172 lines
8.9 KiB
Plaintext
172 lines
8.9 KiB
Plaintext
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LA Times 27-MAY-85
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Psychiatrists Defend New Street Drug for Therapy
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by Miles Corwin - Times Staff Writer
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SAN FRANCISCO - Kathy Tamm was walking to her car following a meditation
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class in Menlo Park when she was abducted, taken to a wooded area, tied up,
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beaten, and then tortured for several hours. For six months after the
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incident she underwent intensive therapy, but she showed little progress.
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She had terrible nightmares. She was terrified to leave the house. Every
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unexpected noise, every shadow assaulted her senses and brought back visions
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of the attack.
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Tamm, 39, a San Francisco marriage and family counselor, said she was
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"suicidal, at the end of my rope." As a last resort, Tamm and her
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psychiatrist decided to treat her with MDMA, and experimental drug that some
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psychiatrists had found to be effective with traumatized patients.
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"I've taken it several times, and each time I felt a little less fearful,"
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Tamm said. "The drug helped me regain some measure of serenity and peace of
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mind and enabled me to begin living a normal life again.
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"For the first time, I was able to face the experience, go back and piece
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together what had happened. By facing it, instead of always burying it, I was
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able to sort of slowly discharge a lot of the horror."
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Tamm's psychiatrist, Dr. Joseph Downing, and other physicians will testify at
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Drug Enforcement Administration hearings in Los Angeles on June 10 and 11 in
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an attempt to persuade federal authorities that MDMA has great benefits and
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should be kept available for therapeutic use. The drug, which is now legal,
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may soon be outlawed by the DEA.
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At the hearing, other health professionals will talk about MDMA as a popular
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and dangerous new street drug. They will warn that MDMA has not been
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thouroughly tested and is a source of increasing abuse and will argue that
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its availability should be highly restricted.
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The hearings in Los Angeles will bring to a head the division between a small
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but not vocal group of psychiatrists, therapists and professors who claim
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MDMA is a useful therapeutic tool and those health professionals who see the
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drug as dangerous.
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The drug, known on the street as Adam or Ecstasy, is a chemical cousin of
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MDA, an illegal psychedelic drug popular in the 1960s. Users say MDMA offers
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a slightly altered state of consciousness without hallucinations, heightened
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sensibility without anxiety. And some psychiatrists contend that the drug is
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valuable because it dissolves emotional and psychological barriers, enhances
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communication, and relaxes inhibitions.
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During the last few years, MDMA has become one of the most sought-after drugs
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on college campuses. The non-medical use of the drug has increased from about
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10,000 doses in all of 1976 to the current 30,000 doses a month, estimated by
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Ronald K. Siegel, a psychopharmacologist at the UCLA School of Medicine.
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At the Haight-Ashbury Clinic in San Francisco, several patients a month who
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have taken high doses of MDMA seek treatment for symptoms similar to
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"amphetamine psychosis" - paranoia, anxiety and delusions, said Darryl Inaba,
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director of the clinic's drug detoxification project.
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Inaba recently received a call from a San Mateo College official who said
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there was a "major outbreak" of the drug at the school and that many students
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were having "panic attacks."
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Classification Protested
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The DEA has been aware of the increasing abuse, but unaware that the drug
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also is being used by about 100 psychiatrists throughout the country as an
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adjunct to therapy, according to Frank Sapienza, a DEA chemist. Last July the
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DEA announced plans to list MDMA as a Schedule I controlled substance, the
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classification for drugs with no therapeutic use and a high abuse potential,
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such as LSD and heroin.
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"After the announcement," Sapienza said, "all hell broke loose."
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The DEA was deluged with letters from angry psychiatrists and therapists who
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challenged the DEA's research and classification procedures. They were
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outraged that the DEA plan would virtually eliminate all research and
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clinical use of the drug, and they demanded a public hearing.
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A Berkeley research foundation and a group of physicians and therapists
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retained a Washington law firm to challenge the proposed classification of
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the drug.
