Summary: The Verge covers the story of Christopher Medina-Kirchner, who was formerly convicted for selling ecstasy as a teenager and is now a Ph.D. student researching MDMA. The article shines a light on the challenges faced by formerly incarcerated people entering the scientific community and statistical errors, biases, and methodological problems within past research that have influenced drug policies. Medina-Kirchner advocates for studies that assess the risk as well as the benefits of MDMA and he supports recently released ex-felons entering science graduate programs and conducting research through his program, FIRST (Formerly Incarcerated Research and Science Training).
Originally appearing here.
For the better part of 2014, Christopher Medina-Kirchner chased a Columbia University neuroscientist across the country. It started in Chicago. Medina-Kirchner, then a student at the University of Wisconsin-Milwaukee, sent Carl Hart, the neuroscientist, an email introducing himself. Hart responded and asked for a CV, but when Medina-Kirchner sent one and didn’t hear back, he borrowed his girlfriend’s car, drove to the Windy City, and nervously waited after a talk Hart gave to deliver the document personally. They didn’t have much time to talk, so six months later, Medina-Kirchner appeared again — this time at a talk Hart gave in Washington, DC. Again, there wasn’t time to get into deep conversation. They finally connected in St. Louis in 2014 after Hart gave a talk on drug addiction.
Caught between a past marred by a prison sentence for selling ecstasy and an unsteady future studying the drug that put him away, Medina-Kirchner was convinced that Hart, a researcher whose work shows that drug policies are often far more dangerous than drugs themselves, was the only person who might help an ex-felon break into scientific research. When they did speak after months of false starts, “He was like ‘You’ve been following me everywhere. What do you want?’” Medina-Kirchner says. “That’s when I started letting everything go.”
Letting go meant telling Hart about growing up near Milwaukee, joining a gang at age 15 and becoming a small-time drug dealer. Medina-Kirchner did a year in juvenile corrections for fighting and damaging property, and just after turning 18, he was charged with two felonies both involving very small amounts of ecstasy. Medina-Kirchner says that the first felony was for selling three ecstasy pills to an undercover cop and that the second involved being present when another dealer sold 15 pills. Medina-Kirchner remembers the judge citing the dangers of ecstasy as he handed down a harsh punishment for a first-time dealing offense: two years confinement, four years extended supervision, and a record that would follow him for the rest of his life. Medina-Kirchner spent 18 months at Prairie du Chien Correctional Institution, got into a fight, and was transferred to a supermax facility. He got out, couldn’t find a job, then went back to prison after being arrested for selling marijuana. He spent another 18 months bouncing between three different correctional facilities. He took classes and decided to become a drug counselor.
“I wanted to redeem myself,” he says. “I’m going to research these drugs and I’m going to warn people about the horrors of this drug. That was going to be how I paid back society.”
Today, Medina-Kirchner is a PhD student who studies MDMA, but his work veered in an unexpected direction. Working under Hart in Columbia’s Neuropsychopharmacology Lab, Medina-Kirchner is one of a small handful of researchers nationwide who administer pure MDMA — the chemical sold in impure forms as ecstasy or molly — to human study subjects. Right now, the laws that govern MDMA are based on controversial research, and Medina-Kirchner’s work is part of a rapidly growing body of studies that directly contradicts it. And as perhaps the only scientist in the field who has experienced the impact of those laws from within the prison system, he’s also creating a pipeline to help other formerly incarcerated people transition into scientific research.
For Medina-Kirchner, the barriers are steep. Personally, he’s fighting stigma, a record that still haunts him when applying for apartments and jobs more than a decade after his release, and the deep cultural gulf between the Ivy League and where he grew up. Scientifically, he’s pushing for studies that assess drug risks as well as benefits and for research that better contextualizes both. There’s pushback. There’s pressure to succeed, and there’s uncertainty that even if he does, his record could prevent him from working in drug research once his PhD is complete.
“I know that I’m doing good work and I’m doing work that can eventually set people free,” he says. “With that in mind, I’m able to keep doing this.”
