Reality Sandwich features an excerpt from Tom Shroder’s new book, <i>Acid Test</i>, highlighting how MAPS Founder Rick Doblin began his career-long work to complete the research necessary to make MDMA-assisted psychotherapy into a prescription treatment. The article details Doblin’s initial efforts to study psychedelics, describes Doblin’s long-term follow-up of Walter Pahnke’s “Good Friday” psilocybin experiment, and recounts Doblin’s work to receive a Ph.D. from John F. Kennedy School of Government at Harvard. Doblin had the goal to "remake himself into someone who could research psychedelic medicine with the sober caution that would be required if it had any chance of ever winning FDA approval,” writes Shroder.
Originally appearing here.
<i>Acid Test</i> follows the converging life stories of three men, Nicholas Blackston, a Marine who suffered terribly in heavy and relentless combat in the Iraq war and developed life-threatening Post Traumatic Stress Syndrome; Dr. Michael Mithoefer, a compassionate psychiatrist who believed in the healing potential implicit in altered states of consciousness and was willing to risk his professional reputation to test this idea in clinical trials; and Rick Doblin, a self-invented crusader for bringing psychedelic medicine out of the highly stigmatized deep freeze where it had been stuck ever since widespread popular abuse in the 1960s overshadowed two decades of earlier clinical success. Rick, who had dropped out of college to explore his psyche with repeated LSD experiences, more or less appointed himself — against all conventional logic — as the point man for bringing psychedelic therapy back into the mainstream, and began a decades-long struggle that continues today. He is currently the founder and executive director of the Multidisciplinary Association for Psychedelic Studies (MAPS), a non-profit research and educational organization that, according to its mission, “develops medical, legal, and cultural contexts for people to benefit from the careful uses of psychedelics and marijuana.” The following chapter picks up as Rick begins to prepare himself for the battles ahead.
If Rick was going to run an organization dedicated to providing “rigorous scientific evaluation of the risks and benefits” of MDMA, he was going to have to learn how to do rigorous science. He set out to teach himself, beginning with his senior thesis at New College. It was an evaluation, twenty-five years after the fact, of what many considered to be one of the most rigorous early studies on the effects of a psychedelic. On Good Friday, 1962, in Boston University’s Marsh Chapel, Walter Pahnke, a physician, psychiatrist, ordained minister, and Harvard PhD candidate, administered capsules of white powder to twenty Protestant divinity students just prior to the holiday service.
Ten of the capsules contained nicotinic acid, a stimulant. The other ten contained psilocybin. The thesis was that spiritually inclined individuals engaged in a sacred ritual might react to the psychedelic drug by having a full-blown religious experience. It was an attempt to re‑create in a contemporary Western context the religious visions obtained in the peyote rituals of Native Americans and to assess their impact on individuals’ lives. The stimulant administered to half the group was meant to serve as an “active” placebo, because clearly a sugar pill wasn’t going to make anyone think he had been given a psychedelic drug.
True, the effects of nicotinic acid—a warm flush sensation created by dilation of the blood vessels and a systemic feeling of relaxation—bore little resemblance to a psychedelic trip, but what did? Pahnke had chosen subjects who had never taken psychedelics, hoping that they would be more easily fooled by the stimulant. This was important, because in trying to assess purely subjective effects—and little was more purely subjective than a mystical experience—the expectation in the minds of both subject and observer could easily create a false positive. This lack of a double-blind aspect—which left both the researchers and subjects uncertain of who got the good stuff—was a flaw common to the early psychedelic studies, and a key reason why they were so often dismissed.
As it turned out, Pahnke’s double-blind attempt failed. After brief confusion among those given the nicotinic acid when its effects began to be felt, the overwhelming perceptual changes brought on by the psilocybin were so obvious to all that the study participants, who were in the church together, might as well have worn labels.
The crumbling of the double-blind procedure would have been “quite damaging” to the credibility of the results, Rick wrote, if the experiment had been purely intended to measure psilocybin’s ability to produce mystical experience in isolation, regardless of set and setting.
But in this case the religious context of the Good Friday service and the spiritual bent of divinity students were all part of the exercise. Pahnke had chosen the participants and location precisely because he wanted to observe the effect of the drug administered in a spiritual set and setting.
However, Rick wrote, “restraint should be used in attributing the experiences of the experimental group entirely to psilocybin.”
In Rick’s critique it is possible to see the beginning of a transformation: a “Tim Leary for the ’80s” attempting to remake himself into someone who could research psychedelic medicine with the sober caution that would be required if it had any chance of ever winning FDA approval.
