Pubdate: Tue, 27 Nov 2001
Source: Wall Street Journal (US)
Copyright: 2001 Dow Jones & Company, Inc.
Contact:  http://www.wsj.com/
Details: http://www.mapinc.org/media/487
Authors: Julie Holland MD, Michael Mithoefer MD
Bookmark: http://www.mapinc.org/mdma.htm (Ecstasy)
Referenced: http://www.mapinc.org/drugnews/v01/n1894/a09.html

TAKE THE EMOTION OUT OF ECSTASY

Regarding Your Nov. 6 story "FDA Permits Test of Ecstasy as Aid in 
Stress Disorder":

The reason Alan Leshner of the National Institute on Drug Abuse knows 
"of no evidence in the scientific literature that demonstrates the 
efficacy of Ecstasy for any clinical indication" is because that is 
what happens when there is political influence on the scientific 
process. Millions of people around the world are taking the drug 
Ecstasy, but precious little clinical research is being done to learn 
more about this drug. NIDA, with a clear political agenda, is the 
leading financial supporter of America's research on illicit drugs.

Suggesting that MDMA (Ecstasy) "competes head on" with Zoloft is 
misleading. MDMA has already been patented, and it is typically given 
once or twice in a patient's lifetime. This is not about money. There 
is an international group of scientists, physicians, psychotherapists 
and political activists who believe that psychoactive drugs deserve 
to be explored for their benefit as well as their harm. The ultimate 
goal is knowledge, and improved therapies.

Ecstasy is a complex, multifaceted issue. There is too much 
sensationalism and binary thinking in the media. Labeling it a demon 
drug, or a "love drug" is inflammatory and inaccurate. We need to 
have clear heads to make a thorough evaluation and a rational 
diagnosis of the pros and the cons of MDMA. All medicines have a dose 
that is more safe and one that is more toxic, and all medicines come 
with various levels of utility and risk.

Clearly there is abundant misuse of this drug. Ecstasy is a public 
health concern, and the priority needs to be thorough clinical 
understanding. I applaud the FDA for having the courage and political 
independence to let this study get underway; I hope the Medical 
University of South Carolina will follow suit.

Julie Holland, M.D. New York

(Dr. Holland is an attending psychiatrist at Bellevue Hospital and 
the editor of "Ecstasy: The Complete Guide, A Comprehensive Look at 
the Risks and Benefits of MDMA.")

- ----

I would like to offer a clarification. Your story about the study for 
which I have received FDA approval is generally accurate; however, in 
the early editions of the paper, which were distributed in this area, 
there is one seriously misleading statement. It states that my wife 
and I are "psychedelic psychotherapists," implying that we use 
psychedelics in our practice.

This is not true. As part of my psychiatric practice we do use a 
number of nondrug techniques of experiential therapy to work with 
patients in deep emotional states for the treatment of post-traumatic 
stress syndrome and other problems. These techniques are quite 
similar to the approach we are proposing to take in MDMA-assisted 
therapy in our research.

In regard to Dr. Gualtieri's characterization of our hypothesis as "a 
quaint idea": Dr. Gualtieri goes on to point out that for the 30% of 
people with PTSD who do not respond to existing treatments, PTSD can 
be one of the most "debilitating of psychological conditions." MDMA 
is a drug about which there have been a number of published reports 
by psychiatrists and other therapists who used it therapeutically 
before it became illegal. Although they did not do controlled 
studies, their clinical impression was overwhelmingly that it was a 
useful clinical tool. It seems to me that it now behooves us to do 
careful scientific research to determine whether MDMA in fact might 
be a helpful treatment for some of our patients who are suffering 
daily. This is more than a "quaint idea."

Michael Mithoefer, M.D. Clinical Assistant Professor of Psychiatry 
Medical University of South Carolina Charleston, S.C.
- ---
MAP posted-by: Josh