Medina-Kirchner is measured in practice and appearance. Standing 6-foot-1, he often wears neat, all-black ensembles complemented by black-framed glasses and offset by diamond studs sparkling from each ear. A small tattoo of three diamonds — a remnant from his gang days — curls down his neck from behind his right ear. When he lectures on the neurobiology of amphetamines to undergrads in Columbia’s drug and behaviors class, he speaks slowly and precisely, a habit developed over years of watching cops, journalists, sometimes even other researchers mischaracterize what scientists know (and don’t) about drugs. Underneath this composure, he’s angry that there’s a need to set people free, especially since many in the medical community opposed making MDMA illegal in the first place.
Like other drugs, the legal history of the chemical 3,4-methylenedioxymethamphetamine, better known as MDMA, is driven more by fear and politics than science. Developed as a blood-clotting agent in 1912, MDMA gained popularity in the 1970s and ‘80s as a party drug and as a psychotherapy tool used in conjunction with traditional treatments. Though the drug was not approved by the Food and Drug Administration, some therapists incorporated it into their treatment regimens for patients struggling with PTSD, depression, phobias, and relationship problems. They credited MDMA with inducing empathy, hailing the drug as “penicillin for the soul.”
That changed in the mid-’80s during first lady Nancy Reagan’s “Just Say No” anti-drug campaign. A sharp uptick of young users and unpublished research indicating that a similar amphetamine called MDA caused cognitive damage when injected in rats prompted the Drug Enforcement Administration to call for an emergency ban of MDMA in 1985. Bolstered by separate research that showed cognitive and nervous system damage in animals given MDMA at levels wildly above what humans would take, the DEA classified MDMA as Schedule I — the punitively harshest category reserved for drugs like heroin that are deemed to have no medical uses and a high potential for abuse — and set a series of public hearings to determine if the classification would become permanent.
DEA officials were shocked when mental health professionals pushed back. Psychiatrists, pharmacologists, and biochemists presented evidence and testimony on MDMA’s therapeutic benefits throughout hearings in 1985, but the DEA overruled these objections and dismissed the administrative law judge’s recommendation to give the drug a far lighter Schedule III classification. Aside from a stint in the late-‘80s when the classification was challenged, MDMA has stayed Schedule I.
When Medina-Kirchner went to court in 2002, MDMA dominated headlines. The federal government had launched a nationwide campaign publicizing the dangers of club drugs, supported by a body of studies that detailed MDMA’s neurotoxicity and linked it to conditions including depression, memory issues, sleep problems, paranoia, psychotic episodes, and motor degeneration. Oprah showed terrified parents scans that purportedly showed holes the drug had bored into a girl’s brain. Just weeks before Medina-Kirchner’s court date, journalists were going wild about a study published in Science, which suggested that using MDMA multiple times over several hours could increase the risk of developing Parkinson’s and other related diseases later in life. Two of the ten animals in that study died. Alan Leshner, former director of the National Institute on Drug Abuse, likened ecstasy to “playing Russian roulette with your brain function.”
While Medina-Kirchner served his time, drug laws became harsher as some of the studies that inspired them were coming under fire. The holes-in-the-brain scans promoted by Oprah were revealed to be images of changes in cerebral blood flow, not holes. Less than one year into Medina-Kirchner’s sentence, the Science paper and an additional study were both retracted because methamphetamine was accidentally used instead of MDMA.
Several scientists said that the retraction was part of a broader pattern of research that over-exaggerated MDMA’s potential neurotoxic effects. Over the next several years, many additional early studies were criticized for using heavy doses far beyond what people typically take, extrapolating findings from studies on street ecstasy where the amount of MDMA in each pill is unknown, failing to provide adequate control groups, and injecting the drug instead of administering it orally as human users typically take it.
