In her master’s thesis on outdoor adventure education, Mara wrote: “Risk is an essential element in adventure programming . . . To shelter youth from reality, with all its dangers and uncertainties, is to deny them real life.” And she practices what she preaches.
A week after checking out of the hospital, as June sweeps into July, at 10:45 a.m., Mara drops 140 mgs of MDMA, adding a booster pill of another 55 mgs about an hour later.
“Buy the ticket,” said Hunter S. Thompson, “take the ride.”
6.
Rick Doblin is fifty-six years old, with a strong, stocky frame, curly brown hair, a wide forehead, and a face creased with laugh lines. His demeanor is mostly high school guidance counselor, though his stories are often Burning Man. He was born Jewish, in Oak Park, Illinois, and raised, he says, “under the shadow of the Holocaust.” This produced a teenager who eschewed sports and girls for books about civil disobedience. At fourteen, he had already devoted his life to social justice. By sixteen, he’d decided to become a draft resister, meaning he would always have a criminal record and “couldn’t be a lawyer or a doctor or do most of the things a good Jewish boy was supposed to do.”
Instead, Doblin enrolled in the New College in Florida. He was then seventeen years old. “I had yet to speak to a girl,” he says. “I thought the Beatles wrote silly love songs.” To this day, he’s never drunk alcohol or coffee or smoked a cigarette or tasted a fizzy drink, but back then it was 1971 and Doblin believed the hype. “Acid scared me,” he says. “I was sure one hit made you crazy.” Then he got to the New College and discovered a nudist colony at the campus pool and psychedelic dance parties going on all night and, well, it didn’t take him long to get over that fear.
“LSD was an eye-opener,” he says, laughing. “When I was younger, like everything else, I took my bar mitzvah very seriously. I had all these questions about religion that I wanted answered. I expected a spiritually transformative experience. When it didn’t happen, I got really pissed off at God. A decade later I did psychedelics for the first time and all I could think was: LSD is what my bar mitzvah should have been like. This was what I wanted.”
Doblin was instantly obsessed. There were more trips and more research. He stumbled across John Lilly’s Programming and Metaprogramming in the Human Biocomputer — Lilly’s attempt to map the mind while on acid and inside an isolation tank — and Stanislav Grof’s Realms of the Unconscious: Observations from LSD Research (Grof was one of the main LSD researchers during the 1950s and 1960s). “Psychedelics were exactly what I was looking for,” Doblin says. “Here was a scientific way of bringing together spirituality, therapy, and values. You could journey deep into the psyche and come back with important moral lessons free from prejudice. Talk about a tool for social justice. I thought then, and think now, psychedelics, used properly, are a powerful antidote to Hitler. ”
Antidote or not, Doblin was too late for that trip. “The drug war had shut everything down. Researchers were moving onto dreaming, meditation, fasting, chanting, holotrophic breathwork — ways to alter your consciousness without drugs. And it wasn’t the establishment’s fault; it was our fault, the counterculture’s fault. We had it in our grasp and lost it.” So Doblin dropped out of college, took more drugs, raised a wolf as a pet, underwent intensive primal scream therapy, underwent plenty of other therapies, learned to build houses for grounding purposes — whatever he could do really to distract himself from the fact that psychedelic research was the only thing he wanted to pursue.
In 1982, he caught a break. MDMA had just arrived on the scene, and Doblin was enthralled. “It was a great tool to liberate inner love, to promote self-acceptance and deep honesty. I knew immediately it had amazing therapeutic potential, but it was already being sold in bars. Too many people were doing it. Obviously, a government crackdown was coming. But I knew that if we could get out ahead of that, this was our chance to make up for all that arrogance, this was our chance to do something different.”
