Please enjoy this transcript of my interview with Rick Doblin, PhD (@rickdoblin), the founder and executive director of the Multidisciplinary Association for Psychedelic Studies (MAPS). He received his doctorate in public policy from Harvard’s Kennedy School of Government, where he wrote his dissertation on the regulation of the medical uses of psychedelics and marijuana and his master’s thesis on a survey of oncologists about smoked marijuana vs. the oral THC pill in nausea control for cancer patients. Rick was also one of the early students under the legendary Dr. Stanislav Grof.
Please listen to this entire episode, as there is a $10M surprise at the end.
If you are interested in learning more about MAPS’s critical work and Phase 3 studies to make MDMA-assisted psychotherapy an approved treatment for PTSD, please visit maps.org/capstone.
Transcripts may contain a few typos. With some episodes lasting 2+ hours, it can be difficult to catch minor errors.
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Tim Ferriss: Rick, welcome to the show.
Rick Doblin: Tim, it’s great to be doing this with you today.
Tim Ferriss: We’ve spent quite a bit of time together. We’ve traded a lot of emails. We’ve burned up a lot of minutes via cell phone, and I’m thrilled to finally be having a public conversation with you. And I thought we could start with the origin story of MAPS. How did MAPS come to be?
Rick Doblin: Well, let’s start with MAPS was started in 1986 and it was actually the second nonprofit that I started. The first one I started in 1984 with two women, Elise Hagar and Debby Harlow, and it was Earth Metabolic Design Lab. It had been affiliated with Buckminster Fuller, and a friend of mine had started it and wasn’t using it. And so that nonprofit was started in order to gather support from the psychedelic therapy community in anticipation of the DEA moving to criminalize MDMA, which at the time they only knew about ecstasy.
And so from early ’84, up until ’86, we were working with Earth Metabolic Design Lab. And our main focus was once in the summer of ’84, once DEA moved to criminalize MDMA, there’s a 30-day public comment period. And I went to DC and walked into the DEA offices on day 28 or 29 and demanded a DEA administrative law judge hearing to argue that MDMA should stay available as a therapeutic drug. And we ended up getting administrative law judge hearings, and we actually ended up winning that hearing. And what that means is that the judge sends a recommendation to the head of the agency, so it was the DEA administrator.
And the judge said that MDMA should be Schedule 3, meaning that it should be able to be used as a medicine, a prescription medicine for psychotherapy, for a whole range of different things. And the administrator of the DEA rejected that recommendation. So it was very clear that there was no way that we were going to be able to use the law to keep the therapeutic use of MDMA legal, which had been used since the middle ’70s to the early ’80s, about half a million doses had been used by psychiatrists and psychotherapists.
And some of those people that had experienced it decided that more people should have it, that they could make a bunch of money, they turned it into ecstasy. And so once this effort that we had attempted with multiple years, multiple people to try to protect it through the law, then I recognized that the only way to really bring MDMA back as a legal substance was through the FDA, was through science, through medicine, through working with people that are suffering and showing that there was value there.
And so that’s really when MAPS was created in order to try to be a nonprofit pharma to move MDMA and other psychedelics and marijuana through the FDA.
Tim Ferriss: Okay. So we timestamp that several decades ago, you, along with a number of other friends like Roland Griffiths, have been fighting the good fight and pushing the ball forward with great resistance at points for a very long time. And first I want to thank you for that, but let me just mention some of what we’re seeing now and then I want to go back in time to closer to the founding of MAPS. So MDMA, I want to speak to some of the effects of MDMA, then we can talk about what exactly MDMA is, and maybe contrast it with other things that could also be of interest.
So I’m reading here from a recent bulletin from MAPS. So MAPS completed phase two trials with 107 participants, this is MDMA-assisted psychotherapy for PTSD, so post-traumatic stress disorder. 56 percent no longer qualified for PTSD after treatment with MDMA-assisted psychotherapy measured two months following treatment. At the 12-month followup, 68 percent no longer had PTSD. Most subjects received just two to three sessions of MDMA-assisted psychotherapy. So I want to underscore that part first. It’s not three times a week indefinitely.
This is two to three sessions of MDMA psychotherapy and then the next piece I think, is worth letting people take in. All participants had chronic treatment-resistant PTSD. That means it’s failed other interventions before or other interventions have failed, I should say, and had suffered from PTSD for an average of 17.8 years. So that seems to defy almost any conventional psychiatric explanation that one would have of a mental illness and possible treatments. So I want to just mention that, but let’s go back in time so that’s just a preview of things to come.
But let’s go back in time. MDMA, I guess it’s methylenedioxy-methamphetamine. What is MDMA? Where did it come from and how did it find its way into the therapeutic context?
Rick Doblin: Well, MDMA is a synthetic molecule, so it did not come from nature. There are drugs that are in sassafras, safrole that are used as precursors to make MDMA, but it does not itself appear in nature. And it was actually invented in 1912 by Merck Pharmaceutical Company. And they were not looking to create MDMA. They were looking to evade a competitor’s patent on a synthetic route to get to a different drug. And so they found a new pathway and they patented every drug along the way. MDMA happened to be one of those drugs.
And as far as we know, from the records of Merck, they did nothing with it for 15 years until their patent was about to expire. And they did some studies in animals and found nothing interesting. This is 1927. The next we know of it, and this will help explain what it is, was in 1953, where the US Army Chemical Warfare Service were looking for mind control drugs, and they tested a series of drugs for toxicity in animals. And MDMA was one of those drugs. The other drugs went from methamphetamine on one side to mescaline on the other.
So MDMA is basically halfway more or less chemically between methamphetamine and mescaline. So of all the classic psychedelics, MDMA is the most like mescaline from peyote. So it’s got the energizing properties of methamphetamine, but it doesn’t make you jittery. You can sit quiet, people have taken half doses and it’s facilitated meditation. And it’s like the sort of psychedelic properties of bringing to awareness inner material that mescaline has, but it doesn’t do it in the same kind of ego dissolution way that you go generally stays intact.
And so that research was actually classified and wasn’t released until the early ’70s, so people didn’t really know about that. And in the ’60s, there was a drug called MDA, which is methylenedioxyamphetamine, and it was used a little bit in therapy and it was also used as sort of a therapeutic, recreational personal growth outside of medical contexts. And when all of those drugs got criminalized in 1970 with the Controlled Substances Act and even before, a chemist named Sasha Shulgin had been looking at various psychedelics and trying to understand structure, activity relationships.
And he had had his first psychedelic experience with mescaline and felt it that was extraordinarily profound. So he was tinkering with the mescaline molecule with other drugs. He was aware of MDA and he sort of independently re-synthesized it. And the way Sasha and his wife Ann worked is that they would take the drugs that they created themselves. First, Sasha would do it in very low doses. He would work the doses up. If he thought it was something important, he would share it with Ann and they would do it together. And then if they thought it was important, they had a group of 12 people that they would share it with.
And this would be a team that was very experienced testing out all sorts of new psychedelics that Sasha had invented. And then once they got this whole range of perspectives from this group of 12 people, if they still thought it had value, then the next step was a fellow named Leo Zeff. And Leo was the leader of the underground psychedelic psychotherapy movement —
Tim Ferriss: The Secret Chief.
Rick Doblin: The Secret Chief. Yeah. So we’ve published the book, The Secret Chief, and then after a few years when his family got comfortable, we published The Secret Chief Revealed. So it’s okay for us to mention his name. And so Leo was about to retire. He’d been mostly working with LSD and other classic psychedelics and he was going to retire. And when he tried MDMA, he felt that it had such incredible potential that he decided not to retire. And so from the middle ’70s, he started training psychiatrists and psychotherapists and others in the use of this new drug.
And it was really there that its therapeutic potential was both, I would say, discovered, expanded on, and it revitalized a lot of the psychedelic community because now once the psychedelic research was shut down near the end of the ’60s, early ’70s, a lot of the psychedelic researchers went on to other things to study meditation or mindfulness or other different things. And some small group still continued to work underground, but they had tools that were basically illegal. And so now they had this tool, MDMA, that was legal and it was kept quiet for fear that if it was something that entered the public consciousness, the DEA would criminalize it.
