The History Of Mdma

Julie Holland, M.D.

Although MDMA (methylenedioxymethamphetamine) has been in the public spotlight only since the mid-1980s, its history extends back to the beginning of the twentieth century. MDMA was synthesized some time before 1912. The German pharmaceutical giant Merck was attempting to create a new medication to stop bleeding when it stumbled across MDMA as an intermediate step in the synthesis. On Christmas Eve in 1912, Merck filed the patent for this styptic medication, called hydrastinin; MDMA was included in the patent application as an intermediate chemical only (Beck, 1997). The patent was received in 1914 and has long since expired. For this reason, MDMA no longer can be patented. Contrary to the stories of most reporters and even some scientists, there was no use mentioned for MDMA in Merck's patent application. MDMA was never marketed as an appetite suppressant, nor was it used in any way during World War I. Its chemical cousin, MDA (methylenedioxyamphetamine, an analog and metabolite of MDMA), however, was patented by Smith Kline French and tested as an appetite suppressant in humans in 1958. It was then abandoned because of its psychoactive properties; this is likely the cause of the confusion.

Between 1912 and 1953, MDMA appears twice in the scientific literature. Both times it is cited as a side product of chemical reactions, news that was published and received with very little fanfare. In 1953, the Army Chemical Center funded secret testing of various psychotropic chemicals, including MDMA, for their potential as espionage or "brainwashing" weapons. These toxicity and behavioral studies, which were declassified in 1969, were performed at the University of Michigan using animals; no human studies were conducted at that time. MDMA was given the code name EA 1475. Some people mistakenly believe that the EA stands for "experimental agent," but it really abbreviates Edgewood Arsenal, where the chemicals were synthesized. Eight psychotropic drugs were studied (mescaline, DMPEA, MDPEA, MDA, BDB, DMA, TMA, and MDMA) in rats, mice, guinea pigs, dogs, and monkeys (Hartman et al. 1973). In late 1952, human studies using MDA were conducted at the New York State Psychiatric Institute, where a volunteer was inadvertently given an overdose of the drug by the researchers

Za and died. MDA became popular before MDplA, in the mid-1960s in the hippie subculture of the Haight AshbtBgrw-^l in San Francisco (Beck and

Rosenbaum 1994). Nicknamed the love drug and the mellow drug of America, MDA was reputed to impart a high that was described as a sensual euphoria that lasted for six to eight hours. Psychotherapeutic studies of MDA reported facilitation of insight and heightened empathy (Naranjo et al. 1967; Naranjo 1973), but the drug was declared illegal in the United States by the Controlled Substances Act of 1970.

Although MDMA did not become popular until the early 1980s, a sample was obtained in Chicago in 1970; it was finally analyzed, and the results published in 1972 verified it was indeed MDMA (Gaston and Rasmussen 1972). Sasha Shulgin, the chemist who often is credited erroneously for creating MDMA, did not synthesize MDMA until September 8, 1976. The first published human study of MDMA appeared in 1978. In this article Dr. Shulgin and another chemist, Dave Nichols, described its subjective effects as "an easily controlled altered state of consciousness with emotional and sensual overtones" (Shulgin and Nichols 1978). Shulgin, who lived in California and had many friends in the scientific community, some of whom were therapists, introduced MDMA to a few of his colleagues. He had had experiences with many psychedelics by that time and felt that this substance in particular could be useful to the psychotherapeutic process. One therapist, referred to as Jacob in Myron Stolaroff's book The Secret Chief, was so impressed with the effects of MDMA that he came out of retirement and began to introduce other therapists to the drug. This led to a slow spread of underground psychotherapeutic work in the late seventies and early eighties. Psychotherapist Ann Shulgin estimates that as many as four thousand therapists were introduced to MDMA during Jacob's tenure.

In March of 1985 Deborah Harlow, Rick Doblin, and Alise Agar, who referred to their group as Earth Metabolic Design Laboratories, sponsored a meeting on MDMA at the Esalen Institute in Big Sur, California. Several therapists who used MDMA in their practices and other psychiatrists who used various other psychedelics were invited to attend. According to an article by George Greer (1985), who attended the conference, "The combined clinical experience in using MDMA during the past several years totaled over a thousand sessions." Because of what had happened with LSD, which many researchers thought was a valuable tool but which was oudawed once too many people had gotten wind of it, most MDMA enthusiasts agreed to keep quiet. The media was discouraged from spreading the word, and very litde was published about MDMA until a story broke in the San Francisco Chronicle in June 1984.

