Features & Columns

Federal Approval Brings MDMA
From Club to Clinic

Three decades after MDMA's ban, recognition of its therapeutic value grows.
MOLLY AND ME: Three decades after MDMA's ban, recognition of its therapeutic value grows. Art by PsyBry.net

For a proper psychedelic trip, the late ethnobotanist Terence McKenna famously prescribed what he called 'the heroic dose' of magic mushrooms: 'Five dried grams and silent darkness.'

Josh Tiefer gobbled up a gram less, but on an empty stomach and a broken heart. Rather than darkness, he opted for a late-night showing of The Last Samurai.

He was 24 at the time, battling the depressive fallout of a breakup and newly obsessed with McKenna's gospel of chemically induced enlightenment. In the theater, the psilocybin began to cast its hallucinogenic spell.

'Something happened,' Tiefer recalls, 'because I was like, 'This movie's getting pretty good.''

Motion trails and vibrant colors overwhelmed his vision. But the euphoria gave way to a soul-chilling terror, a sense that some unfathomable force could delete his soul from the cosmic record—total erasure, a fate worse than death. Horrified, he shut his eyes and shrunk into his seat, crippled by the sense that, in some inexplicable way, everything hung in the balance.

Then it started to get really good.

'I had my beanie in my hand,' he says. 'You know, like my beanie hat, and suddenly everything was very, like, the essence of beanie. Like, you know, the way the actors were up on the screen, you know—the essence of beanie. The patterns of the beanie were shown to be evident in all things in the fucking world.'

In a flash to the present, he realized he'd been pressing into a stranger—a preternaturally patient stranger—in the next seat. Tiefer looked down to see that his feet had stretched a thousand miles underground 'like a bunch of roots and shit.' Then, his mind, forming what seemed like infinite synesthetic bonds between senses and worlds, sparked a revelation of the Buddhist precept of interconnectedness. Or, as Tiefer verbalized it, 'the universe is like one mush' and he was mushing into everyone and everything.

'Like, I'm a Siamese twin with this person over here,' he says, gesticulating with one hand while gripping a sketchpad in the other. 'But the way the actors were expressing themselves was also shown to be, like, this similar medium that was me, and all this other shit at the same time.'

When he summoned the wherewithal to open his eyes, he saw the movie screen swirling with watercolor-like canyons, vibrant greens and blues and shifting pixels, fractals and grids. The performative emotions of the Tom Cruise warrior epic struck open some untapped well of feeling. Once the credits began to roll, Tiefer's friends pried him from the chair and took him to Denny's, where he glutted and purged.

'Most things are disappointing, but this was the real deal,' says Tiefer, an artist by occupation who's 36 now and recounting his trip to a gathering of psychonauts and inquiring minds. 'I've been too chicken shit to do it ever since.'

His audience—a group of about 20 or so people seated around a fire pit on an assortment of mats, blankets, benches, chairs and pillows in a meadowy backyard—laughs and applauds at Tiefer's conclusion.

'I'll have what he's having,' a bespectacled university professor quips.

INQUIRING MIND: San Jose psychotherapist Dmitry V. hopes to one day use legal psychedelics to treat patients. Photo by Jennifer Wadsworth

For Starters

Witching hour on a recent Sunday, and we're about four-and-a-half hours into a potluck raising money for a kilo of pure MDMA. Or as it's colloquially known, molly or ecstasy. There's an eclectic turnout of academics, ravers, techies, a white blazer-and-aviators-clad financial adviser, a toddler, artists, musicians and the husband-and-wife hosts Nadia, a Belarus transplant and therapist, and Dmitry V., an aspiring therapist and Russian émigré.

'It's great to have a whole night just devoted to psychedelics,' says Dmitry, whose gaunt frame and back-length hair make him look like a Byzantine icon. 'There needs to be a coming out in this community.'

Despite the talk of 'coming out' for the cause, though, few people want their full name publicly associated with the gathering and Dmitry preferred to whittle his surname down to its first-letter initial for this story. One attendee remarked on the dilemma of wanting to do her part to legitimize the psychedelic scene with her open support, but being afraid of the stigma associated with drugs as criminalized as cocaine.