And that’s actually what eventually did happen. But what a lot of people don’t realize is that MDMA was a therapy drug before it became a party drug under the name ecstasy. And it was really in Dallas at the Starck Club where MDMA really sort of flourished as ecstasy and became quite well known. And that’s what really attracted the attention of the DEA. And so then in the summer of ’84, they moved to criminalize it. But what it does, it’s remarkable in that it’s very subtle. It’s a subtle shift from normal perception. You can say that the classic psychedelics are anything but subtle.
You know you’ve taken them, but you do know you’ve taken MDMA, but your thinking is clarified. Your feelings are a little bit clearer. There’s a reduction of activity in the amygdala. There’s reduction of fear response. There’s a lot of oxytocin release, which is the hormone of love and nursing mothers. And so people feel more self-compassion, self-love, self-acceptance. The self-critical part of the mind is kind of quieted and people become more able to express their feelings, better listeners. It was used quite a lot in couples therapy.
And so it’s got an enormous wide range of applications and it can be used for posttraumatic stress disorder, which we chose for strategic reasons and it’s also excellent for PTSD, but it has a whole wide range of other uses. And so I think it will become one of the most widely used psychedelics once we make it into a medicine.
Tim Ferriss: So let’s pause for a second. I want to highlight a few things that you said. Number one, it’s been said that two beings are mostly responsible for creating psychedelics, God and Sasha Shulgin. And if people want to learn more about Sasha, he co-authored with his wife, two books, PiHKAL, I think it’s A Chemical Love Story or something like that is the subtitle, which is Phenethylamines I’ve Known and Loved. It’s an incredible encyclopedia of drug/psychedelics. And if you’ve ever heard of mescaline, I’m not sure if they’d be referred to as derivatives or analogs, but 2C-B, 2C-E, the 2C-X class, then you’re familiar with Sasha Shulgin’s work.
And then there’s TiHKAL, which is Tryptamines I’ve Known and Loved, which is a similar compendium, different class of drug. Mescaline would be an example of a phenethylamine, Whereas something like DMT would be an example of a tryptamine for those people who know those acronym. But Sasha Shulgin, fascinating character and prolific, I want to say certainly hundreds, maybe thousands of different compounds that were created.
Rick Doblin: Yeah. And also I learned a lot from him about his political strategy of staying free. And that’s one of the things that Sasha did was he shared his information with everybody.
Tim Ferriss: Can I pause for one second? Just to say also he was a renowned chemist, not just among underground therapists, but also he was a known quantity to for-profit sort of contracted chemists working with large companies. I just want to mention that as well.
Rick Doblin: Oh yeah. He worked for Dow Chemical and invented, I think, it was like a biodegradable insecticide or something and he was by Dow and they said, you can have a lab and do whatever you want. You’re so creative, just we’ll give you a lab and do whatever you want. And he started focusing more and more on psychedelics. And this was as the ’60s was going on and he eventually came to part ways with Dow and went independent and taught chemistry at UC Berkeley. And yeah, he was a very well-renowned chemist.
Tim Ferriss: And you were saying his strategy for maintaining freedom. Is that what you said?
Rick Doblin: Yeah. Yeah. So yeah, sure, sure. Staying free. He actually had a DEA official that officiated at his wedding with Ann Shulgin.
Tim Ferriss: That’s incredible.
Rick Doblin: He would develop these friendships with people and it would be by sharing information and he had his connections through the whole breadth of society so he would share it publicly with chemists who had then learned what he did and build on that or he would share it with the DEA. He just had this view that if he ends up learning something, it’s his obligation to share it with the world and that that’s the way to stay safe. That he had personal trusting relationships with people in the DEA, even though he was fundamentally against the drug war and saw it as a major abridgment of human rights.
But he could meet people for who they were as individuals, not necessarily as representatives or embodying all of the values of the organizations that they worked for. It was just very impressive.
Tim Ferriss: And you’ve been very good at maintaining some degree of Swiss neutrality, I would say. And I mean that as a compliment from a diplomatic standpoint. Because even within the psychedelic communities, you’ve got the kind of drum and feather crowd who might hate the scientist crowd and then the scientist crowd who doesn’t like the new shamanic fill-in-the-blank crowd and then the ayahuasca people don’t like the LSD people. There is a surprising amount of catty bitchiness within the sort of factions of the psychedelic community that are in some cases working together very well.
But you’ve been extremely strategic; you used that word before.
Rick Doblin: Yeah.
Tim Ferriss: And we’ll talk more about strategy. I want to just define a few things real quickly. You said post-traumatic stress disorder. This is something that maybe at some point in the future, I will discuss from a personal perspective, but I’m not going to get into that this episode. Suffice it to say it’s something I’m quite familiar with. And for those people who don’t know so PTSD, I’m just going to read here. PTSD, this is actually from a Psychedelic Science Funders Collaborative document that you have seen. We won’t read the whole thing, and we’ll certainly talk more about PSFC later, probably.
So PTSD, post-traumatic stress disorder, is a serious and prevalent psychiatric condition that is the cause of significant morbidity and mortality. That’s a pretty sterile, boring way to put it, but it affects people you might expect, like military veterans, and it could go by a different name, like shell shocked. People who have difficulty reintegrating and functioning in civilian society. But PTSD is also extremely common in the civilian population. People who have been exposed to war zones, people who have been physically or sexually abused.
There are many different types of traumatic experiences and it causes subjective distress, can lead to alcohol or drug abuse, impair societal family and relationships. Certainly people with severe symptoms may not be able to hold jobs, may draw their blinds and stay indoors in really bad cases. And it also increases the risk of other conditions like depression and suicide and so on, which is higher in PTSD patients than the general population. So I wanted to just give that as a basic. But let’s make that concrete and I’m going to use a more recent example and then we’re going to go back in time to, I think, 1984 with you.
But could you tell us who Jon Lubecky is and why he came into your life, for lack of a better way to put it?
Rick Doblin: Yeah. So Jon is a veteran from Iraq and he had been blown up, was not so physically hurt, but he was physically hurt some, but he was more psychologically damaged. And when he came back from the war, he was so decompensating that he ended up attempting suicide on multiple occasions, including one time where he put a gun to his head and pulled the trigger and luckily the round didn’t work. He called it a squib load. And so he came very close to death and out of desperation, he decided that he would volunteer for this MDMA study. And he was one of the very successful cases.
I didn’t know about him for a while. Because as the sponsor of research, I’m not supposed to know who the subjects are. Their privacy is protected. I only know when they reach out to me or they are willing to reach out to their therapist and they say that they want to either speak in public about what happened to them, about how much benefit they got or whatever. So it was a couple of years after Jon’s treatment that was successful that we got in touch. And what I felt immediately was that his story was so compelling and he had been completely disabled with PTSD.
And after our treatment, he was able to go back to work and he was actually the liaison to the veterans for Senator Rand Paul for his 2016 presidential nomination campaign for the Republican nomination. And so when I met Jon, he was doing much better, but he also had political connections. And so I felt that that’s really what we need to broaden the support for what we’re doing to have a veteran who’s got connections with a lot of Republicans who is willing to speak about the benefits of MDMA.
And so actually Jon has met with Vice President Pence, with Stephen Miller, with all sorts of Republicans that he was able to speak with and have, in a way, the first impressions that they get about MDMA and the potential of MDMA to help prevent suicides among veterans, to help veterans come back and lead more healthy lives. They would hear about it from Jon. So now he’s working as a consultant for MAPS to try to broaden our political support.
Tim Ferriss: And I highly recommend everybody search online for a video. You can find it easily on YouTube from The Economist, which is actually a seven-minute, I would call it, profile of Jon Lubecky, L-U-B-C-E-C-K-Y. And if you just search MDMA treatment PTSD The Economist, the video should pop up and it’s worth seeing. Because a few stats to keep in mind, there are 20 plus veterans per day who commit suicide on average in the United States, that’s one. And the recovery that we’re talking about, at least as it was described in Time magazine, is not unusual given the cohort.
