Pubdate: Wed, 23 Feb 2005
Source: Boston Globe (MA)
Copyright: 2005 Globe Newspaper Company
Contact:  http://www.boston.com/globe/
Details: http://www.mapinc.org/media/52
Author: Raja Mishra
Bookmark: http://www.mapinc.org/mdma.htm (Ecstasy)
Cited: http://www.mapinc.org/people/Rick+Doblin  Rick Doblin
Cited: http://www.maps.org/  Multidisciplinary Association for Psychedelic 
Studies

HARVARD SEEKS TO TEST ECSTASY DRUG ON THE DYING

BELMONT -- Harvard researchers are preparing for the first time in three 
decades to conduct human experiments using a psychedelic drug, a study that 
would seek to harness the mind-altering effects of the drug ecstasy to help 
ease the crushing psychic burdens faced by dying cancer patients. In the 
experiment, 12 terminal cancer patients would be given MDMA, the active 
ingredient in ecstasy, to determine whether the drug helps alleviate their 
anxiety. If the results are positive, the Harvard scientists said, they 
will push forward with large-scale tests that could make end-of-life 
ecstasy treatments generally available to terminally-ill patients. The 
experiment seeks to establish a medical use for a drug whose abuse has been 
on the rise among some young people, who use it recreationally for its 
euphoric effects.

A small but growing group of scientists contends the drug, administered in 
a controlled medical setting, can improve mental and emotional health. But 
critics, including some in the Bush administration, said the experiment may 
destigmatize a dangerous substance.

Complicating matters, the experiment will be bankrolled by the 
Multidisciplinary Association for Psychedelic Studies, a nonprofit that 
advocates legalizing psychedelic drugs.

The group, run by a longtime drug-legalization activist from Belmont named 
Rick Doblin, has ambitions to one day establish a nationwide chain of 
psychedelic therapy clinics that would dispense LSD, marijuana, and ecstasy 
to people with emotional problems.

Doblin acknowledges that getting the experiment accepted by Harvard 
scientists is an invaluable public relations coup for his mission.

Despite the potential for controversy, the Harvard scientists remain 
committed to the experiment.

"There's enough evidence for possible therapeutic benefits that it 
outweighed the risk," said Dr. Bruce Cohen, president of Harvard-affiliated 
McLean Hospital in Belmont, where the experiment will be conducted. "If the 
evidence suggests this has value, then a more elaborate study will be 
done." Cohen acknowledged that others might have been reluctant to pursue 
the study: "Some institutions wouldn't want to even take this risk." Ethics 
boards at McLean and the Lahey Clinic, which will provide the patients, 
have already approved the experiment, as has the US Food and Drug 
Administration. The Drug Enforcement Agency still must approve the 
experiment, and Harvard officials said they expected to hear from the 
agency within weeks. The trial would use a controversial drug to treat a 
group of patients believed ill-served by the medical system.

To qualify for the experiment, a cancer patient must have a prognosis of 
less than one year to live. These patients, said the Lahey Clinic's Dr. 
Todd Shuster, often suffer from deep anxieties that currently can be eased 
only by taking daily doses of sedative drugs that render them disconnected 
from reality.

"We're trying to avoid sedating people, to allow them to maintain a good 
quality of life so they can enjoy the time they have with family and 
friends," said Shuster, who will select patients from Lahey for the 
experiment. Typically, dying patients are given drugs such as valium, which 
can cloud their minds, or antipsychotics that leave them edgy. In any of 
these states, said cancer specialists, it becomes difficult to resolve 
family issues, arrange financial matters, or approach death with a sense of 
peace and understanding. "Any kind of new tools that we could have would 
probably be worth looking at," said Dr. John Peteet, clinical director of 
the psycho-social oncology program at the Dana-Farber Cancer Institute who 
is not involved in the experiment but called it "novel."

David Murray, a policy analyst with the White House Office of National Drug 
Control Policy, said he was worried the Harvard experiment could 
destigmatize ecstasy while failing to find any clear-cut medical use for 
the drug. "It is my impression that we are unlikely to learn anything of 
medical value," he said, citing the trial's small size. "I'm surprised, to 
tell you the truth, that this has passed muster."

Murray listed a number of studies indicating that ecstasy abusers suffer 
neurological problems and said, "The record on the risks of this drug is 
unambiguous."

But McLean's Dr. John Halpern, who will run the trial, said the Harvard 
experiment will be safe: "The studies didn't raise any concerns about 
giving MDMA a few times in a medical setting."

MDMA, short for 3,4-methylenedioxymethamphetamine, works by releasing large 
amounts of the brain chemical serotonin, which helps regulate mood, sleep, 
and appetite. Numerous human and animal studies have shown that heavy MDMA 
use can cause neurological and behavioral problems, though the exact nature 
and persistence of the damage is difficult to gauge.

Meanwhile, ecstasy use has exploded in some subcultures, particularly in 
so-called rave circles, where young people high on the drug dance 
euphorically for hours. "People describe feeling empathy, decreased stress, 
increased confidence," said Halpern.

In the experiment, eight patients will get a dose of MDMA that the 
researchers believe will elevate their mood, while four patients will 
receive a lower dose. The dosing, under the supervision of five doctors, 
will occur immediately prior to an intense 8-hour therapy session that 
Halpern will run. The drug alone, he said, would provide only a temporary 
respite, but when combined with therapy could help permanently resolve 
underlying psychological problems, said Halpern. Halpern said these 
underlying problems often involve uncertainty about loved ones' futures, 
unresolved family conflicts, finances, and fear of death. "The ecstasy is 
not in the drug, it's in the person," he said in explaining his approach. 
"People need to embrace themselves and talk about what's important to them."

Each patient will have two intensive therapy sessions, preceded by MDMA, 
two weeks apart.

The patients will also get six shorter sessions that will not involve the 
drug. Halpern's team will use standardized anxiety tests to see whether the 
MDMA therapy helps, and they will compare the lower- and higher-dose 
patients to help gauge the most effective MDMA dose. If MDMA proves 
successful, the researchers plan to propose a series of more rigorous 
large-scale experiments designed to win federal government approval for 
using MDMA on terminal patients. "There is good evidence that it could 
become a therapist's tool," said Halpern. But Murray, of the White House 
drug office, said the publicity around the experiment could increase "the 
rationalization of young people who can say, 'This can't be dangerous 
because Harvard doctors give it out.' " "Perceptions of risk are a powerful 
determiner of young people using illegal drugs," he added.

Changing public perceptions of psychedelic drugs is a stated goal of the 
group funding the experiment -- and they consider Harvard a high-profile 
venue for doing so. Doblin, whose group, MAPS, plans to spend $250,000 on 
the study, said the experiment could erase the damage wrought by Dr. 
Timothy Leary. A Harvard professor in the 1960s, Leary infamously 
experimented with psychedelic drugs at Harvard until he was ousted in 1963, 
the last time a Harvard researcher there worked with psychedelic drugs.

Leary conducted medical experiments using students, though his aim was to 
determine whether psychedelic drugs could enhance human cognition rather 
than alleviate suffering.

He eventually became a pop culture icon, encouraging casual psychedelic 
drug experimentation in books and lectures.

He also served time in prison for drug possession and lived briefly as a 
fugitive after he escaped from prison.

Doblin said Leary's antics led many Americans to view psychedelic drugs as 
dangerous and escapist, while the drugs' more beneficial aspects were 
ignored. "To restart it at Harvard means that we have healed the wounds 
from that time. With this study we have finally buried the ghost of Timothy 
Leary," said Doblin. The idea for the Harvard experiment came about during 
a conversation between Doblin and Shuster, who attend the same synagogue.

Doblin's enthusiasm and encyclopedic knowledge of psychedelic drug issues 
helped persuade Shuster to undertake the experiment. But in the end, said 
Shuster, it was memories of dying patients filled with distress and sadness 
that persuaded him to take part in the MDMA experiment.

"I think it is a drug that has a real potential for therapeutic benefits. 
Unfortunately, the abuse of the drug has prevented the use of it in 
therapeutic trials," he said, then adding a note of caution: "But I'm not 
sure what we'll find."
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MAP posted-by: Jay Bergstrom