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FIRST SYNTHESIZED IN 1912 -- A BYPRODUCT IN THE MANUFACTURE OF A DRUG TO SUPPRESS BLEEDING -- MDMA w

FIRST SYNTHESIZED IN 1912 -- A BYPRODUCT IN THE MANUFACTURE OF A DRUG TO SUPPRESS BLEEDING -- MDMA was little known until a former Dow Chemical researcher named Alexander Shulgin tried it himself in 1977. Shulgin had made his reputation, and made Dow millions, by inventing the first biodegradable pesticide. After that success, he was able to work on whatever he chose. He chose psychedelic drugs, based on a transforming experience he had with mescaline in the late 1950s. "I understood that our entire universe is contained in the mind and the spirit," he wrote. "We may choose not to find access to it, we may even deny its existence, but it is indeed there inside us, and there are chemicals that can catalyze its availability."

All of these studies are directly or indirectly funded by a surprisingly robust organization whose roots stretch back 40 years to the psychedelic movement of the 1960s. Before Harvard lecturer Timothy Leary started channeling aliens and urging college kids to turn on and drop out, an intense cadre of doctors and researchers had come to believe that psychedelic drugs would revolutionize psychiatry, providing those with a wide spectrum of psychological problems -- or even just ordinary life difficulties -- the ability to, basically, heal themselves.

But Leary's bizarre career, which morphed from doing research on psychedelics to cheerleading their widespread abuse, obscured whatever medical potential the drugs may have had. Instead, authorities focused on the risks, and often exaggerated them. Richard Nixon famously called Leary "the most dangerous man in America." After a slow start, regulators and legislators cracked down hard. Millions of dollars in enforcement efforts were unable to end abuse of psychedelic drugs, but they effectively stamped out sanctioned research into their healing potential.

A small group of psychedelic researchers and therapists willing to break the law continued their work clandestinely. A much larger group did not flout the law, but waited in the wings and is now emerging. Experience had convinced these therapists that psychedelics, along with significant risks, had potential for even more significant benefits.

This may have been especially true of MDMA.

The Peace Drug
Post-traumatic stress disorder had destroyed Donna Kilgore's life. Then experimental therapy with MDMA, a psychedelic drug better known as ecstasy, showed her a way out. Was it a fluke -- or the future?

By Tom Shroder
Washington Post Staff Writer
Sunday, November 25, 2007; W12

THE BED IS TILTING!

Or the couch, or whatever. A futon. Slanted.

She hadn't noticed it before, but now she can't stop noticing. Like the princess and the pea.

By objective measure, the tilt is negligible, a fraction of an inch, but she can't be fooled by appearances, not with the sleep mask on. In her inner darkness, the slight tilt magnifies, and suddenly she feels as if she might slide off, and that idea makes her giggle.

"I feel really, really weird," she says. "Crooked!"

Donna Kilgore laughs, a high-pitched sound that contains both thrill and anxiety. That she feels anything at all, anything other than the weighty, oppressive numbness that has filled her for 11 years, is enough in itself to make her giddy.

But there is something more at work inside her, something growing from the little white capsule she swallowed just minutes ago. She's subject No. 1 in a historic experiment, the first U.S. government-sanctioned research in two decades into the potential of psychedelic drugs to treat psychiatric disorders. This 2004 session in the office of a Charleston, S.C., psychiatrist is being recorded on audiocassettes, which Donna will later hand to a journalist.

The tape reveals her reaction as she listens to the gentle piano music playing in her headphones. Behind her eyelids, movies begin to unreel. She tries to say what she sees: Cars careening down the wrong side of the road. Vivid images of her oldest daughter, then all three of her children. She's overcome with an all-consuming love, a love she thought she'd lost forever.

"Now I feel all warm and fuzzy," she announces. "I'm not nervous anymore."

"What level of distress do you feel right now?" a deeply mellow voice beside her asks.

