Summer 1993 Vol. 04, No. 2 So Close Yet So Far
In the Summer of 1985, while fulfilling some pre-med prerequisites at the University of Pennsylvania, I came across an interesting magazine article. There was a new drug on the scene! Originally used in psychotherapeutic sessions, it had "leaked out" onto the club scene, and was especially popular in Texas. I was majoring in psychopharmacology and biological psychiatry at Penn and was immersed in the club scene in Philadelphia, so needless to say, my curiosity was piqued.
I began to read everything I could get my hands on about MDMA, and then called the authors of the articles to speak directly to their sources: other authors, psychiatrists and basic researchers. It was during this flurry of phone calls that I was fortunate to come across Rick Doblin, now my comrade for the past 8 years in the quest to promote MDMA research.
By the end of the summer, I had created a forty-page paper containing everything I had learned about the "new" drug ( originally concocted in 1912), and I had been on two television shows following the first media bandwagon hyping "Ecstasy". As a college sophomore being introduced as the "regional expert", it was evident to me that there were few people who know much about MDMA, and there were countless questions that needed to be answered. It was obvious to me that the research opportunities and possibilities were wide open. The potential of this powerful, promising, psychotropic seemed limitless: MDMA could be used during any sort of therapy-single, couples, family; as an anti-depressant; an analgesic; to facilitate creative visualization, stress reduction, possibly immune system enhancement; to assist in cognitive restructuring. Who could benefit from a few treatment sessions using MDMA as a chemotherapeutic adjunct? Who couldn’t! What about use in psychosis? In autism? Addiction counseling? As an adjunct to hypnotherapy? I felt like I had just found an "untapped market". I was planning on a career in psychopharmacological research and I had found my area of interest. But it wasn’t going to be that easy.
The Door Closes
On July 1, 1985, when the DEA saw fit to place MDMA on an emergency basis into Schedule 1 (reserved for drugs with a high potential for abuse and no currently accepted medical uses) a cry went up from hundreds of therapists. They were not alone; I was included in that cry. Clinical research with a Schedule 1 drug is practically unheard of. But I had found my "calling". Throughout my pre-med and medical school years, I remained committed to my goal of clinical psychiatric research of MDMA. I continued to follow the media’s love/hate relationship with the drug. I continued to extol the virtues of MDMA to any scientist and lay person who would listen, and I continued to stay in touch and in tune with MAPS, and to be inspired and encouraged by its president who would not take no for an answer.
The Door Reopens
I was fortunate to be in attendance at the FDA hearings in July, 1992 for the review of the proposed protocol by Dr. Charles Grob of UC Irvine for the study of MDMA-assisted psychotherapy in pancreatic cancer patients. Rick Doblin and I sat side by side as we listened to "testimony" from several scientists who recommended to the FDA that the human studies be conducted. As the hearings progressed, Rick and I began to realize that the FDA was actually going to give the green light. When the official "OK" was spoken, I actually had tears in my eyes.
I rushed back to my psychiatric residency in New York City and met with the chairman to discuss my many research ideas. I was so encouraged and excited by the FDA’s approval. Unfortunately, my enthusiasm was not mirrored by my chairman, who basically dismissed my eight year interest in MDMA as a fad, and hype. My request to pursue my own human studies was denied. However, surveying MDMA users was a different story…
The Rave Survey
I have been involved in the rave scene since the late 1980’s and my recent move from Philadelphia to Manhattan has intensified this pastime. I began frequenting a club called The Shelter, run by an organization called NASA. Hundreds of people were taking MDMA recreationally and showing up at NASA week after week. A ready made group of research participants! Rick had the idea to create "Raves for Research" as part of the events commemorating LSD’s 50th anniversary this last April, and he introduced me to Dave McDowell, M.D., another New York City Psychiatry Resident interested in MDMA research. Over the course of a few months, we developed a questionnaire to be administered to people attending a rave, a previously unstudied group of MDMA users. This questionnaire was intended to form the basis of a simple pilot study, testing our research instrument and methodology while also trying to get some idea of the role that MDMA played in the rave scene.
Together, Dave and I administered the survey to over 700 people on two consecutive nights (April 16 and 17), at two raves. A high percentage of ravers took time to fill out the survey, in fact virtually every person we asked to fill out the survey did so. Most of the people were extremely enthusiastic about the prospect of MDMA research, and they were eager to help out. While we cannot say that we have a scientifically determined random sample of the participants at the rave, we feel that our sample is at least a close approximation of the total population those nights. Of course, those people who dropped out of the rave scene due to problems or boredom or any other reason would not be represented in our survey.
