Prescription: Euphoria

New Research Brings Ecstasy Back to the Couch

He reclined on his bed, talking, while another man, a friend, looked on from a nearby chair. The lights were dim, and the soft music floating in the background had no lyrics to distract. Every so often, the friend responded to his words, or, when the recorder stopped, replaced the cassette taping their conversation. They went on this way, intimately, searchingly, for eight hours.

"After the session, I found immediate relief," says Steven, a 32-year-old director of a Washington, D.C.-based nonprofit, who, in May, suffered from a series of panic attacks triggered by a terrible breakup. Prone to low-level anxiety already, he found himself popping the sedative Ativan several times a day just to cope. Then a friend suggested he try Ecstasy. This would be the first of three times he would take two pills of MDMA purely for therapeutic reasons. "The MDMA allowed me to look at experiences otherwise too painful," says Steven, not his real name. "I was able to more rationally observe my behavior, my relationships, my responsibility in the breakup."

Before Ecstasy became illegal in 1985 and illicit recreational use bloomed, MDMA was mainly a couch tool for a handful of therapists. For years, supporters of medical MDMA have pointed to promising anecdotal evidence from that era, saying the drug could help patients accomplish in a couple of sessions what would otherwise take years. Some therapists have continued relying on Ecstasy as an underground practice, and regular people have been dosing on their own. Now the pro-Ecstasy lobby is getting a shot at turning anecdote into fact.

Iilustration by Gilbert Ford

In November, the Food and Drug Administration approved the first ever U.S. study of Ecstasy as helpful medicine. Previous testing has centered not on the drug's benefits, but on issues like how toxic it might be. These new clinical trials—which may be held at the Medical University of South Carolina—will measure the effectiveness of MDMA-assisted psychotherapy for post-traumatic stress disorder. Twelve subjects, all victims of criminal assault, will be given Ecstasy under the supervision of a doctor and then put through a talk session; eight others will receive placebo sugar pills before hitting the couch. Everyone will get 16 hours of drug-free therapy, but supporters think the group taking Ecstasy will see great results.

"Think of [MDMA] as Prozac plus," says Rick Doblin, director of the Multidisciplinary Association for Psychedelic Studies, the organization funding the research. Like Prozac, Ecstasy boosts serotonin, the feel-good neurotransmitter that regulates mood and other critical brain functions. Proponents believe Ecstasy can also relieve pain, anxiety, and depression, and researchers hope to study potential benefits of the drug for people dealing with terminal illness. But while society approves of the myriad mood enhancers regularly prescribed to millions of Americans each year, Ecstasy is considered a scourge. "It's so hard to do research on, but so easy to buy in clubs," says Dr. Julie Holland, a psychiatrist at Bellevue Hospital and editor of Ecstasy: The Complete Guide.

Would-be MDMA researchers argue that the drug's ability to "open people up" will make it a good candidate for PTSD sufferers, who often have trouble discussing the traumatic events that haunt them. "It's kind of like anesthesia during surgery," says Holland. "It allows you to remove this malignant thing." Taking one or two pills of pure MDMA over the course of a lifetime may be safe for some people, but it's not so attractive to pharmaceutical companies. After all, drugs like Prozac turn a profit—and lots of it, since patients need to take them every day. Unlike struggling researchers, the wealthy manufacturers can afford an army of Capitol Hill lobbyists to turn politicians' heads the other way.

Still, the FDA's decision to approve the study of an illegal substance is no fluke. On November 27, Dr. Francisco Moreno of the University of Arizona at Tucson began dosing subjects who suffer from obsessive-compulsive disorder with psilocybin, the active ingredient in mushrooms. The government-approved research is funded by MAPS and another psychedelic think tank, the Heffter Research Institute. "For a quarter century, [psychedelic] researchers have been locked out of the laboratory, but we're starting to get back in now," Doblin says. "Not in massive ways, but in important, small steps."

Scientists overseas are seeing progress, too. The Israeli Ministry of Health has considered a protocol for treating victims of terrorist attacks with Ecstasy—an idea with obvious implications for post- September 11 America.

For Isabel, a 27-year-old journalist living and working in Westchester, this is a good thing. "It's like a truth serum," she explains. Isabel, not her real name, took her first E two and half years ago and says she has done it about 15 times since then, "sometimes at a club, sometimes just chilling at home." She remembers sitting on a park bench, rolling on four pills, with a friend. "He had liked me for a long time, but wouldn't come out and say it," she recalls. That night, they talked about how they felt. "It was freeing," she says.

Other drugs people routinely take—the aspirin, the cold medicine—come with explicit instructions. For Ecstasy, it's not even possible to know exactly what you're taking, and there's no doctor to warn against using too much. Once, coming down off seven and a half pills, Isabel fell into a two-day crying jag. "I felt depressed. Just sad."

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