What I mean by that is on, I guess it was May 1st of 2016, perhaps, you could probably correct me. But The Lancet Psychiatry published a paper about the study that Jon was involved with. And roughly, I want to say, 2/3 of the 26 veterans, firefighters and police officers treated with MDMA’s psychotherapy no longer qualified for the diagnosis of PTSD one month after their second MDMA session. I just want to, again, just underscore how odd that is, how unusual that ratio of number of doses to a disappearance of symptoms is in the world of psychiatry, and that’s where I want to go next.
So part of what fascinates me about MDMA is, as you said, how in some respects how manageable it is compared to classic psychedelics like LSD or psilocybin, which would be associated with mushrooms, psilocybin mushrooms, otherwise known as magic mushrooms. And in that respect, it is much easier to adapt to a therapeutic context, people can speak intelligibly. And I find MDMA deeply fascinating for many reasons. One is that you see cross-species effects. So one word that is often used to refer to, or I should say a term that is used to describe MDMA and some other compounds as empathogen or entactogen. Well, let’s say empathogens, so it’s a compound that creates empathy. And you see this effect in, for instance, octopi who exhibit prosocial behavior with this sort of downregulation of fear response, and that’s interesting because their nervous system is completely different than, say, many mammals that have otherwise been studied.
But in humans, as you mentioned earlier, you have the turning down the volume on the amygdala and what appears to, please correct me if I’m wrong, but based on my very novice understanding what appears to happen in these therapeutic sessions, and people can see video of some of these sessions in a film called Trip of Compassion, which I actually released — I mean, I volunteered to help get it released in the United States. You just go to tim.blog/trip and you can find it. I don’t make a penny from it. But it shows footage of sessions with people who have experienced PTSD. And what strikes me is that these people are able to revisit traumatic experiences, which would otherwise be excruciating or impossible to revisit without re-traumatizing themselves. But with fear somewhat removed or toned down, they can sort of metabolize it and make sense of it as an observer of their own experience.
And I would just love to hear you comment on that and also how do you explain how two sessions with something can have enduring effects over months or years after other interventions have failed for an average of 17 years? That just doesn’t make any sense to most people who take psychiatric medications.
Rick Doblin: Yeah. Or to a lot of people at the VA who are therapists, who’ve had PTSD patients for 30 years that are still struggling with PTSD. So let me just say that the Lancet article was published May 1, 2018 —
Tim Ferriss: 18, there we go.
Rick Doblin: And so we paid for having it to be free to download. So if anybody goes to lancet.com/psychiatry and just “study MDMA PTSD,” you can get to the article and you can download it for free.
I think the reasons why it’s something that can make a permanent change in people that there’s two factors: the first factor is the actual experience while they’re under the influence of the substance, while they’re doing psychotherapy; the second factor is the integration work and the work that that’s what’s really necessary for making it permanent. But so you have a breakthrough during the session and then you work afterwards in non-drug psychotherapy to integrate it. But what we find is that you are actually rewiring your brain.
So the same neuroscientist Gul Dolen, who did this study with octopuses and showed that octopuses who are asocial, unless it’s mating season, which is very rare, but under the influence of MDMA they’ll be more prosocial. It’s a remarkable finding. And so it goes so deep in our evolutionary history that we separated from octopuses like 550 million years ago, but Gul also did studies in mice that were published in Nature, which is considered to be, if not the, one of the top scientific journals in the world. And this study showed that mice under the influence of MDMA release a hormone, oxytocin, which is this hormone, as I mentioned, of love and nursing mothers, but the oxytocin actually stimulates new neural connections in prosocial areas of the brain.
And there’s also a phenomenon called fear extinction and memory reconsolidation. And so the thought about memory is that many people used to think about it as we’ve got sort of a hard-wired memory and you remember it and then you go onto something else. But actually when you remember something, you have to reprint, sort of reconsolidate the memory so that that’s how memories change over time. And so what we’re able to do though with MDMA is that there’s a memory for the incident, episodic memory, and there’s an emotional memory that’s attached to that incident memory, but stored in different parts of the brain and that comes together. And so when you’re feeling safe and you can bring up painful memories and you are not reacting in your normal way of fear and a sense of being overwhelmed and it’s too much, when you’re able to process the feelings —
And I’d say a lot of the people in our studies have said, “I don’t know why they call this ecstasy.” You’ll see that by looking at the Trip of Compassion video too. Some of the sessions are very difficult, people are shaking, they’re crying, they’re letting out stuff that’s been stored within for a very long time. But when they reconsolidate the memory, they are swapping out the emotion that was attached when the trauma happened of fear, of terror. And then they are swapping it out with a sense of it’s in the past, it’s something that you have approached it peacefully. You’re feeling safe when you’re thinking about it. You can recognize it’s not still happening. So the next time that you remember the incident, you remember the incident with a different emotional tone, and that that can be encoded in new neural pathways in your brain.
And what we find is that under the influence of MDMA, people’s memory for the trauma is increased. And you might think that that’s a bad thing, now they can recall a lot more details about the trauma and a whole sections — we had a firefighter that was in our study, and he and a bunch of his fellows were in a fire that the roof caved in and killed about eight or 10 people, he survived. And under the influence of MDMA, he remembered whole story segments of what happened. He thought he had the memory stitched together in the way it happened, but under the influence of MDMA, he remembered more of it. And so when you have these memories that are attached to fear, when they’re unconscious and suppressed, they’re influencing you, the world is not a safe place. You got to be suspicious of this or that, this could always happen again. So the fact that MDMA permits memory to come to the surface where it can then be processed with this fear extinction and memory consolidation, and then it permits new neural pathways so that you can actually change the way you react in one session.
Now, this is also true for psilocybin. Psilocybin has been shown to increase new neural connections as well, and other psychedelics too. So there’s a kind of a rewiring that helps explain how you can have a fundamental change after just one session, but there still needs to be the reinforcement of that. And that’s where the psychotherapy and the integration process comes in. You could say that a lot of people that take MDMA at raves and take ecstasy at raves and parties, they can also have some pretty powerful experiences, but if they don’t do the integration work afterwards, then a lot of times the things will fade. And so that’s why what we talk about our treatment is not really MDMA, it’s psychotherapy facilitated by MDMA —
Tim Ferriss: Right, which is also why you don’t have every smoker who uses psilocybin quitting nicotine. But if you have the structure and format like Dr. Matt Johnson at Hopkins did, looking at a nicotine addiction and recruiting subjects explicitly who want to quit, you have these just never before seen results with abstinence six months later, but it’s the therapeutic vessel and vehicle that is so important.
I’ll mention a few things related to that. Number one, Michael and Ann Mithoefer are simply fantastic. Two exceptional therapists who’ve helped a lot with the MAPS protocol for therapy. One of the tools of the toolkit that we don’t have to get into right now, but that I do find useful and can be useful to people even outside of the psychedelic context is IFS. I think that’s Internal Family Systems?
Rick Doblin: Yes, yes.
Tim Ferriss: And Parts Work, I think, is surprisingly profound and powerful when used well. Let’s talk about another patient, and that is from 1984. I promised we would get to 1984.
And just as a side note also, because you’ve mentioned it but we didn’t get into it, and I know we’re bouncing all over the place — well, actually first MDMA is, and this is true with other psychedelics, but it produces a hypermnesia, the opposite of amnesia. This supercharged memory that is quite incredible. I mean, you will remember the texture of the couch, the exact pattern and fabric and color from when you were three years old, that could come up, something like that, or words in a language you studied for one semester 25 years ago. It brings up a lot of questions about the brain and the mind. And you mentioned that it can produce not just functional changes in the brain, but structural beneficial changes, which is astonishing on some level to think about.
And then the other acronym that I just want to take a second to describe for people, because I think more people listening to this will have heard of MDMA than MDA, just in very brief terms, what are the biggest differences between MDA and MDMA? I tend to think of MDA as somewhere between MDMA and LSD and having a much longer duration of effect, but how would you, in brief, contrast MDA versus MDMA?
Rick Doblin: Pretty much what you just said, I think it is more in this LSD, MDMA combination, meaning that there is more of an ego dissolution. It’s still got the body warmth, it’s still got the reduction of fear, so it’s different than LSD or psilocybin. You can still converse during most portions of it, but the peak is more nonverbal in different ways. It’s more instinctual. And it was used in therapy as well. And one interesting point was that once MDMA became illegal, we could have thought that in the middle ’70s, early ’80s, when the use of MDMA was so widespread in therapeutic settings, that that was because it was legal and the other drugs were not. And so once MDMA was illegal, then the question would be, will these underground therapists, now that all the tools are illegal, will they go back to MDA, which was more popular before MDMA? And to most parts they have not, but it does have a lot of therapeutic potential.
