Prescription: Euphoria
Posted by FoM on January 11, 2002 at 19:04:54 PT
By Carla Spartos
Source: Village Voice
He reclined on his bed, talking, while another man, a friend, looked on from
a nearby chair. The lights were dim, and the soft music floating in the
background had no lyrics to distract. Every so often, the friend responded
to his words, or, when the recorder stopped, replaced the cassette taping
their conversation. They went on this way, intimately, searchingly, for
eight hours.
"After the session, I found immediate relief," says Steven, a 32-year-old
director of a Washington, D.C.-based nonprofit, who, in May, suffered from a
series of panic attacks triggered by a terrible breakup.
Prone to low-level anxiety already, he found himself popping the sedative
Ativan several times a day just to cope. Then a friend suggested he try
Ecstasy. This would be the first of three times he would take two pills of
MDMA purely for therapeutic reasons. "The MDMA allowed me to look at
experiences otherwise too painful," says Steven, not his real name. "I was
able to more rationally observe my behavior, my relationships, my
responsibility in the breakup."
Before Ecstasy became illegal in 1985 and illicit recreational use bloomed,
MDMA was mainly a couch tool for a handful of therapists. For years,
supporters of medical MDMA have pointed to promising anecdotal evidence from
that era, saying the drug could help patients accomplish in a couple of
sessions what would otherwise take years. Some therapists have continued
relying on Ecstasy as an underground practice, and regular people have been
dosing on their own. Now the pro-Ecstasy lobby is getting a shot at turning
anecdote into fact.
In November, the Food and Drug Administration approved the first ever U.S.
study of Ecstasy as helpful medicine. Previous testing has centered not on
the drug's benefits, but on issues like how toxic it might be. These new
clinical trials-which may be held at the Medical University of South
Carolina-will measure the effectiveness of MDMA-assisted psychotherapy for
post-traumatic stress disorder. Twelve subjects, all victims of criminal
assault, will be given Ecstasy under the supervision of a doctor and then
put through a talk session; eight others will receive placebo sugar pills
before hitting the couch. Everyone will get 16 hours of drug-free therapy,
but supporters think the group taking Ecstasy will see great results.
"Think of MDMA as Prozac plus," says Rick Doblin, director of the
Multidisciplinary Association for Psychedelic Studies, the organization
funding the research. Like Prozac, Ecstasy boosts serotonin, the feel-good
neurotransmitter that regulates mood and other critical brain functions.
Proponents believe Ecstasy can also relieve pain, anxiety, and depression,
and researchers hope to study potential benefits of the drug for people
dealing with terminal illness. But while society approves of the myriad mood
enhancers regularly prescribed to millions of Americans each year, Ecstasy
is considered a scourge. "It's so hard to do research on, but so easy to buy
in clubs," says Dr. Julie Holland, a psychiatrist at Bellevue Hospital and
editor of Ecstasy: The Complete Guide.
Would-be MDMA researchers argue that the drug's ability to "open people up"
will make it a good candidate for PTSD sufferers, who often have trouble
discussing the traumatic events that haunt them. "It's kind of like
anesthesia during surgery," says Holland. "It allows you to remove this
malignant thing." Taking one or two pills of pure MDMA over the course of a
lifetime may be safe for some people, but it's not so attractive to
pharmaceutical companies. After all, drugs like Prozac turn a profit-and
lots of it, since patients need to take them every day. Unlike struggling
researchers, the wealthy manufacturers can afford an army of Capitol Hill
lobbyists to turn politicians' heads the other way.
Still, the FDA's decision to approve the study of an illegal substance is no
fluke. On November 27, Dr. Francisco Moreno of the University of Arizona at
Tucson began dosing subjects who suffer from obsessive-compulsive disorder
with psilocybin, the active ingredient in mushrooms. The government-approved
research is funded by MAPS and another psychedelic think tank, the Heffter
Research Institute. "For a quarter century, psychedelic researchers have
been locked out of the laboratory, but we're starting to get back in now,"
Doblin says. "Not in massive ways, but in important, small steps."
Scientists overseas are seeing progress, too. The Israeli Ministry of Health
has considered a protocol for treating victims of terrorist attacks with
Ecstasy-an idea with obvious implications for post- September 11 America.
For Isabel, a 27-year-old journalist living and working in Westchester, this
is a good thing. "It's like a truth serum," she explains. Isabel, not her
real name, took her first E two and half years ago and says she has done it
about 15 times since then, "sometimes at a club, sometimes just chilling at
home." She remembers sitting on a park bench, rolling on four pills, with a
friend. "He had liked me for a long time, but wouldn't come out and say it,"
she recalls. That night, they talked about how they felt. "It was freeing,"
she says.
Other drugs people routinely take-the aspirin, the cold medicine-come with
explicit instructions. For Ecstasy, it's not even possible to know exactly
what you're taking, and there's no doctor to warn against using too much.
Once, coming down off seven and a half pills, Isabel fell into a two-day
crying jag. "I felt depressed. Just sad."
The FDA's timing couldn't seem stranger. In July, Florida senator Bob Graham
introduced the Ecstasy Prevention Act of 2001, which would allocate more
than $22 million to heightened law enforcement, a "Just Say No"- type media
campaign, and the creation of a new Ecstasy drug test. The bill coincided
with a two-day conference at the National Institutes of Health that
summarily blasted MDMA.
"People who take a single, oral dose of Ecstasy run the risk of partial
brain serotonin injury," Dr. George Ricaurte, a leading MDMA researcher at
Johns Hopkins Medical Institutions, told the audience.
