Yediot Ahronot Magazine (Israel) [translated]
March 25, 2005
ECSTASY NOT WHAT YOU THOUGHT
by Adi Alia
Image by David Polonsky
Translated by Gilla Treibich
Precedent – victims of shell shock will be treated with drugs like ecstasy, hashish and marijuana for research conducted in Israel
Victims of shell- shock and rape victims use ecstasy pills trying to cope with the trauma, hallucinogenic mushrooms are used in treatment for compulsive behavior symptoms, the anesthetic drug ketamine helps heroin addicts and an ancient Indian drug helps cure alcoholics. A conference under the auspices of the Israel Ministry of Health shows that these drugs have never been more popular in medical research.
Amir read in the paper about the new research in the US that studies the effectiveness of MDMA, the active ingredient in ecstasy drugs, in treating post traumatic syndromes. The subject came up in the military clinic in Tel Hashomer where Amir is treated regularly but when he asked the doctors what they thought their advice was to wait for the results of a systematic research and the subject did not come up on the agenda anymore.
About 6 months ago, experiencing deep distress Amir decided to take ecstasy without medical supervision and he does not for a moment regret it! Since then he took the pill several times. “I felt tremendous relief” he says “I got a gift of a few hours with no distress and anxiety, I was free of inhibitions’ I managed to communicate better with others. People don’t understand what shell shock is all about. They think that we are all in a state of shock, zombies, but it’s not that at all. Today, when I see characters like Rambo in the movies’ I know that shell shock can look exactly like this. I too was Rambo – that was my initial reaction to the trauma’ but it changed. Today I cannot walk across an open area. I get 100 shekel fines from the Tel Aviv municipality because I am not capable of walking across a street. I can get stuck for four hours until I muster up courage to walk across a street so I drive everywhere and if I can’t get there by car I don’t get there. Look at how banged up my car is, it’s from parking it everywhere. And after I took ecstasy I was suddenly calm. I get 12 anxiety attacks a day and they are stronger than a heart attack. I know it because I have already been through a real heart attack once. During an anxiety attack you’ll do anything to get rid of it: drink smoke grass take pills – anything you can find.
Do you know a lot of shell shocked people who use drugs in a non therapeutic framework? “Loads of them, they mostly drink.”
We meet on the beach, in a place where other shell shocked guys often meet. A guy slowly passes by, a man with a large beer can well tucked away behind his back and he waves at us. He looks 70 plus. Amir who is 50 and suffers shell shock since the Lebanon war says the guy is 53. He too suffers shell shock but does not agree to be recognized a disabled person. He drinks non stop. Alcohol numbs the sensations we can’t stand.
Amir was once considered a success story of recovery from shell shock. Although he describes his trauma as a multi level one – he was a regular soldier in the Yom Kippur war (1973) and a reserve soldier in the Lebanon war (1982) – he succeeded in building a thriving business for the production of events. ” Every production was like Operation Entebbe” he says, I needed the adrenalin it was a substitute for the extreme experiences I had in the military.”
But the success story was just the outer cover deep inside there was the hustle of a totally different life. “At 18 you are completely immune you fear nothing. But it seems that the shock is as deep as the suppression. During my regular service we used to go almost every night into Fattah Land in Southern Lebanon. One time my rifle died on me during shooting and I was left with a broom stick in the midst of an ambush. I found myself all alone in the midst of buildings in enemy territory after most of my friends were killed or wounded and I couldn’t get out for 24 hours.”
What did you feel while this was happening?
Very cool no problem. As long as you are in distress – you function. But when you go home you have to conduct an Operation Entebbe every day in order to feel that you are alive. You get out with a big “scratch in your brain” that can be very productive. Everybody said about me” the guy is rehabilitated” they didn’t understand that it was a reaction to trauma.”