Donna answers with a giggle. "I don't think I got the placebo," she says.

FOURTEEN YEARS AGO, Donna Kilgore was raped.

When the stranger at the door asked if her husband were home, she hesitated. Not long, but long enough. That was her mistake.

"That was it," Donna, 39 now, is saying. "He pushed in. I backed up and picked up a poker from the fireplace. I was screaming. He says, 'I've got a gun. If you cooperate, I won't kill you.' He unzipped his jacket and reached in. I thought, this is it. This is how I'm going to die. My life didn't flash before my eyes. I wasn't thinking about my daughter. Just that one cold, hard fact. I checked out. I could feel it, like hot molasses pouring all over my body. I went completely numb."

She dropped the poker.

Afterward, she stayed strong. She wasn't going to make the classic victim's mistake of blaming herself for provoking the attack. She had no doubts about that. She'd screamed and screamed until the police came through the door. (They later reported that her attacker jumped up, clutching for his pants, saying, "She said I could!")

And, bottom line, she'd survived. She'd be fine, she told herself. She was wrong.

"It was what it must feel like to have no soul," she says. She quit all her hobbies. A passion for tennis died. Devastating nightmares woke her in the dark, her heart racing and palms slick. She dreamed of explosions, tornadoes, bears eating people.

"Psychologists will tell you to go to your happy place," she says. "Well, my happy place had bears in it."

Five years passed. Whatever went wrong, or right, in her life, it felt like it was happening to someone else. She found a wonderful, loving man -- she could still recognize those qualities, even though she couldn't respond to them fully -- and remarried. She had more kids. But even her family felt alien. It was "almost like going overseas and being an exchange student, living with someone else's family . . . I didn't like being close to people, and my children didn't understand that. Mommy was always busy." She was often irritable, and felt an unaccountable anger, which sometimes morphed for no obvious reason into a heavy-breathing, sweat-streaming rage. Almost worse, she couldn't feel the love she knew surrounded her. "I was afraid it was gone -- when you look at your child and say, 'I would die for that child in a heartbeat,' I didn't feel it -- and I was afraid I would never get it back."

As she says this, she never breaks eye contact. Talking about her trauma and her treatment is a decision she's made, she says. "It's important." But it is also, obviously, hard, and she looks a little pale as she explains what it was like for those five years: "I would put my finger on my arm, and it would be like touching a dead body."

Incredibly, she didn't see a connection to the rape. Then, one evening, she was sitting on her couch watching a disaster show on TV -- she calls her interest in the genre "an addiction"-- when her apartment door opened. Something about the angle of it seemed odd. As she looked at the door, the room began to swirl. "It was kind of like a whirlwind, make-you-dizzy moment, and I saw the whole thing, that man pushing through the door, the warm molasses pouring down, my body going numb. I call it, 'when I left my body.'"

Now she understood: She had left her body -- and never come back.

The panic attacks began at work one Friday. She felt butterflies in her stomach, then couldn't breathe. "I thought: 'Oh my God, I'm dying. I'm having a heart attack.'"

It passed, but she was shaken, especially because she'd also been having fainting spells and migraine headaches. She went to a neurologist "sure they were going to find a brain tumor."

The doctor was getting ready to order an MRI scan when Donna just blurted it out: "Things don't feel real to me."

The doctor turned. "Oh? There's a word for that," she remembers him saying. The word is dissociation, which happened to be a prime symptom of post-traumatic stress disorder, or PTSD.

PTSD is usually triggered by combat, rape, childhood abuse, a serious accident or natural disaster -- any situation in which someone believes death is imminent, or in which a significant threat of serious injury is accompanied by an intense sense of helplessness or horror. Not all or even most trauma victims develop PTSD, but enough do so that nearly 24 million Americans, or 8 percent of the population, have suffered from it at some point in their lifetime. It is estimated that in any given year, more than 5 million Americans have active PTSD -- a costly problem in humanitarian and economic terms. Drug and alcohol abuse are all-too-frequent consequences of PTSD, as is loss of productivity and the need for expensive, long-lasting medical treatment.