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The DEA decided it was "obligated to listen to some other views," Sapienza
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said. After the Los Angeles hearings, there will be others in Kansas City and
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Washington, and the DEA will make a decision by 1986.
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Psychiatrists are uncomfortable discussing how they obtain MDMA. Most work
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with chemists and make their own supply, and a few tell their patients to buy
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it on the streets. The drug is readily available for about $30 a dose and is
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now sold by many cocaine dealers in San Francisco, where the drug is more
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prevalent than in the Los Angeles area, said a Haight-Ashbury Clinic
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spokesman.
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Use in Treatment Defended
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The "street misuse" of the drug should not "keep it from being used
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rationally in treatment," psychiatrist Downing said. Most psychiatrists who
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are familiar with MDMA, Downing said, agree that some controls are needed and
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suggest a classification comparable to a prescription drug like Valium.
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Dr. Philip Wolfson, a San Francisco psychiatrist who will testify in Los
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Angeles, agreed that extensive testing is in order, but he believes the drug
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is so useful in therapy that it should continue to be used during the years
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of testing.
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"My patients didn't suddenly stand up and throw their crutches away, but I
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saw some positive developments after a few sessions," he said. "Patients who
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had seen only a negative, tortured world had a shift in perspective, and a
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lighter, friendlier reality was momentarily available to them. For most, the
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positive experience carried over after taking the drug."
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Most drugs used in psychiatry are "downers," and MDMA is unusual because it
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"lightens" moods, Wolfson said. And in addition to aiding the patient, he
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said, it facilitates the work of the psychiatrist. Sometimes after patients
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have taken MDMA, Wolfson said, he has "accomplished the work of 20 sessions
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in one afternoon."
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Defended by Monk
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Brother David Steindl-Rast, a Benedictine monk from the Immaculate Heart
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Hermitage in Big Sur, tried the drug at a conference on the medical uses of
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MDMA. Steindl-Rast, who was a psychologist before he entered the monastery,
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said the drug facilitates the search for the "awakened attitude" all monks
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seek.
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"It's like climbing all day in the fog and then suddenly, briefly seeing the
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mountain peak for the first time," he said. "There are no shortcuts to the
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awakened attitude, and it takes daily work and effort. But the drug gives you
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a vision, a glimpse of what you are seeking."
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Siegel of UCLA, who has provided the DEA information about the street use of
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MDMA, said he is skeptical when he hears of any new "wonder drug."
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"My reaction is 'Here we go again,' Siegel said. "We heard the same kinds of
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things during the early days of LSD and mescaline. When PCP first came out,
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it was known as the 'peace pill.' Now we know it as more of a 'war pill.'
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"in the early '70s when people were using very low doses of cocaine, a lot of
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researchers had never seen a case of coke psychosis and didn't think the drug
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was a health problem. Then the doses increased and so did the problems."
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Known as "Love Drug"
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Health problems associated with MDMA have been escalating as users have been
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taking increasingly high doses, Siegel said. Extensive research is needed
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before the drug is made available by prescription, he said, because little is
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known about its long-term effects and toxicity. And, he said, MDMA has a
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fairly narrow "index of safety." The dose of MDMA "that gets you high and the
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dose that kills you is narrower" than many drugs, including LSD.
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MDMA (3,4-methylenedioxymethamphetamine) has a chemical composition that is
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related to both amphetamine and mescaline. It is known as "the love drug" in
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college campuses where it is considered to be an aphrodisiac, but users who
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were interviewed said it precipitates emotional, not sexual, feelings.
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"You can't sleaze with it," said student Jeff Manning who has taken the drug
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several times for "the experience." "Your true emotions come out, and
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nobody's going to do something they don't want to do. It's not a scary,
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trippy drug. It won't take you someplace you don't want to go."
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DEA officials should not be mislead by the "love drug" and "ecstasy" labels,
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said Tamm, who used the drug several times in therapy after being assaulted.
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If the drug is outlawed because of street use, she said, the harm will be
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irreparable.
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"I'd hate to think that others who have gone through an experience like mine
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wouldn't be able to use MDMA," she said. "I don't know what shape I'd be in
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now without the drug."
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