In 94 a number 5 bus blew up on Dizengoff street right in front of Air’s business. “That finished me off. I could not leave the house for a year and a half. I lost everything I had: my family’ a business of 150- workers, a home, loads of money. My wife didn’t leave me alone, she couldn’t understand why I don’t go out. For her I was like a broken MTA. At night I had to choose which one of my wounded friends I am going to save and who I am condemning to death. This is something that keeps coming back to me all the time.”
A year ago Amir started experimenting with the use of the active substance of ecstasy in an attempt to free himself of the post traumatic reaction. “Judging by my feeling when I am under the -influence of the substance they should have put some MDMA in the medication that we are receiving. You need to check for adverse affects, naturally, but I use so many poisons in the medication I am already taking that I don’t know if this is more or less dangerous.”
Amir would be glad to participate in an experiment of MDMA induced therapy. He is also aware of the danger in using ecstasy in a non therapeutic framework. “I know it can be dangerous for people with high blood pressure, and it is a common thing with people like me who take psychiatric medication.” Dr. Rachel Bar-Hamburger the chief scientist of the anti drug authority disagrees with the illegal use of the drug. “The fact that a certain person took the drug and it helped him is not sufficient proof” she says. “I know that people try by themselves or with underground therapists, I don’t believe that this will bring a break through.”
Therapy induced by substances that serve as drugs has become quite popular in recent years. “Like a fire in a thorn field” writes the London Guardian, “these experiments spread, as if we were in the midst of the merry sixties”. Not only experiments using MDMA are blossoming. An experiment in the University in Arizona studies therapy of compulsive disturbances induced by the Hallucinogenous Mushroom Psilocybin. In the University of California Psilocybin therapy is used experimentally for terminal cancer patient suffering from death related anxiety; in Baltimore a similar experiment using LSD is awaiting FDA authorization; two Russian groups are testing the possibility of helping drug and alcohol addicts using the veterinarian anesthetic Ketamine; while in a small clinic in Peru experiments are conducted to see if you can help alcoholics using an ancient Indian potion extracted from the ayahuascax vine which causes potent hallucination; three years ago in Spain research was interrupted studying the use of MDMA in therapy of rape victims, it is being renewed soon.
In Israel too there is considerable activity in the subject. Prof Moshe Kutler of the Tel Aviv University has lately been granted authorization to conduct an experiment on 12 heroine addicts using the psychedelic substance Ibogaine, trying to test its effect on addiction and he is now working on a research proposal for using MDMA to shell shock victims. Prof Meshulam a cannabis researcher from Jerusalem has already obtained authorization to research the effect mar
ihuana and hashish on reserve soldiers who are shell shock victims. In addition the Ministry of Health is hosting this week an international conference dealing with research of the therapeutic effects of MDMA. Israel is one of the countries where research is planned to study the effects of the known club-drug on shell shock victims. One of the conference participants is Dr Michael Mithoefer, who is the first one in the world to hold scientifically accepted results of an experiment in MDMA induced therapy. Up to date seven people have completed his experiment program (out of twenty planned) all of them suffer posttraumatic syndrome (PTSD) as a result of sexual abuse. Doctors and patients in Israel are among those awaiting the results of his experiment.
“The patients re-live the trauma in various ways” he says. “Flashbacks, recurrent disturbing thoughts, nightmares. In order to avoid the pain they avoid activities or places that remind them of the trauma and they develop emotional numbing. The numbing can sometimes be an obstacle to traditional therapy. It is still too soon to draw conclusions from the experiment but so far the results are very promising and we see dramatic improvement in the patients’ condition – they feel emotionally invigorated. All the participants have severe post-traumatic symptoms, and all had treatment with medication, which did not improve their condition. Recently I was granted approval to include in the experiment not only victims of sexual abuse but also shell shock victims. We are now inviting soldiers who returned from Afghanistan or Iraq to take part in the experiment.
AA: How did the experiment participants react to the idea of using MDMA?
MM: “In the beginning most of them were apprehensive. Some never thought of using this kind of substance but when nothing else helps they were willing to try”.
