SLIDE 1 Rick Doblin, Ph.D. Founder and Executive Director, Multidisciplinary Association for Psychedelic Studies (MAPS)
Scientific Freedom for Psychedelic and Marijuana Research
World Congress for Scientific Freedom European Parliament Brussels, Belgium April 13, 2018
SLIDE 2
A Brief History of MDMA 1912-2018
SLIDE 3
1912
MDMA first synthesized and patented by the pharmaceutical company Merck as “Methylsafrylamin.” It was an unimportant precursor in a new synthesis for clotting agents.
SLIDE 4 First pre-clinical pharmacological tests with MDMA by Merck, nothing interesting found.
1927
SLIDE 5
1953-1954
The United States Army used animal models to investigate the toxicity and behavioral effects of MDMA and seven other related compounds, but the results remained classified until 1973.
SLIDE 6
Merck conducts further animal studies, nothing interesting found.
1959
SLIDE 7 An American chemist, Alexander “Sasha” Shulgin resynthesized MDMA and experimented with the drug himself.
Mid-1970s
Alexander “Sasha” Shulgin
SLIDE 8 MDMA used in psychotherapy with good results. Estimated 500,000 doses
- f MDMA used in therapeutic growth
settings from mid-1970s until 1984. Reported to increase communication, and found to be especially useful for couples therapy.
Leo Zeff
Late-1970s
SLIDE 9 By the early 1980s, "ecstasy" (MDMA + other psychoactive substances) became a popular drug often at dance clubs and raves in the US and Europe.
1980-1984
SLIDE 10 The Drug Enforcement Administration (DEA) moves to classified MDMA as a Schedule 1 controlled substance. Advocates file for Administrative Law Judge (ALJ) hearing within 30 day public comment period.
1984
SLIDE 11 The Drug Enforcement Administration (DEA) classified MDMA as a Schedule 1 controlled substance using emergency scheduling authority, later declared invalid.
1985
SLIDE 12 1986
The Multidisciplinary Association for Psychedelic Studies (MAPS) is founded April 8, 1986.
1986
SLIDE 13
FDA rejects five different Phase 1 or Phase 2 protocols for MDMA clinical trials.
1986-1992
SLIDE 14 FDA approves first Phase 1 dose response safety study for MDMA in humans.
1992
SLIDE 15 Sponsored by MAPS, the first randomized, placebo-controlled, double-blind study investigating MDMA-assisted therapy, conducted in women with treatment-resistant PTSD, commenced in 2000 in Spain but ended due to political pressures after only 6 women were treated.
2000
SLIDE 16
Seven IRBs reject or refuse to review MAPS’ first FDA-approved MDMA/PTSD protocol.
2000-2004
SLIDE 17 Out of desperation, MAPS called Copernicus Group IRB based on their name. Copernicus Group IRB approves the first MAPS-sponsored MDMA/PTSD protocol.
2004
SLIDE 18 Pilot MDMA/PTSD study is published.
Mithoefer et al. (2010). J. Psychopharmacology
Long term follow up paper is published.
Mithoefer et al. (2012). J. Psychopharmacology
2010 2012
SLIDE 19 Expansion of neuroscience research with psychedelics and MDMA. “The world’s populations need more compassion and empathy for one another. The study of MDMA provides one small but potentially important step toward reaching that goal.”
Boris D. Heifets & Robert C. Malenka Stanford University School of Medicine Cell, Vol. 166, Issue 2 July 14, 2016
SLIDE 20 Photo by Nirvan Mullick, PrescriptionX – The Rick Doblin Story
MAPS completes international series of six Phase 2 pilot studies of MDMA-assisted psychotherapy for PTSD. Nov 29, 2016 Successful End of Phase 2 Meeting with FDA.
2016
SLIDE 21 MAPS Sponsored Phase 2 Clinical Trials for MDMA-Assisted Psychotherapy for Chronic, Treatment-Resistant PTSD
Study Location Intent to Treat Sample MP1 Charleston, SC 23 MP2 Switzerland 14 MP4 Vancouver, Canada 6 MP8 Charleston, SC 26 MP9 Israel 10 MP12 Boulder, CO 28 Total 107
SLIDE 22 N=31 N=90
Unpublished Data
N=100 (N=77 had 3 sessions)
SLIDE 23
FDA and MAPS reach agreement regarding the Phase 3 protocol designs through the Special Protocol Assessment process.
