Originally appearing here.
For Rick Doblin, being invited to the Pentagon was an emotional experience. Growing up in the 60s, Doblin embraced the counterculture and protested the Vietnam war and the military-industrial complex behind it.
Yesterday he was at the Pentagon trying to persuade military medical officials to permit a clinical trial that would test MDMA, the active ingredient in the party drug Ecstasy, in conjunction with psychotherapy, in active duty soldiers with post-traumatic stress disorder.
“There’s been this history of conflict between psychedelics and the military, and we’re trying to say that’s not the only vision,” Doblin said. “There’s a way for us to come together.”
Doblin is the founder and director of the non-profit Multidisciplinary Association for Psychedelic Studies (MAPS), which is trying to get drugs like psilocybin, LSD, and MDMA approved for medical use. MAPS has already sponsored small clinical trials of MDMA-assisted psychotherapy for PTSD, first in survivors of sexual abuse and assault, and now in military veterans, police, and firefighters.
Doblin spoke with Wired about his military mission and what it says about shifting attitudes towards psychedelic drugs.
Wired: What were you doing at the Pentagon?
Rick Doblin: I am hoping to convince them to back a study with active duty soldiers with PTSD. But I’m not asking them to fund it. MAPS will fund a demonstration project. If it works, I’d hope they will fund future studies. This was our second meeting to talk about some sort of collaboration, and the meeting went really well.Wired: Was it strange for you to be there?
Doblin: Just walking into the Pentagon and being invited to the Pentagon is a healing process for me personally, and I hope more broadly for society. In the 60s, society went in two directions: There was psychedelics and marijuana and anti-war protestors, and there was alcohol and beer and pro-Vietnam supporters. But now the war on drugs is losing steam, and the culture is coming together again after 45 years.
But I don’t want to underestimate the resistance. When Michael Mithoefer [a South Carolina psychiatrist who has led two PTSD trials sponsored by MAPS] came to the Pentagon with me the first time, he shaved his ponytail off. The last time he did that was when he did his residency interviews after medical school. So we’re trying to do our part not to create countercultural flak, and I think that’s really key.
Wired: The fact that they’re even considering this seems like an indication of how things have changed.
Doblin: For so long the only story that’s been told has been exclusively one of risk. It’s been told for marijuana, MDMA, LSD, and psilocybin, and the risk has been exaggerated. Now that we’ve been able to start getting some evidence on the benefits, it changes people’s calculus. And the benefits are coming in areas that people are more worried about than they are about drugs, like end of life anxiety [in terminal cancer patients] and PTSD in veterans. We’re purposely choosing conditions that will resonate with people.
Wired: What benefits have you seen so far in the study with veterans?
Doblin: We’ve had 13 people enrolled. Three were firefighters, 10 were veterans. Some of them are seeing their symptoms reduced to the point that they’re no longer diagnosed with PTSD. They’re able to go back to work. I’m not saying it’s happening with everybody, but it’s happening to a significant number of them. The symptoms of PTSD are diminished to the point where we can speak about durable remission.
From our long-term follow-up study [to the earlier clinical trial with assault victims] that we published in November in the Journal of Psychopharmacology, we found that at an average of three and a half years the benefits were sustained over time.
Wired: How does MDMA-assisted psychotherapy work?
Doblin: The first thing is three weekly sessions before they take MDMA to build a therapeutic alliance [with the therapist] and get a sense of what the issues are and prepare them for the experience. Then it’s an 8-hour session with a team of one male and one female therapist that starts around 10 in the morning and goes till 6 at night. And we require them to spend the night at the center. It’s like time out of life for them to reflect and integrate the experience.
What happens during the session itself, and this is the hardest thing for traditional therapists to understand, is unstructured. Patients agree beforehand that if they don’t talk about the trauma themselves, we’ll bring it up. But we never have to do that. We’ll ask questions and reflect back what they’re saying, but there’s no set sequence. With MDMA they don’t have their normal fear response, and they’re more able to talk about the trauma and think about it. They look at the triggers, whether it’s a loud noise or seeing someone with a certain type of clothes that reminds them of their attacker.
There’s this whole new understanding of memory which is that when you remember something it’s not like you’re pulling it off a hard drive, playing it, and then putting it away. The memory is reconsolidated or recreated, and that’s how people’s memories can shift. What it means is that when they’re remembering this incident under MDMA it gets reconsolidated without the fear being as strong as it was before.
People actually remember more of the trauma under MDMA. It doesn’t just obliterate the memory in this Ecstasy-like haze.
Wired: What’s your ultimate goal with this work?
Doblin: Here we need to make a distinction between my end goal and MAPS’s end goal. MAPS is a 501(c)(3) non-profit organization, and one rule for them is you do not try to change the law. So our primary goal is to seek FDA approval to make [psychedelics] into prescription medicines and to foster research to better understand risks and benefits so people can reevaluate these horrific penalties for use.
Wired: And for your personally?
Doblin: Legalization. Regulation and taxation.
Wired: The Psychedelic Science conference that MAPS helps organize does not feel like a typical scientific conference. Is it hard to foster serious scientific research without excluding people?
Doblin: That is a delicate balance. Some people were excluded from speaking, and we were careful about which vendors were there. We tried to make a very strong pitch to people that the science is the key.
Wired: So why not exclude the folks who are just interested in recreational use?
Doblin: They’re me. I grew up loving to trip and dance all night. They’re part of the family. We gain strength because we didn’t cut our ties with our roots. We let the counterculture in, but we took precautions, so that the message wouldn’t be about reckless abandon.
Wired: What kind of precautions?
Doblin: There was an all-night party on Bicycle Day that was not sponsored by the conference, it was over in San Francisco, but we defensively deployed doctors and therapists to that party because we didn’t want an event that took place even tangentially associated with the conference to be associated with people flipping out. We had 15 people at our own conference patrolling at all times and being ready in case someone took acid and had a bad trip.
Wired: Did anyone?
Doblin: Two kids, probably in town for the Trey Anastasio show at the Fox Theater, came in. They’d bought some acid on the street, saw the sign for the conference, wandered into the hotel, and they had a difficult trip. And yet our staff assisted them so it didn’t result in a call to the police or the hotel saying “you guys are a hoard of trippers here.” We had a special room set aside just to take care of people who ha
d difficult trips.
Psychedelic harm reduction is an expanding part of what we’re doing [at MAPS]. There will always be people who go to parties and do the drugs and get in over their heads. So we make these alliances with with festival organizers and police so that the consequences won’t be getting shot full of tranquilizers and shipped off to jail for the night. We’re envisioning a post-prohibition world.
Greg Miller of Wired interviews MAPS Founder and Executive Director Rick Doblin about his recent visits to the Pentagon to discuss treating PTSD in veterans with MDMA-assisted psychotherapy with senior military officials. Doblin also discusses the success of the Psychedelic Science 2013 conference and events, explains how MDMA-assisted psychotherapy works, and shares his vision for the future of psychedelic medicine.