It is a pretty incredible drug. And it just is a little bit more what we would say psychedelic than MDMA. And I think that’s why the gentleness of MDMA, the profoundness and the way that it’s such a subtle shift makes it easier to integrate in the long run.
Tim Ferriss: Yeah, not as squirrely.
Rick Doblin: Yeah, and the MDA has more effect on the heart. The military, when they were using it, the CIA mind control, they actually killed somebody with MDA by giving too high of a dose and having heart problems. So it’s got a little bit more of that activation of the blood pressure.
Tim Ferriss: So the blood pressure got up.
As promised, I’m obviously circling this slowly, but 1984, and I believe this is the first-ever therapy session that you did with a PTSD patient. Can you tell the story, please?
Rick Doblin: Yeah. Let me say that it was the first-ever therapy session that I ever did with anybody. I would sit with people — so since 1972, when I was 18 and when I decided to go through psychedelic therapy, myself become a psychedelic therapist, try to bring back psychedelic research, I would sit for my friends and various other people, but these would be people looking for personal growth and they were more or less healthy people. And of course, all of us who are more or less healthy, have a lot of problems and a lot of challenges.
Tim Ferriss: High-functioning neurotics and everything else.
Rick Doblin: So I would deal with difficult cases, but the first time I ever dealt with a patient was in 1984. And so as part of my training to become a therapist, I had studied with Stan Grof and Christina at Esalen in the summer of September ’82 is when I first studied at Esalen with them for a month-long workshop. That’s where I learned about MDMA. And then I went back in ’84 for a month-long workshop that they had called The Spiritual Emergence Network. And the basis of that was that there’s a lot of people that are struggling with what their purpose in life is, what’s their meaning? What do they really care about? How do they approach death and various issues? And that sometimes people have these breakdowns and they can be catalyzed by psychedelics. They could be just a normal breakdown. And that all too often, these are breakdowns that could lead to breakthroughs, that these are dysfunctional patterns and that they need something more healthy. But they break down, and often that gets pathologized and they get medicated and hospitalized and tranquilized. And so the theory of this Spiritual Emergence Network is that if we don’t try to suppress the symptoms, but help people work through their issues, that they will end up potentially finding a new balance and be more healthy.
So I had gone through a month-long training on how to work with people in these spiritual emergencies and I had just come back home to Sarasota, to Florida, to New College, where I was a student. And I was only home for four or five days and then a friend of mine called me up, and he said that he and his girlfriend had done MDMA together, and under the influence of MDMA, she had remembered being raped and almost killed and that this was a terrifying memory for her. She had previously been in and out of mental institutions as a result of this and other traumas that she experienced, and she was so bothered that she might hurt herself. These painful memories had come to the surface that she checked herself into a mental institution and she stayed there for about six days and they gave her the same old drugs that she had gotten before and discharged her. And she felt hopeless that these drugs had not helped her before, there was nothing that she knew of, and she was, even more, deciding to try to kill herself.
And so my friend called me and he said, “Can you help her?” And I had sold them the MDMA so I felt that in some ways I was responsible, but I also felt like I have just got this training in this Spiritual Emergence work, but I’m not qualified to work with somebody that’s at the razor’s edge of death and life, that’s so much worried about committing suicide. And so I felt that this was one of the most important turning points in my entire life. And I felt like if I were to say no to her, she didn’t really have any other options. She tried the best that Western medicine could give her, she’d been hospitalized, she’d been medicated, none of that worked, and so I agreed to at least to talk to her.
And so during our conversation, I asked her that if she would just promise not to commit suicide when we were working together, I would take a chance. I would gather some women friends and we would create a support system for her and we would try to work with her. Because what I knew about MDMA, and I think this is important for people to realize, is that it brings things to the surface, but if you’re not prepared for that, you can end up worse off, a lot. And that’s where the therapy comes in. It’s not just giving the pill, it’s the context, it’s how you react to this internal material as it’s coming up. And so Marcela was the woman, and she agreed to not commit suicide while we were working together and that gave me the courage to work with her.
And so she came down to Sarasota and moved into my house for about a month. And first off, we did an MDMA experience, and it was so hard. It was so painful. It was like a tour of all the traumas that she had in her life. And I think that’s also a clue for people is that most of us, when we experience trauma, we’ll be able to be resilient and can get over it, and it’s not always the case. But those people that end up with PTSD are often those that have had a series of traumas, sometimes going back to childhood. And so this was the case for Marcela. So the first session was MDMA and it was a series of these traumas that she’d experienced throughout her life, and I felt like we made a lot of progress, but it didn’t feel to either of us like the problem had been solved, that she had found a new way to move forward.
And so the next thing I thought was, let’s try LSD. And so the next session began with LSD. This was about 10 days after the first session. So we had the first session, we had some integration time, and now we did an LSD session. What I knew also about LSD is that it was the first drug used in the treatment of PTSD and it was the first psychedelic drug used in the treatment of PTSD, and it was used by a Dr. Bastiaans, who was a Dutch psychiatrist. And after World War II, he started using LSD for what he called concentration camp syndrome. And he worked with a lot of Holocaust survivors, but he also worked with a lot of Dutch resistance fighters who were in the camps. And they later after the war became part of the Dutch government and they protected him. And Bastiaans was the last person in the world that still had legal permission to give LSD to people up until the late ’70s, early ’80s. So I knew that LSD had been used for treatment of PTSD, but that it had been quite difficult.
And so under the influence of LSD, Marcela got increasingly fearful that it — MDMA can reduce the activity in the amygdala. LSD doesn’t do that. So the fear came and she had this images of being on a foreign planet, under a double sun and baking to death. And it was just too terrifying she couldn’t make any progress at all and was stuck. And so I thought, well, maybe if we administer half a dose of MDMA, that would decrease the fear enough so that she could continue to process what was happening, what was coming up to her in her memories. And so that was the breakthrough, was this half a dose of MDMA. And after that —
Tim Ferriss: By half a dose, you’re talking about like 75 milligrams, something like that?
Rick Doblin: Yeah. Yeah, 60, 70 milligrams. Yeah. That it just cut the fear to the point where she could now finally process things. And so this symbolic thing that she had about being in a foreign planet with the double suns and baking to death, the symbolism was such that it was related to something in her life. So under the influence of MDMA, it condensed to being on Earth with a single sun after she had been raped and beaten and was thrown outside under the sun and left alone, so it turned into something in her life. And then what she started sharing was that this had been a date rape situation and that this person had told her that if she ever told anybody about what actually happened or mentioned his name, that he would kill her. And so this had been about 10 years before she and I met, but this kind of fear that if you ever tell anybody about he’d kill her, that was like a poison pill in her brain, that she was a prisoner of this. And so being able to tell the story broke the spell.
And then I think what the next step was is that when she explained that it was date rape, I said, “Well, what did you like about this guy?” And she immediately threw up. It was just this instantaneous reaction of throwing up. And then she started explaining that he had liked animals and that what she had — one of the reasons why she was thinking of committing suicide was that she could never trust herself to find love, to find companionship, because her previous instincts with this guy had been so wrong. And so going back and being able to look at where she made this mistake, that just because somebody likes animals doesn’t mean that you can trust them, she started to regain her ability to trust herself about how to move forward in assessing threats, assessing how people are going to act to her, and she was able to let out all of the fears about what had happened to her. And so that was the transition for her.
And we did not need to do a third session. That was the one that really changed things for her, and so that was 1984. And so over time, as I was watching how she was doing, we kept in touch, she kept getting better and better and better. And I think that’s another really important thing to say is that she had had these overwhelming feelings of fear with these memories, but under the influence of MDMA, the first session, and the LSD, MDMA combination the second session, she was able to learn that if you can bring these feelings to the surface and express them, that they don’t need to overwhelm you, that you can process things, that you don’t have to launch into these fear-based reactions. So what you started out, Tim, by saying early on is that people do better at the 12-month follow-up than at the two-month follow-up, that even without more MDMA and without more therapy, that they’ve learned a process about how they handle their medications, their problems, I mean, and their emotions.
