<p>In this episode, Rick Doblin, founder and executive director of MAPS, discusses MDMA, a molecule that has (at a minimum) revolutionary therapeutic benefits for PTSD, but arguably could have, at the highest order, a lasting impact on humanity's ability to peacefully coexist. Rick details the history of MDMA, what lead to its unfortunate criminalization, and his lifelong work trying to protect MDMA (and other psychedelics) from criminalization (and his subsequent attempt to decriminalize it). Through his founding of MAPS, Rick has made enormous progress in debunking many of the exaggerated risks being claimed against MDMA (neurotoxicity, memory loss, depression, Parkinson's, etc.), and is very close to getting FDA approval for a psychotherapy technique using MDMA. Additionally, in this discussion, you will learn about the history of LSD, psilocybin, and other psychedelics and how the combination of the misunderstanding of them with the crackdown on drug use in the 1970s lead to their designation of schedule 1 substances. But it's important to note that you will also realize from this discussion just how different MDMA is compared to the average psychedelic. We end this discussion with a message of hope: there are going to be many people who are going to wonder what can they do to receive this MDMA therapy. We talk about what those clinical trials look like, what the enrollment looks like, and perhaps more importantly, what a compassionate use license would look like, such that if there are patients who are in need of this therapy (prior to its approval) they can have an understanding of the legal paths to doing just that.</p> <p><span style="color: #212121;">We discuss:</span><span style="color: #333333;"><br /> <br /></span></p> <ul> <li><span style="color: #212121;">Discovering MDMA, how Rick learned about it and his first experiences with it [9:45];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">The timeline of MDMA's evolution, the reinvention in the 1970s, "ecstasy", the criminalization of MDMA [21:10];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">Explaining the different "schedules" of drugs [30:55];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">Rick's fight to protect it for therapeutic uses, losing to the DEA despite winning in the court, the scientific community, and the media [38:25];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">The risks involved with taking MDMA [42:30];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">An incredible MDMA-LSD case study: Rick's story of healing a treatment-resistant PTSD patient in the 1980s [44:45];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">How and why MDMA was declared illegal on an emergency basis going against the judge's recommendation after hearing Rick's compelling case (and multiple appeals) in court [57:15];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">Rick's decision to study politics to affect change from the inside out, and the recent progress being made with the DEA [1:07:00];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">Debunking the exaggerated risks of MDMA (e.g., neurotoxicity) [1:16:30];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">Rick's unbelievable ability to play the long game [1:28:45];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">Which patients would not be good candidates for MDMA from a safety perspective? [1:34:30];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">How MDMA is different from all other psychedelics, the importance of the setting, and Peter's experiences with MDMA [1:36:30];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">MDMA studies which lead to the crucial designation as a "breakthrough therapy" [1:40:30];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">How someone with PTSD can get treated now through "expanded access for compassionate use" [1:46:00];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">Rick's ultimate goal and long term vision for psychedelic clinics [1:50:30];</span></li> <li><span style="color: #212121;">Trip of Compassion documentary, and how psychedelics could change the world [1:52:30];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">Rick's early life: Resisting the draft, his feeling of wanting to change the world, and his profound experiences with LSD and other psychedelics [1:55:30];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">The history of LSD and psilocybin, and the CIA's interest in psychedelics [2:10:45];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">Timothy Leary and the Good Friday Experiment [2:22:00];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">Rick's follow up study to the Good Friday Experiment, and his criticism (and praise) of Tim Leary [2:33:50];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">Peter's experience taking psilocybin [2:44:30];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">The Concord Prison Experiment, and Rick's follow up study 34 years later [2:47:00]; and</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #212121;">More.</span><span style="color: #333333;"><br /></span></li> </ul> <p>Learn more: <a href="https://peterattiamd.com/">https://peterattiamd.com/</a><br /> <br /> Show notes page for this episode: <a href="https://peterattiamd.com/rickdoblin/">https://peterattiamd.com/rickdoblin/</a><br /> <br /> Subscribe to receive exclusive subscriber-only content: <a href="https://peterattiamd.com/subscribe/">https://peterattiamd.com/subscribe/</a><br /> <br /> Sign up to receive Peter's email newsletter: <a href="https://peterattiamd.com/newsletter/">https://peterattiamd.com/newsletter/</a><br /> <br /> Connect with Peter on <a href="http://Facebook.com/PeterAttiaMD"><u>Facebook</u></a> | <a href="http://Twitter.com/PeterAttiaMD"><u>Twitter</u></a> | <a href="http://Instagram.com/PeterAttiaMD"><u>Instagram</u></a>.</p>
Actionable Insights
1. Heal Multi-Generational Trauma with Therapy
Recognize the potential of psychedelic therapy to heal multi-generational trauma passed on through epigenetics, breaking cycles of conflict within a single generation or even session by fostering connection and reducing dehumanization.
2. Explore Expanded Access for PTSD
If you suffer from treatment-resistant PTSD and other therapies have failed, investigate the FDA’s Expanded Access (compassionate use) program to potentially access MDMA therapy before its full approval.
3. Consider Phase 3 Trials for PTSD
If you have PTSD, volunteering for a Phase 3 trial offers effective therapy (even in the control group) and eventual access to MDMA, contributing to research while potentially receiving treatment.
4. Utilize MDMA in Therapeutic Setting
For processing trauma, engage with MDMA in a therapeutic setting focused on internal processing, allowing for safe integration and coming to peace with difficult experiences. This context encourages welcoming conflict rather than avoiding it.
