Science Vs - Molly - Scary Drug or Promising Therapy?

Episode Date: November 16, 2017

Molly, Ecstasy, MDMA... whatever you want to call it, it's all the same thing. This week, we’re turning up the bass and checking out what does it do to your brain. Is it bad for you? Could it be a potential medicine? To find out, we talk to public health researcher Prof. Joseph Palamar, DEA special agent James Hunt, and neuroscientist Prof. Harriet de Witt. Check out the full transcript here: http://bit.ly/2YEl1V2 Selected reading:Harriet’s paper on MDMA and feelings of rejectionJoseph’s paper on club kid hairThis big British report on the risks of ecstasy  Credits: This episode was produced by Heather Rogers, Wendy Zukerman, Shruti Ravindran and Rose Rimler. Our senior producer is Kaitlyn Sawrey. Edited by Blythe Terrell. Fact checking by Michelle Harris, Rose Rimler and Ben Kuebrich. Sound design by Martin Peralta and Haley Shaw. Music written by Bobby Lord. An extra thanks to Johnny Dynell, Jesse Rudoy, Brian Earp, Prof. Jerrold S. Meyer, Prof. Niamh Nic Daéid and Dr. Carl Roberts. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Hi, I'm Wendy Zuckerman, and you're listening to Science Versus from Gimlet Media. This is the show that pits facts against... Yes, grab your chewing gum and your glow sticks. On today's show, ecstasy, E, X, molly, MDMA, whatever you want to call it, whatever you've been told, they're actually all the same thing. Yep, Molly is the same as ecstasy, which is the chemical MDMA. And that's what we're talking about here today. The party drug MDMA has been illegal in the US since 1985.

But a small group of researchers now want to use this drug as medicine. They're looking into whether it can help people with post-traumatic stress disorder, autism, anxiety at the end of people's lives, and even to help during therapy. And for all those people who have taken MDMA recreationally, that's more than 18 million Americans, and even for all their mates who haven't tried it,

it does raise the question, is MDMA as scary as we've been told it is? Hi, how are you? Joseph, hello. Joseph Palomar was a club kid in New York City in the late 1990s and early 2000s. Reporter Heather Rogers and I went to chat with him in Manhattan. My prime year was probably 2000. I mean, I never missed a week at Sound Factory except the week of 9-11 where clubs were shut down.

So you were there when Sandstorm came out. I really remember that. Right? Yeah. You have a very big smile on your face right now. That was a good summer. But yeah. You have a very big smile on your face right now. That was a good summer. But anyway. And Joseph wasn't your likely club kid.

In fact, when he finished high school, he was really square and actually wanted to be a cop. I was ready to become a police officer here in New York City. I passed their physical and psychological. I just wasn't old enough yet to start. While he was waiting to be a big kid and join the police force, Joseph discovered a world that he hadn't known before. Nightclubs and after-hours dance parties. And he remembers that MDMA was big at the time.

You know, week after week, just people having the times of their lives on it. And people were there hugging, people making friends, all sorts of, you know, crazy things were going on. And that's exactly what MDMA can be like. You can feel like the best version of yourself. The stresses of the world are out of your head. And all you want to do is fall in love with your friends, with the world, and just dance. But the fact is that MDMA was and still is one of the most tightly regulated substances in the US. It's right up there with heroin. And from time to

time, clubs would get busted. Like one night at a place called The Tunnel. The lights flick on, the music still blasting. We're there, it was probably 3, 4 in the morning, something like that. And dozens and dozens of police officers start rushing in, like everybody out. And finally the music goes down. And they were frisking, checking for drugs. And this takes us to the other side of this story. The cops.

They see MDMA as a dangerous drug that can hurt us and even kill us. You can go out in the night, take something, and die from it. So it's like Russian roulette. I mean, you can keep on going, taking it, and, you know, maybe you'll never OD. Maybe you take your first one and you'll die at one of these concerts. That's Special Agent James Hunt, and he's in charge of the Drug Enforcement Administration's

New York Division. And James says that if you're buying MDMA on the street, you just have no idea what's really in it. These guys are not skilled chemists. If you're not a skilled chemist, you just start throwing stuff in there, bad things could happen. What are the positives of MDMA?