The name the therapists had given to MDMA was Adam, signifying "the condition of primal innocence and unity with all life" described in the Bible's account of the Garden of Eden (Metzner and Adamson 1988). But MDMA acquired a new name among recreational users of the drug. It is widely accepted that the name Ecstasy was chosen simply for marketing reasons. It is a powerful, intriguing name to attach to a psychoactive substance. The person who named the drug, an alleged dealer who wishes to remain anonymous, had this to say. "Ecstasy was chosen for obvious reasons, because it would sell better than calling it Empathy. Empathy would be more appropriate, but how many people know what it means?" (Eisner 1989).

By the early 1980s, recreational use of MDMA had begun in earnest. A group of entrepreneurs in Texas, known to most as the "Texas group," started to produce and distribute MDMA in small brown bottles under the brand name Sassyfras, a nod to the naturally occurring essential oil of sassafras that is a chemical precursor to MDMA (Eisner 1989; Collin and Godfrey 1997). Because MDMA was not yet a scheduled, or illegal, drug, people could order it by calling a toll-free number and paying for it with their credit cards. It also was available at certain nightclubs in Dallas and Fort Worth, Texas, where over-the-counter sales at the bars were subject to tax. All of this MDMA-fueled nighdife got the attention of Texas Democratic senator Lloyd Bentsen, who sat on the Senate Judiciary Committee and urged the Drug Enforcement Administration (DEA) to make the drug illegal. When the Texas group heard about impending legislation, they stepped up production, from estimates of thirty thousand tablets a month to as much as eight thousand tablets a day. In the few months before MDMA became illegal, it is possible that the Texas group made as many as two million tablets of Ecstasy (Eisner 1989; Collin and Godfrey 1997).

The DEA published their intention to declare MDMA a Schedule I drug on July 27, 1984, in the Federal Register. A Schedule I drug is prohibited for every application, has no recognized medical use, and cannot be prescribed by a physician. In response to the DEA's proposal, a group of psychiatrists, psychotherapists, and researchers (Thomas Roberts, George Greer, Lester Grinspoon, and James Bakalar), together with their lawyer, Richard Cotton, filed a letter within the thirty-day period allotted by law to the DEA administrator, Francis Mullen, requesting a hearing. The request was granted, and the DEA scheduled hearings in Los Angeles, Kansas City, and Washington, D.C.

On May 31, 1985, the DEA announced that it would not wait for the hearings to be completed before acting, because their recent data indicated that the drug was being abused in twenty-eight states. On an emergency basis, the DEA "scheduled" MDMA, taking advantage of a law passed in October 1984 that allows drugs to be scheduled for one year, without hearings, if there is enough concern for public safety. MDMA is the only drug that has been scheduled in this manner. The ban took effect July 1, 1985. The emergency action was an interim measure to curb Ecstasy abuse until the longer administrative process could be completed. The DEA also initiated efforts to criminalize all aspects of MDMA internationally. An expert committee of the World Health Organization recommended that MDMA be placed in Schedule I but urged countries to "facilitate research in this interesting substance"(World Health Organization 1985). The chairman of this group voted against scheduling MDMA and felt that the decision should be deferred while awaiting data on the substance's therapeutic usefulness. MDMA was placed in Schedule I internationally on February 11, 1986.

The DEA hearings took place in February, June, and July of 1985. Many psychiatrists, research scientists, psychotherapists, and, of course, lawyers took part. People who had experience giving MDMA to patients testified as to the unique utility of MDMA to catalyze the therapeutic process, to enhance insight and communication between spouses, family members, and

therapist and patient. Speaking on behalf of the DEA were those who felt that MDMA caused brain damage. Dr. Lewis Seiden of the University of Chicago presented data from animal studies of MDA, demonstrating changes in the axon terminals of rodents given injections of large amounts of that substance. Humans do not take MDMA by injection, but ingest it orally. Moreover, these two drugs are very different in terms of their effects and how long they last, and they have opposite active optical isomers [see "The Chemistry of MDMA" for more details]. Nonetheless, the MDA neurotoxicity data seemed to make an impact for the prosecution's side.