5. Understand MDMA Contraindications
Avoid MDMA therapy if you have compromised heart conditions, uncontrolled hypertension, psychosis, schizophrenia, or bipolar disorder, as these conditions present significant safety or efficacy concerns.
6. Taper Psychiatric Meds Before MDMA
If considering MDMA therapy, be prepared to taper off other psychiatric medications, especially SSRIs, as they can blunt MDMA’s effects. This must be done under medical supervision.
7. Hydrate with Electrolytes During MDMA
When using MDMA, prioritize drinking fluids with electrolytes (like fruit juices) over plain water to prevent hyponatremia from over-hydration. This is a key harm reduction tip.
8. Mitigate Hyperthermia Risk with MDMA
If using MDMA (in legal contexts), avoid hot environments, excessive dancing, and ensure adequate fluid replacement to prevent hyperthermia, which can be a contributing factor to adverse events.
9. Prepare for Emotional Emergence (MDMA)
Be aware that MDMA can bring difficult emotions and past traumas to the surface due to its fear-reducing effects on the amygdala. This necessitates a supportive and prepared setting for processing.
10. Set Clear Intentions for Psychedelics
For profound healing, approach psychedelic experiences with an internal focus and an intention to welcome and process whatever emerges, including difficult emotions, within a safe therapeutic context.
11. Practice Surrender (Classic Psychedelics)
When using classic psychedelics (like psilocybin or LSD), embrace the art of surrender and ego dissolution, as resistance can intensify difficult experiences and hinder progress.
12. Embrace Difficult Experiences Non-Resistantly
When encountering difficult material during psychedelic therapy, aim to not resist it, as non-resistance allows for learning and growth, while resistance causes pain and stagnation.
13. Seek MDMA Co-Therapy Team
When pursuing MDMA therapy, look for a male-female co-therapy team, as this model is believed to be more effective, especially for trauma related to childhood and attachment disorders, by recreating a loving, supportive dynamic.
14. Undergo MDMA Therapy Training (Pro)
If you are a healthcare professional interested in providing MDMA therapy, you must complete a specialized training program to ensure proper administration and patient care, as required by the FDA.
15. Anticipate Future Psychedelic Clinics
Look forward to the opening of psychedelic clinics that will initially offer MDMA, ketamine, and psilocybin therapy for clinical diagnoses, with a future vision for personal growth, couples therapy, and mystical experiences for those without a diagnosis.
16. Advocate Licensed Psychedelic Legalization
Support efforts towards a system of licensed psychedelic legalization, allowing access for personal use (after an initial supervised experience) and medical use covered by insurance for specific diagnoses.
17. Watch “A Trip of Compassion”
To gain a deeper understanding of MDMA therapy for PTSD, watch the documentary ‘A Trip of Compassion’ to see patient experiences and the profound impact of the treatment.
18. Prioritize Psychedelic Integration
Understand that taking more psychedelics does not necessarily lead to faster evolution; prioritize a thorough integration process, which may take years, to ground experiences and work through personal fears.
19. Seek Psychedelic Integration Guidance
If you have powerful psychedelic experiences and struggle to integrate them, seek out resources like Stan Grof’s work or therapeutic guidance to help understand and process them.
20. Leverage MDMA’s Negotiable Experience
Unlike classic psychedelics, MDMA allows for some negotiation with difficult content, enabling users to manage the pace of emotional processing during a session.
21. Understand MDMA’s Unique Properties
Recognize that MDMA differs from classic psychedelics (like LSD or psilocybin) by not causing dissociation or hallucinations, allowing for a more awake and integrated experience that is closer to normal consciousness.
22. Rebuild Discernment After Trauma
Use therapeutic processing to re-evaluate past judgments and regain the ability to discern trust, especially after experiences that undermine self-trust, like date rape trauma.
23. Establish Therapy Safety Agreements
For high-risk situations (e.g., suicidal ideation), establish clear safety agreements with the patient as a prerequisite for engaging in intensive therapeutic work, ensuring a commitment to safety.
24. Consider MDMA-LSD Combination (Advanced)
If experiencing overwhelming fear or getting ‘stuck’ during a classic psychedelic (e.g., LSD) session, a low dose of MDMA might help soften the experience and facilitate processing of traumatic content. This is an advanced therapeutic technique.
25. Acquire Expertise for Complex Systems
If facing a complex regulatory or systemic challenge, consider gaining formal education and expertise in that specific domain to effectively navigate and influence it, as Rick Doblin did with his PhD.
Rather than solely opposing a system from the outside, recognize opportunities to work within established structures (e.g., through nonprofits or policy schools) to effect reform and create change from the inside out.
27. Cultivate Long-Term Purpose-Driven Vision
Identify a deep, multi-generational purpose (e.g., addressing long-term societal threats) and commit to it, leveraging personal freedom to pursue work that may not have immediate, conventional career paths.
28. Extend Compassion to Opponents
Cultivate empathy and compassion for those on the ‘other side’ of an issue, recognizing their potential struggles and offering solutions that could benefit them too, even if it feels awkward.
29. Advocate for Your True Beliefs
Only promote or advocate for things you are genuinely passionate about and believe in, as this ensures authenticity and enthusiasm, fostering trust with your audience.
Seek out information sources that are not influenced by advertising revenue, as this can compromise trust and objectivity in the content being presented.
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