Well, I don't want to say that anything's positive about it. I guess I shouldn't have been too surprised about that one. But still, what are we to make of all this? Is MDMA as dangerous as we've been taught? Or is it actually a safe way to have a great time? A medicine, even. Today, we're going to investigate the science of MDMA.

To find out... 1. Why does MDMA feel so good? 2. Can it be used as a medical treatment? And three, what are the risks? Like, can you really die from taking just one pill? When it comes to MDMA, there are lots of club kids and lots of cops. But then there's science. Science vs MDMA is coming up just after the break.

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starting February 1st. What does the AI revolution mean for jobs, for getting things done? Who are the people creating this technology? And what do they think? I'm Rana El-Khelyoubi, an AI scientist, entrepreneur, investor, and now host of the new podcast, Pioneers of AI. Think of it as your guide for all things AI, with the most human issues at the center. Join me every Wednesday for Pioneers of AI. And don't forget to subscribe wherever you tune in. Welcome back. On today's show, we're delving into the drug MDMA, and we're asking, is it a scary,

potentially deadly drug, or is it a reasonably safe substance that could be used to help people? So MDMA was first made more than 100 years ago. The pharmaceutical company Merck was making a medicine to stop people bleeding and in the process they made MDMA. But as far as we know, they never gave it to people. So they never knew what it could do. Then, in the 1960s and 70s, some scientists who were studying psychedelic drugs started experimenting with MDMA to help their patients. George Greer, a psychiatrist in San Francisco at the time, says that he remembers those days well.

Particularly, he remembers the first time that he took some with his girlfriend. It was quite lovely. And we were both impressed at the ease and directness of our communication style. It's not like we hadn't had communication like that before, but it was just so easy. What did you say that then you thought, oh my, I can't believe I just said that? Well, it's like we would say, some of it's just too personal for me to talk about in a radio interview. But things like, were you upset when I did this? And normally I would have said, oh, no, no, no, no, that's fine.

It was no problem. And I said, yeah, I was upset. I was like, wow, well, that's not the way we would communicate before. We would, you know, protect each other's feelings by not directly just saying, yeah, I didn't like what you did. The fact that George could open up so much made him think that MDMA really could be useful for people during therapy. He'd also heard some good reports from colleagues. And so in the early 1980s, he decided to give it a try with patients.

And that meant he needed a supply of MDMA. Now, even though it wasn't explicitly illegal, it existed in a sort of gray area. So he couldn't just buy it at the pharmacy. Instead, with the help of a chemist, he made it. George told us about the lab they used. There was a little stone fireplace. There were shelves with, you know, colored bottles with handwritten labels of different chemicals. And so they got to work. You know, throwing a dash of piperonylacetone, a pinch of sodium hydroxide, and a thimble full of hydrochloric acid. And we just let it react and kept stirring it and it would get warm and so we sort of started bubbling and went through a coil. After a couple of hours, he had the goods.

So we ended up with a white powder, pure white powder. And so he started giving it to patients. George says that they opened up and it really helped them with their therapy. It was medicine and it was used for healing purposes. George published a study on what he was doing. He followed 29 people, checking in with them over the following months. And the majority said that after having done therapy with MDMA, they had more insight into their personal problems

and even had a better attitude. George was impressed. So it was completely, there was never a drug like it before. George and his colleagues thought that they had stumbled on an amazing new medicine that could help people. But. Around 1983 was when I first heard that it was being used at cocktail parties in New York City. I said, OK, the end is near. And from the cocktail parties to the gallows.

No, George wasn't actually taken to prison. But soon Congress started to get antsy about MDMA. And in 1985, the Drug Enforcement Administration made it illegal. They said that the drug, quote, presents a significant risk to the public health, end quote. But what really hit George hard was when they wrote that MDMA had, quote, no legitimate medical use. Oh, absolutely. It was very disappointing because we couldn't help people with it anymore. So George stopped his work with MDMA just as he was getting started. But the thing is, scientists have started the research back up again. And like George, they're curious about whether MDMA can help people and also about what this drug is doing to our brain. So what is MDMA doing to our brain?

