1995 research trip to the USA

Johns Hopkins

First stop was Johns Hopkins Medical Institute in Baltimore, an enormous research establishment where I spent a week as a guinea pig, to see if they can find any damage to my functions from using Ecstasy. So far the researcher, Dr George Ricaurte, has found indications that Ecstasy damages the brain, yet has failed to find that Ecstasy users' brains function less well. So this study sets out to look for functional damage by testing and comparing users with non users. Over the next two years, a hundred of each will be tested. If you want to take part or see the latest results, see their web page.

I began by being given the most thorough high tech medical exam you could imagine, at the end of which the nurse said: "Unfortunately your sense of taste is normal." I soon discovered why: the food was served like on a cut price charter flight (but without tea, coffee or goodies): a typical meal consisted of a lump of scrambled egg and two slices of bread all under cling film followed by a cardboard bowl full of pink jelly on a lettuce leaf. And I was not allowed out all week in case I sneaked off to have my fix of coffee or chocolate! But there was fascinating stuff going on around me, like research on ageing and the effect of Human Growth Hormone, and when I was transferred to the National Institute of Health they were doing studies on Seasonal Affective Disorder, Chronic Fatigue Syndrome and jet lag.

My days were taken up with endless IQ and personality tests on a computer, psychiatric interviews, pain endurance tests and responses to other drugs. For several hours I had to lie still while I was fed drugs through one arm and blood was sampled from the other; I had electrodes glued to my head while I slept; a spinal that tap that gave me an alarming twinge in one leg and a slight headache for a couple of days, but nothing was as bad as the food.

I made an appointment with Dr Ricaurte for an interview, but I was not very incisive with my questions, as I had been injected with morphine a couple of hours previously! However, in an earlier conversation with Dr Ricaurte he told me that he thought the time was right to research the positive uses for MDMA, and asked me what he thought would be the most promising use to explore. I had suggested the treatment of Post Traumatic Stress Disorder, and a couple of days later heard from his wife and research partner Una McCann that he came home that night enthusiastic about her doing such a trial. Her opinion was that the National Institute of Health was not yet liberal enough to explore positive uses for 'drugs of abuse', but the exchange at least demonstrates that researchers quoted in the media to support strong anti-drugs policies often have far more open views.

Rockefeller University

On to New York where I visited James O'Callaghan, a researcher into neurotoxicity presently at Rockefeller University where he showed me round (and introduced me to his rats which were black with white stripes instead of the usual dozy albinos).

I asked why researchers cannot simply examine the brain cells for damage using a microscope, and he replied that the problem was a matter of scale. There are simply too many cells to check, several billion in fact, so that the task would never get done. Instead, various indirect methods had been devised for finding neurotoxicity and the tendency has been to use the easiest rather than the most reliable. He was particularly critical of assays that depend on subjective assessment, believing that only tests that produced hard data should be trusted.

Dr O'Callaghan believes that MDMA has not been shown to cause neurotoxic damage. Over the past 3 years he has carried out extensive research (costing $750,000) into the best method of assaying neurotoxicity, and has chosen a test known as Reactive Gliosis as the most reliable. This is sensitive to all kinds of damage from air pollution to strokes and even stab wounds, yet it does not show MDMA or fenfluramine as toxic.

Fenfluramine is a drug that has been prescribed for slimming for over 20 years, and both George Ricaurte and James O'Callaghan agree that it has exactly the same physical effect on the brain as MDMA (one saying it is toxic and the other not). The manufacturers have applied for lifetime use, saying that they have prescribed millions of doses without any harmful effects whatsoever, a claim that both experts agree is hard to accept as there are bound to be occasional bad reactions from every drug. But now the authorities will have to consider the conflicting evidence and decide who is right, and this may happen very soon.