So that’s the same thing that happened for Marcela. So throughout the ’80s and into the ’90s, when the whole concern about the rave movement was growing and the NIDA-funded research, the National Institute of Drug Abuse-funded researchers claiming that MDMA was neurotoxic and would produce long-term functional consequences after a single dose, I kept watching Marcela and I kept seeing her get better and better and better and she later then decided that she wanted to become a therapist. She was an artist. She decided that she wanted to become a therapist to help others. She went back to school to become a therapist and now she is one of our lead therapists and she and her husband, Bruce, are one of the lead trainers of other therapists. That was an experience that really motivated me to think about MDMA for PTSD as being an ideal combination.
Tim Ferriss: If we sort of zoom out from that story of one person, I can also say that I personally know at least a dozen people who have had their emotional lives and relationships with their loved ones resurrected because of MDMA and these different compounds to the extent that, just as one example, a friend of mine had his wife say, “You’re once again the person I married.”
Rick Doblin: Wow.
Tim Ferriss: He had been so withdrawn and shut down and compartmentalized and self-isolated that he ceased to resemble the person she married. Just in, not to say this happens all the time, but it happens more often than one might think within a very short period of time, like you said, after two or three sessions with competent guidance ended up with that type of outcome. I’d love to hear what you think of this way of describing the session, because the importance of the therapy is paramount. The way I heard it put to me by someone who shall remain nameless, but very hyper credible, people would recognize the scientist, but said what psychedelics do is they create a window of plasticity and then it’s up to the person and their environment and their support to then mold that plasticity, right?
So you create this window of plasticity where you can grow new — you can experience a neurogenesis, right? That the generation of new connections within the brain and so on and so forth, but to what end, right? For what is it molded? You can hone your direction with the help of therapists who then provide you also with the toolkit that continues to be useful after that molding integration experience, right? At least that’s been my impression. So it’s not a foregone conclusion that you take a pill and all your problems are solved. But with the right shaping and guidance, the outcomes can be really just incredible.
When I think about Marcela or I think about you, I think about people like Roland who have been involved for so long and for so long with so little extrinsic reward, if that makes sense.
Rick Doblin: Yeah, yeah.
Tim Ferriss: You think about it scientifically, for decades it was considered just career suicide at best, right?
Rick Doblin: Yeah.
Tim Ferriss: Then it was a dead end. It’s like, all right, it’s not career suicide, but you’re going nowhere. Then it was minimally interesting. Now, The New York Times, Wall Street Journal, all these major media outlets, major universities are taking notice, funding is being raised. But during those hard times, I’d love to hear what drove you. I know there’s one example that you haven’t spoken about in as public a forum as this, but that it’s perhaps more recent, but I think it kind of speaks to this, which is the suicide letter that perhaps you could describe for people.
Rick Doblin: Yeah. Let me say first off that, just to further illustrate this story about that it’s not just the drug, and then we’ll get to that, which is that one week about 20 years ago, MAPS got contacted by two women with almost identical stories. They had taken MDMA at raves and had remembered being raped and prior sexual assault. But one of them told the story that she was with friends who just wanted to party and that she knew that they didn’t want to hear about this heavier thing that was coming to the surface and so she stuffed her feelings down and she had contacted us months later, feeling way worse.
The other woman who contacted us just days away said that she was at a rave, took MDMA, the same thing happened, but she was with a girlfriend and they went off into the corner and talked about what happened to her and they were able to process it and then she was able to go back to the party and now she felt better after months later. So it’s not the substance itself. It’s how you respond to the material.
Now, what drove me to do this in the first place was a certain kind of desperation I would say about the world. So when I was a very young boy born in ’53 from a Jewish family, I was raised with stories of the Holocaust. I had distant relatives killed. I have a lot of Israeli relatives. Just the thought that there could be this dehumanization and genocide and just irrational thinking was terrifying to me, and that led me more and more to think about psychological factors.
So I just felt that there was this imbalance that we as a species have, and that I as an individual have, where we are overdeveloped in our minds and underdeveloped in our emotions and spirituality. So this was now about 15 years ago, and I had been contacted by this fellow who was quite troubled and he wanted to be referred to an underground psychedelic therapist and I wasn’t ready to do that.
So he happened to live not far from where my therapist lived down in Florida. So I referred him to my therapist and he worked with my therapist for a couple of months. At this point I was in Boston. I didn’t live down there. But he went to my therapist for a couple months and then he called me up and he said, “It’s just not doing what I need it to do. I would like you to go ahead and refer me to an underground therapist.” So we talked about it some more and he indicated that he had had a tendency towards epileptic seizures, and it’s conceivable, it’s rare, but it’s possible that psychedelics can catalyze a seizure. I felt like the kind of underground settings are just not appropriate for somebody that could have a medical crisis.
So I said to him that I just could not in good conscience refer him to an underground therapist. He said, “All right.” He felt kind of sad and seemed to accept it and that was the end of our conversation. I didn’t hear anything for about three more months. Then I got a call from the police in his hometown and they said, “Do you know this guy?” I was like at first a little bit frightened. I wasn’t sure what they were talking about. I said, “Yeah, I do know him and he did contact me and I referred him to my therapist and then he wanted further therapy. I wasn’t able to help him with that.” They said, “Well, he’s committed suicide and he’s left you a suicide note. We wonder, would you like to see it?”
I was taken kind of aback. But I said, “Yeah, if he’s written a note for me, I should read it no matter.” I thought it was going to be, “You could have helped me, but you didn’t, I’m really mad at you. Why didn’t you do this?” When I got the note, the first thing I noticed was that he hadn’t committed suicide a few days before then, he’d committed suicide the very next morning after our phone conversation, after I told him I couldn’t refer him to an underground therapist and that somehow it had taken three months for the police to get around to calling me. So that was shocking once I just saw the date on his letter that it was connected to me giving him no more hope that he decided that he would kill himself.
The note was the opposite of what I thought it would be. It wasn’t condemning me. It wasn’t angry. It was this kind of sad, sentimental, but gracious note and he said, “I don’t blame you for not referring me to help. I blame the system. I blame the drug war. I feel that I might have been one more person who would still be alive if this therapy was legal. You can tell people about this note, if you want to do so, and that I just hope that my experience will motivate others to try to seek treatment and motivate you to keep trying, because there’s a lot more people that need help like this.” It was a beautiful note. It was just so tender in a way. Then just to think that he wrote that and then right then after that killed himself.
So that’s always been in the back of my mind, that there are people out there, people that we know that need help. You talked about 20 veterans committing suicide a day. There’s roughly 50,000 people that commit suicide every year in America and we need to help them. There’s way more whose lives are so warped by PTSD or depression or anxiety or fear that they need our help.
Tim Ferriss: You’ve put in so much time and we are in a very exciting period right now in terms of the place of momentum for what you’ve been working on for so many decades. I’d like to bridge to that because the suicide letter you mentioned speaks to the desperation. It also speaks to what types of therapies could be available to people, even if they have certain medical complications like epilepsy with proper supervision if compounds were reclassified, meaning they were taken from schedule one, the most restrictive drug class, no known medical application, high potential for abuse. There may be other criteria. But things were thrown into there somewhat willy-nilly during the Nixon administration, and it’s extraordinarily challenging to get them out.
But I want to just speak to what’s happening right now, and also perhaps tell an anecdote first, and that anecdote is I’ve come to know we’re recording this during the COVID-19 crisis. It’s far from over. This is going to be, I think, a very long, difficult period for millions of people. I’ve become friends with ICU docs. So senior attending physicians in New York City and elsewhere, and one of them who’s completely psychedelically naive. He’s never used any of these compounds, reached out to me because he does not know how to process what he has seen and what he’s had to do. He’s seen so much death. He’s had to make decisions about who gets ventilators and who don’t. He’s had to talk to, say, someone who is older with a lot of comorbidities who’s probably not going to make it even if they intubate them and talk to the family about why they’re not going to get a ventilator. I mean, things like that.