The DEA’s MDMA crackdown began in early 1984, but Doblin was ready for them. He’d met Laura Huxley, the widow of Aldous, and through her a psychedelic community he never knew existed. “It was then I realized psychedelic researchers hadn’t disappeared, they had merely gone underground.” He used these newfound connections to initiate a number of serious research studies and, in the hopes of winning the PR battle, began sending MDMA to the world’s spiritual leaders. About a dozen of them tried it. In a 1985 story, “The Ecstasy Debate,” Newsweek quoted famed Roman Catholic theologian, Brother David Steindl-Rast, about his experience: “A monk spends his whole life cultivating this same awakened attitude [MDMA] gives you.”
One of the studies Doblin was then trying to get the government to approve involved one subject: his own grandmother. She was dying at the time, suffering unipolar depression along the way. He wanted to try treating her with MDMA, but his parents refused to let him break the law. “Here was this very sick old woman who desperately needed help,” recalls Doblin. “We had a drug that could help her — a drug that thousands of other people had already taken safely — and a law that prohibited it.”
In 1986, Doblin started The Multidisciplinary Association for Psychedelic Studies (MAPS) and — in an attempt to keep Ecstasy legally available to doctors — helped sue the government. He lost that battle. In 1988, the DEA added MDMA to Schedule I, alongside heroin and PCP and other drugs “with high potential for abuse” and “no currently accepted medical use in treatment in the United States.” This meant that if Doblin wanted to reverse that decision he had to convince the FDA that MDMA was both safe and medically useful.
Doblin finished college and decided to go to graduate school to pursue his passion. But this was 1988, and no graduate schools were interested in letting him study psychedelic research. “I realized the politics were in the way of the science,” he says, “so I decided to study the politics.” He enrolled in Harvard’s Kennedy School of Public Policy, eventually getting his PhD, but before that happened, in 1989, the FDA made an internal decision that forever changed the fate of psychedelic research. “They underwent a sea change,” says Doblin. “They decided to depoliticize their work and strictly review drugs based on scientific merit.”
“Rick figured out the secret,” says Mark Kleinman, director of the drug policy analysis program at UCLA and, before he switched universities, one of Doblin’s professors at Harvard. “He discovered that the FDA was going to play it straight.” And for the first time in two decades, psychedelic research was no longer a pipe dream — suddenly it was in the pipeline.
7.
Mara’s second MDMA experience goes deeper than her first. She talks about her issues with intimacy, her fear of losing control, her dread of betrayal. She begins to speak about her recent refusal of medical updates. “I could find out, but I don’t want to be defined in those terms — as a lost cause. Whatever happens, cancer gave me an opportunity to seek God.”
But the MDMA does not help her find God. By early evening, the drug is wearing off. Allan will be out of town for a few weeks, so more work is temporarily on hold — but Mara’s disease is not. By the end of July, her dose of Dilaudid has increased thirtyfold. She is then two months away from the date the doctors told her not to expect to live past. Allan and his psychedelics still seem like her only hope, but MDMA isn’t getting the job done. Mara wants to switch to stronger stuff.
Again, there is discussion. Allan has LSD, but feels that the kind of breakthrough Mara desires requires a breakdown of her emotional defenses — which could trigger a greater fear of death. Mara has rarely spoken of that fear, though she once told Lindsay her concern wasn’t dying. “I’m an only child,” she’d said. “I’m terrified of leaving my parents. I’m terrified about what will happen to them if I die.” Even so, for their next session, Allan feels mushrooms are the better idea, and his opinion wins out.
While there remains quite a bit scientists don’t know about the medical uses for psilocybin, one sure
r thing is its efficacy in treating end-of-life anxiety. Freud believed “existential anxiety” a primary motivational force in humans. In 1973, Ernest Becker won the Pulitzer Prize for arguing that its flipside, which he called the “denial of death,” is the reason for all our behavior — the reason we created society in the first place. A long line of scientists have also pointed out that there’s only one cure to end-of-life anxiety: Attach the finite self to an infinite other. This, they believe, is one of the biological purposes of religion — a way to ease our fear of death. It may also explain why psychedelics can ease the human condition. Psychedelics are known to produce a mystical experience known as unity. Exactly as it sounds, unity is the undeniable feeling of being one with everything. And if you’re one with everything, death becomes irrelevant.
