San Anselmo psychiatrist studying effect of ecstasy in treatment of anxiety caused by fear of death

May 30--For Dr. Philip Wolfson, a San Anselmo psychiatrist embarking on a new government-authorized study of the therapeutic use of MDMA, it's a case of back to the future.

"I'm one of the original people in the 1980s who worked with MDMA therapeutically as a psychotherapist," said Wolfson on Thursday during an interview at his comfy, psychotherapy center located in a aerie atop a San Anselmo hill.

Wolfson, 71, dressed casually and wearing a necklace of wooden beads, was relaxing after enrolling his first participant in the study, which will assess the efficacy of the psychoactive drug MDMA in the treatment of individuals experiencing extreme anxiety or depression due to a life-threatening illness. The drug, commonly known as ecstasy, will be administered in conjunction with talk therapy.

Greatest chemist

MDMA was developed between 1912 and 1914 by Merck and never marketed. The chemist Alexander Shulgin synthesized his own version of the drug and helped popularize its use by psychologists and therapists beginning in the late 1970s.

"Shulgin is probably the greatest psychoactive chemist there ever was except for Albert Hoffman," Wolfson said. Wolfson began using MDMA with his patients at that time to help treat anxiety and depression.

"There was a revolutionary aspect to it, because it forced you to sit with people for up to seven hours -- as long as people were under the influence," Wolfson said. "We crashed through lots of barriers. It made more available people's negative emotions about themselves, so they could express them more easily, and their positive emotions toward themselves and others. That's why we call it an empathogen."

Wolfson said he and his former wife also used MDMA to help them cope with the illness of their son, Noah, who was diagnosed with leukemia at age 12. Noah died in 1988.

"It created a nest in which we could all relate more easily and handle very difficult things," Wolfson said. "Everyone smoothed out,"

Outlawed

But despite the protest of Wolfson and other psychiatrists and psychologists, the U.S. Drug Enforcement Administration classified MDMA as a Schedule I controlled substance in 1985, making its continued medical use illegal.

Since then, however, Wolfson has remained a vocal advocate for the medical use of MDMA as well as psychedelics such as psilocybin. One of the organizations he has aligned himself with is the Multidisciplinary Association for Psychedelic Studies (MAPS), based in Santa Cruz.

"MAPS was founded in 1986 as an immediate reaction to the outlawing of MDMA," said Brad Burge, a spokesman for the organization.

In the early 1990s, however, the U.S. Food and Drug Administration began authorizing MAPS to do some small MDMA studies, all involving people suffering from post traumatic stress syndrome.

"We have four ongoing trials and two completed trials, and we're expecting FDA approval for that treatment around 2021," Burge said. "We're trying to get that approved first with hopes it will ultimately open up the door."

Sandy Walsh, an FDA spokeswoman, said, "We do review investigational new drug applications for psychedelic drugs. There are some studies that have been permitted to proceed. We allow these clinical studies to proceed if they are safe and have a reasonable chance of answering questions about the efficacy of the drug for the intended use."

First in U.S.

MAPS is funding the study that Wolfson is doing, which will be the first in the U.S. to investigate MDMA's effect on people suffering anxiety due to a life-threatening illness. Burge said MAPS has raised $200,000 of the $600,000 it will need to complete the study; but he said fund-raising will be easier now that the FDA has approved the project.

Eighteen people with life-threatening illnesses will participate in the double-blind study. Initially, thirteen of them will receive MDMA while five will be given a placebo capsule. Therapy sessions conducted while participants are experiencing the drug's effects will last four to six hours and take place at Wolfson's psychotherapy center. The center's living room is outfitted with plush, leather upholstered couches and decorated with a bust of Buddha on the mantelpiece and other Asian art. A calm, reassuring setting is considered essential during therapeutic sessions involving psychoactive agents.

Opens doors

Wolfson will be assisted during the therapy sessions by his partner, Julane Andries, a licensed family therapist. Andries used MDMA during 1980s when it was still legal in therapy she received for PTSD.

"MDMA makes one feel empathetic not only towards others but towards oneself, which is what people don't realize," Andries said. "It allows you to trust yourself. You can go to places without feeling shame, without feeling guilt or embarrassment, without it being such a difficult memory that you have to psychologically shut it away. You can open all the doors and look at it and talk about it. And you can finally find a door to go through to leave it behind."

Wolfson said people facing a life-threatening illness often suffer PTSD due to the stress of the disease and treatment process. He said the therapy administered during the study will focus on love and compassion.

"We're trying to make people feel better about their lives when they're stricken," Wolfson said. "We're trying to help people integrate their lives with families and expectations of what they want for themselves, and where they're going."

Individuals with life-threatening illnesses interested in participating in the study may email Wolfson at sf@mdmasites.org.

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