He doesn’t know what to do, right? I say this just because I think this is trauma and the difficulty in resolving trauma and the inefficacy of treatments for say PTSD is so profound, and it’s also very timely, right? I feel like right now talking to these first responders, talking to many other people who have been affected, who have loved ones who’ve died, who were simply suffering from acute anxiety and this is bringing a lot to the surface, that I’m kind of watching the tide go out and that there’s a tsunami on the way of very high volumes of PTSD. I also have personal experience that I may discuss another time.
So for all of these reasons, right, looking at the data, first of all, being driven by that and seeing results that represent an order of magnitude, a jump from anything that is close to being in second place, seeing video of the transformations that can take place, and I recommend everybody watch Trip of Compassion if you can. It’s very intense, but the payoff is worth it.
You, meaning MAPS and PSFC, so the Psychedelic Science Funders Collaborative, have launched a $30 million capstone fund. So this is a campaign to get MDMA-assisted psychotherapy across the finish line and make MDMA a medicine.
After decades and decades of working on this, you have a number of excellent people involved with MAPS on the executive team. You have advisors now who have a lot of experience in pharma, biotech, drug development, and I’m at a point, I’ve been waiting for this point, you might not know this but I’ve contributed to MAPS over the years in smaller ways and I’ve been waiting for this precise window.
Rick Doblin: That’s great.
Tim Ferriss: So you’re raising 30 million to get it to the finish line. You’ve already raised internally, from people you know, around 10 million.
Rick Doblin: Yes, 10 million.
Tim Ferriss: And over the last week or so — and it’s been an incredible week — a lot of things have come together beautifully. I’ve worked with Joe Green, who’s president of PSFC, that’s the Psychedelic Science Funders Collaborative, to get together a $10 million matching grant. Originally, as you and I know, we were going to record this podcast and we didn’t have any matching grant. Then I thought, let’s put together five; I’ll be part of that five. Then we ended up at 10 and the intention was to announce it, as we’re doing, on the podcast. And I’ll explain what that means, and more accurately, it’s a challenge grant.
So you’ve got me, I’m putting in a million. You’ve got Peter Rahal, who’s founder of RxBar, James Bailey, founder of Bail Capital, Blake Mycoskie, founder of TOMS. All seven-figure commitments. Then you have Steven and Alexandra Cohen of The Steven & Alexandra Cohen Foundation coming in in a big way with five million. And then you have other people who are also committing capital.
What makes this so exciting is that you’ve raised 10 of the 30; now we’re committing to the middle 10, which is the hardest to raise, right? That middle 10 is often the most difficult to raise. In a challenge grant, which means that if other people are able to donate 10 million, if MAPS is able to raise an additional 10 million, activates our 10 million and boom, we’re at the finish line. Which is hard to believe. It’s quite amazing that all this came together.
Rick Doblin: I’m so glad the microphones didn’t work the first time and gave you something to do in this period of delay!
Tim Ferriss: Yeah! If everything is happening for you and not to you, what does it look like? And this has been one of the stranger, more surreal and exciting things that has ever happened from a tech delay. And this is extremely close to me and represents such an opportunity. To clarify again, 10 million is raised of the 30. I and the group I mentioned are committing to a $10 million challenge grant, which means if another 10 is raised to activate that, boom, we’re at the finish line. This is so close and represents such an opportunity.
I was speaking with a doctor and a scientist who’s been advising you guys and he said there are some risks, but the asymmetric risk-reward is just incredible for this. Meaning, once done, meaning if you have MDMA reclassified, the ice is broken for a dozen other things for the entire field, for the entire industry, right? So if you’re looking for a spearhead opportunity that is time-bound, right? I mean, if there is time sensitivity to this, because you’re executing phase three trials, this is an immediate opportunity, that if you really want to sort of bend the arc of history and if you’re interested in any of these other compounds, like psilocybin, as I am, I’ve committed a lot of resources and time to supporting research at places like Johns Hopkins and The Imperial College of London, you have to be interested in the outcome of this phase three trial with MDMA. It’s going to be the precedent setter. So I was not planning on making another large commitment like this.
Rick Doblin: Thank you, Tim, for doing things that you didn’t plan, but it is the moment. You’re right.
Tim Ferriss: It is the moment. And of course, huge thanks to Joe. I don’t want to skip over that. And we’re looking for people who can help donate on any level. You can go to maps.org to donate at any level — a dollar, $10 a month, $20 a month. But we’re especially looking for people who can make larger donations. By larger donations, I would say six-figure or seven-figure commitments over a two-year period, so my million-dollar commitment is planned for $500,000 in late 2020, so let’s say late October. And then the remaining $500,000 in the end of 2021, let’s just say October again. So you get to split it across multiple years, it’s tax-deductible. So if you might be able to contribute $100,000 or more over multiple years, then you have two ways that you can learn more. One is going to maps.org/capstone. That’s number one. maps.org/capstone. The second — and you can do both of course — is emailing capstone@maps.org to set up a meeting with Rick or a member of his development team to learn more about the groundbreaking work that they’re doing.
And even if you can contribute say, a dollar, $10, $100, you can go to maps.org and set up some type of, ideally, recurring donation that can also add you to the chorus in support of this to unlock the healing power of MDMA, which has already really been demonstrated and needs to be further demonstrated through these phase three trials.
I’ll just say one more thing. There are a couple of benefits actually, so it’s not going to be one more thing. It’ll be a few more things. There are benefits to doing this if you contribute in a big way.
Let’s just say if you’re able to contribute a million or more, then you can participate in the community known as PSFC, of which Joe Green is the President. Graham Boyd also does great work. The Psychedelic Science Funders Collaborative, PSFC, includes all sorts of members, Matt Mullenweg of Automattic, Genevieve and Steve Jurvetson, incredible entrepreneurs and investors, Austin Harris, Jeff Walker, George Sarlo, and there are all sorts of different community threads. PSFC helps with due diligence and bringing in advisory capacity specialists and so on to assess different opportunities in the psychedelic space. There have been group Zoom chats with people like Michael Pollan, I believe Jared Diamond, if I’m not mistaken.
Rick Doblin: Yes, that’s correct. Yeah.
Tim Ferriss: And others. There are a lot of fun things that are done with this smaller group and I’ll link to more on PSFC, but suffice it to say, this is an incredible opportunity. It represents a lot of money to me. That’s not a small amount. One of my largest contributions to anything ever. The reason that I’m doing this — because raising money is a hard business, Rick. I mean, you’ve done it for such a long time. Fundraising is tough, and what I’ve noticed is that some people seem to think they can take their marbles with them, and you can’t take your marbles with you, meaning the money you’ve accumulated. So I think it’s really worthwhile to ask if you do have some flexibility and finances or some savings, it could be applied to something you care about if you know someone affected by trauma, if you know someone whose lives have been devastated by addiction, which was used to numb or avoid feelings that are the result of trauma, and you’re looking for a very high-leverage, asymmetric payoff possibility, this is an excellent place to put money.
I do think that a dollar now is worth $10 five years from now. This is a time-dependent opportunity is the way that I’m looking at it. If not now, if not with this, if you find it of interest or if these compounds have had a huge impact in your life, where are you going to put the money? Where else? And you should have a good answer to that before it’s an immediate no to this. That’s my perspective. If you’re just holding onto it in case, I just don’t view that as a satisfactory answer. Maybe I’m just all fired up, but I’ve committed something like five percent of my total net worth over my entire life. Everything I’ve done to psychedelic science, including this capstone fund with MAPS, it’s had such a tremendous impact in my life. It’s completely changed my life for the better. I don’t know if I would be here without some of these compounds, quite frankly, and I know I’m not alone in feeling that way.
Rick Doblin: To put the numbers in context, I also want to say that over the history of MAPS, over 34 years, we’ve raised over $80 million.
Now we’re talking about another $30 million, and that will get us approval if the research goes well as we think it will in the United States, through the FDA, in Israel, through the Israeli Ministry of Health, and also in Canada through Health Canada. Because we have 15 phase three sites, two in Israel, two in Canada, and 11 in the United States. The other number to put in context here is the number that it normally takes pharma to develop drugs into medicines, and it’s hundreds and hundreds of millions of dollars. The pharma industry will tell you that it’s well over a billion dollars. In fact, the latest number is roughly $2 billion to make a drug into a medicine. But what they do is they amortize all their failures into the few successes. Around half of the money almost is opportunity costs on their money.
