THE ECSTASY FACTOR

[Alfa]

THE ECSTASY FACTOR

Bad Science Slandered a Generation's Favorite Drug. Now a New Study
Aims to Undo the Damage.

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 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.

"The press release deliberately misrepresented the data," says Colin
Blakemore. "There was no evidence of the 60 to 80 percent cell-death
claim." There were other red flags: 20 percent of the monkeys had
died; another 20 percent had gotten so sick they had to be withdrawn.

Yet there simply aren't thousands of people dying from Ecstasy every
weekend.

Then there was the problem that the drugs were injected-not
administered orally as suggested in the paper's introduction.

"The more I looked at it, the more I felt there was an agenda," says
Blakemore, who immediately fired off a letter to Science editor in
chief Donald Kennedy, complaining of "flaws so radical, so deep, they
would have been picked up by any referee." But Science maintains it
did everything right. "This study was peer-reviewed according to the
same rigorous system used in all articles published in Science," says
Ginger Pinholster, spokesperson for the Association for the
Advancement of Science, which publishes the journal.

According to Pinholster, the prompt retraction proved that "science is
self-correcting."

Public policy, however, is not so mutable.

Weeks after the botched study was published, its conclusions were
repeatedly invoked by witnesses at a House subcommittee hearing on the
Reducing Americans' Vulnerability to Ecstasy Act (RAVE Act). The bill
was quietly passed last April as the slightly reworded Illicit Drug
Anti-Proliferation Act. Aimed at quelling club drugs like Ecstasy and
GHB, the law permits the prosecution of venue owners and club
promoters for drug use on their premises.

Only a month after it became law, it was used by a federal agent to
shut down a benefit for Students for Sensible Drug Policy and the
National Organization for the Reform of Marijuana Laws. And last
weekend, it was used to shutter the Sound Factory nightclub in Manhattan.

As easy as it is to paint Ricaurte as a rogue scientist motivated by
ambition, the scientific establishment and its patrons also played key
roles in the wider scandal, from merely ignoring critical flaws to
blatantly promoting problematic studies.

Alan Leshner, publisher of Science and former director of the National
Institute on Drug Abuse (NIDA), has come under fire for endorsing the
botched study at its time of publication. "It isn't clear why an
officer of the AAAS should be involved at all in publicly promoting a
particular result published in its journal, least of all one whose
outcome was questioned at the outset by several experts," wrote
Nature. Pinholster says she called upon her boss "to serve as an
expert source as a service to reporters," adding, "There was no
conspiracy." Leshner declined to be interviewed.

Leshner has long railed against the dangers of Ecstasy. In 2001, when
he was director of NIDA, he told the Voice, "We've known since the
late '80s that MDMA can damage serotonin neurons, and if you give
enough of it, they're blown away."

Rick Doblin, on the eve of his own study, says the payoffs for such
shoddy science have been immense. "Leshner was willing to exaggerate
findings to pander to politicians for money," he says. Leshner did
help NIDA bring home the bacon: NIDA's budget for Ecstasy research has
more than quadrupled over the past five years, from $3.4 million to
$15.8 million; the agency funds 85 percent of the world's drug-abuse
research.

In 2001, Leshner testified before a Senate subcommittee on "Ecstasy
Abuse and Control"; critics say Leshner manipulated brain scans from a
2000 study by Dr. Linda Chang showing no difference between Ecstasy
users and control subjects.

But NIDA insists it's independent from political pressures. "We don't
set policy; we don't create laws," says Beverly Jackson, the agency's
spokesperson.

NIDA wasn't the only benefactor of Ricaurte and wife Una McCann's
research. "George and Una are cash cows for Johns Hopkins," says
Doblin, who points out that every time a scientist receives a grant,
money indirectly goes to the affiliated institution. While both NIDA
and The New York Times have clocked Ricaurte's NIDA grant money at
around $10 million, Doblin believes that's a low-ball figure. "Just
this one study was $1.3 million, and he has done loads and loads of
them." Johns Hopkins spokesperson Gary Stevenson declined comment
beyond the official statement.

Another consequence of the retracted study and other discredited
NIDA-funded findings is that they've helped obstruct legitimate
research into the possible medical benefits of Ecstasy. Doblin
believes Ricaurte and others are threatened by such research because
it doesn't square with their drug-war agenda.

In the past, Leshner has balked at those accusations. "It frankly bugs
me," he told the Voice in 2001. "It's easy to say that the government
isn't approving studies because they're politically incorrect. The
government may say yes."

' Now that the government-more specifically, the FDA-has indeed said
yes, Doblin's research into the benefits of Ecstasy in treating
post-traumatic stress disorder is under way. The $300,000 MAPS
project, which is funded by private individuals and family
foundations, has had some major setbacks since it initially received
FDA approval in November 2001. The study was to have been conducted at
the Medical University of South Carolina before that institution
backed out; it will now be held in a private doctor's office. While
Doblin believes the program would have gotten off the ground without
Ricaurte's retraction, he says it's made all the players, including
the institutional review board and insurance company, "feel a lot more
comfortable."

A study under way in Spain examining the potential therapeutic effects
of Ecstasy in rape victims hasn't fared as well. The Madrid Anti-Drug
Authority pressured the sponsoring hospital to shut the study down in
May 2002. Doblin largely blames Ricaurte for the mounting difficulties
the research team has faced since then: Ricaurte, who was born in
Ecuador, is fluent in Spanish, and gave four talks in Spain presenting
his bungled findings.

As for the Illicit Drug Anti-Proliferation Act, Margaret Aitken, press
secretary for Senator Joseph Biden, who sponsored the bill, said,
"Senator Biden will not change his position based on this one
[retracted] study." A Senate aide also confirmed the legislation would
not be revisited, and that there's "no official process to go back and
correct the record."

Blakemore, meanwhile, is still calling for a "full and open
discussion" from Science, including the disclosure of the paper's
referee reports. "If the referees didn't spot what I noticed right
away, then what does that say about the quality of [Science's]
referees?" asks Blakemore. "And if the referees did make negative
comments [that went unheeded], what does that say about Science?" At
press time, Blakemore and Leslie Iversen, an Oxford University
pharmacologist, were drafting a letter that Don Kennedy has promised
to publish in Science. That journal, NIDA, and Johns Hopkins insist
there's been no evidence of foul play; no investigations were being
conducted at any of these institutions at press time.

In the end, the ones most negatively affected by the studies may be
those they purport to help. "I'm very concerned about drug use, but
the way to tackle it is not to misrepresent scientific evidence," says
Blakemore. "What's going to be the impact of these studies?

Young people won't believe anything they read."


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