To meet the criteria for Schedule I, the DEA had to prove that MDMA had no accepted medical use and a high potential for abuse. Unfortunately, the fact that no scientists had performed double-blind, placebo-controlled studies examining the clinical efficacy of MDMA hurt those challenging the DEA's move to schedule the drug. There simply was no proof, beyond the anecdotal, that MDMA did what the therapists said it did. Based on the weight of all of the evidence presented at the three hearings, thirty-four witnesses in all, Judge Francis Young, handed down an opinion on May 22, 1986. Because he felt that there was an accepted medical use for MDMA, he recommended to the DEA that MDMA be placed in Schedule 111. This would allow clinical work and research to proceed unhindered and would permit physicians to prescribe MDMA.

The DEA's administrator, John C. Lawn, was not convinced, and Judge Young's recommendation was ignored. During the course of an appeal by Dr. Lester Grinspoon, (from December 22, 1987, to March 22, 1988, a period of time referred to affectionately as the "Grinspoon window"), MDMA was again unscheduled. Grinspoon won his case—the first circuit court of appeals in Boston ruled that the DEA could not use the fact that MDMA did not have Food and Drug Administration (FDA) approval as the basis for their argument that it had no medically accepted use. There were other points at issue. Congress gave the U.S. Attorney General, not the DEA, the power to schedule drugs on an emergency basis. The Attorney General was authorized to delegate that authority to the DEA but the DEA acted against MDMA before the Attorney General had formally delegated that power. This intriguing loophole was used successfully by several attorneys to argue for overturning the convictions of their clients for MDMA possession and trafficking,

convictions that took place before the permanent scheduling of the drug. At the end of all the trials and appeal, John Lawn and the DEA permanently placed MDMA in Schedule I on March 23, 1988.

As a result of the trials, the media got wind of the situation—"Miracle Medicine/Party Drug Goes on Trial" ran the headlines. Many questions began to be posed. Was MDMA an amazing therapeutic tool, as proposed by the West Coast shrinks? Was it a killer drug that causes brain damage, as promulgated by the DEA? Every magazine article and every television news story was free publicity for the drug Ecstasy. The so-called hug drug or love drug was a hot story in the summer of 1985. Indeed, that was when I first heard of MDMA. I remember feeling sorry for the psychiatrists who had based their practices on MDMA-assisted psychotherapy. How hard it must be for them when they had seen the benefits of its proper use. Many of these practitioners, not willing to risk their licenses and livelihoods to administer an illegal drug, ceased using it. But some continued, becoming "underground" therapists. As Arm Shulgin described it, "MDMA is penicillin for the soul; you don't give up penicillin when you see what it can do" (Shulgin and Shulgin 1991).

Some time in the early 1980s, a group of intravenous heroin users in northern California made national news when they inadvertently injected themselves withMPTP (l-methyl-4-phenyl-l,2,5,6-tetrahydropyridine), the unfortunate product of a botched attempt to concoct a synthetic opiate. [See "MDMA Myths and Rumors Dispelled" for more details.] In at least seven of these individuals, a severe form of parkinsonism developed, with shaking tremors and impressive episodes of near paralysis (Ballard et al. 1985). This made for amazing copy, and many television talk shows aired images of these patients on the same shows that were explaining the other popular drug of that time, MDMA. Because of this synchronicity many people became confused and assumed that MDMA caused Parkinson's disease. MPTP has been shown to be toxic to dopamine-producing neurons and is now used as a chemical model for mimicking Parkinson's disease. MDMA has never been shown to damage dopamine-producing neurons or cause parkinsonian symptoms.

With the increased media coverage of Ecstasy during the mid-1980s came growing recreational use of the drug. Several surveys of college campuses reflected this trend—anywhere from 8 percent to 39 percent of those surveyed admitted using the drug [see appendices]. In the early eighties, Ec stasy use in the gay club scene of New York, specifically at Studio 54 and Paradise Garage, enhanced its cachet. British disc jockeys and such performers as Soft Cell and Boy George returned to England from trips to New York City extolling the virtues of the drug. Couriers began smuggling Ecstasy into England from America. There are rumors that the followers of Bhagwan Shree Rajneesh, an Indian guru based in the Pacific Northwest, were proponents of MDMA and may have helped lay the foundation for its international distribution, particularly into the Netherlands, where MDMA remained legal until 1988 (Collin and Godfrey 1997).