Then they have to do a long period of safety studies, which fortunately for us, because MDMA is such — ecstasy is such a demonized drug, there’s been hundreds and — if you go to Medline, there’s over 5,000 papers on MDMA or ecstasy at a cost of somewhere in the neighborhood of $450 million to produce all this data that we’ve been able to review and assess and then submit to FDA. What we’re going to end up spending for phase three is somewhere in the neighborhood of $65 million or so with $35 million already raised, and then another $30 million coming from capstone. The median is around, or the low end is somewhere like $350 million for pharma to make a drug into a medicine. The things that contribute to us being able to do it so efficiently are first off, we have a bunch of highly `mission-driven people. We have 80 people now working for MAPS. We don’t work at pharma salaries. A lot of them are what we call refugees from pharma, from Novartis and other pharma companies that are really passionate about psychedelics, so we’re mission-driven. We’re not returning money to investors. It’s all about donations.
And then once MDMA becomes a medicine, it will be sold in our MAPS Public Benefit Corporation, where we maximize public benefit over profit, and whatever profits there are get reinvested in the mission of MAPS for further research. It’s extremely efficient. The other thing to say is that there’s only two drugs that have been designated breakthrough therapies for PTSD by the FDA. One of them is MDMA or MDMA-assisted psychotherapy. The other was a drug called Tonmya by Tonix Pharmaceutical Companies. It was a repurposed old drug from over 30 years ago that was a sleeping pill, and the thought was that maybe they could make it to help people sleep through the night who have PTSD and not have nightmares and get better rest.
We did our interim analysis in March. Tonmya’s interim analysis was done in February and they failed. They were told that the study was not going to get significant results. It failed for futility, and they had already spent well over $100 million dollars on this study, and that’s all lost.
We’ve got lots of stories like Jon Lubecky, but still, to do it in the context of a clinical study, a phase three study, a very invariable treatment, you can’t customize it to the person, it was a little bit anxiety-provoking. But when I opened the email from the data monitoring committee, I was just elated to learn that we didn’t need to add anybody, that we have at least a 90 percent or greater probability of obtaining statistical significance when the other people are finished the study, and that we have at least a medium effect size, which is good, but our phase two data pooled was a large effect size. We are on track. We have de-risked it. We have demonstrated in this interim analysis that we have a very good chance of succeeding.
I think that when we imagine investments in charitable purposes, you do have to take the chance of, “Is it going to work or not?” We cannot say that it’s going to work 100 percent, but we believe that it will work. One important thing also is scaling, and you hear this all the time in tech. You talked earlier about Michael and Annie Mithoefer being these phenomenal therapists, and they are phenomenal therapists. They treated more people in phase two than anybody else. What we decided to do for phase three was to take Michael and Annie out of phase three and have them instead train new therapists to conduct the phase three studies. Marcela and Bruce, they’re still working on phase three, but they’re also spending much of their time training other therapists.
What we’ve demonstrated in phase three was with about 70 new therapists, many of whom had never done MDMA before, but they had experience in trauma and they were able to get phenomenal results that we’re on track. It’s new therapists who are able to get these results. That’s why I really think that it’s going to be scalable should we obtain FDA approval for prescription use, and this match grant that you’re doing is just phenomenal to really help us do this.
We went into, after we got permission from FDA to go to phase three, we engaged with them in an eight-month process where we reviewed every aspect of the phase three design, the statistical analysis plan, and all the other studies that they were going to want to see, and we managed to get what’s called an agreement letter. That agreement letter means that they are legally bound to approve the drug if we get statistically significant evidence of efficacy and if there’s no new safety problems. They can’t question the methodology or anything like that. I think the 90 percent is the best pharma will do for the regulatory.
The other thing we should be concerned about is backlash against psychedelics. How likely is that? But one of the most important things of our fundraising so far has been that we have obtained funding from people across the political spectrum.
Tim Ferriss: I think this is a really important point, because people might assume that everyone donating to this is sort of tie-dye-wearing hippies with a few extra coins in the pocket, but that’s not true at all. You have people on, say, the right. You’ve got Rebekah Mercer, you’ve got all sorts of folks — Elizabeth Koch. Then on the, let’s just say the left for the sake of simplicity, you’ve got certain of the Rockefellers, who have donated millions. You’ve got people like George Soros. So there’s an entire spectrum of donors who are contributing to this cause, and certainly that minimizes the likelihood of political backlash, but it speaks even more so to the fact that you have such sympathetic populations you are trying to help — including veterans.
Rick Doblin: The Disabled American Veterans just put out, May 1, their bi-monthly magazine, and the cover article is about MDMA for PTSD. I think we’re in as best shape as we could possibly be at the moment.
Tim Ferriss: Which is why I’ve come off the bench and I’m back on the field. I just want to simplify and clarify a bunch of what was just mentioned. First is very few guarantees in life, but I have decided to reengage and push in all my chips on this right now, because I view it as being highly de-risked, high probability of success, with very asymmetric payoff. It opens the door, paves the way, breaks the ice, whatever metaphor you want to use for potentially a dozen compounds, including psilocybin.
This is a very, very important, what I would consider a vanguard moment and initiative for psychedelics, overall. And MDMA is the representative that is furthest ahead, so I’m putting in a million of my own money, which is a lot of money for me. We also have, as I mentioned before, Peter Rahal and James Bailey, Blake Mycoskie, and then of course the Steven & Alexandra Cohen Foundation. Huge thanks to all of them and others who are contributing money for this $10 million challenge grant. And if you have the possibility, if you are open to considering donating six figures, meaning $100,000 or more over multiple years, then please check out maps.org/capstone and you can also email capstone@maps.org.
I feel like I’ve done my homework on this. I mean, I’ve been very immersed in this world and the science for five or six years now and have given MAPS smaller amounts of capital to see how well that’s used. In the past, I’ve done that with other outfits in different universities, and this is the right time to contribute. So, if you need more convincing, then I would suggest watch the Jonathan Lubecky video created by The Economist, looking at MDMA’s treatment for PTSD. Also consider watching Trip of Compassion. You can find that at tim.blog/trip, which I suggest everybody watch anyway, just because it shows how badly someone can feel they are damaged and flawed and irreparable and how they can regain their footing in life and really feel resurrected.
I mean, it’s incredible to watch and you get to see it in visual storytelling with real session footage. But I hope you guys will join in. If you’ve been sitting on the sidelines wondering “How can I support? How can I get involved?” And a lot of people, hundreds of people, have asked me. This is a good place to place some chips. I’m putting in a lot of chips personally, so I’m not just talking the talk. I’m putting a lot of skin in the game.
Rick Doblin: Yeah, Tim, there’s another background factor. So we have tried the traditional sources of funding and that has not worked. So, for example, there is over a million veterans that are receiving disability payments from the Veterans Administration for PTSD and it costs the Veterans Administration somewhere in the neighborhood of 15 to $20 billion a year on these disability payments.
They pay multiple billions of dollars every year on SSRIs and other things to treat people with PTSD and yet we’ve not been able to get a penny from the VA. In fact, we are paying researchers affiliated with the VA to blend MDMA with their non-drug psychotherapies as a way to try to educate the VA. So maybe one day they will get involved, but I don’t think they’re going to help us get it approved. The other thing is the National Institute of Mental Health. So last week there was an article in The Washington Post about how COVID is going to produce, as you said, a tsunami of mental health problems, and one of the people that was quoted was the woman in charge of PTSD research at the National Institute of Mental Health. So we’ve been trying for about 15 years to get any kind of support from the National Institute of Mental Health.
So I just sent her an email the other day, and I said, “Is there a way for an NIMH to help us? This is a crisis. You’ve acknowledged this in public.” The answer was no and the reason is because they say that they only look at mechanism of actions studies, academic science on how things work, but the FDA, to approve a drug, you need to prove safety and you need to prove efficacy, but you don’t have to have the faintest idea how the drug works. In fact, a lot of the drugs that are approved, we don’t really know how they work, but the important thing is, can we reduce suffering? Can we give them to people? And if it seems to help, we don’t need to know the mechanism of action. So National Institute of Mental Health though, says, “No, we only support these scientific studies.”