At one point during the first night of the survey, at NASA, I looked over at the bar and there were at least a dozen ravers, in a row, in their hats and goggles and backpacks, filling out our survey. It was a beautiful sight to see. I had often thought of surveying the people of the rave scene and my dream was finally coming true. Dave and I slapped each other a "high five;" if was a highly successful night.
The second night we handed out surveys at a larger venue with live music. I was approached by several people from magazines and one person from the ABC News Day One show, all interested in the survey and our results. It seems that the second wave of media hype/coverage surrounding MDMA is in full swing. The connection of MDMA to raves and rave culture is a new angle.
The survey itself started out by asking some basic demographic questions, then went on to quantify and qualify drug use-what drugs, how often, in what setting. There were also more open-ended questions where people were asked to describe their best and worst experiences at raves, with MDMA, and what they did to maximize benefits and minimize side effects. The results are still being analyzed but some preliminary results are obvious at this time (complete results will be reported in the next MAPS newsletter).
Demographically, as was our initial impression, raves attract a remarkably heterogeneous population that reflects a diversity of race, class, sex, and sexual orientation so rarely seen in other club settings. Age was the only characteristic that was fairly uniform, with most participants being in their late teens to mid- twenties.
As for drug use, a very large percentage of regular ravers (about 75%) have taken LSD at raves. About the same number have taken MDMA at raves. Marijuana was used less frequently (about 60%) , alcohol was much less (about 20%). There was very infrequent use of cocaine (about 10-15%), and almost no use or heroin or amphetamine. However, while drugs are often used at raves, not everyone does so. Many of the ravers reported that they completely abstained (around 15%). Of those people who do use drugs, many do not do so at every rave they attend. There were very few problems reported as a result of drug use and those problems that were reported were minor; typical problems were losing track of friends at a large rave. There were a wide variety of reported benefits ranging from simple recreation to profoundly moving and insightful experiences. There was a disturbing amount of misinformation concerning MDMA, including the amazingly resilient myth that MDMA drains spinal fluid.
The survey results suggest primarily that the rave scene itself is not likely to burn out in the near future because perceived benefits greatly outweigh perceived harms. Because of people’s overwhelmingly positive experiences at raves, people reported that they intended to continue to go to them, and that they were more likely to use drugs at raves than outside of raves. We found that there is a definite need for the distribution of accurate educational materials at raves both to clear up misinformation and to minimize potential problems such as have occured in the British rave scene. To that end, I have started a column in a local monthly rave magazine addressing drug education and harm reduction.
A few weeks after the survey, I found myself on Jane Pratt’s talk show on Lifetime Cable. The show’s focus was "Raves and Ecstasy" and I was on to discuss the raves for research survey. NASA’s founder/promoter was also on the show, explaining his motivation for promoting the rave scene and rave culture. Several ravers were also on the pane to communicate their experiences with MDMA, and the other panel member was a man from the West coast who was concerned for our nation’s youth. He would have made Nancy Reagan proud.
The show went very well, I thought. The audience members were a mixture of ravers and talk show audience types, somewhat judgmental but open-minded. There was plenty of conflict, heated discussion, and some yelling – just what the producers want to keep the home audience tuned in. The bottom line of the show’s message was that hundreds of thousands of people are taking MDMA worldwide and it is imperative that research be conducted to explore its potential and to have more definitive answers to the questions being brought up by the audience.
So now that the survey data is being entered into the computer and analyzed, and the television producers and magazine writers have stopped calling, I have taken some time to regroup. I had another meeting last week within my department to discuss some more concrete ideas I have to perform SPECT studies (a newly developed brain imaging technique) with recreational MDMA users. The department continues to be wary of the more controversial nature of the research but I was certainly more encouraged and supported than the last meeting. I am beginning to focus more on specific hypothesis-driven research. This entails asking just one question as the center of the study which is very challenging to me. I have so many questions that I don’t know what to ask first!
I have been advised to "distance myself emotionally" from my subject material, so that I may be taken seriously by other research scientists. Trying to focus myself and maintain objectivity could turn out to be my biggest project yet! I certainly have high hopes for the knowledge to be gained by MDMA research, and I am thankful for the role that MAPS plays to that end.