AA: Did any of them use drugs previously?
MM: “Most of them did not and those who did used drugs no more then three times and not recently.”
AA: What happens during this kind of therapy?
MM: “It consists of a series of meetings and only in two of them the patient takes MDMA, with a two to five week interval. It is not a continuous treatment of medication. The patient comes to the clinic in the morning, lies down on the bed and swallows the substance in the presence of two therapists – a man and a woman, at least one of whom is a psychiatrist. I work with my wife Ann who is a psychiatric nurse. It is very beneficial for sex abuse victims who find it difficult to connect with a therapist of a certain sex. There is a basic agreement according to which people are in the experiment to work and the trauma but we don’t direct them to it, we only provide the a secure and supporting environment. People don’t understand how important it is when you are dealing with psychedelic drugs it can mean the difference between a hard and problematic experience and one that helps healing. The most important part of the therapy is to learn how it include the feeling of safety in your life later. After the meetings we talk to them on the phone almost every day during three to four weeks.”
AA: How long is a session?
MM: “Between six and eight hours. The patients receive 125 milligrams – approximately like a typical ecstasy pill’ 40 percent of the patients receive placebo to serve as a control group.”
AA: Why did you choose MDMA or your experiment?
MM: “The substance was used by therapists in the US before it was outlawed. In the beginning of the eighties a lot of evidence was accumulated in the field showing that the substance allows the patient to connect in a deeply emotional way to the trauma without being swallowed by fear. The substance was not outlawed because of problems in therapy but because it became a popular street drug, and I can’t guarantee that our experiment is totally risk free.”
AA: Why would someone agree to revisit the trauma out of his or her free will? Isn’t it better to suppress?
MM: “I will never try to persuade anyone to do this but when people who have been medicated for years and still experience the trauma over and over again it is not new to him or her. I think that the name “ecstasy” is very misleading in this case. The patients don’t experience ecstasy. Some of the time they cry’ they shake but some of the time – and that is crucial, they experience happiness and safety. Still it is ecstasy’ aren’t there serious risks?”
MM”The only danger is that blood pressure could go up and this is why we do early screening on theMM participants. In the framework of therapy and in the doses we administer there is no evidence of nervous poisoning. The problem of high body heat, which happens at parties, cannot happen in this framework, as the patient is lying down and drinks sufficiently.”
Mithoefer’s experiment was delayed 4 years because the FDA required one more approval of an independent source that would examine the ethical aspect. Seven separate groups refused to grant such an approval – not surprising in view of the experiments conducted by Dr George Ricarte published in 2002, where he sates that one dose of MDMA can cause Parkinson’s disease and cause irreversible destruction of brain cells. It was not until September 2003, when Dr Ricarte’s team retracted the results because the substance they administered to the monkeys was not MDMA but rather methamphetamine (speed), that things started moving along. Mithofer’s team obtained the long overdue clearance from the ethics committee in 18 days.
Dr Jose Carlos Buoso, a psychologist from the Autonomous University of Madrid, was exhausted by bureaucracy. In 2001 he started an experiment in MDMA therapy with rape victims. “In May 2002 a Spanish newspaper published an article abut my research and as a result the drug authorities started pressuring the CEO of the public hospital where we conducted the experiment. As a result he decided to withdraw the authorization to use his facility”. Unlike Mithofer Buoso started therapy by using a small dose of MDMA and did have the time to reach a dose higher than 50 mg. “They did not fully experience MDMA” he says. He hopes to renew his experiment next September.
AA: Most people who took ecstasy report increased openness for physical contact. Does this feature influence in any way rape victims?
JCB: “According to experiments, MDMA does not cause sexual arousal but rather intimacy. People like to hug and to touch each other but there is no sexual intention. For women who have been raped the possibility of separating and the association between touching and hugging and a sexual feeling can restore confidence in intimate relations. It is very important in order to enjoy sexual life in the future”.