Indeed, the federal powers that be regulate acid and psilocybin mushrooms as closely as crack and heroin. Yet psychedelics have outgrown their hippie-fringe roots to become, to some extent, part of the mainstream—particularly in Silicon Valley, where users typically lead otherwise straight lives. Government restrictions have started to ease up thanks to the work of advocates who defied the taboo and rebranded psychedelics as therapeutic. The late- April fundraiser marked one of hundreds around the globe to benefit the Santa Cruz-based Multidisciplinary Association for Psychedelic Studies—MAPS for short—an organization devoted to researching the medicinal value of psychedelic drugs and cannabis.

Their primary goal of these psychedelic dinners is to collect $400,000 to buy 2.2 pounds of pharmaceutical-grade MDMA as a potential legal treatment for post-traumatic stress disorder. MAPS spokesman Brad Burge says that's how much it costs for an entirely new supply approved by the U.S. Food and Drug Administration.

The California nonprofit has been using a batch of MDMA made in the 1980s by Purdue University chemist David Nichols. But regulators want to keep their eyes on the entire manufacturing process before it signs off on third-phase clinical trials for up to 400 patients. An estimated 5 million people suffer from PTSD, a condition triggered by rape, combat, natural disasters or serious accidents. Left untreated, it sends the afflicted into life-threatening depression and substance abuse. Antidepressants and antianxiety medication only treat symptoms, while traditional talk-therapy could take years to pinpoint root causes.

In the MAPS trials, patients take a carefully measured dram of MDMA and spend the day discussing their trauma with therapists. Psychotherapy in general and PTSD therapy in particular focus on exposing a patient to distressing thoughts to eventually desensitize them. MDMA's capacity to suspend a person's fight-or-flight instinct, which shifts into overdrive in people suffering from PTSD, allows them to face their traumatic memories until those thoughts lose the brunt of their power.

'The immediate effects of MDMA make people feel intimate, so there's that bonding, that connection,' Burge says. 'People tend to become more present, which lends itself well to therapy, of course.'

In his Pulitzer Prize-winning causa sui The Denial of Death, Ernest Becker points out that humanity goes to just about any length to avoid contemplating their own mortality. Life is fatal, but people forget. Trauma makes it impossible to deny. PTSD sufferers develop a heightened, crippling death-awareness.

Becker writes in his 1973 tome: 'The irony of man's condition is that the deepest need is to be free of the anxiety of death and annihilation; but it is life itself which awakens it, and so we must shrink from being fully alive.'

Yes, he derided psychedelic drugs as a Dionysian excess, bemoaning modern man for 'drinking and drugging himself out of awareness.' Ironically, though, MAPS has found that a certain strain of chemical fix can help confront rather than escape one of the greatest agonies of the human condition: consciousness of our inevitable demise.

'On some level, psychedelics push you to the brink of understanding that you're mortal,' one of the dinner guests, a San Jose musician, explained after a colorful telling of her most memorable, jarring psilocybin trips. 'You know? You're forced to confront those fears. A lot of people are wound really tight, or stuck to this world. Sometimes you have to force your way outside of yourself to realize that to be unafraid of death means accepting that they're part of nature and that there's a lot more possibility than you imagined.'

For anyone who finds it odd to see MDMA classified as a psychedelic, Burge explains that it's more an umbrella term than a scientific one. Think of it this way: all hallucinogens are psychedelic, but not all psychedelics have hallucinogenic effects. Consider MDMA a psychedelic as defined by Humphry Osmond, the mid-century British psychiatrist who coined the term for chemicals he considered 'mind manifesting.'

'That's what we mean when we use the word,' Burge says. 'And it certainly applies to MDMA, which isn't really a hallucinogen but definitely has psychedelic, mind-manifesting, or mind-expanding impact.'

The first two rounds of clinical trials have gone exceptionally well, with success rates up to 83 percent, according to psychiatrists involved in the research. After a few rounds of MDMA-assisted psychotherapy, several patients who took part say their symptoms of trauma have all but vanished. Doctors hesitate to use the word 'cure,' but four years past the first double-blind trials, the results look promising.

'It took a lot of work on the part of MAPS to get to this point, to be on the brink of FDA approval,' Burge says. 'MDMA had been legal until 1985 and had been used in therapy. When it was criminalized, that put all the legal, above-ground therapeutic use to a stop. It also stopped major funding overnight. That probably set us back 30 years. There's a lot of catching up to do.'

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