Mara drops mushrooms for the first time on a muggy day in early August. An hour passes. Two hours pass. Maybe they’ve given her too mild a dose, maybe it’s her own emotional resistance, but not much is happening. Mara wants more mushrooms, but Allan has a different suggestion. He’s also brought along marijuana, which can enhance the effects of psilocybin. Mara decides to try it, but can’t tolerate hot smoke in her feeble lungs. So Marilyn becomes her daughter’s “water pipe.” She takes sips of cold water, breathes marijuana smoke into her mouth, then puts her lips onto Mara’s and blows. Suddenly, for the first time since their last MDMA session, Mara’s pain is gone.
“There is some pain,” she says, “but I don’t feel so uptight about it. It’s there, but it’s not me.”
Then Allan asks about her disease.
“There’s a snake in my house,” is her chilling response.
The rest of the session passes without incident. Mara is disappointed. She wants more, wants to try LSD, but Allan has to go back out of town. Mara will have to wait until he gets back for that session. The waiting is difficult. There is, after all, a snake in her house.
8.
It took ten years for Doblin and his associates to convince the government that Ecstasy might have therapeutic potential. That victory came in 1992 when the FDA approved the first basic safety and efficacy study in humans. At roughly the same time, Doblin had more ambitious plans. He’d teamed up with Michael Mithoefer, a psychiatrist with a specialty in trauma and an interest in psychedelic therapy, to explore a still radical idea. “Therapists had already figured out that MDMA helps people confront traumatic memories — memories with a deep component of fear and anxiety — and get past them. Michael already had experience with PTSD, and PTSD is exactly that kind of problem. It seemed like a perfect fit.”
To help prove he was right, Doblin wrote the first paper to appear in the scientific literature about MDMA and PTSD. It ran in the Journal of Psychoactive Drugs in April 2002. That was also the year Mithoefer received permission to begin his formal study — which is how he met John Thompson (not his real name).
Thompson, forty, now lives in Missouri, but in his younger days was an Army Ranger. During Gulf War II, he was on patrol, chasing insurgents in Iraq, when an IED blew up beneath him. He broke his back and both of his feet and suffered traumatic head injury. “I’ve been in fights,” he says. “I’ve been shot before, but the trauma of getting blown up — it’s a soul shaker.”
Almost immediately, Thompson developed PTSD. He had nightmares every night. Every piece of trash on the road was enough to set off an episode. After about a year, with no respite, Thompson was searching the Internet for cures and found a link on the MAPS website to upcoming studies, including Mithoefer’s PTSD trial. “I’d never done MDMA before,” says Thompson. “I smoked a little pot when I was younger, and when I was in my early twenties tried acid once. At the time, I was already a Ranger, already a well-trained, hardened killer, but on LSD I thought I was a disciple of Christ — that was pretty unusual.”
Mithoefer’s study was nothing but intensive. Patients were given lengthy pretrial counseling. This was followed by three eight-hour MDMA sessions, each with two therapists present (most psychedelic therapy involves two therapists, one male, one female). Between sessions, for integration purposes, there was daily phone contact and a weekly in-person meeting.
“Almost immediately,” Thompson says, “I was shocked by the access I had to my memory. I started recalling parts of the experience that I didn’t remember. I really went deep. It was completely cathartic. The next day [after just one session], the nightmares were gone. I was glowing and extroverted — for the first time since getting blown up. MDMA gave me back my life. I hesitate to use the word ‘miracle,’ but I’d definitely call it a ‘sacred molecule.’ ”
And Thompson wasn’t the only subject to find relief. Mithoefer’s patient population included war veterans, crime victims, and child abuse victims. While he has yet to publish his data, it has already been presented at conferences, so he will say, “With MDMA (instead of placebo) we had a very clear reduction of PTSD — well into statistical significance. And it’s been a year or more after the last MDMA session — in some cases up to five years — so the effects appear to last. I think the treatment holds a lot of promise.”