Why can it make you feel so good? And this isn't just about dancing at parties because the thing is that if we know how MDMA works then maybe we really can start helping people with it. To find out, we asked a real party girl. My name's Harriet DeWitt. I'm a professor in the Department of Psychiatry and Behavioural Neuroscience at the University of Chicago. Harriet first became interested in MDMA one day at a scientific conference. Yeah, a couple of colleagues, actually, and they were people that I didn't see as drug users at all.

And these nerds told her that they'd had life-changing experiences on MDMA. And was it then when you thought, I kind of want to study this more? Yes, yes, definitely. You have just made science so much cooler to an entire generation of people. Oh, no. Now, Harriet told us that the high that people get on MDMA can feel a bit like taking speed. And that makes sense because chemically, MDMA is similar to amphetamines. But there's something very different about MDMA. It produces a behavior that you don't see with any other drugs. Harriet says that it makes you feel a real closeness with other people.

And in fact, you can even see that when you give it to rats. So it makes rats lie together, side by side, as though they were sort of bonding, as though they were sort of connected. So why does this happen? Well, there's this idea out there that MDMA works by simply telling your brain to release feel-good chemicals. The story that you hear is just, well, it's serotonin. Serotonin makes you happy.

Oxytocin. Oxytocin makes you bond. You put them together. It sounds like that's the feeling of being high. It's a nice story, but there's no way there's going to be just a little bump of one neurotransmitter that corresponds to feeling high or feeling good or feeling, I mean, it's just much more complicated than that. Harriet tells us that MDMA does affect serotonin. Part of how it works

is that it latches onto this protein that's used for shuttling around serotonin. So it makes this happy chemical have a powerful effect on our brain. Now MDMA can also affect other chemicals, but Harriet says that its effect on serotonin is really the driver of that special MDMA, I love the world high. But there seemed to be more to this story, and that's what Harriet wanted to unlock. So her next step, like George, she had to score some MDMA. Heather and I asked Harriet about it. And I guess, like, you find it through just researchers in the know. Yes, exactly. Kind of like how you find it on the street?

No. No. So where do you get it from? There's one chemist who has now actually retired and he produced a fairly large quantity of it that he has made available to researchers. Harriet, I've got to ask, have you tried it? Have you taken MDMA? Sadly, no. Really? And why not? I'm a control kind of person, if you really want to know. So Harriet got a bunch of participants who weren't control kind of people,

and then she gave them a pill. And she wasn't shy about the dosage. People compare it to something that they might get in a rave situation and it's a fairly... They wouldn't want more, put it that way. In her first experiment with MDMA, published in 2009, Harriet gave nine people the drug. Then she showed them pictures of faces with various emotional expressions, like a person smiling or another person frowning. She repeated the experiment, giving them a placebo.

Now, when people were high, their brains had a stronger response to seeing happy faces. And here's the thing that really surprised her, though. When people were on MDMA, their brains weren't so affected by the angry pictures. So it sort of makes them less able to detect negative emotions. So they're less responsive to angry faces. While we don't know exactly what MDMA is doing to make this happen, Harriet reckons that it's what makes the drug unique. You feel good because you aren't distracted by that negative self-talk and you can just enjoy your peeps.

And then you can imagine if the people are at a party, then they're going to be less sensitive to kind of judgmental expressions or, you know, in a social situation, you're feeling a little bit like people are looking at you and people are judging you. That is amazing. It's kind of a mechanism or a process that we would never have thought of otherwise until we had done these studies.

She says the fact that a chemical can block our perception of negative emotions is actually really surprising. And while Harriet's first study was small, other work has come along from other scientists and they all find similar things. In another small experiment that Harriet did, she asked people to play this game that was designed to make them feel socially rejected and to lower their self-esteem. Hey, all in the name of science. And here's the thing, people on MDMA didn't feel so rejected after playing the game.