Few of the researchers who arrived in Israel last week heard of the experiment conducted here in the seventies, where victims of shell shock were given shots of [pentathal] (“truth drug”) and with it the trauma was relived through audiovisual means. That experiment was defined as a colossal failure and many of the participants still suffer the consequences. Dr Mithoefer claims there is no comparison between the use of panthotel and MDMA in therapy.
“As far as I know these substances have nothing in common” he says. MDMA tends to reduce fears and defenses and increase trust and security. Pentathal does not have these qualities. In therapy conducted when MDMA was still legal, we [?noticed?] that people were swept with the experience, felt a high degree of self esteem, they experience a certain illumination about the source of their trauma and at the same time discover they have more mental power than they thought. It turns out that not every achievement has to be obtained with sweat and blood”.
Nearly 5,000 people who live in Israel have been diagnosed by the IDF as shell shock victims and there are probably several thousands more who don’t report it.
Gideon, a doctor, who had the misfortune of being prese
nt at two terrorist attacks – one three years ago and the second one a year and a half ago – didn’t know he was suffering from post-traumatic syndrome. “I considered the matter in a fairly rational manner”, he says. “I understood the attacks were no directed at me personally’ but after the first attack my mental situation kept deteriorating. I started drinking tremendous amounts, I could not go anywhere without alcohol. The people in social security used to ask me how I was but I told them nothing.
One day, after the second bombing, he was invited for a meeting with a psychiatrist of the social security and was diagnosed as a post trauma victim and an alcoholic on the way. “He warned me that if I don’t treat it my life is going to go and he explained in medical terms what is happening to me”.
Were does ecstasy come into the picture?
The psychiatric medication that I took at first caused trouble to my digestive system and I could not take them. At that time I tried all sort of things and one evening somebody gave me an ecstasy pill. I took it and suddenly I felt alive”.
In the past year Gideon has been taking ecstasy once a week, at the same time as prescribed psychiatric medication. “MDMA is a strange and complex substance. It does not necessarily make you happy, it makes your emotions more extreme. One time I took ecstasy when I was depressed and my condition deteriorated. Part of my problem is that normal stimulation does not reach me. I came out alive from a bombing where everybody around me died and somewhere you could say that I too died there. Today in odder to feel alive I need loud music, lights, people, noise – and ecstasy sharpens your stimulations very much. Even two days later I still feel like the person I would like to be”.
AA:How do you know that what you are buying is actually MDMA?
G: “I don’t know and that is one of the greatest problems. I buy what I can get. I found out by experience, for instance. That you can’t mix ecstasy with the sleeping pills I take.”
“I was alone and I had pretty frightening hallucinations.”
AA: How do you decide how much ecstasy to take?
G “I try not to take more than one pill’ but I can definitely feel the effect decreasing and the need to increase the dose. I would love to know how much I am allowed to take and when it starts being dangerous but there is no sufficient research in the field yet.”
Trips and Nudism
It is not the first time a conference like this takes place in Israel. Three other conferences preceded it in the last years and behind all of them is a warm Jewish guy by the name of Dr Rick Doblin. The 50 year old Doblin was young boy when he heard President Nixon calling Timothy Leary, a professor from Harvard who conducted experiments with psychedelic drugs, “the most dangerous man in America”. “For me this was a hint that if we use psychedelic substances wisely, it could free us among other things of the manipulations the government is putting us through. At 18 I got an idea that seems wonderful still today: I decided to dedicate my life to research and therapy induced by psychedelic drugs, first for myself and later perhaps to help others as well.
Today Doblin is the engine behind most research conducted in the field of psychedelics throughout the world.
The organization that he founded and heads is MAPS (Multidisciplinary Association for Psychedelic Studies) had a budget of $ 1 million, all from contributions. Dr. Kotler’s experiment in Israel will also be financed by MAPS.
