THE ELECTRIC KOOL-AID MEDICINE TEST

Hallucinogen researcher Charles Grob says psychedelic drugs have the
potential to alter modern medicine.

In 1954, when the national mood was one of suspicion and conformity,
Aldous Huxley wrote, "All ... the hallucinogens that ripen in berries
or can be squeezed from roots -- all, without exception, have been
known and systematically used by human beings from time
immemorial."

Ten years later Timothy Leary was fired from Harvard for
"systematically using" LSD (admittedly not from a berry or a root)
with students. Leary's sensational promotion of turning on and
dropping out closed the door on serious dialogue or research into the
potential benefits of psychedelic substances. Yet today, in the midst
of the current revival of patriotic and moral paranoia, some are
beginning once again to scientifically consider their value as
visionary or psychological medicine.

Charles Grob, M.D., is director of the Division of Child and Adolescent
Psychiatry at Harbor-UCLA Medical Center and professor of Psychiatry
and Pediatrics at the UCLA School of Medicine. He conducted the first
government-approved psycholobiological research study of MDMA, was the
principal investigator of an international project in the Brazilian
Amazon of ayahuasca, and is now studying the use of psilocybin with
advanced-stage cancer patients. He is editor of "Hallucinogens: A
Reader" and recently co-edited, with Roger Walsh, "Higher Wisdom:
Eminent Elders Explore the Continuing Impact of Psychedelics."

Terrence McNally: How and when did you decide to work with psychedelics?

Charles Grob: Growing up in the '60s, it was impossible to not be
exposed to the controversies and the extraordinary powers of these
compounds. In the early '70s, I read much of the literature that was
available at the time, and I was struck by the potential these
compounds had to help us understand the mind and mental illness, and to
help us develop new and novel treatments. I was aware that, in order to
speak out on this issue, one needed credentials, so I went back to
school and got all the degrees and training I needed. It was always my
intention to conduct proactive approved research in this area, though
in the late '70s and early '80s there was virtually nothing going on in
this country or elsewhere.

McNally: In 1973 I interviewed Stanislov Grof, who was then doing
government-funded research in Maryland on the use of LSD with terminal
cancer patients. Six months later I tried to follow up, and the state
of Maryland wrote back that Dr. Grof was no longer in its employ. He
had been let go, and the government funding had ended.

Grob: Around the same time, I heard Grof speak at the annual meeting of
the Humanistic Psychology Association in New York City, and I was
impressed with the enormous potential of the work he was doing.

McNally: Tell us about your study on anxiety in cancer patients.

Grob: At the L.A. Biomedical Research Institute at Harbor-UCLA Medical
Center, we have full regulatory approval to conduct a study using
psilocybin -- the active alkaloid in hallucinogenic mushrooms -- in the
treatment of the anxiety associated with advanced-stage cancer.

McNally: What is the status of the study at this time? Do you have any
preliminary results?

Grob: We've been treating individuals for the past year and a half who
fit all our inclusion/exclusion criteria. To date, we've studied five
subjects in entirety. We're approved for a total of 12, so we hope to
treat seven more. We're finding recruitment very challenging because we
have very tight inclusion/exclusion criteria. We've interviewed a
number of individuals who at first seemed to fit our criteria, but
whose medical condition then drastically deteriorated so that they
could no longer participate. We're very interested in talking with
individuals who might fit.

McNally: Where would potential candidates learn about this, and how
would they apply?

Grob: Our website -- canceranxietystudy.org -- details the
inclusion/exclusion criteria and provides information about the
methodology.

McNally: Can you verify Huxley's contention that all plant
hallucinogens, without exception, have been known and systematically
used by human beings from time immemorial?

Grob: Certainly the anthropological and historical evidence is very
rich that even pre-civilization cultures highly valued hallucinogenic
plants. Aboriginal cultures often used them as one of the core
activities for reinforcing belief systems and tribal cohesion. This is
quite apparent if you look at the indigenous peoples in the Amazon
basin in South America, where the plant ayahuasca is used for
religious, spiritual and healing purposes. As far back as human
habitation of the Amazon basin has been established, there are
indications that ayahuasca was an integral part of their lives and
belief systems.