That's compared to a placebo. And to Harriet, the fact that MDMA can do this opens up a lot of possibilities, like potentially using it to ease anxiety or even helping people with therapy. Well, if you think about it, if they're less responsive to negative emotions in other people, then to the extent that the therapist has some negative expression or the person perceives some negative expression in the therapist, if that's taken away, then the patient is more likely to be able to address negative things in their own lives or reveal more negative things. And while this idea is very preliminary, we do have some research on whether MDMA can treat people

with post-traumatic stress disorder. This past summer, the Food and Drug Administration actually designated MDMA as a breakthrough therapy. A handful of small studies have been done so far. And in one of these experiments, 19 people with post-traumatic stress disorder who hadn't responded to any other treatment were given MDMA and then they talked to a therapist. And afterwards, most of them said that they had fewer nightmares and flashbacks and that their relationships had gotten better. Now, it's still early days, we do need more research,

but even Special Agent James Hunt of the DEA wasn't poo-pooing the idea of using MDMA for therapy. If doctors are examining this and they find that it helps people, you know, in a certain group, if it's, you know, legal studies are done and trained people come up with that this works for some people, I've got no problem with it. And despite this being an illegal drug, from what we know, for most people, MDMA is not very addictive. Conclusion. MDMA affects serotonin and some other chemicals in our brain to give us a high. But studies are finding that it also does this other unique thing.

It makes us less sensitive to negative messages around us. And preliminary research shows us that MDMA might just be able to help some people with PTSD. OK, so all of this makes MDMA sound pretty good, great even. But is it really all love and self-acceptance and sandstorm? Because growing up in Australia, this is the message that I kept hearing. I don't know why she takes it. She always gets so depressed coming down.

I didn't know how many health problems it could cause. I just wanted to try something new. Ecstasy. You don't know what it'll do to you. After the break, the come down. Welcome back. So we just found out, using science, that MDMA can be a lot of fun and it might even help people during a therapy session. But now the sun is up, the high is gone, and we're having our calm down. And asking, is MDMA dangerous? Let's talk about the first few days after taking some because some people say that

they feel low and depressed. In fact, this phenomenon is so commonly known that it's got nicknames like the Tuesday Blues or even Suicide Tuesday. Now, the few studies that we found on this say, yes, MDMA users can feel depressed in the days after taking the drugs. And a lot of the scientific literature on this seems to be blaming serotonin. So we asked Harriet DeWitt from the University of Chicago about it. So what about this idea that you take it, you get this serotonin burst, and two days later, your brain doesn't have enough serotonin so you feel sad. Yeah, right. Well, it's a nice story to tell, but it's been questioned a certain amount. There's actually not a lot of science directly testing this serotonin idea out.

Plus, here's a curious thing. As part of Harriet's research, she asked about 40 people about their moods two days after taking her pure MDMA. And? And we don't see this crash. They were totally normal. Yeah. You go to Harriet's lab, you take MDMA, and no comedown. And while Harriet isn't specifically studying the comedown, she has a couple of ideas about why recreational users might be feeling it and why people in her lab don't. Unlike partygoers, her people... They're well-rested.

They're told to eat before they come in. They're hydrated, so we make sure that they drink water while they're here. We control the temperature in the room. We might not be producing the experience that they're getting in their party situation. Yeah, you might not be producing the experience that they're getting in their party situation. Yeah, you might not. There's no creep talking your ear off about how amazing the DJ is or someone smoking pack after pack of cigarettes next to you. Now, also, this could be a dose thing. Harriet gives her people enough MDMA to get high, but maybe she doesn't give them enough to get that big crash later. Okay, so that's the comedown a couple of days later. But what about the long-term consequences

of using MDMA? Say, if you take it every weekend for months or even years, will it fry your brain? This is your brain. This is drugs. This is your brain on drugs. Any questions? A review paper out last year analysed studies with more than a thousand people who had taken a lot of MDMA. These people, many who were in their 20s, had taken an average of almost 350 pills. And after all that partying, what happened to their brain? Well, for the most part, these people were actually fine. But the researchers did find a few things. Heavier users tended to find it trickier to move from one task to another, and their memory could also be worse. Here's Harriet. People can use a lot. If they keep using it, yes, it's almost certainly damaging to their brains.

