DOCTOR X

Rick Doblin spent high school reading big novels and thinking about big
issues like the Vietnam War and worrying about big things like when he'd be
able to muster up the courage to ask a girl for a date. Not long after his
1971 arrival as a freshman on the campus of New College in Sarasota,
Florida, however, he discovered LSD and mescaline.

He suddenly found himself tripping under the palm trees, dancing all night,
jumping into the coed naked pool at dawn and generally slipping the
shackles of his suburban Chicago upbringing. It was, in many ways, a
typical college education of the early Seventies, and it had a typical
ending: Doblin lasted but one semester. "And that's not the worst of it, "
he says. "There were three semesters in a year. I barely lasted three months."

Not that Doblin hasn't rehabilitated himself since then in fact, we are
standing atop one of his rehab projects right now: a house built when he
was twenty-one years old, when he was so shattered that merely "to do
something and go to sleep and come back the next day and find that it was
still there was a great comfort." Nearly thirty years later, it's still
there, and easy to find: You drive down a street in a typical Florida
neighborhood of stucco ranches and bungalows with red-tiled roofs and lawns
carefully cut around palm trees until a vestige of jungle appears on your
right, and behind the tangle of green you can just make out a cedar-sided,
rambling two-story house.

A knock on the fortresslike double door produces Doblin, a short,
well-built man with a mop of curly hair who greets you with a hug and an
elfin grin that makes him look younger than his forty-seven years.

He proudly users you into one of the strangest interior spaces you've ever
seen.

You go into the living room and stand in front of a granite fireplace, its
soaring chimney adorned by carved wooden idols.

You wander through the warren of spaces demarcated by wooden walls on
wheels, notice the double bed hanging from chains beneath a skylight, the
mandala inlay in a wall, the hand-carved mushroom switch plates, the
gorgeous stained-glass windows, the riot of oblique angles.

You climb the twisting staircase into the six-sided master bedroom that
sits top and center, then up a ladder and out a window and up another
ladder to the terrace astride the roof, all the while listening to Doblin's
nonstop narration of the theory and meaning behind the million details of
this Frank Lloyd Wright-on-acid design, and you can't help but think that
what he is saying is true: that his house beckons you onward and upward and
further and deeper into a world behind the world.

And then you realize something else: The house, which Doblin has named
Arcturus, not only embodies psychedelic drugs' universe-in-a-nutshell
consciousness, it would be the perfect place to achieve it. Which is the
point, he is quick to say. After he dropped out of school, he traveled for
a few months, then returned to Sarasota and began to build a life, and
eventually a house, that would have the ongoing, serious, intentional use
of psychedelic drugs at its heart.

"I spent the next ten years reading, tripping and building," he says.

But it wasn't just about getting high. "I thought " there was a link
between the things I was doing with psychedelics and certain types of
altruistic social consciousness and action" - a thought that has inspired
him to go where few psychedelic warriors have gone before: into the halls
of government regulatory agencies, where he is attempting to get one of his
favorite psychedelic drugs, MDMA, approved for prescription use.

Doblin thinks that MDMA is a unique, and uniquely beneficial, medicine.

He says that because it creates a sense of well-being and fosters empathy
and introspection without the risk of the frightening cognitive and
perceptual distortions of other psychedelics, it can be a powerful aid to
psychotherapy, one that "can be used in any situation in which people have
to confront difficult, emotionally challenging issues, in which avoidance
is likely and insight will be helpful." This, he claims, makes the drug
particularly useful in psychiatric conditions such as post-traumatic stress
disorder, in which, it is thought, the daunting task of coming to terms
with traumas like sexual assault is more than a person can face.

He also claims to have used the drug to help people dying from terminal
illness handle their anxiety and depression and difficulty talking with
their families.

He says it's also benefited couples whose marriages are on the rocks, and
the "worried well" people whose difficulties are below the threshold of
psychiatric illness but are nonetheless likely to be the occasion or a trip
to the therapist or a prescription for Prozac. And, Doblin adds, MDMA "can
help us to study love and self-acceptance, to open a scientific window on
processes that are a central part of human nature."