The ever-lengthening Iraq war will count among its other costs a legacy of thousands of veterans in need of psychiatric treatment. The government estimates that already more than 50,000 soldiers -- about 4 percent of those who have been deployed to Iraq and Afghanistan -- have been treated for symptoms of PTSD. Many more might actually have it: Military studies put the number at 12 to 20 percent of those returning from Iraq and 6 to 11 percent of those returning from Afghanistan. And the news gets worse.

"Vets with PTSD are particularly costly to the [Veterans Affairs] system," says Linda Bilmes, a lecturer in public policy at Harvard's Kennedy School of Government. "They constitute 8 percent of the claims, but 20 percent of the payments." Bilmes, who has studied the ongoing costs of the wars, estimates that treating Iraq vets with PTSD over the next 50 years will cost taxpayers $100 billion. This is based on findings that one-third of vets with PTSD will remain unemployable, and all suffering with PTSD will have a much higher than normal likelihood of needing treatment for physical ailments. And that's just the direct costs to the budget. "Assuming that the war continues, though with lower deployments, through 2017," she says, and assuming the rate of PTSD isn't being underreported, the cost of lost economic productivity to the U.S. economy will be in excess of $65 billion.

Whatever the cause, the symptoms of PTSD are fairly consistent, and Donna's -- which rated severe on a standard diagnostic test -- were typical. Her prognosis was not great. Some antidepressants can diminish symptoms, and various forms of psychotherapy can, long term, sometimes untangle the psychological knot at the root of the problem. But the nature of PTSD makes therapy problematic. The very symptoms -- acute anxiety, heightened fear, diminished trust and inability to revisit the trauma -- are a direct roadblock to healing. At least one-third of people with PTSD never fully recover.

On that day of Donna's first diagnosis, the doctor sent her up to the seventh floor, the psych floor, to begin years of therapy and medication, none of which helped much, Donna says.

And then she found Michael Mithoefer and became the first to take one of his little white capsules.

THE CAPSULES RESIDE IN A SAFE, armed with an alarm and bolted to the floor of Mithoefer's office, a 1950s-vintage cottage on the road between downtown Charleston and Sullivans Island. It's been tastefully remodeled to create a softly lit, high-ceilinged sanctuary in the back, scattered with art and furnished with, among other things, the ever-so-slightly inclined futon where Donna got crooked.

The elaborate security is occasioned by what is inside the capsules: MDMA, a synthetic compound that is a chemical cousin to both mescaline and methamphetamine. Unabbreviated, MDMA is a real mouthful -- 3,4-methylenedioxymethamphetamine -- but it is far better known by its street name, ecstasy, millions of doses of which are synthesized in criminal labs from the oil of the sassafras plant. At one point, Mithoefer recounts, agents of the Drug Enforcement Administration, there to inspect the security arrangements, inquired about the therapist who rents the office adjoining the safe room.

"I guess they were concerned she might drill through the wall into the safe and steal the MDMA," Mithoefer says. "Though there's such a small amount in there, and it's so readily available on the street in such large quantities, I don't see how that would be worth the effort, even if she were so inclined."

Mithoefer became a psychiatrist in 1991, after a decade as an emergency room doctor -- he had found himself less interested in the bodily traumas his patients suffered than the psychological traumas that so often preceded their appearance in the emergency room. He's got that mellow, empathic vibe that they just can't teach at therapy school. He always seems moments away from a sympathetic chuckle, an understanding murmur or a sage observation. A fit 61, with a brown ponytail and relaxed dress code, Mithoefer has become the accidental point man of a movement to revive medical research into psychedelic drugs. His Food and Drug Administration-approved PTSD study that began with Donna Kilgore in April 2004 is now nearly completed, with 18 of 21 subjects having undergone the double-blind sessions. Two Iraq veterans with war-related PTSD, the study's first, are cleared to begin. Close behind are similar studies in Switzerland and Israel. At Harvard's McLean Hospital, researchers are set to evaluate MDMA therapy as a way to alleviate acute anxiety in terminal cancer patients. In Vancouver, Canada, the effectiveness of an ongoing program to treat drug addiction with another potent psychedelic drug, ibogaine, is under scrutiny. There is a proposal, based on case histories, to study the ability of LSD to defuse crippling cluster headaches.