Purdue University

Next stop Purdue University where I interviewed Dr Dave Nichols who has a department where he finds new psychoactive drugs for use as tools for research into how the brain works. One of his inventions was MBDB [presently sold in Britain as Ecstasy tablets with $ and Fido Dido logos], which he believes would be more suitable for psychiatric use than MDMA, one reason being that it does not give pleasure. This, he believes, has a double advantage; it makes the drug more acceptable (i.e. there would be less incentive for the drug to be used outside a medical/therapeutic context) and he believes that pleasure can obscure useful effects. For example, the use of MDMA in a patient who had never had any psychoactive drug experience might produce such an overwhelming effect in the first session that no therapeutic work could really be accomplished. Nichols does not believe that this will occur with MBDB, allowing it to be used more effectively in drug-naive patients. Thus, he is focused completely on the use of entactogens as medical therapeutic agents.

One problem Nichols has in his research is being able to precisely classify potential new psychoactive substances using only rats as the behavioural model. To address this serious problem he wants to develop a technique for assay by placing 4 electrodes in specific areas of a rat's brain, linked up to a transmitter mounted on a harness on the rat's back so it can run around freely. The EEG from the rat would be transmitted to a computer and then processed and filtered to generate "EEG fingerprints", similar to a technique pioneered by a German researcher named Dimpfel several years ago, but never widely adopted largely because of several formidable technical problems that must be overcome. Each rat would need to be "calibrated" using known compounds such as cocaine and LSD, then its response to any new drug could be seen in terms of how similar it is to the known drugs using pattern recognition or neural network approaches. Dr. Dimpfel used this method in a collaborative publication with Nichols to show that the EEG produced in rats by MDMA was distinctly different from the EEG produced by the psychedelic agents DOM and DOB.

I asked Nichols his view about MDMA toxicity, and he believed it was neurotoxic if used in very high doses. There is now some evidence that this toxic effect may be due to the generation of free radicals. He further added, "But that isn't necessarily a bad thing. Let me give one possible example that I have in mind. On ageing, in the brain there is a depletion of dopamine releasing neurons but not serotonin neurons. The brain functions in a dynamic way, with different brain areas working together in a sort of functional equilibrium, and it has been suggested that an unhealthy imbalance may occur as these dopamine neurons die off, leaving an abundance of serotonin neurons as a result. Dopamine may be involved in various cognitive functions, including memory, so this imbalance may lead to certain cognitive deficits in the elderly. So one could speculate that such an balance could be restored to a more healthy level by the use of substances such as MDMA. I am just speculating, but here is an example where MDMA "neurotoxicity" could perhaps actually have a positive benefit. There have been a couple of researchers in the U.S. who have in fact suggested that "pruning" of serotonin neurons might be beneficial. But it would be a very complicated issue to address."

I commented that, after years of research, no one had come up with a drug with a more profound effect than LSD, and I asked Nichols if that implied there were none to be discovered. He was optimistic, believing that among the molecules yet to be synthesised and tried there may well be a few that could provide a basically new experience allowing valuable insights of a different kind. He used the cliche that "I can't describe it but I'll know it when I see it," meaning that it is probably impossible to conceive of the effects of such a new substance until it is actually experienced. He did mention however, that it seems less and less likely to him that such molecules will be discovered in the future, as the pharmaceutical industry focuses on more and more specific disease targets, while at the same time small clandestine laboratories from which such discoveries might also come are becoming fewer in number.

MAPS

From there I flew to North Carolina where I stayed with Rick Doblin who runs MAPS, the organisation campaigning for research into MDMA and psychedelics. There are a few projects in the pipeline, but its a slow uphill task as each one takes years of planning, lobbying and persuasion. The proceeds of the US edition of my book, to be called 'Ecstasy: Dance, Trance and Transformation', will go to MAPS, so we spent a few days editing and Rick found people to write pieces to cover the US scene.

Rick also told me about the follow up he did 25 years after the Good Friday experiment in 1962 in which 10 divinity students were given psilocybin. The results showed that most of those who took the drug experienced something that they felt was significant for their whole lives, and those who later had mystical experiences regarded them as similar in kind to that produced by the drug.

UCLA

On to LA where I was again a guinea pig, this time for Dr Charles Grob at UCLA. First I had an MRI scan. My head was wedged in and taped down with sticky tape over my forehead, my ears were plugged and a barred visor was clamped over my head. I was then motored back right into a narrow tunnel, but a mirror fixed to the visor enabled me to see my feet and beyond I had a glimpse through a window into the control room. The session went on for one and a half hours. There were a series of loud noises, at first like machine gun fire, then a variety of higher pitched noises that could well be sound effects for a sci fi movie.