McNally: I've traveled a bit in the rainforest of Ecuador, and among
the Achuar people it is an important and seldom-used ritual taken at
key passages in life.

Grob: These are not by any stretch of the imagination recreational
compounds. Indigenous peoples use them for very serious purposes, often
having to do with healing.

McNally: Do you view the recent Supreme Court decision to allow
ayahuasca to be taken in a religious context as an isolated instance
based on specifics of the particular case or something more?

Grob: On February 21st, the court ruled unanimously that a branch of a
Brazilian syncretic church, the Unial de Vegetal, or UDV, in Santa Fe,
N.M., had legal sanction to continue to utilize ayahuasca as a
psychoactive sacrament in their religious ceremonies. This is really an
extraordinary decision and establishes a remarkable precedent, although
at this point I believe it only applies to the UDV.

I was an expert medical witness for the UDV, and so followed the case
very closely. I had been the principal investigator of a series of
research studies in Brazil, using members of the UDV as subjects. I
did not expect the case to win in a conservative federal court in the
throes of a vicious decades-long drug war.

McNally: This was one of the first decisions of the Roberts-Alito
court, wasn't it?

Grob: I believe it's the first decision that Chief Justice Roberts
penned himself. Though Alito was not part of the decision because he
had not heard the arguments, he subsequently stated that he would have
gone along with the majority.

The Justice Department appealed, and the appeal was heard by a panel
of the Circuit Court of Appeals in Denver. Again I was not overly
optimistic and again I was surprised: the UDV's position prevailed. It
was then appealed to the full Circuit Court of Appeals and won again.
Then it went to the Supreme Court, where on February 21st they issued
their unanimous decision.

McNally: There was the precedent of the peyote churches of the Native
Americans, yes?

Grob: The Native American Church has for some time had permission to
use peyote as part of their religious ceremonies. Whereas peyote use
among native peoples is established by treaty between the sovereign
Indian nations and the United States, the Santa Fe case does not
involve indigenous people. This was the first time in almost 1,600
years that a nonindigenous people had gained permission from the
government to use a plant hallucinogen for religious ceremonial purpose
- -- not since Alaric the Hun sacked Elevsis in the year 396.

McNally: I guess you can't use that as precedent. What leads you to
believe that psychedelic substances might have therapeutic use?

Grob: There's a very rich body of literature dating back to the
mid-late 1950's that demonstrates it. Though methodologies at the time
were not like methodologies today, they offer ample indication that we
should at least study this further.

There were a number of studies which demonstrated therapeutic response
among patient populations that did not normally respond well to
conventional psychiatric and medical treatments -- first and foremost,
chronic hardcore alcoholics and drug addicts. In the late '50s and
early '60s, Humphrey Osmond in Western Canada demonstrated that some
seriously ill alcoholics who had not responded to any conventional
treatment did remarkably well after even a single dose treatment.

McNally: So your mission is to reopen the pursuit of this knowledge for
the benefit of society?

Grob: Absolutely. My goal has always been to get this research back on
track. By the early 1970s, all of the exciting and promising studies
were forced to terminate because of the cultural turmoil of the time.
Thirty-plus years later, I think it's high time that we review the old
data and initiate new research.

McNally: In addition to your cancer anxiety study, are there other
studies ongoing?

Grob: Dr. Francisco Moreno at the University of Arizona just completed
a pilot study using psilocybin to treat chronic refractory
obsessive-compulsive disorder. A psychiatrist named Michael Mithoffer
in Charleston, S.C., has permission to use MDMA in the treatment of
chronic post-traumatic stress disorder.

Though there are no clinical application treatment studies in Europe,
Franz Volenwieder (also affiliated with Heffter) at the Burhholzi
Clinic and the University of Zurich has done extraordinary work
mapping the effects of MDMA and other hallucinogenic substances on the
brain, using state-of-the art brain imaging technology.

McNally: What's your aim in the new book, "Higher Wisdom," which
includes Ram Dass, Hofman, Sasha Shulgin, among others.