Pahnke’s paper on his experiment stressed the positive results. Nobody suffered any apparent physical harm or long-term psychological harm, and an overwhelming majority of those who took the psilocybin felt the experience had been profound and had made a positive impact on their lives, even six months after the fact. One subject said that he had vividly experienced the passion of Christ, identifying with it completely. Another said that after first going through a period of paranoia and feeling imprisoned in the church (which had bars on the windows and a guard at the door to keep the subjects from going outside during the experiment), he began to experience “the dropping away of the external world,” followed by “the sudden sense of singleness, oneness” that made “the rest of normal waking consciousness” seem like a mere illusion.
Pahnke died in a scuba diving accident in 1971. Fifteen years later, Rick reinterviewed most of the participants of the study, who still believed taking psilocybin that day had fortified their spirit and improved their lives. But he found flaws in the experiment. His thesis assessment, which was ultimately accepted for publication, indicates the distance he had come:
Pahnke failed to report the administration of the tranquilizer thorazine to one of the subjects who received psilocybin [and had an acute anxiety reaction]. There is no justification for this omission. . . . In addition, Pahnke underemphasized the difficult psychological struggles experienced by most of the psilocybin subjects. These very serious omissions point to an important incompleteness in Pahnke’s interpretation of the effects of psilocybin.
Some of the backlash that swept the psychedelics out of the research labs and out of the hands of physicians and therapists can be traced in part to the thousands of cases of people who took psychedelics in non-research settings, were unprepared for the frightening aspects of their psychedelic experiences and ended up in hospital emergency rooms. These unfortunate instances of panic
reaction have many causes, yet some of them stem from the way in which the cautionary elements of the Good Friday experiment were inadequately discussed in Pahnke’s thesis, in subsequent scholarly reports and in the popular media.
[The] optimism regarding the inherent safety of the psychedelic experience did not fully acknowledge the complexity and profundity of the psychological issues associated with psychedelic experiences. With some proponents of psychedelics exaggerating the benefits and minimizing the risks, a back-lash against these substances was predictable.
Rick graduated from New College in 1987, sixteen years after he had begun as a freshman. He aced his Graduate Record Exams, putting him in the top one-tenth of 1 percent—enough to get him interviews at some of the highly competitive clinical psychology programs. In each case, Rick says, “I had these great talks and usually most of them would be clearly super excited about what I was doing.”
But at the end of each interview, Rick would say, “I want to do MDMA therapy research for my dissertation. And I know that’s five years away or whatever and it’s still illegal, but I don’t want to get in a position where I don’t mention that to you and that when I get there after I’ve done all this work you tell me no. So I’d rather tell you now.”
When the last “We regret to inform you . . .” notice arrived in his mailbox, he went to a secluded room in his house—technically now his parents’ house. “I smoked some pot and I started thinking. And I was, like, I feel like there’s a pattern here and the pattern is that I want too much too soon. I want to do this psychedelic psychotherapy research, but the world is not ready for it. It’s like relationships with women: a lot of times I want too much too soon. So then it was just, like, all right, well, if the politics is in the way of science, maybe I should study the politics.”
And if he was going to study the politics of psychedelics, he figured, he needed to do it in a way that would give him the best mainstream credential possible. That, he decided, would be the world-renowned John F. Kennedy School of Government at Harvard.
Rick remembered a magazine interview with a professor there named Mark A. R. Kleiman who had mentioned the MDMA lawsuit. It wasn’t much of a connection, but Rick called him anyway.
“I said, ‘You have no idea who I am but I did this stuff that you know, and would you be my mentor?’ ”
Kleiman encouraged Rick to apply, and this time he got in.
“I think it was just affirmative action,” Rick says. “I was the hippie of the year.”
The hippie took two years to get his master’s degree, then applied for and got a Presidential Management Internship, a prestigious and competitive program for people interested in a career in federal government. The PMI website said it sought “the best and brightest Americans who want to make a difference in the public service” and called the program “a stepping stone to highly visible and respected leadership positions in the federal government.”
Rick didn’t really want a government career, but he did want to know how to manipulate the levers and pulleys that could move public policy on the issue of psychedelic medicine. When a team from the CIA came to recruit from the PMI recipients, Rick raised his hand. He thought, What can I do with the CIA? and the answer that came to him was: Propose a study on the national-security implications of legalizing drugs. To Rick, it was obvious that the quarter-century-old war on drugs had wreaked a long list of harms on the country, including unnecessarily swelling prison populations, wasting billions of dollars on ineffective enforcement, providing an inexhaustible source of funding for organized crime and narco-terrorists, and, of course, preventing research into the beneficial uses of marijuana and psychedelics. Would legalizing drugs and putting them under federal regulation ameliorate any or all of the above?
The Agency interviewers must have been impressed with Rick, even if they brushed aside his proposal. Would he be interested in doing psychological profiles of world leaders? they asked.