All of these studies are directly or indirectly funded by a surprisingly robust organization whose roots stretch back 40 years to the psychedelic movement of the 1960s. Before Harvard lecturer Timothy Leary started channeling aliens and urging college kids to turn on and drop out, an intense cadre of doctors and researchers had come to believe that psychedelic drugs would revolutionize psychiatry, providing those with a wide spectrum of psychological problems -- or even just ordinary life difficulties -- the ability to, basically, heal themselves.

But Leary's bizarre career, which morphed from doing research on psychedelics to cheerleading their widespread abuse, obscured whatever medical potential the drugs may have had. Instead, authorities focused on the risks, and often exaggerated them. Richard Nixon famously called Leary "the most dangerous man in America." After a slow start, regulators and legislators cracked down hard. Millions of dollars in enforcement efforts were unable to end abuse of psychedelic drugs, but they effectively stamped out sanctioned research into their healing potential.

A small group of psychedelic researchers and therapists willing to break the law continued their work clandestinely. A much larger group did not flout the law, but waited in the wings and is now emerging. Experience had convinced these therapists that psychedelics, along with significant risks, had potential for even more significant benefits.

This may have been especially true of MDMA.

Mithoefer states the case in an article he wrote for a book of scholarly essays, Psychedelic Medicine: Social, Clinical and Legal Perspectives:"The reported results [of early therapeutic use] include decreased fear and anxiety, increased openness, trust and interpersonal closeness, improved therapeutic alliance, enhanced recall of past events with an accompanying ability to examine them with new insight, calm objectivity and compassionate self-acceptance."

In short, a therapist's dream. Or is it a hallucination?

THE PROMISE OF A BLOCKBUSTER TREATMENT, one that doesn't just address symptoms but defuses underlying causes, is a particularly seductive vision right now. A report issued last month by the National Academy of Sciences' Institute of Medicine emphasizes the uncertain effectiveness of current PTSD treatments, and the urgent need of returning soldiers who will suffer from it.

To a non-scientist, the very preliminary results of Mithoefer's study would suggest that MDMA might be just what the doctors ordered. Of the subjects who have been through both the MDMA-assisted therapy and the three-month post-experiment follow-up tests, Mithoefer reports, every one showed dramatic improvement.

But scientists are a cautious lot. "It's potentially nice to hear those things," says Scott Lilienfeld, an associate professor of psychology at Emory University. But until results are statistically analyzed and peer-reviewed for publication, "you can't really judge them. The plural of anecdote is not data." Especially with a drug that has considerable risk, Lilienfeld cautions, it pays to be skeptical.

A.C. Parrott, a psychologist at Swansea University in Britain who has devoted a large part of his career to studying the dangers of MDMA, is far more than skeptical. "MDMA is a very powerful, neurochemically messy and potentially damaging drug," he says. The government "should never have given it a license for these trials. Certainly I would not give it a license for any further trials."

But one of the nation's premier PTSD researchers, Roger K. Pitman, a professor of psychiatry at Harvard Medical School, disagrees. Morphine is a powerful, potentially damaging drug, Pitman says, "and we use it to treat the pain of cancer patients. Sound medical reasons should trump."

Current treatment for PTSD is "partial at best," he says. "There's a lot of room for improvement, and we need to be looking for novel treatments."

