TAKE THE EMOTION OUT OF ECSTASY

Regarding Your Nov. 6 story "FDA Permits Test of Ecstasy as Aid in
Stress Disorder":

The reason Alan Leshner of the National Institute on Drug Abuse knows
"of no evidence in the scientific literature that demonstrates the
efficacy of Ecstasy for any clinical indication" is because that is
what happens when there is political influence on the scientific
process. Millions of people around the world are taking the drug
Ecstasy, but precious little clinical research is being done to learn
more about this drug. NIDA, with a clear political agenda, is the
leading financial supporter of America's research on illicit drugs.

Suggesting that MDMA (Ecstasy) "competes head on" with Zoloft is
misleading. MDMA has already been patented, and it is typically given
once or twice in a patient's lifetime. This is not about money. There
is an international group of scientists, physicians, psychotherapists
and political activists who believe that psychoactive drugs deserve
to be explored for their benefit as well as their harm. The ultimate
goal is knowledge, and improved therapies.

Ecstasy is a complex, multifaceted issue. There is too much
sensationalism and binary thinking in the media. Labeling it a demon
drug, or a "love drug" is inflammatory and inaccurate. We need to
have clear heads to make a thorough evaluation and a rational
diagnosis of the pros and the cons of MDMA. All medicines have a dose
that is more safe and one that is more toxic, and all medicines come
with various levels of utility and risk.

Clearly there is abundant misuse of this drug. Ecstasy is a public
health concern, and the priority needs to be thorough clinical
understanding. I applaud the FDA for having the courage and political
independence to let this study get underway; I hope the Medical
University of South Carolina will follow suit.

Julie Holland, M.D. New York

(Dr. Holland is an attending psychiatrist at Bellevue Hospital and
the editor of "Ecstasy: The Complete Guide, A Comprehensive Look at
the Risks and Benefits of MDMA.")

I would like to offer a clarification. Your story about the study for
which I have received FDA approval is generally accurate; however, in
the early editions of the paper, which were distributed in this area,
there is one seriously misleading statement. It states that my wife
and I are "psychedelic psychotherapists," implying that we use
psychedelics in our practice.

This is not true. As part of my psychiatric practice we do use a
number of nondrug techniques of experiential therapy to work with
patients in deep emotional states for the treatment of post-traumatic
stress syndrome and other problems. These techniques are quite
similar to the approach we are proposing to take in MDMA-assisted
therapy in our research.

In regard to Dr. Gualtieri's characterization of our hypothesis as "a
quaint idea": Dr. Gualtieri goes on to point out that for the 30% of
people with PTSD who do not respond to existing treatments, PTSD can
be one of the most "debilitating of psychological conditions." MDMA
is a drug about which there have been a number of published reports
by psychiatrists and other therapists who used it therapeutically
before it became illegal. Although they did not do controlled
studies, their clinical impression was overwhelmingly that it was a
useful clinical tool. It seems to me that it now behooves us to do
careful scientific research to determine whether MDMA in fact might
be a helpful treatment for some of our patients who are suffering
daily. This is more than a "quaint idea."

Michael Mithoefer, M.D. Clinical Assistant Professor of Psychiatry
Medical University of South Carolina Charleston, S.C.