Outside I was showed some views of my scan on screen. Sections were taken across the head and axially; one could zoom in for detail. On to the SPECT scan. I was wedged in, taped down and given a snorkel type device to breath through which turned out to contain a radioactive inert gas (Xenon). After only 6 minutes I was out, but was then injected with a radioactive marker and was scanned for half an hour while the machine made a noise and rocked as though a large mass was being swung round my head. Later they would combine the MRI and SPECT scans, as each shows different kinds of information using software developed by themselves.

I was not given MDMA, but Dr Grob has tested people while actually on the drug and built up data on a variety of its measurable effects. In doing so he came across an unexpected observation that the older MDMA users have higher brain blood flow than the non-users he tested. This just might suggest a benefit, as some old age problems such as dementia and Alzheimer's's disease are associated with low brain blood flow. In case this turns out to be the case, the university has actually taken out a patent on the use of MDMA as a treatment for dementia.

Of the 18 subjects given MDMA, two had bad reactions although all said they were regular MDMA users. One had an allergy to cats and had stayed with a friend who had a cat the night before, so the bad reaction to MDMA was probably related to his allergy or to the proprietary medication he used. This may explain other unexpected bad reactions to the drug.

The second person had such a bad reaction that he was released from the trial. Later, it was found that he had been given a placebo, yet another demonstration that the effect of a drug can depend very much on the 'set and setting'.

Dr Grob had just returned from Brazil where he was chairman of a conference on Ayahuasca, a natural plant psychedelic used by Native Americans for religious purposes. The Brazilian government showed interest in using it to treat cocaine addiction, and the delegates were invited to take part in a religious service where Ayahuasca was used.

Herbal ecstasy

Then to Venice Beach for the afternoon. Within a couple of minutes walk I noticed a herbal ecstasy stall, and saw it was the one with a butterfly logo. I picked up a leaflet and sure enough on the top was "People reported all kinds of effects. Some even saying it was the best ecstacy experience they had ever had. Nicholas Saunders, UK. E for Ecstasy." [In fact I had said that followed by "whether they had taken the herbal ecstasy or the vitamin pill". My actual conclusion was that this product produced no more effect than placebos. See article on this site.]

Behind were two girls and a man with dark glasses. I said "This is me, and I have been misquoted". The guy with dark glasses replied, "Oh yes, and you misquoted me too. I was really disappointed with that article you wrote, but I've quoted you word for word. And I've sold millions of these". He then suggested that I "take a walk", but I said I was going to take a photo of him instead, "Hey, you can't photograph me!" "Yes I can, I'm in a public place" and got out my camera, but he fled by the time I was ready!

San Francisco

Finally to San Francisco where I visited Jerry Beck, the sociologist who wrote Pursuit of Ecstasy, who helped me with some illustrations and statistics for the American edition, and Ed Rosenthal who is to be my US publisher. Incidentally, he does not want me to put the entire book on the Internet, but suggested I put on 'tasters'. My last, and perhaps the most pleasant day was spent with the Shulgins where I was interviewed for a radio programme by them and Robert Jesse.

Spiritual uses of E

Along the way I visited a Christian monk who was keen for me to write a book on the spiritual uses of Ecstasy and psychedelics. He believes that Ecstasy brings us back to the uncorrupted state which has been lost through the pressures of civilization. He believes that although this 'natural' state may not be suitable for our society, it is valuable as it opens the door to religious experience. I also talked to a man who has left a high powered job to devote his life to spreading knowledge about the value of spiritual purposes including, and also that drugs can be used to bring about such an experience.

Euphoria

On the way I was treated to a new experience (not one of Shulgin's) called Euphoria. It was mentally speedy but physically relaxing and to that extent similar to E, but for me produced no inspiration or pleasant sensations. It lasted for well over 24 hours and I felt no come down. I would say it may the ideal thing if you are swatting for exams, as I found I easily concentrated on working without being distracted, and never felt sleepy. But I suppose in a rave setting it could feel very different.

©Nicholas Saunders, 1995