These beliefs lie behind the task to which he has devoted himself for the
past fifteen years.

As the head of the Multidisciplinary Association for Psychedelic Studies -
a nonprofit drug company whose headquarters are in Arcturus - he has
doggedly pursued his ultimate goal: to make MDMA, which you may know as
Ecstasy, safely and freely available to people who need it for medical
purposes.

This part of Doblin's rehabilitation is not finished yet, but he's closer
than you might think, closer than most people know.

Before techno and trance, before the all-night rave, before it was the
scourge of anxious parents and grim law-enforcement officials, before it
was even called Ecstasy, MDMA, officially known as
3,4-methylenedioxymethamphetamine, was a favorite drug among a
little-known, quasi-clandestine group of psychedelic therapists
psychiatrists, psychologists and counselors scattered around the country.

Many of them had long used drugs such as LSD and mescaline in their
professions sometimes exclusively, sometimes as part of a more mainstream
practice.

Indeed, one of the first proposed uses for psychedelics was as psychiatric
medicines; they had shown great promise in the 1950s and 1960s,
particularly in the treatment of addictions. They had been the subject of
many research projects, some of them infamous, particularly those run by
Dr. Timothy Leary and his colleagues at Harvard.

But it wasn't long before Leary, in full messianic mode, tried to bring the
new tablets out of the academy and directly to the people.

Psychedelics spilled out into the street, and the nation was swept by
hysteria about broken chromosomes and defenestrated daughters.

In 1970, the Controlled Substances Act made most of the drugs illegal and
drove underground the few therapists willing to take the risk. But MDMA
wasn't known well enough to be made illegal.

So, not only was it a powerful therapeutic agent that rarely had negative
side effects, it also could be used without the fear of arrest and
imprisonment. And when it was "discovered" in the mid-1970s it had actually
been synthesized by Merck in 1912, for unknown purposes it caused a small
renaissance in the psychedelic-therapy profession.

Like Prozac, MDMA mainly affects the body's levels of a chemical called
serotonin. Also, like Prozac, scientists can't fully explain why MDMA does
what it does. We do know that while serotonin is manufactured everywhere in
the body, in the brain it has a particularly important role: It is one of
the neurotransmitters, the chemicals that carry nerve impulses (and, it is
thought, information) across the synapses - the gaps between brain cells.
Increases or decreases in serotonin strongly affect mood, sleep and
appetite. Large changes in serotonin can lead to hallucinations and other
altered states of consciousness.

MDMA's effect on the brain is to hyperstimulate serotonin manufacture. The
torrent that is unleashed brings about a state of consciousness in which it
is difficult to feel anxious or depressed, or anything other than love and
warmth and good will toward oneself and one's fellow human beings.

This is the quality that got the attention of psychotherapists, some of
whom have written of their work. Typically, they would give the drug to
clients in an intensive, daylong session in which the barriers, both
interpersonal and intrapsychic, which often make therapy slow going, were
quickly and easily lowered.

These accounts suggest that a client, buoyed by a sense of trust in both
himself and his therapist, could talk about his deepest fears and
misgivings about himself, relive his traumas and let them go, recover lost
memories, see his problems in a new and constructive light and experience
what life would be like if he were relieved of all anxiety. Therapists
claimed that a single MDMA session, perhaps followed by infrequent
"boosters" and coupled with talk therapies, could relieve depression and
anxiety for a long time, perhaps even permanently.

One such case study comes from a therapist who calls herself Alice, and her
client Dan. Dan was mildly depressed and prone to panic attacks; he also
had unexplained shooting pains in his legs that plagued him whenever he
flew which his job required him to do often.

Dan had been in traditional therapy for about seven months, with little
progress, when he agreed to an MDMA session.

In the course of the session, Dan recalled something long forgotten: When
he was in second grade, a ceiling had collapsed on his classroom and
trapped him by the legs under his desk. His father, who was the school
principal, and mother had refused to discuss the matter, urged him to put
it out of his mind which he had done, with the result, according to Alice,
that he suffered from a typical post-traumatic stress reaction: low-grade
anxiety and depression, mysterious physical symptoms and difficulty getting
better. Dan never took MDMA again, but a year later he reported that the
leg pains were gone, he anxiety was greatly reduced, he had fallen in love
and was getting married.