Doblin will go further. “Eighty-five percent of our patients saw their PTSD vanish. It took twenty-two years to get this study done, but if that’s all MAPS ever does, it’s enough.”
Thompson, though, goes the furthest. “I think MDMA is a gift to mankind. I think every vet, when they leave the service, should go through MDMA therapy. I think it should be part of the formal discharge process.”
9.
It is late August. The phone rings. Allan is back in town, has a free afternoon and quite a cocktail in mind. The next day Mara, Marilyn, and Allan are again assembled in the green room. Allan has brought LSD, MDMA, and marijuana. LSD is one of the most powerful mind-altering substances ever discovered, and the fear is still a bad trip increasing Mara’s anxiety. But Allan explains that “when MDMA combines with LSD, it can soften the experience, smooth out the overwhelming visuals, and help maintain a train of thought.” He also says that marijuana deepens the trip, allowing them to use a lower dose of the psychedelic. Mara is game. At 4:20 p.m. she swallows 300 micrograms of LSD.
By 6:00 p.m., Mara says, “not much is happening.” At 6:30, she wants to try more LSD, but 300 mgs is already a substantial dose. Allan decides to go with the MDMA instead. An hour later Mara’s pain has diminished slightly, but is still not completely gone. At 8:00, Mara smokes pot. Within minutes, she begins to shake. Tremors are now ripping through her body.
“The pain,” she says, “it’s burning, it’s burning . . . but it’s amazing how good the rest of my body feels.”
Not much happens after that. At 9:00 p.m., Mara wants to go to sleep. The session is over. Marilyn can’t hide her disappointment.
“No glorious cure,” she says, “no dramatic end to the pain, no spark of enlightenment, and no talk of what to do next.”
A week later Mara tells her nurse she’s losing her resolve. “I’m worried about my parents,” she says, “I suck at good-byes.” A week after that, her will has broken. “I can’t do this any more. I want to go fast.” But there was one thing she wanted to do before she goes fast — more MDMA.
That session takes place in early September. At 2:35 p.m., Mara lies down in bed, stares up at the angels, and swallows 135 mgs of MDMA. An hour later she doubles down and takes another pill. Soon afterwards, her breathing calms, spasms subside, and then her pain is gone. By 4:30, Mara is alert.
“Call Dad,” she says.
Marilyn and David Howell divorced years ago, but David lives in the area and has always been close to his daughter. Most nights, he comes by and reads to her. Most nights, Mara worries about him, worries about him more than she worries about her mom. Tonight, the moment he arrives, she starts to well up.
“It’s so special,” she stammers, “I get to have my mother and father with . . .”
But Mara can’t finish that sentence.
Instead, she decides, if there was ever a time fo
r indulgence . . . She sends her father to the store for chocolate. Marilyn goes to the kitchen for a moment. With her parents are out of the room, Mara looks at Allan and starts to cry.
“I’m their only child . . .” but she still can’t finish that sentence.
David returns with Dove bars. Such a glorious indulgence. The music is lively. The Temptations are singing “My Girl,” and Mara wants to dance. Her mother lifts one arm, her father takes the other. They move her body to the beat, swaying in time, one family together, one last dance. Finally, Mara can finish that sentence.
“How beautiful it is to die,” she says, “with my mother and father with me.”
10.
It’s a cold October night in 2009. Rick Doblin is in his kitchen, eating dinner with his wife and their three children. He’s telling a story about the time Lilah, his thirteen-year-old daughter, won a DARE-sponsored writing contest at school (as in, “DARE to Keep Your Kids Off Drugs”). His youngest, Elinore, eleven, was concerned about him. “She thought everything was going wrong in my life,” he remembers. “My teenage son wasn’t doing drugs. My eldest daughter had just won a DARE contest. She took my hand and looked me in the eye and said, ‘Daddy, I don’t want to do it now, but in the future, I promise, I’ll smoke lots of pot.’ ”
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