CONTROVERSY OVER PSYCHOTHERAPEUTIC USE OF 'ECSTASY'

Sue Stevens was severely depressed after her young husband, Shane,
succumbed to kidney cancer in 1999. She took large doses of numbing
anti-depressants to get through the day, and conventional therapy didn't help.

Then, last fall, the 32-year-old Chicago woman chose a more radical
approach. She traveled to the West to see a psychologist whom she had
learned was using the illegal drug Ecstasy for a handful of patients
suffering from severe trauma. In a single session, under the influence of
Ecstasy -- a drug that combines the effects of a psychedelic and an
amphetamine -- she said she was finally able to come to grips with her grief.

"Somehow, I knew Shane was no longer hurting, which made it possible for me
to let go," said Stevens, who hasn't taken any anti-depressants since. "It
was like a wire that was disconnected got reattached and jump-started the
healing process. Even if this feeling was just an effect of the drug, it's
what I needed to do to move forward."

Anecdotal reports from other mental health professionals suggest similar
results from Ecstasy, said Rick Doblin, president of the Multidisciplinary
Association for Psychedelic Studies, a nonprofit group in Boston that funds
psychedelic research.

"There's a whole network of 30 to 40 people around the country -- some are
psychiatrists, some are psychologists -- who risk their licenses to use
MDMA (the chemical name for Ecstasy) with their patients," he said.

Others, however, contend that MDMA is too dangerous to justify its use for
any therapeutic purpose.

But both supporters and critics of Ecstasy agree: The recreational use of
the drug is dangerous. Some people take multiple doses of Ecstasy, and the
drug is often adulterated with other substances to create a potentially
toxic mixture. And Ecstasy is often taken with other illegal drugs.

Lester Grinspoon, a professor emeritus of psychiatry at Harvard Medical
School who has studied psychedelics but does not prescribe Ecstasy to
patients, said the synthetic drug can "greatly accelerate" the therapeutic
process.

"It enhances one's capacity for insight and empathy, and melts away the
layers of defensiveness and anxiety that impedes treatment," he said. "In
one session, people can get past hang-ups that take six months of therapy
to untangle."

Dr. George Ricaurte disagrees. "There's no scientific evidence that MDMA is
beneficial; it's all anecdotal," said the associate professor of neurology
at the Johns Hopkins School of Medicine in Baltimore. Giving patients even
one dose of Ecstasy, he believes, is unethical because of its potential to
harm.

The intense but largely unknown scientific debate over MDMA's possible
pyschotherapeutic use has been overshadowed by the recent storm of
publicity about the health risks of the drug. The news is filled with
horror stories of kids overdosing on Ecstasy at all-night parties, of
machine-gun shootouts over Ecstasy deals gone bad, and of disturbing
surveys that show it is the fastest-growing illegal drug in America.

Fueling concern over Ecstasy's safety has been a growing number of studies
that suggest it may alter the brain, impair memory and concentration, dull
one's intelligence, and cause chronic depression and anxiety. That has led
Alan Leshner, director of the National Institute of Drug Abuse, to
distribute thousands of postcards with images of brain scans labeled "Plain
Brain/Brain After Ecstasy."

Yet some researchers insist Ecstasy may be a valuable therapeutic tool when
used with professional oversight. They contend that critics have
exaggerated the drug's dangers, using weak science to bolster their arguments.

"The issue has become so politicized that it's impossible to get a fair,
objective hearing," said Dr. Charles S. Grob, director of Child and
Adolescent Psychiatry at Harbor-UCLA Medical Center in Torrance. Grob
helped conduct government-sanctioned tests of MDMA on humans in 1995.

Some mental health professionals say that rampant street use of the drug
has tainted the reputation of a potentially valuable tool for treating
mental problems that are resistant to conventional therapy, including
alcoholism, drug addiction and post-traumatic stress disorder.

In addition, studying the parts of the brain stimulated by mind- altering
compounds like MDMA gives scientists insights into brain chemistry,
proponents say. This understanding can assist them in formulating more
effective medications for mental problems.

The scientific community has long had an ambivalent attitude toward
compounds such as MDMA: tantalized by what they can teach us about brain
circuitry and their therapeutic promise, but fearful of their possible
adverse effects.

The history of LSD is a case in point. Research paved the way for the
development of anti-depressants such as Prozac, Zoloft and the class of
anti-depressants known as SSRIs, or selective serotonin reuptake
inhibitors, which maintain high levels of serotonin in the brain.

"If LSD hadn't been discovered, it may have taken decades, not years,
before we figured out what serotonin did," said David E. Nichols, a
professor of medicinal chemistry and pharmacology at Purdue University in
West Lafayette, Ind.

LSD also proved effective in treating alcoholism and heroin addiction in
studies conducted in the 1960s in Canada and Europe, chalking up recovery
rates in the 40 percent to 50 percent range -- much higher than traditional
treatments. But research ceased in the United States in 1966 when the
federal government banned LSD.

MDMA's development as a therapeutic aid was derailed in the early 1980s by
one enterprising patient who recognized its lucrative potential as a party
drug. He renamed it Ecstasy, and the so-called "love drug" became popular
on the college party scene.

Soon, reports about MDMA's dark side surfaced. In 1985, the Drug
Enforcement Administration banned the use, possession and manufacture of
MDMA, and therapeutic research in the United States came to a halt.

There may be some hard data soon on MDMA's ability to enhance conventional
psychotherapy. Two studies are exploring whether Ecstasy can help people
recover from traumatic events, such as rape, incest or physical abuse.

Scientists in Madrid, Spain, have begun prescribing MDMA for rape victims
who haven't responded to conventional counseling. Researchers believe the
drug will reduce these patients' intense fears so they won't feel
emotionally threatened in therapy sessions.

In South Carolina, scientists are seeking government approval to test the
drug's effects on victims of rape and other assaults and who have been
diagnosed with post-traumatic stress disorder. They believe MDMA may help
to overcome the key stumbling blocks in treating these victims.

Still, experts sound a cautionary note. "I'm not saying this type of
research shouldn't be done," said Johns Hopkins' Ricaurte. "But this is a
drug that has documented potential for abuse. So human experiments must be
done in the most careful and clear-minded of circumstances."