Whether stories like this are mere anecdote or part of a record that lends
scientific credence to the therapeutic claims about MDMA is unknown partly
because the therapists who used it, mindful of what happened with LSD and
psilocybin, kept their work very quiet.

But still the drug slipped out, turning up on college campuses and in
nightclubs (and acquiring its familiar nickname) in the early Eighties. In
July 1984, the Drug Enforcement Administration declared its intent to
outlaw it. The MDMA therapists had been so quiet that the DEA was taken by
surprise when it was served with a petition, signed by researchers and
clinicians (and hand-delivered by Rick Doblin, who was once again a college
student, now getting academic credit for helping to sue the DEA), asking
for a hearing on the subject, which was held in 1985.

After a tumultuous three years, and despite an administrative-law judge's
recommendation that MDMA be made a regular prescription drug, the DEA
prevailed, and MDMA was permanently placed on Schedule One in 1988, the
same category designated for heroin and marijuana.

Some therapists continue to practice with MDMA - for instance, a married
couple whom I will call Charles and Virginia. They met with me in one of
the offices on the West Coast where they practice psychedelic therapy -
entirely illegally.

Charles is in his late forties, Virginia is fifty.

Both have advanced degrees and many years of training as psychedelic
therapists.

They work largely with clients referred by a network of psychiatrists and
psychologists - mostly people who have not been able to overcome their
problems in any other way. ("They're desperate when they come to us,"
Charles says.) The couple speaks with a measured clarity and professional
precision that is not unlike what you would expect from their law-abiding
colleagues in a discussion about Prozac and Xanax.

In the last decade, Charles and Virginia say they have administered to more
than 500 people the whole range of psychedelic drugs in a three-day
treatment: The first day is spent getting to know the client, finding out
what they want to get out of the treatment and deciding what drug is best
for them. ("The drugs are like surgical tools - once we understand the
person, we can say that MDMA or LSD or psilocybin is the right one," says
Charles.) The second day is the "session work," during which the therapists
guide the patient through the drug experience, encouraging them to face the
psychological difficulties they encounter, offering whatever help and
support and insight they can. The third day is for debriefing, for starting
the process of integrating the experience into their everyday lives.

And sometimes the third day turns into a fourth and fifth "We don't send
them back until they're ready to go," Virginia says.

"MDMA is very different from the other drugs," she adds. "It gives a
framework, a safety net. It's really good to start psychedelic work with."
Beginner drug or not, "MDMA give you a brand-new relationship with
yourself," she says something that is very helpful in a case like the one
that Charles described.

A man came to see them, and after his first MDMA experience, started having
strange dreams.

In the second session, they encouraged him to explore the images from those
dreams, Charles says, to "really let himself stay with them and see what
they meant to him, and the memories came back. When he was thirteen or
fourteen, his uncle abused him. All this stuff came at him. And it
triggered something very helpful in his life. He looked at his relationship
to his sexuality, to women, to men. His marriage was falling apart, he was
screwing around, he had a hard time being honest, and this one experience
shifted his whole outlook.

He's still married, he's happy.

He did the sailboat trip he wanted to do all his life. But he needed this
powerful therapy to get his life in order."

Charles and Virginia are not the only people practicing psychedelic
therapy. "The West Coast is full of people doing it," Charles says.

The story of legalized MDMA, if it ever comes to pass, will have to be told
by starting with Rick Doblin's own drug tales, about which he is
open disarmingly so. These aren't the war stories of a twelve-step
meeting, or the half-regretful, half-nostalgic accounts of youthful
experiments gone awry. They're stories about what makes a man undertake the
task of getting the United States government to give its seal of approval
to a psychedelic drug.

We're out in the full and unrelenting sun of a Sarasota summer, and we're
talking about his first semester at New College, when he was tripping
frequently (many times on the same sunbaked wall on which we are sitting).
It wasn't all good times, though.

In fact, it was the bad trips, some of them harrowing, that started Doblin
down his strange path. A counselor at school, hearing Doblin's account of a
bad trip (and his wish to figure out how he could get back on good trips)
gave him a copy of Realms of the Human Unconscious, a book by psychiatrist
Stanislav Grof, one of the leading psychedelic researchers of the Sixties.
Under the book's influence, Doblin came to feel that he had set himself
unwittingly on a therapeutic course, that his bad trips were the result of
his alienated emotional life and that his task was to make himself whole a
process that could be aided by psychedelic drugs and that would make their
use more rewarding in the bargain.

Doblin's quest for wholeness didn't allow him to settle for a life of
navel-gazing on the margins of society, waiting for the day when the whole
world would change. "This is not a revolution," he proclaims. "Leary's idea
of revolution is that you start fresh and then it's glorious paradise for
everyone. You're all enlightened because you had this one experience. But
the idea that there's an away we can all go to, that that's somehow an
ethical choice when there's such struggles going on in the world, that's a
mistake. I'm trying hard for the opposite, which is integration."

The key to Doblin's hopes to integrate MDMA into the mainstream is
science generating the data that will prove the claims about the drug's
therapeutic value.

But scientific inquiry, for Doblin, is no mere game to be played because
the authorities require it; nor is it a reduction of the cosmic
significance of psychedelic insight to the mundane terms of a textbook.

Rather, he says, "Science is holy," a maxim that came to him when he
witnessed some of the early research into MDMA neurotoxicity. Doblin had
arranged for studies to be done on the effect of the drug on dogs'
brains research that required them to be killed.

He describes watching the scientists euthanizing the dogs, then opening
their skulls and removing their brains.

"I felt that there was something so feeble and pathetic about our attempt
to understand life in these simple ways," he says, "but I also felt there
was something sacred about this that these procedures were the mind of man
trying to make sure that what we found was really out there rather than
what we wanted to be out there."

Taking the name of science in vain was, according to Doblin, among Leary's
biggest mistakes.

Investigating one of Leary's best-known studies which claimed that prison
inmates who were given psilocybin shortly prior to their release had lower
recidivism rates than other parolees he discovered that Leary had
manipulated the statistics so they would say what he wanted them to say.
Doblin is distressed by this, perhaps most by what it reveals about Leary's
character and how that stacks up against Doblin's sense of the lessons of
psychedelic drugs.

"Tim flitted on the surfaces, kept busy to keep away from things that were
deep and painful.

His message was, 'You'll take drugs and then you'll know.' The part about
how you think you're dying, going crazy the struggle was left out." Doblin
shakes his head, and for a moment he sounds sad. "I've been inspired by
him, but he covered up the dark side. Leary rose to the level of fraud."

MDMA may not make you feel like you're dying, but it may still have a very
troublesome side one that Doblin does not deny, despite the threat it
poses to his cause; MDMA may be dangerous.

Some of the danger is not directly the result of the drug's action.
Tolerance develops very quickly, so frequent users have to rapidly increase
their dosage, which leads to an increase in the amphetamine load the drug
puts on their bodies.

A large dose, followed by vigorous dancing and alcohol consumption in a
poorly ventilated room the typical conditions of a rave can lead to
dehydration, high fever, seizure, organ failure and death; according to
government statistics, forty-seven people may have died in this fashion in
1999 (the last year for which statistics are available), and there were
2,850 Ecstasy-related emergency-room visits that same year.

Doblin's company, MAPS, takes the position that MDMA's risks can be
minimized. They are a major supporter of DanceSafe, an organization that,
among other things, sets up a small chemistry lab at raves to test the
purity of ravers' Ecstasy tablets and provide information on the dangers of
dehydration and overheating. But Alan Leshner, director of the National
Institutes on Drug Abuse, doesn't believe that harm-reduction measures can
make MDMA safe. "You can't create that [low-risk] situation on a reliable
basis," he told me. "You don't have control over a club. You only have
control over the substance that an individual is taking." People ought to
be prevented from taking the drug, he adds, because "the data shows us that
[MDMA] produces long-term changes to serotonin function.
That sends to me a simple message this is risky behavior."

MAPS may be moving a little closer to finding out about the risks and
benefits of MDMA in humans, at least for medical use. In 1999, Doblin
received a letter from the FDA indicating that he has moved a little closer
to his goal. The agency "has decided to allow the sponsor [MAPS] to
undertake a proof-of-principle study without further preclinical data." In
plain English, this means that the FDA, on the basis of its analysis of the
data (some of it generated by MAPS-supported research) about MDMA's
neurological effects, has decided that it is safe enough to give to humans
in order to investigate its therapeutic effects.

A MAPS-supported researcher has already designed a study of the effects of
MDMA on pain and depression in terminal cancer patients.

MAPS is helping to run a research project in Madrid in which MDMA is being
used to treat female victims of sexual abuse who suffer from post-traumatic
stress disorder, and FDA approval is being sought for a similar trial in
this country.

If studies like these can be implemented, and if the results are positive,
then even officials like Alan Leshner will be hard-pressed to continue
their opposition to the drug, at least for medical purposes. "If it works;
if it's a good randomized, controlled clinical trial; if it meets all the
criteria and it's a good medicine, wonderful use it as a prescribed
medicine," Leshner tells me.

If Rick Doblin gets his way, there will be more human studies, and MDMA,
should it prove effective, will eventually get approved as a prescription
drug. He is uniquely prepared for this outcome his Harvard doctoral
dissertation includes a plan for how to regulate and bring to market a
psychedelic drug. He thinks that a first MDMA will have to be stringently
regulated, available only by direct mail to specially certified clinics
that will administer the drug on-site and carefully prescreen and monitor
their patients.

But unlike some medical-marijuana crusaders, Doblin freely acknowledges
that therapeutic use is only the first step toward greater freedom, toward
a policy that encompasses both the benefits and risks of psychedelic drugs
to self and society.

He even envisions a licensing process, in which people who have used
psychedelics under supervision without incident and who have no history of
mental illness get a license to buy and take the drugs independent of any
physician or clinic.

The government would provide neutral information about the dangers of
drugs, and drug users would take it seriously, rather than ignoring the
hyperbolic claims that currently issue from federal and state agencies.

Users who abuse the drugs (and Doblin is clear that MDMA, like any drug,
can be abused) would lose their licenses. It's a loopy idea, to be sure,
but no more loopy than the idea of spending $18 billion a year to make sure
that citizens get high only on alcohol, nicotine, caffeine and Prozac.

"This is just the first step, getting the culture ready," Doblin says. "It
may take another decade or generation or even two generations, but there
will come a point in time when we can introduce people to the idea of
therapeutic use of psychedelic drugs, and they won't be as likely to freak
out. They'll see people who have gone through it and say 'Look at this guy.
He's supposedly healthy and experienced, and he's used these drugs.' "
Doblin, in may respects, is that guy, and he says he won't rest until his
life-long rehab project is complete.

[sidebar]

The Ecstasy and the agony: The Penalty Gets Tougher

Effective May 1st, the United States Sentencing Commission, as instructed
by congress, will adopt an emergency amendment to increase the penalty for
selling Ecstasy. The severity of the sentence is determined primarily by
weight of the drug in question: It used to be if you were caught with
around three kilograms (11,000 Ecstasy pills) or more, you'd get five years
behind bars. The new guidelines require the same sentence for just 200
grams 800 pills.

That's what you'd serve if you were caught with 220 pounds of marijuana, or
100 grams of heroin enough to shoot up 3,300 times. To make another
comparison, in 1999 there 85,000 heroin-related emergency-room visits in
the U.S., compared with 2,850 Ecstasy-related hospital trips the same year.
Citing this statistic, the Federation of American Scientists, whose members
include Nixon drug czar Jerome Jaffe, recommended to the USSC that, for
sentencing purposes, ten doses of MDMA should be made comparable to just
one dose of heroin.

The new propsed sentencing guidelines, a FAS statement says, will "divert
enforcement resources away from heroin, cocaine and methamphetamine toward
MDMA. The result of such a diversion [will] make the overall drug-abuse
problem worse."

- - David Malley