Surrounded by redwoods and Buddhist prayer flags, Phil Wolfson greets me outside his clinic at the top of a mountain in Marin County, California. (I've agreed not to reveal any identifiable details for security reasons.) Wolfson, a 71-year-old psychiatrist with a trim puff of white hair, is barefoot. He requests that I accede to "an element of hippiedom" before I enter: "Shoes off, please."
Today is the first in a series of meetings designed to cut through the red tape that comes with doing legal research on illegal drugs. Wolfson is launching a new study to see if pure ecstasy, also known as MDMA (3,4-methylenedioxy-methamphetamine), can ease severe anxiety in people suffering from life-threatening illnesses.
Inside the clinic, nine of his colleagues—therapists, scientists, and other researchers—sit at a table combing through paperwork. The work is banal—"All these consent forms, where is it all going to be stored?"—but the side conversations keep things animated: A group of clandestine Russian chemists are creating "insane drugs"; an Iranian cleric has issued a fatwa supporting the use of the hallucinogen ayahuasca; a guy in the Santa Fe Buddhist community was ostracized for supporting psychedelic drugs.
The topic of how MDMA can be administered comes up, and the word "intravitreal" is uttered.
"What's that?" asks Wolfson, with a voice that sounds like a cigarette is ashing in his lungs.
"Through the eye."
"What?" Wolfson says, dismayed. "I've never seen anyone do that! We're not doing that."
"But you could do it that way."
"We're not talking about your weird scuzzy drug taking," Wolfson says.
The current study, Wolfson explains, "is an attempt to show by very kosher and scientific means that MDMA is safe and efficacious." He throws his hands up: "But we already know that. This is minor league."
The current study, Wolfson explains, "is an attempt to show by very kosher and scientific means that MDMA is safe and efficacious. But we already know that."
Wolfson first encountered MDMA in the early '80s, when it was still legal and available through psychedelic devotees who were struck by the enhanced feelings of intimacy and closeness brought on by the "empathogen." In particular, Wolfson was taken with its "sultry, velvet, electric energy." The logical next step was to try MDMA-assisted psychotherapy in his practice.
But this "flourishing" period of MDMA's clinical use ended quickly. Against the suggestion of an administrative law judge, in 1985 the Drug Enforcement Agency declared ecstasy a Schedule I drug—a substance considered to have no recognized medicinal value and a high potential for abuse—even though Wolfson and his colleagues had been using it medicinally. "In 1985 when there was legality, there were tens of thousands of doses used. If you go to '86 and beyond, it was tens of millions. Then it becomes dirty, underground; there's contamination and casualties," Wolfson laments. "The war on drugs creates havoc and it creates interest and it creates a money scene."
Wolfson is now affiliated with the Multidisciplinary Association for Psychedelic Studies (MAPS), an organization dedicated to "a world where psychedelics and marijuana are safely and legally available for beneficial uses, and where research is governed by rigorous scientific evaluation of their risks and benefits." He is leading a stage of research that he hopes will help facilitate the return of legal MDMA prescriptions.
Thirty years have passed since Wolfson last prescribed MDMA in a medical setting. MAPS
When combined with psychotherapy, Wolfson says, pure ecstasy is "revolutionary medicine" that can obliterate the restrictions of the traditional 50-minute psychotherapy session. To start, MDMA can balloon therapy sessions to five hours or longer. Unlike antidepressants or anti-anxiety meds, which may be consumed indefinitely, MDMA is only administered a few times over the course of several months. But the breakthroughs inspired by the drug persist, Wolfson says, suggesting that it has the potential to permanently alter a patient's perspective on the crises they seek to overcome. In 2010, MAPS completed the first pilot study of MDMA-treated psychotherapy for people with PTSD, including veterans. More than 80 percent of the patients no longer qualified as having PTSD after just two sessions, and that was sustained for nearly four years, until the study stopped tracking them. Rick Doblin, the founder of MAPS, notes, "So far there have been over 1,100 subjects who've received MDMA in legal studies, and there have been no serious adverse effects."
Wolfson says MDMA was a crucial part his own healing when his son came down with leukemia and suddenly died at age 17 after a failed bone marrow transplant. Wolfson credits the drug with helping him and his wife through the crushing loss. "In the warm afterglow of an MDMA session," Wolfson wrote in a paper published in the Journal of Psychoactive Drugs in 1986, "new possibilities for love, relationships, and self-appreciation emerge."
A gong rings in the clinic, signaling a break from the hours of paper pushing, and the researchers gather on the sun-dappled patio outside. "What do we do if someone tests for something illicit?" one of Wolfson's co-therapists wonders about their research subjects. "I mean, what if they really love their crack? Or they're doing ayahuasca regularly?"
"Deception is worthy of exclusion," says Wolfson. Plus, the study wouldn't really have an effect on "sophisticated users," that is, people who trip regularly likely wouldn't experience MDMA sessions with the same profundity as those with fewer drug experiences.
Seven months after this planning session, Wolfson's study is now in full swing. It has enrolled six subjects, including several women with "a history of violence and rape, abuse as a child," Wolfson says. They're going through the treatment specifically to deal with the fear that comes from brushing up against death. It's still early, but their fears appear to be receding. "People are having breakthroughs, working through the trauma and coming to a new appreciation for their lives," Wolfson says.
It will be 2020 at the earliest before MDMA-assisted psychotherapy can be approvedby the Food and Drug Administration. The MAPS team will still have to go through another much larger study. All for a drug, Wolfson says with exasperation, "which is very safe, that's been used by more people than almost any other drug. And yet we can't get there." A moment of reflection passes, and he continues, "Why is this a really good thing to do? Because the cat's been out of the bag for a long time. People have understood the benefits of MDMA. It's not like it's a big mystery. A lot of people can benefit from this."
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