From Silicon Valley to Hollywood, Californians lead the world with big ideas. For the latest installment of our "Big Think" series, we meet Rick Doblin. He heads a nonprofit that sponsors research into the use of LSD and MDMA to treat mental illness. His Big Think?
“There should be thousands of psychedelic psychotherapy clinics all over the world.”
In the future, Doblin believes anybody with anxiety, depression, marital problems or a fear of snakes could be treated with a drug trip
Doblin came of age in the early '70s, right when President Richard Nixon declared America’s war on drugs.
“Marijuana! The burning weed with its roots in hell,” says the ominous voiceover in the much-parodied 1930s film, "Reefer Madness." “Smoking the soul-destroying reefer, they find a moment’s pleasure. But at a terrible price: Divorcery! Violence! Murder! Suicide! And the ultimate end of the marijuana addict -- hopeless insanity.”
Doblin remembers watching the film as a joke when he was a teenager. But some of the same messages meant to scare young people away from pot in the '30s were recycled in the '70s to create fear around psychedelics.
“In high school I remember thinking drugs like LSD were terribly dangerous and that they would make you crazy,” Doblin says. “The education that I got was that if you took LSD more than a few times, you were going to be certifiably insane.”
When Doblin got to college, he tried LSD. A lot of it. And it changed his life. He dropped out of school.
“I was way out of balance, overdeveloped intellectually, underdeveloped emotionally and spiritually,” he says.
“When I started feeling like this was a tool that could bring me into balance, I realized this was a tool that could bring society back into balance,” he says.
Today, his group has permission from the FDA to research new treatments for mental disorders using LSD, a hallucinogenic, and MDMA, commonly known as Ecstacy, or E, which induces feelings of euphoria and empathy.
Doblin's group is currently studying the use of MDMA to treat post-traumatic stress disorder (PTSD) among war veterans and social anxiety in autistic adults. It's also studying how LSD can help ease the dying process for the terminally ill.
The treatment protocol is highly structured and, Doblin believes, replicable.
“It’s a male-female co-therapist team. People are receiving MDMA around 10 in the morning. It goes till 6 at night or so,” he says. “Then people are required to spend the night in the treatment center.”
The next day, the patient and therapist talk for hours about the drug trip. They check in every day over the phone for the next month. Doblin says this post-trip therapy is key.
“If you don't do that integrative work, then -- like dreams you don't pay attention to -- they fade away and you don't benefit from really learning and growing from them,” he says.
Doblin says one that day there will be a network of these psychedelic psychotherapy clinics around the world. And LSD and MDMA will be used to treat a range of anxieties and phobias, even a fear of spiders or fear of flying. Eventually, he says people with no formal diagnosis will be able to try them.
“I believe that these clinics will eventually expand to treat people that have just an interest in personal growth or spiritual experiences or couples therapies,” he says. “Couples therapy is one of the best uses for MDMA.”
Plenty of other cultures use psychedelics to promote personal growth. People in Brazil and Peru use ayuhuasca, a plant-based psychedelic brew, for spiritual quests and healing rituals. Native Americans use peyote in religious ceremonies. Doblin says kids and adolescents are sometimes involved. He remembers going to a Navajo wedding where a 9-year-old boy participated.
“He stayed up all night. They gave him small doses of peyote,” he says. “These are cultures that have successfully integrated psychedelics. They are good examples of what we can do in a Western culture. They don’t have young people going off and abusing peyote and abusing ayuhuasca.”
That is precisely what critics of Doblin’s work say would happen if he succeeds in opening a network of psychedelic clinics. That would only encourage kids to do drugs and tune out of society, critics say.
But Doblin disagrees. He says the prohibition mentality of today’s anti-drug campaigns doesn’t work. He calls public service announcements implying teenagers will end up in the hospital from half a hit of Ecstasy (MDMA), or decline into utter mental instability after trying LSD, exaggerated and dishonest.
“These are ridiculous attempts at creating fear. They exaggerate the negative and deny the positive,” he says. “We need honest drug education, not crude propaganda that kids these days can easily see through.”
It’s not that Doblin thinks it should be a free-for-all. He says the way kids usually take drugs is dangerous. Drugs are often impure and people are taking them in unsupportive environments, like dance clubs, surrounded by other people who are high.
“If they think they’re doing it only for fun and only for recreational purposes, and something serious comes up, then they’re unprepared for it,” Doblin says.
Doblin has three kids, ages 20, 19, and 17. Watching them go through extensive driver's education training has inspired another big idea.
“You have to take a course, you have to pass a test. They have to do 10 hours of driving with their parents in the car, all different things,” he says. “So the question is, should there be some similar model like that for young people, for anybody who wants to have legal access to psychedelics.”
He says his clinics will be the ideal place where people can get training in how to take psychedelics responsibly.
“I would feel more comfortable if people had their first psychedelic experience under supervision, and then they could get a license and buy it and do it on their own,” he says.
Under Doblin’s clinical protocol, a three-month course of psychedelic-assisted therapy would include three drug trips and cost about $10,000. He says by the time the therapy gets legalized -- 2021 is the goal -- he believes he will have convinced health insurance companies to pay for it.
“Part of the clinical trials is looking not just at the influence of MDMA on PTSD, but we also want to look at health care utilization,” he says. People with PTSD are shown to have more heart attacks and other costly physical health conditions. Doblin believes those costs could be alleviated by effective psychotherapy. And that logic could spill over into off-label uses of the drugs as well.
“A very good economic case can be made that psychedelic-assisted therapy for people looking for personal growth or spiritual experiences, that it’s a part of preventive medicine,” he says. “And insurance companies may start covering that as well.”