For now, Ecstasy's medical potential is all anecdote and no hard fact. Little data exists on its therapeutic value.
But that's not for lack of trying, say supporters of MDMA-assisted therapy. Dr. Charles Grob, director of Child and Adolescent Psychiatry at Harbor-UCLA Medical Center, was the first researcher to gain Food and Drug Administration approval for a study of MDMA, submitting a proposal in the early '90s to treat people with end-stage cancer. The agency initially turned him down, saying a trial was first needed to determine the drug's dosage and safety. After that was completed, Grob went back to the FDA with what he thought were promising results. Again, the government turned down his bid to test Ecstasy among cancer patients. "The bottom line was political, I felt," says Grob. "This would have been the first treatment protocol. This kind of schedule-one drug, with abuse liability, would have been very controversial."
Doblin is more optimistic. "I think the FDA is the most immune of all agencies to outside pressure. They're sympathetic to patients." He also believes the FDA may take issue with the South Carolina study of Ecstasy and post-traumatic stress disorder on the grounds that it's too risky to decrease the serotonin levels of depressed subjects.
It may be this psychoactive element that most hinders the progress of Ecstasy as therapy. With medical marijuanawhich has gained acceptance and been doled out for decades to a handful of patients in a federal programthe high is almost a side effect, since the real good comes from increased appetite, decreased nausea, and a lessening of spasms and pain. With Ecstasy, the benefit isthe high.
In this way, Ecstasy is more like the roster of mood elevators prescribed every day. Without the media scare, a company application to market this drug now, says O'Callaghan, would pass government muster. "MDMA would have slipped through as an approved drug," says O'Callaghan. "No one would think a priori that it was causing damage."