During the first installment of our three-part interview with Multidisciplinary Association for Psychedelic Studies (MAPS) Founder and Executive Director Rick Doblin, the visionary nonprofit head explained that his organization’s “mission is to conduct scientific research into psychedelics and marijuana and their therapeutic potential, to develop them into legal prescription medicines.” Points wanted to hear from Doblin more about MAPS’ unique purpose and how Doblin and staff set about fulfilling it on a daily basis. Doblin can’t help launching into explanations of the historical context that informs that work, so we managed to get another dose of psychedelic oral history out of him, as well. We spoke further about the kinds of drugs into which MAPS is looking, their promising potential uses, and what exactly “prescription psychedelics” look like. The second installment of Points’ engaging interview with Doblin appears below.
Points: We touched briefly on MAPS works to fulfill its mission earlier, but I know there’s a lot more to be said. If the bulk of your work is researching clinical and therapeutic uses for psychedelic drugs, can you talk about some of those uses?
Doblin: Well, our top priority project is MDMA-assisted psychotherapy for post-traumatic stress disorder. MDMA reduces fear: it reduces activation in the amygdala, the fear processing centers of the brain. It increases activation in the prefrontal cortex, where people put things in context, so people can tell then from now, and can overcome the fear that has blocked them from integrating the traumatic experience. We have an international series of Phase II pilot studies: In the United States we’ve completed one; in Switzerland, we’ve got one on-going; [we have one in] Israel; [and] another study in the US underway with veterans with posttraumatic stress disorder. We’re trying to start a new study in the US to evaluate our female/male co-therapist team, that would include a graduate student intern as one of the two therapists. We’ve got a study in Canada, and we’re working to start a study in Jordan. We’ve got other projects in Australia and England in the early stages of development.
There have also been projects with MDMA for cancer patients with anxiety. There’s been a study at Harvard to help people deal with fearful emotions around dying. We have a study with LSD with people who are dying that we have just completed in Switzerland, the world’s first therapeutic study of LSD in about 40 years. We’ve got projects that are about to start with MDMA where we are going to put out a request for proposals for protocols for MDMA for Aspberger’s and autism. There are a lot of reports on the internet of people with Asperger’s who have done MDMA recreationally and found it to be helpful for them.
We have projects in British Columbia with ayahuasca, a psychedelic tea from South America that’s used in religious services, investigating its efficacy in the treatment of addiction. And we’ve got a project in Mexico with ibogaine, a psychedelic root from western Africa that helps people overcome withdrawal symptoms and can motivate people to improve their lives. For opiate addicts, we’re in the early stages starting a similar study in New Zealand.
We’ve got a project that has been politically blocked but the FDA has approved – for marijuana for post-traumatic stress disorder in war veterans. We did early research with marijuana vaporizers and marijuana water pipes to show that the water pipes really didn’t filter out any of the particulate matter, they filtered out equal amounts of the cannabinoids and the particulate matter so it didn’t really help in that regard. And that led to the development of a lot of vaporizer research. And then there is the possibility of trying to facilitate a study on psychedelics and creativity. But again, we are primarily focusing on treating diagnosable illnesses because that’s the clearest path towards creating legal contexts for the beneficial use of psychedelics and marijuana.
Points: What do you mean when you refer to psychedelics as “prescription drugs?”
Doblin: Well, for example, for MDMA for posttraumatic stress disorder, it’s not really the drug that’s the treatment, it’s MDMA-assisted psychotherapy. And again that gets to the fundamental point: it’s about how these drugs are used. It’s about the relationship between the person who is using the drug and the drug, it is not about the drug itself. So as a prescription medicine, MDMA-assisted psychotherapy will not be like a normal prescription medicine where a doctor gives you a prescription medicine and says, “here’s some MDMA, go take it at the beach” or something. Or “go take it with your lover.” It’s something that will be administered like a methadone clinic, so I think for the people
involved with substance abuse treatment, the closest model is the methadone clinic. Initially, the methadone clinics, you’d have to consume the drug there. That’s the way we would do this. So there’d be clinics, that would be like birthing centers, like a hospice center, and you’d have a group of people who are trained to work with non-ordinary states of consciousness and they would run these clinics — psychiatrists, psychologists, nurses, social workers, all that — and there would be a place where they’d go and you’d end up having your experience there during the day, you’d spend the night there. And there can also be non-drug psychotherapy taking place in the weeks before your psychedelic sessions and your weeks after to integrate. But I think as a prescription medicine, it would be highly controlled initially, and it would be only for diagnosable illnesses.
One of the highest and best uses of MDMA is couples therapy, but having a difficult relationship is not a disease. It’s not the way that we can work through the FDA to make something into a medicine. And the same way is the case with spirituality, it’s a problem from a regulatory point of view, because you shouldn’t have to be part of a religion to have a spiritual experience, it should be an individual choice. So freedom of religion is for religions, it’s not for individuals, and when you talk about spiritual use of psychedelics, it gets you close in the direction of individual right to use or drug legalization. And that’s a problem from a regulatory point of view. So that’s where we end up basically in that we are going to focus on medical uses and build up from there.
Points: So basically it’s not a pharmacological difference, it’s a difference in practice?
Doblin: Yes. As a prescription medicine, it’s a combination of therapy and medicine, and both of those have to be taught and regulated.