In 1971 Doblin enrolled in “New College” of Sarasota, Florida which was considered an experimental institution. “I did not know it when I enrolled but part of the college was a nudist colony that gathered regularly around the pool and there was a tradition of long parties where people used LSD. At that time I already knew that my problem, same as the rest of the people around me, was that we were intellectually very advanced but emotionally – gurnischt. The first time I tried a trip I understood that this is the tool that will help me work on this lack of balance. I happened upon a book by John Lilly about experiments he did with LSD inside an isolation tank that he developed. My friend and I tried to create isolated spaces where we could do trips but I was not mature enough to cope with the strong emotions the trips brought up. The college psychologist gave me a book by Stanislav Grof “Realms of the Human Unconscious” that dealt with the results of his experiments with LSD – which was interrupted by the government. This was a decisive moment in my life. The book offered scientific methods to evaluate religious and mystical situations.
After dropping out of college and going into the construction business Doblin returned to school at 28.
“MDMA was still legal at that time. During the first semester I discovered to my amazement that there were underground therapists, researchers and chemists who worked with the substance. I started to think politically: I knew that the minute someone finds out that MDMA is used outside the therapists’ community it’s going to be outlawed, and that’s exactly what happened. When the antidrug authorities made known their intention to declare the drug as a substance with no medical use I organized a group of 15 researchers who argued this was not the case. A hearing started in court and the judge decided that it would be preferable to define the substance as a medication that requires doctor’s prescription but the antidrug authorities used an emergency regulation to bypass the judge and forbid any use of the drug”.
Did you use MDMA in therapy in those years?
“Yes, I sat in many therapy sessions especially with Vietnam veterans. In 84 I worked with a woman who suffered post traumatic symptoms and wanted to commit suicide. Her therapy succeeded above and beyond expectations. She was rehabilitated and became a therapist who worked with us on research in Spain. Ultimately a post Traumatic disturbance is like a phone, it will not stop ringing until you answer. MDMA helps people pick up the receiver.”
Permission is Granted
Dr Rachel Bar-Hamburger’ the chief scientist of the antidrug authority does not object to treatment facilitated by substances defined in the law as unauthorized drugs. “If the treatment has a medical purpose and is administered by a professional, as far as I am concerned it is Kosher. I am not only talking abut MDMA but about any other psychoactive substance that will be developed. In my view it is appropriate, it is right and it is fair.
AA:Do you think there can be risks in this kind of therapy?
RB-H: “The main problem is to verify the source of the substance and supervise its quality. The risks of ecstasy can be under control in the framework of psychotherapy”.
AA: Is there no danger of addiction as a result of therapy?
RB-H:”As far as I know there is no danger of addiction with MDMA. This is not the problem of this drug.”
“A person could fall in love with the substance and try to get it on the street.”
“If it is administered as medication the chance of this happening is minimal. Very few people try to buy in the black market substances that were authorized as medication. When a substance is under supervision it goes through a recognized process of production and marketing”. AA: What do you think of Dr Kotler’s planned experiment?
RB-H:”It is a very focused experiment for a focused purpose, and it certainly has a place. The fact the US has now authorized similar experiments tells us that our move is the right one. I am very much in favor of the development of medication in this way, even in substances that have a halo of dangerous drugs. If you are sick it is a good idea to promote a lobby that will exert pressure to develop the substance as medication”.
AA: Is this not in total contradiction to the position taken by the antidrug authority?
RB-H:”No. Our problem is with occasional use by every ragtag
and bobtail, without realizing the damage.
AA: And the public will know how to make the differentiation?
RB-H:”Listen, if you want to use drugs you’ll always justify to yourself why you are doing it, you don’t need us for it.”
The largest Israeli newspaper, Yediot Ahronot, published a favorable article about MAPS’ Israeli conference, which took place the day before, and the use of MDMA-assisted psychotherapy in treating posttraumatic stress disorder (PTSD). The article was accompanied by an incredible graphic of a drowning man holding on to a life preserver that was actually an Ecstasy pill with a smiling face.