At the same time, emerging research painted a more nuanced picture of the drug’s effects on the brain. Many studies offered evidence that MDMA can potentially damage cells that produce serotonin, a chemical that’s associated with mood and temperature regulation, with heavy users being particularly at risk, while other studies only found small differences in cognitive performance between users and non-users.
“Faith in the neurotoxins model just kind of eroded,” says Charles Grob, a psychiatry and biobehavioral sciences professor at the UCLA School of Medicine. Grob has conducted MDMA research and has written about the political history of the drug. He adds that MDMA does carry risks, such as the increased likelihood of high blood pressure reactions and episodes of an inherited condition called malignant hyperthermia. But he also says that “the emphasis on MDMA neurotoxicity was a distraction away from further exploring genuine risks that users might incur.”
Medina-Kirchner wasn’t aware of the controversy around MDMA research until he left prison. He wouldn’t even know the seismic changes in how studies were conducted and interpreted until he began studying drugs himself.
Upon release, Medina-Kirchner enrolled in a technical college; then still strapped to an ankle monitor, transferred to the University of Wisconsin-Milwaukee in 2009. He was allowed to take classes but was denied campus housing due to his record. He was accepted to the McNair Scholars Program, an initiative that helps under-represented minority students transition into doctoral studies programs. McNair Scholars receive two things that changed Medina-Kirchner’s life: a stipend, which gave him financial freedom when he couldn’t find work, and a mentor.
Under Krista Lisdahl, a neuropsychologist who researches the cognitive impact of adolescent drug use, Medina-Kirchner began digging into ecstasy’s connections to depression.
Using data Lisdahl’s lab had already collected on people with a history of ecstasy use, he found that users showed more depressive symptoms compared to control groups and that users with a specific variant of the S100B gene, which is associated with psychiatric conditions, showed even greater levels of depressive symptoms than users without the variant. To Medina-Kirchner, these results supported the common belief that ecstasy can impair users by causing severe depressive mood disruptions.
But his conclusions changed after finding a 2012 review paper written by Carl Hart. Hart performed an analysis of 29 studies on meth’s long-term cognitive effects. When looking at results from brain imaging studies and from cognitive tests that examined things like memory, attention, and brain-motor function, Hart found that control groups, often non-drug users, did better on a few tests than longtime meth users. Those differences, though real, were still within what scientists considered a normal range on those tests or scans, suggesting that even after years of using meth, people still had normal brain function. “In spite of these observations, there seems to be a propensity to interpret any cognitive and/or brain difference(s) as a clinically significant abnormality,” Hart wrote. Medina-Kirchner looked at his own research and found the same problem. Ecstasy users with a specific gene variant had more depressive symptoms than control groups but were still essentially normal.
Medina-Kirchner kept seeing Hart’s name and learned that the Columbia researcher wasn’t much different from him. Hart also sold marijuana as a teenager. After crack appeared in the Miami neighborhood where he grew up, Hart turned to drug research as a way to warn people about the dangers of drugs. Time and time again, he found that risks existed but were frequently exaggerated. Drug sentences were far more likely to leave permanent marks.
When they connected in St. Louis, Medina-Kirchner was “embarrassed by his record,” says Hart. “I knew of his mentor, so I knew that he was doing the work,” Hart says. “My first impression was, ‘What a shame that he’s embarrassed when he’s doing the best he can.’ I wanted to make sure I did whatever I could to make sure that he realized that his life wasn’t over because of a mistake.”
Medina-Kirchner applied to Columbia and didn’t make it, but was recommended for a two-year bridge program that prepares students to transition into PhD programs. The following winter, he found himself huddled around a broken space heater in a filthy Bronx apartment, which was the only place he could find that didn’t require a background check. He couldn’t believe he had made it to Columbia.
Today, Medina-Kirchner all but lives in Hart’s lab. He has small remnants of his past, like the tiny “Solitary Confinement = Torture” sign on his desk, but Columbia is mostly a new world. Few people there understand the helplessness of watching friends back home get locked up. Many of them, instead, have trained all their lives to attend an Ivy League college and don’t understand how hard it was for Medina-Kirchner to try to catch up. Following Hart’s lead, Medina-Kirchner is determined not to repeat mistakes of the past.