Other scientists that we reached out to also said that there is enough evidence now to know that the heavy use of MDMA can affect how well our brain works. So, for example, in one study, researchers found that it was more common for heavy users of MDMA to say things like, I forgot what I wanted to say in the middle of a sentence. But still. Oh, sorry, I forgot what I was going to say. Oh, no, the researchers said that these effects were small, even compared to those who weren't taking any MDMA at all. And researchers think that these effects can happen because serotonin, which MDMA mucks around

with, also plays a role in memory. Here's how Harriet described how these serotonin, which MDMA mucks around with, also plays a role in memory. Here's how Harriet described how these serotonin systems can work. When you continuously stimulate them, overstimulate them, and the body can't regulate and return the brain to normal. Now, so far, we've been focusing on the real party animals. But for some people, they're just dabbling you know popping some when the kids are asleep. What about these people? If they use it occasionally chances are we don't have very good evidence we don't have very strong evidence and and certainly I

wouldn't be giving it in the laboratory if I had any inclination if I had any belief that it was producing any kind of brain effects, lasting brain effects. Conclusion. Taking a lot of MDMA can probably hurt your brain. There's some evidence that it can mess with your memory and probably other brain functions. But we don't have good evidence that taking a little bit of MDMA once in a while can cause brain damage. Except, well, there's one very big caveat. There are times when it can kill. On a November night in 1995, a young woman in the UK was celebrating her 18th birthday. Her name was Leah Betts and she was partying with her friends at home.

She popped some ecstasy and seemed totally fine. But as the night went on, things took a dark turn. And what happened next got tons of media attention around the world and Leah kind of became the poster child for how dangerous MDMA could be. You see, Leah had started drinking water, a lot of water. Her news report at the time said she was downing glass after glass of it. She started to feel sick and then she lost consciousness. And her stepmum called the emergency.

The call was later broadcast on the BBC. Ambulance emergency. Our daughter's at a party and she's taken ecstasy along with alcohol. How old is she? call was later broadcast on the BBC. A few days later, Leah died in hospital. And this is really rare, but it does happen. A study published last year said there have been dozens of cases like this. It's thought that Leah did die from drinking too much water. But how exactly can that happen? Well, to understand that, you need to know this. Your body needs a perfect balance of salt and water to keep you alive.

And when you're on MDMA, it can mess with this salt-water balance. And it's not clear exactly how this happens, but some reports have found that the drug can release a hormone that stops you from peeing. Drinking a lot of water can make the situation worse. And once you start holding too much water in your body, get this, your cells can swell. And this swelling can happen in your brain too, which can ultimately kill you. While this story of drinking too much water on MDMA got a lot of media attention,

deaths from hypothermia or overheating are actually more common. And that's because MDMA got a lot of media attention. Deaths from hypothermia or overheating are actually more common, and that's because MDMA can drive up your body temperature. But still, deaths from MDMA are rare. We couldn't find a number from the US on how many people die after taking the drug, but in England and Wales, between the mid-1990s and mid-2000s, on average, 50 people died each year after taking the drug. And some of those people were on other stuff at the same time. Conclusion. It's rare, but some people can die from taking MDMA.

To put some perspective on it, though, one scientist has said that it's safer to take the drug than ride a horse. But the thing is, these deaths might not all be MDMA's fault because the vast majority of people who take this drug don't get it from guys like Harriet's chemist. They buy it on the street. So to find out more about what's actually being sold, we talked to Joseph Palomar. My prime year was probably 2000.

That was a good summer. But anyway. Yeah. Remember our club kid from the beginning of the episode? Well, he's not a club kid anymore. He's all grown up and he's a public health researcher at New York University. And Joseph's job right now is to find out what you really get

when you buy MDMA on the street. So Joseph and his team stand in front of New York City clubs asking ravers about what drugs they use and then they collect hair samples. And we don't mention the hair usually until they're maybe halfway done with the survey. Good move. Yeah. And why hair?

Well, because traces of what's in MDMA can show up in people's hair, sometimes months after they've taken the drug. And if their pills have been tainted by other chemicals, well, you can see that too. But as you can imagine, getting hair from party kids can be a bit, well, hairy. I was outside of a club and there was this female on roller skates wearing a big fake afro who really wanted to participate, but she didn't want to mess with the fake afro that she was wearing. And she was there voluntarily plucking out pubic hair.