Some researchers place the beginning of the rave movement on the Spanish island of Ibiza, where two tablets of Ecstasy were confiscated by police in 1986 (Capdevilla 1995; Gamella and Roldan 1999). Certain DJs from London started "spinning" at the nightclubs there in the summers of 1985 and 1986. The summer of 1987 was huge on Ibiza, with large gatherings at the discotecas fueled by Ecstasy and an eclectic mix of music. Paul Oakenfold, an English DJ, tried to import that sound and vibe back to London during the winter of 1987, at the Project Club (Reynolds 1998). Afterward, large all-night dance parties, called raves, began to be held in underground locations or in clubs, with a growing number of attendees taking Ecstasy. What followed thereafter, in 1988, was Britain's "Summer of Love," when the raves were held outdoors with thousands in attendance. Unfortunately, that summer also brought the United Kingdom's first Ecstasy-related death: twenty-one-year-old Ian Larcombe, who was alleged to have taken eighteen Ecstasy tablets at once.

The rave phenomenon sweeping the United Kingdom, which was considered the largest youth movement in Britain's history (Collin and Godfrey 1997), was soon exported back to the United States. New York's Frankie Bones, a DJ and producer, brought the rave to the United States after visiting England in 1989. His "STORMraves" began in warehouses in the outer boroughs of New York and eventually took place monthly throughout 1992, the so-called Second Summer of Love. NASA (Nocturnal Audio and Sound Awakening), a popular rave at the Manhattan club Shelter, kicked off in July 1992, and one of the first large U.S. raves in San Francisco, Toon Town, debuted in 1991 (Reynolds 1998). Raves are still going strong in the San Francisco Bay Area, and Oakland's version, called massives, bring anywhere from five thousand to thirty thousand attendees.

Throughout the nineties, both rave scenes—in the United States and the United Kingdom—fed off each other and grew to become a substantial part of the youth culture in each country. Worldwide consumption of Ecstasy continued to grow exponentially, and raves of thousands of people became increasingly common, spreading throughout Europe, Australia, Israel, and India. At times the Ecstasy supply in the United States and the United Kingdom was sporadic; occasionally, there seemed to be an abundance of methamphetamine compared with MDMA, but at other times, the European market seemed to be flooded with Ecstasy. The sources were underground labs and possibly even abandoned pharmaceutical companies, in Eastern European (former Iron Curtain) countries (Saunders 1993, 1995). The DEA also regularly cited Amsterdam as being a major relay point for Ecstasy manufacture or distribution. Many significant Ecstasy seizures in Amsterdam, Los Angeles, and Newark, New Jersey, airports have been well publicized in the past several years. Russian and Israeli organized crime rings have been implicated in the drug's current distribution network, as have Hassidic Jewish couriers.

By the late nineties, government seizures of Ecstasy in the United States had increased by 450 percent. Congress held hearings in June 2000 and reported that Ecstasy seizures by the United States Customs Service had risen from less than five hundred thousand tablets during 1997 to more than four million tablets in the first five months of2000. Also in 2000, the mobster Sammy "the Bull" Gravano was collared for distributing Ecstasy and admitted to financing sales of twenty-five thousand tablets a week. A dealer in Miami claimed that he could unload one hundred thousand tablets in forty-eight hours.

The Monitoring the Future Study, a yearly survey of eighth-, tenth-, and twelfth-graders in the United States, shows a steady increase in the percentage of students who say they have tried Ecstasy. In 1996, just over 6 percent of twelfth-graders reported using the drug. In 1999 the number jumped to 8 percent, and in 2000, 11 percent of students reported taking Ecstasy. Emergency room visits attributed to Ecstasy and reported through the DAWN (Drug Abuse Warning Network) surveying system also have risen, from 319 in 1996 to 2,850 in 1999.