Much of the last 15 years of MDMA research challenges the initial neurotoxicity reports of the ‘90s and early 2000s. While studies have consistently shown that MDMA can potentially damage serotonin cells, later studies have contested the links between long-term MDMA use and problems with memory and brain function. One study found that MDMA can alleviate some Parkinson’s symptoms for people who are low in a specific brain chemical called dopamine. A small mountain of emerging research suggests possibilities for positive uses in psychotherapy. A nonprofit research and advocacy group called MAPS is currently testing MDMA as a PTSD treatment. Their work has progressed to a phase three clinical trial, which is generally the final phase of testing before a drug or treatment protocol gains FDA approval.
Even as the field improves, there’s evidence that methodological concerns about existing research remain. One review that looked at 19 MDMA studies, some published as late as 2009 and 2011, found that definitions of heavy versus light users varied so much between studies that “heavy users in one study would have been considered light users in another,” making it “unacceptably easy for researchers to report significant findings where no relationship exists.” A separate 2018 review by the same author noted that current and past MDMA research is further limited by studies that gather data from participants who use street ecstasy, which often contains little or no MDMA. The review also found that statistical errors, biases, and methodological problems were so pervasive in the field that despite a wealth of studies that point to MDMA causing brain damage, “the available data can only suggest an association – rather than a causal relationship – between MDMA use and neurocognitive deficits.”
Several MDMA researchers interviewed for this story said that, in general, scientists now are far more deliberate about careful study design and methodologies, but comprehensively understanding the effects of the drug requires testing it in humans. Medina-Kirchner and Hart are part of a small group of scientists who are focusing on human ecology — the amounts and circumstances under which users actually take drugs. Though Hart sometimes collaborates with researchers who study drug effects in animals, his team only studies human subjects, which requires overcoming enormous regulatory and infrastructure hurdles including obtaining a DEA license and recruiting physicians and psychologists to ensure that research is conducted ethically and participants aren’t subjected to unreasonable harm.
Under that umbrella of ecological relevance, Medina-Kirchner is currently investigating two gaps in the scientific literature: how amphetamines interact with other drugs (since users often don’t stick to just one), and the effects of repeated MDMA dosing. This work is slow and expensive. Medina-Kirchner’s experiments require finding participants who have no psychiatric disorders, substance abuse issues, or certain physical conditions and who can pass an in-person psychiatric interview and physical examination.
There’s hope that proving therapeutic use could lead to MDMA being removed from Schedule I and potentially decriminalized. That doesn’t help those who are currently struggling to move past drug convictions. Medina-Kirchner wants a pardon — a hope catalyzed by Wisconsin Gov. Tony Evers’ recent move to grant clemency to someone else who was convicted of selling ecstasy at age 17. He also wants to help other formerly incarcerated people find the same pathways into science that Carl Hart made possible.
In 2017, Medina-Kirchner co-launched the Formerly Incarcerated Research and Science Training (FIRST) program, an initiative that helps recently released ex-felons enter science graduate programs and conduct research. The roughly six-week-long program covers how-to basics, like conducting a literature review and applying to grad school. It also provides participants with mentoring, career development, and a stipend. The challenges for FIRST participants are enormous. Some spent decades in prison and are attempting to scale academia while transitioning into the mainstream, facing employment barriers, and adjusting to using basic technologies like cellphones and tablets. Still, the program shows promise. Out of the five formerly incarcerated graduates in FIRST’s inaugural class, one joined the bridge program Medina-Kirchner did, while others are taking classes at Columbia or have obtained teaching assistant positions there.
How much the scientific community will embrace the formerly incarcerated once classes are finished is a question Medina-Kirchner thinks about as he moves through his PhD. For now, he’s focused on developing the skills to become an independent researcher and hoping that if he works hard enough, science will take care of the rest.
“I just keep going,” he says. “I just keep going.”