So we’ve tried the VA, The Department of Defense, The National Institute of Mental Health, a lot of the major foundations. The Wellcome Trust is the largest foundation in England, started by Burroughs Wellcome stock, by pharmaceutical stock. They’re focused on neuroscience and psychology and they said, “Go away. It’s a reputational risk for us.” I said, “It’s a reputational opportunity.” But that didn’t work.
Tim Ferriss: Yeah. Well, let me speak to that because this has been a question a lot of people have had for me. I’ve been very public, obviously, in The New York Times pieces and Fortune magazine. On the podcast, I’ve spoken very transparently about my support of scientific research related to these compounds. I will say that particularly given the populations we’re talking about, victims of sexual abuse, disabled veterans, people suffering from PTSD, treatment-resistant depression in say the Hopkins studies, I have been absolutely astonished at the zero amount of blowback that I have experienced.
It has been purely 100 percent reputational upside, and that’s not why I did it, but I girded my loins and prepared myself to deal with a bunch of bullshit and it just hasn’t come. It’s been nothing but support and, in fact, people have reached out to me who I never thought in a million years would ever reach out to me to confide in their own struggles and also ask how they can help. So, it is from my perspective, as you said, not a reputational risk at all. I know that’s strange for me to say, and I usually wouldn’t paint such a binary picture, but I really do feel right now it is much more reputational upside than downside.
So let’s do this, Rick. We’ve covered a lot of ground. I want to provide a quick recap to help people. Suffice it to say there is the capstone fund. This is a $30 million fund to get MDMA to the finish line. I believe in this. I’m committing a million dollars. There is a $10 million challenge grant that can be activated if another $10 million more is raised in the next 90 days. I’m going to hold very strong to that deadline. This is all or nothing, and you can contribute and learn more if you’re contemplating at least $100,000 over multiple years, again, tax-deductible, by emailing capstone@maps.org to learn more and/or going to maps.org/capstone.
You can certainly contribute less and every dollar does count at maps.org, but I think we should close up soon because that’s the message. That’s the call to action. I think that’s what we want to leave fresh in people’s minds. We’ll link to everything we’ve discussed, all the names we mentioned, Leo Zeff, Sasha Shulgin, all of the books, all of the resources, all the compounds, they’ll all be in the show notes at tim.blog/podcast, including links to all of the MAPS URLs that we mentioned, and also the funding collaborative PSFC.co.
But Rick, what else would you like to say? Is there anything else you’d like to close with before we wrap up?
Rick Doblin: Well, first I’d like to thank you and Joe Green and Graham Boyd at PSFC for this incredible $10 million challenge grant. I think what I’d like to say though is that, while we’re talking a lot about MDMA for PTSD, I think what we’re saying is that we’re going to be unlocking psychedelic psychotherapy for so many different things, and that there’s so many uses of it, and that we are also trying to market it in a way where we really maximize public benefit and not profit. So, I think we’re going to do two things: open the field to psychedelic psychotherapy and then also try to demonstrate a new approach for public health and for pharma. Just to the extent that people can help us get there, we really are doing this out of love, out of passion, out of a hope that this is what we can contribute. And that humanity is in a crisis; we’ve got to be able to work through our fears to work together, and I think that I’m very optimistic in that sense. I think we have the tools, but we need to really bring them forward, and now is the time. This $10 million challenge grant is going to be an absolutely critical component to our ability to move forward.
Tim Ferriss: Well, Rick, it’s always fun to spend time with you. You’re inspiring. You are a workhorse. I’ve seen you more than once running to catch your plane before they shut the gate with a laptop in one hand, like a waiter running through a restaurant, typing out email. You’re extremely hardworking, and this is a special moment. It’s a special opportunity. It is time-dependent. I’m also honored and thrilled to be part of it, to be able to spend time with people like those names I mentioned, who are contributing capital because they’ve looked at it and believe in the potential significance, which I think is enormous. It’s a great group of people to be involved with. It’s been a real blessing in my life. These are fascinating thinkers, fascinating people.
So if this is of interest at all, if you want to just explore it, please go to maps.org/capstone to learn more. And if you’ve decided that you’ve collected some marbles and you don’t want to just sit on your hands waiting and that this represents a potentially interesting opportunity, please email capstone@maps.org and set up a meeting to chat more with the team about it. But, certainly, I’ve only placed three big bets in this entire space and this is the third. I was only planning on making two because I wanted to tip over some dominoes with the last two.
I just think with all the feedback I’ve had from specialists and doctors and researchers who assessed this, who initially were very, very skeptical, we don’t have to spend time on it now, but they are now converts. I’m very excited for what’s to come. So, again, to recap, it’s a $10 million challenge grant that has to be met within the next 90 days to be activated. maps.org/capstone. capstone@maps.org. If you have $100,000 or more that you could potentially put to work to be part of this, if you can contribute anything less — a dollar, $10 a month, whatever it is, everything counts, and you can go to maps.org, which can show you exactly how to do that.
Rick, thank you so much for taking the time. I know you’re tireless and it impresses the hell out of me, but it’s still meaningful for you to carve out some time to do this. So I want to thank you for having the conversation.
Rick Doblin: Oh, my pleasure, Tim. I think we will be able, together, to bring these healing technologies to the world.
Tim Ferriss: Absolutely. I will leave it there for now. For everybody who has tuned in, thank you for listening, and until next time, take care, be safe, and consider checking out maps.org/capstone. Thanks for listening!
The Tim Ferriss Show is one of the most popular podcasts in the world with more than one billion downloads. It has been selected for "Best of Apple Podcasts" three times, it is often the #1 interview podcast across all of Apple Podcasts, and it's been ranked #1 out of 400,000+ podcasts on many occasions. To listen to any of the past episodes for free, check out this page.
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Tim…I don’t know how else to get in contact with you personally, but I would like to thank you.
I am an avid listener to your podcast but more importantly, I am a dear friend of MAPS. I have worked on the MAPS MDMA clinical studies over the years in several capacities – from having performed the randomization in the Phase 1 trials back in the early 2000’s to recently setting up the Data Monitoring Committee for the Phase 3 trials. I deeply support the work of MAPS and substantiate the absolute quality of the work the clinical team is doing to gain FDA approval of MDMA. This work is real, of quality, and is transformational.
I am listening to your podcast with Rick Doblin and I want to THANK YOU so, so deeply for your donation and capstone call to action. Thank you for your donation to the entire psychedelic community, and to MAPS. It is incredibly appreciated — I am moved to tears. I have witnessed Rick, Amy and the team at MAPS struggle for years to conduct *quality clinical research* guided by their deep conviction that MDMA is a treatment for severe PTSD.
To have someone with your public stature acknowledge the legitimacy of the work many people have been doing in isolation, is mind-blowing. I am moved by your financial gesture and support it wholeheartedly. MAPS is truly changing the course of history, government regulation, and re calibrating the stigma of what “psychedelics” are to our culture.
My sincere gratitude for your support.
Sincerely,
Julie Densmore
Hi Tim!
I am a huge fan of your podcast and books. I just read “4 Hour Work Week” and listened to your Rick Doblin podcast. BRAVO! Loved it and thank you for your advocacy for psychedelics.
I am a member of MAPS & I work with TheraPsil. We are a Canadian organization that is fighting for access to Psilocybin for terminal patients suffering with end-of-life distress. Our Federal Health Minister is avoiding us and even with local government officials hounding her, she refuses to respond.
In Canada, you have the right to die but why is it that patients don’t have the right to try a mushroom that can offer them peace and has been proven to be an effective treatment?
We are in the process of banding together with Oregon, as there is strength in numbers to pressure government officials to listen.
Would you support us in spreading our message?
Please check us out. We have the support of Rick Doblin and the MAPS organization and could use an influencer like you on our side.
http://www.therapsil.ca
Thanks for all your great work,
Tara
I’m very interested in participating in MDMA and other psychedelic treatment for anxiety from advanced prostate cancer. I have recently had a prostatectomy and undergoing radiotherapy and ADT. I would appreciate any suggestions to pursue this type treatment.
Thank you for all you do!