Pubdate: Fri, 08 Oct 2004 Source: Boston Phoenix (MA) Copyright: 2004 The Phoenix Media/Communications Group. Contact: http://www.bostonphoenix.com/ Details: http://www.mapinc.org/media/54 Author: Mike Miliard Bookmark: http://www.mapinc.org/mmj.htm (Cannabis - Medicinal) Cited: Multidisciplinary Association for Psychedelic Studies (MAPS) http://www.maps.org/ THIS IS YOUR BRAIN ON DRUGS Rick Doblin Thinks Pot, Ecstasy, And Other Psychedelics Could Unlock The Human Mind -- And He Wants To Bring Them To Harvard, The FDA, And A Doctor's Office Near You FROM THE OUTSIDE, the only hint about the kind of guy who lives in the modest two-story home on the leafy Belmont side street is the house's molding, painted orange and vibrant violet, in electric contrast with its dark-gray siding. Inside, upstairs in Rick Doblin's cluttered office, there are more clues. Gentle pink walls are bedecked with psychedelic renderings of frantically blooming trees and exploding kaleidoscopic radii. A window hung with stained glass casts lavender light on a floor strewn with clothes, file folders, and copies of High Times and Grow. A smiling Buddha statue stands on a corner bookshelf stacked with tattered tomes: Plants of the Gods and The Big Book of Buds and Everything I Know I Learned on Acid. On one wall hangs a quote from Thoreau: "In wildness is the preservation of the world." On the opposite wall is an ad for the National Organization for the Reform of Marijuana Laws (NORML) that declares, WHAT THEY SAY IS TRUE. MANY PEOPLE WHO SMOKE MARIJUANA MOVE ON TO HARDER THINGS. GRADUATE SCHOOL FOR EXAMPLE. Sure enough, just above it hangs a surprisingly sizable Harvard sheepskin. Rick Doblin, PhD -- he has a doctorate in public policy from the Kennedy School of Government -- is the founder and president of the Multidisciplinary Association for Psychedelic Studies (MAPS). Since 1986, the membership-based nonprofit, which has offices in Sarasota, Florida, but is run largely from Doblin's home office, has been at the forefront of a movement that contends that drugs like MDMA (ecstasy), psilocybin (the hallucinogen found in "magic mushrooms"), and LSD can be used to help treat everything from post-traumatic-stress disorder to obsessive-compulsive disorder. The group also spends about 15 percent of its time and resources advocating for medical marijuana. As its mission statement avers, the studies designed and funded by MAPS aim to "develop psychedelics and marijuana into FDA-approved prescription medicines, and to educate the public honestly about the risks and benefits of these drugs." After almost two decades, Doblin's work seems finally to be bringing about some substantial results. Most momentously, in February the Drug Enforcement Administration (DEA) granted South Carolina psychiatrist Michael Mithoefer a Schedule I license (a dispensation to obtain and possess an otherwise-prohibited drug) for MDMA so he can use it to treat post-traumatic-stress disorder in victims of violent assault. It's the first legal use of the drug since ecstasy was criminalized, in 1985. The study, currently under way, is funded by MAPS; its protocol was developed by Doblin and Mithoefer in conjunction with other scientists. On the medical-marijuana front, Doblin and MAPS -- along with Lyle Craker, a professor in the University of Massachusetts at Amherst's department of plants and soil sciences, and Valerie Corral, co-founder of the Wo/Men's Alliance for Medical Marijuana -- filed a lawsuit in July against the DEA, the Department of Health and Human Services, the National Institute on Drug Abuse (NIDA), and the National Institutes of Health. They are accusing the government of having a monopoly on the production of medical marijuana and stalling unreasonably on UMass's application to grow the stuff. Meanwhile, MAPS, in conjunction with Dr. John Halpern of the Alcohol and Drug Abuse Research Center at Harvard Medical School's McLean Hospital, in Belmont, has asked McLean's institutional review board for permission to conduct a study that would use MDMA to help late-stage-cancer patients deal with their fears of death. If approved, the study would face the review board of the Lahey Clinic (where the study's subjects would come from) and then be brought before the Food and Drug Administration (FDA) and the DEA. If it clears all those hurdles, the study could start by late 2005, making it the first psychedelic research at Harvard since the days of Timothy Leary 40 years ago. If the results of these studies are promising, and if various government agencies are willing to receive their findings in a non-politicized way, it's conceivable that, sometime in the coming years, MDMA could