July 28, 2017
SLIDE 24 FDA Phase 3 Study Design:
MDMA-Assisted Psychotherapy for PTSD
2-Month Follow-up Screen & Enroll 80 or 120 mg 80 or 120 mg 80 mg Inactive Placebo Inactive Placebo Inactive Placebo 3 Prep Sessions 9 Integrative Psychotherapy Sessions 3 Prep Sessions 9 Integrative Psychotherapy Sessions
SLIDE 25 2017
FDA grants Breakthrough Therapy Designation for MDMA-assisted psychotherapy for PTSD. Large scale studies planned to begin enrollment in Spring 2018.
August 15, 2017
SLIDE 26
DEA meeting to discuss increase in Schedule 1 licenses needed for Phase 3 and Expanded Access programs.
December 19, 2017
SLIDE 27 First Breakthrough Planning Meeting with the FDA Department of Psychiatry Products. Discussed submitted questions regarding program requirements for approval.
December 20, 2017
SLIDE 28 First meeting with European Medicines Agency (EMA) to begin negotiations for approval in Europe. Scientific Advice Briefing Document for Phase 3 MDMA/PTSD clinical trials in Europe submitted to EMA.
March 1, 2018 April 4, 2018
SLIDE 29
To be continued…
SLIDE 30 FDA Phase 3 Site Locations
- San Francisco, CA | research institution
- Farmington, CT | research institution
- New York, NY | research institution
- Madison, WI | research institution
- Vancouver, Canada | research institution
- Israel | research institution
- San Francisco, CA | private practice
- Los Angeles, CA | private practice
- Boulder, CO | private practice
- Fort Collins, CO | private practice
- New Orleans, LA | private practice
- New York, NY | private practice
- Charleston, SC | private practice
- Boston, MA | private practice
- Montreal, Canada | private practice
SLIDE 31 Potential European Phase 3 Site Locations
- Prague, Czech Republic
- Utrecht, Netherlands
- Amsterdam, Netherlands
- Berlin, Germany
- Hanover, Germany
- Bristol, England
- Cardiff, England
- Others?
SLIDE 32 Potential Post Approval Risk Mitigation Strategies
- Only prescribed by certified
therapists trained by the sponsor.
- Only administered in certified
clinics.
- Defined safety screening for
specified patient populations.
SLIDE 33 Data Exclusivity
Drug Price Competition and Patent Term Restoration Act of 1984 (Hatch/Waxman Amendments)
September 24, 1984
SLIDE 34
SLIDE 35 Expanded Access, Compassionate Use
“Under FDA’s statute, a sponsor or a physician may submit an expanded access request for widespread access to an investigational product if certain criteria are met”
SLIDE 36 Off-Label Prescription Use Post-Approval
Potential Indications:
- Anxiety
- Depression
- Social Anxiety
- Eating Disorders
- Substance Use Disorder
- Schizophrenia
- Dissociative Identity Disorder
SLIDE 37 US Controlled Substance Act (1970)
“Sec. 101. The Congress makes the following findings and declarations: (1) Many of the drugs included within this title have a useful and legitimate medical purpose and are necessary to maintain the health and general welfare of the American people.” “Sec. 201 (b). The recommendations [about scheduling] of the Secretary [of HHS] to the Attorney General shall be binding on the Attorney General as to such scientific and medical matters.”
SLIDE 38 US Improving Regulatory Transparency for New Medical Therapies Act (2015)
The purpose of this law is to expedite scheduling of newly approved drugs that are currently in Schedule I or not controlled. Requires DEA to initiate a scheduling action for new FDA-approved drugs within 90 days.
SLIDE 39 Safety and Efficacy of Marijuana for Treatment of Posttraumatic Stress Disorder (PTSD) in 76 US Veterans
Funded by a $2.15 million grant to MAPS from the Colorado Department of Public Health and Environment
SLIDE 40
SLIDE 41
“To facilitate research involving marijuana and its chemical constituents, DEA is adopting a new policy that is designed to increase the number of entities registered under the Controlled Substances Act (CSA) to grow (manufacture) marijuana to supply legitimate researchers in the United States.”
SLIDE 42 Return to Law and Order & Drug War Escalation
Attorney General Jeff Sessions President Donald Trump
SLIDE 43 Ending the NIDA Monopoly on DEA Licensed Marijuana
With MAPS’ support, Professor Lyle Craker applied for a DEA license in 2001 and 2017
Scientific Freedom: