Breaking the Drug Taboo:

GROUP OF TRAUMATIZED VETERANS GET EXPERIMENTAL ECSTASY TREATMENT

"We need to be positioning ourselves now to provide the assistance
that our veterans need," said House Committee on Veterans' Affairs
chairman Bob Filner (D-CA) during a hearing, called "Stopping
Suicides: Examining the Mental Health Challenges Facing the
Department of Veterans Affairs," held in December 2007. "Not only for
those brave men and women who are returning home from Iraq and
Afghanistan, but also for our veterans from previous conflicts. We
cannot afford to put this issue off."

Filner's choice of words is instructive, as are his sentiments: With
upwards of 25 million veterans in the United States, not counting
those overseas in the morally murky theater of Iraq and Afghanistan
who may return home sometime after the 2008 presidential election,
that's a lot of assistance and funding needed to head off what he
called a "rate of veteran suicide [that] has reached epidemic
proportions," to the point that it has doubled the suicide rate of
civilians. Safeguards already put into place have failed, for a
variety of reasons, and given the severity of the mental and physical
problems carried by returning soldiers, some daring out-of-the-box
thinking is not only desperately needed, but required.

Enter the Multidisciplinary Association for Psychedelic Studies
(MAPS), and its currently funded trials using
3,4-methylenedioxy-N-methamphetamine -- otherwise known as MDMA, or
ecstasy -- to treat post-traumatic stress disorder (PTSD). Although
the U.S. Army had carried out lethal dose studies of MDMA back in the
1950s, work which was not classified until the close of the 1960s, it
was only centered on animals and was mixed in with a variety of other
compounds. At the closure of that research, MDMA languished in
clinical obscurity until its rise as a club drug in the '80s and '90s
brought it the kind of attention that dooms better drugs to Schedule
I classifications -- that is, illegality -- and lesser drugs to
approval by the Food and Drug Administration (FDA). But MAPS founder
and president Rick Doblin became aware of MDMA in 1982, and since
then has been convinced of its therapeutic uses. Accordingly, his
organization has coordinated and/or funded recent studies into MDMA
treatment of PTSD and has its eyes set on a higher goal.

"We're looking to make MDMA into a prescription medication in the
United States, United Kingdom and elsewhere," he explained by phone.

So far, MAPS has gone a long way to helping legitimize MDMA treatment
for PTSD, as well as anxiety in cancer patients and more. The
organization is supporting and funding Dr. Michael Mithoefer's
double-blind sessions and protocol on MDMA/PTSD, initially approved
by the FDA in 2001 and due to conclude this June, as well as
co-sponsoring a pilot MDMA/PTSD study with the Swiss Medical
Association for Psycholytic Therapy and coordinating research at
Harvard Medical School's McLean Hospital into MDMA's ability to aid
the suffering of terminal cancer patients.

In short, MAPS is putting its money where your mouth is, in hopes of
saving your brain and heart. And their help can't come fast enough,
given hundreds of thousands of troops have already returned home from
Iraq and Afghanistan to face everything from a possible economic
recession to homelessness, homicide and suicide, with hundreds of
thousands on the way behind them. According to some estimates,
America can expect a minimum of 300,000 cases of PTSD, at a cost of
over $600 billion, rivaling the cost of the wars themselves. And
that's just the military wing of PTSD's vast network, which leans all
too heavily on those who have suffered horrific experiences such as
rape, violence, abuse and more. Post-traumatic stress disorder is a
deadly assassin when it comes to the humanity's overall mental
health, and its costs are extensive and lasting. This is why some
physicians and professionals are keeping an eye on MDMA treatment,
which so far has proven to be almost uniformly successful in helping
patients work through their crippling traumas with the help of
ecstasy's cathartic yet calming influence.

"I've seen each and every one of these patients, and, just as a
clinical psychologist, it is impressive to see the degree of
treatment response these folks have had," explained testing expert
Mark Wagner, a clinical psychologist at the Medical University of
South Carolina, to the Washington Post after serving as an
independent evaluator of Mithoefer's work. "I didn't see a single
individual who thought: 'Oh, yeah, this is great fun. I'm going to
try to go out and use this for recreational use.' All of them took
this very seriously and therapeutically."

Indeed, out of all of the MDMA research underway, it seems to be
Mithoefer's work, conducted in a warmly lit cottage in South Carolina
with his wife and registered nurse Annie, that seems best positioned
to aid MDMA's American crossover from a Schedule I danger to a
FDA-approved wonder drug. But that's just the beginning of a long,
bureaucratically tangled road to redemption. "Michael's study is the
furthest along," added Doblin, "and after June, we'll do the data
analysis and submit our findings to the FDA. After that, we will work
with the FDA to come up with ideas about phase three studies, and
that's when we have to spend the millions of dollars and treat
hundreds of patients."

Mithoefer's current study, in phase two and working with barely over
20 patients, is crucial, according to Doblin, "to prove safety and
efficacy." Safety and efficacy are the prime obstacles standing in
MAPS and MDMA's way, especially since the drug was given the Schedule
I assignation in 1985, shortly after it was nicknamed "ecstasy" in
1984. Since then, studies have come and gone in hopes of proving its
lethality, but, as with its cousin-in-controversy cannabis, nothing
conclusive came of it. Doblin, Mithoefer and other interested
physicians and figures from around the world have stepped forward to
subject it to rigorous testing, and have found little to complain
about. In fact, they've found quite a bit to celebrate, which has not
sat well with the shrinking contingency of drug warriors intent on
keeping MDMA from people who may need it.

"I find it important to discriminate between medical research and
drug policy," asserted Pal-Orjan Johansen, a Ph.D. candidate at the
Norwegian University of Science and Technology's department of
psychology who has worked with Michael and Annie Mithoefer on MDMA
treatment and research, via email. "One area cannot be used to
promote the other, and vice versa. It is inconsistent with
traditional medical ethics or outright unethical to block treatment
development and research based on drug policy."

It may be unethical, but it certainly isn't inconsistent, at least
within the last century, which found several drugs with specific
medicinal properties, including MDMA and cannabis, nevertheless
criminalized by governments across the world. And while it is true
that some have loosened their hypocritical restrictions on such
substances, many still harbor puritanical paranoias about them. In
America, it has been far easier to obtain prescriptions for medicine
that can kill you outright, such as oxycontin or vioxx, than for
drugs that can chill you out. And that's before one even engages more
dangerous legal substances, such as nicotine or alcohol, which have
wrecked lives and ruined bank accounts. One could argue, with some
success, that it would be inconsistent with traditional medical
ethics to legalize such substances, even though their positives seem
to far outweigh their negatives.

But, of course, this argument, stretching back for decades if not
centuries, is not about ethics or health, but about money. Just ask
Doblin, who's happy that Mithoefer's work has passed phase two with
flying colors but nervous about the coming challenges of a much more
expansive, and expensive, phase three.

"Where do we get five million dollars?" he answered with a question,
when asked what will be phase three's biggest obstacle. When asked if
a new administration, one less in love with the idea of wars on
abstracts, would come to the rescue, Doblin was equally sanguine.
"The change in administration won't make a difference. We're doing
this now with the Bush administration. The level we're working at now
is made up of mostly scientists interested in science over politics.
From our perspective, the FDA is a delight to work with, because
they focus on that science. It's not until it comes to policy that
the political influences come in. But we're many, many years away from that."

For now, Doblin and his cadre of outside-the-box doctors are focusing
on the data, which is growing by the day, and pointing to a possible
light at the end of PTSD's long, dark tunnel. And that means
navigating the labyrinth of not just the FDA, but also the medical
establishment's program of rigorous testing and analysis.

"We are preparing a protocol to submit to the FDA in February to
train therapists for phase three studies," he explained. "We're going
to ask permission to administer MDMA to therapist trainees, so they
know what the drug is about, and so they can practice with one
another. We're transcribing audio and video of all the sessions, and
developing a treatment manual. We're initiating contact with another
group interested in MDMA for cognitive behavioral therapy."

So, what if it works? What if MDMA treatment of PTSD comes to pass,
and everyone from rape and abuse victims to returning soldiers demand
the catharsis that comes from ecstasy to help them normalize their
turbulent lives? The scenario scares some politicians and physicians
alike, but their fears of rampant XTC ravers gumming up the public
works may, in the end, prove unfounded.

"It's not going to be a normal prescription drug like the
antidepressants," promised Doblin. "It's only going to be
administered under therapist supervision. There would be a chain or
network of clinics where use would be limited to special training.
Patients would be requited to spend the night in the facility. It's
not like cannabis. Our approach is catharsis, enhancing the
psychotherapeutic interchange. We want patients to integrate their
trauma into their normal lives."