Grob: In the late 1980s, when I moved from Johns Hopkins to the
University of California, I established a friendship with Roger Walsh,
a psychiatrist at UC Irvine, who felt that it was important to preserve
the stories and experiences of the leading early investigators and
theorists on the issue of psychedelics. Along with Gary Bravo, another
UC Irvine psychiatrist, we interviewed anyone we could find who had
established a reputation in the field of psychedelic research in the
1950s and 1960s.

McNally: What were a couple of the big lessons you drew from your
conversations with them?

Grob: These individuals were profoundly influenced personally by their
experiences. They shared the vision that, under optimal circumstances
and with all the proper safeguards in place, these compounds had an
extraordinary capacity to help heal, to help enlighten and to help us
learn.

McNally: MDMA was originally used in therapy, wasn't it?

Grob: In the late '70s and early '80s a large number of
psychotherapists, mostly in California, formed an underground where
MDMA was used for a variety of clinical indications, though very little
of their clinical work was published.

Unfortunately the secret got out to the greater society at large, and
it became a very popular recreational drug, particularly among the
youth culture in California and Texas. It then spread throughout the
country, over to Europe and around the world, setting off the ecstasy
rave phenomenon.

McNally: What are the dangers, warnings and cautions with MDMA?

Grob: Oh, there are certainly dangers with MDMA, and individuals really
need to be apprised and not to take foolish risks. There's a serious
danger of malignant hyperthermia, or overheating, which is exacerbated
by vigorous exercise in a hot, stuffy environment, and the failure to
replace lost body fluids. This is just what happens in the rave
setting, and there have unfortunately been some fatalities secondary to
malignant hyperthermia.

The flipside risk is water intoxication. Several young people have
actually drunk so much water that they have lowered their serum sodium
and experienced seizures, and died as well. It can be a very tricky
compound.

Perhaps the biggest danger, though, is drug substitution. A large
percentage of what passes as ecstasy actually does not contain MDMA,
but other drugs. Some are relatively benign like caffeine or aspirin,
but others are potentially dangerous or lethal, like paramethoxy
amphetamine, PMA, the most potent and potentially lethal amphetamine
known. You have no idea what you're getting.

McNally: Because it's illegal, the greatest danger comes from buying
something on the street with no oversight or regulation, correct?

Grob: There are absolutely no controls. In fact, I can't think of a
drug which is more frequently misrepresented and substituted than the
ecstasy MDMA compound.

McNally: In other words, the fact that we have closed our eyes and
pushed all of these psychedelic substances aside as illegal creates
many of the problems associated with them.

Here's a big two-part question. Do you suspect that the roots of any
cultural or scientific trends grew out of the use of psychedelics in
the '60s and '70s? For instance, the rise of Buddhism or other Eastern
spiritual and health practices, or the internet or electronically
networked organizations?

Grob: Yes, of the several million people who presumably took
psychedelics back in the '60s in this country and in Europe, many were
profoundly influenced. It influenced their attitude towards their own
career choices, their relationships, their attitudes towards peace and
conflict. During the '60s there was a tremendous sense that these
compounds, if utilized optimally, could catalyze very salutary changes
around the world.

Until his death in 1963, Huxley held the vision that if these
compounds were introduced wisely, quietly and discreetly to the
leaders of our culture, there would be a ripple-down effect with
enormous positive changes. He believed it might be a mechanism through
which the very likelihood of world survival would be enhanced.

The cultural turmoil, with youth culture radically split off from
mainstream culture, led to a move not only to shut down research but
also to distance mainstream culture, mainstream scholars and
scientists from even exploring the potential benefits of the use to
individuals, families and culture.

McNally: Final question. What do you know of the current cultural
context? What's happening out there these days?

Grob: There's certainly a concern for widespread misuse and abuse of
compounds like ecstasy. Serious use of these compounds has had to go
deeply underground. There's increased interest in ayahuasca,
particularly in the Amazon basin. A big article in a recent National
Geographic Adventure magazine highlighted ayahuasca shamanism, and has
had a very strong apparently positive response.

I think individuals are starting to wake up to the possibility that,
when taken under optimal conditions, these plants might have profound
potential to facilitate positive change. That being said, one also has
to employ all the essential safeguards to minimize the likelihood of
harm.