Though Pitman calls the MDMA study "a fringe hypothesis" -- "I've never heard anybody talk about it at any PTSD meeting I've ever attended in 25 years" -- he also observes that, based solely on a description of the preliminary results, "this seems worth further study. A lot of new ideas meet with rejection and skepticism, and we need to be careful not to be prejudiced against something just because it seems wacky. If it has a 5 percent chance, or even a 1 percent chance, of being effective in treatment of PTSD, it's worth pursuing."

AS THE SESSION TAPE ROLLS TOWARD THE FIRST HOUR, the giggles have passed. Donna Kilgore is still on the crooked couch, but she sounds very level. She's talking about her husband. Her voice is clear, calm, but you can hear something in it, something rising in the throat like water from a newly tapped spring.

"I just have a deep feeling of gratitude for all the love and understanding he's shown. I know it's been tough on him, not understanding what I've been going through and not knowing how to help. But if it wasn't for him, I don't think I'd be here."

The study protocol requires that a hospital crash cart and a trauma doctor be present during all therapy sessions, in case the drug precipitates a medical emergency. They are waiting a room away, a reminder that this is a test of a potent experimental drug, though you'd never know that from the calm, sober tenor of the conversation. It's really more of a monologue: Michael Mithoefer and his wife, Annie, a nurse and co-therapist, mostly listen, only occasionally murmuring supportively. This is their treatment plan: Construct a reassuring, protective environment and "let the drug do its work."

"He used to spend a lot of time laughing and cutting up," Donna continues about her husband, "but things have gotten so serious. I love him with all my heart, but there just hasn't been that warm fuzzy feeling, how you get excited every time you see him. It's put a damper on it. I don't fully enjoy anything. I don't enjoy my kids. I don't enjoy my dog.

"It's frustrating, just going through the motions day after day after day. I don't get any joy out of it."

She stops talking, and you can hear the faint strain of music coming from her headphones. She takes a deep breath. The blood pressure cuff, on a five-minute timer, starts to inflate.

"It sucks to just exist, and not live," Donna announces.

FIRST SYNTHESIZED IN 1912 -- A BYPRODUCT IN THE MANUFACTURE OF A DRUG TO SUPPRESS BLEEDING -- MDMA was little known until a former Dow Chemical researcher named Alexander Shulgin tried it himself in 1977. Shulgin had made his reputation, and made Dow millions, by inventing the first biodegradable pesticide. After that success, he was able to work on whatever he chose. He chose psychedelic drugs, based on a transforming experience he had with mescaline in the late 1950s. "I understood that our entire universe is contained in the mind and the spirit," he wrote. "We may choose not to find access to it, we may even deny its existence, but it is indeed there inside us, and there are chemicals that can catalyze its availability."

Shulgin made it his business to find those chemicals. In a New York Times profile in 2005, when Shulgin was 79, he estimated that he'd synthesized 200 psychoactive compounds and tested them on himself. Their effects ranged from paralyzing him with fear to granting him ecstatic visions. With MDMA, he was convinced that he'd found something special.

"I feel absolutely clean inside, and there is nothing but pure euphoria," he wrote in his field journal. "The cleanliness, clarity, and marvelous feeling of solid inner strength continued . . . through the next day. I am overcome by the profundity of the experience."

It's not well understood why MDMA, or any psychedelic drug, can produce extraordinary experiences. But in MDMA's case, the crude explanation seems to involve a drug-forced rush of serotonin in the brain. Serotonin assists in the transmission of nerve impulses and plays a role in regulating a wide range of sensations and impulses, from mood, emotion, sleep and appetite to sensation, pleasure and sexuality. One recent study pointed out physiological similarities between a brain under the influence of MDMA and the post-orgasmic state, also known for producing emotional closeness and euphoria.

