Last Friday, more than 300 scientists, health care professionals, policy experts and drug reformers met for the Lindesmith Center-Drug Policy Foundation's "The State of Ecstasy" conference. The event, cosponsored by the San Francisco Medical Society, was the first-ever gathering to explore the scientific, medical, cultural, and legal ramifications of ecstasy and to search for commonsense public policy responses to its popularity.

Participants included legendary psychedelic researchers Alexander (Sasha) and Ann Shulgin, as well as other leading scientists and researchers, and representatives of the rave culture that is rightly or wrongly, in the public mind, so inextricably tied to ecstasy. Rick Doblin of the Multidisciplinary Association for Psychedelic Studies (http://www.maps.org) mapped out his strategy for reintroducing the drug into the US pharmacopeia.

Leading ecstasy researchers such as Drs. George Ricuarte and Charles Grob offering opposing scientific evidence on ecstasy's dangers. Ricaurte, a researcher at John Hopkins University, argued that, "the emerging evidence suggests that MDMA produces long-term effects on humans and there is good evidence that it damages the brain. We need to confirm and further expose these studies."

Grob, director of Child and Adolescent Psychiatry at Harbor-UCLA Medical center, disagreed, arguing that research so far was limited. Grob called for more research because of ecstasy's potential as a valuable tool for psychiatrists in therapy, but also because it has become so popular.

"Often, when kids are taking ecstasy, they are not sure of what they are taking -- it worries me that so many young people are putting themselves in a position of unnecessary risk," he said. "Reputable institutions can't get this stuff to study it, which is ridiculous."

MAPS' Rick Doblin wasn't so quick to be done with Ricuarte, who, in studies funded by the National Insitute on Drug Abuse (NIDA) has documented changes in serotinin levels of chronic ecstasy users. Ricuarte has been a prominent voice in the federal government's campaign against ecstasy, serving up such nice sound-bites as, "People who use ecstasy are putting themselves at risk of brain injury."

In the widely reported remarks, Ricuarte added, "Potential consequences of brain damage induced by the drug are not clear, but may include depression, anxiety, memory disturbance and other neuropsychiatric disorders."

"He's the government's point-person in justifying harsh penalties," Doblin told DRCNet. "He's NIDA-funded, and his message has to be 'don't do it.'"

"What struck me at the conference was the brittleness of Ricuarte's and NIDA's arguments," Doblin warmed up. "His presentation was fundamentally misleading and had more to do with the primacy of imagery than with actual measurable harm," he continued, referring to Ricuarte's infamous "before and after" slides of serotonin systems in the brain.

"You can see the changes in the images, but he doesn't explain that at his 'toxic dose' level only two of nine areas of the brain are affected," said the veteran psychedelics researcher. "But people are left with the imagery, and trying to explain that this dose produces almost no toxic effects in humans just wasn't there."

"Look," said Doblin, "nothing is completely and totally safe -- no one on our side says that -- but this kind of thing leaves people with an erroneous impression. With ecstasy, the risk-benefit ratio is pretty favorable; after all, there are millions taking who don't seem to be harmed. They look at what it does with eyes wide open and decide to continue using it."

"The most they can say based on the neurological toxicity literature is that a small group of poly-drug users score slightly lower on some tests than the controls," he explained. "These are pretty minor findings; if there are any consequences of neurological toxicity, they are subtle indeed. Yet at the same time, these findings are presented as demonstrating that ecstasy is so harmful it needs greater penalties."

"At the order of Congress, the sentencing commission is going to ratchet the ecstasy penalties up to be the same as heroin," Doblin said, "but the government's own research shows all we have are minor neurotoxicological effects."

The conference sessions were not all strife and thunder, as the "dance" culture made its presence felt. In one session, Dustianne North, a PhD candidate in social welfare at UCLA, used music and images to portray the subculture to the more staid group of mostly scientists and health care professionals.

"Rave and dance culture has been misconstrued because of drug war policies," she told the audience, remarking on its emphasis on peace, love, unity, and respect. "Our culture is demonized in the media, but our music is used to sell cars and designer clothes to teens."

