesting details about the early history of MDMA from his research in the archives of Merck in Darmstadt, Germany. There is quite a lot of speculation and myth circulating about the early history of this unique entactogen, for example that it was developed as a appetite supressant--see the Reader's Forum note on the history of MDMA by Alex Gamma, MAPS Bulletin, Vol. VIII No. 1--and it seems that recently almost the same work on this topic has been done by two researchers independently.

MDMA was synthesized by Merck chemists as a precursor for a planned pharmaceutical production of Hydrastinin, an isochinoline derivative with vasoconstrictive properties. According to Christian Beck's research, the "birthname" of MDMA was Methylsafrylamin and its stimulant properties were not discovered by Merck until 1933. Details on early toxicology studies of MDMA and other findings by C. Beck will be published in the next Yearbook of Ethnomedicine and the Study of Consciousness, C. Raetsch and J. Baker (eds.), Verlag fuer Wissenschaft und Bildung (VWB), Berlin.

The Third International ECSC/ECBS "Worlds of Consciousness" conference will be held in Basel, Switzerland in the second half of 1999 (exact dates to be announced).

For more information about the European College for the Study of Consciousness, see their new website at http://ecbs.magnet.ch.

Wild Mushrooms Telluride

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Registration fees vary from $200 to $265. For more information, contact Fungophile, Inc., P.O. Box 480503, Denver, CO, 80248-0503, Tel/Fax (303) 296-9359.
Website: http://telluridemm.com/mushroom.html