become an FDA-approved prescription medicine. If so, MAPS's identity could change fundamentally, morphing from a research-and-advocacy organization to something resembling a pharmaceutical company. Of course, not everyone agrees with MAPS. These are illegal drugs, after all, and there's intense disagreement about the extent of their harmfulness. But although Doblin -- with his shock of unkempt hair, his animated demeanor, his fondness for dancing and therapy at trippy gatherings like Burning Man and Earthdance -- may seem less than serious to some, there's no question that he takes the potential therapeutic value of psychedelics and marijuana very seriously. And his years of funding studies and working the system may just be changing the way psychedelics and marijuana are perceived and used. At first, drugs were anathema to Rick Doblin. Indeed, most still are. "I still have never had a cup of coffee, I've never had a cigarette, I've never had a Coca-Cola. I've never had a beer. I don't drink alcohol," he says. "I felt that drugs were a dangerous escape and there was no need for it." But when he first tried LSD in the early 1970s, something clicked. "Freud said that dreams are the royal road to the unconscious. And I think psychedelics are even more so." Doblin was familiar, of course, with the psychedelic studies of Timothy Leary, but he was wary of the sunny gloss Leary put on "turning on, tuning in, dropping out." Doblin suspected that psychedelics could be used in a real and substantial therapeutic way. But he knew that they'd need to be used carefully, deliberately, and honestly. And he realized that struggle, a concerted effort to recognize and exorcise the bugaboos embedded in one's subconscious, would be an integral part of the experience. Doblin's first experiences with LSD led him to drop out of his undergrad studies at New College of Florida, not long after he'd started there. "I took 10 years off to kind of integrate and figure out how I could study what I want to study in the system," he says. "Then I went back to New College as a freshman in 1982, and within four days of starting school, I was out in Esalen [Institute, in Big Sur, California] studying with Stan Grof," a pioneer researcher in psychedelics and the unconscious. It was during his time in Big Sur that Doblin first heard of MDMA (3,4-methylenedioxymethamphetamine), a drug that helps create feelings of empathy, connectedness, and goodwill by increasing the release of the neurotransmitters serotonin and dopamine in the brain. At that time it was not yet illegal, and was in use primarily in psychiatric and therapeutic circles. He tried it with his girlfriend when he got back east in 1982. "The first experience was marvelous," he remembers. "It was just such an eye opener. A heart opener. The core of it, I remember, was having this wonderful exchange with my girlfriend, and feeling like it was us speaking. It wasn't the drug speaking. The drug was liberating, was helping us be in touch with our deeper feelings. It was helping us experience our deeper, better selves. Our clearer selves. And it wasn't an artificial experience. It was so subtle of a shift. I was expecting the drama of LSD or psilocybin. But it was a subtle shift of emotional openness. It was astonishing to me how subtle, yet how profound. It just felt like a way of being that I wanted to learn from." Doblin finished his second stint at New College in 1987 with a degree in psychology. The preceding several years had seen ecstasy creeping out of scientific circles and gaining popularity as a recreational drug -- and drawing the attention of the feds. As an undergrad, Doblin founded a nonprofit group called the Earth Metabolic Design Lab, under whose auspices he lobbied the DEA to classify MDMA as a Schedule III drug (allowing it to be studied by doctors), rather than banishing it to total prohibition under Schedule I status (high potential for abuse, no currently accepted medical use, and unsafe for use under medical supervision) along with drugs like marijuana and heroin. He failed. And he knew then that seeing MDMA used therapeutically and legally would require a new course of action. The drug's blanket illegality meant that the only way to employ it in legitimate scientific inquiry was to get it approved as a medicine by the FDA. But working through the bureaucratic labyrinth to make that happen would be a daunting -- and expensive -- task. Thus MAPS was born in 1986, the first step in Doblin's perhaps quixotic quest to someday establish a "nonprofit psychedelic-pharmaceutical company." But, while he possessed the empathy and the psychological insight to help others with these drugs, Doblin