First, medical marijuana, then medical Ecstasy? The movement to prescribe party drugs
Posted December 13, 2016
Medical marijuana is just the beginning.
As medical professionals look for ways to prescribe fewer opioids, some are hoping they will soon be able to prescribe street drugs like Ecstasy and psilocybin to treat patients with post-traumatic stress disorder, anxiety and cancer.
That would require a radical change of policy for the U.S. Department of Drug Enforcement, which says those drugs and other psychedelics have "high potential for abuse" and "no currently accepted medical use."
But the growing acceptance of medical marijuana, now legal in 28 states, has energized people who believe there is healing potential in so-called "party drugs" if they are prescribed carefully. Among them is a South Carolina veteran whose struggle with PTSD resolved with use of Ecstasy, a synthetic drug also known as Molly. "It changed my life," C.J. Hardin told journalist Dave Phillips of The New York Times.
It could change many more, depending on the outcome of a study recently authorized by the FDA. But whether those lives will change for the better remains a subject of debate.
In repurposing illegal drugs for good, are doctors creating beauty out of ashes, or simply playing with fire? The tangled debate goes back to the 1960s, when the recreational use of mind-altering drugs spiked in the U.S.
'Penicillin of the soul'?
Ecstasy is a synthetic chemical first developed in Germany in the early 1900s. In the 1970s and 80s, it was used in psychotherapy to help patients think calmly about their problems and communicate better with their therapists. But it was banned in 1985 when the government deemed it a "serious health threat," and subsequently it went underground as a party drug.
Earlier this year, three young adults attending a music festival in California died of Ecstasy intoxication. But proponents of the drug say it is safe when used responsibly. (In 2009, the chairman of a drug-abuse advisory board in the UK, Dr. David Nutt, lost his job after writing in a medical journal that riding a horse is more dangerous than taking Ecstasy.)
The Multidisciplinary Association for Psychedelic Studies is a nonprofit organization based in Santa Cruz, California, that advocates the medically supervised use of marijuana and psychedelic drugs, including LSD and ibogaine, for conditions that other drugs have failed to help.
Users of such mind-altering drugs say they have a spiritual component. "After an ibogaine trip, users tend to describe experiences with a powerful other who describes to them how the world works, including the steps they must take to align themselves to their true paths," science writer Jessa Gamble wrote in an Atlantic story on heroin addicts using ibogaine to recover.
Likewise, Ecstasy has been called "penicillin of the soul" because it quickly evokes "feelings of mental stimulation, emotional warmth, empathy toward others, a general sense of well-being, and decreased anxiety," according to the National Institute on Drug Abuse.
It's for those benefits that the FDA, on Nov. 29, gave approval for a large-scale trial of Ecstasy on veterans suffering from PTSD. Depending on the outcome, it could be the final step before medicinal use is formally approved, according to The New York Times article.
In a previous trial funded by MAPS, one participant said after treatment with Ecstasy, "I felt like my soul snapped back into place," PBS Newshour reported.
Dr. Charles R. Marmar, the head of the psychiatry department at New York University’s Langone School of Medicine, told The New York Times that he was "cautious but hopeful" about Ecstasy as a therapy. Current treatments fail up to 70 percent of PTSD sufferers, he said.
As for the caution, Marmar said, “It’s a feel-good drug, and we know people are prone to abuse it. Prolonged use can lead to serious damage to the brain.”
'Shrooms with a view
The medicinal value of mushrooms is not limited to nutrition, researchers from Johns Hopkins University School of Medicine and New York University Langone Medical Center say in the November edition of the Journal of Psychopharmacology.
One study found that when cancer patients were given one dose of psilocybin — a component of the so-called "magic mushrooms" — they reported marked declines in anxiety, depression and fear of death, according to The Washington Post.
"The vast majority experienced an increase in optimism, a feeling of connection with other people, and mystical and spiritual experiences," journalist Laurie McGinley wrote in The Post. Moreover, more than 70 percent of participants said their experiences using the drug were "among the most meaningful of their lives."
One atheist, who said she no longer fears her cancer returning, said after taking the psilocybin, she felt "bathed in God's love." In most people, the effect of the drug lasted for several months.
Psilocybin is derived from more than 100 types of mushrooms.
While some doctors said the studies show that psilocybin and other psychedelics have promise in relieving "existential distress" in seriously ill patients, others have expressed concern, including Glen Hanson, director of the Utah Addiction Center at the University of Utah, who noted that the drug has been known to cause psychosis.
And German Lopez, while advocating for therapeutic use of psilocybin — even for people who aren't sick — in Vox earlier this year, conceded the risk of accidents and "bad trips."
"Hallucinogens aren't perfectly safe, but they're not dangerous in the way some people might think," Lopez wrote.
In an editorial accompanying the research published in the Journal of Psychopharmacology, Nutt of Imperial College London (the same David Nutt who said Ecstasy is no more dangerous than riding a horse) said the new studies show "profound and enduring mental health benefits" and that society needs to let go of the "drugs fry your brain mentality."
"It's time to take psychedelic treatments in psychiatry and oncology seriously, as we did in the 1950s and 1960s, which means we need to go back to the future," Nutt wrote.
More research is needed, he acknowledged, but "we are now in an exciting new phase of psychedelic psychopharmacology that needs to be encouraged not impeded."
He noted in the editorial that Bill Wilson, the beloved founder of Alcoholics Anonymous, believed that LSD could help people recover from alcohol addiction.
Good drugs, bad drugs?
The future of medical Ecstasy and psilocybin — and even LSD — hangs on whether society comes to see them as "good" drugs or "bad." It's an unofficial label that can change over time, and changing mores can lead to complicated laws, like the UK's Psychoactive Substance Act that went into effect in May. The law bans the sale of mind-altering drugs in stores, but does not punish people who use them.
That may be more of a practical matter than a moral judgment. The medical journal The BMJ reported in November that 1 in 20 people in the world — a quarter of a billion adults — used an illegal drug in 2014.
In an editorial, The BMJ's editors said the global war on drugs has failed and that doctors should lead the charge for reform. Others say that, as in the UK, no one should be punished for using or possessing drugs, and that governments should regulate their use.
This change "could help to shift perceptions from considering drugs as inherently 'evil' to a more pragmatic mindset in which scientific evidence, not ideology, drives drug policy," wrote Ruth Dreifuss and Pavel Bern of the Global Commission on Drug Policy in The BMJ.
Supporters of drug legalization, however, are concerned about what a Trump presidency will do for their cause. President-elect Donald Trump, a teetotaler who has said he's never used pot, approves of medical marijuana. But he said during the campaign that he does not think it should be legal for recreational use.
His pick for attorney general, Republican Sen. Jeff Sessions of Alabama, has been called a "drug-war dinosaur" and has said "we need grown-ups in charge in Washington to say marijuana is not the kind of thing that ought to be legalized, it ought not to be minimized, that it’s in fact a very real danger," according to The Washington Post.