In May 2000, Representative Judy Biggert of Illinois introduced bill HR 4553, the Club Drug Anti-Proliferation Act, to combat club drug trafficking, distribution, and abuse in the United States. This bill was meant to include a group of drugs that are known to be used at raves—MDMA, ketamine (an anesthetic), Rohypnol and GHB (sedative hypnotics), and LSD (a hallucinogen)—according to the National Institute on Drug Abuse (NTDA). The bill called for the U.S. Sentencing Commission to amend the federal sentencing guidelines to provide for higher penalties for the manufacture, distribution, and use of Ecstasy. Further, the bill asked for five million dollars in funding to the Public Health Service for school- and community-based abuse and addiction prevention programs aimed at Ecstasy, PMA (paramethoxyamphetamine, a dangerous and potent ingredient in certain "bogus" Ecstasy tablets), and related club drugs.

The club drug provisions were attached to the Children's Health Act of 2000, which passed in the House and Senate in September 2000. The sentencing provision that would have equated MDMA penalties with those of methamphetamine was removed. Also removed was a particularly alarming provision that would make it a crime to distribute information about the manufacture, acquisition, or use of a controlled substance. Specifically, the word "teaching" had appeared in the original draft of HR 4553, which would have made the publication of this book a criminal offense.

At a July 2000 DEA conference on club drugs, it was estimated that two million hits of Ecstasy were coming into the United States every week. These rising statistics, in addition to several deaths due to PMA, caused the government to crack down on club drugs. A website was set up by NIDA specifically to educate America's youth on the dangers of these drugs. Supporting the claims that Ecstasy is a dangerous drug is the NIDA-funded research of the Johns Hopkins University neurologist George Ricaurte, who has made a career out of giving large doses of MDMA to laboratory animals and publicizing the axonal changes he has documented. [For more information, see "Does MDMA Cause Brain Damage?"]

A fascinating consequence of the government's crackdown on club drugs is the media coverage of Ecstasy and its effect on our nation's teens. The Monitoring the Future study statistics for 2000, a survey of fifty thousand students, reflected the largest one-year percentage point increase among twelfth-graders for any drug class in the twenty-six-year history of the study. Eleven percent of high school seniors in the year 2000 had tried Ecstasy at some time in their lives.

But NIDA has chosen to demonize the drug instead of offering guidelines for safer use or publicizing the specific behaviors that endanger the user. It is well known that overheating and dehydration are real risks encountered at a rave, but the government has opted to ignore these issues in favor of scare tactics and slogans. Contrast that with the British legislation enacted shordy after Dr. John Henry reported the first cases of Ecstasy-associated overheating at raves in 1992. In January 1993 the Safer Dancing Campaign was launched in Manchester, with joint backing from Lifeline (a harm reduction group) and the Manchester city council. This ensured that clubs would be monitored for temperature, air quality, and the availability of "chill out" areas, water, and harm reduction information.

Also distressing is the lack of clinical research of MDMA in the United States and around the world. Because MDMA was made illegal in 1985, sanctioned MDMA-assisted psychotherapy completely ceased in the United States, and litde published research beyond anecdotal reports of cases has made its way into the literature. One research group in Switzerland did obtain permission from the government to conduct research on what they called "psycholyric psychotherapy," and they conducted MDMA-assisted sessions from 1988 until 1993. No clinical research on MDMA was being done in the United States at all until the FDA finally agreed, in the summer of 1992, to allow Dr. Charles Grob to conduct human studies of MDMA, using people who had taken the drug before. His study commenced in May 1994.

Since that time two more research groups in the United States have obtained permission to give MDMA to human subjects, but no therapeutic studies have been undertaken in this country yet. At a MAPS-sponsored (Multidisciplinary Association of Psychedelic Studies) conference held in Israel in August 1999, clinical researchers from around the world met for the first time to share their findings, their assessments of where we stand with respect to research, and future plans in the exploration of this invaluable medicine. There is a ray of hope to round out this history. On November 9, 2000, in Spain, a doctoral candidate, José Carlos Bouso, administered the first dose of MDMA in a research protocol designed to test the efficacy of the drug to treat post-traumatic stress disorder. "The four-hour session went very well, and the patient seemed to have gotten to a deeper, more therapeutic level." I hope that this is the first in a long line of treatment studies.

Continue reading here: How Mdma Works In The Brain

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