Points: I’ve always been curious about that. When I hear “prescription,” I think of synthetic drugs like Sativex, but you’re talking about something fundamentally different.
Sativex, a sublingual spray of both THC and CDB, was developed by a despicable company, GW Pharmaceuticals. [Ed Note: Doblin is not alone in this assessment; while I won't speak for Points as a whole, "despicable" sounds like the right word to me.] Because they realize that marijuana would outcompete Sativex for most patients, they have taken to trying demonize marijuana and hired Andrea Barthwell who is one of the most rabid anti-drug people from the drug czar’s office as their spokesperson. They are scared of marijuana legalization. I’m not scared of Sativex. I believe patients should have the full range of options. Some patients would prefer Sativex over marijuana, and they should have it. And so patients should have all the options available to them. But they should also have the cheap, off-patent marijuana, which is incredibly cheap compared to a patented product like Sativex.
Points: As we talked a bit about in an earlier part of the interview, the government has a monopoly on the marijuana that can be used for this kind of research; all the marijuana is grown at the University of Mississippi, right? How does that affect MAPS’ work?
Doblin: Yes, Professor ElSohly now currently [runs the government's operation in Mississippi]. You know, Carlton Turner, who people consider in some ways the first drug czar, was Nancy Reagan’s advisor. He had also worked on the farm in Mississippi producing marijuana. The monopoly is held by the National Institute on Drug Abuse (NIDA) and they have a mission to develop scientific research to show that these drugs are bad and also to try to look at drug treatmetnt. Their mission does not include what is good about these drugs or trying to turn them into medicines. And in fact, the fundamental problem is that survey on drug use trends, funded again by NIDA, show an inverse relationship between perceived risk and drug use. So, the greater the perceived risk, the more drug use will go down. And the sad part about that is that it’s about perceived risk; it’s not about actual risk. And so that gets you to the willingness of NIDA and the DARE program and Partnership for a Drug-Free America to try to increase the perception of risk. And their calculations – they don’t make any distinctions between drug use and drug abuse. All drug use is drug abuse. So, that gets them into this mindset where they exaggerate the risks, deny the benefits, and try to scare people.
So, because of this monopoly that is held on marijuana, we have to get FDA permission, which is not a problem. Our marijuana-PTSD study did get approved by FDA. But we also have to convince NIDA and the public health service. The way that it’s set up by Health and Human Services, and the way that Obama has continued, is that there is a separate review committee that exists only for marijuana. The committee is incredibly biased, and they don’t want to give marijuana to people who want to make it into a prescription medicine. So, it’s the monopoly, and for ten years we’ve been trying to break the monopoly, and we’ve sued the DEA again in another administrative law judge hearing. We won the case, the DEA ignored it and rejected it, and just a couple months ago they issued a final rejection. And what I’m glad to be able to report is that a major DC law firm, Covington and Burling, has taken this case for us pro bono to the appeals court level.
But all along what has been happening when we are in the courts is that the DEA is winning; they’re blocking medical marijuana research, and NIDA refuses to sell us the marijuana. The state medical marijuana programs are a reaction to the federal suppression of research into the benefits. There is no way to make marijuana into a prescription medicine under the current system and therefore states have revolted and there are all these medical marijuana systems going on in the states. But from our point of view, that is not the ideal circumstance. You don’t want marijuana research to be blocked politically. But, at the same time, I don’t think it’s a smart idea to have marijuana become a medicine politically. We should be evaluating it on the basis of data. And so you can say that MAPS is the conservative wing of the medical marijuana movement because we believe in science and data. And we are frustrated in our inability to do the research. There was a great article in the The New York Times recently in July about our study [on marijuana and post-traumatic stress]. And then on October 2, there was a terrific article in the Washington Post about the obstacles we are facing. I think more and more people are coming to see that the system is rigged as far as medical marijuana goes.
And I think when it comes back to drug abuse and drug addiction, my personal belief, and something I wish was national policy, is that the best antidote to drug abuse is honest drug information. And then supporting people, and also to recognize that people should have the freedom to make their own choices. If they run into trouble, [we would treat it] the same way [we do] with alcoholism – we don’t throw alcoholics into jail for being alcoholics, but we have all sorts of support for them. And around ten percent of the population who drinks is an alcoholic, or is a problem drinker. And it’s around the same for marijuana, although I think the problems are less severe. It’s not that much greater for cocaine. The most addictive drug of allis tobacco. So I think addiction is a real problem, but trying to go by scaring people, either with exaggerated information about
the risks, like marijuana causes lung cancer – that’s what they are teaching in the DARE program now, which we know is not the case – or trying to scare people with the threat of incarceration and losing their freedom – all of those approaches are really fundamental violations of human rights.
And then when we get into what you mentioned before, you detected kind of an interest in spirituality [Ed. Note: This part of the interview will appear in the third installment.], then it becomes even clearer that these are violations against fundamental human rights, the drug laws against psychedelics in particular, because people have deeply profound spiritual experiences. And for those to be criminalized, you’ve got to wonder what’s really going on there. We’ve got the freedom of press, the freedom of religion, the freedom of speech, but underneath all of that is the freedom of thought, the freedom to explore your realms of consciousness, and that’s criminalized, and that should be undone. And so our work on medicalization is a way to try to deal with a society where it is now, where they are open to treatments for illnesses and that’s where we’re trying to put our energy.