lacked the instinct needed to navigate the regulatory and political maze. "That's where I had this epiphany while I was smoking pot," he says. "I have this pattern of wanting too much too soon. But since what I wanted was the research, and the research was blocked by the politics, then maybe I should study the politics." As Doblin went "straight," so to speak, he also saw a parallel between his personal and scientific goals. "I always had thought of myself as counterculture. The fact that I could make that shift, to being part of the establishment, [meant] that therefore psychedelics could maybe move from this repressed position to somehow integrated into society." So he enrolled at Harvard. "I just thrived once I got to the Kennedy School and started working on policy. It was just a tremendous opportunity for me -- and it really has led to much of the opportunities that I've been able to create since then." I FIRST interviewed Rick Doblin for the Phoenix almost four years ago. (See "Long, Strange Trip," News and Features, April 6, 2001.) Now, as we walk around Belmont's quiet afternoon streets, he's keyed up about a new and "very exciting" moment in MAPS's history. The group has achieved a "substantially" higher profile since we talked last, he says. Membership is at about 1450 nationwide, and there are plans soon to bolster that with direct mailings to about 10,000 psychiatrists. Last year marked the first time in the group's history that it exceeded $1 million in revenues -- coming either in smaller donations from individual members or large sums from simpatico benefactors. A lot more cash is needed. If MAPS's dreams of FDA-approved medicines ever comes to fruition, Doblin estimates it will take $5 million to $7 million to see MDMA or medical marijuana developed into prescription drugs. But he's keeping tabs on a potentially lucrative revenue stream from a free-thinking, very wealthy segment of the population: young technology execs. In August, Doblin was at Burning Man Festival, in Nevada's Black Rock Desert, where he helped with "psychedelic-emergency work," talking people through bad trips. Among the 30,000 or so neo-tribal alkali-flat revelers was libertarian philanthropist and MAPS contributor John Gilmore, who's pledged to give away $10 million over 10 years to drug-law-reform causes. "And right next to him camping," Doblin says, "were the founders of Google." Doblin's peers, and his track record thus far, suggest that MAPS is a worthwhile cause. "He's very bright and incredibly dedicated to making this medicine available to help people," says George Greer, co-founder of New Mexico's Heffter Research Institute, which, like MAPS, seeks to subject psychedelics to rigorous scientific study. "He has incredible persistence. The fact that finally there's a therapy study happening with MDMA, after being a controlled drug for almost 20 years, I think it's Rick's persistence, along with Michael Mithoefer's, that's led to that. Hopefully it will continue." Indeed, Mithoefer's post-traumatic-stress-disorder study is a watershed moment. He's working with 20 prescreened survivors of sexual assault: 12 of them are given a controlled dose of MDMA, while eight receive a placebo. Mithoefer talks each through their experiences, slowly and deliberately, drawing out their traumas. Ideally, the MDMA will allow the subjects to feel more at ease as they discuss repressed memories and separate them from their present environment. Mithoefer expects the study, which started in March, to last another year or so. Does he foresee MDMA becoming an FDA-approved drug? "It's premature to know the answer to that, because we haven't finished this study, and we don't have the data yet. It depends what the data show," Mithoefer says. "We'll need to have another pilot study if this goes well. And then if that goes well, we'll need to have larger multi-center trials. So there's a lot to be done to answer that question. But I think if the data support it, it's certainly a possibility." Halpern's work at Harvard could potentially be just as momentous. MAPS and Halpern have already devised a pilot study at McLean Hospital assessing MDMA's effects on neurocognitive ability. "So what we've done is built credibility with the people there," Doblin says. "They're not worried they're going to be attacked as the new Timothy Leary, that Harvard's gone crazy again. They've reviewed all the literature on the risks. They're experts. And they know how to balance risk and benefits." To Doblin, the idea that this sort of research could soon be going on right in his back yard is thrilling. "There has not been anything done with psychedelic research at Harvard in 39 years," he says. "I feel like it's been a proverbial 40 years in the desert. And so next year, we have the chance of starting, after exactly 40 years, psychedelic psychotherapy research at Harvard." Further afield, MAPS, with the Heffter Research Institute, has co-funded a University of Arizona study on psilocybin as a treatment for obsessive-compulsive disorder. MAPS is also working with researchers in England on a protocol to explore the use of ibogaine (a psychoactive drug derived from the root bark of an African rain-forest plant; it's legal in Canada, Mexico, and the UK -- but not the US) to treat addiction to drugs like cocaine and heroin. In parts of Africa, ibogaine is central to sacred rituals, and is even given to children. "[You can] protect kids with honest information, and also access to altered states," says Doblin. "It actually immunizes them against drug abuse if the culture provides appropriate context for this." SOME BELIEVE Rick Doblin is naive or even dangerous, touting ecstasy and ibogaine like they're aspirin and Novocain. It's true that all drugs carry risks. People have died from ecstasy-induced hyperthermia, and, once the drug's effects wear off, users show depleted serotonin levels for varying periods of time. Researchers are still debating how serious this is and whether it foretells any lasting brain damage. Repeated phone calls from the Phoenix to the DEA, NIDA, the Office for National Drug Control Policy, and the Partnership for a Drug-Free America did not yield comment. But some health-care professionals continue to assert that any perceived therapeutic value these drugs might have is gravely overshadowed by their risks. Dr. Eric Voth is an internal-medicine and addiction specialist with a private practice in Kansas; he also chairs the Institute on Global Drug Policy, a division of the Drug Free America Foundation. It's in that capacity that he's spent about 15 years tangling with Doblin over the risk-benefit dynamics of psychedelics and marijuana. "Why this big push to try to find medical legitimacy for something that is fundamentally a drug of abuse?" he asks of MAPS's crusade. "How much potential downside is there for a supposed upside? If you look at the literature -- despite [Doblin's] allegations that the literature is flawed, and that the DEA has tried to manipulate it, and all that stuff that he always spews out -- there is a lot of literature out there on hyponatremia [salt depletion], seizures, memory problems, serotonin depletion. And, besides that, [look at the] people who get in trouble abusing it because it's such an intense high." Doblin doesn't argue that, when used under the wrong circumstances or in the wrong doses, ecstasy can be very dangerous. "The fundamental point I'd like to make is that MAPS needs to be at the forefront of looking at risks as well as benefits," he says. "We want to avoid some of the mistakes of the '60s, where people were promoting benefits, out of balance with acknowledgment of the risks." But he also accuses the government and anti-drug groups of having lost credibility when it comes to educating the public about those risks, in part because they deny any benefits whatsoever. "Like when they say this girl died at a rave. They leave the impression that you've got a really good chance of dying at a rave if you take MDMA. It's better for [MAPS] to say, yes, there are a few people who've died at raves. But the chances are one in a million, and these are the reasons, and here's what we do to stop it. It's up to us to acknowledge the risk, and then to put it in some sort of balance, not for us to ignore it. Ultimately, I think our credibility, and our ability to win the trust of the society and move beyond this massive fear, is really contingent on how balanced and believable we are." But Voth, for one, thinks that Doblin is being less than honest. "If [MAPS] was just a straight argument for legalization, that would be a different deal," he says. "But they're clouding the issue with the medical applications, and they're using that to get various drugs in the door. And I think that's a sad Trojan horse that they're putting out there for the public. It would be very interesting to get -- in print -- that [Doblin] would promise that, if ecstasy got accepted as a prescribed, controlled medicine, he would stop. That he would end there if ecstasy was in the hands of physicians only, with tight restrictions like a Schedule II drug [a medically useful drug with a high potential for abuse; more strictly controlled than Schedule III]. That he would stop trying to push its acceptance and saying it's a harmless drug, and that, to people who use it carefully and recreationally, it's no big deal. [But] the next step would be: 'Now that we've got the medical acceptance of it, why should it be so controlled, because it's incredibly safe. And if people want to bring it in from Holland and cook their brains, isn't that their own personal responsibility?' MAPS's sole purpose is to gain legitimacy via trying to find the legal and medical mainstream for those drugs." Still, Voth does make a few concessions. "I would say, and I believe this in virtually any realm, if any drug -- including marijuana -- goes through a rigorous FDA process to prove safety and efficacy, and it remains in the hands of physicians to prescribe it, under tightly controlled conditions, for appropriately selected patients, like we do in the practice of medicine, I'm for it. But I'll tell you what I'm not for. What I'm not for are the ballot initiatives that are a clear end-run around the FDA, the pressure tactics to try to use public support to pressure folks to let go of some of these drugs of abuse." Doblin's views on legalization might not be as insidious as Voth would imply, but they're also more complex than simply advocating for Schedule III status and prescriptions. A member of NORML's board of directors, he says he feels the distinction between "recreational" and "therapeutic" uses of ecstasy is often "artificial." And he describes a philosophical rift that developed between two sets of otherwise like-minded colleagues some years ago: "One faction said, 'Let's just talk about the medical uses of MDMA, and let's not comment on the fact that people also criminalize non-medical use.' The other faction was saying, 'Yeah we want this for medical use, but it's not a good idea, in our view, to criminalize it.'" Doblin was part of the latter faction; he believes that "prohibition, as a concept, is counterproductive, and doesn't get us as a society where we want to go." DOBLIN CALLS this "an extremely delicate time" for MAPS on the PR front. The Mithoefer PTSD study is under way; the Harvard study may soon be, too. But he cites two other aspects of the group that "are going to even further add to this risk of people being upset with what we're doing. One is that next issue of the MAPS bulletin is on 'Rites of Passage: Kids and Psychedelics.' There's this whole idea that the drug war is to protect the kids. The government's fall-back position is 'We've got to do this to protect the kids.'" The new MAPS bulletin features several essays asserting the opposite: "That there are appropriate situations where families can create ... experiences with psychedelics or with marijuana, with minors, that teach them about spiritual connections. That it can be very grounding and empowering for families to share this." The other source of potential controversy has to do with a MAPS fundraiser and conference in New York City, at a venue called the Chapel of Sacred Mirrors. "It's a benefit dinner -- followed by an all-night dance until sunrise," Doblin says. "So, that's pretty clearly associating ourselves with the dance community. I have consciously stayed away from any kind of association, even informally, with the dance community." But he says he's tired of the government's "divide and conquer" mentality, the idea that, by painting MDMA advocates as pie-eyed, glow-stick-waving drug freaks, they can delegitimize the real work they do. Besides, he says, he just likes to dance. Across the sun-dappled grass of an empty park, a tall man in a shirt and tie strides down the sidewalk. "That's the principal of [my kids' school]," Doblin says. "He knows the work that I do. We've had a lot of discussions about it. It's necessary for me to meet the principal and all the teachers, in case one of my kids says, 'My daddy was talking about marijuana the other day.'" By the time his children (ages five, eight, and nine) are grown, Doblin hopes to have achieved the goals he's been working toward since the mid '80s. "What I hope is that, maybe 15 years from now, I can go from primarily focusing on the politics of psychedelics and medical marijuana to actually being a therapist," he says. "My long-term goal would be to have a psychedelic clinic down in Florida, and help people who are tripping. And to trip more than once or twice a year myself." Can he envision some sort of utopia where MAPS's work is completely finished? "I'm pretty good at seeing utopias," Doblin chuckles. "But I think it's unlikely that we'll ever say we've got it all figured out. The study of the mind is what MAPS is about, and I think there will always be a need for more research into the unconscious. MAPS is really not about drugs, so much as the mind and the human spirit." - --- MAP posted-by: Derek