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Thursday, Nov 26, 2009
Drugs dismissed as merely recreational, such as MDMA and psilocybin, are getting a second look for medicinal use in trials underway at several universities.
Feb 17, 2005 | In 1960 a 40-year-old psychology lecturer at Harvard University took a trip that changed his life. In Mexico for a holiday, the academic tried magic mushrooms, triggering an interest in the psychological effects of hallucinogenic drugs that would ultimately lead to his being sacked, arrested, kidnapped and having seven grams of his mortal remains blasted into space after he died.
The lecturer was Timothy Leary, better known as the 1960s drug guru who urged America's youngsters to "turn on, tune in, drop out." Leary believed that hallucinogens could alter behavior in unprecedented and beneficial ways, and in experiments at Harvard he doped graduate students with psilocybin -- the active compound in magic mushrooms -- and LSD.
He argued that the results of his experiments could help treat alcoholics and reform criminals; but they enraged parents and unsettled colleagues. Harvard sacked Leary and his colleague Richard Alpert (later known as Ram Dass) in 1963, and the episode has left an embarrassing stain on the university's reputation ever since. Now, more than 40 years later, research using psychedelic drugs is returning to Harvard.
John Halpern, a psychiatrist at the university's McLean Hospital, is set to study whether the compound MDMA can help ease anxiety in terminal cancer patients. MDMA -- or to chemists 3,4-methylenedioxymethamphetamine -- is better known as the dance-floor drug ecstasy. The study is the latest example of revived interest in the medicinal properties of controlled hallucinogenic or psychedelic drugs, loosely defined by their ability to alter perception, cognition or mood. Some researchers place MDMA in a different class, the empathogens, because it influences emotions.
Trials of MDMA for post-traumatic stress disorder are already underway in America, and psilocybin is being tried for anxiety and obsessive-compulsive disorder. There are even moves to reintroduce research on LSD at Harvard, where Halpern wants to test its abilities to treat cluster headaches -- severe attacks that strike at the same time each day for weeks at a time.
"Drugs can be controlled but that doesn't stop them from being useful," Halpern says. "That's what doctors are supposed to focus on, and that's what I'm trying to do. The Leary connotations are understandable for a popular culture that is still struggling to resolve what happened in the 1960s. Let's face it, it was a huge fiasco back then, but Tim Leary was not a physician and didn't come to this from a medical approach."
Halpern's MDMA trial is different: 12 cancer patients with less than a year to live will be given varying doses under controlled conditions and strict supervision. Crucially, the trial was given the green light by several ethical review boards and approval from the Food and Drug Administration in December. One hurdle remains: Halpern has yet to receive a license from the Drug Enforcement Administration to handle the drug, though he expects to obtain one within weeks.
The ecstasy is not a chemical fix for the patients' anxiety; instead it is intended to help them to open up and get the most from conventional counseling. Halpern says the drug allows people to talk about topics they would otherwise avoid. "It's really tough doing psychotherapy with people who have anxiety disorders because when you get to the heart of the matter it causes a panic attack. For somebody who has a particularly gruesome time trying to talk about important end-of-life issues, it bubbles into anxiety and nothing gets achieved," Halpern says.
"MDMA may be potentially useful in that it doesn't induce that reaction. We want to see if that can translate into decreased anxiety and meaningful increases in the quality of life for these people." The alternative, he says, is heavy doses of sedatives such as Valium. "At the moment these people have a choice of being oversedated and not having anxiety or being alert and suffering panic attacks."
Patients volunteering for the trial will receive up to 125 mg of MDMA over two experimental sessions several hours apart -- about the same or a little more than in a typical ecstasy tablet. They will also receive more conventional help during several non-drug sessions. Psychologists will assess their mental state before and after the trial to judge whether the drug has helped.