She insisted on plucking them one by one. But she only plucked out two or three or four hairs. So Joseph had a sad little pile of pubic hair to work with, which wasn't enough to run his experiment. But he'd already got plenty of hair, though, from more than 170 people. And after analysing all that, he found, well, a lot of MDMA, as he was expecting. But then he found something that the kids weren't expecting. Bath salts. Yeah, now bath salts aren't actually bath salts. That's a slang term for a group of chemicals that feel a lot like amphetamines when you take them. So of the 34 people in Joseph's study that had said they had never used bath salts or similar

stuff, more than 40% had evidence of it in their hair. And so what does that tell you? It tells me that they're using drugs that are potentially more dangerous than ecstasy without knowing it. Or they're lying to you. Yeah. Well, some people would lie, but a lot of these kids have no idea what they're taking. And it's just very likely that a lot of these people who think they're using pure MDMA are actually using drugs like bath salts, all without realizing it.

Now, bath salts are a problem because they can make you panic, hallucinate, and feel paranoid. There's been reports that they can turn you into a cannibal. That was after this creepy case in Florida where a guy chewed off a man's face. But actually, he wasn't on bath salts. Still, if you're going in for MDMA, you don't want bath salts. Other studies have found other stuff mixed in with MDMA, including ketamine, caffeine, and other amphetamine-like chemicals. Some of the samples don't even have MDMA in them. They were just a mixture of other chemicals.

We don't know how these drugs work at the same time. It might be quote-unquote good effects that are increased, or it might be really bad effects that are increased. Or you never know what that's going to do to your brain, your body, a combination of drugs that we don't know about. It's hard to know how much of the MDMA sold on the street is pure or mixed with some other stuff. And, for example, two studies from Spain found two very different results. One showed that most of the pills they tested

had been mixed with something else. But then the other study found that three-quarters of the pills were actually unadulterated. Conclusion. When you buy MDMA on the street or from your friend's friend, you don't know what you're actually going to get. And that makes taking the drug more dangerous. So when it comes to science versus MDMA, does it stack up?

First, MDMA can make you feel euphoric and connected to other people. And researchers think this might be because it makes you focus less on the negative things around you and more on what feels good. MDMA might be a useful tool for therapy and particularly for people with post-traumatic stress disorder, but the research here is preliminary. And then what about the risks? Well, if you take it every weekend for a long time, there is good enough evidence to say that it can affect your memory. But that effect, as far as science knows, is small. Occasional use? Well, there's not much evidence that this is harmful unless it kills you. But that is rare.

And finally, MDMA that you buy on the street can be cut with a bunch of weird stuff. So it's best to score it from the scientists. The funny thing about MDMA is that there's this feeling behind it, that there has to be a bad consequence for feeling so good. I mean, surely you can't have this much fun and not break your brain. But chemicals don't work like that. They don't decide to punish you for having too much fun. They're not like your brain. But chemicals don't work like that. They don't decide to punish you for having too much fun. They're not like your Catholic grandfather.

So instead, you've got to look at the evidence to know if MDMA really is dangerous, or if it really can help people. And from what we've been seeing, this drug shows a real potential. But still, it's not totally benign. That's science versus MDMA. This episode has been produced by Heather Rogers, me, Wendy Zuckerman, Shruti Ravindran and Rose Rimla. Our senior producer is Caitlin Sawry. We're edited by Blythe Terrell. Fact-checking by Michelle Harris, Rose Rimla and Ben Kebrick.

Sound design by Martin Peralta and Hayley Shaw. Music written by Bobby Lord. An extra thanks to Johnny Dinell, Jesse Redoy, Brian Earp, Professor Gerald S. Meyer, Professor Nve McDade and Dr. Carl Roberts. Next week, we'll be taking a week break to do some more reporting, but we'll be back with an episode about birth control. We'll tackle your biggest misconceptions about contraception. Listen, I can give you a study to do. The next time you're having sex,

take some pre-cum, put it under a microscope, and check how many sperm there are. I'm Wendy Zuckerman. Back to you next time.