Ecstasy Relieved from Agony

Today is different: You're speaking to a psychiatrist -- not in a sterile, fluorescent-lit hospital, but in a residential office on a peaceful, tree-lined street. You suffer from post-traumatic stress disorder, and you've talked for hours in this very room, but always skipping the violent chapter that keeps you up at night, giving you flashbacks and causing you to feel estranged from your loved ones. Now an emergency room doctor and nurse are stationed inside the house. You've brought an overnight bag. Today, you've been given 125 milligrams of Ecstasy, and maybe, just maybe, you'll finally be able to face your demons.

On February 24, the DEA issued Dr. Michael Mithoefer a Schedule I license to legally obtain Ecstasy for a study of its potential therapeutic effects in the treatment of PTSD. Researchers hope that the drug, which melts anxiety, will help PTSD patients talk openly about the experiences that scarred them. It is the first study of Ecstasy-enhanced psychotherapy ever green-lighted in the United States, one that's been in the making for almost two decades. "There's been so much struggle over this approval process," says Rick Doblin, director of MAPS, the Multidisciplinary Association for Psychedelic Studies, the organization sponsoring the research.

Doblin's group stands to create a new landscape for Ecstasy, which has been at the center of the nation's war on drugs. The old one -- with its hidden agendas, career-obsessed scientists, powerful patrons and switched pills -- has only recently been scorched. It all began in September, when the journal Science published a retraction from a group of Johns Hopkins scientists who'd discovered that a bottle they thought contained Ecstasy was in fact filled with methamphetamine, commonly known as speed. The mix-up corrupted the results of a study, published in Science in September 2002, which found that a single, recreational dose of Ecstasy was so damaging it could lead to Parkinson's disease. Another study, published in the European Journal of Pharmacology, would also be recalled.

The British journal Nature promptly published an editorial dubbing the incident "one of the more bizarre episodes in the history of drug research." Colin Blakemore, head of the U.K.'s Medical Research Council (the British equivalent of the National Institutes of Health), demanded that an independent inquiry be conducted into the affair. And The New York Times' Donald G. McNeil Jr. wrote a scathing indictment of the study's lead scientist, George Ricaurte, alleging "a pattern of shaky research supporting alarmist press releases."

Ricaurte did not respond to repeated messages left on his voice mail at Johns Hopkins or to an official request through Johns Hopkins representatives, but he has long been dismissive of his work's critics. In 2001, he told the Village Voice, "Everyone in the field has accepted [MDMA] is a neurotoxin. I think those [dissenting] arguments have to be put in perspective." It is this unyielding conviction that has been the hallmark of Ricaurte's career as the nation's foremost Ecstasy researcher.

But critics say the science has been less than convincing. Ecstasy promotes strong feelings of empathy by flooding the brain with serotonin, a feel-good neurotransmitter manipulated by drugs like Prozac. Once the high wears off, users register markedly depleted serotonin levels for about two weeks. What is not known -- and thus is hotly debated -- is whether these changes presage permanent brain damage.

That debate seemed settled when Science issued a press release in September 2002 announcing the devastating results of Ricaurte's study: After taking doses of Ecstasy akin to what teens might take at a rave, 60 to 80 percent of dopamine-related neurons in the test monkeys' brains were destroyed. The release was picked up in headlines around the globe. But some of those who got around to reading the actual study say what they found troubled them.