A MAPS History of MDMA
MDMA was synthesized in 1912 and patented in Germany by Merck in 1914 but
was not the subject of human
research at that time. In the 1950s it was briefly researched by the U.S. Government as
part of the CIA's and the Army's chemical warfare investigations. It was forgotten until
the middle 1970s when it was rediscovered by the psychedelic therapy community and
began to be used as an adjunct to
psychotherapy by psychiatrists and therapists who were familiar with the field of
psychedelic psychotherapy. MAPS published a book,
The Secret Chief, about the leader of this therapy
community.
In the early 1980s, the drug began to be used non-medically, particularly in Texas, under
the name Ecstasy. Both the non-medical and therapeutic use of MDMA were made illegal in
1985 despite the Drug Enforcement Administration Administrative Law Judge Francis
Young's
recommendation that
physicians be permitted to continue to administer it to their patients.
Rick Doblin, Alise Agar and Debby
Harlow helped coordinate the pro-MDMA contingent in the DEA lawsuit. For an excellent
history of the early use of MDMA, see Pursuit of Ecstasy by Beck and Rosenbaum.
In 1986, with the goal of developing MDMA's therapeutic potential through
FDA-approved protocols, a non-profit organization opened a Drug Master File
for MDMA with data gathered from the standard preclinical animal toxicity
studies required by FDA. Five different applications for permission to
conduct research with MDMA were submitted to FDA between 1986 to 1988, to the
Neuropharmacologic Drug Products Division directed by Dr. Paul Leber. All
five applications were rejected. Three protocols for double-blind
controlled trials were from researchers at, respectively, Harvard Medical
School, UC San Francisco Medical School, and U. of New Mexico Medical School,
and were all rejected. Two applications submitted by individual physicians
were for single case studies, one for a terminal cancer patient who had been
successfully treated for pain with MDMA-assisted psychotherapy prior to the
criminalization of MDMA and the other for a unipolar depression patient for
whom all available treatments had been attempted without success. Both of
these single-patient INDs were also rejected. The FDA based its rationale for
rejecting all protocols and single case studies on the hypothetical risk of
functional consequences of potential neurotoxicity from MDMA Proponents of
MDMA research claimed that the rejection of all efforts to conduct
FDA-approved MDMA research was based not on rational risk/benefit assessments
but on an underlying cultural prejudice against medical research with drugs
that were criminalized and on one or more FDA officials' personal opposition
to human research with psychedelics. Since FDA Review Divisions are sometimes
described as operating like fiefdoms
under the control of their Directors, proponents felt profoundly stymied.
Proponents claimed that concerns about MDMA neurotoxicity, which numerous
studies had failed to link with functional or behavioral consequence and
which in any case had not been clearly demonstrated to occur at all at
therapeutic does levels, were reminiscent of scientific research in the
1960s that claimed to prove that LSD damaged chromosomes. These reports
were effective in generating public disapproval of LSD and in hindering
research but were later determined to have no clinically significant effect.
In 1992, FDA reviewed a MAPS-supported protocol
submitted by Dr. Charles
Grob, then at UC Irvine, for a study of the use of MDMA in the treatment of
pain, anxiety and depression in cancer patients. FDA's Drug Abuse Advisory
Committee recommended that the cancer patient study be postponed and that a
Phase 1 dose-response safety study be conducted first. The protocol was
redesigned, with FDA giving final approval for the Phase 1 safety study on
November 5, 1992. The safety study was completed in 1995. Data from the safety study
revealed no unusual risks and indicated that MDMA could be safely
administered within a clinical research context. Dr. Grob submitted the first
draft of the protocol for the study of cancer patients
in 1997. Negotiations
with FDA moved very slowly, due to initial FDA decisions to put MDMA
psychotherapy research on a slow track to nowhere. However, FDA opposition
eventually lessened as MAPS and Dr. Grob persisted in our efforts to obtain
permission for research into the use of MDMA-assisted psychotherapy in cancer
patients.
Back to the MDMA Page