Testimony of Charles S. Grob, M.D.
Before the United States Sentencing Commission on March 19, 2001
on the topic of
The Proposed Amendment
to Increase Guidelines Sentences Concerning MDMA (Ecstasy)
It is a privilege to speak
today before the U.S. Sentencing Commission on the issue of MDMA.
I have been a child and adolescent psychiatrist for almost 20 years and
am currently the Director of a large clinical program and training program in
Child and Adolescent Psychiatry at Harbor-UCLA Medical Center. I am also a Professor
of Psychiatry at the UCLA School of Medicine.
I have studied and written articles on the phenomenon of
substance abuse and misuse among young people, and have serious concerns about the dangers
adolescents and young adult are exposed to. I have learned over time that young
people respond best to hearing the truth, but that they do not respond well when they are
barraged with information they do not trust to be the truth. In this era of high
stakes Drug War politics, the dialogue has too
often been dominated by misinformation and exaggeration, which has led to greater degrees
of risk taking by young people.
Unfortunately, this has particularly been the case with the
phenomenon of "Ecstasy" use, which is often, but not always, the drug MDMA.
I have studied and written on the issue of MDMA for over a decade, and was the
first investigator to receive FDA approval to conduct a prospective research evaluation of
adult subjects administered MDMA.
Since I have only been provided with a very short time to speak,
I am pleased that my recently published article in the journal Addiction Research
(8:549-588, 2000) has been provided to the Commission. In this article I examined in
significant detail the issues which I am only able to touch upon
briefly this morning. I hope the members of the Commission take the time to examine
my argument on the case of MDMA.
Primarily, I am very concerned that the Commission has been provided
scientific information, particularly about neuropsychiatric effects, which suffers from
serious bias and inaccuracies. The Commission has been presented with a scenario
that today's young MDMA users (of which there are millions) will be inflicted in 20 or 30
years with devastating degrees of neurologic damage. This is a gross exaggeration
and misreading of the available data, as the case for so-called MDMA neurotoxicity is
seriously
flawed. Unfortunately, the NIDA funded research record on MDMA is an egregious
example of the politicization of science, which not only clouds our
understanding of the effects of MDMA but also undermines the credibility and integrity of
the scientific process.
Much of the NIDA promoted research record that has been presented to
the Commission suffers from serious flaws in methodologic design, questionable
manipulation of data and misleading and deceptive reporting in the professional literature
and to the media. I will briefly mention several pertinent issues, though keep in
mind that a more detailed analysis is
provided in my article. It is important to note that the phenomenon and implications
of MDMA neurotoxicity are far more controversial within the psychiatric and neuroscience
communities than you have been told. Indeed, prominent neurotoxicologists, including
James O'Callaghan of the U.S. C.D.C, have presented data demonstrating that some of the
classic laboratory markers of neurotoxicity do not occur with MDMA. Furthermore, it
is important to
note that in laboratory models it has proved virtually impossible to demonstrate any
long-term adverse behavioral sequelae in animals injected with repeated and extremely high
dosages of MDMA. Then, there is the relevant clinical example of the weight reducing
drug fenfluramine, which causes in laboratory animals virtually identical effects to the
serotonin neurotransmitter system as are observed in so-called MDMA neurotoxicity.
Over seveal decades, in Europe and the United States, tens of millions of people
were administered fenfluramine daily, often for months and years, and yet during all this
time neuropsychiatric disorders induced by these serotonin effects have never been
demonstrated.
Carefuly examining the record of human research with MDMA, particularly
the NIDA funded studies of George Ricaurte, one observes a persistent pattern
of poorly controlled studies, often with deliberate exclusion of vital data sets from
published reports as well as unreported pre-selection biases in criteria used to recruit
research subjects, which have led to grossly exaggerated and misleading claims in the
scientific literature and in the media.
A careful analysis of the MDMA research record provides a weak case for
long-term dangers. Indeed, my own investigation, which was the first FDA approved
study where MDMA was administered to human volunteers, found no evidence of short-term or
long-term neuropsychological damage. In fact, many
of our research subjects were notable for their impressive level of psychological and
physical health, and successful functioning in the world.
It is very unfortunate that the lavishly funded NIDA promoted position
on so-called MDMA neurotoxicity has inhibited alternative research models which
would better delineate the true range of effects of MDMA, including its potential
application as a therapeutic medicine, particularly for clinical
conditions non-responsive to conventional treatments, such as the severe psychological
distress and existential alienation of people with end-stage
medical illness, as well as other patients with refractory chronic post-traumatic stress
disorder.
As a child and adolescent psychiatrist who has studied and published in
the area of substance abuse, I am very concerned about the welfare of our
children and adolescents, and am well aware of the dangers they are exposed to in their
daily lives. But, I strongly believe, that in spite of the best of intentions, our
current drug policies have been ineffectual at best and grossly counter-productive at
worse in terms of reducing the harmful consequences to young people. Therefore, I
strongly encourage the U.S. Sentencing Commission to reject the temptation to escalate
Drug War policies and consequences and to reconsider its position on the vexing case of
MDMA.
Thank you for your time and attention. |
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