Acid Test: LSD, Ecstasy, and the Power to Heal, by Tom
Shroder, Blue Rider Press, 448 pages, $20
In the 1950s and ’60s, psychedelic drug research seemed to offer
promising paths for treating schizophrenia, obsessive-compulsive
disorder, alcoholism, and other disorders. The Controlled
Substances Act of 1970 interrupted legitimate scientific inquiry,
but there was a brief renaissance in the late ’70s and early ’80s,
when psychiatrists embraced MDMA as a tool to catalyze the
therapeutic process. By 1985, however, MDMA was better known as the
street drug “ecstasy” and was added to the list of chemicals that
the government defined as having a high potential for abuse and no
accepted medical use.
In the early 1990s the tide turned again, as a new wave of
research made a serious case that psychedelics should have a role
in psychiatry. “This research is no longer seen as uncomfortably
fringe,” says Rick Doblin, “but is now being accepted more widely
as promising and important and opening up a long-blocked avenue of
research in psychiatry.”
Doblin, executive director of the Multidisciplinary Association
of Psychedelic Studies (MAPS), has been at the forefront of this
wave. His tale is one of the focal narratives in former
Washington Post reporter Tom Shroder’s Acid Test,
a book that weaves intimate biographies of key players in
psychedelic research with the stories of the patients they aim
to help.
Another important figure in the book is Michael Mithoefer, a
psychiatrist with a private practice in Charleston, South Carolina.
Mithoefer’s research team completed the first major study
investigating MDMA as an aid to treating posttraumatic stress
disorder (PTSD). The study, which was funded by MAPS, revealed its
83 percent success rate in the Journal of
Psychopharmacology in 2010. A follow-up study published two
years later emphasized that the results from the initial
MDMA-assisted psychotherapy sessions were sustained for nearly all
of the volunteers. Their symptoms were relieved, on average, for
just under four years, though two of the subjects experienced a
relapse. This is especially noteworthy because only a handful of
psychotherapy sessions involved MDMA, compared to a dismal success
rate of treatment with a daily regimen of antidepressants, mood
stabilizers, and in some cases even antipsychotics and
tranquilizers.
These are still, to be
sure, preliminary results. The study was conducted as a “proof of
principle” trial, meaning that it focused on a small sample (just
20 volunteers) to show that the experiment could be conducted
safely, that the credibility of the therapist training manual could
be tested, and that MDMA-assisted psychotherapy could produce
favorable results. With successful outcomes for all three
objectives, the study provides a strong argument for further
research. And indeed, a similar study was completed two years ago
in Switzerland. Its outcome was not as dramatic—a third of the
subjects experienced a reduction of PTSD symptoms from severe to
mild—but it was still deemed a successful trial. Additional trials
are still ongoing in the U.S., Canada, Australia, and Israel; if
they go well, researchers plan to petition the U.S. Food and Drug
Administration to approve phase III protocols, the final step
toward making MDMA an approved treatment.
When researchers investigate treatments for PTSD, their chief
tool for measuring their results is the Clinician-Administered PTSD
Scale (CAPS), a structured clinical interview that measures the
severity of the sufferer’s symptoms on a scale of 0 to 130. To meet
the criteria for enrollment in Mithoefer’s study, a CAPS score of
at least 50 had to persist for at least three months while
volunteers received antidepressant treatment and at least six
months of psychotherapy. Before the MDMA sessions, the volunteers
in Mithoefer’s study averaged a CAPS score of 80. That dropped to
below 30 just two months after their final MDMA session, less than
half the average score of the placebo control groups. The dramatic
reduction in CAPS score meant that the volunteers no longer met the
minimum criteria for PTSD. In other words, they were essentially
cured.
While these subjects are left anonymous in the scientific
literature, Shroder puts names and life stories to the people
behind the numbers: veterans, victims of sexual abuse, terminally
ill cancer patients, and others desperate for relief. Nicholas
Blackston, for example, served two tours with the Marines in the
second Iraq war; he participated in Mithoefer’s second MDMA study,
which aimed to treat subjects whose PTSD stemmed from war-related
trauma. Shroder devotes about half of Acid Test to Nick’s
story.
“PTSD was like a file folder sitting on a desk not knowing
where to be stored, therefore piling up other file folders behind
it, creating stress,” Blackston tells me. “The MDMA-assisted
psychotherapy helped my mind properly file it away, allowing for
peace of mind.” Blackston still has
occasional issues with anxiety, but he says these
are easy to manage and are not related to his PTSD. “I experienced
some pretty horrific things in war, and those images can never be
erased,” he says. “Although they’re still within my mind, I’m no
longer haunted nor debilitated by those traumas. The therapy has
allowed my mind to process trauma as information to learn
from.”
MAPS is not the only organization working to bring psychedelic
drugs back into the medical community. The Heffter Research
Institute has been funding research with psilocybin—the active
compound in so-called magic mushrooms—at UCLA, New York University,
Johns Hopkins, and the University of New Mexico. The focus so far
has been on psilocybin’s ability to trigger a mystical experience,
which may be useful in various applications of psychotherapy, from
easing end-of-life anxiety to quitting smoking. The U.K.-based
Beckley Foundation is partnering with researchers at Imperial
College London to examine the effects of psilocybin and LSD on the
brain. Additional research with ayahuasca, an Amazonian brew
containing the psychedelic drug DMT, and ibogaine, an addiction
interrupter from the African iboga plant, are ongoing in
Europe, Latin America, and New Zealand.
Earlier this year, The Journal of Nervous and
Mental Disease published the first clinical trial in more than
40 years that used LSD for psychotherapy. Peter Gasser, a Swiss
psychiatrist, conducted a double-blind placebo-controlled
experiment in 12 people with debilitating anxiety
associated with a life-threatening disease. All 12 subjects
experienced significant reductions in their anxiety following only
two LSD-assisted psychotherapy sessions, with their relief lasting
at least 12 months through ongoing monitoring of symptoms.
Acid Test is a crucial addition to the story of
science’s psychedelic renaissance. By showing what researchers have
accomplished, it makes a strong case against letting regulators
close the door on their work again.
Kevin Franciotti (franciotti.k@gmail.com) is a freelance
journalist based in Boston.