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A nice lie-down and disco bickies February 18, 2005
Dancefloor drugs may have untapped medicinal benefits - such as helping patients get the most out of therapy, writes David Adam.
In 1960 a psychology lecturer at Harvard University took a trip that changed his life. In Mexico for a holiday, he swallowed some magic mushrooms, triggering an interest in the psychological effects of hallucinogenic drugs that would lead to him 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 in the 1960s as the drug guru who urged America's youngsters to "turn on, tune in, drop out". Leary believed hallucinogens could alter behaviour in unprecedented and beneficial ways. 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 to treat alcoholics and reform criminals; but they enraged parents and unsettled colleagues. Harvard sacked Leary in 1963 and the episode left an embarrassing stain on the university's reputation.
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 a compound called MDMA can help ease anxiety in terminally ill cancer patients. MDMA - or to chemists 3,4-methylenedioxymethampheta- mine - is better known as the dancefloor drug ecstasy.
The study reflects revived interest in the medicinal properties of hallucinogenic or psychedelic drugs, loosely defined by their ability to alter perception, cognition or mood.
Trials of MDMA for post-traumatic stress disorder are under way in the United States, and psilocybin is being tested as a treatment for anxiety and obsessive-compulsive disorder.
A team at the Orenda Institute in Baltimore is seeking permission to give cancer sufferers LSD and a Russian group in St Petersburg is investigating if heroin addicts can be helped by treatment with the psychedelic drug ketamine, which is commonly used as a horse tranquilliser.
A small clinic in Peru is also treating drug addicts with a hallucinogen - the native brew ayahuasca, which contains dimethyltryptamine or DMT, the only psychedelic compound our bodies produce naturally.
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 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."
In Halpern's MDMA trial, 12 cancer patients with less than a year to live will be given varying doses under controlled conditions and strict supervision. The ecstasy is not a chemical fix for the patients' anxiety; instead it is intended to help them open up and get the most from conventional counselling.
"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," 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.
Patients volunteering for the trial will receive up to 125 milligrams 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.
Rick Doblin, head of the Multidisciplinary Association for Psychedelic Studies, which funds the Harvard research, says the study could bring one step closer his goal of making MDMA a prescription medicine.
"It's going to be a hurdle but as we get pilot studies that show promise I think it will get easier and easier to raise money for the research," Doblin says. "A lot of people think what we're trying to do is impossible and so don't bother to help out."
His group is funding the world's only clinical trial of MDMA. At his South Carolina clinic, the psychiatrist Michael Mithoefer has given the drug or a placebo to victims of sexual abuse with post-traumatic stress disorder. The trial began almost a year ago and five of a total of 20 patients have been treated so far. After receiving official permission, Mithoefer is preparing to extend the study to US soldiers traumatised by fighting in Iraq and Afghanistan.
Each drug-assisted session lasts about eight hours, during which patients lie down and music is played - though psychedelic classics such as the Beatles' Sergeant Pepper's Lonely Hearts Club Band are out. "Because it has lyrics," Doblin says. "Lyrics plant images into people's minds and we really want people to be free to bring up their own content."
The research is controversial and government authorities have frequently refused permission because of fears of legal action, experimental bias or, in some cases, with no explanation at all.
Serious doubts over the long-term risks of MDMA remain: animal studies show it can lower levels of the neurotransmitter serotonin.
"There is no risk-free strategy," Doblin says. "We're not trying to sell what we're doing as the way to solve all the problems with drugs. You look at the people who are taking MDMA for post-traumatic stress disorder and you would say that's the opposite of ecstasy. They're crying and shaking. They're not saying, 'Oh, I'm so happy and I love the guy who did this to me'."
The results of the South Carolina trial are expected next year. The next stage would be two larger trials involving hundreds of people - one in the US and the second probably in Israel or Spain, where smaller studies are already planned. Halpern hopes to start his Harvard trial of MDMA with cancer patients within months.