Scientific Freedom for Psychedelic and Marijuana Research Rick - - PowerPoint PPT Presentation

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Scientific Freedom for Psychedelic and Marijuana Research Rick - - PowerPoint PPT Presentation

Scientific Freedom for Psychedelic and Marijuana Research Rick Doblin, Ph.D. Founder and Executive Director, Multidisciplinary Association for Psychedelic Studies (MAPS) World Congress for Scientific Freedom European Parliament Brussels,


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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

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A Brief History of MDMA 1912-2018

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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.

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First pre-clinical pharmacological tests with MDMA by Merck, nothing interesting found.

1927

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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.

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Merck conducts further animal studies, nothing interesting found.

1959

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An American chemist, Alexander “Sasha” Shulgin resynthesized MDMA and experimented with the drug himself.

Mid-1970s

Alexander “Sasha” Shulgin

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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

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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

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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

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The Drug Enforcement Administration (DEA) classified MDMA as a Schedule 1 controlled substance using emergency scheduling authority, later declared invalid.

1985

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1986

The Multidisciplinary Association for Psychedelic Studies (MAPS) is founded April 8, 1986.

1986

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FDA rejects five different Phase 1 or Phase 2 protocols for MDMA clinical trials.

1986-1992

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FDA approves first Phase 1 dose response safety study for MDMA in humans.

  • Dr. Charles Grob

1992

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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

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Seven IRBs reject or refuse to review MAPS’ first FDA-approved MDMA/PTSD protocol.

2000-2004

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Out of desperation, MAPS called Copernicus Group IRB based on their name. Copernicus Group IRB approves the first MAPS-sponsored MDMA/PTSD protocol.

2004

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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

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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

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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

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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

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N=31 N=90

Unpublished Data

N=100 (N=77 had 3 sessions)

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FDA and MAPS reach agreement regarding the Phase 3 protocol designs through the Special Protocol Assessment process.

July 28, 2017

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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

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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

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DEA meeting to discuss increase in Schedule 1 licenses needed for Phase 3 and Expanded Access programs.

December 19, 2017

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First Breakthrough Planning Meeting with the FDA Department of Psychiatry Products. Discussed submitted questions regarding program requirements for approval.

December 20, 2017

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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

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To be continued…

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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
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Potential European Phase 3 Site Locations

  • Prague, Czech Republic
  • Utrecht, Netherlands
  • Amsterdam, Netherlands
  • Berlin, Germany
  • Hanover, Germany
  • Bristol, England
  • Cardiff, England
  • Others?
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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.

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Data Exclusivity

Drug Price Competition and Patent Term Restoration Act of 1984 (Hatch/Waxman Amendments)

September 24, 1984

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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”

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Off-Label Prescription Use Post-Approval

Potential Indications:

  • Anxiety
  • Depression
  • Social Anxiety
  • Eating Disorders
  • Substance Use Disorder
  • Schizophrenia
  • Dissociative Identity Disorder
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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.”

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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.

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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

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“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.”

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Return to Law and Order & Drug War Escalation

Attorney General Jeff Sessions President Donald Trump

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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: