Why you should care
Rick Doblin wants to make it legal for psychiatrists to prescribe ecstasy and other psychedelics for their hardest-to-treat patients.
Rick Doblin wants you to trip out on the couch — the therapist’s couch.
Doblin is the founder and director of the Multidisciplinary Association for Psychedelic Studies (MAPS), a Santa Cruz, California-based nonprofit that funds research on therapeutic uses for psychedelic drugs. Its goal: to legalize psychedelics as controlled medications. Doblin has particularly high hopes for MDMA, aka ecstasy or Molly.
In a 2010 study, PTSD patients who were treated with MDMA no longer met the diagnostic criteria for the disorder. Now, MAPS is funding further phase II studies, and recently launched a study of MDMA-assisted therapy for social anxiety in adults with autism. Doblin predicts that doctors could begin legally prescribing MDMA by 2021.
Although ecstasy and Molly technically refer to pure MDMA, they usually contain other ingredients, too, like aspirin, caffeine and dextromethorphan, a cough suppressant.
Therapeutic psychedelics are not new. Psychiatric researchers treated patients with them in the 1950s and ’60s, but the drugs fell from grace as newspapers teemed with reports of tripped-out people jumping out of windows. After the DEA made psychedelics illegal, many other countries did the same.
It looks like there’s a realistic chance we can do it.
— Rick Doblin
But today, more researchers are turning to psychedelics, thanks largely to a new appreciation for their ability to alter how the brain processes signals. Psychedelics often increase serotonin and possibly glutamate, another neurotransmitter linked to short-term but durable brain functions, like learning and memory. Some researchers are investigating LSD’s ability to alleviate anxiety, and psilocybin’s to treat depression, obsessive-compulsive disorder and alcohol addiction.
Franz Vollenweider, a neuroscientist at the University of Zürich, calls Doblin “a dreamer” who won’t succeed in financing or managing a phase III trial. Charles Grob, a psychiatrist at Harbor-UCLA Medical Center, thinks psychiatrists who have undergone training and certification should be able to prescribe MDMA. But even he says Doblin is “a zealot” and thinks a more cautious approach would garner more support. He would have kept the prediction that MDMA would be legalized in seven years “under the radar.” But is Doblin’s goal a lofty pipe dream? After all, there are safety concerns. Thirty-six EDM concertgoers were hospitalized in Boston in June, some high on ecstasy and suffering from dehydration. Others have died, and there have been reports of brain damage.
But Doblin, 61, remains his usual sunny self. “The image for me is like a castle in the air, and now we’re building the foundations beneath it. It looks like there’s a realistic chance we can do it.”
Doblin, a father of three, lives with his wife in a suburb of Boston but speaks from a hotel in Reno, Nevada, en route to Burning Man, where he’s setting up a facility to help Burners ride out bad trips. His wild hippie ringlets have thinned over the years, but his eyes retain a youthful, impish glint, and he speaks with a nerdy earnestness.
He felt ”a deep, deep sense of self that is marvelous, and a high increase in memory … for things that have been difficult in the past.”
A shy bookworm raised Reform Jewish just outside Chicago, he started “seeing the value of psychedelics” after learning that Ken Kesey had written part of One Flew Over the Cuckoo’s Next while high on LSD. After seeing his grandmother struggle with depression and his brother with bipolar disorder, he decided to study to be a psychedelic psychotherapist at New College in Sarasota, Florida.
There, he began experimenting with LSD and mescaline. He dropped out after a semester and worked in construction for 10 years. Although he says he wasn’t addicted, he wanted to “get more grounded” after spending so much time in his head.
Soon after he returned to New College, he purchased MDMA at a workshop on personal self-discovery. When he tried the drug, he felt “a deep, deep sense of self that is marvelous, and a high increase in memory … for things that have been difficult in the past.” But unlike with LSD, he wasn’t afraid to confront them. “MDMA was more gentle.”
The experience moved Doblin to treat PTSD and terminally ill patients with the drug as a therapist. But amid news reports describing MDMA as a dangerous party drug, the DEA made it illegal in 1985.
Doblin had planned to earn a Ph.D. in clinical psychology. But now that no university dared support his research on MDMA-assisted psychotherapy, he opted instead for a Ph.D. in public policy at Harvard; his dissertation dealt with the regulation of psychedelics and marijuana for medical use. Meanwhile, he applied for legal permission to obtain MDMA for his depression-stricken grandmother, but, he says, failed to secure the drug before she lost her will to live, refusing food until she died.
Grieving and realizing that “the only way to make [MDMA] legal was for the FDA to make it medical,” Doblin founded MAPS in 1986. In 2001, the FDA finally allowed MAPS to conduct an MDMA study in PTSD patients. The study, published in the Journal of Psychopharmacology in 2010, reported that 10 out of 12 patients who had received MDMA and psychotherapy no longer met the diagnostic criteria for PTSD, compared with only two out of eight who had taken a placebo. The study was small, though, and another trial in Switzerland saw no significant effect.
Although traditional psychotherapy can improve PTSD symptoms by helping patients recall painful memories, those who suffer from chronic, treatment-resistant PTSD avoid such memories. “MDMA alters the balance of the fear response,” says Doblin, who calls the drug “Prozac-plus.” Prozac kicks the levels of the feel-good hormone serotonin up a notch, but MDMA makes them surge. The euphoria lasts for hours, which could benefit patients who don’t respond well to conventional therapies.
But Doblin says MAPS is on track to legalize MDMA for chronic, treatment-resistant PTSD by 2021. Consulting with a recently retired senior FDA official, the organization is set to finish its phase II studies in 2015 and plans to start two five-year phase III studies in 2016.
Grob has a more sober outlook, but he says that MAPS “has been turning out some good work” and praises Doblin’s “boundless enthusiasm and optimism.” He recalls when the 1994 Northridge earthquake rocked the Harbor-UCLA Medical Center, where Doblin was hooked up to an EEG for a sleep experiment. Even as Doblin slid across the floor, “he had no worries,” Grob says. “He just puts his head down and plows on through.”
Not surprisingly, Doblin has little time for anything other than MAPS. “The culture is changing, MAPS is growing,” he says. “It’s a lot to keep up with.” Doblin might turn on and tune in, but he won’t drop out until he brings psychedelics into the clinic.