Whatever the cause, Shulgin saw in the overwhelming positive feelings the drug engendered huge potential as an aid in the psychotherapeutic process. "I made samples of it for a good therapist friend of mine, Leo Zeff, which brought him out of retirement and into the enthusiastic task of making it available internationally with his psychotherapy friends," Shulgin recalls in an e-mail. "Its popularity spread in part by his enthusiasm, but in part by the fact that its ability to open the doors of communication made it widely popular as a social drug."

BY MULTIPLE ACCOUNTS, MDMA EMERGED AS A STREET DRUG IN 1984 at a new and instantly hot Dallas nightclub called Starck. Sold at $12 a hit, MDMA -- which Zeff's crowd had nicknamed Adam, for its presumed potential to return man to innocent bliss -- became ecstasy. Part of the drug's appeal was that it made dancing feel great, and staying up all night easy. But there was more. Here's an account of first-time ecstasy use from that period, recalled in the Austin Chronicle in 2000:

"The street lights got brighter, I could see the stars, car lights, even the shadows in this alley were, you know, more so. And I felt this tingle that began in my fingers and spread all over my body, coming in waves, just this indescribable feeling of aliveness. It was as if the nerves in my skin had been dormant all these years and were just now waking up and stretching. Just like that. And after this initial rush of pleasure came an overwhelming -- and I mean over-[expletive]-whelming-- feeling of total and complete positivity. Any and all fears I had harbored about doing my first drug were waylaid instantly. It was pure bliss, but it didn't knock me off my feet, or feel scary in any way.

"My girlfriend . . . and I . . . lay in the wet grass and watched the stars and cuddled. And we talked. We talked for hours. We talked about everything. Everything. It was probably the best, most open and honest conversation I've ever had with anyone in my entire life."

Word-of-mouth reviews such as that fueled an explosion of recreational use. From 1984 to 2001, the graph line for the number of first-time users of MDMA in the National Survey of Drug Use and Health quickly shot up, reaching a peak of nearly 2 million new users in 2001 alone. Concern about the drug, spurred by a spike in emergency room visits from rave bars and MDMA-related deaths, went up right along with it. Ecstasy use has since tapered off, though it is still substantial. The 2005 survey estimated that 11.5 million Americans had used ecstasy, and 615,000 had tried it for the first time that year. The average age skewed young. In 2001, 5.2 percent of eighth-graders and 11.7 percent of high school seniors had tried ecstasy (both numbers have been roughly cut in half in the most recent, 2006 survey).

When Zeff began his mission to spread the MDMA gospel in therapeutic circles, the drug was perfectly legal. But federal drug enforcement officials, who had taken half a decade to ban LSD, weren't about to delay on ecstasy. Within months of the rave boom in Dallas, officials announced they intended to list MDMA as Schedule I, the category reserved for dangerous drugs with high potential for abuse and no accepted medical use.

Rick Doblin was waiting for them.

LIKE A LOT OF OTHER PEOPLE, Doblin had discovered psychedelic drugs in college in the early '70s. By his own description a somewhat awkward, searching kid, he tried LSD in 1971 at New College of Florida, then a small, experimental liberal arts school in Sarasota. Very liberal and very experimental. "There was this tradition of all-night dance parties, until sunrise, under the palm trees, using psychedelics," Doblin says. It was bacchanalian, yes, but Doblin found something else in the experience, something "therapeutic and spiritual."

"I was like, man, this is the kind of energy, the kind of psychic stuff" that could lead him to the personal growth he had been yearning for. Ironically, says Doblin, "this was right as research into therapeutic uses was pretty much being shut down."

Doblin's world was legally circumscribed in another way as well. He was a draft resister. "What could I possibly do with my life, because I couldn't be a licensed anything, doctor, teacher a professional of some sort. All that was closed to me because I was a criminal."