DanceSafe (http://www.dancesafe.org), the Oakland-based harm reduction and education group that tests pills at raves for adulterants and substitutions, also showed up at the conference. The group's founder, Emanuel Sferios, called for a temperance-not-abstinence based approach.

"We know that 30 years of drug policies have failed. Harm reduction, or educating users on how to use drugs more safely, is a much better way of keeping young people safe," he said.

Both Sferios and North criticized unregulated nightclubs and some rave promoters as out to make quick money, saying they are "part of the problem."

Shawn Heller, National Director of Students for Sensible Drug Policy (http://www.ssdp.org), had the rave scene and its persecution on his mind as he attended the sessions. "SSDP is very concerned with the ecstasy issue right now," he told DRCNet. "There's been a lot of press about it, and we've seen policy changes toward harsher punishments. One of the things that concerns us is the case of the three promoters in New Orleans who were busted under the federal crack house law (http://www.drcnet.org/wol/169.html#antiecstasy) and what this will mean for the rest of the country."

For Heller, like many other attendees, the conference was also a chance to listen, learn and network. "We came here to find out more about the history of ecstasy and its medical and therapeutic uses," he said. "We provided our materials to people at the conference, and we got a chance to meet more closely with DanceSafe. In fact, we had our first joint SSDP-DanceSafe meeting, between our chapter leaders and their trainers. We'd like to see an SSDP chapter wherever there's a DanceSafe chapter, and vice versa."

It was ecstasy's therapeutic uses, seeded by Shulgin and then stopped short by its classification as a Schedule I drug with no medical use, that provided some of the most positive yet frustrating sessions. Speaker after speaker described the beneficial therapeutic effects of what Doblin calls an "empathogen," and bemoaned the federal roadblocks to further research.

In an illustrative exchange provoked by a Village Voice reporter, Ricuarte was asked why he did not perform "forward-looking" studies where he administered ecstasy in a controlled fashion instead of looking backward on old data sets.

"Any study has to be conducted with an eye toward risk versus benefit," Ricuarte said. "I can't point to one study showing the therapeutic benefit of MDMA."

"Of course you can't," said Grob, "because to date, none have been permitted."

That didn't stop Sue Stevens from delivering an emotionally powerful description of the impact ecstasy had on her marriage as she and her husband Shane faced his terminal cancer. The relationship badly strained, the couple followed a friend's advice to try the drug in a therapeutic setting. Stevens presented a remarkable story of emotional and physical rejuvenation that increased her husband's lifespan and offered both of them an unexpected quality of life for his last few years.

MAPS' Rick Doblin used his presentation at the conference to outline his proposal for a research protocol to study MDMA in the treatment of post-traumatic stress disorder. Such a proposal must gain the approval of the Food and Drug Administration, Doblin said.

"The conference was excellent, not only in the diversity of presenters," Doblin said, "but it also provided an opportunity to invite another group of people to a Saturday meeting where we evaluated the protocol. It's in the very early stages, and we want to break the research barrier in the US."

Doblin told DRCNet that his organization, in conjunction with the Vaults of Erowid ("Documenting the Complex Relationship Between Human and Psychoactives") will shortly make all the conference's papers and reviews available online (http://www.erowid.org).

"We plan to provide a comprehensive overview to everyone in the world," Doblin vowed.

Doblin was frustrated by the government's attitude toward MDMA, illustrated, he said, by the sudden and fleeting appearance of the US Sentencing Commission's window for comment on its proposed "emergency" sentencing increases. "The only reason that was an 'emergency' was to limit our comments," he growled. "Maybe people should write in anyway (http://www.ussc.gov/contact.htm). Tell them you object to that 'emergency' designation that precludes effective comment."

"The sad part of this is that our culture and people desperately need what MDMA has to offer in terms of understanding, love, and therapy," Doblin said, "yet our reaction is fear and repression and inflicting legal pain on people."

Visit http://www.drugpolicy.org/ecstasy/ for further information on the conference, including complete online audio footage.

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