Federal law-enforcement officials have been busy, too. In October, the Drug
Enforcement Agency seized 48,000 Ecstasy pills during Operation Triple X.
Displaying no compassion for compassionate use, the DEA raided the Los
Angeles Cannabis Resource Center a week later, confiscating the
medical-marijuana outfit's computers, patient records, and pot plants. It
was California's third such crackdown in a month. A serious blow had been
dealt to medical-marijuana supporters. Or so it seemed.
A day after psilocybin was being doled out to patients in Arizona, the DEA
gave final approval for two medical-marijuana studies, the first of several
planned by the University of California's Center for Medicinal Cannabis
Research. The center just got a DEA-issued certificate allowing it to obtain
legal, government-grade pot from the National Institute on Drug Abuse
(NIDA). And if the results look promising? "We may see some [reclassifying
of marijuana] if there is reason to believe there are legitimate medical
reasons," says Donald Thornhill, a DEA spokesman in San Diego.
The real source of these changing attitudes is the FDA. According to Dr.
David E. Nichols, president of the Heffter Institute and a professor of
pharmacology at Purdue University, the groundwork for much of the current
research was laid in the mid '90s, when the FDA approved psychiatry
professor Dr. Rick Strassman's studies with DMT, a potent hallucinogen, at
the University of New Mexico. "There was a lot of dialogue in the FDA that
there should be no different requirements with these drugs, which is the way
the FDA should have always been operating," explains Nichols.
In a government bent on eradicating illegal drugs, the FDA may be the agency
most immune to political pressures. It's made up of scientists whose mission
is to help develop medicine, and they're open to the idea that any given
compound is not entirely good or bad. Just listen to the words of Katherine
Bonson, a pharmacologist who addressed an Ecstasy conference organized by
the Lindesmith Center in February. Since her post at the FDA prevented her
from discussing any particular drug, Bonson spoke of a "Drug X," in remarks
now catalogued online -- http://www.drugpolicy.org/ecstasy_conf
"It's unclear whether this alleged Drug X could actually be approved,
because we don't have any data," said Bonson, who stressed that she was
speaking as an independent scientist rather than as an FDA official. "That's
the take-home message. We really need to see something. So if you give us
data that makes it look like a good drug, we'll approve that drug."
If the FDA has been viewed by many as an agency guided by reason and not
politics, its next of kin-NIDA-has been held in less esteem. "I think of
NIDA as science in the service of repression," says Doblin. "They want to
know what's wrong with these drugs and how they can use the data to justify
the drug war."
Proponents of medical MDMA accused NIDA of shutting them out of the July
conference. "They didn't want anyone talking there that would diverge from
the party line," says Dr. Charles Grob, director of child and adolescent
psychiatry at Harbor-UCLA Medical Center, who headed up the first
FDA-approved research with MDMA. That 1994 study was to have considered
benefits for cancer patients. Preliminary research showed the drug was safe
enough for more testing, Grob says, but FDA resistance effectively shelved
the project.
Nearly a decade later, the party line still seemed to be that Ecstasy was
unequivocally harmful. "Maybe this drug will be called 'despair' in the
future," said chairman Jerry Frankenheim during the government conference's
closing remarks.
So how did the scientists behind the new trials get past the gloomy
prognostics? For starters, they were able to gather statistics showing MDMA
was safe at the proposed doses and wouldn't cause the harm to memory feared
by the government. A leading researcher in the field of Ecstasy and memory
wrote a letter of support. And, perhaps most important, the protocol
mimicked drug giant Pfizer's trials for the antidepressant Zoloft. All of
that seem to sway the FDA, opening the door for research.
In the end, other agencies will have to follow the FDA's lead. "If the MDMA
study has been approved through the proper channels, we really don't have a
say in it," says the DEA's Agent Thornhill. Even NIDA, which Doblin says
refused to provide psilocybin for the University of Arizona study, is not
impenetrable-at least on paper. "It's easy to say that the government isn't
approving studies because they're politically incorrect," says Dr. Alan
Leshner, former NIDA director. "The government may say yes."
Scientists hoping to study taboo drugs like MDMA must continue to jump
through bureaucratic hoops. The success of the movement has relied heavily
on trading tie-dyes for ties, and paranoia for faith in
paperwork-Investigational New Drug applications, Schedule I permits, and
outlines for good manufacturing procedures, to name a few. A model for
psychedelic scientists has been the Center for Medicinal Cannabis Research,
created in 2000 by California's state legislature to make studying medical
marijuana easier. "The reason we needed a center established is no one
scientist can easily navigate the regulatory process," explains the
director, Dr. Igor Grant.
Still, for medical-MDMA researchers, who have no state initiative and no
mass base of support, the barriers are higher. Researchers like the Heffter
Institute's Nichols seem antsy about impending controversy. Initial media
attention has upset officials at the University of South Carolina, and
Nichols worries "congressmen and angry drug warriors" may have the last
word. Rick Doblin, however, remains undeterred in his $5 million, five-year
plan to develop MDMA as a prescription medicine. He's got patience, he's
raising money, and he may surprise a lot of his detractors. He's done it
before. "I think we can demonstrate that our society can handle this type of
research," says Doblin. "We have to craft messages based on truth."
Note: New Research Brings Ecstasy Back to the Couch.
Source: Village Voice (NY)
Author: Carla Spartos
Published: Week of January 9 - 15, 2002
Copyright: 2002 VV Publishing Corporation
Contact: editor@xxxxxxxxxxxxxxxx
Website: http://www.villagevoice.com/
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