As long as he was already an outlaw, Doblin reasoned, be might as well be one of those who disregarded drug criminalization and worked underground as a self-trained psychedelic therapist. When he encountered MDMA in 1982, he became convinced that he'd found the perfect therapeutic tool, one that had an LSD-like power to hurdle psychic roadblocks but lacked the frightening disorientation. Plus, it was still legal, and by then, so was Doblin -- President Jimmy Carter had pardoned draft resisters in 1977. Now Doblin had a vision: He would return to the mainstream and bring psychedelic therapy with him.

When, in 1985, prohibition of MDMA came, as everyone knew it would, Doblin had already prepared his case with a coalition of like-minded pro bono lawyers, researchers and therapists. He even won a round -- an administrative law judge ruled that MDMA met the standards for having a legitimate medical application and being safe enough for medical use. But the DEA rejected that recommendation and MDMA remained banned.

Doblin, decided he couldn't win in the courts and switched his crusade to the lab. He would focus on fostering the science that would prove the benefits of psychedelic therapy outweighed the risks. In 1986, he founded a nonprofit organization -- the Multidisciplinary Association for Psychedelic Studies -- to raise money for the research. (Knowing he would need to navigate through the obstacle course of federal bureaucracy, he entered Harvard's Kennedy School of Government and, in 2001, received a PhD in public policy.) On the elaborate MAPS home page -- alongside a psychedelic research library, the organization's financial statements, elaborate news updates and notices of psychedelic art for sale -- is a splash box featuring the MAPS "Rites of Passage Project." It's an extended pitch for the idea that "within responsible limits" parents can sometimes find great benefit in doing psychedelic drugs with their adolescent children, and includes an archive of testimonials with taglines such as "Mother-Son Peyote Ritual . . . a beautiful rite of passage a mother shared with her teenaged son, strengthening his family connection, his sense of self, and his bond with nature."

Doblin is frank about his passionate desire to defuse the drug war, which he believes is counterproductive and an assault on personal liberties. He doesn't think the government should be able to tell Americans what to put in their bodies, and he has even volunteered in interviews that he sometimes finds it useful to consider important personal and strategic issues with psychedelic assistance. He acknowledges that his outspokenness caused a schism in the original coalition that fought against relegating MDMA to Schedule I -- many of his colleagues wanted to stress their support for the criminalization of any nonprescription use. He has seen it jeopardize one of his most prized accomplishments -- MAPS funding of the Harvard MDMA-cancer study almost killed it. Doblin had to withdraw MAPS as a sponsor and persuade a donor to give the money directly to Harvard instead. He must realize he is handing his critics a potent argument, i.e.: Don't be fooled by the careful science and limited goals of the current studies; the real goal is unrestricted use of psychedelic drugs.

So, why does he do it? "Sometimes, it's just a relief to say, 'This is what I believe,'" Doblin says.

His honesty has apparently been no impediment to soliciting cash from fellow believers, which, fortunately for MAPS, include some entrepreneurs with a high regard for the psychedelic experience -- and a distaste for government drug policies -- who struck it rich in the tech boom. Last year, MAPS donations topped $1 million.

MAPS continues to fund Mithoefer's study, which is estimated to cost $900,000 through completion. And Doblin will raise money to support the much more expensive next step -- Phase III trials, which involve multiple sites and multiple therapists who will treat hundreds of people suffering from PTSD. If it proves safe and effective, MDMA would be certified as a prescription drug. That all could take five years and $5 million, Doblin says. "But if it took twice that long and cost twice that much, it would be worth every penny."

Mithoefer speaks far more cautiously of his eventual goal. "If MDMA indeed proves an effective treatment for PTSD," not only should the drug require prescription, but it should be administered only in licensed clinics with specially trained therapists, "like methadone," he says. Regarding Doblin's controversial views, Mithoefer says: "I respect his openness. I think it's a good thing that there's nothing sneaky about Rick, but that's not what I'm oriented toward. I'm oriented toward doing medical research. There are real patients suffering with real problems, and I'm trying to learn through good science if there are some methods to help people heal."
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