After he left, Rick thought about the distance he’d traveled: from being, basically, an outlaw, he had arrived at a place where he was exchanging ideas with the likes of the CIA. For Rick, this wasn’t just one of life’s curiosities but a question of strategic importance.
He asked himself, Am I more effective from the inside working out or the outside pressuring in? It depended, he decided. If he had persuaded the CIA to let him study the potential national security benefits of ending the war on drugs, then going inside would be worth it. “I thought, okay, I would be willing to give up drugs and wear a suit to do that.”
But that wasn’t going to happen. So what other inside job would be worth it? Rick pondered that and came up with answer: he sent an internship application to the FDA.
Once again his timing was uncanny.
For thirty years, ever since the FDA had prevented thousands of horrific birth defects in the United States by refusing to bow to corporate and consumer pressure to approve the sedative and anti–morning sickness drug thalidomide without further testing, the agency had focused primarily on stopping bad drugs from getting to market. But there was a downside to this unrelenting focus on safety: through the seventies and eighties, the time, money, and effort it took to gain FDA approval for new drugs kept escalating. Many helpful medicines were becoming available internationally long before they could be legally prescribed in the United States.
The pharmaceutical industry began to push Congress for FDA reform just as the AIDS epidemic created tens of thousands of new victims each year, all desperate for more effective medicines with the clock ticking against them. In 1987, as the pressure to change ratcheted up, a forward-thinking clinical pharmacologist named Carl Peck was appointed to head the FDA’s center for drug evaluation with a mission to make drug approval more efficient without compromising the public’s safety. Peck created a new staff within the agency, Pilot Drug Evaluation, specifically to find innovative ways to reengineer the drug approval process. To do that, the new division needed some new drug applications to experiment with. Since the FDA bureaucracy had already divvied up all drug categories among existing departments, Pilot Drug would need to wrest some categories from elsewhere.
One of the categories it ended up with—essentially because nobody else wanted it—was psychedelics and marijuana.
Since Rick had founded MAPS, he’d made applications for five small human MDMA studies, each in conjunction with researchers at prestigious universities and each backed by the required animal safety studies. All were rejected. To say that the regulators had an attitude would be no exaggeration. Rick would only learn later, when he wrote his PhD thesis on the subject, that the director of the FDA department responsible for rejecting his applications had once said of the 1960s psychedelic research at the University of Maryland institute where Stan Grof had worked: “It was just an excuse to give people LSD. . . . If I had the power, I would have put the doctor in charge in jail.”
The unlikely confluence of events—that the psychedelic portfolio was now being relinquished to a staff specifically intended to break new ground, shake things up, and find ways to help get beneficial drugs through an obstructionist system just as Rick was blindly applying for an internship—seemed like fate. Rick got a call from the head of Pilot Dr
ug, Dr. John Harter.
“I went down there and I met with him, and he was, like, ‘You’re just what we’re looking for.’ I’m, like, ‘Fantastic.’ The thought was that I would work inside for a couple of years and then I would go back to MAPS and I would try to bring them proposals.”
Here was an opportunity to live inside the belly of the beast and learn its ways, just as he had hoped. He’d gone through all the high-level interviews, and Harter was sold. There was just one problem: when the DEA got wind that the FDA was about to hire Rick, someone senior gave Harter an earful. “They told him, ‘No way can he work on psychedelics and marijuana,’ ” Rick remembers. “So I said, ‘All right, that’s fine, I’ll work on any other drugs; I just want to see how you do stuff.’ ”
Rick was redirected to the bottom of the totem pole, a job that certainly didn’t require a master’s from Harvard Kennedy School. The only remaining interview, with the eight women who would be his coworkers, seemed a formality. Dr. Harter even invited Rick to spend the night before the interview at his house. They’d drive in together in the morning, Rick would do the pro forma interview, and then he’d be hired.
Harter had apparently forgotten to clue the women in on the plan. He introduced Rick, expressed his support, mentioned that Rick wouldn’t be working with any psychedelic drug issues, then left them alone.
“We do a lot of photocopying,” one of the women began. “Are you willing to do photocopying?”
Rick told them he practically lived at Kinko’s. Photocopying would be no problem.
“And then they said, ‘Well, how are we going to keep you away from seeing anything to do with psychedelics or marijuana?’ ” Rick tried to soothe their concerns, but he could see where things were headed. When they voted, he lost in a landslide. As it turned out, one of the innovations in Pilot Drug management involved letting the people on the floor have more say in hiring.
Harter, embarrassed about what had happened, offered Rick a consolation job helping to get a computer system up and running. In the end, they both decided Rick would be better off on the outside.
Besides, Rick thought with relief, now I can still smoke pot and I don’t have to wear a suit.